Tag Archives: Counselor Wellness

Counselor Wellness

Opening keynote underscores a holistic approach to self-care

By Lindsey Phillips April 5, 2021

ACA’s 2021 Virtual Conference Experience started off strong with a keynote panel on self-care.

We all know self-care is important, but it can be difficult to define because there is no “correct” way to engage in self-care.

Gerald Corey, one of the four keynote panelists, stressed the importance of reflecting every day — even if it’s just for a couple of minutes — on how your day is going and what changes you want to make.

“Think of self-care holistically, and not just [as] physical exercise. Think of it in terms of relationships, meaning in life, having fun, recreating our existence, engaging in life rather than pulling back and disengaging,” says Corey, professor emeritus of human services and counseling at California State University at Fullerton.

Michelle Muratori, a senior counselor at the Center for Talented Youth at Johns Hopkins University, finds when she is tending to her self-care needs, her own internal boundaries are stronger, which allows her to be emotionally present with clients in session and let them have their own pain.

Gerald Corey, Michelle Muratori, Jude T. Austin II and Julius A. Austin, co-authors of the ACA-published book Counselor Self-Care, presented the opening keynote of the American Counseling Association’s 2021 Virtual Conference Experience on April 5. The theme for the first week of the monthlong conference is self-care.

Create a self-care plan that works for you

Counselors can have insight and awareness, but if they don’t have their own self-care plan — one that’s simple and realistic — then change won’t happen, asserts Corey, an American Counseling Association Fellow. This plan provides counselors with an opportunity to reflect on ways they can change what they’re doing to function better personally and professionally, he notes.

“It does help to have [the self-care plan] in writing and [to] talk to somebody about it and be accountable. Think of a way to get support to carry out your plan when it becomes difficult,” Corey adds. One useful exercise may be to think about what change you want to see six months or a year into the future, he suggests. Maybe you want to make more time for a hobby or write in your journal more often.

Jude T. Austin II, an assistant professor and coordinator of the clinical mental health counseling track in the professional counseling program at the University of Mary Hardin-Baylor, advises writing this action plan in pencil because obstacles will arise that force you to readjust your plan. He loves to work out in his garage, but when it’s cold outside, he has to find another way.

Counselors can also incorporate their self-care plan into their current routines, notes Julius A. Austin, a clinical therapist and the coordinator for the Office of Substance Abuse and Recovery at Tulane University. For example, they can check in with family or listen to an audiobook during their hour-long commute to work.

Muratori, co-author of Coping Skills for a Stressful World: A Workbook for Counselors and Clients, reminds counselors that they don’t have to do self-care perfectly. Often, doing their best is good enough, she says.

Get to know your stress

Jude Austin shares advice he received from a supervisor: “Make … stress [and] anxiety your best friend. Sit them next to you and get to know them. Understand what stress does to you [and] how it influences you. What are your triggers? How do you deal with it? Who are the people around you that it affects?”

Considering these questions allows people to be intentional about how they approach self-care because they better understand their unique kind of stressors, he explains.

This reflection should also extend to one’s relationship with other people. Carefully consider who you want to be around professionally and personally, advises Jude Austin, a licensed professional counselor (LPC) and licensed marriage and family therapist associate in private practice in Temple, Texas. It’s OK to fire a supervisor or not to be friends with every colleague if the relationship isn’t working for you or makes you feel bad.

Finding ways to cope with stress can be challenging. The keynote speakers, co-authors of Counselor Self-Care, share some activities that help them better manage their stress:

Find some type of physical activity that you enjoy doing and that fits within your lifestyle and do it relatively consistently, Corey says. And it doesn’t have to be time consuming, he adds. You can take the stairs rather than the elevator, for example.
Learn something new. When graduate school became overwhelming, Jude Austin started growing bonsai trees to help him cope with the stress of having things outside his control. He still finds learning something new every year helps him manage his stress and fosters his curiosity.
Connect with others. Julius Austin, an LPC and adjunct professor at Southeastern Louisiana University, takes time to check in with his family, friends and colleagues. Even just a five-minute phone call with his family gives him a sense of warmth and calm after a stressful day.
Muratori watches late-night comedy as a way to decompress.
Enjoy nature. Corey advises counselors to step away from their desks and spend at least 30 minutes outside in nature every day. Jude Austin sometimes finds it challenging to leave his office, so he brought nature inside by adding a few plants to his workspace.
Find meaning and purpose in your life. Think about what makes you want to wake up in the morning, Corey says. He notes that spiritual involvement and service to others can often be a source of meaning for many people.
Go to counseling. All the speakers stressed the importance of counselors seeking their own counseling throughout their lives.

Revising self-care plans

Each new career stage presents new stressors that require counselors to constantly adjust and revise their self-care plans.

Julius and Jude Austin, co-authors of Surviving and Thriving in Your Counseling Program, are in the early stages of their professional careers, and they’ve noticed new professionals often quickly say “yes” to every professional opportunity because they are building their careers and gaining self-confidence. But this behavior can lead to burnout, so they caution new professionals to be more intentional with the job responsibilities they assume.

Corey suggests counselors say, “Let me think about it,” when approached for a professional opportunity. And then they really have to consider if that opportunity is a good one for them in that moment.

Jude Austin also finds it challenging to balance all of his daily responsibilities between his work and personal life. “Your career and family are sometimes growing in parallel,” he says. And juggling these roles is often when he feels the most out of balance.

