Therapist Burnout & How to Prevent It

Ever notice yourself getting a little more irritable than normal? Finding it difficult to interact with colleagues, clients, and even family or friends? Struggling to find empathy and patience for others? This could be the result of therapist burnout. Yes, even therapists get burned out and need to take a step back in order to take care of our own needs.

Therapist burnout happens when an individual’s psychological resources are overpowered by the demands placed on them. It is an extreme kind of exhaustion that can result from working with particularly challenging populations [1].

Not only does burnout cause us to simply feel terrible, but it also contributes to job dissatisfaction and poor job performance. Further, it can lead to frantic job searches, and, at the extreme end, it can result in ethical violations, which may have professional repercussions for the therapist – and may harm the client.

While burnout in behavioral health professions can be common, it is not often discussed. However, it is important to know the signs of burnout. If we make it a practice to incorporate self-care into our daily lives, we can minimize the impact of burnout if it happens to us.

What Causes Therapist Burnout?

Put simply, therapist burnout happens when therapists give more of their psychological resources than they get in return, whether that return comes from their interactions with clients, the institutions where they work, or their outside lives.

Therapist burnout has a number of different causes:

All-Day Empathy

The work therapists do is based on using our thoughts, emotions, and energy constantly, which makes us susceptible to burnout [2]. Providing empathy while listening to difficult stories shared with us by our clients can also leave us feeling psychologically empty, as can working with challenging or demanding clientele while maintaining our professionalism and a therapeutic stance.

The Structure of Therapy

The structure of therapy itself can also lead to burnout. Conducting therapy can be socially isolating for the therapist, and confidentiality limits also make it difficult for therapists to share their struggles or celebrate their successes with friends and family. This can further isolate us and makes replenishing our own psychological resources that much harder.

Systemic or Organizational Factors

The culture of our workplace can also affect us. If the way our organization operates makes our job more difficult, it can negatively impact how we feel. Concerns about our utilization rates, heavy documentation requirements, or a large caseload can also make us feel as though parts of the job are out of our control, which also contributes to therapist burnout.

Difficulty Separating Ourselves From the Work

If we use our clients’ progress as a measure of our own self-worth, it can take a mental toll that leaves us feeling depleted. Moreover, it can lead to behaviors that contribute to feeling burned out.

In the desire to help at all costs, the therapist may go over time in session, ruminate about a client during free time, or become hypervigilant about a client’s successes or failures. Over-investing in our clients’ outcomes can place too much pressure on the therapist and the client, and the resulting extra work therapists do can leave them with less time to replenish their mental resources.

All of these factors can contribute to burnout, but it is difficult to address burnout unless you are aware it is happening. Knowing the signs of burnout and periodically reviewing them will help you know when to seek extra support.

The Signs of Burnout

Professionally

• Feeling like you are dragging yourself into work most days, or being late often [2]
• Engaging in unethical behaviors or disregarding ethical guidelines
• Disregarding professional boundaries
• Decreased interest in new psychology research and training techniques

Clinically

• Feeling relieved when clients cancel
• Beginning sessions late or ending sessions early
• Dozing off or spacing out during sessions
• Finding yourself repeating the same interpretations during sessions
• Giving advice as a shortcut rather than helping clients learn and grow
• Working on your own agenda within sessions instead of listening to the client
• Indulgently self-disclosing during sessions

Globally

• Experiencing a noticeable decline in empathy
• Getting irritated quickly
• Snapping at others (e.g., clients, colleagues, family, or friends)
• Feeling unappreciated or inadequate
• Feeling exhausted or excessively tired much of the time
• Becoming increasingly cynical or losing hope [2]

If you find that you are experiencing several of these signs, or if you begin to feel that you are just not yourself, then it is a good idea to seek out supervision or consultation in order to identify and hopefully catch therapist burnout before it happens. Being burned out without realizing it can impact your personal and professional life. To that end, creating and sticking to a plan to reduce burnout will help you get back on track.

Ease Burnout With Self-Care

The key to minimizing the impact of burnout is self-care. Incorporating self-care into our daily activities can assist in balancing out the giving portion of psychological resources, which form the foundation of our profession.

Self-care can come in many forms, such as taking time out to enjoy your family and friends or engaging in activities you find enjoyable. It is important to identify hobbies, creative outlets, and activities that are fun for you.

Do you like crafting? Is cooking a stress relief for you? Does spending time outdoors help you feel at peace? Is shutting out the world by scheduling a spa day more your style, even if it is in your own home? Then do it!

Looking into local groups or clubs you are interested in is a fun way to set out some “me” time, and trying different hobbies and activities can help you learn which activities are enjoyable for you.

The possibilities are endless, and they do not need to be financially taxing. It is important to identify what helps you feel re-set, or what brings you joy, and ensure you are doing those things on a consistent basis. Finding your self-care niche can be a fun and enjoyable process, so don’t fret if you don’t have a hobby or don’t yet know what helps you to relax.

It is very important to actually schedule this time in your planner. Without blocking out this time, work and life can take over, and the planned self-care activities never happen. The key is to pick an activity, set a date and time, and actually follow through with the activity.

Self-Care is About Boundaries, Too

Self-care is not only about incorporating hobbies and fun activities into your schedule. It also offers valuable practice in setting and keeping boundaries in your professional and personal life, and these boundaries help therapists care for themselves.

Professionally, it is important to set boundaries around after-hours work, including deciding when and how you will make or return phone calls, write or respond to emails, or work on documentation. It is also important to establish boundaries around your vacation and other time off, as well as to set aside time for additional training.

Setting up boundaries in your personal life helps you to make time for yourself, as well as time with friends and family. This allows you to have a full and fulfilling life that is not focused only on your job. At the same time, it allows you to replenish the psychological resources that you use daily at work.

In addition to paying attention to setting boundaries and finding activities you enjoy, there are other ways to manage or avoid burnout. If possible, diversifying the type of work you do and varying the types of clients you see can create balance within the work week.

Seeking continuous supervision or consultation can also provide support and a different perspective on your work.

Entering your own therapy can be a valuable way to understand how and why burnout is affecting you, and it can help you identify solutions that are right for you.

It is essential for therapists to understand what burnout is and how it can happen. If you do find yourself feeling burned out, incorporating different kinds of self-care into your life will provide a greater sense of balance, help you get back on track, and reduce your risk of burning out again.

References

[1] Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. New York: Free Press.

[2] Newell, J. M., & Macneil, G. (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue: A review of theoretical terms, risk factors, and preventive methods for clinicians and researchers. Best Pract. Ment. Health (Vol. 6).