Walking into your first session as a therapist, your brain is probably buzzing.

What if I say the wrong thing?
How do I protect myself from burnout?
What if I secretly have no idea what I’m doing?

You are very much not alone. Across counseling, social work, and psychology, early-career clinicians report high levels of stress, self-doubt, and uncertainty about ethics, boundaries, and career direction. Early- and midcareer psychologists often experience greater stress and a higher risk of burnout than seasoned clinicians, suggesting that the beginning years are a uniquely vulnerable time.

This article walks through the most frequently asked questions by new Therapists, gathers what experts and professional bodies say, and offers you simple, realistic answers you can start using this week.

Take a breath, grab something to drink, and let’s sort through what everyone else is wondering too.

Did you know? Agents of Change Continuing Education offers Unlimited Access to 150+ ASWB and NBCC-approved CE courses for one low annual fee to meet your state’s requirements for Continuing Education credits and level up your career.

We’ve helped tens of thousands of Social Workers, Counselors, and Mental Health Professionals with Continuing Education, learn more here about Agents of Change and claim your 5 free CEUs.

1) The Most Frequently Asked Questions by New Therapists: An Overview

Before exploring each topic in depth, it helps to have a quick, high-level look at The Most Frequently Asked Questions by New Therapists. Think of this as a table-of-contents-style roadmap. These are the questions early-career clinicians ask again and again, across disciplines, settings, and training backgrounds:

1. Confidence, Competence, and Imposter Syndrome

• How do I know if I’m actually helping clients?

• Why do I feel like a fraud even when sessions go well?

• Is it normal to feel anxious before almost every session?

2. Managing Trauma, Emotional Load, and Compassion Fatigue

• How do I protect my own mental health while hearing difficult stories?

• What are the early warning signs of burnout or vicarious trauma?

• How do experienced therapists stay grounded in this work?

3. Boundaries, Ethics, and Professional Conduct

• What boundaries should I set around communication and availability?

• How do I handle potential dual relationships, especially in small communities?

• What needs to be included in informed consent?

4. Supervision, Consultation, and Skill Development

• What should I bring to supervision?

• How do I ask for help without feeling incompetent?

• When should I consult versus refer out?

5. Documentation, Risk Assessment, and Legal Considerations

• What should a good progress note actually look like?

• How do I document risk without overdocumenting private details?

• What steps should I take if I make a clinical mistake?

6. Caseload, Scheduling, and Workload Balance

• How many clients can I realistically see in a week?

• How do therapists maintain boundaries in fast-paced settings?

• What can I do when I’m overwhelmed by back-to-back sessions?

7. Career Path, Settings, and Private Practice Decisions

• Should I start in private practice, or gain experience elsewhere first?

• What setting will give me the best foundation for long-term growth?

• How do I know when I’m ready to work independently?

8. Continuing Education (CE) Requirements and Affordable Options

• What CE topics am I required to complete for licensure?

• Where do therapists find reliable, approved continuing education?

• How can I complete my CE requirements without overspending?

  • (This is where many new therapists turn to Agents of Change Continuing Education, thanks to their $99/year subscription, 150+ ASWB and NBCC-approved courses, and frequent live events throughout the year.)

Learn more about Agents of Change Continuing Education. We’ve helped tens of thousands of Social Workers, Counselors, and Mental Health Professionals with their continuing education, and we want you to be next!

2) The Most Frequently Asked Questions by New Therapists

1. Confidence, Competence & Imposter Syndrome

1.1 “Is it normal to feel like a fraud even though I’m qualified?”

Short answer: yes. Longer answer: very yes.

Imposter syndrome shows up as persistent self-doubt and fear of being “exposed as a fraud” in spite of clear evidence that you are trained and competent. It is well documented among counselors, psychologists, and other helping professionals.

Typical signs:

• Minimizing positive feedback from clients or supervisors

• Overpreparing sessions or notes to “prove” you’re good enough

• Assuming every tough session means you are bad at this

Helpful responses:

• Normalize it in supervision and peer groups. Hearing that others have the same thoughts reduces shame and isolation.

• Gather actual evidence. Keep a brief log of client progress, small wins, and positive comments. Refer back when your brain insists you’re terrible.

• Work with the thought, not against it. Some therapists find it useful to treat imposter thoughts as protective parts that are trying (clumsily) to keep clients safe. You can appreciate the intention and still move forward.

Resources

• Articles on therapist imposter syndrome from counseling blogs and professional sites.

