The Counselor’s Self-Care Paradox
There is a paradox that is still haunting the counseling profession: while one of the goals of the counselor’s job is to be a resource for the self-care of the client, counselors many times forget or neglect to take care of themselves, often finding themselves burnt out (Schaufeli, 2003). The levels of burnout in therapists are overwhelming. In a study by Simionato & Simpson (2018 ) more than fifty percent of sampled psychotherapists experienced moderate‐high levels of burnout.
High rates of burnout in counselors present a large problem: burnout leads not just to general health problems and sleep problems (Beicastro & Hays, 1984) but can also show up as emotional distress such as anxiety, depression, and experiencing helplessness (Niebrugge, 1994). It presents a big challenge just for the counselor and the people in their lives (Niebrugge, 1994), but also for the clients: burnout can lead to such unprofessional behaviors and attitudes such as client intolerance, cynicism, pessimism, defensiveness, lack of motivation, turnover, poor job performance, and absenteeism (Kahill, 1988). If counselors think that they can hide burnout from their clients they need to think again: in a study by Renjilian, Baum & Landry (2008) observers could spot the sign of burnout evn just from watching a tape, and had negative reactions to the signs.
The fact that counselors are impacted so much by burnout, is especially astonishing since one of the main interventions that counselors use is to help their clients finding additional self-care resources in their lives. If counselors are trained in talking about self-care and helping clients to increase self-care activities, as well as dealing with the challenges of life, why are counselors missing that mark for themselves?
One potential reason for the fact that counselors end up burning out so much might be the genuine desire to help many clients. That can lead to working long hours, and with many clients with severe trauma, at a young age without enough experience, all of which have a positive correlation with burnout (Rosenberg, 2007; Lim et al., 2011; Simpson, 2018).
There is more and more emphasis on self-care in counselors in counselor education and literature, however counselors still find themselves burnt out, often surprised by it. The proposed research is intended to further clarify to counselors what leads to burnout and what can reduce it. The problem is that counselors might not know clearly enough what the theoretical construct of burnout actually means for them.
Therefore, the solution can potentially be identifying the specific contributors to burnout and from there identifying the specific personal boundaries that counselors should stick to (as far as they can within the limitations of their workplace), as well as self-care activities to mediate the difficulties of the profession.
The importance for conducting this study is to provide clear parameters for counselors, and counselors educators to pay attention to in order to prevent burnout. If we can identify measurable boundaries for counselors to adhere to when working with clients (for example, no more than thirty hours a week),
The proposed study will measure variables that can affect burnout rate such as amount of hours worked, the age of the counselor, amount of hours spent on non-direct client work (paperwork, communication with clients, etc.), average number of clients seen a week.
The variables that reflect self-care activities that can potentially reduce burnout rates will also be measured: average hours slept at night, average weekly amount of exercise, average weekly amount of spiritual / mindfulness practices, average weekly amount of time spent with friends etc. To summarize, the main goal of the study is to propose a model of effects and mediators of burnout for counselors.
The hypothesis is that after certain levels, there is a positive correlation between the independent variables measured (such as the amount of a counselor’s work hours as well as the acuteness of mental health challenges of the clients), with the counselor’s burnout levels. This study also suggests that this relationship also is mediated by self-care activities that the counselor is engaged with.
The proposed model, shown in the figure below, is a mediated model in which the five independent variables (age of the counselor, amount of clients seen, amount of non-direct client work, and acuteness of mental challenges in clients seen, setting: agency or private practice) are mediated by self-care activities that the counselor is engaged in (time with friends, time spent exercising, average sleep hours, and time spent on spiritual/mindfulness practices).
The independent variables are also affecting burnout levels directly as well as being mediated by the self-care activities. There is evidence that self care helps with burnout, and it is important to continue the research for the benefit of the clients, the counselors, and the people in the counselor's lives.
