Becoming a therapist often starts from a place of genuine empathy and a desire to help others navigate life’s complexities. Graduate programs, internships, and certifications all help shape a foundational understanding of psychology, treatment methods, and ethics. But there’s a difference between learning about therapy and living it day in and day out.
As a therapist, you quickly realize that the role isn’t just about applying theory; it’s about sitting with discomfort, confronting your limitations, and recognizing that some truths can only be understood through experience. These aren’t negative revelations, necessarily. They are sobering, humanizing, and, in many ways, empowering.
They remind you that while therapy is a space of healing, it’s also a space of uncertainty, humility, and growth. Here are three of those truths, which you only learn when you’re deep into this career.
#1. You Can’t “Fix” Everyone—And That’s Not Your Job
One of the earliest emotional hurdles many new therapists face is the realization that they’re not here to fix people. Clients don’t walk in with problems you can patch up with the right advice or insight. Often, they return week after week with the same patterns, the same pain, and minimal visible change.
This fact is soon realized after working with a few clients, and studies back it up. A 2024 meta-analysis of 33,881 patients across 441 trials found that only ~42% of people with major depression and ~36–38% of those with anxiety disorders (PTSD, OCD, panic, GAD, social phobia) achieved a 50% reduction in symptoms. In other words, more than half of treated patients do not fully “get fixed” by first-line therapy.
This is often emphasized during training when budding therapists go through mental health counseling programs. Professors try to prepare graduates for this reality check because many erroneously believe that therapy is all about giving people solutions to problems.
Walsh University quotes Dr. Bradley Erford, former president of the American Counseling Association, who talks about the qualities of a good counselor. As he notes, choosing evidence-based practices is important. No one denies this. However, he also emphasizes the importance of qualities like hope, empathy, and advocacy.
Therapists often come into the field wanting to make a difference.
But it’s tough to ensure this always happens. It’s also why many clients discontinue treatment prematurely. For example, a 2023 Norwegian study reported that 25.3% of patients dropped out of primary-care psychotherapy before completing the course.
This is just something you’ll have to get used to seeing as a therapist, regardless of your skill level. This brings us to our next point.
#2. Progress Is Not Linear—For You or Your Clients
Therapy doesn’t follow a neat, upward curve. Some days, clients come in energized, reflective, and open—only to show up the next week shut down, frustrated, or regressing into old patterns.
Moreover, recovery often involves setbacks. In a large Scandinavian study, nearly half of the patients who recovered from their first episode of major depression relapsed within five years. This recurrence occurred at a rate of 46.1% in adolescents and 49.0% in adults.
Such incidents of therapy not cutting through to the other person can be tough to accept, especially early in your career. You’re young and eager to see results and prove your effectiveness, but that lasting change is slow and often invisible at first.
What complicates this further is that your growth as a therapist mirrors this same jagged path. Some sessions leave you feeling insightful and aligned, while others leave you second-guessing everything you said. You’ll have breakthroughs—real moments of connection and clarity—but you’ll also have ruts, where it feels like nothing is working. And that’s normal.
Learning to accept the nonlinearity of both your clients’ journeys and your own is a quiet kind of resilience. It means letting go of perfectionism and embracing the ebb and flow of emotional work. Therapists who stick with the process come to understand that showing up consistently, even when things feel stuck, is the work. Over time, you develop faith in the process, even when you can’t see the full picture yet.
#3. You’re Always in Therapy, Too (Even if You’re Not Sitting on the Couch)
What surprises many therapists is how deeply personal the job becomes. Every session is an invitation to reflect on yourself, too. This is because clients will unknowingly trigger your unresolved issues from time to time.
It’s interesting how surveys of therapists around the world confirm elevated symptoms of certain issues. For instance, a 2024 survey of 502 Austrian psychotherapists found that 20.5% of therapists had high stress levels and 8.2% met the cut-off for significant anxiety.
You’ll notice patterns: who you feel overly responsible for, who makes you anxious, and who you subtly want to impress. And that awareness becomes a tool for growth if you lean into it.
In that sense, being a therapist means you’re never fully “off the clock” emotionally. The job gently (or sometimes forcefully) nudges you into ongoing self-awareness. Supervision helps, peer support helps, and often, your own therapy becomes essential—not as a crisis intervention, but as maintenance for your emotional health.
This doesn’t mean you lose yourself in the process; it means you learn to manage your inner world more skillfully because you have to. Your ability to help others depends on how well you can regulate yourself.
Essentially, the therapist’s journey is never just about the client. It’s also about how much you’re willing to grow alongside them, even when that growth is uncomfortable. It’s one of the most demanding, yet quietly beautiful parts of the work.
Frequently Asked Questions
1. How common is therapist burnout?
Therapist burnout is more common than you’d think. Around 1 in 3 therapists report feeling emotionally drained or overwhelmed by their work. The emotional weight of constantly holding space for others can wear on you, especially without enough support or personal boundaries in place.
2. Why does therapy not work for everyone?
Therapy doesn’t work for everyone because healing is complex. Some people drop out early, others aren’t ready to face certain truths, and not every therapist-client match clicks. Progress also isn’t instant. Real change takes time, effort, and a willingness to dig deep, which not everyone is ready for.
3. What is the most important aspect of therapy?
The most important part of therapy is the relationship between you and your therapist. If there’s trust, safety, and a feeling of being understood, everything else builds from there. Even the best techniques fall flat if that human connection isn’t strong or authentic.
To put things simply, the lessons you learn after becoming a therapist aren’t necessarily taught in graduate school. Instead, they’re often learned in the tension of difficult sessions and the long silences during therapy.
Being a therapist means embracing uncertainty, relinquishing control, and finding strength in your ability to be present rather than perfect. It’s not easy work, and it’s not always rewarding in the way people imagine. However, it’s deeply human. For those who stay long enough to learn these truths, the role becomes less about performing and more about being with others and yourself.
