Tag Archives: Counselor Wellness

Counselor Wellness

A counselor’s journey back from burnout

By Jessica Smith April 13, 2017

I do not want to get out of bed, so I press snooze on my alarm again. I feel nauseated and think about calling in sick. Finally, I drag myself out of bed and take my time getting dressed for work. I leave my house reluctantly. On the drive to work, I find myself wishing that I could turn around. I dread going to work. I arrive 15 minutes late.

This was my pattern for longer than six months. Why was I the last one to figure it out? I was in burnout.

Learning to fly

I remember learning about self-care in the first semester of my graduate counseling program. I was so intrigued by the topic that I even wrote a paper about it during my first graduate course. My mentor and professor in graduate school focused on self-care in his course topics and research, so I felt very prepared to prevent burnout.

During my graduate program, I grew passionate about working with substance use and offenders. I decided that my dream job would involve working in a correctional setting. Not long after graduation, I obtained a position working on a treatment team in a local detention facility. I remember the feelings of pride and excitement that I experienced upon finding out that I had gotten the position. I was ready to do what I thought I had been trained to do, which was to help people.

I began coming to work early and made sure I was the last person in the office to leave. I would spend time researching and planning out sessions and group topics. Each day on the way to and from work, I would think about creative interventions that I could use with clients. I bought a bunch of workbooks, read a ton of articles, printed out a variety of activities from the internet and even purchased art supplies, stress balls and play dough for my clients to use in meetings. I recall losing myself in sessions and feeling a high after meeting with a client or finishing a group.

I would sometimes stay late or come in early to meet with clients. When I found out that a client was in crisis or had just returned from a disappointing court hearing, I would routinely rearrange my schedule or add in another session spot, even if I didn’t really have the time or energy for it. If a client asked me to jump, I replied enthusiastically, “How high?”

Free-falling

About a year into my work, I felt lost and confused. I would like to say that I could pinpoint the moment when this shift occurred in me, but as with many things in life, it was more of a gradual, slow burn.

Of course I can remember defining moments that stood out to me, such as learning that a client with whom I had worked for six months had been sentenced to 16 years in prison for a nonviolent crime. I was in the hallway and saw him when he was walking back to his “pod” (the name for the housing communities in the jail). He stopped me and informed me of his prison sentence. I barely made it back to my office before I started sobbing. The news literally brought me to my knees.

Another moment also stands out to me. On one of the many nights when I was working late, I ran into a client in the hallway. This client said to me, “Jess, why are you staying late again? You need to take care of yourself and go home.” I pride myself on being a mirror for my clients, but the truth is that my clients are often my best mirrors and teachers — even if I don’t truly want to see what they are reflecting back to me.

Catching fire

Looking back on everything now, it seems obvious to me: I was so invested that I blurred my boundaries. I had so much empathy and compassion for my clients that I sometimes lost myself in those relationships. I wanted to help others first at the expense of helping myself.

As many of us know, however, when we are deep in the swamp, it can be difficult to see a way out. After all, there were times when the work still felt really rewarding. I could still experience little victories, such as when a client was able to voice change-talk or gain insight into the roots of his criminal behaviors. I held on to these moments for dear life because I was terrified of what I might discover if I let go and shifted the focus back to myself.

It took another year before I went from “crispy” to full-fledged burnout. My physical symptoms of burnout continued to worsen, so I sought therapy, just as I had many times before when things in my life became unmanageable. I realized in counseling that if I stayed in my current position, I might eventually hurt others like I was already hurting myself, so I resigned from my job.

Rebirth

I remember thinking that if only I could meditate enough, exercise enough, vacation enough, love enough, relax enough, then I would be OK. The problem with “enough” is that it never really feels like enough. I was too caught up in “doing” because I was afraid of what I would learn about myself in the “nondoing.”

After resigning from my job, I spent the next month traveling and reconnecting with myself. My journey took me to some amazing places, but, interestingly, the place that had the most profound effect on me was also the most unexpected.

