How Can a Therapist Prevent Burnout?

In a previous blog post entitled Which Therapists Are More Likely to Burnout, I surveyed some of the reasons for therapist burnout, including both institutional (type and amount of caseload, lack of supervisor support, work environment) and personal factors such as history of personal trauma. Some counseling settings are so burdensome that no amount of self-care can counter the high potential for burnout in such environments. Yet, scholars have found at least two personal practices that may help serve as a buffer for burnout for therapists working in reasonable conditions.

Source: Mental Health America

Social Support

Zell and Stockus, in a synthesis of 60 meta-analyses which included 2,700 studies and 2.1 million participants, found that social support helps improve mental health (depression, PTSD, stress) and protects from burnout, and this was true across age, gender, and ethnicity. This coincides with a study we conducted with Black mental health professionals (MHP) where we found those with higher levels of social support, defined as having friends, family, or a partner who they emotionally rely on, were significantly less likely to experience burnout or racial trauma. In this study of 182 counselors and psychologists, female health professionals suffered much less burnout and racial trauma symptoms than did male health professionals, which may in part be due to the female participants on average having significantly higher levels of social support.

Maslach noted that racially minoritized persons tended to suffer from burnout less than White persons, a finding we saw within our studies on mental health and school counselors as well. Maslach believed this may be due to persons of color having thicker social support networks and utilizing those support systems better. Like many helping professionals, therapists are more comfortable providing emotional support than asking for or receiving it from others. Being able to create a thick support system and utilizing it, not only during times of crisis but in one's week-to-week existence appears to be essential for personal and professional well-being. Yet, social support can be enhanced with at least one form of self-support to increase one’s well-being.

Self-Compassion

Multiple researchers have found self-compassion, as defined through the work of Kristin Neff, to potentially be a protective factor for burnout. A meta-analysis involving 14 studies concluded that persons with higher rates of self-compassion tended to suffer less from depression, anxiety, and stress. Another meta-analysis of 79 studies, with a collective sample size of 16,416 participants, found that self-compassion had a strong relationship with cognitive and psychological well-being. A third meta-analysis of 60 studies found a positive relationship between self-compassion and self-efficacy, a construct that protects from the feelings of reduced accomplishments that are at the core of burnout. This may be the reason why more than 20 different studies have shown that self-compassion may guard mental health professionals from burnout.

Source: Askar Abayev/Pexels

Self-compassion is not synonymous with what is usually considered self-care. It is not about what we do after work hours, but what we do and say to ourselves in moments of discouragement, pain, or distress. Psychologist, Kristen Neff, defines self-compassion as having three basic elements:

1. Self-kindness vs. Self-judgment. Instead of berating ourselves with criticism we want to be kind and understanding in our self-talk to ourselves, contextualizing our struggles in the same way we would our clients.
2. Common Humanity vs. Isolation. This is where we weave the story of our pain, disappointments, or feelings of failure into the larger narrative of human suffering. Pain and struggle tend to leave us feeling isolated, and a recognition of “common humanity” seeks to combat this head-on. Just as we remind our clients, we need to remind ourselves that many clinicians experience disappointment in their work.
3. Mindfulness vs. Over-identification. Here we practice non-judgemental awareness, which allows us to resist either becoming enmeshed with our suffering or avoiding it. Mindfulness helps us to metabolize our suffering while not being overwhelmed by it.

Perhaps there is a symbiotic relationship between self-compassion and social support. We learn how to better suffer with ourselves as we experience others' compassion for us. Likewise, as we grow in our ability to practice self-compassion we are better able to invite others into our lives without overburdening our loved ones, a fear many therapists may have.

Work environments that are too underfunded or unhealthy cannot be compensated by individual mental or social practices. It has been said that we cannot self-care our way out of the effects of toxic environments. But as we learn to practice compassion with ourselves and learn to receive support from others within our communities our well-being will increase, which will lead to further professional resilience if our work environments are not too burdensome.