8 Signs of Therapist Burnout That No One Taught You in Grad School

Have you ever heard of the phrase “You can’t pour from an empty cup?” 

You may have even said it to some of your clients to help them realize they need to meet their own needs, before meeting the needs of others. This same piece of advice applies to you as the therapist. 

If we aren’t filling our own “cups” so to speak, what value do we have to give to anyone else? 

Maybe you’ve done really well, built up a steady roster of clients, and got lost somewhere in the hustle of building your practice. We hope that you’re just thriving, but it’s possible you might be feeling like your well has run a bit dry. 

Have you had a chance to take a break and evaluate whether your own essential desires are being met? 

If you’re experiencing a loss of enthusiasm for your work, showing up and doing the bare minimum, or thinking, “I’m taking care of everyone else, who's taking care of me?” – These can be major red flags that you’re at risk of burnout. 

There’s no need to feel any shame or guilt about this, we’re human and it happens to the best of us. What you can do is take the time to examine the stressors in your professional and personal life that are contributing to you feeling this way. 

Let’s take a look at why burnout is so common in our profession, and how to spot the signs to help manage and prevent it from taking over our sense of balance. 

Why Causes Therapist Burnout?

Burnout in the workplace has become an increasingly discussed and researched issue among mental health professionals. Even the most skilled counselors are usually the last to notice signs of defeat in themselves. 

A survey conducted on therapists found that most reported being happy in their roles, and none reported impairment in their jobs. In a seemingly contradictory study, almost half of psychologists reported burnout because the demand for their services has increased in the last few years. Healthcare workers are not superhuman and can experience the same negatives as their clients, like emotional distress and even vicarious traumatization.

Therapists are highly susceptible to burnout because of the prolonged stress and emotional demands of the profession. Up to 67% of mental health professionals might experience burnout at some point in their careers (Morse, Salyers, Rollins, Monroe-DeVita, & Pfahler, 2012). The responsibility of creating a safe and supportive environment for their clients while being emotionally taxed themselves can hinder their ability to provide quality care. 

We could even argue that our mental health is more important because it affects our capacity to effectively and compassionately address the client's needs. When a therapist is meeting their own needs, the quality of care and the client’s outcome also improves — it sounds like a win-win situation to us.

Recognizing Therapist Burnout Symptoms

No matter how much you love your work, there may be phases or circumstances during your career that can wear you down physically or emotionally, and as a result you find yourself unable to perform your job at your best. 

You might be working with draining clients that aren’t a good fit for you, doing paperwork for long hours, or balancing too much with personal obligations. 

If you feel like you’re struggling to meet the responsibilities of managing your practice and personal life without detriment to yourself, continue reading to see if you relate to these signs of burnout. 

1. Having Less Empathy

Loss of empathy is an unfortunate consequence of burnout. Being constantly exposed to the pain and emotional suffering of others makes us prone to becoming numb or developing compassion fatigue. It’s possible you won’t even notice the decline in your ability to relate to clients, but one day realize a sense of connection missing.

Empathy can also be lost when you constantly interact with people that idealize you and are eager for your support and guidance. This phenomenon of transference in the medical system is given the name “God Syndrome.” It creates further division in relationships with clients as you begin to feel superior, and this comes across as cold and distant. 

Holding this jaded perspective as a therapist can affect the overall quality of the counseling sessions. If you lose the ability to understand a client's feelings, they can begin to feel unheard, ignored, and even unimportant. They may begin to lose their feeling of safety in the session and no longer openly discuss their thoughts – sounds like it might defeat the entire purpose of coming to see you.

As mental health providers, it's important to be able to relate on an emotional level, and without empathy, the perceived quality of care will likely decrease. Empathy is a vital skill for the success of your career and your patient’s as well. 

2. Feeling Relief When A Client Cancels

If you look at your work schedule for the week and feel the “Sunday Scaries” because of the number of appointments on your calendar – it's time to evaluate how much you can actually handle. Finding yourself feeling relief when cancellations happen, even with those pesky last minute ones, is a clear sign that your workload has become too taxing. 

Some of us treat clients back-to-back with limited downtime and it might not be enough to energetically recover from one to the next. It’s understandable if you find it challenging to emotionally recharge from some potentially heavy encounters with clients, which can contribute to burnout and exhaustion.

Then there are those that work extremely long hours, and have given up on some of your own passions to accommodate clients' needs. If you find yourself in this situation, think about the number of cases a day you can reasonably manage, while still being able to make it to dinner with your friends or pick up a new hobby that's been on your mind.  

