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Building Sustainability Amidst the Chaos

A swimmer floats on open waters, striking the delicate balance between resting and drowning.

Therapist communities are flooded with stories about burnout, exhaustion, and questioning your career choices.

One such story I heard was from Alma clinician Laura Brassie.

With six years in mental health under her belt, Laura thought she had a good handle on things. She had been through the highs and lows of private practice, with all the financial uncertainty and isolation that comes with it. Then the opportunity to join a startup presented itself.

“That was mid-pandemic,” she recalled. “So I was like, I really should have health insurance. I want the stability of a W-2 job.”

The startup promised more than just a steady paycheck and health benefits. It offered her a professional community and administrative support—an appealing package that could make her life easier in ways that a business-as-usual private practice couldn't.

Just when Laura thought she'd found her groove, the ground beneath her shifted. The company went through a major merger, and suddenly, the stable environment she had joined was anything but.

I'm like, ‘this was supposed to be my good job!’ At the time, I thought that I wasn’t going to get a better direct care job than this – it was a pretty good salary. It was good benefits. It was all these things and I'm like, if this is still horrible, I can't get out.

Laura Brassie, Psychotherapy, LMHC, LPC, LCPC

Productivity requirements ramped up. Flexibility dwindled. The stress was so stifling, it made her reevaluate not just her job but her entire career. Laura decided to step back from mental health for a time, to catch her breath and reassess.

“I was just trying to figure out what to do and where to go,” Laura confessed. “I was just like, I need to do something.”

So, she pivoted. Laura started a virtual assistant business, supporting other therapists.

“I kind of decided I could do the virtual assistant job. That's something I have all the skills already; it's fairly straightforward,” she said.

I’ve listened to stories like Laura's more times than I care to count. There’s a noticeable pattern among certain companies and organizations that make big promises, only to push us therapists beyond what's humanly sustainable. These particular bad actors have this way of making it seem like it’s their high-paced highway or no way at all.

But we’re licensed clinicians. That’s not just some certificate gathering dust; it’s our right to build a career and practice that works for us.

Organizations don’t get to dictate your journey. You’ve got options. Maybe it’s tweaking your hours, diving deep into a specific area you’re passionate about, or just stepping back to recharge those batteries.

We’re in a profession where our main goal is to nurture and guide. Let's make sure we're nurturing ourselves too.

If you're contemplating the idea of a breather or making some shifts in your schedule, stick around. Up next, we’re diving into the nitty-gritty logistics of taking that break and making those adjustments, ensuring you find the balance you deserve.

Need: A Complete Break from the Field

There's no shame in admitting you need a breather. It's human, and in fact, sometimes it's the most responsible decision we can make for ourselves and our clients.

As therapists, our well-being directly impacts our ability to serve others. If you're feeling run down, taking a step back isn't just about self-care; it's about professional responsibility. And for those who need to hear it: it’s okay to pause. It's okay to breathe.If you’re considering quitting the field entirely, give yourself permission to take a break first. Time away might be exactly what you need to find your passion again- and to decide what a sustainable career in mental health looks like for you.

Here are some tips if you feel like you need a hiatus:

1. Set a Time Period for the Break.

Whether you’re contemplating a short-term sabbatical or a more extended hiatus, each has its own implications. Short breaks are like pressing a quick reset, while longer ones give you time to recalibrate entirely.

2. Create Milestones.

Instead of diving into the abyss of a break without direction, set some markers. Monthly check-ins, for instance, to gauge how you're feeling, review your financial landscape, and check the pulse on your passion for returning.

3. Budget for the Break

You’ll need to figure out a way to sustain your financial needs while you replenish your emotional reserves. That includes:

  • Estimating Expenses: Mapping out your non-negotiables, your rent, utilities, insurance, as well as variables: entertainment, dining, and the occasional retail therapy.
  • Setting Aside a Safety Net: Before you take that leap, stash away a little extra. Think of it as a cushion for those "just in case" moments or if you find yourself needing a bit more time off than initially planned.
  • Considering “In the Meantime” Jobs: Therapists make excellent employees because of their innate social and emotional intelligence. Always wanted to try your hand at bartending, or just a work-from-home customer service gig? Now’s a great time to explore those whims.

