Conflicting Truths About Therapists
A friendly reminder that two things can be true - at the same time!
If you’re in the mental health world, you’re probably no stranger to black-and-white thinking. You may talk about all day with your clients - yet that doesn’t necessarily make you immune to it. We’re all guilty of all-or-nothing thinking sometimes. I especially notice this when talking with therapists about professional identity and work-life balance.
There’s a reason one of my slogans is “Human first, therapist second”. It’s so easy to get caught in the trap of ONLY thinking like a therapist, or only seeing ourselves as therapists. But the fact is, we’re all constantly wearing multiple hats. Therapist + business owner… therapist + student… therapist + parent… therapist + human, etc. The thing is, though, we don’t have to choose between one mindset or the other. Both can coexist. Here are some examples:
Therapists can care about accessibility AND money.
The biggest black-and-white thought I see among therapists is that if you care about accessibility to services, you’ll take insurance. And if you’re private pay, you must not care about accessibility. I personally find this to be dismissive and a bit toxic. In discussions online, I constantly see therapists pat themselves on the back for taking every insurance because “they’re not here to get rich” or “access to care matters more than money”. If that philosophy works for you, great. But it’s not your place to judge someone else’s values just because they make different business decisions than you.
I’m mostly private pay. I also care about accessibility for clients. But I also have to make sure that my work is accessible to me. If you’ve read my experiences with insurance, you know that I tried putting accessibility first and how badly it went. So I found other ways to meet my own needs while still helping others. There’s more than one way to offer accessibility - superbills, sliding scale/pro bono spots, taking 1-2 less common insurances, etc. For many of us, the issues and costs that come with taking insurance lead to burnout and financial hardship. Those factors could eventually lead to us job hopping, or leaving the field entirely. That doesn’t exactly help with accessibility. We all care about helping people, and it’s unfair to suggest otherwise simply because some of us have different experiences/preferences.
Therapists can “not be in it for the money” AND be working toward financial stability/wealth.
This brings me to my next point: the idea that therapists shouldn’t care about making money because “that’s not why we got into this field.” It’s often a divide between older and younger therapists, likely due to the different financial landscapes we face. True, we all got into this field to help people. But last time I checked, the main reason that people work - in ANY job - is to make money. We all work so that at the very least we can survive, or perhaps even thrive. And that’s not a bad thing!
We can value helping people and find our work rewarding, AND also value our own financial stability/success. We don’t have to accept low pay and remain in poverty ourselves because “at least it’s rewarding” or “I didn’t get into this for the money”. Again, if that’s your approach and it works for you, cool! But please do not pass judgment on other therapists for having different mindsets about money and business. I’ve said it before, but you can’t pay your rent on altruism, nor can you retire on good feelings. Simply caring about money or having personal financial goals does not inherently make someone greedy or unethical, nor does it mean that they’re seeking wealth at the expense of others.
Therapists can have boundaries/be human AND still be ethical.
If you’re part of any online discourse among therapists, you’ve probably seen everything deemed as “unethical” at some point. Late cancel fees, limiting your hours, not taking insurance, making a scheduling mistake, referring someone out, NOT referring someone out… you name it. There are so many folks who still carry the outdated mindset that therapists are supposed to be these perfect, super-human archetypes, whose altruism supersedes their human needs/qualities. We can have boundaries - but not too many boundaries, right? We don’t get to make mistakes, and whatever we need or feel doesn’t matter, because “what about the client!”
But I don’t agree with this. In fact, I think that allowing yourself to be human and have limits is more ethical than not doing so. Client welfare comes first, but our own welfare is also related to that of our clients. If you don’t want to work with certain populations, don’t. If you can’t function after 4pm, don’t offer sessions then. If your gut tells you to refer out, do so. Need to charge no-show fees so you can feed your family? Go for it. The alternative doesn’t actually do our clients any favors. By not allowing ourselves space to be human or have limits, we propel ourselves toward resentment and burnout. You can own your human qualities, AND still be a good, ethical therapist.
Therapists can care about ourselves AND our clients.
This pretty much sums up the theme of this article. It does not have to be one or the other - nor should it be. We can take care of ourselves AND our clients (not INSTEAD OF our clients). We can care for others, consider their feelings, prioritize their wellbeing, and work around their schedules - while ALSO taking care of our own emotional needs, working toward financial goals, prioritizing our families, and being mindful of our limits. It’s unrealistic to try to choose one over the other. And frankly, it’s unfair to suggest that these things are mutually exclusive. Everyone is entitled to their own beliefs, money mindsets, and business practices. But judgment or casting out labels like “selfish” or “unethical” is not needed, or appropriate. As long as it’s not harming someone else, there is nothing wrong with a therapist helping themselves too.
Thank you for supporting the Authentic Therapist’s Guide! For more offerings and resources, check out the links below: