Access to therapy is about to get easier for Pennsylvania residents who travel out of state
Pennsylvania is poised to become the 40th state to join the Interstate Counseling Compact, which enables counselors to practice across state lines.
After giving birth to her first child, Jennifer O’Mara sought therapy for postpartum depression.
But when O’Mara left her Delaware County home to visit her in-laws in North Carolina, her counselor had to cancel a virtual session because she wasn’t licensed to practice outside of Pennsylvania.
“My therapist had always asked me if I was in Pennsylvania before a session started, and there was actually a time where I was not, and we couldn’t meet, and I didn’t understand why,” O’Mara said. “I was confused.”
Unbeknownst to the new mother, Pennsylvania counselors need a separate license for each state they practice in.
O’Mara, a Democrat elected as a state representative in 2018 and a co-chair of the legislature’s Mental Health Caucus, said she’s been working to change that regulation since that canceled therapy session.
Four years later, O’Mara’s efforts are about to pay off under a bill expected to soon go to Gov. Josh Shapiro for his signature.
The legislation would make Pennsylvania the 40th state to join the Interstate Counseling Compact. It enables counselors who are licensed in Pennsylvania to practice in any state that is part of compact.
Pennsylvania will join already participating states, including Delaware, New Jersey, Maryland, Ohio, and yes, North Carolina.
The bill only applies to licensed professional counselors, or LPCs. Pennsylvania separately participates in multistate healthcare compacts for doctors, nurses, and physical therapists to provide inpatient care or telemedicine across state lines.
Shapiro plans to sign it
O’Mara helped advance the bill in the House. The Senate had passed it in July 2025 by a 45-5 vote. The House approved it last week by an 188-to-14 vote.
It now goes back to the Senate for a perfunctory, final signature by that chamber’s president before heading to Shapiro’s desk, according to a spokesperson for Sen. Lisa Boscola (D., Lehigh and Northampton), the bill’s prime Senate sponsor.
O’Mara and leaders of the Pennsylvania Counseling Association (PCA), which has about 700 members statewide, said they expect Shapiro to sign the bill into law once it gets to his desk. A spokesperson for Shapiro confirmed on Tuesday that he plans to sign it.
The bill aims to benefit recent high school graduates who want to keep the same therapist but plan to attend college out of state; active duty military members who are deployed outside Pennsylvania; and residents who physically work in New Jersey or Delaware and opt to do sessions during their lunch break, according to O’Mara.
“This feels like a small bill that will make a big difference,” O’Mara said.
Addressing a shortage of counselors
Post-pandemic, the demand for mental health services has increased, and providers have struggled to keep up. The nation is expected to have a shortage of more than 40,000 counselors by 2030, and roughly 62% of Pennsylvania communities lack adequate mental health services, according to the PCA.
The legislation is designed to ease that burden, said Nicole Palman, a counselor at the Main Line Counseling and Wellness Center in Haverford.
“We’ll be able to continue to see clients when they move to New Jersey or when they move to Delaware without having to end care that may have been going on for years,” said Palman, a PCA member who advocated for the bill.
It’s not always easy to find a new counselor, she noted.
“A lot of people get discouraged,” Palman said. “The process is worse than dating to find a therapist you align with.”
Inquirer staff writer Gillian McGoldrick contributed to this article.
