Mel Lay, Business Coach, AAT, SMACCPH’s Post

Can we talk about how therapist damage clients or,…also look at how clients can damage therapists? Every relationship, for whatever its purpose be, is made up of an exchange. For this to be balanced, equitable and fair it will need to contain exchanged elements, of more or less, equal value where both parties engaged gain something from the interaction. In our profession this is no different. The therapist gives fundamental skills in rapport building and maintenance, empathy and unconditional + non-jugemental listening. This helps in the collaborative creation of a safe & secure space where the client can explore himself and his presenting issues in authenticity and genuineness. However this may not always be a clear cut as this. Here are some of the ways in which clients can impact on therapist wellbeing in a negative way: 📲 Emotional & Psychological Burnout X Vicarious trauma and compassion fatigue The therapist becomes affected by the clients’ experiences X Working with clients at certain pace and volume can leave the therapist feeling drained X Burnout - Therapist experiences exhaustion, overwhelm & disengagement from their work 📲 Boundary Violations X Clients develop emotional dependency on the therapist demanding more time and attention outside of the therapeutic agreement X Non respect of ethics by clients can cause therapists to have to deal with client related issues outside of the therapeutic space - harassment, lip service, manipulation, deception, in appropriate contact, … 📲 Legal Ethical Risks X Clients making false allegations in an attempt to ruin the therapists’ reputation X Boundary crossing complaints where clients cause issues for the therapists over well meaning actions X Dealing with clients’ legal battles are draining in terms of reporting, court appearances, subpoena,… 📲 Financial Strain X Clients argue, refuse to, or are late about fee payment X Cancellations & no-shows with no intention to honor the original agreement set about this. The result is disruption in income and schedule 📲 Overdependence & Role Confusion X We are professional guides and contain our clients while fostering autonomy and independence. Anything else puts a toll on the therapist X Working with complex presentations can cause emotional depletion 📲 Difficulty disengaging from client issues X In wanting to bring the best service to clients we can sometimes blur the lines between and across our cognitive responsibility towards those X We invest so much of our skills into what we do that we sometimes get over-focused on achieving outcomes, making progress, and perfecting our sessions. This can lead to frustrations, doubt, and more complex emotions What are your thoughts on this? #mentalhealth #therapy #psychotherapy #selfcare #boundaries #therapistlife #mentalwellness

One of the major problems facing therapists is who they work for. There are many companies who tend to exploit or undervalue their therapists. Having worked and managed at various organizations; common issues include low pay, lack of independence, working an 8 hour day plus an additional 4 hours to complete assigned tasks, and micromanaging. Finding a company who values us and treats us as experts in our field can be a daunting task. it took me moving halfway across The United States to find a company who truly values their providers and encouraged them to grow. Nystrom & Associates has been the best company I have worked for. Upper management is filled with therapists and providers who know the challenges of being a therapist. This is heavily reflected in the culture of the company. With three different pay models, the ability to act independently, as well as a solid support system; it sounds too good to be true, yet it is true. While some companies become more rule oriented and strict, Nystrom & Associates has given more freedom. We are always looking for more therapists, join us today and see what it should be like to be a therapist.

Burnout among healthcare professionals isn’t just a personal struggle—it’s a systemic challenge that affects patient care, team morale, and our entire profession. In my latest blog, I explore the unspoken realities of burnout, its impact, and actionable strategies to reclaim balance and resilience. It’s time to prioritize care for the caregivers. Let’s spark a conversation and drive meaningful change. Read more here: https://lnkd.in/guUNGfjN How do you combat burnout in your career? Let’s share and support each other. #ClinicianBurnout #HealthcareLeadership #SelfCare #MentalHealth #Resilience

🚨 New Blog Alert: "$65K per Therapist Departure: Understanding the True Cost of a PT’s Burnout" 🔍 There have been plenty of blogs and articles written in the last few years regarding burnout among physical therapists. However, what hasn’t been particularly well established is... What is the actual dollar amount tied to having a therapist walk out the door, and the cost to replace that therapist? Our latest blog dives deep into the myriad of expenses, from immediate loss of productivity to recruitment and training costs, that can total up to $65k per departure. 📈 Based on insights from leaders at practices of various sizes, we've broken down the costs layer by layer. Thank you to Dr. Robert Bacci, PT DPT, Daniel Johnson, Jeff Hay, Derek Halladay, Austin Afshar DPT, CSCS and more for your contributions! 💡 Learn how to keep your team stable, satisfied, and focused on what they do best. Dive into the full analysis and start turning these insights into action today! https://lnkd.in/gaYf_ZxX #PhysicalTherapy #HealthcareManagement #EmployeeRetention #PracticeManagement

