Why Therapists Quit

Curt and Katie chat about the systemic reasons that therapists leave the profession. We look at the work environment, the infrastructure of community mental health, as well as the frequent ways that therapists set up their own private practices. We also identify changes on a systems level as well as calls to actions for individuals who would like to continue as a therapist.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

In this episode we talk about why therapists quit:

• Challenges in the mental health system leading to therapists quitting the profession
• Why therapists don’t stay therapists when they wanted to stay therapists
• Obstacles and lack of opportunities
• The lack of quality of supervision or inadequate training for other elements of the job
• The lack of research on therapist workforce issues
• Not a lot of empathy for therapists as we “chose” to do this
• Caseload sizes, the weight of carrying the challenges of many people

“With these curated caseloads or these very specific programs, it feels like the whole world is experiencing this same type of trauma, or this same type of challenge, and it becomes very heavy.” – Katie Vernoy, LMFT

• Niche fatigue and hearing the same story over and over
• The challenge of holding the hope for clients and communities
• The heaviness and the boredom of hearing so many similar conversations
• The full workload including paperwork and other consultations, case management and advocacy
• Who is drawn to the work, the desire for deep and meaningful work, and the problems of the bureaucratic system in providing meaningful work
• The training doesn’t match the actual job
• The status quo and inertia in the work, while at the same time that all the changes that happen in the other pieces of the profession
• Productivity standards and billing, differences in philosophy
• Systemic problems with under and unpaid services and requirements
• What we’re asking from the professional organizations and the challenges that professional organizations may have in advocating for these types of systemic changes
• What could actually move forward in legislation
• The issues related to antitrust
• People are more concerned about our patients than about therapists
• Why clinicians in all settings (including community mental health, private practice, etc.)
• The sameness of the workload when you’re in private practice
• The isolation as a therapist
• Increased demands with higher demand, less delineated work/life balance
• The appeal of a job where you can just show up
• The weight we carry as business owners, including decision-making and responsibility to generate income
• The benefit of diversifying your caseload

“Quality of the environment around you is something that directly affects the way that we end up approaching our jobs and therefore client outcomes.” – Curt Widhalm, LMFT

• Calls to action: advocating for quality workplaces, finding peer support, setting boundaries for yourself throughout your professional journey, what we can do if enough of us make these changes
• The time is now to address mental health systemic problems – shining a light on how we are well-situated, making sure we are paid, and sharing messages to support the community

Our Generous Sponsor for this episode of the Modern Therapist’s Survival Guide:

Heard Bookkeeping and Tax

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Plans begin at $60 per month and can easily be tailored to fit your business’ financial needs. You can schedule your first consultation at http://www.joinheard.com.

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below might be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

NY Times: No One Has Openings

The Rand Report: How to Transform the U.S. Mental Health System

Relevant Episodes of MTSG Podcast:

Quarantine Self-Care for Therapists

Toxic Work Environments

Antitrust for Therapists

Who we are:

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also Past President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

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Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm 0:00
This episode of The Modern Therapist’s Survival Guide is brought to you by Heard Bookkeeping and Tax.

Katie Vernoy 0:04
Tax season is about to get a whole lot easier. As a mental health care professional dedicated to your own practice you’re probably more familiar with your session notes than with your financial records, and this time of year can feel stressful and daunting. Luckily Heard Bookkeeping and Tax is a platform designed to help you track the financial health of your practice and alleviate the stress around your business finances. Built specifically for therapists Heard offers affordable bookkeeping services, personalized financial reporting, and tax assistance to ensure clinicians make the most of their business.

Curt Widhalm 0:37
Schedule your first consultation at joinherd.com That’s join herd j o i n h e a r d.com.

