Staff Perspective: Trauma Therapist, Heal Thyself: Seven Tips for Self-Care
I don’t know any colleagues who aren’t on the brink of burnout right now, myself included. Perhaps it’s our increased caseloads, the impact of multiple global crises, our collective COVID fatigue, or all of the above.
The topic of self-care has been coming up consistently in my workshops and consultation, especially from colleagues who work most often with trauma and PTSD. It’s motivated us at CDP to reflect on what helps us stay centered and healthy.
Here are 7 tips for practicing self-care:
- Keep a routine. Just like we tell our clients, it’s important to schedule healthy behaviors and maintain some consistency in our daily lives. Identify a start and end time for your workday and don’t check email outside of those hours. Schedule time for regular meals (not just a Venti coffee!) and exercise. Try to get to bed around the same time every night and preferably log off from your electronics beforehand.
- Utilize evidence-based practices. A fair assumption is that doing trauma-focused work is draining for providers. While it’s hard work, the associated stress can be tempered by witnessing progress in your patient. Also, having a structured approach to treatment can be reassuring in providing a roadmap to navigate the work. For these reasons, using evidence-based practices can reduce the stress associated with providing trauma-focused care.
- Vary your caseload. Although trauma-focused work may be your passion, there’s a benefit to working with other presenting concerns, too. Periodically switching gears away from trauma can provide a much needed emotional “time out.” When you do work with trauma, stagger courses of treatment, so that you are not beginning or ending treatment with many clients at the same time. If you are doing exposure-based treatment, don’t schedule too many exposure sessions in one day. And as you start to see the fruits of your labor, allow yourself to keep a few “easy” clients on your caseload, notably those who are have made and are actively maintaining improvement.
- Get up and out. Scheduling clients back-to-back may be efficient, but sitting all day can contribute to burnout. Carve out a few minutes each day to get away from your desk. If you use an activity tracker, set a timer to remind you to stand up and walk around. Get out of the office if the weather and environment allows. Even a quick 10-minute break can do a lot for your cognitive and emotional functioning. If you can’t take a chunk of time away from your desk, spread a few shorter breaks throughout your day.
- Don’t treat trauma alone. Listening to and supporting clients all day can be an isolating experience for therapists. This is especially true for therapists who listen to details of trauma for hours at a time. Trauma therapists are at risk for vicarious traumatization, which can impede objectivity and neutrality. For these reasons, it’s important to maintain relationships with other mental health professionals who can provide support, perspective, and a kind ear. This may take place in a formal consultation group or through informal ad hoc consultation with respected peers. Either way, routinely engaging in consultation promotes emotional, ethical, and legal health.
- Take your vacation days. And your sick days, too. Many of us have been stockpiling our vacation time because travel opportunities have been so limited. Staycations are losing their charm, but taking time off is one of the best strategies we have to prevent burnout. Even if you can’t get away, truly disconnect for a couple of days. Put on your “away from the office” auto response and don’t look at your work schedule. Take the opportunity to do something different, like cooking a new recipe, checking out a local tourist attraction, or diving into a non-work-related book.
- Don’t wait until you’re burned out. There’s no award for “Most Dedicated Therapist Ever.” Even if there was, you wouldn’t want it! Practicing self-care daily is like taking a multivitamin; treat self-care as a preventative measure that keeps you healthy so you can more easily fight off fatigue, illness, and burnout.
I recognize that this an idealistic list. Depending on your practice and how much control you have over it, you may not be able to implement all of these recommendations. A better approach is to identify one or two things that you can start doing differently right now. Maybe that’s finding a consultation group. Or maybe it’s getting out for a walk or bicycle ride this afternoon. Most importantly, don’t delay self-care until you “have time.”
In addition to the tips above, we recently covered the topic of self-care on an episode of our podcast, Practical for Your Practice. On the episode titled “Practicing What We Preach - Applying Best Clinical Practices to Caring for Ourselves,” I talked with my friend and colleague, Dr. Andy Santanello, about how to apply what we tell our clients to ourselves. You can check it out here: https://deploymentpsych.org/CDP-Podcasts
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Carin Lefkowitz, Psy.D., is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.