I spent six days as a student at a Zen Buddhist monastery in Crestone, Colorado. Crestone is considered to be one of the most spiritual places in the world. The land was called the sacred center of North America by the native peoples, and tribal members would travel from all over the country to attend healing ceremonies in the valley. The Manitou Foundation has provided grants and financial support to religious and spiritual projects in Crestone, leading to 15 different spiritual centers putting down roots in the area, including ashrams, churches and monasteries. My schedule consisted of the following: wake up at 4 a.m., meditate for two hours, participate in morning service, eat breakfast in silence, engage in morning work practice, eat lunch in silence, engage in afternoon work practice, take a one-hour break, meditate again for two hours, repeat the next day.

At one point I remember thinking that I desperately wanted to get in my car and drive away, but I reminded myself that I had consciously chosen to be here and there was a lesson I needed to learn from this experience. In actuality, I learned many lessons in my six days there, but the one that stood out to me most was that I tend to give much more than I take in and receive from others. Others are waiting on the sidelines, ready to help me carry some of my burden, if only I will ask. Too often, I choose to smile, wave and run right past them.

Rising from the ashes

As counselors, our out-breath tends to be longer than our in-breath. We often feel it is easier to give than it is to receive, yet we need to give and receive in order not just to survive but thrive. We do difficult work each and every day, then offer pro bono services to clients when we are already stretched thin and barely covering our overhead. We volunteer our time and hearts for a worthy cause or a friend in need even when we have no remaining headspace or heart space.

When I feel sad, lonely, disappointed or powerless, I give because that is what I know how to do. But what I really need in those times is to seek and genuinely receive help from others. I would like to share a few ways I have discovered that I can receive from others that truly fill me up when I feel depleted.

Seeking community. Two years ago, a few therapists in our community came together to start a support group that we call a “sangha.” A sangha is a supportive community that meets regularly to share knowledge and practice skills to foster understanding, acceptance and awareness. We meet twice monthly for two hours total. I can honestly say that it has been one of my most rewarding, nourishing and sustaining experiences, both personally and professionally.

It is interesting that as helpers, we often preach the power of community and support groups to our clients, but we rarely engage in this type of group on our own. Nearly every time our sangha meets, we comment on the ability of this group to empower and uplift us. I have spoken with a number of therapists who share the same interest in starting a professional support group. I highly encourage counselors reading this article to begin talking to other interested professionals in their home areas. Consider starting your own group to receive the support, guidance and compassion of other healers.

Naming burnout. Whether it is during our own personal therapy or with other professionals, I think it is important to unpack our counseling experiences in a healthy way. We do incredibly difficult work, and we need a way to empty our cups when they are overflowing. I now surround myself with people who can hold space for the tough emotions and who want to help me carry some of my professional “stuff.”

As therapists, we can sometimes feel shame around voicing our feelings of compassion fatigue or burnout to others. We sometimes think these feelings mean we might be flawed because we are not able to take our own advice. However, I believe shame breads in secrecy. We need to share these experiences with others to take away the power they might have over us. We also need to be able to receive any feedback and insights that others might have for us during these vulnerable times. I encourage you to have an open conversation about burnout with your professors, mentors, supervisors or colleagues to reduce the stigma it holds for us as helping professionals.

Exploring spirituality. As I have mentioned, early on in my career, my idea of self-care was focused in “doing” rather than just “being.” This was a superficial view of self-care. I have since learned that self-care is so much more than the “doing” part.

The missing component in my self-care practice for many years was spirituality. When I added this to my practice, I felt free. My spirituality practice is a hybrid of many different ideologies and approaches, but finding what works best for you is most important.

I remember hearing that prayer is sending a message into the universe, whereas meditation is receiving a message from the universe. This has always stuck with me. There are times when I will sit down to meditate and I will just cry. Sometimes I am not even aware of an emotion until I sit down on my mat in stillness. Spirituality can ground you when you feel like you are floating away. It can humble you by reminding you that you are one tiny part of a vast system and universe. I believe there are many paths to the same destination, but I encourage you to explore and figure out the path that anchors you and allows you to receive whatever insights your practice offers.

Conclusion

Jim Morrison is attributed with saying, “You can’t burn out if you’re not on fire.” Often, we get into this work because we are wounded healers who are passionate about helping others. Passion is fire. If you are passionate about this work, then eventually you will catch on fire, but you ultimately get to choose whether you will burn out and fade away or rise from the ashes.

