Career mobility for psychotherapist/counsellors?

March 14, 2019 4:25 PM

Practicing psychotherapists/counsellors: how hard is it to move from state to state within the US over the course of your career? If I train in New York but in ten years time want to go live to Chicago, would this be really hard? Same question, but for between the US and the UK. If I train in one country, should I accept that it would be really hard to move to the other country, or at least would involve expensive retraining? Soon to be ex-academic expat considering future options...

I am strongly considering a career change from academia to psychotherapy/counseling. I’ve read and really appreciated many of the other threads here on AskMe about careers in psychotherapy and counseling. Particularly this prior thread, which is basically my situation except I don’t have an interest in working with students in the future.

My additional question, however, is about how much mobility there is in this career. In terms of moving state (in the US) or moving between the UK and US. All the threads I've read so far talk about how the license requirements change by state, and I've been doing some research on what's required in the states I'd love to live in. But does this mean that once I'm trained I'm basically stuck working in that state?

I’m at the beginning of this journey, where I’m currently just figuring out options and what I might like to do and getting the courage to make the jump. I know it’ll be a few years before I can start specialist training (an MA in the US or a BA conversion in the UK) because I don’t have a BA in psychology and I’ll need to save some money first, not to mention getting some volunteering experience in the mental health field. But I’m excited that this could potentially be a fresh start!

Moving within the US: One big attraction is that, if I leave academia, I could finally actually choose where I live. I am currently in Michigan and our little family is pretty miserable here. We moved so I could do a postdoc and that’s the only thing keeping us here. We would love to be in back in Chicago or New York, but the idea of picking one place to live for the rest of my life makes me feel kinda claustrophobic.

Moving between the US and UK: I’m from the UK but have lived in the US nearly 15 years. I never ever intended to stay here this long, but whenever I’ve tried to move back to the UK I couldn’t get an academic job there. I now have a family here in the US, friends, have spent most of my adult life here, etc etc… it’s not so bad (Trump and Brexit kinda cancel each other out in terms of awfulness). But I’d love to keep the opportunity to go back to the UK at some point, especially as my kid gets closer to school age. Could this be the time to go? If I train here in the US, does that mean I am closing the door to ever returning to the UK?

With all that angst in mind, as I’m preparing to start this career change it would be really helpful to know more about how easy/hard it might be to move from one country to the other in the future, or around the US, beyond the basic info I can kind about qualifications. For instance, I've read that working in the UK with a foreign license requires acquiring a "Statement of Equivalence" from the UK professional body, but I'd love to hear if anyone has any actual experience of trying to practice in another country. What was it like?

This is perhaps tangential, but these are some of my pros and cons so far...

UK
- Despite having British citizenship, I would have to work (not study) in the UK for three years, before I qualified for UK tuition fees.
- I would need to do a 1 year conversion course for psychology then a 3-4 year DClinPsych. Much of the training involves unpaid internships but if I was a UK resident, I might get a government grant for the DPsych.
- My impression is that there are fewer opportunities for private practice, and most employment is in the NHS or organizations like Relate. I could be totally off base here though. I just get the impression talk therapy is less stigmatized in the US than the UK and people are (for better or worse) more used to paying for private health care.

US
- I am currently taking psychology courses at a community college, which in addition to my existing BA/PhD might cover some of the requirements for an MA course?
- From previous MiFi threads, I understand that it's possible to get licensed in many states with a Masters, like the one at Hunter College, so I wouldn’t need to do another doctorate.
- It would only take me a year to get residency in a new state, so I could apply for in-state tuition (I have zero intention of staying in Michigan but would be happy to work in whatever-job for a year if it meant living somewhere my family was happier).

Thank you in advance! I have learnt so much already about this topic from the MetaFilter community and am so glad it exists.

posted by EllaEm to Work & Money (12 answers total)

I can't speak to the US > UK question. But moving from State to State requires forethought, because you want to have a degree that is an accepted category of practice in the destination State, and where the receiving State's requirements are not unduly onerous. For example, a psychologist colleague who relocated to another State had only to accrue CE hours that were acceptable to the other State, which she did by taking nationally accredited courses (including a State-specific Laws and Ethics course) and then take that State's licensing exam.

But other classifications can be more difficult. As an example, there's a relatively recently recognized certification in California of Licensed Professional Clinical Counselor, which is a Master's level credential. I gather there is a National exam, but different States have different requirements for ultimately getting the license. The American Counseling Association has this on their webpage about license portability:

Licensure portability—the ability to transfer a professional counseling license when a practitioner moves to a different state—is one of the foremost concerns of professional counselors. Counselor licensure titles and requirements, which can vary widely from state to state, can force even the most experienced of counselors to obtain additional supervision hours or meet other requirements before they can secure a new license after a move across state lines. In some cases, counselors with decades of experience are told that they cannot transfer their license to their new home state under any condition.

Here's a document from Calfornia's Board of Behavioral Science Examiners (the licensing body for LPCCs) where they explain what's needed to practice in California with an out of state license.

