What to Expect in Your First Year As a Licensed Therapist
You might be fresh off the exhilarating high of receiving your passing licensing exam score, or in the throes of weighing your first licensed clinician job offer. Or, you may be assiduously monitoring your accumulating hours, waiting for the totals to finally allow you to notify your licensing board. Wherever you are in your licensing journey, it is exciting and helpful to envision your post-licensure career and start to mentally prepare for the transition!
I’ve culled 6 categories of takeaways from my experience as an LMFT who worked in a wide array of clinical settings before licensure, all while navigating enormous growth in professional confidence. Of course, much like with our biopsychosocial model for holistic health, every therapist comes to licensed status with unique combinations of momentum, bandwidth, and dreams. But by pooling our experiences, we can lighten the psychological and emotional loads that come along with this rite of passage.
You might encounter imposter syndrome
You’re now independent, possibly starting fresh, and will be relating to your clients differently (even unconsciously so). You get to update your signature and online presence to reflect your proud new level of official competence. More importantly, you’re no longer attached to a supervisor’s license. This can often generate false pressure to know exactly what you’re doing, to have impeccable therapist intuition and timing, or to have psycho-education content down neatly. This type of inner pressure is nerve wracking! I myself had a new client in my first year as an LMFT who addressed me as ‘Doctor’, and while technically incorrect, it also surprised me with how dissonant their respectful gesture felt with my awakening sense of clinical authority.
This is where your empathic, ever-refining clinical intuition will serve as your anchor. You will likely continue to build conceptual understanding of how you believe healing occurs, learn emotional boundaries with certain types of clients, uncover areas of countertransference as your variety of clientele expands, practice how to provide succinct psycho-education tools in an elegant way, and settle in an embodied way into your chosen modalities and their treatment pacing. The intuitive and highly perceptive parts of you that were already present when you entered the field will support you in all of these growth areas.
You’ll track more license requirements
After licensing board paperwork has been settled, be sure to identify your CEUs requirements for future renewal. Stay organized and make a list of future requirements so you can project what courses you may want to take and at a frequency you can maintain. Under the Board of Behavioral Sciences requirements for LMFTs and LPCCs, every 2 year renewal requires completion of 36 CEUs including law and ethics topics, and several one-time specialized courses.
Thankfully, there are many sources for free or low-cost CEUs, including this therapist-made website.
Also note the increased fees for your optional association memberships. I highly recommend continued membership despite changes in rates from the associateship level, particularly to access legal support. For example, California’s Association of MFTs has a robust on-call legal team from whom you can seek detailed advice (something I’ve done many times).
You’ll continue building your network
If you’re leaving your associateship site, take some time to document your existent network connections. Write down the direct contact information of past supervisors, or any notable figures you had relationships with at previous placements. These connections may be fruitful sources for recommendation letters and job referrals.
Also, continue to establish your online presence on platforms like LinkedIn. While LinkedIn connections are a mix of actual acquaintances and new industry connections, it’s common for contacts to widen through common ties. You never know who will be a useful source of guidance for breaking into a specialized area of therapy, finding consultation groups, or accessing peer support.
You’ll keep pursuing continued education
You’ll no longer have individual or group supervision as a holding space, but you can seek out consultation groups and 1 on 1 resources typically for a fee. Be sure to find out if your workplace has a consultation group offered even if unpaid, and consider committing to it or dropping in when case questions arise.
Being qualified for licensed-only training and certifications is an exciting feature of fresh licensure. Whether you want to explore new areas such as ketamine-assisted therapy, pursue EMDRIA certification, or earn an advanced IFS education, you now have access to a swath of specialty offerings.
Or, perhaps you are interested in supervising pre-licensed clinicians. For LMFTs and LPCCs, this opportunity opens up after 2 years of licensed work and completion of 15 supervisor training hours. I’ve known therapists who aimed specifically for this adjunct or full time role due to their love for teaching and mentorship. It’s a non client-facing path to consider, whether within a practice or independently as part of your professional services.
You’ll explore preferred workplaces
Glean from the insight you have about yourself, your values, and your training experiences to explore your desired type of work setting — whether in an EAP, private practice, group practice, DMH site, community center, etc. This is an unfolding process with numerous factors in play, including job market demands and your lifestyle needs. Of course, your vision will evolve over time and work settings (along with companies) will also need to align with your shifting needs and goals.
Due to the current proliferation of online venture capitalist mental health companies, you may easily find yourself engaging with recruiters from nationwide companies such as Spring Health (an Employee Assistance Program), Headspace (which provides billing services but not referrals), Octave (which panels you with insurance companies), or state-specific platforms. Be sure to cull from the collective experiences of existent or former providers to gauge whether a company may be a good fit for you.
There are public and private online groups where therapists share their personal experiences at these companies. You can leverage their knowledge of policies around referring clients, tracking performance metrics, internal privacy of EHR systems, or interacting with client care navigators to forecast your employee or contractor experience.
You’ll deepen clinical specializations
Exploring your modality and/or population niches is one of the most meaningful aspects of your burgeoning career. I know newly licensed therapists who accepted positions working with new demographics that they hadn’t sought out before, such as with children or the elderly, just to round out their skills. Or, for those who acquired a breadth of internship experiences, specific areas might now be in focus. And certainly, while the job market might play a major role in what you accept for your first licensed role, it is deeply empowering to craft a map for your own desired course.
From studying bottom-up therapies like Somatic Experiencing for trauma recovery to integrating the mindfulness techniques of Acceptance and Commitment Therapy, you can acquire unique combinations of therapeutic skills to position strategically in your treatment toolkit with desired populations.
Of course, working with broader populations like in general outpatient settings is also ripe for rich experience and growth. Your path does not have to be clear yet, and regardless of what graduate school professors may have suggested, out-of-network private practice is not the only or best destination to have.
Final Thoughts
Your therapist licensure is, or will soon be, a major milestone to celebrate! I hope you are able to give yourself the freedom to enjoy this exciting period, while navigating the challenging aspects of the transition with mindful presence. Your professional journey unfolds one step at a time, and you will be able to glean valuable insights from every decision or pivot you make.
Following your gut about what resonates and what doesn’t will take some reflection, but you already have the self-awareness and capacity to honor this inner metric while rejecting the comparison trap. Stay attuned to your financial, professional, and lifestyle needs and preferences, and let the course of your career reflect your own authentic evolution.
Marian Ting is an LMFT licensed in 2023 who currently works in the Kaiser behavioral health system, and is passionate about writing on mental health advocacy and related topics.
