What You Need to Know About Starting Therapy While Living Abroad
Therapy abroad can lighten the emotional load you don’t realize you’re carrying
Moving abroad is a bold leap—a choice that often brings adventure, new perspectives, and beautiful growth. But for many expats, the emotional weight of that transition sneaks up quietly. You’re navigating unfamiliar systems, rebuilding a support network from scratch, and redefining what “home” even means. It’s exciting—but also disorienting, exhausting, and sometimes lonely.
As a therapist who has lived this journey firsthand, I often describe it like carrying a backpack full of invisible weight. You might not realize how heavy it is until you set it down—maybe during a visit back home, or when life finally offers a rare moment of ease. Therapy should feel like that: a place where you can unpack, find relief, and decide what to carry forward and what no longer serves you.
If you're considering therapy while living abroad, you're not alone—and you're in the right place. Let’s unpack what therapy abroad looks like, what to consider, and how to find a provider who truly understands your experience.
Emotional Challenges of Living Abroad for Expats
When my family moved from the U.S. to Spain nearly a decade ago, we were full of high hopes. We had left our community, our routines, and our lazy days along the Boise River behind to chase something new. It was exhilarating—but in the early months, every day felt like an uphill trudge. Setting up phone service, finding a family doctor, trying to decode a foreign school system… the to-do list was endless, and our energy was not.
At one point, my husband sketched a graph on his phone to capture how he’d been feeling: back home, we had a relatively stable emotional baseline. But in Madrid? That baseline dipped. The lows were lower, the frustrations more intense—but the highs? Breathtaking. Watching our daughter perform in a choir of children from around the world. Wandering through Retiro Park at golden hour. Booking a last-minute flight to see a West End show in London.
That emotional whiplash—what researchers call emotional volatility—is common in expat life. According to AXA Global Healthcare, expats are twice as likely to experience anxiety and depression than those living in their home countries. Meanwhile, the International Organization for Migration reports that mental health services for expats remain underdeveloped, leaving many without adequate support.
How Expat Therapy Helps with Emotional Challenges
Therapy abroad isn’t just about fixing a crisis. It’s about creating space to reflect, build resilience, and reconnect with yourself. You don’t have to wait until you’re barely holding it together.
Here’s how therapy can help:
Process transitions and identity shifts that come with international moves
Build emotional agility to ride the ups and downs without crashing
Improve communication in relationships under stress (especially in a different culture)
Untangle burnout, culture shock, or homesickness that doesn’t go away
Strengthen your internal stability when external life feels unpredictable
Good therapy offers relief. Great therapy helps you grow. For expats, it often does both.
What Expats Should Consider Before Starting Therapy Abroad
Choosing therapy abroad can come with some logistical and emotional nuances. Here's what to think about:
1. Licensure and Legalities
Make sure your therapist is licensed in a country whose laws align with your needs. If you're working with someone online, they should be transparent about where they are licensed to practice and whether that coverage extends to you.
Some countries regulate therapy tightly; others don’t at all. When working across borders, clarity matters.
2. Cultural Competence
Working with someone who “gets it” makes a world of difference. Therapists with expat experience—or better yet, those who have lived abroad themselves—can offer insights that go deeper than textbook empathy.
You're not starting from scratch with your backstory. There's built-in understanding of the losses, micro-frustrations, and emotional gymnastics that come with life abroad.
3. Time Zones and Availability
Scheduling across time zones can be tricky, especially if your therapist is working from a different country. Make sure you clarify their availability, response times, and any cancellation policies.
Therapists who specialize in expat mental health usually build their schedules with international clients in mind.
How to Find a Good Fit for Expat Therapy
Here are a few tips to help you find someone who is skilled, safe, and supportive:
Search international therapist directories, like International Therapist Directory, or Psychology Today with the “online” and “cultural expertise” filters.
Look for licensed mental health professionals with experience in international counseling, not just coaching or wellness services.
Ask about their understanding of expat mental health, including culture shock, identity loss, and invisible grief.
Trust your gut. If something feels off in the initial consult, it's okay to keep looking.
Therapy Should Feel Like Setting Down the Backpack
In my own practice, I’ve seen time and again how transformative therapy can be for expats—especially those who’ve been “holding it all together” for years. I work with people who are high-functioning, smart, emotionally aware, and exhausted. If that sounds like you, you might appreciate this post on why celebrating small wins is essential for mental health—especially when you’re used to pushing through without pause.
Therapy isn’t about fixing you. It’s about offering space to breathe, to make sense of the jumble, and to gently examine what you’ve been carrying. Maybe it’s a lingering grief you didn’t have time to process during a move. Maybe it’s a new identity crisis sparked by shifting roles or language barriers. Or maybe it’s just needing someone to say, “Yeah, this is hard. And you're not alone.”
FAQs About Therapy Abroad
-
A: Expat therapy is mental health support tailored to the emotional needs and lifestyle of people living outside their home country.
-
A: Expats face unique stressors—isolation, identity shifts, and loss of support networks—on top of life’s difficulties. Therapy helps manage these challenges with compassion and clarity.
-
A: Research shows that online therapy can be just as effective as in-person sessions, especially when working with a therapist who understands the expat experience.
-
A: Most countries allow you to access therapy online, especially if your therapist is licensed in their home country. Still, it’s wise to double-check regulations for the country you're residing in.
-
A: Some global or travel insurance plans cover therapy, but many don't. Check your plan and ask your therapist if they can provide a superbill for reimbursement.
-
A: Many expat therapists offer continuity of care as long as it aligns with licensing laws. Clarify this upfront so you don’t have to start over if you relocate.
-
A: It depends on your needs. A therapist from your home country may understand your cultural background more deeply. Someone in your host country might offer better familiarity with local systems. Many expats choose a licensed provider online who offers culturally informed, accessible support.
Final Thoughts
Life abroad is full of nuance—grief and joy, growth and challenge, isolation and connection. Therapy offers a soft landing, a place to make sense of it all and feel a little more grounded in the process.
You deserve support that honors both your bravery and your burnout. Whether you’re six weeks into your international move or six years, it’s never too early—or too late—to start unpacking.
If you’re an expat feeling the weight of transition, I’m here to support you. Learn more about my therapy services designed specifically for expats.
