Counselor Self-Care Practices

Guest Post: Hollie L. Hancock, M.S., CMHC

Reflect on how well you take care of your own needs. Help me learn more by filling out a counselor self-care practices questionnaire.

While attending an ethics conference last week, I took the opportunity to solicit participation from my fellow counselors and psychotherapists for my dissertation research.  As I described the study, and as the words “counselor self-care” crossed my lips, a loud and obvious laugh erupted from various corners of the large ballroom where the conference was being held.  From the front of the room I saw people looking at one another, laughing, and rolling their eyes; I even read the lips of one man in the front row as he said to the woman next to him, “Yeah, right!”

Honestly, I was not surprised.  In fact, I almost expected this type of response.  The laughter, snickers, and side-ways comments are exactly the reason I am researching counselor and psychotherapist self-care practices.

As therapists, we use our education, training, and skills to help patients live more rewarding and healthy lifestyles, independently.  Ironically, many therapists seem reluctant to offer themselves the same kind of understanding and care.  Yet, in reality, it is this self-care, both personal and professional, that ultimately is the most important, not just for patients, but also for we as therapists as well.  It is quite possible that mental health professionals are one of the few professions that does not purchase or utilize their own product.

Lack or absence of self-care practices among mental health professionals appears to be almost synonymous with compassion fatigue and burnout.  The literature seemingly suggests that by mentioning self-care – counseling professionals are burned out or experiencing compassion fatigue to some degree.  Do a small research study of your own: Conduct a Google search using the words “counselor self-care”.  You are likely to find half of the top results include the word “burnout”.

Participate in my dissertation research on counselor self-care practices

In an effort to understand the possible phenomenon of the lack of self-care practices among counselors and psychotherapists, I am asking colleagues across the nation and even around the world, to provide responses to a brief questionnaire created for my dissertation research.  Therefore, you are cordially invited to participate in a study that will ask questions about your experiences with self-care practices as a counselor or psychotherapist. This inventory is called The DEFT Questionnaire. “DEFT” represents what counselors and psychotherapists “do” for self-care, how they “experience burnout”, how they “feel” about their self-care practices, and finally what counselors and psychotherapists “think” about self-care. The purpose of this study is to explore whether or not there is a correlation between self-care practices and burnout among counseling professionals.  Completing the questionnaire will take about 15 minutes of your time.

To be better clinicians in our roles as counselors and psychotherapists, we owe it to our patients, and more importantly ourselves, to be aware of our self-care needs, and adjust our behaviors accordingly if necessary to avoid impairment, burnout, compassion fatigue, and even post traumatic stress disorder.

I have provided the link to the questionnaire below.  I respectfully ask that you take 15 minutes of your time to complete the questionnaire.  Then, please share the link with your peers and colleagues.  I thank you in advance for contributing to the body of literature available regarding counselor self-care practices!

Fill out the counselor self-care survey here:

https://acsurvey.qualtrics.com/SE/?SID=SV_cvWrM4l8iqBWU1D

The questionnaire will be available until March 31, 2013

Hollie L. Hancock, M.S., CMHC is in private practice at Iron Mountain Counseling is a Doctoral Candidate in Counseling Psychology, Argosy University, Salt Lake City, UT

Adventures in Private Practice: Psychotherapist Diane Spear, LCSW

Get to know New York City licensed clinical social worker and psychotherapist Diane Spear, LCSW-R.

Tell us a little about your practice...

I’m a licensed clinical social worker in private practice over sixteen years. I treat people from older adolescents to senior citizens, in individual and couples sessions.  My practice approach can be described as psychodynamic, interactive, and reality-based, so I’m dealing with how a patient’s formative years affect his/her current conscious and unconscious attitudes about love, work, and play, so that they can build on what works and rethink what doesn’t in order to have a more satisfying life going forward.

Why did you decide to open a private practice?

I decided to open a private practice because I like the flexibility and autonomy of working when I want, setting my own fees, working with a theoretical orientation I find helpful, and choosing a supervisor whose way of working is compatible with mine.

What have you learned from your toughest clients?

What I’ve learned from my toughest patients—and my wonderful supervisor, Dr. Ed Campbell—is that they get to be crazy till they’re ready to listen, and that my responsibility is to “put it out there” consistently and to work hard at doing that, but that I’m not responsible for whether or not they are willing to take it in and use it consistently or at all.  That was enormously freeing!  And a great way to avoid burnout.

