[miki123211]

Okay, here's one thing I really don't get.

There are plenty of native English speakers in third-world countries. Presumably, some of them could become qualified (from a practical point of view, not a legal point of view) therapists. Therapy can be offered via telemedicine, over the internet. At least some of these people are far enough from US jurisdiction that they could probably offer this service to anybody who wants it over the internet, and just not care what foreign governments have to say about it. This feels like an easy way for people there to make relatively large (by their standards) amounts of money. Why isn't this happening yet?

[PretzelJudge]

Sure, if you just want someone to talk to. But most clinical psychologists are dealing with more severe cases. Would you want your suicidal teenager talking to a licensed therapist trained to deal with their case, or to someone overseas whose qualification is that they speak English?

[rafram]

Because people want therapists who’ll connect with them and understand their life experiences.

I’m sure there are fitness/“life” coaches working online from who-knows-where, though. That’s more or less a form of counseling.

[Suppafly]

The problem with this, and we see this in the US already with medical providers, is that even if they are 'native' speakers in their own country, they miss a lot of important nuance and conversational skills to work with US native patients. And that's before you even consider the cultural stuff that they just don't have a frame of reference to understand. Someone from a country where women don't have rights, or where normal things like divorce or abortion are illegal, isn't going to be able to offer useful therapy to someone from the US.