• PositivePsychology’s worksheets on coping strategies for imposter syndrome: PositivePsychology.com

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1.2 “How do I know if I’m actually helping my clients?”

You will almost never get perfect clarity here, although you can gather good clues.

Signs you are helping:

• Clients keep showing up and generally engage in the work

• They report shifts in thinking, behavior, or relationships, even if modest

• Risk has stabilized or decreased over time

• You see increased insight, emotional regulation, or problem-solving skills

Use:

• Collaborative goal-setting and periodic check-ins to track progress

• Simple outcome measures or rating scales, where appropriate

• Supervision to reality-check your perceptions

Remember, therapy outcomes are influenced by many factors, including therapeutic alliance, client readiness, and life context, not just your technique.

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2. Managing Trauma, Emotional Load & Compassion Fatigue

2.1 “How do I listen to trauma all day without burning out?”

Listening to traumatic material regularly can lead to vicarious trauma. That can shift your views of safety, trust, and control, and can show up as intrusive thoughts, nightmares, emotional numbing, or hypervigilance. 

Research on mental health professionals highlights:

• Exposure to ongoing traumatic narratives

• High caseloads

• Limited organizational support

as key contributors to burnout and vicarious traumatization. 

To protect yourself:

• Use supervision and consultation to process your own reactions, not just “treatment plan” the client.

• Have a personal plan for decompression after heavy days: movement, connecting with safe people, creative work, spiritual practices, time in nature.

• Watch early warning signs such as irritability, dread before sessions, or emotional numbness. These are signals to adjust, not personal failures

Resources

• Review blog posts on vicarious trauma and burnout in therapists.

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2.2 “How do I separate my life from my clients’ stories?”

You will never be completely separate. You can, however, create healthy psychological distance.

Strategies:

• End-of-day rituals such as a short journaling exercise, closing the office door with intention, or a brief grounding practice

• Clear work-home boundaries such as finishing notes before you leave and avoiding checking work email late at night

• Personal therapy when your own history gets strongly activated by certain cases

Over time, you learn to care deeply while recognizing that your clients’ choices and outcomes are not fully in your control.

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3. Boundaries, Ethics & Professional Conduct

3.1 “Can I be friends with my clients or follow them on social media?”

Ethics codes across professions (NASW, APA, ACA, AAMFT) consistently warn against dual or multiple relationships that can impair objectivity or risk exploitation or harm.

Key points:

• A multiple relationship occurs when you are in a professional role with someone and concurrently have another role (friend, business partner, etc.).

• Some nonsexual dual relationships are unavoidable in small or rural communities. The question becomes how to manage risk, not whether to disappear from the community. 

Good practice:

• Avoid becoming social media “friends” with current clients

• Use a clear social media policy in your informed consent

• When unavoidable overlap exists, discuss risks openly, document the discussion, and consult colleagues or supervisors regularly

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3.2 “What exactly should informed consent cover?”

Informed consent is more than a form. It is an ongoing conversation about what therapy is, how it works, and what the client’s rights are.

For social workers, for example, the NASW Code of Ethics states that valid informed consent should clearly cover: purpose of services, risks, limits due to third-party payers, costs, alternatives, clients’ right to refuse or withdraw, and the time frame of consent.

The ACA Code of Ethics notes that informed consent should be reviewed both verbally and in writing, and that counselors document these discussions throughout the counseling relationship.

A solid template includes:

• Nature and goals of treatment

• Risks and potential benefits

• Alternatives and right to refuse or stop

• Confidentiality and its limits (including duty to warn / protect, abuse reporting, court orders)

• Fees, billing, and cancellation policies

• Who has access to records

• Telehealth policies, if applicable

Resources

• NASW Code of Ethics section on responsibilities to clients

• ACA Code of Ethics, especially sections on informed consent and technology use 

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4. Supervision, Consultation & Skill Development

4.1 “What should I bring to supervision and how honest should I be?”

Supervision exists so you can talk about the messy, confusing parts of therapy, not to prove you never struggle. Qualitative studies and supervision literature emphasize supervision as a space to explore emotional reactions, ethical tensions, and learning needs. 

Useful things to bring:

• Cases that feel stuck or confusing

• Strong countertransference, especially if you feel ashamed of it

• Ethical concerns, boundary questions, risk scenarios

• Questions about treatment planning, diagnosis, and interventions

Aim to be as honest as you can. If you feel pressure to perform for your supervisor, name that too.

