If you’re anything like me, you’ve been a part of hundreds (if not thousands) of conversations about burnout and self-care. From brief mentions in graduate school classes to psychoeducation with clients, or articles just like this touting how important it is for clinicians to care for themselves. Something these conversations often miss is the how part. How can we implement the messages of “take rest,” “have a support system,” and “be consistent in self-care” enough to make a sustainable difference in maintaining our well-being in a demanding profession?
The life of a clinician can be too nuanced and, let’s face it, busy to make sense of what these things could look like for us. Not to mention, our lives have changed a lot! So, what rest may have looked like a few months or years ago may no longer be the case.
That’s why I believe that talking about ways to figure out what you need and then how to make sense of it is a well-rounded approach to burnout prevention. This blog will take the implementation lens to those practical strategies and techniques of maintaining wellbeing so that your efforts can shift and evolve as your life does too.
Look at the structure of your schedule.
Let’s be work-specific for a second. Creating an ideal schedule, one that honors your needs and natural rhythms is a crucial part of protecting your energy. This goes beyond making sure you take time for lunch and reserving time for admin work on top of clinical things. (Though definitely do those things, too.) The structure should also address how and when things happen.
Fighting against your natural flows is bound to make the days harder. Look at your current schedule. When in the day do you feel the most “on”? What days do you feel the most drained after? After how many clients in a row do you find yourself glancing at the clock more and more waiting for a break? Are there days that you feel good amounts of energy after? Re-structure your tasks to better align with these answers.
Manage and reduce your workload.
Therapists often speak in terms of clients per week. But your job is so much more than your caseload. Look at your other routine work tasks and assess them. Are you spending time doing things you simply don’t enjoy or care about?
Therapists can often feel locked out of relief because simply reducing one’s caseload isn’t always possible or the full picture of burnout. Can adjustments be made to how much time is being spent on other work needs? This could be taking a break from posting on social media, outsourcing tasks, or completely revamping what gets your energy just to name a few.
Run a personal inventory.
Have an honest check-in with yourself by really looking at your life. I like doing this in two ways.
1) Map out what your life as a whole currently looks like. Pay attention to all aspects of life you find important for holistic balance: physical, social, mental, emotional, spiritual, and occupational. Now write down what you want your life to look like in the same holistic way.
2) Look at your average day and week. Putting this on paper in black and white helps to figure out where changes are needed and how to fill in your wants. As you look through this, gauge your reactions. What pieces are making you feel tired or overwhelmed just on sight? Are certain tasks or areas making you sigh, tense up, or try to find reasons to procrastinate (maybe even avoid)?
Big picture: balance the number of hours worked – again, not just caseload – with an equivalent number of hours spent cumulatively in other meaningful areas of life. Notice this isn’t necessarily saying an equal number of hours. That may not be realistic. But we want to make sure we are building up our energy as it is being used. If 4 hours of X refuels 16 hours of Y, that’s awesome and good to know! And it is way easier to follow through with than feeling like we can’t do something at all if they’re not completely equal.
Listen to your needs and care for them.
At this point, you’re learning some valuable information about yourself. Do you feel like work and/or life is monotonous? Are you bored or drained? Shake things up!
What is it that’s boring you – the clients, the problems, the approach, where and how your sessions happen, your physical environment? Maybe now is the time to hone in on your ideal client again. Change your office layout. Learn a new modality or delivery method. Wanting things to change does not have to mean sweeping changes. Test out some adjustments and see if your feelings change too.
Consistency of self-care. And not just big self-care.
I’ll admit this is one of those tough ones to hear. It’s a “practice what you preach” moment. Our field seems to foster a mentality of doing it all at all times. But who can do that indefinitely? Even robots programmed to do all their tasks all of the time need to take a break to recharge.
The idea of therapists distancing themselves from their work to emotionally protect their peace is layered. Boundaries are necessary and important. But a potential latent effect is that therapists can also be distancing themselves from the same helpful resources they provide to others all day long because they now feel othered.
Relying on big chunks of self-care typically involves becoming depleted first. While that weekend trip to the spa or a week’s vacation sure does feel awesome, building in more accessible care will help you from getting that low in the first place. Go back to the wants you identified and find small ways to incorporate them into your weekly life.
Bonus – take care of your physical body. For most therapists, it’s easy to become pretty stagnant. Bring in mindful breaks to give your brain a rest from firing on all cylinders and move intentionally. This is another great way of releasing things therapists may take on during sessions before they build up.
Remember it doesn’t all fall on you.
Therapists are people too. We live full lives, and being a therapist is just one facet of this. Find support in your safe people, reach out to peer groups, and find professional mentorship, supervision, and therapy for yourself. While we can explore all the things above ourselves, we know all too well sometimes relief can come from external support.
Let’s reduce the stigma of having a hard time with our work. Having personal struggles is not a sign that you are not a tremendous therapist. Having a community around you that gets it could make a difference. Your safe people may be wonderful for a lot of reasons, and not quite understand the nuances of therapist stress. By sharing our hardships with other professionals who intimately understand the demands of the job, we can build spaces to let go within on a routine basis.
Take time off from wearing all the hats.
A common experience in this field is heavily relying on one-on-one client time for income. If you’re not there, you’re not making money. Unfortunately, this often leads to overworking because of the difference in utilized time off. Explore your finances and budget for taking days away from the office. Also, assess if it’s possible to have non-client days here and there where you can close the loop on those other work tasks piling up without adding another work day to get it done.
Preventing burnout is a daily, holistic effort. Yes, it’s helpful to know what to do if you’re already there. But, I think we’d all love not getting there in the first place. Value and protect yourself just as you do those around you.
Take good care of yourselves, friends. The world appreciates you.
Meet Elise Robinson, LCSW
Elise is a Licensed Psychotherapist in New Jersey and Massachusetts. She is the founder and lead clinician of Mindful Care Therapy and Consultation.
Elise helps clients with anxiety, self-esteem, life changes, and more with neurodivergent & queer-affirming care. People come to her looking to connect with a fellow human because therapy is a place to feel genuinely seen and valued.
