What is a clawback?
Learn more about clawbacks and how you can prevent them.
Taking the steps to keep your caseload current can be tedious — but it’s important.
Working in private practice, you get to make important decisions about your work, including how many clients you want to see.
There’s no set number of clients that makes a therapist full-time. Instead, working full-time as a therapist typically means practicing for standard “full-time” work hours. How many sessions you can fit in during that time frame depends on several important factors, including your own capacity and your clients’ needs.
Deciding on the right number of clients for your caseload is a personal decision that requires some reflection and strategic planning — and a willingness to adapt as needed.
It’s standard for a full-time therapist to schedule 20 or 25 therapy appointments each week, says Natalia Tague, clinical engagement lead at Headway.
If you see each of these clients weekly, you may have that many people on your caseload. But if most of your clients are bi-weekly or monthly, then you may have 40 or 50 total people on your caseload.
Ultimately, Tague says, your caseload is a personal decision. How many clients you see will depend on several factors, such as:
To determine your ideal caseload, first consider your own values. How many hours a week do you want to dedicate to therapy, and when do you want to work? If you want to earn enough money to take more time off, for example, then you might need to see more clients (or be OK with a pay cut).
Then, think about your specialty and the type of clients you might be seeing.
“Let’s say you have clients with intense symptoms or who require more crisis management. In that case, your caseload will be on the lower side,” says Tyler Willis, a full-time private practice therapist in California. “If you’re experienced in a specific niche and specialize with clients in that niche, you can likely take on more.”
Your caseload should, of course, factor in burnout and your ability to provide clinical excellence.
“I’d warn people against squeezing in 40 sessions a week just to make money,” says Tague. “Then you’re sacrificing your wellness and your clients’ care.”
Willis also cautions against comparing your practice to others or shaping your caseload based on another provider instead of accounting for your own preferences, skills, and values. “Have confidence in your ability to determine your own needs. Ignore what others are doing if it's not relevant to your situation,” he says.
Ultimately, how many clients you see in a day depends on how many hours you want to work in a day and how long your typical sessions are. If you typically provide traditional 50-minute therapy sessions and you have 25 clients on your weekly caseload, then you’d likely see 5 to 7 clients a day.
If you want to work longer days so you can take Friday off, then you may need to squeeze in more clients. But be honest with yourself about how your schedule may be impacting your quality of care: After a long day, your seventh or eighth client might not be getting you at your best.
Either way, Tague says it’s important to leave time for breaks and administrative work (like writing progress notes) between sessions.
Full-time work is typically seen as 40 hours per week, but you may work 35 or so hours and still be full-time. For example, in a report from the American Psychological Association, full-time clinical psychologists reported working an average of 36 hours a week (with most time spent on direct clinical care).
If you work full-time, you can determine how you want to break up your week. For example, some therapists work 9-5, Monday through Friday. Others may decide to work longer days for four days of the week so they can have one day off.
(If you want to estimate your potential earnings in private practice, remember that your billing and coding will only reflect the actual amount of time spent in session.)
Mental health practitioners who prescribe medication, such as psychiatrists and nurse practitioners, may see more clients in a given day or week. That’s because these providers bill their sessions differently, often with shorter appointments.
No matter what type of therapy you provide or in what context, willingness to pivot as needed is an essential skill.
“Accept that this is a process of learning about yourself, and adapt as you go,” says Willis.
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