 

****

 

Jessica Smith is a licensed professional counselor and licensed addiction counselor in private practice in Denver. She is also a trauma-informed therapist who is trained in eye movement desensitization and reprocessing and yoga therapy. Contact her at jsmith@radiancecounseling.com.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having your article accepted for publication, go to ct.counseling.org/feedback.

 

****

 

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.

Nonprofit News: Self-care for caregivers

By “Doc Warren” Corson III March 20, 2017

The field of counseling is one that offers great rewards. We get to see people go from their worst to their best. We get to be a part of the change that our clients are seeking.

Even so, the hours and hours we spend listening to the pain of others can take its toll. That raises an important question: While you invest so much in “saving” others, are you neglecting yourself? If so, you, like many of us in this profession, could be in danger of compassion fatigue or burnout.

 

Understanding compassion fatigue and burnout

Working as a counselor can weigh on you. You may find that you are having more difficulty being empathic in situations in which it once came naturally to you.

And although this compassion fatigue may start at your job, it can bleed over into your most intimate relationships. You may even find yourself feeling that you cannot possibly give anything else emotionally to others.

Among the signs of compassion fatigue are:

  • Excessive blaming
  • Bottled-up emotions
  • Isolating from others
  • Substance abuse
  • Compulsive behaviors
  • Poor self-care
  • Legal problems
  • Apathy
  • Feeling mentally and physically tired
  • Feeling preoccupied
  • Living in denial about problems
  • Difficulty concentrating

Burnout is closely related to compassion fatigue, but in extreme cases it can have more serious impacts on a person’s physical and mental health. Some of the signs of burnout include:

  • Chronic fatigue
  • A quick trigger to feel angry or suspicious
  • Susceptibility to illness
  • Forgetfulness
  • Insomnia
  • Loss of appetite
  • Anxiety
  • Depression

Burnout does not just happen overnight. Instead, there are stages and patterns that can help you to identify the issues and assist you in addressing them. Although having a great deal of enthusiasm for a project is considered positive and can often lead to a wealth of progress, look for signs of stagnation, frustration or apathy that may follow. Each is a sign of trouble.

Stages of burnout:

  • Enthusiasm
  • Stagnation
  • Frustration
  • Apathy

 

Prevention

Prevention is vital if one wants to keep working at optimum levels. Look at the list of practical ways to find balance, recharge and stay focused. Be prepared to think outside of “normal therapist behaviors” and identify those things that help you remain focused and energetic. Consider hobbies and activities that you once enjoyed but perhaps stepped away from because of graduate studies or other life-related obstacles. Embrace what you once enjoyed, especially those things that are far removed from the helping professions.

As for me, I re-embraced classic car restoration and time spent in nature, while adding classic farm tractor collecting (among other hobbies). So, go see that play or musical, get your hands dirty, listen to loud music or take part in other events. You cannot stay “on” all the time and still be effective as a counselor.

Here are some tips on prevention of compassion fatigue and burnout for helping professionals:

  • Get educated on signs and symptoms of compassion fatigue and burnout
  • Practice self-care
  • Set emotional boundaries
  • Engage in outside hobbies
  • Cultivate healthy friendships outside of work
  • Keep a journal
  • Boost your resiliency
  • Use positive coping strategies
  • Identify workplace strategies
  • Seek personal therapy

We are involved in one of the most emotionally draining professions that exist. You are here because you want to help people make a change and sustain that change. So give yourself the ongoing maintenance that your body and mind require. Find the answer that works best for you and follow through. We have too many people depending on us. We owe it to them, but, most importantly, we owe it to ourselves. Let’s do this.

 

****

 

Dr. Warren Corson III

“Doc Warren” Corson III is a counselor, educator, writer and the founder, developer, and clinical and executive director of Community Counseling Centers of Central CT Inc. (www.docwarren.org) and Pillwillop Therapeutic Farm (www.pillwillop.org). Contact him at docwarren@docwarren.org. Additional resources related to nonprofit design, documentation and related information can be found at docwarren.org/supervisionservices/resourcesforclinicians.html.

 

 

 

****

 

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.