Announcer 0:46
You’re listening to The Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 1:02
Welcome back modern therapists. This is The Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast where we talk about all the things that affect therapists. And today we are looking at Why do therapists quit being therapists? And we’ve discussed a number of these things on our podcast through the years, many of them in a positive light of people with side hustles, people looking to expand their practices, people who have bigger messages to share, people who start podcasts and conferences and this kind of stuff. But looking at the overall mental health workforce, there are a lot of reasons why many of them are things that we just kind of know: the pay is crap for a lot of positions. The case loads are high, the number of hours required of positions often extend beyond those that are paid for or advertise, the work life balance can be atrocious. Why do we quit? Katie?

Katie Vernoy 2:17
Just as you were talking about that, I was like, so many people are just so tired. It’s ah and I feel like it’s even worse right now with a pandemic, because there is not a lot of other distractions. There’s, you know, we did a, an episode about this. So I won’t go too deep into why it’s so hard to be a therapist during the pandemic. But I think back to my own career trajectory and if I would have stayed, my goal would be right now: I am either the clinical director or executive director of a community mental health organization. That’s what I wanted to do. And that is totally not what I’m doing. And so I think it’s, it’s something where the focus of this episode we tried to kind of grapple with how do we talk about this, the focus of this episode seems to be why do people not stay therapists when they had planned to or want to. Because I think there was a recent article in The New York Times about how a lot of people are trying to find therapist and just cannot. We have a workforce issue, we have a mental health access issue and part of it is that we can’t keep therapists as clinicians like doing the clinical work long enough, or they don’t, or that, you know, we can have a whole conversation about saving psychotherapy with Ben around why they don’t become therapists because the vetting process or the gatekeeping is too intensive. But to me, I feel like there’s systemic things that probably are huge and daunting and maybe won’t feel helpful, but maybe validating around why people don’t stay therapists. But maybe we’ll come up with some individual things that people can do to try to stay therapists if they want to. But to me, I can only speak to my own story, I became very burned out. My ability to advance was better than others, but I think there are, there are a lack of advancement opportunities and a lack of setting people up to successfully advance. The system is run by therapists. And therapists aren’t necessarily good at training other people to be supervisors, to being managers. There’s, once you move into more of a diverse workload, so to speak, where you’re managing people and you’re doing programs stuff, all the stuff I loved to do. There’s not necessarily the training or sufficient training around how to do the other pieces. And so we lose the upper end because they aren’t doing a good job. And so then we don’t also have quality supervision for the folks who are doing clinical work and that doesn’t pay very well and the like all the things that you talked about. So to me, it feels like systemically. We’re not making being a therapist, especially in community mental health, that appealing.

Curt Widhalm 5:24
I’m glad that you said that. This is something that’s anecdotal, because when I look at the research of why did therapists quit? Where are the retention problems for therapists? The research shows basically nothing. That this is something where, again, research into therapists workforce issues, seems to be something that is not funded, not looked at very well, and probably contributes a lot to these very problems. And the research that is out there, that kind of applies to us tends to look more at general physicians, it looks at nurses, it looks at other things that are maybe a little bit easier to study, because so many of those positions are based in hospitals and kind of easier things to track people in. And those research things seem to apply very much to therapists sort of things as well as we hear anecdotal stories from everybody. Better pay. Better manageable case loads. Having good work environments to work in with supportive colleagues. And probably most importantly, is we kind of work in thankless jobs, that…

Katie Vernoy 6:48
Oh, yeah.

Curt Widhalm 6:50
Despite us moving into this profession, to help people, to wanting to improve the world, to helping people better understand and live with mental illness, even in private practice, where we might have a more cultivated clientele. We tend to see people at their worst. And when they get better, they disappear from our lives, and they are replaced by somebody else at their worst. And even for very long term clients, I have several clients that I’ve been working with for several years, and being able to see them through their ups and downs, it’s not like we really get to celebrate a lot of things very publicly when things are going well. And this becomes a huge factor towards isolation. Of, we don’t get to celebrate wins, we kind of complain to each other about when things are difficult. But when we do complain for those who aren’t in our profession, the criticism is, Well, if you don’t like it, why are you a therapist? that…

Katie Vernoy 7:57
This is what you signed up for.

