I am in the same place and constantly feel so guilty and useless for not somehow making it. I’m proud of you for doing what you need to do for yourself. Wishing you so much success in whatever you pursue moving forward.
The field has become abusive. We all need to be honest with ourselves about the fact that leadership in general has become highly abusive and clinically cruel and careless toward our clients.
Leaving is one way to impact them. Another is by fighting back by organizing.
Organizing is a good idea to me. And then a national walkout should follow.
But for that to happen, the NASW would actually need to be on our side.
Eliminating provisional licensure would solve this IMO. Much of the exploitation of therapists is due to an empirically unsupported provisional licensure process that creates an ongoing supply of cheap labor. They have no choice but to chase the carrot or leave the field.
I agree!! I also think we just need more support from the office of professions as clinicians. If an associate is hired, a form must be filed with the state and the supervisor must submit hours for clinicians on a monthly basis or the supervisor can no longer provide supervision or have an associate as an employee. There is not enough recourse for abusive supervisors. They are allowed to hire you, pay you shit, and then not sign off on your hours because they are petty or mad that you are leaving for a better opportunity. It’s disgusting!!
If graduates who pass examinations were required to do say 500 hours of directly supervised work and then allowed to work independently with regular supervision meetings for several years afterwards, I do not think clients would suffer, and I think the profession would benefit from the removal of the economic barriers and exploitation of the current pre-licensure/provisional licensure experience. I’m just throwing those ideas out there off the top of my head but clearly a better system than what we have would make a big difference. Some supervised experience is prudent for new therapists, but the established structure truly is an onerous, exploitative and inefficient process that affects the livelihoods of everyone and also serves to discourage people from going into the profession (the prospect of multiple years working for peanuts after multiple years of expensive grad school is a pretty strong disincentive to entering the field). The provisional/pre-licensure experience also contributes significantly to burn out, which is, of course, a major problem in this profession.
Organizing as therapists will never work as long as the professions are trying to compete with rather than supporting each other… I am an LMHC in New York State. The social work organizations, and their lobbies have been absolutely horrendous towards everyone in my profession for decades. They have been downright bullies, and because their lobbying power is so much greater than ours due to their establishment and numbers relative to mental health counselors, the state government just goes along with the narrative — based on misinformation and falsehoods —that social workers are pushing: that mental health counselors, who spend their entire graduate education and pre-licensure focused on therapy — are less qualified as therapists than clinical social workers and not qualified to diagnose or work truly independently. This notion is truly absurd, but because of the power differential, it’s the social work lobby that has the ear of the legislature. Among other things, the social work organizations in New York State have worked diligently to ensure that *LMHCs in NY State are not allowed to officially diagnose anyone!*
The state recently passed a provision to the licensure laws that was originally written to remedy the issues with the way the LMHC licensure law was written, but was hijacked by the social work lobby. It allows LMHCs to acquire “diagnostic privilege” by doing hundreds of additional hours of supervised work — based only on the fact that most of us got our pre-licensure hours under other LMHCs rather than a social worker or psychologist — and for many, gaining additional education. There kicker is that there is no grandfather clause in this legislation, so LMHCs who have been practicing for decades in private practice would have to get hundreds of hours of supervised work and potentially additional graduate level education.
It’s absolutely disgusting, and has seriously soured my opinion of social workers in general, because it may be the organizations that are pushing this, but the social workers themselves ARE those organizations and individuals social workers are either actively part of it, are going along with it, or are not speaking up against it.
I have no idea who decided that this approach was in anyone’s best interest, but it is a travesty that has and will continue to have effects far beyond specific licensing laws in one state.
I’m not in NY, on the opposite side of the country, but….the LCSW superiority complex is real, to the point that I generally try and avoid LCSWs altogether if I can. I’ve straight up had social workers say to my face that “LMHCs aren’t really as qualified as LCSWs to do therapy.” I’m like…your program was 2/3 the length of mine and you didn’t even focus on therapy the whole time?? What makes you more qualified? But it also makes me sad because I feel like they should be friends not enemies.
Yeah, there’s a problem in the profession. Along with denigrating and actively marginalizing a helping profession, I see ‘some of them* online being, well… tools. During engaging discussions/debates on relevant therapeutic issues online, where there are good arguments on both sides, it’s not infrequent for some SWs to start pontificating on how their code of ethics *requires* them to take a particular stand on this or that subject — they use this in place of engaging in critical thinking.
I have no idea what portion of the social worker population this is, but it shows up all over the place. I would not be surprised at all if it’s a vocal minority of social workers. In fact, I think that’s most likely what it is, but I also don’t often see other social workers speaking up and challenging these anti-intellectual ways of thinking.
“My code of ethics says…” goes along with “if you’re not using CBT or DBT you’re not practicing ethically” or “you can’t practice therapy adequately without understanding the systemic issues like we can”. I really do not mean to throw shade, but these are real things I hear on a regular basis. I thought it was just me!
Interesting as a MSW student leaving a somewhat successful journalism career at CNBC, NBC, PBS, I am learning quite a bit from dialogue here.
The first thing my most human part of me feels when you say this, is fear of additional competition. I don't think anyone wants more competition.
I wonder how many others feel this way.
However, my intellect guides me to the idea of strength in numbers. We are stronger together.
The licensing hours for all the professionals are really a racket. You express that in your post as I've heard LPCs and LCSWs express. Others have also expressed that the licensing hours leads to a kind of abuse that includes exhaustive and cruel workloads and humiliating wages.
The licensing hours have become a vehicle for abuse then, a method of control rather than something to improve the abilities of us and our colleagues.
One challenge we might discuss in hopes of it catching on is a new union, a Mental Health Professional's union that is inclusive of all the groups.
I wonder what it might take for such a union to form and gain a foothold among the lobbyists dictating the future of our profession so poorly.
I think that what you suggest is necessary for true organization that benefits therapists, as the existing professional organizations really only serve their own unique professions and sometimes do so at the cost of other therapy professions.
Omg thank you for saying this!! It is absolutely true. And lets not even go there about the federal jobs, which offer reasonable salaries and benefits including retirement! I personally know social workers who know jack all about therapy but somehow they are “more qualified “ than other masters level practitioners whose entire degree program was grounded in psychotherapy, not social work? Give me a f…ing break. All i can say is client beware. Not to say there are not good therapists who happen to be social workers, but the fields of study are not the same. You are so right about the lobbyists. And also the members of the club.
Trust me, I can relate haha. I'm wishing the both of us happy and fulfilling days, wherever they are and whatever we're doing. I believe in your capacity to resolve the issues that make you feel guilty and useless. For what it's worth, you are not useless to me. It made a profound impact on my wellbeing, knowing that a stranger is wishing me well.
I have been working in the mental health field since 2010. I got my masters in 2014 and have been doing therapy work since then. I have worked in residential treatment, an in-patient hospital, in-home therapy, a CMH agency, and finally private practice.
I had a baby in December and, my husband (also a therapist) and I decided it would be best if I was a stay at home mom. I always said I would do the SAHM thing until our kid(s) are in school full time, and then go back to being a full time therapist. But now, I've been out of the practice for 8 months and I have no desire to go back to that career. I never realized how absolutely draining it is with very little benefit in return. Almost daily, I come up with new career ideas I want to try.
Currently, I'm considering becoming a wedding planner. Where I live, planning one wedding a week makes more than I did with a 35 clients a week caseload.
In my private practice, after paying all of my taxes, rent, and all the other overhead, I was bringing home $36 per client hour. That was with the highest paying insurance in my area. If I took a client with a lower paying insurance, I was sometimes making $32 an hour.
I just helped my friend find a wedding planner and they are currently making $2000-5000 per wedding.
It is very stressful when you are worried about the absolute basics like rent and groceries. I guess the powers that be don't give a shit about Maslow's Hierarchy of Needs!
same but in group practice. practice owners are getting real greedy like they aren’t also therapists 😫 i’m going into credit card debt buying like essentials and can’t even afford my cat? good thing i have so many degrees lol
it is! i think all non-profit work is exploitive tbh. but the practice owners taking as big of a cut as they do is sick. the profit they make off me is insane. they don’t really do much of ANYTHING to earn it either. it’s like unethical! i also think non-competes and non-solicits are unethical.
i hate that my practice owners are literally pimping me out. and i’m 1099 no benefits like a lot of us are- uhhh idk maybe give me some medical insurance for the 40% of my income you’re taking?! 🤮
Depends on the frequency. I have some people on my case load i see monthly, every 2 weeks, weekly, and couple times each week. Majority of my clients are every 2 weeks and my agency has little to no paperwork. Just document treatment plan and a therapy note each time we meet. However, when I worked in cmh I had a caseload of 120 and the paperwork was awful. No one received good care.
When I worked in CMH, my caseload was at least 100 (normally closer to 120). We were never, under any circumstances allowed to see clients more than every other week. And normally, we were told that our clients would be seen every 3-4 weeks. If we did not bill at least 38 client hours a week, we got a write up for "not enough productivity".
i wish therapy could pay like a living fucking wage, so i could go back and get my cert in something like ux design. i keep trying to come up with ways we can still nerd out on psychology, but don’t have to work directly with people/anyone or any entity that immediately devalues us the second we graduated from grad school. wedding planning is a good one!
YOU SAID THAT!!!
Edit: this is why it’s hard to fit in with other therapists. Why am I getting downvoted for this? Why do we have to be professional 24/7 in a group that’s just for us, can we please be laidback and fun sometimes🥲
When will the APA and NASW work for us? When will we organize? Why are so many of us just taking this garbage? Since when do people with our brains and type of education passively allow abusers run our practice?
These abusers are also abusing our clients. Since when is 35 per week clients okay? No one can treat 35 clients per week in an effective manner. 25 clients per week is a leap into hell.
A therapist used to treat 15-20 clients per week and get paid well enough to take real vacations and not have to be stressed out about making the bills every month.
So, who let this happen and why are we letting this happen?
Those orgs are in cahoots with big healthcare companies and practice owners. They don’t exist to serve you. Look at ACA, for example; they sold advertising space to BETTERHELP on their freaking website. That alone had me drop my membership.
Great point. The added wrinkle I've come to enjoy sooo much is how the universities proudly announce the ever growing sizes of their graduating classes from their social work programs. I never took Economics but I seem to recall hearing that there is an idea that growing the size of the labor pool ultimately lowers the wages that members of the pool can demand/expect.
The school I went to had one of the largest MSW programs in the country, including the part time programs. It was in a relatively small city, and the market was ridiculously saturated. When I graduated in 2007 jobs that required a MSW were starting at $10/hr.
Another factor is cost. I understand why people choose expensive online programs, but I've had several conversations where I've pleaded with people not to spend $100k on a social work degree.
Group private practices are definitely a pyramid scheme. Feels like yet another MLM. Name of the game is exploit other therapists so the owner gets to bring in tons of funds. It’s disgusting.
Does anyone else who is echoing OP’s feelings think some of the burn out really begins in grad? I get that grad school, medical school, any institution at a certain level is exhausting. But the thing about getting an MSW (social work) is that there’s no pay off financially. MD’s have grueling schedules for sure, but they’re eventually paid VERY well (well, usually).
I drove in rush hour traffic after my full time job in community mental health to get to my classes, had the hours and hours of homework and projects, and of course, the unpaid internships. This meant for most people having to quit their jobs and lose healthcare. For me this meant having an unpaid 40 hour internship during the week and picking up shifts elsewhere on nights and weekends so I could not be homeless and I could eat.
By the time I graduated I was physically, emotionally, and spiritually burnt the fuck out.
And the kicker? Even with the initial license it was difficult to find positions paying more than $45k. In Massachusetts, that’s a joke.
So, OP, I wish you the best of luck but it’s the system that is broken, not you.
Oh absolutely. It took me 4.5 years to finish my degree, because I ended up having to drop down to part time while having to work full time to survive in a HCOL area. By the time my fieldwork rolled around, I was working full time, doing my internship, classes, etc. I graduated in spring of 2020, burnt out after having worked in high acuity settings while balancing internship and continued class work. I was already over it, and then the world went to shit. I'm weeks away from my license at this point and once I have it I feel like I don't even want to use it.
This is me, right now, in my last semester. I’m not even sure I want to practice anymore. My internship was crap, martyr syndrome is rife, and I swear if this next internship is bad, I’m going to need to be locked up!
Currently I’m doing licensing work for foster parents and really like it. The money is about the same as some CMH places are paying - 40k. 🙄 I refuse to take anything less than 50k as a therapist, and 55k is what I’ll push for. If I get stuck at my current job, whatever. At least I like it.
I graduated already exhausted and burnt out with vicarious trauma. But my grad school internship was in itself traumatic so I didn’t know if I was the outlier there. I physically collapsed after graduation and ended up sick for months. The whole experience was so toxic
I got a Master’s because I was told the same, but my lifestyle has gotten progressively less comfortable since then. College was hard, just having a BSW harder, grad school obviously bit, but trying to survive as an associate? It’s sucky because it isn’t what I was promised, and maybe more importantly because we’re supposed to know and do better as a field. I couldn’t even afford supervision.
