Office, check; supervisor, check; license application, check; website, check (sort of)

I've made a lot of progress, I just haven't had a chance to post! First of all, I've signed a lease to rent an office 1 day per week. I like the neighborhood, I like the building, I like the office, and I like my landlords. So I'm pretty happy about that, and it allows me to move forward with other things, like getting business cards printed and publishing my website. More importantly, I have an office, which makes my practice feel much more solid and grounded. Now that I'm paying rent, I'll be more motivated to start getting clients.


My rent is about $25 / week, that is, per Saturday. I think that is pretty reasonable, and it does not feel like a huge financial investment. My first day is this Saturday, and of course I have no patients yet, but I think I'll go there, soak up the atmosphere, and maybe do some writing.


I can't start seeing clients yet because my Associate license is still being processed. That's another bit of progress I've made: I completed the application, settled on a supervisor, and submitted all the paperwork. This included an official MSW transcript; and a certification of my license from New York. It's been about a week, and according to the DOH updates, it is now being processed. Who knows how long that will take, but I'm hoping I have my license number in the next week.


I weighed the risks and benefits of going "live" with my practice, and only scheduling any new clients in two weeks or so, hoping that I'd have my license in time; but I decided that that was too risky - for all I know the application will be delayed and then I'd be in a weird spot. So I'm just getting my website ready so that I can go "live" as soon as I have my license number.


Speaking of websites, I've been designing a simple site using WordPress.com themes. WordPress is a blog site but it is pretty simple, using pages, to tweak the blog so it looks like a website. You can also purchase a URL for your site, which I did a few days ago.


I'm still working on the website text - it is hard to know how much info too much info. I've noticed a trend in private practice sites: Its the scatter-shot method - mention as many specialties as you can, with the aim that something will catch the eye of the viewer. The general consensus I've seen is that it's actually better to focus on a niche. But since I'm starting out new, I haven't really found my niche.


Anyway, I tend towards simple, and I'm somewhat averse to selling myself, but I also want a website that will connect with potential clients, so I'm writing somewhat more than I'm naturally inclined.


In summary, I feel like I've made a lot of progress in February. My original "launch" date was Feb. 1; that didn't happen because I got a job. But I've made a lot of the second half of last month, and I expect that sometime in March I'll launch my website, start dropping business cards around town, and list myself on a few sites. Then we'll see if anyone calls.


Next Steps:


Malpractice insurance - can't decide which plan
Business cards - can't decide which design
Phone - do I need a separate phone or phone line?
Client info and disclosure statement - write it


On top of all this, I keep reminding myself that I'm actually going to have to do therapy too. That in itself is pretty intimidating.

Submitted my License (Associate) Application

This week's progress:

• Associate Licensing Application submitted (need that to practice under a supervisor and move towards full licensure)
• Met with one potential supervisor. Grade: 7/10; meeting with another one in a few days
• Beefed up the content of my website and worked out some kinks
• Maybe found an office to rent!

Getting Licensed
I spent a lot of time yesterday and today completing my application for my associate licence (in case you haven't been reading, in Washington, you are an "associate" until you've gotten all the hours of experience and supervision needed to get a full licence.) It shouldn't have been a surprise, but it turned out to be more work than I expected. And it cost a bit more, too.

There were two main reasons for this:

1. I didn't realize that I needed to request my M.S.W. school transcript. I had to request that... then it turned out that I never completed "Financial Aid training" prior to leaving, so a hold was placed on my account. So, even though I paid all my loans of a few years ago (Thanks, wife's savings!), I had take a bunch of on line quizzes about why defaulting isn't a very good idea. Well, I passed the training and I am now prepared to be a responsible lendee. I submitted evidence of that, and hopefully that will get the transcript processed.
   Cost: $9
2. I didn't realize I needed to get official certification from other states where I've had licenses. I have a LMSW license in New York State. It doesn't help me at all in Washington, but just to be safe I'm having the New York State Dept. of Education certify that I have that license. I had to send the form in by mail, so who knows when it will get processed... (You can just look it all up online, anyway, so I'm not sure why the official certification is necessary).
   Cost: $20

After dealing with all that, I submitted the main application (Cost: $50). The only thing I am missing is the form that verifies that I am receiving supervision, and is signed off by an LMHC. I still don't have a supervisor, but I hope to have one by Monday (I'm still shopping around a bit). Once I decide I'll get the form signed and drop it in the mail. Then I will pray that all the pieces of the application come together into the same folder and get processed swiftly. (The WA DOH says they are processing applications who's checks cleared on 2/2/12, so it looks like there is a 2 week timelag for start of processing. That means I can probably only expect a license number by March 15 if I'll lucky.

