Burnout

Running on Empty

3 tips to prevent therapist burnout.

Posted Mar 01, 2020

pixels
Source: pixels

Mental health professionals, specifically psychotherapists, are known to enter the mental health profession with the goal of helping others achieve the best versions of themselves. Psychotherapists encourage and assist in the facilitation of attitude and behavior modifications that lead to overall positive health and wellbeing—psychologically, physically and socially.

Despite therapists’ best efforts and intentions, under certain circumstances, they can fall prey to professional burnout, sometimes at the expense of providing substandard care to the populations they serve. Burnout is common among most helping professions; however, the rate of burnout among mental health professionals is significant and estimated to range between 21-67% (Morse et al., 2012).

Professional burnout among mental health professionals is best described by Maslach & Jackson (1996) and is commonly referred to as work-related stress that negatively impacts three core dimensions, including emotional exhaustion (feeling that there is nothing else to give), depersonalization (detachment from the client and decreased empathy), and reduced personal accomplishment (feeling incompetent and unsuccessful as a therapist).

Sometimes the beginning stages of professional burnout are difficult to detect. Regarding preventative interventions, it is best to intervene with a problem sooner rather than later, and always best to prevent a problem before it even starts. When it comes to professional burnout, the good news is mental health professionals can proactively intervene in ways that allow them to remain most effective to the populations they serve.

Preventative measures to avoid professional burnout have historically focused on self-care topics, including a balanced diet, sleep, exercise, as well as engagement in mindfulness-based activities (e.g., meditation, religious/spiritual coping). As mental health professionals, these self-care interventions are widely known, accepted and readily practiced to some degree. While it is important to implement self-care interventions on a regular basis to avoid burnout, the following is a shortlist of practices that may sometimes get overlooked, but are valuably necessary to facilitate stress-management and work balance among mental health professionals.

1. Embrace Limitations 

The demands placed on mental health professionals vary in scope and practice and can range from a variety of tasks, including emotionally laden therapy cases, lengthy medical record reviews, detailed health record documentation and billing, consultation with other medical professionals, as well as supervision, training and other administrative tasks. Depending on the mental health professional’s work setting, some of these demands may occur more frequently than others.

For example, individuals who work in managed care or public health sectors may be confronted with institutional demands and stressors not shared by their peers in private practice settings. Regardless of the work setting, there is always a demand for the mental health professional to give more and more of their time, energy, and effort—no matter how much they have already given.

Despite the pressure to give in to unyielding demands, along with requests to produce more in clinical practice, it is important for therapists to embrace their limitations, including accepting the reality that they cannot “do it all.” It is important for therapists to identify their own boundaries and limitations, and most importantly to operate within these frames to prevent overextending themselves to the point of exhaustion, lowered work-productivity and decreased job satisfaction.

2. Consult Peers

One benefit of graduate and post-graduate training programs is the availability of ongoing feedback and supervision opportunities, which are essential to professional development. Unfortunately, when mental health professionals enter the independent level of practice, clinical oversight, supervision, and consultation significantly decrease. Limited to non-existent peer and/or supervisory clinical support can lead to professional burnout over time. In the absence of peers and/or supervisory clinical support, therapists are expected to solve complex and ethically challenging cases alone.

While there may be some benefit to the therapist attempting to solve complex cases alone, including opportunities to exercise critical thinking and case conceptualization skills, this can become a highly stressful scenario when confronted with a large number of high-risk cases. The opportunity to consult on high-risk cases is critical to patient safety and in some cases consistent with sound ethical practice. Peer consultation not only benefits the therapist seeking feedback, but also the peer being consulted.

In a consultation scenario, both parties are afforded the opportunity to learn and grow together, including feeling they are not alone as well as feeling professionally trusted and supported. Peer consultation can occur in one-on-one or group settings, including monthly peer-to-peer consultation gatherings where selected cases are presented.

3. Engage in Professional Organizations 

The mental healthcare delivery system is constantly informed by new research and scientific advancements. As such, staying up-to-date on important developments in the field is critical to successful delivery of care and treatment outcomes. Opportunities to participate in continual education and professional supportive activities can be both fun and rewarding. Professional connections prevent the feeling of isolation within one’s practice, as well as provide opportunities for therapists to rejuvenate a sense of purpose and affirmation in their clinical work and overall contributions to the field.

Over time, it is not uncommon for a therapist to feel a bit rusty with a particular treatment protocol, assessment or conceptualization approach. Neither is it uncommon for a therapist to feel uncertain about complex ethical or legal concerns. Struggling with these matters in isolation can be overwhelming and surely lead to professional burnout overtime.

Alternatively, membership within professional organizations, such as national and state associations, affords valuable benefits, including continuing education opportunities as well as ethical and legal consultation services (in many cases at no financial cost). Additionally, professional organizations provide unique opportunities (e.g., conferences, trainings, continuing education) for mental health professionals to explore and learn new clinical skills to diversify their practice, including certification in a new therapy, for example. These are all wonderful benefits of creating a sense of professional community, peer support and career-long learning experiences that could serve as protective factors against professional burnout. 

Professional burnout among mental health professionals is considered high compared to other helping professions. These aforementioned tips to avoid therapist burnout are by no means exhaustive. They are intended, however, to highlight the importance of acknowledging the limitations and boundaries therapists operate within, the value of peer consultation and support, as well as the benefit of professional organization membership. Mental health professionals are sometimes considered superhuman in their capacity to care for and be present with others in need, but they too require personal and professional balance and support.

Copyright 2020 John A. Nelson, PsyD, MDiv 

References

Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach burnout inventory manual (3rd ed.). Palo Alto, California: Consulting Psychologists Press.

Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341-352. doi: 10.1007/s10488-011-0352-1