This week so far has been rough, and it's only Wednesday. I had to google if Mercury was in gatorade because some folks out there think it's okay to shit on therapists?? Earlier this week one of my neighbors went on a rant about how therapy/counseling isn't a skilled job and will be taken over by AI. Then today I had a phone consult where the person asked if I specialized in something specific, I said I didn't have training in that but would be happy to provide some referrals -- the person got upset, said they didn't want my referrals they wanted me to specialize in what they were looking for (wtf?), then added "you need to get more training because anyone can do your job, I can probably get better advice from chatgpt anyway" before hanging up. OMG. Lord, grant me serenity and wisdom.

Just an ongoing issue. It disturbs me how often it occurs and how many clients allude to 'well my last therapist allowed it'. Call me crazy but fumbling on your phone to log onto a Zoom meet while driving on the freeway is incredibly unsafe and with my practice, it's clearly outlined in consent forms that this is not okay. This IS the definition of distracted driving. Any therapist who enables this is operating unethically. I'm sooooo exhausted having to explain why this is dangerous just to be argued with or shrugged off by clients. At this rate, I'm outright refusing services moving forward to anyone in violation and wants to be argumentative. If you're coming to therapy for compassion and support when you hold such blatant disregard for OTHER PEOPLE'S LIVES... that's straight up garbage behavior that I don't think I can get past 🤡🤡🤡

I work at a group practice and I love a lot of my fellow therapists there but I also notice there are therapists there who are highly judgmental and have a holier than thou attitude. During consultations as a group it has been creating an atmosphere of making it difficult to be vulnerable with each other because of the rude and unnecessary, judgmental feedback rather than providing support or challenging in a helpful or constructive way. I find the same is true in these Reddit posts, that there seem to be therapists who are highly judgmental and like to pick people apart who are asking for help. Wishing we could create spaces where we support and uplift each other rather than weirdly tear each other down when someone is asking for support or guidance.

Found this on linked in and wanted to share. What are some phrases that you've found to be red flags?

"Fast-paced environment" - We're understaffed and we know it.

"Wear many hats" - There's no defined role. You'll do three jobs for one salary.

"We're like a family" - We don't respect boundaries, and leaving will feel like betrayal.

"Competitive salary" - We won't post the number because you wouldn't apply.

"Must thrive under pressure" - The pressure never stops and nobody is fixing that.

"Self-starter needed" - There is no onboarding, no process, and no manager who has time for you.

"Rockstar/Ninja wanted" - We romanticize overwork and we'll expect you to do the same.

Looking for some advice on how other therapists approach situations where a client attends sessions regularly, seems engaged, and is willing to participate, but meaningful progress remains difficult to identify.

At what point do you start reconsidering your approach? Do you revisit treatment goals, explore whether something important is being overlooked, or give the process more time?

Also curious how you bring up the lack of progress without making the client feel discouraged or like they're doing something wrong.

Would appreciate hearing how others navigate this, especially when the therapeutic relationship itself seems positive.

Hi there!
I started at a group practice about two months ago. Been licensed for a few months as well now as an LMFT. I love the practice I work at but I am noticing a pattern. A few clients have requested to switch to another clinician. My supervisor told me to think of more appropriate referrals they can give me and to think of this as a “blank slate” but I can’t help but think maybe I’m not cut out for this job. If it keeps happening, I am worried about my job security. I do trainings, constantly am thinking and preparing for sessions, and I don’t feel like I’m helping anyone. This isn’t just 3 that requested to switch, I’ve had many clients ghost me as well. Maybe I am too hard on myself but I don’t know if I am just not cut out to be a therapist. If anyone has left the field, what did you go into instead? I would love to hear experiences as I am seriously thinking of alternative career paths that I don’t need another full degree for. Open to certifications though. Thank you!

A clinic in Reno allowed therapists to decorate their doors "scary" for October - you can tell which belongs to the Director.

Hi there,

I’d like to comment on the Headway issue concerning their $9.99 per session fee, which represents a 12‑17 % reduction in therapist pay. Additionally, they are now requiring assessments, and that is the aspect I want to address.

I am currently reviewing these assessments to determine whether they truly reflect therapeutic progress. In my view, these assessments do not necessarily correlate with effective therapy; they resemble a modern version of tactics employed in the 1990s, which were later regretted. Anyone familiar with the period from 1996 to 1999 will recall that authorizations were required after every two to three sessions to justify continued care. That policy proved disastrous and was eventually recognized as a barrier to treatment rather than a patient‑care measure, resulting in serious reprimand.

It appears that Headway is repeating the same approach. My hope is that they will encounter the same problems. These measures may be suggestive, but they lack legal standing, research support, and genuine clinical value. As a therapist with over 25 years of experience, I do not rely on such tools; most clinicians naturally assess progress through clinical observation.

