Your client says he feels overwhelmed, overworked, exhausted, and less effective in a job he used to love. His old enthusiasm and motivation for his work is gone. Your diagnosis? Burnout.

As he speaks, you find you identify with some of his feelings. While you’ve always loved your job, lately your enthusiasm hasn’t been there. You feel drained. Each day you sit with clients whose levels of depression, anxiety, and trauma seem higher than ever. The pandemic may have hit you hard, also – both personally and professionally. You may have fallen behind with documentation and billing. And chances are you are handling all of your clinical and administrative burdens without support. This additive stress can build up slowly and quietly, leading to burnout.

While any professional can suffer the effects of ongoing stress, research has shown that there is a higher risk for burnout and job turnover in the healthcare profession, especially during the first three years of practice.

But can we recognize burnout in ourselves?

Despite our advanced diagnostic skills, therapists may be the last to recognize our own burnout. In one survey, a majority of counselors reported satisfaction with their work, and not one reported feeling impaired. However, when given burnout questionnaires, 30 percent showed signs of impairment, burnout, and/or compassion fatigue. And that was before the pandemic. This may be no surprise, since most of us don’t receive training in how to recognize the subtle early warning signs of burnout, or how to prevent it.

Defining Therapist Burnout

Burnout is defined as the stress and mental exhaustion caused by the inability to effectively cope with the continuous mental demands of our work environment. Studies of therapist burnout typically identify three main components:

• Emotional exhaustion: Feeling emotionally overextended and/or psychologically drained by work
• Compassion fatigue / Empathy loss
• Personal ineffectiveness: Feeling a lack of competence when working with people

14 Signs of Burnout

You may be experiencing burnout if you:

1. Drag yourself to work, and/or miss appointments (or whole workdays)
2. Feel relieved when clients cancel
3. Begin sessions late, watch the clock, or end early
4. Find yourself distracted, or not listening as closely as usual when clients are speaking
5. Give advice as a shortcut rather than asking questions to help clients get insights
6. Take fewer risks in session
7. Feel less effective with clients, doubt your competence
8. Feel less empathetic, more impatient, or more judgmental toward clients
9. Feel burdened by (or unable to stop thinking about) clients’ traumas
10. Stop behaving as ethically and carefully as you have in the past
11. Self-disclose more often, in ways that don’t help the client
12. Feel overwhelmed, chronically tired, or overextended
13. Feel bored or unenthusiastic about your job
14. Lose boundaries / Make yourself too available to clients

Any of this sound familiar? Don’t worry. It is common for therapists to go through some level of burnout at some point in their career, if not multiple times. It is not a sign that you’re in the wrong profession, or that you aren’t a great therapist. It simply means that you are human, that this work can be emotionally draining, and that it’s time to take steps to address the issue.

10 Tips to Combat Burnout

1. Take more time off. Open your calendar now and plan a getaway or stay-cation. Since therapists typically don’t get paid vacations, we often take too few. But our work can be emotionally taxing, and frequent breaks to recharge are essential and make you a better therapist. Make sure your vacations allow time for relaxation.
2. Reconsider your schedule. Research has shown that burnout risk is not directly related to how many clients you see, but is higher if you are seeing more clients than you would like. So, take time to assess how many sessions you can do each day before your brain starts to feel full, or you start to feel depleted. Can you start an hour later to enable an extra hour of sleep? Consider shorter workdays and longer breaks between clients. Schedule time to get out of the building between sessions.
3. Be less accommodating. Maintain a consistent schedule of time slots available for therapy, administrative tasks, and breaks each day, and  try not to deviate to suit a client’s schedule, except in emergency situations. Model good boundaries by not allowing clients to go overtime in sessions.
4. Leave work at work. Make home your sanctuary. As you leave work and close the door, take a deep breath and imagine leaving your clients’ emotional energy in your office. If you bring work home, and answer emails and phone messages from home, see if you can make a plan to stop this.
5. Reduce your note-taking stress. In my recent survey of 500 therapists, respondents reported writing and keeping up with progress notes was a major source of stress. Consider scheduling time each day to complete documentation, perhaps your last hour, so you can leave work with this done. Or end sessions on time and immediately take notes after the session. Taking some notes in session and transcribing afterwards can also speed the process.
6. Mix it up. Burnout can come from a lack of variety in your work activities. Consider supervising, providing consultations, writing, giving workshops, teaching wellness classes, or volunteering. Conversely, if you’re doing too much, learn to say no, and simplify your life.
7. Separate your self-esteem from client progress. Therapy can be a slow process, and you may become frustrated, or doubt your effectiveness. It’s important not to tie your self-worth to client feedback or client progress: One week, a client may idealize you, and the next, you may be the object of intense criticism. You may have clients who are progressing and some that are not. Remember – you can’t heal everyone, and there are more factors at play other than your skill.
8. Get some new training. Often, learning a new approach or technique or simply attending an inspiring workshop can invigorate your enthusiasm and self-confidence.
9. Practice what you preach. You teach self-care every day, so take your own advice. Call a friend. Schedule a fun night out. Get more sleep. Get out in nature. Meditate. Unplug from devices. Take a mindfulness class. Read for fun. Do something creative. That is, do more things that bring you joy, and have nothing to do with work.
10. Get support. This can be a very isolating profession, especially in solo practice. It’s easier to catch the early signs of burnout when you’re doing routine check-ins. Become active in your professional association. Consider sharing office space with others. Explore what tasks you can outsource, perhaps by hiring a personal assistant or biller. Consider personal therapy to deal with both the stress in your personal life and the inherent stress of this rewarding but difficult profession. And instead of struggling with difficult cases or business concerns on your own, schedule case consultation sessions with a colleague.  You’ll be amazed at how much better it feels just to talk about difficult cases.

The Quiet Killer of Our Passion – and Compassion

It may go without saying that when we’re emotionally spent, it affects client care. We may be less observant in session. We may not be able to give clients hope. We may not operate as carefully. Our documentation may suffer. But worst of all, burnout can even lead us to consider abandoning a career we were once passionate about, despite years of study and preparation. This would be a tragic loss, both for us, and for the clients who need our services.

It’s important to remember that burnout is common and treatable. It can be a challenge to find the time and money for self-care measures such as personal therapy, regular consultations, seeing fewer clients, or taking more vacations. However, an investment in self-care is essential to keep you functioning effectively and happily year after year in this profession.