Workplace burnout is real, even when you’re your own boss.

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Running your own therapy practice gives you more freedom than you might enjoy working as someone else’s employee. But the factors leading to burnout are still in play, even when it’s your name on the letterhead.

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Here’s what to do now to anticipate, identify, and prevent workplace burnout as a self-employed therapist. 

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What is burnout?

While the concept of burnout has been discussed since the 1970s, it didn’t earn official designation from medical authorities until 2019.

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In 2019, the World Health Organization (WHO) introduced burnout to the 11th edition of the International Classification of Diseases (ICD-11).

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In the words of the WHO, burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It’s characterized by three dimensions.

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• Feelings of energy depletion or exhaustion
• Increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job
• Reduced professional efficacy

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According to the ICD-11, burnout applies specifically to a workplace context. In larger organizations, the effects of employee burnout can be seen in absenteeism, lowered productivity, and high turnover.

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But what does it look like when you’re a self-employed therapist?

How to tell when you’re burned out as a therapist

The earliest symptoms of burnout may register, to the one experiencing them, as normal workplace stress.

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However, stress is tied to particular tasks and goals. It comes and goes. Burnout, on the other hand, manifests as a constant (albeit fluctuating) state, characterized by:

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• Mental and physical exhaustion
• A sense of dread about work
• Out of-the-ordinary cynicism, anger, and irritability
• Feelings of apathy and hopelessness

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Dr. Jen Blanchette is a licensed psychologist who specializes in helping therapists find joy after burnout. According to Dr. Blanchette, burnout occurs when chronic work stress leads to emotional, physical, and mental exhaustion. 

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“Therapists often experience exhaustion even after resting, along with cynicism or resentment towards clients, which reduces their professional effectiveness,” she explained.

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Dr. Blanchette shared a few warning signs of burnout specifically for therapists. 

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• Cynicism
• Emotional exhaustion
• Decreased productivity
• A sense of hopelessness

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If any of these sound familiar, then it may be time to check-in with yourself and evaluate your own level of burnout. 

Feeling burned out as a therapist is not failure

It’s important to remember that burnout is the result of working conditions, not a weakness or failure on your part. 

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You became a therapist in order to treat clients, not because you wanted to manage employees. Part of managing employees is giving them reasonable workloads, sustainable schedules, and healthy work environments that allow them to thrive. When you’re your own employee, it’s easy to forget that, and set unrealistic expectations for yourself.

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So look at burnout as an employee management problem, not a personal failure. And make plans to change conditions for your most important employee—you—so you have everything you need to succeed and be healthy.

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What causes burnout for therapists

Elizabeth Grace Saunders, a leading time management coach, identified six causes of burnout.

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1. Workload
2. Perceived lack of control
3. Reward
4. Community
5. Fairness
6. Values mismatch

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Here’s how each of those may look when you're a self-employed therapist.

Workload

No matter how many hours you put in, you can’t seem to catch up with the work you have to do. 

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Maybe you’ve taken on more clients than you can manage, and outside of clinical hours you find it impossible to complete your notes and prepare for future sessions. Or maybe it’s the added tasks that come with running a business that weigh you down.

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Running social media accounts, keeping your website updated, responding to emails, bookkeeping, tax prep and filing, attending conferences, and keeping up with changes in the field: all of these take time and energy, and when your practice depends on you for its success, they can add an enormous amount of extra pressure.

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According to Dr. Blanchette, “The combination of high caseloads and long working hours can be overwhelming for therapists, affecting their ability to provide the intense emotional care required.”

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“Dealing with clients who have undergone trauma or difficult life experiences can be emotionally draining, leading to compassion fatigue and contributing to burnout,” she added.

Perceived lack of control

You’re startled awake by your phone at 3 AM because a not-so-urgent email marked URGENT just buzzed into your inbox. You keep responding to queries from new potential clients, booking consultation calls despite your already-heavy caseload. A grad school friend asked you to give a talk at their workplace, and you just can’t say no.

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Even when you’re your own boss, you may feel like you’ve lost all control of your workload. Your waking hours are completely taken over with work, and you have no idea how to break free. This lack of control may lead to frustration, despair, apathy—and eventually, burnout.

Reward

Rewards may be extrinsic (public recognition of your work) or intrinsic (satisfaction at having completed a task well and in line with your values). Both are essential. When you work hard but you aren’t rewarded, burnout may be on the horizon.

