12 Ways to Battle Therapist Burnout

As therapists we are holding a nation whose mental health is worse than it has been at any point in the last 20 years. And, at the same time trying to hold our own mental health and the mental health and wellness of our family. 
 
When reading this article HERE by Forbes, as a therapist, I felt so seen. 
 
It speaks to the full caseloads of therapists (even pre-pandemic) which are swelling over at this point.  In my own community finding the support for a child to see a therapist with a specific set of skills like Play Therapy or EMDR can be a daunting task and usually lands a child on a waitlist. A waitlist for a child and family that need services now. 
 
And our existing clients and caseloads?  In my years of practice I have never experienced collective environmental stress that this pandemic has brought on.  I see how stressed out young people are, how much they want to see their friends and go to their activities, and the back and forth of in person, distance, and hybrid learning models.  Ugh. 
 
Then there are the parents.  The adults in these young people's lives that are trying to hold it all together, work a job (that may be significantly different and distanced), be a teacher, and still find time to try to take care of themselves.  And if dinner is on the table? Massive success.  
 
We are holding them too.  Helping them learn skills and tools to hold the mental health of their children in a time that nobody asked for and certainly did not prepare for. 
 
Oh, and this thing I thought was going to last for a couple weeks, maybe a month tops, well...we are entering into our 11th month.  Eleven. Long. Months. And an end date? Uncertain. 
 
So in all of this it is essential, not just for our own needs, but the needs of our clients that you are assessing yourself for this thing called burnout and getting a plan - either way.  A plan to stay thriving and functioning OR a plan to regulate and make your way out of that burnt out space. 
 
According to this article HERE by Simple Practice if you check any of the boxes below you are likely somewhere between slightly singed and full into burn out mode: 

• Loss of empathy
• Decreased sense of accomplishment 
• Feeling emotionally exhausted 

 
Now, what does this look like in real life? Coming to session in a rush or late, feeling distracted or daydreaming during the session (hello grocery list!), the felt sense of not being present, dreading starting your day, being behind on notes, not wanting to wake up in the morning, and the list goes on. 
 
So how did we get here? 
 
Well first off, we are in a pandemic.  Deb Dana writes HERE that our nervous system is constantly being taken out of ventral vagal state due to the indefinite and unpredictable nature of the pandemic, which sends cues of danger to our nervous system.  Living constantly in this state is exhausting to our brains and bodies. 
 
And then there is learning how to do our jobs drastically differently - whether that is Tele-Play, developing safe sanitizing and play procedures, or a combination of both.  Oh, yea, and if you are a parent, guardian, or caregiver there is a high likelihood you have had to learn how to be a teacher. OR switch your schedule for two weeks to be all at home if you or one of your family members was exposed to COVID.

Yea, all of those things are a giant piece to this puzzle. 
 
Some other key factors for burnout can be difficulty holding professional boundaries, overscheduling, not engaging in self care, taking on too many clients, or lack of professional support. 
 
So….what next? Below are the most essential ways that I am active in battling burnout.
 
Redefine self care 
 
Self care can look like so many things. While bubble baths, meditation, and getting a massage can be absolutely wonderful ways for self care, I have a broader definition that includes any activity that decreases overall stress and improves mental, physical, environmental and relational wellness. 
 
SO for some self care could look like reaching out to a friend, but for others it might be putting up intentional boundaries in relationships.  It could look like making sure your dishes are done at night or your notes done on time. It can look like creating a budget or making sure you exercise.  All of these things count as self care too.    
 
Check out the World Health Organization’s definition HERE.
 
Schedule self care 
 
Like, sit down and schedule it on your calendar at the beginning of your week.  If you are not intentional it will never happen. What is the top thing that is giving you stress and how you can be intentional in moving the needle and making progress? What are one or two things that will help fill your cup up and give you energy for the week?
 
That’s your self care list. 
 
Maybe it is the backlog of emails you have or reports to write. Maybe it is making space to have coffee with a friend.  It can even be finally starting that book that has been sitting on your night stand, or Gretchen Rubin’s favorite - organize a closet! 
 
Once you have this list literally sit down and schedule when you will do this task, this thing that you know is important for you.  My preference? In writing - but electronically will do just fine too!  
 
The other thing for scheduling is balance - if you put all the self care things on your plate week one you might overload your system.  Start with one or two things to move the needle on a stressor and one thing to fill your cup and assess from there! 
 
Develop Great Systems and Schedules 
 
Those things from the last point, you know, the ones that cause you the most stress - these are the things we need to operationalize and create systems for.  
 
This is why I have a solid morning routine. You can grab this free course HERE to get on the path to elevate your morning routine. 
 
Other areas in my practice that were leading to burnout?  Late night schedules, feeling overwhelmed with paperwork, and trying to balance it all. This is the reason behind all the systems I have developed in my practice around note taking, keeping up on documentation, keeping scheduling boundaries, and all the other little things that are on auto-pilot now that were a huge source of stress in the past.  
 
If documentation is something you struggle with, take this free course HERE for the roadmap to faster progress notes. Need more?  Check out my 5 Minute Note course!  Take this assessment HERE to see how satisfied you are with your schedule. Check out this resource HERE to help you get your ideal schedule. 
 
