One of the state’s leading LGBTQ+ nonprofits has seen nearly a complete turnover of clinicians in its therapy department this year.
Encircle, founded in 2016, helps support Utah’s LGBTQ+ youths and their families by providing resources and a safe space to gather in its “homes” in Provo, Salt Lake City, St. George, Heber and Ogden.
The turnover began in mid-March and spanned 10 weeks. Seven of Encircle’s nine therapists have left the organization, either through layoffs or by resignation. Two original therapists remain, and the nonprofit has since added new hires and interns for a current total of seven therapists.
Clinicians who have left said they did so because of unrealistic workload expectations, while Encircle maintains that its practices meet “industry standards” and the changes were necessary to provide stable financial footing for the nonprofit.
Young LGBTQ+ Utahns, meanwhile, were caught in the middle.
Encircle said all clients were either transitioned to other clinicians or chose to follow their providers who left, but therapists who departed the organization have said the transition left clients feeling “unmoored” and “hurt.”
“Most clients had to find new therapists and many have had to go without therapy altogether,” ex-Encircle therapist Sami Simpson said. “We certainly witnessed an increase in suicidal ideation across the clients who would not be able to continue seeing their therapist.”
In the Beehive State, there’s a stark need for mental health care for young LGBTQ+ people. According to a report conducted last year by LGBTQ+ suicide prevention nonprofit The Trevor Project, 47% of young Utahns wanted access to mental health care but did not receive it, listing reasons like cost, parental permission, and fear of speaking about their concerns.
The split
(Trent Nelson | The Salt Lake Tribune) Encircle's Heber City location in 2023. The nonprofit has seen an exodus of therapists.
Members of the clinical team received word about the restructuring of their department in March. Changes included a requirement that clinicians meet a workload of 25 cases per week to reach what the nonprofit called “industry standards.”
If those expectations weren’t met, then the therapists would transition to an hourly wage structure, eliminating their salary benefits, such as health care.
Simpson said those options weren’t sustainable for clinicians, financially or workload-wise. “It almost felt like they wanted us to quit,” she said.
Therapist Jack D. Haden made attempts to prolong his resignation to ensure there was time to help clients be transferred to new providers, but said Encircle was unable to accommodate that request or speak about who would take over his clients.
“Even though Encircle’s actions were targeted at clinicians,” Haden wrote to The Salt Lake Tribune, “it fostered a sense of distrust of the agency.”
Therapist Devin Gold, meanwhile, added that her clients had to “abandon months of therapeutic progress” in order to start over with new providers.
“Instead of focusing on their therapeutic goals, my clients spent sessions processing the distress caused by Encircle Therapy’s mismanagement,” Gold said. “They experienced additional anxiety and trauma from the very organization meant to support their healing.”
The therapists contend that a 25-client-a-week workload is more demanding than most would think because their work goes beyond facilitating individual sessions. They also give research referrals, prepare for sessions, craft notes, write letters and consult with colleagues.
“Twenty-five clients is like you’re seeing five clients a day. That’s five hours a day,” Gold explained. “But on the ground it is very, very different from that, because … that’s five different humans that you’re there individually with every day going through everything that they’re going through.”
Change was needed, Encircle insists
Callie Birdsall-Chambers, Encircle’s vice president of marketing and communications, said the workload changes were made to “provide stabilization for the organization” and to “make sure we’re sustainable financially.”
She said clinicians were given 10 weeks to work toward the new caseload requirement. The nonprofit, she said, worked with providers who were leaving or taking on new clients to ensure the impact on clients “wasn’t so drastic.”
The changes, Birdsall-Chambers said, are a part of a wider approach the organization is undertaking to revamp the therapy department. Other shifts included outsourcing billing, adding more required credentials for clinicians to increase accepted insurance options, and upgrading software.
“By the time 2024 rolled around,” Birdsall-Chambers said, “we had six months of billing data that made it really clear that our therapy program, as it was originally structured, wasn’t really financially sustainable.”
But C Meyer, a Utah therapist who also works with LGBTQ+ youths, said these types of changes can be destabilizing for young clients because they have a “really hard time trusting people.”
“Therapy isn’t just about the tools or advice; it’s about trust, safety, and feeling seen,” she wrote. “For [LGBTQ+] youth, who typically already face rejection or instability in other parts of their lives, losing a trusted therapist can bring up grief, anxiety or even old trauma around abandonment.”