Should You Leave the Agency Life? A Therapist’s Guide to Finding Work That Actually Feels Good

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Hey there, fellow therapist!

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If you're reading this, there's a good chance you're on the edge of a life change. 

Maybe you're a few years into working in an agency or hospital and starting to wonder if it's always going to feel this exhausting. 

Or maybe you're fresh out of grad school, full of ambition but unsure whether to accept the first salaried offer that comes your way—especially when that offer comes with a caseload of 35 and no bathroom breaks.

Either way, as the owner of a therapy practice, I see you.

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Today I interviewed three smart, talented, deeply empathetic therapists who were burned out from agency work. 

And the stories were nearly identical: they entered the field full of passion and idealism, eager to make a difference. 

But years of red tape, overbooked schedules, and making less than an intern left them questioning why they got into this in the first place.

And honestly? I relate. 

I’ve been in this field long enough to know how easy it is to lose your spark when you're spending your days doing more documentation than actual therapy. Or when your worth is measured in units, not impact. 

Or when you feel like a cog in a machine that never slows down—not even when you’re crying in the staff washroom between sessions.

But here's the thing: therapy is sacred work. And when you're doing it in the right setting—when you're supported, paid fairly, and actually have the autonomy to show up as your full clinical self—it can be magical again.

So let’s talk about the two most common career paths for therapists: agency/hospital settings vs. private group practices (like mine, KMA Therapy). 

I’ll walk you through the pros and cons of each, help you reflect on what you actually want, and maybe even help you remember why you fell in love with this work in the first place.

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Why Agency & Hospital Settings are the “Secure” Route That’s Slowly Killing Your Joy 

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Let’s start with the path most therapists are told to follow after University.

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On paper it makes total sense. You get to clock in and out. You have a supervisor. You’re technically part of a team. You’re probably salaried. You might even have benefits—if you're lucky.

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But behind closed doors (or in my case, on Zoom interviews all day), what I hear is this:

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“I feel like I’ve aged ten years in two.”

“I’m always behind on notes and worried I’ll get written up.”

“I wanted to help people. Now I just try to get through the day without crying.”

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The truth is, agencies and hospitals were designed for volume. They’re meant to move people through systems, not necessarily support the human beings working inside them. Therapists are often underpaid and overworked, asked to hold extreme clinical content without the resources to decompress, and constantly being handed more. More clients. More forms. More groups. More crises. More... everything.

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Pros (because yes, there are some)

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• Built-in experience: You’ll see a high volume of clients with diverse backgrounds and concerns, fast. If you're new, this can accelerate your growth (or at least give you material for future memoirs).
  
  
• Supervision & licensure hours: You might be able to collect your hours with support, especially if you’re still working toward registration.
  
  
• Structure: You don’t have to market yourself. You show up, your clients are there, and your calendar is booked.
  
  
• Benefits: Health coverage, vacation days, pension plans—sometimes the stability alone is a reason to stay.
  
  

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Cons (a.k.a. why people are quitting)

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• Burnout is real: When you’re seeing 30 clients a week and writing 30+ notes with minimal breaks, something’s gotta give. And usually, it’s you.
  
  
• Low pay: You might have a master’s degree, years of experience, and still earn less than your cousin who works in corporate HR.
  
  
• No autonomy: Want to adjust your schedule? Choose which clients you work with? Take a day off? Not without three approvals, twelve forms, and possibly a reprimand.
  
  
• You forget why you started: This is the part that breaks my heart the most. I meet so many gifted clinicians who’ve lost their spark because the system made them numb to their own brilliance.
  
  

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For me personally I’m not here to bash agencies. They’re incredibly important, serve an important purpose, and some are genuinely wonderful. But if your current role is costing you your joy, your health, or your sense of purpose—it’s okay to want something different.

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It’s okay to want more.

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Group Practice (Like KMA): The Sweet Spot Between Solo & Supported

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Something I wish someone had told me earlier in my career is you don’t have to choose between burnout or going it completely alone.

There’s a third option. And when it’s done right, it’s pretty magical.

I’ve now interviewed hundreds of therapists—new grads, seasoned clinicians, people on the verge of quitting the field entirely—and I’ve seen the whole spectrum.

I’ve hired the ones who found their voice again. 

I’ve cried with the ones who were burnt out and ashamed to admit it. 

