Learning from my mistakes

Dec 7, 2012 by

No matter how good of a therapist you are, if you don’t take good care of yourself, you won’t be in the profession very long.

I learned this firsthand during my internship.  Let me tell you a little bit about what I did wrong.

I worked two jobs during my internship.  The first was a full time position at a community mental health center.  The second was a part-time position in a supervised private practice.

In my job at the community mental health center, I was working with children and families.  I did not have much training in working within systems, and that was pretty much the sum total of what I was doing in that job.

Most of my child and teen clients had experienced trauma.  Many of their parents had, too.  Families had few resources.  There was very little stability.  I had about 40 families on my caseload at a time.

So, as you can imagine, in spite of offering my best efforts, change was slow and often painful.  Some days, it felt I was doing little more than putting out fires– ones that reignited most weeks.  There was very little quiet space for change.

I worked at that job from 8-5.  And then in the evenings, I worked with clients in private practice.  Some days, if all my clients showed up, I would see 8 or 9 in a row.  Often, I would get home after 8 or 8:30 pm.  When I look at that now, that adds up to a 12 hour day.

I hope I don’t need to tell you why this was a bad idea.

And, it’s probably no surprise to you that I finished my internship in the shortest period of time allotted.  I had more hours than I knew what to do with.

And I was beyond burned out by the end of it.

Toward the end of my internship, I started having health problems.  I had a hard time getting excited about anything.  I kept pressing for the finish line of my internship, and then once I crossed it, I sort of collapsed.  It probably took me about 6 to 8 months to get back to feeling like my old self again.

I don’t want you to make the same mistake I did.  Even if you’re aiming to finish your counseling internship in the shortest period of time, there are still ways you can take care of yourself in the meantime.

9 self-care tips for therapists

Please learn from my mistakes, and put these tips into practice.

1.)     Get a good supervisor.  I cannot emphasize this enough.  Work with someone who is really invested in your development.  Pick someone who models good habits—who starts and ends sessions on time, who has boundaries to protect themselves from the stress of the work.  You will likely adopt some of these habits, so make sure you’re modeling after a good example.  If you need some tips on how to do this, read on.

2.)    Stop the series.  Just because you can book appointments back to back doesn’t mean it’s a good idea.  Everyone has a different limit around this, but I find that more than 4 clients back to back without at least an hour break means I’m not as present for that fifth client.

3.)    Stick to a 45 or 50 minute hour.  Give yourself those extra 10 minutes between sessions—for more water, a bathroom break, or returning a phone call.  If you insist on having 60 minute sessions, schedule accordingly.  Give yourself breaks between meetings.

4.)    Set good boundaries with your work.  Everyone needs different boundaries.  For me, I don’t answer my phone outside of business hours.  I limit how often I check my email over weekends.  This helps me stay sane.  Figure out what your boundaries are and stick to them.

5.)    Refer out if you need to.  Not every client will be a good fit.  You may be limited in how much you can pick and choose your clients in an agency, but you can probably make a case to your boss for a referral if needed.  If you find yourself referring people all the time, be careful and get curious what’s that about.  But every now and then, you may come across a client that really isn’t a good fit.  Don’t be afraid to say so to your supervisor and make arrangements to refer.

6.)    Practice wellness.  This is your mama’s common-sense wisdom, and it’s no less true now than it was when you were young.  Get enough sleep.  Take a lunch break.  Take vacations.  You may think I’m silly for saying so, but I’ve found that professional caregivers like therapists, counselors, nurses and doctors often do the worst job at taking care of themselves.  If you don’t hold back something for yourself in this work, you’ll end up empty.

7.)    Get your own therapy.  It’s a valuable experience—your own personal growth, a place to bring everything you can’t take home with you.  It also teaches you what it is you’re asking your clients to do.  Learning from the other side of the couch is a very valuable experience.  Even if your budget is limited, there are treatment options available for you.  You can learn more about making therapy more affordable here.

8.)    Check in with yourself.  If I was honest with myself 6 months into my internship, I would have said it was too much.  I would have made other arrangements.  I didn’t, I powered through, and I finished quickly.  Now, being a few years on the other side of my internship experience, I wonder what my hurry was.  I think, if I could do it again, that I would have slowed down and taken better care of myself.

9.)    Quit that job.  Some jobs are set up that it is nearly impossible to practice these tips.  You may be pressured to book appointments through lunch, or to take on more clients than you feel you can reasonably handle.  Or you may be paired with a supervisor who is unavailable or acts put-upon every time you send them an email.  Don’t be afraid to make other arrangements if your placement isn’t working out for you.  If changing sites absolutely isn’t an option, be sure to seek out support in other areas of your life.

You don’t have to do all of these—the more the better, but even one or two can help you stay honest to your own needs.

Our job, as therapists, is to help others to have better lives.  And that starts with having better lives of our own.  Let’s practice what we preach and remember to take good care of ourselves—in internship, and throughout our careers.

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