Why I limit my practice to UK clients

I often have enquiries from overseas. I am genuinely touched that someone very far away might consider me as a possible therapist for them.

Although the digital age makes the world feel smaller, here are the main reasons why I restrict my client base to UK residents.

I hope that explaining might reduce some of the disappointment and confusion that I understand someone might otherwise feel.

● In some places, it’s simply illegal for me to work with you. In most US states, for example, only a therapist licenced by the Board of Psychology in your state can legally work with you.

As an HCPC registered psychologist, a very high standard of practice and conduct is expected of me. I am not allowed to ignore or flout the laws of another country. Furthermore, I would be uninsured if I did so.

● In countries where laws are less strict, the picture can be opaque at best. Although my HCPC registration indicates a very high (world-recognised) standard of professional training and evidence-based practice, I nonetheless must check whether there are additional standards, ethics, practices or registrations in your country that will apply to me if I am working with you.

For example, some countries have specific regulations around telehealth, data protection and sovereignty. Investigating these issues is difficult, convoluted and very time-consuming. 

● The bedrock of therapy is safety for the client. Whilst it’s an unusual event in private practice, if a client were to suddenly enter a state of distress or crisis, for example following a sudden bereavement or loss of employment, my duty of care means I must quickly act to keep that person safe.

This process is smoother when my client is also in the UK. After working two decades in the NHS, I understand the systems. Other healthcare professionals I may reach out to (e.g. GP) also speak English and share the same time zone as me. We therefore have a good chance of acting together to safeguard someone who may suddenly feel in crisis.

In an emergency, navigating unfamiliar systems, language barriers and time zones is stressful at best, and can become an unsafe situation for the client.

Given risks like these, most practitioners find that the administrative and legal burden required to practice safely across borders is prohibitive, which is why most maintain a UK-only practice.

Whilst I can’t offer online therapy to people outside the UK, I do strongly believe in the power of schema therapy. I encourage international readers to visit the ISST website to look for a therapist closer to home. Visit Schema Therapy Society e.V. (ISST) - Find a Therapist

Maintaining this boundary doesn’t mean that I care more about procedures and rules than I care about you. Working only within the UK means that the container for the therapy is safe, legal, and fully supported by clinical governance and infrastructure. Everyone deserves therapy that starts from a clear, well thought-out and strong place.

If you live in the UK and would like to talk with me about starting therapy, please reach out to me using the button below. 

Schedule a free 20 minute consultation