In Brief
The New Reality for Therapists After COVID
In the years following the COVID-19 pandemic, demand for mental health care in the United States has increased dramatically. Surveys from the Centers for Disease Control and Prevention and other public health agencies showed steep rises in symptoms of anxiety, depression, and stress during the pandemic years, and many clinicians say those needs have not returned to pre-2020 levels. Instead, therapists across the country describe a sustained surge in patients seeking support for both long-standing conditions and newer forms of distress tied to economic uncertainty, social isolation, and long-term stress.
At the same time, the number of available providers has struggled to keep pace with demand. Federal workforce analyses from the Health Resources and Services Administration indicate that many regions of the country remain designated mental health professional shortage areas. The American Psychological Association has also warned that shortages of behavioral health providers continue to affect both urban and rural communities.
The result is a system under significant strain. Many therapists report that their schedules fill weeks in advance, while some practices maintain waiting lists for new patients. The cases clinicians encounter have also grown more complex, with individuals seeking help for overlapping concerns such as anxiety, trauma, substance use, and chronic stress.
For therapists themselves, the sustained demand has reshaped daily work. Heavier caseloads and longer hours have become common in many practices. Professional organizations have also documented rising rates of burnout among behavioral health providers. Therapists often describe a sense that they are treating a prolonged national crisis, but without a corresponding expansion of the systems meant to support the profession.
The Structural Pressures Behind Burnout
While the emotional intensity of therapy has always been part of the profession, many clinicians say that burnout today is driven less by the therapeutic work itself and more by the structure surrounding it.
Administrative Overload
Documentation requirements have steadily increased in modern health care. Therapists must maintain detailed progress notes, track treatment plans, record diagnoses, and ensure that patient records comply with insurance and regulatory standards. These tasks are intended to protect patients and maintain continuity of care, but they also require significant time outside of sessions.
Insurance compliance adds another layer of complexity. Clinicians must verify coverage, submit claims, and respond to occasional requests for additional documentation. These administrative responsibilities can consume hours of a therapist’s week. Many clinicians say that time spent charting and managing paperwork often rivals the time spent providing therapy itself.
Financial Squeeze
Financial pressures also shape the experience of running a therapy practice. Rent for office space has risen in many cities, while operational costs such as malpractice insurance, licensing fees, and continuing education requirements remain constant. Technology costs, which are now essential for running a practice, have added another layer of expense.
At the same time, reimbursement rates for mental health services have been a point of ongoing concern among professional organizations. In federal health programs, including Medicare and Medicaid, changes to reimbursement structures have sometimes resulted in reduced payments for certain services. Clinicians who accept insurance may also face denied claims or delayed reimbursements, which can create uncertainty for small practices.
Technology as Both Solution and Expense
Technology plays an increasingly central role in therapy practices. Electronic health record systems help clinicians manage patient records and billing. Telehealth platforms allow therapists to see patients remotely. Secure messaging and scheduling systems help maintain communication between sessions.
These tools have expanded access to care and improved efficiency in many cases. Yet they also come with costs. Many practice-management platforms operate on subscription models, requiring therapists to pay monthly fees for scheduling, documentation, telehealth, and billing tools. Additional features such as claim clearinghouses, analytics, or AI-assisted documentation may require separate add-ons.
For large organizations, these costs may be absorbed across multiple providers. For solo therapists and small practices, however, each subscription represents a recurring expense. As overhead grows, many clinicians say the business side of therapy has become increasingly difficult to manage, sometimes overshadowing the clinical work itself.
Efforts in 2026 to Support Therapists Nationwide
In response to these pressures, a number of organizations and advocacy groups are working to address the structural challenges facing therapists. These efforts range from policy advocacy and workforce development programs to grassroots campaigns designed to raise public awareness.
Professional associations have been particularly active in pushing for reforms related to reimbursement and administrative burden. The American Psychological Association has publicly advocated for improvements in insurance reimbursement rates for mental health services and has highlighted excessive administrative requirements as a barrier to care. The organization has also engaged in federal policy discussions surrounding Medicaid and Medicare funding for behavioral health services and has encouraged psychologists to contact lawmakers in support of mental health infrastructure.
