4 Surprising Ways to Prevent Burnout

@christnerfurt

When it comes to preventing burnout, we might think of things like getting massages, or doing more yoga. But that approach actually misses the deeper truth about where burnout comes from. And, often “self-care” can start to feel like it’s own burden. You are already stretched thin, and then you get the advice to add more to your schedule? I have nothing against yoga or massages! I love both, in fact. But, if you have set your business up in a way that is burning you out, all the “self-care” techniques in the world aren’t going to save you.

The first part of burnout prevention is understanding the TRUTH about where it actually comes from. And then once you know it, the answer to preventing it becomes much more clear!

Today we’ll cover just that. Let’s get started!

The truth about burnout is this:

Burnout is the result of feeling ineffective and stuck over a period of time.

When it comes to real burnout prevention, it’s about identifying what makes you feel ineffective and stuck in your business.

Today I’m going to talk about four common things that therapists do (that we often don’t even realize) that lead to burnout, and what to do about them.

Burnout Behavior #1: Taking All-Comers to Your Practice

We can’t be the right therapist for everyone.

If you’ve worked in an agency, you’ve probably been programmed to feel like you a) don’t have a choice (because in an agency you literally have no choice) and b) to not even think about the concept of therapist/client fit.

Agencies are usually so strapped for resources, and have such long waitlists that your caseload is probably going to be filled with those most in need, and not necessarily the ones you are best suited to help.

When you run your own business, if you want to help the most people, over the longest period of time, it’s important for you to understand who you work best with, target your marketing to those folks, and screen as best you can when you get inquiries.

If you don’t do this, the danger is that you can start to feel (you guessed it!) ineffective and stuck.

Burnout Behavior #2: Seeing High-Risk Clients Without Enough Support

In an agency, as tough as that work is, you usually have things like: administrators, case managers, emergency services, security, medication evaluations, groups, intensive tracks or programs, and the ability to pop into a colleague or supervisor’s office to vent or get support.

In private practice, you generally have to piecemeal services together, and often you will go the whole day (or week!) without seeing any colleagues, unless you make a point to do it, because they are behind a closed door doing their work too.

Also, remember any coordination of care that needs to be done, the driving energy comes from you. Hiring an administrative assistant for your private practice can definitely help alleviate some of the practical burdens, but ultimately as a solo practitioner there’s no such thing as being totally hands-off.

If you’re going to work with a population that is high-risk (such as addictions, or eating disorders) you need to take an honest appraisal of the structures and supports you have in place for yourself and your clients.

One way to still help the high-risk clients you are passionate about serving, while protecting yourself from burnout is to help the loved ones of those clients. For example, family members of a person struggling with addiction, or parents of a teen or young adult with an eating disorder. You are still having a huge impact while taking on less risk for yourself and the client.

Burnout Behavior #3: Learning a new skill for every person that you see

I‘m all for self-improvement, and lifelong learning! But when you’re doing it out of a place of anxiety (or desperation), it’s not healthy anymore, and it’s certainly not going to increase your longevity as a therapist.

@siora18

I made a deal with my supervisor early on in my career: If I felt compelled to buy a book about something related to a client’s treatment, instead what I would do is put a pin in it and bring it to supervision.

Sometimes I would still end up buying the book, but not until I explored the feelings first.

What I discovered is that much of the time, my impulse to buy a new book was related to a nagging voice that says: “I am not enough.”

That message showed up as “I don’t have the right skills” “Someone else would do a better job” or “I’m not competent enough”.

And listen, I hate to say this, but sometimes that voice is actually right. There are absolutely some areas where we should become competent to responsibly do the work. And yes, sometimes it’s true that someone with more experience would probably do it better (but of course, you can never become that person with more experience if you don’t do the work).

But we only have so much time and resources to learn all the things. So how do we know when we should pursue more education or specialization? Let’s look at these two scenarios and see you can feel the difference:

Scenario 1: I’ve always been interested in treating people with ADHD, and it’s a population I feel really passionate about helping. Right now in my life I have the bandwidth to dig a little deeper. Maybe I’ll start with learning a little bit more about it, and if it seems like it could be a good fit for me, I’ll sign up for a training this year, and get some CEU’s while I’m at it.

Scenario 2: This client that I just saw who I thought was coming in for anxiety, actually seems to have ADHD. I really felt like I didn’t know what I was doing in that session, so I’m going to go buy 3 books about the treatment of ADHD right now. Then I’m going to read about 30 pages of one of them, feel anxious every time I’m about to see the client, fudge my way through the protocol, and then feel crappy that I did a half-ass job. AND, I’m doing this for any of the following reasons:

  1. I don’t want to the client to think I suck.

  2. I don’t want the client to tell other people I suck.

  3. I don’t want the client to leave (because I’ll feel abandoned and like I suck).

  4. I should be able to help everyone.

  5. I want this client to like me.

  6. I can’t deal with this client’s disappointment in me.

  7. I don’t want to ask for help from someone else.

  8. I will feel like a failure if I can’t help this person.

See the difference? Also, see how that could get pretty exhausting with time? And, if you’re like me, you probably aren’t just doing that one time and learning from it (lololol, learning from mistakes, that’s funny), but you are doing it again and again.

Burnout Behavior #4: Not referring out when it’s time to refer out

This goes along with all of the above, but it brings up some slightly different things in the therapist that need to be looked at.

First of all:

Referring out is not a treatment failure, but a success.

We have a lot of trouble seeing it this way, but here’s why it’s true:

  1. You are contributing to your client getting what they truly need (whether that’s more support, or a certain specialty service).

  2. Often times by the time you are referring out you’ve actually already helped the client and/or their future treaters by getting closer to the heart of what’s actually going on.

So why is it so hard for us to refer out sometimes? Here are a few reasons (and no judgments here, I’ve experienced all of these, and it doesn’t make me, or you, a monster):

  1. We think the client is going to feel rejected.

  2. We are in a scarcity-mindset (e.g. “I can’t refer this client out because what if I don’t get another client”).

  3. We are bumping up against our own “hero complex” (e.g. need to prove to ourselves that we are worthy by being able to “save” everyone).

  4. We are overidentified with the client and there’s become some confusion about whether it’s their issue or our issue (or we are working through our own issue through their therapy).

  5. We are caught up in some kind of transference with the client and there’s some feeling that you are “the only one” who can help them, or that you are so special that they will never be able to get better without you.


If you’ve seen yourself in any of the above, it’s probably really good fodder for supervision! Especially if you can see it, but you’re having a hard time acting on it.

There are some other sneaky ways we can set up our businesses to burn ourselves out, and if you’d like to learn more about that, check out this post The Sneaky Little Actions That Lead to Big Burnout and this post Patterns and Mindsets That Are Lowkey Draining Your Private Practice.

And if you need some support in making some changes to your business, get in touch, I’d be happy to help!

Melissa KellyComment