The Importance of Wellness & Self-Care Among Mental Health Professionals - for GCCA
1. Nadia G. Barnett, PhD, LPC, NCC, CPCS
GA College Counseling Association Conference
January 28, 2016
The Importance of Self-Care &
Wellness Among Mental Health
Professionals in the 21st Century
3. Stress is presumed to result from a complex set of phenomena
and is not just a consequence of a single external event acting
on a person (Danna & Griffin, 1999).
• Personal
• Life Events
• Professional
• Job Demands
• Role Responsibilities
• National
• Campus shootings
• Interpersonal violence
• Global
Rationale
4. In addition to your Job Demands …
• Level of
organizational
wellness
(Lambie & Young, 2007; Leedy & Ormrod, 2010;
Robertosn, 2012)
• Life Events
(Bhagat 1983; Conty & Landy, 2009; Craig & Sprang
2010; Gladding & Newsome 2014; Lepkowski, Maddux,
Packman, Richmond, & Smaby 2005)
5. The qualities that make mental health professionals effective with
their clients, such as empathy, compassion, and caring, may also
leave them vulnerable to negative outcomes, risk factors
(Amatea, Thompson, & Thompson, 2014).
6. RISK FACTORS FOR MENTAL HEALTH
PROFESSIONALS
Mental Health Professionals who are unwell (stressed, distressed,
or impaired) may not be able to offer the highest level of services
to their clients (Lawson, 2007)
8. Causes of Burnout
Work overload
Lack of control
Insufficient rewards
- Extrinsic
- Intrinsic
Breakdown in community
Absence of fairness
Conflicting values
Leiter & Maslach
1997
9. Symptoms of Burnout
Physical manifestations:
• Chronic fatigue
• Insomnia
• Headaches
• Gastrointestinal
problems
• Hypertension
Emotional Manifestations:
• Cynicism
• Irritability
• Loss of morale
• Decreased self-
concept
• Client = case, not
person
• Disbelief in
effectiveness
Pace & Rosenberg, 2006
10. Burnout
Occupation specific
• Education
• Training
• Experience
• Quality Supervision
• Type of Clientele
• Workplace
Personal aspects
• Life outside of work
• Natural coping style
• History of trauma
• Beliefs about seeking help
• Unwilling to accept difficult client
connections
• Overextending in order to prove
competency
• Those who deal with stressors and
problems by focusing on the
feelings associated with them
• Glamorized expectations of the
work – new professionals
Factors that increase vulnerability of burnout:
Lawson & Venart
2005
12. Professional Responsibility
Risk factors can prevent the mental health professional from being empathetic,
lower his or her ability to show acceptance, lead to incongruence, and increase
countertransference, the unconscious transferring of thoughts, feelings, and
attitudes onto the client (Neukrug, 2012).
13. You are.
Per:
• American Medical Association (Medical Ethics - physician health and wellness)
• American Nursing Association (Code of Ethics for Nursing – Professional Role Competence)
• American Psychological Association (Ethical Principles & Code of Conduct – Personal Problems &
Conflict)
• National Association of Social Workers (Code of Ethics – Impairment)
• American Counseling Association (Code of Ethics – Impairment)
• National Association for Alcoholism and Drug Abuse Counselors (Code of Ethics – Professional
Responsibility, Counselor Attributes)
Who is Responsible for addressing risks?
14. Protective Factors to
Increase Wellness
The focused, empathic response to client concerns is critical to
effective client care but at the same time may act as an emotional
drain on mental health professionals who do not adequately
attend to their own self-care (Morris et al., 2010).
15. A holistic perspective focused on full
integration of body, mind, and spirit in
order to achieve balance in one’s life;
an active process through which people
become aware of and make choices
toward a more successful existence
(Balkin & Perepiczka, 2010; NWI, 2015).
Wellness
17. Behaviors that establish a balance between
personal and professional demands that target
the physical, emotional, or spiritual domains of
wellness
(Adapted from Bamonti et al., 2014).
Self-Care
18. Wellness Domains – Self-care Strategies
Physical Emotional & Interpersonal Spiritual
• Personal
• Professional
19. These are considered “escapist activities”
• Mindlessly watching television
• Playing computer games
• Shopping
• Drinking or substance use
• Surfing the internet
All undermine wellness and contribute to
impairment(Morgan, Morris, Morris, & Warren, 2010)
Ineffective Self-care Strategies
20. Honor Yourself
• What can you commit to doing starting today
to honor yourself?
• What area of wellness will your self-care
strategy address?
21. Case Study
• What would be a way to initiate a
conversation with your colleague, whom you
suspect may be experiencing a decline in their
overall wellness?
22. “Caring for myself is not self-indulgence,
it is self-preservation,
and that is an act of political warfare.”
–Audre (the) Lorde
Questions or Comments ?
Thank You for Participating
NadiaGBarnett@gmail.com
Editor's Notes
The nature of work and employment in the 21st century has become unpredictable for most Americans due to national and global occurrences over the past few decades. Mental health professionals may need to be more hypervigilant and/or hypersensitive to the stress associated with issues of diversity in addition to fulfilling their role as a therapist. Taking command of developing, implementing, and/or maintaining effective self-care strategies can assist in career-longevity for mental health professionals.
Factors that impact your wellness
Lambie & Young 2007 – note that the way an organization is structured contributes to the wellness or impairment of its professionals. Research in organizational behavior has begun to focus on how organizations may be judged to be healthy in terms of the social interactions among its members.
Bhagat 1983 states that Life events can be defined as experiences that force individuals to confront a situation or a series of situations which present a demand, limitation, or an opportunity. Gladding & Newsome 2014 report that Life events have been noted to be a source of additional stress for counselors. This variable was not included in this study because the focus of this investigation is on the application of interventions to burnout not on possible sources or causes of burnout in counselors.
Neukrug 2012 notes that Compassion fatigue, vicarious trauma, and burnout can all hinder the counselor’s ability to work with clients.
Stebnicki 2007 reports that Compassion fatigue was first introduced in the nursing literature in 1992 and then expanded into the psychological literature in 1995. Lawson & Myers 2011 state that compassion fatigue is a product of bearing witness to the suffering of others resulting in a reduced ability or capacity to be present with clients along with feelings of powerlessness, isolation, and confusion
Craig & Sprang 2010 report that the concept of vicarious trauma was first developed in 1990 to describe the transformation in cognitive schemas and belief systems as a result of empathic engagement with trauma survivors. These transformations result in significant disruptions in the therapist’s sense of meaning, connection, identity, and worldview.
Lawson & Myers 2011 specify that a counselor’s unresolved history of trauma can elevate their risk of experiencing compassion fatigue and/or vicarious trauma
Pace & Rosenberg 2006 characterize burnout as Physical and emotional exhaustion resulting from the development of negative self-concept, negative job attitudes, and loss of concern or feeling for clients
The authors disclose that although compassion fatigue, vicarious trauma, and burnout are associated with the risk of caring for others in emotional pain, they are conceptually and operationally distinct.
According to Stewart 2009 Burnout factors focus on the personal experiences of the counselor and work setting demands, regardless of the client experiences shared in therapy. Therefore, the risk of burnout places counselors in a position of needing to become their own advocates for resources required to keep themselves well so they can continue to provide appropriate treatment for their clients and meet their job demands.
In 1997, Maslach & Leiter identified six causes of burnout
Work overload – refers to how much work one does based on the degree of intensity, demands on time, or complexity of the job
Lack of control – is the reduced capacity for one to set priorities for day-to-day work, select different approaches to doing work, or one’s inability to make decisions about the use of resources
There are 2 types of insufficient rewards
Extrinsic includes – inadequate money, prestige, or security
Intrinsic includes – one’s inability to enjoy work or the organization suppresses opportunities to build connections with respected colleagues
Breakdown in community – refers to an environment that encourages greater conflict among its members, less mutual support and respect, or a growing sense of isolation
Absence of fairness – means that there is a lack of trust, openness, and respect in the workplace
Conflicting values – refers to the values of the work environment (or organization) conflict with the values of the individual employee
What do you do if/when you experience that symptom? (physical manifestations)
Emotional indicators of burnout are most often cited as feelings of hopelessness, futility, despair, boredom, cynicism, anxiety, withdrawal, irritability, loss of morale, feelings of isolation, depression, suicidal ideation, lowered self-concept, increasing inflexibility, distancing from clients, treating clients as cases rather than people, disbelief in effectiveness, and increased family and social conflict (Pace & Rosenberg, 2006).
Here, Personal Aspects include -
Current stressors and/or changes in the counselor’s life outside of work.
Natural coping style of the counselor in managing stress
The counselor’s personal history of trauma.
Beliefs that may limit a counselor’s likelihood of seeking support.
Due to the potential interconnectedness between the risks of working as a mental health professional, wellness, and treatment effectiveness, the 2014 American Counseling Association Code of Ethics, 2008 National Association of Social Workers Code of Ethics, and 2010 American Psychological Association Ethical Principles and Code of Conduct mandates that their respective professional be aware of their own physical, psychological, and/or emotional troubles (ACA, 2014; APA, 2010; NASW, 2008).
Additionally, the ACA Code of Ethics, APA Code of Conduct, and NASW Code of Ethics requires their professional to refrain from offering therapeutic services when their problems are likely to affect their clients’ treatment and seek help in dealing with their problems as they arise (Baggs et al., 2012; ACA, 2014; APA, 2010; NASW, 2008). However, there is an inherent paradox in the fact that ethical codes and code of conduct place responsibility for self-monitoring in the hands of the individual therapist (Witmer & Young, 1996).
Impairment implies that the individual is not making good decisions or has a diminished capacity to perform on the job (Witmer & Young, 1996). One could assume that the individual is also impaired in self-awareness and is not conscious of the problem(s) that family members or coworkers may be aware of (Witmer & Young, 1996). This assumption places the responsibility for preventing impairment on those in the therapist’s community, including other mental health professionals (Witmer & Young, 1996).
Roscoe (2009) and Smith-Adcock, et al., 2012 agree that A holistic approach to wellness is related to the person and the environment; therefore it is partially dependent upon individual responsibility and motivation
Myers & Sweeney 2005 note that the understanding of human behaviors requires an emphasis on the whole rather than the parts and the interaction between the whole and parts.
In 2003 Myers & Sweeney created a holistic model of wellness, called the indivisible self model of wellness, which focuses on strengths as opposed to weaknesses. This model of wellness is choice-oriented in that wellness practices reflect intentionality in lifestyle decisions
eating regularly or healthfully, exercising, receiving regular medical care for prevention or when needed, engaging in sports or physical activities, getting enough sleep, and taking vacations (Pearlman & Saakvitne, 1996).
spending time with others whose company one enjoys, staying in contact with important people in one’s life, laughing, and seeking out comforting activities, objects, people, relationships, or places (Pearlman & Saakvitne, 1996).
making time for reflection, spending time in nature, meditating, praying, and connecting to a spiritual community (Pearlman & Saakvitne, 1996).
