The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy

Is Independent Private Practice Sustainable? Data on Caseloads, Insurance & Income

Is independent private practice still financially sustainable?

Curt and Katie sit down with Lindsay Oberleitner, PhD, Director of Clinical Strategy at SimplePractice, to examine national data on caseload trends, insurance participation, income realities, and therapist burnout. Drawing from Lindsay's research at SimplePractice, they explore whether independent private practice is truly viable long term - and what clinicians need to understand to remain financially and professionally sustainable.

In this episode, we discuss:

• Why some clinicians are seeing declining caseloads despite high demand for mental health care
• Typical full-time caseload ranges in independent private practice
• How insurance participation is shifting year over year
• The financial impact of reimbursement rates and overhead costs
• Why burnout is both a personal and systemic issue
• The significant role independent private practice plays in delivering outpatient behavioral health care across the United States

Independent private practice represents an estimated 15–20% of outpatient behavioral health services. This episode helps therapists think strategically about income, sustainability, visibility, and long-term viability in today’s healthcare landscape.

For full show notes and resources, visit mtsgpodcast.com.

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Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCannhttps://www.facebook.com/McCannDW/

Music by Crystal Grooms Manganohttps://groomsymusic.com/

Why You’re Exhausted in Private Practice: The Hidden Work Behind the Client Hour

Exhausted in private practice - even with a “manageable” caseload?

Seeing 20-25 clients a week does not mean you’re working 20-25 hours. Every client hour includes hidden administrative work, financial decisions, emotional labor, and CEO-level responsibility.

In this host-led episode, Curt and Katie break down why private practice feels heavier than expected - and how to think strategically about the real math behind your workload.

Key Takeaways:
• 20 client hours often equals 30+ hours of actual work
• Emotional task-switching drains capacity
• Burnout often comes from business demands, not just clients
• Sustainable practice requires protected CEO time and clear boundaries

Full show notes and resources: https://mtsgpodcast.com

Patreon: https://www.patreon.com/c/mtsgpodcast
Facebook Group: https://www.facebook.com/groups/therapyreimagined

Creative Credits:
Voice Over by DW McCann:
https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano:
https://groomsymusic.com/

Burnout Recovery in a Failing System – An Interview with Shaina Siber, LCSW

Therapists are navigating hiring freezes, wage stagnation, insurance instability, identity-level threats, and mounting systemic uncertainty — all while supporting clients experiencing the same instability. What happens when burnout isn’t just about workload, but about working inside a system that feels like it’s failing?

Curt and Katie talk with Shaina Siber, LCSW, about moral injury, burnout as a fawning trauma response, and how therapists can move from control strategies to agency using Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT).

Shaina shares how psychological flexibility, compassionate prioritization, and values-based action can help therapists recover from burnout without abandoning their humanity.

In this episode, we discuss:
• Burnout as a trauma response
• Moral injury in modern mental health care
• The “K-shaped” labor market and therapist stagnation
• Moving from overcontrol to agency
• Sustainable contribution without collapsing

Guest Bio:
Shaina Siber, LCSW is the founder of Affirm Mental Health, host of The Affirming Minds Podcast, and author of the forthcoming Routledge book Using ACT and CFT for Burnout Recovery: The Beyond Burnout Blueprint (available for pre-order February 25, 2026). She brings over 15 years of clinical and leadership experience and specializes in trauma-informed, LGBTQ+, and culturally responsive care.

Full show notes and resources: mtsgpodcast.com

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Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann – https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano – https://groomsymusic.com/

Should Texas Therapists Stop Treating Kids? Texas SB14, Gender-Affirming Care, and the Risks for Therapists

In this episode of the Modern Therapist’s Survival Guide, Curt Widhalm and Katie Vernoy discuss a new interpretation of Texas SB14 that may place therapists at risk for providing gender-affirming care to trans youth. They explore how a recent opinion from the Texas Attorney General could broaden the law’s reach beyond medical providers to include mental health professionals.

Curt and Katie break down what this interpretation could mean for therapists working with minors, including possible risks related to licensure, malpractice coverage, mandated reporting, and criminal liability. They also discuss the ethical tension between evidence-based care and compliance with state law, and the difficult decisions clinicians may face when considering whether to continue working with kids.

Key Takeaways:


A new interpretation of Texas SB14 may include mental health professionals as part of the “healthcare pipeline” facilitating gender transition for minors.


The legal term “facilitating” could potentially include referrals, letters, or even supportive therapy conversations.


Therapists may face risks related to licensure complaints, malpractice coverage exclusions, or legal consequences if their care is interpreted as supporting gender transition.


Mandated child abuse reporting requirements could create additional legal and ethical concerns.


Clinicians may need to assess their personal risk tolerance when deciding whether to continue working with minors.

Full show notes and additional resources will be available at:mtsgpodcast.com

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https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits

Voice Over by DW McCannhttps://www.facebook.com/McCannDW/

Music by Crystal Grooms Manganohttps://groomsymusic.com/

The Licensing Racket: Therapist Licensing, Discipline, and Access to Care – An Interview with Rebecca Haw Allensworth

Who does licensing protect - the public or the profession?

Curt and Katie talk with Rebecca Haw Allensworth, law professor and author of The Licensing Racket, about how professional licensing boards actually function, and what that means for therapists, discipline, and access to care.

After attending licensing board meetings across professions and states, Rebecca identified a troubling pattern: entry requirements that continually “ratchet up,” while discipline decisions can lean toward giving professionals the benefit of the doubt. The result? Higher barriers to entry, workforce shortages, and inconsistent public protection.

This episode explores therapist licensing reform, self-regulation, professional turf wars, board funding structures, and the tension between prestige, professional identity, and public safety.

About Our Guest:Rebecca Haw Allensworth is the David Daniels Allen Professor of Law at Vanderbilt Law School and author of The Licensing Racket: How We Decide Who Is Allowed to Work and Why It Goes Wrong. Her research focuses on antitrust and professional licensing and has been cited by the U.S. Supreme Court.

Key Takeaways:
• Why licensing requirements tend to increase over time
• How self-regulation can create blind spots in discipline
• The impact of licensing barriers on workforce shortages and access to care
• Why complaints about unlicensed practice may be prioritized over client complaints
• How professional identity and funding structures shape board decisions

Full show notes and resources: mtsgpodcast.com

Join our community:
Facebook Group: https://www.facebook.com/groups/therapyreimagined
Patreon: https://www.patreon.com/c/mtsgpodcast

Modern Therapist’s Survival Guide Creative Credits:
Voice Over by DW McCann https://www.facebook.com/McCannDW/
Music by Crystal Grooms Mangano https://groomsymusic.com/