When Therapists Experience Burnout

What is burnout?

Burnout is a state of physical, emotional, and mental exhaustion caused by exposure to long-term stressors in one’s profession.

Dr. Christina Maslach, a burnout expert and a professor at the University of California-Berkeley, is the creator of the Maslach Burnout Inventory. In her research, she finds that burnout is particularly common in professionals who work with people. Doctors, therapists, nurses, policemen, teachers, ministers, prison officials, immigration officials, and caregivers – including mothers – all fall into this category.

Why is burnout more common in these help-oriented professions?

Mainly because, Maslach writes, these types of jobs focus on problems. The clients come to the professional when they are sick, depressed, anxious, or in some other state of distress or need. The mental health profession, after all, revolves around problems. A lack of positive feedback and high emotional stress also characterizes many of these professional interactions.

There are three key components to burnout:

  1. Overwhelming exhaustion
  2. Feelings of cynicism and detachment from the job
  3. A sense of ineffectiveness and lack of accomplishment

These things can happen to anyone in any job, but they happen in the helping professions more frequently than others.

Why Does Burnout Happen?

Here are three theories about why burnout occurs. Doing too much. Maslach writes, “One theory is that it is the best and most idealistic workers who experience burnout – as captured in the common phrase, ‘You have to have been on fire in order to burn out.’ The notion here is that such dedicated people end up doing too much in support of their ideals, thus leading to exhaustion and eventual cynicism when their sacrifice has not been sufficient to achieve their goals.”

  1. Doing too much. Maslach writes, “One theory is that it is the best and most idealistic workers who experience burnout – as captured in the common phrase, ‘You have to have been on fire in order to burn out.’ The notion here is that such dedicated people end up doing too much in support of their ideals, thus leading to exhaustion and eventual cynicism when their sacrifice has not been sufficient to achieve their goals.”
  2. Chronic job stress. Working with high-risk clients can be stressful, especially if clients are suicidal, victims of trauma, or are aggressive and/or violent.
  3. Overload. This is similar to doing too much. When there are too few resources and too much demand, this can cause overload on the staff. For example, some mental health treatment centers have a low staff-client ratio. Because there isn’t enough staff, caseloads are high. Therapists treat more clients than they can physically or emotionally handle. This can cause burnout.

Experiencing Burnout                  

So what do you do if you experience signs of burnout?

Alyson Orcena, LMFT, program director at Evolve Vanalden (a comprehensive residential treatment center that specialized in Dialectical Behavioral Therapy, a.k.a. DBT) says the most important thing to do is talk about it with your supervisor.

“Acknowledge burnout when you see signs of it increasing. Problem solve with your team or supervisor on how to manage it,” she says.

Your supervisor might be able to help in several ways. If the stress comes from overload, perhaps they can lighten your workload. If you think a vacation would help, ask for time off. Whatever you do, don’t ignore your burnout and keep working. Not only does that not fix the problem, it’s harmful for you and your clients.

The American Psychological Association (APA) states that therapists must “strive to be aware of the possible effect of their own physical and mental health on their ability to help those with whom they work.” When problems or conflicts arise in a clinician’s personal life, the APA directs them to take appropriate measures such as asking for professional supervision or consultation, and – if that doesn’t help – considering limiting or terminating one’s clinical practice.

Self-Care Prevents Burnout

To prevent burnout from occurring in the first place, Orcena has a few suggestions for self-care.

First, maintain a daily mindfulness practice. A few minutes of yoga or meditation when you wake up can make your whole day look so much better. The same goes for mindfulness at midday or in the evening: a few minutes can make a big difference.

It’s also important to try and disconnect from work when you’re not on the clock.

“That means not checking email constantly and not spending a lot of time thinking about work or worrying about your teen clients,” Orcena advises.

You can also make time to engage in activities outside of work that are enjoyable. Leave work on time, have dinner with friends, get some takeout and plop yourself on the couch – whatever it is, the only requirements are that you enjoy it and it’s not work.

Finally, Orcena emphasizes the need to get enough sleep. Sleep deprivation can mimic the symptoms of burnout. If you’re not sleeping well, you might be moody, tired, and find it hard to concentrate on your clients or give them your full energy. This can lead to negativity, cynicism, frustration, and in some cases, anger. To maintain optimal performance, therapists should make sure they come to work every day well-rested.

Give Yourself a Break

Dr. Jeffrey Barnett, a researcher on self-care, often reminds therapists that no one is perfect. There’s no shame in admitting that you’re experiencing burnout.

“Accept that you’re human, in need of assistance, and a work in progress. Don’t try to be perfect, to have it all, or to do it all. Know your limits and be realistic. Strive for balance (a moving target and aspirational goal at best)!”