The Importance of Clinician Well-Being

Mental health clinicians, from social workers to psychologists, have one of the most demanding jobs in society: shouldering their clients’ burdens and providing them space to heal. As the mental health crisis intensifies the workload continues to build. The job can be traumatic at its worst and stressful at best. And yet, clinicians push on, knowing that their work saves lives. 

But who helps the helpers? 

Clinician well-being is an essential aspect of any mental health practice, not only to protect the workforce but to protect clients as well. 

Compassion fatigue

One of the most common risks for mental health clinicians, especially those working with a high-acuity population, is empathy or compassion fatigue. Empathy fatigue is defined as the physical, emotional, and cognitive exhaustion from providing emotional support for others. Symptoms can include: 

• Isolation
• Feeling numb or disconnected from the people around you
• Feeling overwhelmed or powerless
• Self-blame
• Headaches
• Trouble Sleeping

When mental health clinicians begin to feel empathy fatigue, it can impact their relationships with clients, causing them to be unable to provide the assistance clients may need. Disengagement or depersonalization at work is related to a lower ability to express empathy, which can reduce the quality of the relationship between clinicians and patients. 

Burnout

When compassion fatigue lasts too long or escalates, it can lead to burnout as well as secondary post-traumatic stress. Burnout, as defined by Maslach in 1982, is “a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy,” (p. 397). It is often caused by being overworked and feeling a lack of control in a work environment, and severe burnout can take anywhere from 1-3 years to recover from.  

Turnover rates among mental health clinicians due to burnout are extremely high, with rates between 30-60% annually. Early-career clinicians are especially prone to burnout and report more personal exhaustion, less personal accomplishment, and higher rates of overwhelm with caseloads. These same clinicians express a greater intent to leave their positions than veteran clinicians. This high turnover in early-career clinicians creates a barrier to building a robust mental health industry. This concern has only increased as the youth mental health crisis in the United States has grown. A decreasing workforce and an increase in caseloads is a perfect recipe for additional burnout. 

Burnout in BIPOC Clinicians

Because of deeply rooted systemic issues within the medical and mental health field, therapists of color are experiencing burnout at an even higher rate than their white counterparts. This is due in part to the lack of BIPOC therapists available overall, which can cause existing BIPOC therapists to feel responsible for taking on a heavier workload so that more BIPOC clients can be seen by culturally competent clinicians. Additionally, BIPOC people historically have less access to mental healthcare, so when a  BIPOC clinician starts to experience stress, anxiety, or even depression, there are often fewer resources for them to access. Finally, BIPOC clinicians may experience discrimination within their practice which can exacerbate and hasten the onset of burnout. 

Client outcomes

Not only does clinician well-being impact clinicians themselves, but it can seriously affect client satisfaction, retention, and outcomes. As mentioned previously, compassion fatigue reduces the connection between clinicians and their patients. A 2018 study found that higher rates of burnout and lower job satisfaction from mental healthcare providers had significant negative impacts on clients’ anxiety and depression outcomes. Staff turnover also contributes to client disengagement, with one study finding that clients who experience therapist turnover are 86% more likely to miss a future scheduled appointment (Babbar et al., 2018). 

Protecting Well-being

According to both the American Counseling Association (ACA) and the American Psychological Association (APA), clinician self-care is an ethical requirement for treating patients (American Counseling Association, 2014; Ethics Committee of the American Psychological Association, 2018), because of the impact that clinician well-being has on clients. Providing clinicians with workplace education or support groups has been shown to help decrease overall burnout, and reducing administrative work, such as paperwork, can give clinicians a chance to breathe. Additionally, interventions that teach personal skills (such as relaxation techniques) have a greater impact on reducing emotional exhaustion than large organization-wide changes. Self-care skills and hobbies outside of work help protect clinicians against burnout, especially for clinicians who start these practices before experiencing burnout. 