I don’t know any colleagues who aren’t on the brink of burnout right now, myself included. Perhaps it’s our increased caseloads, the impact of multiple global crises, our collective COVID fatigue, or all of the above.
The topic of self-care has been coming up consistently in my workshops and consultation, especially from colleagues who work most often with trauma and PTSD. It’s motivated us at CDP to reflect on what helps us stay centered and healthy.
Here are 7 tips for practicing self-care:
- Keep a routine. Just like we tell our clients, it’s important to schedule healthy behaviors and maintain some consistency in our daily lives. Identify a start and end time for your workday and don’t check email outside of those hours. Schedule time for regular meals (not just a Venti coffee!) and exercise. Try to get to bed around the same time every night and preferably log off from your electronics beforehand.
- Utilize evidence-based practices. A fair assumption is that doing trauma-focused work is draining for providers. While it’s hard work, the associated stress can be tempered by witnessing progress in your patient. Also, having a structured approach to treatment can be reassuring in providing a roadmap to navigate the work. For these reasons, using evidence-based practices can reduce the stress associated with providing trauma-focused care.
- Vary your caseload. Although trauma-focused work may be your passion, there’s a benefit to working with other presenting concerns, too. Periodically switching gears away from trauma can provide a much needed emotional “time out.” When you do work with trauma, stagger courses of treatment, so that you are not beginning or ending treatment with many clients at the same time. If you are doing exposure-based treatment, don’t schedule too many exposure sessions in one day. And as you start to see the fruits of your labor, allow yourself to keep a few “easy” clients on your caseload, notably those who are have made and are actively maintaining improvement.
- Get up and out. Scheduling clients back-to-back may be efficient, but sitting all day can contribute to burnout. Carve out a few minutes each day to get away from your desk. If you use an activity tracker, set a timer to remind you to stand up and walk around. Get out of the office if the weather and environment allows. Even a quick 10-minute break can do a lot for your cognitive and emotional functioning. If you can’t take a chunk of time away from your desk, spread a few shorter breaks throughout your day.
- Don’t treat trauma alone. Listening to and supporting clients all day can be an isolating experience for therapists. This is especially true for therapists who listen to details of trauma for hours at a time. Trauma therapists are at risk for vicarious traumatization, which can impede objectivity and neutrality. For these reasons, it’s important to maintain relationships with other mental health professionals who can provide support, perspective, and a kind ear. This may take place in a formal consultation group or through informal ad hoc consultation with respected peers. Either way, routinely engaging in consultation promotes emotional, ethical, and legal health.
- Take your vacation days. And your sick days, too. Many of us have been stockpiling our vacation time because travel opportunities have been so limited. Staycations are losing their charm, but taking time off is one of the best strategies we have to prevent burnout. Even if you can’t get away, truly disconnect for a couple of days. Put on your “away from the office” auto response and don’t look at your work schedule. Take the opportunity to do something different, like cooking a new recipe, checking out a local tourist attraction, or diving into a non-work-related book.
- Don’t wait until you’re burned out. There’s no award for “Most Dedicated Therapist Ever.” Even if there was, you wouldn’t want it! Practicing self-care daily is like taking a multivitamin; treat self-care as a preventative measure that keeps you healthy so you can more easily fight off fatigue, illness, and burnout.
I recognize that this an idealistic list. Depending on your practice and how much control you have over it, you may not be able to implement all of these recommendations. A better approach is to identify one or two things that you can start doing differently right now. Maybe that’s finding a consultation group. Or maybe it’s getting out for a walk or bicycle ride this afternoon. Most importantly, don’t delay self-care until you “have time.”
In addition to the tips above, we recently covered the topic of self-care on an episode of our podcast, Practical for Your Practice. On the episode titled “Practicing What We Preach - Applying Best Clinical Practices to Caring for Ourselves,” I talked with my friend and colleague, Dr. Andy Santanello, about how to apply what we tell our clients to ourselves. You can check it out here: https://deploymentpsych.org/CDP-Podcasts
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
Carin Lefkowitz, Psy.D., is a clinical psychologist and Senior Military Behavioral Health Psychologist at the Center for Deployment Psychology (CDP) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland.