Am I a good therapist?

Sometimes, working in this field can leave us feeling like we’re not good therapists. Largely, this is a reflection of our burnout and the system that we’re having to force ourselves to work within. 

Whatever the reasons, it’s not a great feeling to have – it certainly didn’t feel good when I was practicing, and despite credentials that said otherwise, I sometimes even felt like a fraud when working in my practice. 

Surprisingly, the feelings intensified as I leveled up in experience and certifications. I always chalked it up to the heightened sense of self-awareness that we tend to take on as mental health professionals. However, seeing other therapists share their feelings of inadequacy in places like Reddit has shown me that my feelings may have stemmed from the heavy workload I was taking on. So, what to do? Well, that depends on what’s causing you to feel this way. 

In this post, I'll talk about why therapists sometimes feel this way and what to do about it. 

Why you may feel like a bad therapist

In truth, I don't think we’re "bad" therapists. It's more that we may feel ineffective. Here's a look at why that might be.

Imposter syndrome

It's not a bad sign if you feel like a fraud as a therapist. Hear me out! Research shows that imposter syndrome is common among high-achieving people. High achievers tend to be perfectionists. From what I've seen in studies, it's these perfectionist traits that drive imposter syndrome. If you're a therapist with an advanced degree, you worked hard to get to where you are. Unfortunately, the drive that helped you get to this point can also fuel the same voice telling you that you don't deserve to behere. While imposter syndrome is common among high achievers, unchecked self-doubt can lead to burnout, decision fatigue, and avoidance of opportunities for growth. 

Imposter syndrome can be a strength if we're not letting it eat us up. The key is to acknowledge these feelings without allowing them to dictate our sense of professional worth. According to information shared by Basima A. Tewfik at MIT Sloan, one study looking at the phenomenon of imposter syndrome found that student doctors who had frequent "imposter" thoughts were actually better at handling sensitive interactions with patients. In the end, it earned these doctors higher interpersonal-skill ratings in training. Meanwhile, we don't have any studies on the books confirming that imposter syndrome degrades performance. What I'm getting at here is that these thoughts of being a "bad" therapist do not need to become your reality.

You're struggling with therapist burnout

How's your client load looking? If you're taking on too much, the inkling that you're getting about being a bad therapist could simply be the result of your inner mind knowing that you're spread far too thin. 

If you're like me, you went from intensive schooling and training to jumping straight into client work. I don't think I had more than 24 hours "off" between the ages of 28 and 35. I was suffering from tunnel vision that made it hard for me to feel the passion I had for my work. Consider the idea that burnout can distort your perception of your effectiveness. This can make you question your abilities even when you are doing good work. 

If you're feeling burned out, it's worth examining both your workload and the structural factors contributing to it. Many therapists work within systems that encourage overextension, and burnout isn't a personal failing — it’s often a sign that something needs to shift at an organizational or systemic level. 

Lack of work/life balance

You could feel like a bad therapist because you're resentful of your responsibilities. It's hard to show up as our best selves when we feel like we're being drained, overburdened, and potentially taken advantage of in our workplace. Does your practice or employer expect you to prioritize work over life in every scenario? Unfortunately, these feelings of resentment can transfer over to our client interactions. We feel like we are showing up with half a brain, half a heart, and a whole countdown to the weekend. Of course, the reality is that your training and professionalism enable you to "feel" one way while still providing professional, competent services to your clients.

It's time to have a heart-to-heart talk with yourself about how much you're pouring into your job. If you feel that the "life" portion of your life is being eclipsed by the hours you're working, consider a new arrangement. For some, that might mean stepping back from taking on new clients. For others, it might mean a shift to a different environment with fewer hours.

Vicarious trauma  

Therapists are often drained by the emotional needs of clients. According to the National Child Traumatic Stress Network, up to 26 percent of therapists working with traumatized populations are at high risk of secondary traumatic stress. They are also at a higher risk for conditions of PTSD. For child welfare workers, that number climbs to 50 percent. Many mental health professionals are operating in survival mode in response to undetected and untreated secondary traumatic stress.

Part of our job description as therapists is hearing a person retell the worst day of their life. We often deal with difficult situations that can include suicidal ideation, child abuse, and intimate-partner violence. For those of us who are deeply empathetic, we can practically experience these situations in our bodies as our clients tell them. It's easy to become overwhelmed.

Client resistance

In addition, many of us are exhausted by client resistance. While it's often subconscious, many clients fight tooth and nail against any sort of growth, change, or progress. Watching clients struggle with resistance to change can be exhausting, especially when you care deeply about their progress. We may question if we're bad at our jobs when clients fail to progress. We may also wonder if we're still giving it our all when it feels like we're the only one between the two of us who actually wants to be in the session.

Ethical dilemmas

As therapists, we also live in a space where there's a need for constant judgment calls. The stakes are high if the call you make is the wrong one. Think loss of clients, loss of license, lawsuits, and other serious penalties. We are always facing ethical dilemmas when it comes to stepping in to break confidentiality when a client is a danger to themselves or others.  

