The Clinical System Is Broken

The frustrations of the therapist journey

I remember the day I decided I wanted to be a therapist.

I was sitting in front of my own therapist. He asked me what I wanted to do since the screenwriting thing wasn’t working out. I was at a low place in my life and wanted change. I thought about it for a long second, then what came out of my mouth was, “I want to do what you’re doing”. Long awkward beat as I even surprised myself at what I said. Then I continued, “If I can’t move people by the masses, I will do it one at a time.”

Then he said something I wasn’t expecting.
“Do it.”

And just like that, I was back in grad school. Well, after the inner street fight and back and forth of whether I should go back to school in my mid-thirties since I’m not a school person. At all.

What my therapist forgot to tell me were the three thousand hours it took to become licensed. I did take a year off because I thought I was losing my effing mind. And I didn’t think I could help anyone if I lost my mind. So I took a break then kept trudging. It took me roughly six years to get those — and let me write it in numbers if it didn’t hit you in words, 3,000 hours!

There are two common ways to get these hours. One, find an internship at a private practice. You can work under the license of a supervisor. But you will be responsible for bringing in your own clients. Your supervisor will take 40–60 % of your session fee. And you will also have to pay about a hundred a month for the two hours of weekly group supervision that will count toward your hours.

What’s tough about this structure is how difficult it is to get clients on your own when you’re just starting out. Client’s don’t just fall from the sky. I mean, unless you have some kind of social media presence which most people do not. When I was getting my hours, social media wasn’t even an option. It wasn’t a thing yet. You had to find people in real life. Get on boards. Go to seminars. Churches. Communities. Hustle your ass off. Second, even if you were able to get a full caseload (about 20 clients a week), it’s nearly impossible to live off what you will be making because you’re giving half to your supervisor.

So most have to do this part-time because they can’t quit their day job. That means it will take forever to accumulate the 3000 hours. But of course, there is a six-year window before your hours start to expire. Yes, a ticking clock. More pressure to add to your hefty student loans and self-doubt from not having enough practice at your craft.

Here’s the other way to get your hours.

Work at a treatment center. You’ll rack up hours fast. People who take this path can get their 3000 hours in like 3 years or so, assuming you’re working at the center full time. You’ll also probably get primo health insurance. No co-pay for anything. You’ll be fearless when it comes to jaywalking. But you’ll also be underpaid, pushing tons of paperwork, and seeing so many clients that the chance of you burning out will be pretty damn high. Aka overworked.

This is the route I took. I worked in various treatment centers, from high-end addiction treatment in Malibu to non-profit working with underprivileged teens in Los Angeles. My experience working in non-profit was actually very meaningful. It helped me grow tremendously with my own journey and became the spark which later turned into my first book. But at the end of the day, the experience of getting my hours was draining and I felt like a starving student barely making ends meet.

No one tells you how long and difficult the journey is to become a therapist. Well, you may know on paper but you don’t really know until you’ve swam too far to turn back. Until you’re sitting in weekly supervision without anything to talk about because after six months you still don’t have a single client. Or you’re hiding out in the bathroom of your treatment center, emotionally and physically spent from the twelve hours of seeing back to back clients every day.

No one tells you that you will be overworked and underpaid like teachers. No one tells you how lonely you will feel. No one tells you that you may be driving to people’s homes in unsafe neighborhoods to counsel kids in abusive households, and then spend more time on paperwork than actual sessions.
The clinical system is broken because the fire you had to help others turns into a very dim pilot light by the time you come out the other end and finish your 3000 hours. If you finish. Many quit. Many burn out. Many aren’t able to get enough clients. Many cannot afford to pay student loans and live off the shitty pay.

The internet saved me.

Honestly, it’s the only reason why I am a therapist today.

Let me explain.

During my days working in non-profit, I started a little blog called “The Angry Therapist”. I decided to pull the curtain back and document both my personal and professional journey. I didn’t know this at the time, but I did something that therapist are really not supposed to do. I showed myself. I practiced transparency. I talked about my feelings. Shared my struggles, including the journey I was on in becoming a therapist. I wrote about love, therapy, and my addiction to donuts. I wrote like no one was going to read it. Then hit “post” for the world to read.

People had questions. Questions turned into sessions. Suddenly, I had a full practice. But as a therapist, you’re only supposed to see clients that are in the state where you are licensed. Most of the people who wanted my services were spread across the globe. I didn’t understand why the board would limit therapists helping people based on where they lived. Yes, I understand the licensure guidelines are different depending on what state. But at the end of the day, a therapist is a therapist and how we learn to help people are generally the same. I didn’t think it should matter where your clients came from. People are people. Where we live doesn’t change our problems. Why couldn’t we use the internet as a therapeutic tool? We could reach more and instantly. Many want to change but don’t have the motivation to seek a therapist, make an appointment, then drive there. The internet could be the greatest thing to happen to this field. I felt the board was afraid of the internet. Because it could change everything and boards don’t like change. Because it means then they needed to change.

So I called myself a life coach. I started to help people in ways that were honest to me. I decided that if we’re going to talk about life, let’s do life while we’re talking. I met my clients at coffee shops (I couldn’t afford an office). Went on walks with them. Did more coaching than therapy. This allowed me to survive and pay my bills so that I could keep the lower paying jobs and get my hours.

Today, online therapy sessions are becoming the norm. I believe still, you’re not supposed to see anyone outside of your state. But I’m not sure how much longer they can keep that rule. Because they can’t fight how the world is changing. At the end of the day, it shouldn’t be about us. It should be about the clients. And the clients want online sessions. The clients want to meet at coffee shops. The clients want a different type of therapist, one who is willing to humanize herself. They less about the letters after our names and more about who we are.

There is a new therapist emerging and she is a hybrid. She may have a clinical background but she is also a life coach, because she shares her story on her blog, does yoga, teaches meditation, and sees her clients online. Runs retreats and online courses. She creates a practice, brand, a community, and a life that doesn’t allow her to burn out. But instead helps people in a way that’s unique to her and make a good living doing so.

If you’re a therapist and also want to be a life coach, I created my own life coaching intensive called The Catalyst Intensive. We are not training people to be therapists. We are training people to be life coaches. People who want to take people from baseline to thriving by doing it in a way that’s honest to them.

I believe therapists are important and we need more therapists in the world. But I also believe the world is changing and there are other ways to help people help people.

  • Angry

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Author of “I Used To Be A Miserable F*CK” and “Single. on Purpose.” IG: theangrytherapist