How we're thinking about mental health in 2025
Clinicians, clients, readers, and thinkers share their predictions, hopes, and fears for the new year.
Hello friends and readers, and welcome back for the first Reality Test of 2025. It’s been a tumultuous start to the year. There are just a few days left until the official start of Trump 2.0, and I’m starting to feel the dread I’ve been avoiding catch up to me. It hurts tremendously to watch LA burn from across the country. It’s a good time to pitch in to some mutual aid efforts if you are so inclined. This week’s newsletter brought some gratitude and comfort by giving me the chance to reach out to some of my community in this work. I hope you too have the chance to connect with your people.
Over the past couple weeks, I reached out to a variety of people who have something to say about therapy – providers, clients, media people, readers of this newsletter – and asked about their predictions, hopes, fears, and intentions for the mental health & healing industries in the new year. The result was a fascinating window into what people are pondering as we enter into an era that will continue to challenge us to define what mental healthcare can and should look like as our institutions, infrastructure, and nervous systems are pushed to their limit. Some respondents answered multiple prompts, others answered more generally.
From: Jessalyn Maguire (she/they), LMSW
Somatic Psychedelic Facilitator, Trauma Practitioner, doula, poet @jessalynmaguire
Any personal intentions or goals for your work in the new year?
“As I sit here to write, I am in a haze of the Palisades wildfire smoke, and while I’d already been thinking of distress tolerance as a central theme for the coming year, that idea feels more urgent than ever. In 2025, we may find ourselves and our clients grappling with intensifying challenges that can feel truly intolerable. And rather than intellectualizing, avoiding, shutting down, or pushing through to fight until burning out or worse, we need to build our capacity for staying with and getting curious about discomfort. It is not about bypassing emotions or pretending the things are not wrong but equipping ourselves with the tools to preserve our energy and health. Tools to help us to navigate stressors without them turning into stress. To gain the capacity to fight with intention and compassion the battles we can make a material change in. This year for me and for the work I will do will be always connected to tolerating the intolerable —taking sips of breath even when literally surrounded by smoke.”
What are your predictions for our industry in 2025?
“I hope to see an increased interest in group and community-centered, holistic approaches in mental health— group work, collective healing spaces, cultural and spiritual integration, retreats, somatic modalities, breathwork, and plant medicine work – the list could go on. Given the rising political, environmental, and social stressors, I anticipate more practitioners will recognize the importance of mind-body-spirit integration and hopefully clients too. I hope that groups/collectives/gatherings in living rooms or cafes etc. start forming so we can collectively liberate and collectively heal. Personally, I’ve been speaking with and collaborating with shamans, healers, and therapists to form gatherings where we can face the unknown together, feel it, grieve it, and empower ourselves for the uncertainty.”
What do you hope to see?
“In this space of grieving and healing, my hope is that we continue building ethical frameworks that genuinely serve and empower clients. Part of that means looking hard at who our current systems benefit—are we prioritizing client well-being, are we giving them the tools, resources and support in the way they need them to handle our world? It will take an interdisciplinary, culturally humble, and curious approach that honors diverse epistemologies, the body/mind as a whole, and the idea of humans as beings in community to look at our current system and see that it needs a gentle hand or a complete overhaul. Another key concept for this year, which dovetails with building these frameworks, is harm reduction: how can we lessen the impact of this administration on my clients and my own psyche, reduce violence against historically marginalized groups, and ease the stress on our bodies?How can we reclaim our identities from the prevailing norms that try to define us? This collective effort to reduce harm and claim what’s ours is one way we move forward—together.”
What are you worried about/excited about?
“When the focus is truly on collective care and liberation, we can learn to navigate the intolerable together—and that, I believe, is how we make space for real change.”
From Foster Kamer, writer, FOSTERTALK
What are your predictions?
“All those “People Are Quitting Therapy” pieces finally get their overdue sequels: “The Wrong People Quit Therapy.” Also, maybe not quite pandemic-levels-of-bad, but therapist burnout reaching new extremes amid a second Trump administration. I can’t imagine any training will prepare you for some of the existential discussions you’ll be having over the next four years, to say nothing of clients (especially middle aged ones) reckoning with a sense of uselessness as AI continues to proliferate.”
From Mia de Graaf, Health & Features Editor, Business Insider @miadegraaf
What are your predictions for the mental health/healing industries in 2025?
“Hacking your mental health through consumerism.
Five years ago, when everything locked down, we had Big Conversations about the perils of grind culture, and the importance of taking things slow. Mindfulness was huge. Everyone was talking about this being a big reset, a wake-up call for us all. But now COVID is ‘over,’ and we’re back to the grind more than ever.
I think we’re reaching the zenith of a strange time in wellness that is a natural backlash to feeling helpless, under threat, and at the mercy of a dysfunctional healthcare system during COVID. (See some thoughts on this from PE Moskowitz.)
Investment is pouring into wellness companies that promise to influence your mental health with products. This year, there will be huge hype around wearables and apps that promise to hack your hormones, face creams that promise to boost your serotonin levels (‘neurocosmetics’), personalized nutrition to harness the ‘gut-brain axis,’ supplement regimes for men to combat ‘the manopause’ (a marketing term for male aging), GLP-1 drugs to treat addiction and food noise.
The implication is that these companies are handing you the reins to take control of your own body, or suffer the consequences. This is the mantra of RFK Jr, the probable next HHS secretary who encourages people to take control of their own health (his close advisor has a glucose monitoring app) and to mistrust medical professionals and government-employed researchers.
