residential assistant

clinical assistant

therapist

registered nurse

chef

Paradigm Treatment

I will preface this review by saying I gained a lot of valuable experience at Paradigm, even if much of the experience was negative. If nothing else, I am grateful for that.

That being said, leadership and culture were a huge issue during my time here. In addition to virtually nonexistent training (huge red flag), the organization seems to favor a very specific type of clinician who will conform without hesitation to its expectations, which often felt ethically ambiguous or overly authoritarian. If you don’t fit this particular mold, as I didn’t, it will likely be difficult for you to succeed here.

Expanding on that, I was frequently pressured to do or recommend things here that went against my education, experience, training, and values. My main concern was that Paradigm expects therapists to act as both clinical assistants AND therapists (including having therapists do things like personally administer medication to their clients). They do not properly disclose this in listed job duties or interviews, and this is virtually unheard of in this field, for good reason. In addition to being a huge cause of burnout, it was a dual relationship and very confusing for clients in that we often had to do things that were inherently anti-therapeutic, like policing what they wore. As a point of more extreme concern, we were regularly openly told that it’s bad for your clients to like you, and if they do, it means "you're doing something wrong."

When I voiced concerns or struggled due to the lack of support and training, I felt my credibility was unfairly questioned and that I was seen as a problem employee, something I've never been at former jobs. Minor issues were penalized disproportionately for some staff, while others faced far less scrutiny for similar or far more serious concerns. There was a lack of consistency in how expectations and consequences were applied. Favoritism and bias was a consistent theme, with certain staff and clients clearly receiving more opportunities and protection than others. This made the environment feel highly political and generally hostile, and some leadership and senior staff were unnecessarily antagonizing. While most of my coworkers were wonderful, the broader culture often felt more competitive than collaborative, with cliques and frequent gossip impacting team cohesion.

Therapists here can generally expect themselves to be overworked and underpaid, receive little to no positive recognition for hard work (unless considered a favorite), and work under absentee leadership with little support. It’s not a great place to grow, and a haven for burnout...it wasn’t a mystery why Paradigm wins the award for the highest turnover I’ve personally ever seen in a workplace. Despite how rewarding it was working with the awesome clients and most of the staff (why I stayed as long as I did), I regret not leaving here much sooner. I did gain the experience I needed and was able to earn a decent wage as an associate, which I appreciate, but it was not enough to mitigate the overall negative impact this work environment had on me. I’ll disclaim that if you are a favorite here, you will likely have a radically different and much more positive experience than I did. But if you put a premium on authenticity, a healthy therapeutic alliance, and ethics, I strongly encourage you to apply to another setting where they prioritize similar values.

What is the best part of working at the company?
The kiddos and the staff (and the food)! Being able to provide some of the highest quality therapeutic care ive seen to patients who can be a notoriously challenging population consistently made me feel proud and fulfilled. A fantastic element of the treatment provided is that I could honestly say that no matter which therapist you were assigned, you had an amazing provider. The clinical assistants worked their butts off to support both the clinical staff and clients, which in my opinion makes their job one of the hardest to navigate of all of us. When we eventually found a program manager that stuck around for longer than a few months, both she and the clinical director (who had been doing the job of both clinical and program director in the interim!) Are fantastic and effectively struck a balance between program goals and attempting to support staff in maintaining a high level of client facing care while managing burnout, which I have come to find is a rare quality in management to be able to navigate. Finally, our amazing chefs are consistently bright spots in both the staff and the kiddos days.