And I’ve built KMA Therapy with those people in mind. People who love the work, but need a better container to do it in.

Here’s what I know now: when therapists are actually supported, trusted, and paid properly? 

They thrive. 

Their clients thrive. 

Their careers finally feel sustainable. And therapy becomes joyful again.

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Pros (and there are a lot)

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• Clinical autonomy, finally: At KMA (and other good group practices), you choose the types of clients you work with, the modalities you use, and the pace that feels good for you. No more being forced into “Jack-of-all-trades” mode. You get to specialize. You get to shine.
  
  
• No more receptionist multitasking: One of the biggest differences? Admin support. You’re not scheduling your own sessions or chasing invoices—we’ve got a team for that. You get to do what you’re trained for: therapy.
  
  
• Peer connection without the toxicity: We actually like each other here. There’s collaboration, mentorship, and real community. We share wins. We talk shop. And no one’s side-eyeing your lunch break.
  
  
• Flexibility & lifestyle: You can set your schedule around your life—not the other way around. Want to pick your kid up from daycare? Train for a marathon? Take Mondays off? Great. We’ll help you make it happen.
  
  
• Pay that reflects your value: Therapists at KMA often earn far more than they did in agency roles—and they’re doing fewer sessions. Wild, right? But also… not. This is how it should be.
  
  
• Space that inspires you: I’m not going to pretend this is everything, but the environment you work in matters. Our offices are clean, beautiful, and designed to make both you and your clients feel held. You won’t be doing trauma work beside a flickering light and a crusty bulletin board from 2009.
  
  

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Cons (let’s be honest)

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• Client load builds over time: You might not be slammed with clients your first week—and that’s actually a good thing. We build intentionally, so the fit feels right. But yes, your caseload won’t be full overnight.
  
  
• You're not anonymous: In a small team, we see you—and we want to. That means showing up with integrity, self-awareness, and a growth mindset. If you’re someone who thrives in quiet rebellion, you might miss the structured hierarchy of a hospital setting.
  
  
• Still work—but the right kind: You’ll still work hard. But the work is aligned, clean, and impactful. You’ll feel it. Clients leave sessions saying, “That was exactly what I needed.” And so do you.
  
  

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I say all of this not to sell you a dream—but to remind you that the dream is real. I’ve built it. 

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I’ve watched dozens of brilliant therapists walk through our doors looking defeated… and six months later, they’re glowing. 

Fulfilled.

Alive in their practice again.

And you deserve that too.

If you’re a therapist reading this and nodding so hard your neck hurts, maybe it’s time to make a change. 

You didn’t get a master’s degree and thousands of hours of training to feel small. You got here because you have something to give—and you need the right container to give it.

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So… What Do You Really Want?

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Let’s take a breath here.

If you’ve made it this far into the article, chances are something inside you is stirring. 

Maybe it’s the part of you that knows deep down you’re meant to feel good in your work. Or maybe it’s just exhaustion whispering, “Please, for the love of God, let me pee between sessions.”

Whatever brought you here, I want you to know this: you are not crazy for wanting more.

More freedom. More support. More impact. More pay. More joy. 

These aren’t wild, entitled asks. These are basic conditions for a sustainable, fulfilling life in this field. You deserve to thrive as a therapist—not just survive.

And yes, that’s possible.

I’ve seen it happen dozens of times, right here at KMA. 

Therapists who were ready to leave the profession entirely found their spark again in a setting that actually honors their brilliance. 

We’ve created a space where both clients and therapists can heal, grow, and feel good showing up every day.

So whether you're just starting out or you're years into your career and feeling the burnout creep in—here’s your gentle invitation:

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→ Explore careers at KMA

We’re always hiring exceptional therapists who want a better way. If this sounds like you, we’d love to meet you.

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→ Book a session

Yes, we treat therapists too. You don’t have to carry it all alone. If you're feeling lost, depleted, or just need someone to hold space for you for once—come talk to us.

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→ Or simply pause and reflect.

What kind of work do you want to be doing? What kind of life do you want to build around it? You don’t have to have all the answers right now. But you do deserve to ask the questions.

You’re not meant to burn out. You’re meant to light people up. Let’s build the career—and life—that allows you to do just that.

With love,

Kimberly Moffit
Founder, KMA Therapy 💗

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