Mid-career is often a time when people assume more work-related responsibilities, Muratori says. And they may need someone to hold them accountable and ensure they aren’t taking on too much. She also points out it’s a time when counselors may experience new family stressors such as a child going off to college or caring for older parents.

Corey credits his long, productive counseling career with two things: 1) He took the time to create a self-care plan that worked for him and encompassed all facets of wellness, including physical, emotional, relational and spiritual health. 2) He took the time to reach out and connect with colleagues. “This can be a lonely profession,” he notes. “Don’t wait for somebody else to … reach out. … It’s important for us to reach out to those friends and colleagues and take the initiative.”

Counselors shouldn’t feel guilty for taking time to care for themselves. “Pay attention to yourself; listen to yourself; allow yourself to guide you through this [self-care process],” Jude Austin says. “If something doesn’t feel right, doesn’t feel comfortable, then reevaluate. … Self-care is flexible. It’s not selfish. It’s responsible. So, just be kind to yourself.”

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This keynote panel kicked off a month of virtual events, including hundreds of educational sessions and three additional keynotes, that lasts through April 30.

Find out more about the American Counseling Association’s 2021 Virtual Conference Experience at counseling.org/conference/conference-2021

Registration is open until April 30; participants will have access to all conference content until May 31.

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Lindsey Phillips is a contributing writer to Counseling Today and a UX content strategist. Contact her at hello@lindseynphillips.com or through her website at lindseynphillips.com.

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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.

Yoga-informed self-care strategies to help counselors avoid burnout

By Olivia Schnur

When I was in graduate school, burnout seemed like something that would never happen to me. I worked out regularly, ate healthy, and had a well-rounded social life and plenty of hobbies. I thought self-care was that simple.

Fast-forward 10 months into my career: I quit my first professional counseling job to do a yoga teacher training and move to Australia. I was burned out and swore I would never return to counseling.

As it turns out, the yoga teacher training was the exact thing I needed to make my safe return to counseling. I would like to share with my fellow counselors some tips and tricks I learned along the way that go beyond bubble baths and workout plans. These tips are for anyone regardless of fitness level, religious affiliation, age or experience.

Evidence-based breathing

Several breathing techniques have an evidence base to support their effectiveness. I share them first because I know, if you are anything like me, you want solutions and you want them now. I do encourage you to notice how each practice makes you feel, however. So many things that professional counselors do are results-driven; for once, allow yourself to do something simply because it feels good.

Deep belly breathing: Most people know the benefits of deep belly breathing (diaphragmatic breathing). Breathing into the low belly stimulates the parasympathetic nervous system and massages the vagus nerve. It is the quickest way to return to a state of calm, and yet it seems to be the most often overlooked form of self-care.

Deep belly breathing can be done anytime and anywhere. That being said, people often do not know how to breathe into their lower lungs. To begin, practice lying on your back with one hand on your chest and the other on your belly. Notice where the breath flows. It can be helpful to imagine blowing up your stomach like a balloon as you inhale and deflating it as you exhale.

Once you master this technique, you can start to do it sitting up. This is where the real magic happens. You can deep belly breathe in session, at your desk or even in a boring Zoom meeting that definitely could have been an email. It may seem simple, but it is the foundation for every other breathing technique.

Breath retention: Breath retention should be done with caution. It can be extremely helpful for individuals who experience anxiety and panic attacks. Paradoxically, it can be quite anxiety-producing.

Breath retention is the practice of holding the breath. It can be done at the top of an inhale or the bottom of an exhale. For the least amount of anxiety, begin by practicing holding at the top of the inhale.

To begin, take a few deep breaths into the low belly. Start counting the number of seconds it takes to inhale and exhale and try to make them even. Then, at the top of the inhale, hold for one second before exhaling.

You can experiment by holding your breath longer as you become more advanced. Try to find the edge just before you reach your window of tolerance. Anxiety is not the goal. Instead, attempt to calm the mind and find comfort in the pause between the inhale and exhale. Trust that the next breath will always come.

4-7-8 breathing: Once you have practiced deep belly breathing and breath retention, you can put them both together and discover the magic of 4-7-8. In this technique, you inhale for a count of 4, hold for a count of 7 and breathe out for a count of 8.

Notice, this is a practice of breathing deeply into the low belly combined with holding the breath. Another great way to stimulate vagal tone and tap into the parasympathetic nervous system is extending the exhale for twice as long as the inhale. This breathing technique has it all.

Yoga-informed strategies

As both a yoga teacher and reiki healer, I have learned strategies to release the energy that is exchanged between students and teachers in a session or class. Yet, I was never taught how to deal with the spiritual and energetic exchange that occurs with my counseling clients. I believe this is what led to my experience with burnout. Counselors, just like energy workers and yoga teachers, need to have practices in place to let go of any lingering energy after a therapy session is complete.

In the years since I began my yoga teacher training, I have picked up several yoga techniques that I have integrated into my self-care practice. A few of them come from my reiki training, which is a form of energy healing. While these techniques are not evidence-based, I once again encourage you to feel into them and choose what feels right. Feel free to modify in a way that meets your unique needs.

Energy sweeping: Energy sweeping is a reiki technique. However, it is similar to a self-care technique utilized in Lisa Dion’s Synergistic Play Therapy. The longer I work in both the yoga and counseling fields, the more similarities I discover.

