Overwhelm SOS: What to do when you’re drowning in client work

January can be a busy month for therapists and other mental healthcare providers. And while you want to help as many people as you can, a surge in new clients can lead to feeling overwhelmed, exhausted, and burned out. 

And it’s not just the long hours taking their toll, seeing more clients may lead to compassion fatigue and vicarious trauma.

If you’re feeling frazzled (or worse), know that a few practical steps can help you regain control of your workload and protect your own mental health — putting you in the best place to help your clients too. 

Here’s our guide for what to do in busy times. 

Recognize the signs of overwhelm 

Before we dive into the advice, let’s talk about the signs of feeling overwhelmed to look out for. 

The earlier you catch yourself feeling a little overwhelmed, burned out, or exhausted, the better. Taking steps to address your workload or schedule early on can prevent the problem from progressing into full-blown burnout and other health impacts for you, or compromised care for your patients. 

Signs of being overwhelmed include: 

• Increased irritability (with clients, family, or friends)
• Trouble switching off from work after hours or trouble sleeping 
• Feeling emotionally exhausted or drained
• Hypersomnia or insomnia 
• Difficulty concentrating or making decisions 
• Not having zeal for your career anymore 
• Feeling detached or disillusioned about helping clients 
• Feeling like the state of the world is beyond repair 
• Losing confidence in your therapy skills 
• Feeling vicarious trauma from dealing with complex client issues 

The list could go on, though, as overwhelm and burnout affect us all differently. For example, a 2024 paper covers the physical, emotional, and psychological effects of burnout in therapists. While some reported feeling numb or dread, others reported a sense of “being there but not being there” at work. These feelings weren’t contained to work, either, as some felt distress in their personal lives, too.

It can be tricky to spot these signs while you’re in the thick of a busy work week. So make it a habit to check in with yourself regularly to see how you’re doing. If your work hours or caseload increases, it’s even more important to look out for signs of feeling overwhelmed. 

7 steps to take when your caseload feels unmanageable

Now it’s time for the practical advice. We know you won’t always have control over how much you work and what your schedule looks like, but small changes can go a long way to feeling more in control. 

1. Triage clients and refer some to colleagues or peers, if possible 

This one is tough. But if a large caseload is causing you to work long hours or feel emotionally drained or traumatized yourself, try to take steps to reduce it.  

Look critically at your client list to see who’s in most need of care and who could do well if you discharged and referred them to trusted colleagues or peers in your network. 

If you don’t have control over your caseload, speak to your supervisor about feeling overworked and discuss ways you can redistribute your clients if possible.

Actionable steps: 

• Consider triage software if you’re handling a lot of client inquiries. 
• Look up appropriate therapists to grow your referral network on platforms.
• Seek supervision or consult on cases to get the best care for your clients and feel supported yourself — especially if you’re feeling detached. 
• Implement a caseload cap or waitlist once you find a sustainable workload for you. This can change over time.
• Regularly assess how you're feeling, how many clients you’re working with, and how cognitively demanding your work is, and make adjustments when needed. 

2. Delegate or outsource admin tasks 

If you can’t refer clients — and even if you can — consider other tasks you can take off your plate to reduce your work and mental load. Consider which tasks you’re best suited for (probably meeting with clients), and which could be handled by someone else. 

Actionable steps: 

• Hire junior support staff or a virtual assistant to respond to inquiries.
• Bring on a contractor to help with marketing or web design. 

3. Harness AI to streamline your workload 

Speaking of removing tasks from your plate, consider harnessing AI to lighten your workload. 

AI tools like Upheal can reduce the time you spend on documentation, such as progress notes, intake forms, post-session summaries, and treatment plans. It can even help with scheduling headaches. Upheal’s upcoming newly revised scheduling functionality will allow you to see all of your clients and plans in one calendar. So, whether work or personal commitments, you’ll see them all. Plus, automatic session reminders and buffers between sessions save time and create space for you.

Actionable steps: 

There are many ways to harness AI, but here’s one step to get you started: 

• Use Upheal to securely record sessions and create a first draft of your progress notes. This reduces in-session note-taking, helping you stay present with clients, which is especially useful when you’re feeling mentally drained and struggling to focus. 

4. Schedule breaks throughout your day (and take them)

The cliché saying is true: You can’t pour from an empty cup. Take breaks throughout your day to give your brain a break and help you refocus. 

If possible, build in buffer time between your sessions for this. And if you’re taking steps to reduce your workload, make sure you protect that new-found time.  

Actionable steps:

• At some point in your work day, get outside for a quick walk and some fresh air and sunlight. 
• Don’t skip lunch — and ideally, eat it away from your desk for a true break. 
• Block breaks into your calendar so you don’t forget to take them (or overbook yourself!).
• If you only have a few minutes, do some breathing exercises or stretches. 

5. Try task batching

Task batching is when you group together tasks of a similar nature and do them one after the other. 

This can reduce context switching (when you jump between unrelated tasks) and multitasking to help you complete tasks faster and with less cognitive load. 

Research shows switching between different types of tasks slows you down, especially if you’re switching between complex tasks or tasks you’re unfamiliar with. 

Actionable steps:

• Make a list of the tasks you need to do over your week and group together similar items. 
• Prioritize tasks, separating tasks that need to be completed today or this week and allowing yourself to push other tasks to a later date.
• Block times in your schedule to complete similar tasks together. For example, you could set aside Friday afternoon to complete all of your marketing tasks in one sitting, or 4 p.m. to 5 p.m. every day to do all of your client documentation.

6. Take time to recharge before and after work 

When you’re feeling overwhelmed, take extra time to recharge before and after work hours. 

Establish a self-care routine that covers the basics of exercise, nutrition, and good sleep. You can also consider therapy for yourself to process vicarious trauma and burnout too. 

We’ve got more advice on how to unplug from work here. 

Actionable steps:

• Develop a transition ritual to mark the end of your work day — this could include jotting down lingering thoughts, closing your laptop, and going for a brisk walk before moving on to your evening plans. The ritual can act as a powerful signal to your brain that it’s time to power down from work mode.  
• Practice an enjoyable activity or hobby. This develops your identity outside of work. Plus, it can act as a creative outlet for stress and a distraction if you find yourself ruminating on work. 
• Take an inventory of how you spend your time and whether this gives you or drains you of energy. How’s how:
  1. Write down your values
  2. List out how you currently spend your time
  3. Reflect on your feelings after these activities
  4. Link the three above points together to determine if you’re spending your free time in ways that align with your current values. If not, consider blockers and changes you could make to align more closely with your values and feel as good as possible with the free time you have.  

Taming overwhelm is possible.

As a therapist, you’re already at risk of mental health challenges, burnout, and vicarious trauma. So when work gets busy, it’s easy to feel overwhelmed — and for this overwhelm to get out of control.  

Remember, feeling overwhelmed doesn’t make you less of a therapist or less suited to this field. It’s a tough job, and you’re protecting your long-term career and health by keeping overwork and overwhelm in check.

There are small steps (like scheduling breaks throughout your day) and bigger steps (like referring patients or using AI to streamline tasks) that can help. 

And one final tip from us: set a recurring date to reflect on how you’re feeling mentally and physically, perhaps in a weekly journaling session or monthly check-in with your supervisor. Recognizing the signs of overwhelm early can help you make changes to keep it under control.