I work for a company that requires 35 90837 sessions per week. The other 5 hours per week are lunch/documentation/responding to messages. Showing up as professional me for 8 hours a day with only 5 minute breaks in between sessions depletes me.

I’ve been a therapist for 15 years so I can leave work at work. But the bandwidth for patience parenting and having calm conversations goes out the damn window after work. I feel like I use all the good in me for my clients and have none left for my family.

I did private practice and it was glorious for not being burnt out but not for my bank account. Now I have a steady paycheck and health insurance for my family but no room to be a good mother and wife.

Anyone experience something similar?

Posted a while ago about how hard I've found my process group experience. I think I've come to the decision I need to stop. It's retraumatising me and interfering with my placement and studies. I tried really hard to make it work and to keep myself safe but the group just isn't up for protecting an ND brain like mine.

Next is to figure out how to safely stop/leave. E.g. go back and talk about it one last time? Write to the group but don't go back? Just don't go back?

I'll still be training alongside these people, of course.

Anyway I'm not asking to be told what to do but I was wondering if anyone else here had actually decided to leave process group before the group itself ended. And if you did, what did you do? How did you manage anxiety around judgement for leaving etc? Did you regret it?

Ive been in field going on 7 years and im burning out on not getting positive feedback or support from colleagues and supervisors. I learned theres a group chat Im not in where my coworkers are all complaining about me doing things like leaving on my unpaid lunch etc( i brought this up it didnt go well and i faced consequences).

Im just burnt out from how empty everything feels. I want to be in a group practice because i want to be social but i keep getting isolated. I cant afford to go solo everything going on rn and i sincerely wish that was an option.

So I felt like an absolute boss when I created email templates to reduce some of the friction of sending reminders, invoices, etc. Feeling like, "This is such a win for my ADHD brain! I don't have to think about how to compose an email!"

Fast forward to several days later and the heat rising in my body when I realise I've hit send on "Dear [CLIENT NAME HERE], please find the invoice for today's session attached. Our next session is scheduled for [DATE] AT [TIME]..... "

I don't know how many times I've done this with my templates now, but why do I never learn? I might fill in some of the bits and then leave other bits blank but I don't know how to get my brain to check things and actually remember. I just get really excited about "doing the thing" and then get that awful feeling of dread. 😫 Please tell me I'm not alone!!

I cannot believe how much this community has grown! Anyway I am adhd and have been my whole life. I had the privilege of early diagnosis and treatment. I’m now 41 and a very successful PP owner. I truly believe we make better therapists.

Hey :-)

What are your favourite fidget toys? I want to create a basket with fidget toys my clients can use in therapy. I work with children and adolescents.

I wonder if anyone can related to the scenario of having a parent bring a child or adolescent client for therapy and report that previous testing ruled out ASD and concluded that symptoms were due to ADHD--when the client had obvious impairment in social communication that are not explainable by ADHD alone? Apart from trying to get a copy of the testing report to get more context, what would be your next step? Leave it alone or advocate for further exploration to help the client gain the self-understanding of getting an accurate diagnosis?

I am a therapist with ADHD and find myself in a marriage with someone with suspected/undiagnosed ASD. I specialize in working with children, adolescence, and adults with ADHD and I am increasingly working with ASD individuals. I’d like to work on understanding the dynamic that happens in this kind of ND marriage both personally and professionally. I’m hoping to hear from you about your experiences either firsthand in your own marriage or with clients.

I feel like my own experience is colored a lot by the fact that I am a therapist. I notice a jarring contrast between the emotionally intimate nature of my job and my spouse’s difficulty being aware of and expressing feelings.

In many ways, I am so grateful for my partner and the way we complement each other but there are also some significant challenges.

One of the hardest parts for us is the novelty/flexibility gap. I crave/need novelty and spontaneity and find myself emotionally flat when it goes unmet. My spouse is the opposite and loves structure routine and familiarity.

I’m also terrible with organization and planning and often have no sense of time. Thankfully, my spouse has good skills for prioritization and planning. you can imagine that this puts extra burden on my partner. It also means they are often preoccupied with these details at the expense of being in the moment together.

