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Section 9
Self-care for Secondary Traumatic Stress

Question 9 | Test | Table of Contents

Q:  I’ve been a therapist at a community mental health center for six years and I feel burned out—tired, unmotivated, questioning my ability to effect change. What should I do?

A: Before therapists can get control of burnout, they must get control of their attitudes about self-care and self-worth. How many therapists take time to take stock of how well their personal lives are going? Too often, they live life in FASDt forward, working long hours and nights to accommodate clients’ needs, while ignoring their own. Let’s face it, therapists dispense advice to clients about making time for themselves that they themselves don’t take. So here are some tips on what therapists can do to treat themselves better and avoid or overcome burnout.

Self-Assessment. Take a personal inventory of your risk for burnout. Do you: 1) see multiple clients without taking a break (not even a bathroom break); 2) feel inadequately trained or like you stay with the same old stuff when it doesn’t work; 3) feel isolated; 4) have unrealistic expectations; and 5) put your clients’ needs before your own? And the most important self-assessment question of all, are you happy? If the answer is no, it’s time to determine a course of action by following some of the steps below.

Prepare a Mission Statement. Many therapists who experience burnout feel as if they’ve lost their way and that nothing they do is good enough. Developing a mission statement that encapsulates the passion and conviction that led you into therapy to begin with can help you rediscover the personal meaning in your work And knowing why you do what you do is a great boost to self-appreciation, self-acknowledgment and self-validation.

For example, after lots of thought about my passion and conviction, I wrote that my mission is: “to promote social justice through consciousness-raising of such issues as race, class, gender, sexual and orientation. Toward this end, I strive to empower clients to be self-knowledgeable, self-accepting and self-loving, so that they can make a claim for themselves in relationships.”

Commit to Self-Care. Recognize the sacredness of taking care of you. Choose something positive that works for you.

Exercise; do mental exercise, such as self-reflection and meditation; have a cup of really good coffee; sit down to breakFASDt; pay yourself compliments or listen to your favorite music. Center yourself before taking on the challenges of the day. One of the most successful women in America, Oprah Winfrey, doesn’t leave home without feeding her spirit. She watches the sunrise with a cup of her favorite coffee as she contemplates her day. I listen to gospel music as I walk for an hour on my treadmill.
Don’t stay in bed hitting the snooze button on your alarm clock. Get up and take charge of your life. Ask yourself what you would do if you were in love with the most wonderful person in the world—you—and then do it.

Shoulds cause us to lose sight of our own needs. I don’t have an open-door policy at work, although some colleagues think they should. Keeping my door closed lets me focus on my own priorities and give my undivided attention to those I schedule appointments with. The closed door also reminds me of the importance of my own needs.

Another aspect of self-care is quiet time. Every therapist needs intentional silence at least once a day. Close your door for 15 minutes of silence each day. Wiggle your toes and burn a scented candle.

Take regular breaks. If you work on the 50-minute hour, don’t let clients use up your 10-minute transition period writing checks or asking last-minute questions. Ask them to make out checks ahead of time. Or stop 20 minutes before the hour so they can have their 10-minute check-writing ritual and you can have your break.

Make time for lunch. I don’t have a specific lunch time every day, but I plan special lunch dates with “moi.” Having a three-course lunch in a wonderful restaurant is an automatic deposit in my self-worth bank account.

Meditate or pray throughout the day. Take a few minutes to repeat a prayer at your desk or to relax with the soothing image of blue-green water in Aruba and the warmth of the sun. Another way of lightening your mood is to write a letter of self-appreciation or self-affirmations that you can pull out when you need to recharge.

Stay connected with friends. Isolation is a major cause of therapist burnout. Two black female therapists I know in Philadelphia recognized their need for sister-therapist support, given the added stressors of racism and sexism in the workplace, and formed a black women therapist support group. I have a buddy system with a therapist. We call on each other when we’re feeling down on the job or need advice on a given case. Personal connections help you deal with work stress, so it doesn’t become a private hell.

Since men are often socialized to keep silent about their troubles, male therapists might find it more difficult to seek support. Try journaling. It frees you from keeping thoughts and feelings concealed inside of you and connects you to a deeper part of yourself.

Do something special for yourself before you go to bed each night. I end my day with a steaming-hot cup of Earl Grey tea. I associate hot tea with my grandmother and the special feeling of home and love that I got from her, so I go to sleep surrounded by her loving presence.

Structure and organize yourself with a schedule. Create a schedule that helps you manage your time effectively and incorporates self-care into each day. For example, if you see clients at different locations, plan to see those in the same area of town on the same day. That will save you excess physical and mental fatigue and allow you to be more productive.

Burnout leads to unjust relationships. It’s not selfish to make your needs a priority. It’s just. Don’t be afraid to switch the order of your priorities and make you first and the client second. Decide in advance how many nights you’re willing to work. When you’ve filled all those evening hours, refer clients or establish a waiting list. But don’t sacrifice your needs by breaking your own rule.

You deserve a life, too.

Personal Reflection Exercise #2
The preceding section contained information about getting unstuck and learning to heal the healer. Write three case study examples regarding how you might use the content of this section in your practice.

Update
Passionate Healthcare Workers
in Demanding Intensive Care Units:
Its Relationship with Daily Exhaustion, Secondary
Traumatic Stress, Empathy, and Self-Compassion

Moreno-Jiménez, J. E., Demerouti, E., Blanco-Donoso, L. M., Chico-Fernández, M., Iglesias-Bouzas, M. I., & Garrosa, E. (2022). Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion. Current psychology (New Brunswick, N.J.), 1–16.

Peer-Reviewed Journal Article References:
Bocian, B. (2020). Fear, self-support, and “good introjects”. The Humanistic Psychologist, 48(4), 363–368.

Butler, L. D., Carello, J., & Maguin, E. (2017). Trauma, stress, and self-care in clinical training: Predictors of burnout, decline in health status, secondary traumatic stress symptoms, and compassion satisfaction. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 416–424.

Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25(2), 72–81.

Wartski, S. (2020). Ode to self-care. Families, Systems, & Health, 38(3), 327–328.

QUESTION 9
What is the most important self-assessment question? To select and enter your answer go to Test.

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