15 Things You Should Learn During the Interview Process (Therapist Edition)
10 minute read.
My dear friend and podcast co-host Johanna Dwinells recently told me about a dream she had: “I was interviewing for my old job and I knew all the right things to ask for.“ Johanna’s dream has inspired this post.
Therapy Jobs
Ever wonder if a difficult job experience would have been better if you knew what questions to ask during the initial interview process? Well, if you are a therapist, you’ve come to the right place. Stop searching “questions asked during a therapist job interview“ and start thinking about what you need to ask.
Remember, therapists are in demand and they can work in a lot of different settings. You are needed. Your skills, your experience and your wealth of knowledge are highly valuable. But because it is an emotionally cumbersome job held mostly by women, the labor of therapists is very exploitable.
With that in mind, I give you 15 things you should learn during the interview process: therapist edition.
1. How much the therapy job pays.
Every therapy job is different, including the way they pay. If you work in a hospital setting and some group practices, you are making a yearly salary. If you are working in community mental health or private practices, you have a projected salary. This means you can decide on the salary you want, and then take on enough clients to hit that salary. You are likely to hit this desired salary if you have a cancellation policy in place, but more on that later.
2. If your position is fee-for-service.
Community mental health is known for offering services for clients who have less access, meaning they are unable to pay private pay rates or they may not have private insurance. This is a wonderful thing that exists in our terrible healthcare system.
With clients who carry private insurance, you can easily let them know that a no show or late cancellation will result in a fee, oftentimes the full rate of service. In settings that only accept Medicaid or Medicare, the clients are often unable to pay this fee.
Community mental health settings will often not cover the fee of a missed session, leaving the therapist without income if a client does not show up for their session.
To add to this, if the position is salaried, you may be tied to a certain number of clinical hours that is difficult to enforce or keep up with when it comes to cancellations and client drop off.
3. If there is a cancellation policy to protect your income.
As written above, many therapists in private practice employ a cancellation policy that protects their income in case of a client’s late cancellation or no show. Group practices may have a company wide policy, or you may be allowed to set your own.
Personally, my policy is that cancellations made within a 48 hour window of the session are subject to a fee, which is the full rate of service (this includes no shows). My clients know this when they enter my care. I rarely have missed sessions and when I do, clients understand that my income needs to be protected.
4. Benefits, including: PTO, sick leave, short/long term disability, FMLA.
Workers hear and internalize the following excuses every day: “we can’t afford to pay benefits” and “when the company grows, we’ll be able to”. Excuses like these are red flags, and they indicate that you may be entering into an exploitative work environment.
What these companies are actually saying is “our wealth has not grown enough to offer benefits to employees yet.” The sooner you understand and accept this, the better.
Every day, managers, supervisors and bosses in every part of the US are exploiting their therapist employees for financial gain. Most of these higher-ups are therapists themselves, and subscribe to the same bullshit that they were told early in their career: “Every therapist has to pay their dues.”
5. What type of maternity/paternity leave is offered.
Family planning and pregnancy should not negate you from maintaining financial security and a career. If you plan on growing your family, it is an added comfort to know that not only will your job be available when you return, but that you’ll be supported throughout your leave.
Don’t plan on having children? Another good reason to be aware of a company’s maternity/paternity leave is less obvious: you can learn a lot about how management treats their staff by the benefits they have available.
This is especially true for the gendered benefits. How does this apply to both maternity and paternity leave? The US is infamously known for not having nationwide maternity leave, often leaving moms who give birth unemployed, and without financial security. This has roots in our white supremacist and capitalist culture, which calculates a return on investment for the human experience. It is obviously sexist, but it is so much more than that (which will be covered in a future post).
Further, companies that do not offer paternity leave are exclusionary of male same sex/queer couples that adopt/utilize surrogacy. For heterosexual couples, it posits that the woman does not need assistance in minding an infant, and that the father does not need to bond with the infant, furthering the disconnection of emotional intimacy and closeness that men in the US experience every day.
6. Hours of expected clinical hours per week.
In case you are reading this and don’t already know, the traditional 40 hours work week for therapists absolutely does not mean you are seeing clients for 40 hours per week.
In fact, if a job asks you to work 20+ clinical hours weekly, it is possible that you are filling the position of a therapist who needed to leave due to burnout.
If you intend to work part-time, that is great. But you must be clear about the amount of hours you are limiting yourself to (and it doesn’t hurt to get it in writing).
7. If you will be penalized for going below these hours.
Not seeing your agreed upon amount of clients due to client drop out, no shows, or bad fits in the therapy space? That’s fine and very normal. However, some therapy practices will penalize therapists for this reduced number of clinical hours, offering them a decreased percentage of their original pay.
This is an extremely poor way to treat employees, and it is not something you need to accept. If you find out that you will be penalized with less pay, I would encourage you to not accept the job.
8. How you get clients or what the marketing strategy is.
Who is in charge of scheduling you with new clients? What type of marketing strategy does the company use? Do they buy ads on Google, use social media or rely on SEO? Knowing the rate at which your caseload will be filled is very good information to have.
