Why Therapists Stop Working with Kids and What It Takes to Stay: Sustainability, Boundaries, and Pivots for the Long Haul
Curt Widhalm, LMFT, and Katie Vernoy, LMFT push back on the field's quiet stereotype that working with kids is the "starter home" of private practice, the place clinicians put in time before graduating to a cardigan and a wing-back chair. Working with kids and teens is not entry-level work. It is some of the most clinically and physically demanding work in the profession, and it has a sustainability problem that rarely gets named honestly.
Curt and Katie examine why so many therapists who work with kids and teens hit a wall around the five-year mark, and why that wall is rarely about clinical depth. They unpack the sensory toll, the parent communication load, the school and provider coordination, the cost of running a play therapy room, and the way a child caseload can quietly distort a clinician's sense of what is developmentally typical.
They also talk about how to build a long-haul career working with kids, teens, and families without becoming, in Curt's words, "a cynical, glitter-covered shell of a human being." This is a conversation for therapists in private practice, supervisors of clinicians who work with minors, and anyone weighing whether to keep working with kids, scale back, or pivot.
In this episode, we discuss:
Why working with kids is not a lesser clinical specialty
Why the work is hard to sustain, and why "burnout" alone does not fully explain it
How shifting from kid sessions to family work and parent work extends the clinical impact
The sensory, physical, and administrative load of working with kids
Why parents contact child therapists more than adult clients contact their own therapists
The financial and logistical reality of running a play therapy room
How a clinical caseload can distort a therapist's sense of typical development
When a pivot to adult, family, or parent work is healthy, and when it is avoidance
Timestamps:
00:15 — The "starter home" stereotype, and the five-year wall
06:03 — The 167-hour problem and why kid work is family work
10:08 — The sensory and physical toll
12:58 — Caseload diversification and structuring the day
19:41 — The unpaid hours: parents, schools, and the village
23:43 — The play therapy industrial complex
27:59 — Keeping up with kids' culture without losing yourself
30:19 — How a clinical caseload distorts the sense of typical development
33:09 — Expectations, moral injury, and what "fix my kid" really costs
35:01 — When a pivot is survival, and when it is avoidance
Full show notes and resources: mtsgpodcast.com
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