Pros
You get to work with a wide variety of children and adolescents who are experiencing various mental health and behavioral health challenges, and you get to do so in a team of other outpatient therapists, clinical supervisors, skills trainers, and psychiatrists. You also get free supervision each week that can be used towards earning your LPC or LMFT licensure in Oregon. There is also an amazing benefits package and fairly fast-accruing PTO. You also develop and improve your clinical skills quickly, and get to figure out your own personal style (so long as you still use evidence-based therapy modalities).
Cons
- There are no caseload caps, requiring therapists to manage an increasing number of clients along with all six-month treatment updates, annual assessments, and safety plans.
- Extensive coordination with schools, ODHS Child Welfare, and medical providers is required, significantly reducing available documentation time.
- High weekly targets are limited strictly to direct contact hours, making these standards difficult to meet when faced with client no-shows or cancellations. In the child and family therapy population, at least in community mental health agencies like LifeWorks NW, it is very frequent that clients no-show or same-day cancel appointments due to school, work, transportation, illness, or other issues that come up.
- These pressures are compounded by current shortages, with only three therapists and rotating interns serving the county where I work.