More than five years after the COVID-19 pandemic disrupted the nation, the behavioral health field continues to undergo profound and lasting shifts. Early in the pandemic, the World Health Organization (2022) reported a global 25 percent increase in anxiety and depressive disorders, a surge that did not fade with time, as subsequent analyses continued to document widespread mental health burden (Kupcová et al., 2023; Kola et al., 2022). Instead, demand for behavioral health services has grown steadily, and clinicians now encounter increasingly complex and layered presentations requiring longer, more intensive episodes of care and thoughtful intervention (APA, 2022; SAMHSA, 2023; Savaglio et al., 2023).
As the complexity of client needs continues to rise, the behavioral health workforce is simultaneously experiencing significant strain, setting the stage for broader workforce pressures and the burden on leaders. Despite the growing demand for services, many organizations continue to struggle with staffing. The United States Bureau of Labor Statistics (2023) projects an 18 percent growth in employment for mental health counselors, behavioral disorder specialists, and substance use providers between 2022 and 2033, alongside similar increases for marriage and family therapists, social workers, and psychiatrists. In practice, however, many agencies face a shortage of qualified providers and ongoing difficulties with recruitment and retention. Burnout, chronic stress, and overwhelming workloads remain persistent themes across the field (Crocker et al., 2023).
As these pressures intensify, the impact is felt not only at the direct-care level but throughout the supervisory and administrative layers of an organization. Supervisors and Program Directors, even those without full caseloads, shoulder significant pressure as they work to stabilize teams, ensure compliance, manage operations, and navigate organizational demands. Under these conditions, emotional strain often begins to circulate through the system, revealing itself in the form of parallel process. Supervisors often experience bottom-up parallel processes, in which emotional dynamics from the therapy room emerge within the supervisory relationship. Zetzer and colleagues (2020) found that supervisors frequently internalize the emotional weight of clinicians’ most challenging cases, leaving them vulnerable to compassion fatigue and role strain, especially when managing multiple layers of responsibility.
The same emotional patterns can move upward through an organization, impacting directors and senior leaders. Tracey, Bludworth, and Glidden-Tracey (2012) highlight that parallel process can flow in both directions, shaping not only supervisory relationships but the culture of the entire organization when cumulative pressures go unaddressed. As these pressures accumulate across organizational levels, the role of leadership becomes central to shaping workplace climate, staff stability, and overall system functioning, underscoring why supporting supervisors matters.
Organizational stability depends greatly on the quality of leadership. A recent study found that clinicians were more likely to remain in their roles when they experienced supportive administration, meaningful work, manageable work–life balance, fair compensation, and strong peer and supervisory support (Pathman et al., 2025). The widely recognized idea that “employees leave managers, not organizations” is deeply reflected in behavioral health research. When leaders model respect, empathy, accountability, and empowerment, they help retain staff and strengthen organizational morale.
Supporting supervisors, therefore, is not simply beneficial, it is essential to maintaining ethical practice, reducing burnout, and preserving the integrity of the system (Barnett et al., 2007; Edwards et al., 2023; Milne & Reiser, 2017).
One effective strategy for supporting leaders involves combining top-down and bottom-up approaches. In top-down models, senior leadership sets goals and guides the direction of the organization. In bottom-up approaches, staff on the ground identify needs and share insights that inform decision-making. When combined, these approaches create a more accurate picture of staff experiences and allow organizational leaders to respond with policies and structures that meaningfully support the workforce (Li, 2023). This responsiveness can interrupt negative parallel processes and improve client care by reinforcing a healthy organizational climate.
New York Psychotherapy and Counseling Center (NYPCC) applies this combined leadership philosophy to invest intentionally in its supervisory workforce and develop future leaders. As a growth-centered organization, NYPCC provides consistent support for Supervisors through collaborative forums, shared problem-solving, and structured opportunities for reflection. Because the quality of supervision depends on the support supervisors receive, the organization ensures that Supervisors participate in dedicated supervisory sessions that help them reflect on their work, refine their clinical and administrative skills, and address challenges such as countertransference. Directors conduct shadowing not only for evaluation but also to provide mentorship and space to explore the complexities inherent in leadership roles. Collaboration is further reinforced through NYPCC’s supervisor line, a system that allows clinicians to reach a network of Supervisors during crises or complex situations. This model distributes responsibility, reduces pressure on individual leaders, and reinforces the organizational belief that no one should navigate difficult circumstances alone.
Taken together, these structures demonstrate NYPCC’s commitment not only to strong supervision but to the overall wellbeing of its workforce. These practices naturally connect to the broader organizational priority of preventing burnout; a challenge that affects behavioral health systems at every level.
Burnout in behavioral health involves emotional exhaustion, depersonalization, and reduced sense of accomplishment, symptoms that are difficult to reverse once they emerge. As Posluns and Gall (2019) emphasize, prevention is essential. NYPCC treats self-care as an organizational responsibility rather than an individual burden. In addition to traditional paid time off, clinical staff receive quarterly Mental Health Days, access to Health and Wellness fairs, and opportunities to connect with colleagues through monthly social events. These initiatives help sustain morale, promote connection and strengthen the sense of belonging that makes day-to-day work more manageable.
Recognizing the demands placed on leaders, NYPCC also offers robust Clinical Supervisor Training to clarify expectations and equip Supervisors with the tools needed to guide their teams. The annual leadership retreat provides additional time for connection, reflection, and strategic planning, with follow-up meetings ensuring that leadership practices continue to evolve alongside program needs. Thematic Clinical Supervisor Consultation Groups deepen this learning by supporting Supervisors in training their teams on essential tasks such as documentation, workflow management, and quality assurance.
A strength-based approach is woven into all aspects of the organization. Leadership development is matched by strong recognition practices, including a structured rewards system and the Circle of Champions program. Through peer nominations and executive acknowledgment, staff are celebrated for their skills, commitment, and alignment with organizational values.
Together, NYPCC’s focus on burnout prevention, supervisor development, and leadership support reflects a broader commitment to creating conditions in which staff can thrive. After more than fifty years as a behavioral health organization, NYPCC demonstrates that prioritizing staff well-being and cultivating strong leaders are essential to sustained effectiveness. Its recognition by Mental Health America with the Platinum Bell Seal for Workplace Mental Health and by City and State as a top place to work in New York in 2025 illustrates how these efforts contribute to a workplace culture that supports employees at all levels and the communities they serve.
Marellyn Lajara-Ottley, LMHC, is the Training and Development Manager at the New York Psychotherapy and Counseling Center. She can be reached at MLajara@nypcc.org or (718) 540-7790. Tanya M. Sanchez, LMHC, is a Success Coach at the New York Psychotherapy and Counseling Center. She can be reached at TGonzalez@nypcc.org or (718) 540-7785.
For more information about at the New York Psychotherapy and Counseling Center, visit www.nypcc.org.
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