This "caseload" for mental health therapists often comes from the therapy practicum or a social work internship, where a therapist-in-training learns that their fully licensed peers maintain a certain number of clients. This caseload number set by the agency and has little to do with what is sustainable for the mental health counselor. I've seen averages of 30-40 clients on a caseload, and I've seen some caseloads as high as several hundred clients!
Mental health folks LOVE a good black-and-white answer, which is ironic because so much of their training equips them to embrace the space in the middle! Instead of frantically googling how many clients you should see each week, ask yourself, “how many clients do I want to see? What do I envision my ideal schedule as a mental health counselor to look like?”
A full caseload changes when you go into private practice because of various factors (read the full piece on how to set your fees here). So many "caseloads" only look at therapists who see clients 1:1 and don't consider the extra preparation or energy exertion for a therapist who runs groups, sees couples, or works with families. In those cases, additional tweaking is needed.
How Many Clients Does a Full-time Therapist See in a Week?
I've seen new therapists (or new to private practice therapists) ask themselves, "How many clients can I see before I burn out?" which is the wrong approach! Instead of getting as close to possible as burning out as an outpatient therapist, I urge you to consider a sustainable number of clients for you to see.
Therapists who see 30 clients a week often use this as a benchmark of "full" because it mimics a 40-hour workweek by the time you account for notes, emails, and the like. I can't imagine being fully present for thirty clients in an outpatient private practice setting! As a private practice owner, I do most of the heavy admin lifting and would be scrambling to keep on top of emails, return phone calls, complete my psychotherapy notes, and, quite frankly, keep all of my clients straight if I saw 30 clients a week. I prefer having spaciousness with and in between my clients and ensuring I'm fully present as a therapist.
Sample Therapist Schedules
These sample therapist schedules are based on the model of seeing 15-20 adult clients weekly for a 50-minute or 60-minute session. Tweak as needed if you run groups, work with families or couples, or have clients who need longer appointment times, such as working with a neurodiverse client or a client with a trauma history that requires extra time for grounding and safety before getting into their therapy session.
Mind Money Balance Therapist Schedule
Don’t you want to know how I do it as a financial therapist in private practice?! I kid, but also, I think it’s helpful to learn how other people set up their therapy practices.
At the time of this post (February, 2021), my version of having a "full" caseload is 18 clients. I see five per day Tuesday through Thursday, and three clients on Fridays. I prefer this therapy schedule to do administrative tasks, blog writing, and record podcast episodes on Mondays, shift into clinical mode on Tuesday and end early on Fridays to get all of my case notes done before the weekend. You’ll see I “batch” my psychotherapy notes and do them all at once at the end of the week. I used to do my notes each day, but I’ve switched to doing them weekly to take away some of the admin time on client-facing days. I have some therapist friends who like to see seven or eight clients a day back-to-back, three times per week, and I have others who want to see two or three clients each day on weekdays. This is just the weekly schedule that currently works for me as a therapist.
Monday: Admin day (notes, scheduling, billing), blog writing, podcast recording, client coaching.
10 am-4pm with a 30-minute lunch break
Tuesday-Thursday 5 clients
10 am-1 pm, Three clients
1-2 pm Lunch
2-4 pm Two clients
Friday 3 clients
10 am-12 pm Two clients
12-12:30 Lunch
12:30-1:30 One client
1:30-3 pm Notes and wrap-up
As of August 2021, my schedule has shifted to better accommodate my changing energy and capacity. My updated, and reduced caseload, is below:
Monday: Admin day (notes, scheduling, billing), blog writing, podcast recording, client coaching.
10 am-4pm with a 30-minute lunch break
Tuesday-Thursday 3-4 clients
10 am-1 pm, Three clients
1-2 pm Lunch
Admin time
3-4 pm, One client bi-weekly
Friday 3 clients
10 am-12 pm Two clients
12-12:30 Lunch
12:30-1:30 One client
1:30-3 pm Notes and wrap-up
Early Bird Therapist Schedule
For therapists who identify as early risers, they might like to start their days off early! This can be a great schedule if you want to be home in the afternoons, work with a lot of professionals, or generally have more energy at the start of your day. This sample therapist schedule front-loads the therapeutic work at the start of the day and leaves notes for the end of the therapist’s workday.
7 am-1:30 pm Monday-Friday, caseload of 20 clients per week
7 am-12 pm Four in a row, 15-minute break in-between sessions
12-12:30 Lunch
12:30-1:30pm Admin time
Night Owl Therapist Schedule
Night owl therapist looking for a schedule? This sample schedule focuses on the therapist who has more energy in the afternoons and evenings. In this sample, the admin work is at the start of the clinical day, so the therapist can use their peak energy for seeing their therapy clients.
Monday-Friday 3 pm-9:15 pm, caseload of 20 clients per week
3-4 pm Admin hour
4-6:15 pm Two clients, 15-minute break in-between sessions
6:15-6:45 pm Dinner
6:45 pm-9:00 pm Two clients, 15-minute break in-between sessions
Weekend Warrior Therapist Schedule
The weekend warrior schedule works great for a therapist who wants—or needs—to be home for most of the workweek. This one is set up for a therapist to see fifteen clients over three days, but depending on your needs and energy, you could easily add on an additional client to Saturday and Sunday, seeing 12 clients over two days and eliminate work on Fridays. Play around with the timestamps; this weekend schedule closely mimics a traditional 9-5 workday.
Friday-Sunday, 9 am-4:30 pm, caseload of 15 clients per week
9 am-12:30 pm, three clients, 15-minute break in-between sessions
12:30-1:15 pm Lunch
1:15-3:30 pm, two clients, 15-minute in-between break sessions
3:30-4:30 Admin hour
Average Number of Clients Per Psychiatrist
The average number of clients per therapist varies. Seeing more than six psychotherapy clients a day (in my mind) is a recipe for therapist burnout. Now, psychiatrists in private practice are different than traditional psychotherapists when it comes to an average caseload. A psychiatrist's average caseload could be in the hundreds because they see their clients monthly or quarterly. Besides the psychiatric assessment, most return appointments with a psychiatrist are 15-30 minutes and focus on medication benefits, side effects, and adherence. If you are a psychiatrist reading this, please tweak the sample caseload schedules according to your energy levels and how you prefer to manage your caseload.
What's Your Ideal Caseload?
There you have it! The trouble with trying to mimic agency work as a private practice outpatient therapist, how to craft your schedule to work for you, sample weekly therapist schedules, and tweaks to make to your caseload if you are a psychiatrist.
More Private Practice Help
If you need help, I have a couple of things you might be interested in. If you are a DIY-er and want to watch a workshop full of tips on how to take your private practice from “on the side” to full time so you can create your ideal caseload, check out the 1-hour workshop here.
If you want to work with me 1:1, I offer 1-time Power Sessions where I help clinicians troubleshoot 1-3 specific questions plaguing them in their private practice. We can cover anything from raising fees, to choosing a marketing platform, or setting financial goals in practice. Learn more about Power Sessions here.
And, a few times a year, I run a small coaching group for private practice therapists. In the program, I help them to rewrite their money stories, charge sustainable fees and maintain their ideal caseload, and learn the foundations of niching and marketing to call in their ideal clients and reduce burnout. Learn more about Grow a Profitable Practice From the Inside Out here.
