Telehealth couples therapy in California

Video sessions are one way to fit couples therapy into two schedules. This guide covers the California rules that protect you and the practical steps that make online sessions work for two.

Who can provide online couples therapy in California?

Where you are during the session decides which license is needed. The Board of Behavioral Sciences (BBS) says you must have a current, active California license or registration to provide marriage and family therapy, clinical social work or professional clinical counseling to clients located in California, including by telehealth. Psychologists are licensed separately by the California Board of Psychology, which publishes its own telehealth FAQ.

This means:

• A California-licensed LMFT, LCSW, LPCC or psychologist can see you by video anywhere in California, even if you live far from their office.
• A California licensee who is temporarily outside the state can keep seeing California clients by video, if their license is current and active and they follow California’s telehealth regulation (16 CCR § 1815.5).
• A therapist licensed only in another state generally cannot start seeing you while you are in California.

What is the 30-day temporary practice allowance?

BBS offers a one-time per calendar year, 30-day allowance for MFTs, professional clinical counselors and clinical social workers licensed in another US state. It covers only an existing client with an established, ongoing relationship who is located in California for a limited time. The therapist must tell you they are not licensed in California and that the services are for a limited time, give you the BBS website address, and apply to the Board for the allowance. It is not a way for out-of-state therapists to take on new California clients.

What must a therapist do before starting telehealth?

Under the BBS telehealth FAQ, when starting telehealth a licensee or registrant must:

1. obtain your informed consent;
2. tell you the potential risks and limitations of treatment by telehealth;
3. give you their license or registration number and type;
4. document reasonable efforts to find emergency resources in your area.

Expect a consent form that covers these points, plus what happens if the connection drops and how to reach the therapist in an emergency.

How do we make video sessions work as a couple?

• One screen or two? Sitting together on one laptop is simplest. Use a larger screen if you can so the therapist sees both faces.
• Privacy. Pick a room with a closed door. Children, roommates and smart speakers can overhear. Headphones help when someone else is home.
• Connection. A wired connection or sitting near the router reduces freezes. Close other apps.
• A buffer. You may want to leave some time after the session before getting back to work or family.
• Separate locations. If you join from different places, both of you need privacy. If one partner is outside California, ask the therapist first.

Is telehealth safe if there are safety concerns?

Video sessions at home can be overheard. If one partner is afraid of the other, couples sessions, online or in person, may not be the right step. The National Domestic Violence Hotline notes that devices can be monitored without you knowing it and that browsing history can never be completely erased. See when couples therapy isn’t the right step and get help now.

How will profiles show telehealth?

Each therapist profile will list whether they offer video sessions and the states where they say they can see clients by telehealth, alongside their license number so you can check it. See how to check a California license.