Adventure! Necessity! Exploration! Education! There are a million great reasons to move some exciting, some heart-breaking. Maybe your practice is in that beautiful, easy place where referrals roll in effortlessly and it pains you to leave it. Maybe you are still in the building stages and are tired at the thought of investing all over again. Fair enough.
Here are some things I’ve learned as I’ve ping-ponged across the United States as private practitioner:
You are in transition. You know all those therapists who love to work with “people in transition,” that’s you sweetheart. And if there’s a market for therapists working with this population, you may want to consider that it’s just plain hard to transition. Don’t hold on to the brave face all the time. Don’t pull the BS of “I’m a therapist with a million tools so transition shouldn’t be hard for me.” Transition is hard for everyone. Consider therapy in your new town as you build your local social support. Call or Skype with your friends a lot. My phone bill when we first moved to Seattle? Ridiculous. My mood? Improved.
Take some time grieve what you left but be careful about comparisons. When we moved from Seattle to Asheville I couldn’t even look at pictures from our years there. It was like a break-up. Over a year later I still deeply miss Seattle and I also absolutely love Asheville and feel like it’s Home. I can compare little things (the Seattle drivers are SO polite! The hikes in Asheville are so much closer!) without getting bogged down in better than/worse than.
Online counseling is not awkward or weird like you might think. It’s an awesome option for the clients you currently have who are stable, have low risk behaviors, and are private pay. There are very important legal and ethical considerations and ignorance isn’t an excuse to do what you want. A few VERY important standouts from the trainings I’ve taken:
- Legally, you need to be licensed in the state your client is in. So I’ve maintained my Washington licensure in order to continue to see some of my awesome clients there.
- Ethically, I only offered this to people who were in a stable place and since I work with folks with eating disorders, I also stipulated that they maintain their relationship with either their dietitian or physician so I would have “boots on the ground” in case the head I was seeing on my screen was atop a quickly shrinking or expanding body.
- Legally and ethically, please please please do not justify using Skype for therapy. It’s not HIPAA compliant and it’s really spotty. I use VSee and have been pleased with their video clarity and reliability. Their HIPAA compliant option costs money but you can make that up in 1-2 sessions. Thera-link has gotten some good press lately and is significantly less expensive.
Rob Reinhardt at Tame Your Practice wrote about other considerations about online counseling on his blog.
Get clear about the licensing requirements in your new state. Get used to the idea that reciprocity doesn’t exist. You will probably have to apply like the newly licensed including a new sign off from that supervisor you had years ago. A good LCSW friend in Georgia moved to Washington right after getting licensed. In Georgia at that time you could have to 50% of your hours be supervised by a psychologist or an LPC. In Washington at that time, you had to have all supervision done by a fellow social worker. She couldn’t get licensed in Washington until she redid (and paid for) however many hours of supervision she needed.
Apply for licensure in your new state ASAP. In North Carolina one of the licensing boards only meets to review applications quarterly and if they don’t have a quorum, will cancel the meeting. I hear horror stories of license-eligible folks waiting 6 months to get licensed. Start that process as soon as you know what state you’re moving to.
If you plan to get on insurance panels do it as soon as you’re licensed and have an address to give them. Skype-network or email-network (or be old fashioned and use a telephone) with folks in your soon-to-be town and ask which are the most common & highest reimbursing.
Look at map to see where you want your practice. I’m on a street that was obviously full of therapists (thanks for the info, Google Maps). Look at proximity to highways and make sure you’re in a part of town that isn’t stressful to park in if that’s important to you. See which cities or towns are likely to commute in.
Don’t pay attention to anyone who says anything about a saturated market. As my friend Allison says, it’s like finding your spot at the beach. There’s room for everyone, you just may be close to your neighbors. Need some convincing that saturated markets don’t exist, I got you covered here.
Find folks to network with and people you’ll refer to. Does your client population often need psychotropic meds, a great medical provider, a specialized dietitian? Google the psych prescribers, medical practices and RD’s in your new area. Check out Psychology Today, Good Therapy, and Google for other therapists in the area. Make a list or spreadsheet so you can jump on networking when you get there.
Google business lists you on Google Maps. Once you have an office, hop on! It’s free!
Learn about your new community and culture. Attend local events, read the local paper, drive around, get to know what cities and attractions are around you. It’ll be great for getting settled in and for knowing that when a client says “I went to Clingman’s Dome this weekend” that they were hiking, not watching a sporting event.
If your practice was smooth sailing for years, you may need to revisit the practice-building information you used to build in the first place. Also check out some of the newer practice-building resources that have popped up since. It’s a new world with a larger emphasis on having an online presence.
Have you moved your private practice before? What tips can you share in the comments?
Allison Puryear is an LCSW with a nearly diagnosable obsession with business development. She has started practices in three different states and wants you to know that building a private practice is shockingly doable when you have a plan and support. After retiring her individual consultation services, she opened the Abundance Party, where you can get practice-building help for the cost of a copay. You can download a free private practice checklist to make sure you have your ducks in a row, get weekly private practice tips, listen to the podcast, hop into the free Facebook Group. Allison is all about helping you gain the confidence and tools you need to succeed.
thanks, allison! I am moving my practice from houston to portland. It is terrifying leaning a successful practice to start over from the beginning. It’s encouraging to know other folks have taken the risk as well!
