Counseling Awareness Month 2026 – Trends to Watch in the Field

Meet the Expert: Jill Vance, PsyD

Dr. Jill Vance is a licensed clinical psychologist and the owner-founder of Mentella Health (also known as Wellspire Counseling). She brings over a decade of experience in college counseling centers, hospitals, community clinics, and private practice, offering secure telehealth therapy across Illinois, Ohio, and all PSYPACT states. 

Dr. Vance works with individuals, couples, and teens to address anxiety, depression, trauma/PTSD, OCD, relationship issues, and perinatal mental-health concerns. 

Her therapeutic approach is client-centered and relational, blending evidence-based techniques like Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and trauma-focused therapies to tailor support to each person’s unique needs. 

Therapist Vitality as a Key Performance Indicator

For decades, therapist well-being was treated as a nice-to-have, something individual clinicians were expected to manage on their own. Dr. Jill Vance says that is shifting. “If a therapist is not living a vital life, if they’re tired, burnt-out, exhausted, and dreading their work, that’s going to show up in the therapy room,” says Dr. Vance. “We have found at our clinic [works best] when therapists are happy, healthy, and thriving…it leads to better client outcomes.”

In 2026, vitality is emerging as a measurable performance indicator. Forward-thinking practices are tracking factors like caseload sustainability, administrative burden, access to supervision, schedule flexibility, and opportunities for rest. The emphasis is simple: healthy therapists can provide better, more responsive, and more ethical care. This trend reflects a larger movement toward valuing clinicians not just as service providers, but as human beings whose wellness drives the entire system.

Clinician-Centered Benefits

A second trend Dr. Vance highlights is the rapid expansion of clinician-centered benefits. Traditionally, benefits in mental healthcare settings lagged behind other industries, driven by slim margins and productivity-focused models: “A lot of therapists are 1099 independent contractors, which means no benefits. There’s no paid time off, no sick leave. They’re on their own for healthcare, dental, and vision benefits. As the workforce becomes harder to recruit and retain, that’s beginning to change,” notes Dr. Vance. 

Organizations are now adopting benefits that directly support clinician wellness, including paid parental leave, protected documentation time, student-loan support, sabbatical options, predictable scheduling, and hybrid or fully remote work arrangements. Some are even offering professional development stipends and built-in consultation groups as part of their employment packages.

This shifts acknowledge that supporting clinicians is not only an ethical obligation but also a strategic advantage. Practices that prioritize clinician-centered benefits are finding it easier to attract qualified providers and to keep them.

Human Infrastructure Over Tech Hype

While the last few years have seen an explosion of mental-health apps, AI tools, and digital platforms, Dr. Vance notes that many clinicians are reclaiming the importance of human infrastructure.  “I’ve already seen a lot of practices moving towards the AI world and wanting to keep up with the most innovative and most cutting-edge tech,” says Dr. Vance. “ I feel concerned about that as a human being, and I feel concerned about that as a therapist.”

The industry is recognizing that technology cannot replace the therapeutic relationship, and an overemphasis on automation can actually burden clinicians by adding extra documentation steps or communication expectations. 

In 2026, the focus is moving toward tech that enhances—not replaces—high-quality care. Practices are investing in better supervision models, manageable caseload structures, collaborative team cultures, and training that supports nuanced clinical judgment. Technology is still part of the ecosystem, but the trend is toward tools that improve workflow efficiency and protect therapist time, rather than those that compete with or dilute the core of the therapeutic process.

Insurance Reimbursement Raises

Dr. Vance points to reimbursement reform as one of the most urgent and long-overdue issues in the counseling profession. In Illinois, for example, lawmakers recently passed House Bill 1085, which establishes a new minimum reimbursement floor for mental-health services. It represents the first meaningful adjustment since the early 2000s. While medical reimbursement has steadily increased over the past two decades, rates for mental-health providers have remained largely stagnant, even though mental-health care accounts for only a small fraction of total insurance spending.