 

Wellness matters

By Ashley J. Blount, Glenn W. Lambie and Daniel B. Kissinger November 2, 2016

The concept of wellness can be found across history, from ancient civilizations through the foundational tenets and ethical codes of contemporary counseling and allied mental health and medical disciplines. Counseling professionals in particular have embraced a holistic, wellness-oriented approach that contrasts with traditional medical/illness models, and many of our theoretical approaches have adopted health-enhancing, prevention-oriented ideals. As a result, counselors serve as agents of wellness promotion and models of wellness by integrating and practicing wellness-based philosophies and practices in their personal and professional lives.

The notion of “therapist, heal thyself” is often used to suggest that helping professionals can and will, simply by virtue of their knowledge of wellness ideals and practices, be better prepared to address life’s diverse challenges. Although counselors certainly possess a dynamic range of concepts and interventions that can be applied in times of distress (and eustress), we remain susceptible to life’s idiosyncrasies just as our friends, families and, yes, clients do. Our effectiveness in serving others as counselors, then, is often connected to our ability to maintain a wellness perspective in our own lives.

The question is: How do we go about healing ourselves as counselors and promoting wellness in our own lives? Awareness appears to be a significant first step in promoting counselor wellness.

A common view of wellness depicted in the media is the notion of “I must,” which suggests that people must do specific things and take explicit actions to be considered healthy. For example, obtaining eight hours of sleep per night and drinking eight glasses of water per day are often cited as keys to good health. We are also told that weight training, cardiovascular exercise, a specific body mass index and consistent social interactions are requisites for health and branding-images_wellnesswellness. Although few would argue that these factors have positive wellness implications, actually attaining all the media-driven perceptions of an ideal wellness state is unreasonable, if not impossible, for many individuals.

The concept of wellness among counseling and allied health professionals provides a healthier, holistic and evidence-based understanding of wellness. In effect, paying attention to the totality of one’s personal wellness facilitates a more accurate perception of wellness and allows one to devise more intentional, individualized wellness plans.

Increasing counselors’ awareness of their current wellness states is an essential component in healing, maintaining wellness and promoting wellness in others. We view wellness in two forms: perceived wellness and aspirational wellness.

Perceived wellness refers to individuals’ self-understanding of their wellness levels, whereas aspirational wellness refers to the level of wellness people wish to achieve. Similar to the concept of cognitive dissonance and the differences between actual and ideal individual states, this perspective of wellness looks at where people are and where people want to be in relation to their personal well-being.

When people are struggling, who they are (how they perceive themselves) can be vastly different from who they want to be (their aspirations). For example, if we look in the mirror and don’t like what we see, it is likely that there is a discrepancy between what we are seeing (e.g., physically, mentally, emotionally) and what we desire for ourselves. The central idea is that the less discrepancy that exists between one’s perceived and aspirational wellness, the higher one’s potential is for optimal holistic wellness (i.e., if who I am is close to who I want to be, I am more likely to experience well-being). Conversely, the higher the discrepancy is between perceived and aspirational wellness, the less likelihood there is for achieving advanced well-being.

Assessing your wellness

Contemporary wellness models continue to evolve, providing us with expanding views of the meaning and structure of wellness, as well as numerous interventions and strategies for improving distinct aspects of wellness. Although these models have increased our understanding of wellness as a holistic concept, there remains a need to clarify and address the distinctions between perceived and aspirational wellness.

To assess the wellness discrepancies in helping professionals (counselors, psychologists and social workers), two of the authors of this article, Ashley J. Blount and Glenn W. Lambie, developed the Helping Professional Wellness Discrepancy Scale (HPWDS). The wellness domains measured within the HPWDS are:

  • Professional and personal development activities
  • Religion/spirituality
  • Leisure activities
  • Burnout
  • Optimism

The professional and personal development activities domain includes activities such as furthering knowledge in personal and professional arenas, reading or conducting research relating to the helping professions and taking actions to advance general knowledge (e.g., reading a book, attending seminars or conferences).

The religion/spirituality domain involves partaking in activities centered on advancing spirituality or religious rigor. Examples include having religious or spiritual beliefs that are sustaining, engaging in prayer, experiencing satisfaction with spiritual or religious activity and meditating with a focus on a higher power or spiritual entity. Spirituality and religion have roots in the wellness literature and are included in the majority of wellness and wellness-related models and assessments. 

