Episode 16

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

Published on: 18th November, 2025

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 hear

  • The early imprint that wired a lifelong scarcity mentality and how it shows up in leadership
  • How clinician burnout becomes an identity instead of a warning sign
  • The quiet ways a broken mental health system shapes everything from hiring to ethics
  • Why fear-based decisions masquerade as responsibility and feel impossible to avoid
  • The moment a seven-figure practice revealed its fault lines in real time

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!

Website: www.offthechair.com

Instagram: @offthechairpodcast

YouTube: @offthechairpodcast

Colleen Long, Psy.D.

Website: www.claritypsychologicaltesting.com

LinkedIn: Dr. Colleen Long

 

Jennifer Politis, PhD, LPC

Website: www.wellnesscounselingBC.com

Instagram: @wellnesscounselingnj

TikTok: @wellnesscounseling

LinkedIn: Jennifer Politis

 

Erika Bugaj, MA, MSW, LICSW

Website: www.dandelioncounselingcare.com

Instagram: @dandelioncounselingcare

LinkedIn: Erika Bugaj

Transcript
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About the Podcast

Off The Chair
Breakout From Burnout
In a world where a nail artist can out-earn a licensed therapist, behavioral health professionals have no choice but to get scrappy, color outside the lines, and start writing our own rules. The old path—graduate school, licensure, paneled with insurance, packed calendar of 1:1s—is broken. It’s time for a new blueprint.

That’s where Off the Chair comes in. We’re not just talking about surviving the grind, we’re exploring radically different ways to thrive. From building passive income streams to launching scalable service lines, we dive into business models that break the mold. We cover how modern technology; AI, digital products, automation, and online communities—can even help clinicians step out of the therapy chair and into a more expansive, creative, and financially free version of practice.

Off the Chair is the no-BS podcast for therapists and clinicians from all disciplines, trapped in a broken healthcare system, ready to break out of burnout, reclaim their income, and build values-driven businesses beyond mis-managed care and trading hours for dollars.

Hosted by Dr. Colleen Long, Dr. Jennifer Politis, and Erika Bugaj, LICSW—three clinician-entrepreneurs who’ve built, broken, and rebuilt thriving mental health companies—this show brings you weekly conversations on what it really takes to succeed in today’s broken behavioral health system.

Whether you're a growth-minded psychologist, a private practice owner, or a therapist wondering how to scale without selling your soul, Off the Chair is your roadmap to redefining what success looks like in mental healthcare.

What You’ll Learn
- Business & Practice Management: Navigate the operations side of private practice with insight into EMRs, scheduling workflows, profitability pivots, and systems that scale.
- Hiring & Leadership: From managing your first intern to leading multi-state teams, get real-world advice on creating aligned, sustainable teams (and firing fast when it’s not a fit).
- Financial Freedom for Clinicians: Understand compensation models, create recurring revenue streams, and stop trading time for money—all without compromising your ethics.
- Mental Health Industry Reform: Challenge the status quo with honest dialogue on insurance gatekeeping, clinician burnout, and what it takes to build a more human-centered system.
- Personal Resilience & Growth: Behind every spreadsheet is a dark night of the soul. We talk mindset, mission drift, and how to stay motivated when the math doesn’t math.
- Overcoming Challenges: The podcast addresses common challenges faced by therapists, such as negative reviews, legal threats, and the fear of failure, offering strategies for navigating these obstacles. Overall, Off the Chair aims to empower clinicians to: Become more effective leaders and managers. Build strong, efficient, and profitable practices. Enhance their personal well-being and achieve a fulfilling career. Stay ahead of the curve in a constantly evolving industry.

Why Listen?
Off the Chair isn’t just about the logistics of running a practice—it’s about reclaiming your creativity, your autonomy, and your voice as a leader. No jargon, no perfectionism. Just vulnerable, strategic conversations that meet you in the messy middle.

New episodes drop every Tuesday.

Connect with us!
Podcast Website: www.offthechair.com

Dr. Colleen Long, Psy.D.
Website: www.drcolleenlong.com
LinkedIn: Dr. Colleen Long

Dr. Jennifer Politis, PhD, LPC
Website: www.wellnesscounselingBC.com
Instagram: @wellnesscounselingnj
TikTok: @wellnesscounseling
LinkedIn: Jennifer Politis

Erika Bugaj, MA, MSW, LICSW
Website: www.dandelioncounselingcare.com
Instagram: @dandelioncounselingcare
LinkedIn: Erika Bugaj