This is a mental and physical exercise for sweeping energy from the body. This can be a great practice at the end of the day for counselors or used between each client session for a quick reset. It might feel a little odd at first. I simply double-check that my door is shut before I start.

Begin by placing the palms of your hands at the top of your head. Start making sweeping motions moving down and out. Work your way down your body with gentle sweeps. When you get to the toes, brush the last of the energy toward a window or door and imagine it leaving your body. You can flick your fingers like you are flicking water off your hands.

Alternate nostril breathing: As an eye movement desensitization and reprocessing (EMDR) therapist certified through the EMDR International Association, I love anything bilateral. Alternate nostril breathing (nadi shodhana) is said to connect both hemispheres of the brain. It is also meant to balance the energies of the body. When I teach this breathing technique, I call it a “911” breath. A few moments with this breathing technique can rescue me from any mental state.

To start, get in a comfortable seated position. Bring your right hand to your nose and rest your left hand on your lap. Place your ring finger over your left nostril and your thumb over your right. Begin by breathing deeply into the belly through both nostrils. Then, block the left nostril with your ring finger and breathe in through the right. Switch and block the right nostril with your thumb while breathing out through your left. Breathe in through the left and switch again.

Complete a full breath cycle (inhale and exhale) through each nostril. Repeat this as many times as necessary to feel a state change. I typically find one to five minutes to be sufficient. End by breathing out through the right nostril, placing your hands on your lap and resuming a normal breath. Check out my website for a guided alternate nostril breath practice at oliviaschnur.com.

Breath of Union: There are still moments when I find myself completely depleted after a long week. When I become too busy or distracted to complete these small self-care rituals each day, I can lose myself rather quickly. The Breath of Union is another reiki practice that has helped me return to myself, time and time again.

To begin, bend your elbows at your sides with your right palm facing up and your left palm facing down. As you inhale, imagine energy moving up from the Earth and down from the cosmos. You can modify your sources to align with your belief system.

Hold the breath in and bring the hands together at the heart, making three clockwise circles. As you exhale, return the arms to the sides of the body, but this time the left hand faces up and the right hand faces down. Inhale and circle the hands over the heart three times clockwise, once more. Exhale and face the right palm up and left palm down. Your hands will be in the same position as when you started.

That is one cycle. Complete the cycle a minimum of three times. Continue as long as you would like, but stop if you start to feel dizzy, nauseous or tired. Ideally, you will begin to feel more balanced after the first cycle.

Make it a ritual

The biggest lesson I learned from experiencing burnout is that self-care is not something that can be saved until the end of the day or week. Self-care does require lifestyle commitments such as a healthy diet, exercise, relaxation and fun. However, no self-care routine is complete without little life hacks that reset the nervous system and prepare you for yet another hour of energy exchange.

Every one of these self-care strategies can be done in less than five minutes. While I know that the minutes between client sessions are precious, save a few of them to breathe and reconnect to yourself. At the very least, take five minutes at the end of the day to recenter and breathe before rushing out of the office.

Aim to integrate at least one to two of these practices into your daily routine. Here are a few suggestions:

Practice deep belly breathing while you type your progress notes.
Try alternate nostril breathing after crisis sessions or challenging days.
End the workday with a quick energy sweep so you can leave work at work and be present for the rest of your evening.
Practice the Breath of Union on the weekends to reconnect to your purpose, higher power or source.

Whatever method works for you, make it sacred. This small routine is your mindful moment to reconnect to yourself. You are replenishing your soul so you can complete your mission on this earth to help and heal others.

Practical and ethical concerns

Most of these exercises can be done on your own. However, you should consider your unique health profile before beginning any of these exercises. You may choose to work with a yoga teacher or follow a guided online video.

To ethically and responsibly share these practices with clients, you should first receive formal training in the practice of yoga. Counselors should pay particular attention to Standard C.2. Professional Competence in the ACA Code of Ethics. Counselors interested in new specialty areas of practice are encouraged to seek education, training and supervised experience.

I began my formal training by completing a trauma-sensitive yoga certificate with Street Yoga. A trauma-sensitive yoga training may be sufficient to begin introducing breathwork into clinical sessions. However, for a comprehensive understanding of yoga anatomy, philosophy and ethics, I recommend a 200-hour yoga teacher training. The registering body for yoga teachers is Yoga Alliance, which has its own ethical code that yoga teachers must follow.

Lastly, I began the Usui Shiki Ryoho reiki training in 2019. I completed my level 1 with Jai Westgard in Iowa City, Iowa. I completed my level 2 with Mikah Jaschke in Decorah, Iowa. The registering body for reiki practitioners is the International Association of Reiki Professionals.

You do not need any formal training to care for yourself, however. Yoga and reiki are holistic, natural ways to attend to your emotional, mental, physical and spiritual self-care. I hope these simple yoga-informed self-care strategies will serve as the shift that allows you to safely and effectively continue this life-changing work as a professional counselor for years to come.

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Olivia Schnur is a licensed mental health counselor in Iowa and a certified EMDR therapist. Additionally, she is a 200-hour registered yoga teacher and a level 2 reiki practitioner. She currently offers online yoga and reiki at oliviaschnur.com. Contact her at olivia@oliviaschnur.com.

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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.

Five regrets of the counselor

By Whitney Norris March 8, 2021

When I am supervising rookie counselors, one of my favorite discussions that often arises naturally concerns how unique the work of a therapist is. Yes, it is often incredibly tough work, but at the same time, we get an intimate, front-row seat to the experience of hope, pain, change and healing. (Along these lines, if you haven’t read Irvin Yalom’s The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients, I highly recommend it.) If we can truly be witnesses to this on the deepest level, there are so many incredible lessons that we are privileged to receive.