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One more important reward to keep in mind: your salary. If you’re new to running your own practice and uncertain about the potential financial ups and downs lying ahead, underpaying yourself for your work may seem like an insurance against uncertainty. But eking out a meager existence with no raise (or Christmas bonus) in sight can lead you to resent your work and eventually lead to burnout. 

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Check out our article on how to pay yourself as a therapist.

Community

When you’re working for someone else and you’re part of a team, community is a double-edged sword. Ideally, you and your colleagues form a network of mutual support and encouragement. Less ideally, personal and professional friction creates a stressful work environment.

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When you’re self-employed, it’s a different story. “Insufficient support and supervision can leave therapists feeling isolated and unsupported,” said Dr. Blanchette.

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Some therapists miss the camaraderie of working alongside others, or the friendships they established when they were in school training to become therapists. And that can have negative effects in the long term.

Fairness

Most employees feel a sense of unfairness at some point in their careers, whether it’s because of good work that went under-recognized or decisions by management that seem totally out of touch with on-the-ground realities.

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And when you’re self-employed, it’s entirely possible to be unfair to yourself. That lack of boundaries between work and life? That salary that just barely allows you to scrape by? They aren’t fair, and they may lead you to resent your own practice as much as you’d resent an overbearing boss. 

Values mismatch

Does your work match your values?

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Maybe you started your own practice because you were passionate about helping clients in their teens. But, eager to turn a profit and pay the bills, you filled up your list with older clients. And now you’re forced to turn away teens because you lack capacity.

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Or maybe you saw a colleague rocket to viral success because of her TikTok videos, so you started making your own. Now you’re neck deep in therapy TikTok, spending more hours per week perfecting your brand image than you do helping clients.

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When the work you’re doing fails to match your values, it can lead to the sort of internal discord that makes you dread going into the office. It’s unsustainable, and likely means you’re headed for trouble.

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How to prevent burnout as a therapist

The best way to avoid burnout is to prevent it from ever occurring. That means being proactive, taking measures to make sure your life as a self-employed therapist is sustainable (and even enjoyable!). 

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“Engaging in self-care activities, like exercise and mindfulness, helps reduce stress and replenish emotional resources,” said Dr. Blanchette.

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Beyond that, here are some tips to help you stay on track and healthy.

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A quick note: If you’re already feeling burned out from running your own practice, consider booking sessions with a therapist or coach who specializes in helping business owners. Getting outside help to manage the symptoms in the short term—and preventing them from worsening—is more important than tackling the root of the problem immediately. And the suggestions below are easier to implement when you’re in the right headspace for the task. Plus, there’s a good chance seeing a therapist is tax deductible.

Set a realistic workload

It’s easy to accept new work on an ad-hoc basis and overshoot your limits, then struggle with scaling back. 

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Instead, set a hard limit. Literally type out, print, and sign a contract to yourself stating how much you are willing to take on.

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Only revisit this limit and adjust it upwards once you’ve reached it and you feel enthusiastic about the prospect of taking on new work.

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For instance, most “full-time” self-employed therapists only spend 20 to 25 hours per week seeing clients. The rest of their time is spent on admin. If your practice is brand new, you might set a hard limit of 20 clients per week. 

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Once you’re comfortable with 20 client hours per week, consider creating a new contract for yourself for 25 hours, and gradually increase your workload to reach the new limit.

Delegate and outsource 

From marketing to scheduling to accounting, there’s a lot of work that goes towards keeping your practice up and running. Collectively, these tasks are referred to as the back office: the part of your weekly workload that clients never see, but which keep your business operational.

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If you’re like most self-employed therapists, back-office work is not the reason you went into business for yourself. Very few therapists start their own practices because they want an excuse to do their own bookkeeping.

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It’s okay to get outside help. 

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• A part-time virtual assistant who can manage your emails and scheduling
• A marketing contractor who’s an expert at social media
• A bookkeeping and accounting solution like Heard

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By reducing your back-office to-do list, all of these help you focus on the work you find most intrinsically rewarding, and which most clearly reflects your values.

Regain control of your time

There’s a good chance you’ve already counseled some of your clients on creating boundaries. If only it were as easy to follow your own advice as it was to give it.

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Many therapists who excel at helping clients create the boundaries they need to grow and thrive overlook major gaps in their own defenses, particularly when it comes to work-life balance.