Curt Widhalm 7:59
Exactly. That there’s, you know, and you get the other half of this message, which is just like, your job must be so fulfilling and what you did. Yeah, I mean, I love being a therapist working with clients. I’ve very deep and meaningful two way relationships with many of my clients that I get benefits out of too. And there’s a grind of seeing clients week in and week ou, that is just burdensome, because it does inherently have this self sacrifice of I have to be present for other people and on many hours out of every day.

Katie Vernoy 8:43
Yeah. And I think when you talk about the cultivated caseload for private practitioners, and I think this also aligns for very specific, like, evidence based practices with specific grants and community mental health, the caseload is pretty similar. And I know when I was working in the Welfare to Work program in South Los Angeles, there were times when I felt like I was hearing the same story, tackling the same challenges, session after session after session after session. And also feeling the weight of the system and the systemic racism and inequity and all of the things that our clients are facing. But again, behind this, behind this divide, where I’m not I can publicly advocate but I can’t necessarily celebrate the win, or shout from the mountaintops a specific challenge of my client. I mean, obviously, there’s variations around advocacy and that kind of stuff, even within the clinical work. But it feels very much, and I remember one of my supervisees long ago saying I can’t hold the hope for this client or this whole community, all the time. It’s exhausting. And with these curated case loads, or these very specific programs, it feels like the whole world is experiencing this same type of trauma or the same kind of challenge. And it becomes very heavy. And honestly, and maybe, maybe I will be lambasted for this, but it kind of gets boring. I feel like there are times when, and I’m sure we all experienced this in the pandemic, I think you even made a joke about like, all of the notes are like: talked about COVID. Like, it’s, it’s something where, especially with a global crisis that people are facing, and granted, people have individual things that are going on separately, but like, every conversation feels so similar. I feel pretty fortunate because I’m not experiencing that as much in this moment. I think my boredom is outside of my therapy practice right now. That’s a whole other conversation. But I think that this compassion fatigue, boredom, dissociation, desensitization, whatever it is this kind of holding so much, especially when your caseload is gigantic, or extremely curated, especially towards trauma, in my experience, it just feels like it’s hard to do, or both, or all of the things. I want to just shift a little bit because I think that that we’ve talked about this a lot, but I don’t know that we’ve talked about what the workload actually means to therapists, especially in more of a mental health, community mental health kind of setting. Or even in a private practice, where you’ve not set your fees at a rate where you can say, like, I’m going to see 15 clients, and then I’m going to do yoga, or whatever it is, like I think it’s, it’s something where when you have your caseload really high, there’s all of the paperwork that comes, that associates with it, whether it’s Department of Mental Health kind of paperwork, where you’re doing lots and lots of documentation, it could be writing letters for court, or it could be in a, you know, interacting with parents, or it could be sitting on the phone with an insurance company, or whatever it is, there’s all of this additional work that’s in the background. And I think systemically, especially with a lot of government funded mental health programs, therapists are relied upon to do work that is not therapy. And I may have talked about this, but I literally had clinician standing by fax machines, this is how long ago it was, but standing by fax machines, and waiting for reports to go through to the welfare office. And, and still having to meet the same productivity standard around billing, because that’s how we got the money. But there was all this administrative stuff. There was case management stuff, there was stuff that was not necessarily either paid for or paid for at the same rate where therapists were just grinding away and not actually getting to the rich clinical work, which you know, Maslow, Maslow’s hierarchy of needs, we do need to take care of base level things. But we don’t necessarily have to be the ones doing it as clinicians.

