In the world of private practice, we often wear the badge of a full caseload like it’s a sign of success. And while there’s certainly value in having a steady flow of clients and offering meaningful care, the truth is: there comes a time when many of us need to step back.

Sometimes it’s a season of life—caring for aging parents, raising young children, facing your own health challenges. Sometimes it’s business growth—like starting a group practice and needing more time to lead well. And sometimes? It’s just burnout.

There are many reasons a therapist may need to decrease their caseload, and I want to normalize that. Not only is it okay to reduce your client hours, but it’s often the *wisest* and most faithful next step in your journey.

The Shift From Solo to Group Practice

When I first launched my group practice, I didn’t expect how quickly things would shift. I had been seeing between 18 to 21 clients a week, and I was holding it all together—barely. But as my team grew, I realized that leading a group practice is a job in itself.

From onboarding therapists to creating systems, managing payroll, supervising clinical cases, and fostering a healthy team culture—I had more hats than I could wear at once. Something had to give.

Eventually, I dropped my caseload down to 3 to 5 clients per week. It didn’t happen overnight, and I’ll be honest—it brought up a lot of emotion and even guilt. But it was the best thing I could’ve done for my family, my team, and my clients.

If you’re in a similar season, here are some practical ways you can make the shift.

1. Assess Your Current Caseload for Discharge Opportunities

One of the first things I did was sit down and review my entire caseload. I asked myself:

Who is close to completing their goals?
Who is ready for a new level of independence?
Who could benefit from less frequent sessions or graduation?

You may be surprised to find that several clients are within 4 to 6 weeks of finishing up. From here, you can create thoughtful discharge plans and help them wrap up well. Not only can this make space in your schedule, but it also gives clients a sense of pride and closure in their progress.

2. Adjust Your Schedule With Intention

Another big shift? I stopped offering evening sessions. Those late appointments had become emotionally draining and physically exhausting—especially with little ones at home who needed me.

Another thing you could also do is remove one full day a week from your client calendar and dedicate it solely to running your practice. That day can become a sacred space for:

Vision casting
Supporting your team
Marketing
Meeting with your biller or accountant
And—yes—getting coffee alone in silence sometimes!

This small change can give you the breathing room you may be missing.

3. Refer Clients to Other Therapists in Your Practice

As group practice owners, we often assume we have to keep seeing certain clients. But one of the beautiful gifts of a team is being able to connect clients to someone who’s actually a better fit.

I had a client struggling with severe PTSD, and despite my best efforts, we just weren’t making the progress she deserved. One of my therapists had more training in trauma work, so I gently explained the situation and made the referral.

It was one of the best decisions I made—not just for my schedule, but for the client’s healing journey.

4. Be Honest With Clients—Even If It Feels Vulnerable

Sometimes, we just have to tell the truth.

I’ve had seasons where I felt burned out. I was still showing up, but I wasn’t offering my best. While it can feel scary to admit, here’s a way you could break down the conversation:

“I’m realizing I need to take better care of myself in this season so I can continue showing up for you—and everyone else—well. That means I need to decrease my caseload, and I want to talk about what that might look like for us.”

You may be surprised how many clients appreciate the honesty. This can help mold healthy boundaries and show them that it’s okay to listen to their limits. And in some cases, it may even open the door for deeper healing.

5. Trust That God Can Use Your Yes—for Them, Too

One story I’ll never forget:

I had a young client who was about three or four months away from graduating. I felt terrible even considering referring her elsewhere. She had made so much progress. We had a strong relationship. And I knew she’d be disappointed.

But I also knew I needed to make more time for my family.

So I sat down with her and said something like:

“I’ve been feeling the Lord leading me to be more present at home. My kids are growing up fast, and I don’t want to miss it. That means I need to step back from some of my client work.”

To my surprise, she teared up—but not in the way I expected.

She was thankful that I told her and told me it meant a lot to her. She explained how her parents weren’t around very often when she was a kid because they were always working. When she heard me choose my family, it showed her that it was possible to live differently.

I was so worried about hurting her by stepping away, but the very thing I thought would be a setback was used for healing in her life.

God can use our boundaries to minister in ways we never expect.

Final Thoughts: Don’t Be Afraid to Step Back So You Can Lead Well

If you’re a group practice owner (or just a therapist navigating a new season), reducing your caseload isn’t a failure. It’s actually an act of wisdom, stewardship, and courage.

You’re not just building a business—you’re building a life.

You’re modeling balance, boundaries, and Spirit-led decision-making.

So if your next step is to discharge a few clients, adjust your hours, or simply ask for help, do it. Trust that God is still working, even when you step back.

He’s not asking you to carry it all—just to walk faithfully with what He’s given you.

Want more support as you grow your group practice with clarity and confidence?
Join us at the Wise Practice Summit, where we value building faith-based practices that reflect your values and support your life.

You don’t have to do it alone.

How to Decrease Your Caseload in an Ethical Way