I’ve shared with you before that I have a fabulous peer consultation group that meets monthly. At our last meeting one of the Licensed Professional Counselors of the group, Traci Hart of Hart Counseling, LLC, facilitated a discussion on the self-care of therapists. The information and resources that she shared were so thorough that I invited her to share some of them with you here.
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A Guest Post by Traci Hart, MA, LPC
(If you want to guest post on this blog, check out the guidelines here.)
“Compassion for others begins with kindness to ourselves.” ~Pema Chodron
When I first began practicing counseling, I was a contract therapist and had the flexibility of scheduling my own hours. I quickly learned I was a lot harder on myself than any boss would ever be. I took the saying, “if you don’t work, you don’t get paid” to heart.
When I took vacation time, I would double my hours upon my return to make up for the lost pay. I tracked cancellations and no shows and increased my caseload to over 50 clients a week to compensate for the clients that would not be able to make it to their appointments. Sometimes, they all showed!
I came home from work on Fridays and wanted to sleep until Monday morning when I had to start the madness all over again. Gradually, my life became work and sleep. The necessity of counselor self-care was not a familiar concept to me until this point of my career.
How do we know when we are pushing ourselves so hard we are negatively affecting our effectiveness with clients? Each of us has our own “red flags” and our own methods of getting ourselves back on track.
Here are a few useful tools I have found along the way to help 1) measure and identify our risk for burnout and 2) identify wellness activities that are helpful to each of us.
- The Professional Quality of Life (Pro-QOL-III) – This test measures compassion fatigue, compassion satisfaction, vicarious traumatization, and the potential for burnout in counselors. B. Hudnall Stamm. (1995-2002) Professional Quality of Life: Compassion Satisfaction and Fatigue Subscales-III, http://www.isu.edu/~bhstamm.
- Self-Care Assessment – This assessment focuses on how well we are caring for ourselves across several facets of wellness. Saakvitne, Pearlman, & Staff of TSI/CAAP. (Norton, 1996). Transforming the Pain: A Workbook on Vicarious Traumatization.
When taken together, the ProQOL-III and Self-Care Assessment provide useful information on life balance.
The American Counseling Association has their own task force and web page on counselor wellness and impairment. There you will find information regarding risk factors, assessment tools, and wellness strategies. You will also find tools for self-care that include Self-Care Assessment, Self-Care Strategies Worksheet, Self-Care Life Pie Worksheet, and a Self-Care Social Support Worksheet.
Additionally, Jeffrey A. Kottler has written The Therapist’s Workbook: Self-Assessment, Self-Care, and Self-Improvement Exercises for Mental Health Professionals, 2nd Edition, This book is described as a guide for self-reflection, growth and change.
I am interested in knowing how all of you keep yourselves in check when it comes to your own self-care. Do any of you use any of the above tools or do you have any new and creative suggestions? Even sharing all of these ideas among those of us in private practice is a step in self-care!
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Traci Hart, MA, LPC, is a therapist in private practice with Hart Counseling, 
LLC in Littleton, Colorado, USA. She specializes in helping people find new directions and balanced lives by providing knowledge, skills, and support.
Hello –
I appreciate your referenced articles and self-assessments. I do think that it is important as a professional helper who listens to others, to also listen to ourselves. I find that meditation and a regular practice of yoga and walking are important to me. It is important to listen to our bodies and know our temperments and how stress effects us as individuals. I could have never kept up the work load that you had Traci! But, I know this about myself. I also know that I can only see 3 clients back-to-back without a break, that I need a whole day committed to my paperwork/claims processing, and that I need to be there for my family. These needs are put into my schedule. Balance in life is critical – and I need to be a whole and healthy person in order to help others. As a mother I learned this, and coming into private practice later in life I am able to apply the wisdom I have learned over the years – as well as, be open to learning and becoming better as the years roll on. I also read a lot in the field and I find this inspires me to be open in my practice. Good luck to all!
Thank you for sharing, Vivian! It sounds like you have a good handle on knowing your triggers, knowing your limits, and knowing how to maintain that balance!
Traci
Hey, Traci! I’m so glad you are dropping in to day to join the conversation!
I love all of these ideas!
Hi, Vivian! Welcome back! Thank you for sharing some of the things that you do to keep your self-care in focus. I think it’s so helpful for us to hear what other professionals managed to prioritize and do to maintain that balance.
