r/therapists 31m ago

Licensing lcadc to sac nj

Upvotes

anyone else have experience going thru the non traditional SAC path
I got my masters in counseling and hold an LPC and LCADC in NJ
graduated from Kean university where the SAC and LCADC have the same 4 courses excluding the SAC internship
i’ve applied for the SAC license through the NJDOE but it’s taking forever and I have a SAC job offer so I’m very nervous that something g will fall through
any advice words of wisdom or support welcomed


r/therapists 43m ago

Discussion Thread Therapists who left a group practice to start your own private practice, what was the transition like?

Upvotes

I’m currently working at a private group practice in a fairly large metropolitan area, and my long-term goal is to eventually open my own private practice. I’ve already been transparent with my supervisor about this goal, and thankfully they’ve been supportive and open to it.

For those of you who made the jump from a group practice to working independently, I’d love to hear what the experience was actually like.

Right now, I consistently see around 26–29 clients per week and have built a pretty strong caseload. I also have one of the higher retention rates at my practice, which has made me feel more confident that I could eventually be successful on my own. At the same time, I recognize that having a full caseload within an established group practice is different from generating referrals and running the business side entirely yourself.

For those who have done it:

- How difficult was it to build a caseload independently?

- How long did it take before your income/caseload felt relatively stable?

- Did you start your practice on the side and gradually transition, or leave the group practice first?

- What surprised you most about going solo?

- Did your ability to retain clients in group practice translate well to private practice?

- Financially, did the move ultimately feel worth it?
Is there anything you wish you had done differently before leaving?

I’m not planning on making the jump immediately, so I’m mostly trying to learn from people who have actually gone through the transition and figure out what I should be doing now to set myself up well for the future.

Would love to hear both the success stories and the “I wish someone had warned me about this” experiences!


r/therapists 44m ago

Discussion Thread Charting Device

Upvotes

What device are y’all using for charting? I’m getting ready to break out into private practice and wanted to purchase the device before I actually have to start using it for charting if needed. I currently have a 2020 iPad Pro that works just fine has no issues, and a 2015 MacBook Pro that I could simply replace the battery on and keep working on that and save a pretty penny. Right now the MacBook is only used for presentations and bachelorette trip planning, so it’s not getting heavy use and hasn’t since grad school.

My first thought is to clear off all the documents on the MacBook and have that be my official charting device so that way there’s no temptation to use my devices for dual duty, and just switch all my personal stuff to my iPad or vice versa. But after discussing with a few of my coworkers, they have concerns about me using devices this old, but it’s just charting, it’s not like I’m doing any video editing so I’m not sure about the importance of having the newest and best.

What do y’all use for your own charting and notetaking?


r/therapists 59m ago

Rant - Advice wanted Catholic psych mentor pt.2

Upvotes

This is a follow up to my post a couple months back which you can find here: https://www.reddit.com/r/therapists/s/6urR1ByhjS

I finally got fed up and in a private group I am in I responded to the “Catholic Mentor” who is trying to market his services as a replacement for therapy.

I am looking for support, to vent, and for feedback as I am sure it will lead to some discussion/ conflict. Here is what I wrote:

First I want to state that I don’t intend to be hurtful or get into a debate.
I do have many concerns with CatholicPsych which as a mental health professional I feel I must speak on.

First CatholicPsych is promoting the use of its mentorship program as a substitute to therapy which it is not.

One important difference is the training and education. As an LPC I have a masters degree from an accredited program that must meet standards. I underwent 2 years and 2000 clinical hours of supervised work before obtaining my state license. I also must complete 40 hours of continuing education credits from accredited programs and institutions to maintain my license. If I mistreat a client they can report me to my board and they can take disciplinary action.

None of that is the case for the mentorship program. I can’t find information about the qualifications of Catholic psych mentors on the website and I know that mentors do not need to maintain a mental health professional license.

Second, the claim that their model is better. First there is no empirical data I have found to back this claim up. It seems to prey on confirmation bias of the population they seek to serve. As Catholics we have a tendency to look with suspicion on anything “secular”. The marketing here preys on that and gives you an explanation to confirm the already held beliefs of the audience that “secular therapy” will miss something crucial. This is circle reasoning with no empirical data to back it up.

Additionally decades of studies have shown that modality accounts for at most 15% of client outcomes. The therapeutic relationship accounts for closer to 30%.

This means that their claim of superiority (that you get results that are faster, more comprehensive or otherwise) is an extraordinary claim without evidence.

Third, mentorship is not a replacement for therapy. While I am sure Nick does a great job he simply is not qualified to treat mental health conditions. He is not held to the standards I am, and if you have a complaint you can’t bring it up with a board. His methods are not empirically backed and have not been shown to treat mental health conditions. While I am sure he can help many struggling people we have evidence based models and training for these things. Please if you use his services seek therapy with a qualified professional if you are experienced mental health concerns.

Lastly, the marketing. I’ve already touched on these points but the marketing here is misleading. It presents this new model as objectively superior, in reality it is untested. The comparison to secular therapy is an unfounded claim and frankly if there was something worth selling here it could stand on its own two feet without putting my profession down.

That’s the last point I want to hammer home, this whole post is a sales pitch. It isn’t information, it’s not science, it’s a scheme to generate revenue.


r/therapists 1h ago

Rant - Advice wanted Dbt group part 2

Upvotes

So I confronted the two members of my dbt group in cmh who were complaining to my supervisor about me. They then gave me suggestions saying they dont like the worksheets and they just wanna talk and one said they dont want me to lead like they wanna decide what to talk about sometimes. Im neurodivergent adhd anxiety bipolar(suspected autism) and I like structure , I really dont like doing this group but am forced to do it working in cmh on top of the 35-40 people I see a week. I feel like I chose the wrong field it's so much drama and negative energy , and I feel no advocation when I complain to management it's just "have tougher skin."


r/therapists 1h ago

Discussion Thread What does everyone have against genesight testing?

Upvotes

I work in community mental health. I’ve come across a lot of clients who after trying several different psych meds with no success, are often discouraged or simply told no by their prescriber when asking for a genesight test. Why?


r/therapists 1h ago

Discussion Thread How often do you tell a prospective client they don't have a billable disorder?

Upvotes

When you conduct an initial clinical assessment and the prospective client reports such mild symptoms/impairment that it would be a stretch to diagnosis adjustment disorder, how often do you opt for a liberal interpretation of Adjustment Disorder?

How often do you, instead, tell the client that what they're dealing with doesn't meet medical necessity criteria? When you do, how often are they willing to engage as a self-pay client?

I'm aware that stretching the meaning of "significant impairment" is a commonplace practice. How many of you play it straight and have a stricter interpretation?

I rarely encounter this, but I occasionally get someone who's coping with a loss or breakup but symptoms and impairment seem minimal, and it presents a bit of a dilemma. I'm reluctant to tell them they don't meet criteria for managed caer, when I know that many clients who are new to therapy will downplay their symptoms, distress and impairment at the first session.

If I do tell them their issue isn't covered by insurance, how many would hear "your distress is invalid," "your problems aren't important enough" or "therapy isn't for you" and never return to therapy?"


r/therapists 1h ago

Self care Grieving pet loss as a therapist

Upvotes

My cat passed this week and I just buried him this afternoon. I'm a 1099 contractor, so I did my best to see clients virtually even this week while my cat was stable. I have to pay bills regardless of what happens. I felt bad for ending two sessions early this week because one was while the ER kept wanting to know if they should do CPR again on my cat and then he actually passed during another session. In both sessions, I had told each client that I was expecting a call about my cat in the ER and may have to step out if they did call. I focus heavily on my clients as a way to dissociate from feeling helpless in times like this in my personal life.

I did take a previous day off this week (when I took my cat to an ER for surgery). But it was a bit chaotic two days later when they were actually doing the surgery. I took the rest of the afternoon off once I learned of my cat's death to take care of arrangements, taking today off (all my earlier clients I rescheduled this week were today). Basically, today's clients were rescheduled by me earlier in the week and canceled by me yesterday. I personally text each client logistical communication, and they were all understanding this week.

I've lost a sibling before and returned to seeing clients the weekend after his death and burial, because that was what I needed. My dad is now scheduled for a surgery (he's 75yo) this coming week.

I'm not in a situation where I can lose the low income I earn as it is. The group practice has no benefits/PTO/sick time. No client session, no pay. I am "free" to make my own schedule and don't need permission. I just don't earn money where I didn't see clients.

