Balancing Heavy Workloads & Caseloads as Therapists in Training

Between your practicum and academic courses, if you’re in graduate school, you probably have a heavy workload. We all have a lot we need to accomplish in a relatively short amount of time.

But most of us would also like to enjoy a life outside of our professional career. So when there are multiple deadlines, projects without firm deadlines, and not always a clear line between “working hours” and “personal time,” how do we balance our priorities?

Always Consult with Supervisors

If you’re seeing clients, always consult with your clinical supervisors about how many and which type of cases are appropriate for you. Your caseload should be aligned with your level of experience and designed to help you achieve your training and career goals.

If possible, request not to take on another client when you’re feeling overwhelmed.

Consider more than the mere number of cases, but also the amount of prep time required for each. For example, are you implementing a treatment you’ve never done before? Do you need to spend extra time with a manual or preparing client worksheets? Also keep in mind the amount of mental energy necessary for high risk clients and the time it takes to follow up with certain clients between sessions.

Besides your mentor, clinical supervisors and peers can be some of your greatest resources in managing the demands of graduate school.

Keep Your Goals in Mind

This same construct of keeping your training and career goals in mind is applicable for research projects as well. Keep your focus clear to ensure you only take on projects or tasks in line with your own goals. Don’t use your precious time doing something for the purpose of adding it to your CV or because you think it will impress someone. Keep your professional narrative in mind and utilize your time wisely to build the skills you’ll need. If tasks are aligned with your goals, you’re also more likely to maintain your motivation when it comes time to complete them.

Capitalize on the Time You Have

Utilize those awkward breaks within your day.

Have 20 minutes? Keeping an up-to-date (prioritized) task list will help you identify small chunks of work that can be done in short breaks, such as responding to emails, writing just one paragraph or section of a clinical report, or making a phone call.

Routines are Your Friends

With so much to manage, it can be useful to not have to think about certain parts of your life all the time – like food, sleep, and exercise. I find that having a set schedule for meal planning, meal prep, grocery shopping, sleeping, and exercising can not only help me keep up with these required tasks, but also ensures I don’t overschedule myself to the point where I find my pantry empty in the middle of a work week! Keeping a routine of basic health tasks (e.g., eating, sleeping, and exercise) is also helpful for our circadian rhythms and metabolism.

Take Your Own Advice

As a therapist (in training), it can sometimes feel easier to guide our clients to make healthy decisions in their lives than it is for us to make those same choices in our lives. I sometimes think about what I would say to a client experiencing the same struggles I am. Take a moment to imagine: If your new client were a graduate student who was feeling overwhelmed by the amount of hours they had to work and the emotional burden from seeing clients, what might you say to them?

(No really, take a moment to think about it. I’ll wait…)

Now, what would need to change for you to be able to do that for yourself, in your own life?

Prioritize the Re-Charge

Psychologists often preach self-care due to the resounding evidence of its utility – but it’s even more important to heed our own advice.

We all have the same amount of hours in a day. What we “have time for” depends on what we prioritize.

Being a graduate student is only one part of my identity. I am a daughter, a friend, a pet mom, a neighbor, and a community member. I re-charge by tending to these other aspects of my life on a routine basis. I enjoy acroyoga, bicycling, reading, going to concerts – and of course, the occasional Netflix binge-watching session.

If you’re clinically oriented, you might also find yourself experiencing compassion fatigue. We work with clients and extend patience and compassion all day long that by the time we get home, we have little left for our other loved ones. Working with trauma, a book I’ve appreciated is called Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others by Laura Van Dernoot Lipsky. This book articulates how working to make the world a better place can lead to exhaustion, cynicism, and professional fatigue, and also suggests restorative practices to care for ourselves.  

Developing a mindfulness practice can also help you commit to yourself amidst all the chaos. Mindfulness can be practiced in as little as 1-5 minutes, and is recommended to be practiced at least 5-15 minutes a day for a beneficial practice. There are several free or low-cost apps to assist with breathing or guided meditation (e.g., Headspace; Stop, Breathe, & Think; Insight Timer). I personally prefer to incorporate deep breathing and mindful focusing into parts of my natural day (e.g., at every red light while driving, while brushing my teeth, or before bed).

Another way I care for myself is by seeing my own therapist. Beyond contributing to my goal of destigmatizing therapy, it’s useful! Life happens outside of my program, so I work with a therapist to discuss the issues that might interfere with my ability to be my best self. Not all issues are relevant or appropriate to discuss with my clinical supervisors, but that doesn’t mean they don’t affect the way I approach my work.

Take Breaks

I almost always have a nagging feeling that there’s something more to do. There’s always something I could be making more progress on.

But what I’ve discovered is: if you take a break, that work will still be there waiting when you return.

Maybe your break is 15 minutes, maybe it’s 3 hours, maybe it’s an entire day or weekend. Or maybe it’s just a break from one specific project that’s been hanging over your head.

Give yourself permission to excuse yourself from work, just for a bit. Just because there is always more to do does not mean we always have to be doing it.

So what about the times when it’s hard to take our own advice?

It’s okay. We aren’t static beings. We can’t be successful and organized all of the time. We have hiccups; we fall back into old habits and patterns we thought we broke. Maybe the times when you feel like you can’t are cues from your mind or your body that you need a break – you need to address something else. Do that first. Then you can get back to your healthy mindset and keep moving toward your goals.