I'm Rose Markotic, MA, LMFT — a TEAM-CBT therapist licensed in California, Connecticut, Maine, Rhode Island, and Vermont. All sessions are telehealth, which means if you live, work, or study in any of those five states, we can work together. And if you move between them, we keep going.
Most therapists are licensed in a single state. That's a logistical and financial constraint, not a clinical one — and for clients whose lives don't fit neatly inside one state line, it creates a real problem. This page is about that problem and how a multi-state practice solves it.
In the United States, mental-health licensure is regulated state by state. A therapist licensed in California cannot legally see clients who are physically located in Vermont, even by video, even if the relationship has been going for years. The therapist who knows you, your history, and what works for you has to refer you out the moment you cross a state line.
For most clients, this is invisible — until it isn't. It surfaces when someone moves for a job, takes a remote-work sabbatical, sends a kid to college in another state, or splits the year between two homes. At that point, the choice is usually: stop therapy, or start over with a new clinician. Starting over means a new history to retell, a new rapport to build, a new approach to learn. It's often the moment people drop out of therapy entirely.
Maintaining licensure in multiple states takes ongoing fees, continuing-education requirements, and state-specific board oversight in each one. Most solo practitioners simply don't do it. I do, because the alternative — handing clients off every time their life moves — is the opposite of how good therapy works.
Home in one state, school in another. Therapy that follows you between dorm and home means you don't lose continuity over winter break, summer, or a transfer. Particularly common across the CT / RI / ME / VT footprint, where students from across the Northeast cluster.
The mobile professional class — people whose jobs let them live in multiple cities, or who relocate every couple of years. Most therapists don't fit that life. Multi-state licensure does.
Splitting the year between, say, Connecticut summers and a different home elsewhere. Therapy continues during the months you're inside the five-state footprint, and doesn't require restarting the relationship every season.
If you know you're relocating to one of the five licensed states in the next 6–12 months, it can make sense to start therapy with a clinician who will still be your therapist after the move — rather than building a relationship you'll have to break.
Therapy isn't just a service that happens for 50 minutes a week. It's a working relationship that compounds over time — your therapist learns your patterns, your history, how you talk about things when you're struggling versus when you're doing well. That accumulated context is what makes therapy effective.
When you switch clinicians, you don't just change schedules. You restart the foundation: the first 5–10 sessions of a new relationship are largely spent getting a new therapist oriented to the territory the previous one already knew. For people who move often, this repeated foundation-laying can mean years of effective therapy time gets eaten by relationship-restarts. The five-state footprint is one way to opt out of that pattern.
Telehealth therapy for residents of California. Licensed LMFT, TEAM-CBT trained.
Learn more about therapy in California →Telehealth therapy for residents of Connecticut. Licensed LMFT, TEAM-CBT trained.
Learn more about therapy in Connecticut →Telehealth therapy for residents of Maine. Licensed LMFT, TEAM-CBT trained.
Learn more about therapy in Maine →Telehealth therapy for residents of Rhode Island. Licensed LMFT, TEAM-CBT trained.
Learn more about therapy in Rhode Island →Telehealth therapy for residents of Vermont. Licensed LMFT, TEAM-CBT trained.
Learn more about therapy in Vermont →A 15-minute video call with Rose. We'll talk about what's bringing you in and see if I'm the right fit. No pressure to book sessions afterward.
No credit card · 15 minutes · Talk directly with Rose