Speaker A: This is the Finding Joy After Burnout podcast, a podcast for therapists and mental health professionals. Together, we unravel Burnout and find our road back to Joy. Here’s your host, Dr. Jen Blanchett.
Speaker B: You. Hey, therapist. I wanted to let you know about a free resource that I’ve developed for you, introducing the Before You Quit guide. This is a free resource I wish I had when I was in the throes of Burnout. So it’s going to include focused journal props on areas of struggle and burnout in clinical practice, identification of depleting experiences in your practice and in your life, and then we’ll hopefully identify some actionable items for change. If you’re feeling depleted in your role, please give yourself the gift of slowing down and assessing what’s really going on with your career turmoil. As a therapist, I know it can be confusing, isolating, and totally overwhelming. So grab your freebie. The link for that is in the show notes. Thanks. Hello, therapists. Thank you for tuning back in. This is the second episode of the podcast, and I wanted to share a framework for how you can recover from Burnout first, but also figure out what the hell you’re doing with your career or your practice. I want to lay that out for you because what I think was helpful for me when I went through the two years of figuring out whether or not I was not going to do therapy anymore, was trying to think about key decisions that I needed to make. So the first phase is love it or leave it. I know it’s corny. I’m so sorry. So I was a little bit inspired by a podcast. I heard of someone who it’s not the name of their program or anything, but it made me think of that show, Love It or List It. I don’t know if anyone’s ever seen that home show on HGTV where a couple will come on the show and they’ll be putting they can’t stand their house anymore. They either need to renovate the house or they’re going to get a new house. Many of you have probably seen it and it seems like a very simple decision, like you’re either going to love the house or you’re going to list the house. But I think the decision making process, while we see the end product of that decision making process, we don’t see all the agony they’ve had with their home. We don’t see all the longing they might have had for that new home. And I often think about myself when I was thinking about and this was during the height of the pandemic where I felt literally trapped in my role as a therapist. And there’s so many layers, which I’ll probably break down many of those layers in other podcast episodes, however, I thought about, I really just need to figure out this is in retrospect, I kind of need to say, am I going to stay in this therapy practice? Or am I going to leave the therapy practice? And it took me a long time to figure out what the answer to that question would be. Ultimately, this was a decision I made at the end of 2022, and I’m talking to you in March of 2023. So at the time of this recording, I didn’t even know that. So while this is the first stage, you might have to do other things to figure out if ultimately therapy doesn’t work for you, you might need to figure out, does the setting not work for me? Are you in an agency or are you in a place where you just can’t work? And if I back up to my time where I worked in an agency, I didn’t go back to agency work because I had a new baby. And that’s when I launched my private practice nearly ten years ago, because there was no way I could fathom with a newborn baby who had just had heart surgery, by the way, how I could go back to doing therapy for 30 hours a week and they were not willing to budge on my hours. I had to work that amount. There was no other negotiations they would have. It’s either you come back full time or don’t come back at all. There’s so many layers to that piece right there from my journey where I wish someone would have said, like, it’s okay, there’s another option. But there really wasn’t a lot of options here in my state. So I live in the state of Maine in the US. And here there’s not a lot of group practices. So a lot of the psychologists I’m a psychologist by training, a lot of the psychologists either are in private practice or that’s it. I mean, there really aren’t a lot of psychologists in private practice due to insurance, of course, reimbursement rates, and that really wasn’t the case in other places that I lived. So I say all that to say I made one decision back ten years ago to leave agency work because I couldn’t do that workload. I knew as a new mother I couldn’t do that workload. So I decided to actually go into private practice where I would have more flexibility back up to that. So I also had a part time job at an educational institution, so I taught undergraduate psychology, and that maybe made up about $25,000 of my income, so I didn’t need as much from my therapy practice. And I kept doing that like the whole time I was working full time in the agency. I think for someone who’s working in a group practice or working in an agency where there’s those hours of expectations that they have to meet, whether that be in the light side, for a full time version, that might be a 26 hours thing. On the high side, that might be a 30 35 hours expectation. And for private practice folks, there’s just so much overhead with private practice that I didn’t realize until actually going into it. I think, oh, I can make I think at the height my therapy practice, maybe I was making $80,000, but I wasn’t working full time because I have small children and I will state my privilege with having a husband