What’s Next for Therapists? Not Private Practice
February 02, 2026
It’s 2026 and Americans are still asking why it’s so hard to find a therapist. No one likes hearing their lifeline is completely booked, out of network, or too expensive. It hurts even worse not getting a call back at all. But the truth runs much deeper, and helps explain the nationwide therapist shortage. Yet, Indeed found that LPCs and LCSWs are two of the best seven jobs in America this year. I worry this won’t be the case for long if things don’t change.
Here are my predictions on the mental health workforce:
The Glamour of Private Practice Wears Off
Three evolvedMD clinicians in the halls of a primary care clinic.
Being an entrepreneur can be an exhausting and lonely endeavor. That’s true in any industry. The business side of behavioral health isn’t glamorous either – especially in private practice.
When I hear someone is considering private practice, it’s usually because they believe that’s where the money is; that it’s the only way to earn more and feel financially secure. Believe me, I’ve built my own private practice, and I get why it’s so attractive, but people don’t talk enough about its unique clinical, emotional, and financial challenges.
If you think about it, private practice demands you wear many hats: juggling caseloads, administrative work, payer reimbursement, business expenses, operational challenges, referrals, marketing your services – the list goes on. And while it can be lucrative, even the most skilled, business-savvy clinicians struggle to stay afloat. Reimbursement rates are shrinking, business costs are rising, and patients are discontinuing services because they can no longer afford it.
That’s why I’ve devoted the back half of my career to creating a better path forward for the mental health workforce. One that strikes a healthy balance where therapists can do their best work and be financially stable, without losing confidence or burning out.
My Take: Private practice isn’t the only path to independence and financial stability. This year, I think therapists will see past the glamour in favor of a new challenge. One that allows them to learn, earn, and grow without going into private practice. And it’s not community mental health.
Therapists Choose a Collaborative, Measurement-based Approach
After nearly two decades working in community mental health and private practice, I decided to join evolvedMD, an early-stage startup eager to fix the broken healthcare system. Working in a primary care office was strange at first, but I quickly learned that truly effective patient care can’t – and won’t – happen in silos.
It was immediately apparent when I saw my first patient. Their primary care provider didn’t just check out after the warm hand-off; they stayed engaged throughout the patient’s whole journey, and over time I built positive relationships with every provider in the office. In private practice, I never even talked to anyone’s PCP, much less had a working relationship with them. Using this collaborative, tight-knit approach empowered us to treat the whole patient which improves the quality of care.
Every visit we would measure each patient’s progress using validated mental health screening tools, like the PHQ-9 for depression and the GAD-7 for anxiety. Measurement-based care isn’t common in community mental health or private practice, but the data truly makes a meaningful difference. As people see their scores steadily decrease, it confirms they aren’t just feeling better in the moment, we have tangible proof of real progress. We could also clearly link the skills learned in session and behavior changes to their improved mood. This reinforces the important work we do and helps our patients sustain their improvements over time.
That hard data gave me confidence that I was genuinely helping my patients heal. And at the end of the day, isn’t that why we became therapists?
My take: As CoCM adoption rapidly grows, and the spotlight shines on its proven outcomes, I think therapists will realize that CoCM works better for everyone: patients, practices, and without question, the mental health workforce.
They Prioritize Learning + Development, with the Right Support
What comes next after grad school and internships? There are plenty of specialized trainings and workshops available. The big problem is that therapists must do them on their own time and, unfortunately, on their own dime.
That’s especially true if they’re seeking licensure. Finding a clinical supervisor is one thing. Paying for it out of pocket is another. Recently I read about one therapist who pays almost half of what they earn towards supervision. Investing in your future, and your patient’s care, shouldn’t be a financial burden.
One solution is allocating more money to professional development budgets. At evolvedMD, our budget supports in-house clinical supervision with licensed supervisors, a two-year integrated care training program, CEUs, and much more – at no cost to our clinicians.
Since 2017, this investment resulted in 47 clinicians achieving independent licensure and over 40 graduating from our first Collaborative Care Leadership Development Program cohort.
My Take: We must invest in developing the mental health workforce. An employer who makes learning and development a top priority, not an afterthought, will undoubtedly retain and grow the therapists the industry risks losing.
Therapists Seek an Employer Who Makes their Well-being a Top Priority
If we ever meet in person, chances are I’ll talk your ear off about the well-being of the mental health workforce. Maybe I’m a little biased, but I truly believe that therapists are some of the most compassionate people you’ll ever meet. They bend over backwards for their patients, their colleagues, and just about anyone they come across.
That’s why I get frustrated when the behavioral health industry doesn’t reciprocate. You’d think the healthcare system would understand the value of taking good care of those who take good care of their patients. But it seems the deeper we get into the nationwide mental health crisis, the more therapists sacrifice their well-being each day.
If I’ve learned anything in this field, it’s that a happier, healthier workforce results in happier, healthier patients. That’s true for any industry, but especially behavioral health. In practice this looks like:
- Providing emotional support when navigating complex cases.
- Offering in-person and on-the-spot support from licensed supervisors
- Leading team supervision sessions for added connection
- Building clinical judgment and confidence with thoughtfully curated professional development opportunities
- Offering a consistent Monday through Friday 8-5pm schedule, with no on-calls, weekends, or holidays—ever.
, we’ve done all the above and more. In turn, patient care improved, too, with 64% of patients achieving a significant response for depression and anxiety in 2025, far exceeding the industry standard.
My Take: We must invest in the emotional wellness of the mental health workforce or they will leave their practice or the field altogether.
From one therapist to another, if you’d like to learn more about:
- Why working in Collaborative Care is better for you and your career
- How to grow your clinical skills without unnecessary stress – at no cost to you
- What emotional support in your profession looks like
- Potential next steps for moving to an integrated, team-based environment
Please feel free to reach out at sarah@evolvedmd.com. I’d love to hear from you and support your journey however I can!
About Sarah: Sarah Hanchett is a well-rounded and collaborative mental health professional with expertise in facilitating a compassionate and supportive care environment. As a Licensed Clinical Social Worker (LCSW), she is committed to delivering exceptional integrative care to both individuals and families in need. As evolvedMD’s Chief Clinical Officer of Collaborative Care, Sarah leads and supports a team of engaging and effective providers to ultimately deliver critical behavioral health services to practices nationwide. As the first employee of evolvedMD, Sarah’s experience and expertise helped establish the company as a national leader in behavioral health integration. Her attentive, engaging persona carries well beyond office and clinic hours as she enjoys spending time with her partner, supporting both of her children’s athletic pursuits, volunteering for her church and winding down with a good mystery novel.