Helen Sprague

When you're standing at the edge of the Responsibility–Authority Gap, the problem isn't your resilience. It's the distance between what you're accountable for and what you're actually allowed to control. How the Responsibility–Authority Gap Turns Burnout, Moral Distress, and Impossible Caseloads Into a System Design Problem You know the pattern. It starts with a no‑show that you can’t bill for, so you use that “free” hour to catch up on notes. Then the insurance company rejects a pre‑auth you...

You walk into a room and your body goes on patrol. Exits, faces, tension—mapped in seconds. This letter is for the Protector shaped by trauma, the nervous system that never powers down, and the quiet part of you that wonders what it might be like to rest.

Imposter Syndrome doesn’t just live in early‑career clinicians. It quietly shapes how your supervisors, team leads, and program managers show up in the room — how they make decisions, how they set boundaries, and how safe their teams feel speaking up. When the ‘Imposter’ is running the show, leaders delay decisions, soften necessary feedback, and over‑function until they burn out.