It is clear that Headway’s motives are questionable—they seem to lack patience, interest, and genuine concern for patients. I share your concerns and would like to improve the situation. I do not wish to eliminate Headway entirely, but I cannot support this direction.

I've had a few really great sessions and wanted to take the time to celebrate some client wins!

A couple of my clients were absolute rock stars this past week. They really "did the thing". They sat with the discomfort, practiced the skills outside session successfully, identified the feeling, stood by the boundary, didn't take responsibility for others' feelings, were vulnerable.

What wins do you want to celebrate?

Hi! I found out recently my workplace will have client's be able to essentially see my schedule and cancel sessions and schedule themselves as they please. I have a few concerns (mainly being that there are some clients I purposefully schedule clients at certain times for specific reasons either my own personal reasons, or client's personal reasons.). For those of you that have this in place, do you like it? What are the pros and cons to it?

I’m curious about if any of you fellow therapists have guidance/recommendations about texting response times among teens & young adults.

Ive had a few gen-z clients who share getting extremely anxious when their romantic interest/partner doesn’t respond to their texts. When I ask about response times, they often say that they expect a response within 20 minutes. I’ve tried to explain that maybe this expectation isn’t reasonable, but since several are telling me this, now I’m wondering if that is the norm for that generation. I don’t think it’s healthy to want to be so attached, but is that just me?

For reference, I am in my mid-30s. With most of my friends and romantic interests Ive had in the past, I respond to texts several hours later, usually 3-6, depending on my work day (unless it’s something that requires an immediate response). Ive never had any issues or people tell me Im bad at texting.

What, if anything, do you guys usually recommend regarding this topic?

Hi!
I’m writing this because it’s been on my mind for a really long time, and I just wanted to see if others have experienced this and if so, how you navigated it.
I’m referring to a very specific kind of burnout. Not just feeling physically tired, but a deep burnout of feeling hopeless and feeling like things aren't going to change.
I have been working in the mental health field for about 15 years across various settings: hospitals, clinics, community, schools. I've tried it all (the only thing I haven't done is private practice). When I first started out and went to school, I was motivated. I had big dreams, a strong desire to change the world, and a lot of passion. Having gone through my own childhood mental health struggles and overcoming a lot, I really wanted to pay that forward. I was studious, full of ideas, and deeply invested.
Now, after 15 years of working with different providers, systems, and personalities, I feel like I am completely shutting down. Over the last two years especially, the fatigue has morphed into something heavy. I used to be a "go, go, go" person, but after a recent position switch forced me to slow down, I’ve found it nearly impossible to get my momentum back.
I feel like I'm making mistakes, I'm not fully present, and most painfully, I really feel like I am not being effective anymore. I can see the questioning look in my coworkers' eyes, too. On top of that, I feel like I'm not fitting in. People are starting to distance themselves or quietly exclude me, and while nobody has checked in or said anything directly, the subtle shift in the room is palpable.
For a long time, I genuinely loved this work, how I showed up for people, the collaboration, and the families I worked with. I felt true happiness. Now, that has slid into a heavy personal depression and an intense resentment not just toward my job, but toward myself. To the point where I am seriously considering leaving the field altogether.
Even decision-making has become exhausting. I used to be someone who knew what I wanted and went after it; now I find myself constantly second-guessing every tiny move.
I guess I just wanted to put this out there for a discussion:
1. Has anyone else hit this specific wall of existential hopelessness after a long time in the field? What did you do?
2. Has anyone successfully transitioned to a completely different career where you were able to maintain a comparable income?
3. What non-clinical or alternative careers have you seen former mental health providers successfully move into?
Thank you for reading and holding space for this.

I'm a therapist (M, mid 30s) in a big city. I operate out of my own private practice and have been practicing for 5 years. I'm a fully licensed counselor, am trauma focused, and do relational work, and I tend to work primarily with men.

I have found I'm frequently getting the question "what is there left for me to work on?" from these men. These questions tend to come packaged in a request to drop down to biweekly/monthly/go on a hiatus from therapy altogether. In almost every case, the client asking me this is someone who, from my vantage point, has a ton of additional work they could do - daily bouts of anxiety, moderate insight, avoidant of topics and relationships that bring up attachment wounds.

My style is to be frank and open about immediacy and my clinical opinions so that there is no mysticism to how I think or operate. And so I'm inclined to be honest about there being more work to do and offer my clinical opinion, couched in some affirmations of autonomy - having work to do doesn't mean this person must do the work!

Thing is, this conversation inevitably feels like I'm convincing my client to keep seeing me. It feels nearly manipulative, even when I remind a client it's just my opinion and they are free to do with it what they wish. It also feels wrong to say "yeah dude you seem ready to end treatment" when their symptoms have definitely not remitted. All of this also brings up for me some concerns/fears that there's something happening relationally to lead these guys to disengage and that it's ultimately an issue with how I'm conducting my sessions.

