Why Being a Therapist Is a Real Job: Reflections from the Couch
As a millennial psychotherapist at Resilience Therapy, I often navigate challenges that extend far beyond the therapy room. While our society is increasingly open to mental health conversations, there persists a misconception that therapy—and the professionals who provide it—aren't engaged in "real" work. Let me be clear: my clients are my absolute priority, and I'm committed to showing up fully for each person who trusts me with their mental health journey. Today, I want to share some candid reflections on the realities of therapeutic work, and why the boundaries, schedules, and financial aspects of this profession aren't just valid—they're essential.
The Boundary Dilemma
Why Therapist Boundaries Are a Sign of Care, Not Coldness
One of the most challenging aspects of being a therapist is maintaining healthy boundaries. When I establish limits around session times, cancellation policies, or payment structures, it can sometimes be misinterpreted as indifference. There's a persistent myth that therapists should be perpetually available, that our work is purely vocational rather than professional. In reality, boundaries aren't about emotional distance—they're about sustainability. Without them, I cannot provide the quality care my clients at Resilience Therapy deserve. Boundaries represent mutual respect between client and therapist - they are for us both!
In reality, boundaries aren't about emotional distance—they're about sustainability.
The Invisible Work of Scheduling
Few recognize the considerable effort that goes into accommodating clients' schedules. I regularly rearrange personal commitments—mealtimes, family gatherings, even my own healthcare appointments—to create space for clients. When sessions are missed or rescheduled with minimal notice, it can feel as though my time lacks value. While therapists strive for flexibility and understand that some circumstances are inevitable, our schedules are thoughtfully designed to serve clients effectively while preserving our own wellbeing and preventing burnout.
The Insurance Conversation
Perhaps the most complex part of being a therapist is navigating how our work fits into the healthcare system. Insurance can be helpful, but it often adds layers of complexity that impact both clients and clinicians. When I talk with clients about our out-of-network policies, I sometimes see confusion or disappointment — and I completely understand that. But the truth is, the current insurance model often creates barriers that make it harder for us to do our jobs in a sustainable, client-centered way.
Insurance can absolutely make therapy more accessible, and we’re glad to offer that option when it’s available. Some of our therapists do accept select insurance plans, and for many clients, that’s the right fit.
At the same time, insurance can sometimes come with limitations — like session caps, rigid timelines, or restrictions around how therapy is delivered. These constraints don’t always match the real-life, real-person work of healing.
That’s why many of our therapists choose to work out-of-network. It gives us the flexibility to:
Focus fully on your goals, not just your diagnosis
Adjust session length or frequency when needed
Keep our conversations truly confidential
Prioritize care over paperwork
Ultimately, it’s about finding what works best for you. Whether you’re using insurance or exploring out-of-network care, we’re here to help you understand your options and support you in choosing what feels most sustainable and supportive for this season of your life.
The Reality of "Real" Work:
Therapy is unquestionably real work. It demands emotional resilience, intellectual engagement, and continuous professional development. The fact that it doesn't conform to traditional work models doesn't diminish its legitimacy. As therapists at Resilience Therapy, we function as clinicians, business operators, educators, advocates, and compassionate supporters. Our profession deserves respect, our expertise deserves recognition, and our boundaries deserve acknowledgment.
Therapy is unquestionably real work. It demands emotional resilience, intellectual engagement, and continuous professional development. The fact that it doesn't conform to traditional work models doesn't diminish its legitimacy.
Honoring the Professional Reality of Therapeutic Work
If you're considering therapy or currently working with a therapist, I invite you to recognize your mental health provider as a complete person—someone deeply invested in your wellbeing who must also attend to their own. And to my fellow mental health professionals: you're not alone in navigating these challenges. We provide our best therapeutic support when our work is recognized for the essential service it is. Our profession is legitimate, our impact is significant, and our wellbeing matters too.
With warmth and commitment to your mental health journey,
Alexis Sturnick, LCSW, PMH-C
TL;DR: Why Being a Therapist Is a Real Job
Boundaries aren’t cold — they’re essential. They protect the therapeutic relationship and help therapists provide consistent, sustainable care.
Scheduling takes invisible effort. Therapist calendars are designed to balance client needs with therapist wellbeing.
Insurance complicates care. It often limits what therapists can offer and forces a system that doesn’t always match what clients actually need.
Being out-of-network allows for personalized, flexible, and ethical care — focused on you, not paperwork or quotas.
Therapy is real work. Therapists juggle emotional labor, clinical expertise, business responsibilities, and deep human connection. That deserves respect.
