Abused Early Career Therapists: The Reality of Toxic Mental Health Internships and What to Do

Abused Early Career Therapists: The Reality of Toxic Mental Health Internships and What to Do

Lisa Marie Bobby, PhD, LMFT, BCC

Dr. Lisa Marie Bobby is a licensed psychologist, licensed marriage and family therapist, board-certified coach, AAMFT clinical supervisor, host of the Love, Happiness, and Success Podcast and founder of Growing Self.

There’s something in our profession that doesn’t get talked about nearly enough: mental health internships.

Every year, thousands of early career therapists step into the field through internships — full of heart, hope, and the desire to help people. Yet before they get a real chance to thrive, many find themselves pushed to the breaking point. They face overwhelming caseloads, unpaid or underpaid labor, and minimal support. As a result, many quietly break down before their careers even begin.

I hear this story again and again from early career therapists. Supervisors often insist that toxic mental health internships are simply a “rite of passage.” Students are told that struggling in silence proves their dedication. However, when they try to speak up, they encounter gaslighting — or worse, silence.

Therefore, it’s time to break that silence.

In this episode of Love, Happiness, and Success for Therapists, I sat down with Dr. Ambra Born, the founder and executive director of Reaching Hope, a trauma-informed nonprofit in Colorado. Her organization does extraordinary work supporting survivors and training the next generation of clinicians with integrity and care. Together, we had a real and honest conversation about how toxic mental health internships harm therapists, what safe and ethical training should look like, and how healing and change remain possible — both individually and collectively.

What’s Going Wrong in Mental Health Internships?

Many training programs, even the well-intentioned ones, fail to support students as people, let alone as developing clinicians.

Here’s what that often looks like:

• Supervisors assign interns caseloads far beyond their developmental capacity.
• Students feel pressured to respond to client crises outside of internship hours.
• Programs deny students the right to say “no” to overwhelming or triggering cases.
• Systems treat interns as free labor instead of valuing them as future colleagues.

All of this, however, gets reinforced by the unspoken message: You’re lucky to be here. Don’t complain.

As a result, when therapists are in the most vulnerable stage of their professional development, this pressure doesn’t just shape one training year. It damages their self-worth, weakens their boundaries, limits their ability to ask for help, and creates long-term confusion about money and sustainability in this field.

Why Toxic Mental Health Internships Hit So Hard for Early Career Therapists

If you’re reading this and nodding, I want you to hear this clearly: You are not the problem.

The real problem is that many systems in our field rely on outdated, hierarchical, or exploitative models. Hospital settings, community agencies, and even private practices often perpetuate these harmful approaches. Interns receive pressure to work beyond their limits, to sacrifice their health, and to tolerate unethical practices just to “earn their place.”

Consequently, toxic internships don’t just harm students. They harm the future of our profession. When we burn out talented clinicians — especially those without financial privilege — we lose the diverse, passionate, deeply committed therapists our clients need most.