For a therapist, the decision to leave the field doesn’t come easily.
Most of us know that the pandemic has taken a significant toll on people's mental health. Everyone from young kids who missed out on important socialization and learning during the lockdowns to older adults who experienced isolation, to teens, college students, young people just starting out in the world of work and parents … every slice of the population had legitimate struggles. Those seeking therapy were often left stranded due to long waitlists or difficulty finding a therapist that accepts their insurance. That's if they were lucky enough to get a callback.
Therapists themselves have become so overwhelmed and badly burned out that many have just thrown in the towel, and the situation continues to get worse. I was one of those therapists! Walking away was the hardest thing I’ve done because of how much I care about the people I help.
For a therapist, the decision to leave the field doesn’t come easily. By nature, many therapists are compassionate and empathetic people who truly care about their clients and the practice of mental health. For some therapists, walking away can be a choice between life and death. Therapists being pushed to the brink of suicide is not unheard of. Some even succeed in taking their own lives. I knew several therapists who ended their lives, and I was forced to push through the grief until finally the overwhelm became unmanageable. I felt guilty adding to the shortage of therapists, but something had to give.
Like everyone else, therapists have been hit by the pandemic and other tragic events such as mass shootings, but unlike everyone else they are expected to hold the fear and pain of every client they see on top of their own. Many therapists have their own therapists to help them carry the load. The number of therapists to go around just isn’t enough.
Currently there are approximately 530,000 therapists in the United States to serve a population of 330 million people. This number includes clinical social workers, clinical psychologists, licensed counselors and marriage and family therapists, and it also includes those who have left the profession but maintained their license. Obviously every person in America isn’t seeking therapy but it’s clear that there’s a disparity in numbers.
Therapists have to hold everyone else's pain on top of their own.Photo by Sydney Sims on Unsplash
The exodus from the profession is more than simply the high demands of clients. There are multiple factors, including the grind of dealing with insurance companies, many of which require therapists to jump through a lot of hoops to get paid. Insurance companies often reimburse therapists well below what their actual rate of service is, and insurance companies are notorious for doing “clawbacks,” which is essentially when they take money back. Clawbacks can be done for minor things like using a 60-minute code instead of a 45-minute code even though you spent a full hour with the client. Some insurance companies don’t feel that every diagnosis deserves a 60-minute session. There have been reports of clawbacks being tens of thousands of dollars and collected several years after the date of service.
Big box therapy providers have also come in the mix, promising better hours and more control over schedules, only for therapists to feel duped and exploited. Companies like Better Help and Talkspace offer low rates of pay and often require overscheduling for a therapist to be able to make a decent salary without them having to hold a second job.
All in all, therapists are just tired, and trying to figure out what’s best for themselves as well as their clients in that state is not enjoyable or rewarding. For those seeking mental health services, the outlook is a little bleak. Of course, it is possible to find a mental health professionals to help, but it generally takes a good measure of time and effort to find the right one.
Directories such as Therapy Den and Psychology Today are good places to look to find a local therapist who is accepting new clients. Then there's Therapy for Black Girls and Clinicians of Color specifically for people looking for a Black, Indigenous or POC therapist. If you’re uninsured or underinsured you can search for a therapist offering low-cost slots on Open Path Collective.
It's not a stretch to say that the current system is broken, and that negatively impacts both therapists and clients. Of course, there are new therapists joining the profession, and therapists who have taken a step away may well rejoin the profession after a much-needed break. Let's hope that these professionals are eager (again) to help shoulder the problems of the world.