Ethical dilemmas are a natural part of therapy work, but they don’t have to be navigated alone. Professional organizations, licensing boards, and consultation with colleagues or supervisors can provide guidance. If you often feel unsupported in ethical decision-making, it may be a sign to seek out stronger professional mentorship and support.

What makes a good therapist? 

In case you’re still experiencing self-doubt and criticism, please remember that sometimes, it’s not about us and our skills. It’s possible to feel better with one therapist over another based on the invisible chemistry created through a unique combination of culture, life experience, personality, and age. However, that doesn’t mean we’re “bad” at what we do. If there are racial, cultural, or gender-based differences, we can be aware of and address these with our clients, making sure we capture the meaning we’re supposed to. It can even inform the therapy. 

That aside, there are some characteristics that great therapists do share. Here are a few of these in case you’d like to take a moment to honestly self-assess, and hopefully prevent a fear or anxiety spiral: 

• Empathy - Empathy is necessary for therapy. It fosters a strong therapeutic relationship. It helps clients feel understood and accepted. Chances are, if you’re in this field, you’re high in empathy already.
  
  
• Non-judgment - A good therapist is there to support. We are asking clients to divulge their deepest feelings and secrets, after all. They must feel safe and comfortable doing so. In addition, we’re there to help clients build up their own healthy sense of self-reliance and judgement.
  
  
• Self-awareness - A therapist must possess self-awareness. Good therapists have a deep understanding of who they are. They know how their unconscious beliefs influence the therapeutic process. This awareness helps drive further personal growth, as well as informs supervision. 

After reading these, we hope you can see you’ve already demonstrated at least two of these three criteria! You’re being self-aware by noticing that something is off (even if it may “just” be burnout), and you’re showing empathy too, by being concerned about this topic in the first place, which shows you care about your clients! That said, if the feeling persists, please continue reading below. 

What to do if you feel like you're a bad therapist

As someone who has felt this fear and worry, I know that all of the pep talks in the world can't make you feel like you're succeeding. However, I can offer some practical advice based on what helped me turn things around. Ultimately, it's not about being a "good" or "bad" therapist. It's about committing to showing up as an effective, competent professional who is utilizing all of the tools available to support positive outcomes for your clients. My tips for making that happen are below.

1. Supervision

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I can't stress the importance of mentorship and good supervision in the therapy space enough. If you feel like your supervisor or boss has left you floating at sea, consider asking for more support. Ask for a weekly meeting where you can address the struggles you're facing in your client load. This is a time to ask about those "sticky" situations that make you feel like your judgment and expertise aren't enough.

2. Self-care

I remember living by the clock during my time in practice. It was like I was dividing up the periods when I would give myself time to breathe based on when client sessions began and ended. Giving yourself time to simply exist as a human without seeking validation based on how many clients you've seen in a day or how much paperwork you've covered is so important! It's especially easy to feel guilty about taking time for self-care when our livelihood depends on squeezing in one more appointment.

3. Personal therapy

Address your own feelings including worries about inadequacy, burnout, or vicarious trauma with a therapist. You're a sounding board for everyone else's problems for eight hours a day. You need a space where you can actually process the experiences you're having as a therapist. In addition, you need to explore the intersection of your personal identity and professional identity in the therapy space to live a more integrated life as someone with a high-pressure job.

4. Taking time and reducing workload

If the sense that you're a bad therapist is so strong that you're reconsidering your career, I recommend starting with some time off, either by reducing your workload or if you’re able to financially, taking a couple of weeks or even a month off of work. See how you feel after a break and some time to introspect. Try to get specific about why you’re feeling the way that you are. Did you receive direct client feedback? Are your clients not progressing? The mind can play tricks on us, so looking for evidence is a good way to dispel this “feeling” that most likely isn’t a reflection of reality but your traumas, projections, and your tired, overworked being. If the feeling persists even after a break and deeper introspection, then seriously consider that you may indeed need a career change.

5. Consider that career change

Therapists are allowed to change jobs! Put feelers out just to see what's possible. Consider reaching out to a recruiter specializing in the mental health field. I've seen many peers who were burned out by private practice thrive when they switched to school counseling or hospital settings because they felt like they were part of a bigger infrastructure that eased some of the burden of bringing in their own clients. It’s possible! And sometimes, just knowing that there are other options can help us a great deal. 

Final thoughts: It’s unlikely that you’re a bad therapist

The irony is that questioning whether you're a good therapist often means you're engaged, self-reflective, and invested in doing right by your clients—traits that are linked to more effective therapy.

What I will tell you is that little changes can go a long way; create mindfulness breaks using music you love, add some plants to your office, or even consider bringing in some art supplies for you. Anything to slow down your day and create pockets of joy and distraction. 

Finding ways to lighten your administrative load can help prevent burnout. For example, AI-generated therapy notes can free up mental space and save valuable time, allowing you to be more present with your clients. 

Think about switching to Upheal for a HIPAA-compliant way to claim back six hours every week! You’re doing the job for a reason – help yourself stay energized and maintain those emotional as well as work/life boundaries. You can’t help your clients if you burn out.