Preventing therapist burn out
I have always made self-care a priority in my life. But during COVID-19, I overlooked an important piece – taking time off was missing. I was not setting aside time to remove myself from the therapy room. It seemed there was no place to go for a holiday. Getting on a plane and taking a trip wasn’t an option now. So I just plugged away 5 days a week for 2 years straight. Yes, I took the odd day or two off to go camping a few times in the summer and had a daily self-care routine, but it wasn’t enough to feel nourished in the long run.
None of us are immune to burnout.
Isolation and loneliness are the leading complaints of experienced independent practitioners (Tyron, 1983; Gundogan, 2017). Especially during a Pandemic when many are working from home and there is a higher demand for mental health services and client concerns are becoming even more intensified.
As therapists, it’s easy to focus on supporting others. This is what we're trained to do. However, we may not realize when our own well-being is affected.
Therapists are impacted by COVID-19 and other world events just as their clients are. It’s more difficult to leave these concerns at the office because they’re also altering our personal lives. We are facing the same world concerns as our clients. Therapists can also be impacted by what's going on in their personal lives and this adds to their level of stress. Therapists may be faced with stressors such as illness, loss, divorce, empty nest, parenthood, or caring for family members.
Over time, this can lead to burn out. Common signs of burn out are:
- feeling drained
- loss of appetite
- sleep problems
- recurring illness
- mild depression
At work, this may show up as:
- dragging yourself to work most days
- having less empathy for clients
- spacing out during sessions
- beginning sessions late or ending them early
- feeling relieved when clients cancel
- self-disclosing in ways that do not help the client
- giving advice vs helping clients learn and grow
- pushing your agenda or technique rather than listening and adjusting
- haven't read anything psychology-related for a while
The cumulative effects of witnessing so much human suffering can wear down the most competent professionals unless they are committed to self-care (Welfel, 2015). Clearly, the responsibilities and stress of therapy work and daily life are commonly experienced by most therapists.
Norcross & Vanden Bos (2019) noted that self-care is a human requisite, a clinical necessity and an ethical imperative. We must advocate for ourselves. We can do this by having empathy for ourselves and allowing time to recharge and nurture ourselves.
Fortunately, wellness of Psychologists is now a focus of and built into the Continuing Competency Program for Alberta Psychologists. We are asked to commit to three areas of wellness that we will engage in throughout the year. My three areas are daily exercise and Yoga, practicing Emotional Freedom Technique (EFT) to reduce stress, and listening to motivational podcasts each week.
There is evidence that therapists who engage in personal emotional wellness are better protected from feeling burnt out (Welfel, 2015).
We can take this a step further and focus on becoming more self-aware to reduce the risk of burn out. We can self-monitor our stress levels regularly using a simple rating system (rate stress from 0-10) to keep an eye on how we’re feeling and coping. We can become mindful of our thoughts, feelings, and bodily sensations and just observe them in a non-judgmental way. Hatchard et al., 2017 found that when therapists engage in this type of mindfulness practice, they are less reactive when unpleasant emotions arise and are able to process emotions more effectively.
Taking time for ourselves is an act of self-compassion. Practicing self-compassion regularly can increase our resilience and emotional strength. Self-care means giving yourself permission to pause (Cecila Tran).
A self-compassion practice can take only 2 minutes and could be done between client sessions. It could become a daily practice of emotional self-care.
Here is an example of a 2 minute self-compassion exercise - https://youtu.be/abOzd7hCKso
Also, this self-care assessment can help you increase awareness of your own level of self-care. It will give you a clear picture of what you’re doing well and what may need your attention to ensure you are keeping your batteries charged.
As therapists, most of us talk with our clients about their own self-care. Now it's our turn. Let’s practice what we preach - for our sakes!
I'm curious to hear from you. What is one self-care strategy that you can't live without?
Written by Beth Matthews, R.Psych.