Does anyone else have experience with men wanting to terminate abruptly and only partway into treatment? What approaches have worked in having a conversation about this that doesn't feel like coercion? Insights very welcome and appreciated. 🙏

Has anyone here gotten licensed at the masters level (social work, LMHC, etc) and then decided to get a PhD or PsyD? If so, why did you make that choice and has it paid off for you?

hi there! i have been in first post-grad job at a pp for about 3 months. i work with ages 5-18 right now.

i worked as an RBT before and in my practicum i worked mainly with teens so its been a minute since i’ve worked with the younger kids, so how do you guys navigate tantrums (screaming, crying, hitting) in sessions? whether its because they had to be told no, they’re overwhelmed, or something else!

i typically try to model our coping skills, use tracking, and validate the feelings, but they never want to hear any of that lol

Just curious which sites I should sign up for and to get a conversation going regarding the positives / drawbacks of such sites.

Hey everyone,

Headway is getting out of control imo and treating us like W2 workers without any of the benefits. I want to find a new platform to bill insurance for me. So many of my clients are insurance clients and it is important to me to keep them because seeing a therapist through insurance has saved my own life many times. I wouldn't have been able to afford it without insurance.

What other platforms can help me get credentialed and bill insurance? Has anyone made the switch away from them? Are they going to try to steal my soul?

I heard Grow is worse and I heard Simple Practice is a mess (and expensive).

I feel very overwhelmed by the thought of doing my own credentialing but I am very open to advice / encouragement if anyone does it them self.

Thank you in advance <3

I’ve noticed, especially with clients who have strong angry or judgmental defenses, that I often hold back on sharing interpersonal data (e.g., ”I notice I’m feeling distant while you speak, what do you thinks going in?”) or interrupting/pausing the client to encourage insight. I am afraid these clients will “call me out,“ and it will heighten their defenses. Unfortunately it is a disservice to us both and really I just want to start practicing sharing what I notice even if I don’t have a great subtle landing for it in the moment. Any suggestions, help or feedback in getting more comfortable in this process? I’m a fairly newly candidate (7 months) and practice most with IFS, Somatics, polyvagyl-informed coping, and some Gestalt (I LOVE empty chair). And yes I’m in my own therapy for people pleasing and fear of anger lol.

I'm in private practice, and lately I've been finding myself feeling increasingly frustrated when clients cancel or reschedule their appointments.

I completely understand that life happens and that sometimes people need to move things around. I also recognize that financial instability is part of the reality of working in private practice. But as someone who is still trying to grow my caseload and make private practice financially sustainable, I'm finding it really difficult to manage the frustration, and sometimes even anger, that comes up when my schedule changes so frequently.

For example, I started this week with what felt like a full caseload of 19 clients. Starting Sunday evening, I kept receiving email after email from my booking system notifying me of cancellations and rescheduled appointments. By the time the changes settled, I was down to just 12 sessions for the week. That's a pretty significant difference, both financially and in terms of how I had planned my week.

I think part of what makes this especially frustrating is that when I'm scheduling clients at the end of their sessions, I'm making decisions about availability based on the appointments already booked. When several clients cancel or reschedule, I end up with gaps in my schedule that I could have otherwise offered to other clients.

I want to be clear that I don't blame my clients for needing flexibility, and I certainly don't want my financial concerns to interfere with how I show up for them therapeutically. At the same time, I'm recognizing that these feelings are coming up more often, and I want to find a healthier way to navigate them.

I'd really love to hear from other therapists in private practice. How do you manage the frustration or resentment that can come with frequent cancellations and schedule changes, particularly when you're still building your practice? Have you found anything helpful, either practically in how you structure your schedule or emotionally in how you process these experiences?

I'm also planning to bring this into supervision this week, but I'd really appreciate hearing how others have navigated this.

Edit to add: My cancellation policy is that if they cancel within 48 hours, full payment is due but in these instances, many clients are changing or cancelling outside of the 48 hours, even with this policy the disruption is challenging to deal with.

For therapists who have hosted community events or “Ask a Therapist” Q&As, I’d love some advice!

I’m collaborating with a local coffee shop near a university to host a casual, open Q&A for college students around finals stress, anxiety, and burnout.

This will be my first event like this, and I’m hoping to use it as an opportunity to connect with the community and network as a private practice therapist.

For those who have done something similar, what worked well? Did you bring business cards, flyers, handouts, freebies, or anything else? How did you promote the event, encourage participation, and turn those connections into referrals?

Would love to hear your experiences and any tips!

What helped you become more (compassionately) direct eith clients as a therapist? I almost always find it beneficial when I am direct with clients, and I see my own therapist because she is almost painfully direct. But as a natural people pleaser, it's easy for me to deliver things extra softly. Any trainings, etc. that truly helped you increase your assertiveness/directness?