In many ways, this trend toward the personal and fearful feels antithetical to a balanced and peaceful life. But I think it makes sense in the wake of COVID, and in a healthcare context that can feel impossibly expensive and hard to navigate.
This year, I want to understand this broader movement better and cover it compassionately.”
What do you hope to see?
“More from ProPublica’s ongoing coverage of mental health care and insurance.
Unique, original stories on people’s relationships with traditional gender roles. Everyone’s talking about the manosphere and trad wives and yet there is so much more to say.”
Personal goal
“Publish more mental health stories.
I rarely accept mental health pitches. I have been a health editor in digital media for almost 10 years. Increasingly, I have found our stories about mental health are not as successful unless they have a physical component.
The stories that get reader engagement online generally follow this formula: a surprising story about one person who has experienced a radical transformation — usually physical and noticeable, involving fat loss and muscle gain and pain relief — and consequently is cured of any anxiety and depression that was holding them back before.
You can tell good, nuanced, critical stories about mental health using that formula as a springboard. That’s what I hope to do more of this year.”
From Kelsey Woida, Licensed Massage Therapist. Info and Booking
“Related to specialization in mental health fields, I see this happening more in massage therapy, too. Massage therapists are being hired more by hospitals and plastic surgeons, and I see more trainings offered in oncology, lymphatic drainage for post-op care, post-op care for gender-affirming surgeries, etc. as a newly licensed massage therapist, I am consistently coming up against the binary of ‘sports vs spa’ massage, and I wouldn't be surprised to see a third node of ‘medical’ grow in dominance. while it's cool to see massage gain legitimacy in the broader healthcare field, I worry about private, for-profit hospital and insurance systems doing what they do best and making it difficult for providers to work without exploitation and compromised values. I also think we have seen some of the damage over-specialization can wreak on both the provider and patient side of things in medicine. Being bounced around and requiring approval for treatment focusing on one area of the work can rob the craft of its sort of humane je ne sais quoi, and more holistic approach that makes up a lot of its healing capacity.”
From Dr. Idil Franko, PsyD, Staff Psychologist at Columbia University Irving Medical Center. Info and Contact
Any personal intentions or goals for your work in the new year?
“Mindfulness practice is a fundamental component of DBT. Patients learn and practice mindfulness skills in order to increase self-awareness, reduce distractibility, enhance compassion towards self and others. My intention for 2025 is to practice mindfulness more frequently and deliberately– setting aside several minutes every day would help me notice my emotions, thoughts, and urges, reduce reactivity, and choose my clinical responses more thoughtfully.”
From Diana Fox Tilson, LICSW, psychotherapist and author of Other Interests
“Not a prediction, but more of a hope for 2025: as someone who does a lot of eating disorder work, I would love to see more therapists educating themselves about HAES1/anti-diet work. There is so much pressure right now for people to use GLP-1 drugs to manipulate their body size. I've lost count of the number of clients who have told me that their doctor pressured them to try these drugs. As therapists, we have an opportunity to offer people a safe space to counterbalance all the diet culture messaging clients receive and to offer them unconditional support and acceptance for their body. I have been practicing from this framework for the past few years and it has been transformative. I am often the only person in my clients' lives not harping on them to lose weight. I can see people visibly relax when they realize I'm not judging them for their size, and that sense of acceptance and safety opens up conversations that otherwise would not have happened.”
From Jess Chermak, Independent Educational Consultant, Certified Educational Planner, and Licensed Professional Counselor, writer of Narrative Musings
“I'm seeing a lot more of my clinician friends getting certified for different treatment modalities. A lot more psilocybin and ketamine-assisted therapy trainings are popping up all over Colorado, Oregon, Washington, and California (and I'm getting an ungodly amount of mail for them). More grad programs are offering specific tracks, even at the master's level (trauma, health, sports, forensics seem to be the top four across the US). EMDR continues to intrigue for some reason.
My biggest worry is the prevalence of compassion fatigue, and how it's impacting therapists outside of their professional work. Also: I've been collecting data from my students' interviews this cycle for clinical PhDs, PsyDs and master's and even the questions that are being asked have morphed dramatically since last year: my students have been asked direct (and incredibly inappropriate in my professional opinion) questions about the Gaza/Palestinian conflict, politics, trauma, and drug use. More people seem to be seeking therapy, waitlists are a mile long at most orgs that are on insurance boards, and there seems to be a greater crackdown on providing services across state lines virtually (a stark change from early pandemic years). The licensed therapist shortage and crackdown on unregistered psychotherapists is likely informing the expansion of graduate training programs, so I foresee there being a lot more underqualified practitioners joining the mix, which will ultimately lead to supervisor burn-out.
The list of CACREP2 accredited schools is dwindling (I am genuinely floored by how many schools are currently on accreditation probation), so more schools are only getting accredited by regional agencies. Graduates from those programs are likely going to have a harder time getting clinical hours, getting licensed, or transferring licenses if they move around to different states after school.
But on a less doom and gloom level: more positions in hospitals and schools are opening up for mental health service providers, and that's exciting and needed. More people are seeking therapy. We'll never be out of a job in the mental health space if we choose to remain in it. I'm excited for some of the newer drug-assisted treatment modalities, and there's a lot of promising new research being conducted. The mental health industry is certainly bracing for impact, but at least we're on some semblance of a steady track so whatever impacts do hit won't entirely derail.”
Have any predictions, hopes, or fears of your own? Anything you were surprised to see (or not see) here? Let me know in the comments. As always, if there’s something you’d like to see in a future edition of Reality Test, hit me up. Take care, stay warm. I appreciate you.