4. Plan a Sustainable Return:

Making plans for a return is as crucial as the break itself. Time away will give you a chance to reflect on your needs, including:

  • Reassessing Priorities: Reflect on what triggered your need for this break. Was it the overwhelming workload? Lack of work-life balance? Pinpoint those pain points, so you can choose a return path that avoids them.
  • Seeking Flexible Roles: There's no rule that says jumping back in means full-time, 9 to 5. Look for roles that align with your refreshed priorities. Part-time positions, teletherapy gigs, or even consultant roles can be your ticket back without feeling overwhelmed.

5. Stay in the Loop:

Just because you’re taking a break from full-time clinical work doesn’t mean you should disconnect entirely from the mental health world. Staying connected will help make sure you don’t feel completely discombobulated when you eventually make your return.

  • Maintaining Licensure: Our field is always evolving- and renewing your license is a lot easier if you don’t let it expire. So, even if you're on a break, keep up on your webinars, online courses, and other CEU’s.
  • Networking: Stay connected, even if it's just casual coffee catch-ups or checking in on LinkedIn. Being in touch with peers keeps you informed and might just present opportunities you hadn’t considered.

Need: Reducing Caseload or Going Part-Time

Therapists are often expected- by companies and by ourselves- to be on the front lines, day in and day out. But what if the best way to truly serve our clients and community is to step sideways, even just a little? Perhaps more therapists should embrace the idea of becoming part-time practitioners.

Reducing hours can foster a heightened sense of well-being, both emotionally and physically. With fewer clients on your roster, you can offer a depth of focus and engagement that's challenging to maintain in a full-time setup. The intimacy of these sessions often leads to richer connections and better therapeutic outcomes.

Now, let's explore how this shift might look:

1. Explore Part-Time or Contractual Opportunities:

  • Negotiating with Current Employers: Broaching the topic of reduced hours doesn't have to mean walking away. By highlighting the potential mutual benefits, you might just pave the way for a more sustainable work structure.
  • Identify Autonomy-Friendly Organizations: If your current role doesn’t have any room to reduce your caseload, it may be time to consider another position. There are organizations, like Alma, that empower therapists to take the reins, allowing them to set their own schedules and caseloads. This model recognizes that clinicians are at their best when they have control of their schedule- and that’s when their therapeutic impact is maximized.

2. Augment with Complementary Roles:

Being part-time can offer the bandwidth to diversify your professional life. Here are a few roles therapists can take on once they have a little more time in their schedule:

  • Supervision: Your expertise is invaluable. Guiding newer therapists can provide a fulfilling contrast to direct client work.
  • Workshops and Seminars: Share your knowledge on specialized topics, connecting with larger audiences and diversifying your reach.
  • Consulting: Your frontline experience is gold to companies in the mental health space. Influence product development, ensure ethics are at the forefront, and bridge the clinician-corporate gap.

If you want to explore potential alternate roles in the mental health startup world, check out Therapists in Tech, a 501(c)3 organization dedicated to elevating therapists into diverse roles in the industry.

Laura made it back into direct practice after over a year of running her virtual assistant business. This time, she chose to work with Alma. Her advice to other therapists feeling the burn? “Believe yourself – take the break.  If you need to be a barista, if you need to be a bartender, if you teach yoga – you do whatever. Don't tell yourself you need to have a big new undertaking!”

Our careers in mental health can be fluid. We can step back, recalibrate, and dive back in when we're ready. To ensure sustainability for clinicians — the lifeblood of the mental health industry — more organizations need to follow Alma's lead, recognizing that when clinicians have control over their schedules and caseloads, burnout can be reduced, and patient care enhanced.

Remember, if you're feeling overwhelmed, the solution isn't always to walk away. Sometimes, the wisest choice is to learn how to rest, not quit.

Your journey in mental health is uniquely yours, and your license has your name on it. That means only you get to call the shots- and if mental health is your calling, you have the right to make your career work for you.

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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.

Article Reviewed by Laura Brassie

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