Burnout is an occupational syndrome characterized by mental, physical, and emotional fatigue — along with depersonalization and reduced personal accomplishment. Unlike general workplace stress, burnout in mental health therapy stems from a unique combination of continuous empathic engagement with patients’ challenges and the administrative burden that surrounds clinical work.

This article breaks down:

The World Health Organization's ICD-11 defines burnout as a phenomenon resulting from chronic workplace stress that hasn't been successfully managed. Research from the American Psychological Association estimates that between 21% and 61% of mental health practitioners experience burnout at some point in their careers.

Psychologist Christina Maslach developed the most widely used framework for understanding burnout, breaking it into 3 components:

According to Tebra's 2025 Physician Burnout Survey — which surveyed 219 private practice providers across 6 specialties — therapists reported these top burnout symptoms:

What makes burnout particularly tricky for mental health professionals is that the same skills that make someone an effective therapist — deep empathy, emotional attunement, sustained presence — are the exact resources that get depleted over time. The tools of the trade become the source of the problem.

Burnout, compassion fatigue, and vicarious trauma often get lumped together, but they come from different sources and respond to different interventions. Knowing which one you're dealing with matters for figuring out what to do about it.

Burnout tends to build gradually from organizational factors like documentation demands, inadequate support, and unsustainable caseloads. Compassion fatigue, sometimes called secondary traumatic stress, emerges specifically from the empathic engagement required to help people in pain. Vicarious trauma goes deeper still, actually changing how you see the world after repeated exposure to clients' traumatic experiences.

Mental health therapists often experience all 3 at once, which is part of what makes this work uniquely demanding.

The causes of therapist burnout fall into 2 broad categories: the emotional load of clinical work itself, and the cognitive and administrative burden that surrounds it.

According to Tebra's survey, therapists ranked documentation and charting as the number one contributor to burnout, along with low compensation. Low compensation was the highest voted burnout driver for therapists compared to the other 6 specialties in the study.

Following close behind was difficult patients. For mental health therapists specifically, the emotional weight of the work compounds the administrative frustration.

Top burnout drivers for therapists:

Continuous empathetic engagement with people experiencing trauma, abuse, domestic violence, PTSD, and substance use disorders creates sustained emotional depletion. Sixteen percent of mental health therapists cite difficult patients as a top burnout driver. That's not necessarily due to client wrongdoing, but more so because the complexity and emotional intensity of the work is genuinely taxing. 

Holding space for someone's suffering can take a toll, no matter how skilled you are at providing therapy. Kristin Trick, therapist and private practice owner, shares her experience with challenging patients: "I've experienced 'difficult' patients in regards to their attitudes towards sessions or payments. Both types intensify my workload in a manner I'm not willing to tolerate. I now ask screening questions before setting an intake, monitor new clients' interactions, and keep a small caseload to protect myself and my practice from this burden."

Beyond the emotional weight, there's the mental juggling act. Managing 15 to 20 or more active cases simultaneously means tracking treatment plans, monitoring progress, making clinical decisions, and holding each person's story in mind.

In Tebra’s survey, mental health therapists reported the highest rate of cognitive issues (39%) among providers in other specialties. Decision fatigue accumulates throughout the day. The mental overhead of complex case management compounds the emotional demands, leaving little cognitive reserve by evening.

Progress notes, treatment plans, intake assessments, insurance authorizations — all of it consumes hours beyond direct patient care. And unlike a difficult session that at least feels meaningful, paperwork rarely provides any sense of accomplishment.

Many practice owners report inadequate administrative support for non-clinical tasks, which means therapists end up handling billing, scheduling, and paperwork themselves. The result is late-night documentation sessions that eat into recovery time. When you're finishing notes at 10pm, you're not getting the rest you need to show up fully for tomorrow's clients.

Clunky EHR systems requiring constant workarounds add another layer of frustration. Many therapists view their digital systems negatively, citing disconnected platforms and after-hours charting requirements as major pain points.

When scheduling lives in one system, documentation in another, billing in a third, and patient communication in a fourth, the cognitive load multiplies. Each login, each workaround, each manual data transfer adds friction to an already demanding day. The technology that's supposed to help often makes things worse.

The most common coping approaches among therapists include: 

Mental health therapists also uniquely prioritize professional help; according to Tebra's research, they are the most likely to seek their own therapy than other specialties.

Tebra's study also revealed that therapists are the most comfortable discussing mental health or burnout issues with peers, with 62% of respondents saying they are always or often comfortable doing so. This reflects the value of peer support in processing the emotional demands of the work. 

However, maladaptive coping also shows up frequently. Therapists reported the highest rates of emotional eating (58%) and doomscrolling (48%) compared to other specialties, suggesting that current coping approaches aren't fully meeting the need. When healthy outlets aren't accessible or don't feel like enough, less helpful patterns fill the gap.

"It's heart-wrenching to listen as client after client shares their stories of trauma, abuse, or depression," Trick shares.

Practice-wide changes show promise in reducing burnout. Providers in Tebra's survey reported these as the top practice-wide coping strategies they use to manage burnout: 

AI-assisted documentation can reduce charting time significantly. Automated workflows for intake, appointment reminders, and insurance verification reduce cognitive load. Integrated platforms eliminate the juggling act of multiple disconnected systems.

Telehealth can also be a solution. Forty-four percent of therapists in Tebra's survey said telehealth improved burnout for them, compared to in-person care.

The goal isn't to replace human judgment. It's to remove the repetitive tasks that drain energy without adding clinical value, so you can save your mental resources for the work that actually requires them.

When burnout symptoms persist despite self-care efforts, or when they begin affecting patient care quality, professional support becomes important. If you're experiencing depression, anxiety, or thoughts of leaving the profession entirely, those are signals worth heeding.

Mental health therapists use professional help at higher rates than providers in other specialties, which reflects both the occupational hazards and the recognition that therapy works. The same tools you offer clients can help you too.

The irony isn't lost on anyone: The people who help others heal sometimes struggle to seek healing themselves. Yet modeling healthy help-seeking behavior is part of the work. And getting support isn't a sign of failure — it's a sign of taking the work seriously enough to protect your ability to keep doing it.

Burnout in mental health therapy isn’t a personal failure or a lack of resilience — it’s a predictable response to sustained emotional labor layered with excessive cognitive and administrative demands. When empathy, attention, and decision-making are required nonstop, without enough recovery or support, even the most skilled therapists will feel depleted over time.

Addressing burnout means moving beyond individual self-care alone and looking at the systems surrounding clinical work. Reducing documentation burden, simplifying technology, and building workflows that protect therapists’ time and mental energy can meaningfully change day-to-day strain. 

Ready to reduce the administrative burden contributing to burnout? See how Tebra's integrated platform with AI-assisted documentation helps mental health practices reclaim time for patient care and provider well-being.