Counselling can be a very rewarding profession: helping clients to make positive changes, assisting them in developing better relationships or aiding them on their journey towards healing and closure, is a tremendous privilege. It is these kinds of moments that make people choose to enter the profession, or to remain in it, despite difficulties; so it is no overstatement to say that the counselling profession is unique. But while its rewards are unique, so too are its challenges and stresses, which can include constant relationship endings, empathy fatigue and burnout. If practitioners do not possess effective ways of coping, and resources that help counteract these stresses, then they may be at significant risk of becoming impaired.
In light of the particular stresses and risks facing counsellors, much has been written about prevention and coping strategies, with the notion of self-care receiving more and more attention. For example, the American Counseling Association (ACA) set up a task force in 2003 to highlight the risks of counsellor impairment and to develop resources to address this issue more rigorously,1 and has developed ‘wellness strategies’ that include workshops and self-care tools to enhance practitioners’ wellbeing and to prevent counsellor impairment, such as burnout. This correlates with several research findings that indicate that self-care can reduce burnout.2,3
My interest in counsellor self-care
My personal interest in this topic as a researcher developed when I realised that, although in my work as a trainee counsellor, I encouraged clients to respond to themselves with care and compassion, I was not offering myself this kindness and compassion – at times I could be very critical of myself. The discrepancy between how I was with my clients and how I responded to myself a lot of the time, surprised me, and that was when my journey began. The notion of self-compassion4 encouraged me to treat myself with more kindness and care. However, I also came to realise that it is not an easy process – it is challenging and requires time and patience. As I reflected on this, I began to wonder how other counsellors viewed and practised self-care.
This article describes a study I undertook for my MA, which explored how counsellors and counselling students view and practise self-care. It discusses some of the findings from the study, including themes around the meaning of self-care, examples of self-care and finally some of the barriers identified by the study participants to achieving effective self-care.
Within the literature, ‘self-care’ is a rather vague term. It is often used interchangeably with phrases such as ‘coping strategies’, ‘career sustaining behaviours’, and ‘burnout prevention’. For the purposes of this article, I will define self-care as a process of recognising one’s physical, emotional and spiritual needs and finding personal and flexible ways of meeting these needs. My hope is that the following observations and findings will provide some insight into counsellors’ views and experiences of self-care and that this will be of value and interest to other therapists.
When looking at features of counsellor impairment, such as burnout, or compassion fatigue, the causes can be summarised as being a mix of both external and internal factors. External factors relate to stresses within the work setting. These can include the emotional involvement required when working with people who are suffering, as well as the struggle to balance numerous work-related demands and commitments. Internal factors refer to the person of the carer, or helper. The practitioner’s personality, self-concept, upbringing and significant life events can play a major role. Maslach,5 and Grosch and Olsen6 point out that the reason why people often enter a helping profession in the first place may be to earn approval and appreciation. If this is the main underlying motivation, the risk is high that practitioners will seek acceptance and assurance primarily through their work role, and consequently will overextend themselves and eventually ‘burn out’.
My research study
The aim of the research was to understand the unique experiences and views of trainee and novice counsellors around self-care, so I adopted a qualitative approach. Ethical approval was given by the relevant ethics committee of the University of Manchester. Seven participants were recruited, six female and one male. They were all white British and their ages ranged from 28–52 years. Two of the interviewees were counselling students who were just about to start placements, four were students with client work experience and two participants had been qualified for less than a year. I decided to use thematic analysis7 as a way of finding and understanding the meaning that the participants attached to their own experiences.
The following themes were identified from the interview responses: the meaning of self-care; examples of self-care; the motivation behind self-care; the challenges of being a (trainee) counsellor; fostering an environment of self-care; and barriers to self-care.
What does counsellor self-care mean?
