You most certainly do not have to live in the same state as your therapist. I drive three hours to see mine, I live in Maryland and she is in another part of Pennsylvania. I actually first saw a therapist in New York City, but she will act as my second opinion. Fortunately, my regular therapist has seen me fit enough that she does not believe in keeping me in therapy if she feels I do not absolutely need it. Which means I won't always have to be regularly driving the 3 hours one way to see her.