I recently came across an article about the book The Top Five Regrets of the Dying: A Life Transformed by the Dearly Departing, written by Bronnie Ware. After years of transformative work in palliative care, Ware summarized much of what she had learned from her work, first in a blog post and later in a 200-plus-page book. As I read, I found myself taking each of Ware’s lessons and adapting them to the unique work we do as counselors. I think that many counselors will be able to relate to these regrets and lessons.

1) “I wish I’d had the courage to live a life true to myself, not the life others expected of me.”

The work of Virginia Satir immediately came to mind when I read this one. It seems to me that perhaps a few too many of the pioneers and educators in our field want to, essentially, clinically clone themselves. Often, models come with a complete list of do’s and don’ts. I was even given an acronym in graduate school that taught me the exact way to sit during a counseling session. What I’ve always appreciated about Satir’s work is that she encouraged clinicians to be their own unique version of a great therapist.

When we’re new to the field, especially as interns, most of us do, in a sense, “try on” the techniques and styles of those we’re learning from. This, I think, is totally appropriate. Problems can arise, however, if we never grow out of that.

I’ll never forget the first time I was undoubtedly confronted by this “clinical differentiation” process. There was one specific professor in my graduate program whose therapeutic way of being I nearly idolized. I learned so much from him, and it so happened that much of our unique styles naturally overlapped. Then, one day, I was challenged to see some distinct ways in which they didn’t.

I had had a tough, conflict-ridden family session a few days previously, and we were watching the tape together in supervision. After talking through an overview, my supervisor told me he thought I should call and apologize to one of the family members for drawing the hard boundary that I had. After what felt like the longest eight seconds of my life, I swallowed hard and said, “But I’m not sorry.” I still felt I had done the right thing and could easily articulate why.

My supervisor paused thoughtfully and said, “Then you shouldn’t apologize.” And that was it.

He taught me an incredible lesson that day. We all need to be open and receptive to the information we can glean from what mentors, supervisors and others expect of us as counselors. And we need to be intentional about how and why we do what we do, whether that involves the companies we choose to work for, the clientele we choose to see, or the model and theories we posit. But we were never meant to do someone else’s therapy. We are meant to do only our own. To live the “therapy life,” we are meant to live uniquely.

2) “I wish I hadn’t worked so hard.”

The standpoint from which we view quotas and session numbers is greatly influenced by our training, workplace, financial situation, capacity, etc. With this lesson presented by Ware, I find myself wondering whether, at the end of my career or end of my life, I will be wishing I had worked more to see more clients or given more individual attention to each of the clients with whom I worked.

To put it more bluntly, if I have regrets here, will I regret quantity or quality? Will I wish I had worked with a smaller caseload in order to pursue more specialized training or to take more time to read books and research about the specific needs and patterns of the clients with whom I worked? Or will I look back and wonder why I didn’t work to see more clients in order to help more people? Will I wonder why I didn’t find a way to branch out on my own so that I could have more choices in how much I worked? Will I end up regretting that I didn’t follow what my mind and body were telling me about my capacity?

I don’t believe there are many rights or wrongs here. I believe our best bet is simply to make this choice more consciously. When I think ahead, I imagine myself wishing only that I had made my choices with more intention — made them on purpose instead of letting other factors, in a sense, choose a path for me.

3) “I wish I’d had the courage to express my feelings.”

I sat with some of these lessons longer than others in applying them to our work as counselors. After I read this one though, the application came to mind immediately.

While writing this article, I’ve also been reading through Louis Cozolino’s The Making of a Therapist: A Practical Guide for the Inner Journey. There have been many aspects of his candidness in writing to counselors-in-training that I have appreciated. This has stuck out the most to me in his many pleas to approach the work with humility — to admit when we’re in over our heads or when we need help. What I most appreciate is how Cozolino points out, much like Jeffrey Kottler does in his writings about counselor development (especially in On Being a Therapist), that this never ends. We never hit a stride where we no longer have questions, insecurities and specific struggles with clients.

Beyond that, most excellent therapists I know have at some point even questioned whether they should or want to be doing this work. Those of us who work through that well don’t keep it to ourselves. Doubts aren’t built for that kind of response. The path of least resistance is to talk through them with courage or, as Brené Brown would say (in Rising Strong), “rumble” with all that being a therapist does and will continue to bring up in us. I think the bravest among us have come to realize that there’s no shame in that.

As I said earlier, this work is tough — beautiful and tough. To not expect it to be accompanied by a somewhat constant dose of vulnerability can set us up for burnout and, eventually, at the end of the road, perhaps regret.

4) “I wish I had stayed in touch with my friends.”

In my mind, this one piggybacks off of No. 3. I have little doubt that when I look back at the end of my career, I will perhaps be even more grateful than I am now for the colleagues who made themselves available to process through these courageous conversations about the difficult and emotional work that crossed our paths.

One of the dangers of the field shifting more toward private practice than larger agency work is how easily this can lead to a sense of isolation before we see it coming. Even when we work with people we enjoy in these settings, we’re often just “ships passing in the night” during the last five minutes of the hour. Experts in interpersonal neurobiology are speaking more to the importance of the co-regulatory processes in therapy (see The Heart of Trauma: Healing the Embodied Brain in the Context of Relationships by Bonnie Badenoch). We will be best served to keep this in mind beyond just our one-on-one work with clients. I believe that getting support from colleagues is not just important, but actually essential, to doing good work.