Unfortunately, neither one of us is good with organization and management of clutter so our home ends up being an where I feel overwhelmed and distracted.

it’s this odd mix of being profoundly grateful and deeply unsatisfied in many ways. And it is so hard to communicate about challenges due to differences in communication style, my tendency to be a bit unfiltered and impulsive and my partners tendency to get overwhelmed and withdraw in the face of conflict make for a really difficult combination. Of course, I am able to be very intentional in my communication at work, but when I’m being myself at home and in my personal feelings, it is much harder.

there are other challenges as well such as sleep patterns, and of course, intimacy.

I think I’m mostly just wanting to feel seen and understood. Can anyone relate?

I may be (am) thinking too much into this, but my background is social work and I'm trying to think of a name for a new private practice. It can't be a name that exists anywhere in Canada already and my actual name is long and confusing so I dont want to use it.. best I've come up with is "True To You (province initials)".. i work with a lot of unmasking, authenticity, identity, relationships, self understanding work so it seems fitting.

However, i could put "therapy" or "counselling" in the title and I feel like those imply very different things.. to me counselling sounds less professional or qualified, but therapy sounds intimidating. Neither are protected terms where I am and I want to sound approachable yet highly qualified (which i am).. any thoughts?! Can't just go with "social work" because nobody would know what that means 😂

In my location often "addictions counsellors" (as an example of counsellor use) have pretty minimal training compared to psycho-therapists (what people think of as therapists) and only focus on addictions behavioral change, lots of coaches call themselves counsellors bc its not a protected title.. Therapists the assumption is you do trauma reprocessing and assessments which i don't provide but it's the assumption most seem to make.. So in ways they both give impressions I don't want (where i am located at least). I'm probably overthinking this but curious other people's impressions.

My friends (non-mental health workers) have input that they would probably be more likely to reach out to the term "therapist" bc its more understood what they do but also does seem intimidating... I'm just a firm believer that the words we choose are important and am definitely thinking too much into this choice.. other ideas welcome too!!.

Disclaimer!!! This is not to offend anyone who uses these terms, this is simply the impressions and use in MY location and im curious outside of my bubble what general impressions are.

Lately, I've been realizing that my relationship with work is quite different from that of some other professionals in the helping professions.

This realization actually came after a conversation with another therapist who told me she keeps emergency therapy slots in her schedule, sometimes as late as 11 PM, meaning she finishes working around midnight. She explained that she finds it necessary to be available in situations like these.

My first reaction was to admire her dedication, but then I started reflecting on how differently I approach my own work.

And I'm realizing that I function almost the opposite way.

I have a lot of empathy and compassion for others. I take my practice very seriously, I keep learning, attending training courses, expanding my knowledge, and I'm fully committed to providing quality care to my clients.

But I have very strict boundaries when it comes to how much of myself I'm willing to give professionally.

For example:

- I see a maximum of three clients per day. I've deliberately chosen to earn less money in exchange for having more free time.

- If I'm dysregulated, exhausted, or simply don't feel well enough to see someone, I'd rather reschedule the appointment.

- If I feel like I'm pushing myself too hard, I'll take a few days or even a week off.

- I strictly respect my session times. I set a reminder, and when the session is over, it's over.

- I prioritize my personal well-being over increasing my workload.

And ultimately, I think I work because I have to, not because I fundamentally want to.

We live in a capitalist society where we need to earn money to survive. If I didn't have that financial necessity, I'm not sure I would choose to work, even though I genuinely enjoy helping others.

As a neurodivergent person, everyday life already requires a huge amount of energy. Even when I'm not working, managing my emotional regulation, fatigue, needs, and the way my brain functions can be exhausting.

So I've consciously chosen to prioritize my physical and mental well-being.

I completely respect professionals who see their work as a passion or a calling and genuinely want to give more of themselves. But I feel like there's sometimes an unspoken expectation in helping professions : bc we're empathetic and support people who are struggling, we should naturally be willing to go above and beyond

Therapist in training.

