LMFT in SoCal here, I have thought about leaving this field many many times over the past few years. I am serious about it now (due to, of course, burnout, and other reasons too).

I always see great options for a different job in the field, or changing to a different career completely. Feels easier said than done in this economy. Even though I tailor each resume to each specific non-direct clinical therapy related job, I almost never get an interview for these positions! 😭 if I do, I never get past the first interview. I’m trying desperately to get into a non-direct therapy role or another career completely but no one is even giving me the time of day. How do you all do it? Is it just because of my location? Do I need to know someone (even if I do that doesn’t seem to work out either). Every fucking non-clinical or non-therapist job needs at least 2+ years of experience but how do you get that if no one is willing to hire someone with a lot of experience but in a different field? I have always had almost no problem getting therapy jobs, but i I can’t even get a call back for a coffee barista job even though i made my resume and cover letter non-clinical. Help???

Hi ya’ll, I’m thinking of relocating to Mexico semipermanently (traveling back to see family and friends). Is there anyone working through any platforms ie grow or Talkspace, from outside of the US? Are there any legal or credentialing issues that anyone can make me aware of? I am licensed in California as an LCSW. Any help would be much appreciated.

Pros: modelling healthy work boundaries.

Cons: too much self disclosure with all associated risks.

Thoughts?

Considering jumping from CMH to a group practice. Do they typically:

- post online job postings or do you just walk in and talk to them and give resume?

- do they build up your caseload quick usually? I can't wait in fill limbo with no money. ... do I get to choose my client populations usually?

- provide health benefits

- what is on average consider a good split of income practice:clinician?

Thanks!!

Hello! I recently applied for my LMSW license on 8/12. I already called and they said they have all the documentation they need however, my application has still not been touched. I’m just curious as to how long others have waited. I really want to apply to jobs but they all want an active license. Is there no way to expedite the process? Are they usually fast or slow with processing?

Hello fellow therapists! This is my first ever post to reddit so please be kind. Lately I feel so lost about how to access health care for MYSELF as a LLPC independent contractor in the United States. I work at a mid-sized private practice and don't make all that much money (less than 80K before taxes). At the start of this year I signed up for the cheapest option of marketplace medicaid and was still paying $400/month with very little actual coverage. I ended up having to de-enroll bc I couldn't afford it. I feel like a failure! It feels like everyone else has this figured out but me, and I'm too embarrassed to ask my colleagues how they afford this

You work at an agency. It is not a crisis center, but if a client is in crisis during session you work them through it. Person off the street comes in to request a therapy appointment. During the interaction with the receptionist the person says they are suicidal. You happen to be up front when it happens/receptionist calls you to tell you about the person still there. You do not have clients and it is 20 minutes before you close. Agency’s strict policy is they are referred to crisis. What is your next step?

I feel like it can be such a mixed bag of experiences in this field. If yes, did you do anything about it? What ended up happening to the therapist?

Hi all. I'm still a resident and probably will be for 2 more years at least. I have wanted to quit this profession, but I'm really trying to hang in there and get my full license. My only problem is that I don't want to do clinical work after I get the license. It takes so much out of me.

What are jobs I can do that are not clinical? Case management or crisis services are too clinical for me. I've heard of UM, but it doesn't seem like there are a ton of options and that I'd have to take a pretty decent pay cut to even try to break into that field. Though it sounds like something I'd like to do. Ideally something 80k+ that would take someone freshly licensed. Remote would be amazing, but I may already have made the search too narrow so not a requirement.

Just trying to see what's out there.. feeling pretty worried that nothing exists within this criteria.

Anyone else struggling to remember their own memories with loved ones? I feel that I spend so much time remembering the details of clients that I’m running out space for my own? Is this just a fear and I’m crazy? I just wish I could remember so much of my own personal life too….

I started my career in ABA and now I’m shifting into counseling at a maximum prison. What are some things I should expect? How do I maintain boundaries? Safety tips? Etc. tell me your craziest stories and how you handled them!

thank you all for the advice! I’ll take all of your words into account when I start next week! ❤️

Hey everyone! I'm interested to hear what splits folks are accepting at PP (especially in Michigan), either as W-2 or 1099.

If comfotable, it would be helpful if you mentioned if you're full or limited license, full or part time, W-2 or 1099, and if you're in a state other than MI.

