Tag: Burnout

Great Books Volume 5: Contemporary and Wildly Useful Books Written by People I Know

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Great Books Vol 5: Contemporary and Wildly Useful Books Written by People I Know (at least on Twitter!)

Transcend by Scott Barry Kaufman – This book is for everyone! It’s deeply humanistic and optimistic and transformational. If you thought you knew anything about Maslow’s “hierarchy of needs,” you should FOR SURE read this! It’ll both blow your mind and give you a great new metaphor for understanding human needs and actualization. Also, SBK is just this very cool, super authentic, and genuinely KIND human person. Oh, and he has the best podcast ever, too – The Psychology Podcast.

Show Your Anxiety Who’s Boss by Joel Minden – This is my favorite CBT book for clients. It’s easy to read, and the take-home message is simple and easy to remember (even though Joel knows I always roll my eyes at acronyms that are made to be cute, it turns out they are memorable!). One of my favorite things is how comprehensive it feels without turning into a long list of cognitive distortions. And I just really like the term “anxious fictions!” 

The Habit of a Happy Life: 30 Days to a Positive Addiction by Jeff Zeig. Jeff has written a lot of books, and I like all of them that I’ve read (because the way he thinks, especially about therapy, is just brilliant), but they’re not all for a very broad audience. This one, however, would be very useful for many clinicians and clients alike. If you ever read Positive Addiction by William Glasser, I’d say this is like an update version – same great concept, newer research, and I like Jeff’s writing better than Glasser’s, too! 

The Suicidal Thoughts Workbook by Kathryn Gordon – Is it weird to get really excited about a book on so heavy a topic? NO! Not for therapists, it’s not! Haven’t you lamented how few good resources there are for clients around suicide? This workbook is incredibly compassionate and thorough, gentle and practical. There’s no shying away from any difficult topics, and everything is handled with confidence in and grace for the reader. This is an indispensable resource for therapists, and I have no doubt it will be life-saving for clients. 

Brains Explained by Micah & Alie Caldwell (and sort of by their cats). Look, I know I’m an intense nerd and so you won’t like all the books I like. But if you’re one of the HUGE number of therapists who is both really interested in neuro/brain stuff but sometimes also intimidated by neuro/brain stuff, you’re going to SWOON for this book! There’s definitely enough in there that’s genuinely relevant to clinical practice to make it worth the buy on its own – but be prepared to accidentally get swept up in all the rest of it, too. It’s just so…. accessible and hilarious! And the chapters are almost bite-sized. They’re like…dessert-sized. What more could you want? (Oh, they have a fun YouTube channel, too!)

ZigZag by Michael Apter – Michael is one of my most treasured mentors. If you’ve read any of the Reversal Theory blog posts, you have also benefitted from his brilliance! He’s also written several books, but this one is the newest introduction to RT and it’s really accessible. So many more people (including your clients and yourself!) will find this book somewhere between interestingly useful and life-changing, so give it a try! 

Updated! Come As You Are by Emily Nagoski CAYA is my all time favorite book about sex!! Although it’s geared toward women, I almost always have men in relationships read it, too, especially if they’re in relationships with women. Emily is an incredible writer – she has a wild gift of taking really good, dense research and turning it into something both understandable and meaningful for the lay reader. Make sure you get the newest (revised & updated) version that was published in 2021, mostly because she says she likes it better. 

Also, CAYA has a workbook! (In fact, two cool things about the workbook. One is that I am one of the people who helped review it for initial edits, which was super fun! The second is that I’m pretty sure my husband is the reason the book exists – when we first read CAYA in 2013, before Emily was crazy famous and busy, he just emailed her to ask if she had any of the exercises in PDF, so we didn’t have to mark up the actual book and we could have 2 of each of them. So, she made them into PDFs and emailed them. Then, she put them on her website. Then, this book became a thing!)

