A recent federal court decision shows how a landmark U.S. Supreme Court ruling on mental health counseling, Chiles v. Salazar, is beginning to influence other legal disputes involving licensed mental health professionals. As the leading resource for the social work profession, NASW is committed to helping members understand important legal developments that may affect practice, licensure, and client care.
Background: The Supreme Court’s Decision in Chiles v. Salazar
In Chiles, the Supreme Court considered whether state laws banning conversion therapy could be enforced against licensed mental health professionals who argued that such bans restricted their ability to speak freely with clients. The Court held that talk therapy—the conversations through which many mental health professionals assess, counsel, and treat clients—is protected speech under the First Amendment. The Court rejected the argument that these conversations lose constitutional protection because they occur within a licensed professional-client relationship. The Chiles decision raises concerns about how courts may apply the First Amendment when states regulate professional practice and standards of care.
NASW joined an amicus brief in Chiles explaining the importance of protecting professional judgment and the ability of licensed mental health professionals to engage in evidence-based therapeutic conversations with clients. This underscores the association's ongoing commitment to advocating for the profession while supporting professional judgment and evidence-based therapeutic practice.
The Brokamp Decision
On June 24, 2026, the U.S. District Court for the District of Columbia, in Brokamp v. District of Columbia, applied the Supreme Court’s reasoning in Chiles that talk therapy is protected speech to a professional licensing dispute. The court considered whether the District of Columbia could require an experienced Virginia-licensed counselor to obtain a D.C. license before providing teletherapy to clients located in the District.
The plaintiff, Elizabeth Brokamp, is a professional counselor licensed in Virginia who provides therapy by video and telephone. She wanted to serve clients located in the District of Columbia . However, D.C. law generally prohibited counselors from practicing professional counseling with a client in the District without a D.C. license, even when the counselor remained physically outside the District and provided services remotely.
Although D.C. offered a path to licensure by endorsement, it required an application, fees, proof of education and supervised practice, examination documentation, and other qualifications. Virginia and the District also lacked the reciprocity arrangement that would have allowed Brokamp to practice without a separate D.C. license. As a result, Brokamp had to turn away potential D.C. clients unless she completed the District’s licensing process.
Relying heavily on Chiles, the court concluded that the D.C. licensing requirement violated the First Amendment. Because Brokamp’s practice consisted essentially of speaking with clients, the court concluded that her practice involved protected speech.
The court analyzed the law under intermediate scrutiny; the standard generally used for content-neutral restrictions on speech. Under that standard, the government must show that the restriction advances an important interest and does not burden substantially more speech than necessary. The court concluded that the D.C. requirement failed even that standard as applied to Brokamp because the District did not adequately explain why requiring this already licensed, experienced counselor to obtain a second license was necessary to protect D.C. clients.
What the Decision Means
The Brokamp decision is narrow. The court did not strike down the District’s professional licensing laws, create a general right to practice across state lines, or eliminate licensing requirements for mental health professionals. It held only that the District could not enforce the challenged licensing provisions against Brokamp under the specific facts of her case.
The decision also does not presently change licensing requirements for social workers. Licensed social workers should continue to comply with all applicable state laws governing licensure, interstate practice, and telehealth. A social worker should not rely on Brokamp as permission to serve a client in another jurisdiction without confirming that jurisdiction’s requirements.
Why This Matters for Social Workers
Although its immediate legal effect is limited, Brokamp is significant because it extends the Supreme Court’s reasoning in Chiles beyond the context of conversion-therapy bans and into a different type of regulation: professional licensing. That development raises concerns for social workers and other licensed mental health professionals.
Treating therapy primarily as protected speech risks minimizing the professional nature of social work practice. Clinical social work is not simply conversation. It is a regulated professional service grounded in specialized education, supervised clinical experience, licensure, ethical obligations, assessment, diagnosis, treatment planning, and standards designed to protect clients. A First Amendment analysis that focuses primarily on the words exchanged during therapy may fail to account adequately for the training, judgment, and professional responsibilities that distinguish licensed practice from ordinary speech. Maintaining these professional standards is essential to ensuring quality social work practice.
This concern extends beyond interstate teletherapy. If courts increasingly characterize licensing requirements and other professional rules as restrictions on speech whenever a practitioner’s work involves communication, longstanding standards governing professional qualifications and practice may become more vulnerable to constitutional challenge. Such an approach could weaken states’ ability to establish qualifications, enforce standards of care, and protect the public from unqualified or unethical practitioners.
At the same time, interstate licensing barriers remain a significant obstacle for social workers seeking to provide teletherapy across state lines, particularly in underserved communities. The broader challenge is therefore to improve portability and access without diminishing the professional status of social work or undermining the legitimate public-protection purposes of licensure. And as technology continues to change how services are delivered to clients, NASW supports thoughtful exploration of policies that improve portability and access while preserving professional standards.
Whether courts will extend Chiles to additional licensing or regulatory issues remains to be seen. Because NASW is committed to keeping our members informed with timely information that addresses emerging legal issues that affect the profession, we will continue monitoring these developments. We will also advocate for an approach that protects constitutional rights while recognizing the education, training, ethical duties, and professional judgment required of licensed social workers.
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