Curt Widhalm 13:14
Part of this is who gets drawn to this profession? People who want to find deep meaningful work. Congratulations, everybody. I mean, we like that, but doesn’t work in such a bureaucratic system that requires such output like this. And we’ve talked about the divide between graduate education and then the real world. One of my private practice associates recently was talking about her supervision in community mental health, where she was initially told Kate, you’re not in grad school anymore. This is, this is actually what your job is. And it being completely a different experience altogether. So part of this is we just kind of keep moving the goalposts as far as when people actually get to do the things that they want to do. And that the training doesn’t necessarily match which yeah, these are things that we’ve talked about over and over and over again. An added piece is despite so much status quo-ness, everything being the same, that our field’s kind of being stuck in a lot of ideas of: these are things that we’ve always done. This is why this particular thing works. There’s constantly changing requirements from licensing boards, from funding services, that we end up with almost this weird thing of like, all of our clients sessions end up being largely the same. But all of the dancing around and training and education that we have to do in the background to keep those conversations with clients the same ends up becoming this other aspect of burdensome sort of work. Oftentimes, un or under compensated, and a tremendous amount of requirements that in community mental health, that if you want to go to a certification or training or I don’t know, take a few days off, that your productivity standards are still required to be met. That those aren’t days that you get to plan to take off, where your productivity standards get to, to move in sync with that. You just have to overburden yourself on other days that are there as well.

Katie Vernoy 15:36
And that’s not across the board. But yes, I’ve definitely heard that. And I think it’s something where this goes back up to the systemic level, which is there is a certain amount of money that you have to bill, and the only people who can build it are therapists. And then if they have them, social skills, or advocates, or case managers, or those kinds of things that social skill trainers. And so those folks are paying for everyone, all of the administrative support, all the billing support, all the supervisors who are not seeing clients, all the all the managers who are not seeing clients. These folks who are providing services to clients are required to bill at a certain level. And so the budgeting around that is huge, huge weight on the clinicians and the other mental health service providers. And so, some organizations are able to make it so that it’s like, yeah, you have to build up this rate, and we have enough people, and this is what we’re paying, and blah, blah, blah, and you can take your training days, or you can be sick or go on vacation and your productivity is not affected by it. And then others are like, well, you know, people who take a lot of sick days, or who are constantly out or training a lot, or doing all that stuff, like they’re carrying less of the load. So it’s fairer to have everyone have this is how many hours you bill per month, regardless of your if you’re here or not. And so, even so, like there’s different, you know, budgeting strategies, it still means that the people who are providing the services, the need and mental health services are also having to hold up the system, where there’s a lot of unfunded mandates. There’s a lot of bureaucracy. There’s a lot of underpayment of services. I was reading the RAND report, we’ll link to it in the show notes, but it’s talking about how there is a suggestion, it’s a wild suggestion, that you actually pay for services, evidence based services, at cost, versus underpaying it. And this was something I was, you know, advocating and screaming it from the mountaintops when I was in Community Mental Health like this is this is an unfunded mandate, you know, and getting so upset because the systems are not getting enough money, but they still rely on clinicians and other mental health service providers to do all the work. And so that’s hugely onerous.

Curt Widhalm 18:11
I, I’m gonna put you on the spot here a little bit. Why aren’t the professional organizations advocating for this stuff? I say this as a former board member of a professional organization, and knowing fully well, that you might might have a little, little position here that for the next couple of months might might get you into some lukewarm water. I served several years on on one of the professional organization boards. This seems to be the place where some of that advocacy stuff could happen. From your perspective, why don’t you see stuff? I’ve got my opinions, but I’m throwing this question at you.

Katie Vernoy 18:56
All right. All right. So I am not speaking for the California Association of Marriage and Family Therapists. Nor do I wish to in this moment, but I think CAMFT actually does a pretty good job at advocating for different mechanisms for MFTs to get paid. And so that’s an element of that. As far as generally professional associations not advocating for this stuff. I think there’s a lot of different reasons given. I think that the focus or the charge that professional associations are given can sometimes be focused on very specific goals that may or may not support this type of stuff; like workplace stuff, or identifying ways to make sure that things are fully funded versus underfunded, or workplace settings, or those kinds of things. I think, when professional associations take on their charge to try to make the profession to advocate for the professionals under their care, they have to make decisions. And I think the low hanging fruit within our society, oftentimes are either parity for different types of clinicians, which does kind of trickle down to more pay. It can also be overarching mental health access or decreasing mental health stigma or making sure mental health services generally are funded. Or it can be little nuance-y little things where it’s making sure that there’s this further in the future goal that can be reached. But this little step needs to happen and it’s going to take a big lift. All of that to say, these are gigantic, oftentimes organizations where they are gigantic ships rather than little sailboats, right, like they can’t move quickly, oftentimes to address little things. And if they, if they’re going in a single direction, it’s very hard to shift course, and identify; this thing would make a big difference, this thing would make a big difference and like actually shoot out and take care of those things. It’s like, here’s something that looks like it’ll make a difference. Let’s sail forward in that direction. So obviously, I’m being very vague for a lot of reasons. But what are your ideas because I feel like I’m…

