6 Strategies for Therapists to Prevent Burnout Before It Happens

Newly-licensed practitioners, and those who have recently started their own private practice, tend to jump into scheduling and seeing clients—giving it their all. 

This initial enthusiasm to take on as many clients and clinical responsibilities as possible may lead to an increased chance of burnout down the road. 

When ignored, burnout can have serious consequences—for you, as well as for your loved ones and clients.

Some of the contributors to burnout are fundamentally systemic. 

According to the Bureau of Labor Statistics, licensed marriage and family therapists (LMFTs) saw a median annual salary of $49,880 in 2021, even though even entry-level therapists must have their master’s degree. 

A decade ago, the median student loan debt for a Doctorate of Psychology (PsyD) was $200,000. In comparison, PhD students completed their degrees with student loans averaging $75,000.

In addition, student loan debt has continued to increase over the past decade. According to the 2016 National Postsecondary Student Aid Survey (NPSAS), for those who completed medical doctorates, average student loan debt increased approximately 97% between 1999–2000 and 2015–16 and for those who received PhDs outside the field of education, student loan debt increased by 104%.

In 2020 the pressure of student debt in the mental health field was so acute that the APA introduced a bi-partisan bill known as the Student Loan Forgiveness for Frontline Healthcare Workers Act. Although it didn’t pass, the bill was reintroduced to Congress in 2021.

Financial struggles are just one factor contributing to burnout for therapists, but it doesn’t end there.

“In the U.S., the therapy profession is culturally considered to be feminine, and like many other types of labor that are culturally coded as feminine, it’s devalued,” says Amalia Miralrío, LCSW, founder of Amity Detroit Counseling in Detroit, Michigan. “Therapists are underpaid, undervalued, and overworked.”

However, preventing burnout, even with these systemic concerns at play, is possible. 

In honor of World Mental Health Day on October 10, SimplePractice launched a series of resources, guides, and articles (of which this is one) that will help therapists unwind and take time for themselves. 

How practitioners can avoid burnout before it happens

Here are six key considerations to prevent burnout before it starts. 

1. Find quality support and supervision

Therapists may launch their career as part of a larger team or division. Every team includes a hierarchy, but the tone and autonomy that a hierarchy provides matters deeply. It’s going to inform how you can effectively institute care for your most challenging or emotionally taxing clients.

“For example, is the therapist able to freely voice their feelings in supervision or to peers?

Does the therapist have a supportive space to talk through case conceptualization, to better understand why [a challenging] client isn’t finding relief?” says Miralrío.

As you’re looking to find your first few jobs in the industry, prepare interview questions that ask about how supervisors and peers support one another through challenging caseloads.  Supportive supervision, paired with a personal sense of autonomy, can allow you to go far, even with a stressful caseload.

2. Price your time with preventative care in mind

As much as therapists are passionate about helping others, your time is valuable and you’ve studied extensively to prepare for your role. It’s imperative that you price your time accordingly.

“Therapists face a real conflict around wanting to offer affordable services and needing to make a living, and a lot of therapists end up taking on a large caseload to make ends meet,” says Andrea Niles, PhD, psychologist and founder of Prospera Maternal Mental Health in San Francisco, California. This mindset can wreak havoc as time goes on.

You’re not always going to have the capability to pick and choose your hourly rate, however, pricing your time in a way where you’re putting your needs front and center can go a long way in preventing burnout. It’s not uncommon to feel conflicted about wanting to help people access care affordably, but you simply can’t help clients if you’re stressed about how you’re going to pay your bills.

3. Make pragmatic changes

Burnout can feel large and looming, but it is possible to make small, impactful changes based on awareness.

Let’s say a client asks for an appointment on a Friday evening at 7:30 PM. You usually don’t work on Friday evenings, but because you want to accommodate the client and need the money, you say yes.

The appointment comes and the session is intensive. When you leave the office, you’re exhausted.

Your Friday night is gone, and the tone of your weekend has shifted because you didn’t keep that scheduling preference in place.

“A big part of it is being aware of your internal monologue and how you’re feeling in a moment.

Often we push that away,” says Gabrielle Juliano-Villani, LCSW, owner of GJV Consulting. “If you’re feeling burnt out or exhausted, notice the moment when it comes up like a theme or a pattern. That can tell you, OK, this client is a bit more effort, maybe I need to see [them] early in the morning or earlier in the week when I have more energy.”

Analyze your schedule. Are there times when you’re feeling especially slow or sluggish? 

Test things out to determine which appointment times do and don’t feel good to you. 

Once you identify which schedule aligns with you feeling your best, set your availability accordingly.

4. Diversify your day

As you’re launching your career, there are going to be opportunities to reinvest in yourself. Consider taking these opportunities so you can offer diversified services and generate new income streams over time.

“If therapists can include additional income sources–like supervision, consulting, training, or teaching alongside their clinical work–that can help mitigate the exhaustion associated with patient care,” says Niles.

Even if you can’t diversify your days just yet, identify therapists who successfully have. Reach out and see if you can learn more about how they’ve built their business while balancing their time and energy. That same assortment of services can be in the cards for you down the road.

5. Visualize a distance

All therapists have experienced the moment when something a client says steps across the carpet and settles on them, like a weight that can’t be shaken off.

Whether that is a client outlining trauma, problems, or their innermost thoughts and feelings that intersect with you personally, you’re only human. There are going to be moments when challenging sessions hit too close to home. Before you know it, your personal life is weighed down by your work.

For Juliano-Villani, one of the tried and true methods to overcome this sensation is the power of visualization. “I imagine myself in a bubble, or a forcefield, and that creates distance between what my clients are telling me when it’s difficult or detailed,” she says. “I imagine them bouncing off my bubble, so it’s not coming into my energy field, but I have a hole in my bubble where the information that is helpful can come in.”

Use your mind to visualize imagery that helps you place space between you and your client.

It’s not your job to personally take on their pain.

6. Accept trial-and-error

All in all, burnout is far too normalized within the mental health field. Therapists want to help—sometimes at their own cost. 

You may make decisions that put others’ needs ahead of yourself. It can take time and practice to develop your boundaries and stick to them.

However, burnout doesn’t have to be a  constant occurrence, or a requirement in a successful, rewarding career.

“Burnout is often the result of spending too much time doing work that isn’t fulfilling,” says Niles. “By balancing time between different professional activities and balancing the severity of one’s caseload, it’s definitely possible to avoid it.”

Check out the other articles, courses, and resources that SimplePractice created to support clinicians experiencing burnout this World Mental Health Day.

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If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.

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