The American Counseling Association has made federal advocacy a central part of its policy agenda as well. Among its priorities are efforts to improve Medicare reimbursement conditions for counselors, enforce mental health parity rules that require insurers to treat behavioral health services on par with physical health care, and address long-term workforce sustainability.
Other organizations are pursuing related goals through legislative initiatives. The National Board for Certified Counselors has supported policy proposals such as the Improving Access to Mental Health Act, which aims to expand provider recognition and address payment gaps affecting counselors and social workers. Meanwhile, the National Association of Social Workers continues to advocate for reimbursement policies that protect social workers’ ability to provide care through federal health programs.
Alongside these policy efforts, workforce initiatives also aim to strengthen the pipeline of mental health professionals. Programs such as the National Health Service Corps offer loan repayment for clinicians who practice in underserved communities, while federal grants administered through the Health Resources and Services Administration support behavioral health workforce development. State governments have also introduced loan repayment incentives and scholarship programs designed to encourage clinicians to enter and remain in the profession.
These programs attempt to address one of the most persistent barriers facing the field: the financial challenge of entering and sustaining a career in mental health care.
Grassroots Advocacy and Public “Give Back” Campaigns
Beyond formal policy initiatives, grassroots advocacy has also begun to play a role in raising awareness of the pressures facing therapists.
In New York City’s Union Square, a recent gathering of therapists and mental health professionals used symbolic demonstrations to reflect the realities of modern clinical work. One performance installation featured individuals covered in paperwork as they moved slowly through the plaza, a visual representation of the administrative burden many clinicians say has grown alongside rising demand for care.
Around the space, advocates held signs highlighting issues affecting the profession, including reimbursement challenges, documentation requirements, and the continued shortage of mental health providers across the country.
Nearby, a small table invited members of the public to leave notes or tokens of appreciation for therapists in their lives. The installation formed part of a broader “pay it forward” style initiative intended to acknowledge the labor involved in mental health care while drawing attention to the structural pressures shaping the profession.
What Structural Change Could Look Like
Although these initiatives take different forms, their goals often overlap. Whether through federal lobbying, statewide policy efforts, or grassroots campaigns, many advocates are focused on similar areas of reform.
Reducing administrative burden is one recurring theme. Simplifying documentation requirements and insurance processes could allow therapists to spend more time on clinical care and less time on paperwork. Improvements to reimbursement structures are also widely discussed, particularly policies that better align payment rates with the rising costs of operating a practice.
Lowering overhead costs is another area of interest. As technology becomes central to therapy practices, some clinicians and developers have begun exploring alternative pricing models that could reduce financial barriers for small practices. This includes tools designed to simplify billing workflows, improve scheduling systems, and incorporate artificial intelligence to assist with documentation tasks.
Support for early-career clinicians is another important focus. Expanding loan repayment programs and training opportunities could help attract new professionals to the field while ensuring that experienced therapists remain in practice.
Although the specific solutions vary, many advocates agree that meaningful reform will likely require coordination across multiple sectors, including policymakers, professional organizations, and technology developers.
The Outlook for Therapy and Therapists
Demand for mental health care in the United States is increasing and will continue to go up. As awareness of mental health issues continues to grow, more individuals are seeking therapy and other forms of behavioral health support. This increased openness has the potential to expand access to care and improve outcomes for millions of people.
At the same time, therapists themselves continue to face significant structural challenges. Administrative responsibilities and paperwork remain substantial parts of the profession, and many clinicians say these pressures will persist unless broader changes occur within the health care system.
Advocacy efforts may influence future policy decisions, particularly around reimbursement rates and workforce support. Technological innovation could also reshape the profession in meaningful ways. Tools that assist with documentation or streamline administrative tasks may reduce some of the workload therapists currently face.
Grassroots campaigns and growing public awareness may play a role as well. As more people recognize the complexity of the work therapists perform, conversations about how to better support the profession may gain momentum.
For now, therapists remain on the front lines of a sustained mental health crisis, supporting individuals and families through anxiety, trauma, and uncertainty. The future of the profession may depend on whether the systems surrounding that work evolve quickly enough to support the people who provide it.