In The Making of a Therapist, Cozolino spoke to some of his pushback on this need and his own reconciliation of it over time: “Put a group of us together in a facility designed to help clients and you find that at least half of our time and attention is dedicated to taking care of each other. For years, I found this confusing and demoralizing, and I wondered why we couldn’t put our own problems aside and just do our jobs? After much reflection, I realized that this attitude doesn’t work. Everyone in mental health, clients and caretakers alike, needs help, support and healing. Trying to help clients without helping the helpers ultimately fails.”

5) “I wish that I had let myself be happier.”

Lately, I’ve been finding myself wanting to abandon the term “self-care” because it’s so overused and, I think for the most part, misunderstood. The last point I want to make here really goes beyond the term anyway.

There’s no way around the frequent intensity of our work and the unique stressors found in such close and intentional proximity to pain and suffering. Sure, there are tangible things we can do about that, as I’ve mentioned earlier (and as Emily Nagoski and Amelia Nagoski expertly highlight in their book Burnout: The Secret to Unlocking the Stress Cycle). But we also can’t escape the reality that, as counselors, we don’t have the luxury of not taking care of ourselves. We can’t do the work we do, at least not for very long, unless we tend to ourselves.

I tell students in my practicum classes that if you’re not willing to make attending to your own physical and mental well-being a distinct aspect of your job day to day, then you need to find another career. We have to take care of ourselves like it’s our job. Because it is. That’s how we let ourselves be happier, among other things. Suffering as a badge of honor and martyrdom has no place in this profession. It certainly doesn’t make us more effective as counselors, and it definitely doesn’t make us healthier, more loving people outside of the office.

The following quote from Brianna Wiest, from a blog post she wrote for Thought Catalog, comes to mind so often for me that I think people are tired of hearing me say it: “Self-care is often a very unbeautiful thing. … True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape from.”

Thinking about the end of life while still somewhere in the middle of it can bring incredibly valuable insight — into our priorities, how we spend our time, our expectations, our habits and even our worldview. I think it is really important to ask ourselves whether our perspectives and patterns are forging paths of regret or paths of health and healing. Then, with appreciation for whatever arrives with this exploration, we have the opportunity to cultivate a courageous, balanced, emotionally honest, collaborative and happier work life that we can look back on with pride and immense gratitude.

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Whitney Norris is a licensed professional counselor and supervisor who co-founded and works as a trauma specialist at Little Rock Counseling & Wellness in Little Rock, Arkansas. She is currently pursuing her doctorate in clinical and translational sciences, with plans to study childhood adversity and prevention through the lens of public health and policy. Contact
her via whitneynorris.com.

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

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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.

Using the ‘tap in dedication’ technique

By Nicholas Salazar January 13, 2021

Emma quickly checks her watch as she turns her key in the lock. It’s 9:57 p.m. She sighs as she pushes open the door and quickly moves to her room to drop off her bags before heading to the kitchen to make dinner, her second meal of the day since leaving at 6 that morning. She fills up a pot and turns on the stove, dropping in some noodles before opening her laptop to check emails and begin working on her course readings. It’s 10:03 p.m.

Emma’s eyes glaze over as she skims through the endless screens of text, and her head nods until she is awoken by a text from her boss: “Hey Emma, I just had someone call off. Can you open tomorrow morning?”

Emma immediately replies, “Sure thing, see you tomorrow!”

She glances at the time on her phone — 11:13 p.m. She panics and runs to the stove to turn it off. Greeted by a pot devoid of water, she throws away the burnt noodles and closes her laptop. She has finished only one of her five readings, but she needs to be up early tomorrow morning for work. She has six hours of classes after that and internship the following day.

It’s 11:30 p.m. Emma lies in bed with closed eyes and an empty stomach. Her mind races thinking about the different clients she has been working with and how they are holding up. She considers which clients might have which urges — and what she could do to help them, if anything. She thinks about the classes that she didn’t complete readings for and wonders whether she can get by without doing the readings. She thinks about herself as a counselor and questions whether she can ever be successful if she is already struggling.

It’s 12:25 a.m. Emma is asleep, but she will wake up in three hours to get ready to do this all over again.

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As a second-year graduate student who is also working on-site at a residential treatment program, I have discovered it can be difficult to not let every piece of life bunch together and form one massive challenge. It seems that everything of which I am a part is geared toward becoming a mental health counselor. It can be hard to engage in clinical experiences and separate the emotional intensity I experience on-site from my schoolwork, personal life and all other aspects of life.

In our field, being emotionally present and available and working through the sensitive topics of other people’s lives is our daily bread. But being able to stay engaged with a client can be a challenge, especially when you are burned out from the day before, or the events of that morning, or the previous client — not to mention school, work and other life tasks. Taking time to check in with yourself, support yourself and separate one facet of life from another is a skill I have found to be useful when applied in a genuine and purposeful manner.

Overview

“Tap in dedication” is a technique adapted from theater creators when dealing with highly intimate work on stage. It has been used for scenes ranging from a staged slap to simulated intercourse, and the intended purpose is to allow the actors an opportunity to establish their readiness to engage in sensitive and potentially harmful work.