Some of my toughest patients are what my supervisor calls “help-rejecting complainers.”  Realizing that they have every right to reject my help, and learning to not take that personally—“You’re not listening to the great Diane Spear????!!!!”—has been really important!

What's your biggest pet peeve about private practice?

My biggest pet peeve (and it’s not very big at all, frankly) about private practice is that I don’t get paid sick days and vacation days.  But it’s a small trade-off for the autonomy I value.  Actually the worst deal is having to pay for my own health insurance.

How did you discover or develop your practice "niche"?

In terms of a niche, I originally worked with a lot of actors, artists, and writers, probably because I had an arts background.  Now I have patients from all walks of life, and I enjoy that variety.  My practice is a general one, and I enjoy that.

What resource (book, website, person) helped you the most when setting up your private practice?

The resources that have helped me the most in setting up my private practice have been my wonderful therapist, Nancy Becker, LCSW-R, and my tough-love supervisor, Ed Campbell, Ph.D., because they told me and modeled for me that if you want to have a successful practice, you have to treat it like a business and market it, and set it up in a way that’s fair to me.  This was a very different approach than what I learned in social work school, where it was politically incorrect to mention aspirations for a private practice.

What has surprised you most about being in private practice?

What has surprised me most about being in private practice was that my therapist and supervisor were right:  with hard work, a business attitude, and a commitment to learning theory and technique I could have a successful business, as they do.  In other words, their success wasn’t based on luck; if I wanted their results, I needed to put in the hard work they did and I could have a great business that I enjoy.

Has your private practice helped you grow professionally? How so?

My private practice has helped me grow professionally because there can be room for laziness at some agencies, without too many repercussions.   But if I’m lazy about learning theory and/or technique, or marketing, I will see the results in a failing practice, so having to be responsible to myself has forced me to have a better work ethic.

Has it helped you grow personally, too? How so?

Private practice has helped me grow personally, too, because I’m forced to confront my own narcissism on a daily basis with my patients, to know the limits of what I can do—I can’t change anyone except myself, though I can work with someone and help them change if they want to change.  And let’s face it:  anything that makes us confront our narcissism on a daily basis is going to help in every aspect of our lives!

Being a therapist can be emotionally exhausting. What do you do to care for your own emotional and psychological health?

I avoid burnout by getting lots of treatment from my long-time therapist, and participating in a weekly supervision/study group.  What also helps is, once again, knowing that I can’t change anyone—all I can do is put it out there, and the patient is responsible for using it or not.

How do you cope with the inevitable stressors involved with being your own boss?

I cope with the stresses of being my own boss by setting up my business in a way that is fair to me, so that I don’t resent my patients.  When I started out, I paid $12 an hour for office space and my first patient paid me $20 per session.  I built from there, but had not learned to set it up yet in a way that was fair to me.  So when a patient cancelled on me, I rescheduled sessions, which meant that I had to pay $24 for office rent ($12 for the cancelled session and $12 for the make-up session), but just get paid $20 for the session.  No small surprise that I wound up resenting my patients!  My supervisor helped me set it up to be fair to myself with time and money.

What personal strengths have helped you succeed in private practice?

Creativity and a good sense of humor have worked well for me in private practice.  I enjoy coming up with analogies that will fit a particular patient’s situation or to explain a complex concept.  I’ve also found that humor can be a great way past a patient’s defenses.

To learn more about Diane Spear, LCSW-R visit her website

World Mental Health Day: I've Never Met A Shrink Who Didn't Need One

My grandpa used to say, "I never met a shrink who didn't need one," as if that was a valid reason for not seeking help for mental health problems. After being a therapist for nearly two decades, I totally agree with my Grandpa.

Therapists are an interesting and colorful bunch and we definitely have our own share of mental health problems. I'd take grandpa's phrase even farther by saying I've never met a person who didn't need a shrink. We can all benefit from examining our experiences and getting an outside perspective from a mental health professional during difficult times.

The most effective therapists I've worked with, as a colleague and as a client, are those who've already worked through some of their own mental health and relationship struggles with a therapist, have a handle on their own pain and vulnerability, understand their family relationship patterns, and are comfortable walking with others through their pain. Not only is working through issues with your own therapist good for your own mental health and personal relationships, it's also good for your therapy practice.

