Pros
Minimal day-to-day micromanaging.
Several colleagues were genuinely caring and skilled.
Cons
Associate-level with minimal supervision. I was hired as an LCSW-A. After ~1 hour of orientation, I was largely on my own; across four months my designated supervisor never initiated a check-in.
Case assignment without fit or prep. Clients were assigned with little regard to clinical fit and often with limited background information provided in advance.
Billing-first incentives. In my experience, the model prioritized billable hours over clinically necessary but non-billable tasks (collateral calls, coordination, extended documentation).
Session volume tied to “full-time.” I reached ~32 active clients (some non-weekly). Cancellations/no-shows were common; beyond “drop after two,” support felt limited.
Turnover & forced reassignments. During my tenure I observed multiple clinician departures. Several clients told me they were reassigned repeatedly after prior therapists were terminated or left; more than a few reported being on their third (or more) therapist within a 12-month period. This disrupted continuity of care.
Termination meeting dynamics. A meeting scheduled to “discuss concerns” became my termination. I had asked that it be recorded; I was told there were technical issues so it wasn’t recorded. Over ~40 minutes, when I tried to brief leadership on higher-risk client handoffs for continuity, I observed repeated eye-rolling/smirking and was told those issues were not my remit after separation.
Benefits confusion and delays. I received conflicting guidance about when benefits would begin and what “full-time” meant (30 vs. 25 sessions; retro look-back). During an illness, I lacked expected coverage despite asking for clarity in advance in writing; I used accrued sick time while waiting on answers.
Uncompensated necessary work. A typical week ran ~60 hours with ~15 billable; the remainder were integral job tasks that were not compensated.
Documentation squeeze. We were advised to run 50-minute sessions and use the remaining 10 minutes for “detailed” notes—reducing flexibility for clients who clinically needed the full hour. As well as not fitting the requirements of the billing codes we were told to use.
Scheduling guidance vs. access. We were told not to “over-accommodate” outside 9–5, though many clients work or attend school. And we told we would never be "expected" to work outside of normal business hours-however client's available was our responsibility and if we didn't meet them outside normal business hours, than we just wouldn't see them. Adding to further confusion how to maintain requirements to both be eligible and sustainable for benefits, and significant concern to provide client support.
Safety & facilities. I raised concerns about inadequate pre-session case info, vague in-office safety procedures (guidance amounted to “sit near the door and call 911”), and slow facility fixes (e.g., a damaged office wall remained unrepaired for weeks).
Post-separation silence to clients. Several former clients later told me they weren’t contacted promptly about my departure, raising continuity-of-care concerns.
Bottom line
In my view, the combination of minimal supervision for associates, billable-only incentives, unclear benefits administration, and weak follow-through on safety/continuity created avoidable risk and burnout. I documented these issues in dated emails and have reported my concerns to appropriate authorities.
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