A Guest Post by @DorleeM
(If you want to guest post on this blog, check out the guidelines here.)
I hope you will take a moment out of your busy day, to slow down long enough to read what she has to say, add your own thoughts, and visit her blog. It’s worth your time to check her out.]
One of the occupational hazards of being a psychotherapist is burnout. Psychotherapy is a demanding profession and the successful therapist must be able to tolerate the emotional depletion, isolation, the threat of lawsuits and other job-related frustrations.
A burned-out therapist is likely to have low energy, reduced interest and satisfaction, as well as a dread of work. The burned-out therapist’s emotional exhaustion may manifest itself as a detached attitude toward his or her patients.
Burnout may occur to both neophyte and seasoned therapists alike. It is the leading cause of the high rate of depression, drug and alcohol abuse and suicide among psychotherapists.
Prevent Burnout with Self-Care
- Engage in your own therapy
- Consult with others and/or seek supervision
- Employ different psychological theories and draw from other disciplines (to assist clients with different needs)
- Join a professional organization for both support and to be kept up-to-date on relevant information
- Take continuing education courses
- Develop non-professional interests
- Take periodic vacations to recharge
Aside from the above-mentioned long-term recommendations by Dr. Zur on burnout prevention, there are also some small things that you could do on a day-to-day basis that may help you to refuel.
Some Simple Ways to Recharge During the Day
- Talk to a friend on the telephone
- Text a friend
- Have lunch with a friend or co-worker
- Connect to social media
- Exercise for 20 minutes (walking counts too!)
- Go outside and watch the clouds
- Walk/play with your pet (or offer to walk someone else’s)
- Play a solitary game (video, cards etc.)
- Read a book, magazine, newspaper or poem
- Take a 20 minute nap
- Meditate
- Do some stretches
- Listen to some music
- Eat some chocolate (or some other food you enjoy)
- Make yourself a nice hot cup of tea, coffee or soup
What are some things that you do to help yourself re-energize during the day? Are there other things that you would recommend doing to prevent burnout?
References:
McKay, M. et al. (2007). The Dialectical Behavior Therapy Skills Workbook. New Harbinger Publishers Inc. (for ideas of things to do on a daily basis)
Zur, O. (2011). Taking Care Of The Caretaker: How To Avoid Psychotherapists' Burnout. Online Publication by Zur Institute. Retrieved 5/13/2011 from http://www.zurinstitute.com/burnout.html
What a helpful article, writing a gratitude list has helped me re-energize my day and avoid burnout.
Hi, Chelsea! Thanks for dropping in here to chat at Private Practice from the Inside Out!
Yes, I love the idea of writing a gratitude list. It helps me, too! Someone taught me a long time ago that if you can walk around with an attitude of gratitude, that you are walking around saying prayers. I love that!
Chelsea, it’s good to have your voice here! I hope you’ll drop back in to share you thoughts often as we continue to grow our online community!
Burnout is alive and well. I’m sure psychotherapists are very susceptible. I think many people in many different functions and industries are experiencing burnout and they may not even know it. Back in the 70’s we used to hear this term frequently.
I have a prediction: Burnout will become one of the most talked about issues of the 21st century. We would do ourselves a favor to talk about it much more and allow people to talk about it.
Thanks for starting and reviving the conversation!
Hi, Terry! Thanks for dropping in here to check out my blog! I just checked yours out, by the way. Nice job – I’ll be back often!
Yes, I think you are right about this being a topic that is going to gain momentum in the 21st century. The more we allow our lives to remain unbalanced, the crazier it’s going to feel – for us and our clients!
I hope you’ll drop back in often to share your voice with us here at Private Practice from the Inside Out!
Hi Chelsea,
Writing a gratitude list – What a lovely way of preventing burn-out and providing yourself with self-care 🙂
Thanks so much for sharing that idea!
It is also one that is likely to bring us much closer to all those whom we care about because we will be making a point of expressing our appreciation and you can just see the positive ripple effects of that…the warm love going around 🙂
Best,
Dorlee
Dorlee,
I talk with my clients all the time about the importance of self-care. Some days, I need that reminder for myself as well. This was a nice reminder.
In addition to a general gratitude list, I also pause before starting each work day to set my intentions for my clients and to remind myself that it is a privilege to do this work.
Warmly,
Ann
Hi, Ann! Thanks for dropping in here to chat! I love your ritual of starting each day by setting your intentions! Surely that helps you stay focused and on track as your day shifts into high gear! Thanks for sharing!
Those in the “helping” professions are prone to overcare – a more balanced approach is to recognise that this can occur and then, have strategies in place, like your well-put-together list, to counteract it.
