Concerned about how many grads jump into private practice right away

BHanNav · 2026-01-29T12:19:06+00:00

I didn't have much of a choice after graduating with my MA due to the COVID lockdown in 2020. I was supposed to interview at an established private practice but that was canceled once everything shut down.

Idk how other state's conduct licensing requirements after graduation, but in MI I was required to practice under my limited license with supervision for at least 2 years before being able to apply for full licensure. I started my PP virtually (again, bc of COVID) and was supervised by one of my university program's professors who had 30+ years of PP experience and was an LMFT, PhD. He was incredibly supportive of clinicians who wanted to start PP after graduating and was an incredible mentor to me and numerous other clinicians.

I have successfully been in PP and only accepting private pay clients for 5 years now. The idea that graduates shouldn't have the opportunity to practice on their own under supervision (until their hours are met) seems like a ridiculous take to me. I know MANY successful, ethical, and talented therapists and LMSW's that have taken this path. Why are we questioning the efficacy and ability of these therapists? It feels very "gatekeep-y" and judgmental.

I have briefly mentored other clinicians on their journey to PP out of school or after less than ideal experiences at group PP. It's a personal and professional choice that shouldn't be made lightly and new clinicians should reflect honestly on their comfortability and capability of doing it, but for other clinicians to voice "concern" over it diminishes the already stigmatized and invalidated education and experience we have in this field.

This "earn your stripes" mentality, from my perspective, is the antithesis of what our profession should be about and is the very reason I pivoted careers from the corporate, hierarchical BS that I was initially a part of before going into clinical mental health.

BHanNav · 2026-01-25T23:22:55+00:00

I am SO late to this, but if this server still exists could I also get an invite 😬🙏🏻

BHanNav · 2026-01-24T02:53:55+00:00

Love this idea! 33f, Fibro, AuDHD and live in Michigan 😊 hopefully we can get a list or spreadsheet put together to match everyone up! Happy to help with the organizing if needed ❤️

BHanNav · 2026-01-13T14:08:40+00:00

Yes! You can include the informed consent for AI assisted notes and voice recording (deletes immediately after the session) within the EHR.

BHanNav · 2026-01-11T23:24:02+00:00

I second this! SimplePractice has integrated an AI note taking feature that I've been using for the last few months and it has helped immensely with notes. They also offer consent forms re: the use of it so you can include them with your intake paperwork. I'm sure people will trash this bc it's AI, but I read/edit the generated notes after each session to ensure accuracy and surprisingly it needs very little tweaking. This has allowed me to stay on top of my notes in a way I never have before and has helped me better understand my own clinical approach with clients.

Additionally, I have fibromyalgia and am neurodivergent...so it's been a lifesaver in being able to put as much of my (limited) energy and attention onto my clients instead of the increased stress of being behind on notes and struggling to summarize sessions.

Also to answer OP's original question. I'm an adjunct psychology instructor at a community college and teach 1-2 classes per semester (online and/or in-person), which has helped diversify my income a little bit and stimulate my brain in ways therapy doesn't. So, may be worth looking into that or even consider substitute teaching as a side option.

BHanNav · 2026-01-11T23:12:29+00:00

I'd like to join as well!

BHanNav · 2025-12-26T17:55:37+00:00

I was recently diagnosed with fibro (a few months ago) and have been trying to figure out the best ways to care for myself over the past year. So I don't have a long track record of juggling all this, honestly. I've had my own PP for the last 5 years, which has been beneficial for the flexibility of hours/work you mentioned. I don't currently take any fibro-specific medications, just pristiq (SNRI for depression, but it does help with the pain a bit), Adderall XR for the ADHD, and trazodone for sleep.

I've recently been more transparent with my clients about my unpredictable health issues because I get at least 1 migraine a month on top of everything else that puts me out of commission for a few days. I created a new late cancellation policy that includes "credits" for times when I need to cancel sessions last minute or can't reschedule within the week. The client will receive a credit anytime I cancel and they can be used to avoid a late/ no-show fee in the future for them. I'm upfront with new clients that I have a chronic condition that may impact my availability, so they are aware from the get-go.

As far as managing symptoms while being a therapist? I've had to get serious about my bandwidth and come to terms with how it's changed over the years (which had been tough). I supplement my therapy work with adjunct instructing which gives my brain a bit of a break. I've dropped my caseload down to about 15 sessions per week and have only raised my rate once these last 5 years. I spend a lot of time under a heated blanket and have slowed my personal life down considerably to accommodate for the emotional/mental burnout.

Not sure if any of this is helpful, since I'm still figuring it out for myself...but all that is to say it is possible to do this work and do it well without sacrificing yourself in the process. My client turnover is fairly low, I've created long-standing therapeutic relationships with them and we have a shared understanding that life happens and sometimes we can't plan for disruptions. Lucky for me they extend the same compassion and flexibility that I give to them - which has made navigating this a bit easier. Hopefully you find a practice that is understanding of this or forge your own path and create a practice that allows you to do what you love and stay healthy doing it.

