(Editor's Note: This article won the 2013 NASW Media Award for best magazine article. SaraKay Smullens' book, Burnout and Self-Care in Social Work, which grew out of this article. The book's foreword is by Linda May Grobman, publisher/editor of The New Social Worker. Read an interview with SaraKay.)
The training to become a social worker is arduous, demanding, and complex. My concentration was clinical social work, which during my graduate education was known as casework. I well remember studying my basic curriculum; taking more electives than were required; receiving excellent supervision of my clinical work with individuals, couples, families, and groups; and before it was required, taking many continuing education classes.
Suffice it to say, I learned a great deal���but what it seemed that no one shared with me during these years, or seemed to discuss among themselves as either teachers or therapists, was the sheer exhaustion experienced in clinical work as we do our very best to meet the needs of others day after day, year after year. When one of my deeply trusted supervisors died, and I met his wife for the first time, she told me that sometimes he would return home too exhausted to even speak, and that a frequent statement she heard from a man who obviously treasured his clinical work, teaching, and writing was: ���They feel better, but I surely do not.� How well I understood this feeling, I thought. How well so many in our field must understand this feeling. And yet many of us lack the attendant knowledge that can assess and direct this feeling, which is called ���burnout� in the literature���or knowledge of the necessary practices to heal and soothe ourselves, which are collectively known as ���self-care.� What I have learned over the years is the necessity of addressing this complicated exhaustion before the feeling of depletion leads to dysfunction and beyond. With this in mind, I share the precise information that I wish I had known about ���burnout� and ���self care� in the early years of my work, with references for your further study.
1. Employ stimulus control and counterconditioning when possible.
This strategy is actually two common sense, personal organization strategies in one, which I refer to as ���necessary selective gifts to oneself� in a setting where you will spend more daytime hours than you spend at home. The first, ���creating a professional greenhouse at work� (Skovholt, Grier, & Hanson, 2001), involves decisions such as the resolve to eat lunch at one�۪s desk as little as possible, the importance of social exchange as well as a comfortable chair, providing calming music as background for writing and thinking, and taking plants to your office. (A personal aside about plants: I well know that forgetting to water them is a sure wake-up call that you are not giving yourself what you need.)
The second part of this strategy is the ���counterconditioning� that physical activities, healing modalities, and the diversion of reading and films, to cite some examples, can provide. Is there a gym you can visit first thing in the morning or after hours? Would it center you to visit a place for worship during your lunch break or on your way home? Would you like to hear a book-on-tape at certain hours? In one study of self-care strategies, Mahoney (1997) reported pleasure reading, physical exercise, hobbies/artistic pursuits, and recreational vacations as the most commonly reported self-care activities, followed by practicing meditation and prayer, doing volunteer work, and keeping a personal diary.
2. Seek personal therapy.
Nearly 90% of mental health workers seek personal therapy before, during, and after their professional training (Mahoney, 1997). In addition, more than 90% of those who do seek personal therapy derive satisfaction and growth from their experiences therein, creating more fulfilling lives (Norcross, 2000). Toward this end, when we need consultation, we must seek it; and if such consultation directs us to deeper psychological work, we must not deny this necessity
3. Diversify, diversify, diversify.
Whereas clinical responsibilities can totally deplete us, we can also use our hard won skills in various ways that replenish us. Many find balance, camaraderie, and stimulation through ongoing discussion groups with colleagues. Others find it by shifting client focus. For instance, those of us concentrating primarily in group therapy can also turn to individual, conjoint, and family therapy for a small part of our practice. I have found it invigorating to combine marital work and group therapy in an unusual way. For marital clients with complex problems, I place the couple in separate groups, trying to find one in each group who will remind each of his or her partner.
Another important sustaining resource is to use hard won skills in areas other than clinical practice. A few years ago, for example, I became a clinical consultant to a local Philadelphia theater company, meeting with directors and cast members to discuss the lives of actual clients (disguising all recognizable aspects of lives, of course) that parallel lives and events in the plays. My most memorable experience was consulting work done on the very controversial play Blackbird, by David Harrower. Blackbird is a play about sexual abuse, as well as the pain and loneliness that can lead to this horrific act. One of the most poignant moments in my professional life occurred during a TalkBack for this play, when an audience member confided that she had been abused, and her assailant had never owned this abuse or apologized. But she explained that events in this play felt as if an apology had been made to her, and would help her to heal.
My life and work have taught me that the strongest lesson in avoiding burnout through self-care is to accept that we are human, and in that we are each limited and���yes���flawed. Despite best intentions and very hard work, we will each experience failure, and our losses and the losses of those dear to us will bring the most unbearable pain imaginable.
Yet, with all of the pain and loss of life, we can, if we will it, grow and learn and move forward in our life journey. If we hold on to this, we can understand how important self-care is. It will give us the strength to claim the joys of living and endure what we must. And it will help us to assure that our clients are able, whenever possible, to do the same.
SaraKay Smullens, MSW, LCSW, CGP, CFLE, BCD, whose private and pro bono clinical social work practice is in Philadelphia, is a certified group psychotherapist and family life educator. She is a recipient of a Lifetime Achievement Award from the Pennsylvania chapter of NASW, which recognized her longstanding community organization, advocacy, and activism, as well as the codification of patterns of emotional abuse and the development of the model to address it. SaraKay is the best-selling author of Whoever Said Life Is Fair: A Guide to Growing Through Life�۪s Injustices and Setting YourSelf Free: Breaking the Cycle of Emotional Abuse in Family, Friendships, Work, and Love. SaraKay's professional life continues to be devoted to highlighting destructive societal forces through communication, advocacy, and activism.
This article appeared in the Fall 2012 issue of THE NEW SOCIAL WORKER. Copyright 2012 White Hat Communications.