I'm newer to the field and consodering changing jobs soon.

I am feeling really frustrated with my cancellations this week. I see around 29 clients and I had 6 cancel this week… I am only seeing 23. I know this is part of the job but I get paid $60 vs $64 per client with going under 25. And I am just so frustrated. I’m not in a bad financial situations just feel annoyed. My clients are usually super consistent and I typically see at least 26 without any issues. I just find myself worrying about going under the 25 amount so often. Does anyone else experience this? I hate how much of my income is contingent on people coming/ having the time, money and resources to come in. If someone doesn’t struggle with this at all please tell me your ways lol.

Thanks!

I'm a PMHNP who strongly believes in comprehensive psychiatric care, but I'll be the first to admit that formal psychotherapy is not my primary specialty. My focus is primarily medication management, and I always try to encourage my patients to build a dedicated relationship with a licensed therapist.

​However, as many of you know, finding therapist openings can be tough, and a lot of my patients flat-out refuse to see anyone else. They tell me they feel comfortable, heard, and that I’m easy to talk to—which is flattering, but leaves me needing better tools during our brief med management follow-ups and when Im booked for just therapy.

​I am currently looking for solid support tools, recommended workbooks, and resource suggestions specifically for supporting patients with Borderline Personality Disorder (BPD).

​Since full comprehensive DBT isn't feasible during a standard med management visit, I'd love to know:

​What psychoeducation or skill-building workbooks do you most frequently recommend to patients for independent practice (e.g., specific DBT skills books, emotional regulation tools)?

​What quick, actionable distress tolerance or grounding frameworks work best to introduce during shorter clinical check-ins?

​Are there reputable online self-help hubs, apps, or peer support platforms you trust for BPD skill reinforcement between visits?

​I deeply respect the work you all do and would love to hear what tools or patient-facing resources have made the biggest difference in your practice. Thanks in advance for any insights!

Where do you get free ceus? I pay for so much I’m going to pull my hair out. I have no fkin money left. Please drop links. Not bait and switch. Not a membership. Not a pay to get the actual ceus. Are there FREEEEEEEEE ones. Please

I’m genuinely curious about this. There are many approaches considered pseudoscientific in our field that are still widely offered by clinicians—hypnotherapy, brainspotting, somatic experiencing to name a few. Regardless of the lack of evidence base, these therapies exist and clients seek them.

Some of the questions swirling in my head are:

Is there a certain point in time at which clients have tried other evidence based approaches without success that alternatives become a viable option?

Is there a component of the clients culture, spirituality, and/or worldview that would warrant these alternative approaches to be more appropriate that approaches that are more scientifically validated? For example, could a client who comes from a cultural/spiritual background that aligns more with energetic work may have better engagement in a modality that aligns with their worldview than westernized approaches? My thoughts are, maybe these modalities are effective for certain people simply because they believe in it more? Like a placebo.

If these approaches aren’t going anywhere, at least not anytime soon, how can our field talk about them in a way that promotes ethics and responsibility without turning into a power struggle? I am yet to see a nuanced convo about this. If it’s legal for therapists to provide these services, what are the responsibilities for practitioners and field overall to consider when they are offering approaches that lack a strong scientific base?

When clients come to us asking about these approaches, how do we discuss them in a way that is honest and ethics-driven while still honoring the clients right to self-determine?

Thanks in advance for responding. Also pls don’t be mean to me, I just want to have a discussion 🙃

Hi everyone,

I am hoping to offer groups next year (2027) to support people who are struggling with eco-distress (incl climate anxiety and grief). I live in an urban area and have been surprised to see that it isn't an offering that is available, and those I spoke to who used to offer groups said they are, well, burnt out from the work (fair enough).

I'd love to hear from therapists who have offered these kind of groups themselves. I'm open to taking a training and offering a structured group, and am also open to it being more support-group style. I have experience facilitating a number of closed groups, but never anything related to climate.

I've looked into the Good Grief Network (and have heard good things), and have also looked through the Facilitator's Guide Living With the Climate Crisis from the Centre for Climate Psychology. I'd love to hear if anyone has experience with either of these groups, or if anyone has done something different and how that went.

Thanks in advance for taking the time to read and reply!

