What Is A Full Caseload?

A “full” caseload is different for everyone in private practice depending on client population, presenting issues, length of treatment, living situation, debt, long term financial goals, health, and ability issues.

Some folks are exhausted seeing 6 clients daily while others are tapped out after client number 4 of the day.

While comparing ourselves to other clinicians is easy, it is not helpful.

What Impacts A Clinician’s Caseload?

Some therapists find intakes and the early stages of a therapeutic relationship more exhausting than working with clients they already have a relationship with.

Some therapists work with more challenging populations and symptoms (e.g. trauma, grief, eating disorders) which causes more emotional fatigue.

Here are some questions to ask yourself as you consider what a sustainable caseload is for you:

• How many days do I want to work?

• How many clients do I want to see per day?

• How many clients can I see back to back before needing a break?

• How many breaks do I need per day? How long should these breaks be?

Tips For Identifying An Ideal Caseload

• Experiment

  • You can try out various types of schedules and adjust as needed. Mix it up!

• Money

  • How much money do you need to make to have your basic needs met? How much do you need to make to live the life you want? If you have a lower fee, you might have to see more clients to earn your desire income. Consider a fee that’s fair, just, and also works for what you need to be present and healthy for all your clients.

• In person or telehealth?

  • Energy levels differ depending on whether you see clients in person or over the internet.

• All numbers are not equal.

  • Seeing 20 clients a week who require a higher level of care or needs is much different than seeing 20 clients who are coming into therapy for personal growth and existential issues. Consider intensity, length, and severity of symptoms.

• When do I have the most energy?

  • Morning? Afternoon? Nights?

• Therapy length.

  • Do you see clients long term? Short term? This can impact your energy level and what an ideal caseload is for you.

• Do you care for others? Have a family? Children?

• This also impacts what an ideal caseload looks like.

• Create a schedule around your life, rather than your clients. Long term, this will help with burn out, counter transference, over extension, energy levels, and holding healthy boundaries.