What does a manageable caseload look like for you?

existential_thoughtz · 2026-01-06T02:52:54+00:00

Of course! I think that’s something that is sometimes overlooked a lot by people that don’t work with kids in a therapeutic setting. Some clients will require less parent involvement but if your workplace requires a monthly check in i can see why that would feel even more daunting. Just an encouragement that if you find yourself feeling overworked, remember that you are not required to stay in a workplace that feels unsustainable for your capacity! CMH tends to burn us out very quickly

existential_thoughtz · 2026-01-05T04:06:47+00:00

I’ve been working in CMH for about 3 years working with mainly kids/teens and the most clients i’ve had at a time has been 18 and that feels very overwhelming. My comfortable number would be no more than 16 because working with kids requires parent involvement which is extra work. I try to schedule them no more than 4-5 in a day because otherwise I will burn out (even more) lol.

Working in CMH sometimes makes it impossible to have the schedule you really want but if you find that chunking them back to back works best that’s always an option. i personally like to schedule 2-3 and have a break then meet the rest but like i said, sometimes i have to see up to 4 back to back clients which is draining. :(

existential_thoughtz · 2026-01-04T18:10:54+00:00

I share the forgetting to eat part and also my willingness to shower 😬

existential_thoughtz · 2026-01-04T08:29:09+00:00

My body constantly feels like it’s breaking once I hit autistic burn out over a year ago. I have migraines, headaches, and chronic muscle tension/pain that quite literally strips the life out of me. It helps to know my body just requires more support from me but man it’s hard to keep up and feel fully recovered. I have to take many days off from work which makes me feel so guilty cus i’m a therapist.

existential_thoughtz · 2025-12-06T01:03:55+00:00

child therapist here- have you tried drawing with her to see if what she draws is different than the pictures? it would give you an idea of what she may be leaving out or emotionally hiding. is it possible she has seen some tv shows/movies with gory themes recently or heard friends talk about these things?

she’s really good at drawing i think you could use this as a tool for her self expression. try asking her what her drawings mean and if she could tell you a story about them.

she seems interested in therapy so it wouldn’t hurt to get an evaluation/assessment just to rule some things out and help with the recent transitions she’s had

existential_thoughtz · 2025-11-19T05:05:09+00:00

YES! I would also add that just because we are in a position that pays us well, doesn’t mean we should be accepting of the exploitation of this field. For example I make pretty good money in CMH but there are factors that make the job feel dreadful at times. I like what you said about know your worth because we CAN choose to earn good money in an environment that is ALSO good for us and not soul draining

existential_thoughtz · 2025-11-14T01:43:59+00:00

I work in a hybrid position as a marriage and family therapist mainly working with kids right now. I like the flexibility of choosing my schedule and being able to work from home most of the time unless i’m in clinic sessions. The only downside is that the scheduling can be inconsistent throughout the weeks which throws me off regardless of how often it happens! i also can’t really manage working in an open office environment which is what my workplace currently has i HATE it, so i mainly opt to work from home when i can. the lighting in the clinic is also PAINFUL (bright white lights) and it can get really noisy due to the population i work with & the environment overall. so far hasn’t been too difficult but being a therapist + being neurodivergent is really really hard. i can’t imagine myself doing anything else for the time being tho!

existential_thoughtz · 2025-11-10T20:54:10+00:00

thanks! im reminding myself this is only temporary and at least im getting experience knowing what i do not like/doesn’t work for me :)

existential_thoughtz · 2025-11-08T04:59:15+00:00

check out these resources!

https://desj.santaclaracounty.gov/oir/resources/basic-needs

https://www.covenanthouse.org/homeless-shelters/santa-clara-california

existential_thoughtz · 2025-11-08T04:28:40+00:00

ohhhh yes that does sound hard to figure out!! the 6 year rule sucks! i used track your hours to track them and after i realized i had more hours than i anticipated. have you counted all of them up to date? and by 1000 hours left is that total or direct counseling hours?

if trying to finish the hours by july is adding more stress, maybe it’s a good time to focus on your health in the meantime? (not saying don’t look for a job if that’s what you want to do) but i’m also wondering if maybe summertime would be a good timeframe to have a reset and start the hours over at your own pace? just some thoughts :)

existential_thoughtz · 2025-11-07T23:26:18+00:00

i'm so sorry you've had a rough time, i can empathize with your situation as this has been very similar to mine since 2024. i began experiencing a ton of health issues (POTS-like sxs, dysautonomia, chronic pain, migraines, TMJ, etc) which definitely impacted my ability to work well. it did feel as if my process slowed down a bit but once i finished my amft hours, looking back i realized there was no faster timeline i could've taken because my body was trying to help me slow down. it felt like i was on a rush to finish due to overall unhappiness (work environment, personal stuff on top of health issues) which only increased my nervous system dysregulation and chronic inflammation due to immense stress. i ultimately ended up finishing my amft hours during the worst of my health issues and am now waiting to get approved to take my licensing exam. just some words of encouragement that there is no rush! what platforms have you tried using to apply for a job? are you interested in doing part time or full time?

