The big secret!  Are we a danger to ourselves and our clients?

 

You signed on as a helping professional to serve and to heal.  You may be a psychotherapist, a doctor, a teacher, a nurse or a mother, a caretaker or a combination of several of these.  You are anyone who serves others. Many of you are helping professionals and that is just where it starts.  You have sick kids; your aunt is in the hospital and your husband wants to host his work retreat all while you have a cold and are working full time.  You help, you serve and you provide the utmost care…. for other people.  What about you?  You are finding that something is not working because “as simple as self-care sounds you are finding it’s not”.   The most serious and scary aspect that is often overlooked is the “dark side” “big secret”.  When what can happen is shown in the research that we don’t always read.   The following gives some somber stats on what can happen if we are not proactive.

Why are we, as helping professionals, not taught to handle burnout? The concept of self-care has not been ingrained in therapists, counselors and social workers, psychologists and other helping professionals as a rule.  We have not traditionally identified ourselves, with the concept of ethics as it relates to self-care.  We are expected to be professionally fit and available.  We are supposed to be able to handle the day in and day outs of holding space for others.  It’s as if having knowledge of compassion fatigue and burnout should be enough to keep it away.    We are led to think that the occasional massage or going to the doctor is sufficient to fulfill our professional responsibility to ourselves and our clients.  We know that most people do not seek the services of helping professionals until or unless they are in crisis.  We do ourselves and our profession a great disservice if we think we are immune to our own humanity.  At the same time, we also provide daily care for our own family members, those in our organizations, those we work with and others. We do not have super powers and if by some chance, we do then this is our kryptonite.

Psychologists who fail to take care of themselves are less likely to be competent providers, said Erica H. Wise, PhD, a presenter at an “Ethics and Self-Care” continuing-education workshop at APA’s 2006 Annual Convention. In addition, when psychologists’ mental or physical health affects their work, it can create an ethical problem because their ability to help clients is compromised, said Wise, a psychology professor at the University of North Carolina at Chapel Hill.

Impairment doesn’t always take an obvious form like substance abuse, said Wise during the APA Continuing Education Committee-sponsored session. Snowballing personal stressors-such as health problems, marital problems or even day-to-day stressors-can foster mental distress that can impair a psychologist’s effectiveness or even cause improper behavior, such as inability to set appropriate boundaries, breach of confidentiality, fraud or negligence.

Learn the importance of avoiding such problems through preventive self-care.  Click HERE to sign up for my upcoming 6 hour NBCC approved CE course:  Law & Ethics in Practice: The Clinician in Private Practice.

 

Applying the Code of Ethics to the Concept of Self-Care

The following sections have been copied from the ACA Code of Ethics (eff. 1995). How do they apply to the issue of self-care as discussed in the module? Do you comply with additional professional codes? What do they say about the importance of counselor self-care?

C.2. Professional Competence

  1. 7. Impairment. Counselors refrain from offering or accepting professional services when their physical, mental, or emotional problems are likely to harm a client or others. They are alert to the signs of impairment, seek assistance for problems, and, if necessary, limit, suspend, or terminate their professional responsibilities. (See A.11.c.)

How does self-care relate to ethics?

It has been researched and shown that the single biggest factor in determining outcome of therapy is the relationship between the therapist and the client.  This makes a more significant difference than the type of technique used or any other factor in the relationship.

Can you be effective if you are not healthy?  If you are negative, exhausted and overworked can you be fully present for your clients?  I would argue you cannot and research shows the same thing.  The big question is can you be a danger if you are burned out or not taking the time to take care of yourself?  Who has not snapped at a family member or co-worker every now and then?  This does not happen intentionally but it happens.  What if this is bleeding over into the treatment of the most vulnerable of the clients who come to see us.  I venture to say we have all gone to work when we didn’t have enough sleep, didn’t have any down time for ourselves, we push on and push through and at times this works for us.  What makes me argue that self-care is an ethical imperative is the times that the pushing through does not work for us.

Self-Care is vital – not a luxury- a look at helping professionals and self-care

This Medscape article  shows how physician drug abuse is not a new problem — William Stewart Halsted, the father of American surgery, was addicted to cocaine — but it’s a persistent one.[1]    A number of surveys, conducted by Guy and others, reveal some very real and somber statistics about therapists’ lives and well-being. At least three out of four therapists have experienced major distress within the past three years, the principal cause being relationship problems. More than 60 percent may have suffered a clinically significant depression at some point in their lives.  Read the entire article here.  Even more sobering and making an even stronger case for the need for helping professionals to have an active self-care plan is this statistic found in the same article.  One out of every four psychologists have suicidal feelings at times, per one survey, and as many as one in 16 may have attempted suicide.  A study initiated by that task force, published in 1980, concluded that “psychiatrists commit suicide at rates about twice those expected [of physicians]” and that “the occurrence of suicides by psychiatrists is quite constant year-to-year, indicating a relatively stable over-supply of depressed psychiatrists.” No other medical specialty yielded such a high suicide rate.  Self-care and finding support are necessary and not a luxury for “other people”.

Before we really start to dig into all the aspects that self-care encompasses’ let’s see where you are now.  Think about your own self-care.  What are you doing for you now?  What are some of your core beliefs about self-care?  This is important stuff!

If you are one who would say “I don’t have time to take care of myself”.  My response is that you need it even more than someone who does have time.  You are the keeper of yourself, your body, your mind, spirit and most importantly your soul.  If you need more convincing, go back and read through the statistics again. This is important.  Self-care is a term which I define as any action intentionally done to improve your physical, emotional and/or spiritual wellbeing.  When you can integrate those aspects of self then you fully move into who you are and only then can you truly help others. 

Stay tuned for more on the ethical imperative of self-care for helping professionals.  The upcoming live webinar Law & Ethics in Practice: The Clinician in Private Practice will dive deep into the how and why of taking better care of you.  Read more about it HERE.

Love and light,

 

Jamie

 

 

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