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You should be prepared to turn down new potential clients, reject offers of contract work, and even turn off your phone when you’re away from the office. Knowing your limits and clearly delineating between your work life and your personal life will go a long way towards preventing burnout. 

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Some helpful tools:

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• Clearly-set limits on your workload (covered above)
• Designated no-phone, no-internet periods during some of your off-hours
• A personally enforced “no work” rule during particular days or hours, eg. the weekend, dinner time, your best friend’s wedding

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Saying “no” is hard, but the more you do it—when appropriate, of course—the clearer those boundaries become.

Let go of perfectionism

Like any other professionals in virtually any other field, you’re bound to have good days as well as bad days. 

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Sometimes you may come out of a session feeling like you didn’t give your client one hundred percent. Other times you might make an embarrassing error: a typo in your newsletter, a joke on social media that doesn’t quite land, a bookkeeping entry that has your accountant scratching their head. 

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It’s okay for mistakes to happen, and it’s okay if you fail to be perfect every single second of every day as a self-employed therapist. Learning to recognize when “good enough” is good enough is part of the responsibility of running your own business. Let go of perfectionism, give yourself room to breathe, and you’ll be taking a major step towards preventing burnout.

Tap into community resources

It’s easy to lose touch with classmates when you finish your degree, or let old work relationships fall off once you strike out on your own as a self-employed therapist.

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But, as Dr. Blanchette noted, “Social support, such as having a network of colleagues and friends, reduces feelings of isolation and provides validation.” 

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It’s worth putting in a little extra work to maintain those relationships and meet regularly with other therapists. Local meetups, networking events, and professional associations can also help you meet other self-employed therapists.

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Other therapists may be able to offer advice on managing your workload and avoiding burnout. And, more generally, having a network of colleagues to turn to for advice, support, and good, old-fashioned friendship can help mitigate the sense of isolation many self-employed therapists feel.

Balance tasks

Does this sound familiar?

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After six hours of catching up on client notes, you’re googling “cheapest wrist braces in my area.” After eight back-to-back client sessions, you’re too emotionally drained to order takeout for dinner. After spending the whole weekend preparing your tax filing, you see our list of deductible expenses for therapists when you close your eyes at night. 

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Running your own practice is hard, but it doesn’t need to be exhausting. Managing your schedule so you regularly switch between different types of tasks helps conserve your energy and avoid the “zombification” effect burnout-sufferers describe. 

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For instance, book your client sessions so that, rather than forming one long, emotionally-exhausting chain, they’re interspersed with back-office tasks that don’t put demands on your interpersonal skills. 

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And rather than booking off one day of the week to catch up on office admin, sprinkle one- or two-hour admin sessions throughout the week, so you’re not staring at your computer all day long for one protracted spell of eye strain. 

Schedule breaks

Employees have mandated breaks and vacation time. As your own employee, you deserve your own scheduled time off, no matter how hard you may find it to step away from work.

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Ironically, this is a situation demanding self-discipline. Even if you don’t really feel like leaving the office for your daily lunch break, you should do it. Even if you’re worried your practice will fall apart due to your absence, you should book time off for summer holidays.

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Be firm with yourself. Take fun seriously. Business owners across the board are notorious for never taking a break. While a few preternaturally gifted people may be able to endure that sort of lifestyle, 99.9% of business owners can’t. 

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Time off isn’t just a reward for your hard work, it’s essential for building a sustainable practice.

Celebrate successes

“By this date, I’ll have X clients on my list,” or “Every week I will have coffee with two colleagues or mentors”—these types of goals can help your business grow, and help you grow as a professional, too.

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But it’s all too easy to hit your goals, take it in stride, and move on. Maybe it sounds corny, but you deserve to give yourself a pat on the back once in a while.

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“Job satisfaction is important, as therapists who feel fulfilled in their work are less likely to experience burnout,” said Dr. Blanchette.

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Just wrapped up your first year running your own practice? Throw a little party with your friends, share it on social media, and take a day or two off. Finally hit the target salary you set when you went into business? Treat yourself and someone special to a nice dinner out.

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You don’t need champagne, oysters, or a string quartet to make it a celebration. Just taking the time to celebrate helps to make your career as a self-employed therapist rewarding.

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Need a break? Here’s how to take time off as a therapist.

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This post is to be used for informational purposes only and does not constitute legal, business, or tax advice. Each person should consult their own attorney, business advisor, or tax advisor with respect to matters referenced in this post.

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Bryce Warnes is a West Coast writer specializing in small business finances.

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