Curt Widhalm 21:26
So I’ve got kind of my top three, and congratulations on your corporate board sort of speech there. The number one job of most professional organizations is to run the professional organization itself, in order to stay solvent and stay in business. Number two, is to address many of these systemic issues around mental health is that the advocacy efforts do not get heard by politicians, unless it deals with patient care, and clinicians are kind of largely thrown out as being any sort of factor in it. Your job as a clinician in a community mental health position, means pretty little to a person making a decision on a legislative floor, that well, well, they, you know, I’ve never met a politician or a staffer who doesn’t like as a person care. But as far as a bill goes, being like, hey, we need to treat clinicians better and like bump up their pay a little bit, means nothing to any sort of advancement of any sort of legislative bill. And number three is the implementation of these things, professional organizations largely have to stay hands off as far as how it goes as far as running an agency or running a community mental health department, due to antitrust sort of things, due to just kind of not being the ones who run those businesses, because they don’t represent the businesses, they are the agencies, they represent the people who come and pay their dues to the organization. And so what ends up happening around this communication from these organizations that offered lots of good individual benefits, is they speak to here’s things that you as the individual can do, but they don’t speak to here’s how to run your business better in order to take care of your employees, very often. And so this leads to a lot of the individual responsibility that is so inherent in our profession, that leads to a lot of this burnout, that we have this, you know, overarching, like, well, you’re working with one person, so it talks about how that one person can change things. That puts a lot of the systemic burnout that you’re talking about, onto individual responsibility factors. Despite these organizations being collective representations of all of us speaking to these very systemic problems.

Katie Vernoy 24:06
You said that way better than I was saying it.

Curt Widhalm 24:08
Well, I had time to prepare and think about this, during the first part of the episode, rather than just having…

Katie Vernoy 24:15
You liked, you liked putting me on the spot. I think, even in how, like we we’ve talked about continuing education, no matter where we land, it always feels like people are more concerned about, and I’ll use the word patient because it makes it clear, people are more concerned about our patients than they are about us. And so everything has to be framed around how this impacts mental health care, the mental health of our society, individual patients, you know, and and even looking at how does this improve the homelessness problem in my community? How does this, it becomes about how does this help me me as an individual, whether I’m a legislator or a community advocate or whatever, versus how do I help the people that are going to solve this problem for our society?

Curt Widhalm 25:11
It’s so those who have gone through community mental health, who see, you know, the greener pastures of private practice or, you know, untethered work when it comes to government contracts, or this kind of stuff, even if it’s shifting over into taking insurance contracts. Why are those people quitting? Why’re people who, you know, feel chewed up by the community mental health system, the agency system, the rehab drugs abuse center, sort of, you know, the people who are taking that leap? Why do we see those people quitting?

Katie Vernoy 25:53
Ironically, for the same reasons. I mean, I look at my practice, I look at the practice of folks who are either my consulting clients or colleagues or any of that stuff. And there’s: you’ve niched down, you’re having the same conversation, you’re holding space for a lot of folks that need a lot of emotional care, you know, whether it’s from themselves or whatever, just it’s, it becomes heavy. I know for myself, and this was something I actually talked about with, you know, a colleague. I liked the diversity of my workload in community mental health. And so solely seeing therapy clients has never been sufficient for me. I can’t just pack my caseload with therapy clients, because I want to do systemic work, I want to do leadership work, I want to do podcasting, or whatever, like, I want to have these other things. And so for me, I see doing private practice, whether it’s a private pay hybrid, or insurance based practice, a lot of it becomes doing the same type of work with less resources. And being completely in charge of your own work life, having to, you know, if you don’t meet productivity, you don’t get paid versus you get in trouble at work. You know, the so it’s without a salary oftentimes, it’s without guidance, oftentimes. And so yes, you can create this beautiful practice, but there’s so much stress involved for many people, especially from the beginning. And so it’s, it’s a lot of the same things, but without, unless you deliberately created, it’s without the cohort, it’s without the colleagues to, to have those processing sessions or to vent with or to…