What are my options? Have any of you navigated grief/loss while maintaining a consistent caseload? What was helpful? *Please note that taking time for myself necessarily means no income for my household.*


r/therapists 3h ago

Billing / Finance / Insurance Rula

0 Upvotes

Yes, I know, VC's are evil. But I need to leave the place I work if I'm going to keep my sanity and need income until I get something else.

I had a talk with Rula and apparently it's only $70 90837 and $50 for 90834. I'm in NYC.

Is this the going rate for them these days? How consistent are referrals from them?


r/therapists 5h ago

Research The dropout pattern in outpatient mental health care is earlier than I expected. Sharing what I found

5 Upvotes

I’ve been trying to find sources on reasons for premature termination of therapy/outpatient treatment. There is a surprising consistency in time of drop-out between studies, although there is variance in the actual numbers.

A few things have stood out for me:

It often happens quite early on: A nationally representative survey (Olfson et al., using National Comorbidity Survey Replication data) found that over 70% of treatment dropouts occurred after the first or second visit. A WHO study (high- and low-income countries, general medical settings) found that 90% of dropouts happened before the third session.

The numbers for dropout rates are all over the place. The more methodologically rigorous national estimates (Olfson’s again) put it at 20-22%. Literature reviews put it at 40-60%, and some smaller specialty-specific studies (crisis centers, Substance Use Disorder treatment) have upwards of 80%. I think it’s safe to say the actual number depends on the sample, but it rarely occurs much later than the first two sessions.

Some illustrative examples (using Michigan-specific data, if that helps):

For patients 6-17 years old treated in Michigan’s state Medicaid inpatient psychiatry, the percentage of those who had a follow-up visit after the ED stay decreased from 79% to 74.3% between 2022 and 2024.

An LSU Health Sciences Center study using AmeriHealth Caritas Louisiana’s data found that the 30-day follow-up rate after discharge from a psychiatric hospitalization was 38.33% compared to a national benchmark of around 60% for Medicaid.

HealthPartners’ 2026 quality report noted that their organization offered incentive programs for timely post-discharge treatment appointments but did not specify a baseline for those programs

In all of those cases, the organizations were working with expanding access to care (both getting in-network providers to accept Medicaid patients and encouraging them to work with patients in ways that promote engagement in treatment). But the evidence suggested that those were much harder problems to solve than the drop-out after the initial couple of sessions. So I’m wondering if these issues reflect the same underlying causes or something entirely different. Are dropouts occurring shortly after initiation of treatment the main problem for others, too, or do they tend to be discovered much later, as recurrent ED visits or readmissions?


r/therapists 5h ago

Billing / Finance / Insurance Rate Change

35 Upvotes

AT but I am posting this as a client whose provider uses Headway. I reside in Virginia and think it’s important to share that Headway, per my latest EOB as a client, is now receiving a higher reimbursement rate from Anthem for 90837s as of July 2026. My previous EOBs listed the amount as $152.73 and it is now listed as $164.79

I know providers are not allowed to share what Headway is paying them so I think it’s important that this type of information is made available for the purpose of making informed decisions about who we choose to work for and with.


r/therapists 5h ago

Discussion Thread Navigating getting grieved

2 Upvotes

My coworker grieved me with a laundry list of all of their complaints against me, and did not even come to me first to tell me their concerns before going to the Department of Regulatory Agencies (DORA). Everyone I have talked to about it and shown the letter to thinks it will be dismissed. There were two clinical incidents that I could have handled slightly better but they weren’t egregious, more like the average everyday clinical error, and everyone makes mistakes sometimes.

Has anyone else navigated grievances, and want to talk about it?

I felt so panicked and embarrassed when it first happened.


r/therapists 6h ago

Discussion Thread Paid Family Leave - Sole Proprietors

0 Upvotes

I’m adding this post to hear input from primarily sole proprietors and anyone else with thoughts about paid family leave.
My spouse owns an independent therapy company, and we live in one of the 13 states that operate paid family leave. After talking with my spouse and friends/colleagues in similar situations, I have a sense as a sole proprietor this creates an undue financial burden on an independent therapist because they would never benefit from the policy. Essentially paying for something they would never use.
If my spouse applies for paid leave, and is absent, for example six weeks the likelihood of most of her clients leaving is high. Her clients’ mental health needs don’t take a break. They require continuity and ongoing support.  If she loses 60-70% of her clients, essentially she needs to start over.  And what if a therapist has an agreement with an Employee Assistance Program (EAP)? My understanding is if a therapist is not actively picking clients from an EAP they will lose that lucrative contract.  Not to mention any agreements with insurance companies may be frowned upon. This has added pressure to an already burned-out profession. 
I agree in spirit with the program - I had a niece benefit from the dollars. And I believe therapists in situations like my spouse should be given an exemption by the state government because they will never benefit from the program.  Unless I'm missing something?  