This discrepancy has had real consequences. Therapists’ pay has not kept pace with inflation, leaving many clinicians struggling to cover basic living costs while managing high professional debt. “Part of therapist vitality is being able to make a living and take care of ourselves,” Dr. Vance notes. Without fair reimbursement, clinicians face financial barriers that undermine their stability and, ultimately, the sustainability of the workforce.

Dr. Vance also highlights a contradiction often felt across the field: public officials routinely emphasize the importance of mental health, especially in the wake of community tragedies, yet concrete legislative support has lagged behind the rhetoric. Entering the profession requires significant financial investment, and stagnant reimbursement rates offer little incentive for new clinicians to join or remain in the field.

As demand for care continues to rise, Dr. Vance hopes to see more states create reimbursement floors or require insurers to adjust their rates in line with inflation. Money is a powerful motivator in healthcare systems, she notes, and meaningful reimbursement reform would signal that policymakers are truly committed to building a stable, accessible mental-health workforce.

From the Archives: Counseling Awareness Month 2024

Meet the Expert: Briana Severine, MS, LPC, LAC, CPRP

Briana Severine began her career working in inpatient psychiatric facilities in southern California and continued to pursue her passion for psychosocial rehabilitation in Colorado through private practice. She also served as director of marketing and admissions at a trauma-integrated intensive outpatient program. She was ultimately drawn back to clinical work, which prompted her to found Sanare to bring psychosocial rehabilitation services to the Colorado community.

Severine earned her bachelor’s in psychology from California State University, Long Beach and her master’s in developmental psychopathology from the University of Reading, England.

Demand Leveling Out 

It’s no secret that the pandemic was detrimental to the public’s mental health. Financial insecurity, changes to routine, social isolation, and a myriad of other factors all contributed to higher rates of depression, anxiety, and PTSD among all kinds of people and populations—causing demand for therapy to skyrocket.  

“Not in my 25-year career have I ever seen that much demand for counseling, private practice, intensive outpatient programs [or] residential treatment programs,” says Briana Severine, owner of Sanare, a psychosocial rehabilitation clinic in Colorado.

In 2022, the Washington Post reported therapy wait lists of three to six months or even longer. While demand has cooled somewhat over the last two years, “we still do have a much larger demand than we had prior to Covid beginning,” says Severine.

One positive side effect that came out of the dire situation was increased public awareness about mental health. Due to the collective nature of the experience, there has been a considerable reduction in the stigma associated with seeking mental help, which has prompted new types of clients to seek therapy that otherwise may not have.

“What we’re seeing, especially in private practice and private agencies, was that during the height of Covid, people that might otherwise never have sought mental health services were seeking mental health services,” says Severine.

The supply-demand imbalance is thankfully not as skewed as it was during the public health emergency, but the need for therapists is still projected to rise.

Greater Need for Addiction Counselors

It’s also important to note that looking forward, certain mental health specialists will be in higher demand than others. “The biggest mental health crisis that we’re having right now is the opiate epidemic and drug addiction,” Severine says. Indeed, the rate of opioid-related deaths has been growing incrementally for decades, but spiked significantly in 2020 and again the following year.

By 2021, one out of every 22 deaths in the U.S. was due to unintentional opioid toxicity, “underscoring the urgent need to support people at risk of substance-related harm, particularly men, younger adults, and adolescents,” a 2023 study on opioid-related deaths before and after the pandemic points out. However, “the amount of counselors wanting to go in [the substance abuse] field hasn’t really changed,” says Severine.

“We have a big problem in the highest-need areas, which are the areas that most counselors want to avoid. As treatment centers open, they have a really hard time with staffing because people are just not open to working in addiction treatment.”

A shortage of counselors in rural states like Mississippi has left some treatment centers understaffed, which means patients—many of whom could be in dire need of lifesaving care—are sometimes turned away, KFF HealthNews reports. “Especially for the more rural states, those specialty practitioners probably have the longest waiting lists,” says Severine.