Getting Burned from Juggling Fire Ever tried juggling flaming torches while riding a unicycle? Now imagine doing that while treating patients in a long-term care facility—that’s burnout for rehab therapists. Burnout among rehabilitation therapists is driven by high productivity demands and the emotional toll of patient care. Causes of Burnout: - Unrealistic expectations: Expecting 80-93% of the day to be billable, leaving little time for quality care. - Emotional impact of patient loss: Constant exposure to death in end-of-life care environments. - Family challenges: Lack of family support adds to therapist stress. Coping Strategies: - Support from colleagues and mental health resources like therapy and medication. Systemic Issues: - High productivity demands vs. quality care. - Undervalued work: Little recognition, inadequate pay, and low autonomy. COVID-19 Impact: - Increased loss of life: Losing many patients worsened emotional exhaustion. - Isolation: Therapists lost access to normal stress-relief outlets. Needed Changes: - Adjust productivity standards. - Improve compensation and give therapists more control over their schedules. This article highlights that burnout is not just an individual issue; it’s a systemic one that requires urgent attention. Source: Hughes, C., Borrero, L., Santurri, L., & Ewen, H. (2024). The experience of burnout of rehabilitation therapists in long-term care settings: A qualitative exploration. The Open Journal of Occupational Therapy, 12(4). https://lnkd.in/ez2HZPPq Click ☝️ to read the full research article

Therapists, especially newer/newly graduated therapists, here’s a hard pill to swallow from someone who’s been in the mental health field for the last 7 years 💊: ❌ You can’t self-care your way out of the stress, anxiety, and gradual burnout caused by a job that doesn’t pay you enough, especially if said job also happens to be demanding too much from you. 💰As providers in a helping profession, we often don’t talk about money and compensation enough, but there’s no amount of meditating, journaling, or frankly coping skills that will help if you’re not making enough money to pay your bills, save some, and still have some left over to actually live your life outside of work. ‼️So here’s your reminder if you needed it that we deserve to be paid WELL for all it took to get our degrees, licenses, certifications, and it’s okay to change jobs to one that pays better so you can live your life and ACTUALLY take care of yourself. Your clients will be okay. It’s also okay to negotiate, negotiate, negotiate and not just accept the first salary or commission split offered to you. Mental health providers right now have unprecedented leverage to negotiate for better pay and conditions, but it only works if we actually do it. Good luck out there, therapist friends ✨ #mentalhealthprofessionals #mentalhealthjobs #mentalhealthparity #mentalhealthpay

According to the Mayo Clinic (there is an entire page dedicated to this): "Job burnout is a type of stress linked to work. It includes being worn out physically or emotionally. Job burnout also may involve feeling useless, powerless and empty." Let’s talk... I personally believe that one of the main causes of burnout is a LACK OF POTENTIAL for UPWARD GROWTH. A few years back, a position opened for a therapy manager at the company I was working for. The person in the role was to oversee 3 home health offices, manage all of the therapy staff = multiple therapists at each office, within territories that covered almost half of Pennsylvania. I was legitimately excited. I applied, interviewed, and was offered the position. However, when it came to negotiations, turns out the salary was less than what I was making as a staff physical therapist. There was no discussion about the potential for bonuses or anything of that nature, no additional benefits above those as a staff physical therapist, and the company was not willing to negotiate the salary at all; substantially more work, for less pay. I declined the position. I began to realize that there was really no further potential for upward growth. It was at that time that I also had a revelation that my future looked a lot like what I was currently doing, day after day, with little change; a staff therapist, forever. However, I did nothing to make a change. The revelation I had years ago is coming full circle. More years of experience, more years of professional development, and more day-to-day work being expected of me; but no raises, no changes… Only more emails telling me that I’m "doing a great job, keep it up”. This is my way of explaining burnout. There may have been future benefits to taking that therapy manager position that I couldn’t see at the time, and maybe I let them pass by. But at that time, there was no excitement about the future. There may be potential for upward growth in other sectors of the physical therapy/healthcare industry. However, I am recently hearing over and over again, stories from other physical therapists, occupational therapists, nurses, etc... That match my story and my feelings almost to the T. And let me point out, the stories that I hear, are coming from all sectors. BURNOUT IS REAL. I am now looking for a career path change, specifically in the Medical Device Sales industry. I am a Goal-oriented and results-driven healthcare sales, relationship-building, problem-solving, and account management expert. I have a Proven 10+ year track record in generating new revenue, developing and fostering new accounts, managing existing accounts, and improving retention rates in constantly changing market conditions. I have a strong clinical background in direct patient care proves my unwavering desire to help others. Any help would be greatly appreciated - DM or email me. Comment below and share your story, suggestions, reflections, and thoughts!