It can be challenging, but I get the impression that you can make it work by doing the preparation. Figure out some places where you would want to move to first, and then learn the licensure requirements for that place.
posted by jasper411 at 4:54 PM on March 14, 2019

Yeah, it depends on the states involved. My wife is the therapist, not me, so my knowledge is second-hand. But we moved before she was licensed, and IIRC the clinical hours she had accumulated in the old state were applied to her licensing application in the new state. I also remember her saying that the opposite was not true, that the old state doesn't count out-of-state hours. Several of her friends have also moved, and all of them seem to have had different experiences. There seems to be a general pattern that states with a reputation for stricter regulation in general have stricter rules (surprise!), while more laissez-faire states are more accepting. The one state I remember hearing about is New York, which is apparently difficult to move to.

This information should be publicly available on each state's licensing website.

One additional piece of unsolicited advice: if you're interested in practicing with a Master's degree, consider an MSW. Some schools offer a combo BSW/MSW where the final year of the bachelor's degree overlaps with the first year of the master's, making it a five-year program. If you already have BA credits, this could be the fastest route.
posted by kevinbelt at 5:08 PM on March 14, 2019

I went to a Social Work school with an international focus, some of the professors have the ability to work in Canada or the UK specifically so I know it's possible, you can pm me for more detail.

I've always heard that California is the state to be super concerned about social work wise, if you want to work there, go to school there .

Other than that, it's really state dependent .

I had a coworker just transfer NY to Chicago successfully.
posted by AlexiaSky at 6:03 PM on March 14, 2019

Once you start your master's, you'll also want to save copies of all the syllabi for your courses. I just scanned all of them to a grad school classmate who was trying to transfer her license from CA to IL, and IL required not just transcripts from the school but proof of exactly what she studied in each class to see if it met their educational requirements.
posted by lazuli at 9:22 PM on March 14, 2019

I'm sure you are already aware of this but as far as I am aware, clinical psychology courses in the UK are still massively competitive with many people applying for several years in a row before getting a place. The only person I knew who got in first time was someone who I had just done a psycholinguistics PhD with. Just something to factor into your plans.
posted by kadia_a at 11:40 PM on March 14, 2019

A friend of mine is a newly qualified counsellor in the UK. She did a BACP accredited masters in counselling, having not completed a bachelors degree in anything beforehand. I suspect this is not portable to the US though. If you want to work in the UK then that accreditation is helpful and they probably have information about reciprocity.

As far as I’m aware, social work degrees are not an entry route into counselling in the UK. (As in, that’s not part of the social worker role.)
posted by plonkee at 1:55 AM on March 15, 2019

My wife navigated this situation when we moved from New York City to Northeast Florida four years ago. Her Ph.D is in clinical psychology, which as others have alluded to was a significant boon because you can practice anywhere with that degree. She doesn't have a MeFi account and is currently at work so if you've got specific questions for her feel free to email me (contact info in profile) and I'll be happy to pass them along, but in my recollection the recredentialing process wasn't too onerous. She had to take a test or two down here to get licensed with the state board, and jump through a few paperwork hoops, but that was it. It also took her a while to clear the various insurance panels, but again this was just a bureaucratic hassle, nothing particularly egregious. Again though, she'd be the one to talk to, so definitely get in touch if you've got more questions.
posted by saladin at 5:47 AM on March 15, 2019

I should also add that several of her colleagues from grad school were licensed in and practiced in New York for years after graduation, and have since pulled up stakes and moved to other states where they now see patients, including Massachusetts, North Carolina, and possibly California. So it's very much do-able.
posted by saladin at 5:48 AM on March 15, 2019

Seconding check out MSW programs. I think the MSW degree is more standardized, more easily transportable than a masters in counseling, but that may have changed in recent years. Smith College has one of the best. I guess it depends on what you want to do.
posted by mareli at 6:00 AM on March 15, 2019

for information about UK Clinical Psychology courses see https://www.clinpsy.org.uk/forum/ but as previous poster has noted, this is an extremely competitive route to qualification and you plan of "I would need to do a 1 year conversion course for psychology then a 3-4 year DClinPsych" would most likely need adding X amount of years to get necessary NHS experience, quite often unpaid.
posted by coffee_monster at 6:08 AM on March 15, 2019

This is all so helpful -- thank you everyone! I really appreciate you taking the time to answer my questions.

From this I am hearing that:

1) Moving states in the US requires keeping track of paperwork, organization, and research, but is not that big a deal.

2) Doing my training in the UK is likely to be more difficult than I already anticipated. Going to the UK after I've been trained in the US might also be hard, especially if I only have an MA from the US. Perhaps it might be possible after I'd been working in the US a long time -- a US qualification + X years experience might convert? But this isn't something I should count on.

Sadly, this is all making me realize that even with a career switch, it's unlikely I'll ever be able to move home to the UK. Urgh. That makes me sad. But, even if I can't go home, I can at least work on trying to get a better career here in the US. And one that might hopefully lead to me being able to afford to at least go visit once a year.
posted by EllaEm at 9:52 AM on March 15, 2019

1) Moving states in the US requires keeping track of paperwork, organization, and research, but is not that big a deal.

I'd be a little careful in this assumption. It's a bigger deal if you're moving to a stricter state, and it can have financial consequences if you end up having to redo supervised associate hours (which generally pay less, or don't pay at all) for a year or more.
posted by lazuli at 11:12 AM on March 15, 2019