Healthcare Brew's interview slices through the facade of "routine" therapy licensing.

The issues named here parallel the ones I hear from Michigan therapists. However, they could add to the list. Someone should ask them to do so.

Outstanding journalism here. The first article I've seen break the story of what messy state barriers these professionals face.

Motivo founder talks ‘prohibitive’ therapist licensing process

The process of becoming a licensed therapist can be very expensive.

February 7, 2023   · 3 min read

This week’s Making Rounds spotlights Rachel McCrickard, a licensed marriage and family therapist who co-founded Motivo Health in 2018 to help therapists with the licensure process.

McCrickard, who is also the company’s CEO, spoke about the challenges therapists face in becoming licensed—which contributes to the ongoing shortage of mental health providers—and how her startup is trying to make the process easier.

This interview has been lightly edited for length and clarity.

What’s the problem you want to solve with Motivo Health?

The licensure process is harder than it should be—65% of therapists who get a master’s degree in counseling never make it through the licensure process [according to internal Motivo research], so we’re losing over half of the supply of available therapists just from the licensure process itself.

Motivo is a platform that connects therapists with clinical supervisors. You need about 200 hours of clinical supervision to become a therapist [though requirements vary by state]. A new therapist gets a master’s degree in counseling or psychology, and then they have to work under the supervision of another therapist for [about] two years. Historically, it’s been in-person meetings with your supervisor once a week. I’m from a rural area of north Georgia, and when I was working toward my license, the closest supervisor was two hours away in Atlanta. The idea for Motivo came about when I saw that states had started passing laws saying you could do your supervision virtually. We’ve helped move that process online so that it’s more accessible.

What are some other barriers in the licensing process?

It’s oftentimes cost prohibitive. Entry-level wages as a therapist are often quite low. You’re serving mostly the Medicaid population. You make $30,000–$40,000 a year as a new therapist, and you have student loans coming due. You have to pay for your supervision as well. I paid about $8,000 to get all the hours I needed to become a licensed therapist.

The other piece is that you have to get licensed within five years [depending on the state] or start the process over. In mental health, 74% of clinicians are women. A lot of times, women will take a break to have a family, and if they come back to it, they might have to start over.

Another big barrier is there’s no state-by-state reciprocity, so you might be licensed in California, but then if you move to Wisconsin, it’s a whole new process to get licensed again.

What’s the biggest misconception people might have about your job?

That clinicians can’t be CEOs. I lead the company with empathy and compassion, and know how to make hard decisions. Therapists have the emotional intelligence and the business acumen to accomplish a lot more than people think.

What’s the most fulfilling aspect of your job?

Last year we helped over 1,000 clinicians achieve licensure.

What healthcare trend are you most optimistic about and why?

Expanding telehealth opportunities for care, supervision, and other aspects of the virtual healthcare system. Virtual supervision allows therapists in rural areas to receive affordable and effective supervision.

https://www.healthcare-brew.com/stories/2023/02/07/motivo-founder-licensing-process

Maia Anderson is a Los Angeles-based reporter and founding reporter of Healthcare Brew, where she covers the pharmacy industry, women’s health, digital health, and how venture capital is shaping healthcare. She previously worked as a fellow covering the aerospace industry at Insider, as well as a healthcare reporter for Becker's Hospital Review. She has won an award from the Society of Professional Journalists for her work.