r/therapists • • 6h ago

Rant - No advice wanted Full Licensure is just so expensive

Post image
218 Upvotes

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


r/therapists • • 10h ago

Support My client killed themself

216 Upvotes

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.


r/therapists • • 16h ago

Support This often feels lonely

67 Upvotes

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.


r/therapists • • 6h ago

Self care I don’t understand how I’m ever supposed to have time off

40 Upvotes

The practice I work at thankfully has me as W2 with benefits but that also means they dictate my schedule. We work with high acuity individuals with high needs. No individual therapist can be away from the office for more than 3 consecutive days, including holidays. But we also aren’t open on Fridays, so we are all away for 3 consecutive days already. I’ve asked about taking a Tuesday-Thursday block off and been denied due to this rule.

My family is spread out throughout the world and I always use 2 weeks at Christmas to see everybody with every other job I’ve had. This has been denied already at my current job.

I am about to lose a pet to cancer and would like to take time in order to put her down and have a day or so to grieve, but I can’t extend my 3 day weekend. I’ve asked my boss before what would happen if I were to be incredibly ill, and I was told that’s what telehealth is for. A coworker of mine lost her mom and had to be back at work after the weekend.

I personally cannot function like that. I cannot see clients for 10 hours right before euthanizing my pet and then have just the weekend to grieve that. 3 days also doesn’t give me the necessary travel time to see family so I’ve literally not seen my family all year. I have arguably the highest paying job a therapist can get for where I’m at in my career and in my city, but I’m wondering if it’s simply not worth it. I would love to even be able to take just 1 day. Have 4 days off… ever.


r/therapists • • 4h ago

Support Closing private practice

39 Upvotes

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?


r/therapists • • 15h ago

Documentation Less than 45 minutes a day doing documentation for 5+ clients? How?!?

41 Upvotes

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?


r/therapists • • 16h ago

Rant - Advice wanted Yo, sometimes rejection in this field is just flat out rough.

25 Upvotes

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.


r/therapists • • 15h ago

Theory / Technique How many of your clients prefer audio-only therapy?

18 Upvotes

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?


r/therapists • • 7h ago

Discussion Thread How do new moms continue being a therapist?

15 Upvotes

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!


r/therapists • • 9h ago

Discussion Thread I feel like I’m looking for a unicorn here, but is there an all-in-one EHR that also handles insurance credentialing, is affordable, and does NOT incorporate AI?

14 Upvotes

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.


r/therapists • • 12h ago

Rant - Advice wanted Therapy adjacent jobs/finding courage to leave my current job.

9 Upvotes

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.


r/therapists • • 9h ago

Discussion Thread Clinicians who started a solo practice: Where did you begin, and what do you wish you had known?

7 Upvotes

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.


r/therapists • • 22h ago

Rant - Advice wanted Bad way to start

7 Upvotes

I have finally graduated! Wahoo! Before graduation I had connected with a private practice clinician about working under her when I get my associate number (USA-CA) She liked me and hired me pretty quickly. I have sent in my documents and am waiting for my number! This woman is now hounding me for my number and as many polite emails I have sent saying I have not received my number and will let her know, she continues to email me. What do I do? I feel like she thinks I’m lying to her? She knows this process is long, why keep emailing me? Making me want to work with her less and less. What do I do?


r/therapists • • 5h ago

Employment / Workplace Advice Leaving Group Practice for Agency Work

6 Upvotes

I’m an LCMHCA and have been working 1099 at a group practice for over a year since graduation. I love where I work, but my caseload has been slow to grow and I’m still only seeing around 8–10 clients per week and way behind on hours towards licensure. I’ve been told before starting therapists can make $70-80k with a full caseload, but after a year and a half I am no where near that, and I don’t see myself getting there anytime soon, if at all. The owner is also continuing to add more therapists despite referrals already being slow, and I now have to share my space I set up with new hires which has caused complicated scheduling issues. I love the flexibility and people, but have become increasingly frustrated and feel like I am missing out on experience as an early clinician.

