In especially stressful times, the question is not “How can I give more?” It is, “How can I sustain this work for the long term?”

Mental health therapists are trained to hold space for their clients. We are present for grief, trauma, anxiety, uncertainty and crisis. In especially stressful seasons – whether driven by social unrest, economic strain, community trauma, or personal transitions – clients appear to need more from us and sometimes, we naturally respond by giving more. We cease to be “conduits” for compassion, and we begin to give from our own stores of self-compassion.

When we do this consistently, that is prioritizing our client’s perceived needs, it comes as a big expense to ourselves and our practices.

Recent research focused on issues of “burnout” as a clinically significant occupational condition shows characteristics of emotional exhaustion, depersonalization (or mental/emotional distancing), and a reduced sense of professional efficacy.

Mental health clinicians, especially those in private/solo practices, are more vulnerable and are at a higher risk for “burnout”. Without the buffer of colleagues down the hall, shared caseload responsibility, or institutional “mental health/personal/sick days, private/solo practitioners often carry the full weight of client care, administrative tasks, and business operations every day (7 days a week in most cases), financial responsibility, and ethical decisions often in isolation.

And how do therapists often respond? They extend their hours, loosen boundaries, reduce fees, or push through their own fatigue to ensure continuity of care. While this may be seen as being “deeply compassionate”, this pattern can erode emotional and financial reserves.
When I speak with therapists who are struggling with their professional and personal wellbeing, they report an increase in irritability, emotional numbness and/or detachment, dreading sessions they once looked forward to, difficulty concentrating, being behind in required documentation, feeling less effective sometimes saying they feel like “imposters”, and finally they feel persistently exhausted and cannot seem to get good quality rest to alleviate this fatigue.

When therapists operate from depletion, the therapeutic relationship will shift. Presence becomes harder. Empathy requires more effort. Clinical creativity narrows. And over time, both the therapist and the client will be impacted.

With this in mind, it becomes an ethical issue for us as professionals to engage in regular personal self-care! This includes getting our own therapy or emotional support work. Recent research identifies practices for self-care to include being clear with boundaries, managing our caseloads, engaging in peer consultation groups, and other restorative practices.

When therapists model healthy boundaries, self-awareness, and proactive support, they reinforce for their clients the very principles we try to teach.

So, going back to our original and most important inquiry, “How can I sustain this work for the long term?”  We need to realize the practice is not just to care for others today, but to remain whole enough to be able to care tomorrow.