Clinician Wellbeing at Charlie Health

Clinicians at Charlie Health are acutely aware of the importance of their own mental health as therapists and virtual employees. They both teach their clients about self-care and practice what they preach. Below you can find just a couple of examples of how our clinicians replenish their own well-being: 

“As committed as I am to wholeheartedly helping to create a healing space for others, I am just as passionate about filling my own cup. Part of this work is making sure that I feel taken care of by myself before each and every client session. I find that my individual self-care often looks like asking my body what it needs – grounding, stillness, a release of restlessness, or sometimes a cuddle with my cat. My own therapy has been an incredible tool in helping to recognize when and where my emotions might be showing up in my body as well. Attuning to my own needs helps to replenish the energy that I can offer to others. Charlie Health allows me the time and space to find a true balance in my work and personal life. With a 4-day work week, I am able to return to my clients each week feeling refreshed and rested.”  

— Nina Kornberg, Creative Arts Therapist

“Charlie Health fills my cup by being inclusive, diverse, and supportive for employees and clients. We are greatly improving clinical outcomes while also aiding in breaking the stigma associated with mental health and expanding access to all. Clinician well-being for me looks like reminding myself that I am a human first and a therapist second. What this means is, I made things like work-life balance, boundaries, and self-care a priority. I love to start my mornings off with exercise and I enjoy nature walks on the weekend. I love a good spa day. Massages and facials are so relaxing and rejuvenating for me! Music is also a big part of my life. Music often conveys my feelings and thoughts when I cannot. J. Cole is one of my favorite artists! Lastly, I see my own therapist as needed. They create the space for me to be me!”

— Meg Billups, Group Facilitator

Clinicians across our program practice self-care in a myriad of other ways from spending time with family, friends, and pets, to finding art or literature that inspires them. Even tidying your workspace can create a sense of relief in a moment of stress. 

Tips for managing well-being as a clinician

There are many ways to take care of your well-being as a clinician, but if you need help getting started here are a few tips to incorporate into your routine: 

1. Practice mindfulness

Mindfulness can be practiced in many ways, from consciously breathing after a session to establishing a regular meditation practice. No matter how busy your schedule is, mindfulness can be an easy way to re-center yourself and release stress.

2. Develop a transition ritual

A transition ritual is a task or set of tasks that help you mentally and physically transition from one activity to another. For employees working in an office environment, the transition ritual can be as simple as packing up, going home, and setting a boundary to not work while at home. For employees who work from home, a transition ritual can be harder to establish but even more critical to prevent overworking. Transition rituals at home can look like changing into loungewear, going for a walk, or cooking dinner. The important thing is the mindset that the task signals that work is over, and you can unplug for the day. 

3. Take breaks and vacations

Having time to unwind is a necessity for combating burnout. Too much of anything is bad for you and that includes work. Take time to be with friends and family, or by yourself if that’s what you find the most relaxing. Paint. Read. Take walks. 

4. Find a support network

Support networks not only provide a space to express yourself, get assistance in hard situations, and feel seen, but they also provide a space to be held accountable and hold others accountable. It is often hard to recognize when you start feeling burnt out, but if a friend can help spot the symptoms—and vice versa—you can attempt to resolve the issues before it gets worse. 

5. Go to Therapy

When you can feel the burnout starting to surface it’s important to have a safe space to talk about it and decompress. Talking to your own therapist can help you see through issues you may be having, or practice the tools that you have to destress during heightened moments.

Clinician well-being and Charlie Health client outcomes

When clinicians take care of themselves, they open the door for greater healing for everyone that they work with—a point that’s exemplified by the client outcomes at Charlie Health. Research shows that clients in our virtual Intensive Outpatient Program (IOP) make industry-leading strides in their mental health, including significantly fewer depressive symptoms and self-harming behaviors at discharge. These mental health improvements are due in large part to our expert clinicians, who fill their own cups and care for their well-being (as mentioned above) in order to better support clients. Read more about Charlie Health’s industry-leading mental health outcomes here.