My experience with this technique stemmed from my theater work during my undergraduate studies under the direction of Carin Silkaitis and Gaby Labotka, the latter being a certified intimacy director with Intimacy Directors and Coordinators. They introduced the technique of “tapping in” to those of us in the show, focusing on respect, safety and well-being for ourselves and for those with whom we were working. We used this technique regularly during scenes of overt sexuality, abuse, trauma and death.

We would physically tap each other’s hands, like a “high-ten,” as a way to say to one another, “I am ready to engage in this work with you.” When work on that scene or sequence had been completed, we would perform this action again to provide a physical symbol that communicated, “We did the work, and now we are stepping outside of it to be ourselves.”

Adapting this technique for counselors to use is a nice fit because of the themes of respect, safety and well-being — something that we helping professionals are adept at offering to clients but may not always apply to ourselves. In the counseling profession, it is important to find ways to respect ourselves and our work because if we do not, it can become all too easy to face burnout, experience vicarious traumatization or even fail to respect our clients.

I coupled the technique I learned in theater with aspects of dialectical behavior therapy to allow helping professionals to engage in mindful participation in their careers while providing them the time to check in with themselves before and after a day’s work. In the case of a particularly difficult session, counselors can also use this technique quickly between clients. Depending on site regulations, it may even be used with some clients.

The goal of the technique as I describe it here is to provide a way for counselors, counselors-in-training and other helping professionals to deal with sensitive subjects, to be present and engaged for the difficult work they take part in daily, and to be able to “leave work at the door” when they reach the end of the workday. It can be detrimental for helpers to bring troubling work home with them because it can impede their self-care and have a negative effect on the relationships they have outside of work. Ideally, using this technique will make it easier for clinicians to allow themselves to be engaged fully in their work life while helping them to separate this time from their personal life.

The technique

Practice self-care: Begin by entering or coming to the place where work will be done for the day. Next, take a moment for yourself by performing some action that is soothing and regulating for you. This could be making a cup of coffee or tea, enjoying a snack, reading a few pages of the newspaper, doing a crossword puzzle — anything you find that helps you feel relaxed or calmed. If this is a technique that you would like to use several times per day, between sessions or simply as it feels necessary, an activity that takes less time may serve you better.

Engage in mindfulness: Once you complete your self-care activity, it can be helpful to become grounded in your work environment. For example, take a few minutes to use a “five senses” grounding technique: Identify five things that can be seen, four that can be heard, three that can be touched, two that can be smelled and one that can be tasted.

Skills for distress tolerance can also be beneficial. An example is radical acceptance — taking time to accept one thing that you cannot change about how your day may go, while acknowledging that you can affect your own presence in the day. A technique such as one-mindfulness could be used to promote purposeful attention by focusing on one thing and allowing yourself to see, hear and appreciate it, whether it is physical, emotional or something else (e.g., a plant, a feeling, a thought). Any activity that helps you feel mentally at ease and instills feelings of calm and preparedness can be used for this activity.

An important consideration is to decide where and when you will engage in this process daily. For example, will you do it before you leave home? In the car or on the bus while traveling to work? Once you arrive at your office? From my experience of using similar techniques in theater, once the actions have been set, it is helpful to always do them the same way or as close to the same way as possible to preserve the integrity of the actions and process.

With practice, you will likely be able to engage in your self-care and mindfulness processes anywhere, although a change in environment or process initially could make it difficult to establish and maintain the mindfulness you hope to achieve. If you are in a position where you must travel regularly for your sessions, it can be helpful to have one specific action that you engage in prior to each session. It can also be useful to practice that action several times in settings that are calming before engaging in the activity in a more fluid and potentially stimulating environment.

Literally tap in: After you complete your grounding activity, you will literally tap in. This means to physically tap your hands on a surface or object. Your physical tap in signifies that you are mentally, emotionally and spiritually ready to be 1) devoted and engaged in the activities that follow in an effortful and conscientious manner, 2) fully present in your interactions and 3) aware of the effect that your effort and presence can have on clients and others.

Your physical tap in action serves to signify that your day has begun, and you will give conscious attention to all that occurs from that moment forward. Importantly, tapping in marks the time that is about others (rather than about one’s self), while the preceding actions were exclusively for the individual performing them (i.e., you). This can allow you to engage and deal with more demanding emotions and experiences by allowing you to acknowledge that this time is about being wholly devoted to another, just as the actions before were devoted to taking care of yourself. And in essence, you are taking care of yourself while caring for others because you have intentionally prepared yourself for your service.

Literally tap out: After your sessions, work or treatments are completed (or between sessions if content was particularly difficult), it is time to tap out — literally — just like you tapped in. This is a physical action in which you physically tap the same surface or object you used to tap in. It is important to use the same object every time if possible to symbolize the ending of the specific dedication to your work.

This tap out provides a physical action to close out of what has been occurring during your workday and allows you to engage with the nonwork you again. Additionally, this action signals that the feelings and emotions that may have come up during your work are meant to be kept in that specific time; they are not necessarily meant to exist beyond the scope of that session or that day.

Enjoy your post-tap-out activities: At this point, it is time to go about the doings of your personal life and nonwork time. This means to do anything you would normally do after work — exercising, playing with your children, grocery shopping, attending to your home, spending time with friends and so on — without interruption from what occurred during your work time.