Curt Widhalm 27:53
So basically what you’re talking about: It’s, it’s being able to not feel so isolated, which I think is, you know, one of the things where it gets boiled down early in our careers of like you know private practice is so isolating. But it’s the richness that goes beyond just that statement that really doesn’t hit with people. And so what ends up happening is, this work life balance blends so much, and especially what a lot of clinicians are facing here during the pandemic, working from home or living at work now is kind of rare, a lot of us are that the work life balance aspect of it is, we have an increased demand for our services. Many of us are, you know, facing very full practices, the management of our own lives, you’ve got kids and family members, your own mental wellness, going, you know, just outside of your at home office door, or your bedroom door or your living room couch, wherever you are, that things just are not delineated very well. And I’ve felt this way, I’ve heard this from other clinicians kind of throughout my career. There are times where I just want to have a job where all I have to do is show up and to be able to save my care for after work activities that comes from this place of not being able to, not wanting to continue to fix the world and knowing that there’s so much more that can be done.

Katie Vernoy 29:33
Yeah. Have I told you about my experience of doing some supervision after I’d been in private practice for a while doing it for committee mental health? Did I tell you about this?

Curt Widhalm 29:44
No.

Katie Vernoy 29:45
So one of my, one of my mentors talked to me and was like, Hey, we have someone out on a leave and we need somebody to come in and do supervision for like 10-15 hours a week. And so we set an hourly rate and whatever. And I was in this weirdly lit office. And that’s how I’m always very sensitive to that, like I was in this horrible little office, reviewing charts, doing group supervision, doing individual supervision. And, you know, everything like the office was kind of awful, the commute was awful. The people were great, though. So I want to be very clear on that. I felt my shoulders drop, I just was like, Oh, my gosh, I’m gonna sit here for 10 hours, 15 hours a week, and I wasn’t getting paid even my hourly rate, it was a little bit lower, but um, like 10 or 15 hours a week, I just get to work. I don’t have to worry about marketing and getting clients. I don’t have to worry about anything, I can just do the work. And it was like this dream vacation. And it wasn’t like it was a great office, like I had an awesome office when I was in community mental health, like, two of the walls were windows, I had a beautiful view, like it was amazing. I had this horrible little like interior office. I had a horrible commute, I had all of these things. And I just, I felt such relief. Because I was just getting paid to do the work. And granted, I was doing supervision, so I didn’t have to worry about productivity. So it was it was it was a good combination. But to me, I think that’s, I didn’t realize what I was carrying until I sat down into that little role for a few hours a week and realized the weight we carry as business owners is that we are constantly having to scavenge for work, and maybe not as you go forward. But then it, then it becomes like: Do I take more cases? You know, does money appealing? Do I have the space? Like it becomes so much responsibility to make all of those decisions and be solely responsible for your own income. It’s freeing, but it’s also a weight that I think it’s very exhausting for folks, especially if they’ve not set their fee properly. We’ve had a couple episodes recently on that, or if they don’t set parameters around how much they work and that kind of stuff, because it becomes this constant decision making and responsibility.

