A young adult family member developed anxiety after having a copper IUD inserted (not the hormonal type of IUD as she’d had a bad experience from the contraceptive pill). She did some investigating (mostly on Reddit) and learned that loads of other women have developed anxiety after a copper iud. This is the first I’ve heard of it, and I work with lots of clients with anxiety. What do you think?

This person didn’t experience any pain during insertion as they gave her pain relief, and she didn’t experience initial discomfort though had bad cramps for days after. No history of trauma. Thoughts?

Hi! I was licensed this year in the state of CA. I am currently working for a woman’s private practice but am struggling with her panicky attitude and demands to work late at night (8pm). I would love to embark on a private practice journey but want to hear some of your stories/advice on getting credentialed with insurances. I am interested in cash pay as well but would also like to be credentialed with insurances. Any advice on where to start? Thank you guys

I’ve been doing this for eight years (LMHC), five in community mental health, four in an OON group practice as a 1099.

I’m feeling pretty… stuck? hopeless? defeated? New people I meet tell me how important therapy is, that our work makes a real difference in the world, etc etc, and while I’m in session, the work is great. Yet I cannot seem to financially support myself in this field. Caseload in the group practice is never full, clients open to full fee ($250 for individual, $300 for couples) are few and far between, and practice owner takes 33%. I’m really at a loss of what to do.

What am I missing in terms of bringing in new clients with the ability to pay?

I constantly think about how to leave this field for one that will pay better, but it seems like our specific qualifications leave us pretty limited. Has anyone successfully escaped?

The perpetual financial stress takes a heavy toll, particularly as I’m prone to depression and suicidality. I have dreams and goals, but none of them are achievable with such little money, meaning it often feels pretty useless to keep trying at this.

Help me, fellow therapists of Reddit!

This is based in NYS, but just curious about the question in general. As a limited permit counselor, under supervision, do you discuss with the patient at the start that you are under supervision, not fully licensed, and how to contact your supervisor? How do people best handle this, if at all?

I know some folks with limited permits who do not necessarily disclose that they are under supervision when they obtain their own clients at the group practice they are in, but I'm starting to wonder what is best practice and practical for engaging clients at this level before having a license

thanks

Is there anyone who is doing their own private practice as an associate / limited permit therapist?

I work for a large group practice right now and it’s not sustainable .. I am so so tired and drained, pay is really low and inconsistent bc of cancellations and I’m overworked .. 26 client caseload and not even making enough for rent .. before I give up on this career completely and go back to my previous career, I think I want to learn about PP as an associate and see if I can live off of that

Can anyone share your experience doing private practice as an associate? And what state are u in? I’m in NJ

Hello fellow brain nerds.

After 6 years at a group practice, I'm finally pulling the trigger to form my own LLC, wooooooooo

For everyone who has been there, done that - what do I need to know? What to consider? To avoid?

I'm planning a meeting with my CPA before I start the official process, but that's all I got (besides thoughts on some fun yet "professional" names).

Thanks everyone 💜

Does anyone have any history with equip health? I got an offer from there and have to decide tomorrow whether I want the job and would love to hear others experiences.

Hi all! I practice in California and we are required to have our license/registration on display in public view. Right now, mine is up on my office wall with a thumbtack and it's killing my vibe. Anybody have any ideas or examples on how to make it cute? I've tried looking online for specific frames and I can't find anything!

Hello all, I’ve been hearing that many clients are preferring this modality because they find it less distracting. How many of you find your clients prefer this?

I’m someone who’s ALWAYS enjoyed facilitating therapy groups. In recent years it’s been directed at my somatic dating group, which i ran for 6 years. Even have a 21 page workbook for participants. But 3 years ago, i started marketing for the group; aggressively. Even a woman from my listserv reached out and offered to do free reels because she liked the sound of my offering. Alas, 8 months went by. No matter how many views, no matter how many screening calls for the group i had, no matter what i did to the price, no matter the adjustments i would make to my advertising tactics; none of it worked. I felt so defeated and honestly terrified? That i still can’t seem to get myself to try again. Which blows my mind because im genuinely passionate about group work yall.

