Balancing therapy and chemotherapy

As therapists, we hold space for others, offering a steady presence through life’s challenges. But when cancer enters our own lives, the balance shifts. Suddenly, we’re not just supporting others - we’re navigating our own emotional and physical struggles while continuing to show up for clients.

If you’re a counsellor undergoing chemotherapy, you might be wondering:

• How do I manage my practice while taking care of myself?
• Can I still offer my best to clients while going through this?

The answer is yes - with adjustments, boundaries, and much self-compassion. I want to offer both practical guidance and encouragement because I know first-hand that this journey is not just about getting through - it’s about adapting, softening, and finding a rhythm that honours your work and healing.

1. Acknowledge your dual role: Healer and healing

Cancer treatment forces us to confront vulnerability in a way few other experiences do. As therapists, we often feel a responsibility to be strong, to keep going, and to put our clients first. But now, your well-being must come first.

Encouragement:

Your experience will make you an even more compassionate therapist. Clients don’t benefit from perfection - they benefit from your presence, your ability to listen, and your deep understanding of what it means to face adversity. You do not have to be 'fully well' to be an incredible therapist. You have to be realistic about your limits.

A colleague of mine, Sarah, was diagnosed with breast cancer while running a full-time therapy practice. She shared that once she allowed herself to work at half-capacity instead of pushing through full weeks, she felt more engaged with clients - not less. “I learnt that my worth as a therapist wasn’t tied to how much I worked, but how present I could be in the moments I did.”

2. Create a sustainable work schedule

Chemotherapy brings fluctuations in energy, mental clarity, and emotions. Mapping out your schedule to align with your treatment cycle can make all the difference.

Example work schedule for therapy practice during chemo:

• Chemo day and the day after: Prioritise rest. If you feel up to it, do light admin work from home, but avoid client sessions.
• Low-energy days (two or three days post-treatment): If needed, keep this time clear or see only one client in a flexible format (e.g. virtual, shorter session).
• Moderate-energy days: See two or three clients, ensuring breaks between sessions.
• Better days: If you feel strong, schedule three or four sessions but still allow yourself buffer time.

David, a trauma counsellor, switched to seeing only virtual clients on chemo weeks and spaced out in-person sessions on better weeks. “I used to think I had to power through,” he told me. “Now I honour my body’s needs first. My clients are still getting the best of me - just in a different way.”

3. Set boundaries with clients (with grace and confidence)

Deciding how much to share with clients is deeply personal. You don’t owe anyone details about your diagnosis, but a brief, professional disclosure can help set expectations if it impacts your availability.

Example boundaries:

• “I’m currently balancing some health treatments so that I may adjust my schedule slightly in the coming months. I’ll always give you as much notice as possible.”
• “I may offer more virtual sessions for a while to ensure I can continue working safely.”

Clients don’t need to know everything, but offering reassurance that their care is still a priority can ease concerns.

One therapist I know, Emily, chose to tell only long-term clients, while newer clients saw minor schedule changes. “I was worried they’d feel abandoned,” she admitted. “But I found that clients respect boundaries when we set them with kindness.”

4. Manage your energy and emotional load

Beyond physical fatigue, cancer treatment can bring emotional exhaustion. As therapists, we absorb a lot, which can feel overwhelming when our reserves are lower.

Practical energy management tips:

• Shorter sessions or increased breaks - even a 10-minute gap can reset your energy.
• Teletherapy, when possible - conserve energy by reducing travel.
• Mindful self-checks - before and after each session, take three deep breaths and ask: Do I have enough to give? If not, it’s okay to adjust.

Your resilience is not about working through exhaustion - it’s about adapting to work with your energy levels. Every time you make a choice that prioritises your well-being, you also model healthy boundaries for your clients.

5. Release guilt and embrace support

If you take one thing from this, let it be this:

• You can adjust, slow down, and take breaks.
• Your practice will not collapse.
• Your clients will not suffer.
• You are still a phenomenal therapist - even if you see fewer clients, even if you take time off.

If you need to refer some clients out for a while, that’s OK. If you need to ask for help - from colleagues, supervisors, or even a therapist - that’s a sign of wisdom, not weakness.

Cancer changes things but it does not take away your ability to offer warmth, insight, and care. If anything, it deepens your empathy, strengthens your understanding of resilience, and reminds you of the power of presence over perfection.

So, to my fellow therapists navigating chemo: You are enough, exactly as you are. Your work is still valuable. Your wisdom is still profound. Most importantly, you deserve the same care and compassion you so readily give to others.