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4.2 “When do I need consultation instead of just my usual supervision?”

Consultation is especially important when:

• A client presents risk you feel unsure how to manage

• You are considering breaching confidentiality

• You face a potential dual relationship or conflict of interest

• You are practicing near the edge of your competence and wondering if a referral is needed

Document:

• Who you consulted

• The main issues discussed

• Key options considered

• Rationale for your final decision

This documentation can be crucial clinically, ethically, and legally.

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5. Documentation, Risk Assessment & Legal Worries

5.1 “What does a ‘good enough’ progress note look like?”

There is no one universal format, yet certain elements are widely recommended in risk-management and ethics literature. 

Your note should generally:

• Briefly summarize the client’s current concerns or session focus

• Describe interventions used (for example, cognitive restructuring, exposure planning, emotion regulation skills)

• Capture the client’s responses, including changes in affect, insight, or behavior

• Document ongoing risk assessment (suicidality, self-harm, violence, abuse) and how you responded

• Indicate how this session fits with the treatment plan

Avoid:

• Overly detailed transcripts of the client’s disclosure

• Judging or shaming language

• Material that is irrelevant to treatment goals

Frameworks like SOAP (Subjective, Objective, Assessment, Plan) or DAP (Data, Assessment, Plan) help keep things focused.

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5.2 “What do I document when there is risk of harm?”

When a client expresses suicidal or homicidal ideation, or there are concerns about abuse, you need clear documentation of:

• What the client said, in neutral language

• Your questions about intent, plan, means, and protective factors

• Your clinical judgment about level of risk

• Steps taken, such as safety planning, contacting supports, or arranging higher level of care

• Any consultation or supervision obtained

Guidance on suicide risk assessment from professional organizations and CE courses typically stresses thorough, timely documentation as a core risk-management strategy. 

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5.3 “What if I make a clinical mistake?”

You will. Everyone does.

Ethics and risk-management experts consistently encourage: 

• Prompt consultation or supervision

• Honest reflection on what happened and why

• Corrective action, which may include apologizing, revising the treatment plan, or referring

• Clear documentation of the event and your response

Trying to hide mistakes tends to increase harm and professional risk. Addressing them directly tends to protect both you and your clients.

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6. Caseload, Scheduling & Workload Balance

6.1 “How many clients should I see per week?”

Research suggests that psychological therapists are vulnerable to burnout due to frequent exposure to intense emotional material, especially when combined with high caseloads and little control over work conditions. 

There is no magic number, yet you can ask:

• After how many sessions do I feel noticeably less present or empathic?

• How much time do I need between sessions for notes and a short reset?

• What other responsibilities do I have outside direct client care?

Many new therapists:

• Start with a slightly smaller caseload

• Track data for a month or two (energy, mood, errors, client crises)

• Adjust with supervisor input

If you notice frequent dread, irritability, or emotional exhaustion, your caseload or schedule may be too heavy.

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6.2 “How do I keep boundaries with my time without feeling selfish?”

Poor boundaries often lead to exhaustion, mistakes, and stronger imposter feelings, which can eventually push capable therapists out of the field.

Practical time boundaries:

• Fixed start and end times for sessions, with a predictable ending process

• Clear policies for late cancellations and no-shows

• Rules around after-hours contact that are explained in informed consent

• Protected time for documentation and supervision within your work week

Boundaries protect your clients as much as they protect you, because a rested, grounded therapist offers better care.

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7. Career Path, Settings & Private Practice

7.1 “Should I go straight into private practice?”

Many early-career therapists fantasize about private practice, then feel guilty for wanting it or scared they are jumping too soon.

Factors to consider:

• Do you have solid exposure to a range of diagnoses and risk scenarios?

• Have you had consistent, high-quality supervision?

• Are you willing to learn basic business skills, including marketing, bookkeeping, and dealing with insurance or self-pay systems?

Commentary from experienced clinicians and career blogs often suggests beginning in settings that offer robust supervision and diverse caseloads, such as agencies, hospitals, or schools, then moving into private practice once you feel more grounded clinically. 

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7.2 “How do I know when I’m ready for private practice?”

Signs you may be closer to ready:

• You can identify your scope of competence and articulate what you do not treat

• You have a consultation network or plan for ongoing supervision

• You have at least a basic understanding of liability, documentation requirements, and emergency procedures

• You can tolerate financial uncertainty and gradual caseload building

CE courses on building a practice, marketing ethically, and managing finances can help fill gaps. 