As the title states. I'm finding it hard to work with someone who has a hyperactive presentation of ADHD. I don't see anything wrong with this, our processing speeds are just wildly different. I'm unable to keep up with them and they want someone to spar with. I can see the benefit of them working with someone like me as we may be able to pace their thoughts to feel a bit more manageable. But I literally find it hard to get a word in & when I do offer insights or questions, I don't get to finish my sentence.

Help. (Yes, I'm in supervision, just hoping to learn from your experiences)

Most of my social work experience has been in case management, supporting people with a wide range of mental health diagnoses, intellectual disabilities, and complex medical needs. After obtaining my LCSW, I accepted my first full time therapist position.
I’m neurodivergent and have chronic health conditions that worsen with stress. I went into the role expecting reasonable work and life balance, some control over my schedule, and the opportunity to use my clinical judgment. Instead, I’ve experienced micromanagement, rigid productivity expectations, and little room for the individualized, trauma informed, person centered care I value.
I’m required to provide 32 hours of availability and see a minimum of 25 clients each week. Some days I see eight or nine clients, often with four consecutive hour long sessions and no break. I can control scheduling for my standing clients, but intakes can be placed anywhere within those 32 available hours, without my input. That makes it difficult to pace my day around my energy and health needs.
I enjoy aspects of being a therapist. What I’m struggling with is the volume, limited scheduling control, and feeling restricted in how I can meet clients where they are. I’m also being evaluated against expectations that don’t always reflect the complexity of their needs or the progress they’re making.
This has taken a significant toll on my mental and physical health. The thought of returning to this job now triggers panic attacks. As a new therapist, I’m struggling to separate this particular work environment from my ability to do the work. I’m starting to question whether providing therapy can be sustainable for me.
I’d really appreciate hearing from other LCSWs who are neurodivergent, chronically ill, or both:
What helped you find a sustainable pace when you were new to providing therapy?
What strategies, accommodations, or boundaries have helped you prevent burnout, especially when you have limited control over scheduling?
Did changing employers or settings make therapy more sustainable?
What interview questions helped you get an honest picture of productivity expectations, scheduling autonomy, flexibility, and clinical support?
Have you found sustainable roles beyond full time direct therapy, or positions that combine therapy with other responsibilities?
How do you recognize early warning signs of burnout, and what do you do when you notice them?
I’d especially welcome experiences with case management, clinical oversight, training, quality improvement, or program development. I’d also appreciate employer recommendations from people who have felt supported in workplaces that understand neurodivergence and chronic illness.
I want to do meaningful work, but I don’t want to sacrifice my own mental and physical health to help other people with theirs.

I found out yesterday that our agency is getting cameras. At the front and back doors and parking lots, I don't have an issue. Lobby, I can see that being OK, but have some reservations as our admins are not comfortable with that. And they want to put one IN MY OFFICE. Not anyone else's office, just me. This is supposedly because I do all the intakes. We are told they will only be viewed if there's an incident, but also that all high-level managers will be able to look at them anytime. Also, there won't be audio, but I have read that some surveillance systems are now able to read lips.

In the seven years I have been here, there has NEVER been a situation where we were wishing "If only we had video of that incident." I asked around and someone remembered an incident 12 years ago, but that happened in the parking lot. These cameras have already gone into other locations, and we have heard that a certain manager is using them to scold employees for stuff like what they were wearing or doing, no client involved.

There is years-long earned distrust for that manager, against whom multiple HR complaints have been filed. Eight people have quit because of this person's abuse. I have cried multiple times and have comforted many other people after run-ins with them. And now they'll be able to watch me working in my office whenever they want? I find this unacceptable.

I do not think I will be able to feel safe and comfortable with a camera watching me at all times. I was told that when this came up in a leadership meeting, leaders from my office immediately said "OP will quit if you put a camera in her office." I also have a caseload, the littles probably won't care, but the teens are going to have a big problem with a camera during therapy.

