Clinician Self-Care in the COVID Era

There has been much discussion about the mental load of therapists, especially as we are treating clients through the same world crises that we ourselves are facing while shifting our business models, and probably having more responsibilities at home. This is a hard time to be a therapist. No doubt. My friend and colleague Jo Muirhead talked recently about progressing this conversation from identifying the problem to taking action and I could not agree more.

Yes, this is hard. Yes, it is a lot. But what do we do about it?

Perform a Self-Assessment

It is important to take a look at yourself and see where you’re at right now.  What you could or should do in the “before COVID times” may be irrelevant to what you can or should do now. I’ve seen quite a range of responses to the quarantine and on-going world crises. Some have made huge shifts in their business models; others have hunkered down and solidified their current offerings or slowed down to focus on family and self-care. There is no one right answer to what we should do right now because there are so many variables that each of us faces.

Schedule some time for yourself (potentially with a business partner, colleague, or consultant) to answer the following questions:

1. What are my practical needs right now? This includes financial, scheduling, and personal obligations. What do you need at a bare minimum? This is not a list of what would be ideal. This is a list of what you absolutely need to get by.
2. What resources do I have available to me? For example, what do your revenue and reserves look like? Has your ability to set time aside for work increased, decreased, or stayed the same? Who is available to help you take care of personal and professional needs (like childcare, clerical tasks, technical support, etc.)? What level of energy and focus do you have to do therapy or the other elements of your business?
3. What opportunities have become available to me? When there are dramatic changes, there can be new possibilities that open up. The metaphor of staring at a closed-door while not noticing the open window can be powerful to consider during times like these. Listen to what your clients are asking for now. Pay attention to what seems to be missing. Uncover what is bringing you joy and purpose now.
4. What new challenges, threats, or risks am I facing? When we look at the global crises we’re facing, we can predict that there are more challenging problems that clients might bring to us while not having the same ability to pay. We may also have different expenses or more complicated decisions to make about our offices, where and how to meet our clients, etc. Take a good look at the decisions you have to make and the risks you’re facing as well as the ways you can mitigate risk for your particular set of circumstances.
5. What is my ideal situation if things do not go back to normal? When we are in crisis, we often cobble together solutions. At this point, it is time to create something with more sustainability. Imagine your ideal workday, clientele, business model, or personal life for the current situation. This is accepting what is and planning as if this is not temporary. We can always shift back if we need to, but purposefully settling into this moment will help with focus, productivity, and peace of mind.

Create Actionable Plans

Whenever I talk with clinicians who are ready to make changes to their practice, there are a lot of big ideas and shoulds, but not a lot of detailed action plans. When looking at what you want to create, identify the first small step, then each of the steps after that. Plan for how much time each step will take and put each of these steps on your calendar. Let’s not make the situation worse with vague to-do lists that add to your mental load as you continue to put them off and take care of the daily grind. Scheduled action gets the job done, not to-do lists.

Incorporate Best Practices

When you’re looking to get your schedule or your life back on track (or on track for the first time – let’s be honest ????), it can feel overwhelming to get started because you’re already tired and the problem you’re trying to solve is a lack of sustainability. If you already can’t do what you’ve set out for yourself, how can you add more?

1. Create a schedule that works for you. When you assessed your energy during your self-assessment, you may have identified when you’re most or least productive or when you’re most able to do creative or generative tasks. (If not – spend a couple of days doing that. Identify your most productive times, track your energy levels as well as the type of energy you have.) Make sure to align the types of tasks you have set for your day with the type of energy you have at the time, whenever logistically possible. In a great book on timing, When by Dan Pink, the author noted that many people have the most energy and ability to tap into creativity in the morning. So, don’t spend that time scrolling through social media or mindlessly responding to emails.
2. Set reasonable expectations for yourself. When you maximize your energy output, you can increase your productivity, but not indefinitely. Every single one of us has limitations. We all can (and should) put forward energy and push ourselves at times, but that must be paired with rest and recuperation. So – figure out what you can reasonably accomplish in a day or week (and remember that this assessment could be very different now than it used to be) and limit your commitments to what you actually can do. When you over-commit or overload yourself, you might fail to deliver, which can let others down and damage their trust in you. Further, when you continue to try to deliver at a level higher than is sustainable, you put yourself on a fast track for burnout and may have your body start screaming at you to slow down or stop.
3. Plan your breaks strategically. It can feel decadent to take frequent breaks, but when you’re a therapist, it is often mandatory. When done well, therapy requires deep focus and attention from therapists. In looking at how individuals can perform this focused work effectively, Cal Newport (author of Deep Work) identified that our brains are not able to handle indefinite amounts of focused time. Interestingly, one of the timeframes that can work well is 50 minutes on, 10 minutes off. (Sound familiar?) What that means is making sure you take a break during those 10 minutes after your 50-minute hour rather than madly completing your notes or checking emails. Further, the types of breaks can be important. Getting outside, shifting your attention away from work, and (for me) shifting my focal length to rest my eyes after a lot of screen time can all be very valuable and help you sustain focus during longer clinical days.
4. Find a supportive community. During this time of isolation and division, it can feel excruciatingly tough to come together in community with others – and we need it more than ever. Checking into a virtual community can feel awkward or unsatisfying if you’re not sure of the rules or don’t connect to the values of the other members. Find people who are facing the same hurdles and hold similar values. Look for opportunities to have important conversations and re-learn how to sit with differences of opinion. Embrace those who understand and commiserate but are also willing to call you out.

Thinking About the Bigger Picture

Getting yourself back to a place of grounded, focused energy can support you in sustaining your work during these challenging times. But it is not easy and it is not the same for everyone. There are a lot of variables that you may have to consider that I didn’t mention. There may be challenges that are insurmountable that keep you from being the therapist you’d like to be right now. When we look at the bigger picture of huge groups of people isolated, overwhelmed, and facing crises our world has not faced in recent history, there are no easy road maps or magical 5-Step processes that solve them. We must do our best within our own circumstances and then start thinking about the bigger picture.

So I’m inviting you – when you’re ready – to come together to improve our situations and the profession we love.

To that end, my business partner, Curt Widhalm, and I worked with Brighter Vision recently to bring you a webinar on moving beyond burnout prevention to optimize your practice. We also created a worksheet that can help you incorporate some of the best practices: Beyond Burnout Prevention and Recovery – Free Schedule Worksheet. You can also join us in our Modern Therapists Group on Facebook and at our virtual Therapy Reimagined Conference on September 24-26th.

We have put together a special offer for Brighter Vision customers to join us at Therapy Reimagined 2020: use the code Bright45 at checkout to get $45 off your ticket.

We’d love to have you join us wherever you can, not only so we all can weather the current times, but so we can plan for the future of our profession.

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About Katie Vernoy

Katie Vernoy is a coach, consultant, and therapist as well as the co-host of The Modern Therapist’s Survival Guide Podcast and the co-creator of the Therapy Reimagined Conference. Katie helps therapists grow thriving practices, without burning out. If you are overwhelmed -- but dream of making a bigger impact -- check out Katie's Strategic Business Breakthrough (with special bonuses for Brighter Vision) right here!