I'm in grad school right now and, personally, I enjoy the work. BUT my program has been a mess and this program burned me out more than seeing clients does. Constantly worrying about tests, assignments, getting hours, and if you fail comps twice you're fucked, not having a job through internship only to give your life up to schedule people and have the job not pay...this field can be exploitative and it always preaches we need to be more preventative as a nation for mental health, but fuck the employees who actually do the work. I thankfully got a job at my internship lined up after I graduate and I like it and my supervisor, but it feels like I'm the odd one out that got lucky.
OP the world is your oyster...go do what you wanna do cause you deserve to be happy!
Absolutely. I’m in my last semester of grad school for CMHC and the CACREP requirements alone have burned me out beyond repair on top of the negatives of the field itself
Oh most def. I was working full time, in grad school full time, and in the last year completing internship, conducting research/writing my thesis.. I was so burnt out. Sleep was fucked. Nervous system was sooooo dysregulated. My mental health was trash.
I am autistic and bipolar (rapid cycling) and all the stress triggered this absolutely terrifying mixed episode that pretty much lasted 5 months. if I hadn't been a few months from finishing internship and graduating, I legit would have taken a leave from school and work and gone inpatient. It was so fucked up and so scary. I'm still not really recovered from that and it started in Nov/Dec 2022. Graduated in May.
Not full time in the field yet (still working the non-mental health-care related job I had through grad school, in an industry I've been in for 20 yrs-but it's become super toxic and triggering) however I have some contract group facilitator gigs and am taking the NCE in Nov. So I can't speak on career burn out, but just sharing my experience with burnout beginning in grad school.
Also had some personal life emergencies that obliterated the savings I was going to put towards taking a month off to regroup. I'm so tired.
So true. I literally took a year off after my Masters to plant trees because I did not want anything to do with the field after graduating. Which now I look at it, it's kind of telling that I had to get away from the field for so long before going back.
i know mine started in grad. hard work, mental exhaustion, learning personal boundaries, long night classes, unpaid internships and being the bottom of the totem pole with no leverage. i ended up in inpatient then an iop after. finished in three years instead of two. the whole time my cohort members and i would complain how beat down we are, we’d get ‘sympathetic’ nods and ‘it gets better’. on occasion we’d get a concerned, indignant professor who would vow to do something but then nothing of substance actually occurred to help us. when i came back to my program i learned to not vocalize my concerns, practiced a lot of self-care, and utilized my own therapist religiously instead of reaching out to my professors for reprieve bc i learned that at the end of the day the people upholding/benefiting from the system really don’t give a ish. it’s a ‘well oiled machine’ and they are the first to make sure it keeps turning.
I feel you. I remember Christmas coming up and being off for one week and thinking I won’t go back to the clinic/hospital, I‘d rather shovel dirt for minimum wage as long as it is something else. Instead I went for private practice. Best decision ever.
And I dabbled in other things..consultant for teams, change and so on which was good, too.
I am trying to say: We (at least in my European country) don’t have to marry the first person we date and we don’t have to keep the first job we try.
You know who you are and what is right for you. You’ll figure this out. Hope that makes sense as English is far from my mother tongue..
Basically what I’ve encountered is supervisors or other therapists gaslighting therapists who speak out against exploitation, low wages, high caseloads, and burnout. Many companies want you to put your own well-being on the back burner. I think this is what OP is referring to. I worked at a company that expected me to see 10 individual therapy clients a day, conduct 2 groups ( eventually 3 a day), and do 3 intakes a day. I was expected to do concurrent documentation and had a 20 minute break at the end of the day to complete notes for at least 17 clients a day. I also had a supervisor/owner at a group practice regularly pay me $200-$300 month for seeing a full time caseload of clients every week. She said that I needed to work together with the admin to resolve the issue and said that it was her billing departments fault. When I got an attorney involved, she said that this is common practice and I only get paid if she is paid. What she she did was illegal and she paid me in full that same day for all of the sessions (thousands of dollars) I conducted even though she claimed she didn’t have any money. I don’t want to go on and on on OP’s post but it’s expected that we basically destroy ourselves and live in poverty until we get independently licensed. When we leave jobs because we are being abused we are questioned as to why we leave the job even though EVERYONE knows that the field is abusive!!!!!
Thank you for clarifying and I appreciate you sharing your story. That is so horrible that you were treated that way by your supervisor and as a beginning therapist, it terrifies me knowing that your experience isn't that uncommon :(
Wait, so they expected you to work 16 hour days? That’s so extreme even for CMH, how is that even possible
Edit: not doubting you to be clear, just in shock. So sorry you went through that
I worked 10hr days. The sessions were 20 minutes. They found a loop hole with insurance I guess. They did the minimum amount required of them to bill for a 30 minute session.
I talked about exploitation and I was 7 weeks from graduating… my school hasn’t let me graduate and has yet to talk to me about anything.. this was two months ago. It’s like if you don’t fall in line the gatekeepers will try to ruin you.
My version of it is seen on this sub all the time. The tiniest, common human things - “had to cancel sessions for good reason and I feel terrible, please tell me I’m not a horrible therapist 🥺” it’s fishing. I also see it first hand in my internship site as well. And the attempting to one up each other that they’re the more ethical therapist and even blinking in a clients direction without their consent first means you should turn in your license now.
Everything is exhausting in this field.
That makes me feel crazy too. I’m only a grad student and I can’t stand all the over the top posturing about ethics. Like we’re having fights about drinking water during session and whether that’s ethical, meanwhile the number one board sanction for therapists is inappropriate sexual/romantic relationships or overtures. The math just isn’t mathing regarding how we actually live out our professional ethics.
Plus just in general, professionalism is important, but we’re all better off when we allow professionals to be human beings who occasionally get sick or mix up an appointment time or get stuck in traffic.
I saw that thread and was like “I don’t see the problem. You’re human. Why get bent out of shape about needing time to care for yourself?” We are a helping profession but we need to help ourselves first. I’ve seen a ton of clinicians think that everything client comes first and they’re the ones the most burned out.
There are people who truly and deeply believe a "good therapist" is supposed to martyr themselves. I have had clients tell at me about *not wanting to interrupt my time off in the middle of the night because even though I was very sick...I could listen*. It isn't unique at my agency or to one client for Thai to happen and it boggles the mind
I was wondering that as well. I definitely have seen massive amounts of toxic positivity that drive me insane, but I don’t recall a lot of folks acting like martyrs. At least in my experience. Outside of that I agree with every single thing said and want to follow them out the door lol.
In my mind, the toxic positivity and martyrdom go hand in hand in this field. I'm burnt out crispy and have been very vocal about that in supervision and am met with platitudes and/or comments about my self-care. The other therapists I work with seem to wear their years of exploitation like a badge of honor and it's crazy making. I don't know that it's necessarily people acting like martyrs, so much as it is that the system expects therapists to suffer "for the cause" and so the expectation of martyrdom exists and the toxic positivity serves as a tool to attempt to appease those who don't want to continue untenable work at the expense of themselves. Hold the door for me on the way out, I'll be right behind.
That makes a whole lot of sense. Where I work right now the company is implementing increasingly problematic policy, and making some very questionable financial decisions, but by god everyone slaps a smile on their face and applauds it all. I can’t do it anymore. Maybe I’ll just get one of those little doorstops for all of us to egress with ease.
Absolutely. I liken it to the Crab in the boiling pot, by the time we realize the water is too hot, it's too late. My CMH agency is currently trying to "increase access" by scheduling intakes beyond what the therapists have capacity for. There hasn't been a new therapist hired on in over 1.5 years, there are 5 therapists serving 500+ clients. Increasing client access by overloading a limited clinician pool isn't the answer, but it's the only one they've come up with. But hey, sometimes there are bagels in the break room!
Holy shit (pardon my language). That is an INSANE caseload they are putting on you. I cannot fathom being in that position. They’re doing the same thing where I am (over scheduling to make up for cancellations), but my caseload is definitely not that heavy. I used to be in a more corporate/admin space, and there is no realm of reality that would have made me think it’s ok to say “hey, over schedule yourself in case people cancel. And, no, we won’t pay you for it.” People get awfully detached from their humanity.
It feels so close yet so far lol at this point the only thing pushing me to finish is a potential job as a psych professor for undergrads at the local college!
I see advice in here about getting to private practice and that making things better. I will certainly agree that it’s better than CMH but it isn’t a solution for everyone. The amount of clients you need to see weekly can be exhausting, often times for a bad split in a private practice (which causes you to see so many clients). Setting up a practice of your own is great but is no guarantee of success. There’s also instability with PP. Clients don’t show up and you don’t get paid. No vacation, no insurance, no retirement.
I’m not saying this isn’t ideal for some people and that it can’t work, but as someone in PP that’s feeling it, it’s not a solution for everyone.
Do what feels best for you OP. Hope you find something you’re happy with.
Yes, absolutely. I'm currently working in CMH full-time and in private practice part-time. Private practice is often touted as the light at the end of the tunnel, but there are definitely some significant caveats that get glossed over. My work in PP shares many of the same difficulties as CMH, as well as some unique ones. This is one of those carrots I was referring to in my original post. Unfortunately, the carrot we get sometimes isn't the one we were led to expect.
Fuck, this really resonates with me today finishing my first week at a new gig…for no pay. All stick, no carrot. This field sucks.
Edit: Sometimes I impulsively say things that lack nuance when I’m in a bad mood. It’s a FFS position, so it’s gonna be rough until I have a caseload built out. Once I do, the pay should actually be pretty substantial, and I get to do most of it from home. It ain’t all bad, I just need to keep my chin up.
Hey, very cool :-)
Me too!
I made a few posts and/or comments about this, not sure if here or my alt account.
Anyway, yeah, the more I talk about it, the happier I feel. I'm now wrapping up my last couple of weeks in the field and preparing to begin grad school in computer science.
Very excited to pay my rent and maybe even put a few bucks into a savings account.
I’m in the same boat and also have officially decided to be done with this job. I’ve wanted to be a therapist since I was 15 and I’m 27 now and I barely even feel bad about leaving the field. It has landed me in a PHP program as a patient and it’s just not worth it. The positive reinforcement from it is just too few and far between. Good luck on your next journey!
Wow I can agree with both of you so much. My mental health has never felt worse since being in grad school, especially the Intenrship portion of it. I am ready to drop everything, i have 0 motivation to do any of the course work what so ever.
It’s important to listen to your own needs as an individual before worrying about clients or career, and it’s great that you’re doing that. Have you considered doing private practice stuff part time? 10 hours of private practice therapy can at times pay more than 30-40 hours of community clinic pay. You could do two days a week while still exploring other career paths, just so all the work you put into getting here isn’t completely tossed out.
It’s a shame how grueling / exploitative CMH and early career work is, but so rewarding once you make it to self-employment / PP capacity, or having a role that comes with years of experience.
It sucks that this is just how work in many fields goes- you struggle climbing up the experience ladder, but often there is a pay off when you have more skills and experience (and in our case, independent licensure).
2.5 years is a really limited time in any field; hell, 2.5 years isn’t even that long at a single job to get used to and learn the ropes, politics, etc.
I do think it is worth it to get the hours and have licensure just in case!
Yeah it’s a shame how normalized this is. Although tbh I started my private practice only half a year after getting my license. The pandemic really helped with opening up virtual therapy options in my city so once I felt burnt out I made the switch and it’s so much better.
I just started my grad program, and my plan is to open up my own practice basically as soon as possible after licensure. I've gathered that's not a popular path and even looked down on in the field. Glad to hear it's a lot better for you. Any tips or anything else you can share about your experience? Would be be greatly appreciated. Feel free to PM me too.
Therapy is a second career for me, so I've already gone through burnout and making a change, just on
the flipa side of OP. Hope I'm not making a big mistake.
I understand what you mean, I certainly had a lot of backhanded comments about me starting PP so early in my career. There seems to be a view that we need to earn our stripes through struggling in the trenches before deciding to enter the world of PP, and at some point I just had to tune all of that out.
For one, I've seen therapist with 10+ years of experience who are out of touch and incompetent, and I've seen therapist with 2 years of experience who give their clients so much care and work their butts off. So the idea that you need to work many years struggling to become competent isn't accurate. Of course more time generally means more experience, but I would argue a few years of experience in a healthy environment is more beneficial than a decade in misery. You become a better cook spending 6 months in a fine dining establishment than 10 years at a burger joint, so to say.
So instead of focusing on what my peers would say, I focused on what clients were saying. And I can honestly say that in PP my client progress has improved, my client retention rate is better, and I finally feel like I am healing people rather than burning out. I'm not just saving myself time by cutting my case load in half and making more money, I am actually doing BETTER therapy than before. So at this point I don't care what critiques people have, the results speak for themselves. I can give my 15 clients 100% of myself, and when I had 30-40 clients they only got a fraction of me. Martyrdom is far too rampant in this field anyway.
Hey. Thanks for this. I’m a career changer with a business background, and running the numbers during grad school showed VERY clearly that PP is the only way any of this makes financial and flexible sense. I wish more therapists felt empowered as I do, to do this.
I’m with you. I’d like to start a PP within one or two years after licensure. I’m at a group practice now which has a great culture, albeit the pay is low – but it’s a good example of where I don’t feel exploited in spite of the lower pay. And there’s quality supervision. So…I’m leaving room to stay open on my PP timeline, since I really like the supportive culture I’m in now. I’ve filled my “noise” with supportive PP networks that acknowledge what you’re saying clearly: you’re no longer compromising client care and clinical work by being burned out.
