Therapist burnout occurs when therapists are faced with chronic stressors, day after day without any chance to reset and recharge. When a therapist is not able to recover from these ongoing stressors, they begin to emotionally, mentally and even physically shut down. They may notice signs of exhaustion, apathy or negativity towards their work, and practicing endless empathy and patience feels impossible.
What is Therapist Burnout?
Burnout is a state of mental, physical, and emotional exhaustion brought on by accumulated stress. Therapist burnout happens when therapists face stressor after stressor without relief. Burnout is included in the 11th Revision of the International Classification of Diseases as an occupational phenomenon resulting from unmanaged, chronic workplace stress. Therapists and counselors are also at risk of developing secondary trauma and compassion fatigue.1
Therapist Burnout: Signs & Symptoms
A therapist experiencing burnout may notice that they are starting to dread client sessions, finding reasons to cancel, showing up late or daydreaming during sessions. They may feel an overall sense of disconnection, decreased empathy, or more negativity or cynicism about their work.
Common signs and symptoms of therapist burnout include:2
- Cancelling appointments or showing up late
- Dreading work
- Daydreaming or feeling distracted during appointments
- Feeling emotionally drained
- Feeling overwhelmed
- Experiencing a decline in empathy
- Self-medicating or numbing out with alcohol or other behaviors like scrolling on social media or shopping
- Feeling mentally distanced from one’s job
- Increased feelings of negativity, cynicism or loss of purpose related to the job
- Reduced professional efficacy
- Depression
- Sleep issues, worry or anxiety
Causes of Therapist Burnout
A huge number of social, political, economic and workplace stressors have contributed to therapist burnout in recent years. One recent study of social workers found that 63.71% had experienced burnout, 49.59% had experienced secondary trauma, and 26.21% had met full criteria for PTSD since the beginning of the Covid-19 pandemic.3
Stressors that contribute to therapist burnout include:
- Current political, social and pandemic related stressors
- Inability to detach from clients’ issues and concerns
- Secondary trauma
- Exposure to aggressive/depressed/suicidal clients
- Emotional fatigue
- Focusing on others’ needs rather than their own
- Being on call
- Administrative task build up
- Financial stress
- Client emergencies and crises
- Slow progress with certain clients
Therapist Burnout & COVID-19
The recent pandemic years have placed mental health providers under unprecedented strain. Therapists have been in the position of personally navigating the pandemic while helping their clients through it at the same time. Many therapists pivoted to providing video therapy online very quickly, while others still saw clients in-person as essential workers.
The Covid-19 pandemic has caused additional concerns about childcare, education for therapist’s and their client’s children, client/therapist safety including avoiding illness, privacy, or abuse at home, challenges to maintaining positive relationships online, and policy changes related to HIPAA, privacy and service delivery. All of this while therapists have faced higher caseloads, waitlists and an increase in client distress levels.
Self-Care for Therapists: 17 Tips to Prevent Burnout
Therapists can start by building excellent basic self-care into their day, including things like daily meditation, staying hydrated and getting up to move regularly. Therapists can also prevent burnout and recover by practicing stress management, cultivating a positive mindset, setting boundaries around their time and energy and getting support.
Some strategies that can help prevent therapist burnout include:
1. Practice Excellent Physical Self-Care
It is critical for therapists to build self-care into their busy days, rather than waiting for the next spa day or vacation. These include things like drinking enough water, getting up and moving around, taking time to breathe, and making good sleep a priority.
2. Practice Emotional Self Care
Self-care is not all about bubble baths and manicures. Therapists also need to prioritize emotional self-care by nurturing and caring for their emotional inner lives, find time for fun and utilize their support systems.
3. Leave Work at Work
It is important for therapists to have solid boundaries between their work time and their personal time. For those who are working in an office, it can be helpful to notice crossing a physical line on the way home from work, like a river or a highway.
When working from home it has become so much harder to find ways to leave work at work. Try leaving the room, setting a timer, shutting down the computer, leaving for lunch, or other ways to separate work time from personal time.
