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Key points
- Sustainable practices help therapists maintain balance without self-compromise.
- Early recognition of burnout signs is key for career longevity.
- A healthy financial mindset is an important but overlooked aspect of therapist sustainability.
- Simple reflections on what energises or drains therapists can lead to significant improvements in well-being.
As a therapist, the idea of a sustainable career seems elusive, as burnout is often the norm.
In fact, disbelief is the most common response Rebecca Black, a clinical psychologist and sustainability coach, receives when she tells therapists it is possible to be a therapist and work in a way that is sustainable and fulfilling.
The concept of sustainability has become more prominent in the last few years, particularly for therapists and health professionals, because the pandemic brought burnout to the forefront.
Rebecca is living proof that sustainable practice is possible, having cured her chronic illnesses and revitalised her professional life.
And now, through coaching and group programs, Rebecca helps other therapists create balanced, sustainable, and enriching careers as therapists.
As a therapist who is a little sceptical about the possibility of a burnout-free career, I sat down with Rebecca and asked her all about sustainability and how to implement sustainable practices as a therapist.
The article below is based on the interview and Rebecca’s answers.
Sustainability in Therapy
Sustainability encompasses several aspects, including the ability to maintain activities over time, while causing minimal or no harm in the process. Rebecca defines sustainability when applied to therapists as an ability "to maintain their workload and their lifestyle at a stable level over time without compromising themselves.”
Challenges That Therapists Face
Rebecca explains that therapists face unique challenges when working sustainably. One challenge involves individual factors, and the other involves the environmental or systemic factors at play. Using a schema therapy framework, she highlights, "We all have patterns or schemas, and therapists typically have a trifecta of unrelenting standards, self-sacrifice, and approval-seeking," This trifecta can severely affect a therapist's ability to maintain balance, leading to emotional and physical exhaustion, and straining both personal and professional relationships.
Environmentally, there is an intergenerational passing down of practices that normalise burnout in the mental health profession, which further complicates this issue, making burnout a systemic problem.
Signs of Burnout
Burnout among therapists can manifest in various symptoms, including feeling fatigued or feeling wired but tired, struggling to slow down and relax, emotional exhaustion or compassion fatigue, irritability, general stress and overwhelm regarding daily tasks, dreading going to work, a lack of excitement and passion, and even physical ailments such as headaches and IBS-like symptoms. "If you're getting home and you're so exhausted," Rebecca says, "it’s indicating that you're definitely not in a sustainable place."
If our nervous system is in a continually heightened state, it can take no fewer than several days for it to return to being regulated. Rebecca observes that clients often don't realise how dysregulated their nervous system has been until they return from a long holiday. “And so there's this awareness of what their body's meant to feel like and it feels nothing close to that in their normal day-to-day life.” As a result, therapists often have an epiphany that something needs to change.
Emphasising Awareness for Sustainability
Self-awareness and understanding one's own needs, and then responding to those needs, are the foundational elements for therapists aiming for sustainability. Rebecca explains the importance of starting with simple reflections. It’s about tuning into ourselves and asking, "What do I enjoy? What lights me up?" as well as learning, "What drains me? What do I dread?"
She highlights how integrating small changes towards the former and away from the latter, such as walking and adjusting client schedules, has made significant improvements in her and her clients' well-being. These manageable steps demonstrate that achieving sustainability doesn't require overwhelming transformations, but rather thoughtful, deliberate changes.
Nourishing the Nervous System
Rebecca also notes that as therapists, we often don’t spend time taking care of our nervous systems in the way that we truly need. She stated that “because of the schema therapists hold, and the high demands that are placed upon us, we’re often focused on prioritising tasks and achievement as well as meeting other people’s needs, and so our own needs and nervous system care are placed at the bottom of the list or often forgotten about.”
Without a regulated nervous system, we can’t reach sustainability. Making simple changes in this space, such as focusing on one’s own breathing more regularly, using mindfulness or meditation to become present, or making space for soothing and compassionate imagery, are all aspects Rebecca helps therapists reconnect with.
Enhancing Time Management and Financial Health
Rebecca highlights the significance of effective time management in achieving sustainability. She suggests a practical approach: a "time audit" to evaluate and optimise daily schedules. For example, "If you know that walking helps you feel better and you want to incorporate that into your life but feel you don't have the time, we can discuss where you are spending your time and what we can adjust," she explains. This method enables individuals to identify time sinks and reallocate those moments towards more fulfilling activities. As Rebecca states, “It might seem small, but it all adds up.”
Financial security is another important element for therapist sustainability, yet the stigma surrounding therapists earning money often overshadows it. "If your bank account is suffering, your sustainability will suffer too." This connection between financial health and professional sustainability highlights the need for therapists to create a healthy relationship with money so that their relationship with money supports rather than detracts from their well-being.
Broader Implications
Looking toward the future, there's hope for systemic changes that promote sustainability from the onset of a therapist's career.
Rebecca’s vision for mandated free therapy in academic settings could greatly benefit future mental health professionals, so they can address patterns such as unrelenting standards, self-sacrifice, and approval-seeking before beginning their clinical roles: "It’s about how we can practice as therapists in a way that works for us...that’s my dream," she says, aiming for a profession that values therapist well-being as much as client care.