Supervisor

I'll have more to write about this topic once I've chosen one for sure.

Website

For now I am using a Wordpress theme that I've converted to look like a website. I can't afford to hire a web designer and I want to be able to change content and design easily. I am pretty happy about the look of my page. Still working on the content - how to describe your practice in the way you want? AND in a way that will attract clients? And what about the all-important photo portrait? Here's a post by Tamara Suttle on using professional photos for our websites, blogs, avatars, etc. I agree with her about the worst offenders of style or business common-sense, but It's still hard to figure out that sweet spot between formal and relaxed/natural.

 

Office

I may have found a weekend office space that I like. The location is quite good; I like the style of the building a lot. Seems quiet. I'm not thrilled by the office furniture - I like chairs that are chairs, not mini sofas - but I can live with it. The one question I have is how to find a child-friendly space that doesn't look like a daycare - that is, where adults would feel good about going to - not full of toys, doll houses, etc.. I'm even thinking of just doing adults and adolescents in this office and, on another day, renting space in the evening for a couples of kids+family sessions. We'll see... And I'll let you know if I put down the money for the office: That will be a big step! I have to rent it for March, so hopefully my licensure application won't eat up that time. I will keep you updated!

Summary: I'm feeling pretty good about this plan. I get waves of, "who the hell do I think I am, a therapist?" and "What the hell will I do once I have clients?" and, "Will I have clients?" But overall, I'm excited.

Okay, back on track

The last two weeks have been tumultuous. I accepted a job in a field that is not directly related to mental health: I hadn't had any luck with social service agencies in the area, and it was time to start getting some paychecks. The job is a research position in the field of education; I'm still kind of bummed about this step, as it feels like I'm moving away from what I want, not towards it. This is more symbolic than real - I know I can always leave after six, twelve, or 15 months when something more relevant comes along - but can symbols still have a strong hold on our ideas about ourselves.

But I've come to some acceptance about this step. Now I need to make some progress on my practice: The whole point of taking this job (besides not becoming homeless) is to have the financial stability to move ahead with my licensure and with my private practice.

My current goal is this: By the end of the year I will have saved a decent amount of money; I will have 4-6 regular clients (I'd be happy with 4) on one day a week (and maybe an added evening); I will have made a number of mistakes and corrected for them, thus learning what I need to learn about what works and what doesn't, and honing my business into a well-functioning practice. Then I'll only be 4 months or so away from getting my license. I'm hoping that, around 2013, a promising part-time agency position will open up somewhere. I like the idea of working at a mental health center for 2-3 days a week and doing my private practice 2-3 days a week.

My plan of 'opening shop' by February 1 is looking like it needs scaling back. I still need a supervisor signed on, then I need to file the forms with the Dept. of Health. I need to write my blurbs, website, etc.

But as long as I take it one 'action step' at a time I think I can move forward. Stay tuned!

Progress and Procrastinations

I'm happy to report that I've made some important progress in the last week. I've also had a few steps I've been procrastinating on.