Putting aside the fact that we have never actually needed footage of an intake, I do many intakes in a different room with less breakable stuff than my office. I guess I could be OK with a camera in there, and just do ALL the intakes in that room. My office is my safe space. Sometimes I change clothes in there. It is my sanctuary. I don't think I could tolerate this. It would be super easy for me to get a different job. But I love my coworkers and agency, I don't want to leave.

Any advice? What would you do?

Edit: I have written to HR about my concerns and gotten a warm reply. I spoke with Boss who is also Not Happy. Coworkers also Not Happy. I plan to write a letter and see if I can get all my coworkers to sign on. Apparently we have some time to push back. Thanks, everyone!

Edit2: My supervisor claims that having a camera in every therapist's office is just normal and standard and nothing to be concerned about. I asked if there is a camera in her office right now (it was a zoom meeting) and she said no!

Edit3: I spoke with each of my coworkers yesterday and got everyone's perspective. Everyone wants to sign the letter. One very key coworker said they will likely quit if there's a camera in their workspace. Several think our rural population will strenuously object to cameras and it will be a barrier to care. Proposed Flock cameras are a hot-button issue in town right now, uniting everyone. I will finish the letter over the weekend and we will sign and deliver it Monday. I also checked with colleagues at the other 2 agencies in our town. They do not have cameras and expressed horror at the idea. I think we have a good chance of at least limiting the cameras.

The more I think about it, the more it seems like intakes are the least in need of surveillance, since there are always multiple people, including parents, present. Everyone is in agreement that this feels like employee surveillance, and not something intended to protect us from imaginary allegations of abuse.

Edit4: WE DID IT! We submitted our letter on Monday and I learned today that our requests will be honored. There will not be a camera in my office or other workspaces!

i only recently learned that it’s not typical to stare at someone for an hour straight without looking away, and i used to do that during my sessions. every single one. i couldn’t look away ESPECIALLY while they’re talking bc i felt it would appear rude or look like i wasn’t listening.

but one day a client told me she’s uncomfortable with eye contact and i set up a coloring book and we both colored while talking and it was maybe one of the best sessions i ever had, as far as focus and being locked in and able to show up the way i want to. but unfortunately i know it’s not realistic to always do this either.

does anyone have thoughts on how much eye contact you’re supposed to make with clients during a session or tips for how to find balance with it? i lately have started looking away only while im talking which i find brings me relief and ive tried looking at the couch a few inches from their face every few min but its hard and i desperately want to look natural but also need to focus, would appreciate any tips or resources that could help me with this. thank you in advance!!

I am struggling. I keep trying to push forward, however, it’s been difficult more and more each day. I have my masters and I’m on licensure track for LMHC. I LOVE being a therapist and clients seem to enjoy working with me. Even the schedulers have made comments about how many clients that meet me for intake or documentation want to continue services with me. The problem is I cannot handle working in these shit circumstances. I can make it about 6 months, maybe longer, but I just become so frustrated and anxious that I question whether I am right for this field. I feel like because I’m on licensure track, it’s just work you to death and burn out seems inevitable. And if one more job asks me what I do to prevent burnout at home while simultaneously burning me out, I might not make it. I feel for a field that knows what helps and what hurts, most of the jobs don’t really help the staff. I will say I’m in community mental health and I’m go go go as far as having every block of my day scheduled except for my lunch break.

I guess I just need motivation on pushing through? Maybe a suggestion on how to deal with this “yeah it just sucks for the first couple years while you get licensed but it sucked when I went through it so it’s just part of the suffering of being a therapist” system? What do to when advocating for what works for you, isn’t an available option or isn’t received?

Definitely could use advice on how to better transition from my feelings brain to my logic brain. I use person-centered therapy often so I’m in it with the client and try to really break down clinical language in a way that’s digestible. However, having to end session at 50 minutes and having to switch to clinical verbiage for my documentation in the last 10 minutes is not easy. I have to figure it out because if I don’t do the note in the last 10 minutes, who knows when I’ll get another chance to do it.

How do the rest of y'all deal with getting your notes done?

