Private Practice Startup Podcast
Episode 121: Immigration Hardship Evaluations and Practice Building
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Juan Santos, LPC
Date: February 2, 2019
Episode Overview
This episode shines a spotlight on the emerging specialty of immigration hardship evaluations within private psychotherapy practice. Hosts Kate and Katie are joined by Juan Santos, a bilingual psychotherapist based in Greensboro, NC, who shares insights from his niche practice working extensively with immigrant populations and attorneys. The conversation delves into the process, challenges, and rewards of conducting immigration evaluations, as well as actionable marketing and business-building strategies for mental health professionals considering this area.
Key Discussion Points & Insights
Juan’s Motivation & Background
- Personal Ties to Immigration: Juan’s own experience immigrating from the Dominican Republic as a child inspired his desire to help others facing similar challenges.
“I am from the Dominican Republic and my family came here … my experience going through immigration prompted my desire to help others.” - Juan Santos [06:50]
- Therapeutic Inspiration: Growing up with a sister on the autism spectrum, Juan witnessed firsthand the impact of helping professionals, steering him towards the mental health field.
"I grew up in a household where we had a lot of kids. My sister Diane, she is on the autistic spectrum. So we always had just different professionals in the home. And I love that." - Juan Santos [06:36]
Path to Specialization
- Starting Point: Immediately after graduate school, Juan entered private practice and received his first immigration evaluation referral via an attorney.
"I graduated in May, started in private practice right away... My first patient, it was around September." - Juan Santos [08:28]
- Mentorship Matters: Early support from a supervisor with legal experience was key to building confidence in this niche.
"She had a background in custody evaluations... She took me under her wing." - Juan Santos [08:49]
Immigration Hardship Evaluation Services
- Clear Delineation: Juan doesn’t mix ongoing therapy and evaluation roles due to ethical boundaries.
“We have counseling, right? So we have psychotherapy, then we have evaluations. We don't want to mix those, of course…” - Juan Santos [09:41]
- Case Types:
- U Visa: For crime victims cooperating with law enforcement.
- Hardship Waiver: To show the emotional/mental impact if a loved one is deported.
- VAWA: For abuse victims (Violence Against Women’s Act).
- T Visa: For human trafficking victims.
- Asylum and Cancellation of Removal also noted.
“There's the U visa, the VAWA, Violence Against Women's Act...There’s a T visa, victims of trafficking, there's a cancellation of removal. There's asylum...” - Juan Santos [12:41]
- Role of the Clinician: Comprehensive evaluation, psychometric testing, and a detailed written report to support legal proceedings.
“Our role would be to work with the client, ask them structured, unstructured questions, provide psychometric testing...write...an evaluation discussing current emotional state and the impact of leaving the US.” - Juan Santos [11:15]
Building The Practice: Marketing & Referrals
- Attorney Relationships Are Key: Attorneys and their paralegals are main referral sources.
“We want to build a relationship with the attorneys because the attorneys are the ones that are going to help that individual navigate through the process.” - Juan Santos [14:47]
- Ninja Marketing Tip: Create explainer videos for attorneys/paralegals describing your process and what they and clients can expect.
“Create videos of you discussing the immigration process … if you're introvert, you don't have to go to the office...you send that over to the attorney…” - Juan Santos [16:26]
“That is a #major ninja tip that you just offered. That is awesome…” - Dr. Kate Campbell [17:22]
- Templates and Samples: Sharing redacted evaluation samples can help attorneys understand your approach and set expectations.
“I encourage individuals to create some sort of template, like a write up...and then send that over to the attorney…” - Juan Santos [19:55]
- Word-of-Mouth Matters: 40% of referrals come from clients in the undocumented community.
“About 60% are referrals from attorneys, the other 40 from the patient.” - Juan Santos [20:53]
Client Experience & Rapport
- Demystifying the Process: Education is crucial, both due to cultural stigma and lack of familiarity with psychological services.
“I'm explaining from the root up… what mental health is, what counseling is, what an evaluation is—providing the entire education.” - Juan Santos [22:16]
- Trauma-Informed Approach: Recognizing the courage and anxiety involved for clients, many of whom fear deportation.