What is the most stressful part about working at the company?
Unfortunately, because the company does put so much emphasis on finding and hiring high quality therapists and uses a model in which clients receive up to 5 therapy sessions a week, each, combined with the fact that paradigm is a crisis residential program, burnout is even more prevalent than in other sectors of the mental health industry. The extreme pace that is required, which includes daily groups, therapy sessions, UR, notes, and managing high risk clients, as well as weekly updates with parents meant that retaining, and then trying to hire new therapists who were able to sustain the workload without compromising their own mental health or the integrity of the program led to a tremendous amount of pressure. This may or may not be a problem for the type of person who thrives in this setting, as there is defintely a certain personality type that thrives on high pace, intense environments like these (I imagine the same types who are well suited to emergency room medicine). Additionally, if you have trouble keeping your work and home life separate, this may not be the right place for you, as it can easily consume your entire life if you let it, and then burnout will become a serious concern

What is the work environment and culture like at the company?
Positive, supportive, and management tries to work with you to find ways to grow through the various professional and even occasional personal challenges you will undoubtedly face working in a crisis residential setting. I received the highest quality supervision and (free) continuing education trainings of any agency I have worked at in the 5 years of mental health work I have been a part of

What is a typical day like for you at the company?
As a therapist, you would come I'm at either 7 am or 1 pm depending on if you are morning or evening shift, check to see who needs to be seen for therapy that day, run your process group, provide 3 to 5 therapy sessions and/or 1-2 family sessions depending on who needs to be seen, call a parent to check in, write notes, and depending on the day, run your specialized group that each therapist runs as their specialization (these run the gamut from cultural development and identity to DBT to art group).

The company doesn't give its on-site employees enough resources and plan set up when changes are in place for the residential housing. Employees (Program Coordinator and director Included) were kinda thrown to the wolves to report back what worked and didn't work, which clients were able to observe and sometimes act on ( someone leaving "sharps" out, know that we as CAs were pretty much just winging it and looking quit unprofessional sometimes. The program Director was over worked and over stressed and though PD always came through, to me it showed the lack of support paradigm as a company provides its employees. When a specific group was unavailable, I was charged with providing a simulation of the group therapy since I was not a licensed therapist. I had to take up a lot of responsibility for the failings and lack of support company gives on site employees.  
Burn out is very real here, though there is a major sense of purpose. Your pay will most likely not go up, and there is no real chance for promotion unless someone leaves. But if the higher ups have someone in sights, sometimes there will be no interview process (depending on the position)  and that people will just be given the job. 

Often times I was unable to get a break because therapists would be out and there was no support on the floor, and CP and PD were not on site. I had one other CA with me often, and because they needed a lot of guidance with 5+ clients I was unable to take a break ethically for weeks. With no official lunch (waived). 

This job provides great mental health experience, clinical assistants are very involved in clients’ treatment journeys and the connections you make with clients are really what makes Paradigm a great place to work. The food is amazing (and free) and the other clinical assistants and therapists are really supportive, it really is a family environment. 

However, it is very easy to burnout in this position. Crises happen frequently and there is a lot of pressure for CAs to handle these situations perfectly without any training on how to do so. Training is very insufficient, CAs are expected to train each other so it’s really a game of telephone in terms of how to handle certain situations, which rules we need to enforce, etc. In addition, there is basically no communication from management (I think I only spoke with my boss 3 times in my entire time working there). CAs are generally overworked and underpaid. 

 Overnight CAs need some serious work, there were multiple crisis situations that were severely mishandled by overnight staff and clients were traumatized as a result. Nothing was done about it by upper management. I did not want to work for a company that would allow these things to happen without any change or preventative measures.  

Most of my problems were with upper management, but I am grateful for my time at Paradigm. 

Pros: The most rewarding part of my job was the connection I had with both the therapists and the clients. Their dedication and resilience were truly inspiring and kept me motivated even during challenging times.

Cons: Unfortunately, management was a significant drawback. They often failed to listen to employee concerns, which created an atmosphere of frustration and distrust. Decisions seemed arbitrary and lacked transparency, leaving many of us questioning their judgment.

I also observed that minorities seemed to be disproportionately affected when it came to treatment decisions, often being dismissed for minor issues. This was troubling and indicative of a larger problem within the management's approach to inclusivity and support.

Additionally, the workplace was rife with drama among clinical assistants. There was a pervasive culture of competition, where many colleagues felt compelled to undermine one another in hopes of securing a better position. This not only affected team cohesion but also made the work environment stressful and unpleasant.