The leisure activities domain refers to engaging in free-time activities and time away from work or chores. This factor can include time spent with others socially or time spent alone. Regardless, leisure time is influential in maintaining well-being.

The burnout domain involves feeling exhausted, run-down, worn out and stressed as a helping professional. Correlations between burnout and unwellness are found throughout the counseling literature, and it is logical that if we are struggling in our work environment, this will overflow into our personal lives as well. Burnout influences us on many levels and can have a negative effect on our well-being. 

Finally, the optimism domain is considered a universal construct and is associated with health and well-being. Helping professional optimism includes feeling optimistic personally (e.g., “I am hopeful about my future”) and feeling optimistic about clients’ futures.

Each of the five domains contributes to helping professionals’ overall health and well-being. Increasing your knowledge about your personal experiences in any of these areas can boost your wellness awareness and help you make positive life changes.

Informal wellness assessments

If taking a wellness assessment isn’t on the docket, counselors can choose from other techniques oriented toward wellness awareness. One example is the Wellness Starfish awareness technique, which is based on the sea star balancing exercise developed by Lennis G. Echterling and colleagues (2002).

Here, the first step involves drawing a starfish on a blank piece of paper and filling in each “arm” with an area of life that you feel is important to your well-being (e.g., family time, spirituality, walking with the dog). The wellness starfish example shown [in the print version of this article in Counseling Today] contains the wellness-influencing factors of Jane E. Myers, Richard M. Luecht and Thomas J. Sweeney’s Five Factor Wellness Inventory (2004).

Second, take a couple of minutes to process the items you have written down. Next, consider that starfish are rarely the symmetrical, five-armed creatures we are accustomed to seeing represented in pictures and posters. In reality, starfish can be unevenly proportioned and may even lose and regenerate an appendage during their lifetime. This unique ability to regenerate, or actively change, is central to achieving aspirational wellness. Thus, the final step involves drawing a second wellness starfish, but this time with arm lengths that correspond to your “aspirations” for each area. For example, if your relationship with your partner contributes (or if you want it to contribute) most to your well-being, that area would be represented with the longest arm. See the figure on the lower right for an example of a recreated wellness starfish.

Now consider your new wellness starfish. Which arms are longer or shorter? Why is that? Do any of the shorter arms or missing arms constitute areas that need work in your life or areas in which you could make a change to start the regeneration process? As this simple exercise demonstrates, informal assessment techniques can be tremendously effective in helping you learn about your personal wellness and highlight areas for future growth and development.

Another useful technique involves creating an individualized wellness plan. The plan can contain a single area or many areas for growth. This written plan can follow established wellness tenets such as Bill Hettler’s Six Dimensions of Wellness (i.e., emotional, occupational, physical, social, intellectual and spiritual), the HPWDS tenets discussed earlier or areas that are based on personal experiences. Regardless of how a wellness domain is labeled, assuming and maintaining an aspirational stance can help ensure that one’s aspirational goals remain the central focus.

The example [in the print version of this article in Counseling Today], adapted from Darcy H. Granello and Mark E. Young (2012), provides a sound framework for addressing key factors that can either support or act as barriers to one’s well-being.

Wellness as prevention 

Roughly 75 percent of health care dollars in the United States are spent on treating chronic diseases, whereas only around 1 percent goes to the prevention of illness. Assigning more value to a wellness perspective could help mitigate or even eliminate many illnesses by refocusing attention on lifestyle strategies that are conducive to improving overall well-being. Consider that prominent diseases such as diabetes, coronary heart disease and obesity are often associated with unhealthy lifestyle choices. Adopting a wellness-oriented outlook and lifestyle can lead to positive changes in our diets and our physical and leisure activities.

Wellness is something that is fluid. Because it remains dynamic, it provides individuals with opportunities for change. The challenge for many of us, of course, is awareness and integrating these new behaviors into our lives. Along with adopting a wellness-oriented lifestyle, this requires learning to navigate the discrepancies between who we are and who we want to be, increasing our personal awareness and, ideally, enhancing personal well-being.