These systems have been the foundation and bedrock of de-stressing in my practice.  I encourage you to figure out how to develop your own routines for your biggest stressors! 
 
The “Three Big Things” 
 
The three things that I think have the most impact on mental wellness and I talk with all of my clients about the very first session? Good sleep, eating foods that feel good to your body, and moving your body.  These three things are essential, every day, for mental wellness! 
 
Get into a great consult group 
 
One of the things about being in private practice is that there sometimes aren’t peer lead consult groups.  This can also happen at an agency where you have a specialty like Play Therapy or EMDR that nobody else has. AND sometimes if you are in a supervision role or are a licensed and more senior member of your group or agency you are in charge of leading groups. 
 
One of the best things I did in 2020 is join two peer lead consult groups where others that had more experience or different experiences than me were present.  Having a group of peers where you can talk about cases, stressors, and stuck points is absolutely essential. You get that validation when times are tough and a celebration at those miracle moments in therapy! 
 
Regulate during sessions 
 
Keeping regulated and holding space for clients (who are sometimes very dysregulated) is hard.  Doing it over telehealth can be harder. It is so important to be intentional about how to stay regulated and connected to self during these sessions. 
 
This might mean having a grounding object near you.  I have a rock from Lake Superior that I can touch and ground myself with if I feel like I need to be in a more centered place. I also have a weighted lap blanket I love.  This could also be remembering to breathe during a session and being mindful of your pace of breath or having a drink of water. 
 
Regulate between sessions 
 
Okay - you get the theme of regulation! AND it is so important I wanted to put it on here twice.  Between clients check in with your body and see what you need.  Bathroom break? To stretch? A quick snack? A visual resetting exercise? All of the above? Check in with yourself often to see what you need.
 
Time blocking 
 
This one is a biggie!  Time blocking means creating intentional chunks of time to do a specific task and ditch the multitasking.  As therapists it is easy to time block out our client sessions.  But what about the time in between?  Get intentional.  If you try to write your note, check your email, and see who that voicemail is from you will likely have 3 half done tasks.  
 
And again schedule it in. I sound like a broken record but the key to all of this is intentionality. 
 
Close your email tabs and only check email during the times you have set aside for collaboration.  Sometimes things that FEEL like an emergency could wait for the end of the day.  And to be honest if it is a real emergency than 911, a crisis line, or the hospital is the appropriate system to handle the emergency.  
 
Schedule your collaboration calls and paperwork time within your schedule to make sure you can be present and focus on the thing that is in front of you. 
 
Learn something new 
 
Okay - hear me out on this one.  I know that in this world the last thing you feel like you have energy for is to learn something new.  You are barely surviving right now. 
 
AND the therapists I talk to and work with feel more energized and ready to go into sessions after they have learned something new and amazing during a training.  One of the gifts of the pandemic also happens to be so many online trainings and increased accessibility to things that you previously might have to fly across the country to take. 
 
Learning something new doesn’t only mean trainings - take in a podcast, read an article, or watch a YouTube Video.  Need inspiration?  Start HERE for my favorite blogs and podcasts and HERE for trainings that might interest you. 
 
Organized your physical space 
 
I am a huge believer that our physical space we keep is representative of our internal state.  AND clutter can actually cause stress.  The reverse is also true that if you are in a decluttered environment it can lower stress and increase productivity. 
 
Seeing your physical space in your office as prime real estate is a must.  What are the things that are essential to be on your desk that need your attention now and where can you store things that aren’t necessary away or clean them up.  

For me post-its are life and how everything comes together. I am in a completely different mental state when I have a zillion post its all over my desk than when everything is cleaned up and in its place.
 
Also, your computer also becomes your physical space too so I definitely notice I feel more regulated when I only have the necessary tabs open. Confession time - my computer has exactly 18 tabs open as I write this.  
 
Compartmentalize 
 
We just addressed your physical space - what about your mental space?  What rituals do you have to leave work at work? Maybe it is shutting your computer and logging off at a certain time.  It might be a mental exercise to leave your workday behind.  It could be a journaling exercise, a mantra, or really anything that helps separate your work day from your home life.  If you don’t have a commute home this is essential to create a ritual around ending your day. 
 
Ask for help 
 
We can’t do this alone.  Help may be getting someone to sit with your kids during virtual learning for a couple of hours.  Help may be asking a coworker to be an accountability partner for getting on top of paperwork.  Help may be getting your own therapist to hold space for you in the way you hold space for others. 
 
Think of the top 3 stressors in your practice.  THESE are the areas you want to develop systems around.  These systems and habits will help you decrease the unnecessary and extra stress that can lead to burnout.  In my practice it was my notes, my schedule, and paperwork (how it was stored, when it was due, etc.).
 
Are all of these going to happen seamlessly at the same time? No. The secret is doing the best you can with what you have and giving yourself grace. 
 
Want to learn more resources to battle burnout?  

• Want to see how close you are to burnout?  Take this mini inventory HERE.
• Check out the Zur Institute’s resource list HERE.
• Deb Dana talks more about nervous system regulation in the pandemic HERE.

 
What are your favorite battling burnout tips?  Drop them in the comments below?

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