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Everything I've learned about moving abroad while keeping my US therapy practice, with step-by-step task lists, email drafts & a glossary.
When I shared that I was moving from Dallas to Madrid & keeping my US practice, my DMs filled up with questions from other therapists. Can I keep my clients? Will I be taxed twice? What about malpractice insurance? This guide is my answer to every one of them. Each of the 16 questions is answered in two layers: what it actually looked like for me (licensed in five states, private pay, moving to Spain on a digital nomad visa) & what's generally true for US-licensed therapists, plus an exploration to help you work out what it means for you.
What's inside
16 questions, each with my answer, the general answer & an exploration
A step-by-step task list, in order, from your first board email to your first session abroad
6 ready-to-send emails: licensing boards, malpractice insurers, an immigration lawyer, a cross-border accountant, your payment processor & a client FAQ
A licensing board tracker & a glossary of the terms you'll run into
Best for: US-licensed therapists dreaming about (or already planning) a move abroad while keeping their US clients
Format: 28-page fillable PDF · the Quick Answers version is also sold separately
Fill it in digitally: tick the checkboxes in every exploration & type your reflections right in the PDF. Works best in the free Adobe Acrobat Reader (desktop or mobile) or Preview on Mac. Save a copy after filling it in so your answers stay.
Or print it & work through it by hand.
This guide doesn't cover working with clients outside the US, how my clients responded (out of respect for their confidentiality), insurance panels or therapy platforms (I'm private pay), or step-by-step visa applications for other countries. It isn't legal, tax or immigration advice, and it reflects my research & steps through October 2026. For your own use; not for resale or redistribution. All sales final.
updated October 2026
Everything I've learned about moving abroad while keeping my US therapy practice, with step-by-step task lists, email drafts & a glossary.
When I shared that I was moving from Dallas to Madrid & keeping my US practice, my DMs filled up with questions from other therapists. Can I keep my clients? Will I be taxed twice? What about malpractice insurance? This guide is my answer to every one of them. Each of the 16 questions is answered in two layers: what it actually looked like for me (licensed in five states, private pay, moving to Spain on a digital nomad visa) & what's generally true for US-licensed therapists, plus an exploration to help you work out what it means for you.
What's inside
16 questions, each with my answer, the general answer & an exploration
A step-by-step task list, in order, from your first board email to your first session abroad
6 ready-to-send emails: licensing boards, malpractice insurers, an immigration lawyer, a cross-border accountant, your payment processor & a client FAQ
A licensing board tracker & a glossary of the terms you'll run into
Best for: US-licensed therapists dreaming about (or already planning) a move abroad while keeping their US clients
Format: 28-page fillable PDF · the Quick Answers version is also sold separately
Fill it in digitally: tick the checkboxes in every exploration & type your reflections right in the PDF. Works best in the free Adobe Acrobat Reader (desktop or mobile) or Preview on Mac. Save a copy after filling it in so your answers stay.
Or print it & work through it by hand.
This guide doesn't cover working with clients outside the US, how my clients responded (out of respect for their confidentiality), insurance panels or therapy platforms (I'm private pay), or step-by-step visa applications for other countries. It isn't legal, tax or immigration advice, and it reflects my research & steps through October 2026. For your own use; not for resale or redistribution. All sales final.
updated October 2026