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I stared at a stack of yellow files, all waiting for my review to be sent to Medicare for payment. Piles of notes and treatment plans made my soul sink. I didn’t go to school for this, pushing paper and unrealistic expectations and quotas on other therapists. I was worn out, irritable, tired and no longer finding joy in the work that I once had loved so much.
That’s when the thought hit me, “I don’t want to be a therapist.”
But I had invested so much time and energy to get here. Even after looking into other grad programs for a medical career, I decided to try shifting how I was doing the work and began a business on my own.
Private practice was my last-ditch effort to fall back in love with my career.
Maybe you’ve felt it before, that inkling that something isn’t right or is creating a level of discomfort that you aren’t sure how much longer you can tolerate. Truth is, we have more people leaving our field than entering it. But why? Why do we really not want to be therapists anymore and is there anything we can do to change the course?
Reason #1 You Don’t Want to be a therapist: The mental health system is set up for burnout.
For all of us in this mental health field, we were born out of systems that do not serve us. Working for unpaid internships and practicums, and acquiring high student loan debt. All while the powers at be KNOW we are in fact some of the worst paid masters degrees. We come out of graduate school already set up for stress and overwhelm.
Add to that the weight of people’s lives that we serve, being told we are responsible for the outcomes when the resources of the system are so limited. The system is the cause of a lot of their mental distress, much of which we can’t do anything about.
When we wrote the book on Therapist Burnout, we realized that many people thought burnout came from just feeling stressed about work. Burnout in the mental health system is almost always seen as a personal weakness, instead of a normal response to a broken system. In order to heal burnout one of two things needs to happen. One, the system has to change or, two, we have to change how we interact with the system.
For example, I left my government job because it was causing burnout. I created a practice from there that supported my needs as well as for my clients. Changing the setting made all the difference in me continuing on my path as a therapist. Suddenly I truly loved being a therapist again, and I felt inspired to help other therapists find their love again too. It was like a switch flipped.
I know private practice isn’t the path for everyone, and that is ok. For those who don’t want to take the entrepreneurial route, can you change the system from within? it’s going to take push back, setting new boundaries and speaking up all in the name of self care to heal the burnout. The truth is, your labor is incredibly valuable! We are taught often that we are expendable, but truly our work is invaluable.
Reason #2 You Don’t Want to be a therapist: Private practice is failing you.
But what if you are already in private practice and you don’t want to be a therapist anymore? Private practice is the dream for a lot of therapists. It signifies independence and freedom. Often that freedom is sucked away by fears around marketing, low paying insurance companies with horrendous clawbacks, tech companies that take advantage of therapists and their clients and overwhelm with learning how to be a business owner. It is a lot and nobody learns these skills in grad school.
Many therapists go into their private practice with the same mindset they had in their agency work and replicate processes and ways of doing/being that often continue the harm they were trying to leave, such as unrealistic sliding scale fees, overworking, documentation that is over and above what is needed, and accepting any potential client who calls. Any chance to deviate from those norms has often led to being shamed by peers who tell them that what they are doing can’t be done or is unethical, such as charging a rate for therapy that allows them to live beyond the poverty line.
Side note: The sliding scale fee structures that we bring from non-profit organizations are often based on millions of dollars worth of grants that allow for pro bono or sliding scale spots. Those sliding scales aren’t appropriate, or sustainable for most for profit models without extensive grants. In fact, mental health attorneys advise AGAINST sliding scales in private practice for legal and ethical reasons. You can learn more about the law, ethics, and legal advice in free How to set fees training.
Before you end your career as a therapist, first look at what you created with this private practice and ask yourself:
- Is this really working for me? It is so easy as therapists to stay checked out focusing on everyone else. What is your body, mind, heart, and spirit saying about your life right now? Is work and personal life in balance and truly aligning with your values?
- Am I making a livable private practice salary? You may need to relook at your financial plan to ensure you have a fee that is viable for your needs to live in your community with balance and health.
- Am I doing things that don’t make sense and drain me? Whether it be your documentation processes or billing, look at how you have been running your process and see what you can streamline, eliminate or delegate.