I think you are right when you note that age plays into the knowledge and wisdom that we bring to self-care. I have been in mental health since my early 20’s. I am now 52. What I can see now is that in my 20’s and 30’s I was focused on building my career and, truthfully, proving myself. That, coupled with my youthful perception that health and stamina were in endless supply . . . . I didn’t really give a thought to self-care and work-life balance. That’s really unfortunate because as the body ages, if you haven’t set up those habits of self-care, then it’s a rude awakening for some of us in our 40’s that there’s a price to pay. (I’m sure some of you now what I mean:)
Most counselors these days still sit 8 hours / day to do their work. Weight tends to creep up on many of us as we age – especially if we haven’t been put healthy habit and choices in place. Our needs for sleep and rest as well as our emotional and spiritual needs also change. I suspect, Vivian, you came into the field much wiser than many of us who started our careers in mental health in young adulthood. I’m sure your clients benefit from that wisdom, too! At 52, my clients – both my counseling clients and my consulting clients – often hear me say . . . “Don’t do as I did . . . . Learn from my mistakes!”
Thanks for expanding the conversation!
Over the past few years I’ve made a conscious effort to do small things that nurture and incorporate them into my day to day activities. i love to read biographies and I keep a stack of them on my nightstand and make time to read every night before falling asleep. If I didn’t schedule it I would never find the time for that pleasurable reading. Lavender is relaxing to me so I use lavender linen sprays on my sheets and blankets and I light a lavender scented candle in my office or when I’m home. It helps me stay calm. A new pair of socks has always been a special treat for me and now I always keep several new pair in my sock drawer. After getting home from a difficult day at work I’ll put on a pair of new socks, prop up my feet and relax with a cup of coffee or iced tea depending on the time of year. Makes me feel pampered.
Pam,
Reading your post made me feel relaxed! That is definitely a productive self-care routine. I like the special treat idea!
Thanks!
Traci
Hey, Traci – what is it you are doing to take care of you?
I like to walk different trails in the mornings and see parts of Colorado that I have never experienced. It is also a great time for reflection. I read a lot of historical fiction and novels at night. Reading has become my “settling down activity” before bed. I have recently started receiving acupuncture on a weekly basis and it helps relax me. I love trying new things to add to my forever growing list of self-care activities!
How about you, Tamara? What do you do for self-care?
Traci, in addition to reading a lot, I protect my family time, go to the gym, put “play time” on the calendar (literally), gardening, schedule visits to health care providers like clockwork, drink water all day long, avoid sugar and carbs as much as possible, tell the truth (to myself and to others), practice saying “no,” look for opportunities (the right opportunities) to say “yes” to, and keep at least two or three passion projects on the burner. The other thing that I do to take care of me is remind myself to B-R-E-A-T-H-E long, slow, and often. Stress passes . . . if we don’t hold on to it.
Oh, my gosh, Pam! I’m loving your attention to your self-care! I, too crawl into bed every single night with a book. There is never enough time to read all that I want to read and can’t imagine how I would go to sleep without reading / learning something new every evening! I, too, use scented candles every day. (But . . . don’t forget to ask clients about scent sensitivities!) Your sock treats, though! Those are fabulous! I love that you know that new socks are self-soothing for you and that you use them on difficult days! I’m so going to be talking about your sock treats the next time I’m presenting on self-care! (Of course, I’m tempted to call them a “sock fetish” just get the audience going!:)
Thanks for sharing some of your practices in self-care!
Aren’t we funny creatures? And we think we are helping our clients. If I knew I was even the 22nd client in that weeks’ schedule, I wouldn’t feel that I received a fair value for my investment of time and money. There is only so much work a person can do effectively. Our latest brain science shows us that.
So here is to taking time for other activies in life! Now that makes us better Therapists.
I know what you mean, Kristene! I sometimes tell colleagues (and clients) that if I was really being truthful, I should charge my clients less as the day progresses . . . and after 3:30 my fees should go to half price because my brain is typically fried! If any of you stumble across any of that brain research that relates to this thread, feel free to cite the sources here so we can all be reminded!
Kristene,
Well said! Isn’t self-realization wonderful? I now know my peak “functioning” hours and when I can best serve my clients. My brain seems to fry late afternoon!
Thanks!
Traci
WOW! This article is for me… I juggle so much, and my favorite phrase is “If I don’t workI don;t get paid”… I won’t even list all that I am responsible for outside of the practice (it will make your head spin), while working on dissertation. This was just confirmation that I have to slow down ASAP!
Carla, I know exactly what you mean. That sounds like operating from a place of fear rather than a place of gratitude and abundance. I lived there for the first five years I was in private practice 20 years ago.
Then, again, 10 years ago when I relocated to Colorado from Texas, I was bored that first year but wasn’t ready to hang out my shingle so I took a part time retail job while setting up house here. I finally got around to hanging out my shingle and the clients came. However, I found myself revisiting that place of fear briefly – wondering if I could afford to give up the little income from retail to move back into a full time practice.