It is important to note that although the list may vary from person to person, there is a commonality between each list. Too often, one gets stressed and stops doing the things that are restorative.
It is also empowering to know and see how one’s heart rate variability changes for the positive when recalling people, places or things that one loves. It all starts in the heart – the place where care resides!
Marianna, thanks for stopping by to chat and making the point that how we prevent and deal with burnout can vary from person to person. The key is building in that restorative time and activities and finding your work / life / spirit balance, isn’t it?! My colleague, Beth Patterson, MA, LPC talks about building in transition time and rituals to help her ease out of her work-related stresses and back into her home life.
I hope you’ll drop back in to chat as we continue to build our online community here at Private Practice from the Inside Out!
Terry, Ann and Marianna,
Thanks so much. You are all so kind to have come to visit and comment on my guest post here chez Tamara’s blog 🙂
Terry – how interesting – I had no idea that burnout was actually quite hot in the 70s… And regretfully, I think I agree with your forecast…it doesn’t help that regardless of what profession you are in, you are more and more likely to be pulled in too many directions all the time.
Ann – what a beautiful and caring thing to do…to make a point of talking with all your clients about the importance of self-care. I also love your variation of gratitude idea…This, in turn, is likely to get reflected in the tender loving care you give your clients and in the joy you reap with your life as a whole…
Marianna – I’m wondering what you mean by “overcare?” Somehow, I can’t envision anyone in any professions spending too much time on the items that help counteract burnout due to the fact that nobody really has excess free time… But yes, as you point out, the key is that one needs to continue to do some restorative things despite being overwhelmed, stressed and/or when all is well…
I like that image of picturing people/places you love and it bringing you peace…
Warmly,
Dorlee
Dorlee, I do hope Marianna drops back in to explain what she mean by “overcare” because I think I assumed she was talking about having lousy boundaries. Now you’ve got me wondering if I misunderstood!
Hello all,
I’m just starting out in my training as a counsellor/psychotherapist (haven’t decided the entire direction yet). Just finishing a 7 month starter course and about to move onto a degree. Finding the whole thing fascinating and so much more fulfilling than current work in IT.
I think burn out is in ‘every’ proffession, though those in helping or more self aware practices are much more likely to feel it, and personally, I think more likely to take on others burn out for them. I hadn’t heard of the gratitude list before, but will bring it up in class next time, to give those with essay stress and such a chance, not to mention those of us studying ‘and’ working!
An idea I often comment on, is getting back to nature (where possible). Even ten minutes just sitting in a park or near some greenery helps to ground you and relax the mind and muscles. Though there’s also the buzz word over here in England of ‘Mindfulness’ which I think could really be a good help against burn out!
Lovely to see so many friendly faces here at the beginning of my journey, keep safe all!
Lee
Welcome, Lee, to Private Practice from the Inside Out! Yes, I also find that getting back to nature – whether it’s hiking in Sawnee Mountain Preserve (like I did when I was in Georgia earlier this week) or just getting out in my garden – it all helps to reset the balance I need to keep working with trauma and grief.
My colleague, Marguerite McCormack, LPC often talks about the need for “reflexive self-care” as a choice that mental health professionals must consciously choose in order to manage the stresses that we face. Choosing to build time in every day for those acts of self-care whether out in the garden or, as Dorlee suggests, making that cup of hot tea, it is ultimately our responsibilities – not our colleagues’, not our bosses’, and not our clients’ – to manage our stress and choose lovingly to insure that we are each healthy and whole individuals.
Lee, thanks again for dropping in. I hope you’ll be back often to share your thoughts with us as we continue to build our online community here!
Hi Lee,
How exciting that you are entering our field of counseling/psychotherapy – I’m wishing the best of luck on your journey!
Yes, you are right that one may experience burn out in every profession; the unique experience or qualifier, if you will, to the burn out that therapists may experience is that they are there in an emotional way for their patients; they in essence act like a sponge for all the aches and pains and ills of their clients – something that in reality, is too much for one person to bear…which is why Jack Kornfield, a well-known buddhist psychologist, recommends that therapists often place various symbols of spirituality for themselves and their patients on the wall behind them so as to offer them that symbolic type of support. Those items may serve as a reminder to the therapist each day that he/she is only a tiny part of the huge universe and as much as we are there for our clients, we are not responsible for what has happened to them…
And yes, as you suggest, practicing mindfulness meditations and spending time in nature are wonderful ways of preventing burnout 🙂
Thanks so much for sharing your ideas ,
Dorlee
Oh, Dorlee! I do love this idea of strategically placing symbols of spirituality around the office to remind us that we are only a tiny part of the solution and not the whole solution! Did you get that from one of Jack Kornfield‘s books or did you hear him talk about this? Thanks so much for sharing that little nugget! You know it can be so ego-inflating to “help” people all day long, day after day, and hear about how helpful we are. That’s another one of those things that doesn’t get talked about much in graduate school, does it?