As therapists, we dedicate ourselves to helping others find meaning, connection, and resilience. But let’s talk about something we don’t often discuss—the loneliness and unique challenges that come with working in private practice. - Professional Isolation In many fields, colleagues are around, ready to chat, brainstorm ideas, or share a laugh. In private practice, it’s often just you and your clients. That isolation can make it hard to stay energized and keep growing. - The Business Side Managing a private practice means wearing many hats: therapist, marketer, administrator, financial planner. Therapy is a passion, but in private practice, it’s also a business. The demands of running a practice—from client acquisition to admin work—can sometimes feel overwhelming, especially when support is limited. - The Financial Ups and Downs Without the cushion of a steady paycheck, alot of us face financial fluctuations that can lead to stress. - Decision Fatigue from Wearing Many Hats With so many roles to juggle—the number of small and large decisions made daily can lead to burnout. Decision fatigue can be an overlooked factor in private practice isolation. - Finding and Maintaining a Personal Support System For private practitioners, having close friends or family who understand the demands of this work can be tough. The need to protect client confidentiality sometimes means we can’t fully share the emotional toll of our work with our usual support systems. So, how do we find solutions to these realities? Here are somethings that have helped me: -Find a Support Circle – Regular check-ins with a few trusted colleagues can make all the difference. Whether it’s a peer support group, professional supervision, or just an accountability partner, having a small network can help us feel less alone in this work. (We even have a psychology community you can join! https://lnkd.in/gTK3J9vZ ) - Get Mentorship and Business Guidance if you're building something bigger – Running a practice/ comapny is a skill in itself. Investing in mentorship or business training not only lightens the administrative burden but also helps us grow professionally with confidence. - Remember Your "Why" – Staying connected to the core reason you entered this field can be grounding. Revisiting your purpose regularly can renew your sense of fulfillment and sustain you through the quieter moments. If you’re also in private practice, know that these struggles are part of the journey. You’re not alone in feeling the loneliness, and there are ways to make this path a bit lighter. I’d love to know: What do you do to stay connected and grounded? What can we, as a community of therapists, do to support each other better and grow together in this profession?

Therapists have options. If you aren’t going to pay them for what they are worth , or value and appreciate them , they will go to a place that does. It is an employee market. People will go where they feel valued and appreciated it. Value and appreciation goes beyond a pizza party or gift card. If you have a high turn over rate in your community mental health clinic , for example , you need to take a real and honest look in the mirror at yourself and your leadership team. It’s as simple as that. But so many companies struggle with something so basic. #mentalhealth #healthcare #leadership

Why I never promise to accept a therapy client back. First, way to go if you’re thinking about adding therapy services to your healthcare goals in 2025. Secondly, let’s unpack some important info. Adding therapy to your goals is a powerful step toward continuing to elevate your emotional intelligence and agility to prevent burnout. Here’s what you need to know: 1. Your previous therapist may not automatically accept you back as a client. Don’t take it personally—just be prepared to adjust. 2. Therapists, like any professionals, evolve their practices over time. Office hours, focus or specialties, capacity for clients, fee structures or payment options change. It’s not personal or an ethics violation—it’s professional. 3. Approach re-establishing or even starting care with awareness, flexibility and be proactive. - If they’re unavailable, ask for referrals. - Reach out early to start the conversation. - Review their website to check for changes. 4. Boundaries aren’t about rejection. If your therapist can’t take you back, it’s about their capacity—not your value. Don’t take it personal. Boundaries help therapists provide the best care while protecting their own mental health. 5. If this is part of your New Year’s goals, start planning now: - List possible therapists (old or new). - Set realistic expectations for restarting. - Check your insurance coverage or budget. If you’re ready to prioritize therapy in the new year, remember to plan ahead and give yourself grace. Therapy is a resource to navigate the demand of life. How? Strengthening your resiliency capacity. If therapy is part of your vision for a healthier, grounded you in 2025, start preparing now. P.S. There is no shame in therapy. Right?