When I realized that I was making those choices based on fear, it was a wake-up call for me. Fear is never a good reason to do anything. In fact, although both we and our clients may do many things based solely on fear, what I know is that there are only two things that are really effective in dealing with fear . . . . Either get more information OR take action! I took action and gave up the retail gig. I hope you are able to take action and slow down. You deserve it! We all do.
Carla,
I am glad this blog could help as a reminder for self-care!
Traci
Traci,
Thanks for the wonderful reminder. I find that time on the Internet or reading a good mystery or fiction book is wonderful stress relief. I also find it important that my close friends and family understand that time to myself is important, because a lot of days it seems like everybody wants something all at the same time. I also try to check in with coworkers because I honestly believe that only mental health professionals can truly understand the work stresses of mental health professionals.
Oh, and there is the almost nightly baseball game on TV for about nine months out of the year and dreaming of my next scuba diving trip – whenever that is going to be.
And Tamara, reading your blog has become a part of my routine because the positive (and very informative and thought-provoking) environment is refreshing compared to the attitude of some of my coworkers!
Lauren! Excellent additions to our growing list of strategies for self-care! I appreciate all of your contributions to Private Practice from the Inside Out!
Lauren,
I can relate to the sports outlet! I am a huge football fan, so during the fall that is a major self-care activity for me! It sounds like you have a good handle on the activities that help you!
Traci
I love this topic. It is one of my soapbox topics when I teach. I hammer it into students all the time. I have the opportunity to have an intern from where I teach. She stated to me “I thought you were crazy about all this self-care but now I know it is essential.” I’m glad it has an impact. I have even given credit for doing self-care activities as part of class.
For me, I cook to relax. It helps me to eat better but it is also a relaxing activity for me. Self-care.
Nice job, Bryan! When I was in graduate school no one talked about self care! No one! I see so many reasons now to attend to self-care but I wish I had had professors spell out to the inexperienced and youthful counselor that I was why and how to integrate that into my routines and daily habits. In many ways, I was raised in a healthy family that modeled good practices. However, coming from that same . . . traditional, Protestant background 50 years ago, there was also those messages like “Sports and physical activity are for boys” and “Don’t be needy” so don’t ask for what you need and . . . high caloric food is the sign of a “good family and . . . and . . . and . . . . . Obviously I’ve learned over time and now know better but at 52 . . . . Let’s just say that it would have been a bit easier to have learned and incorporated those things into my life at the age of 10 rather than 52!
So very glad that you are teaching it and giving credit for those self-care activities, too!
Bryan,
Thank you for teaching this to your students! Like Tamara, I can not remember hearing about this topic in graduate school. I guess I had to learn the “trial by fire” way!
Cooking is great idea for self-care!
Traci
Thank you for this wonderful post, Traci. I bookmarked the ACA sites and am looking forward to taking the assessments and sharing them with my peers.
For self care, I, like you, Tamara, schedule in gym time, free time, family time, etc. I find that when I treat “me” or “us” time as a commitment to honor rather than something I might get to if I have the time, I feel more balanced.
Tara! It’s good to have your voice back after all this time! I know what you mean about scheduling “me” time! I learned as an undergrad that the work ethic that my parents had instilled in me has some drawbacks including neglecting me! The way I’ve learned to balance that out is to put “me” on the schedule in writing and stick to it! Gym – Monday, Wedesday, Friday. Hair – every 4 weeks. Massage – 1 x month. That stuff happens only because it goes down in writing and I work my clients around those things. What is it attorneys say . . . .”If it isn’t in writing, it didn’t happen!” It’s true for our clinical records and it’s true for my own self-care.
Thanks, Tamara, it’s great to BE back!
I’ve even had to schedule in my own reluctance to go to the gym…I write in 5-6 exercise sessions so when I inevitably get lazy and decide to snuggle with my dog instead, I still make it at least 3-4x’s/wk. I’ve got to roll with my own resistance! Either way, I win!
YES YES YES, Tara! It’s so funny that you do this! I’m giving serious consideration to doing the very same thing. I swear – I know the research talks about endorphins kicking in but mine never do when it comes to exercise!!
Tara,
I love the term “commitment to honor”! That helps my perspective of self-care and maintaining a balanced life. It seems to take the “have to” out of it and put the “want to” in to it! Thank you!
Oooh, yes! It makes it something sacred, don’t you think?!
Thanks so much for sharing a link to this post! It’s such an important topic and needs to be addressed much more often in much more depth than our graduate programs typically do!