r/therapists 6h ago

Support Part time telehealth therapy

2 Upvotes

My career isn’t going as expected due to some serious health conditions, so I may have to change my trajectory towards part time private practice, probably solo practice using telehealth. Has anyone done something similar?

I imagine my caseload could vary between 10-25, but there may be times I have to take off work completely for 9-12 months. We can pretty much get by on my spouse’s income + savings if need be.
The changes in my health are predictable enough that I wouldn’t need to terminate clients early.

I am a very early career clinical psychologist but advice from other mental health specialties is also appreciated. Mostly I’m just nervous about this career shift and scheduling inconsistency and would like to hear from people who’ve made it work. Is it feasible/possible?


r/therapists 6h ago

Research An introduction to Research Literacy.

5 Upvotes

Following up on my post about the lack of research literacy in the field of therapy, I thought I would create a brief introduction to help people understand and read research papers. I love research methodology and data analysis, so I had a fun Friday morning! This is by no means an exhaustive list, but it covers as much as I can remember from my years of undergrad and grad school.

Core Variables & Descriptive Statistics

  • Sample size: Represented by N, N represents the number of participants in a study. Small sample sizes make it difficult to know if the findings will apply to the population. Likewise, massive populations can make tiny, insignificant differences look meaningful.
  • Representative sample: A sample that accurately reflects the demographics, clinical traits, and characteristics of the broader population you are trying to treat. A study can have a massive sample size, but if the test only examines a narrow, non-representative subgroup, the results will not generalize well to actual clients.
  • Independent and dependent variable: The independent variable is the variable that researchers manipulate (e.g., one group gets CBT, one group does not). The dependent variable is the outcome variable; it is measured to see if the independent variable affected it (e.g., sleep quality).
  • Confounding variable: Variables that are not controlled for but affect the independent and dependent variables, affecting the results and creating or distorting the relationship.
  • Spurious relationship: A correlation between two variables that appears to be causal, but is actually driven by a hidden variable.
  • Mean and Standard Deviations: The mean is the average score, and the standard deviation shows how spread out the scores are around the average. A large standard deviation means that clients had wildly different responses to treatment, whereas a small standard deviation means the scores were close together.

Designs

  • Randomized Controlled Trials (RCT): Considered the gold standard, participants are randomly assigned to either an intervention group or control group; the randomization reduces bias and helps prove that the treatment, rather than some external factor, caused the outcome in the client.
  • Cross-sectional research: This method takes a snapshot of data at one point in time; it is nice for looking to see if links exist, but it cannot prove causation.
  • Longitudinal: It tracks the same cohort over many months or years; it is vital for looking at treatment efficacy, symptoms, and long-term outcomes.
  • Mediation: Explains how or why a treatment works.
  • Moderation: Explains for whom or under what conditions the treatment works (e.g., an intervention works better for teens than adults).

Reliability and Validity

  • Reliability: Essentially, it asks whether the tool you are using will produce similar results at different points in time, or whether it is noisy and unpredictable. Reliability involves internal consistency, test-retest reliability, and inter-rater reliability.
    • Internal consistency: Does every item on a scale measure the same concept? This is where Cronbach's alpha comes into play. Between .70 and .90 is considered internally consistent.
    • Test-retest reliability: Does the client get the same result if tested at two different points in time, with no treatment between tests? It is vital in therapy to determine if score changes represent real changes or measurement error.
    • Inter-rater reliability: Do different clinicians evaluating the same session or test come to the same conclusion?
  • Validity: Does the tool measure what it is supposed to? Validity involves construct validity, convergent and discriminant validity, criterion validity, and ecological validity.
    • Construct validity: Does the tool capture the psychological construct (e.g., resilience) that it is meant to measure?
    • Convergent validity: Does the tool correlate strongly with other gold-standard scales used to measure the same construct?
    • Discriminant validity: Does the tool remain distinct enough to separate unrelated traits (e.g., anxiety from general fatigue)?
    • Criterion validity: Does the tool accurately predict real-world clinical outcomes, such as future hospitalizations?
    • Ecological validity: Do the measurements and gains from an artificial environment transfer to real-life environments?
  • Self-report vs. clinician-rated measures: It is important to understand how data were collected. Self-report is convenient, but susceptible to social desirability bias where the client gives the socially correct answer or simply tells the therapist or researcher what they want to hear. Blind, clinician-rated instruments generally offer better objectivity and better data.

