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Therapists: You're Not Ineffective, You're Exhausted.

A hand holds a charred, smoking piece of palo santo wood in total darkness.

It was 2015, and I was a Master’s Level Social Worker applying for entry-level customer success roles.“Burnt out” seems like too nice of a term to describe what I was experiencing just a year after graduation. “Charred” might fit the bill a little closer.I had a caseload of over 40, and I’d reached a point where I cried in the car on the way to most of my appointments.

I'd love to tell you that I buckled down, found some inner well of inspiration, and carried on by sheer force of will. But the truth is that I almost quit. For good. After one year.At the last minute, right when I was talking to my husband about Starbucks’ excellent health care benefits, I scored an interview for a dream job: therapy work with teens in a school district. It wasn't just a career move; it was a soul-saver.

Unfortunately, not everyone gets that Hail Mary pass.

According to the APA, almost half of clinicians report feeling burned out. Many of these 'charred' therapists hit the exit and don't look back, leaving a field they once cherished. And the proliferation of high-caseload, low-wage mental health company models isn’t helping matters.

The Lie of Individual Ineffectiveness and the Unraveling of Therapist Well-Being

There’s a harmful narrative circulating that goes like this:If you're burnt out, overwhelmed, or just plain exhausted, you're just not meant to be a therapist.

Let's be clear—that's a story designed to divert blame from systemic issues onto individual shoulders. Don't buy it. (And don’t be duped by the trite self-care advice either. Lighting a scented candle is hardly a match for a caseload that feels like a freight train. You're not failing at self-care; it's the hollow concept of self-care that’s failing you.)

Here’s what’s really going on: the landscape of mental health care is changing, fueled by venture capital and a drive for scale. You're not expendable; you're a skilled clinician caught in a business model that doesn’t allow you to function at your best. These high-caseload, low-wage paradigms aren't accidental; by design, they maximize billable minutes at the expense of other concerns. For some therapists, a 30+ caseload might be manageable (and if that's you, more power to you!) But if it's not, hear me clearly: you still belong in this field.

You went into mental health for deeply personal reasons that make you perfect for it- the compassion that led you here is what makes you so well-suited for your work.  Your skills, empathy, and experience are desperately needed. But with the changing landscape in mental health—fueled by venture-capital-driven models — many of us are being pushed to the edge faster than ever before.

So, before we dive into the specific signs that could indicate you're nearing a meltdown, I need you to understand that these classic symptoms are exacerbated by the new strains on our profession. Recognizing these red flags is the first step toward reclaiming your well-being – and holding this industry accountable.

Recognizing the Need for Change

Now that we've unmasked some of the systemic culprits behind your work-related stress, let's shift gears to you—the individual therapist. While the industry's escalating pressures may be to blame, knowing the personal signs of burnout is the first line of defense in maintaining your professional and emotional health. Below are therapist-specific warning signs that your stress isn't just routine job fatigue but an urgent call for a change of pace:

  1. Feeling Emotionally Worn Out: We all have days when we're not running on full emotional juice—that's just part of the job. But if you find yourself counting more days where tapping into your well of compassion feels like a chore, you're veering into burnout territory.
  2. Dragging Through the Week: You're doing all the self-care you used to do, but it's not enough to get you to the weekend. Once there, the weekend doesn't seem long enough to recover before the cycle repeats.
  3. Going Through the Motions: You catch yourself watching the clock more than engaging with the profound truths waiting to unfold in your office.
  4. Physical Symptoms: You're getting stress headaches. You're not sleeping well. Your jaw is constantly clenched.
  5. Doubting Your Impact: Intellectually, you know you care about your clients, but that heartfelt empathy is AWOL. You start to question if you can even be effective without it.
  6. Mental Fog: Concentration is a struggle even with the coffee gallons you're downing.
  7. Strained Personal Relationships: Your empathy tank is so drained, there's nothing left for family or friends – and they notice.
  8. Unhealthy Coping Mechanisms: The wine or nightly Netflix binge is more about numbing than pleasure or relaxation.
  9. Second- Guessing Your Career Choice: You find yourself daydreaming of a 9-5 gig with zero emotional labor involved.  "Should I have been a [Insert Alternate Career Here]?" is becoming a recurring thought.
  10. Alarming Mental Health Decline: Whether it's a sudden need to adjust your meds or even darker thoughts creeping in, your own mental health is setting off alarm bells.

Recognizing these signs isn't an admission of failure; it's the first step toward reclaiming your career and, more importantly, yourself. It's an invitation to examine what's not working and to take actionable steps before you hit a point of no return.

It's also a chance to push back against the increasingly prevalent corporate mindset that views therapists as expendable gears in a larger machine—there to meet quotas and then be discarded once they're 'spent.'

Therapists preach self-worth, boundaries, and the importance of self-care to their clients. Now, it's time we exercise our right to apply these principles in our own professional lives.

Design Your Own Path in Mental Health Care

You don't have to keep suffering in silence, and you certainly don't have to hit the emergency eject from a field you're more than qualified to be in.

You're not just a 'therapy robot' to churn out billable hours until you're replaced by the next model. You're a clinician with unique insights, wisdom, and empathetic skills that are irreplaceable.

There are clients out there who need exactly what you have to offer, and they're the ones who will make you remember why you decided to do this work in the first place. By taking control of your work environment and pace, you can fully engage with these clients without losing yourself in the process.

It’s time we build a mental health career that works for us—the clinicians—as much as it does for the clients we care about. Maybe that means scaling back your hours, diving into a different work setting, or shaking up your role entirely. Whatever it is, you have more control than you think.

Still skeptical about hitting pause or making a shift?  My next piece is a deep dive into how other therapists have navigated taking a break without throwing in the towel completely. From sabbaticals and workload shifts to side hustles and total career reinventions, we'll explore how you can breathe new life into your work—without leaving mental health behind forever.

Stay tuned while we reframe what 'being a therapist' can mean– and do it on our own terms.

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A painting-like image of Megan Cornish, sitting in front of blurry bokeh-style lights, wearing a yellow jumper.
Megan Cornish

About the Author

Megan has a Master’s degree in social work from the University of Washington, and is a licensed clinical social worker with hands-on experience in clinical mental health. For years, Megan assumed she'd practice as a social worker until retirement.

She planned on supporting her creative, entrepreneurial drive (and financial obligations) with her writing side hustle, but while devoting most of her time to one-on-one clinical work.

Then... her career path changed. As a result of a cross-country move and new family obligations, Megan was forced to walk away from my social work dream job — but she vowed not to walk away from her commitment to mental health.

And with the mental health industry's radical changes, she had the chance to improve mental health outcomes on a larger scale with her unique combo of mental health and communication skills.

Over the past several years, she has had the honor of working with some of the world’s most exciting mental health startups.

Megan's vantage point allows her to see tensions in the industry, and she doesn't want to sit by and watch them grow.

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A therapist and their client seated at a café table in wishbone chairs, with the therapist taking notes on a clipboard.
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