Local therapists address increasing caseloads, new patient boundaries


Illustration by Olivia Abeyta

Some therapists say they’re seeing increasing demand for services and rising amounts of anxiety, depression and isolation.

Aviva Bechky, Assistant City Editor

Content warning: This article contains mentions of abuse, depression and anxiety.

Danielle Shannon started their own Chicago therapy practice with colleague Eva Ball during the pandemic. Many therapists did the same, Shannon said, finding new clients with an ease she’s never seen before.

“It’s weird when your profession can expand more quickly and easily because of a societal crisis,” Shannon said. “That feels very strange for a lot of therapists who went into this field because they care about helping people.”

As the pandemic continues, some therapists say they’re seeing increasing demand for services and rising amounts of anxiety, depression and isolation among their clients. They’re also responding to new challenges posed by telehealth therapy and changing relationships between therapists and patients.

Increasing demand

In a December New York Times survey of 1,320 therapists, nine out of 10 said they experienced a rise in demand for their services. Among those seeing greater interest is Sadie Baker, a therapist at Chicago Therapy & Wellness.

“Isolation is one of the biggest risk factors for depression and mental illness more broadly,” Baker said. “It’s sort of forced a lot of people to look at things that maybe they wouldn’t have.”

Baker said isolation commonly causes worsening mental health. She added that many of her clients live with HIV and are dealing with the trauma of having already survived a pandemic.

As pandemic restrictions change, psychotherapist Max Beshers said people’s worries do, too. Small losses of connection make an impact.

“One of my patients was telling me today in his session that he noticed that he doesn’t smile when he’s out in public anymore because it’s covered by a mask,” Beshers said. “It takes a toll.”

Eric Cho, a psychotherapist and owner of IMPROVing Life Counseling Inc., said most therapists at his practice have full caseloads. They’ve been referring interested patients elsewhere, he said, but many of the locations they refer to are now filling their caseloads as well.

“A lot of comments that I’ve actually gotten from potential clients is they haven’t actually been hearing back from some people,” Cho said. “There’s just been pretty high demand right now.”

However, that increase hasn’t been universal or steady. Valerie Cifuentes and Alison Stoll, therapists who work at Children’s Advocacy Center of North & Northwest Cook County, said patient referrals slowed slightly when schools switched to virtual learning. Their waiting lists, however, have consistently remained present.


The pandemic forced many therapists to move their practices online. While some have returned to in-person work, many have continued offering telehealth therapy.

Online therapy is easier to attend for some, like those looking for a therapist of a particular identity group, those in rural areas or those for whom leaving their homes is difficult. Baker said she saw those benefits for her clients. 

“(Many of my clients) would never have been able to find a trans therapist, but they were able to see me because we can do teletherapy,” Baker said. “I would never have even thought (to do) teletherapy if I hadn’t been forced to.”

But Baker said virtual meetings make it harder to gauge patients’ emotional states. Beyond that, not everyone has a safe, private space for therapy sessions. Cho said he’s had sessions with some patients in their cars and knows other therapists who have done the same.

Some patients are also left doing therapy in the same places where trauma occurred. Stoll frequently works with children under age five who have experienced abuse.

She and Cifuentes spoke about balancing who to see in-person.

“A lot of times, we’re asking to do therapy in an environment where abuse has either taken place, or the abuser may still have access to that home,” Stoll said. “Trauma treatment only works best if you are in a safe environment.”

Changing relationships

This year, many of the traumas that patients discuss are ones that therapists are enduring, too.

“When they’re experiencing things that I’m also experiencing, I found it taxing in a different way,” Beshers said. “When I’m worried about COVID, and then I have six people who all want to talk about being worried about COVID … that was a new sort of experience for me of just feeling worn out.”

That sentiment was echoed by others, like Shannon, who mentioned that the usual boundary between therapist and patient has shifted the past two years. Zooming from home, she said, means a client might get a glimpse of them wearing casual pants rather than a professional outfit or see them get up to grab a package.

Providing therapy through the pandemic has added a layer of stress, Shannon said. Though therapists are trained to handle emotional issues, she said many felt more burnt out — especially because they’ve been isolated from their support systems.

Stoll, likewise, said her teammates at the Children’s Advocacy Center are key to supporting her.

“There’s the saying, ‘It takes a village to raise a child,’” Stoll said. “I think it takes a village to support a therapist.”

Email: [email protected] 

Twitter: @avivabechky

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