Comment by reify

For what it’s worth I’m on the other side of this. I’ve been a licensed counselor for 13 years and working in behavioral health for 17-18 years and I’m itching to change careers. Basically the opposite of the post above.

The work can be rewarding but it can also be emotionally demanding and the pay and benefits can be quite shit, frankly. The mental health system (assuming USA) is designed to be exploitive to someone; either it’s going to exploit you, your clients, or both.

You can get an administrative job that pays a bit better and has better benefits but your work life balance will be poor and you’ll still generally struggle to make what tech workers make in equivalent roles. You can work outpatient but you’ll make less unless you charge a lot but then you’re excluding a large segment of the population who have a high need for services. Depending on where you live this may not be feasible even if you’re open to it. It’s dependent on your ability to keep a stream of somewhat affluent individuals coming in, obviously

Or you work with insurance but then you open yourself up to a great deal of red tape and financial liability that you either eat or pass on to clients, thus creating financial burden and worsening their mental health. It’s not your fault but it can feel really awkward and shitty to charge a client $800 when their insurance claws back 6 sessions worth of appointments. Alternatively you eat the loss, which can be something that inherently happens because (rarely) they’ll claw back appointments from 12+ months ago. This can also be challenging from an obtaining clients perspective. I run a private practice and contract with a group and right now I have 0 people coming in with no wait list. This isn’t common but it does happen and it means my income dries up a bit. It’s not the end of the world because the holiday season was a heavy period and it will likely pick up again soon but even people with insurance struggle to afford therapy now. More and more people have high deductible health plans with sizable deductibles so they end up paying $70-150 a visit, pretty considerable weekly/biweekly expense. Around summer I start getting a strong uptick because the high deductible people start meeting their deductibles (although young healthy ones often never do)

Sometimes it’s hard to leave work at work with this job. That’s any job of course but with this job you can hear some real heavy shit sometimes. That’s generally not the norm though; most people are just not doing so hot or having relationship troubles or whatever. But every once in a while you’ll get a person that has had some truly awful experience that sticks with you for a bit. Or a person that is manipulative, constantly tests your boundaries, and sticks with you in a bad way.

There’s a lot of positives to it too of course. I set my own hours, I don’t have dumb staff meetings, I set my boundaries with people so if a client goes too far or is outside my scope I can cut things off, etc. I earn 100% of my money minus minimal overheads (telehealth practice is really light on overheads). There are tedious clients of course but many clients are interesting and challenging in an intriguing way. But I feel like people don’t advertise the ugly side really