Erica Sawyer, a licensed mental health counselor and art therapist in private practice in Vancouver, Washington, knows firsthand the benefits and challenges of being a highly sensitive therapist. (Approximately 20% of the population has an innate temperament trait referred to as sensory processing sensitivity; individuals with this trait are categorized as “highly sensitive people.” Right after graduate school, she started working 40 hours a week at an enhanced care facility for adults with severe and persistent mental illness. She quickly realized that the constant needs in the 16-bed locked unit were overwhelming for her.
“It was very intense,” Sawyer says. “There were times I couldn’t even get out the door to take a break because there was a crisis with a resident trying to leave the facility, so we couldn’t open any of the doors. So, on my break time, I had to sit in an office where there were constant interruptions.”
Sawyer tried to escape the overstimulation by visiting the restroom, but she couldn’t stay long in there because there was only one bathroom in the entire facility and other people needed it.
On the positive side, she found she was able to connect with many of the residents in a way that surprised and baffled the other therapists. She realized, however, that being good at this type of work didn’t mean that it was a good fit for her.
In fact, Sawyer says she was on a path to quick burnout, so she determined to figure out what she could control — such as her work environment, her hours worked, and the type of clients she saw — and start making changes.
She went from a full-time inpatient position to a part-time outpatient position, but even that was too much because of the hours needed to get all the work done for her caseload of 70 people. “The quantity of clients, along with being assigned the higher needs cases, was far from optimal,” Sawyer says. “I was experiencing my own anxiety and had to go out to my car and do some tapping [therapy] to just manage the day.”
Now, Sawyer is working part time in her own private practice so that she can control the amount and type of clients she sees and the days and times she works. She also lets clients know that she can’t guarantee a response to an email after 5 p.m. Highly sensitive therapists have to recognize their stress points and the environments that aren’t conducive to their temperament because it’s not good for them or their clients, she adds.
Because highly sensitive people process more deeply, counselors with this trait may have difficulty leaving work at work, notes Heather Smith, a licensed professional counselor and an assistant professor of human development counseling at Vanderbilt University. It’s important for highly sensitive counselors not to compare themselves to counselors who do not have this trait, she says. Instead, they have to figure out their own needs and best practices. For example, they may need to see fewer clients per week or work fewer hours.
Elaine Aron lists some possible self-care practices for highly sensitive therapists on her website:
- Practice “The Five Necessities” — believe your trait is real, reframe your childhood in light of this trait, heal from past wounds, don’t try to live like the other 80% of the population without the trait, and find a group of other highly sensitive people
- Reduce therapy work time (ideally, no more than 20 hours a week)
- Screen clients
- Have downtime
- Don’t take your work home
- Charge clients appropriately
- Find a good consultant
- Seek out your own therapist
- Take frequent vacations
Julie Bjelland, a licensed psychotherapist in private practice in California who specializes in working with people who identify as highly sensitive, recommends that highly sensitive therapists see no more than 10-12 clients per week. “You can’t see seven clients in a day as a highly sensitive person and be well because you’re taking in too much information,” she notes. Bjelland also suggests other ways that these therapists might reduce potential overstimulation and burnout. For example, they could increase their fees and see fewer clients per week, or they could see clients three or four times a week and then have three or four days off.
Smith, an American Counseling Association member who researches the sensory processing sensitivity temperament trait, advises highly sensitive therapists to create healthy habits to reduce overstimulation and to give their brains extra time to process. For example, counselors could schedule breaks between sessions, or they could make a point to finish their work notes before leaving for the day to avoid continuing to process this information when they get home. “Some of these practices can help over time to decrease the susceptibility to burnout,” Smith says.
Louisa Lombard, a licensed professional clinical counselor in private practice in California, makes a point to practice self-care habits. For instance, she takes a 30-minute break between clients so she can finish writing her notes, eat a snack, or engage in activities that she finds soothing, such as meditation or using essential oils.
Sawyer, also an ACA member, has colleagues who perform a ritual of literally washing their hands between clients as a way of letting that session and all of its associated information go down the drain before the next client.
Even though highly sensitive therapists have particular needs that must be addressed to avoid burnout, they also bring unique gifts to therapeutic sessions. Highly sensitive counselors “are well wired for this type of work,” Smith notes. “They’re going to process information more deeply. There are new research findings that suggest they have more mirror neuron brain activity and, thus, possibly stronger empathy.”
These counselors often have deep intuition and more attunement with others, and they tend to make clients feel safe and easily build rapport with them, Sawyer adds. As she points out, these qualities are “huge assets in being a good counselor.”
Bjelland, an author and global educator on the highly sensitive person, agrees that highly sensitive therapists have a lot to offer to clients because of these qualities. She finds that these therapists often have a strong connection with clients, are able to pick up on patterns and connections, and sometimes know things even before their clients do. She has had clients who weren’t able to reduce their anxiety even after working for years with other therapists. But within two to three weeks of working with her, their anxiety started to decrease.
Bjelland says highly sensitive therapists can benefit from thinking about the way that healers used to operate within a tribe: They had their own hut, and after they did their healing, they would spend a lot of time alone. “If you see one client, you’re going to need to process that session and then … rest and restore after that session,” Bjelland says. “Because if you take care of yourself well in this field, you can be a powerful healer.”
Look for a related article, “Finding strength in sensitivity” in the October issue of Counseling Today magazine.
Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist living in Northern Virginia. Contact her at firstname.lastname@example.org or through her website at lindseynphillips.com.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.
As an introverted, intuitive, HSP therapist in private practice, I found this to be helpful. I’m fortunate to be able to control a lot of the aspects of my practice and prevent myself from getting burned out and overstimulated. Having firm boundaries (and sticking to them), not just with clients, but with ourselves and our families is crucial. Thanks so much!