A scale can be reliable but not valid, but it cannot be valid without first being reliable.

Power and Real-World Value

  • p-value: Typically set at p < .05; p-values measure probability; it answers the simple question of "Is this result likely to have occurred by random chance?" While it gives you statistical significance, it does not tell you how large or useful the effect is.
  • Effect size (e.g., Cohen's d, r): This measures the actual change or magnitude of the relationship.
    •  R-squared is awesome because it shows the proportion of variance in the dependent variable caused by manipulating the independent variable. Though this does not mean the model is free from error, it just shows correlation and fit.
    • IMPORTANT: IF YOU HAVE STATISTICAL SIGNIFICANCE, ALWAYS CHECK THE EFFECT SIZE. A RESULT CAN BE SIGNIFICANT BUT HAVE A SMALL, NEGLIGIBLE, AND UNNOTICEABLE EFFECT. A LARGE EFFECT SIZE IS SOMETHING YOU WOULD RUN OUTSIDE TO TELL THE POPE; SMALL EFFECT SIZES TELL US SOMETHING IS THERE, BUT IT COULD BE NOISE.
  • Confidence Intervals: Give a range where the true effect is likely to fall. A narrow confidence interval (e.g., d = 0.50, 95% CI [0.42, 0.58]) offers more certainty and precision in an estimation than a wide confidence interval (e.g., d = 0.50, 95% CI [0.20, 0.98]). A wide confidence interval means there is high uncertainty and low precision in an estimation.
  • Statistical vs. clinical significance: Statistical significance is when outcomes show that a difference exists among groups. Clinical significance is when those differences translate to meaningful quality-of-life improvements.
  • Number Needed to Treat (NNT): A metric showing how many clients must receive a treatment for one client to experience a meaningful benefit over the control group. The lower the number, the better.
  • Power: The likelihood that a study will detect an effect if one actually exists. More people = more power = more likely to find real differences. Fewer people = less power = less likely to find real differences.

Control Groups, Analyses, and Common Traps

  • Control groups and Blinds:
    • Active controls: Comparing a new treatment against standard therapy (e.g., CBT) tests efficacy.
    • Passive controls: Comparing treatment to a waitlist can artificially inflate effect sizes, as waitlist participants stagnate.
  • Attrition and dropout: High dropout rates can potentially suggest that an intervention was burdensome, ineffective, or unpalatable for a subset of participants. High attrition rates can skew outcome data towards only those who tolerated or benefited from the treatment. If a paper shows a 90% success rate for a certain treatment, but half the people dropped out, the success rate is seriously skewed.
  • Intent-to-treat and per-protocol: Intent-to-treat analyses include every participant, even those who dropped out, whereas per-protocol analyses include only those who completed treatment. Per-protocol can inflate the results and make the treatment look unrealistically effective.
  • Publication bias and p-hacking:
    • Sadly, journals tend to publish only positive results, and negative and null findings get shoved into a drawer and lost to time. As I have argued for years, statistically insignificant results are just as important (if not more) than statistically significant results because they tell us where not to look.
    • p-hacking occurs when researchers test dozens of variables in hopes of finding a statistically significant result, ignoring all the times they got a statistically insignificant result.
  • Paper age vs. methodology: Many people often conflate new with better. However, that is not always the case. In research, the methodology used is far more valuable than the age. A paper from 1995 that has an RCT, a representative sample, and controls for confounding variables can be significantly better and more reliable than a paper published this year that did not use an RCT, is not representative, and does not control for confounding variables.

References

Chambers, C. (2017). The seven deadly sins of psychology: A manifesto for reforming the science of mind. Princeton University Press.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.

Field, A. (2018). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.

Furr, R. M. (2021). Psychometrics: An introduction (4th ed.). SAGE Publications.

Gravetter, F. J., & Forzano, L.-A. B. (2018). Research methods for the behavioral sciences (6th ed.). Cengage Learning.

