A day in the life
I got asked a while ago to talk about a "day in the life" of a therapist. Here has been my experience.
Just as the clients we serve every single day are unique in their own right, so too are the day-to-day experiences of being a therapist utterly unique and often unpredictable. There are so many different types of roles in mental health, with so many different practice settings, interventions, client populations & needs, funding sources, policies and procedures, scheduling preferences, and more. Some folks will be running around in their vehicles all day providing in-home therapy or crisis interventions 5 days a week for 6-8 hours a day, while some folks will be nestled into their favorite couch at home or in their office, seeing a few clients a day for a couple days per week—and literally everything else you can imagine in-between.
As for me, I’ve worked in a few different settings, from internship through today. Since 2017 when I started internship, I’ve worked in…
A co-occurring disorder treatment facility, providing group and individual therapy for substance use treatment, upwards of 20 hours per week while working a full-time job in tech
A county-funded partial hospitalization program and mental health clinic, providing group therapy, individual therapy, and mental health assessments, also upwards of 20 hours per week while working a full-time job in tech
Two different non-profits providing intensive in-home family therapy (multi-systemic therapy and family centered treatment), where I spent half of my time driving around and away from a typical “office” setting, which I also did via telehealth once COVID hit
A group practice, providing in-person individual, family, and couple’s therapy, for 24 - 30 hours per week (and struggling financially in some big ways)
My own private practice, seeing adults in a 100% telehealth setting, starting at nearly 30 hours per week and reducing it down to 12 - 15 per week this coming January
While it’s impossible to capture the “average” day or week for any particular mental health provider, I can capture my own “average” daily and weekly experience, to give you some insight into what working as a telehealth private practice therapist might look like.
I see clients on Wednesdays, Thursdays, Fridays and Saturdays. I used to see clients on Sundays, too, but that was much too much, so I scaled back my schedule in August, and I am scaling back even further in January, cutting Thursdays from my clinical schedule and instead opening up some space for consultation/coaching clients and a 3-hour block dedicated to co-working, self-care, working on my business, and other non-face-to-face work.
Over time, my work life has undergone some painful but highly necessary scaling-back, rather than constantly scaling-up. This has been an important lesson for me as someone who has recently come to learn that I am probably a Highly Sensitive Person (still struggling with that label) and that I likely have ADHD (not confirmed, though I am going to get evaluated by a psychiatric NP in December).
As such, my schedule now may look “cushy” and I will fully admit, I find myself in that "magical” land of self-directed private practice work—where I get to decide my hours and my fee and all that good shit—this hasn’t been without some significant struggle, burnout, mental and physical health struggles, and lots of internal self-negotiation over the past several years. While it’s a schedule that suits me, it’s still one that pushes me right up to my personal emotional & mental limits sometimes.
The changes I am making in January—ending my contract with an agency where I provide insurance-based services and clearing a whole day for coaching work & coworking days—is scary as shit but feels so vitally necessary for me to maintain some semblance of wellbeing. I feel lucky to have that space to reduce my caseload, and while I am scared of open space on my schedule, I am willing to sit with it and to learn how to avoid filling it with endless busy work and more therapy sessions than I can handle.
So, with that being said, let me go over what a day in the life looks like for me right now, as a 100% Telehealth private practice therapist, and then I’ll talk a little bit about how this schedule will look come January 1, 2023. After that, I’ll explore some of the day-to-day/week-to-week tasks, as well as the overarching themes you might experience in the “actual work” of therapy with clients.
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