And, I appreciate your reference to supervision, too. I was just chatting with a woman earlier this week who was bemoaning “all the gatekeeping and roadblocks” (his words, not mine) that have kept her from getting licensed. She saw no benefit to clinical supervision or continuing education requirements, or licensing requirements. At the end of this conversation, I thought “How sad that she has had such lousy experiences and has skewed her perceptions in such a negative way.” Good clinical supervision can really set you off on a terrific journey and bad supervision can make it really difficult to make your way in mental health! (Of course, the other thing I thought is that if any of my supervisees had ever thought – much less said – such negative things, I think I would want to turn in my license!)
Tamara,
Regarding Marianna’s overcare comment, thanks so much for clarifying.
Your interpretation of “overcare” meaning boundaries makes a lot of sense… yes, that is an area where therapists may err and this could stem from lack of sufficient supervision, lack of sufficient awareness of countertransference feelings towards the client (the client may remind therapist of own child for example; hence therapist may take on more of a parental role) and other reasons.
And of course, when a therapist is doing this, the therapist is engaging in another activity that increases the scale on the burning out scale…
One of the antidotes for this would be to ensure sufficient supervision and to be honest about your feelings so as not to let your feelings interfere with your work with your client. This is something that every good therapist aspires to…
Thanks 🙂
Dorlee
Thanks, Tamara
I happened to be lucky in attending one of Jack Kornfield’s and Dan Siegel’s workshops this past April…please see http://www.dorleem.com/2011/05/10-take-aways-from-workshop-on.html for my post on it: 10 Take-Aways from Workshop on Neuroscience, Meditation & Health.
As for that woman, I don’t know what to say… if there is one thing that “I know for sure” (as Oprah would say) is that clinical supervision and continuing education are not only important but are critical for all clinicians.
Everyone, regardless of how skilled one may be, may have blind spots…(hence the need for supervision); and education – the clinical arena, like any other, is constantly evolving and changing… and I think it behooves every practitioner to keep up.
Thanks, Dorlee! I’m right there with you! After 20+ years in the field, I shudder to think how much I wouldn’t know (and how many mistakes I would have made) had I chosen to stop supervision, consultations, and continuing education in 1990!
Things I do to continue self care is to surround myself with friends both in and out of the counseling profession, have a variety of interests, and probably the biggest one for me is to KNOW WHEN TO SAY NO tactic so that I keep good professional and personal boundaries, and reminding myself that the other parts of my life (my relationship with God, and my family) are even more important than my career. Also, I find that it helps to have a varied caseload and also other interests within the area of our profession (ie writing, presenting, and yes. BLOGGING) help too.
Hi, Jill! Thanks for dropping in to continue the conversation here! It’s always good to hear from you!
I can really relate to knowing when to say “no.” Saying “no” to one thing is saying “yes” to something else! Early in my career, I thought I wanted all my clients to be dealing with grief-related issues and so I said “no” to anyone who wasn’t presenting with grief / trauma-related issues. What I didn’t realize is that I was saying “yes” to massive amounts of sadness and frustration to enter my office at my own expense. Eventually I learned that by taking on a greater variety of clients and issues, I achieved greater balance in my life. Once I learned that balance included who and what I invited into my professional life as well as my personal life, I changed what I said “yes” and “no” to!
Hi Jill,
Thanks for sharing all the things that you do and have found helpful in maintaining a healthy balance.
Yours idea of making sure to have a variety in both your friends and interests (professional and personal), as well as holding to healthy boundaries sound like great Rxs of self-care!
Best,
Dorlee
When I did my training for stress coaching, we learned about care versus overcare. Overcare can be explained as an over-identity or attachment to any number of things, people, places, pets and ideas.
Overcare depletes energy rather than restores it. It muddies the waters instead of clarifying them. It triggers the stress response.
Becoming aware of when one is in overcare, then knowing how to move into a more balanced state by balancing the nervous system is a practice that is beneficial, not only to oneself, but to everyone and everything in one’s environment.
The good news is that balancing the nervous system can be done wherever you are – with a client, in the pool, on the operating table (yes, that was me!) or driving. Once the techniques, which involve activating the power of the heart, are learned you can do them while slicing onions, showering or sharing a cup of coffee. Even while breathing. You have to breathe anyway, so why not make it count?
