Q: I’ve been a therapist at a community mental health center
for six years and I feel burned out—tired, unmotivated, questioning my ability
to effect change. What should I do?
A: Before therapists can get control
of burnout, they must get control of their attitudes about self-care and self-worth.
How many therapists take time to take stock of how well their personal lives are
going? Too often, they live life in FASDt forward, working long hours and nights
to accommodate clients’ needs, while ignoring their own. Let’s face
it, therapists dispense advice to clients about making time for themselves that
they themselves don’t take. So here are some tips on what therapists can
do to treat themselves better and avoid or overcome burnout.
Self-Assessment.
Take a personal inventory of your risk for burnout. Do you: 1) see multiple clients
without taking a break (not even a bathroom break); 2) feel inadequately trained
or like you stay with the same old stuff when it doesn’t work; 3) feel isolated;
4) have unrealistic expectations; and 5) put your clients’ needs before your
own? And the most important self-assessment question of all, are you happy? If
the answer is no, it’s time to determine a course of action by following
some of the steps below. Prepare a Mission Statement. Many therapists
who experience burnout feel as if they’ve lost their way and that nothing
they do is good enough. Developing a mission statement that encapsulates the passion
and conviction that led you into therapy to begin with can help you rediscover
the personal meaning in your work And knowing why you do what you do is a great
boost to self-appreciation, self-acknowledgment and self-validation.
For example, after lots of thought about my passion and conviction, I wrote that
my mission is: “to promote social justice through consciousness-raising of
such issues as race, class, gender, sexual and orientation. Toward this end, I
strive to empower clients to be self-knowledgeable, self-accepting and self-loving,
so that they can make a claim for themselves in relationships.”
Commit to Self-Care. Recognize the sacredness of taking care of you. Choose
something positive that works for you.
Exercise; do mental exercise,
such as self-reflection and meditation; have a cup of really good coffee; sit
down to breakFASDt; pay yourself compliments or listen to your favorite music.
Center yourself before taking on the challenges of the day. One of the most successful
women in America, Oprah Winfrey, doesn’t leave home without feeding her spirit.
She watches the sunrise with a cup of her favorite coffee as she contemplates
her day. I listen to gospel music as I walk for an hour on my treadmill.
Don’t stay in bed hitting the snooze button on your alarm clock. Get up and
take charge of your life. Ask yourself what you would do if you were in love with
the most wonderful person in the world—you—and then do it.
Shoulds cause us to lose sight of our own needs. I don’t have an open-door
policy at work, although some colleagues think they should. Keeping my door closed
lets me focus on my own priorities and give my undivided attention to those I
schedule appointments with. The closed door also reminds me of the importance
of my own needs.
Another aspect of self-care is quiet time. Every therapist
needs intentional silence at least once a day. Close your door for 15 minutes
of silence each day. Wiggle your toes and burn a scented candle.
Take
regular breaks. If you work on the 50-minute hour, don’t let clients
use up your 10-minute transition period writing checks or asking last-minute questions.
Ask them to make out checks ahead of time. Or stop 20 minutes before the hour
so they can have their 10-minute check-writing ritual and you can have your break.
Make time for lunch. I don’t have a specific lunch time every
day, but I plan special lunch dates with “moi.” Having a three-course
lunch in a wonderful restaurant is an automatic deposit in my self-worth bank
account.
Meditate or pray throughout the day. Take a few minutes
to repeat a prayer at your desk or to relax with the soothing image of blue-green
water in Aruba and the warmth of the sun. Another way of lightening your mood
is to write a letter of self-appreciation or self-affirmations that you can pull
out when you need to recharge.
Stay connected with friends. Isolation
is a major cause of therapist burnout. Two black female therapists I know in Philadelphia
recognized their need for sister-therapist support, given the added stressors
of racism and sexism in the workplace, and formed a black women therapist support
group. I have a buddy system with a therapist. We call on each other when we’re
feeling down on the job or need advice on a given case. Personal connections help
you deal with work stress, so it doesn’t become a private hell.
Since men are often socialized to keep silent about their troubles, male therapists
might find it more difficult to seek support. Try journaling. It frees you from
keeping thoughts and feelings concealed inside of you and connects you to a deeper
part of yourself.
Do something special for yourself before you go
to bed each night. I end my day with a steaming-hot cup of Earl Grey tea.
I associate hot tea with my grandmother and the special feeling of home and love
that I got from her, so I go to sleep surrounded by her loving presence.
Structure and organize yourself with a schedule. Create a schedule that
helps you manage your time effectively and incorporates self-care into each day.
For example, if you see clients at different locations, plan to see those in the
same area of town on the same day. That will save you excess physical and mental
fatigue and allow you to be more productive.
Burnout leads to unjust
relationships. It’s not selfish to make your needs a priority. It’s
just. Don’t be afraid to switch the order of your priorities and make you
first and the client second. Decide in advance how many nights you’re willing
to work. When you’ve filled all those evening hours, refer clients or establish
a waiting list. But don’t sacrifice your needs by breaking your own rule.
You deserve a life, too.
Personal
Reflection Exercise #2 The preceding section contained information about
getting unstuck and learning to heal the healer. Write three case study examples
regarding how you might use the content of this section in your practice.
Update
Passionate Healthcare Workers
in Demanding Intensive Care Units:
Its Relationship with Daily Exhaustion, Secondary
Traumatic Stress, Empathy, and Self-Compassion
Moreno-Jiménez, J. E., Demerouti, E., Blanco-Donoso, L. M., Chico-Fernández, M., Iglesias-Bouzas, M. I., & Garrosa, E. (2022). Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion. Current psychology (New Brunswick, N.J.), 1–16.
Peer-Reviewed Journal Article References:
Bocian, B. (2020). Fear, self-support, and “good introjects”. The Humanistic Psychologist, 48(4), 363–368.
Butler, L. D., Carello, J., & Maguin, E. (2017). Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 416–424.
Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25(2), 72–81.
Wartski, S. (2020). Ode to self-care. Families, Systems, & Health, 38(3), 327–328.
QUESTION
9 What is the most important self-assessment question? To select and
enter your answer go to Test.