Overworked therapist taking a breakMany professionals, especially health care workers, find themselves busier than usual on occasion. This might include working longer hours, taking work home, or spending time off thinking about what they still need to get done. 

A brief period of overwork may cause some stress, but it may not have any serious implications as long as your schedule returns to normal before too long. More consistent overwork, however, can have serious implications for your physical and emotional well-being. Prolonged overwork can increase your risk for depression, and it often signals that burnout lurks on the horizon. 

Signs of Overwork and Burnout 

Overwork often involves scheduling and seeing too many clients per week. But overwork for mental health professionals can also involve other aspects of your work, including billing and scheduling. 

If you’ve been overworking, you may:

  • Find it difficult to stop thinking about work on your days off
  • Feel unable to work less due to financial demands or client needs
  • Feel distracted or frustrated when working with clients
  • Lack adequate time for self-care or relaxation
  • Feel too tired for enjoyable activities or household tasks
  • Have trouble getting enough restful sleep
  • Dread going to work or no longer enjoy providing therapy

Watching for signs of overwork can help you take steps to reduce your workload. If you continue to put too much energy into your work, burnout may follow. 

Therapists dealing with burnout generally notice:

  • Less empathy and compassion for others, particularly clients
  • Physical and emotional fatigue
  • Less pride and accomplishment in your work

Burnout can also involve other signs, including ethically ambiguous behavior in therapy such as unnecessary disclosure to clients and general dissatisfaction with your work. Burnout symptoms may also spill over into your personal life or negatively affect mental health. 

Many professionals struggling with burnout or overwork may also have feelings of depression or use substances to help cope with stress.

Causes of Overwork in the Mental Health Field

Overwork is a key factor in therapist burnout, suggests a 2018 review published in Frontiers in Psychology. While overwork and subsequent burnout can happen to any mental health professional, certain factors can make these outcomes more likely. Research exploring burnout in mental health services found some evidence to suggest burnout appears particularly common among social workers, in comparison to psychiatrists and nurses. 

People might overwork themselves for a variety of reasons. Sometimes, unique and specific situational circumstances might lead to short-term overwork. In other cases, people might work more than usual to avoid personal difficulties. 

Generally speaking, many therapists may fall into a pattern of overwork when they:

  • Aren’t making enough income to see a profit
  • Have worries about a client (or more than one) who’s dealing with extreme distress
  • Want to help more people than realistically possible on a typical schedule
  • Don’t schedule enough time in their workday for paperwork or insurance claims
  • Feel helpless or believe they aren’t doing enough to make a difference
  • Work alone and have few colleagues, mentors, or opportunities for professional feedback

How to Address Common Causes of Overwork and Overwhelm

Despite your best attempts, you may not be able to resolve every cause of overwork or workplace overwhelm. But you can take steps to address some situations, which can help lighten your workload and reduce stress to some extent. 

For more information about how to simplify your private therapy practice, read about GoodTherapy Membership.

Revisit your insurance policy

The decision to accept insurance is a personal one. Many therapists choose to take insurance because they want to increase access to care for clients who couldn’t afford therapy without insurance. However, working with insurance companies (especially multiple insurance companies) can be a challenging, time-consuming process. 

The reimbursement you get from the insurance company might also be less than the fee you’d receive from a client who paid for their session themselves. If you take insurance, you may end up needing to see more clients in order to make up the difference. 

Possible solutions include:

  • Choosing to work with only one or two insurance companies
  • Limiting insurance-paid sessions to a set amount of weekly sessions (say, half)

These two changes may help cut down on weekly paperwork and billing. When these changes aren’t enough, it may also help to slowly phase out your insurance policy. In other words, you might continue to work with current clients who use insurance but no longer accept insurance from new clients.  

Recalculate your rates

It’s always wise to revisit your fee structure from time to time, but this becomes even more important when you find yourself struggling to make a profit. While you may have chosen a career as a mental health professional in order to help people, not make money, if you don’t make enough money to support yourself and your business, you could end up in serious financial distress. It’s essential to make a reasonable living in order to continue providing quality therapy. 

Business management tools, including worksheets and calculating guides available on most private practice websites, can help you calculate individualized rates that take into account your business management costs and preferred number of weekly clients. 

Scrap your paperwork

Most people dread paperwork, and some of this dislike often stems from a fear of completing it incorrectly. If you’re already experiencing stress or overwhelm, you may feel even more anxious and frustrated about getting the paperwork done correctly, in a timely manner. 

If your level of paperwork has reached the point where you can’t manage it easily in your typical workweek, you might find yourself working longer hours in order to complete it all. You may feel as if you never want to see it again. Well, that’s something you can certainly manage. 

While you can’t exactly get rid of those essential documents, you can delegate paperwork to someone else: a part-time administrative assistant. It may seem expensive to hire an assistant for your practice, but most trained administrative professionals can manage your weekly paperwork in just a few hours. This can reduce your stress and quite possibly free up a few extra timeslots for therapy sessions—the work you actually want to do. Depending on your session fee, adding just one additional session each week could even pay your assistant’s weekly salary. 

When attempting to address overwork and overwhelm, involving trusted colleagues and other professionals can have benefit. Isolation can put you at higher risk for burnout and make it tough to recognize when you’re trying to manage too much. 

You may think that working longer hours allows you to make more of a difference with the therapy you provide. But since overwork can lead to burnout, which affects your ability to provide quality therapy, the opposite is often true. 

If you feel distracted while providing treatment, notice you have less empathy for your clients, or struggle in other ways, don’t hesitate to reach out to a therapist of your own.

References:

  1. Barnett, J. E. (2014). Distress, burnout, self-care, and the promotion of wellness for psychotherapists and trainees: Issues, implications, and recommendations. Retrieved from https://societyforpsychotherapy.org/distress-therapist-burnout-self-care-promotion-wellness-psychotherapists-trainees-issues-implications-recommendations
  2. Fradera A. (2018, June 22). Burnout is common among psychotherapists – Now a review has identified the personal characteristics that increase the risk further. Retrieved from https://digest.bps.org.uk/2018/06/22/burnout-is-common-among-psychotherapists-now-a-review-has-identified-the-personal-characteristics-that-increase-the-risk-further
  3. Mallonee, B. C. (2018, April 19). The messy truth about insurance-based therapy. Retrieved from https://www.brennancmalloneelmhc.com/blog/2018/4/19/the-messy-truth-about-insurance-based-therapy
  4. McCormack, H. M., MacIntyre, T. E., O’Shea, D., Herring, M. P., & Campbell, M. J. (2018, October 16). The prevalence and cause(s) of burnout among applied psychologists: A systematic review. Frontiers in Psychology. doi: 10.3389/fpsyg.2018.01897
  5. Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012, September 1). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health, 39(5), 341-352. doi: 10.1007/s10488-011-0352-1
  6. Professional health and well-being for psychologists. (n.d.). American Psychological Association. Retrieved from https://www.apaservices.org/practice/ce/self-care/well-being
  7. Rudow, H. (2012, January 27). Overworking can lead to depression. Counseling Today. Retrieved from https://ct.counseling.org/2012/01/overworking-can-lead-to-depression
  8. Therapists’ burnout: Facts, causes and prevention. (n.d.). Retrieved from https://www.zurinstitute.com/clinical-updates/burnout-therapists