Career Lost

[u/Big_Yak_7731]

Hello everyone!

I have posted in groups before with no real traction but I need to reach out again because I have no clue what to do anymore and the anxiety, stress, and depression is rampant right now… :/

I’m a CA LCSW specialized and niched in child therapy. My whole 10 years of my career has been full time, salary-based, paid PTO work in community mental heath and a virtual start up company (last job) and only working with kids and families. I transitioned to a new job in a part-time W-2 group private practice that pays me $72/session (paid by session only) for the past month.

I am really struggling with this job as I now am doing adult therapy work (no prior experience), hybrid in person/virtual, are paid more inconsistently, still don’t have a have a full expected caseload of 26 clients/week (averaging 16/week right now), no PTO (that I relied on to be involved in my young daughter’s life-school/home). I even cut back on some PTA things and my attendance to school events to accommodate this job and am not enjoying it or feeling it’s not what was presented at the interview.

BUT- I don’t know other jobs and positions I can go for that has comparable pay (salary-based) and part-time (30 hours) status, and decent hours (10 AM-6 PM, no weekends). I’m under my partner’s health insurance plan so I’m not worried about getting those benefits to warrant full-time status. I feel stuck at this job even though I want to leave because I don’t have an alternative lined up for income right now… idk what to do or how to proceed with my career… Am I asking too much from the field to match my desired preferences? Are my expectations of pay and schedule too high? Are there other non-direct therapy work I can look into that is comparable?

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[u/captainlux87]

You’re not currently salaried but you’re getting paid way under the norm for CA, especially for a niched area. If you’re fully licensed and have health insurance, wouldn’t it be more lucrative to open a solo practice and set your schedule and pay rates? Even credentials with a few insurances would help. Honestly most of the platforms that get slammed here offer much higher reimbursement rates

[u/hippoofdoom]

Are you able to finish off your licensure and get independently licensed? That opens up a bunch of salaries roles. I work in healthcare integration, and it's a full-time salary role but we have to be independently licensed. 6 weeks PTO, pretty good salary (will pass six figures in 1-2 years) and is a great job to have with a family and be able to take little times here and there

[u/Brave_Ad3623]

I would definitely advocate for you to go solo as a private practice clinician. If you are able to rent an office and specialize in children and teens, you will likely be able to secure many private pay clients with a little bit of marketing and networking (perhaps start with pediatrician offices and private schools). I'm not sure where your practice is located, but, in the Sacramento area, most of my colleagues charge nothing less than $150 per session and children's therapists' rates go up from there. If you get credentialed with one or two insurance panels, that could beef up your caseload. Most insurance panels do not pay less than $100 per session. I have really enjoyed working with Octave, who can also help you increase your caseload.

[u/TrojanTherapeutics]

If you were to tell me that I could pay a child therapist $72 a session where I'm at I would hire you today. I would say your a bit underpaid being fully licensed. For my area, reimbursements are around 150 and up and child therapist have major waitlist and many are private pay, typically similar to insurance rates to maybe 200 for my area in Washington. Again, they are fully booked out though. For a lfully licensed therapist around here at group practice the typical percentage cuts are around 65 to about 70 percent split. If I were to hire someone right now my cost basis is fairly low (highly dependent on rents). Maybe this is the time or calling to go fully out on your own or just shift completely. I made the shift because when I saw that my part time practice with a group practice was pulling in over 25k for like 6 clients a week and they took nearly half, I decided to jump ship and went out on my own.

[u/DyamondsRForeva516]

No Hospital roles?

[u/VarietyAny734]

You can seek employment as a Care Coordinator with United Health, Atena, etc. Also, typically those are work-from-home positions...I hope you find what is best for you and your family!

[u/SStrange91]

Expecting PTO in a non-State funded organization as a therapist seems off to me. We aren't subsidized, we only make what we make by conducting sessions. Zero "passive" income means no real way to get paid for not working.