r/psychotherapists

I'm an LMSW and I've been getting my clinical hours through a psychoanalytic institute in NYC. I just sat and calculated how long it's going to take me to get the clinical hours needed for my LCSW based on my current client load and I'm really cutting it close to the 6-year cut-off. The recent loss of a couple of clients (who left the state) set me back and I'm worried that I won't make the necessary hours if anyone else leaves. I also don't think I can do my best therapy while feeling desperate to hang on to clients.

An LCSW hired me to work under her license but I haven't managed to actually get any clients at her practice because I'm running into trouble getting OON reimbursement by insurance (seems very few cover supervised billing here in NY State). She's very supportive and a good clinical supervisor but doesn't have the bandwidth to take on fighting insurance and getting me clients. I'm on my own there.

Should I just get a job for a year at a community-based mental health organization or a large group practice that has staff dealing with insurance and I'm guaranteed a steady stream of clients?

Currently I'm doing 6 sessions a week. I'd love to get that up to 15-20, which would see me finish my hours in around a year. I have kids at home so only interested in part-time.

Questions:

1. Is it unethical for me to start working with clients knowing I plan to stay only a year? 

2. Is there such a thing as part-time work in the CMH/grouppractice world? How does one start looking for those kinds of jobs? (I've seen such horror stories on reddit about employers demanding insane caseloads, it really concerns me.)

3. Are there any other options I'm not thinking of? I'm having a really hard time drumming up paying clients on my own and even my institute's consultation center hasn't had many inquiries recently.

 

I hope this makes sense. Thanks for any advice given.

I sought grief counseling when my mother passed and I divorced in 2023. I found it very helpful.

I started dating shortly after my divorced and my counselor was opposed. We worked through it. I then dated a woman with MS and my counselor said I would ultimately end up in the role of caregiver.

That relationship was great in 2024 but ended up 2025. I feel like my counselor never understood the relationship and never approved.

I don't want to continue with my counselor any more but do like the weekly talks so will find another counselor.

Do I owe my counselor an explanation when I end my sessions with him?

Hello,

I've been using Headway as a therapist for years despite how problematic it has been at time. However, the recent policy for "identity verification" and the collection of biometric data through facial scans is an escalation of the tech industry's exploitation of personal data for profit.

I would love to hear from other therapists who are concerned and want to communicate this to the company. I will be sending the following statement to Headway, feel free to send around.

Headway's new policy to collect biometric and identification data on therapy patients is very concerning. It violates patient privacy and threatens the trust between patients and providers. It goes against professional standards and ethics rules for social workers and therapists, and there are clear HIPAA concerns. It is clear that this is an effort to gather data for the profit of the company and not to reduce waste and fraud as Headway is claiming. 

I was planning on expanding my use of Headway for my group practice with the addition of supervisory billing, but I no longer believe that Headway's policies align with the interests of therapists and my patients. 

This change will harm providers, patients, and ultimately Headway. It's unnecessary and I am requesting that Headway terminate the collection of identify verification immediately. 

Hi,

I'm currently at the beginning of my retraining journey as a therapist, and am Black and part of the LGBTIQ+ community. I'm wondering about the income of a newly qualified therapist practising privately versus an experienced therapist, and I want to hear from Black people about their experiences, particularly Black women. I've seen a lot of people on here talk about income depending on the population you work with, and I want to work with LGBTIQ+ people of colour, which is quite different from the vast majority of therapists in the UK.

It'd be great to hear how other Black people (cis, straight, or queer) navigate private practice and delivering therapy, and the type of income you make and how you get by.

Hi everyone, I’d love to get some honest feedback.

I recently found ePsych Billing and noticed they focus exclusively on mental health practices. That really stood out to me, because most billing companies seem to lump therapists in with general medical providers and don’t understand our unique needs.

I’m curious if anyone here has actually worked with them before. What was your experience like? I’m especially interested in how they handle insurance claims, denials, and telehealth codes for therapy sessions. Also, how’s their communication and transparency with reporting?

Trying to decide if they’re worth moving my billing over to. Thanks in advance!

How are folks using AI in their practices?

Hello all. It’s rare that in 14 years of practice I’ve had to refer a patient out because of my own countertransference that I couldn’t overcome/regulate. However, today I had to do so. I feel like I failed this patient who I have already worked with for two months. He is a veteran and a first responder. He needs lots of help. However, I was so dysregulated by his presence that I was losing sleep. I know I need to seek therapy myself for this in order to get down to the bottom of it. I’m just really struggling with feeling like I failed him.

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