Despite trumpeting the importance of self-care to patients every day, clinicians struggle to practice what they preach. Mental health practitioners must juggle many important responsibilities, personally and professionally, so self-care is usually delegated to the bottom of the list of priorities. Unfortunately, this is occurring at the same time that clinicians are reporting higher levels of stress. Research shows the tendency for therapists to neglect themselves is becoming more prevalent in the mental health field. This tendency to devalue self-care can result in burnout; a condition more serious than the name implies. Burnout is described as emotional exhaustion, diminished self-efficacy, depersonalization, and reduced personal accomplishment. It can also lead to poor quality of life and is associated with other mental and physical health problems, including depression, headaches, and muscular pain. Therefore, we need to protect what we consider to be the most important therapeutic tool: ourselves.
Unfortunately, and unsurprisingly, this may result in negative treatment outcomes for our patients and decreases overall therapeutic effectiveness. In addition to a reduced level of care, practitioners are more likely to engage in inappropriate behavior that can be harmful to patients due to the practitioners’ own stress levels. In fact, some professional regulatory bodies even consider it mandatory to practice self-care as an ethical standard. Therefore, to provide effective care to patients, practitioners must be well themselves.
Interestingly, it appears that burnout prevention is more effective than reactive measures. A study conducted by Van Dam and his colleagues (2011) found that interventions in reaction to burnout demonstrated limited or no positive impact on the practitioner’s mental health. This tells us that it’s the clinicians’ responsibility to take a proactive approach to self-care. It’s unsurprising to learn that those clinicians whom researchers referred to as ‘master therapists’ reported prioritizing their self-care.
What is self-care and how can practitioners implement it into daily life? Below are some common descriptions:
- to refuel
- maintain oneself in healthy ways
- engaging in behaviors that promote emotional and physical wellbeing
- a caring attitude towards oneself
- self-reflection
- conscious action to seek out resources to fulfill needs and foster well-being.
- maintaining a sense of equilibrium in both professional and personal realms
- a healthy work-life balance
- avoiding high caseloads or
- fostering non-work-related interests
- limiting the scope of practice when coping with significant personal life events
- maintaining work and personal life boundaries
- using time management skills
- taking needed break
- setting realistic work goals mindfulness and meditation training to increase self-reflection capabilities
Therapy work is generally sedentary in nature so many practitioners report health concerns such as fatigue, insomnia, neck or back pain, headaches, and GI issues; therefore, physical health self-care is also vital. To combat these issues, researchers recommend engaging in sleep hygiene by getting ample sleep each night and maintaining a regular sleep schedule. Sleep hygiene techniques include:
- relaxing nightly rituals
- making one’s sleep environment restful
- avoiding going to bed thirsty or hungry
- a balanced diet
- regular physical activity at least several hours before bedtime to allow the body time to wind down
Self-care is mandatory, not a luxury, for mental health professionals. Therefore, we must take care of ourselves first. I find it helpful to remember what we are told to do in an emergency on a flight: put your oxygen mask on first before helping the people around you.
References:
Kaeding, A., Sougleris, C., Reid, C., Vreeswijk, M. F., Hayes, C., Dorrian, J., & Simpson, S. (2017). Professional burnout, early maladaptive schemas, and physical health in clinical and counseling psychology trainees. Journal of Clinical Psychology, 73(12), 1782–1796. https://doi.org/10.1002/jclp.22485.
Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Enhancing professionalism through self-reflection. Professional Psychology: Research and Practice, 48(3), 167–174. https://doi.org/10.1037/pro0000135.
Norcross, J. C., & Guy, J. D. J. (2007). Leaving it at the office: A guide to psychotherapist self-care [Adobe Digital Editions version]. Retrieved from https://ebookcentral.proquest.com
Posluns, K., & Gall, T. L. (2019). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International Journal for the Advancement of Counselling. https://doi-org.lib.pepperdine.edu/10.1007/s10447-019-09382-w
Thériault, A., Gazzola, N., Isenor, J., & Pascal, L. (2015). Imparting self-care practices to therapists: What the experts recommend. Canadian Journal of Counselling and Psychotherapy, 49(4), 379–400.
