Therapists cannot give of themselves unless they take care of themselves. Even though this idea is simple and logical in many ways, it is easy for therapists to disregard it. In addition, although self-care is talked about in counselor preparation programs, I do not see the topic emphasized. It is almost an after thought. The necessity of self-care is not hard to understand, but it apparently it is hard for therapists to practice.
The more I supervise advanced therapists the more I become convinced that self-care is critical to their growth and survival. Being a therapist is very demanding and at times it can be frustrating. If your clients are not changing or growing, the work can be discouraging and some therapists can experience it as draining. Having professional and personal support systems at your disposal is an essential part of self-care. Unfortunately, many therapists assume care-giving roles in their personal lives. If this is the case, the risk of personal and professional stress, strain and potential burnout is increased.
As Skovholt (2001) noted, therapists need to maintain themselves personally to function effectively as professionals. ?Constant renewal is essential so that our ?pond? does not become stagnant. Being fed by ?springs? and ?streams? is important so that we can continue to attach professionally as practitioners who assist others? (p. 147). According to Skovholt, therapists need to be ?searching for and finding positive life experiences. By this, I am suggesting that personal self-care should focus in part on producing feelings of zest, peace, euphoria, excitement, happiness, and pleasure? (p. 147).
One self-care issue that is discussed infrequently is professional loss. Therapists experience loss when a client terminates, even if the termination is appropriate, planned and therapeutic. If the therapist and client have a deep and meaningful connection and the client reaches the end of the process, the therapist loses a relationship that is valuable. Skovholt (2001) described a caring cycle in therapeutic relationships that involved three parts: empathic attachment, active involvement and felt separation. Assuming that the therapist is attached to the client in a meaningful way, termination will be experienced as a loss to the therapist. What is the best way to process the loss? How do experienced therapists go through this experience of separation effectively?
In counseling literature, there is very little written about this third part of the cycle, but Skovholt (2001) compared the process to that of teachers who end a semester or year with their students. I have taught in a university for seven years and have experienced a feeling of loss when certain classes ended. If I am particularly fond of a group, it is hard at times to end the class even if I know I?ll continue to see the students because the experience we have in the class will not be the same. With supervisees, it is even harder. I supervise advanced doctoral students for a year and get attached to many of them. It is sad to end a relationship in which we have shared so many personal and professional struggles together.
Skovholt recommends honoring the loss as one way to work through it. When a class is coming to an end, I bring up the issue to the class and process it with the students. In my role as an instructor, I do not typically cry in front of a class but I have allowed a few tears to come if I feel sadness. With supervisees, the process is somewhat easier for me because I do not feel as compelled to stay in a professional role. As a supervisor, I am like a therapist to an extent. I try to be as genuine as I can be so being honest about this loss seems to be a more natural process. When you are terminating with a client, I would recommend processing it with the client and with a supportive colleague.
Landreth (2002) recommended individual or group therapy for aspiring play therapists as a means to promote self-understanding. Because humanistic therapists operate in the here-and-now more than some therapists, personal therapy is even more important. I cannot recommend personal therapy highly enough to anyone that wants to use an approach to sandtray therapy similar to the humanistic approach. If you are drawn to deep meaningful work with clients, if you are interested in facilitating growth in clients through a here-and-now focus and a quality relationship, it is essential for you to sustain yourself and gain as much self-understanding and self-awareness as possible. In addition, personal therapy allows all therapists to work through their own issues and unfinished business, which helps to prevent their issues from affecting the quality of the therapeutic relationship.
Supervision is another positive life experience that provides therapists with strong self-care benefits (Skovholt, 2001). When I went back to get my Ph.D. in 1999, I had been a Licensed Professional Counselor for over 15 years. When I learned that I would be supervised for two years in the doctoral program, my initial response was negative. In addition to my experience, I had been trained for several years in gestalt therapy, which gave me confidence as a therapist. After one semester, however, I realized that I had been completely wrong. Supervision became an oasis for me in which I could blow off steam, get feedback, improve my self-awareness, grow as a person, learn new strategies and interventions and develop my conceptualization skills.
Assuming that the supervision relationship is one of mutual trust, supervision can ?help the practitioner move energetically along the development rather than the stagnation path? (p. 52). The less evaluative the supervision the less defensive the supervisee will be. Fear hinders development and fear of being evaluated and judged certainly hinder supervisee development.
In summary, self-care is a necessity for therapists because they are expected to give so much of themselves to others. Without self-care, therapist?s ponds will run dry and they put themselves at risk of burnout or impairment. Personal therapy and quality supervision have been proposed as significant aspects of self-care for therapists. It is hoped that therapists will make taking care of self a priority rather than a luxury.
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