The Hazards of helping::

Burnout for the therapist

David Parmer M.A., L.P.C., L.C.D.C.

CONROE INDEPENDENT SCHOOL DISTRICT
Coordinator of Crisis Counseling and Prevention

STRESSED OUT
Stress contributes to 90% of all diseases. Half of visits to the doctor are stress related. Anxiety reduction is one of the largest businesses in America. Professionals who have a higher rate of suicide are in helping or care-giving occupations.
(Croucher, 1982)

DISCUSSION
What is stress? What is burnout?
What are some things that cause you to feel optimistic and hopeful? What are some common behaviors for a professional who feels hopeless or empty? On a scale of 1 10 how stressful is you life right now?

Several Hazards for Counselors

The disparity between expectations and hard reality. Lack of clearly defined boundaries. Workaholic mentality Conflict over leading and serving at the same time. Confusion of role identity with self image. Deriving too much self-esteem from what we do. Balance between practice and personal life.

Time Management Problems. Small number of perks. Multiplicity of Roles. Difficulty in managing interruptions. Taking ourselves too serious. Difficulty being spontaneous. Administration overload. Supervision either too demanding or too light. Resentful about duties not commensurate with pay. Concerned about job security.

STRESS
When events are perceived as things that must be solved or corrected not under our control of that person.
Expectations + Reality = Disappointment

Stress does not happen to me. Stress results from my own absorption of what has occurred.

BURNOUT
Burnout is not simply excessive stress. Burnout is a complex human reaction to ongoing stress. Burnout occurs when the counselors inner resources are inadequate for managing tasks and situations.

TEXAS STATE BOARD OF EXAMINERS OF PROFESSIONAL COUNSELORS ETHICALGUIDELINES Impairment of the counselor can create many breaches in the ethical codes regarding jeopardy and mistreatment for the client.
Code 681.35 Drug and Alcohol Abuse Use or Promote Illegal Drugs Possession of Illegal Drugs or Alcohol while providing intervention services

Code 681.33 Sexual Misconduct

Code 681.33 (i) Reporting another licensees misconduct to the licensure board (see overhead)

CASE STUDY SCENARIO

You are a practicing LPC in private practice Archibald, a new client comes to see you due to feelings of depression and work related stress. As a part of the details, he shares that he has been having a extra-marital affair with his previous therapist.
The client states that their counseling relationship ended less than a year ago. Out of loyalty, the client reports that the therapist discontinued counseling a year before any intimacy occurred. What do you do?

You have 30 days after you learn of the relationship to inform the licensure board.
Provide your name

The client can remain anonymous

Describe the details Provide the name of the perpetrator

Local law enforcement must be notified

DEPLETION OF THE SOUL

Burnout is an erosion of the spirit.
(Freudenberger, 1980)

(Minus)

High Ideals & Motivation - Depletion of Spirit & Faith in our capacity to make a difference B U R N O U T

HOW TO KNOW IF YOU ARE ON THE ROAD TO BURNOUT Rate each of the following feelings. A = never B = occasionally C = frequently

1) Feel like others dont give you support. 2) Feel like you are responsible for things you dont really have control of. 3) Feel like you are being let down by others. 4) Feel like you cant be yourself most of the time. 5) Feel or act defensive. 6) Feel intimidated by others.

7) Think only about your job with little interest in outside hobbies. 8) Think that you are better off isolated from others. 9) Think that you are unappreciated. 10) Think about running away. 11) Think that the system is against you. 12) Think that most of your attempts end in failure.
(Messina & Messina, 2005)

DIFFERENCES BETWEEN BURNOUT AND STRESS

Dr. Arch Hart

Burnout is a defense characterized by disengagement. Stress is characterized by over-engagement.

In Burnout the emotions become blunted. In Stress the emotions become over-reactive. In Burnout the emotional damage is primary. In Stress the physical damage is primary. The exhaustion of Burnout affects motivation and drive. The exhaustion of Stress affects physical energy. Burnout produces demoralization. Stress produces disintegration. Burnout can best be understood as a loss of ideals and hope. Stress can best be understood as a loss of fuel and energy.

DIFFERENCES BETWEEN BURNOUT AND STRESS

The depression of Burnout is caused by the grief engendered by the loss of ideals and hope. The depression of Stress is produced by the body's need to protect itself and conserve energy.
Burnout produces a sense of helplessness and hopelessness. Stress produces a sense of urgency and hyperactivity. Burnout produces paranoia, depersonalization and detachment. Stress produces panic, phobic, and anxiety-type disorders. Burnout may never kill you but your long life may not seem worth living. Stress may kill you prematurely, and you won't have enough time to finish what you started.
(Croucher, 1982)

PREVENTION of burnout
1. Scan your life experience periodically
How much enjoyment and satisfaction comes solely from work? Do I have feelings of hope and optimism in my life? How important is it for me to be appreciated by others? How am I getting my own personal needs met outside of counseling relationships?

2.

Get good supervision

Does my supervisor promote genuine healthy personal growth for counselors? Does my supervisor have a healthy style of life? Do we discuss in supervision counter-transference responses? Does my supervision focus my growth as a therapist to avoid blind spots and avoid tunnel vision.

PREVENTION of burnout
3. Assess the balance of activities
How one-dimensional am I? Do I think, read, and study only what is relevant to my profession and neglect other interests, people, and ideas? Do I nurture my own spiritual development? Do I have hobbies and interests beyond helping others?

4. Honestly assessing family life

Do I get feedback from current family members on my attitude and mood? What were the messages about work I received from my family of origin? How did my family of origin resolve conflict? How did my family of origin relax and play?
(Grosch and Olsen, 1994)

REFERENCES
Croucher, R. (1982). Resources for Pastors. Retrieved June 22, 2005, from
http://www.churchlink.com.au/churchlink/forum/rcroucher/stressburnout.html.

Freudenberger, H. (1980). Burnout: The high cost of high achievement. New York: Doubleday. Grosch, W., & Olsen, D. (1994). When helping starts to hurt. New York: Norton.

Messina, J.J., Messina, C.M., (2005). Retrieved June 22, 2005, from
http://www.coping.org.