Additionally, some people find it incredibly helpful to engage in some kind of self-care at the end of the day, similar to what they did at the beginning of the day. This might involve watching a specific show, enjoying some ice cream, doing another crossword puzzle — anything that can help you to decompress and relax. This activity can be done at any time but may be more useful to do soon after tapping out so that it can serve as a nice, calming cap to your workday.

Technique considerations

This technique was adapted from a theater practice used in scenes in which violence or intimacy was approximated that could cause effects similar to reliving traumas or increase actors’ emotional discomfort. It is important to recognize when something goes beyond the scope of dedication to work. It is up to counselors to use their best judgment to determine when an event may need further intervention to protect their well-being. Some subjects may be difficult to “leave at work,” and if this circumstance arises, it may be wise to seek support. If a counselor has a troubling response to a client’s trauma, it may be useful to discuss this in the clinician’s own therapy sessions or to process it with trusted colleagues or supervisors so as not to shoulder the burden alone.

Using this technique can take up a fair amount of time depending on the self-care actions the counselor chooses to use. Given that reality, it can be useful to find a quick-and-easy action, or to incorporate parts of the technique into one’s daily routine so that it does not become a burden to the user. However, taking the time needed to prepare for one’s day is imperative to staving off burnout and to increasing wellness.

Although this technique is not intended as a catch-all for reducing stress, it may prove useful in helping to establish firmer boundaries between personal life and work life, which is a common stressor among counselors. The goal is not to fix every stressor that clinicians may experience, but rather to provide an opportunity for clinicians to have a solidified and intentional process of entering and exiting their daily work in a demanding field.

In the event that a counselor must travel between environments during the workday, it may help to tap in and tap out before and after each client and to use travel time for a bit more mindfulness. Especially because of the variety of possibilities, such as traffic or accidents, that can occur when traveling between places, practicing mindfulness during the journey may be helpful in terms of keeping travel stress separate from your work. Additionally, using this technique can allow helpers to reduce personal stressors that often are carried over into work with clients, thus enabling a fruitful and intentional work experience.

Suffice it to say there are many situations that may not benefit from the ability to tap in and tap out. Using this technique ultimately comes down to each person’s discretion. It is simply meant to give them increased autonomy in how they choose to handle their time in a helping profession.

Getting started

Ask yourself the following questions to get started with the tap in dedication technique:

What would it be like for you to intentionally tap in to your workday and tap out of it? Do you have any hesitations? What can you do to resolve those hesitations?
What self-care routines would you like to use to start your day? Which ones are you doing already?
Mindfulness is an integral part of preparing to tap in. What mindfulness practices do you have established on which you can draw? If you do not participate in mindfulness, do you have other religious or spiritual practices that you might use (e.g., prayers, religious texts, songs)?
Where will you tap in at the beginning of your work and tap out at the end?
What does it mean to you to practice your work in a conscious way?
What practices do you want to establish if your work life enters your personal life after you have tapped out?
What resources do you possess to process particularly difficult clinical workdays? Jot them down and use your list when you need it.

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Nicholas Salazar is a second-year master’s student at Marquette University in the Department of Counselor Education and Counseling Psychology. He works part time and is an intern at Rogers Behavioral Health in Oconomowoc, Wisconsin. Contact him at nicholas.salazar@marquette.edu.

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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.

Paths to wellness

By Rebekah Lemmons December 9, 2020

I have been working in the mental health field since 2010, and in that time, the topic of wellness has come up often across an array of settings. In my professional counseling roles as an instructor, supervisor, trainer, consultant, therapist and manager, I have witnessed a growing need for wellness practices. And as I have learned more about the impacts of stress on the brain, I have come to better understand the necessity of all professional counselors having strong wellness practices.

Counselor wellness is essential to providing quality services to our clients. I have been able to observe counselors with strong self-care practices who balance boundaries well and maintain strong professional helping relationships with their clients. I have also witnessed the opposite end of the spectrum, in which therapy progress is hindered due to counselor issues such as burnout, compassion fatigue, vicarious trauma and overcommitment to myriad duties.

The dynamic nature of wellness

Wellness and burnout are not mutually exclusive. Instead, they operate more on a continuum. So, rather than viewing counselors as “burned out” or “not burned out,” we should understand that many counselors oscillate between various levels of wellness and burnout. It is common to see many professional counselors cycle back and forth between varying stages of wellness and burnout. A particular therapist might present with symptoms of burnout during a specific period of time but be well and maintaining strong self-care practices during another period of time. Because of the dynamic nature of wellness, counselors need to revisit this topic frequently.

The theme of self-care has become a hot topic over the past decade. From articles and books on how to promote self-care to ways to address burnout, the professional helping fields have been inundated with information on burnout, compassion fatigue, vicarious trauma and associated subjects. Even with these themes being more openly discussed in graduate programs and across supervision settings, many counselors could still benefit from practical strategies designed to increase overall mental health and well-being.

One way to provide such information is within the framework of a practical model. Some models found in current counseling articles do address self-care components. However, models could more holistically include self-care components that tie into larger wellness frameworks as an area of growth. Many clinicians verbalize an array of variables that inhibit effective self-care practices. On that basis, I have conducted qualitative research to identify themes related to what gets in the way of wellness. From interviews with master’s-level counselors, I have learned the importance of expanding wellness models to include the array of factors that contribute to self-care or a lack thereof.