who works full time. There were some things there where maybe I didn’t need to at the time and my kids were young, so I digress. So this decision of loving your therapy practice or loving the place you’re in or leaving it can come down to finances. So you think in the short term, do I need to make the decision to stay in my therapy practice or to leave it? Some folks are. I had to make that decision when I came off maternity leave very quickly, and it was at the height of postpartum anxiety and depression that I needed to make that decision. And I really wish at that time I had another choice. I wish at that time there were more supports in place for me as a new mother to not have to feel like I needed to scramble, that I could have really healed from the trauma of having a child have heart surgery after five days. But it didn’t happen, so I had to scramble. And I think I got into so much scarcity about developing the new private practice that I just felt like I had to do literally everything myself. So that’s a whole podcast episode in itself of getting help in private practice, if that’s your decision. So that was one of my quick love it or leave it decisions with therapy because I really felt like I couldn’t leave my baby and I’m grateful that I made that decision now, but it was tough. It was some of the hardest days and nights of my life. So just because it was a quick decision doesn’t mean it wasn’t with a lot of angst and pain that I went through that. My more recent decision to leave therapy was also painful, but very much a long decision because it was in the height of the pandemic and there wasn’t really any therapists to refer my current clients to. So I think people can make these decisions at different timetables depending on where they are. So that’s the first phase. We need to figure out, are we going to love it, are we going to leave it? And that may be a long process, it may be a shorter process, but we kind of have to make that first decision. And so there’s a lot of things that we can kind of do to get at that love it or leave it question, so it could be looking at is it therapy? That’s the problem. I never thought that doing individual therapy would be something I would want to leave just because of not loving individual therapy, because it’s therapy, it’s what I was meant to do of course, which if you’re a therapist, you know what I mean. However, I really reflected on the times in my career where I felt more like myself, where I felt more in alignment. And many of those experiences were experiences where I was in collaboration and I had collegial relationships with other professionals. So in my postdoctoral training, I trained at a NeuroRehab setting and I had a lot of opportunity to collaborate. There was less clinical hours that I needed to do. I had a position where we met every morning. We had a clinical team meeting. We co treated with speech therapy, with physical therapy nurses. So it was just this really rich experience and I probably would have stayed in that job had it not been for finances. So it’s just a heart out there in those therapy streets for the work that we feel lit up to do a lot of times does not financially sustain us. Anyway, that had me go to the agency and then that’s what I had my baby. All the things happened after that first stage, love it or leave it, lots of things that we need to think about. So healing from burnout would be something we need to do in that stage. And so I think, how do we heal from burnout? So I come from working with people with a TBI and brain injury. So I understand an overwhelmed brain and a burnout brain is an overwhelmed brain. And everything that NeuroRehab and my time, everything that NeuroRehab taught me has helped me understand that being overwhelmed and having a brain that has been overtaxed for quite some time really needs multiple systems and multiple layers of care. So that could be getting a team on board to help you. And you may not think you need a team, but I’m going to tell you need a team. So my personal team to help me recover from brain out. I’m not a brain injury survivor, but my personal team has included at times a physical therapist because my body was a hot mess, my personal therapist, my business coach, at times my partner, of course, has always been a support person. I have a business best friend and I hope to have them on the podcast as well. And other people, other colleagues that have supported me through the decisions that I’ve made have really been part of my support team. And my family too. My kids are smaller, so I haven’t talked with them that much about that. But I get more into your support team, I think, and other conversations that I have. I think I operate through my four pillars of brain health that are key. So we need to think about joyful, movement, nutrition, sleep. You’re likely struggling with sleep if you’re burnout and belonging. So a lot of us, I know after the pandemic, my social life is very different and times the only people I’d interact with were my family and my clients that just did not promote a ton of health for me. So I think Healing from the Burnout looking at kind of my four pillars of brain health, which I’ve worked with, with clients who’ve struggled with issues related to their brain health, with feeling overwhelmed, dealing with problems with executive functioning, things like that, I also see some parallels with that regarding Burnout. So certainly I love to talk all things neuropsych and neuroanatomy and all that stuff. So we’ll have a geeky deep dive, I’m sure, in another podcast episode. Okay, so