It might feel difficult to cut back on the number of clients you have right now because you can’t or don't want to lose the income. The good news is, we can help you figure out how to charge what you’re worth, while still meeting your financial goals, and attracting the types of clients you really want. 

You don’t have to miss out on enjoying your own life to take on every client – a good therapist is one that can maintain boundaries and sets a great example for your clients to follow. 

3. Difficulty Falling or Staying Asleep

If you’ve ever laid in bed all night feeling both completely fatigued and restless at the same time, you have cortisol to blame. When faced with high amounts of stress, the hormone is released to help modulate your body’s “fight or flight” response to danger. When it’s released in larger than normal amounts due to ongoing challenges, it can directly affect the quality of your sleep. 

People experiencing this often feel “wired but tired” meaning they have difficulty winding down or shutting their minds off at night, which only perpetuates the issue in the long run. This deprivation of quality sleep only worsens symptoms of burnout, including anxiety, irritability, and difficulty focusing. 

What could possibly be keeping therapists up at night? 

Mental health professionals can be occupied with the same ongoing stressors of life just like anyone else. They could be laying there thinking about their grocery list, but also frequently worry about the safety of some of their clients from self-harm or other dangerous situations. This is a pretty unique concern of the mental health field, and can be a major trigger for stress. 

There are plenty of other factors that can affect your sleep quality, like having sugary snacks before bed. However, if you find yourself starting to toss and turn without other identifiable reasons, chances are your stress is most likely causing this early sign of burnout. 

4. Mental or Physical Exhaustion

Whether you work in private practice or for someone else in a clinic, there may be times where you feel like you have to take on more than you can handle. About 51% of psychotherapists reported experiencing moderate to severe physical health problems (Rupert & Morgan, 2005). When therapists are unable to manage their caseload efficiently, they can become overwhelmed. This is a clear sign that you're doing too much and pushing beyond your limits. 

This extreme fatigue isn’t always easily recognized immediately as a symptom of burnout because it can present in so many different ways. Even though the actual duties of a therapist aren’t necessarily physically demanding, heavy emotions can take a toll on your body and manifest this way.

Physically, it can show up as fatigue, muscle aches, headaches, and general weakness. Emotionally, you may have become so drained that your ability to cope with even minor issues has diminished and you’re more easily irritated or angered. 

If you’re waking up everyday feeling exhausted, overly emotional, or feel a mystery illness coming on everytime you walk into your office — it could be that your emotional exhaustion has reached a tipping point and is seeping into other areas of your life.  This is why it's so important to recognize these symptoms and evaluate how to manage your caseload to restore your sense of well-being. 

5. Zoning Out or Difficulty Focusing on Tasks

When you’re feeling tired or have personal issues to deal with, it's understandable that those topics might become front and center in your thoughts. This can happen sometimes, but if it's becoming a frequent occurrence and you’re missing out on everything going on around you, this is a sure sign that you’re starting to check out.

Zoning out might not be such a big deal if you’re just re-watching an episode of Friends, but in the mental health setting, it could turn problematic. If a therapist isn’t fully engaged with clients they could miss important details, and the client can start to feel unheard and insecure. When the client is coming to you looking for a safe space to analyze their thoughts and behaviors, they do expect you to be fully present and provide insightful feedback. 

If you’re losing focus during appointments with clients, there are a few things you can do to help stay engaged and on task. The first is to examine your body language and posture, make eye contact, and actively listen. A counselor can also add some structure or plan to a session, and this can include taking a short break if you need to recenter before continuing the conversation. 

Clarity Cooperative also offers a Progress Notes Generator that helps you easily pick and choose pre-filled items for your chart. If you’re able to actively work on completing some of your notes while in discussion with a client, this can help keep you focused. 

6. Negative Emotions

As mental health providers, we’re not immune from the same negative emotions our clients experience. Besides the normal ups and downs, you might start finding yourself stuck in periods of sadness, anger, or frustration for longer than usual. When you start noticing this, it means it's time to start addressing what isn’t working for you anymore. 

If you get stuck in negativity or feel completely drained, your defenses are lower and as a result become more susceptible to developing mental health issues due to transference from your client. 

Vicarious trauma is a type of transference that occurs when a therapist is exposed to the painful experience of another, or to the narrative of that experience, and is in turn traumatized themselves. This unfortunately develops as a result of empathetically engaging with the person that suffered or witnessed the event. Even though you were never actually there, just hearing about it, and discussing these things can negatively impact your own outlook. 

Depersonalization usually develops following emotional exhaustion that has reached an extreme. This can significantly alter your view of the world and perception of self. Some might begin to view their clients as a source of anxiety, or become cynical, dehumanized, and emotionally distant towards them. If this situation goes on for too long, severe anxiety, depression, and even panic disorders can develop. 

