The truth behind therapist burnout

A definitive guide to its causes and what you can do about it

There’s no doubt about it: Being a therapist is one of the most challenging professions in the world. Although therapist burnout rates have come down since their post-Covid peak, they still remain high, with over one-third of therapists reporting that they feel burned out in a recent survey by the American Psychological Association. 

The reasons behind therapist burnout are complex. Many therapists feel burned out due to worsening client symptoms (especially during and after Covid), but there are other factors involved as well – including unreasonable caseload numbers and time-consuming documentation demands.

Experiencing burnout does not mean that you aren’t a good therapist or that you’re not cut out for this line of work. It doesn’t mean that you don’t care about your clients’ well-being. Unfortunately, the profession is currently set up in a way that puts unrealistic demands on therapists – that’s not your fault, and it’s nothing to be ashamed of. What you’re feeling is valid.

Here, I’ll talk about the reality of therapist burnout as someone who’s faced this myself – including its most common causes (hint: it often has nothing to do with the clients themselves) and practical tips on how you can protect yourself.

What does burnout look like for therapists? 8 signs of therapist burnout

Burnout is a psychological state that causes you to feel exhausted or unfulfilled in your role. We often talk about burnout as it relates to employment, but people can become burned out on any responsibility or task, including caretaking and parenting.

For therapists, the issue of burnout is complex, because it’s closely related to – but not the same as – other common emotional phenomena like compassion fatigue or vicarious trauma. While compassion fatigue and vicarious trauma are also important issues that affect many therapists, it’s important to understand how burnout, specifically, affects therapists.

Compassion fatigue and vicarious trauma have to do with clients’ needs and issues. As therapists, an important part of our job is to help alleviate people’s suffering, and sometimes, we can end up taking on a lot of those painful emotions. Compassion fatigue can cause you to worry excessively about your clients during your time off, or even start to experience some PTSD symptoms yourself.

Compassion fatigue and vicarious trauma can contribute to burnout for many therapists, but in many ways, these can be signs that you’re still connected to the work that you do. On the other hand, when you reach a state of therapist burnout, you may feel like you no longer care about your job at all. Additionally, burnout can be caused by so many different aspects of the job, not only your clients’ needs.

What are the signs of therapist burnout?

Here’s a checklist of some of the most common signs of therapist burnout. If you can relate to many of them, it’s possible that you’re becoming burned out.

1. You feel emotionally exhausted or drained; you might experience this feeling all the time, but especially after long days at work.
2. You dread going into work, and sometimes find yourself hoping that clients will no-show.
3. You find yourself zoning out or having a hard time following what your clients are saying.
4. You feel like you aren’t making any difference in the world at all – the optimism from when you first graduated is gone.
5. You feel frustrated with yourself and your clients because you feel like they haven’t progressed.
6. You feel detached from your clients and have less investment in their lives and outcomes.
7. You feel cynical about the therapy profession in general; you often wish you had chosen another career.
8. You’ve lost confidence in your skills, and may feel like you “don’t know what you’re doing.”

Causes of therapist burnout

People outside of the profession often misunderstand therapist burnout, and may believe that therapists burn out solely because of the emotional nature of the work itself. In reality, therapists attribute burnout to a wide range of causes, many of them having nothing at all to do with their clients. 

I, myself, faced burnout due to a combination of overbearing documentation requirements (I was a social worker working at non-profits) and working with a very high-risk population. I loved working with clients, and they carried none of the blame – but the combination of all the stressors became too much to handle.

Here are some of the main causes of burnout that I’ve heard other therapists discuss.

Overbearing documentation requirements

Unfortunately, a big part of being a therapist – regardless of the setting you work in – is documentation. One study found that therapists spend over 30% of their working time on documentation alone. 

Whether you work in a non-profit organization or health clinic and need to send billing documentation to the government, or you work in private practice and need to take notes for insurance purposes, taking good notes can be time-consuming and exhausting. The pressure of note-taking leads to burnout for many therapists. 

Too many clients on your caseload

Having a caseload that’s too large can also lead to burnout. This especially affects therapists working in non-profit, government, or agency settings, who don’t typically have control over their caseloads. But even therapists with their own practice can feel pressure to take on more clients than they can comfortably handle due to financial pressure.