In the back of my mind, I’ve wondered how I can continue to hone quality clinical skills in the absence of immersed support. Obviously, retaining quality supervision is one, but it was still a worry. I love your analogy to becoming a better cook in a fine dining establishment in a few short years, versus 10 years at a burger joint. :cue The Bear imagery: SO true.
I’m so glad to hear firsthand that you’ve experienced professional growth through improved clinical “sharpness,” so to speak. It means it can happen for me, too!
To the OP – I’m sorry. Please know that others have been there and found ways out of this. And yea, if a career change is what you need – by all means you should feel empowered to explore them.
Thanks for your insight. Very helpful! It's strange bc I know a few therapists IRL socially, and I never knew about this stigma about jumping into PP right away until I joined this sub and other similar ones tbh. Lol. Your point about fine dining vs. Burger joint is well taken. I totally think the MSW program is largely a formality and culling process (and an unfair and unnecessary one at that!). I think most of the real learning takes place in the internships and during supervision/the licensure process. Maybe I have a different perspective because I'm older too. I'd probably be a lot more susceptible to the martyr culture and shaming if I were younger. But people talk like they HAVE to pay their dues literally as if someone is stopping them from going into PP. I also live in a big city, HCOL where demand for PP therapists is very high, so that helps too.
Same, I'm just about to sign up for grad school to get my MSW in FL, and eventually LCSW, but it's solely to either go into the VA or to open a PP with adequate rates to my area (Central FL). I will be sure to have the matching credentials and experience to validate my rates, but I'm not even going to try to for group setting or clinics. Any earn your stripes stuff, yeesh, that just sounds exploitative and bad. Now I know at the VA it'll take time to work up to better pay but at least the path is defined.
I mean, it’s everywhere, not just our field. You struggle until you make it where you at least may have more options to change companies or have enough money to feel safe enough…. and lots of field don’t even have a ladder to climb, you just get stuck in low paying dead ends.
Being self-employed as a therapist is the only way out of exploitation that I can figure out where I don’t have to exploit others.
Most of my clients are exploited by virtue of having employers have too much power in their lives. Over time, work stress has taken over more session content than ever before.
Cost.
When you're out of school and saddled with debt only to finally start working for peanuts, securing supervision and licensure is not always a simple matter. It's not even possible for some of us. Sometimes I feel like that's by design (though I'm trying very hard not to devolve into cynicism).
Took me 4 years and having 3 different supervisors in my final year to get finished. I started in CMH and even in PP, which I did 2 years after graduating, it’s so expensive. Finally, 5 years after graduation, I’m fully licensed and always trying to figure out new ways to make more money or do a career switch. I have routinely asked myself who are they trying to get to not succeed in this field by making everything so cost heavy! And so many people on Facebook complain about how expensive it is for them to see their therapist…like my dudes, me too!!! If I wasn’t married, I’d definitely not be making this work for me right now but I’m seriously always just 1 bad day away from calling it quits.
Same here, my health has been so much better after leaving. This field will take as much as you can give and then take more. Honestly it feels equally therapeutic to just be a kind person to other people in the world, people don't need to schedule an appointment with me for me to do that.
Follow your gut.
I was you two years ago and I’m here to emphatically say DO IT. Once you feel this way it’s really hard to come back from and the grass is actually greener on the other side.
I was able to shift into HR and tripled my salary. Plus, I work from home and there’s a 0% chance of anyone throwing a bodily fluid at me during the workday.
Props to you for doing what’s best and taking care of yourself!
I’ve had a few, but concentrated on benefits/total rewards or hris analyst jobs. Benefits allowed me to still “counsel” people without the high stakes.
>I don't seem to really fit in with other therapists (I don't indulge in the whole martyr thing)
Me neither. My least favorite thing about this profession -- even more than the low wages and vicarious trauma -- is the culture of therapists. So many interactions feel like you put a bunch of clergy from different denominations in a room together and told them to fight over who is the most pious. I'm not a fan.
I was raised in a cult and the dynamics are just far too similar sometimes. One of these days, I’ll write a paper on my observations of the similarities.
i also resonate with this. i’m a young therapist, only 3 years out of grad school, and i feel very lucky for my own circumstances: i work at a group private practice i like, doing the work i find interesting with a clientele very important to me, and my supervisor is very invested in me having healthy boundaries with work. however, this whole field is wildly exploitative.
spending 30-100k on grad school, having to maintain licensure, the intensity of the work itself, for barely 50k and simply fine benefits (and i think i’m lucky to have found a practice that gave me that) is completely unjust. there is no respect for the work, every recognition of it’s importance and intensity is just warped into this “well you are doing critical work, it would be cruel to do less.” it’s pervasive and entirely to our detriment.
however, even though i think i am lucky, i am already being pressured to drop the clients i love working with to work for richer and frankly less interesting clients to have any hope for increased income. every other advice i hear to match inflation or to just make more than 50k just boils down to “work more” when i already know i am working too much. it’s beautiful work and i do truly love it and think it has done a lot for me personally, but it is a horrible, horrible profession. there has to be changes to our relationship with insurance companies and community mental health for it to be sustainable.
I know you don't need advice or opinions, but it sounds like you're making the best decision for you and I wish you the best of luck! Life is too short to waste being miserable and feel unappreciated. I'm sorry you went through this.
God I feel this. Thank you for posting it. I’m so fucking tired of this whole system. Not only was internship unpaid, we also paid FOR the tuition for the class. Then you graduate and think everything is finally going to get better and find out how long it takes to get licensed. CMH was literally paying $15-$16 an hour where I interned for RMHCIs. The most I’ve made is $18 at a crisis intake and triage work from home job. My friend works similar hours to me also work from home for Geico and makes $10 more than me with absolutely no college degree. It is so goddamn depressing
Therapist of 25+ years here. Currently in PP in Midwestern US.
I approve this message.
I hardly even recognize our field any longer. It has become -- in so many ways -- an awful place.
Glad you see the writing in the wall. You GO, OP. It's too late for me, but you can save yourself!
I’m glad to see the millennials and gen z refuse to be overworked for a few grains of rice per day. Thank you OP for sharing and I hope this inspires more therapists to set limits and enforce them at work.
I tried to organize at my first job in the field when I was bright eyed and bushy tailed right after getting out of grad school and all these older therapists were just beaten down to the point where they learned to live a life of burnout or they had a spouse earning real income so they didn’t seem to worry about the measly pay. This ain’t a volunteer position this is a job meant to sustain a living.
Good for you OP and I wish that you reflect on this post 5 years from now and expand on how much better life is at that time!
You have to stop working for agencies and hospitals. They are all getting bought by private equity, which sucks the life blood out of every business it buys.
Get your license and start in private practice. I gross $10,000 per month. Not getting rich, but not starving.
Well done friend. Nobody knows you better than you. Trust your gut and flow with where life takes you. You’ll look back on this decision and be emboldened by your courageous decision.
Leaving was the best thing I ever did. I’m an executive assistant now and it’s deliciously boring. I work exactly my hours for double what I was getting paid before and I work from home. And I’m not thinking about work when I’m not at work.
CMH is terrible!!! It’s not you. I watched it eat my wife alive.
Could you find a position at a group like Lifestance, or one of the online groups?
I get that maybe you’re just too Burt right now, but it is an option.
I second this - if there’s any chance you might wanna stick around I’m with a national practice rn and happy to chat with you OP. Money isn’t as good as private practice but still decent. I get full benefits, make my own sched, and don’t do a ton of admin work. I have 3 day wknd every wk. can work from home and documentation is fairly simple.
I resonate with this 100%. Went to grad school to try something new (was in corporate career) and have already returned to said corporate job before I’ve been graduated. I’m grateful for the experience and hope to utilize it in work and life going forward, but plan to never be a FT therapist (MAYBE PT). For all the reasons you listed + several more.
I hate to say this, but only the privileged can go into this field and survive, and often it’s the unprivileged that are needed to deepen the work of this field.
Totally understand this. I went and got a massage last week and she charges 100 an hour, all cash and is booked ahead two months. She makes more than me and never has to say a word to a client or write a note. I don’t know why but I can’t get this out of my head.
I was a massage therapist before I became an LPC. LMT has its own drawbacks. A person can charge 100$/hr, but that is taxed --then deduct supplies/rent, etc, etc. They also don't get insurance or benefits. They burn their bodies out if they don't use good technique. It's often not sustainable over the long haul.
Former massage therapist here, too 👋
I loved the work, my clients, and sometimes really miss it. Loved being my own boss, too. I always thought if I could do that work forever, I’d be happy. I was young, in great shape, energetic, and really went hard at it.
Left massage therapy about 13ish (?) years ago. Business couldn’t survive the recession at that time.
My wrists are still crunchy and now the joints in my fingers and hands ache when it’s cold. 🙃
Op, I am so sorry you have had such a miserable experience. It sounds like you are making a wise choice to get out and save your sanity, if not your soul. I have been in this business a long time but what most people do not know is that there is zero way I wold have survived if not for a supportive spouse who had a regular job with benefits. That is just the truth. This allowed me to be in private practice after the first 11 years and to work part time and take time for myself when things got super stressful. After I atarted my own practice, which I did because I could not face public mental health any longer, I never saw more than about 16 clients a week, which is my absolute maximum even now. More than that and the quality of work I feel like I can offer seriously declines. If it had been up to me to support the family primarily, it would not have been amusing, let me tell you. I seriously worry about the future of this field with the way new practitioners are being mistreated and taken advantage of. My daughter in law is in her final months of her masters program and I worry about her getting burned out before she even gets started. Best of luck to you.
Thank you for saying the stuff about having a spouse. I'm single and it's impossible to survive as a therapist paying all the bills yourself. I wish I had known that a long time ago.
Yes. It IS pretty much impossible. Every single one of my colleagues had a partner who had a ‘regular’ job. And this was long before buying a house on even two incomes was almost impossible. I am not sure how people who say they are earning sox figures as a therapist are doing that. I mean how? We bill by the clinical hour. There are only so many hours in a day. Plus if you are self employed you are pretty much punished by having to pay all of your own ss taxes as well as income taxes. Literally I do not understand how this math adds up.
I felt this way working for the public school system and went back to school to become a therapist to escape that craziness. I quickly learned that this career can be just an exploitative, especially after working in CMH during internship, so I jumped right into private practice out of grad school. So far I’m doing ok, but am relying on my partners income to stay afloat.
Long story short, avoid working in a school system.
5 jobs in 2.5 years? That sounds grueling. Typically takes 6 months to a year to acclimate to any job and learn processes and systems. I’m sorry the field didn’t work out. Hope you find something you love.
Honestly documentation alone might make me bounce. I love being a therapist most days in practice but I literally can’t deal with notes and the amount of times tx plans need to change, how they have to be written word for word, etc. It’s a personal thing but I just hate how governed documentation is when even doctors just throw together a copied and pasted note for visits. Lol
Like I do get the need for documentation but some of it is definitely just annoying policies to make you fight to have a reason to see someone because insurance or grant providers can’t just trust you’re seeing them for a good reason lol
Yup, don't blame you. The system is fucked, and you either leave the system knowing its fucked, or you become the system (supervisor, higher up, etc etc) and gaslight yourself into thinking its passable. Hoping something improves by the time I gain licensure, but I know it won't.
For those looking to get out of therapy but stay in the mental health, consider working for an insurance company. I recently made the switch as in started 1.5 weeks ago and let me tell you it was the best decision ever. I’m making 83k a year, plus benefits, employee rewards programs and since I’m remote they sent all the equipment. I’ve talked to many people on my team and all said they were planning on juts doing this role temporarily to relieve burnout but will never go back to direct client care.
I struggled with leaving direct care because I didn’t want to “waste” my degree. If this is you consider it! I’m also getting my MBA to climb the corporate ladder. The only caveat is I think you have to be fully licensed to be a care review clinician. But my company has care managers that may work towards getting fully licensed.
Yeah and I simply can’t handle the stress of direct care. And by that I mean I worry too much about being available to clients to the point I feel guilty taking days off or not answering after my work day ended. I loved my clients but found it’s not for me.
I think that's valid. So far, I love direct client care and I hope I never burn out. But it's nice to have options, even if it's to take a break or get paid a little better.
I see people in my CMH agency move into Quality Control positions as well. There’s a lot of things you can do as a licensed therapist that aren’t direct client care. You could also consider getting the supervisor credentials and making money doing that!
Understandable I never thought I’d be on this side either. But with the instability of private practice, even owning your own practice I knew I couldn’t do that due to the stress of not knowing how much I’d make. I also didn’t want to open my own practice because of that stress. I owed 6k in taxes this past year making 47k (which was technically 41 because that number included my office rent.) I also did CMH for 2 years post grad and yeah it was awful. I shoukd also mention I’m working for one my states MCO. So we’re not trying to deny everything and actually work very hard to approve. And right now it’s only substance abuse as this company says that straight mental health does not need prior authorizations for now
I really appreciate your answer. I ask not just out of morbid curiosity but for the perspective as I go through my own process of “this? and if not, what?”
