What causes therapist burnout? Signs, Symptoms, and Recovery

Burnout rates among mental health care workers, social workers, doctors, nurses and those in people-focused roles is a huge issue in today’s society. According to a study published in July 2020 by the American Academy of Psychiatry, among 2,084 North American psychiatric providers who responded to an online survey, “A total of 78% (N=1,625) of participants had an [Oldenburg Burnout Inventory (OLBI)] score ≥35, suggestive of high levels of burnout, and 16.1% (N=336) of participants had PHQ-9 scores ≥10, suggesting a diagnosis of major depression.” The stats don’t lie, and while that was taken during the height of the first wave of COVID-19, it paints a grim picture for mental health and medical professionals nation-wide.

This probably doesn’t come as a surprise to you if work in a social services role like psychiatry, mental health, occupational therapy, nursing, education, or skills coaching. Despite how rewarding it can be to work with others and provide essential care to those who are hurting, there’s a major risk of burnout for those in social services roles due to the heavy emotional content encountered, the high level of need, stagnant wages in many industries, and overburdened care facilities across the country.

Although burnout doesn’t have an official diagnosis in the DSM-V, the World Health Organization (WHO) has officially classified it as an “occupational phenomenon,” in the ICD-11. It’s not considered a medical condition or phenomenon, but the WHO does outline some of the major components that come as part of the burnout phenomenon:

• Exhaustion—often emotional in nature, but many also report physical exhaustion as a result of burnout. This is often a feeling of energetic depletion across multiple areas.

• Loss of empathy, feelings of caring, and compassion for others, even those you serve in your role

• “Increased mental distance from one’s job,” which may include “feelings of negativism or cynicism related to one's job”

• Lowered sense of accomplishment and satisfaction in the work you do

Burnout is often compared to Vicarious Trauma (VT), which is another occupational hazard faced by social services workers, doctors, teachers, and those who come into contact with the public frequently as part of their work. While someone can experience burnout and VT simultaneously, they are technically two separate “conditions” or phenomenon, with Vt more closely mimicking the symptoms of PTSD.

According to the Society for the Advancement of Psychotherapy, Vicarious Trauma often features the following signs and symptoms:

• intrusive thoughts and images related to the client’s disclosures

• avoidant responses

• physiologic arousal

• somatic complaints

• distressing emotions

• addictive or compulsive behaviors that may adversely impact one’s competence

How to deal with therapist burnout

As a therapist for burnout who treats other therapists, educators, healthcare workers and social workers in Indiana, I am often asked, “how do you deal with burnout as a therapist?”

First and foremost, I need to emphasize the fact that burnout doesn’t have a one-and-done solution. Treating burnout is something that should be done with consideration for your unique circumstances. How to treat burnout for therapists and other social services workers depends on several factors, including:

• how your work environment impacts your levels of burnout

• how your boundaries (or lack thereof) impact your burnout

• whether you are experiencing co-morbid anxiety or depressive disorders, which can look a lot like depression and often come together

• how your social and romantic life is impacted by your burnout

• how “bad” your burnout is and whether it’s impacting your ability to work, take care of yourself, and engage in your life outside work

• whether you have any other mental health or physical health conditions that interact with your burnout

When working as a therapist for burnout, my general suggestions for clients and colleagues come down to a few key points.

Ways to start fixing burnout:

Keep it small

Try to take teeny, tiny steps toward making changes that support your mental and physical well-being and healing from therapist burnout. Because you’re already exhausted, trying to take on a major change will probably induce even more exhaustion and feelings of hopelessness. Pick one small thing you can change about your day to day life—for example, taking 5 minutes at the end of each work day to journal out how you felt about the day’s sessions, process your emotions, and mentally “close” the day before leaving your office space.

Keep it simple

Similar to above, don’t make your changes too complicated. Break big goals into small, simple, doable tasks. Try not to take on changes that require lots of upkeep, task management, and complex ideas. Using the above example, there’s no reason to create a whole structure and process around your journaling—just grab a pencil and the closes piece of scrap paper, write out whatever you’re thinking, and tear it up and toss it in the bin when you’re done.

Flex boundaries like a muscle

Often, therapists burn out because they have big hearts and find it difficult to say no. Just keep in mind that when you say yes to any and all client requests, unreasonable demands from your boss, or big asks from your colleagues, you’re saying “no” to your ability to manage your own emotional overwhelm, take care of your physical body, and keep a schedule that is doable for you. Instead, I’d encourage you to start flexing boundaries like an under-used muscle: slowly at first, until you build enough strength and stamina for “heavier lifting.” Using the framework from above, start with small “less risky” boundaries that don’t require a lot of things to keep track of. Work your way up.

Go to therapy for burnout

Sometimes, managing burnout on our own is too hard, or it may be complicated by co-occurring anxiety and depression. Sometimes, folks develop substance use disorders or other addictive habits to help manage the overwhelm they feel with burnout. If this is the case, know that seeking therapy for burnout is recommended to help you manage your mental health and to find ways to reduce burnout in the long haul.

Find therapy for therapists, healthcare workers and more in Indiana

If you are a therapist, teacher, social worker, or healthcare professional in Indiana who is looking for therapy for burnout, depression, and anxiety, reach out to Lykke Counseling & Wellness today. Megan Kelly, MA, LMHC specializes in treating burnout for adults in the state of Indiana and provides telehealth for adults in Fort Wayne, Indianapolis, South Bend, Valparaiso, Bloomington, and Michiana.