How to Avoid Mental Health Professional Burnout – Interview with an Expert
Counseling Schools Search
Compassion is like a muscle. If you overtax that muscle, you eventually can’t do anything anymore and you need time to rest.
Dr. Kirk Honda, Marriage and Family Therapist and Professor at Antioch University
During the frenzied month of March 2020, the era of social distancing arrived suddenly in the U.S. The changes to social rules and lost jobs hit the nation like a shockwave that left very few unaffected in one way or another.
Thirty million Americans—about 20 percent of the workforce—were suddenly laid off and thrown into financial uncertainty. But those that have been able to keep their jobs have faced other hardships. Cashiers, delivery drivers, and medical workers are at higher risk of being exposed to the virus due to constant interaction with the public. Even the lucky demographic that has been able to transition to working from home have faced mental adversity from being isolated inside.
Regardless of how the pandemic has changed your specific situation or altered your routine, there is a good chance that your mental health has been strained from triggers related to financial concerns, fear that you or your loved ones will get sick, feelings of sadness caused by social isolation, fear about the future, or a myriad of other potential worries.
The Mental Impact of the Pandemic
So far, conversations about mental health have taken a backseat in mainstream media to more immediate concerns related to the pandemic, such as hospital capacity and containment strategies. But in May, the World Health Organization (WHO) released a unique report entitled “COVID-19 and the Need for Action on Mental Health” addressing the potential impact of the crisis on mental health, which stated that psychological distress caused by the virus has become “widespread.”
One of the biggest demographics of concern is healthcare workers, who are under exceptional stress due to “being faced with extreme workloads, difficult decisions, risks of becoming infected and spreading the infection to families and communities, and witnessing deaths of patients,” the report said.
This comes as no surprise. Since the onset of the pandemic, heartbreaking personal videos and testimony from healthcare workers on social media have been circulating, broadcasting the trauma nurses and doctors have endured in dealing with the influx of COVID-19 patients.
Other vulnerable groups that the report says are also experiencing extra stress during this time are children and adolescents, who have been displaced from their school routines; women, who may be enduring a larger burden of childcare and household duties and increased domestic violence; and people in conflict settings, such as refugees.
As the economic burden of COVID-19 continues to rise, the WHO anticipates there will be “a long-term upsurge in the number and severity of mental health problems” in general. This is based on studies of the fallout from the 2008 economic crisis, which showed a rise in “deaths of despair” (i.e., suicides and substance-use related deaths) among working-age Americans.
The report gives a call to action for governments: to prioritize, preserve, and strengthen existing mental health services.
The Heightened Risk of Mental Health Professional Burnout
Counselors and therapists will be a key part of mitigating against the potential mental health crisis by helping individuals deal with their trauma, but that doesn’t mean that the mental health professionals themselves aren’t also vulnerable during this time.
“Depending on our client population, we absorb a lot of really traumatic stories,” Dr. Kirk Honda, a therapist based in Seattle said. “We know through empirical observation that it will take a toll on someone. Similar to first responders, police officers, medics, firefighters, [therapists] show signs of burnout as well.”
Meet the Expert: Dr. Kirk Honda
Dr. Kirk Honda, a marriage and family therapist based in Seattle, has 25 years of experience working with couples, families and individuals on issues like personality disorders, trauma recovery, anxiety, post-traumatic stress disorder, domestic violence, among other issues. He is also host of the “Psychology in Seattle” podcast and a professor within the School of Applied Psychology at Antioch University.
Burnout is something that Dr. Honda helps his supervisees and students tackle on a regular basis, but with the limitations of social distancing, certain remedies Dr. Honda would recommend for de-stressing are no longer on the table.
“Going out to dinner, meeting up with friends, going to a movie, going on a vacation, travel, hugging your coworkers—when you’re prevented from doing those things, then you have all the stress and none of the stress relief,” Dr. Honda said. “I suspect there will be an uptick [in burnout among therapists] for sure because one of the biggest protective factors is just enjoying your life.”
Symptoms and Causes of Counselor & Therapist Burnout
More than half of clinical psychologists and psychotherapists experience varying degrees of burnout at some point in their careers, which can be triggered by a variety of factors.
Dr. Honda shared an example of burnout in which one of his supervisees was working with children that had been sexually abused. Internalizing especially harrowing stories can lead to secondary traumatic stress and symptoms of burnout.
“She became depressed, anxious, demoralized, sad, unmotivated and couldn’t feel compassion or excitement for work and developed resentment,” Dr. Honda said. “It can definitely get under your skin.”
The sheer volume of clients that a therapist is working with is also a major contributor to burnout. Many of Dr. Honda’s supervisees see 30 clients per week, sometimes eight clients in a row each day.
Over-exposure to listening to others’ experiences of trauma can dampen the natural human response of outrage and concern, which is not only detrimental to therapists’ mental health, but inhibits them from doing their job well, as it can lead to a sense of apathy toward patients.
“Compassion is like a muscle,” Dr. Honda said. “If you overtax that muscle, you eventually can’t do anything anymore and you need time to rest.”
How to Fight Mental Health Professional Burnout
Knowing the challenges that therapists face in managing burnout in normal circumstances stacked on top of the added pressure to help clients navigate their fears during a time of crisis, how can mental health professionals avoid the dreaded feeling of burnout? Dr. Honda gave us a few tips.
Don’t Be Afraid to Seek Therapy Yourself
First and foremost, therapists need to get comfortable admitting when they need support, which may be easier said than done for some. There is a lingering false belief that mental health professionals should not need the same help that they provide—and that if they do, that they are less legitimate as professionals.
“Therapists tend to be self-sacrificial. There’s this culture and personality profile of saying, ‘I’m okay, I’m going to take care of other people. I don’t need help. I’m the helper,’ rather than acknowledging it and saying, ‘I’m not perfect and I need help, too,’” Dr. Honda said. “There’s a lot of shame in a lot of the helping professions in that to ask for help is somehow unprofessional—that you’re an amateur—but research demonstrates that couldn’t be farther from the truth.”
A study from the Journal of Humanistic Psychology that collected personal narratives from 9,000 therapists found that emotional struggle among mental health professionals is not only normal, but beneficial in helping others.
Like a student-teacher dynamic, it’s better to learn from someone who has first-hand experience in a subject rather than someone that has formal education but no real-world experience to back it up. In other words, therapists that acknowledge and work on their personal issues are better equipped to help clients work on their own therapy goals.
‘Download’ Your Feelings
In addition to seeking therapy, mental health professionals benefit from having a personal support system that they can lean on in their day-to-day lives.
“Being a therapist can be so stressful. There are times when every corner of your insecurities is pushed upon, and unless you have someone you can ‘download’ to every day, it’s going to build up,” Dr. Honda said.
Communicating your daily experiences to trusted friends and family, i.e. “downloading,” is key in avoiding burnout, yet Dr. Honda says that many of his supervisees and students don’t have these relationships.
“Having someone at the end of the day where you can come home and say, ‘I’ve just got to get something off my chest’ is important. A lot of therapists don’t have that. I’ll ask for a raise of hands in class and ask, ‘How many of you can go home tonight and immediately talk to someone and say whatever is on your mind?’ and half the class raises their hand. The other half doesn’t. You can’t wait for your therapist once a week. You have to download.”
Know When to Take a Step Back
As is true with any profession, therapists need work-life balance to maintain mental wellness. But prioritizing self-care has a similar stigma attached to it as the shame associated with therapists that seek therapy; it can wrongly be perceived as selfish or illegitimate.
“There does come a time when I will start advising my supervisees and students that they might need to pull back emotionally a little bit, compassion-wise, because they’re overextending themselves and it’s having those ill effects,” Dr. Honda.
In some cases, Dr. Honda says he has to make strong suggestions for students and supervisees to take vacations. But ideally, therapists should lighten their loads and schedule vacations before burnout takes its toll.
“It’s better to do 75 percent good enough job with all your clients than try to do 100 percent and then end up being 15 percent with all of your clients,” Dr. Honda said.
Acting in martyrdom—even when coming from a place of empathy—can end up causing more harm than good. As therapists brace themselves to help the population navigate this time of uncertainty, rather than feeling pressure to be the perfect therapist, they should keep in mind that in order to help others, they must first help themselves.
“One of the things I find with trainees is that I have to tell them to take care of themselves. You should do the best job you can, but don’t overextend yourself; if you do, then you’ll suffer and then all your clients will suffer,” Dr. Honda said.
You can tune in to listen to the “Psychology in Seattle” podcast online, where Dr. Honda and co-host Humberto Castañeda dive into managing anxiety during the pandemic, as well as other topics of interest to mental health professionals.