Wellness at work

Aligning our lifestyles with a holistic wellness approach can also have considerable occupational benefits for us as counselors. Gerard Lawson (2007) highlighted several key career-sustaining behaviors for counselors that can, by extension, have a positive impact on client outcomes. These behaviors include:

  • Maintaining a sense of humor
  • Spending time with your partner/family
  • Maintaining a balance between your professional and personal life
  • Maintaining self-awareness
  • Maintaining a sense of control over work responsibilities
  • Reflecting on positive experiences
  • Trying to maintain objectivity
  • Engaging in quiet leisure activities
  • Maintaining professional identity
  • Participating in continuing education

Some other counselor behaviors found to be beneficial include:

  • Consulting with colleagues
  • Attending trainings/conferences
  • Socializing
  • Receiving supervision
  • Limiting caseloads
  • Attending personal counseling sessions

Although individual needs and expectations will vary, failing to attend to personal wellness is a recipe for poor wellness outcomes, both at home and at the office. Conversely, the activities aimed at raising awareness of wellness are numerous and can be tailored to each counselor’s personal and professional needs.

There is likely no shortage of counseling professionals who feel a bit hypocritical when advocating for their clients to adopt a wellness orientation while simultaneously struggling to maintain balance in their own lives. Even Carl Rogers noted, “I have always been better at caring for and looking after others than I have been at caring for myself.”

Often, the challenge for counselors is not ignorance of the wellness literature or the benefits of wellness, but rather the tendency to forgo our own wellness for the sake of caring for clients and others within our spheres of influence. Thus, adopting or rededicating ourselves to a lifestyle that recognizes our own needs and desires is key to maintaining a healthy work-life balance.

Conclusion

The American Counseling Association, the Council for Accreditation of Counseling and Related Educational Programs and the American Psychological Association all support the idea of monitoring the wellness of helping professionals. The HPWDS is a tool that helping professionals can use to assess their areas of wellness strength (low discrepancies between where they are and where they would like to be) and wellness areas for growth (high discrepancies between where they are and where they would like to be). Other wellness assessments (whether formal or informal) can be tailored to meet individual preferences and needs to increase overall well-being.

When it comes to our personal wellness, we often think, “I’ll start next week” or “I’ll get around to that.” It is easy to put ourselves below work deadlines, client responsibilities, family duties — the list goes on and on. Unless we are functioning well, however, we are setting a poor example for the people around us. And beyond that, we may not be providing the best services to
our clients.

 

*****

 

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Ashley J. Blount is an assistant professor at the University of Nebraska Omaha. She is a national certified counselor and chair of the American Counseling Association Graduate Student Committee. Her research interests include wellness counseling, counselor education and supervision, and counseling athletes and former athletes. Contact her at ablount@unomaha.edu.

Glenn W. Lambie is chair of the Department of Child, Family and Community Sciences and a professor of counselor education at the University of Central Florida. He is an American Counseling Association fellow, a national certified counselor, a national certified school counselor and a certified clinical mental health counselor. His research interests include counselor development and supervision, counseling children and adolescents, and professional school counseling.

Daniel B. Kissinger is an associate professor and chair of the Department of Counseling at the University of Nebraska Omaha. He is a licensed independent mental health practitioner and certified professional counselor. His research interests include the student-athlete experience, wellness and clinical supervision.

Letters to the editor: ct@counseling.org

 

****

 

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.

The Counseling Connoisseur: Break away: Five vacation hacks for the responsible counselor

By Cheryl Fisher September 5, 2016

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.

 

Conclusion

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 …

 

Surf fishing before sunrise in the Outer Banks, North Carolina

Outer Banks, North Carolina/Photo via unspash.com

 

 

****

 

Cheryl Fisher

Cheryl Fisher

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 cy.fisher@verizon.net.

 

 

 

 

 

****

 

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.
****

Counselor addresses self-care, guilt in the wake of Orlando shooting

By Samuel Sanabria July 5, 2016

“When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’” — Fred Rogers

 

It was 9:53 a.m. on Sunday, June 12, when I received a text from my husband regarding the mass shooting at Pulse, an Orlando, Florida, nightclub catering mainly to lesbian, gay, bisexual and transgender (LGBT) individuals.

I was wrapping up the week at a sex education and counseling conference in San Juan, Puerto Rico, where I was sitting in our closing plenary session. It had been a week of personal empowerment. I had been absorbed by the many workshops on sexual inclusivity, especially regarding the LGBT community. I was surrounded by like-minded professionals who were advocating for change in our society’s attitudes toward sexual minorities. My evenings were spent enjoying time with my husband and 7-year-old daughter, who had come with me to Puerto Rico to enjoy the beach and pool at the conference hotel. It was a nice way to kick off the summer with my family.

As I sat in the final session, I looked down at the text and read the headline of the link my husband had sent me, “Orlando Shooting: 50 People Killed.” Reading further, I learned the shooting had taken place at Pulse, which is just a few miles from our home. I had enjoyed visiting the nightclub with my husband and friends on numerous occasions.

After reading the article again, my thoughts quickly turned to my immediate friends who might have been at Pulse when the shooting occurred. I began to worry. I could no longer focus on the session and stepped outside to begin texting friends to see if they were OK. Thankfully, my friends were safe, but they were as distraught as I was and were anxiously going through their own lists of friends. Social media was filled with news of the shooting. Some posts provided reassurances of loved ones’ safety. But, heart-wrenchingly, other posts were from people seeking information about family and friends who were still missing.

As we traveled back home the next day and as the names and faces of the victims were gradually released in the media, I was struck by how many young people of color were killed on what was “Latin Night” at the nightclub. As a gay Latino man who had visited Pulse, I felt a strong connection to the victims and their families. I didn’t talk much during our flight back to Orlando. I spent the time turned inward, trying to make sense of what had happened and thinking about what my city was going through. I was distressed by my roiling emotions and felt trapped by the logistics of travel. I couldn’t wait to do something to help the victims and their families.

After arriving home, I visited The Center, Orlando’s LGBT community center, to volunteer crisis counseling and Spanish translation services. The common area of The Center was a beehive of activity as volunteers welcomed visitors, organized donations, worked crisis phone lines and did their best to help people affected by the shooting. Local individuals, organizations and

Lucia Lassiter-Sanabria, the author's 7 year-old daughter, at a memorial site set up recently at the Dr. Phillips Center for the Performing Arts in downtown Orlando. "I had been talking to Lucia about the [Pulse] shooting and wanted to show the enormous amount of love and support that was given.  It was a tender moment watching her walk around and look at the pictures of the victims and reading some of the signs of love," says Sanabria.

Lucia Lassiter-Sanabria, the author’s 7 year-old daughter, at a memorial site set up recently at the Dr. Phillips Center for the Performing Arts in downtown Orlando. “I had been talking to Lucia about the [Pulse] shooting and wanted to show the enormous amount of love and support that was given. It was a tender moment watching her walk around, look at the pictures of the victims and read some of the signs of love,” says Sanabria.

businesses had donated food, water, services and gifts, while others were providing safe spaces for anyone who needed support. People from all over the country and the world were donating money to support the survivors and victims’ families. And, of course, professional counselors from around the state had stepped up to provide grief and crisis counseling.

Witnessing all of this activity and the many people who were traumatized or retraumatized by the news and stories of the shooting, I felt the magnitude of what this tragedy had done, not only to the victims at Pulse but to our entire community. It was at this point, standing there witnessing the outpouring of grief and anger, that I felt anxious, insignificant and powerless. I immediately felt an internal pressure to do as much as I could to help.

Throughout the week, I met with and provided support for survivors of the shooting; debriefed with my students in each of my summer classes; took my daughter and a couple of her friends to the LGBT center with sympathy cards I had helped them create; attended vigils; donated money; and locked arms with other LGBT activists and allies to block the well-known hate group, Westboro Baptist Church, from disrupting the funeral of one of the victims.

Despite this involvement, I still felt anxious, insignificant and powerless. These feelings stubbornly remained in the face of so much need. As my anxiety grew, I began losing sleep, had difficulty concentrating and was irritable. The worst part was my need to reenact, in my imagination, some of the stories I had heard on the news and from the survivors I had spoken with. These feelings were exacerbated by the litany of anti-gay and pro-gun political messages being expressed by the talking heads on various media outlets.

I realized I was experiencing burnout as a result of vicarious trauma and needed to make some immediate changes, starting with recognizing the importance of self-care.

