Executive Stress and Anxiety: A Guide for Therapists in Leadership

Dear Fellow Therapists,

As mental health professionals, we are trained to care for others. Yet for many of us who also hold administrative or executive roles, there is another layer of stress that often goes unspoken: executive stress.

What is Executive Stress? Executive stress refers to the unique pressures and anxieties experienced by professionals who occupy leadership roles. It encompasses the demands of decision-making, organizational responsibility, managing teams, and balancing multiple priorities simultaneously. For mental health professionals, executive stress is compounded by the emotional labor of clinical work. (American Psychological Association, 2022)

How It Shows Up For therapists in executive or administrative roles, executive stress may manifest in several ways:

• Feeling constantly “on,” even outside of work hours

• Anxiety about staff performance, client outcomes, or organizational expectations

• Difficulty delegating tasks or trusting team members

• Physical symptoms like headaches, fatigue, or insomnia

• Emotional responses such as irritability, guilt, or feeling overwhelmed

• Cognitive challenges like difficulty focusing or making decisions

Why It Matters in Mental Health Settings Holding both clinical and administrative responsibilities requires juggling multiple roles at once. For example, a mental health program director might:

• See clients for therapy sessions

• Supervise clinical staff and interns

• Manage administrative responsibilities, including budgets, compliance, and reporting

• Handle crises among staff or clients

• Lead strategic planning and organizational development

This “dual load” can create sustained stress and anxiety, impacting both personal well-being and professional effectiveness.

Managing Executive Stress as a Therapist Just as we teach clients strategies for coping with stress and anxiety, we must apply these tools to our own executive roles. Some strategies include:

1. Prioritize Self-Care – Schedule regular breaks, maintain healthy boundaries, and honor personal time.

2. Delegate Effectively – Trust your team with responsibilities and recognize that you do not need to do everything alone.

3. Seek Clinical Supervision – Even executives benefit from supervision or consultation to process challenging decisions or ethical dilemmas.

4. Engage in Mindfulness and Stress Reduction – Practices like meditation, journaling, or guided breathing can reduce tension and improve focus.

5. Professional Development – Leadership coaching or executive mentorship can provide new strategies for managing stress and workload.

6. Know Your Limits – Set realistic expectations for yourself and your team; perfectionism can amplify anxiety.

A Note to Fellow Therapists in Leadership If you hold both clinical and administrative responsibilities, you are not alone in feeling the weight of executive stress. Recognizing the signs and implementing intentional strategies can help you sustain both your leadership role and your clinical practice. Remember: caring for your well-being is not a luxury, it is a professional necessity.

Balancing clinical and administrative roles is challenging, but with awareness, support, and intentional practices, it is possible to lead effectively without losing yourself to stress and anxiety.

Resources for Executive Stress

• American Psychological Association. (2022, October 24). Stress in America 2022: Concerned for the future, beset by inflation [Press release]. https://www.apa.org/news/press/releases/stress/2022/concerned-future-inflation

• Mindful. (n.d.). Mindful: The most trusted resource for mindfulness and meditation. Retrieved October 30, 2025, from https://www.mindful.org/

Wishing you all wellness and growth,

Jinia