Off The Chair

The Clinician Holiday Reset Series Part I: Rest

Burnout doesn’t always mean you need more rest. Sometimes it means your nervous system is asking for a different rhythm—or even a different container for your work.In this special three part holiday series of Off the Chair, Dr. Colleen Long dives into the science of nervous system regulation, winter hibernation, and why clinicians feel more depleted than ever during December. You’ll learn how seasonal biology, unfinished stress cycles, trauma physiology, and systemic pressure collide—especially for therapists, psychologists, physicians, and helpers who feel for a living.This episode helps you identify what kind of tired you’re actually experiencing—the kind a nap will fix, the kind that needs a nervous system reset, or the kind that signals a deeper career redesign. You’ll also hear why December is not a neutral month for clinicians, how rest can bring uncomfortable clarity, and why evolving your work is not failure—it’s biology.If you’re feeling exhausted, flat, or quietly done, this episode offers language, permission, and practical tools to slow down without shame and listen to what your nervous system is asking for next.Who this episode is for:• Therapists, psychologists, counselors• Physicians, psychiatrists, dentists• Coaches, healers, helpers• Burned-out professionals considering a career pivot

Redefining Success: A Therapist's Path to Peace with Sarah Olson

Burned out, questioning everything, and wondering if you’re allowed to want something different from your work and your life? This episode is for therapists, group practice owners, and mental health leaders who have hit a wall and know they cannot go back to “business as usual.”In this conversation, Sarah Olson opens up about slamming into burnout at full speed, even while her practice and life looked successful from the outside. She traces the moment everything stopped working, the fog that made it hard to think straight, and the reckoning that forced her to step back, rest, and rebuild her relationship to work, productivity, and worth.You’ll hear her talk about how hard it actually is to delegate, release control, and trust a team when you’ve been holding everything together for too long. Sarah describes what it took to take real time off, reconnect with her body, and how healing her own trauma shifted everything.Key takeaways:➡️ Burnout can manifest unexpectedly, even when things seem to be going well.➡️ Recognizing the signs of burnout is crucial for recovery.➡️ Taking a break is not a sign of weakness but a necessary step for mental health.➡️ Delegation can be challenging but is essential for sustainable practice management.➡️ Self-care should not be viewed as selfish but as a priority for well-being.➡️ Redefining success involves understanding personal limits and needs.➡️ Quality work can be achieved in shorter, focused periods rather than long hours.➡️ It's important to listen to your body and respect its signals.➡️ Leadership styles can shift significantly after experiencing burnout.➡️ Finding peace in professional life is a continuous journey.➡️ Listening to your body is crucial for maintaining well-being.➡️ Healing personal trauma can enhance professional practice.➡️ Small changes can lead to significant improvements in well-being.➡️ Prioritizing what truly matters can help manage stress and burnout.If you've ever wondered what sustainable work-life balance as a clinician could look like, Sarah outlines a pathway there in this episode.Episode chapters:00:00 – The burnout experience03:40 – Recognizing the signs of burnout07:32 – The decision to step back18:30 – The shift in mindset24:58 – Finding community and support26:45 – Recognizing personal limits and the need for rest29:12 – The journey back from burnout30:50 – Learning to delegate and trust the team33:02 – Navigating the challenges of group practice ownership35:47 – Understanding burnout and its impact38:22 – Shifting perspectives on productivity42:16 – Finding motivation and embracing change46:03 – Dismantling old beliefs about success53:33 – The evolution of leadership in practice ownership01:03:02 – Leading with connection and inspiration01:06:58 – Listening to your body: a journey to self-care01:14:12 – Shifting therapy practices: from management to leadership01:18:47 – Marketing and building a sustainable practice01:21:31 – Advice for clinicians: small steps to avoid burnout​If this episode speaks to you, hit subscribe so you don’t miss future conversations. Leave a review so other clinicians can find these stories, and share this episode with a colleague who is on the edge of burnout and needs to know they are not alone.​Connect with us!Website: www.offthechair.comInstagram: @offthechairpodcastYouTube: @offthechairpodcastTikTok: @offthechairpodcast​