One study found that community therapists with higher caseloads were more likely to face emotional exhaustion.

Being a new therapist

As we mentioned before, compassion fatigue can absolutely contribute to burnout for many therapists – one could even say that it’s an experience that affects almost all therapists at some point in their careers. 

Therapists who work with higher-needs clients or clients who have faced significant trauma may be more likely to experience compassion fatigue. In addition, newer therapists, who are still figuring out what boundaries make sense for them, are sometimes more vulnerable to compassion fatigue.

Clients with complex needs

Working with clients who have high or complex needs can also lead you to burn out as a therapist. For example, working with many clients who are constantly in crisis, like facing suicidality or self-harm, can be exhausting for the most experienced of therapists – even if you have willingly chosen to specialize in working with these populations. 

Becoming exhausted by complex client needs doesn’t mean that you’re not meant for this work or that you’re not a good therapist; it simply means that you may need to take a step back and assess how you can make sure your own needs are met.

Mandated clients

Similarly, working with mandated clients – clients who are required to see you against their own wishes, such as clients who need to receive therapy as part of a court mandate – can be very challenging and lead to burnout. Working with mandated clients can inadvertently reaffirm your feelings of inadequacy and futility.

Role ambiguity

Especially in non-profit or agency settings, there might not be clear boundaries around your role and responsibilities as a therapist. For example, many agency therapists are responsible for transporting clients, case management, community outreach, crisis intervention, and more. 

This can lead to scope creep – a situation where you’re taking on far too many tasks in addition to your role as a therapist. Understandably, this scope creep causes many therapists to burn out.

Low pay

Many new therapists start out getting their licensing hours in agency settings, and are paid a very low wage that can make the rest of their lives stressful. This can build to resentment and burnout – some therapists even need to pick up second jobs on the weekends to make ends meet, which severely impacts work-life balance.

Navigating licensure

If you’re a therapist, you already know how long and complicated the licensure process is. Not only do therapists need to complete a graduate degree from an accredited institution, but they need to meet a large array of additional requirements, including completing post-grad clinical hours and passing exams – all of which vary from state to state.

The process, although important, can lead to many newer therapists becoming burned out and deciding not to complete licensure. One paper even found that only 43% of Masters-level clinicians ever apply for their licenses. 

Business logistics

If you’re a therapist in your own private practice, then you also need to take on the role of being a small business owner. This involves so many tasks that none of us learned in graduate school, including leading marketing efforts, figuring out web design, doing administrative and scheduling work, hiring employees, and more.

Many therapists aren’t prepared for this completely new role, and there is so little support out there in this area.

Lack of supervision and professional development

Many therapists feel burnt out because they have no support, especially after finishing licensure. You might have consistently gone to supervision and conferences as a new therapist, but once you’re licensed, it’s become more difficult to find the time to engage with CEs and trainings. You’re in your own private practice bubble, and this can feel very alienating – not to mention the lack of professional development can cause a hit to your confidence.

Unmanaged trauma or mental health concerns

Many therapists also have experienced their own personal trauma or mental health concerns – a desire to help others who’ve had similar experiences is often what leads people to become therapists in the first place. We have found that mental health professionals actually experience mental health issues at higher rates than the general population.

It is absolutely not true that someone who’s faced their own trauma or mental health issues can’t be a good therapist. In fact, many of the best therapists have battled their own demons, which allows them to have more firsthand experience and empathy for clients.

An issue arises when these mental health concerns are unmanaged, then working with clients – especially those who have been through similar experiences as you – can be triggering. Unfortunately, mental health among treatment providers still carries a stigma, which can lead some therapists to feel ashamed about needing support.

How to recover from burnout as a therapist

Battling the wide spread of therapist burnout will be a community effort; many changes (some systemic and some personal) may be needed, including adjustments to pay, documentation requirements, and caseload limits.

In the meantime, there are many things you can do as a therapist to protect yourself and deal with burnout. Here, we’ll give a short list of practical tips to help you recover from therapist burnout – including using AI to simplify your documentation process.

