Compensation was exploitative. As a licensed clinician, I was paid just $40 per session—nowhere near a livable wage (in San Diego nonetheless), especially given the emotional and admin labor required. There was no meaningful path toward higher pay, tiny raises based on tenure, and absolutely no transparency around how billing translated to clinician pay. Meanwhile, the company continued to grow and profit by opening new offices and hiring more staff, all while refusing to invest in the clinicians already carrying the weight of the work. They got around this by saying we had the flexibility to earn more money if we took on more cash pay clients. But the practice took literally every insurance, so cash pay clients were not actually an option.
The caseload expectations were unrealistic and manipulative. WAVE advertised flexibility and the ability to build your own schedule—but in practice, you were shamed or penalized for not hitting arbitrary productivity quotas. Clinicians were expected to maintain at least 25 clients per week, which realistically meant scheduling closer to 30 to account for cancellations or no-shows. That volume is clinically unsustainable, yet leadership discouraged setting boundaries around scope, availability, or specialty. If you didn’t take on every referral—no matter how inappropriate for your training or clinical focus—you were accused of not being a “team player” or not being committed enough. It was a clear case of marketing autonomy while enforcing exploitation.
There was a toxic culture of micromanagement disguised as flexibility. The company repeatedly claimed therapists could build their own schedules, but behind the scenes, leadership monitored availability, pressured us to take clients we weren’t equipped to serve, and penalized us for cancellations or no-shows that were completely out of our control. Data dashboards were weaponized to critique and control, rather than support or understand what was happening clinically.
Therapists were expected to do unpaid labor constantly. Required meetings, client emails, crisis support, clinical documentation, and coordination were either unpaid or underpaid. Associates got nothing for required meetings. Licensed therapists got half-pay. This created a system where the more you cared and showed up for your clients, the more your time and energy were taken advantage of.
Leadership was dysfunctional and frequently unprofessional. The CEO prioritized expansion and launching other ventures over clinician support. Leadership turnover was constant. Favoritism was rampant. When therapists left—which happened often—they were talked about behind closed doors in disrespectful and retaliatory ways. There was no effort to repair harm or take accountability. Just more expansion and more burnout.
Ethical concerns were widespread. From questionable billing practices to pressuring clinicians to take clients outside their scope of competence, there were repeated red flags. Many of us stayed longer than we should have because of our loyalty to our clients and peers—but ultimately, it became clear that our integrity and well-being were not valued.
This company targets associate-level clinicians because they’re easier to exploit. WAVE heavily markets itself to associates—largely because it can’t afford to pay licensed clinicians a livable wage, and associates have fewer options when collecting hours. On the surface, it all looks appealing but behind the curtain, it’s a deeply harmful environment. Associates are emotionally manipulated (indentured servitude) , pushed to ignore their clinical instincts, and pressured to take on workloads and cases they’re not ready for. The long-term impact of working in this kind of system is real—many clinicians are still recovering from the burnout, self-doubt, and emotional distress they experienced here. WAVE does not build up new clinicians; it uses them until they leave.