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8. Continuing Education, Licensing & Affordable Learning

8.1 “How many CE hours do I need and who decides that?”

Continuing education requirements are determined by each state or provincial licensing board, and they differ by license type. The Association of Social Work Boards (ASWB) and National Board for Certified Counselors (NBCC) both emphasize that individual boards control the number of hours, renewal cycle, and required topics. 

Typical patterns:

• Fixed number of hours per renewal period (for example, 30 or 45 hours every 2 or 3 years) 

• Specific requirements for ethics, sometimes suicide or cultural competence

• Limits on how many hours can come from certain formats

You always need to check your own board’s website or a reputable summary like those from Agents of Change here, and keep your own records.

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8.2 “Where can I find trustworthy, affordable CE courses?”

You want three things:

1. Approval from recognized bodies such as ASWB ACE and NBCC

2. Content that truly strengthens your practice

3. Reasonable cost

One option many therapists and social workers use is Agents of Change Continuing Education, which is ASWB ACE-approved and NBCC-approved as a CE provider. 

According to their FAQ, Agents of Change offers:

• An Unlimited Continuing Education subscription that costs $99 per year, which includes access to 150+ CE-credit earning courses and at least 12 live CE events per year, all in one subscription.

• Courses approved for social workers, counselors, and other mental health professionals

• A variety of modalities, including live webinars, recorded video, audio, and more

For early-career therapists watching their budget, a flat-fee subscription model can be significantly more affordable than piecing together one-off webinars.

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8.3 “Are there any free CEU options while I’m getting started?”

Yes. Several professional organizations and CE platforms offer free or low-cost CE credits.

Agents of Change Continuing Education maintains a dedicated Free Continuing Education page, which currently includes:

• A free course on ChatGPT and AI for social workers and mental health professionals that offers 3 CE credits

• A free course on powerful home-school partnerships worth 1.5 CE credits

• A free course on business skills and extra income for social workers and mental health professionals

Other organizations, such as NASW, also provide some free or discounted CE opportunities to members.

Combining free CE offerings with an affordable subscription like Agents of Change can make it much easier to meet licensing requirements without constantly worrying about money.

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9. Quick “Meta” FAQ: Questions About The Questions

To round out The Most Frequently Asked Questions by New Therapists, here are two final meta-questions that almost everyone carries at some point.

9.1 “If I still have all these questions, does that mean I shouldn’t be a therapist?”

Every study and expert commentary on imposter syndrome, burnout, and early-career experiences says the same thing: doubt is common, sometimes expected, especially when you are new and care deeply about doing no harm. 

Your questions signal:

• Awareness of your impact

• Willingness to reflect

• Commitment to ethical practice

The people who never question themselves at all are usually the ones to worry more about.

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9.2 “What is the most important thing I can do for long-term sustainability?”

From the research on burnout, vicarious trauma, and therapist wellness, common protective factors keep showing up:

• Regular, honest supervision or consultation

• Ongoing education that feels meaningful, not just mandatory

• Boundaries around time and emotional energy

• Personal support systems and self-care that fit your real life

• A willingness to adjust caseload or setting when needed

Put simply: stay curious, stay supported, and keep learning.

When you combine that mindset with practical tools and accessible education, including platforms like Agents of Change Continuing Education that help you meet CE requirements while strengthening your skills, you give yourself a real chance at a sustainable, satisfying career in this work.

Agents of Change has helped tens of thousands of Social Workers, Counselors, and Mental Health Professionals with Continuing Education, learn more here about Agents of Change and claim your 5 free CEUs!

3) Important Tips for New Therapists

Starting your career as a therapist is exciting and meaningful, yet it can feel overwhelming when you’re still figuring out your identity, your workflow, and the emotional rhythm of the job.

These important tips are drawn from clinical supervision themes, research on therapist development, and real-world experience from providers across settings.

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Build a Sustainable Clinical Foundation

Your early years lay the groundwork for your long-term professional health. You don’t need to know everything, but you do need structures that protect your growth.

Choose Supportive Supervision

A strong supervisor accelerates your development and protects you from burnout. Look for someone who:

• Invites honesty rather than performance

• Offers clear, actionable feedback

• Helps you reflect on countertransference and emotional reactions

• Balances encouragement with challenge

If you ever feel pressure to “be perfect” in supervision, bring that up directly. Many supervisors see that moment as a turning point in your professional confidence.