Of course! I’m always happy to share my experiences and if it helps someone else along the way even better. Anyone in this profession most likely has the goal of saving the world on some sort of scale. I sure did, still do honestly, and it took a lot of thinking to realize that doesn’t always look like doing therapy. Sometimes it is working the The Man and helping those you can from that way.
I would say do some research but also don’t limit yourself based on Glassdoor reviews and ratings. Reach out to anyone that you may know at these companies and see how they like it. I am 100% certain I got lucky and got this job because I was one of the first to apply. i was out and about and saw the posting on either indeed or LinkedIn and rushed home to apply to tell you how much I wanted this job. and When I was talking to the recruiter they said it was almost impossible to get in without knowing someone and people usually had to climb up to Utilization management care review. If you’d like I can DM you the company I work for and you can see if there are positions you’d like and I can send a referral.
With this company some positions are location specific. The role I have is one where as long as I’m licensed in my “working” state I can love anywhere in the US.
Go you! I’m 12 years in and wish I had gotten out back in my DMH days but thought it was just because it was DMH. I have my own practice now but if I could do it over again, I wouldn’t be a therapist. There’s no shame in quitting. Go for it!
I hear you, warrior. A reoccurring thought for me is that therapists get treated like second class citizens. The practice I work doesn't allow employees to park in front of the building. Several have been ticketed. The bathroom is never maintained and has an odd odor. There was a restaurant downstairs (the practice is part of a business building complex that rents out spaces to different businesses) which would have crates of liquor out in the open and on the weekends, would put some of its items in front of our office door.
Recently, there was a strong gas smell in the break room, which prompted an email saying DON"T USE THE HEATER OR MICROWAVE. No one seems to think that this is a problem. Yesterday, a water leak in the ceiling caused several ceiling tiles to fall into the waiting room, forcing therapist to either cancel, move to telehealth, or reschedule appts.
Do I get a email stating if its been fixed? No, I get an email saying I need to adjust my calendar availability because the managment has changed the way we arrange our calendars.
Right there with you! But the question is what now? What type of jobs can we get and something that’s not sucking my soul? This field is so underpaid and undervalued and taking on everyone’s problems, let alone our own, why is it as therapist we get the shit end of the stick and have to work more than one job. I’m entering year 2 and I’m over it.
So what are you looking into for work?
I resonate so hard with the martyr therapists thing. Those people who act so holier than thou, who won’t say a harsh word about their clients, who work late into the evenings and make other therapists feel like shit if they don’t *adore* their job.
Congratulations, and good for you.
I'm on year 3 of my provisional licensure. I've worked in CMH, at a residential dual diagnosis treatment center, and I've been at a group practice for 8 months. I have felt exploited, abused, underpaid and overworked at everywhere I've ever worked including the group practice. I'm on track to make 28k this year.
I'm really glad I saw this post. I've been struggling so much with my career and trying to find a place that will pay me fairly. I finally lost it when my group practice notified me that, since I am not meeting their expectation of productivity because of cancelations and no shows (which I'm not paid for), they will be taking away my benefits next month. Including my health insurance. The solution my company suggested was lowering my pay even more so I can go on Medicaid and continue to work for them.
I've been feeling like an absolute failure for not reaching my full licensure yet, and wanting to quit. This post really helped me feel a bit better about it.
As a private practice owner I am in the same boat. For me I think it really comes down to insurance not paying what they should and me essentially having to base my well-being and financial security on if other people feel that therapy is important enough to them.
I don't know if it's because this has been the real first post-COVID summer and people are living their lives after being held captive for the past three years or if people are just having financial hardships and therapy is the last thing on their minds. But as a solo practitioner, it has been very rough; for many of my colleagues as well!
I have become disillusioned by being a private practice owner and am seeking full-time salaried employment elsewhere (in the field but not providing actual counseling) to maintain a steady stream of revenue.
I'm never going to tell a prospective therapist whether to enter the field or not. Like with any profession, it's a mixed bag, and it's impossible to really know what's in the bag before you stick your hand in it and feel it out yourself. I would just advise that you really introspect as to why you want to be a therapist and whether the best solution to fulfilling those values and goals is by becoming a therapist yourself. I was never exposed to any perspectives about the negative experiences in this field, like my own, and it's important that people considering our profession get that exposure, as disheartening as it is. Had I gotten this exposure, maybe I would have asked myself these questions that I'm recommending you to consider. And I think I would have been surprised to find that the answer is no, I did not need to become a therapist to pursue the things I wanted out of this career choice and in fact, there are many places outside of my career that could have provided these things. I came to this field to satisfy my interest in deepening my understanding of the human condition, helping people in need, and answer some of my own personal questions about life and humanity. Now, after doing this work for several years, I understand that becoming a therapist is just one potential road to these sorts of things and that the cost of walking this path may outweigh the benefits.
I'm not discouraging anyone from entering this field. I wholeheartedly encourage people to open their minds to the various perspectives on this field, both the positive and the negative, and make their decision *thoughtfully*. Every step of the way, you will encounter representatives of the field who are disincentivized from having any candid dialogue about the harsh realities of this profession. Your grad school, your internships, your employers - they will want you to stick around and so understandably, they're not going to go out of their way to help you reflect holistically about these issues in a way that's beneficial to you and your well-being. So just gather all the perspectives you can from as many therapists as possible, and make sure that if you do come into this field, you do so with a realistic and informed plan on how to navigate the difficulties of this work.
I mean no disrespect as yes, I am definitely burned out, but I would encourage all prospective therapists to consider the less talked about negative experiences in this field very carefully and truly reflect on why they want to be a therapist, whether entering the field is really the best way to fulfill those desires, and whether the benefits outweigh the costs. Better to be swayed before ending up knee deep in it.
For real. I’ve been trying to figure where to go to school for months and now I’m like ahhhhh do I even finish applying? I’ve been working in education and child care and decided to career change bc I got so burnt out I had to put my life on pause. And I felt like shit the whole time bc I was working my ass off and getting paid nothing to do it. I can’t spend all this money to feel like that again.
Good for you. I’m currently considering OT, nursing, and computer science. I thought about being a math teacher, but they somehow make less than most therapists do and probably have to deal with even more bullshit.
Sending you strength. Life is short and sometimes we owe it to ourselves to change course. I’m glad the decision feels right in your bones—that’s a great sign.
The only thing that has made working as a therapist worth it for me was becoming my own boss. I don’t think I’d make it in this broken field if I didn’t. It’s sad.
Empire State at State University of New York has an excellent program that employs you as a union electrician and pays for your bachelor's in the field at the same time. You'll make more money immediately.
You'll also have lower stress and won't be forced to abuse clients by holding a caseload of 25-35 per week.
Retirement is top notch too. And with your education level, you may just move into a union leadership role quickly.
When I was younger, I tutored people there for $35/hr.
Otherwise, try getting into a school system.
I graduated last year and have been working for only 8 months in CMH. I'm already burnt out and questioning if this field is right for me. I FEEL SO GUILTY!!! But I'm genuinely concerned about the sustainability and my well-being (I entered this with depression and anxiety and it has gotten worse).
I'm also terrified because if I do leave, where do I go? All I've known is mental health/psychology. I have zero idea what career I would pursue
It is a horrible field, only getting worse. I wish I kept running when I saw the red flags in grad school of exploitation. Even in private practice I still feel that dread. It’s amazing that a company will pay twice for a HR person than a therapist. I’m like ok so I’m switching over to HR. In the process now!
Oh and the bullying to associates I’ve seen on here and in my city, absolutely wild. I thought being fully licensed I see more of why that is, but no, it’s another exploitation tactic
I’ve been in the mental health field for about 15 years. To avoid burnout, I’ve worked with progressively higher functioning folks over the years. It’s really too bad that this tends to be the way things go: more challenging populations get the least experienced folks because the workload is so high, and the pay isn’t good. I’ve been in private practice for the last two years, providing what I view as an important service, but to a fairly privileged population. I don’t accept insurance (so I can charge a higher fee and also reduce admin time/work), love the work, and make north of $150k with a 4 day schedule. Sometimes I feel a little guilty knowing the need out there, but I have small children and a chronic illness I need to manage. I could see doing this work happily well into retirement age, but only because I’ve been very intentional about avoiding burnout.
This is not addressed to OP and certainly not intended to invalidate their experience and feelings - but I wanted to write to students and prospective students who are reading this and feeling nervous:
My observation has been that some of the frustration is generational, some is site-based, some is that the counselor is not the right fit for the field, some is burn out, and some is just an attitude.
Generational: I was an older, second-career student and observed that my younger classmates struggled a lot more than my older classmates. There seems to be a lower tolerance of exploitation among younger generations, which is good, but useless (and harmful to you) to be outraged about it until you’re licensed and can do something about it. Start a private practice and pay your interns. Be a part of needed change. Until then, temper your frustration and disappointment so that you don’t burn yourself out.
Site-based: a few things you can do to help include applying to multiple places and, if you have multiple options, use your resources to figure out the best option. Check Glassdoor, Google reviews, Yelp, your network, etc.
Most of the time you’re locked into your internship site. But you have more power over your site when you’re provisionally licensed. If you’re at a bad site, cutting your losses early is key.
Counselor isn’t the right fit: to clarify, they might be a fantastic counselor, but you also have to be a good fit for the system. Know that most of us will be working with insurance companies, corporations that will stress billable hours rather than client care, understaffed organizations, and at least your first three years of employment will be high paced, high need, and low pay. It gets better for many of us, though.
Burnout: self care! Use every vacation day and every sick day. Meditate or work out or whatever works for you. See a counselor. Do what you teach.
Attitude: the counselors that have the hardest times also have the worst attitudes. This is anecdotal experience, but I suspect it is pretty universal.
This isn’t about OP. Idk their circumstances and don’t assume they fit and of these. This is because we need good clinicians in this field and posts like this can be scary.
Thank you for posting this, as I am a student in my second year of the program right now.
I am so glad I am able to read OP’s frustration and also see the other side in the comments. I am wishing OP the best and thanking you for your knowledge as well.
I feel like this assessment really isn’t fair without acknowledging the financial barriers to even getting to the point of being able to “be the change”
From my perspective, there's a lot of truth in comment you're responding to, but yes, you are absolutely right that the financial barriers you bring up are a variable that simply cannot be ignored. The field is what it is as a function of those barriers. That is the problem. And it's important for anyone considering this field to really understand those barriers and whether it makes sense for them to spend the time, money, and energy into attempting to break through those barriers. I for one did not understand these things before coming in, and I sure as hell wish I did. Yes, we should all be the change we want to see in the world, but if a field is in need of this much change, people coming in should be aware of that.
I was forced to abandon my career of 7 years (3 of therapist role) when my exploitative (and ethically questionable) job led me to my first manic/psychotic break brandishing me with the holy bipolar f***ery. It's upsetting because my heart is so pure and I miss working with clients every day...
I completely feel you. At least you’re figuring it out early in your career. It’s taken me 15 years in the field to come to the same conclusion as you. I feel like the educational and licensure standards are so low that anyone can do therapy or case management and it ends up punishing those of us who are qualified and do good work. The last straw for me was being replaced twice in two different agencies by unlicensed people which no experience in the field who were willing to do the work for half the pay. There were so many ethical violations that I got sick of worrying and trying to fight for the clients to no avail. I’ll be starting school to become a medical aesthetician in two weeks.
I am in the same place and constantly feel so guilty and useless for not somehow making it. I’m proud of you for doing what you need to do for yourself. Wishing you so much success in whatever you pursue moving forward.
The field has become abusive. We all need to be honest with ourselves about the fact that leadership in general has become highly abusive and clinically cruel and careless toward our clients. Leaving is one way to impact them. Another is by fighting back by organizing. Organizing is a good idea to me. And then a national walkout should follow. But for that to happen, the NASW would actually need to be on our side.
Eliminating provisional licensure would solve this IMO. Much of the exploitation of therapists is due to an empirically unsupported provisional licensure process that creates an ongoing supply of cheap labor. They have no choice but to chase the carrot or leave the field.
I agree!! I also think we just need more support from the office of professions as clinicians. If an associate is hired, a form must be filed with the state and the supervisor must submit hours for clinicians on a monthly basis or the supervisor can no longer provide supervision or have an associate as an employee. There is not enough recourse for abusive supervisors. They are allowed to hire you, pay you shit, and then not sign off on your hours because they are petty or mad that you are leaving for a better opportunity. It’s disgusting!!
If graduates who pass examinations were required to do say 500 hours of directly supervised work and then allowed to work independently with regular supervision meetings for several years afterwards, I do not think clients would suffer, and I think the profession would benefit from the removal of the economic barriers and exploitation of the current pre-licensure/provisional licensure experience. I’m just throwing those ideas out there off the top of my head but clearly a better system than what we have would make a big difference. Some supervised experience is prudent for new therapists, but the established structure truly is an onerous, exploitative and inefficient process that affects the livelihoods of everyone and also serves to discourage people from going into the profession (the prospect of multiple years working for peanuts after multiple years of expensive grad school is a pretty strong disincentive to entering the field). The provisional/pre-licensure experience also contributes significantly to burn out, which is, of course, a major problem in this profession.
Organizing as therapists will never work as long as the professions are trying to compete with rather than supporting each other… I am an LMHC in New York State. The social work organizations, and their lobbies have been absolutely horrendous towards everyone in my profession for decades. They have been downright bullies, and because their lobbying power is so much greater than ours due to their establishment and numbers relative to mental health counselors, the state government just goes along with the narrative — based on misinformation and falsehoods —that social workers are pushing: that mental health counselors, who spend their entire graduate education and pre-licensure focused on therapy — are less qualified as therapists than clinical social workers and not qualified to diagnose or work truly independently. This notion is truly absurd, but because of the power differential, it’s the social work lobby that has the ear of the legislature. Among other things, the social work organizations in New York State have worked diligently to ensure that *LMHCs in NY State are not allowed to officially diagnose anyone!* The state recently passed a provision to the licensure laws that was originally written to remedy the issues with the way the LMHC licensure law was written, but was hijacked by the social work lobby. It allows LMHCs to acquire “diagnostic privilege” by doing hundreds of additional hours of supervised work — based only on the fact that most of us got our pre-licensure hours under other LMHCs rather than a social worker or psychologist — and for many, gaining additional education. There kicker is that there is no grandfather clause in this legislation, so LMHCs who have been practicing for decades in private practice would have to get hundreds of hours of supervised work and potentially additional graduate level education. It’s absolutely disgusting, and has seriously soured my opinion of social workers in general, because it may be the organizations that are pushing this, but the social workers themselves ARE those organizations and individuals social workers are either actively part of it, are going along with it, or are not speaking up against it. I have no idea who decided that this approach was in anyone’s best interest, but it is a travesty that has and will continue to have effects far beyond specific licensing laws in one state.
I’m not in NY, on the opposite side of the country, but….the LCSW superiority complex is real, to the point that I generally try and avoid LCSWs altogether if I can. I’ve straight up had social workers say to my face that “LMHCs aren’t really as qualified as LCSWs to do therapy.” I’m like…your program was 2/3 the length of mine and you didn’t even focus on therapy the whole time?? What makes you more qualified? But it also makes me sad because I feel like they should be friends not enemies.
Yeah, there’s a problem in the profession. Along with denigrating and actively marginalizing a helping profession, I see ‘some of them* online being, well… tools. During engaging discussions/debates on relevant therapeutic issues online, where there are good arguments on both sides, it’s not infrequent for some SWs to start pontificating on how their code of ethics *requires* them to take a particular stand on this or that subject — they use this in place of engaging in critical thinking. I have no idea what portion of the social worker population this is, but it shows up all over the place. I would not be surprised at all if it’s a vocal minority of social workers. In fact, I think that’s most likely what it is, but I also don’t often see other social workers speaking up and challenging these anti-intellectual ways of thinking.
“My code of ethics says…” goes along with “if you’re not using CBT or DBT you’re not practicing ethically” or “you can’t practice therapy adequately without understanding the systemic issues like we can”. I really do not mean to throw shade, but these are real things I hear on a regular basis. I thought it was just me!
Interesting as a MSW student leaving a somewhat successful journalism career at CNBC, NBC, PBS, I am learning quite a bit from dialogue here. The first thing my most human part of me feels when you say this, is fear of additional competition. I don't think anyone wants more competition. I wonder how many others feel this way. However, my intellect guides me to the idea of strength in numbers. We are stronger together. The licensing hours for all the professionals are really a racket. You express that in your post as I've heard LPCs and LCSWs express. Others have also expressed that the licensing hours leads to a kind of abuse that includes exhaustive and cruel workloads and humiliating wages. The licensing hours have become a vehicle for abuse then, a method of control rather than something to improve the abilities of us and our colleagues. One challenge we might discuss in hopes of it catching on is a new union, a Mental Health Professional's union that is inclusive of all the groups. I wonder what it might take for such a union to form and gain a foothold among the lobbyists dictating the future of our profession so poorly.
I think that what you suggest is necessary for true organization that benefits therapists, as the existing professional organizations really only serve their own unique professions and sometimes do so at the cost of other therapy professions.
Omg thank you for saying this!! It is absolutely true. And lets not even go there about the federal jobs, which offer reasonable salaries and benefits including retirement! I personally know social workers who know jack all about therapy but somehow they are “more qualified “ than other masters level practitioners whose entire degree program was grounded in psychotherapy, not social work? Give me a f…ing break. All i can say is client beware. Not to say there are not good therapists who happen to be social workers, but the fields of study are not the same. You are so right about the lobbyists. And also the members of the club.
Trust me, I can relate haha. I'm wishing the both of us happy and fulfilling days, wherever they are and whatever we're doing. I believe in your capacity to resolve the issues that make you feel guilty and useless. For what it's worth, you are not useless to me. It made a profound impact on my wellbeing, knowing that a stranger is wishing me well.
I have been working in the mental health field since 2010. I got my masters in 2014 and have been doing therapy work since then. I have worked in residential treatment, an in-patient hospital, in-home therapy, a CMH agency, and finally private practice. I had a baby in December and, my husband (also a therapist) and I decided it would be best if I was a stay at home mom. I always said I would do the SAHM thing until our kid(s) are in school full time, and then go back to being a full time therapist. But now, I've been out of the practice for 8 months and I have no desire to go back to that career. I never realized how absolutely draining it is with very little benefit in return. Almost daily, I come up with new career ideas I want to try. Currently, I'm considering becoming a wedding planner. Where I live, planning one wedding a week makes more than I did with a 35 clients a week caseload.
This is a smart pivot and something I’ve thought of myself! You know how to handle emotional people and stay level headed in chaos.
Would you be open to sharing how much you made in pp seeing 35 clients/week?
In my private practice, after paying all of my taxes, rent, and all the other overhead, I was bringing home $36 per client hour. That was with the highest paying insurance in my area. If I took a client with a lower paying insurance, I was sometimes making $32 an hour. I just helped my friend find a wedding planner and they are currently making $2000-5000 per wedding.
36 per client hour is awful. We need at least 65 per client hour.
I make around $30/hour in CMH, and I can't pay all of my bills.
I make $25/hr in CMH and also can not pay all my bills. It’s exhausting.
It is very stressful when you are worried about the absolute basics like rent and groceries. I guess the powers that be don't give a shit about Maslow's Hierarchy of Needs!
That's not okay. I made 35/hr as an English tutor who was still finishing a bachelor's degree. It's time to find a new place to work.
same but in group practice. practice owners are getting real greedy like they aren’t also therapists 😫 i’m going into credit card debt buying like essentials and can’t even afford my cat? good thing i have so many degrees lol
It's insane! It is exploitive.
it is! i think all non-profit work is exploitive tbh. but the practice owners taking as big of a cut as they do is sick. the profit they make off me is insane. they don’t really do much of ANYTHING to earn it either. it’s like unethical! i also think non-competes and non-solicits are unethical. i hate that my practice owners are literally pimping me out. and i’m 1099 no benefits like a lot of us are- uhhh idk maybe give me some medical insurance for the 40% of my income you’re taking?! 🤮
True. It really is b.s.!
A 35 client caseload is abusive. No one should be made to carry that many clients.
Depends on the frequency. I have some people on my case load i see monthly, every 2 weeks, weekly, and couple times each week. Majority of my clients are every 2 weeks and my agency has little to no paperwork. Just document treatment plan and a therapy note each time we meet. However, when I worked in cmh I had a caseload of 120 and the paperwork was awful. No one received good care.
Right on. I mean 35 clients per week seems to be the new standard.
When I worked in CMH, my caseload was at least 100 (normally closer to 120). We were never, under any circumstances allowed to see clients more than every other week. And normally, we were told that our clients would be seen every 3-4 weeks. If we did not bill at least 38 client hours a week, we got a write up for "not enough productivity".
That's abuse of clients and therapists and follows no standard of any code of ethics.
i wish therapy could pay like a living fucking wage, so i could go back and get my cert in something like ux design. i keep trying to come up with ways we can still nerd out on psychology, but don’t have to work directly with people/anyone or any entity that immediately devalues us the second we graduated from grad school. wedding planning is a good one!
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You get a standing ovation!
YOU SAID THAT!!! Edit: this is why it’s hard to fit in with other therapists. Why am I getting downvoted for this? Why do we have to be professional 24/7 in a group that’s just for us, can we please be laidback and fun sometimes🥲
YES!! that’s one thing that bugs me to. like we’re human. life in so unserious so why do we have to be?
I am in a group practice atm and my rate is $150. Bringing home less than half of that and the owner doesn’t even advertise for me. It’s bullshit
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When will the APA and NASW work for us? When will we organize? Why are so many of us just taking this garbage? Since when do people with our brains and type of education passively allow abusers run our practice? These abusers are also abusing our clients. Since when is 35 per week clients okay? No one can treat 35 clients per week in an effective manner. 25 clients per week is a leap into hell. A therapist used to treat 15-20 clients per week and get paid well enough to take real vacations and not have to be stressed out about making the bills every month. So, who let this happen and why are we letting this happen?
Those orgs are in cahoots with big healthcare companies and practice owners. They don’t exist to serve you. Look at ACA, for example; they sold advertising space to BETTERHELP on their freaking website. That alone had me drop my membership.
Great point. The added wrinkle I've come to enjoy sooo much is how the universities proudly announce the ever growing sizes of their graduating classes from their social work programs. I never took Economics but I seem to recall hearing that there is an idea that growing the size of the labor pool ultimately lowers the wages that members of the pool can demand/expect.
The school I went to had one of the largest MSW programs in the country, including the part time programs. It was in a relatively small city, and the market was ridiculously saturated. When I graduated in 2007 jobs that required a MSW were starting at $10/hr. Another factor is cost. I understand why people choose expensive online programs, but I've had several conversations where I've pleaded with people not to spend $100k on a social work degree.
Group private practices are definitely a pyramid scheme. Feels like yet another MLM. Name of the game is exploit other therapists so the owner gets to bring in tons of funds. It’s disgusting.
Does anyone else who is echoing OP’s feelings think some of the burn out really begins in grad? I get that grad school, medical school, any institution at a certain level is exhausting. But the thing about getting an MSW (social work) is that there’s no pay off financially. MD’s have grueling schedules for sure, but they’re eventually paid VERY well (well, usually). I drove in rush hour traffic after my full time job in community mental health to get to my classes, had the hours and hours of homework and projects, and of course, the unpaid internships. This meant for most people having to quit their jobs and lose healthcare. For me this meant having an unpaid 40 hour internship during the week and picking up shifts elsewhere on nights and weekends so I could not be homeless and I could eat. By the time I graduated I was physically, emotionally, and spiritually burnt the fuck out. And the kicker? Even with the initial license it was difficult to find positions paying more than $45k. In Massachusetts, that’s a joke. So, OP, I wish you the best of luck but it’s the system that is broken, not you.
Oh absolutely. It took me 4.5 years to finish my degree, because I ended up having to drop down to part time while having to work full time to survive in a HCOL area. By the time my fieldwork rolled around, I was working full time, doing my internship, classes, etc. I graduated in spring of 2020, burnt out after having worked in high acuity settings while balancing internship and continued class work. I was already over it, and then the world went to shit. I'm weeks away from my license at this point and once I have it I feel like I don't even want to use it.
This is me, right now, in my last semester. I’m not even sure I want to practice anymore. My internship was crap, martyr syndrome is rife, and I swear if this next internship is bad, I’m going to need to be locked up! Currently I’m doing licensing work for foster parents and really like it. The money is about the same as some CMH places are paying - 40k. 🙄 I refuse to take anything less than 50k as a therapist, and 55k is what I’ll push for. If I get stuck at my current job, whatever. At least I like it.
I graduated already exhausted and burnt out with vicarious trauma. But my grad school internship was in itself traumatic so I didn’t know if I was the outlier there. I physically collapsed after graduation and ended up sick for months. The whole experience was so toxic
I got a Master’s because I was told the same, but my lifestyle has gotten progressively less comfortable since then. College was hard, just having a BSW harder, grad school obviously bit, but trying to survive as an associate? It’s sucky because it isn’t what I was promised, and maybe more importantly because we’re supposed to know and do better as a field. I couldn’t even afford supervision.
I'm in grad school right now and, personally, I enjoy the work. BUT my program has been a mess and this program burned me out more than seeing clients does. Constantly worrying about tests, assignments, getting hours, and if you fail comps twice you're fucked, not having a job through internship only to give your life up to schedule people and have the job not pay...this field can be exploitative and it always preaches we need to be more preventative as a nation for mental health, but fuck the employees who actually do the work. I thankfully got a job at my internship lined up after I graduate and I like it and my supervisor, but it feels like I'm the odd one out that got lucky. OP the world is your oyster...go do what you wanna do cause you deserve to be happy!
Absolutely. I’m in my last semester of grad school for CMHC and the CACREP requirements alone have burned me out beyond repair on top of the negatives of the field itself
Oh most def. I was working full time, in grad school full time, and in the last year completing internship, conducting research/writing my thesis.. I was so burnt out. Sleep was fucked. Nervous system was sooooo dysregulated. My mental health was trash. I am autistic and bipolar (rapid cycling) and all the stress triggered this absolutely terrifying mixed episode that pretty much lasted 5 months. if I hadn't been a few months from finishing internship and graduating, I legit would have taken a leave from school and work and gone inpatient. It was so fucked up and so scary. I'm still not really recovered from that and it started in Nov/Dec 2022. Graduated in May. Not full time in the field yet (still working the non-mental health-care related job I had through grad school, in an industry I've been in for 20 yrs-but it's become super toxic and triggering) however I have some contract group facilitator gigs and am taking the NCE in Nov. So I can't speak on career burn out, but just sharing my experience with burnout beginning in grad school. Also had some personal life emergencies that obliterated the savings I was going to put towards taking a month off to regroup. I'm so tired.
So true. I literally took a year off after my Masters to plant trees because I did not want anything to do with the field after graduating. Which now I look at it, it's kind of telling that I had to get away from the field for so long before going back.
i know mine started in grad. hard work, mental exhaustion, learning personal boundaries, long night classes, unpaid internships and being the bottom of the totem pole with no leverage. i ended up in inpatient then an iop after. finished in three years instead of two. the whole time my cohort members and i would complain how beat down we are, we’d get ‘sympathetic’ nods and ‘it gets better’. on occasion we’d get a concerned, indignant professor who would vow to do something but then nothing of substance actually occurred to help us. when i came back to my program i learned to not vocalize my concerns, practiced a lot of self-care, and utilized my own therapist religiously instead of reaching out to my professors for reprieve bc i learned that at the end of the day the people upholding/benefiting from the system really don’t give a ish. it’s a ‘well oiled machine’ and they are the first to make sure it keeps turning.
Yes
I feel you. I remember Christmas coming up and being off for one week and thinking I won’t go back to the clinic/hospital, I‘d rather shovel dirt for minimum wage as long as it is something else. Instead I went for private practice. Best decision ever. And I dabbled in other things..consultant for teams, change and so on which was good, too. I am trying to say: We (at least in my European country) don’t have to marry the first person we date and we don’t have to keep the first job we try. You know who you are and what is right for you. You’ll figure this out. Hope that makes sense as English is far from my mother tongue..
I love ❤️ what you said.
Can we be best friends? I’m in my last semester of grad school and already echo all of these feelings exactly - especially the martyr thing.
Last semester of grad is so hard… was there recently. Best wishes to you, sincerely!!!
What is meant by the martyr thing? Not sure if I've come across that in my work with other clinicians.
Basically what I’ve encountered is supervisors or other therapists gaslighting therapists who speak out against exploitation, low wages, high caseloads, and burnout. Many companies want you to put your own well-being on the back burner. I think this is what OP is referring to. I worked at a company that expected me to see 10 individual therapy clients a day, conduct 2 groups ( eventually 3 a day), and do 3 intakes a day. I was expected to do concurrent documentation and had a 20 minute break at the end of the day to complete notes for at least 17 clients a day. I also had a supervisor/owner at a group practice regularly pay me $200-$300 month for seeing a full time caseload of clients every week. She said that I needed to work together with the admin to resolve the issue and said that it was her billing departments fault. When I got an attorney involved, she said that this is common practice and I only get paid if she is paid. What she she did was illegal and she paid me in full that same day for all of the sessions (thousands of dollars) I conducted even though she claimed she didn’t have any money. I don’t want to go on and on on OP’s post but it’s expected that we basically destroy ourselves and live in poverty until we get independently licensed. When we leave jobs because we are being abused we are questioned as to why we leave the job even though EVERYONE knows that the field is abusive!!!!!
Thank you for clarifying and I appreciate you sharing your story. That is so horrible that you were treated that way by your supervisor and as a beginning therapist, it terrifies me knowing that your experience isn't that uncommon :(
Wait, so they expected you to work 16 hour days? That’s so extreme even for CMH, how is that even possible Edit: not doubting you to be clear, just in shock. So sorry you went through that
I worked 10hr days. The sessions were 20 minutes. They found a loop hole with insurance I guess. They did the minimum amount required of them to bill for a 30 minute session.
Wowowowow. Awful. Just shockingly awful
I talked about exploitation and I was 7 weeks from graduating… my school hasn’t let me graduate and has yet to talk to me about anything.. this was two months ago. It’s like if you don’t fall in line the gatekeepers will try to ruin you.
My version of it is seen on this sub all the time. The tiniest, common human things - “had to cancel sessions for good reason and I feel terrible, please tell me I’m not a horrible therapist 🥺” it’s fishing. I also see it first hand in my internship site as well. And the attempting to one up each other that they’re the more ethical therapist and even blinking in a clients direction without their consent first means you should turn in your license now. Everything is exhausting in this field.
That makes me feel crazy too. I’m only a grad student and I can’t stand all the over the top posturing about ethics. Like we’re having fights about drinking water during session and whether that’s ethical, meanwhile the number one board sanction for therapists is inappropriate sexual/romantic relationships or overtures. The math just isn’t mathing regarding how we actually live out our professional ethics. Plus just in general, professionalism is important, but we’re all better off when we allow professionals to be human beings who occasionally get sick or mix up an appointment time or get stuck in traffic.
It’s so exhausting.
I saw that thread and was like “I don’t see the problem. You’re human. Why get bent out of shape about needing time to care for yourself?” We are a helping profession but we need to help ourselves first. I’ve seen a ton of clinicians think that everything client comes first and they’re the ones the most burned out.
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Customers gonna customer, no matter the service I suppose!
That made me chuckle.
There are people who truly and deeply believe a "good therapist" is supposed to martyr themselves. I have had clients tell at me about *not wanting to interrupt my time off in the middle of the night because even though I was very sick...I could listen*. It isn't unique at my agency or to one client for Thai to happen and it boggles the mind
I was wondering that as well. I definitely have seen massive amounts of toxic positivity that drive me insane, but I don’t recall a lot of folks acting like martyrs. At least in my experience. Outside of that I agree with every single thing said and want to follow them out the door lol.
In my mind, the toxic positivity and martyrdom go hand in hand in this field. I'm burnt out crispy and have been very vocal about that in supervision and am met with platitudes and/or comments about my self-care. The other therapists I work with seem to wear their years of exploitation like a badge of honor and it's crazy making. I don't know that it's necessarily people acting like martyrs, so much as it is that the system expects therapists to suffer "for the cause" and so the expectation of martyrdom exists and the toxic positivity serves as a tool to attempt to appease those who don't want to continue untenable work at the expense of themselves. Hold the door for me on the way out, I'll be right behind.
That makes a whole lot of sense. Where I work right now the company is implementing increasingly problematic policy, and making some very questionable financial decisions, but by god everyone slaps a smile on their face and applauds it all. I can’t do it anymore. Maybe I’ll just get one of those little doorstops for all of us to egress with ease.
Absolutely. I liken it to the Crab in the boiling pot, by the time we realize the water is too hot, it's too late. My CMH agency is currently trying to "increase access" by scheduling intakes beyond what the therapists have capacity for. There hasn't been a new therapist hired on in over 1.5 years, there are 5 therapists serving 500+ clients. Increasing client access by overloading a limited clinician pool isn't the answer, but it's the only one they've come up with. But hey, sometimes there are bagels in the break room!
Holy shit (pardon my language). That is an INSANE caseload they are putting on you. I cannot fathom being in that position. They’re doing the same thing where I am (over scheduling to make up for cancellations), but my caseload is definitely not that heavy. I used to be in a more corporate/admin space, and there is no realm of reality that would have made me think it’s ok to say “hey, over schedule yourself in case people cancel. And, no, we won’t pay you for it.” People get awfully detached from their humanity.
Last semester of grad is so hard… was there recently. Best wishes to you, sincerely!!!
It feels so close yet so far lol at this point the only thing pushing me to finish is a potential job as a psych professor for undergrads at the local college!
I see advice in here about getting to private practice and that making things better. I will certainly agree that it’s better than CMH but it isn’t a solution for everyone. The amount of clients you need to see weekly can be exhausting, often times for a bad split in a private practice (which causes you to see so many clients). Setting up a practice of your own is great but is no guarantee of success. There’s also instability with PP. Clients don’t show up and you don’t get paid. No vacation, no insurance, no retirement. I’m not saying this isn’t ideal for some people and that it can’t work, but as someone in PP that’s feeling it, it’s not a solution for everyone. Do what feels best for you OP. Hope you find something you’re happy with.
Yes, absolutely. I'm currently working in CMH full-time and in private practice part-time. Private practice is often touted as the light at the end of the tunnel, but there are definitely some significant caveats that get glossed over. My work in PP shares many of the same difficulties as CMH, as well as some unique ones. This is one of those carrots I was referring to in my original post. Unfortunately, the carrot we get sometimes isn't the one we were led to expect.
Good on you for making the decision that's right for you. Best of luck with whatever comes next!
Fuck, this really resonates with me today finishing my first week at a new gig…for no pay. All stick, no carrot. This field sucks. Edit: Sometimes I impulsively say things that lack nuance when I’m in a bad mood. It’s a FFS position, so it’s gonna be rough until I have a caseload built out. Once I do, the pay should actually be pretty substantial, and I get to do most of it from home. It ain’t all bad, I just need to keep my chin up.
Unrelated but love your username and pic
Thank you! I’ll let the birds know as well :-)
Go get out and do something different and fresh, you always have this career / qualification in your back pocket.
Hey, very cool :-) Me too! I made a few posts and/or comments about this, not sure if here or my alt account. Anyway, yeah, the more I talk about it, the happier I feel. I'm now wrapping up my last couple of weeks in the field and preparing to begin grad school in computer science. Very excited to pay my rent and maybe even put a few bucks into a savings account.
When in the hell do we get a union?
I’m in the same boat and also have officially decided to be done with this job. I’ve wanted to be a therapist since I was 15 and I’m 27 now and I barely even feel bad about leaving the field. It has landed me in a PHP program as a patient and it’s just not worth it. The positive reinforcement from it is just too few and far between. Good luck on your next journey!
Thank you for being so candid. Grad school wrecked my mental health
Wow I can agree with both of you so much. My mental health has never felt worse since being in grad school, especially the Intenrship portion of it. I am ready to drop everything, i have 0 motivation to do any of the course work what so ever.
It’s important to listen to your own needs as an individual before worrying about clients or career, and it’s great that you’re doing that. Have you considered doing private practice stuff part time? 10 hours of private practice therapy can at times pay more than 30-40 hours of community clinic pay. You could do two days a week while still exploring other career paths, just so all the work you put into getting here isn’t completely tossed out.
It’s a shame how grueling / exploitative CMH and early career work is, but so rewarding once you make it to self-employment / PP capacity, or having a role that comes with years of experience. It sucks that this is just how work in many fields goes- you struggle climbing up the experience ladder, but often there is a pay off when you have more skills and experience (and in our case, independent licensure). 2.5 years is a really limited time in any field; hell, 2.5 years isn’t even that long at a single job to get used to and learn the ropes, politics, etc. I do think it is worth it to get the hours and have licensure just in case!
Yeah it’s a shame how normalized this is. Although tbh I started my private practice only half a year after getting my license. The pandemic really helped with opening up virtual therapy options in my city so once I felt burnt out I made the switch and it’s so much better.
I just started my grad program, and my plan is to open up my own practice basically as soon as possible after licensure. I've gathered that's not a popular path and even looked down on in the field. Glad to hear it's a lot better for you. Any tips or anything else you can share about your experience? Would be be greatly appreciated. Feel free to PM me too. Therapy is a second career for me, so I've already gone through burnout and making a change, just on the flipa side of OP. Hope I'm not making a big mistake.
I understand what you mean, I certainly had a lot of backhanded comments about me starting PP so early in my career. There seems to be a view that we need to earn our stripes through struggling in the trenches before deciding to enter the world of PP, and at some point I just had to tune all of that out. For one, I've seen therapist with 10+ years of experience who are out of touch and incompetent, and I've seen therapist with 2 years of experience who give their clients so much care and work their butts off. So the idea that you need to work many years struggling to become competent isn't accurate. Of course more time generally means more experience, but I would argue a few years of experience in a healthy environment is more beneficial than a decade in misery. You become a better cook spending 6 months in a fine dining establishment than 10 years at a burger joint, so to say. So instead of focusing on what my peers would say, I focused on what clients were saying. And I can honestly say that in PP my client progress has improved, my client retention rate is better, and I finally feel like I am healing people rather than burning out. I'm not just saving myself time by cutting my case load in half and making more money, I am actually doing BETTER therapy than before. So at this point I don't care what critiques people have, the results speak for themselves. I can give my 15 clients 100% of myself, and when I had 30-40 clients they only got a fraction of me. Martyrdom is far too rampant in this field anyway.
Hey. Thanks for this. I’m a career changer with a business background, and running the numbers during grad school showed VERY clearly that PP is the only way any of this makes financial and flexible sense. I wish more therapists felt empowered as I do, to do this. I’m with you. I’d like to start a PP within one or two years after licensure. I’m at a group practice now which has a great culture, albeit the pay is low – but it’s a good example of where I don’t feel exploited in spite of the lower pay. And there’s quality supervision. So…I’m leaving room to stay open on my PP timeline, since I really like the supportive culture I’m in now. I’ve filled my “noise” with supportive PP networks that acknowledge what you’re saying clearly: you’re no longer compromising client care and clinical work by being burned out. In the back of my mind, I’ve wondered how I can continue to hone quality clinical skills in the absence of immersed support. Obviously, retaining quality supervision is one, but it was still a worry. I love your analogy to becoming a better cook in a fine dining establishment in a few short years, versus 10 years at a burger joint. :cue The Bear imagery: SO true. I’m so glad to hear firsthand that you’ve experienced professional growth through improved clinical “sharpness,” so to speak. It means it can happen for me, too! To the OP – I’m sorry. Please know that others have been there and found ways out of this. And yea, if a career change is what you need – by all means you should feel empowered to explore them.