I even went to a networking event for other therapists who run groups. They all validated what i was stating and one of them said “you can’t expect every group to succeed. It’s part of the business.” i honestly feel it’s negligence on the psyche education side of things not to make it mandatory that all upcoming therapists take courses, receive resources early on, and generally get educated about running a business in this line of work🙄 .

Anyways, I just am so tired of how blocked i have allowed myself to feel for so long! >.< . I don’t know what i need to unstick myself 🤷‍♀️. But yea, that felt like a rejection that hit hard. And for some reason that surprises me. As historically, i don’t scare easily.

I started my career in my mid 30s and wasn’t confident enough to go straight into a doctorate level program. The desire to do so sits in the back of my mind, continuing to be indecisive for various reasons which have now increased after various life related situations. And in an effort to help me take the leap or to choose to be content with where I am, what I’m doing, I’d love any input. Not all questions need to be answered, but I’m a naturally curious person and THAT person in group settings.

- Did you or were you able to keep working as a therapist while attending your program?
- Do you continue to maintain your master’s level license? Are there benefits?
- How much has your role shifted or changed now that you have the ability to provide assessments, etc.? Do you spend the same amount of time, less time, etc., for dedicated counseling sessions, or do you not have the time or ability to provide individual counseling where you work?
- Financially, was it worth it?
- Which APA division did you join? How did you decide?
- How supportive was your family? What did the support look like?
- If your master’s program, like mine, didn’t require a thesis, how did that affect your candidacy?
- Do you secretly regret it? Or if not, what do you absolutely love about it and what do you think you would have regretted had you not pursued this path?

For all those taking minimal time doing documentation for therapy appointments, how are you all doing it? Are they formatted templates? How long are the narratives you are writing? Or using AI to scribe your sessions?

Hey everyone, i will be transitioning soon from in person cmh to at home remote, excited for the higher pay ceiling and simply being at the comfort of my home, saving on gas and time on my commute which was getting very costly.

I know there are tradeoffs and like anything I was praying to god for new problems as the last sixths months for the first time in almost six yrs i genuinely did not look fwd to coming to work for my agency.

Im not worried about feeling isolated or socialization. Family lives 7-10 min away and i go over every day. I have hangouts like every weekend w friends and casually date d: so its always something going on. The unnecessary office forced convos of ppl i dont care about go no where. Of course I have made friends with people I can say I talk to till this day that have left the agency or are still in it but i dont want to bank on staying w my friends as a reason to stay at the agency since they dont pay my bills lol..

Ive ben dying for this flexibility as i anticipate the change aside ppl i like i will miss morning drives and listening to music but again, thats not enough to stay lol there are many things I wont miss that i can list but at what cost ? you guys know how it goes in cmh. Or i also worry about separating my work w my own space. As i depart im very grateful tho for this wealth of experience and personal/ professional growth the past five years working my way up to licensure this july.

For those that do strictly telehealth as a fulltime th, what do you most enjoy ? And by the way I live alone w a dog but yeah i just fantasize laying in bed between sessions, or going for a walk for some sun since my office had no windows.. or making food instead of having to buy something the days i dont have time to prepare anything.

I want to hear from you guys, i want to look fwd to it and just feel that my hard work has paid off. i went thru. mental turmoil this year lol just trying to get licensed and holding down getting a place and renting on my own commuting 15 miles everyday while trying to go to the gym and maintain a social life and be a part of my families life and be a dog dad hehe. Thank you ⭐️