Curt Widhalm 32:18
So some calls to action here. Number one, if you are working in agency, community mental health, that kind of stuff. Especially if you have an opportunity to join a union that’s already there, make sure that part of the union advocacy is towards workplace environment issues. If union is not available for you advocate for that anyway. Quality of the environment around you is something that directly affects the way that we end up approaching our jobs and therefore client outcomes. Number two, if there’s not peer support in your work environment, have something regular for peer support for yourself. And I know that a couple of our listeners have reached out to me, as far as looking for peer support groups for therapists. Stay tuned, Katie and I are trying to figure out how we can make something like that potentially work. If you have those kinds of resources out there already, please share them with us either privately or through our Facebook group, the Modern Therapist group. And number three, is really be able to set some boundaries for yourself throughout the profession as far as what you’re willing to accept from the profession. And I know that all three of these are pseudo, sort of, individual responsibilities. But if you’re still listening at this point in the episode, the system’s not going to bend unless there’s enough people within the system who advocate for a lot of these changes. And, you know, we’ve heard from people throughout our careers of just kind of the, I asked by myself and things didn’t change and at the end of the day, I just wanted to self sacrifice more to take care of clients because there’s people in need. That just reinforces the system being the way that it is. So, make some changes, have some good boundaries and continue to listen to The Modern Therapist’s Survival Guide.

Katie Vernoy 34:26
We too and we’ll have more ideas. I wanted to just add a couple more ideas there because I think there is, there is a need broadly for mental health to be respected and in the spotlight and I think the time is now. People are talking about it. There are more and more articles about it.

Curt Widhalm 34:50
Never let a good crisis go to waste.

Katie Vernoy 34:52
Yes. I just was thinking about the your crisis is my productivity. I think We’ve mentioned that before. But I think right now everyone is feeling the weight of mental health concerns, whether it’s a friend or family member, whether it’s their own mental health concerns. And so there’s an opportunity here to bring this into the spotlight. I know there’s a lot of you out on Tik Tok, doing great stuff, people who are blogging, there’s so many things where people are bringing it to the forefront. But I think showing how we are situated, well situated to manage this crisis, to support the people who need the support, to help heal our communities in whatever way that we can. I think that’s, that’s a way that each of us individually, especially those of us who that’s part of our business model anyway, you know, let’s show people how they can take care of themselves. Let’s show them how mental health is going to improve their life. And I think that decreasing stigma is part of it, I think, helping to make sure that money is being paid for mental health services, whether it’s through advocacy, through the way you charge your own fees, whether it’s advocating for yourself with insurance companies to get raises, I think that becomes part of the solution too. And then for other folks like me, diversify your workload. If you don’t feel like you can see another client. Don’t. Decrease your your caseload a little bit and see what other opportunities that you can use to share your knowledge. But don’t don’t stop being a therapist, if that’s what you want to be. Just diversify your caseload or your workload.

Curt Widhalm 36:47
You can find our show notes at mtsgpodcast.com. Follow us on our social media and until next time, I’m Curt Widhalm with Katie Vernoy

Katie Vernoy 36:56
Thanks again to our sponsor Heard Bookkeeping and Tax.

Curt Widhalm 36:59
As a therapist you’re probably too preoccupied with your caseload to want to think about bookkeeping your tax filing. Heard Bookkeeping and Tax is a platform built specifically for therapists that helps you track and improve your practices financial health. Regardless of whether you’re a seasoned clinician or in your first year of practice, Heard will help you identify areas for growth and streamline best financial practices for your business. When you sign up with Heard, you’ll work directly with financial specialists track your income and expenses, file taxes online and grow your business. You’ll also receive financial insights such as profit and loss statements and personalized monthly reports. You can say goodbye to poring over spreadsheets and guessing your tax deductions or quarterly payments. Focus on your clients and Heard will take care of the rest.

Katie Vernoy 37:42
Dr. Jennifer Kashani, a licensed clinical psychologist based in Los Angeles says Heard has simplified and streamlined bookkeeping and best business practices in a digestible and accessible way. Having the foundation of Heard for my business has made myself and in turn my patients feel more solid.

Curt Widhalm 37:59
Plans begin at $60 per month and can be easily tailored to fit your business’s financial needs. You can schedule your first consultation at www.joinherd.com

Announcer 38:09
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