Create Routines That Ground You

You’ll find your rhythm over time, but a few grounding habits can help:

• A predictable end-of-day ritual to release client stories

• Short breaks between sessions to reset your nervous system

• Regular time each week dedicated to documentation and planning

• Simple movement or breathing practices before or after intense sessions

These rituals make your work more sustainable, not indulgent.

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Take Care of Your Emotional Health

Therapists often underestimate how much emotional weight they carry each day. You matter as much as the clients you serve.

Watch for Early Signs of Fatigue

Burnout isn’t always dramatic. It usually begins quietly. Keep an eye out for:

• Irritability or emotional numbness

• Dreading sessions with certain clients

• Trouble sleeping after heavy clinical days

• Feeling detached from your work or personal life

Catching these signs early lets you make adjustments before exhaustion sets in.

Use Your Support Systems Wisely

You don’t have to manage everything alone.

• Bring emotional reactions to supervision

• Use peer consultation for tough or complex cases

• Lean on personal relationships outside of work

• Seek your own therapy when needed

Healthy therapists help clients more effectively.

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Stay Aligned with Ethics & Boundaries

Boundaries protect you and your clients. Early-career therapists often feel guilty enforcing them, but clarity helps build trust.

Keep Professional Limits Clear

Helpful boundaries include:

• Consistent start and end times for sessions

• Clear policies for cancellations and late arrivals

• No texting or casual messaging unless clinically appropriate and documented

• Limited after-hours availability, communicated upfront

Remember, boundaries are not barriers. They’re structure.

Practice Ethical Decision-Making

When faced with dilemmas, try using a quick ethical framework:

1. Identify the key issues

2. Review relevant laws and ethical codes

3. Consult with your supervisor or peers

4. Document your reasoning

5. Act in the least harmful, most client-focused way

Ethical confidence builds over time, not overnight.

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Grow With Ongoing Education

Learning doesn’t stop after licensure. The field evolves quickly, and continuing education helps you stay effective and grounded.

Be Strategic With Your CE Choices

Look for courses that strengthen areas where you feel less confident, such as:

• Trauma-informed care

• Risk assessment and safety planning

• Telehealth best practices

• Cultural competence

• Documentation and legal concerns

• Specific treatment modalities (CBT, DBT, EMDR, ACT, etc.)

A great example is Agents of Change Continuing Education, which offers more than 150 ASWB and NBCC-approved courses, frequent live events, and a $99/year subscription that keeps CE costs manageable while giving you access to a constantly growing library.

Utilize Free Educational Resources

Early-career budgets are tight, so take advantage of free CE opportunities when you can.
Agents of Change has a dedicated page of free CEU courses, including topics like AI in mental health work, home–school collaboration, and business skills for clinicians.

Free or low-cost learning helps you grow without financial pressure.

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Protect Your Time & Workflow

Therapists who thrive long-term are the ones who manage their workload intentionally from the beginning.

Avoid Overscheduling

It’s tempting to take every client to fill your caseload, but sustainable practice requires realistic pacing.

• Start small and increase gradually

• Leave time for documentation, supervision, and breaks

• Don’t cluster too many emotionally intense clients in one day

You will thank yourself later.

Develop a Documentation Routine

Notes become significantly easier when you build a consistent structure. Try:

• Completing notes immediately or at designated times

• Using templates like SOAP or DAP for consistency

• Keeping notes concise but clinically meaningful

Documentation is part of client care, not busywork.

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Trust the Process

Above all, remember that you’re in a profession that values growth, reflection, and curiosity. You will evolve with experience, support, and continued learning.

Key things to remember:

• You’re not supposed to know everything

• You’re allowed to ask questions

• You deserve support

• Growth takes time

• Small improvements count

You don’t become a seasoned therapist by avoiding uncertainty. You become one by staying engaged, reflective, and connected.

4) Conclusion

► Learn more about the Agents of Change Continuing Education here: https://agentsofchangetraining.com

About the Instructor, Meagan Mitchell: Meagan is a Licensed Clinical Social Worker and has been providing Continuing Education for Social Workers, Counselors, and Mental Health Professionals for more than 8 years. From all of this experience helping others, she created Agents of Change Continuing Education to help Social Workers, Counselors, and Mental Health Professionals stay up-to-date on the latest trends, research, and techniques.

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Disclaimer: This content has been made available for informational and educational purposes only. This content is not intended to be a substitute for professional medical or clinical advice, diagnosis, or treatment