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Therapists: Do You Practice Self-Care?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

People often think therapists don’t have the same kind of problems the rest of us have.

They have all the coping mechanisms at their disposal, so they should be fine – right?

But the truth is that more than three-quarters of psychologists acknowledge experiencing distress in their personal lives. And almost forty percent say that it’s a problem, because it negatively impacts the care they provide to clients.

Psychologists, social workers, marriage and family therapists, and trainees are not immune to the routine struggles everyone else faces, whether it’s bills, financial difficulties, family members to care for, health issues, or something else.

Therapists who work with high-risk clients, in particular, are vulnerable to stress and burnout. For example, working with teens who struggle with substance abuse or suicidal ideation can be mentally taxing for some therapists. It can also be difficult expending so much time and mental energy with a client if a therapist doesn’t see marked improvement, or clients with alcohol or drug use problems relapse. Additionally, clients with behavioral issues (like oppositional defiance disorder, attention-deficit hyperactivity disorder, or disruptive mood dysregulation disorder) can become aggressive or violent, which can upset even the most stalwart professional.

There’s also the concept of vicarious trauma – also known as compassion fatigue or the cost of caring – which describes the phenomenon that occurs when therapists experience trauma from working with trauma survivors. Vicarious trauma is not the same as burnout, because it’s an acute state, but it’s real, and may contribute to burnout over time.

What Therapists Say About Burnout

In the paper “Creating a Culture of Self-Care,” co-authors Jeffrey Barnett and Natalie Cooper note the following:

Having a client attempt or commit suicide, dealing with a wide range of crises during the day…and experiencing emotional distress from clinical work with trauma patients can leave us feeling frustrated, overwhelmed, stressed, or upset.”

Granted, not everyone experiences clients committing suicide or observes co-workers in extreme emotional distress, but everyone who works deals with a certain amount of work-related stress.

Why can’t therapists just leave their clients’ struggles in the office, or block out their private concerns when they come to work each day?

Barnett and Cooper have a response:

“There is no clear line of demarcation between a therapist’s personal life and his or her professional one. Efforts to keep the challenges and stresses of our personal lives from impacting our professional work, and our professional work from impacting our personal lives, are most probably ineffective.”

If compartmentalization isn’t feasible for therapists, then what can they do?

Self-Care is the Answer

Over time, all therapists may feel the effects of burnout if they don’t regularly practice self-care. Self-care can be both preventative and a response to distress, but most experts agree that consistent self-care can prevent burnout.

It makes sense – and it’s not a new concept.

Here’s a piece of advice first-time mothers often hear:

You need to take care of yourself so you can take care of your baby.

With just one word change, this sage advice applies directly to therapists:

You need to take care of yourself so you can take care of your clients.

If therapists don’t take care of themselves, then they suffer the consequences, just like anyone else. But in the case of therapists – just like with new moms – they’re not the only ones who may suffer.

Their patients may suffer as well.

Symptoms of Burnout

All therapists should monitor themselves and their quality of care. Self-reflection is important to prevent distress and emotional exhaustion. Self-honesty is key: it’s easy to shrug away concerns and ignore the severity of certain stressors, but it’s neither helpful nor productive for therapists or their patients.

Dr. Barnett recommends watching for the following signs of burnout:

  • Wishing your clients would skip sessions
  • Daydreaming during sessions, finding it difficult to focus
  • Feeling tired all the time
  • Experiencing boredom or anger during sessions
  • Missing or canceling sessions
  • Feeling a need to end sessions early or arrive late
  • Violating boundaries with your clients
  • Self-medicating through substance abuse

When therapists see these signs in themselves, it’s time for self-care.

Here are some of his suggestions for self-care from the Society for the Advancement of Psychotherapy:

  • Socialize with family and friends
  • Maintain hobbies and outside interests
  • Exercise
  • Eat properly
  • Get clinical supervision
  • Seek out personal therapy
  • Schedule and participate regularly in pleasurable activities (just like you’d recommend to clients)
  • Take regularly scheduled breaks
  • Take vacations
  • Participate regularly in relaxing activities like meditation, yoga or reading

With that in mind, we encourage therapists to get up from the computer and participate in one self-care activity today. It can be something small, like a 20-minute yoga exercise or a nap. Or, it can be something bigger, like a massage or a night out with friends.

Whatever the choice, remember it’s not a luxury – it’s a necessity!

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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