Reciprocity Doesn’t Always Mean What You Think It Does

Almost 9 million Americans will move out of state this year.  A significant percentage of those will be mental health and allied health professionals.  While the American Counseling Association continues to work with licensing boards across all fifty states to make practicing across state lines easier for all professional counselors, there is still work to be done. 

I had been licensed for over ten years in 2002 when I closed my practice in Texas and opened up shop in Colorado.  That’s when I first learned about the stamina and hoops a therapist must jump through when attempting to have her license in one state recognized by another.  Over the last twelve years, I have supported other therapists on an almost weekly basis as they move in and out of different states while trying to practice independently.   

When my colleague and friend, Cathy Wilson, MA, LPC, NCC  was faced with a similar challenge of relocating from Colorado to Arizona, I asked her if she would be willing to share her experience and some of the lessons learned concerning reciprocity.   She graciously agreed to guest post on this topic.

(If you are interested in writing a guest post, check out the guidelines here.)

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A Guest Post by Cathy Wilson, MA, LPC, NCC

 

Reciprocity as it currently stands may not be what you expect it to mean.  I am a Licensed Professional Counselor in Colorado and a few years ago it seemed I was possibly going to move to Arizona.  Circumstances ultimately changed and I will remain in Colorado, but at the time I needed to prepare to move.   My first challenge in making the move possible was to get licensed in Arizona so I could work as a professional counselor there.  I considered doing other work, but working with clients as a counselor is what I love to do.  The following are lessons I learned along the way.

Lesson #1 – Read the New Licensing Board’s Rules Thoroughly

This may be an obvious one, but I still want to emphasize it here because when I initially read Arizona’s guidelines, I really thought I had read them thoroughly.  I hadn’t.  One important mistake I made was because I didn’t understand the overall structure of how their rules were written.

That huge document included not only current requirements but also their obsolete requirements.  I missed a very important line that said,  “This subsection expires December 31, 2006” which resulted in me using the wrong set of requirements when preparing my documentation and application.  That was an extremely important and not very obvious line!  Read every word of the rules, the statutes, and the application form to be very clear on what you will need to do.

Lesson #2 – Determine What Type of License You Want to Obtain

The first thing I looked for in the guidelines was whether they offered reciprocity or not.  They do.  However, it is not at all what I thought reciprocity meant.  I thought if I were already licensed in one state, applying for reciprocity in another state would be simple and would allow me to begin working in the same capacity I already held.  In reality:

• Before I could even apply, I needed to have been licensed in my state for at least 5 years;
• If I was granted a reciprocal license, I would not be able to practice independently for at least one year, and I would also have to get 1600 hours supervised; and
• After all that, I would have to go through another application process to get a regular LPC license.

I ultimately chose to apply as if I was a relatively new counselor, which still would require the same amount of  time and supervision before I could work independently, and applied for a Licensed Associate Counselor (LAC) license.

Lesson #3 – Be Prepared to Spend a Lot of Time on This

I thought that since I had already gone to school and made the effort to get licensed as a Professional Counselor in one state, that it would be easy to apply with another state and get licensed.  I was worthy of getting licensed already, so I shouldn’t have to prove myself all over again, right?  Wrong!   It took months to get all the documentation I needed before I was able to submit my initial application.  I was asked to provide additional information multiple times.  From the time I began actively pursuing an Arizona license, it took a total of 17 months to finally get approved.

Lesson #4 – Network with Mental Health Professions in the New State

One of the most helpful things I did was to get to know other counselors already working in Arizona. (Thanks to Tamara for this suggestion early in the process!).  I joined the Arizona Counselors Association and the Private Practice Network for therapists in private practice in Arizona.  I was then able to reach out to counselors who were familiar with how things worked in Arizona and had already been through the licensing process.  These contacts were invaluable.  Facebook, Twitter, Google+, or other social media can also be a great source for networking.

Lesson #5 – Ask a Lot of Questions

I asked a lot of questions of both the other counseling professionals in Arizona and of the person who was my contact on the Arizona Licensing Board.  Sometimes I just wasn’t clear on what a requirement meant even though I had read it over and over.  My contact at the Licensing Board was helpful in clarifying those matters.  In addition to asking questions, there were a few times that simply talking with other professionals about my application and where I was in the process helped me to learn what questions I needed to ask.

Lesson #6 – Be Patient with Yourself

It can get discouraging.  I can’t count how many times I almost gave up on the whole process.   Being in this profession, we know the importance of the things we teach our clients, but I admit I had to remind myself again and again to step up my self-care and my positive self-talk to persevere.

 Lesson #7 – Consider Other Options

This was a difficult thing for me to do but there were times when I had to consider the possibility that my application would be denied and if I was going to work in Arizona I may have to do something a little different.  Some of the ideas I considered were the following:

• Provide coaching as well as counseling and possibly expand this aspect of my practice nationally;
• Expand my existing practice in Colorado to include contractors so that the practice would continue to produce income;
• Continue seeing clients in Colorado where I am licensed via telephone, Skype, or other media (after an initial face-to-face contact);
• Providing online counseling;
• Adding services in my practice that my contractors and I can provide such as clinical supervision and group counseling;
• Obtain employment in another capacity in the field of mental health such as getting employed by Magellan Behavioral Health as a caseworker; or
• Some combination of these.

New Beginnings

I did finally obtain the LAC license in Arizona.  And, while I was working on that I combined a few of the ideas above for my practice in Colorado.  I’ve expanded my existing practice to include a few other counselors who contract with me to see clients in my practice. We now offer a wider variety of services including both clinical supervision and group counseling.  Even though I am no longer planning to move, the experience created unexpected growth in my business.

If you, too, have had the experience of leaving one state to practice in another, I hope you’ll share your story and lessons learned, too. My experience is just one and we can all learn from each other in navigating this often ambiguous terrain. 

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Cathy Wilson, MA, LPC, NCC owns LifePaths Counseling, a private practice in Littleton, Colorado where she and other counselors providing support and guidance to clients of all ages helping them to build resilience, improve well-being, and bring positive change to their lives.