Each week, I coach at least one therapist who mentions that they are considering leaving the therapy field.  This sentiment seems to have increased among psychotherapists in the past two years with challenges related to COVID (for therapists and clients), including a) sickness, b) working from home, c) relational and family transitions, among others.

Of course, each therapist has their own particular reasons for their desire to leave their profession. Also, from my interaction with thousands of therapists each week, I have noticed several common challenges emerge in conversations about leaving the field. 

1 |  Clinical “Overwhelm”

While I generally dislike using “overwhelm” as a noun, it seems to be the best word for what therapists experience when their clients present with multiple, complex crises.

Clinical overwhelm presents as:

• Not knowing where to begin with clients

• Struggling to facilitate goal-setting

• Feeling fatigued or “annoyed” with clients’ stories (a.k.a. “content”)

• Questioning one’s knowledge, or expertise

While some of these challenges are commonplace with therapists new to the profession, when they are a consistent experience of a seasoned practitioner, they point to a deeper struggle, perhaps related to other pain points on this list.

2 | Low Pay

Sure, many therapists are successful financially, and therefore are able to experience a buffer against financial stress. On the other hand, therapists are also striving to earn a decent income and facing barriers posed by competition, including big tech mental health providers and an increased percentage of therapists offering online therapy across state lines. In addition, low Insurance reimbursement and/or low referrals to their practices are income-related stressors that therapists are frequently communicating in our discussions.

3 |  Restrictions and Oversight

State boards rule over licensed therapists’ practices (in states where therapists are licensed). They dictate continuing education, scope of practice, location of services, and even, at times, how to document sessions. Due to living through some unexpected freedoms during the pandemic, such as working from home, and the availability of cross-state practice due to temporary telehealth licenses, therapists began to wonder how they could maneuver making these freedoms more permanent.

Some therapists have grown weary of dealing with restrictions, and are seeking the flexibility of a coaching business, or online education business, over the rigidity of a licensed profession.  Further, this transition has happened naturally for some psychotherapists, as their services expanded due to demand during the pandemic. They are now left with the decision of returning to restrictions, or embracing their new, expanded services.

4 | Professional and Personal Growth

Personal and professional life cycles may override our desires to remain in a comfortable, or even enjoyable position. Therapists have found that while the profession is “good enough,” they are growing past the time when it was energizing, or exciting. They also have reevaluated their priorities, and recognized that their relationship to their work and/or profession has shifted, in order to make room for new dreams.

5 | Burnout 

Holding space for others, year after year, takes its toll. When we suffer, without having a system for self-care, we feel the effects as exhaustion, irritability, depression, and more. Therapists have discussed with me the “deep drag” of burnout resulting from overscheduling, personal conflicts, health struggles, and compassion fatigue. Some have made it to the other side, by taking time off and creating a regimen for rejuvenation. Others have realized that this field is not for them any longer.

Summary

The purpose of this post has been to normalize your feelings, if you have found yourself considering leaving the field of mental health. You are not alone!

Let’s Chat

Let me know, in the comments below:

• How are you feeling in the profession, lately?