mental health therapist

psychiatrist

psychiatric nurse practitioner

patient care coordinator

medical administrative assistant

Transformations-Care-Network

A typical day at work involved managing a heavy workload with almost no support from leadership. I now know it is because my clinic director had no idea how to do my job or even know how to do treatment plans. Any time I asked for help with processes or clarification, I was met with frustration instead of guidance. The manager at my location literally yelled at me for asking for help, slammed boxes near me out of anger, and treated me poorly from that point forward. It created an environment where you quickly learn that you cannot go to anyone about anything without being ripped to shreds.

I did not feel like I learned much in terms of professional development, but I learned the clinic director’s job very quickly because I had to pick up her responsibilities — not everyone’s, just hers — due to how much was pushed onto staff without proper training or support. Any actual skills I gained came from self‑teaching, not from management or structured onboarding. I honestly do not think my clinic director taught me one thing while working there almost a year.

Management was reactive, unprofessional, and often retaliatory. When I accurately charted a patient’s r*cist statement, I was told to “fix it” — which would have been charting fraud — only to be pulled into a meeting where I was reprimanded and spoken to aggressively. I was only called out for it because my clinic director needed a reason to get me in trouble after I reported her behavior to upper management. The meeting itself was created out of retaliation, and it even involved the director of operations. Instead of supporting staff or addressing inappropriate patient behavior, leadership focused on finding something to yell about. 

We also had another clinic director whose own location hadn’t even opened yet, but she acted like she was in charge of ours. She inserted herself into situations she didn’t understand, created unnecessary conflict, and seemed to go out of her way to make things harder for staff. Her involvement added even more instability and tension to an already chaotic environment.

The workplace culture was tense and uncomfortable. Staff were discouraged from raising concerns, and bringing up legitimate issues—whether about workflow, patient behavior, or disrespect—resulted in being confronted rather than supported. It felt like leadership prioritized avoiding responsibility over creating a safe, functional environment.

The hardest part of the job was dealing with the lack of leadership support and the emotional toll of constant criticism, even when following proper procedures. The most enjoyable part of the job was helping patients who genuinely needed support, but that was overshadowed by the overall environment and the way staff were treated. I loved my prescribers, too.

Working at this agency has been a mixed experience. While the hourly rate of $44 sounds competitive at first glance, the compensation is entirely dependent on client attendance. You're only paid for the clients you see. So even if your caseload includes 50 weekly clients, it's common to have only 25–30 actually show up, especially in community mental health settings. Paychecks were never consistent, and I often had to budget on a daily or weekly basis, depending on how many sessions actually occurred.

It took me more than nine months to build up a full caseload, and even then, the no-show rate made it difficult to rely on predictable income. When you break down the numbers, the effective rate often dropped closer to $32 an hour. So although it’s technically a $44/hour position, the take-home pay can resemble a salaried role with less security and more instability.

One significant frustration is the minimal pay differential between licensed and unlicensed clinicians. Fully licensed professionals can expect to earn only a few dollars more—typically in the $50–$58/hour range. This is a modest bump considering the years of training, education, licensure costs, and responsibility required. Even at the higher end of that pay scale, a fully licensed clinician seeing 15–20 clients per week—standard for a full-time caseload—would still be making roughly the same or less than what you'd expect in a more traditional, salaried setting, but without the benefits or stability.

Supervision was fine, but there was a noticeable imbalance between licensed and unlicensed staff, with the latter making up a disproportionate share of the team. Clinical Trainees (CTs) were often brought on quickly, and in some cases, their interpersonal skills or boundaries raised concerns. Many staff were assigned high-risk or severely mentally ill (SMI) clients, increasing the emotional and clinical demands without a matching increase in pay or support.

The workplace culture can feel reactive and strained. There’s limited organizational support for staff, and a noticeable lack of mutual aid or solidarity between clinicians. CTs are expected to manage their own wellness and present themselves as put-together at all times. There’s an unspoken pressure to appear flawless, even when navigating the inevitable challenges of community mental health work. Rather than fostering clinical growth and collaboration, the culture often leaves clinicians feeling isolated and overly responsible for managing both their clients and themselves without meaningful backing from leadership.