 

Counselor self-care

Most counselors are familiar with the importance of self-care. Many of us spend hours each day listening to difficult stories, and for those who work in crisis care, these stories can be exceedingly tragic. Providing empathy for our clients is the hallmark of our profession, but it is also a main contributor to compassion fatigue. Counselors often become so involved in their work that they do not take adequate time to check in with how that work is affecting them physically and emotionally.

It is important that counselors remain alert to the warning signs of compassion fatigue. Physiological symptoms may include physical exhaustion, headaches, insomnia and increased susceptibility to illness. Emotional symptoms include anger, irritability, gradual disassociation, depression and difficulty concentrating. Ignoring these warning signs can lead to counselor impairment, which puts clients at risk for harm.

Red sky with rainbowIt is a counselor’s ethical and professional responsibility to work toward reducing compassion fatigue. This does not mean fighting against these feelings, but rather working through them, both before and after meeting with clients. Giving oneself permission to break for self-care can also help reduce compassion fatigue. This can be as simple as pausing for a deep breath and identifying one’s physical and emotional responses throughout the day. It can also be vital to create some mental space between oneself and the work, perhaps by spending quality time with family and close friends.

Taking these steps may be challenging for some, especially when working with a community impacted by a tragic event. Luckily, my close friend and colleague has a background in crisis work and, knowing the importance of self-care, reached out to me daily with reminders to take breaks and meditate on my physiological and emotional responses.

Once I recognized the symptoms of compassion fatigue within myself, I made sure to spend quality time with my family and to show appreciation for them. These were meaningful experiences that helped me re-center myself.

Also, at my friend’s suggestion, and for the first time in my professional life, I attended a support group for counselors. I appreciated being able to share how this tragedy had affected me in a room of supportive individuals who were going through the same experience. This group outlet was important and I noticed a reduction in my level of anxiety. However, there was still something that kept me from moving forward. It wasn’t until I heard another counselor share her experience with guilt for not doing enough that something clicked inside me.

 

Recognizing and addressing guilt

Another common experience among crisis counselors is the feeling of empathy guilt and survivor’s guilt.

Empathy guilt is a reaction to someone’s pain or distress that leads to the belief that one should try to work toward relieving those feelings. This can also lead to the feeling that one is not doing enough to help others relieve their pain. Survivor’s guilt can occur with someone who has survived a traumatic event or, in the case of counselors, works directly with victims impacted by a traumatic event. The symptoms of empathy guilt and survivor’s guilt include feeling regret, isolation, helplessness and, in serious cases, suicidal ideation.

One of the best ways to work through guilt is to share the experience with others and to recognize that this is a common emotion that, if properly managed, can be used to further empathize with the experiences of our clients. During the counselor support group, I was able to share my feelings of guilt and begin the acceptance process. I realized that it was not necessary to fully rid myself of these feelings of guilt; instead, I could use them to gain better insight into my internal emotional processes.

I came to understand that there was no amount of hours I could volunteer, marches I could walk, sympathy cards I could help my daughter create or money I could donate that would change what had happened to the victims of the shooting. I realized that “never enough” was good enough. This realization became a central part of my self-forgiveness and healing.

 

Conclusion: Never enough is good enough

This tragedy has shattered lives. It will take years to understand why this happened, if we ever can. The greater Orlando community has been galvanized, and I can feel a sense of unity and compassion that is heartening.

Personally, I have come to grasp one of the most important lessons of being a counselor, advocate, ally and humanitarian: Despite our best efforts and whatever time we put in, we will never achieve “enough.” Once I understood this, I felt a profound sense of peace and self-forgiveness. As I write this, the need for caring and supportive counselors in Orlando continues. Fortunately, I am able to volunteer service in a way that doesn’t deplete me or put those seeking my help at risk of harm.

It still breaks my heart to think about the bright lives taken from our community. As I sat with the other crisis workers in our support group, I realized that we had all been affected by this senseless tragedy and that we needed support just like everybody else. We laughed, cried and hugged each other; we respected our own emotional struggles; and we sat in silence to honor the lost lives. Most important, we helped strengthen one another so that we can go back out there and do work that will never be enough.

 

 

****

 

Samuel Sanabria is a licensed mental health counselor in the state of Florida with more than 15 years of clinical experience. He is an associate professor in the graduate counseling program at Rollins College in Winter Park, Florida. Contact him at ssanabria@rollins.edu.