Caretakers in Crisis: Data Shows Therapists Overworked, Overwhelmed, and Concerned for their Patients

State of the Therapist Profession, 2021

New data from SimplePractice shows that behavioral and mental health professionals are facing burnout and increased anxiety as compared to pre-pandemic

LOS ANGELES—February 24, 2021—New survey data from SimplePractice, an EngageSmart healthcare solution and leading EHR platform for private practice, shows that therapists are under more pressure than ever before to keep up with client demand, and with rising levels of depression, anxiety, and stress-related disorders in both their patients and themselves. While not surprising, the data does speak to specific areas of concern to therapists that could be addressed with changes to policy specifically regarding  mental health services and telehealth coverage, as well as improved access to childcare and social services for therapists and their patients, respectively. 

The annual State of the Profession survey from SimplePractice was conducted between January 11 – 21 of this year and features the observations of more than 2,400 therapists, psychologists, and counselors nationwide. Question topics included the use of telehealth in response to the pandemic, post-pandemic plans and concerns, insurance and patient payment options, and other areas pertaining to the business, well-being, and state of therapy in early 2021. 

Burnout on the Rise

Compared to the last SimplePractice State of the Profession survey in late 2019, professional burnout among therapists in early 2021 has increased significantly from 14% to 20% in a little over a year. 

While the COVID-19 pandemic has certainly played a large role, deeper dives into the data reveal some key differences among respondents: 

  • Reports of burnout were more prevalent in younger age groups, with 27% of 35 & under saying they “often” or “always” have feelings of professional burnout.
  • Burnout is more likely when a providers’ clients are almost all affected by a social situation(s) (poverty, unemployment, lack of education, drug addiction, etc.).
  • Corresponding to the points above, 19% of early-career therapists reported that half or more of their clients are affected by a social situation compared to only 15% of mid and late-career therapists.
  • At the same time, more therapists than ever reported that they would recommend the profession to younger people, which has typically been a key indicator of job satisfaction. 87% said they would recommend their profession to young people. 

Telehealth, Insurance Coverage a Looming Concern

Responses to the survey included 1,800 written comments that reflect a high level of anxiety regarding continued patient insurance coverage for telehealth once the pandemic is over. This corresponds to other data points revealed in the survey that show most respondents plan to continue offering telehealth: 

  • 62% of respondents accept some or all clients that use insurance to pay or their services
  • 88% of respondents said they plan to continue offering telehealth services post-pandemic. What makes this noteworthy is that 64% had never even used telehealth before the COVID-19 pandemic. 

The survey closed with this open-ended question: “Please share any closing thoughts (For example, how this unprecedented period has been for you; how it has impacted on your practice? What have you learned? What keeps you up at night?)” Most comments emphasized that telehealth had not only saved their livelihood but allowed their clients to continue treatment.

A sampling of written responses to the question above include the following from two different respondents: 

  • “My business would’ve failed without telehealth as an option.” 
  • “If insurance companies had not allowed telehealth, I’d be in a bad financial situation.”

These findings are noteworthy because many mental health professionals had voiced concerns about the effectiveness of remote therapy compared to in-person sessions–despite the growing research that says otherwise. Over 165 comments mention letting go of office leases in the last year and having no place to practice (or the ability to pay for office space) outside the home, making telehealth more vital than ever to the livelihood of many practitioners. 

Supporting the needs of therapists must be priority says CEO Howard Spector

“We’ve known for years that the people who have dedicated their lives and careers to the mental health and well-being of others are too often disregarded when it comes to their own needs as clinicians and small business owners,” says SimplePractice CEO Howard Spector. 

“I can only hope that this data—along with so much other research and evidence out there to back it up—will help to finally put these front-line workers on the priority list for support from policymakers, insurance carriers, and even public perception. The work they do is important in ‘normal’ times and beyond critical in the midst of the largest pandemic the world has seen in the last 100 years.”

Additional highlights from the SimplePractice State of the Profession survey include:

  • A shortage of other mental health professionals and limited internet connectivity in rural areas are concerns for therapists in rural areas, which speaks to both the importance of continuing telehealth coverage and improving broadband in communities across the country. 
  • Therapists with more children at home reported higher levels of anxiety and challenges in finding space to work within their own homes; this speaks to wider challenges faced by working parents in the midst of the pandemic.

Many questions from SimplePractice’s last State of the Profession survey in the late 2019 were repeated for a comparative data sample and based on the standard State of the Profession physician survey. Findings also closely reflected those of the American Psychological Association’s November 2020 survey of 1,800 mental health professionals, which also showed an increase in patient anxiety in depression and an increase in practitioner burnout. 

Access to the full range of survey data is available upon request. A full report with additional data points from the survey will be released in e-book form this spring. For more information, contact the SimplePractice team at

About SimplePractice

SimplePractice, an EngageSmart solution, gives health and wellness practitioners everything they need to succeed as entrepreneurs. With telehealth, scheduling, billing, form intake, continuing education, and more all available on one elegant, HIPAA-compliant, and HITRUST-platform, SimplePractice is the leading cloud-based EHR software for private practitioners. More than 100,000 practitioners trust SimplePractice to run their business, advance in their profession, and increase their capacity to help others, all without sacrificing the quality of life and control over their own destiny that should come with running a private practice. For more information on SimplePractice, visit and join the conversation on LinkedIn, Facebook and Twitter.


The State of the Profession survey was conducted online within the United States from January 11 through January 21, 2021. A randomly selected sample of SimplePractice customers were invited to participate. In total, 2,461 respondents completed the survey. This online survey is not based on a probability sample and therefore no estimate of sampling error can be calculated.

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