So many of the people I work with are chest breathers, an adaptation of chronic stress. (I was one!)
By spending moments here and there, as you go about your day, you begin to correct and even reverse some of the symptoms of stress, of which there are many!
This is the Reader’s Digest or Cole’s Notes version. I hope that it answers some of your questions, Dorlee and Tamara.
Marianna! Thanks so much for showing back up to explain. Are you trained in HeartMath? Is that where this concept comes from? I think I’ve heard someone else use the term “overcare” to mean this same thing. I dropped in to your website thinking you might have written about overcare but didn’t find anything. I do recognize how I have been most vulnerable to burnout when I have over-identified with a client or attachment to a particular outcome . . . when my boundaries have not been clear. And, yep! That stress response gets triggered and then I have found myself feeling worn out and used up . . . and in the midst of a great big pity party!
Overcaring. That’s not the language that I would have used but I think I get what you are saying. Thanks for presenting a new word and a different slant into our discussion! I hope you’ll be back to share your thoughts in the future!
Thanks so much, Marianna, for coming back to clarify what you meant by overcare. It certainly suggests being on the alert should one find oneself getting too attached…
I agree wholeheartedly with you about the importance of breathing evenly and slowly…this is also a key part of mindfulness meditation which is a lovely antidote to stress. Another positive benefit is that it may increase one’s self-awareness and self-compassion (critical skills for psychotherapists).
Warmly,
Dorlee
All of those ideas are great things to do for self care. Other things I would recommend are:
1) Establish and maintain clear boundaries with co-workers, clients, and people you collaborate with in regards to your availability.
2) Set limits on the amount of overtime you work each week. Its hard for us to say no to people in need, but unless its a true crisis it can wait until the next session or the next day.
3) Establish and maintain open and clear communication with your supervisor about your needs. Don’t be afraid to let them know if you need a break from more projects or extra assignments. They are there to help you succeed and have your best interest in mind.
4) Don’t be afraid to use sick time for a “mental health day”, if you need it. That doesn’t mean you have to be completely transparent about why your calling in sick. Keep it brief and don’t over explain. A simple “I’m not feeling well today and I need to take care of myself.” is enough. Don’t allow people to make you feel guilty about this!!!
5) Try to schedule your vacations at regular intervals such as every 3 months, etc. This will give you time to plan out your work schedule every quarter, and manage time efficiently in order to have your paperwork in on time.
6) Try to schedule a “paperwork day” every week so that you can catch up on tasks. This gives you a productive day away from clients.
7) Worse case scenario is to take a leave of absence if nothing else is helping. It could be that you suffer from compassion fatigue or secondary trauma which is much different than burnout. If this is the case, please consider the possibility that you may have to take a temporary break from the profession for a little while until you can heal your wounds. This is something I had to do for myself.
lovEternal! Welcome! I love your additions to the list! Your emphasis on boundaries really resonates with me. Making the choice to set limits on my work and my availability has certainly prevented me from struggling with the burnout that some of my colleagues have faced. And, the clearer I have gotten about what my needs are, the better I’ve been able to get them met – with time, money, rest, relaxation, etc.
Thanks so much for taking time to drop in here to chat! I hope you’ll be back often to join our conversations about building strong and vibrant businesses in mental health!
As a therapist in private practice, I find that I am subject to burnout when I do not structure my day to allow for unforseen occurrances. I try to get to the office at least 30 minutes to an hour before my first client arrives. That gives time for chart review on each client of the day; time to read, pray, and meditate; time to listen to music or inspirational tapes; and, time to get my office in order. I also allow enough time between client sessions to regroup, complete progress notes, make phone calls, etc. I try to complete all tasks of the day before I leave the office so that I am not playing catch-up the following day. Years ago, I would arrive at the office as the first client was arriving, schedule clients back-to-back, and not build in time for myself. I experienced burn-out as a result along with some health problems. Now that I am doing things differently, I am much less stressed and look forward to my day.
This is a helpful list of advice to remember that therapists need to take care of themselves. We often can forget about our own well-being because it is so important to us to help others. We’ve got to remember that we are more likely to be a better help to our clients when we are helping ourselves and practicing what we preach! Thank you.
Hi, Shannon! Thanks so much for dropping in this evening. And welcome to Private Practice from the Inside Out! I agree 100%! Wondering how you remember to take care of your while you are also taking care of others? And, how do you take care of you?
Hey, Shannon, I meant to tell you . . . . I just noticed that you don’t have a little picture of you next to your comments. You’re missing an opportunity to help people remember who you are. If you want to have a little picture of you show up in your comments, you can find out how right here. It’s really simple – I promise!