In honor of August’s National Wellness Month, it is important to highlight the significance of clinicians educating their patients on self-care and building their individual clinical care routines. It is undeniable that the current clinical and academic landscape prioritizes psychoeducation on self-care practices for patients, including creative and individualized options. As mental health professionals, teaching our patients how to build resilience by utilizing their self-care schedule and acquisition of skills assists in building the resilience needed to create a life worth living. The difficulty often arises in the parallel process for clinicians (Ziede & Norcross, 2024). Clinician self-care must be equally emphasized. This routine may include clinical consultation and supervision, therapeutic support, engaging the basics, active engagement in hobbies, and vacation breaks (Rivera-Kloeppel, & Mendenhall, 2023). With the goal of subjective well-being, research proposes that self-care practices for clinicians can improve life satisfaction and reduce the risk of heart disease. The implementation of intentional clinical self-care practices for mental health professionals can even arrest more serious health conditions including premature death (Yan et al., 2024).
The relationship between the clinician and the patient remains the best predictor for successful treatment outcomes. Without a strong clinical care routine, the results for both clinician and patient may range from minor to catastrophic. Missed connection, exhaustion, compassion fatigue, and ultimately overarching adverse treatment outcomes occur. Clinical rapport is directly impacted by the clinician’s overall mental health and well-being (Ziede & Norcross, 2024). However, multiple studies establish that most clinicians lack the self-awareness needed to provide accurate self-reports. Therefore, it is essential to involve clinical supervision, consultation, or personal therapy as one of the first building blocks in the foundation of a clinical self-care routine (Lambert, 2010; Waltman et al., 2016 Ziede & Norcross, 2024).
Clinical Self-Care Routine
- Clinical Consultation & Supervision: The practice of clinical supervision began as an established concept in the psychoanalytic tradition, where clinicians such as Freud would correspond with others through face-to-face meetings and letters of correspondence (Lohani & Sharma, 2023). Today, students, trainees, associates, and interns seek clinical supervision as a requirement for licensure. However, once licensed, clinicians often cease consultation with their supervisor viewing it only as a box to check on the road to licensure. Rather than understanding the true value of lifelong consultation, mental health professionals often head out on their own resulting in a narrow, subjective lens to treatment. Ultimately, this may compromise the effectiveness of treatment. Training institutions owe it to the clinician to provide improved psychoeducation for both initial and continued supervision. As the building block of the clinical care routine, consultation and supervision result in increased self-awareness, improved skill, insight, and the self-efficacy required to succeed in the therapeutic environment (Lohani & Sharma, 2023).
- Therapeutic Support: If you are a therapist, you should have a therapist. How will you know what is yours and what is not? Awareness of transference and countertransference through personal therapeutic work is needed to differentiate your emotions from your patients. Research suggests that therapeutic support for clinicians increases adaptability, self-efficacy, and resilience. Mental health professionals without personal therapeutic experience risk exposure to vicarious trauma, through daily pain, distress, and grief. Burnout can also occur when clinicians don’t provide themselves with the same interventions they would recommend to their patients. The negative effects of burnout might include emotional and physical exhaustion, cynicism, detachment, and reduced effectiveness. Compassion fatigue also has a high prevalence rate amongst the clinical population. Compassion fatigue is defined as the decrease in access to empathy for others due to exposure to distress with physical and mental exhaustion (Inman et al., 2024). Without adequate therapeutic support for mental health professionals, burnout, transference, and compassion fatigue are inevitable. Most importantly, awareness of the aforementioned is imperative if therapists are to do their job effectively and safely.
- Eat. Sleep. Move: Don’t underestimate the importance of the basics. Without consistent fuel, routinely rebooting our system with sleep, and basic movement our main tool the brain, is not fit to function. Research demonstrates that regularity with sleep impacts memory, mental and physical health, immunity, hormone regulation, and cognition (Baranwal et al., 2023). Sleep hygiene impacts alertness and satisfaction, which leads to increased self-efficacy (Ghose et al.,2023). Finding a sleep hygiene practice that fits your personal needs delivers significant health advantages. Recommendations include consistent practice, regular exercise, and avoiding caffeinated substances, heavy meals, and specific light exposure close to sleep time. Our basic human needs are significant predictors of success and effectiveness.
