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International Online Therapy: The Good, the Bad, and the Complicated

Phi Atratus
  • Jan 05, 2022
  • 5 min read
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These days, people move across the States and abroad for jobs, relationships, healthcare, and many other reasons. These changes bring great opportunities to our lives but also great challenges. Sometimes, those challenges are just too much, but by moving away, we’ve made getting therapy even more difficult.

Language, insurance, and location are some of the factors to consider when choosing therapy. This brought about the need for internationally-applicable therapy solutions. Within the world of mental health, this need has become more prominent and relevant with each year.

If you find yourself in such need, don’t worry. International online therapy has come to the rescue and is ready to take you towards your destination. Though the journey might have complex routes and risky turns, you are bound to reach that destination with distance therapy.

Do I Need International Online Therapy?

As an ex-pat, there might be multiple issues you can face. When home feels too far away, loneliness, as well as a constant struggle to adapt to the new culture and even find new friends, can make life difficult.

Even if you come to understand that you do need professional help, finding it can be its own challenge. Would a local therapist in a foreign country be able to understand you with English as their second language?

A therapist can do their best, but these types of issues make it difficult to find the right therapist for you, one with whom you can connect with and who can understand you and your unique struggles and background.

Like any other online counseling, international online therapy is a promising avenue for many who feel far from home. In online therapy, your therapist can help you reintegrate your thoughts and feelings about both cultures, new and old, and help you overcome the struggles of navigating between them.

In a survey conducted in the U.S., it was found that 40% of clinical psychologists had provided online therapy. With nearly half of all American therapists being available online to some degree, the odds of finding one that’s right for you are pretty high.

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Things to Consider With International Therapy

Are there any clauses to online therapy? Any prerequisites? These questions naturally come to us when we want to see a virtual therapist. The following are the issues that may come up.


Not all countries have strict regulations when it comes to online therapy, and the U.S., in particular, has been struggling with this since the pandemic started. When you opt for online therapy, it is not only your jurisdiction’s law that applies but also the jurisdiction of where your online therapist lives.

The laws for therapy in Canada are not the same for those in the U.S., be it online therapy or in-person. Some therapists also have multiple licenses to increase their flexibility and availability, but the issue remains one with no clear answers.

Insurance coverage

Getting medical coverage for your mental health is as important as getting coverage for physical health. Insurance coverage varies from one provider to another, but it is common for U.S. providers not to cover online therapy, and consequently, international therapy.

However, recognizing this need, some providers are introducing distance therapy as part of the insurance coverage. It is always best to check with your insurance provider.

Language and culture

Our language is one of the primary sources of communicating about our culture. Therapy with a non-English native can be tricky. Meanings can get lost in translation and idioms misunderstood, complicating the process.

In addition, having a therapist who isn’t that familiar with your culture can present some barriers of understanding even when the language itself is no issue. At times, these problems can feel unmanageable and overwhelming.

These issues are mitigated by online therapy. Even though there may be too many jurisdictions to follow, you are assured safety even far from home. Insurance providers have been considering international online therapy as an essential service, especially in COVID-19, and communicating with a native English speaker with the same cultural background helps strengthen the therapeutic alliance.

Overall, a virtual therapist is about as good as you can get in these situations. If you think online therapy may be the right solution for you but still have some doubts, let’s go over some of the smaller details.

The Pros and Cons of Online Therapy

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As an ex-pat, you can expect online therapy to offer you the same benefits as offline therapy, and sometimes even more.

No cultural or language barriers. When your online therapist understands where you’re from and speaks the same language, there are simply no such barriers.

It supports mobility. If you are someone who has to constantly travel for work but wants to continue with the same therapist, online therapy is readily available for you.

Access. Online therapy reaches out to different corners of the world. You might have a doctor in your area to look after your physical health, but not everyone has a mental health professional living near them.

Scheduling. If you’re a parent or a full-time working professional, your schedule is jam-packed. Online counseling completely removes the burden of scheduling, as it can be done instantly and fit in whichever open slot you have during your busy week.

Comfort. You can wear your pajamas or sit on your sofa with your favorite pillow while talking to your online therapist. Online therapy gives you the luxury of opening up in the comfort of your own home.


However, there are certain things you should be aware of before opting for international online therapy.

Severity of your issues. Online therapy is not meant for people who have been diagnosed with severe disorders, such as major depressive disorder. In times of crisis, online therapy may not allow your therapist to offer immediate support, and so in-person therapy is needed. If you believe your problem to be severe, online counseling is most likely not the answer.

Legality. As addressed above, not all U.S. states allow interstate online counseling. Once you add countries abroad to the mix, legality becomes inscrutable really fast. While awareness of the issue is growing, there’s still a long way to go before the legality of online therapy is clear to all.

Insurance. Only recently has mental health been added by service providers in their insurance plans, and therefore, online therapy is yet to be added by most providers. It is always best to check with your individual insurance provider to see if they cover online counseling.

So Should I Try International Online Therapy?

If you are away from home and struggling with any sort of psychological issue, international online therapy is a good starting point. Considering both the pros and cons of online therapy, you would do well by giving online therapy a try under most circumstances. 

If you’re looking for an online therapy platform, DoMental helps streamline the process for you and onboard you with a therapist that best understands your preferences and needs.

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