Here are 5 Reasons Your Own Therapy Is Good For Your Practice:

1- Increased empathy for and effectiveness with clients

Being willing to be "the client" in therapy is a gift to your own clients. Just like it's impossible to be a trail guide on a mountain you've never climbed, it's impossible to take a client into emotional terrain you've never traveled before. As we sit with clients in their painful crises, we are better able to "go there" with them in the therapy process if we can access of our own experiences.

2- Awareness of countertransference keep clients engaged in therapy

After training and managing therapists for several years, I've noticed that those who've done their own work in therapy have a better handle on countertransference issues that arise with their clients, they are less overwhelmed by the feelings, and they are more willing to process their own emotions in supervision. Therapists who have done their own therapeutic work  are better able to keep clients engaged in meaningful therapy, which is crucial to success in private practice.

3- Feel deserving of success and financial compensation

Therapist's I've supervised or consulted with who have difficulty collecting fees, setting boundaries, or allowing themselves to be successful in their practice are usually plagued by unresolved issues from their past. Working through your own childhood wounds, past trauma, or family of origin issues can free you to create and to embrace your own success in private practice.

4- Healthy boundaries with client's and colleagues

Therapists who've done their own work are less likely to enact their unresolved issues with colleagues and clients. They are also able to set and maintain appropriate boundaries with clients with out guilt. For example, if a therapist is still stuck in trying to please a parent, it may be extremely difficult for a therapist to tell a client that they don't have any evening appointments available because they may want to avoid dealing the client's disappointment.

5- Create a meaningful practice and avoid burnout

Your own work in therapy allows you to be a healthier individual and create a thriving therapy practice. Unresolved and untreated mental health issues will block your success. Your business will likely mirror the places you're stuck personally.  Doing your own therapy work will allow you to feel empowered to work with clients that energize you, work from an abundance mindset, and feel worthy of professional success.

How has your own work in therapy impacted your private practice?

Read my World Mental Health Day blog post on JulieHanks.com "Do your emotional family history"

5 Self-Care Tips For Therapists

You take good care of you clients but are you taking good care of you? Being a therapist in private practice is incredibly fulfilling and very emotionally draining. While it's an honor to be trusted with client's deepest fears, pain, and vulnerabilities, it can take an emotional toll. Therapists seem to be particularly vulnerable to putting our own needs on the back burner to attend to others. It's why we're good at what we do. It's also why prioritizing self-care is crucial to professional and personal success, and to avoiding burnout.

At work and at home (I'm a wife and mother of 4 children) I emotionally and physically nurture others, so I've had to work hard to figure out what I need and how to prioritize self-care. Here are some ways that I've learned to take good care of myself as a private practitioner.

1) Start and end sessions on time

Build in 10-15 minutes in between clients to take a bathroom break, do some deep breathing, have a snack, clear your head, or consult with another therapist. Don't give away your time to clients at your own expense or you'll end up resenting them because your needs aren't being met.

2) Remember to eat and drink

This sounds so basic, but I've had times when hours would go by before I realized that I was parched and famished! I used to book  8-10 clients a day without scheduling a break assuming that someone would cancel or no-show. On the days where no one did I'd work straight through. Exhausted and starving I usually grabbed junk food and a sip of water. I've learned to build in time to eat and drink so I can maintain my energy level.

3) Schedule transition time after work

Take a few minutes to clear your head so you don't bring the emotions of work into your personal time. If you have a commute you may want to listen to relaxing music on your drive home. There was a period of time where I'd work out at the end of my work day to help release the stress of the work day before heading home and that worked well. Take a few minutes to "shift gears" after work.

4) Get consultation and supervision

It's crucial to build in support for your emotional and professional needs in order to prevent burnout. Meet with colleagues to process countertransference and consult on difficult cases so you don't internalize your client's issues. This is particularly important for solo private practitioners to prevent isolation.

5) Solve recurring complaints quickly

If you have chronic complaints about your practice, act quickly to resolve them.  If you hate your office space, start looking for a new one. If you are overwhelmed by paperwork, reports, and managed care authorizations, consider hiring office help. Take action when something is bothering you so it doesn't drain your emotional energy.

One of the benefits of being in private practice is that you are in charge of your own schedule. Be sure to build your self-care into your schedule. We are modeling self-care for our clients so let's make sure we're practicing what we preach.

What do you do to "fill your own bucket" during your work day so you can continue to feel energized, to be effective with clients, to manage your practice, and maintain a personal life? I'd love to hear your ideas and suggestions. Feel free to comment below.

photo credit: rofanator