For example, in a research performed with Eighty-nine Australian counselors, the researchers found that spiritual well-being accounted for some of the variance in Maslach Burnout Inventory scores, and mediated the effect of trauma on emotional exhaustion (Hardiman & Simmonds, 2013). If there are proven ways that can help reduce the burnout levels in counselors, then emphasizing them in counseling education for example, might have a positive effect on counselors across the globe.
An important assumption of the model is that therapists in private practice will have different burnout rates then therapists in agency, since it is a very different setting, that might allow higher degrees of freedom (how many hours to work, when to work, with whom, etc.).
Potential limitations of the model: the model will need to be tested and probably trimmed.
There is a chance that the model is not taking into account important independent variables that affect burnout in counselors, and it might be missing additional important mediating variables beyond self-care. Also, there is a chance that the model might not be a cookie-cutter approach cross-culturally, since in different countries and cultures there might be different prevailing self-care approaches and traditions.
A Brief Description of Method
The proposed research will be quantitative. It will examine a group of 400 therapists in the U.S., who are working today ,in the age range of 25-65. One group of 200 therapists in private practice will be collected from the Psychology Today profiles of counselors across all states. The second group of 200 working in agencies will be collected from counselors from a few agencies across the U.S.
The counselors will complete online anonymous surveys to measure the independent variables. They will also complete two questionnaires: counselor burnout inventory (Lee et al., 2007), and the professional quality of life scale (ProQol-5) instrument (Hemsworth et al., 2018). The data analysis will then look at the relationships and the mediation effects drawn in the model in the figure.
References
Belcastro, P. A., & Hays, L. C. (1984). Ergophilia… ergophobia… ergo… burnout?. Professional Psychology: Research and Practice, 15(2), 260.
Hardiman, P., & Simmonds, J. G. (2013). Spiritual well-being, burnout and trauma in counsellors and psychotherapists. Mental Health, Religion & Culture, 16(10), 1044-1055.
Hemsworth, D., Baregheh, A., Aoun, S., & Kazanjian, A. (2018). A critical enquiry into the psychometric properties of the professional quality of life scale (ProQol-5) instrument. Applied Nursing Research, 39, 81-88.
Simionato, G. K., & Simpson, S. (2018). Personal risk factors associated with burnout among psychotherapists: A systematic review of the literature. Journal of clinical psychology, 74(9), 1431-1456.
Lim, N., Kim, E. K., Kim, H., Yang, E., & Lee, S. M. (2010). Individual and work‐related factors influencing burnout of mental health professionals: A meta‐analysis. Journal of Employment Counseling, 47(2), 86-96.
Niebrugge, K. M. (1994). Burnout and Job Dissatisfaction among Practicing School Psychologists in Illinois.
Kahill, S. (1988). Symptoms of professional burnout: A review of the empirical evidence. Canadian Psychology / Psychologie canadienne , 29 (3), 284.
Renjilian, D. A., Baum, R. E., & Landry, S. L. (1998). Psychotherapist burnout: Can college students see the signs?. Journal of College Student Psychotherapy, 13(1), 39-48.
Rosenberg, T., & Pace, M. (2006). Burnout among mental health professionals: Special considerations for the marriage and family therapist. Journal of marital and family therapy, 32(1), 87-99.
Schaufeli, W. B. (2003). Past performance and future perspectives of burnout research. South African Journal of Industrial Psychology, 29, 1-15
Sasha Raskin, MA, is an international #1 bestselling co-author , a life, and business coach and a psychotherapist in Boulder, CO. He is working on a P.h.D in Counseling Education and Supervision and is an adjunct faculty at the Contemplative Counseling master’s program at Naropa University, from which he also graduated. Sasha has been in the mental health field for more than 10 years, worked with youth at risk, recovery, mental health hospitals, and coached individuals, couples, families, startups, and groups. He has created mindfulness stress reduction and music therapy programs within different organizations. Whether it’s in person or via phone/video calls, Sasha uses cutting-edge, research-based techniques to help his clients around the world to thrive.
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