The Use of Telehealth is Evolving

Another silver lining of the pandemic is the increased use of telehealth. According to Severine, the modality’s popularity remains strong among mental health practitioners and clients alike: “Most [therapists] had never had any experience with it or hadn’t used it,” she says. “Now, most therapists that I know see some clients virtually and some clients in person.”

One of the most commonly lauded benefits of telehealth is its ability to expand mental healthcare access to patients who have difficulty attending in-person therapy due to scheduling conflicts or physical distance. It also gives patients with particular diagnoses or disorders access to more specialized professionals.

“If you have an eating disorder and you live in the mountains, and there are only three therapists there and none of them are trained in eating disorders, you can now access someone that’s a specialist in your area for support,” says Severine, “Versus [before], those folks typically just had to see whichever therapist was in town and they may or may not be highly qualified in the [type of] support they need.”

According to Severine, telehealth is also gaining traction for tasks like conducting psychiatric assessments and delivering care for intensive outpatient patients. “We have a lot of … people [in Colorado who] wouldn’t otherwise be able to access specific mental health services if we didn’t have the virtual option,” she says.

While private practitioners and clinics incorporating telehealth have thrived, some trendier, 100 percent digital mental health platforms that debuted around the pandemic have struggled to stay afloat. Headspace Health, which offers coaching, therapy, psychiatry and meditation content, laid off 15 percent of its workforce in 2023. Pear Therapeutics, a suite of apps for treating addiction, insomnia, PTSD, and other conditions, filed for bankruptcy and sold its assets the same year.

The APA reports that “a second wave of mental health technology” in 2024 will likely see startups incorporate lessons learned from hasty startups.

Compact Laws Progressing

During the Covid-19 pandemic, many states loosened interstate practice restrictions to quickly expand public access to telehealth services, including those for counseling. In some cases, providers could provide their services to patients across state lines using telehealth.

The measures proved to be a boon during the surge in demand for therapy but were intended to be rolled back at the end of the public health emergency. However, due to the abundant benefits—including expanding access to care and improving patient-provider matching—many states seek to make changes permanent by joining the counseling compact.

The agreement, which began to gain traction in 2021, will allow professional counselors licensed in a compact member state to practice in other member states without applying for multiple licenses. This is already being done within psychology with the PSYPACT agreement, of which 39 states are active members. 

“Now, the momentum is moving forward for counseling,” says Severine. Eleven states (Arkansas, Indiana, Iowa, Kansas, Montana, North Dakota, Oklahoma, Virginia, Vermont, Washington, and Wyoming) joined the compact in 2023, bringing the total number up to 28 members.
Counselors interested in providing services to clients across state lines must apply through the compact. Applications are expected to open in mid-2024.

Payment Parity Movement Gains Steam

Payment parity also became a hot topic during Covid-19 due to the increased use of telehealth.  This refers to requiring insurance payors to reimburse healthcare providers for telehealth services at the same rate they do for the equivalent in-person services. For instance, if a counselor usually receives a $80 payment for a 50-minute in-person therapy session from a particular insurance company, they will receive that same amount when providing the session via telehealth.

Prior to the pandemic, only 10 states required payment parity from insurance providers. However, Covid-19 and the telehealth boom encouraged states to explore parity legislation. One 2023 cohort study showed that the implementation of state-level payment parity laws was associated with measurably increased mental healthcare availability in those states. So, ensuring the continuation of these standards will be important for maintaining the progress made within the past few years, in terms of access. 

Payment parity is predictably unpopular among insurance providers, which prefer to pay providers less when possible—or as Robert Bell, head of the Nebraska Insurance Federation words it, “[They] prefer the flexibility to continue to negotiate telehealth rates separately.”

Lobbyists for insurance companies want to see state legislation like LB 256, Nebraska’s payment parity bill, shot down. However, 2023 was a good year for advocates of the movement. In 2023, Colorado, Hawaii, and Nevada each passed state legislation mandating payment parity. Now, most states have implemented some kind of parity legislation (leaving 21 still without any related legislation in place).

Hopefully, more states will consider writing similar laws in the coming years to ensure that telehealth continues to be a ubiquitous option for clients who depend on it.