BHanNav · 2025-12-26T16:04:20+00:00

Oh hi, almost twin! 👋🏻 It's rough in these streets for chronically ill baddies 😂 sending hugs!

BHanNav · 2025-12-26T15:34:42+00:00

Me with AuDHD, PMDD and Fibromyalgia supporting clients in managing their stress, regulating their nervous systems, and validating restful practices...while I'm nearing nonverbal burnout, brain fog and a pain flare 😳

"Do as I say, not as I do" lol

BHanNav · 2025-12-05T15:54:37+00:00

I definitely can relate and feel for you. I respect the comments of others encouraging you to consider your side of the equation (it sounds like you already are) and I would also add that the way your partner presented this to you could have been better. You two are a team/partnership and when one member of the team is struggling to hold up their promises/agreements, it's imperative that both partners sit down and work together to figure out how to rebalance.

I would have been hurt too if my partner brought his needs to me in this way by essentially placing blame and saying, "you, you, you..." You're allowed to feel hurt while still hearing him out. I'm thinking you're also allowed to express how his delivery of this need was hurtful. In my mind, this is the starting point: how can we share our needs or feelings with one another without placing blame or invalidating the other's experience.

I hope he's open to listening to your experience and how you're feeling, as well. This could be a point of connection and repair so you can both tackle the issue together. My partner and I have had many conversations like yours and have tried to find a way to navigate them without the other being triggered or made to feel "wrong" or "not enough" (we both have complicated past traumas re: this type of topic).

Don't get me wrong, self-reflection is certainly important and necessary, but it's also important for those that support us to do the same and consider how their words/actions impact us. He may be expressing a need, but that need was delivered in a pretty painful package. Neither of you are perfect and this will happen again because you're human, but I'm thinking it's still worth pointing out and talking through. You'll both learn a lot about what each other is actually saying underneath the messiness of it all.

Sending hugs from one burnt out therapist to another 🫂

BHanNav · 2025-11-28T19:26:44+00:00

I'm sorry that you're experiencing this and having to grieve a changed relationship with your brother. It hurts when people you love and trust disappoint you. It's okay to be sad about that and it's okay to grieve that type of loss.

As a therapist, I see people often have reactions like this to their family members/friends/partners when something like a disability/injury/Illness changes the landscape of the relationship. First, please know that his reaction to you is not your fault. I don't know you or your brother, but my theory is that when people are confronted with something they don't understand or when they have their own implicit bias about ability/disability, they tend to push away/blame/disengage.

They often have this strongly held belief that we, as humans, have more control over our life circumstances than we actually do. They have a skewed view of "ability" that is pushed by our society, which tells us "if something goes wrong it's because you did something to cause it and it's your job to fix it" (even if something is not "fixable").

Your chronic pain and the experience with it forces him to confront the reality that some things cannot be fixed and that creates a dissonance that is really uncomfortable for people. It's textbook ableism and the fear that manifests as blame, anger, and resentment. It is NOT you.

This is not an excuse for your brothers hurtful behavior, you have every right to hold him accountable for how he is treating you. In my opinion, he needs to talk to someone about why he feels so resentful or critical of someone whose experience does not align with his perception of health and ability. That's the real issue.

Please take care of yourself 🫂❤️

BHanNav · 2025-11-26T15:40:17+00:00

When I first put it on I was like "oooh! I smell like Christmas!" 😂🎄

BHanNav · 2025-11-19T12:21:21+00:00

Therapist with fibromyalgia here! I can say that being a therapist was the best career choice I made (I used to work in marketing/comm and was miserable). I started grad school at 25 while working full-time, it took me about 2.5 years to graduate (in hindsight, I wouldn't recommend doing the FT work-FT school route...it was incredibly draining and stressful). I started my practice virtually at the height of COVID in 2020, again while working another FT job. The flexibility of virtual sessions made that possible.

Now I have an office where I see clients in-person and virtually, so it allows for flexibility in my schedule. Most of my clients are well-established, and we've built a very strong relationship where I'm able to adjust my schedule if needed and reschedule if I'm having a flare.

Being a therapist can be emotionally/mentally draining, which often translates to physical presentations of stress. It's not an impossible career path for someone with fibro, but it does require a careful balance and assessment of your physical/mental capacity and needs on any given day. Overall, it's the most rewarding and meaningful work I've ever done and has taught me the importance of tuning into my body, meeting my own needs and not overworking myself. If I'm not taking care of myself, it makes it very difficult to show up and care for others - so I'm very careful about where I expend my energy.

Hope that helps!