Participants were asked to comment on what the term ‘self-care’ meant to them. For most participants, self-care meant ‘putting yourself first’ and ‘remembering the importance of yourself’. Three interviewees saw self-care as having a connection with self-worth and self-value. For example, participant E stated:
‘I think it’s so much about your worth, for me. When you treat yourself with that worth, you’re showing actually what your value is, and that’s important.’
Ideal vs reality
Although all participants recognised that self-care is important, five participants also expressed views that self-care can be challenging to embrace. They voiced difficult feelings relating to self-care, such as guilt, selfishness and self-indulgence. Implicitly, rather than explicitly, these interviewees expressed a degree of conflict concerning this topic. On the surface, they recognised the importance of self-care and a counsellor’s obligation to practise it, but engaging with it on a deeper level seemed to raise difficulties. On a more implicit and subtle level, it seemed that a number of participants had an ‘ideal’ in their mind of what self-care should and should not look like. For example, four participants mentioned watching TV as a way of ‘relaxing’ and ‘switching off’. Yet, simultaneously, all four were critical of it, describing it as ‘mindnumbing’, ‘terrible’ ‘rubbish’ and ‘crap’. All four felt embarrassed by it, stating that they felt they should not watch escapist TV. Participant G described it as follows:
‘I started watching terrible, terrible, escapist programmes… trashy TV. And I just feel like I should be doing all these other things – but I don’t.’
It's a process
When asked to comment on the meaning of self-care, all interviewees stated that their own understanding and their views on self-care had changed over time. Most felt that they had had a basic understanding of it, through training workshops in their workplaces, for example; but at that point, it was mainly about the physical aspect of self-care. The experience of being on a counselling training course had had a significant impact on all participants. Interviewees reported that it was often the practical aspects of training, such as client work on placement, that had contributed to the change in their views. Accordingly, self-care became less about physical health and more about maintaining emotional wellbeing. For example, participant D stated:
‘At the beginning of the course, I was very much of the view that it’s all about the client; and I would put so much energy into them and trying to be in their frame of reference. That was all the terminology we were getting during that early stage, and I was completely fixated with it. I was completely leaving myself out of it. So I think that was when self-care became relevant to me and that was probably a few months into actually practising.’
The notion of self-care being a journey and a process was important for all participants.
Examples of self-care
Participants were asked to comment on the notion of personal and professional self-care strategies and to give examples. The majority of participants described personal self-care as taking place ‘outside of the counselling environment’, whereas professional self-care was directly linked to client work.
Personal self-care activities related to the physical and psychological self.
Physical self-care activities:
- health diet
- being outdoors
Psychological self-care activities:
- seeing friends and family
- spending time alone
- watching TV/films
- reading and writing
- mindfulness exercises
The most frequently mentioned professional self-care activities were:
- group supervision
- peer support
- conferences and workshops
- personal therapy
- personal development groups
- skills groups
- journal writing
Barriers to self-care
Participants were asked to explore potential barriers to self-care. These barriers can be summarised as consisting of external and internal factors.
External factors as barriers to self-care
All participants commented on time and money as being the biggest challenges to practising self-care. The general consensus was that there were just too many demands on their time, especially as a trainee counsellor. Interviewees reportedly felt that often the challenge was to integrate self-care when life was so busy. They felt that practising self-care seemed much easier at quiet times. Consequently, self-care was often the first activity that was neglected at stressful times. Participant E described the dilemma as follows:
‘When we juggle everything, self-care is the thing we give up first… so I have to make it a priority… So I’d say time first of all, but I’d also say prioritising it.’
Money was another significant barrier for five participants, especially the cost of training, supervision, workshops and personal therapy. Referring to supervision and personal counselling, participant A stated:
‘That you have to pay for it is a massive challenge for me… when money is involved, it does not feel like a relationship of care.’
Internal factors as barriers to self-care
The significant role of participants’ upbringing emerged during the interviews. Six participants commented on how their childhood experiences had had an impact on how they viewed self-care today. To varying degrees, five participants explained that they had learned to look after others and to elevate others’ needs above their own. Participants A, C and G described the messages and values they had adopted as children, as follows:
‘I have a very strong sense that I’m meant to look after other people… I feel guilty about doing self-care… It’s not OK for me to stop doing – I’ve got to carry on.’