And, yes, I’m a Nagoski superfan, so Burnout: Unlocking the Secret to the Stress Cycle (by Emily & Amelia Nagoski) makes this list, too. Incredibly useful, especially for that subset of adult female clients who grew up learning that they had to always play support roles, even unto exhaustion (and maybe developed resentment, anxiety, or low self esteem as a result). Goes along nicely with the podcast The Feminist Survival Project 2020. Just a note – both the book and the podcast lean pretty heavily liberal, but as long as I have warned my conservative clients about that, it’s been ok. 

Oh, and SURPRISE! I wrote a book, too! 😉 But you can’t have it until August! 

 

 

Comment below: What are your favorite therapy-oriented books these days? 

Before burnout begins

EllisLeave a comment

Before burnout begins…

How do I know when my client load is getting too high?

 

First, let’s define “client load.” Number of clients is part of it, certainly. Number of clients divided by number of available sessions and days at work is also a part of it. (Having 16 clients in 16 session spots over two days is way different than having 16 clients in 35 session spots over 5 days!) But clients aren’t all created equal. So, a lot has to do with combinations of clients, your own feelings of effectiveness and meaningful work, diagnoses and personality types you work with best, if you’re one of those clinicians who gets energy from couples/families vs. finds them to be energy vampires. So, how many clients we have often has very little to do with if our client load is too high.

I think we’ve been trained to notice when it’s already too late. You know the signs of burnout, right? You have trouble getting out of bed for work, you’re “phoning it in” with clients, you can tell you should care but you don’t, you are isolating from colleagues, you’re catastrophically behind in your documentation and yet not making headway, you’re emotionally numb or nonreactive.

And before burnout comes overstress. That’s when you wake up anxious before work, “bring clients home” with you mentally, begin dropping behind on documentation and feel pressured to catch up, having trouble shutting your mind off, are cranky or a bit emotionally reactive even at home.

It’s also quite good to notice this before you really get all the way to overstress and/or burnout, because if it gets that far, and you need to reduce your load, that can be another additional stressor.

I’d like to share a few ways I notice when I’m reaching my effective client load limit.

  • I’m not learning something new for a client
    • There’s never a time when I have a case load that is so low or clients who I know so well or I’m so “knowledgeable and competent” that I don’t have something to be learning outside of session. Sometimes, that’s psychotherapy theory or skills related; sometimes, it’s learning about something that’s relevant in a client’s world (e.g., the path to professional soccer, the pokemon universe, and Japanese cultural mores around drug use have been things I’ve learned about recently). If I don’t have the mental space and time outside of session to be learning something for a client, it’s a sign to me that I’m needing to use all of my non-client time for family and self-care. That means the next thing that will slip will be client care!
  • I’m bored or distracted in session (with a client I’m not usually bored or distracted with)
    • Some clients are boring, and that’s good clinical information. Some clients are distractible, because it’s part of their diagnosis. And I get distracted in a way that’s normal for me, that’s session related. But when I get bored with a not-boring client, or distracted (especially by thinking about other clients during one client’s session), that struggle to “stay present” is an early sign to me that client load, in the mental capacity way, is getting too high.
  • It’s takes more than 20 minutes at the end of the day to finish notes
    • For me, I almost never take notes in session after the intake. Also, I’m quite bad at letting clients out at the :50. So, I usually end up with about 3-6 minutes to write notes, read last week’s notes on my next client, and maybe do one other thing (this is either run to the restroom, refill my coffee, or do a super quick meditation or centering exercise). My notes include two main parts – a summary of the important session material (so I can read it next time before session), and “the boring stuff” – client name, date, session #, MSE check boxes, treatment plan updates, etc. So, I write the summary in my 3 minutes along with the client’s name right after session and then I leave the “boring stuff” for the end of the day. It’s no problem to finish the final note and 6 “boring stuffs” in 20 minutes. If I’m not able to, it’s because I mismanaged myself during the day, and that’s usually because my client load is too high. I’m keeping clients extra long and then running behind, I’m not taking time for centering, or I’ve struggled to summarize.

Noticing is one thing. Committing to doing something about it is another. Ask your favorite colleague, your best non-work friend, and the person you share a budget with (if you have one) to all help you commit to delivering excellent care by acting when you’ve noticed you’re approaching your limit, not past it!

Comment below with the ways you notice you’re approaching your limit!