Therapy as Human Connection

After 30 years as a therapist, I’ve come to realize that the most straightforward ideas in therapy are often the most transformative. I was trained in non-directive play therapy with children—a style deeply influenced by Carl Rogers’ humanistic approach. At first, I didn’t fully grasp how revolutionary his ideas were: the belief that healing isn’t about fixing people but about fostering a space where they feel safe enough to discover their own path.

Rogers taught us that the core of therapy is connection. He believed that all humans have an innate capacity for growth and transformation and that this potential could unfold in an environment of empathy, authenticity, and non-judgment. His vision was revolutionary—and simple.

He outlined six conditions for effective therapy, but the three that resonate most with me are:

• Empathy: Deeply understanding and resonating with the client’s experience.

• Unconditional Positive Regard: Accepting clients without judgment, regardless of what they share.

• Congruence: Showing up as your real, authentic self in the therapeutic relationship.

It’s these principles that made me fall in love with the work. They’re also the principles I’ve had to fight hardest to hold onto in a system that often prioritizes efficiency over humanity.

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From Connection to Commodification

When I started practicing, therapy felt more spacious. There was time to build relationships, understand the whole person, and meet clients where they were. But over the years, the landscape has shifted.

Insurance companies demand diagnoses to authorize treatment, limit the number of sessions, and pressure therapists to focus on symptom management over more profound healing. Pharmaceutical companies have turned normal human emotions—grief, sadness, fear—into markets for medication. Diagnostic manuals like the DSM, which were initially intended as tools, have become rigid frameworks for fitting people into narrow categories.

Here’s how this plays out:

• Someone grieving the loss of a loved one might be diagnosed with Major Depressive Disorder. The diagnosis might secure insurance coverage for therapy, but it also frames their pain as a problem to be “fixed” rather than a natural part of the human condition.

• Insurance companies approve treatment plans focused on short-term, measurable outcomes, often ignoring the messy, non-linear nature of healing.

• Therapists are left juggling large caseloads, rushing through sessions, and meeting productivity quotas instead of focusing on relational depth.

I see the toll this takes every day—not just on clients, but on therapists, too. The system that’s supposed to support healing often dehumanizes both the people seeking help and the professionals providing it.

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Therapist Burnout: The Hidden Cost

After three decades in this field, I’m tired. I am not tired of my clients or the work itself—I still find so much joy and meaning in sitting with people, hearing their stories, and watching them grow. But I’m tired of fighting a system prioritizing profits and efficiency over connection.

The demands placed on therapists are relentless:

• High caseloads that leave little room for reflection or rest.

• Outcome-driven metrics that reduce therapy to a checklist of symptoms and goals.

• Emotional exhaustion from working within a system that feels more transactional than relational.

This is why so many therapists are leaving the insurance-based system for private pay practices. It’s a way to reclaim autonomy, set boundaries, and focus on providing deeper care. But this shift comes with a price.

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Privilege and Accessibility

I’m fortunate to have built a career where I can take insurance while maintaining a sustainable workload. But I know this isn’t the reality for many therapists—or for many clients. Fee-for-service practices, while offering therapists more freedom, often make therapy inaccessible for people who need it most.

Here’s the reality:

• Many private therapists charge $150–$300 per session, which is out of reach for most clients.

• Public mental health systems are overburdened and underfunded, leaving many people without adequate care.

• Insurance reimbursement rates are often so low that therapists can’t make a living without taking on unsustainable caseloads.

It’s an impossible situation. Therapists face a choice between burning out in the system or leaving it and unintentionally excluding those who can’t afford private care. Meanwhile, clients are left navigating a two-tiered system: those with resources can access personalized, high-quality care, while others are left behind.

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Healing Through Presence

Despite all of this, I hold onto what Rogers taught us: healing happens through connection.

The moments that matter most in therapy aren’t about techniques or strategies. They’re about the times when a client feels truly seen—when they realize they’re not alone in their struggles, and that their pain doesn’t make them unworthy of care.

This is why I stay in the work, even when it feels overwhelming. It’s why I still believe in the power of empathy, unconditional positive regard, and authenticity, even in a system that often feels at odds with these values.

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Practical Takeaways: How We Can Move Forward

For therapists:

• Reconnect with your purpose: Reflect on what brought you to this work and how you can honor that, even within the system.

• Start by caring for yourself. Many seasoned therapists I know struggle with mental or physical health challenges after years in the field. Prioritizing your own well-being is not optional—it’s essential. Taking care of your needs, setting boundaries, and seeking support allows you to show up fully for others while sustaining your own health and resilience.

For clients:

• Ask questions: Don’t be afraid to ask your therapist about their approach and whether it feels right for you.

• Look for creative options: Sliding scale clinics, nonprofit organizations, and training institutes can offer more affordable care.

• Trust the process: Healing isn’t linear, and it’s okay if it takes time.

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Reflective Questions

• How do you feel about the role of diagnosis in mental health care?

• What qualities do you think make a therapist effective?

• If you are a therapist, do you have any deliberate practices to help you be more empathetic present or empathetic with your clients?

• If you’ve been in therapy, what moments felt most healing or transformative?

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Journal Prompt

Write about a time when someone showed you deep empathy. How did it feel to be understood? What did it teach you about connection and healing?

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A Few Things That Caught My Attention This Week

1. “The Gift of Therapy” by Irvin Yalom: A heartfelt exploration of the therapeutic relationship, full of wisdom for both therapists and clients.

2. Carl Rogers on YouTube: Watching videos of Rogers in action is a reminder of the profound simplicity of his approach. Search for “Carl Rogers Gloria” for a classic example.

3. This Play Therapy Center on TikTok is just plain fun for me to watch these fake play therapy sessions.

Healing is about being seen, heard, and understood. That’s what Rogers believed, and I still feel today.

I’m a therapist based in Charlotte, NC, specializing in working with neurodivergent women. One of my passions is writing newsletters—I currently have four! Wishing you a wonderful weekend.

Warmly,
Kristen McClure MSW, LCSW