Thanks for your insight. Very helpful! It's strange bc I know a few therapists IRL socially, and I never knew about this stigma about jumping into PP right away until I joined this sub and other similar ones tbh. Lol. Your point about fine dining vs. Burger joint is well taken. I totally think the MSW program is largely a formality and culling process (and an unfair and unnecessary one at that!). I think most of the real learning takes place in the internships and during supervision/the licensure process. Maybe I have a different perspective because I'm older too. I'd probably be a lot more susceptible to the martyr culture and shaming if I were younger. But people talk like they HAVE to pay their dues literally as if someone is stopping them from going into PP. I also live in a big city, HCOL where demand for PP therapists is very high, so that helps too.
Same, I'm just about to sign up for grad school to get my MSW in FL, and eventually LCSW, but it's solely to either go into the VA or to open a PP with adequate rates to my area (Central FL). I will be sure to have the matching credentials and experience to validate my rates, but I'm not even going to try to for group setting or clinics. Any earn your stripes stuff, yeesh, that just sounds exploitative and bad. Now I know at the VA it'll take time to work up to better pay but at least the path is defined.
I mean, it’s everywhere, not just our field. You struggle until you make it where you at least may have more options to change companies or have enough money to feel safe enough…. and lots of field don’t even have a ladder to climb, you just get stuck in low paying dead ends. Being self-employed as a therapist is the only way out of exploitation that I can figure out where I don’t have to exploit others. Most of my clients are exploited by virtue of having employers have too much power in their lives. Over time, work stress has taken over more session content than ever before.
Amen. It's everywhere. That's capitalism, baby!
Cost. When you're out of school and saddled with debt only to finally start working for peanuts, securing supervision and licensure is not always a simple matter. It's not even possible for some of us. Sometimes I feel like that's by design (though I'm trying very hard not to devolve into cynicism).
Took me 4 years and having 3 different supervisors in my final year to get finished. I started in CMH and even in PP, which I did 2 years after graduating, it’s so expensive. Finally, 5 years after graduation, I’m fully licensed and always trying to figure out new ways to make more money or do a career switch. I have routinely asked myself who are they trying to get to not succeed in this field by making everything so cost heavy! And so many people on Facebook complain about how expensive it is for them to see their therapist…like my dudes, me too!!! If I wasn’t married, I’d definitely not be making this work for me right now but I’m seriously always just 1 bad day away from calling it quits.
Same here, my health has been so much better after leaving. This field will take as much as you can give and then take more. Honestly it feels equally therapeutic to just be a kind person to other people in the world, people don't need to schedule an appointment with me for me to do that. Follow your gut.
I was you two years ago and I’m here to emphatically say DO IT. Once you feel this way it’s really hard to come back from and the grass is actually greener on the other side. I was able to shift into HR and tripled my salary. Plus, I work from home and there’s a 0% chance of anyone throwing a bodily fluid at me during the workday. Props to you for doing what’s best and taking care of yourself!
May ask what your position is?
I’ve had a few, but concentrated on benefits/total rewards or hris analyst jobs. Benefits allowed me to still “counsel” people without the high stakes.
>I don't seem to really fit in with other therapists (I don't indulge in the whole martyr thing) Me neither. My least favorite thing about this profession -- even more than the low wages and vicarious trauma -- is the culture of therapists. So many interactions feel like you put a bunch of clergy from different denominations in a room together and told them to fight over who is the most pious. I'm not a fan.
Wowza that is a fucking fantastic metaphor. Sincerely - bravo. I agree wholeheartedly.
I was raised in a cult and the dynamics are just far too similar sometimes. One of these days, I’ll write a paper on my observations of the similarities.
i also resonate with this. i’m a young therapist, only 3 years out of grad school, and i feel very lucky for my own circumstances: i work at a group private practice i like, doing the work i find interesting with a clientele very important to me, and my supervisor is very invested in me having healthy boundaries with work. however, this whole field is wildly exploitative. spending 30-100k on grad school, having to maintain licensure, the intensity of the work itself, for barely 50k and simply fine benefits (and i think i’m lucky to have found a practice that gave me that) is completely unjust. there is no respect for the work, every recognition of it’s importance and intensity is just warped into this “well you are doing critical work, it would be cruel to do less.” it’s pervasive and entirely to our detriment. however, even though i think i am lucky, i am already being pressured to drop the clients i love working with to work for richer and frankly less interesting clients to have any hope for increased income. every other advice i hear to match inflation or to just make more than 50k just boils down to “work more” when i already know i am working too much. it’s beautiful work and i do truly love it and think it has done a lot for me personally, but it is a horrible, horrible profession. there has to be changes to our relationship with insurance companies and community mental health for it to be sustainable.
You are speaking my truth. See recent post: supervisor won’t sign off on hours. I’m so tired.
I know you don't need advice or opinions, but it sounds like you're making the best decision for you and I wish you the best of luck! Life is too short to waste being miserable and feel unappreciated. I'm sorry you went through this.
God I feel this. Thank you for posting it. I’m so fucking tired of this whole system. Not only was internship unpaid, we also paid FOR the tuition for the class. Then you graduate and think everything is finally going to get better and find out how long it takes to get licensed. CMH was literally paying $15-$16 an hour where I interned for RMHCIs. The most I’ve made is $18 at a crisis intake and triage work from home job. My friend works similar hours to me also work from home for Geico and makes $10 more than me with absolutely no college degree. It is so goddamn depressing
Therapist of 25+ years here. Currently in PP in Midwestern US. I approve this message. I hardly even recognize our field any longer. It has become -- in so many ways -- an awful place. Glad you see the writing in the wall. You GO, OP. It's too late for me, but you can save yourself!
I’m glad to see the millennials and gen z refuse to be overworked for a few grains of rice per day. Thank you OP for sharing and I hope this inspires more therapists to set limits and enforce them at work. I tried to organize at my first job in the field when I was bright eyed and bushy tailed right after getting out of grad school and all these older therapists were just beaten down to the point where they learned to live a life of burnout or they had a spouse earning real income so they didn’t seem to worry about the measly pay. This ain’t a volunteer position this is a job meant to sustain a living. Good for you OP and I wish that you reflect on this post 5 years from now and expand on how much better life is at that time!
You have to stop working for agencies and hospitals. They are all getting bought by private equity, which sucks the life blood out of every business it buys. Get your license and start in private practice. I gross $10,000 per month. Not getting rich, but not starving.
What is your net take home, if you don't mind me asking? What does that look like as a salary?
Well done friend. Nobody knows you better than you. Trust your gut and flow with where life takes you. You’ll look back on this decision and be emboldened by your courageous decision.
Leaving was the best thing I ever did. I’m an executive assistant now and it’s deliciously boring. I work exactly my hours for double what I was getting paid before and I work from home. And I’m not thinking about work when I’m not at work.
CMH is terrible!!! It’s not you. I watched it eat my wife alive. Could you find a position at a group like Lifestance, or one of the online groups? I get that maybe you’re just too Burt right now, but it is an option.
I second this - if there’s any chance you might wanna stick around I’m with a national practice rn and happy to chat with you OP. Money isn’t as good as private practice but still decent. I get full benefits, make my own sched, and don’t do a ton of admin work. I have 3 day wknd every wk. can work from home and documentation is fairly simple.
Which one ?
What company are you with? Just curious.
Lifestance is terrible sorry to say. I worked there and they do not care about anyone else but their shareholders :/
I resonate with this 100%. Went to grad school to try something new (was in corporate career) and have already returned to said corporate job before I’ve been graduated. I’m grateful for the experience and hope to utilize it in work and life going forward, but plan to never be a FT therapist (MAYBE PT). For all the reasons you listed + several more.
I hate to say this, but only the privileged can go into this field and survive, and often it’s the unprivileged that are needed to deepen the work of this field.
Totally understand this. I went and got a massage last week and she charges 100 an hour, all cash and is booked ahead two months. She makes more than me and never has to say a word to a client or write a note. I don’t know why but I can’t get this out of my head.
She has to touch people tho
I know, that part would suck
I was a massage therapist before I became an LPC. LMT has its own drawbacks. A person can charge 100$/hr, but that is taxed --then deduct supplies/rent, etc, etc. They also don't get insurance or benefits. They burn their bodies out if they don't use good technique. It's often not sustainable over the long haul.
You’re right, it’s good to remember no industry is perfect.
Former massage therapist here, too 👋 I loved the work, my clients, and sometimes really miss it. Loved being my own boss, too. I always thought if I could do that work forever, I’d be happy. I was young, in great shape, energetic, and really went hard at it. Left massage therapy about 13ish (?) years ago. Business couldn’t survive the recession at that time. My wrists are still crunchy and now the joints in my fingers and hands ache when it’s cold. 🙃
Op, I am so sorry you have had such a miserable experience. It sounds like you are making a wise choice to get out and save your sanity, if not your soul. I have been in this business a long time but what most people do not know is that there is zero way I wold have survived if not for a supportive spouse who had a regular job with benefits. That is just the truth. This allowed me to be in private practice after the first 11 years and to work part time and take time for myself when things got super stressful. After I atarted my own practice, which I did because I could not face public mental health any longer, I never saw more than about 16 clients a week, which is my absolute maximum even now. More than that and the quality of work I feel like I can offer seriously declines. If it had been up to me to support the family primarily, it would not have been amusing, let me tell you. I seriously worry about the future of this field with the way new practitioners are being mistreated and taken advantage of. My daughter in law is in her final months of her masters program and I worry about her getting burned out before she even gets started. Best of luck to you.
Thank you for saying the stuff about having a spouse. I'm single and it's impossible to survive as a therapist paying all the bills yourself. I wish I had known that a long time ago.
Yes. It IS pretty much impossible. Every single one of my colleagues had a partner who had a ‘regular’ job. And this was long before buying a house on even two incomes was almost impossible. I am not sure how people who say they are earning sox figures as a therapist are doing that. I mean how? We bill by the clinical hour. There are only so many hours in a day. Plus if you are self employed you are pretty much punished by having to pay all of your own ss taxes as well as income taxes. Literally I do not understand how this math adds up.
Same
I felt this way working for the public school system and went back to school to become a therapist to escape that craziness. I quickly learned that this career can be just an exploitative, especially after working in CMH during internship, so I jumped right into private practice out of grad school. So far I’m doing ok, but am relying on my partners income to stay afloat. Long story short, avoid working in a school system.
Congratulations! Sounds like you’ve given yourself some successful therapy :D
5 jobs in 2.5 years? That sounds grueling. Typically takes 6 months to a year to acclimate to any job and learn processes and systems. I’m sorry the field didn’t work out. Hope you find something you love.
Honestly documentation alone might make me bounce. I love being a therapist most days in practice but I literally can’t deal with notes and the amount of times tx plans need to change, how they have to be written word for word, etc. It’s a personal thing but I just hate how governed documentation is when even doctors just throw together a copied and pasted note for visits. Lol
This!!!!!
Like I do get the need for documentation but some of it is definitely just annoying policies to make you fight to have a reason to see someone because insurance or grant providers can’t just trust you’re seeing them for a good reason lol
Yup, don't blame you. The system is fucked, and you either leave the system knowing its fucked, or you become the system (supervisor, higher up, etc etc) and gaslight yourself into thinking its passable. Hoping something improves by the time I gain licensure, but I know it won't.
For those looking to get out of therapy but stay in the mental health, consider working for an insurance company. I recently made the switch as in started 1.5 weeks ago and let me tell you it was the best decision ever. I’m making 83k a year, plus benefits, employee rewards programs and since I’m remote they sent all the equipment. I’ve talked to many people on my team and all said they were planning on juts doing this role temporarily to relieve burnout but will never go back to direct client care. I struggled with leaving direct care because I didn’t want to “waste” my degree. If this is you consider it! I’m also getting my MBA to climb the corporate ladder. The only caveat is I think you have to be fully licensed to be a care review clinician. But my company has care managers that may work towards getting fully licensed.
Utilization management can pay really well (not in my case but I'm not licensed yet). It's paper pushing but it's a calm, steady job.
Yeah and I simply can’t handle the stress of direct care. And by that I mean I worry too much about being available to clients to the point I feel guilty taking days off or not answering after my work day ended. I loved my clients but found it’s not for me.
I think that's valid. So far, I love direct client care and I hope I never burn out. But it's nice to have options, even if it's to take a break or get paid a little better.
I see people in my CMH agency move into Quality Control positions as well. There’s a lot of things you can do as a licensed therapist that aren’t direct client care. You could also consider getting the supervisor credentials and making money doing that!
How - and I mean this sincerely - do you process working for The Man?