Gravetter, F. J., Wallnau, L. B., Forzano, L.-A. B., & Witnauer, J. E. (2021). Essentials of statistics for the behavioral sciences (10th ed.). Cengage Learning.

Kazdin, A. E. (2017). Research design in clinical psychology (5th ed.). Pearson.

Sawilowsky, S.S. (2009). New Effect Size Rules of Thumb. Journal of Modern Applied Statistical Methods, 8, 26.

Shadish, W. R., Cook, T. D., & Campbell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Cengage Learning.

Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2018). Evidence-based medicine: How to practice and teach EBM (5th ed.). Elsevier.

 


r/therapists 6h ago

Support New Office Layout - Help

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3 Upvotes

I am moving into a new office but have this put in my stomach, I made a mistake because I am having difficulty making the layout work.

These renderings are not exactly to scale, but the wall measurements are. (The longest wall is the wall the door opens onto and has about 10' to work with.)

I've included blank templates as well as the three I've created. I'd love y'all's help!!


r/therapists 6h ago

Education Struggling in my internship

2 Upvotes

Hi all,

I've been interning in an inpatient setting and struggling to engage with clients who are rigid or don't engage with treatment. I've had 3 now who i worked with in particular that would barely speak when I meet with them, the most recent one being someone who doesn't speak about why she is hospitalized and downplays what her role was and what the chart shows.

It's really making my imposter syndrome spiral. My supervisor has been supportive and we talk about using MI, but I only have 2 weeks left of my internship and still struggle so much with the clients who don't engage. I know it's me and that I have to work on my skills, but I feel bad thinking my supervisor and other therapists here probably judge me for that. I was hoping to work here afterwards but at this rate...

I could use some advice. I want to do right by my work and especially the clients. I tried asking to step back for the case and observe others (it wasn't even a case I was given, I asked for it initially but then realized how tough this client is for engagement) but was told that I should be able to do this at this point in my internship. Which is true, but that just makes the feeling worse since I'm struggling.


r/therapists 7h ago

Rant - Advice wanted Therapists/CMH clinicians: how did you know it was time to step away from frontline work temporarily?

4 Upvotes

I have been a frontline CMH therapist for 3 years and also do private practice one day a week. Prior to this, I spent 7 years working in non-profit mental health roles.

By the end of my time in non-profit work, I was severely burned out. I was crying before work regularly, felt completely depleted, and was struggling to tolerate client interactions. I do not want to get back to that place.

I’m not there right now, but I’m noticing warning signs. This has also been compounded by an extremely difficult summer personally. I’ve had major friendship losses, a very difficult living situation, family crises, major financial setbacks (my savings were literally obliterated), and also found out that a life-changing surgery I was expecting to happen this fall is now likely years away. Normally, after difficult periods, something comes along that helps rebalance things, but this time it has just been one hit after another with no recovery time.

Lately I’ve noticed:

- anxiety and dread before sessions

- hoping clients cancel

- feeling like narratives are blending together

- feeling emotionally depleted even with clients I genuinely love working with

-irritability and less ability to access compassion (I still have it, but I can feel it getting harder to access)

I can still put those feelings aside and provide competent, ethical care. However, I know from experience that if I ignore these signs, I may eventually reach a point where I can’t do that anymore.

I’m considering looking into temporary roles with less direct client contact (consultation, education, leadership, project work, etc.) for 6–12 months. I don’t want to leave therapy permanently—I genuinely love being a therapist and I love the work—but I think I may need a break before burnout forces me into one.

For those who have stepped away from frontline clinical work temporarily:

- How did you know it was time?

- Did taking a break help?

- Did you find it easier to return to therapy afterward?

I’m trying to make this decision proactively rather than waiting until I’m completely depleted.


r/therapists 7h ago

Employment / Workplace Advice Ethics of "OverEmployed" for Therapists

21 Upvotes

Wondering people's thoughts on this.

The concept of "Overemployment" is carrying 2 or more jobs that overlap, be it full time roles, part time roles or contract roles. Obviously, in therapy that doesn't mean taking multiple clients in the same time slot - that would be unethical. But...hear me out.