- All work and no play makes Jack a Dull Boy: While sitting with patients can be inspiring and engaging, providing therapy can also be emotionally demanding. Intentionally integrating personal interests into your daily schedule is critical to the clinician’s health and the well-being of the patients. Successful work-life balance and the integration of active recovery practices and hobbies, such as arts and crafts and sports, are beneficial to a clinician’s self-care practice as they increase subjective life satisfaction and happiness. (de Bloom et al., 2009).
- Vacation Breaks: There are clear health benefits to vacation time, so it is essential to utilize time off from work. Research demonstrates that extended time off proves to be a more effective recovery style than the use of nights and weekends for recuperation. Longer breaks are essential for workers to allow the build-up of workload to dissipate. Effort Recovery Theory and Allostatic Load Theory highlight the importance of preventing the build-up that can result in fatigue, heart conditions, sleep irregularities, and more (de Bloom et al., 2009). In addition to longer vacation breaks, the research also suggests the use of shorter, vital breaks, which assist in increasing long-term clinician productivity and resilience. Vital breaks can include appealing and personalized activities in short increments throughout the day (Ziede & Norcross, 2024).
Improvement in the clinical self-care model is crucial to building therapist resilience and supporting connection with patients. Patient rapport is directly impacted by the clinician’s subjective experience and overall well-being, therefore it is important to educate new and seasoned therapists on the consequences of ignoring this parallel process. There are many strategies for achieving mental and physical well-being. As mental health professionals, we learn about them in school, speak about them in the room, and expect our patients to practice them in real-time. I hope that starting this month, we can all integrate one of these basic aspects into our clinical care routine together. Let’s work to increase our own resilience and work-life balance.
References:
Baranwal, N., Phoebe, K. Y., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in cardiovascular diseases, 77, 59-69.
de Bloom, J., Kompier, M., Geurts, S., de Weerth, C., Taris, T., & Sonnentag, S. (2009). Do we recover from vacation? Meta-analysis of vacation effects on health and well-being. Journal of occupational health, 51(1), 13–25. https://doi.org/10.1539/joh.k8...
Ghose, S. M., Dzierzewski, J. M., & Dautovich, N. D. (2023). Sleep and self-efficacy: The role of domain specificity in predicting sleep health. Sleep health, 9(2), 190-195.
Inman, K. K., Browning, N. E., Barboza, K. I., & Collins, A. G. (2024). Resilience Levels of Counselors-in-Training Who Have Received Personal Therapy (Master's thesis, Brenau University).
Lambert, M. J. (2010). Prevention of treatment failure: The use of measuring, monitoring, and feedback in clinical practice. American Psychological Association.
Lohani, G., & Sharma, P. (2023). Effect of clinical supervision on self-awareness and self-efficacy of psychotherapists and counselors: A systematic review. Psychological services, 20(2), 291.
Rivera-Kloeppel, B., & Mendenhall, T. (2023). Examining the relationship between self-care and compassion fatigue in mental health professionals: A critical review. Traumatology, 29(2), 163.
Waltman, S. H., Frankel, S. A., & Williston, M. A. (2016). Improving clinician self-awareness and increasing accurate representation of clinical competencies. Practice Innovations, 1(3), 178–188. https://doi.org/10.1037/pri000...
Yan, Nanxi, de Bloom, J., & Halpenny, E. (2024). Integrative review: Vacations and subjective well-being. Journal of Leisure Research, 55(1), 65-94.
Ziede, J. S., & Norcross, J. C. (2024). Personal therapy and self-care in the making of psychologists. In Psychologists in Making (pp. 53-86). Routledge.pdf