In the end, the agency promotes flexibility and control over your schedule—but that independence comes with significant financial and emotional trade-offs. While some may find this setup workable, those seeking a stable, supportive, and growth-oriented environment may find this agency falls short of expectations.



It could be such a great place for employment, but the company allows one lady in the WV Market to control every single thing and continuously treat everyone with disrespect.  Speaks rude publicly via their internal communication tool.  There is no employee recognition unless it’s negative and every request for a raise has been denied and there was an email sent to management to support that.  You cannot go to higher management to express your concerns without retaliation towards that employee by middle management.  The communication between leadership and staff is the worst I’ve ever experienced anywhere and policy is never consistent from one minute until the next.  Spreadsheets galore and some have overlapping information.  You have to be redundant with charting and put one piece of information in several different places and maybe even on a spreadsheet too.  Favoritism is not hidden and if there are openings for opportunities people are hand picked  rather than announcing there is an opportunity that needs filled.  Code of conduct enforcement is not consistent and HR does not respond to emails that concerns are being shared.  There have been staff yelling in the hallway in front of patients but bc that staff has favoritism they don’t get any discipline and continue to bully other coworkers.  Most coworkers are amazing and you’ll make lifelong friendships, but even though patients go for mental health help, the leadership team does nothing to help improve employee’s mental health and sometimes even worsen it. Team building is non existent and if there is any division within the team leadership allows it to continue rather than help improve the overall environment.  Overall it’s a negative toxic environment with no improvement in sight.  There is constant turnover in all positions so eventually the experience and knowledge will be elementary and non existent.  

The good:
- In my role, the schedule is flexible. If there are more patient appointments in the morning, I am able to come earlier and leave earlier. I am also able to leave as needed for my own personal appointments.
- I truly love my patients. It's rewarding to be able to talk to them every day and see their progress throughout treatment.
- Occasional lunches are provided by drug reps.
- Low pressure, fairly quiet and calm environment day to day.

The not so good:
- Management is EXTREMELY disorganized and there is little to no communication between the higher ups and the office staff who actually work with patients. I am constantly asked questions by patients that I am unable to answer - we are just as confused as they are. There is practically no way to know what is going on with the company as it's changing and growing constantly - and not in a good way. There are a million different sets of outdated paperwork, a ton of phone numbers that lead nowhere, people coming in and out of the office every day from sister companies that don't introduce themselves, and just generally a LOT of confusion that is never resolved.
- The vast majority of staff, including management, have NO medical training - even though many management members act as though they do.
- For a psychiatry clinic, there is a complete and terrifying lack of anything even resembling crisis training.
- The actual work is incredibly mundane as it's so easy and it's the same thing every day. Some days there are a ton of patients, and some days there are only a few, so there is often a lot of free time between appointments.
- There is practically no chance of career advancement.

Overall: I don't mind this job as a short to intermediate term position - but I know I won't be here forever.

I'm writing this because I do not feel heard as an employee at this company. The people I work with directly are kind. However, I do not feel supported or that the "higher ups" care at all about associate therapists getting fairly compensated for our work. If you interview here, ask about the PTO structure during the interview or before you sign a contract and have a lawyer look at it if you can. It is worth doing so. After actually working here you will then learn that it takes 48 BILLABLE UNITS between a two week period of work for you to acquire any PTO at all. If you don't hit that "productivity mark" then you don't get PTO. As a fee for service provider you have to work insanely hard to gain any PTO so the work/life balance is horrible. You do not get paid for admin time or the time it takes you to write notes as a FFS. Also, was just told during a company meeting that for my position I am eligible to get only one "floating holiday" per year. This would also start after one full year of work at the company.  It would be great if you could do something to help your current employees to assist with this problem ASAP.

First of all, I love my clients. I genuinely love interacting with them and being there for them. Unfortunately, before I accepted this position, my first out of college, I did not ask enough questions. 48 units per pay period (24/wk) is the minimum for therapists. I am a rare one that does 32-37 per week and its well over 40 if I don't have cancellations. 