A proposed wellness model

From this research in 2019, I and my fellow researcher, Steve Zanskas, developed a three-tiered model for self-care that identifies levels of responsibility targeted at providing an integrative way to increase the effectiveness of wellness pursuits. This model looks at wellness accountability through the lens of individual, supervisory and organizational responsibility. This mirrors feedback provided during interviews with 77 counselors discussing what helps and what hinders their self-care.

This model also provides practical approaches to increasing our awareness of the self-care domains that influence wellness. The model was titled Paths to Wellness based on the idea that wellness pursuits are similar to a journey with many roads leading to the same destination. When we view wellness as a journey, we are able to acknowledge the individuality of self-care pursuits and the layers of wellness that can help to buffer negative professional hazards.

Wellness domain: Individual level of responsibility

Practical wellness check-in:

What makes me feel recharged?
What stresses me?
Where do I feel stress in my body?
What recharging activities do I need to do when certain stressors occur?
Do I have a balance of self-care activities across various domains (physical, emotional, intellectual, financial, social, etc.)?
What can I do to increase balance among my self-care domains?
Do my values as a person align with the work I am doing?
Does my job overall give me a sense of satisfaction?
What job factors are increasing or decreasing my overall wellness?
What changes can I implement to help me become present and peaceful?
What resources and supports do I need to make these changes?
Do I have regular check-ins with myself to reflect and make needed adjustments to my wellness plans?

Wellness domain: Supervisory level of responsibility

Practical wellness check-in:

Does my supervisor practice self-care and model overall wellness?
Does my supervisor discuss self-care and check in on my overall wellness?
Does my supervisor respect my individual self-care needs and support my self-care endeavors?
Does my supervisor support the use of vacation, sick leave and other paid time off?
Does my supervisor provide coverage for time off?
Does my supervisor provide a positive work environment?
Does my supervisor facilitate teamwork and a positive team culture?
Does my supervisor support time off for mental health?

Wellness domain: Organizational level of responsibility

Practical wellness check-in:

Does my organization provide paid time off for vacations or hobbies?
Does my company provide resources to staff for growth and development?
Does my company encourage a positive work culture?
Does my company regularly obtain and utilize employee feedback?
Do leaders communicate openly and honestly with employees?
Does my company care about me as an individual?
Does my company promote work-life balance?
Does my company provide benefits related to wellness activities (gym reimbursements, health coverage, paid sick time, employee assistance programs)?
Does my company have policies and processes in place specifically targeted to promote wellness?

Model usage

The Paths to Wellness model can be used across counselor roles and functions by clinicians, supervisors, counselor educators and organizational leadership. Benefits of this model include use as an assessment and evaluation tool as well as a resource for reflection on further wellness development.

Counselors can use this model as a tool for evaluating their own levels of wellness, helping to inform them of both weak and strong areas related to self-care. In alignment with this, this framework can empower professionals to strategically weigh the benefits and drawbacks of their choices on their overall wellness to make the best decisions for their own self-care at that moment in time.

In the professional realm, counselors could use this evaluation tool when they are asked to consider a new position or added role opportunities or when considering a move to a different employer. New professionals could use it as they decide where to begin their work. The tool can help counselors evaluate how a potential new role or task might affect their self-care and wellness pursuits across individual, supervisory and organizational domains. Such evaluations can provide counselors with a framework to make decisions that align with their wellness goals.

Supervisors can use this tool both at the individual level for themselves and at the supervisory level. The supervisory level aims to assess the current level of wellness modeling and promotion they are providing to their supervisees. The counseling profession regularly promotes supervision and consultation as a positive way to buffer negative client impacts associated with burnout and a lack of overall counselor wellness. The level to which supervision assesses for and positively addresses needs related to self-care and wellness may greatly influence the gains from attending regular supervision.

For supervisors within agencies, this model can help to facilitate increased worker satisfaction by allowing supervisors to better understand and address individual differences that occur within staff groups. This promotes an approach of all staff receiving what they need to support their wellness versus using an “equality standpoint” that provides all staff with the same resources regardless of individual need area.

Organizational leaders can use this model as a screening tool to evaluate the potential wellness impacts associated with each agency policy, process and procedure. Leaders can then advocate for specific policies that better foster employee wellness.

Ideally, policies and procedures would be designed based on feedback gathered directly from agency employees. Regular check-ins with employees and program evaluations designed to get specific responses can provide leaders with employee perspectives. These perspectives can then be used to update and revise wellness-related measures. Furthermore, leaders can model wellness pursuits to help infuse a wellness focus into the fabric of their organizations. This may include leaders showing that it is truly OK to take breaks, set boundaries with time off and maintain healthy habits.

Through agency, employee and supervisory collaboration, wellness gains are possible. Integration across these domains is vital to the successful implementation of self-care pursuits. Because of the dynamic and complex nature of counselor roles and demands, wellness endeavors and need areas should be evaluated often. The Paths to Wellness model serves as one approach that can facilitate wellness promotion and integration. Furthermore, the model can be added to current wellness strategies or used along with other self-care assessments.

With awareness and accountability across individual and systemic levels, wellness cultures are developed. These cultures then begin to thrive as wellness is intentionally integrated into daily practices. This can lead to a ripple effect, with the counseling profession serving as a model for wellness integration throughout other organizations.

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Rebekah Lemmons strives to improve outcomes for children, emerging adults and families. For the past decade, her practice and research have primarily been based in the nonprofit sector, with an emphasis on conducting program evaluation, teaching, engaging in service leadership, consulting and providing supervision to clinicians. Contact her at rebekahlemmons@yahoo.com.

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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.