Are you a mental health professional or work in the field of mental health? Are you a caregiver? What are some of your most vivid experiences? There is always at least one experience that made some kind of impact on you emotionally, psychologically, or even physically (i.e, injuries during restraints, etc.). The experience could be positive or even negative. Either way, the experience will probably always be apart of your existence. It’s difficult to work in the healthcare field and not be affected. For most mental health professionals, the field of psychology allowed them to reach out to other people, help people make positive changes and identify their potential, and even promote personal growth. I must admit, I love my field and reaching out to others. It’s an honor that I am grateful for. Many other professionals would probably share my sentiments. Despite the many issues that plague the field and the politics that have dominated good hearted people for years, the field offers so many opportunities for us to be the difference in a cold and lonely world. It allows us to engage in the science of understanding human life and contribute our knowledge to society. It can be intellectually and emotionally stimulating. But there are also times when mental health professionals (or even caregivers) are barely hanging on due to burn-out or compassion fatigue. If we’re honest, some of us have probably felt burned out quite a few times than we care to admit. This article will discuss some of the challenges that therapists face. The sole purpose of this article is to highlight challenges you may be unaware of.
Unfortunately, the stressors of life are just enough to temporarily put your therapist out of commission. Some clients are even puzzled when their therapist seems “unavailable” or “tuned out” at times. Mental health professionals are often traumatized, experience strain in the workplace, and sometimes taken advantage of by the profession. Despite a true desire to help, relate, and support, mental health professionals are sometimes overwhelmed by their duties. There are many things most mental health professionals would want for society to know about their human side. It’s important that clients are aware that their therapist may be struggling with some of their own challenges and can seem a bit “distracted” or “tuned out” some sessions, but that this has nothing to do with them. It’s not personal, it’s just human. Some of the most important things we should be aware of in the lives of healthcare professionals include that:
- We sometimes feel terrible about reporting families: Believe it or not, the field of psychology often calls on therapists to be like detectives. When working with children, we’re often held to ethical and legal standards that require us to report any suspicion (big or small) of child abuse, neglect, or maltreatment. This is also the case for adults, but cases involving minors can be a bit more complicated. The reporting process can feel long and tedious. It can also make a therapist or mental health professional feel guilty if the suspicion of abuse is minor. In many cases, one utterance from an individual in therapy, most often children and teens, of being hit or mistreated must be reported, even if the story is not 100% believable. Because of so many mistreated children and teens across the nation, different states have different guidelines but many are strict and require that reports be made to err on the side of caution. According to childhelp.org, about 3 million reports of child abuse are made in the United States each year. It’s an epidemic. We have one of the worst records among industrialized nations of reporting abuse. We lose at least 7 children everyday to abuse. It’s no wonder protective services require healthcare providers to report information within 24 hours of having received a report of potential abuse. But for many innocent families, being reported to child protective services is like being “turned on” or mistreated. The reporting process, for many therapists, can be uncomfortable because so much information is requested on a family. For families, detectives and social workers often show up at many doorsteps announced or unannounced. It can destroy the therapeutic relationship and rupture trust. It’s difficult for everyone involved including the children or teens who are sometimes removed from the home for extended periods of time.
- We feel our client’s trauma: Have you ever heard of the term vicarious trauma or secondary trauma? The term refers to an individual who is emotionally and psychologically affected by the traumatic experiences of someone they are close to, working with, or speaking to. For example, a therapist is rarely able to escape files coming into the office that reports a client’s extensive abuse or traumatic history. Child abuse, child neglect, murder, crime, violent behaviors in the home or neighborhood, gang related violence, poverty, or domestic violence are all situations that clients seek counseling for. Dr. Eric Gentry has provided a wonderful training on Secondary Traumatic Stress or Compassion Fatigue through PESI (a continuing education platform for professionals). His goal is to educate society to the powerful effects of working in the mental health field. His goal is certainly not to place blame or make clients feel guilty, but to educate society. A therapist, other mental health professional, or even first responder who listens to someone’s story, often more than once, can begin to feel overwhelmed, anxious, or even hypervigilant. These are often the first symptoms of secondary traumatic stress. As hard as it might be to believe, some mental health professionals have their own histories with trauma and can easily become “triggered” by a story or experience. The National Child Traumatic Stress Network reports that about 10 million youngsters in the U.S. endure the trauma of abuse, violence, natural disasters, and other severe events. No one likes to see a human life being mistreated, especially young children. Therapists and other mental health professionals must listen to details of a traumatic event by a family, child protective agency, or other individual. While working in the healthcare profession, there is no way around it. This is why so many agencies provide trauma informed trainings and teach therapeutic crisis intervention (TCI) or sanctuary model training for staff members. Sadly, many professionals experience secondary trauma and lose the ability to provide emotional support to their clients. This is often when a professional must take a step back and engage in self-care.
- We get tired, very tired sometimes: Mental health professionals are overworked and mostly underpaid. Even therapists who are in private practice or working for great organizations struggle with fatigue. In fact, therapists who are in private practice might feel more tired than those of us who aren’t in private practice due to having to care for their client’s alone, balance their own finances, etc. It’s a balancing act that requires mental and emotional stamina. Sometimes therapists are simply spent.
- We want clients to trust us and to be honest: We are all socially connected. In fact, I’m a firm believer that we are more connected spiritually than socially. What I mean by this is that we have a natural tendency to gravitate toward people who fill an empty void we have. We have a tendency to look for people who connect with our own views, feelings, and life perspective. It can be difficult to listen to and reach out to people we don’t feel we connect with. All lines of communication can be lost if two people aren’t in sync. The entire therapeutic relationship is sometimes contingent upon how well a therapist and the client connects and relates to each other. It’s called rapport. Without this, all is lost! While I can’t speak for all therapists, I do know that many therapists want their clients to trust them and be open with them. If you are a client and feel unheard, tell your therapist. Most therapists want their clients to be honest and provide constructive feedback about whether therapy is working for them or not. Clients deserve more than the minimum. Many clients drop out of counseling for this reason alone.
- We want to go home at the end of the day: At the end of the day and in cases where negative things are going on at home, it can be really difficult for a therapist to concentrate on the duties of the day. For many therapists their duties not only include counseling clients, but also speaking with a client’s case manager(s) or service coordinator(s), probation officer(s), police, teacher(s), school, place of employment, extended family members, coaches, and other support providers. Many people believe that therapists sit in their offices and talk to clients on a daily basis. While part of this is true, many also engage in case management, testify in court, write evaluations or treatment plans, conduct assessments, respond to subpoenas, coordinate services with agencies, give presentations or trainings, attend trainings (that are sometimes 8hrs or more), respond to phone calls, fax and email paperwork, respond to crisis calls or emergencies, accompany clients to hospitals when they are 302’d, attend county or company meetings, provide psychoeducation at seminars, write articles or books and blogs, etc. The duties of a mental health professional can vary each day, week, and month. By the end of the day, many therapists want to go home or see their families and have a time out. Many therapists aren’t aware that they are burning themselves out. Sadly, this can cause therapists to be emotionally “unavailable” to their clients.
- We experience problems with no easy solution too: It can also be difficult to engage with clients and support them when the therapist him/herself is struggling. For example, I’ve known colleagues who have had death in their families and still came to work, often hiding behind a half smile and preppy voice. Clients feel this and they are very aware of when their therapists isn’t acting the same.
As you can see, a mental health professional’s job never ends! It’s really tough. Self-care must become a regular part of daily life for all of us. A small treat, a gym membership, family time, going to church or youth groups, a date night, etc can all be helpful. What good is a job if you feel too overwhelmed to succeed and truly be of help?
It’s also important that clients understand that the above 6 points do not mean that a client should feel burdened by their therapists problems. If you start feeling like your therapist is “tuned out” the majority of the time, move on. You deserve better. But it’s just as important to remember that perhaps your therapist is going through a rough patch and will recover.
I encourage you (and remind myself!) to be mindful of how much time you afford yourself. Your health is important. I think you deserve some compassion because after all, you are only human.
As always, I wish you well.
Stay tuned for tomorrow’s article on Personal Stories Week which focuses on a father who lost his son to suicide.