9. Free individual + group supervision from a licensed clinician.
Therapist jobs in all treatment settings can expect to have some free supervision offered for individuals who are pre-licensed or just want to continue practicing therapy with support. However, it is always important to ask and never assume.
10. Who your supervisor will be.
Maybe you are told during your interview that you will be receiving supervision but you are unsure who the supervisor will be. Some therapists who also function as supervisors can be blindsided when a new therapist is hired that they are “responsible for.”
It is best to have this figured out before accepting the position, that way both you and your supervisor know you will be working together.
11. The amount of administrative work you are expected to do.
There is clinical administrative work and there’s regular old administrative work. Clinical admin work includes progress notes, updating treatment plans, responding to/sending emails, keeping in touch with members of your client’s treatment team, etc. General admin work includes insurance reimbursement, running credit cards, and other things that have nothing to do with your clinical work, but can still affect the quality of your work.
At my first private practice job, I had very little admin responsibilities at first. As time went on, more responsibility was added to my plate, including keeping up with client payments, what they owed/were owed due to insurance deductibles and reimbursements and other tedious items that took up my time and caused strain in the relationships.
Knowing what your responsibilities are is helpful, having it built into your job description is even better.
12. If you will be assigned by availability or by appropriate fit.
Are you being assigned clients because of the multiple certifications you have to treat specific symptoms or because you are available Thursdays at 4pm?
Many companies will assign clients by availability rather than appropriate pairing. This eliminates free consultation calls, which are important in determining if you and the client are a good fit to work together. This can cause harm to the client and burn out for you, especially if the company does not allow referring out. Read more about the dangers of assignment by availability here.
13. The company’s policy on referring clients out.
Referring out occurs for many reasons. It can happen if the client feels they are not getting the treatment they need, if the therapist feels ill equipped or triggered by the client’s trauma, and a myriad of other reasons. Referring out is normal and it is ethical.
Many companies find referring out as a threat to revenue, often putting the blame on the therapist for not “making it work”. Some will even put the blame on the client, going as far as to banning the client from seeing anyone else at the practice. This moralizes basic human needs and vilifies individuals for seeking treatment from a clinician they trust and connect with, and it is unethical.
14. If you’ll have your own office, or if you will be sharing.
It is very important to know where you are going to be working everyday, especially in a job as emotionally demanding as a therapist. In my first two therapy jobs, I shared an office with other clinicians and it was great. We all benefited from the support, the easy communication and the ability to wind down together.
Issues can certainly arise in these settings, and in those times, it is good to know if you will at least have your own desk and the ability to plug in headphones like I did.
When I transitioned into private practice, sharing an office was no longer an option in that sense (other therapists worked in “my” office on the days I was not in).
The issue arises when your space is not guaranteed. In my old private practice job, I ran into a few issues with shared space. One day, I showed up to work to find my office occupied with another therapist having a session behind the closed door, while my client sat in the waiting room. Another time, I watched a coworker hold sessions outside because a psychiatrist decided they were unhappy with their assigned office and used the therapist’s without permission. One time, I opened my office door to find the chair missing. While none of these occurrences are overly traumatic, it let me know that there was little attention paid to organizing compared to how much money could be made that day.
You need to know that your job values your time, your space and the work that you do. This can easily be shown by providing you with a consistent, safe space to work in.
15. If you’re expected to be available after you’re finished for the day.
Research tells us that as the job of a therapist takes so much emotional labor, that the boundary between work and home is very important. You do not need to be available after work hours.
Ethically, you are not allowed to abandon your clients, but there is a whole lot of space between abandonment and functioning as a crisis worker. Jobs that tell you that you need to be available to clients 24 hours, 7 days a week, are enforcing a rule that will lead to burnout. There is no reason for it, it isn’t even written about in our ACA code of ethics.
If a job tells you that you must be available at all times to clients, higher-ups or admin, I would firmly suggest you not accept the job.
What do I do now?
Great question! If you have made it to the end of the interview process, you have asked all these questions, and you’re still unsure about how to move forward, that’s OK.
I encourage you to trust your instincts. Like any area of life, a career as a therapist is littered with learning opportunities and surprises. As long as you arm yourself with as much information as possible and grow with your experiences, you can have a long, successful and financially secure career as a therapist.
Thank you for reading!
Email contact@teletherapywithsarah.com with questions/comments/concerns.
I provide therapy to professional millennials from working class backgrounds. I coach “Exploited Therapists” or therapists who have been exploited by managers, bosses and supervisors. I help them build their dream private practices.
Teletherapy in all corners of Pennsylvania from Philadelphia to Scranton to Erie to Pittsburgh.
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Ready to get started? Click here, or reach out to contact@teletherapywithsarah.com for a free 20 minute consultation.
I do not work through insurance, but I provide superbills for EMDR therapy sessions and regular therapy sessions. Learn about getting reimbursement from your insurance provider here.
Very Best,
—Sarah (she/her)
*Disclaimer - This piece was written by a straight, cis, able-bodied, white woman. Intersectionality (coined by lawyer, civil rights advocate, scholar and philosopher Kimberlé Crenshaw) tells us that race, ethnicity, class, sexuality, gender, etc. that differ from the above identifiers encounter hardship and oppression at a much higher rate.*
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