Where Does a Therapist Truly Belong?
In conversations with therapists, I’ve met those who left salaried NHS roles and those longing for them. Their motivations vary, but a common theme runs through their stories: a loss of agency over their working lives, and the slow erosion this creates, often ending in burnout.
The hum of anxiety
Most therapists in the UK work in solo or small practices. Many describe a constant hum of anxiety around unpredictable income. They must market themselves, manage admin, chase invoices, maintain records, handle accounting, book rooms, and ensure supervision and insurance – all before they even begin the emotional work of therapy.
For early-career therapists, this weight can be particularly heavy. There is no single destination for clients to find them. A Google search throws up multiple directories, each with subscription fees – Psychology Today alone costs £29 per month. Layer on onboarding, scheduling tools, secure note-keeping, invoicing systems, and accounting software, and the financial and mental overhead quickly accumulates.
If a therapist charges £60 per hour, their real earnings often sit closer to £35-£40. And unlike many professions, you cannot simply “do more hours.” Most therapists can sustainably see four to five clients per day because therapy is not transactional work. It requires emotional presence, self-regulation, and deep attunement. Beyond a point, more clients do not mean more income – they mean emotional depletion.
Stability but little autonomy
On the other side, the NHS offers security, a salary, and freedom from commercial considerations. Yet the therapists I spoke with who left NHS roles described a different kind of frustration. Endless admin, rigid systems, relentless caseloads, and little choice over the complexity of clients left them exhausted. They had stability, but little autonomy.
So where does a therapist feel at home? For many, neither space feels truly sustainable. Private practice offers freedom, but also isolation and financial precarity. The NHS removes financial risk but often at the cost of autonomy and emotional bandwidth. And then there are the platform-based therapy models like BetterHelp – a topic best saved for another day.
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A perfect solution?
I do not pretend to have a perfect solution. But what if therapists did not have to choose between autonomy and overwhelm? What if there was a way to bring client acquisition, practice management, and emotional support into one seamless, intelligent system? A space that lightens administrative load, reduces isolation, and safeguards the emotional health of those who carry others’ emotions for a living.
That is the mission of HearMeNow. Not to replace the therapist. Not to turn therapy into a pipeline. But to quietly support the people who spend their lives supporting everyone else.