Saturday, October 29, 2011

Self Care: Who is your most important client? You are.

I distinctly remember that throughout my graduate program there was a lot of discussion about self-care.  A lot.  I, however, had been a teacher for many years and had worked in two different residential-life programs with high-school students.  I was sure I could easily manage any demands that were put upon me from my future job as a school counselor, and I was so excited and enthusiastic about getting to work and eager to see one kid after another and assist them with their problems.  By the end of the program, I thought that maybe there was some overkill with regards to the whole "self-care" thing.  How hard could it be?

Two months into my first job, exhausted and overwhelmed,  I realized that it was probably the most important thing we could have covered in my degree program.

I am working this year with all of the new school counselors in my county, and true to form about a month or so into the school year there were signs of stress:  long hours, extra hours on nights and weekends, a never ending barrage of parents, students, teachers, and administrators coming at you via e-mail, phone, or in person.  We tend to get into this job because we are nurturing--we want to help others.  However, as I and others quickly learned, in your role as a school counselor you are being asked to "give" constantly.  The counseling relationship is indeed a relationship, but it is a one-sided relationship.  Unlike friendships where you give emotional support to your friends and they also give emotional support to you, the counseling relationship is all give and no take from the counselor's perspective.  All of our energy goes out to the students with very little coming back to us.  Further, in order to empathetic we must be willing not only to be open to feeling and understanding a student's joys, but we must also be open to understanding their pain (Shallcross, 2011).  Additionally, as school counselors we can often end up in situations where we are assigned many non-counseling duties, leaving us with less time to help our students, families, and staff members.  Combine this with large case-loads, throw in a lack of support from other counselors, a director, or your administration, and you can find yourself melting down fairly quickly (Falls, 2010).  Thus, this is the reason that good graduate counseling programs regularly talk about self-care--it is important for new counselors to already have some ideas and structures in place that will assist them in taking care of themselves.

Think about it.  If you are impaired and emotionally drained, how can you hope to help others deal with their own problems and feelings?  In a 2011 article in Counseling Today, Lynne Shallcross discusses how on airplanes, the instructions are always to place your own oxygen mask on yourself before helping someone else with theirs.  Why?  Because if you've passed out from a lack of oxygen, you will be unable to help anyone.  She quotes counselor and doctoral student Sandra Rankin:
"If you're gasping for air, you can't help other people.  Counselors who neglect their own mental, physical and spiritual self-care eventually run out of 'oxygen' and cannot effectively help their clients because all of their energy is going out to the clients and nothing is coming back in to replenish the counselors' energy."
Moreover, self-care is an explicit ethical mandate for school counselors.  In the ASCA Code of Ethics, E.1.b, Professional School Counselors:
"Monitor emotional and physical health and practice wellness to ensure optimal effectiveness. Seek physical or mental health referrals when needed to ensure competence at all times."
It is also in the introduction to Section C: Professional Responsibility of the ACA Code of Ethics:
"...counselors engage in self-care activities to maintain and promote their emotional, physical, mental, and spiritual well-being to best meet their professional responsibilities."
Thus, it is not only helpful but ethical and a best practice to develop a plan and a structure that allows us to replenish our physical and emotional energy so that we are truly able to help our students and clients.  I compare it to singing.  As a singer, my whole body is my instrument--if I am tense in the wrong place or sick or exhausted, I am unable to produce the best sound possible for my conductor or my audience.  Similarly, in the art of counseling, we are also the instrument.  If we are physically and emotionally exhausted, how can we hope to be able to empathize with our clients or stay focused enough on what they are telling us and showing us in order to best assess their needs and devise a plan to help them?

How can you tell if you or a colleague is beginning to fray a bit at the edges?  You might not do well with a crisis, you might find yourself being ever more cynical about students and your job, you might find yourself taking more and more "mental health days," you might withdraw more and more from family, friends, and co-workers, your personal relationships may be suffering, and you might become extremely defensive with any constructive criticism about your job performance (Williams, 2011).  Additionally, there are some great questions from Gerald Corey to ask yourself if you are concerned about impairment or burnout:
  • Is my personal life satisfying and rewarding?
  • Are my relationships where I want them to be?
  • To what degree am I taking care of myself, both physically and emotionally?
  • Would I be willing for other (school counselors) I respect to know about my professional conduct and decisions?
  • Am I willing to express my vulnerabilities through consultation or peer supervision?
  • Am I generally consistent in my practice? (Williams, 2011)
Your answers to these questions should help to guide you in determining how much impact your work is having on your whole life.

It may seem counter-intuitive to make time to take care of yourself, but in this job the e-mails, phone-calls, and needs of all of our stakeholders will never stop--there will always be something else you could be working on or "one more thing" you could do before you leave the office.  I am someone who has perfectionist tendencies--I like to have everything done right, every "I" dotted and every "T" crossed before I leave the office.  However, I quickly had to realign my thinking once I began working as a school counselor.  Here are some tips and ideas about how to either remain well or find your way back to wellness:
  • Work to accept that you will never have everything done at the end of the day--this job simply does not lend itself to that concept.  It is okay to leave work at the end of every day.  While it is normal to need to stay late on occasion or to come in every once in a while on a Saturday, this should not be an every day or every week occurrence.  If you are staying late every single day, limit yourself to staying late only two days during the week.  If you come in every Saturday, limit it to one Saturday during the month.
  • Set boundaries for yourself.  It is okay if you do not want to have a parent conference at 5 p.m. on a Friday and instead offer an alternative day and time.  It is okay if you are trying to leave on-time at the end of the day and ask a teacher to come back and talk to you about a non-emergency topic in the morning.  It is okay if you do not check your work e-mails after you leave work at the end of the day or over the weekend.  For example, I know that if there is a pressing crisis in the evenings or on the weekend with regards to work or my students, I will get a phone call from my boss.  Anything else can probably wait until the next morning when I am at work.  If you do not set some reasonable boundaries for yourself, people will expect to have access to you and your skills 24 hours a day, 7 days a week, and it is important that you have time to recharge so that you can best address their concerns.
  • Schedule time for healthy habits.  Find time to cook and eat a good meal.  Get as much sleep each night as you possibly can.  Go the gym, yoga class, or take a walk with a spouse/partner/friend/child each day.  Schedule these into your week and make them priorities.  I make sure that I hit the gym or do yoga at least 5 times a week for an hour at a time.  Oftentimes I am able to work out frustrations from my day on the treadmill or center myself through the healing breath of a sun salutation.
  • Develop a list of pleasurable activities and schedule at least one or two per week.  We do this so often with our students who may be a bit down--find out what they enjoy doing, whether its attending a ball-game or going to the movies with friends, and then help them to make it happen.  We need to take our own advice--when was the last time you went out with your girlfriends and laughed yourself silly over drinks with chips and guacamole?  When was the last time you went to a basketball game with your guy friends?  When was the last time you attended one of your kids' school-programs that you weren't in charge of making happen?  Not only do these help to recharge us, but they also tend to be great "perspective-checks"--there is a world and a life outside of our jobs.  I am a singer and often have one to two rehearsals per week and also take private voice lessons--I find it to be a wonderful way to force my mind to focus on something wholly unrelated to my job on a regular basis.
  • Engage with friends and family. I have always thought that everyone who works in schools--teachers, custodians, counselors, administrators--need to have friends outside of that school to talk to.  This is especially true of counselors, as so much of what we deal with is confidential information--it's not really appropriate to share our frustrations with a parent or the intimate details of a student's life with anyone in our buildings.  It is important to maintain those relationships with our friends, partners, and spouses and allow those to replenish us when we are down or emotionally drained.  I make it a point to find time to have dinner or brunch with friends or attend a party, even if I'm exhausted or feel I don't have time--in hindsight I'm always glad I went.
  • Consider supervision--either formal or informal. This is probably worth a separate blog entry, but in short, as interns we have this amazing support network--our on-site supervisors, our university supervisors, and a whole lot of peer supervisors who are in our classes.  Then we suddenly get into our first job and a lot of that goes away.  Hopefully you have a mentor, other counselors, or a director who you can go to for help or additional perspectives, but many counselors are alone in their buildings a great deal of the time.  It is a great idea to consider joining a formal supervision group, especially if you are thinking of pursuing state licensure as a therapist, but if not even getting together with some other counselors in the area on a regular basis to share cases and check for best practices.  It can make you feel a lot less isolated, help to validate the good work you are doing, and give you great ideas for situations you may be struggling with.
  • Seek out your own therapy if needed.  Sometimes, even with our best efforts, it is still too overwhelming.  Sometimes we get that case that strikes a little too close to home and counter-transference gets in the way.  Sometimes what is going on in our personal lives begins to effect our day job.  Thus, sometimes it is necessary to get therapeutic help ourselves.
In this way, with your oxygen mask firmly in place, you can continue to help others put their own on for years to come.

The following work cited is available for members on the American Counseling Association website:

Shallcross, L.  (2011).  Taking care of yourself as a counselor.  Counseling Today, January 2011.

The following works cited are available for members on the American School Counselors Association website:  
 
Falls, L.  (2010)  Fan the flame.  Retrieved from http://www.schoolcounselor.org.  
Williams, R.  (2011)  The importance of self-care.  Retrieved from http://www.schoolcounselor.org.

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