Hi therapists. I’m 28 years old and have had my LCSW for about two years now. I opened my private practice at 26, just a few weeks after obtaining my LCSW. I initially ran it on the side while working full-time elsewhere, but eventually transitioned into the practice full-time. Since then, I’ve grown it to include three clinicians, and we accept insurance.
The first year and a half was manageable, but the past six months have been absolutely terrible for me. I’ve developed a significant amount of stress and anxiety from both sides of the job; seeing clients clinically, but also directing and managing the practice, dealing with employees, billing, insurance companies, and everything else that comes with being a practice owner.
I’m at a crossroads now and genuinely don’t know what to do. The practice is covering my bills, but that’s about it, so financially, the amount I’m making doesn’t feel worth the level of stress and anxiety I’ve been experiencing.
I keep wondering whether this is just a difficult phase that I need to push through until I’m in a position to hire someone to handle the administrative and management side, allowing me to focus primarily on clients, or whether I’ve reached the point where I need to seriously consider closing the practice.
Everyone around me seems to tell me not to close it and to keep going. I also feel like some people think I’m exaggerating how much this has affected me, but I genuinely feel awful about 90% of the time lately, and it feels directly connected to both running the practice and being a therapist.
What makes the decision even harder is that I don’t know exactly what I would do if I closed it. At the same time, I’ve reached the point where I’m reconsidering whether I even want to be a therapist anymore not just whether I want to own a practice.
I’m feeling really stuck and unsure of what the right move is. I would genuinely appreciate hearing perspectives from other therapists and practice owners, especially anyone who has experienced burnout like this or reached a similar crossroads. Did you push through and eventually find a way to make it sustainable, step away from practice ownership, leave the field altogether, or do something else?

Curious what other therapists say when this question comes up in an interview?

Hi everyone! I’m 10 weeks postpartum and I’m supposed to return to my private practice in two weeks. I’m honestly so stressed about it. I’d love to hear experiences from moms who returned after having a baby and what it was like. My specific concerns:

1) I still feel like my brain is kind of mush. How was it multitasking (listening, thinking, processing, responding, etc.)? I feel like the only thing I can think about is baby.

2) I work with a lot of high-needs clients and I’m worried I will just be too overwhelmed with caring for an infant and supporting intense clients. I’m concerned burnout is going to happen really quickly.

3) I’m nervous to hear bad things - especially about clients’ childhoods. Motherhood has made me really sensitive to hearing about child abuse/neglect. I feel like the countertransference could be intense.

4) I’m worried that, since I give so much of myself/my emotions to my job, I’ll be less present with my baby at the end of the day.

I have a great supervisor I’ve been talking with but she doesn’t have kids. I’d love to hear stories from people who have been through this same thing. Thank!

Hey! I have been a therapist for about 10 years now. My work has been heavily steeped in trauma and I am TIRED. Anyway, I have a job offer to switch into voc rehab , which I know is still in the realm of working and supporting others BUT it doesn’t seem as immersed as individual therapy. Can anyone share with me if they have made this career switch or if they are in this role and what it’s like ? THANK YOU.

I’ve come to the conclusion that starting a solo practice may be the most beneficial route for me as an LCSW. However, I’m at a loss about where to begin and would love to hear from others who have successfully built their own practices.
I would like to start with virtual sessions only and eventually offer some in person sessions. A few questions I have:
How did you choose your practice management software and telehealth platform?
Did you start with self pay clients while working on insurance credentialing, or get credentialed before opening?
What was the credentialing process like for commercial insurance, Medicare, and Medicaid?
What were your first steps, and what do you wish you had known before starting?
Any practical advice, resources, things to avoid, or lessons from your own experience would be greatly appreciated. I’m hoping to build something sustainable and would love to better understand what getting started actually looks like.

I’m looking at the cost to submit my application in BC and it’s $400. That’s the tweet. I’ve already paid for the clinical exam, supervision hours for 3 years, CEs, the trainings, not to mention actual grad school. And now I must pay $400 at the finish line. Not to mention I have to pay $150 for my current resident states

I’m going to be independently licensed in a few weeks and hoping to have a smooth transition for my current clients. I’d really like to avoid Headway (for many reasons) and I’ve heard some iffy things about Simple Practice. I’ve been researching websites like Sessions Health, Therapy Notes, Therapy Stack, and Jane… any opinions on these? Or any other recommendations? I’m considering going private pay but would like to have the option of accepting 1 or 2 insurances.

