Avoiding Counselor Burnout While Seeking Resilience: An Interview with Thomas Skovholt, University of Minnesota Counseling Psychologist
Work-life balance—maintaining this can be a challenge for any working adult, but especially for those of us who are counselors. It’s not easy spending every work day delving into clients’ serious personal problems and trying to help the clients work through them. The clients’ pain and suffering can become the therapists’ pain and suffering, and even the most dedicated counselors can find the daily grind to be emotionally exhausting.
“How do you enter the world of the other person without losing yourself? You have to be present in the persons’ life, but also present in your own life,” says Thomas Skovholt, counseling psychology professor at the University of Minnesota.
Skovholt has been counseling clients and teaching new classes of counselors since the 1970s, and has written dozens of articles and treatises on the issues that those in the profession face. And a recurring theme in his teaching and writings through those decades has been the risk of counselor “burnout” and the importance of counselor resilience.
Many counselors find themselves drained and overwhelmed. For some, the novice years are the most difficult, for others being a seasoned counselor is more challenging. At times, they come down with many of the same symptoms that their clients suffer: depression, anxiety, frustration, and feelings of helplessness and futility.
Some end up quitting their jobs. Others stay on but show clear wear and tear: Their sessions become less and less fruitful as they become less engaged with the clients and put less and less energy and effort into each case.
“More hours and very intense cases can lead to less ability to creatively enter other people's lives in the one-way helping relationship that can be very helpful to the other person. Practitioners can fall back on manualized procedure, have little time for the reflectivity that leads to improved competence, and can develop an emotional depletion so that one's personal life is dulled,” he says.
Bonding and Separating
One contributing factor, according to Skovholt, is the sheer emotional investment—the affective attunement required to be a master counselor. A counselor has to listen to client after client retell the traumatic experiences that he or she lived through: sexual assaults, drug or alcohol addictions, domestic or family violence, and so on. It can be hard to endure these stories all day, every day, without becoming a little traumatized, in turn.
Skovholt has been there himself. Entering your clients’ worlds is scary and unpleasant sometimes. The key is to not become too deeply enmeshed. A good counselor firmly separates the client’s personal life from his or her own. From his own research, a term “Boundaried Generosity” has emerged to describe this intense focus on the wellbeing of the other while maintaining oneself.
“I had a refugee tell me about escaping from a refugee camp, and the people being shot trying to escape. I’m hearing it, and thinking how deeply must I listen to be of maximum value to this client as she describe her suffering. But I also had to have a sense of my life. This is not happening to me,” Skovholt says.
Compounding this is the difficulty of measuring success. A teacher sees students’ test scores rise and the students eventually graduate, and the teacher knows that he or she is making a difference. But how does a counselor know if his or her counseling is succeeding? Client’s don’t “graduate,” per se; they just stop coming, either abruptly or and in a planful way.
And some clients continue suffering from the same behavioral or emotional problems throughout their lives. Often the human change process is slow and erratic. Other times people have a readiness when they begin counseling and, in these situations, there can be rapid progress. Skovholt says “People come to counseling because they have unsolveable problems that must be solved and this demands counselor patience as together counselor and client do the counseling process.”
It hits many counselors especially hard when clients do not progress as hoped. Those counselors spend large quantities of time interacting with the clients person-to-person, and they have become personally invested in the clients’ problems. This can be especially difficult for practicum counselors who tend to tie their feelings of success to rapid reduction for clients in affective distress—less anxiety, less depression, less anger. Seasoned counselors tend to have a more complex way of thinking about their own counseling performance.
This, too, is a matter of boundaries, Skovholt points out. A counselor must accept that the clients will ultimately make their own life choices, and that those won’t always be choices that the counselor will like.
“When the client is less stressed or less depressed, the counselor may feel joyful, but when the client doesn’t get better, the counselor can get demoralized,” he says. “So it’s learning to separate oneself from the other person’s efforts.”
The Cycle of Caring
Skovholt makes a point of discussing burnout with his students and sharing with them ways to avoid it. One of his lessons centers on the “Cycle of Caring,” a circular process that a treatment process for a client will ideally follow:
- Empathic attachment phase. The counselor empathizes with the client and forms a personal bond of trust with him or her.
- Active involvement phase. The counselor dives into the client’s personal problems and works with him or her on them.
- Felt separation phase. The counselor experiences the end of a human relationship and reaffirms his or her own identity and separation from that of the client.
- Re-creation phase. The counselor is reenergizing the self in order to enthusiastically enter another cycle of bonding and separation with the next client.
This Cycle is about being present and separate at the same time. Counselors have the challenge of attaching to one client after another, and then letting each one go. . The Cycle of Caring is a model Skovholt has developed to describe the essence of, what he calls, the Relationship-Intense Professions ( e.g. helping professions, health care, teaching etc.) where the interpersonal process is central to client /patient/ student success.