4. Eat Mindfully
One study showed that eating mindfully can improve mood and reduce the risk of binge eating. Try sitting down at the table, eating more slowly, and really taking time to smell, taste and experience food.4
5. Tap Into Hobbies & Passions
Brene Brown taught us that unused creativity is not benign and can be very harmful to our well-being. Revisiting an old hobby or taking up a new one is a great way to improve mood, get inspired, and prevent burnout.5
6. Connect With Peers for Support
Being a therapist can be an extremely lonely and isolating job. It is very hard for those not in the field to understand the pressures, and privacy laws prevent therapists from sharing details of their day. Professional organizations and peer support groups can be a helpful way to connect with others who get it.
7. Exercise
Exercise has been shown to reduce the effects of stress, emotional exhaustion, and distress related to burnout. Even when it is not realistic to get in a sweaty workout at the gym, even standing up, moving around or stretching can help.6
8. Make Time for Family & Friends
It’s important for therapists to step away from work and spend time with people who know them, care about them or make them laugh. It can be helpful to make a standing appointment weekly or monthly with a friend, family member or colleague.
9. Set Boundaries With Clients
Therapists need to have policies in place so clients know what to expect: how to contact their therapist between sessions and when this is appropriate, cancellation policy/fees, times that the therapist will respond to calls and messages, etc. It is so important to set those policies, communicate them to clients and most importantly, stick to them!
10. Set Your Ideal Schedule
Crafting an ideal schedule, putting systems in place and sticking with them is a great way for therapists to protect their time and energy. It is helpful to block out time for lunch breaks, administrative time, and once a month, a day off to do activities that nurture the spirit.
11. Consider Your Work Environment
If the current work environment is not supportive and does not allow for any flexibility of schedule or room for self-care, it may be time for a therapist to talk with their boss and possibly consider other options. Sometimes, overcoming burnout requires changes at the organizational level.
12. Set Personal Boundaries
There is only so much precious time and energy to go around. It is important for therapists to get comfortable saying no to the things that drain them, and yes to the things that light them up! It is truly impossible to pour from an empty cup, so a therapist making room to fill their own cup is not a luxury, but a necessity.
13. Know Your Worth
When therapists charge too-low fees that leave them resenting their clients or their work, this can contribute to burnout. Therapists are notorious for under-valuing themselves, and it is important to be fairly compensated for their education, experience and expertise.
14. Limit Client Caseloads
With the increased demand for mental health services in the last couple of years, this can be tough. Many therapists are tempted to try to squeeze in just one more client. Remember that having a caseload higher than is ideal doesn’t really help the therapist or the client. Therapists have to keep in mind that they are not able to help everyone all the time.
15. Work With Ideal Clients
Spending some time thinking about who their ideal clients are and filling their caseload with them is a great way for therapists to enjoy their work more and decrease the risk of burnout. When therapists work with clients who are out of their scope or not a good fit, this can lead to dreading work and feeling emotionally exhausted.
16. Get Trained in a New Modality
Learning a new modality like Eye Movement Desensitization and Reprocessing (EMDR), Internal Family Systems (IFS) or Dialectical Behavior Therapy (DBT) can help therapists re-discover their passion for their work and gain effective new tools for helping clients.
17. Change Your Mindset
A fixed mindset keeps people stuck and believing that there is nothing they can do to change their situation. A growth mindset, on the other hand, perceives every situation as an opportunity to learn, grow and change for the better. Practice nurturing a growth mindset.7
When to Seek Professional Help
Occasionally, therapist burnout can turn into something more serious that demands professional help. Some warning signs are ruminating about clients, changes to appetite or sleep, or decreased ability to function at home or work. Finding a therapist may be helpful at this point, and an online directory is a great place to start looking.
EMDR can be extremely helpful for therapists dealing with secondary trauma. Cognitive Behavioral Therapy (CBT), DBT and IFS are also very helpful in increasing distress tolerance, changing negative thought patterns and helping therapists understand how their own beliefs contribute to or protect from burnout.
Final Thoughts
Due to the emotionally demanding nature of their work, especially in recent times, therapists and counselors often find themselves burned out. It’s crucial to take stock of your own needs and practice self care to help manage stress and prevent burnout.