‘Looking back, I’ve always been the one who looks after everyone… Everybody else always had to come first, apart from me. So that’s what I learned growing up; that’s what you do.’
‘You put yourself last, but you do the job and the reality of work is that it’s exhausting and it takes it all out of you; but that’s how it is and you just keep working.’
Class and religion featured in this quote by participant A:
‘I live a very middle-class life, but I come from a very poor working-class background… I can access something that a lot of people can’t afford… I have a lot of things, but they are not a lot of pleasure to me, because I feel very guilty all the time… I’m not religious now, but I was brought up as a Catholic and I’ve been given a great sense of “love your neighbour”. So these values are absolutely ingrained in me… So there are things I think I should do and I do them, but I don’t really want to do them.’
Based on their expectations and values internalised from childhood, four interviewees commented that it requires a conscious effort to change these introjects into messages of self-care, kindness and self-compassion. For some, it is a continuous challenge to learn to accept care from others and to change their own learned behaviours.
Participants D and F described it succinctly:
‘So it’s a really important thing for me now to be self-caring of me, and also accepting it from the people that are closest to me.’
‘Not wanting to ask for help is still there very much, or that feeling of wanting to feel like I can handle it, because if I can’t handle it, then what does that mean? Or what are other people going to think? And that real fear of letting people see that I’m not coping. So, for me, I’m constantly fighting against my upbringing to be able to look after myself.’
Implications for counsellors
My research showed that how practitioners view and practise self-care seems to be partly shaped by their childhood experiences and family background. Several participants reflected that putting others first, caring for everyone around them and simply carrying on regardless of the emotional impact, were attitudes they had adopted in their childhood. I wonder whether this sense of a lack of entitlement to self-care might also be due to the expectations society as a whole places on women, in particular. Interestingly, the male participant in this study did not express any feelings of guilt about self-care.
The new BACP Ethical Framework for the Counselling Professions8 states that it is the counsellor’s responsibility to maintain their own wellbeing and to practise self-care, in order to ensure good client care. However, self-care generally, perhaps, needs to be conceptualised more clearly, and be discussed and understood more. For instance, following the example of the ACA, BACP could produce more literature and resources on this topic.Future research could explore in more detail potential barriers to self-care and how to tackle them more effectively. Ultimately, the whole counselling community needs to acknowledge that, ‘self-care needs to be modelled, taught and supported as a professional resource… It is neither a luxury nor an indulgence’.9
This research project has had a lasting impact on me and has changed me, both as a person and as a practitioner. For example, I have discovered that I enjoy times of solitude and that these times help me to connect with my psychological and spiritual self. But I have also begun to notice my own struggles towards exercising self-care. For me, barriers to self-care are thoughts like: ‘You don’t deserve self-care’, or ‘You are lazy. You should be doing more productive things.’ Now I recognise these thoughts and I can see the effects they can have on my self-care. Being engaged with this topic has helped me to embark on my own personal journey of self-care. I have started to develop and practise self-care activities that have meaning to me and which help me embrace and express all the different aspects of who I am, as a person and as a counsellor.
This article is based on research carried out for the award of MA Counselling, at the University of Manchester, supervised by Peter Jenkins. My thanks to the participants for allowing publication of their comments.
The Good Practice in Action resources which support the Ethical Framework for the Counselling Professions will include self-care.
Elisabeth Brownlee holds an MA in Counselling from the University of Manchester. As a counsellor she works with adults as well as with young people in schools. Elisabeth has a great interest in practitioner wellbeing and the notion of self-compassion.
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9 Christianson C, Everall RD. Constructing bridges of support: school counsellors’ experiences of student suicide. Canadian Journal of Counseling 2008; 42(3); 209–221.