I Want to Quit

You haven’t said it out loud yet. Maybe not even to yourself.

But it’s there. Somewhere between the third no-show of the day and the stack of treatment plans you haven’t touched. Somewhere between the client who cursed you out in session and the email from compliance about your late notes.

📚 This is Blog #18 in the New Clinician Survival Kit Series (Click to explore the series)

Weekly honest support for the struggles every clinician faces: “I hate group therapy.” “I can’t do this.” “My client hates me.” “I’m making it worse.” “I can’t say no.” “They’re going to report me.” “I’m too tired to care.” “What do I even say?” “I don’t know enough.” “They keep relapsing.” “Am I documenting wrong?” “My supervisor doesn’t get it.” “I can’t handle this caseload.” “Nobody told me about the paperwork.” “I don’t like my client.” “My client’s cute.” “My client likes me.” “I got a complaint.”

These aren’t signs you’re failing. They’re signs you’re human.

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It Doesn’t Happen All at Once

For years I worked at a Federally Qualified Health Center. Caseload hit 80 at one point. Mondays I was at a high school — individual sessions, groups — then to the office or home for more sessions after school. Tuesdays, different school, same routine, leaving between 8 and 10 PM. Wednesdays were the killers. Alternative school in the morning, another school after that, back to the office for a community group in the evening with individual sessions packed around it. I’d leave around midnight. Sometimes 1 AM. Thursdays, two more schools. And then Fridays, Saturdays, and Sundays I worked my second job at a private practice — sessions all day and evening with maybe a scattered free hour if I was lucky.

That was every week.

And I loved the work. I loved my clients. I felt genuinely fulfilled. But fulfillment doesn’t pay your electric bill twice, and passion doesn’t replace sleep. I wasn’t burning out in some dramatic, made-for-TV way. I was just… leaking. Patching the holes with coffee and stubbornness until the patches stopped holding.

You don’t notice the water rising until your shoes are wet. And according to SAMHSA’s workforce data, the behavioral health field is facing significant shortages across the board — in part because this kind of slow drain pushes people out faster than training programs can replace them.

When the Environment Turns on You

Sometimes it’s not the work. It’s the place.

I worked at a local private practice for a while. Things were fine at first — the boss was professional, even warm. I could tell she played favorites and I was grateful to be one of them. I just prayed I’d never end up on her bad side.

Then I mentioned I was thinking about opening my own business.

Everything changed. Not overnight — that would’ve been easier to name. It was passive-aggressive emails. “Why did you do that? What were you thinking?” The kind of messages where you walk away feeling gaslit but you can’t quite point to what happened. You’re not sure if you actually messed up or if you’re being punished for having ambition.

When the Clients Break You

And then there’s the work itself.

I’ve supervised interns who came in ready to change the world. And I’ve watched some of them hit a wall so hard they didn’t know how to get back up.

One of my supervisees attended a few groups at a middle school and told me she was never doing group again. I couldn’t even argue with her. It was an awful group. Middle school in general can feel like a jungle. The kids were rude, refused to engage, showed up intoxicated on more than one occasion, interrupted her constantly, walked out mid-session. She was trying to facilitate a therapeutic experience and they were treating it like a free period to act out.

That’s not a failure of technique. That’s a reality of the setting. But when you’re new and you’ve never experienced that level of chaos, it doesn’t feel like a setting problem. It feels like a you problem.

So Which One Is It?

About the Glass Ceiling

I want to say something that might sting.

If you’re a substance use disorder counselor, the system was not designed for your career growth.

I sat in a Zoom meeting once with peers and the director of behavioral health at a former employer. They were discussing staff morale. I asked a direct question: Why do the supervisory and leadership positions advance on the mental health side but not substance abuse?

Silence. Then the answer — and it was worse than the silence. They were genuinely surprised. In their minds, substance use counseling was a stepping stone to mental health. Not a career. A phase you go through on your way to “real” therapy.

I challenged that. I asked them to think about what kind of message that sends. That maybe the reason we have a workforce crisis in addiction treatment is because we treat the people doing the work like they’re temps. The National Council for Mental Wellbeing’s research confirms what we already know: a third of behavioral health workers spend most of their time on administrative tasks, and 68 percent say it takes away from direct client care. But despite all of that, the majority remain passionate about the work. The problem has never been the people. It’s the systems.

That moment made something very clear. I was never going to reach the professional heights I wanted inside that system. Not because I wasn’t capable. Because the system wasn’t built to let me.

And I still stayed for years after that. Because leaving is complicated when the clients need you, the paycheck is steady, and starting over is terrifying.

What I Actually Say

When a clinician sits in front of me and says “I want to quit,” I don’t talk them out of it. I don’t give a pep talk. I don’t say “remember why you started.”

I say: “Let’s talk about that. You may decide that’s the best thing for you. But let’s think about it rationally, not passionately.”

Because the worst career decisions happen in the heat of the worst moment. The client who just screamed at you. The supervisor who just embarrassed you. The note you forgot that just got flagged. Those moments make quitting feel urgent. Sometimes it is. But most of the time, the urgency is the emotion, not the logic.

So we slow it down. We look at what’s actually happening. Is this about the career, the job, the setting, the population, the supervisor, or just the season? Because each one has a different answer. And only one of them is “leave the field.”

I Didn’t Quit. I Pivoted.

I worked at a local health department for over a dozen years. I wasn’t impatient to leave the work — I was impatient to rest. Saying goodbye to my clients was hard. Having only one job for the first time in years felt like putting down something very heavy.

The private practice ended differently. I was winding down, open to keeping a small caseload while I built my business. My boss told me not to come back. Changed the locks. Moved my stuff out before I could even pack it myself. When she met with me to hand over my things, she told me I’d made poor choices and let everyone down. I found out later she told some of my clients I could have lost my license — for what, I still have no idea. There were tears. She was cruel. And I understand that more clearly now with distance.

Neither of those exits was quitting. One was planned and bittersweet. One was forced and ugly. Both led me to where I am now — running my own platform, building resources for clinicians, creating something that didn’t exist before.

Before You Make a Move

Here’s the Part That’s Hard to Hear

You can love this work and hate what it’s doing to you. Both things can be true at the same time.

You can leave a job that’s destroying you and still be a good clinician. You can want more than what this field has traditionally offered and not be ungrateful. You can stay and fight for better conditions from the inside — be the supervisor you never had, build the program that doesn’t exist yet. Or you can go build something entirely different.

Both are valid.

What’s not valid is pretending you’re fine when you’re not. That’s how good clinicians disappear from a field that can’t afford to lose them.

Next in the series: “My Coworker Is Terrible” — because sometimes the thing making you want to quit isn’t the work. It’s the person two desks over.

This is Blog #19 in the New Clinician Survival Kit Series by The Underrated Superhero. If this hit close to home, you’re not alone. Follow along for more real talk about surviving your first years in clinical work.

Until Next Week | The Underrated Superhero

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