some of the tasks involved in Love It or Leave It would be Healing from your Burnout multiple systems team needs to be involved again, even if that’s a short decision on your leaving your therapy practice or your job, you still need that team in place. When I think of my first go around with Burnout as a therapist, I’ll back up even further, I’m sure in some episodes regarding my time as a case worker, I worked as a case worker before I became a psychologist, and I had a whole nother mess of Burnout that I dealt with with regard to that. And I think because I was younger, I just kind of was able to move into another job and just say, like, okay, that was the job, and so it’ll be better the next one. And Burnout kept finding me because I didn’t treat it. Burnout kept finding me because I didn’t listen to it. So I think a lot through listening to Burnout, letting it give us cues on what we need, so we need to heal. That takes time, of course, you know all that. We need a support team. We need to kind of just make that decision and we might go back and forth. I made a decision that I can’t do therapy anymore this last go around, and it took me nearly two years to finally figure out that I just can’t do it anymore. So anyways, that would be phase one. Phase two is looking at your career and having a career refresh. That could look like completely changing your career or trying to figure out how do I do this in a different way. The main decision here is decide on career changes or changing how you’re doing therapy. So that might be you need to change the setting. If you’re working in an agency or a group practice, you’re going to say, I need to do private practice, do it my own way, have something that financially sustains me, et cetera, et cetera, or we might be thinking about a career change. So for me, I’m still a psychologist, of course, and I’m working as a consultant in a school, and I’m doing school based reports. So I am not doing therapy, but I’m working as an evaluator, so I’m still working in my role as a psychologist in a different way. So I think we can get creative about what we can do for psychologists, we do have testing for other therapists or mental health professionals. There might be just different things we can do. So I think it’s good to kind of explore that if that’s going to be your tract of how you’re going to refresh your career. So some of the things we’re going to look like is possibly changing your offerings. If you have your own practice or changing something in your practice, wherever you are, increasing your fees could be part of that. That’s something that I did. Just see if that was something if I worked a little less and made more money, stopped taking insurance, I did all of that stuff too. I went off insurance panels. So if you need support with kind of going through, how do I even get off insurance panels? How do I start to figure out all this stuff? How do I start discharging clients and getting them off my caseload if I don’t want to work with that panel anymore? All those things are certainly part of this phase. So exploring your values could be part of that. Exploring what are those right fit job experiences that I explained one earlier that made you feel like, man, this is what I’m supposed to do. And for me, I’m a strange person, I believe, because I love meetings like at my new job at the school, I am pumped for professional development Day, and that is just not typical, I think. So if there’s something that you really enjoy, it may not be Professional Development days. I think I really loved my job as a foster parent trainer. That was one of my jobs that I loved. I loved training, I loved teaching. I love instruction. I think it more fits with my personality to be in that collegial environment. I almost went into academia, so I could see working in administration, potentially all of those things light me up, and they’re very different than individual therapy. So it could be looking at some of those experiences and seeing what clues we have of kind of the light up meter, what used to light me up, and how can I listen to some of those clues. This is not exhaustive, but there’s certainly more that we would do. We’d look at values, we look at strengths, we’d look at some personality tests. So I do like a good personality test. I’m a psychologist, after all, so I love some assessments. I have some favorite ones that I like to look at when I’m thinking of kind of values and career change. So certainly we can do a deep dive into assessments and how they can be helpful. All right, so the last one is accountability. Really getting accountability on maintaining your decisions and forming your team of support. I think the team is going to be part of each decision process, but accountability is figuring out actually who is that person who’s going to hold your feet to the fire when stuff gets hard, when you have to tell clients, you need to refer them out, for example. And if you’re working anywhere, we need to start having conversations about right fit clients. If a client is not making progress in their treatment, if we’re not looking back at their treatment goals. And I have gotten into bad habits too, because of burnout, because of having a therapy practice for multiple years, some people just want to stay on your caseload, and that’s not productive for them or you. So I think really conceptualizing therapy differently, I need to be driving it back to the treatment plan. And so that’s a clinical issue as well. So if we are not thinking through and we’re getting into these kind of bad therapy habits, which I am guilty of 100% of doing that, of having poor boundaries and not discharging clients when they’re not making progress or when I’m not being effective in the relationship, why are we keeping them? It’s not benefiting the client or us. So I think really getting support in those decisions, especially because I don’t know about you, but when I was in training to be a therapist, we’d see clients in our training experiences maybe for six months or a year, and it was part of the relationship. We knew that there was an end date to that. But when we’re fully licensed and we have a therapy practice, or when we’re at a group practice or an agency as a fully licensed clinician, we don’t really look at that as much. We didn’t really talk about it, about, oh, well, they’re not meeting treatment goals. I need to work at discharge now. Maybe there’s some therapists out there that were really great at this, but I was not. I saw clients for years, and because of that let me just put this out there as well. There were clients that I had that were absolutely wonderful, and that was a majority, majority of my clients. Of course they were wonderful. They were gracious and thought about me as well. There were some clients, due to many times their diagnoses, their life circumstances, the issues that brought them to therapy, that made them very difficult to work with in therapy. And of course we were trained to handle those issues, but not on if we don’t think we can work with them anymore, if we don’t think we can be effective in that particular relationship. There was clinical issues that I felt like I could just be a ninja with, like, couples. They could be cantankerous and angry and spitten and stuff. And I loved it. I just wanted to get in there with a whistle and get in the mud with them. But for developmental trauma, borderline personality disorder issues, I was not very effective, and it was very hard for me to set boundaries. So I think we need to know our blind spots doesn’t mean that we decide to not take those clients necessarily. But maybe it does. Maybe it does. I’m really thinking about where do I do my best work? How do I do more of that work with those clients in that situation? And if we’re talking about a totally different career change, then how do I do more of the things that light me up, that keep me away from burnout? Because, by the way, I love all the therapy marketing that is like burnout free business. I’m going to help you build it as a trauma therapist. So I’m EMDR trained. I just need to submit my certification. I’m going to do it one day. It’s just like hundreds of dollars, but I did it. I just need to submit it, by the way. But anyway, I just love that burnout free business as a therapist. It’s just not realistic. How, as a therapist, can we say we can totally avoid burnout? I can’t, because I don’t know what situations a client is going to bring in. I don’t know. And maybe I’m talking more about compassion fatigue and vicarious trauma because many times I didn’t know that I was going to be walking into someone’s trauma that would then activate me and make me have vicarious trauma. So I think we can’t avoid that. We can look at prevention, which is very different from when we’re dealing with in the depths of burnout. And those are different things. Like we can prevent ourselves from having a cold, from having some chronic illness by doing exercise, all the things that you know about. However, when you already have said condition, when you already have said burnout, you have to treat the burnout. You have to do all the things that I was alluding to earlier that are going to help you recover from that problem. We’re talking about accountability. So how do therapists even get that accountability? Yeah, I struggle with that one. So I’ve certainly been in peer supervision groups. I love advanced training for therapists. I love going to trainings. I was just like a training junkie. Give me all the good trainings because why didn’t I get EMDR training in my actual training to become a psychologist or another evidence based therapy besides CBT? I didn’t have training in CBT, I’ll say, but you know what I mean. We don’t get these advanced trainings on how to do these therapy practices that we know are effective from the research. So I would always go to a bunch of trainings and found that was really helpful for myself to work through some issues actually in the training session. So how we can do this is through that accountability person setting a date if it’s with a peer. So we don’t necessarily have to have a business coach or a therapist, but you have to have someone maintaining those boundaries for fees. So if we decided we need to raise our fee and we’re not pulling it out of the thin air, I want you to think of your business plan, look at your finances. And I have some hacks for that, certainly. But we need to think about how much money do we need to make and then our fee needs to support us in that way. I could talk probably all day on the financial burnout that many therapists struggle with because we are the lowest paid of the highly educated professions. I don’t have to tell you that. You know this as a psychologist, I make a little bit more than some therapists, but it’s not like dramatic. But I think it’s a huge piece of what we’re dealing with. It’s a huge piece of a lot of us are in debt and we don’t have fees that sustain us. So it will be certainly talked on the podcast very frequently. And I’m very passionate. One of my mantras I’ll just add my mantra one of my mantras is that a dentist doesn’t feel