Autopsy of a Practice Part III: Your Not Broken, The Game is Rigged

Burned out, morally injured, and wondering if you’re the problem? Good news and bad news: it's not you, it's the system. This episode is for clinicians, group practice owners, and mental health leaders who feel trapped between their ethics, insurance demands, and the crushing weight of “doing it all.”In this conversation, we unpack the evolving challenges facing clinicians in independent practice, especially the shift from “I’m just burned out” to recognizing true moral injury. We look at how systemic forces, insurance requirements, and changing rules in healthcare are reshaping what it even means to do ethical, sustainable clinical work.You’ll hear how isolation in leadership, constant multitasking, and opaque power dynamics erode both capacity and integrity over time. The episode also explores why so many group practice owners feel like they “failed,” when in reality the rules changed without their consent or control.What you’ll learn➡️ Why your group practice didn’t fail just because you “couldn’t hack the rules”➡️ The difference between burnout as a capacity failure and moral injury as an integrity failure➡️ How clinicians become the vicarious “fall guy” for insurance companies and broken systems➡️ Why burnout can stop being a phase and start to feel like an identity you can’t escape➡️ How isolation at the top quietly harms clinical judgment, leadership, and well-being➡️ What it looks like to reinvent your work using technology and AI without losing your humanity➡️ Why “off the chair” means refusing to believe that suffering is the price of legitimacy in this fieldIf you’ve ever thought, “I can survive this if I can just see a way out,” this episode sketches the contours of that way out. It offers language, frameworks, and possibilities for clinicians who are ready to stop surviving in silence and start reimagining what practice can look like.Episode chapters00:00 – Introduction to the journey of clinicians06:46 – The illusion of freedom in group practice09:05 – The changing landscape of healthcare10:26 – The new power dynamics in healthcare12:53 – The burden of multitasking in practice management13:11 – Understanding moral injury vs. burnout17:55 – The impact of moral injury on clinicians21:13 – The isolation of leadership in healthcare25:07 – Navigating workplace turmoil27:48 – The burden of leadership in mental health30:27 – The impact of insurance on mental health practices36:43 – The journey to selling a practice40:24 – Reinventing mental health care in a changing landscape45:58 – Embracing technology for sustainable practice48:33 – Finding hope and healing in the chaos50:33 – Understanding human behavior and cues51:24 – Taking action for changeIf this episode resonated with you, hit subscribe so you don’t miss future conversations. Leave a review to help other clinicians find this show, and share this episode with a colleague who is quietly burning out or carrying moral injury alone.Connect with us!Website: www.offthechair.comInstagram: @offthechairpodcastYouTube: @offthechairpodcastTikTok: @offthechairpodcast

Trailblazer Series: Transforming Leadership in Group Practices with Julianne Guinasso & Poonam Natha

In this conversation, the hosts discuss the challenges of leadership in group practices, emphasizing the importance of trauma-informed leadership and building a culture of trust. Dr. Colleen Long introduces Poonam and Julianne from Level Up Leaders, who share their journey from clinicians to leadership consultants. The discussion covers the significance of understanding group practice owners, navigating isolation, and integrating culture into daily practices, especially in remote work environments. They highlight the costs of neglecting culture and the need for compassionate accountability in leadership, ultimately encouraging leaders to embrace their humanity and foster relational ecosystems within their teams.Key takeaways:Trauma-informed leadership is essential for sustainable practices.Turnover is costly, affecting both finances and morale.Survival mode hinders effective leadership.Building a culture of trust is crucial for team cohesion.Daily practices can automate culture cultivation.Compassionate accountability balances empathy with expectations.Honesty in leadership fosters trust and growth.Neglecting culture leads to high costs and low morale.Everyone in a team shares responsibility for culture.Transitioning from clinician to entrepreneur requires strategic planning.If you are in the thick of it, you are not alone. And you are definitely not the only one trying to survive inside something that was never built to support you.Connect with us!Julianne and Poonam: Website: https://www.levelupleaders.org/ Newsletter: https://levelupleaders.myflodesk.com/newsletterOff the Chair:Website: www.offthechair.comInstagram: @offthechairpodcastYouTube: @offthechairpodcast

Autopsy of a Practice: How Scarcity Mentality and Fear-Based Decisions Took Down a Seven-Figure Clinic [Part 1]

WATCH THE FULL VIDEO EPISODE HERE!This one is personal. In part one of our deepest dive yet, we begin the autopsy of a seven-figure practice that rose fast, broke even faster, and exposed what happens when the realities of a broken mental health system collide with raw human limits. This is not a business teardown. It is a confession, a reckoning, and a mirror for every therapist pushing through clinician burnout while trying to hold an entire organization together with grit and fear.We unpack how early conditioning shaped a lifelong scarcity mentality, how that scarcity mentality fueled a grind that looked like ambition from the outside, and how scarcity mentality quietly infected every decision behind the scenes. The result was a domino effect of fear-based decisions, the kind of fear-based decisions that feel logical in the moment but corrosive in hindsight, the type of fear-based decisions that eventually collapse even the most profitable seven-figure systems.We name what clinicians are rarely allowed to say out loud. We name what happens when clinician burnout becomes an invisible job requirement. We name what happens when the broken mental health infrastructure pushes good providers into survival mode. And we name the emotional cost of carrying all of this while trying to convince yourself you are fine inside something that looks like a thriving seven-figure business from the outside.This is part origin story, part accountability, and part solidarity with every therapist who ever wondered if they were the problem when in reality they were operating inside a system that is fundamentally the problem. If you feel the weight of clinician burnout, if you have made fear-based decisions out of desperation, or if you are navigating the fallout of a broken mental health landscape, this episode will land exactly where it needs to.What you will hearThe early imprint that wired a lifelong scarcity mentality and how it shows up in leadershipHow clinician burnout becomes an identity instead of a warning signThe quiet ways a broken mental health system shapes everything from hiring to ethicsWhy fear-based decisions masquerade as responsibility and feel impossible to avoidThe moment a seven-figure practice revealed its fault lines in real timeIf you are in the thick of it, you are not alone. And you are definitely not the only one trying to survive inside something that was never built to support you.Connect with us!Website: www.offthechair.comInstagram: @offthechairpodcastYouTube: @offthechairpodcastColleen Long, Psy.D.Website: www.claritypsychologicaltesting.comLinkedIn: Dr. Colleen Long Jennifer Politis, PhD, LPCWebsite: www.wellnesscounselingBC.comInstagram: @wellnesscounselingnjTikTok: @wellnesscounselingLinkedIn: