Understanding and Managing Therapist Burnout

As we enter the end of Summer and beginning of Fall, I want you to check in with yourself and see how you are doing? As a therapist, this time can be fraught with many emotions. Client sessions tend to reduce as clients are on vacation and want a break from therapy.

You may be relieved and secretly happy for the client cancellations, but you may also be worrying about the drop in income. If you are the sole provider, or your income is necessary for the running of your household, this may be of concern.

In addition to concerns about your practice, there is backdrop of things happening in the world, such as an election, fears of a recession, and wars taking place overseas.

And then of course is the functioning of your household and responsibilities. Are you thinking about Fall activities and readiness for Fall (i.e. activities and back to school).

But here is something that you may not be thinking about. Therapist burnout. Have you checked in to see if you’re at risk? Because this is the time of year when you are susceptible to experiencing it.

Therapist burnout has been an ongoing issue and recently a study came out identifying the high levels of burnout that mental health professionals experience.

Burnout is a critical issue in the mental health profession, and I see more and more professionals choose to leave the profession as a result.

In this blog, we will explore the signs of burnout in therapists, the underlying causes, and effective strategies for managing and preventing burnout to maintain a sustainable and fulfilling career.

Burnout is Personal

I will admit that I too have suffered burnout. It was often discussed where I worked, however it felt like it was something that I was addressing, through mental health days and boundary setting. Little did I know, I had all the warning signs but I didn’t truly understand it. It wasn’t until I had a meltdown did I realize how truly burnt out I was and I was not able to cope.

Because I couldn’t manage it effectively, I left the profession for three years. It took me three years to recover and even now, I recognize how easily I can fall into burnout. Now that I am a therapist in Private Practice, I am solely responsible for ensuring that I keep my burnout in check. At times, it feels like burnout is more likely, and requires extra attention.

So, this blog post is hopefully not just a reminder and warning for you, but a reminder to myself to be careful. In Part 1, I’ll discuss burnout and the signs of burnout. In part 2, we’ll explore practical ways to manage it in our private practice.

What is Therapist Burnout?

Burnout is a state of chronic physical and emotional exhaustion resulting from prolonged stress and overwork. Burnout can manifest as feelings of hopelessness, emotional fatigue, and a decreased sense of personal accomplishment. This not only affects the well-being of the therapist but can also impact the quality of care provided to clients.

Causes of Therapist Burnout

Understanding the causes of burnout is essential for developing effective strategies to prevent and manage it. Here are some common factors contributing to therapist burnout:

1. High Emotional Demands

Therapists are exposed to clients' traumatic experiences, emotional pain, and distress daily. The constant emotional demands of listening to and supporting clients can lead to emotional exhaustion.

2. Heavy Workload

A heavy caseload and long working hours can contribute to burnout. Therapists may feel overwhelmed by the number of clients they see and the paperwork and administrative tasks that come with the job.

3. Lack of Support

A lack of support from colleagues, supervisors, and the organization can exacerbate burnout. Therapists may feel isolated and unsupported, making it difficult to cope with the challenges of their work.

4. Poor Work-Life Balance

Therapists who struggle to maintain a healthy work-life balance are at higher risk of burnout. The inability to disconnect from work and engage in self-care activities can lead to chronic stress and burnout.

5. Unrealistic Expectations

Therapists may place unrealistic expectations on themselves to solve all their clients' problems and achieve perfect outcomes. These high expectations can lead to feelings of inadequacy and burnout.

6. Personal Factors

Personal factors such as financial stress, family responsibilities, and health issues can also contribute to burnout. Therapists may struggle to manage their personal and professional lives, leading to increased stress and burnout.

7. Secondary Traumatic Stress

Exposure to clients' traumatic experiences can lead to secondary traumatic stress, also known as vicarious trauma. This can result in symptoms similar to those of post-traumatic stress disorder (PTSD) and contribute to burnout.

Signs of Burnout in Therapists

Recognizing the signs of burnout is the first step toward addressing it. Here are some common indicators of therapist burnout:

1. Emotional Exhaustion

Emotional exhaustion is characterized by feelings of being emotionally drained and depleted of emotional resources. Therapists experiencing emotional exhaustion may feel overwhelmed by the emotional demands of their work and personal lives.

You may find it difficult to engage with clients empathetically. Demands at home may also feel overwhelming and you feel like you don’t have the emotional bandwidth to deal with your loved ones’ needs.

2. Depersonalization

Depersonalization involves developing a detached and impersonal response to others. You may begin to view clients as objects rather than individuals with unique needs and emotions.

This may also lead to resentment of clients and critical judgment of clients and their behaviors. This can lead to a lack of empathy and a diminished ability to provide effective care.

3. Reduced Personal Accomplishment

Therapists experiencing burnout may feel a diminished sense of personal accomplishment and question the value and effectiveness of their work. You may feeling ineffective and believe that you are not making a meaningful difference in your clients' lives.

4. Physical Symptoms

Burnout can manifest as physical symptoms such as headaches, fatigue, sleep disturbances, and gastrointestinal issues.

This may include overeating and drinking or comfort eating and excessive drinking. This may include staying up late and engaging in things like doom scrolling, which creates more stress. Chronic stress can take a toll on the body, leading to these and other physical health problems.

5. Cynicism and Negativity

Therapists experiencing burnout may develop a cynical and negative attitude toward their work and clients. You may become increasingly critical and pessimistic, which can affect your ability to maintain a positive therapeutic relationship. This may also lead to more instances of complaining/venting in support groups or to friends and family members.

6. Increased Absenteeism

Burnout can lead to increased absenteeism as therapists struggle to cope with the demands of their job.

You may take more sick days, cancel sessions or express relief when clients cancel. This can further exacerbate feelings of guilt and inadequacy, especially if you depend on the income to pay your bills.

7. Isolation and Withdrawal

Therapists experiencing burnout may withdraw from colleagues, friends, and family. You may isolate yourself and avoid social interactions, leading to feelings of loneliness and further exacerbating burnout.

In an attempt to connect, you may also go into networking groups and complain about your clients and/or the state of things going on in your practice.

8. Difficulty Concentrating

Burnout can impair cognitive functioning, leading to difficulty concentrating, making decisions, and remembering important information. This can affect a therapist's ability to provide effective care and maintain professional responsibilities.

How Did I Miss The Signs That I Was Burnt Out?

As a twenty-something, right out of grad school, I was taught that I have to put in my time and put in my hours to develop the clinical skills to be a therapist. As a result, I worked in agencies where the pay was low and the workload was high.

Because I wasn’t making enough money, I often worked two or three extra jobs on weekends to make ends meet. I justified my fatigue as a consequence of working multiple jobs.

Because I was working multiple jobs, I also did not have the time to spend with my family and friends.

I was isolated and unable to connect with loved ones.

I managed to cope, in part, because I had a great support system (from a distance). I would take days off here and there to binge-watch shows and visit loved ones, so I thought that I was beating burnout.

This dance of burnout and recuperation lasted for 10 years.

As I entered my 30s, I started to resent the work and my clients. I couldn’t afford to pay for basic needs, engage in self-care, spend time with friends via vacations and experiences, or take time away from my multiple jobs to recharge. I started consuming toxic content, like reality TV shows, and surrounding myself with people who complained all day.

In addition to that, the nature of the work that I was doing, trauma work, was taking an emotional toll. I couldn’t disclose client issues because of privacy issues. And to be honest, in my free time, I didn’t want to talk about the things that I was working on with clients.

I started to experience secondary and vicarious trauma because I didn’t know how to manage the traumas of my clients. It felt like I had a lack of support from the organization that I was working for.

Luckily, I had tremendous support from my supervisors and co-workers, so I denied that burnout was happening. 

I took more training to develop the clinical skills to help clients with trauma. I completed a Yoga Certification with a specialty in trauma. I took Sandplay training. I completed EMDR training, all with the hopes of developing the skills to better serve my clients.

I kept telling myself that soon it would get better as I’d either get a raise or a promotion.

None of those things came and I never stopped long enough to work with what I had instead of pushing through to get to the other side.

I got married in 2015, and still, I denied that I was getting burnt out. I chalked it up to wedding planning and selling a house. It wasn’t until 2017 that it all came crashing down.

In Part 2 of this blog, I’ll share how I navigated burnout, left, and came back....stay tuned