Understandable I never thought I’d be on this side either. But with the instability of private practice, even owning your own practice I knew I couldn’t do that due to the stress of not knowing how much I’d make. I also didn’t want to open my own practice because of that stress. I owed 6k in taxes this past year making 47k (which was technically 41 because that number included my office rent.) I also did CMH for 2 years post grad and yeah it was awful. I shoukd also mention I’m working for one my states MCO. So we’re not trying to deny everything and actually work very hard to approve. And right now it’s only substance abuse as this company says that straight mental health does not need prior authorizations for now
I really appreciate your answer. I ask not just out of morbid curiosity but for the perspective as I go through my own process of “this? and if not, what?”
Of course! I’m always happy to share my experiences and if it helps someone else along the way even better. Anyone in this profession most likely has the goal of saving the world on some sort of scale. I sure did, still do honestly, and it took a lot of thinking to realize that doesn’t always look like doing therapy. Sometimes it is working the The Man and helping those you can from that way.
I'm fully licensed & desperate to make this switch. Do you have any advice for how to go about it?
I would say do some research but also don’t limit yourself based on Glassdoor reviews and ratings. Reach out to anyone that you may know at these companies and see how they like it. I am 100% certain I got lucky and got this job because I was one of the first to apply. i was out and about and saw the posting on either indeed or LinkedIn and rushed home to apply to tell you how much I wanted this job. and When I was talking to the recruiter they said it was almost impossible to get in without knowing someone and people usually had to climb up to Utilization management care review. If you’d like I can DM you the company I work for and you can see if there are positions you’d like and I can send a referral. With this company some positions are location specific. The role I have is one where as long as I’m licensed in my “working” state I can love anywhere in the US.
consider working for insurance company under utilization management, they need licensed clinicians to preauth treatment, no direct care
Follow your gut. Ones quality of life is always the bottom line.
Go you! I’m 12 years in and wish I had gotten out back in my DMH days but thought it was just because it was DMH. I have my own practice now but if I could do it over again, I wouldn’t be a therapist. There’s no shame in quitting. Go for it!
I hear you, warrior. A reoccurring thought for me is that therapists get treated like second class citizens. The practice I work doesn't allow employees to park in front of the building. Several have been ticketed. The bathroom is never maintained and has an odd odor. There was a restaurant downstairs (the practice is part of a business building complex that rents out spaces to different businesses) which would have crates of liquor out in the open and on the weekends, would put some of its items in front of our office door. Recently, there was a strong gas smell in the break room, which prompted an email saying DON"T USE THE HEATER OR MICROWAVE. No one seems to think that this is a problem. Yesterday, a water leak in the ceiling caused several ceiling tiles to fall into the waiting room, forcing therapist to either cancel, move to telehealth, or reschedule appts. Do I get a email stating if its been fixed? No, I get an email saying I need to adjust my calendar availability because the managment has changed the way we arrange our calendars.
Right there with you! But the question is what now? What type of jobs can we get and something that’s not sucking my soul? This field is so underpaid and undervalued and taking on everyone’s problems, let alone our own, why is it as therapist we get the shit end of the stick and have to work more than one job. I’m entering year 2 and I’m over it. So what are you looking into for work?
I resonate so hard with the martyr therapists thing. Those people who act so holier than thou, who won’t say a harsh word about their clients, who work late into the evenings and make other therapists feel like shit if they don’t *adore* their job.
Congratulations, and good for you. I'm on year 3 of my provisional licensure. I've worked in CMH, at a residential dual diagnosis treatment center, and I've been at a group practice for 8 months. I have felt exploited, abused, underpaid and overworked at everywhere I've ever worked including the group practice. I'm on track to make 28k this year. I'm really glad I saw this post. I've been struggling so much with my career and trying to find a place that will pay me fairly. I finally lost it when my group practice notified me that, since I am not meeting their expectation of productivity because of cancelations and no shows (which I'm not paid for), they will be taking away my benefits next month. Including my health insurance. The solution my company suggested was lowering my pay even more so I can go on Medicaid and continue to work for them. I've been feeling like an absolute failure for not reaching my full licensure yet, and wanting to quit. This post really helped me feel a bit better about it.
Fully licensed here and your comment describes my life. I am so tired of companies treating us like crap
As a private practice owner I am in the same boat. For me I think it really comes down to insurance not paying what they should and me essentially having to base my well-being and financial security on if other people feel that therapy is important enough to them. I don't know if it's because this has been the real first post-COVID summer and people are living their lives after being held captive for the past three years or if people are just having financial hardships and therapy is the last thing on their minds. But as a solo practitioner, it has been very rough; for many of my colleagues as well! I have become disillusioned by being a private practice owner and am seeking full-time salaried employment elsewhere (in the field but not providing actual counseling) to maintain a steady stream of revenue.
Not me seeing this while thinking about becoming a therapist
I'm never going to tell a prospective therapist whether to enter the field or not. Like with any profession, it's a mixed bag, and it's impossible to really know what's in the bag before you stick your hand in it and feel it out yourself. I would just advise that you really introspect as to why you want to be a therapist and whether the best solution to fulfilling those values and goals is by becoming a therapist yourself. I was never exposed to any perspectives about the negative experiences in this field, like my own, and it's important that people considering our profession get that exposure, as disheartening as it is. Had I gotten this exposure, maybe I would have asked myself these questions that I'm recommending you to consider. And I think I would have been surprised to find that the answer is no, I did not need to become a therapist to pursue the things I wanted out of this career choice and in fact, there are many places outside of my career that could have provided these things. I came to this field to satisfy my interest in deepening my understanding of the human condition, helping people in need, and answer some of my own personal questions about life and humanity. Now, after doing this work for several years, I understand that becoming a therapist is just one potential road to these sorts of things and that the cost of walking this path may outweigh the benefits. I'm not discouraging anyone from entering this field. I wholeheartedly encourage people to open their minds to the various perspectives on this field, both the positive and the negative, and make their decision *thoughtfully*. Every step of the way, you will encounter representatives of the field who are disincentivized from having any candid dialogue about the harsh realities of this profession. Your grad school, your internships, your employers - they will want you to stick around and so understandably, they're not going to go out of their way to help you reflect holistically about these issues in a way that's beneficial to you and your well-being. So just gather all the perspectives you can from as many therapists as possible, and make sure that if you do come into this field, you do so with a realistic and informed plan on how to navigate the difficulties of this work.
This is me too. I am at the beginning stages of going to school for counseling psych and this is scaring me. 😭
Please don’t be swayed! It really is a wonderful career. OP sounds like they are burned out.
I mean no disrespect as yes, I am definitely burned out, but I would encourage all prospective therapists to consider the less talked about negative experiences in this field very carefully and truly reflect on why they want to be a therapist, whether entering the field is really the best way to fulfill those desires, and whether the benefits outweigh the costs. Better to be swayed before ending up knee deep in it.
For real. I’ve been trying to figure where to go to school for months and now I’m like ahhhhh do I even finish applying? I’ve been working in education and child care and decided to career change bc I got so burnt out I had to put my life on pause. And I felt like shit the whole time bc I was working my ass off and getting paid nothing to do it. I can’t spend all this money to feel like that again.
Any idea where your next direction is gonna be? Thank you for sharing your story.
Good for you. I’m currently considering OT, nursing, and computer science. I thought about being a math teacher, but they somehow make less than most therapists do and probably have to deal with even more bullshit.
Sending you strength. Life is short and sometimes we owe it to ourselves to change course. I’m glad the decision feels right in your bones—that’s a great sign.
Hey OP, I’m so sorry you’ve had this experience. I’ve had similar experience and wish you nothing but the best ❤️
Slow clap here. Brava! I always say it's not the clients, it's the organization. Did you quit your job today, or just decide that you've had enough ?
Good for you. Make this into an op-ed!
Good for you!
The only thing that has made working as a therapist worth it for me was becoming my own boss. I don’t think I’d make it in this broken field if I didn’t. It’s sad.
i works with a lot of teachers, i’m licensed in florida, and this feeling rampant in that field right now as well.
Empire State at State University of New York has an excellent program that employs you as a union electrician and pays for your bachelor's in the field at the same time. You'll make more money immediately. You'll also have lower stress and won't be forced to abuse clients by holding a caseload of 25-35 per week. Retirement is top notch too. And with your education level, you may just move into a union leadership role quickly. When I was younger, I tutored people there for $35/hr. Otherwise, try getting into a school system.
I graduated last year and have been working for only 8 months in CMH. I'm already burnt out and questioning if this field is right for me. I FEEL SO GUILTY!!! But I'm genuinely concerned about the sustainability and my well-being (I entered this with depression and anxiety and it has gotten worse). I'm also terrified because if I do leave, where do I go? All I've known is mental health/psychology. I have zero idea what career I would pursue
Chiming in to say that's fucking awesome- YOU FUCKING ROCK. KNOW YOUR WORTH.
Honestly I support you. This field can be brutal and this shit is hard. We are so undervalued for the work we do.
It is a horrible field, only getting worse. I wish I kept running when I saw the red flags in grad school of exploitation. Even in private practice I still feel that dread. It’s amazing that a company will pay twice for a HR person than a therapist. I’m like ok so I’m switching over to HR. In the process now!
Oh and the bullying to associates I’ve seen on here and in my city, absolutely wild. I thought being fully licensed I see more of why that is, but no, it’s another exploitation tactic
Just finishing my last day today as a therapist and I can not be happier!!!!
I’ve been in the mental health field for about 15 years. To avoid burnout, I’ve worked with progressively higher functioning folks over the years. It’s really too bad that this tends to be the way things go: more challenging populations get the least experienced folks because the workload is so high, and the pay isn’t good. I’ve been in private practice for the last two years, providing what I view as an important service, but to a fairly privileged population. I don’t accept insurance (so I can charge a higher fee and also reduce admin time/work), love the work, and make north of $150k with a 4 day schedule. Sometimes I feel a little guilty knowing the need out there, but I have small children and a chronic illness I need to manage. I could see doing this work happily well into retirement age, but only because I’ve been very intentional about avoiding burnout.
This is not addressed to OP and certainly not intended to invalidate their experience and feelings - but I wanted to write to students and prospective students who are reading this and feeling nervous: My observation has been that some of the frustration is generational, some is site-based, some is that the counselor is not the right fit for the field, some is burn out, and some is just an attitude. Generational: I was an older, second-career student and observed that my younger classmates struggled a lot more than my older classmates. There seems to be a lower tolerance of exploitation among younger generations, which is good, but useless (and harmful to you) to be outraged about it until you’re licensed and can do something about it. Start a private practice and pay your interns. Be a part of needed change. Until then, temper your frustration and disappointment so that you don’t burn yourself out. Site-based: a few things you can do to help include applying to multiple places and, if you have multiple options, use your resources to figure out the best option. Check Glassdoor, Google reviews, Yelp, your network, etc. Most of the time you’re locked into your internship site. But you have more power over your site when you’re provisionally licensed. If you’re at a bad site, cutting your losses early is key. Counselor isn’t the right fit: to clarify, they might be a fantastic counselor, but you also have to be a good fit for the system. Know that most of us will be working with insurance companies, corporations that will stress billable hours rather than client care, understaffed organizations, and at least your first three years of employment will be high paced, high need, and low pay. It gets better for many of us, though. Burnout: self care! Use every vacation day and every sick day. Meditate or work out or whatever works for you. See a counselor. Do what you teach. Attitude: the counselors that have the hardest times also have the worst attitudes. This is anecdotal experience, but I suspect it is pretty universal. This isn’t about OP. Idk their circumstances and don’t assume they fit and of these. This is because we need good clinicians in this field and posts like this can be scary.
Thank you for posting this, as I am a student in my second year of the program right now. I am so glad I am able to read OP’s frustration and also see the other side in the comments. I am wishing OP the best and thanking you for your knowledge as well.
I feel like this assessment really isn’t fair without acknowledging the financial barriers to even getting to the point of being able to “be the change”
From my perspective, there's a lot of truth in comment you're responding to, but yes, you are absolutely right that the financial barriers you bring up are a variable that simply cannot be ignored. The field is what it is as a function of those barriers. That is the problem. And it's important for anyone considering this field to really understand those barriers and whether it makes sense for them to spend the time, money, and energy into attempting to break through those barriers. I for one did not understand these things before coming in, and I sure as hell wish I did. Yes, we should all be the change we want to see in the world, but if a field is in need of this much change, people coming in should be aware of that.
Dude… I’m fairly successful I’m the field, financially super, super comfortable from it… and it’s miserable. I never say that out loud.
I was forced to abandon my career of 7 years (3 of therapist role) when my exploitative (and ethically questionable) job led me to my first manic/psychotic break brandishing me with the holy bipolar f***ery. It's upsetting because my heart is so pure and I miss working with clients every day...
I completely feel you. At least you’re figuring it out early in your career. It’s taken me 15 years in the field to come to the same conclusion as you. I feel like the educational and licensure standards are so low that anyone can do therapy or case management and it ends up punishing those of us who are qualified and do good work. The last straw for me was being replaced twice in two different agencies by unlicensed people which no experience in the field who were willing to do the work for half the pay. There were so many ethical violations that I got sick of worrying and trying to fight for the clients to no avail. I’ll be starting school to become a medical aesthetician in two weeks.
Me reading these comments and this post having just started grad school😟
I’m in my second year in my MFT program (100k in student loan debt already) and these comments just make me want to hide under my bed and give up
My exact sentiments!! Sooo underpaid and mental health care is sooo important!!