any type of way about charging me for his fee or her fee. Mine’s a he. But they don’t I don’t think about and I get I don’t know, there might be some lawyers that listen to this, but the type of work that we do, heart focused work, work that touches your soul and affects your personal life, how can it not? And we have to justify our fee. I am so done with that for therapists. I really am. Because I think you just need the support to be able to charge not your worth, but the value for your service. And that’s a key distinction because your worth is infinite. Like the worth of someone who works at McDonald’s or who’s a construction worker, their worth is priceless. Their worth is infinite. However, there is value to your service. And we can look at, are my services valued more than I’m charging? That would financially sustain me in a different way. So let’s do some recap. So I didn’t talk about all the things that we need to talk about in that accountability portion in our phase three, but we can move between the phases all the time. As I told you, I left agency work when I became a new mother and I had a child with heart surgery, and I couldn’t go back to agency work. And I started my private practice and it was really great for several years. I just needed a small private practice and that was great for me. That’s all I needed at the time. That’s all I could work at the time. So there’s nothing wrong with being I don’t really care if you quit your job or don’t. I just want you to feel like it sustained you and that the other parts of your life are being supported, that you can live a full life. So phase one is love it or leave it. We need to make that decision about are we leaving therapy or not? And that is a process some people are very quick in doing that. Are we going to leave our current job or not? So for me, leaving all of therapy was a process. For me, leaving my agency job was very quick. So there’s nuances, there’s layers to that. But the phase sounds very simple. Of course we know it’s not, but it’s there. Phase two would be our career refresh. So what do we need to do? Do we need to change our setting? Do we need to change the how of what we’re doing? Do we need to completely change the paradigm and do something different? So one of my favorite stories was a therapist that I was actually referring a very beloved client to told me that a therapist friend went to become an air traffic controller after being a therapist, which is apparently pretty lucrative with little training. So I don’t want to shout it out to the rooftop, but I’m telling you, maybe some air traffic controlling is in your future. Okay, check it out, check it out. So that’s your career refresh. So we’re going to decide if we’re going to change our practice. We’re going to decide kind of the how we’re going to do that. So that could be looking at values, strengths, that alignment, that fit for our temperament, for the job. And then our last phase is accountability, getting support. You need your people. So we’re going to find our people. We’re going to find the people that will hold our feet. We’re going to find those people that are going to hold our feet to the fire. So for me, I will tell you, those people have been my business coaches. Honestly, those are the people that have been able to do that. The my therapist I think as well. I think my poor partner was just like, I don’t know what you do, but whatever you’re doing is not working. You are definitely not happy in private practice. So I think our partners can hold that mirror. Our really close friends can hold up that mirror, but someone who really knows you and can let you know when you need to know that it is not working for you or that you’re onto something. My therapist always tells me I have the best ideas and because I have this squirrel brain that I’ve always wondered if I’m ADHD, I don’t know, maybe I should get tested. I test people for ADHD all the time in my current role as a consultant. However, maybe I will one time. But I just know my brain goes everywhere and it always has. And I love to think of possibilities and all the different businesses I could start or the different Hobies that I have because I’m multi passionate. And if you are that way like me, then you need all the different avenues to think about and all the hobbies, all the things that you want. So that would be our accountability portion. And I really like to. Think about journaling for accountability. I try. When in my best zone I’m journaling. I’m writing down my ideas every day. I’m having a practice of mindfulness of meditation in the morning that really keeps me grounded. And then doing some kind of audit or quarterly deep dive is really important to see if the things that the changes you’ve made are still working for you, are still working for your practice, for your life, making those subtle shifts if you need to or not. That’s what I got for you today. I hope you enjoyed hearing my ideas on a framework for burnout recovery, especially related to the career of being a therapist. So if you have any insights or some ideas about the framework, reach out to me. So certainly I’d love to hear from you. So my website is Drjenblanchette.com. So that’s Blanchette. B-L-A-N-C-H-E-T-T-E on the end. And I hope to hear from you soon.
Speaker A: Hi, thank you for listening to the Joy After Burnout podcast. Be the first to hear new episodes by following the podcast in your podcast player. This is an informational podcast only. Any information expressed by the host or guest is not a substitute for legal, medical or financial advice.