Provider Self-Care? In This Economy?!
“You can’t pour from an empty cup.” All of us in the field have probably heard this phrase plenty—from mentors, parents, or friends helping us work through moments of exhaustion or burnout. The message is always the same: to have the energy to care for others, you must first care for yourself. Yet, in the fast-paced world of client sessions, emails, Zoom meetings, case notes, trainings, conferences, accreditations, insurance companies, writing projects, and clients in crisis, where can we find a moment for ourselves? And after work, we know other people, pets, chores, and adult responsibilities await us at home. It is easy for self-care to fall to the bottom of this daily laundry list – how can we fight to keep it at the top?
Why Is This So Hard?
When asked what the biggest barriers are to mental health providers engaging in appropriate self-care, this is what the pros had to say:
“We tend to put our own needs last.” – Captain Bailly Thompson, MOT, Occupational Therapist, United States Army
“Another challenge […] stems from the lack of examples of what self-care looks like in our mentors, faculty, and first supervisors. Somehow, we are [seen as] less human than those we serve and the lack of acknowledgement that we have needs/boundaries.” – Dr. Yadira Torres, PsyD, Licensed Psychologist, Lakeland, FL
“I think it’s that there is so much need for services that we can’t possibly keep up with working a standard week and then taking time off. If there are more hours in a day, it’s more people we can serve.” – Dr. Theodora Coffman, PhD, Licensed Psychologist & Practice Owner, St. Petersburg, FL
“[It’s] our own willingness to enforce boundaries. I think most people will say it’s time that’s the problem, but the root is more finding the will to create and hold the time to prioritize yourself. People drawn to a helping profession tend to do so eagerly, and knowing when and where to draw lines is really challenging because you have to weigh your needs versus the cost of helping someone else. Most of the time we tend to default to the latter, even to our own detriment.” – Dr. Keri Franklin, PsyD, Licensed Psychologist, Raleigh, NC
“One obstacle would be the work culture and environment for mental health professionals. I have found it easier to engage in self-care when it is promoted and accepted in the work culture, particularly when there are accessible opportunities for consultation about difficult cases, which I would consider self-care within the work setting.” – Dr. Mike Drury, PsyD, Licensed Psychologist, Tallahassee, FL
“The biggest obstacle is caring for other people. We went into this field to help others, but this usually comes as a detriment to ourselves.” – Dr. Kathryn Hill, DNP, PMHNP, Psychiatric Nurse Practitioner, Chicago, IL
Why Should We Do It Anyway?
There’s a lurking cognitive distortion for providers that self-care is optional, or even selfish. Self-care would be nice, but it’s the thing that can be sacrificed while keeping all the truly mandatory things afloat. However, ethical guidelines caution us against becoming “impaired practitioners.” For instance, the APA Ethics Code requires that “psychologists refrain from initiating an activity when they know…there is a substantial likelihood that their personal problems will prevent them from performing their work-related activities in a competent manner. When psychologists become aware of personal problems […], they take appropriate measures, such as obtaining professional consultation or assistance, and determine whether they should limit, suspend, or terminate their work-related duties” (Principle 2.06; APA, 2017). Self-care has been described as an “ethical imperative” (Abramson, 2021), and lack of self-care can lead to burnout and stress, negatively affecting rapport, therapy effectiveness, clinician boundaries, clinician work attendance/tenure, medical errors, administrative task completion, and provider credibility (i.e., clients want to see us practice what we preach) (Barnett & Homany, 2022; Posluns & Gall, 2020; Simionato et al., 2019).
“The benefits of self-care far outweigh any negative effects of stress and barriers that could interfere with the use of self-care strategies that reduce stress” (Lashley, 2019, p. 69). If you set a boundary and take care of yourself, everyone will not be mad at you, and you won’t run out of time to get your work done. If either of those things do happen, those may not be “you problems.” Bottom line, if improving quality of life isn’t reason enough, self-care will keep you out of trouble and make you better at your job; it’s part of your job.
What Actually Works?
We know all of these things, and we know self-care is important, and yet here I am writing this article. This is tough stuff to enact, but in the effort of saving you the trial-and-error, here’s what the evidence says works best to build sustainable self-care:
- Self-Awareness: Knowing the risks inherent in the field, taking the time to check-in on your own mental state/needs, and asking trusted others to provide feedback on your stress management are crucial first steps to self-care (Barnett & Homany, 2022; Posluns & Gall, 2020).
- Health Behaviors: Have boundaried routines around your own sleep, meals, exercise, and even “bio breaks” in the day (Posluns & Gall, 2020).
- Recharging: Engage in activities that allow you to restore your capacity for emotional regulation (Bressi & Vaden, 2017). Self-care activities should feel flexible, refreshing, affordable, and fit well in your day, rather than feeling stressful, rigid, or overly time-consuming (Barnett & Homany, 2022).
- Variety & Balance: Find opportunities for variety in your work (e.g., providing different types of therapy, teaching, writing, consulting, outreach) and meaningful activities outside of work (Barnett & Homany, 2022; Posluns & Gall, 2020).
- Processing: Take time to process your work via consultation, supervision, mentorship, personal therapy, journaling, or producing art. Meaning-making and advice-seeking can decrease burnout (Barnett & Homany, 2022; Bressi & Vaden, 2017; Lashley, 2019; Posluns & Gall, 2020).
- Using What You Know: The mindfulness, acceptance, positive psych, and CBT-based strategies that we teach our clients can also help us reduce stress and burnout when applied to our own lives (Lashley, 2019; Rudaz et al., 2017).
- Spirituality: Yoga, meditation, and access to other spiritual practices/communities are known to promote relaxation and purpose and reduce burnout and emotional exhaustion for practitioners (Lashley, 2019; Posluns & Gall, 2020).
- Time Management: Know that you will need to have good time management— boundaries, priorities, planned breaks, taken vacation days, and reasonable expectations for your work—to make time for appropriate self-care (Barnett & Homany, 2022; Posluns & Gall, 2020). The phrase, “if you don’t choose to make time for wellness, you may be forced to make time for illness” comes to mind.
- Institutional Change: Self-caring is so important, but it does have its limits. Environment also matters greatly, and appropriate role expectations, meaningful work, training opportunities, structural emotional support, a positive ethical culture, and graduate level education about self-care (Barnett & Homany, 2022; Lashley, 2019; Posluns & Gall, 2020; Simionato et al., 2019) are all key to providing a steady foundation for individuals’ self-care efforts.
Further Resources
American Psychological Association (2023). Helping ourselves: Self-care for psychologists. https://www.apa.org/members/content/secure/self-care
Davis, T. (2022). 6 research-based self-care tips. Psychology Today. https://www.psychologytoday.com/us/blog/click-here-for-happiness/202208/6-research-based-self-care-tips
Doran, J. (2014). The unspoken truth about self-care. gradPSYCH Magazine. https://www.apa.org/gradpsych/2014/04/corner
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About the Author
Taylor Thompson, Ph.D., serves as a distance learning developer and literature coder on the Services and Products Development team at PracticeWise. Learn more about Dr. Thompson on the PracticeWise team page.