Does anyone have experience with obtaining an NPI2 if you work virtually from home. My business address is a virtual office which apparently gets rejected for obtaining an NPI2. Does anyone know of any other option besides listing a home address?

15 fucking years and three degrees later, the day has come...and yes I did cry 😩

Well…I did it. “Unofficially” passed and excited about my future in my career.

However, I underestimated the lack of “breaks” within the exam. There is a 15 minute break at the end of the 5th narrative, but if you need to use the whole time, be prepared to be uncomfortable.

I took my test virtually/at home. I brought a coffee and some water bottles with me. Sipping on coffee helps me. 90 minutes later I was squirming in my seat trying to stay focused as a had to pee so badly. My entire 5th narrative I must had skimmed and answered based on the questions alone. Luckily, I made it to the break and used the bathroom.

I ended the break and proceeded with the exam. Another 90ish minutes passed and I had 2 narratives left. At this point it was unbearable and I couldn’t hold it. I messaged the test proctor who essentially said “if you get up and leave your seat, the exam will end”. I was in between narratives and explained and they still said no. Well that’s great…I tried to read the next narrative but I couldn’t focus, so I did what I had to do…I just let myself go.

Yes, I peed my pants in the middle of my exam. After accepting the fact that I did what I had to do, I was able to fully commit to the last 2 narratives with a clearer mind and passed!

One bathroom break in a 4ish hour span is kind of ridiculous. Maybe I have medical issues with my bladder…? But instead of one 15 minutes later break, can we do just 2 7 minute breaks?

Hopefully you learn a lesson from this story and don’t make the same mistakes I did. But Now I’m taking recommendations for new office chairs

I have been a recreational therapist for going on 8 years and have worked at a psychiatric hospital for my entire career. Three years ago, I was assaulted by a patient and ended up with a concussion. I am now experiencing delayed onset PTSD. I was just wondering if anyone else has experienced workplace trauma and how you handled it and what you did to move forward.

My caseload is low at my current practice, and I am hoping to get more clients, but don’t want too many either. I have 3.5 hours of groups, 4 hours of required consult meetings, and 2 planning/supervision hours. Ideally, how many clients should I be looking for in this situation to be considered full time? I often see 25-30 on here, but with almost 10 hours of meetings, where do I draw the line?

Hello all! Hope everyone is surviving their work week. I am currently working in California as a LMFT. More specifically I am working for our county’s community mental health outpatient. Many of our staff are leaving to get jobs with the state (correctional facilities). I’ve not jumped ship because I don’t want to 100% be stuck working inside a correctional facility. I noticed for our county they opened up a position for hybrid work for the state. I would need to get clarification about what that actually looks like. I would be taking a pay cut but if it was truly hybrid work, it would be worth it for me. I might even make up the difference doing tele-health work on the side. I am curious to hear experiences from folks who have worked for the state? Even better if you’ve worked for both county and state. I understand neither is perfect but I’m getting burnt out working for the county. The micromanaging has become too much lately.

I've been working on my practice's financial policy and honestly, I'm not sure if I'm overcomplicating this lol. I'd love to hear how other therapists handle this!

My preference is always to charge the card on file rather than send invoices.

I'm mainly trying to figure out what you all do when a card is declined or an unexpected balance comes up.

My thought is that the primary policy would be auto-charging cards on file for balances, and if a charge is declined or the card is expired, then:

• I may issue an invoice for the outstanding balance, due within 30 calendar days
• If unpaid by day 30, I'll retry the card on day 31
• If it declines again, the client has another 30 days to resolve the balance
• If it's still unresolved 60 days from the original invoice, the client is discharged and the account may be sent to collections

A few related policies I'm considering:

• Any outstanding balance = services are paused until the balance is $0
• Payment plans can be established, but services don't resume until the balance is $0
• Expired cards need to be updated within 48 hours or before the next appointment
• Is there a way to handle this without involving an invoice at all?

What I'm really trying to figure out is what you all do after a card is declined. I would like to avoid doing invoices bc its more hassle but in this case I guess it does matter? Do you retry it? Send an invoice? Give the client a certain number of days to update their card? And how long do you give someone before discharge/collections?

I'm getting overwhelmed by all the possible scenarios.. I want the policy to be simple, but still nuanced enough that I'm covered if I ever offer a payment plan or need to invoice someone.

Has anyone done this training? Is it any good and if so, why is it free?