Working with families who are in the process of restructuring, as we do, is hard work under the best of circumstances. I have had the dubious honor of trying to maintain my practice in Saint Paul, Minnesota, as our state, particularly the Twin Cities metro area, has experienced a surge of over 3000 federal agents in what is being described as “the largest immigration crackdown in [recent American] history.” Regardless of your politics and/or your feelings about the federal government’s handling of this situation, there are undeniable practical implications for providers. Here are a few things I have experienced since the crackdown began just over two months ago, along with some “pro tips” gleaned from some of my colleagues.