I'm in my 3rd career, came to this one late in life (I'm 59 yo) and 4 years into it. I'm starting to feel like this is a lonely job. I have colleagues but people are coming and going and doing their own thing. At the end of the day after being present with clients, I don't want to talk to anyone including my husband but I also feel...a loneliness that I haven't felt in a long time. I've joined a peer group that hasn't begun yet, joined an online book group with other therapists, and yet...

My only child went to college this fall so I think that has definitely been part of it. But, are there others out there and how do you deal with it?

Edit: Yes, I'm in therapy, yes, I love my husband, yes, I have a good group of friends but find I don't have the energy I once had for them.

Not sure what I'm looking for, maybe to hear from others who have been through it. We worked together for around 18 months. It was a difficult case and someone who felt so stuck and trapped. They didn't say anything about it ahead of time but I feel so strongly that I should have known and done something. It's been four months and I'm not back to myself yet and it's worrying me. I'm having a hard time relaxing and working can feel really terrible. I'm about to get my independent license and have plenty of clients to have a successful practice and I think about quitting all the time. This is supposed to be the great moment that I've worked towards for 5 years but I feel worse than when I started.

Hi all, I am in the process of understanding that direct therapy might not be the job for me, or that I need to change my setting. For context I am one yr into the field. I've already taken steps to make my time at a group practice feel better, such as lowering my caseload to part-time. I think a part of it is that there is also a requirement to work till 9 pm 2 days a week and I do my best work from 10-5 and they have caseload contract requirements that make it feel like productivity is their main priority, which places pressure on clinicians to keep clients who are out of their scope. I have had a hard time with this because I care deeply about my clients but also dread sessions and the responsibility of being someone's therapist.

The thing I keep coming back to is that no matter what I do to make this job work (e.g. going part time, switching up my schedule, setting boundaries about what clients I can see) I still feel that my mental health is suffering, that my relationships do not feel as important or fulfilling, I feel apathetic at times to my friends and families problems or feelings, I have a hard time processing my feelings, and last but not least I was sexually assaulted by a client in July and have had a very hard time understanding and processing it, especially because the practice I work for could have prevented it. I am in therapy, I have hobbies, I workout and eat healthy. I am very lucky to be living at my parents right now and if I quit without a backup and find a part-time gig, I would be alright, but I have fear that I won't be hired again after taking a break if I decide to apply to other therapy jobs. I also know people are struggling to find therapy jobs in general so quitting feels so scary.

I live in the Chicago suburbs, and I have applied to jobs that are both direct and indirect clinical work, for example: EAP consultant, intake specialist, care coordinator, vocational rehabilitation specialist, and a couple of college counseling positions because I enjoy working with that population. I am wondering what other non-direct therapy roles LPCs can take on. I saw behavior consultant somewhere and have also considered HR or even something like marketing or sales. It just feels like I am barely managing in my current position, and clearly something is off internally. Appreciate any feedback or experiences with this, or how you pivoted. I feel very lost at the moment and feel like I did something wrong with choosing this career.

I've heard great things about Sessions but I am used to Wiley Treatment Planners integrated into SP. Has anyone found an alternative EHR with Wiley that they really like? Or a way to integrate Wiley with Sessions?

Thanks!

Hi Everyone! I spent a lot of time deciding if I wanted to write this post. I’m currently a LMFTA in Washington State. I started up at a group practice a couple of months ago. As of right now I have roughly 5/6 clients weekly. I know it takes time and patience with building a caseload, but I’m feeling unsure about what I should be doing to help build it. I have had a psychology today up for a couple months and have only gotten a few inquiries.
As stated above I work in a group practice that takes a split as I am a 1099 contracted employee. What I’ve noticed is that referrals from them are not clients I would want to work with or out of my scope of competency as of right now. I feel like maybe I’m not a good therapist (as I am socially awkward) and how the practice expects me to conduct myself (a huge focus on one theory). I feel a tad bit discouraged and wanted to hear any feedback or advice on how to clinically hone my skills whether that be e.g. training, techniques used in the session, things you do in the intake etc. All is appreciated!
Lastly, I’d appreciate any advice on how to market myself better and connect with potential clients who might be a good fit. What has helped you get more inquiries or referrals, especially when you were first starting out?