The alarm was relentless, even with several taps on the snooze button. I finally surrendered to the morning and rolled out of bed, practically tumbling over my 65-pound goldendoodle, Max, who was snoring below my feet.
With one eye open, I made my way to the shower and blasted the scalding droplets over my sleepy body, allowing the water to wash away the slumber. Eventually, I resurrected to a new day.
Walking to my bedroom, I threw on the work attire I had set out the evening prior and towel dried my hair, desperately trying to hide the impending gray that was peeking through faded highlights. I painted on my face, twisted up my hair and headed to the kitchen, where I grabbed my oatmeal packet and a glass of juice.
Perusing my day planner (yes, I still use the old-school paper kind), I reflected on the day ahead. It would include seeing eight clients, submitting end-of-the-month claims, contacting an insurance company regarding a denial, returning phone calls from prospective clients and scheduling my own dental appointment. Glancing over the client list, I noted that my last two appointments were with couples that were still refining their communication from competitive yelling matches to accusatory squabbling.
Sigh. By this point, I felt horribly exhausted — and it was only 6:30 a.m.!
I texted my husband, “I am working till 8 tonight. Love you.”
“I love you too!” I heard from the other room. He was still home?
I walked into the other room, kissed the dogs and rubbed my husband behind the ears. Perhaps coincidentally, I suddenly realized it was time for a vacation.
Take a break
As counselors, we spend hours listening with great attentiveness to the pain and suffering of others. I see approximately 25 clients per week. That is 25 hours of meetings with individuals who are hurting and hoping to discover an elixir to their pain in our therapeutic work together. It is, by far, the most rewarding (and exhausting) vocation I have had the privilege of engaging in.
With that privilege comes great responsibility, which includes accessibility. Technology allows clients to seek immediate connection to their counselors via text, instant messaging and email. Counselors are now (theoretically) accessible 24/7.
I remember receiving a text message from a client at 11:30 p.m. I am normally snoring at that time, but this particular night, I was up reading a book when the message buzzed through. The client was texting me her suicide note.
Of course I acted on it by calling the police on my landline and hanging on the business phone with the client until she was found and taken to the hospital. But the magnitude of responsibility around receiving that message haunted me for days. What if I had been asleep when it came through?
The point is that we do “people work” that often involves crisis intervention related to life-and-death issues. Our jobs, while incredibly rewarding, are stressful, so we need to take breaks to retain some form of homeostasis in our lives.
Strike a balance
Unlike many other career paths, counselors must navigate the needs of their clients when planning vacations. There are ethical and legal issues to consider when taking a hiatus from a clinical practice. Standard A.12. of the ACA Code of Ethics mandates that counselors do not abandon or neglect clients and instead make “appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, illness, and following termination.”
Furthermore, counselors may be held legally liable should something happen to a client in the counselor’s absence if no backup care was provided. Therefore, there must be a balance between self-care and client care.
Tips for a smooth (and responsible) getaway
Here are five quick tips for planning that much-deserved vacation while still attending to your practice.
1) Alert your clients of your pending absence in advance and discuss backup plans with them. My daughter (who lives out of state) requested that I spend a month with her following the birth of my grandson. Although I longed to spend as much time as possible with them, I also was concerned about the needs of my clients. I discussed this with my daughter (and son-in-law), and we decided on a three-week visit instead (to be evaluated and changed as needed). I then began informing my clients about my pending absence several months prior to the delivery. Together we discussed strategies for coping and created scenarios for possible relapse that allowed for preventative measures. Finally, we discussed using a backup counselor for added support.
2) Arrange for a backup counselor. I have made arrangements with several of my colleagues to trade off services when vacations arise. Although my clients have never activated this backup system, I have found that it is a great comfort to them to have it in place.
3) Set a clear away message on your phone and email settings that provide the telephone numbers for the Warm Line, Hot Line and emergency backup counselor. Not all clients will require a session with a backup counselor, but a brief interlude with a Warm Line professional can alleviate their nervous jitters in your absence.
4) Unplug. This is probably one of the most challenging aspects of going on vacation as a counselor today. In the olden days — you know, in the age of landlines — clients left messages that were addressed when the counselor returned to the office. But technology provides the impression of total accessibility, even when you are on vacation. For example, while I was in Scotland, I had a client continually attempt to email and call me. Despite my months of preparation with her and my detailed away message that provided phone numbers for additional support, she was relentless in her pursuit. Finally, I returned her call, directed her to a support in my absence and turned off my phone.
5) Contact the ACA Risk Management Helpline for additional guidance. Invariably, there are going to be times when you must leave unexpectedly and are not able to provide your clients with weeks of preparation. The Risk Management Helpline, sponsored by the American Counseling Association, can provide guidance to ACA members concerning standards of practice that will best support the safety and well-being of your clients … and the enjoyment of your much-needed and deserved downtime. See counseling.org/knowledge-center/ethics for more information.
As counselors, it is imperative that we take time for vacation, unplug from our clients and reconnect with ourselves, our family members and friends, and that which is sacred in our lives. In doing so, we not only replenish our own reserves (which allows us to remain available to our clients over the long term), but also provide our clients and colleagues with a model of good self-care.
On that note, I think I will pack up my Jeep and head to the beach for a few days of sun, sand and solitude!
Till next month …
Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland, and a visiting full-time faculty member in the Pastoral Counseling Department at Loyola University Maryland. Her current research examines sexuality and spirituality in young women with advanced breast cancer. She is currently working on a book titled Homegrown Psychotherapy: Scientifically-Based Organic Practices, of which this article is an excerpt. Contact her at firstname.lastname@example.org.