By: John Codd, LCSW, CADC, ATE, PEL

Conducting therapy during a pandemic has added an unforeseen level of stress upon therapists. Research has linked job stress to heart disease, ulcers, depression, anxiety, dissatisfaction, tension and low-self esteem. Therapist burnout produces a sense of emptiness, aloneness, frustration, failure and fatigue.

Guy (1987) suggests that reducing stress while taking proactive steps to rejuvenate therapists on an ongoing basis is the most useful in preventing and treating burnout. Therapists self care means taking an active role in one’s life to reduce personal and environmental stressors that may impact the professional life.

Self-care includes:
Self-monitoring and awareness of a problem, identification of stressors, accurate appraisals of transactions with the work environment, commitment to action and acquiring or enhancing personal coping resources. It is important to have a variety of self-change skills and one should embrace multiple strategies.

Self-Awareness:
Self-awareness is central to preventing burnout. One of the most important steps in managing burnout is recognizing the signs. One needs to know when they feel stressed and when it is time to seek help. Awareness of how one tends to respond to stress also provides a database against which to measure change and growth. Self-awareness is the first step in self-care that combats burnout.

Physical Health:
Improving and maintaining one’s physical health is an important part of self-care. When one is operating under optimal physical and psychological health, one is better able to handle the stress of providing therapy. Physical health and exercise, as well as adequate opportunities for rest and relaxation are essential for maintaining a sense of stability and well-being. Therapists have demanding jobs and it is important to have time for recharging, rest and relaxation. Relaxation reduces fatigue and aches, decreases stress responses, replenishes energy, enhances the ability to sleep soundly and facilitates an overall sense of calmness and well-being. Research indicates that exercise and relaxation are effective in reducing burnout among therapists.

Leisure Activities:
Balancing professional activities with a life outside of work is an important form of self-care. Therapists often do not receive direct feedback and gratification from their work. Therefore, it is essential to have sources of gratification other than work. Taking part in an enjoyable activity replenishes one’s energy, reduces tension and makes relaxation easier.

Coping Strategies:
Individuals with adequate coping strategies are less likely to burn out. Coping strategies are the “ability to draw on emotional, physical, and social resources that allow one to avoid the adverse impact of stress” (Patrick, 1981, p. 46). When dealing with burnout, one may need to engage in direct coping strategies: confronting the source of stress, changing oneself and changing the environment. Some concrete coping strategies include: reappraisal of goals, time management, acknowledging vulnerabilities, compartmentalizing life and work, self-reinforcement and a change of attitude. Self-assertion and conflict resolution skills may also help with stress from interpersonal relationships.

Support Network:
Social expression of emotions decreases the isolation and loneliness that often result from burnout. Emphasizing the interpersonal element in one’s self-care and utilizing various helping relationships seems to be beneficial. Healthy friends and family are an extremely important support to have. Seeking personal therapy is also a method of gaining support that a majority of therapists engage in.

Cognitive Factors:
Individuals with an external locus of control may be more susceptible to burnout than those with an individual locus of control as they take a more active stance. Goal setting can also help reduce burnout because it acknowledges personal accomplishments. Therapists should avoid wishful thinking and self-blame wherever possible. Wishful thinking reduces problem solving and accentuates distress; self-blame causes more distress and may paralyze the therapists’ adaptive resources.

Resources

Guy, J. D. (1987). The personal life of the psychotherapist. Toronto: John Wiley & Sons, Inc.

Maslach, C. (1986). “Stress, burnout, and alcoholism.” (53-76) In R. R. Kilburge, P. E. Nathan, & R. W. Thoreson (Eds), Professionals in distress: Issues, syndromes and solutions in psychology (53-76). Washington, DC: American Psychological Association, Inc.

Muldary, T. W. (1983). Burnout and health professionals: Manifestations and management. Garden Grove, CA: Capistrano Press, Ltd.

Norcross, J. C. (2000). Psychotherapist self-care: Practitioner-tested, research-informed strategies. Professional Psychology: Research and Practice, 31, 710-713.

Patrick, R. K. S. (1981). Health care worker burnout: What it is, what to do about it. Chicago, IL: Blue Cross Association.

Whitfield, M.D. (1980). Emotional stresses on the psychotherapist. Canadian Journal of Psychiatry, 25, 292-296.