• Find a mentor: A lack of professional development and training can make you feel helpless and create a sense of futility in your work. Connecting with a mentor or a supervision group, even if you’re already licensed, can give you the encouragement you need to keep going. Join PESI or another local organization to gain continued training, get feedback, and connect with others in the profession. This can not only help you feel less alone, but also make you more confident in your therapist skills. You can also consider getting supervision more frequently to get the support that you need.
• Connect with your values: Many therapists, as well as people in other professions, become burned out because they lose sight of what really matters to them. To combat this, remember what led you to become a therapist in the first place. How have your values changed since then, and how have they stayed the same? For example, maybe you were passionate about working with one group of people as a new grad, but now have new interests in different areas. What needs to be adjusted in your work life to allow you to align with your new values?
  
• Get down to the basics of self-care: As a therapist, you obviously already know about the importance of self-care. But sometimes, the idea of practicing self-care yourself can feel so daunting and time-consuming that you let it go by the wayside. Try to get back to the basics when it comes to self-care; remember that you don’t need a full day at the spa to take care of yourself. For example, eat lunch mindfully instead of having a working lunch. Get yourself outside in the sun at least once a day. Prioritize restful sleep. Move your body. These things are simple, but make a huge difference.
  
• Get your own therapy: Therapists need therapy, too! Although therapists can sometimes feel like they need to have it all together in order to be able to support their clients, this is simply not the case. If you’re experiencing stress or burnout, then therapy can give you a space to vent, work out specific obstacles, and reconnect with your values (and make adjustments as necessary). It can help to see a therapist who specializes in providing mental health support for other therapists.
• Save time on documentation: Therapists spend over 15 minutes per clinical hour on documentation alone – think about what else you could be doing with that time. Using AI and other digital tools to automate what you can is a great way to save valuable time (so you can use it doing the things that charge your battery). Using the AI progress note feature, you can securely record sessions and quickly create progress notes that meet documentation guidelines, in SOAP note, GIRP note, Intake note, and other formats. Or, you can even use the AI to create treatment plans for you, which you then only need to review and approve.
  
• Outsource the tasks you don’t enjoy: Almost none of us enjoy every part of private practice ownership. If it’s possible, try outsourcing some of the tasks you don’t enjoy – like billing, scheduling, and other business logistics. Or if you can’t outsource, you can even consider letting go of some tasks – like maintaining an active social media presence. Try to fill your practice and time with tasks that are fulfilling for you, not the ones that you dread.
  
• Express boundaries to supervisors: If you work at an agency or group practice and your caseload is getting too full – or if the clients you’re getting assigned aren’t who you’re passionate about working with – then gather the courage to set and express boundaries to your supervisors. Open conversations with them about your ideal caseload and what it would take to respect your boundaries. You might not arrive at the perfect solution, but you can start the journey of compromise.
• Split your time or try other things: It’s perfectly okay if you decide that you don’t want to do clinical work 100% of the time, which is an important lesson that I myself, along with other members of the Upheal team, learned during therapist burnout. For example, you could do part-time clinical work and do something completely unrelated – like dog-sitting, which is what I did – on the side. Or you could pivot into a related field, like training or health writing (something I also did!). Splitting your time can help ease therapist burnout and create excitement for new projects.
  
• Be kind to yourself: Lastly – but most importantly – practice self-compassion. As therapists, we so often have a hard time listening to our own advice about being kind to ourselves. It can be easy to split into a place of self-blame for not being able to “handle” the work, or feel like you’re failing your clients. But burnout happens to everyone, especially therapists – this work is hard. Try to talk to yourself the way you would a client. Allow the painful emotions to connect you with a wide community of other therapists who have been in the exact same boat.

Prevent therapist burnout 

Therapist burnout is a very real problem with valid causes. If you’re experiencing this as a therapist, know that you’re not alone. There are many challenges to being a mental health professional.

Hopefully though, the above article has helped you understand more about the causes of therapist burnout and given you some tangible tips for how to help yourself, as well as permission to find things hard. They are! 

That said, you are best placed to understand what you need. Don’t hesitate to care for yourself too, not just your clients. And finally, know that you can also use innovative technology like Upheal with their AI progress notes to save up to 6 hours a week on documentation. Try Upheal for free  and see if it can help you create more time for self-care. Hope this helps!