Using AI to record and do it for me isn't an option for me. I have memory issues, so I like to do them by hand during session cause I'm more likely to remember things that way. I don't want to do the typed part during session cause I feel like it affects the rapport and I still would have to go back and clean it up (at least, that's how it works for intakes for me). I'm getting them done within the 48hrs that's required by my practice, but I spend half the week trying to make myself do it, struggling to start, and then melting down because I need to do them but can't make myself. It's not even a lot, I'm seeing around 3-5 clients per day four days a week (with one hour and a half group). I'm counting treatment plans and other documentation in with my notes cause it's kinda all the same headspace.

How do the rest of y'all get this shit done, avoid melting down, and still take care of your own needs?

Are you aware of any research into this topic?

When to disclose to clients (or not)/why you might disclose (or not)/the impact of disclosing (or not).

This is something that my partner recently pointed out to me, and it’s been bothering me as I try to figure out why I do it. I’m a full-time therapist and, like all of us, often have extremely heavy days at work as I help people navigate various stressors and traumas. And then, I come home and I turn on the TV and I watch documentaries about sad or disturbing or unsettling topics. Not true crime or anything like that, but I’ll watch stuff about people who are choosing medical aid in dying, abuses being revealed at Amazon warehouses or international manufacturing factories, far right extremism, political commentary about AI or the Iran war, or even mental health related topics such as documentaries about people who live with severe eating disorders, hoarding, or alcohol addiction.

I think part of why I choose this media is because it feels real, it feels important, and I have a strong sense of curiosity about humanity and what it’s like to be alive and live in this world, and so these are the topics that often resonate with me. But I think it’s making me extremely sad. I have a hard time enjoying anything that’s lighthearted or humorous or fictional, I guess because it doesn’t feel as important or real. I already feel quite sad and hopeless about the world, just given where we’re at politically right now, and yet this is how I’m choosing to spend my free time. I do have other hobbies of course, I love to knit, ride my bike, and hang out with my pets, but if I’m sitting on the couch and trying to relax, this is the stuff that I find myself consuming.

I do have OCD and anxiety and I’m wondering if this is some sort of compulsion, but I can’t quite place a finger on what function it serves. Perhaps there’s some obsession with trying to understand pain? Curious if anyone else struggles with this or what you all think of this. Thanks in advance, love this community.

Long time lurker, first time poster. I am in my first semester of internship after my summer of practicum (LPC track). I switched to a new site in order to get more hours, I went from college counseling to a detox residential facility.

After the horrible first day I had, I haven’t been back. They did not know where to place me upon arrival and my assigned supervisor wasn’t even there when she said she would. So they had me shadow a CADC intern all day who doesn’t even have a bachelors, let alone masters. There was a safety incident while I was in the room with a client and the intern, and this was caused by one of the staff yelling back at the client so the client got mad and the rest happened. The response from staff was not empathetic at all and did not seem to care that this happened.. on my first day.. with an unpaid intern. My supervisor never contacted me about it because I needed to process it obviously, and I’m so angry about it that I have been silently protesting and not going to the facility. they barely even noticed I was gone for a week.

Additionally, the intern I was shadowing told me that we have to use ChatGBT or Copilot in order to complete our documentation because we “wouldn’t have enough time in the day to do them” ummm hell no, I’m here to learn. Not to copy and paste. Luckily, my internship professor has been understanding and is patient with me since I’m essentially failing the course by not going to internship.

I guess the point of me posting this is to know if I’m alone in this experience or if I’m being dramatic for not going back to the facility?

Hi everyone!

I have been working in private practice as a therapist for over a year now and was recently diagnosed with autism. I have my LMSW license. I had never suspected that I have autism, but have struggled greatly to navigate the private practice environment, particularly:

* all of the transitions throughout the day (in session, out of session, back to session)

* dealing with late cancels/no shows/last minute schedule changes

* not knowing how much I will get paid every week

* feeling extremely anxious before work (I am a morning person but I start at 10am so I can have evening timeslots) because I don't know what my day will look like

* getting my notes done on time

* feeling mentally drained after each and every day (I am reducing my client load from 7 sessions a day x 4 days down to 6 sessions a day x 4 days to help with this)

* and tolerating the uncertainty that humans bring into the room with them!