Prior to signing, I did the math of how much I would make based on my desired case load. What's funny is, every check that I have seen 60+ clients, somehow, someway payroll has found something wrong and has found some way to reduce my pay then will tell me they cannot fix it until the next pay rolls around. 

We are paid to see clients but then have mandatory meetings and other things that take away from that, not to mention the fact that we have to do notes or take phone calls, all unpaid. I can't get a clear answer about anything I ask a question about. 

There is so much more to say but my suggestion is, if you are looking for a small part time thing, I think this is great. Making a full time career at this place is hard due to SHADY pay model practices, inconsistent responses about policy, and an overall lack of care for therapists in my opinion

What is the best part of working at the company?
I have worked for TCN for over two years Prior it was Northeast health services for 7 Years.
Since the merge the company went down hill, Corp doesn't care of their front end employees all they worry and bend over for are the therapist, They don't really know what mental health stands for. Their looking to make a buck. 
When the merge took over, they were getting rid of the old Northeast employees one by one, they wanted new people that they can control. You do not get a raise while you been there for a long time. you have to fight to get more money. The Benefits are ok but again it more out of your own pocket. Look else where. 

What is the most stressful part about working at the company?
They have no imathy for their employee's

What is the work environment and culture like at the company?
Stressful and you get anxity all day just trying your best to get things done correctly. People hate it here. 

What is a typical day like for you at the company?
Stress, No Motorvation with working with employers that don't care about your well being, or your mental health problems.

High turnover in all areas. Management is disorganized and unprofessional. Policies are unclear. Productivity (aka profit) is prioritized and a lot of times it's out of your control because patients cancel or you are mandated to attend the company's meetings or something was messed up. The benefits were not that good and they can be taken away at any time if you don't meet their expectations. I worked outside of my hours a lot in order to keep up. Communication between staff outside of meetings is discouraged. Things change frequently and without notice. I never felt supported. Most questions were answered with "I don't know" and they'd promise to get back to you and never did. Everyone seemed overworked and bothered. The only way to move up was into Management and they seemed miserable and catty. Clients complained often about the phones not working or prescriptions not being called in or problems with scheduling. Ever since they got bought out they've taken a complete nose dive. 

The cancelation and no show rate is unbelievably high, so even if you are scheduling 40 clients a week and putting in that time and effort, don't expect to see that many clients, expect 27-30 to show. Your benefits are stopped if you hit lower than the 27 clients (Temporarily 24 due to billing changes). The bi weekly productivity report adds unnecessary stress, since clinicians shouldn't be held responsible for the organizations no call no show. The policy is person centered which is great but it is not an encouraging environment for the clinician.  New procedures keep getting added onto clinicians as well. The other clinicians are wonderful and supportive but the clinical director is more focused on client intake then clinician feedback. There is a salary option and it is not live-able, at 44k a year, although there are quarterly bonuses they don't equal what a fee for service clinician could make. Weekly group supervision only seems mandatory for certain clinicians.  Benefits package is fair if you can manage to keep them. 

Complaints fall on deaf ears. Low pay, no raises. Manipulation. Dangle carrot that will forever be out of reach.  You can get a promotion as long as you don’t expect any additional pay to come with it. Basically you could take on more work without additional pay. They want to know what you’re doing every second of the day and how long that task takes you to do. Very numbers based. It feels like you’re in a sales position combined with a little bit of prison. 
What that says to me is that they don’t care about the clients or the employees. They care about the bottom line.  Maximum revenue and Maximum Micromanaging. There are things that are done that aren’t legal. There are people, many people, in Sr. management and lower management roles that don’t have management experience, and were put their based on who they knew . No experience managing people and some don’t know what they’re doing. So that’s fun. I can only hope they get audited. If that all sounds good to you and you have a sense of humor, you should apply. 

Top Job Titles	Average Salary
Mental health therapist 1 salary reported	$96,553 per year
Psychiatrist 2 salaries reported	$350,000 per year
Psychiatric nurse practitioner 31 salaries reported	$138,823 per year
Patient care coordinator 44 salaries reported	$18.56 per hour
Medical administrative assistant 1 salary reported	$18.58 per hour

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