“It takes a huge act of courage to be able to say, hey, I need help.” - Katie Lemieux [21:50]
- Session Structure:
- 3-4 sessions per evaluation preferred for rapport and thoroughness
- Session frequency tailored to client finances and logistics
- Involves attorney collaboration with client’s consent
“My sessions typically are three to four sessions...I like to do three to four sessions versus one long one, just to have more rapport with the client.” - Juan Santos [25:29]
Pricing, Deliverables, and Sustainability
- Fees: Ranged from $800 (early career) to $1,100+ depending on time, report length (10-20 pages), translation, and attorney contact.
“I started charging when I first began $800, and then now it's at $1,100.” - Juan Santos [27:45]
- Market Rates: National range typically $500–$1250 per evaluation.
Practice Growth Mindset
- Continual Learning: Emphasis on education, reading, podcasts, and immediate implementation of new ideas.
“I read books on marketing. I listen to podcasts like yours...And then I make sure that when I learn something, I implement it.” - Juan Santos [17:59]
- Genuine Helpfulness Attracts Referrals: Even when a client can’t afford the fee, treating everyone as an informed consumer leads to positive word of mouth.
“If they feel that my prices are too high, that's fine. My goal is to provide them with education so that...they know what to ask for, they know how to advocate for themselves.” - Juan Santos [24:05]
Notable Quotes & Memorable Moments
-
On Getting Started in This Niche
“I fell upon immigration evaluations...by having a client reach out on behalf of the attorney. And that's really what sparked it.”
— Juan Santos [07:38] -
Marketing Like a Pro
“Create videos of you discussing the immigration process...this is genius. That's an awesome ninja tip, you guys.”
— Dr. Kate Campbell [16:26, 17:21] -
The Importance of Client Education
“...my goal is to provide them with education so that if they do call someone else, they know what to ask for, they know how to advocate for themselves, they know the entire process.”
— Juan Santos [24:01] -
Empathy for Client Experience
“I am a clinician that sits in a session and then I am not afraid to cry with a client. It is so difficult...there's also the stigma...the Latino community...when individuals come in for this service, I'm explaining from the root up.”
— Juan Santos [21:55-22:34] -
On Professionalism and Sustainability
“When we do the evaluations, we want to collaborate, want to work together. So I want to show the attorney, hey, this is what I have. You want their insight. Because I didn't go to law school, they went to law school. And the client needs support from both ends.”
— Juan Santos [20:02] -
Practice Building Principle
“Even though you may have joined this podcast to really understand the immigration stuff, I think Juan just gave a lot of great things that are consistent through branding and marketing your business overall. It doesn't matter what niche you're in.”
— Katie Lemieux [28:33]
Timestamps for Important Segments
-
Juan’s Background & Path to Immigration Evaluations
[06:30] – [09:32] -
Explanation of Immigration Evaluation Types & Clinical Role
[09:39] – [13:31] -
Practice Structure: Balancing Evaluations and Other Work
[13:49] – [14:33] -
Referral Building and “Ninja” Marketing Tips
[14:45] – [17:42] -
Process Walkthrough: From Attorney Referral to Report
[19:54] – [24:05] -
Pricing and Time Investment
[27:37] – [28:20] -
Juan’s Training Offer & Resources
[29:21] – [30:22]
Actionable Takeaways
- Build relationships with attorneys and, especially, their paralegals
- Create short, informative videos as a scalable introduction
- Develop redacted sample evaluations/templates to set expectations
- Educate clients thoroughly, no matter their background or ability to pay
- Structure evaluations over several sessions to build rapport and depth
- Invest in continual marketing and practice-building education
- Consider formal training to enter or optimize this niche
For More Information
- Juan Santos’s Course on Immigration Evaluations: Details and 20% off link available in episode show notes at theprivatepracticestartup.com.
- Contact Juan Santos & Access Resources: Visit his website (details in show notes).
- A to Z Practice Building Cheat Sheet: Free resource at Private Practice Startup’s Resources tab.
This summary captures the essence and actionable specifics from Episode 121 for private practice owners and clinicians curious about growing a practice in the high-impact field of immigration evaluations, while also providing universally applicable marketing and practice-building wisdom.