Progress:

• Made some progress with my website design (using WordPress templates for now - pretty easy, but I don't love any of the designs), and had a couple of friends look it over
• Registered new business (sole proprietership - why? I'll try to write about that a bit later), and received UBI (but not the license, yet), which is the business ID I need to set up a business account at my credit union
• Almost opened my business account - I went in and got all the info, but, since I want my wife to be a partner in the sole proprietorship, and since she's on the license, it turned out I couldn't open the account without her present. But that should take 5 minutes - hoping to do that before Friday.
• (Side note: The main reason I want a separate business account is so I can put all my expenses on one card, which will make bookkeeping a lot easier I hope.)
• I confirmed (per my most recent post) from the WA DOH that I CAN have a supervisor who is NOT an LICSW - more on that later.
• Which brings me to: I think I found a great supervisor! It was based on a professional recommendation. We're not officially signed on yet - she's still checking on availability and details, but her background, focus, theoretical orientation, are great matches. Once we meet and make sure we're a good fit, I'll be really relieved because I was not looking forward to shopping around
• (Side note 2: I already emailed several people, but they are on hold for in case my current favorite falls through; for the record, this seems to be a good place to find supervisors in Washington State).
• I emailed several people about office space; one person required a 2-day/wk commitment, including a Saturday; another one caters to new practices, lets you rent by the hour, has family and play facilities, and is in a decent, although not great, location. I'm hoping to visit their site next week.
•   (Side note 3: I used the Counseling Seattle Office Space Page)
• Oh, yeah, and I got a part-time job! I'll discuss that later, but I'm generally very happy about this development. It will put me and my family on a solid financial base, and I can start up my practice as slowly as I want, without feel pressure to make it grow faster than I feel comfortable.
• I also went to the store and bought a bunch of office supplies

Okay, on to what I haven't done. Looking over my to-do list and action-step list, I see a few things that I am clearly resisting... 

Procrastinations:

• Everything to do with writing content for my website and 'listing blurb' (is that what you call it?)
• Why do I resist this? Despite being a therapist, I have a deep aversion to therapist language on websites - it just sounds fluffy, self-promotiony, and so on. How do I write something that is 'me' but also will attract strangers - basically, customers? It's much easier to do other things.
• Also, I'm not quite out of the closet about my 'theripality' as it were. I have relatives who look down on therapy, or think it's crap; others maybe think, "What, Justin's a therapist?" This boils down to self-confidence, of course, but it's projected on others. How will I feel when my uncle or father-in-law or high school friends read my website? Can I take myself seriously and ignore what others think? Does part of me secretly think therapy is a load of crap?
  Here's a question for readers: What are the best private practice therapist sites you have seen?
• Fill out LICSW Associate application form
• There is a simple reason for this: I didn't have any printer paper; now I do, so I might as well get it filled out - especially the form I need my new supervisor to complete.
• Come to think of it, maybe now's the time to have my OLD supervisor fill out my hours - that way I won't have to worry about him dropping off the face of the earth.

Next priorities on my agenda are:

• Finish opening business account
• Start writing content for my website and blurb
• Make sure I have a supervisor and meet with her
• Check out offices

Licensure: Seems like it should be simple enough...

One of the issues that feels like a road block for me is obtaining licensure. Typically, in this day and age, we obtain our license over three years (at least in my former state, and my current one) at an agency. New York State now actually requires this - i.e., you can't hire a supervisor to supervise you outside of an agency setting, so there is no way to open a private practice until you work for three years in "psychotherapy setting"; then you take the test and get an LCSW (Licenced Clinical Social Worker), which allows you to practice privately, or not. This is a controversial issue - at least it was when I got my MSW - but I won't go into it now. Currently I am living in Washington State, and I want to get my LICSW (Licensed Independent Clinical Social Worker). I have two years of experience in New York that I want to transfer, then I have to get the rest of the hours completed, take the test, and I'm done! In the mean time, I have to be a "licensed social work associate-advanced clinical" (which is just a terrible string of words) in order to practice. The "Associate" essentially means "Under supervision".

My original plan was to go the standard route - get a job in an agency and work for another year or so to complete my 3 years. However, I haven't gotten a job in the last few months, and I can't just wait around going broke, so I'm starting a private practice without my LICSW (hence this blog). This is perfectly legal in Washington, as long as I am under the supervision of an LMHP (Licenced Mental Health Professional) who is an approved supervisor. (Note: Washington has two types of SW licensure: LICSW, and LASW, but for the life of me I don't know why LASW credential exists; maybe a reader can illuminate me in the comments... Meanwhile, everything I write applies to LICSW, which is what you need to practice privately.)