7. Getting Sick

It’s already tough enough to recover from catching a simple cold – throw burnout and a bad mood into the mix and it could take even longer to bounce back. 

Emotional distress can have a huge impact on the body. Positive emotions like happiness and joy, have been linked to improved immune response, while negative emotions, such as sadness, anxiety or anger, have been linked to a decrease.

The first sign you might notice is fatigue and if you aren’t adequately giving yourself time to rest and recover, your body can develop illness to the point where you have no choice but to rest. You might develop frequent headaches, gastrointestinal issues, or frequently catch colds which don’t seem like a big deal, but over time these can turn into more serious conditions. Chronic stress causes inflammation in the body and long-term can trigger autoimmune disorders, adrenal fatigue, heart disease, and more. 

8. Losing Your Sense of Purpose

We’ve all been there –  Fresh faced and full of optimism that we’d help change the world and heal people. At one point in time we were just beginning to enter the workforce after studying hard, finishing grad school, and obtaining our licenses. We may have had slightly different reasons for pursuing a career in the mental health field, but helping others feel better is probably a common denominator. 

You might be a couple months or several decades into your practice now and feel like you’re not making a difference, or don't know what purpose you serve anymore. The reward from this field isn't always instantaneous. Some clients take lots of work over years of sessions, while others might only come for a short period of time and each individual will have different goals. 

Working with clients that have psychological disorders can be challenging – they can show up in a great mood one day, and next week show up feeling negative and wonder if the therapy is doing anything. All of this can leave you feeling confused about whether you're a skilled practitioner and if you’ve chosen the right field of work. 

Clients can have unrealistic expectations and trying to meet those can leave you doubting yourself and feeling inadequate. 

How To Manage Therapist Burnout

When you notice the signs of burnout start to creep in, it’s time to take a step back and evaluate your work and personal life. It's possible some adjustments will need to be made to bring some balance and well-being into your day to day. This isn’t just for the sake of your performance at work, but more importantly for your happiness. 

Incorporating some of the practices listed here can help you hold stronger boundaries, and help you feel more self-fulfilled. 

Practice Self Care

Self-care can mean a lot of things, and look different from one person to the next. If you’re an introvert and recharge from having quiet time alone, you might be different from an extrovert who prefers having a night out with friends. What it does mean though, is that you’re looking after your own needs and creating the space for those to be met. 

Self care can look like incorporating healthy habits: regular exercise, going to bed at the same time every night and eating a nutritious diet. 

Taking breaks throughout your work day to get up, go for a walk and catch some sunshine can give you just the reset you need – and yes, this is your permission to take that long lunch, or better, that long vacation. 

Perhaps you’ve had things on your bucket list like getting scuba diving certified, or learning to make glass-blown art, but never found the time. The toughest part is that you have to create the space so you can have fun and enjoy your life outside of work. 

Once you realize how much value this adds, it’ll be easy to see how important this is for preventing burnout. 

Leave Work at the Office

How often are you completing sessions for the day and still working on progress notes, responding to client messages, or catching up on operational tasks while you’re at home? 

Boundaries are something that burned out therapists struggle with because we want people to feel good. People-pleasing can be detrimental and it's important to learn how to say no when appropriate. Enforcing boundaries could mean letting your clients know you only respond to messages within certain business hours, or scheduling fewer appointments so that you have more time during the day to finish progress notes before heading home. 

By taking the time to unplug from work and establish a distinction between your personal and professional life – you can create a healthy balance and prevent burnout from taking over. 

Seek Support From Others

Remember that you can always talk to your colleagues, supervisors, or former classmates if you’re feeling overwhelmed. You might even find that a lot of them have gone through similar situations and have tips to help you get through a tough time. Seeking out counseling services can also be a great way to help you identify some of the stressors and actively work through how to better manage them. 

Whether you’re burnt out, on the edge, or have been through it and back – Clarity Cooperative is here for you with a supportive community of like minded practitioners. Sound-off, seek support, and create new friendships with others in the industry. 

Who could understand you better than another therapist who's been through the same struggles? 

You’re Not Alone: Clarity Cooperative is Here to Help Manage Therapist Burnout

Burnout can happen in any field of work, but it's especially common in the mental health environment because it can be so emotionally taxing. If you’ve noticed any of the 8 most common signs of burnout in yourself, please know you’re not alone. 

Clarity Cooperative is here to support you through every step of your journey. We have tons of resources and tools, including a Progress Notes Generator to help you save time while creating and updating client records for your practice. And don't forget, our community to look to for support during challenging times.