Overall, while I valued the relationships I built and the impact we had on clients, the management issues, workplace culture, and lack of equitable treatment left much to be desired. I hope future improvements can be made for the sake of both staff and clients.

I am grateful for the hours I got here since you can count every single hour of the shift as a clinical hour but this place severely hurt my well being working here as a therapist.

I had extreme anxiety and couldn't sleep after work. We were severely understaffed and often client safety was at risk. Clients self harm in front of you and you have to figure out what to do. Poorly organized and unsupported, you are not just a therapist here but are expected to be on the floor all day while you write notes and do case management essentially.

I have never been more taxed by a job.

When therapists bought up their concerns to the CEO she said, "You should be able to handle it."

Great place to get your hours but be prepared for clients with extremely high trauma, demanding work where it's hard to take breaks and you're regularly asked to stay late, weekend work, zero useful training and $38 an hour for some of the hardest work in the industry.

Working in the mental health field, more specifically residential treatment is not easy. Finding a work life balance will always be a practice but If you’re looking for a job where you will be working alongside team members who are dedicated, professional, compassionate and will challenge you to reach your highest potential, this is the place for you. It is a great place to work. Teens and young adults get 5 to 6 Intensive individual therapy sessions PER WEEK with weekly group and family therapy which is rare. It’s not a one size fits all program. Every individual coming in receives a treatment program tailored to each client’s unique needs and with such a Low client-to-clinician ratio we are able to make a real impact.  I would have no hesitation sending my child, younger sibling to this program for mental health treatment and that’s what matters to me. 

The job is often extremely stressful with one crisis after another. The pay is low for what is asked of the staff and while all the staff are extremely supportive of each other, it is the norm/culture for staff to overwork themselves. Direct supervisors are very supportive but the people at the top levels are not. Company admits kids that require a higher level of care than the program can support. Company provides great meals but your lunch is “on duty” (you can opt out but no one does). You work hard nonstop from the time you get there to the moment you leave. You have to always be on your toes. The work is extremely rewarding, there are many fun moments and you build amazing bonds with the kids. Facility is beautiful and you get to take kids on fun field trips. There is not much training but you will constantly be learning. If you’re up for a challenge, have a lot of patience and want to learn a lot this may be for you. Just know it will be exhausting and very hard work.

What is the best part of working at the company?
Great place to gain licensure hours, with supportive staff, good benefits, and plenty of learning.

What is the most stressful part about working at the company?
Balancing clinical responsibilities with administrative duties can be challenging, and staffing shortages often increase the pressure, making it difficult to maintain a healthy work-life balance.

What is the work environment and culture like at the company?
Overall, staff are great and willing to help, but there can be some cliquish dynamics between senior and newer employees. Upper management can feel somewhat removed from the team’s day-to-day experience.

What is a typical day like for you at the company?
Each day is different, which makes the work interesting and dynamic. However, the lack of a predictable schedule can make it harder to maintain work-life balance for those who prefer structure.

The location of all the houses were beautiful but they were >1 mile away from each other meaning staff would need to travel between houses when one of them was short staffed (which was always). Also, for being short staffed all the time the company certainly doesn’t do much in attempts to keep employees, even when employees approach them with solutions. The clients made it fulfilling work. I have been the recipient of a few “it’s stressful but…”. No. The job is stressful because of the lack of support and investment on behalf of the company. Aren’t we in the mental health field to help people make sense of this difficult things? But you’re just going to tell your employees, “that sucks, but I can’t change it” - actual words out of a mangers mouth. There are a lot of SW that run things here so that’s probably why they are so frigid.  

Top Job Titles	Average Salary
Residential assistant 5 salaries reported	$21.40 per hour
Clinical assistant 35 salaries reported	$21.87 per hour
Therapist 14 salaries reported	$77,393 per year
Registered nurse 10 salaries reported	$43.06 per hour
Chef 10 salaries reported	$26.20 per hour

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