The Patterns Keeping Therapists Burned Out and Clients Stuck — And How to Do Better | Episode 14

This is not a therapist-bashing episode.

Sandy is a therapist. She cares deeply about this field. Which is exactly why she is saying something.

Because when patterns get passed down as "this is just how it's done" without anyone questioning them, nothing changes. And change — in the therapy room and in the field itself — is exactly what we are here for.

This one is an invitation, not a callout. But it is honest. And it is overdue.

What This Episode Holds

• Why insight without embodied change means something critical is being missed in the therapy room — and what to do instead
• The problem with treating coping skills as the destination rather than the doorway
• Why ignoring the body means working with half the picture — and how sleep, blood sugar, hormones, and nervous system states are not optional parts of the conversation
• The nuanced and necessary distinction between trauma and poor lifestyle support — and why collapsing the two keeps clients stuck
• Why normalizing therapist burnout and calling it dedication is one of the most damaging things happening in the field right now
• A candid and unflinching look at therapist group culture online — what happens when venting becomes a shared identity and support spaces become echo chambers
• The real reason therapists keep asking "can I really leave insurance panels?" — and why the answer has very little to do with logistics

Who This Episode Is For

• The therapist who suspects something in her practice isn't working but hasn't had language for it yet
• The clinician who is overbooked, under-resourced, and quietly wondering if this is just what the job requires
• The therapist curious about building a sustainable private pay practice but stuck in fear and waiting for permission
• Anyone in therapy who has worked hard, gained insight, and still doesn't feel different — and wonders if they are allowed to want more
• The healer who knows she cannot keep modeling depletion and calling it dedication

Key Quote

"We've created systems and conversations that prioritize endurance over sustainability, normalize struggle instead of questioning it, and reward over-functioning instead of regulation. And that impacts both therapists and the people they're trying to help."

Getting it perfect is not the point. Being willing to see what is not working — and having the courage to do something different — is.

This field is worth fighting for. So are the people in it. Both the ones sitting across the room and the ones behind the desk.