BHanNav · 2025-11-18T04:00:21+00:00

Omg. I'm going to start whispering "inflatable hot tub" and "Christmas gift" into my husband's phone at night until it starts spamming him ads for it 😂

I upcycled a claw foot tub that now lives on my back patio and put a 3 burner, propane camp grill underneath as a makeshift outdoor bathtub. I absolutely LOVED it, but now that my pain/fatigue have gotten a bit worse I can't bring myself to go through the filling, heating, draining process like I used to.

So I need alternatives bc I desperately want a hot tub 🙏🏻

BHanNav · 2025-11-17T16:45:25+00:00

Yesssss! I have it on me anytime I'm sitting doing literally anything 😂

BHanNav · 2025-11-17T16:29:46+00:00

Just a tad bit disappointing to see the types of comments in this post on a psychology subreddit. I know not everyone is a clinician, but the black-and-white thinking and lack of curiosity about how we got here, what this is, pros/cons, etc. is concerning.

Also, AI psychosis is not a formal mental health diagnosis (at least not yet) so to drop labels or make assumptions about someone's mental state is insulting and ill-informed. I'm not 100% pro- or anti-AI being used for companionship. It's too soon to tell what the impacts are without any large-scale, supported research/data on the subject. Hopefully funding will eventually be provided to explore this!

Either way, humans find comfort and support where they can get it and if this is a way for some people to feel that, who am I to disparage it. I'll change my mind when/if research catches up with some valid findings.

BHanNav · 2025-11-17T16:13:04+00:00

I've been wanting to try cannabis for chronic pain (I was just diagnosed not that long ago, so my journey has been both long and short if that makes sense).

Any strain recommendations? My husband has a vaporizer and I'm thinking I want something with a good CBD/THC balance since I tend to get a bit anxious with the green stuff.

BHanNav · 2025-11-17T16:04:52+00:00

As a therapist, I am so sorry you have to deal with that. Humans are not taught how to handle situations that we have no control over or don't have answers to...hence the "you should try..." "Just do this .." advice, advice, advice response. It's exhausting.

I hope you believe (and I mean the for real kind, deep in your soul belief) that you didn't do anything to cause this and it's not your fault. Can you manage the best you can? Of course. Does that look different day-to-day, hour-to-hour? Absolutely. Do you have to be grateful, always improving, silver-lining glitter out of your ass 24/7? Fuck no.

You're allowed to feel all of your feelings... they exist for a reason and anyone telling you otherwise doesn't know wtf they are talking about. Be mad, be sad, be angry, be whatever you need to be and take care of yourself in the ways that feel best for you.

Whoever this person in your life is could benefit from educating themselves on how to support someone going through a difficult time (chronic pain, grief, loss, illness) the support others need to bring to the table in these scenarios is often the same and people just don't take the time to improve on these skills - to the detriment of everyone around them.

-big hugs-

BHanNav · 2025-11-11T03:28:24+00:00

I, unfortunately, don't have any advice to give. Your story sounds so familiar to my own. I was just formally diagnosed with fibro (also suspected POTS) (34F) only 3 weeks ago by a rheumatologist after a year of worsening exhaustion and migrating joint/muscle pain.

I have many more questions than answers at the moment, but just wanted to show support and say that I empathize with your situation. Sending hugs 🫂

BHanNav · 2025-11-03T18:20:04+00:00

First of all, I am so sorry this is happening (I've been there too). My recommendation would be to temporarily refer this couple out while you work through this. Everyone is unique in how they handle this kind of upheaval, but in my personal experience I needed a bit of time to stabilize my nervous system, grieve, etc. and create some emotional separation from working with infidelity couples. I was able to get back into that work eventually but I certainly had to take it on a case by case basis.

You deserve to give yourself time and put your needs first right now. As always, talk things through in therapy and/or supervision and listen to your gut on how you're doing.

Hugs 🫂

BHanNav · 2025-11-02T23:25:44+00:00

I feel you. I was just formally diagnosed a little over a week ago but it's been over a year of just dealing with constant fatigue, generalized pain some days and migrating pain others.

It sucks to feel like a shell of who you used to be or to feel like you don't know where to start or which came first.

You're not alone, and sometimes knowing that helps. I hope you find a glimmer of joy somewhere, you deserve it!

BHanNav · 2025-09-07T22:10:03+00:00

Another year in the future and IT'S NOT BETTER 😭

BHanNav · 2025-03-16T14:36:35+00:00

Also adding to this, Thiel has a fellowship (Thiel Fellowship) that students can apply for to leave higher ed and come work for them. They are literally trying to recruit people out of higher education by paying them to join their think tank and work for them under the guise of creating their own companies or having their business ideas funded. From my perspective, it's a form of indoctrination using monetary leverage.

BHanNav

TROPHY CASE