Absolutely, Maegan! I’ve done it twice now & known lots of other therapists who have! Congrats on your move! Portland is awesome!
Maegen, I’m moving from Arkansas to Portland. Were you successful in starting a new practice? Do you have any tips you can offer me? (I’m an lpc)
Amy and Maegan:
I’m considering moving from southern california to Portland because, well adventure awaits and I have to see green hills for a change. I have a successful practice here but the cost of living is crazy, let’s face it. Any good advice you can throw my way? Thanks for your time!
dO YOU USE A PARTICULAR “sCRIPT”WHEN cOLD-EMAILING POSSIBLE REFERRALS TO MEET? I’m TRYING TO EXPOSURE-THERAPY MYSELF THROUGH THIS, *AND* I DON’T WANT TO SOUND GOOFY. aPPRECIATE YOUR THOUGHTS!
I do, Gina. I’ll email it to you!
I would also like some suggestions for calling to make some new connections
Hey Sophia, From Fri 11/11-11/18 my “What to say When: Scripts and Templates for Counselors in Private Practice” will be available for purchase. there’s a huge section on networking that could be really helpful. you’ll be able to purchase it at that time(only $99) at abundancepracticebuilding.com/product/what-to-say-when/
Wonderful info! I would love to get the scripts you mentioned, however they arent available for purchase on the page you listed. Is theRe another way to get them? Thank you!
Hi Amie! The scripts are all available in our Scripts and Templates course in the Abundance Party
Thank you so much for your emotional support! I am in the process of moving to Charlotte- from Florida, and in process of opening a PP (Joys of waiting for NC licensure board). I hope I get to meet you while there, I know I will be following your blogs!
Charlotte is only a couple hours from Asheville! Definitely give me a shout when you get here; I’d love to grab coffee! Congrats on your move! And good luck with the board- if you’re an LPC it can take a while!
Thanks for this information. I’m contracted with multiple insurance companies in California (Aetna, Blue Shield, Magellan, Medicare, MHN). If I move my practice to Pennsylvania, will I Have to re-apply or can I just update my address for some of these insurance companies and maintain my contract?
Hey Lindsay,
Unfortunately, I think you’d need to call each and ask. Some allow an easy transfer once you’ve shown that you’re licensed in PA. Some are completely different despite having the same name (kinda like franchises). I’d call each ASAP since, as you know, the application process can be time consuming.
Thanks for this:) That was my question as well
Thank you so much for this post! My husband and I are seriously considering a move from MD to NC and this answered a lot of my transition questions!
C’mon down! NC is fantastic! 🙂
I need to read this. One of my bigger fears is what am I going to do when we have to MOVE again (my husband is active military) and is it worth it…to build and take down and build?
I hear you (and thanks to your husband for his service and you as a military wife). The more practices you build, the better you get at it, IMO. If you’re stationed for 3 years, I think it would be worth it. You can also keep your licensure in each state and see clients online. I have a podcast series about moving and private practice coming out in early July. Keep an eye out for it.
YES I HAD TO RELOCATE MY HYPNOSIS BUSINESS NOT ONCE BUT TWICE IN 6 MONTHS. LEAVING A SUCCESSFUL BUSINESS IN MY HOME TOWN- top 3 2 years in a row. Was just starting to really ramp up the customers at the 5 year mark. Still in process of reestablishing for the 2Nd time in Cairns australia. Been hete 3 months so i know there is aprocess. I have new websites nearly ready and just getting ready to network. Had a frw clients but this has been so challenging. I feel like i have lost my PASSION-for my business. So i am kind to myself do my fitness everyday and just keep moving doing the steps i need to do with the busoness. And yes talking to another therapist i muzt do that..
Anyhow we juzt have to be gritty and mindful at the same TIME .
It’s so hard! But you’re right, tapping into that grit and staying mindful while doing the next right thing is really all we can do!
Just found this post and probably moving to Spokane WA. HAve already begun the Licensure process. Thanks for all the tips above and will look for that podcast in your history!
Allison: Love reading your stuff, thanks for publishing it!
Hi Allison, I want to be able to practice as a snowbird…3 months in Carolina and 9 months in New England….any suggestions?
I also would love to know if there is a way to snowbird…?
ABSOLUTELY if you’re doing online therapy. Get licensed in both states, find a great online platform, and see folks online!
Hi Allison, Can you also be paneled in both states? I just moved from CT To TX and am dually licensed and took my clients with me virtually. Thanks!
Great question! Have you asked in the Abundance Practice Building Facebook group?
Hi Allison,
I am thinking of moving the location of my practice only about 20 minutes away. I am credentialed with all major insurance companies. Do you know if this will be an issue with the insurance companies?
Thank you so much for this article! Im an LCSW and as a military spouse i have so many questions. My main one is, can i be licensed in multiple states and be paneled with insurance with those states? I plan to be comPlEtely online for right now.
Hi Samantha, did you ever get an answer to this question? I’m wondering the same now that I’m dually licensed and fully online. Thanks!