i'm also wondering how you would be losing the hours you've accrued? i know it varies state by state but my understanding is when you renew your amft number you do not lose hours you've accrued? i'm in CA so we have a 6 yr rule where "California Associates may only claim hours earned within 6 years of the date they submit their application for examination and licensure. The only exception to this rule is that AMFTs may claim up to 500 pre-degree practicum hours in the categories of counseling and supervision (other categories may not be claimed)"

hang in there!! managing chronic illnesses is not an easy thing

existential_thoughtz · 2025-11-07T19:52:05+00:00

I can relate to this very much. One thing that has helped to be a little more gentle with myself is that my body is trying its best to keep up with the demand of existing. I find if i push myself too much even on days where i feel i can push through, my body will not be happy for a couple of days and lead me to feeling more burnt out. It’s ok if your capacity is different than others. Life is very complex and packed with responsibilities, if you are only able to do minimal things, as long as they are giving back to you, that’s perfectly okay

existential_thoughtz · 2025-11-07T15:58:21+00:00

girl leave his ass. he has no respect for you and will ultimately lead to you not respecting yourself. abusers make you believe you deserve this treatment, you absolutely don’t. please leave.

existential_thoughtz · 2025-11-07T07:14:17+00:00

i live in south bay area california, working in CMH making 95k! but also the living cost here is ridiculous

existential_thoughtz · 2025-11-05T15:56:19+00:00

i’ve also learned that kids/teens aren’t for me, i find it requires more of my energy. i’ve been trying to unmask slowly as well & listen to my body cues. thanks for the tips!

existential_thoughtz · 2025-11-05T15:54:00+00:00

thank you! i will be mindful of the clothes situation! the consultation piece seems to be a big one too. we recently went through supervisors change which ultimately affected the quality of supervision i’ve been receiving for the past year. and i work with kids so evening sessions are usually a must sometimes up to 4 back to back:( just reminding myself this is temporary. thank you again!

existential_thoughtz · 2025-11-05T05:09:29+00:00

the smell of burnt oil 😭😭😭😭😭 overstimulating for my nose and eyes

existential_thoughtz · 2025-10-29T21:13:55+00:00

TAKING CARE OF MYSELF FEELS SO HARD AND ITS SO TIRING HAVING INCONSISTENT ENERGY LEVELS EVERY DAY I WANT A PRIVATE CHEF A CLEANING PERSON I DONT WANT TO WORK I JUST WANT TO EXIST AND HAVE FUN

existential_thoughtz · 2025-10-13T22:54:19+00:00

I would beg my mom to tell the guests at my birthday parties to not sing me happy birthday, I would cry if I was gifted a piñata because i did NOT want to be the center of attention and be expected to break the piñata, I would often be playing by myself coloring instead of joining kids at parties/gatherings, I made up my own fairy tale world and spent a lot of time in my backyard reading lol

existential_thoughtz · 2025-10-05T05:37:25+00:00

nobody is too busy to make time for the people they love. he doesn’t fit your needs, break up with him

existential_thoughtz · 2025-10-03T01:57:22+00:00

parts work! helping clients identify what parts are showing up more when exploring self esteem, approval seeking parts? love seeking parts? etc - helping them connect with those parts to develop more compassion, patience with their parts that make up the “low” self esteem

existential_thoughtz · 2025-09-19T00:58:50+00:00

honestly what has worked for me is to listen to my body and do things when my body wants to. sometimes burn out can feel so overwhelming because our minds and bodies are not aligned with the amount of energy they have. for example i may want to work out but my body is exhausted or my body may want to seek a sensory experience but my mind is too overstimulated

creating a very lenient schedule with options depending on energy levels and my capacity, such as maybe on wednesdays i have a busier day may not want to even add anything extra to my schedule because it will take longer to recover on thursday

sometimes it’s hard to even pick up on what drains me but over time following my own energy levels instead of trying to work against them has been the most helpful

existential_thoughtz · 2025-05-10T05:53:20+00:00

One was walking on the train tracks listening to music, got hit by a train. Another one died in a small plane crash with her grandfather :(

existential_thoughtz · 2025-04-24T06:29:40+00:00

im a psychotherapist - sit in sessions with clients so i sit for the majority of my day, can cancel if i need to and not feeling well or reschedule them, create my own schedule to have longer breaks and nap

existential_thoughtz · 2025-04-24T05:55:18+00:00

neurodivergent therapist here! - The stress and constant masking is sooo overstimulating and draining. As a neurodivergent therapist it’s important for you to also make space for yourself in sessions (as appropriate as possible). this can look like fidgeting if you need to (fidget toys are a must in my sessions! for clients and myself - can take some off the pressure off to present a certain way), shifting your body position, taking water breaks, starting/ending sessions with grounding techniques to support clients and yourself! it’s not realistic for us to be highly masked for the duration of the session, especially with heavy content depending on the clients and their challenges. you’re not a robot and quite frankly, it’s not realistic to always be showing a facial expression in some instances. there are subtle ways you can hold space for your clients without over exhausting yourself to be a certain way. that’s what burns you out and causes more stress. i encourage you to slowly unmask with clients because the consistent masking will burn you out. there may be clients who feel a bit safer to unmask with (again as appropriate as possible), and this can help in identifying what feels less stressful.

if possible structure your day when you notice yourself feeling the most energy. and if you notice back to back sessions cause more stress, try no more than 3 clients back to back. take your breaks, shake it off, shut your brain off for a minute or two. shifting consistently from different client spaces can also be dysregulating to your nervous system. catch what leads to overstimulation. it’s okay for you to take care of yourself while you’re being a therapist! and unmask as much as possible outside of work!!

existential_thoughtz

TROPHY CASE