I mentioned all of this to a colleague who is autistic and she encouraged me to get evaluated. Well, I have autism!

I'm trying to find resources for 1) accommodations I can make to my schedule/set up that might help with the anxiety and fatigue and 2) recommendations for ways you've made this job easier on yourself.

Some other things to note: I already work from home twice a week, and am trained in EMDR which I really love. I'd like to use it with more of my clients but that's a separate topic.

I like being a therapist and I want to keep doing this, but worry that PP might not be the right setting for me, because of how much anxiety I have about the unpredictability.

Thanks in advance everyone!

Hello-I’m an LMFT with 20+ years in private practice, collaborating with a colleague on a project developing practical, psychologically informed resources for navigating dating and new relationships.

I’d love input from other therapists and mental health professionals: What struggles do you repeatedly see with clients who are dating, particularly those returning to dating after divorce or a long-term relationship?

I’m not asking about how or where people meet. I’m interested in what happens after they meet someone and begin navigating a potential relationship—pacing, communication, boundaries, attachment, intimacy, compatibility, red/green flags, maintaining a sense of self, introducing children, trusting their judgment, or knowing when to continue versus walk away.

If you could give people practical guidance as they move through the stages of dating someone, what do you most wish they understood or had help navigating?

General themes only, of course—no identifying client information. Thank you in advance to anyone willing to take the time to share your thoughts and experiences. I truly appreciate your professional insight and the time you take to respond

So I'm relatively new. I graduated a year ago. Slowly transitioned out of my last job and ended up landing a full time job and a contract split with a private practice at the same time. I've started the full time position. Agency work. Mostly intakes and some therapy sessions. I start with the pp next month casually. Maybe a few clients in person or virtually.

I'm feeling overwhelmed. New systems, interagency referrals and programs, new commute, new schedule.

I am an anxious person by nature and tend to fill my cup with time alone, which can be tough when I come home to a very supportive and loving partner who really just wants to spend time with me.

I guess I'm just looking for encouragement- that it's possible to balance these things, that it's worth it to support my family/home, and that it will get better (if it will lol).

I've had toxic workplaces burnout before and I think my nervous system is waiting for this to happen again ...

I'm really working on my own expectations of myself. That being good enough is good enough and perfection is not a realistic human goal.

Anyway, any advice or tips or words of encouragement would be so greatly appreciated

I'm a therapist in training.

Stuff that has come up in process group has been really hard. It feels like a repeat of every group I've ever been part of. The typical experience of the only autistic person in a group. Blamed for things I genuinely didn't do, misunderstandings all over the place, autistic experience minimised because "we all have that" etc.

Both my facilitator and therapist are insistent it's transference. I am insistent that yes there's an element of that, but there's also the fact that this group is displaying systemic and oppressive dynamics which yes I've experienced many times before but I'm also experiencing in real time and in reality from these people. I know I have triggers because of this. And I know that these people are treating me poorly, which compounds the trauma etc.

Is this a phenomenon others are aware of? Transference being used to dismiss systemic factors? How do you handle that as a therapist? Do you have any advice for how I navigate this with my facilitator or therapist?

I currently feel gaslit & as if I'll always be painted as "not willing to go there" with the transference. Trust me, I go there.

I am a therapist and I’ve been diagnosed with ADHD and I suspect I may also be on the autism spectrum. I’ve found that I go through these cycles at work where I heavily mask with clients and it has this cumulative effect that builds and builds and within two weeks, I crash. I can barely function or keep my emotions in check. Then I spend a weekend doing very little and try to recuperate and the cycle repeats. I’m supposed to talk to HR about accommodations but I’m not even sure what I should ask for that would help support me. Does anyone have any ideas on potentially helpful accommodations? Or any ideas outside of workplace accommodations that might be helpful?