This process can be hard. A counselor has to care about each client, to an extent, or else he or she won’t put in the time and effort to really understand them and help the client—and besides, most clients can tell if their counselor doesn’t care, and it will turn them off. But getting overly attached to clients will be draining, all the more so when many of them don’t recover or progress as hoped.
While it’s not easy, counselors must learn to do it. Otherwise, their own well-being will suffer, and their clients’ well-being will suffer in turn, according to Skovholt, who adds that he will be writing a book on the topic later this year.
“How often do you hear a client say ‘you seem totally disengaged and totally unable to help me, but 10 years ago you helped a lot of people, so I am grateful for that.’ You don’t,” he says. “We’re as good as the person we see tomorrow.”
He also emphasizes learning to make peace with occasional failure or mixed successes. A good counselor will not expect to understand everything about a client or to completely solve his or her problems. Also, that counselor will accept that not every client will make a substantial recovery. Counselors must pursue excellence, but not perfection.
“I used to talk to people about learning to sometimes do ‘B+ work,’ not ‘A+ work,’ learning to be a ‘good-enough counselor,'" he says. This is a version, Skovholt says, of the ‘good enough mother’ concept from David Winnocott, the English psychiatrist. “Knowing when the client needs an intense effort from you or a less intense effort is a finely-tuned skill that takes time to develop. This is true for all the Relationship-Intense Professions.”
The Inspiration to Keep Going
Once in a rare while, a counselor may get a note from a former client expressing gratitude for the counseling and explaining how much better his or her life is now. Skovholt encourages counselors to celebrate those notes, and even save them in a box—but make it a small box, he says, because those notes do not often get sent. It’s one—one of the only—concrete proofs they can give themselves of personal success.
“Counselors love getting these notes and they wonder why they don’t get more. And I tell them, when‘s the last time you wrote to your dentist to say thanks for the dental work? When’s the last time you wrote to an author about an article that you liked?,” he says.
Caring for Oneself and One’s Clients
Above all, counselors must make efforts to keep themselves emotionally healthy, Skovholt says: Only then can they truly be present and effective for their clients. Here are a few pointers that he shares toward this end:
- Join counselors associations and support groups. Spending time with other counselors is a great way to share the ups and downs of the work with others who are going through them with you.
- Consider getting some counseling for yourself. Counselors, like anyone else, can find it help to talk to a professional therapist about things that are troubling them on the job—or off the job, for that matter. “People have to be good at dealing with their own tragedies, their own losses their own grief—partners leaving them, children growing up and moving out, parents dying. Then they have energy and ideas to help their clients with losses,” he says.
- Get additional training and certification for other kinds of counseling and research. Adding some variety to one’s counseling work—different types of clients, or even different kinds of roles altogether, such as taking on some non-clinical research outside the office—can make the daily grind much more satisfying. “Counselors love learning about people. When they learning something new, it’s exciting,” he says. “But when they feel like they’ve heard the same thing over and over, the cognitive stimulations of the novelty kind of goes away,” he says.
- Have more sources of positive energy in your life: fun, friends, and family. We all need recreation, hobbies, and down time with the people who are close to us. Those non-work experiences refresh our minds and relieve the stresses of work. Also important, they give us chances to make tangible accomplishments—something that all counselors could use more of, in Skovholt’s opinion. “To have concrete hobbies, such as weaving, gardening painting walls, a collection of this or that—you can work hard with clients all day, and then you go home and paint a wall, and you can say, ‘It was yellow, and now it was blue. Look at that. I really accomplished something,’” he says.
Hard Work, But Meaningful Work
Having treated clients himself, Skovholt has known firsthand the exhaustion, frustrations, disappointments, and tensions that counselors experience while working with clients. But he’s felt other things, too: joy and purpose. A counselor helps people to make tremendously positive changes in their lives, from ending destructive substance addictions to overcoming a mood disorder such as depression. While it’s not always obvious to a counselor, great things do happen as a result of his or her work.
Skovholt reminds himself of this and encourages other counselors to do the same. Relish the fulfillment and the meaning that drives counseling, he explains. It can be a source of positive energy in itself.
“In my view, counseling is one of the great inventions of the last half of the twentieth century. We have a method to help people transform their lives,” he says. “It can give great meaning and be very gratifying to be part of that process.”
Here are four recent books by Skovholt that may be of interest to the reader:
Skovholt, T. M. and Trotter-Mathison, M. (2011). The resilient practitioner: Burnout
prevention and self-care strategies for therapists, counselors, teachers, and health
professionals. Second Edition. New York: Routledge.
Ronnestad, M.H. and Skovholt, T. M. (2013) The developing practitioner: Growth and
stagnation of therapists and counselors. New York: Routledge.
Skovholt, T. M. (2012). Becoming a therapist: On the path to mastery. New York: John Wiley
Trotter-Mathison, M., Koch, J., Sanger, S. and Skovholt, T. (2010). Voices from the
field: Defining moments in counselor and therapist development. New York:Routledge