Why are so many therapists experiencing burnout?

Spoiler alert. It isn’t because you are bad at your job or because you aren’t doing enough at work.

Burnout happens when there is a misalignment between our needs and values and our workplaces needs and values. There are often larger systemic reasons that directly impact us and our mental health. Read more below!

Over the past few years, a spotlight has been on the mental health crisis and providers. When Covid-19 started, a lot of people had anxiety about the impacts on themselves and loved ones. Businesses and cities were doing their best to keep people physically safe while trying to remain calm and not hurt business. Families were being torn between trying to stay connected to folks while also staying safe. There were a lot of changes with work, school, and our hobbies. All of this impacted our mental health.

With the changes and uncertainty, a lot of people started to reach out for therapy! Plus, with a lot of people working from home or therapist changing their services, telehealth was becoming a common and effective tool for people to get support. I saw a lot of people sharing more openly about their mental health, getting various supports, and challenging the stigma around mental health. It was so encouraging to see the amount of people reaching out for therapy for the first time and finding time to prioritize their needs.

How did this impact therapists?

Most therapists enjoy the part of our jobs where we get to interact 1:1 with clients! It is why most of us got into this field and for some, it really fills their cups with energy and purpose. So what was different? During this time, a lot of therapists were going through life and experiencing the same things as their clients which can make things tricky. Even if a therapist has a similar experience to a client, oftentimes they have worked through that experience or are able to get supervision or consultation to make sure it doesn’t impact therapy. This time was tricky because it was an ongoing trauma/stress that had a lot of uncertainty and big feelings. Therapists are human and had their own feelings around covid, worry for family, and wanting to balance doing great work while also taking care of themselves. It was a hard balance to find!

Therapists are not immune to feeling guilty. As helpers, we have this urge to want to do all the things and help all the people. We feel immense guilt when we aren’t able to. When therapists were filling their caseloads, many of them shared how much guilt they had turning someone away. It is so hard when someone reaches out and wants help, then to say you are full or you don’t match up. If you have read my other blog posts, you know how powerful guilt is and how it impacts us, even trained therapists!

Also- if you have read my blog post about work-life balance, it applies to therapists too! This means that therapists have to learn to set boundaries with their workplaces and sometimes clients. This could look like limiting your caseload or referring clients out. When therapists tried this, many said they felt guilty or like a bad helper. It brought on shame and disappointment.

Therapist work-life balance also means that therapists have to prioritize their needs at times. It means therapists need to get their own support. Their own self-care routines and habits. This is actually SUPER hard for a lot of therapists. Again, guilt is a major factor. We also experience imposter syndrome, anxiety, stress, and may not know how to do some of these things ourselves. All things that make us human AND can make being a helper hard at times.

So what causes burnout in therapists?

The systems we are in. You don’t get burned out simply because you don’t like your job enough or because you’re a bad helper. In fact, many people didn’t get burned out from the client aspect of the job, but rather the other aspects we had to do. Being a therapist is more than directly seeing clients. We do paperwork, bill insurance, make phone calls when insurance claims are denied, get training, have meetings and supervision, and more! Some people travel for work. Some people prep groups. All this to stay, our jobs are busy! Many therapists don’t get in the field wanting to do hours of paperwork or deal with insurance companies. We want to help people. So when caseloads increased- so did many therapists extra responsibilities and that became a lot to manage.

I saw this a lot in community mental health. This is not to say that private practice owners can’t get burned out. We can. But community mental health agencies are in a lot of different systems, often with competing goals and values so juggling ALL of that can be exhausting. Many community mental health workers also do not get a lot of say in their schedules, caseloads, documentation, etc. so all of that can build up and impact a person’s mental health.

Community Mental Health

I can only share my experiences but I know I am not alone. When I was working in community mental health, management was not always supportive and understanding of my boundaries and limits. We are taught in grad school to do self-of the therapist work and know when we need breaks but in the real world, places were not honoring those. They needed money and would rather fill up my caseload than listen to my scheduling needs. The problem is, many people in management systems at community mental health places are removed from the day to day work that it takes to do our jobs. They think paperwork can be done in 5 minutes (lol) so why would I need a few hours a week? They didn’t care that I needed evenings to unwind after a long day to take care of my own mental health and they wanted to make sure we could see as many people as possible because that looked good to the community. On top of all that, they expected me to work over 40 hours a week for a barely livable wage. My experience is not unique. If you’re reading this and can relate, I hope you find your way out of burnout like I did.

My story

So fast forward to now, and I am thankfully out of that system and actively work to empower and advocate for therapists! It also benefits clients too, because despite what you may think, if you’re burned out- you’re not giving your best work to your clients.

If you’ve known me for a while, you’ll know that private practice was never in my plan. I never had the desire to run a business or work from home. I loved the agency concept and being around others and helping people get quality mental health services. When a supervisor suggested I try part time online private practice, I laughed at the idea because who would want to private pay for therapy from me? I had an annoying inner critic that was preventing me from flourishing and thriving. Once I challenged that, my whole world changed. I found myself being inspired and excited to work again. I found a new sense of confidence and competence that I didn’t know I had lost. I ignited a creative part of my brain and realized this was the path for me.

So what shifted?

I personally needed the freedom with my schedule and caseload. I needed control over when I saw clients and when I could take breaks. I needed to compensate myself fairly for the years of schooling I did and amounts of training and testing I did to get (and maintain) my license. I needed to be free from insurance systems and grants that controlled what I could and couldn’t do in treatment and what documentation I needed. I needed to be able to listen to my body and work in a way that set me up for success. Those may not be your needs, and that’s okay! What’s important is that YOU find your work values and needs for success.

Starting a business was terrifying for me because it was a spur of the moment decision and not something that I had envisioned for years to come. I thankfully had amazing mentors, watched all the trainings, and built up an amazing network of people because even though I was a solo practice, I didn’t have to do this alone. I learned that is wasn’t weak to ask for help. I learned that I can be successful and not know everything. I learned that people are happy to help. I learned to push myself and problem solve. I also grew a new passion of helping others who walked similar paths that I walked.

I am not saying the only way out of burnout is to start a business or even quit your job. But in my story, it was the right thing to give me the freedom and flexibility I needed to prioritize my mental health. I remember what it was like to be burned out, confused, lost, and helpless and I don’t want other therapists to feel that way. I don’t want people to feel alone and isolated, especially when we have all this technology that can connect us! If you are thinking about starting a business, I would love to stand in your corner and help you get out of burnout and back to enjoying your job! Learn more about therapist resources here.

Final Thoughts

Whatever you do, keep kicking butt! Figuratively, of course. The great thing about our field is that there are so many options and we can do what is best for us. We need you to take care of yourself so you can continue to do the meaningful work and help others. So start small, try some things out, and find what works for you.

Stay tuned for an upcoming blog on boundaries ! Sign up HERE to be informed of new blog posts and resources.

Alicia Johnson, LMFT

Online Therapist in Ann Arbor and across Michigan, Florida, South Carolina, and Oklahoma.