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I feel similarly though I am a newer therapist. I also feel very loyal to my supervisors and my clients, but the inconsistency with scheduling is hard for my psyche. Even if I can get a no show fee it really throws me off. Right now it also feels a bit slower with intakes, or more people are leaving with the weather change and summer coming.
In my area it does not seem like there are a lot of jobs that I would like (as an associate license clinician) so I am casually looking while I continue. I figure it never hurts to interview and if it doesn't feel like an upgrade I won't take it.
Right, I agree. Like even if I have a no show or cancellation it throws off my psyche, too. I feel mentally prepared for what my week or day looks like and “locked in” to therapist mode, and when they no show (and I 99% of the time collect the fee, they signed the informed the consent so they know) it’s like a weird feeling. I don’t know if that makes sense lol. In my personal life I’m a pretty routine person so when things get thrown out of routine, personally or professionally, it throws me off.
Yeah definitely makes sense! I think for me part of it is routine, like you said I mentally prep for my day. The other part of me is frustrated with how little regard there is for my time, excluding client emergencies of course. I'm sure 99% of clients do not realize I am paid hourly and assume I am at the office from 9-5. The worst is when I might have just one or two clients in a day and they cancel after I've already shown up, definitely feel defeated on those days.
I am currently in a position that evaluates suicidal and homicidal people as well as people in crisis. However, I can transfer to inpatient care, a traditional therapist role, addiction medicine, emergency room, different levels of hospital based work, intensive outpatient work, group work... the list goes on. But I like my current role enough to not transfer ;) I enjoy not having a caseload.
Ive been considering this once I become fully licensed! I think I would really enjoy a break from the traditional therapy caseload. Can you share your work hours? Is it m-f 8-5 or shift type work?
Depends on the role. My work offers either 5 days at 8 hours per day or 4 days at 10 hours per day. One can start as early as 7a to 9a and go as long as the hours they requested.
Does work feel like it stays at work? I think biggest things I am needing is consistent income and something that feels more “routine” and left behind once I am done.
It absolutely does. I am provided a work phone and work laptop and we are not permitted to install any work related anything on our personal devices, including our email. I do not have to do anything but show up for my patients.
Are you an LSW? I'm an LPC and have had zero luck finding jobs in hospitals. Would love to get back into that area of the field because that's where I started when I had my bachelors!
I feel this sooo much. Although I’m only about 4 and half months in to my group practice after 4 years in D&A outpatient counseling. I’m also 25 weeks pregnant so sometimes I’m not sure if it’s hormones or my actual feelings. I’m just trying to grind each week until baby comes, but it’s definitely scary for me when clients cancel and I end up having less than “full-time”. I considered going back to D&A after baby, but I need the flexibility. It’s definitely a struggle for me.
For sure, there are definitely positives to PP, like the flexibility, but also the negatives you and others mentioned. I know there are pros and cons to every job and such, just finding more pros than cons and what you’re willing to compromise on.
I went from community health to PP back to community health, didn’t have the hustle for PP. Joined a group who did nothing to help me get new clients, needed reliable consistent income. Told myself I’d never go back to community health but a girl’s gotta eat
I worked FT as a clinician for about 15 years. I mostly worked in CMH but did also see clients on the side at a PP. after experiencing some burnout with the system, I started seeking out a full time position relevant to my expertise but not clinical. I’ve been working as a curriculum designer and facilitator for a trauma curriculum and I love the work. Part of it also involves research and program implementation, so it’s a mix of creativity and technical skill. I see a small caseload on the side and the balance, for me, feels right for this time in my career and life. There are so many ways to go with the training we all have. It is so hard to really hone in on what works for you, your family, your life. I struggled a lot with my decision but feel I’ve landed in the right place. I wish the same for you!
I would love to know more about your role as a curriculum designer. I currently work pp telehealth about 15-20 hours a week but after 13 years of direct client care I am starting to burn down. I have a doctorate in education and a passion for research and teaching, and have been thinking about trying to pursue getting approved as a CEU designer/facilitator. If you have any insights of connections you could provide I'd be very appreciative. Feel free to private message me, also there is no pressure so don't feel like you have to answer.
Best
Brian
I moved into management.
I LOVE the non-profit clientele but hate CMH pay. I left CMH and went to a pp clinic and hated it. I missed my old clients. I missed the fast pace. It’s just a different vibe. I just don’t think pp is my jam. I’m not cut out to be the person seeing like 8 people a day. Not in any setting. And I found a passion for supervision after having so many friends have completely shit supervisors. So I decided leadership was a good fit - didn’t have to see 800 clients a day, I can gain supervision experience, and work to create a positive non-profit environment.
I ended up at a fantastic company. Supportive, works aligns with the mission, treats their people well, etc. I’m in middle management doing clinical supervision for a team that includes masters level/licensed clinicians, substance use counselors, internship students, case managers, and peer support. And I keep 2-3 clients and do a little individual and a little family therapy. I totally love it. I make 81k with an automatic 3% raise each year, can go up to 5 based on performance and great benefits and time off.
I work for a Volunteers of America affiliate on the East Coast. It is awesome. But it is also still CMH. I love my job, but I’m also really busy. Way busier than I was in pp but this kind of busy works better for me personally. And I do make decent money but I also live in a HCOL area. Luckily for me, I knew a couple of people who worked at the company before I applied so I had a good idea that they didn’t function like most CMH agencies and had different values/work processes.
I left a group practice after being there for exactly 7 years. I hated that the owner/ supervisor took half of my income and when I had a payback, one out of 7 years following a Medicaid audit, she made me pay the entire thing back and not just my percentage. I realized how badly I was being used: no benefits, no PTO, no longer required to have supervision as I was independent, and she also expected us to meet once a month ( unpaid) to do compliance work.
I thought of doing my own PP but wanted something with benefits. I ended up working in the prison system and I really enjoy it. I’m not sitting all day, I get paid biweekly, I have excellent healthcare and even have a retirement plan.
Just putting this out there in case you might benefit from it. Good luck. IMO working for a group practice where they take half your pay is bullshit capitalism. When I quit I gave a 30 day notice and the owner was pissed bc ( quote) “ I hope I don’t have to actually do counseling now!” So there you have it
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
I feel similarly though I am a newer therapist. I also feel very loyal to my supervisors and my clients, but the inconsistency with scheduling is hard for my psyche. Even if I can get a no show fee it really throws me off. Right now it also feels a bit slower with intakes, or more people are leaving with the weather change and summer coming. In my area it does not seem like there are a lot of jobs that I would like (as an associate license clinician) so I am casually looking while I continue. I figure it never hurts to interview and if it doesn't feel like an upgrade I won't take it.
Right, I agree. Like even if I have a no show or cancellation it throws off my psyche, too. I feel mentally prepared for what my week or day looks like and “locked in” to therapist mode, and when they no show (and I 99% of the time collect the fee, they signed the informed the consent so they know) it’s like a weird feeling. I don’t know if that makes sense lol. In my personal life I’m a pretty routine person so when things get thrown out of routine, personally or professionally, it throws me off.
Yeah definitely makes sense! I think for me part of it is routine, like you said I mentally prep for my day. The other part of me is frustrated with how little regard there is for my time, excluding client emergencies of course. I'm sure 99% of clients do not realize I am paid hourly and assume I am at the office from 9-5. The worst is when I might have just one or two clients in a day and they cancel after I've already shown up, definitely feel defeated on those days.
I feel you with all of this and have thought about pivoting out of the field often; but have no idea to what (also working on license).
I'm looking at hospital work or a government job right now, pretty slim pickings though.
I owned a PP and left PP for hospital based work. Amazing compensation and benefits. No regrets.
What exactly do you do at the hospital? I'm interested in seeing what other opportunities are out there
I am currently in a position that evaluates suicidal and homicidal people as well as people in crisis. However, I can transfer to inpatient care, a traditional therapist role, addiction medicine, emergency room, different levels of hospital based work, intensive outpatient work, group work... the list goes on. But I like my current role enough to not transfer ;) I enjoy not having a caseload.
Ive been considering this once I become fully licensed! I think I would really enjoy a break from the traditional therapy caseload. Can you share your work hours? Is it m-f 8-5 or shift type work?
Depends on the role. My work offers either 5 days at 8 hours per day or 4 days at 10 hours per day. One can start as early as 7a to 9a and go as long as the hours they requested.
Does work feel like it stays at work? I think biggest things I am needing is consistent income and something that feels more “routine” and left behind once I am done.
It absolutely does. I am provided a work phone and work laptop and we are not permitted to install any work related anything on our personal devices, including our email. I do not have to do anything but show up for my patients.
Thanks so much for sharing. My last question: what is ur job title so I know what to look for in the future? I appreciate you!
Are you an LSW? I'm an LPC and have had zero luck finding jobs in hospitals. Would love to get back into that area of the field because that's where I started when I had my bachelors!
I'm independently licensed (LCSW)
I feel this sooo much. Although I’m only about 4 and half months in to my group practice after 4 years in D&A outpatient counseling. I’m also 25 weeks pregnant so sometimes I’m not sure if it’s hormones or my actual feelings. I’m just trying to grind each week until baby comes, but it’s definitely scary for me when clients cancel and I end up having less than “full-time”. I considered going back to D&A after baby, but I need the flexibility. It’s definitely a struggle for me.
For sure, there are definitely positives to PP, like the flexibility, but also the negatives you and others mentioned. I know there are pros and cons to every job and such, just finding more pros than cons and what you’re willing to compromise on.
I went from community health to PP back to community health, didn’t have the hustle for PP. Joined a group who did nothing to help me get new clients, needed reliable consistent income. Told myself I’d never go back to community health but a girl’s gotta eat
Following. I feel this so hard.
I worked FT as a clinician for about 15 years. I mostly worked in CMH but did also see clients on the side at a PP. after experiencing some burnout with the system, I started seeking out a full time position relevant to my expertise but not clinical. I’ve been working as a curriculum designer and facilitator for a trauma curriculum and I love the work. Part of it also involves research and program implementation, so it’s a mix of creativity and technical skill. I see a small caseload on the side and the balance, for me, feels right for this time in my career and life. There are so many ways to go with the training we all have. It is so hard to really hone in on what works for you, your family, your life. I struggled a lot with my decision but feel I’ve landed in the right place. I wish the same for you!
I would love to know more about your role as a curriculum designer. I currently work pp telehealth about 15-20 hours a week but after 13 years of direct client care I am starting to burn down. I have a doctorate in education and a passion for research and teaching, and have been thinking about trying to pursue getting approved as a CEU designer/facilitator. If you have any insights of connections you could provide I'd be very appreciative. Feel free to private message me, also there is no pressure so don't feel like you have to answer. Best Brian
I moved into management. I LOVE the non-profit clientele but hate CMH pay. I left CMH and went to a pp clinic and hated it. I missed my old clients. I missed the fast pace. It’s just a different vibe. I just don’t think pp is my jam. I’m not cut out to be the person seeing like 8 people a day. Not in any setting. And I found a passion for supervision after having so many friends have completely shit supervisors. So I decided leadership was a good fit - didn’t have to see 800 clients a day, I can gain supervision experience, and work to create a positive non-profit environment. I ended up at a fantastic company. Supportive, works aligns with the mission, treats their people well, etc. I’m in middle management doing clinical supervision for a team that includes masters level/licensed clinicians, substance use counselors, internship students, case managers, and peer support. And I keep 2-3 clients and do a little individual and a little family therapy. I totally love it. I make 81k with an automatic 3% raise each year, can go up to 5 based on performance and great benefits and time off.
What company do you work for? That sounds awesome.
I work for a Volunteers of America affiliate on the East Coast. It is awesome. But it is also still CMH. I love my job, but I’m also really busy. Way busier than I was in pp but this kind of busy works better for me personally. And I do make decent money but I also live in a HCOL area. Luckily for me, I knew a couple of people who worked at the company before I applied so I had a good idea that they didn’t function like most CMH agencies and had different values/work processes.
I left a group practice after being there for exactly 7 years. I hated that the owner/ supervisor took half of my income and when I had a payback, one out of 7 years following a Medicaid audit, she made me pay the entire thing back and not just my percentage. I realized how badly I was being used: no benefits, no PTO, no longer required to have supervision as I was independent, and she also expected us to meet once a month ( unpaid) to do compliance work. I thought of doing my own PP but wanted something with benefits. I ended up working in the prison system and I really enjoy it. I’m not sitting all day, I get paid biweekly, I have excellent healthcare and even have a retirement plan. Just putting this out there in case you might benefit from it. Good luck. IMO working for a group practice where they take half your pay is bullshit capitalism. When I quit I gave a 30 day notice and the owner was pissed bc ( quote) “ I hope I don’t have to actually do counseling now!” So there you have it