Okay, that should be simple enough, and maybe it will be, but I'm having a hell of a time parsing the law to figure out what, exactly I need to do. First, let's take a look at the relevant legislation (with my highlighting):

(2) The following are the supervised postgraduate experience requirements for the social worker applicant's practice area:

     (b) Licensed independent clinical social worker. Successful completion of a supervised experience requirement. The experience requirement consists of a minimum of four thousand hours of experience, of which one thousand hours must be direct client contact, over a three-year period supervised by a licensed independent clinical social worker, with supervision of at least one hundred thirty hours by a licensed mental health practitioner. Of the total supervision, seventy hours must be with an independent clinical social worker; the other sixty hours may be with an equally qualified licensed mental health practitioner. Sixty hours must be in one-to-one supervision and seventy hours may be in one-to-one supervision or group supervision. Distance supervision is limited to sixty supervision hours.

[Pause; let's discuss]

I've color-coded the relevant requirements, and will parse each one below:

• Green: Minimum of 4,000 hours of experience - This should be fairly simple: If I work at an office, 40 hours per week, I will accumulate 4,000 hours of work experience in 100 weeks, or about two years (counting staff meetings; chatting at the water cooler; and surfing the net in my office). What, though, does 'experience' mean for some one working as a private practitioner under supervision? What do I count for hours? If I count just client contact, I need to have a very full load of clients. Can I also count planning? Scheduling? Administration? Paperwork? Who knows? And, maybe more importantly, who decides? 
• Blue: 1,000 hours of direct client contact - This is pretty clear too. I essentially need to sit down, face-to-face, with clients, for 1,000 hours - more or less, have 1,000 sessions with clients. Okay.
• Yellow: Over a three year period - I THINK this means that I can't cram all 4000 experience hours and all 1000 client contacts into a whirlwind 18 months and get my license, the presumable, and understandable, rationale being that I would be so overworked that I would not learn much or do much, and that it takes three years of growth to get to the point where you can do things on your own. But I could be wrong in my interpretation. "Over a three year period" could mean I have to get all my hours done within a three year period. Hmmm...   
• Orange: Supervised by a LICSW - This seems to suggest pretty clearly that during all 4,000 hours of experience, all 1,000 hours of client contact, and all three years, I must have an LICSW as a supervisor. Right? Well, look at the next section...
• Purple: With supervision of at least 130 hours by a Licenced Mental Health Practitioner; of the total supervision, seventy hours must be with an independent clinical social worker; the other sixty hours may be with an equally qualified licensed mental health practitioner. ["Licensed mental health practitioner" (LMHP) is a more general term that includes licensed psychologists, psychiatric nurses, psychiatrists, marriage and family therapists, etc.] Wait a minute... I thought they just said all of my 3 years and 4,000 hours needed to be supervised by an LICSW? So what the point of saying that some of my supervised hours can NOT be under a LICSW?

This last point isn't just a technicality: I have received some good recommendations for supervisors, but they have MAs, not MSWs. I don't want to find out, after applying, that, ooops, no, those hours do not count! So how can I be sure? (my concern may be prompted by my experiences in New York, where some SWs I knew worked three years at agencies, only to find out that the work they were doing did not count as "psychotherapy" (it was school psychology, or case management) and they had to start from scratch. (Just to make clear, I don't think licensure requirements should be loosened; I only wish it were more clear what was required).

All this is to say that I've been pretty confused, but I haven't found any info online that would help me. Even the otherwise very helpful Counseling Seattle website just cuts and pastes the laws; as does the Washington State chapter of the NASW (seriously, WA NASW, you could really enhance your website - these laws you list are "drafts" from 10/04 - that's seven years ago - and you list "new sections" and "amendatory sections" in a way that doesn't make sense. This isn't convincing me to get a membership anytime soon. How about a few useful FAQs?)   

Anyway, the point of all this is that I couldn't find the info so I contacted the DOH directly. When I get answers to my questions, I will post them here, on this blog, so that future social workers don't have to wonder the same questions I'm wondering.