Distress, Therapist Burnout, Self-

Care, and the Promotion of Wellness

for Psychotherapists and Trainees
PRESENTED BY: EMAN, MAHAM, MEMOONA & NAFEESA
 01 Therapist burnout

02 Role of Balance and Self-Care

in Avoiding Therapist Burnout

03 Self-Care Activities and

Strategies

04
Table of
Warning Signs and Self-
Assessment for Therapist

Contents
burnout

Distress
Distress is described as the subjective
emotional reaction we each experience
in response to the many stressors,
challenges, and demands in our lives.
While distress is a normal part of life,
distress left unchecked over time can
lead to burnout, which is “the terminal
phase of therapist distress”
 Therapist
Burnout

Burnout, a term first coined by Freudenberger (1975),

has three components:
1. Emotional exhaustion
2. Depersonalization (loss of ones empathy, caring,
and compassion)
3. A decreased sense of accomplishment.
Vicarious Traumatization
When treating clients who were victims of trauma,
psychotherapists may themselves be traumatized by
the emotionally intense experience of engaging in
this type of psychotherapy. This may result in the
psychotherapist developing many of the same
intrusive and debilitating symptoms for which the
client was being treating.
Vicarious Traumatization
SYMPTOMS
intrusive thoughts and images related to the
client’s disclosures
avoidant responses
physiologic arousal
somatic complaints
distressing emotions
addictive or compulsive behaviors that may
adversely impact one’s competence
The Ubiquitous Nature
of Distress and its
Impact
Distress left unchecked may result in an impaired
ability to effectively utilize and implement our
knowledge, skills, and abilities.
Its development may be a gradual process and fall
on a continuum.
The line between distress and impairment may only
be seen in the rearview mirror.
We are all vulnerable to some form of distress-
related problems with professional competence at
some point(s) in our lives and careers.
Distress and problems with professional competence
are not discrete entities. They fall along a continuum.
Role of Balance and
Self-Care in
Avoiding Therapist
Burnout
Factors That Can
Cause Distress
Work related
Personal
Challenges throughout career
 Work Related
Factors
Setting, client type, lack of progress, chronic illnesses and
relapses, on-call commitments, emergencies and crises, suicide
attempts, violent and aggressive clients, ethics complaints, and
licensure board complaints, difficulties with fee collection, etc.
Putting others' needs first while frequently ignoring our own.
Receiving un-favourable comments, not getting immediate
feedback, and not feeling valued.
There is not enough time to do everything due to time constraints
and pressures.
Personal Factors
Family, health, financial, relationship, mental health, substance
abuse, and related issues.
Examples include: caring for an ill family member, getting
married, going through a separation or divorce, having a child,
experiencing depression, etc.
APA Ethics about Self Care
and Promotion of Wellness

Principle A: Beneficence and Nonmaleficence:

“Psychologists strive to be aware of the possible
effect of their own physical and mental health on
their ability to help those with whom they work”
Self-Care Activities
and Strategies
Activities Getting adequate sleep each night
Maintaining a healthy diet
Engaging in regular exercise
Spending time with family and friends
Meditation or yoga
Attending to your spiritual and/or religious side
Playing with your pet
Engaging in artistic expression
Activities Doing pleasure reading
Setting limits
Saying ‘no’
Maintaining healthy boundaries
Maintaining a healthy balance between various
professional activities as well as between the
professional and personal parts of our life.
Strategies Schedule breaks throughout the day.
Watch out for warning signs, such as violating
boundaries, self-medicating, wishing patients
would not show up, finding it difficult to focus on
the task at hand, boredom, fatigue, and/or missing
appointments.
Watch out for distress, burnout, and competence
problems in your colleagues.
Conduct periodic distress and competence self-
assessments and seek help when it is needed.
Strategies Focus on prevention.
Make time for self-care!
Seek out personal psychotherapy.
Use colleague assistance programs.
Participate in peer support groups.
Accept that you’re human, in need of assistance,
and a work in progress.
Don’t try to be perfect, to have it all, or to do it all.
Know your limits and be realistic.
Warning Signs, and
Self-Assessment for
Therapist Burnout

 ASSESS YOUR I have disturbed sleep, eating, or concentration.

WARNING SIGNS I isolate myself from family, friends, and colleagues.
I fail to take regularly scheduled breaks.
I enjoy my work less than in the past.
I find myself bored, disinterested, or easily irritated
by clients.
I have experienced recent life stressors such as
illness, personal loss, relationship difficulties,
financial problems, or legal trouble.
 ASSESS YOUR I feel emotionally exhausted or drained after
WARNING SIGNS meeting with certain clients.
I find myself thinking of being elsewhere when
working with clients.
I am self-medicating, overlooking personal needs,
and overlooking my health.
I find my work less rewarding and gratifying than
in the past.
 ASSESS YOUR I am feeling depressed, anxious, or agitated
WARNING SIGNS frequently.
I am enjoying life less than in the past.
I find myself experiencing repeated headaches and
other physical complaints.
I sit staring into space for hours and can’t
concentrate on my work.
CHECKLIST FOR POSITIVE
COPING BEHAVIORS
I take regularly scheduled breaks.
I take vacations periodically and don’t bring work with me.
I have friends, hobbies, and interests unrelated to work.
I exercise regularly, have a healthy diet, and maintain and
appropriate weight.
I limit my work hours and caseload.
I participate in peer support, clinical supervision, personal
psychotherapy, and/or journaling as preventive strategies.
I attend to my religious and spiritual side.
I regularly participate in relaxing activities (e.g., meditation,
yoga, reading, music).
I regularly participate in activities that I enjoy and look forward
to.
CHECKLIST FOR MALADAPTIVE
COPING PRACTICES
I self-medicate with alcohol, drugs (including over the counter
and prescription), and food.
I seek emotional support and nurturance from clients.
I keep taking on more and try to just work my way through
things.
I try to squeeze more into the day, get more done, and measure
success by how many tasks I complete and by how much I can
accomplish in a day.
I isolate, avoid colleagues, and minimize the significance of
stresses in my life.
I know that distress and impairment are for others and don’t
take seriously the warning signs I experience.
I believe that everything will turn out fine just because I say so!
 Concluding Thoughts

It is hoped that all psychotherapists will heed the call to practice

ongoing self-care. Its importance cannot be overstated.
Regardless of where you are in your training and professional
development, now is the time to begin the ongoing practice of
self-care. Also, failure to engage in adequate self-care now can
have a deleterious impact on the services you provide to your
clients right now. So, it is never too soon to begin these important
self-care habits. I can assure you, you’ll be glad you did!
Thankyou!