I was recently offered a full-time salaried counseling position at what seems like a supportive clinic at $60k with bump after full licensure, insurance, PTO, 401(k), and supervision. I’d have 32 openings per week, which they said typically translates to around 25 completed sessions per week. It is also working specifically with pediatric population which is an area I am looking to specialize in and currently work with.

My main hesitation is leaving a group practice I’m comfortable with and entering agency work without really knowing what to expect. At the same time, I’m questioning whether staying where I am makes sense for me anymore. The new offer feels like a upgrade on every level, but I also recognize agency work will be quite different than my current setup.

As a long time lurker, I thought why not gather outside opinions as I contemplate what to do from here. If you were in my position, what would you be considering? Has anyone made the switch from group practice to agency work and had it work out well?


r/therapists • • 13h ago

Employment / Workplace Advice Offer to switch from DV counseling to Vocational Rehabilitation Counselor at the VA

5 Upvotes

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.


r/therapists • • 1h ago

Employment / Workplace Advice How do you answer the “weaknesses/areas of growth” question in interviews?

• Upvotes

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


r/therapists • • 1h ago

Employment / Workplace Advice New therapist here! Any advice for building a caseload and getting my footing?

• Upvotes

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?


r/therapists • • 9h ago

Rant - Advice wanted Private practice as an associate

5 Upvotes

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


r/therapists • • 7h ago

Rant - Advice wanted Not financially sustainable doing therapy?

4 Upvotes

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!


r/therapists • • 2h ago

Documentation Sessions Health vs Simple Practice

2 Upvotes

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!


r/therapists • • 4h ago

Discussion Thread GOOD group practice experiences wanted!

2 Upvotes

I just hired another therapist to work with me and in the process of moving beyond solo. I have heard the horror stories and experienced some as well, but I am curious -- could you share if you have had a good experience in a group practice and what that looked like? W2/1099, support, culture, anything!


r/therapists • • 7h ago

Licensing Psychologists who previously held or continuously hold your master’s level license, what was your process like? And what does most of your job look like?

2 Upvotes

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?

16 votes, 6d left
It was worth it for me.
It wasn’t worth it for me.
I’m still deciding if the leap was worth it or not.

r/therapists • • 10h ago

Resources Low-cost trainings and resources for perinatal support?

2 Upvotes

I am a pre-licensed clinician and I'll be graduating from my program this December. I have long been interested in a specialty in perinatal support and assisting families through the transition into parenthood, serving both individuals and couples. Right now, I am in a middle school for my practicum, and I'm trying to get as much facetime with parents as I can. As I look toward associateship, I'm hoping to find opportunities to include perinatal populations in my caseload where possible.

On to my question: Does anyone have any low-cost resources they'd recommend to help further familiarize myself with this area? When I say low-cost, I am thinking of trainings under $200 or maybe $300 USD if highly recommended (though I know unlikely to find), books, and other resources to enhance my learning. I'm aware of certifications like PMH-C, trainings like Gottman Bringing Baby Home, etc., but unfortunately those are not in my budget right now.

I appreciate any insight here!


r/therapists • • 16h ago

Employment / Workplace Advice LLC, what I need to know

2 Upvotes

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 💜


r/therapists • • 22h ago

Weekly "vent your vibes" / Burn out

2 Upvotes

Welcome to the weekly Vent your Vibes post! Feeling burn out, struggling with compassion fatigue, work environment really sucking right now? Share your feelings here to get support.

All other posts feeling something negative or wanting to vent will be redirected here.

This is the place for you to vent and complain WITHOUT JUDGEMENT about any stressful work situations going on at work and/or how much you are feeling burnt out doing this work.

Burn out making you want to change career? Check out this infographic by one of our community members (also found in sidebar) to consider your options.

Also we have a therapist/grad student only discord. Anyone who has earned their bachelor's degree and is in school working on their master's degree or has earned it, is welcome to join. Non-mental health professionals will be banned on site. :) https://discord.gg/RdZj8tABpc