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Transcript

SPEAKER_00 0:10

Hey y'all, and welcome to the Brain Dump with Sandy Boone. This episode is going to be about things that I wish therapists would stop doing. I've been thinking about this for a while, and I'm just going to say it. There are some things happening in the therapy world that I really wish we would stop doing. Not because therapists are bad at what they do, but because sometimes these patterns, they're not helping in the way that we think they are. And in some cases, they're actually keeping people stuck. And before I get into this, I want to say this is not a therapist bashing episode. I am a therapist and I care deeply about this field, which is exactly why I'm saying something. Because if we don't talk about these things and they just keep getting passed down as this is how it's done, we don't make any change. And change is exactly what we're called to do. So this is less of a call out and more about we can do better. The first thing I'd like for therapists to stop doing is stop overintellectualizing everything. We are really good at helping people understand themselves. But understanding isn't the same as change. You can have incredible insight and still feel exactly the same in your body. And if someone leaves session knowing more but not experiencing anything differently, we're missing something. That's the whole point they're coming to therapy, right? They're wanting change. And it's not that we have to push our clients for change in every single session. Some sessions are just for integration. But people should be moving forward in therapy. That's the point. The second thing is we've got to stop treating coping skills like the solution. Coping skills are helpful, yes, and also readily available on TikTok, Instagram, and Facebook. But if we're only giving tools without addressing what's underneath, we're just helping people to manage symptoms long term. And people feel that. They may not say it like that, but they feel like they're working really hard without actually getting relief. Third, we have to stop ignoring the body. We can't keep treating mental health like it exists only from the neck up. Sleep matters, blood sugar matters, hormones matter, nervous system states matter. If we ignore the body, we're working with half the picture, and that isn't going to get anybody where they want to be. Many of our clients come to us completely in this place of logic. And logic is often what keeps things like anxiety fueled. We need to do better. Fourth, stop making everything about trauma. Everyone has trauma, and it matters. It absolutely matters. But not everything is trauma. Sometimes it's poor lifestyle management. People are exhausted, they're unsupported, they're dysregulated, they're overwhelmed. And if we label everything as trauma, it allows our clients to stay stuck in this space where they don't get relief. And we went into this work to provide relief. If we make it all about trauma, we miss what's happening in the present. And this is also a space where it allows us not to not to advocate, not to make change in the world as we see it, not to show up and make a difference. We can't use trauma as an excuse. We have got to stop normalizing burnout and calling a dedication. This one is really uncomfortable. But we have to look at how normalized it is for therapists to be overbooked, underpaid, and emotionally drained. And somehow that's framed as passion. We cannot model depletion and expect our clients to learn regulation. Too often I hear of therapists who are seeing 25 and 30 clients a week. Is that really sustainable for the long term? Is being so overbooked that you don't get to eat lunch or even go to the bathroom really what we want to model for our clients? We're not robots. We have got to stop normalizing this and expect more for ourselves. And again, as therapists, we're just as guilty of it as the system we live in. This one is really important, and I see it show up over and over again. There is an issue with therapist group culture. And by therapist group culture, I'm talking about groups that are created on Facebook for mental health therapists. Sometimes they're divvied up by modality or practice structure or even just resources. There's lots of them. So to say this clearly and carefully, some therapist support groups aren't actually supportive. There's spaces where people vent, which is valid, and then that venting gets reinforced and it turns into a shared narrative of this is just how bad it is. And what happens over time is we stop looking for solutions and we start normalizing suffering. We start bonding over burnout instead of challenging it. And again, venting is human. But if the space never moves forward, what can we do differently? It becomes an echo chamber, and that doesn't help anything, anyone grow. Or worse, last week there was a post in a Facebook group that I'm a part of. And this person was asking if anyone knew of a resource to aid in creating a treatment plan for this particular modality. I responded, I've used ChatGPT without client identification. And you would have thought I murdered a baby. This therapist replies back, ChatGPT is an ethical and moral atrocity, so I'm going to strongly discourage anyone from reading this, from following that path. If you, the human being trusted and paid to come up with a treatment plan, cannot do so, you need to honestly inform your client and refer them, not start relying on AI. Wow. Is this how this person shows up for their clients? Judgy? This person asked for a tool. How do you do this? And I provided a tool. Of course, I manage this much better than I would have done several years ago, perhaps because of all of my work as a therapist. And I just simply said, thanks. I am a university professor that teaches counseling students to write treatment plans. The original poster was asking for tools. And of course, other therapists chimed in about how anyone who's gone through the hard work of getting their license is entitled to make their own clinical decisions without criticism and judgment from others. Then there was, that's a really unfair comment to make. You may experience ChatGPT in that way. However, I found it to be an invaluable tool in my clinical practice, as oftentimes there are perspectives that I may not have considered. Of course, as clinicians, we need to know what we're doing, but to absolutely dismiss AI as a supportive tool is unfair and misleading. To which she says, I am absolutely not here to debate whether the use of generative AI at all, let alone in clinical mental health practice, is an abomination. I said what I said. Any basic understanding of how violently racist, wasteful, literally factually wrong, and deeply violating of the earth we all call home all generative AI models are, would contradict this use for anyone with their humanity intact. It was impressive. It was impressive. But these are how people are showing up in these spaces. Judgy, not supportive. Notice this person offered nothing as far as a tool. Just don't use that tool. Now, I'm not here to debate the logistics of Chat GPT, not doing it. But now we're in an environment where people are posting in these groups anonymously so that they can avoid situations like this. What have we become? Do we show up for our clients this way? Would we be okay if our clients showed up in the world that way? So, enough about that. The insurance panel question. Stop asking for permission to build a sustainable practice. This one comes up all the time. Can I really come off of insurance panels? Is it possible to do private pay? Will people actually pay for this? And what I notice is the question is rarely about logistics. It's about permission, it's about fear, and it's about am I allowed to build something that actually works for me? And when that question gets asked in groups, it gets met with caution, skepticism, worst-case scenarios, or name-calling about how you're a capitalist jerk. People are speaking from their own experience. But if you only listen to people who are burned out, overwhelmed, and stuck in systems that aren't working, you're going to get answers that reflect that. So we've now created a culture where sustainability feels risky and burnout feels normal. And when you step back and look at all of this, there's a pattern. We've created systems and conversations that prioritize endurance over sustainability, normalize struggle instead of questioning it, and reward overfunctioning instead of regulation. And that impacts both therapists and the people that they're trying to help. We don't just need better tools. We need better standards for how we work, for how we live, and for what we consider normal in this field. And I say this as someone who has had to look at my own patterns too. This isn't about getting it perfect. It's about being willing to see what's not working, to have the courage to explore that and to do something different. So if you're a therapist listening, this isn't criticism. It's an invitation. Step back and ask what am I participating in that isn't actually working? And what would it look like to do this differently? And if you're someone in therapy listening, you're allowed to want more than just insight. You're allowed to want change that you can actually feel, and you're allowed to want a practitioner that's willing to evolve too. I have said more than once, I cannot expect from my clients what I can expect from myself. You don't get to sit in this seat as a therapist unless you've sat in that seat as the client. Thanks for being here.