- Do I have support in private practice? Private practice can be isolating. We have seen many therapists go back to employment simply because they felt so alone in private practice. You want community in your personal life and in your business. For your private practice, that might mean getting involved in a local AAMFT chapter, inviting colleagues out to get together, signing up for group case consultation and more. You may need some direct guidance and support from an expert, whether that is clinical or in the realm of running a business. You don’t have to do everything on your own.
Once you look at these questions you can either choose to make adjustments or you may decide that private practice isn’t for you. That is all ok. The goal is to create a way of working that really lights you up, not sucks you dry. Private practice may not be for you or your private practice may simply need some adjustments.
Reason #3 You Don’t Want to be a therapist: Obligation is dictating the focus.
The style of working or the way you offer your services might be coming from a place of obligation and not conscious creation. You do what you have been taught to do or feel you must do. You know when you were taught that a 45-50 minute session is the standard of care. Sure, for billing insurance companies it is, but that doesn’t mean that is proven to be what is needed for great clinical outcomes with the clients you like to work with and how you like to work.
Many therapists who don’t want to do this work anymore are really no longer wanting to do the work in a way that doesn’t fit them. Yet, we are raised to fear losing our license so heavily that we become paralyzed with our innovation and creativity.
We have helped many therapists engineer clinically outcome focused services that break the mold of traditional therapy. From walk and talk therapy, intensives, retreats, longer sessions, shorter sessions, it’s all a perfect opportunity to really evaluate if the service you are providing is one that you believe in and do good work in.
Reason #4 You Don’t Want to be a therapist: Clients are draining.
Another reason you may want to quit being a therapist is because of who you are doing therapy with. This is not to blame or shame the client. This is to simply explore that you may have said ‘Yes” to working with people who are not a good fit. Or, something for you has shifted and who you once loved to work with, is no longer the case.
How does this happen? There is often an unspoken code that if you are a helper and a healer, you do not discriminate or turn people away from healing. That would be cruel! You can’t be a good therapist unless you are truly willing to help anyone that comes through your door.
It could be argued that it is quite the opposite, the more clarity you have leads to better clinical outcomes and is better for the clients for you to refer out than to work with them from a half hearted or burned out place. People get better clinical outcomes when they have a focus, speciality or passion behind who they are serving.
Take Sam for example. They loved doing couples work but after their own recent divorce, they find working with couples to be absolutely challenging. We would never suggest that Sam just suck it up and work through it. Instead, we recommend Sam to honor the challenges and changes in their own life and to see where else there might be passion for them to see clients - such as with individuals. Ask yourself if the clients you are working with are ideal for you and make a commitment to only working with those who you feel drawn to support out of ease and confidence, not fear or scarcity.
Reason #5 You Don’t Want to be a therapist: Avoiding the feeling and projecting the solution.
You might be blaming the work of therapy for dissatisfaction in your life that is sourced from elsewhere. Instead of giving ourselves space to feel our feelings and understand the sadness, yuck and muck we can tend to look at our work as what is wrong and what needs to be fixed.
“I went to work today and I just didn’t want to hear another person talk about their pain.”
You can’t address an internal issue from the outside. It has to come from within.
Sure, this could be because you don’t want to do therapy, or it could be that you aren’t well resourced in your own life due to stress and other circumstances. But then it can quickly turn into “the solution could be a career change”.
I can’t count how many times people have come to me wanting to quit, and then with time and feeling they realize what is really going on are things in their personal life - all very valid and real stressors.
Before you jump ship, look at your life and what it is asking of you. Does it need more time and attention, compassion and love so you can then make a decision about your work from a place of grounded confidence and not exhaustion from your daily struggles?
Please don’t go.
Or at least, before you do consider whether your environment or system needs a shift. If you still feel a change is necessary, know that the lessons learned will enrich your next journey. Creating a fulfilling career is about discovering or even inventing paths that bring joy to your life.
Need assistance? Our Business School for Therapists, operational since 2010, has aided thousands of therapists in finding their passion and navigating the financial aspects of their practice. We're here to support you in this journey.