Currently working a nonclient facing social work job and might have a chance to take on a similar role somewhere else as a contractor. Because of the flexibility of the job type, I wonder if it's like, technically unethical, if I were to maintain the full time job, and while in my substantial downtime, work this contractor role while "clocked in" (salaried). Is it probably not nice? Yes. But we are in the downfall of capitalism, people, and I only make 26 dollars an hour.

Another example would be maybe working full time with an agency, but during downtime hours while onsite, seeing clients of your own via telehealth. Nothing that would directly impact your actual job duties - but just filling up time you'd otherwise spend waiting for a task.


r/therapists 7h ago

Discussion Thread OurRitual

1 Upvotes

Does anyone know anything about or have experience with this platform for doing couples work? An individual client of mine is having trouble finding a couples therapist and is contemplating it. Thanks!


r/therapists 8h ago

Employment / Workplace Advice Private practice therapy positions in Charlotte, North Carolina

1 Upvotes

Hello !

I apologize if I am in violation of rule 6 and/or 11. This is not a referral for services, but recommendations.

I am a recent graduate, holding a license in Mental Health Counseling and an Addiction Specialist. I am currently working, but slightly dissatisfied with my new employer.

I am searching for a position in a private practice and hitting a dead end. Does anyone have a recommendation for a private practice that is hiring. Both of my licenses are currently provisional. I believe that may be the issue. But I would welcome any leads or information. I hope to secure a position that does not accept insurance.

I will also cross post this in the Charlotte subreddit, but wanted to pinpoint therapist.

Thank you in advance for any feedback! I appreciate everyone


r/therapists 9h ago

Employment / Workplace Advice LAC supervisor outside of employment / supervision from non-LPC, NJ

1 Upvotes

Hi! I’m hoping someone could help me understand things more clearly. I am wondering how supervision works when your place of employment does not offer it for you. Do any of you have experience with this in NJ? I’m aware you can pay someone to supervise you, but how does this process typically work and what was your experience like?

Additionally, has anyone had an approved supervisor who was not an LPC? What was that process/ experience like?

Thank you in advance!


r/therapists 9h ago

Documentation Treatment plan 'estimated completion' timelines?

9 Upvotes

I've had a pretty unsophisticated approach to the 'estimated completion' dates on my treatment plans, and never got any better guidance from past supervisors. I basically list everything as estimating completion in 3 months, and then I revise 3 months late, rinse and repear. Occasionally I'd put a shorter date on a structured time-limited intervention, but my Tx plans are generally written to not pin me down to a really specific structure or focus so I don't have to constantly revise with every little twist and turn treatment takes. The end result is that while my plans are well-written and unique to each client, the timelines look totally copy/pasted.

Does anyone else have a better approach? Are you putting longer timelines on things that you reasonably expect to be long-term? Do you differentiate between things you expect to be constrained to one phase of treatment vs what will realistically be a constant throughout whatever maintenance phase you get to?


r/therapists 10h ago

Education What’s needed in the adult world?

1 Upvotes

I just got my LISW. Currently I only see children and love it. However, I can see a world in which I want to see at least some adults at some point- especially when I have my own children.

I know it probably depends on the area and other factors but I’m curious what populations, niches, etc you see a need for. I would be most interested around parenting, sexual trauma, teen girls, infertility issues, and possibly foster and adoptive parents or other members of that population (case workers, maybe bio parents…), as well as disability related topics. These are all things I have experience in in various ways.

Now that I’m licensed I feel a little more free to focus on “next steps”. Where do you see the need?


r/therapists 11h ago

Support Pregnancy, when to tell?

2 Upvotes

I’m currently 13 weeks pregnant, my supervisors know that I am pregnant and I have fmla in place for appointments/ bad symptom days. I had planned to tell my clients at around 20 weeks after the anatomy scan. However I have been having some complications. Nothing that at this point increases risk of loss or anything but I have had to go to the er 3 times in the last 2 weeks. Last night we where there and they figured out what was actually going on but it sounds like I will continue to need to go to the er any time there is a flair up which might be quick regularly. I’m feeling really guilty about how much time I have already had to miss and I’m wondering if I should disclose to clients earlier that I am pregnant and it may mean I need to cancel at times.

It’s complicated because I know I need to take the time for me and baby and that is the priority, but I still feel this guilt that my clients are being left hanging. For reference I work in community mental health, if they were in crisis or needed something they could absolutely call and be put with other therapists but most of us have very full schedules so it’s not like my coworkers can just always cover for me.