Burn-out and our responsibility to ourselves and our clients.

Every time I share my working situation with friends or family, I get the same set of questions:
“How do you manage with those people? Don’t you take your work home with you? You must hear some really hairy stories, how do you detach from them?” and so on and so on. Its all relevant and worth taking note of.
Counsellor burn-out is a huge dilemma in this field and we need to be acutely aware of our own “mental and emotional health care” so that we can provide the best, most focused and most productive experience for our clients. Substance abuse is one of the most difficult problems to treat, and addiction counsellors are not immune to the negative attitudes and feelings that come from working with difficult clients. Reducing counsellors’ entanglement with their own negative thoughts may be particularly important because there is evidence that these processes contribute to provider burn-out, staff turn-over, and to decreased effectiveness in working with people in need.

Burn-out is a term commonly referred to by those in many fields of the so-called caring professions or human service fields and is often broken-up into three core areas:
(1) emotional exhaustion (the sudden or “creeping” inability to feel compassion for clients),
(2) depersonalization (detachment from the emotional needs of their client),
(3) lack of perceived outcome accomplishment leading to over critical evaluation of our capabilities.
-( Shoptaw, Stein & Rawson 2000 ).

Do some counsellors burn out more frequently than others?
There is no reliable research to suggest that some personality types or even behavioural aspects of counsellors will predetermine whether they are more prone or susceptible to burn-out than others, however certain situational factors may be relevant.
Some are personal : age, educational level, recovery status – while others are organizational characteristics: the number of clients per counsellor, the availability of supervision, the level of team support from colleagues, the level of decisionmaking , the working hours and time off allocated to staff members and the role expectations that the counsellor carries.

How can we manage possible burn-out effectively?
The National Institute of Health (NIH) in the USA published a study that reviewed the scientific literature on preventing and dealing with burn-out in the mental health and substance abuse field. The study highlighted some critical areas:

• Heading off the psychological factors that lead to burn-out is a crucial intervention strategy.
  This requires mindfulness on the part of the individual addiction counsellor.
• Organizational aspects to “protect” addiction counsellors are crucial.
  These included:
  • Managing workloads
  • Providing support activities to improve worker morale,
  • Involving staff in decision and policy-making in order to create an environment that values their input.

While not often addressed in classic 12 rehabilitation centres with regard to staff burn out the aspects of transference and counter transference are fundamental.

Regardless of the structure that step work provides and the minimisation of the transference possibilities, we are in relationship with our clients and the transference cannot be avoided.  As much so, neither can the counter transference and hence the need for case discussions, team meeting and supervision if possible.

• Take time for physical activity every day.
• Do not be afraid to express your limits and say, “No.”
• Stay organized and on top of paperwork.
• Ask for help when you need it.
• Celebrate even the smallest victory.
• Get creative and more interesting with group sessions.
• Get out of the office whenever possible.
• Take up a hobby you love.
• Schedule a weekend trips away on your off weekends
• Take breaks between clients.
• Set boundaries.

How do we care for each other at Crossroads Recovery Centre? At Crossroads we (the staff) are continually looking out for each other. Working together in such an emotionally charged environment results in continual feed-back to each in respect of our moods, attitudes and behaviours towards our clients. Daily staff meetings and regular staff support discussions ensures that if one of us is experiencing the effects of burn-out or if we are “out of sorts” due to work stress or even personal issues the professional team is there for us to share discuss talk about what may be concerning us.

Stories of Recovery

• The encouragement, love and support from the team at Crossroads allowed me to eventually see that I was worth something - that my life could be turned around and that I could accomplish the things that had long been a forgotten dream.
  Oliver VG
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• On the last day of my stint at Crossroads I could only express gratitude towards all who works there. A wise councillor once commented on my question when one is ready for rehab by explaining that when one is ready for rehab, rehab is ready for you.
  Johan B
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• I was lost and my soul was broken until I ended up at Crossroads and was introduced to the Twelve Steps. With the help of their excellent staff and amazing support I have recently been clean for 18 months, I could not have done it without them!
  Carla S
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• "Just for today I am more than three years in recovery. I have Cross Roads to thank for this wonderful gift. Cross Roads helped me to set a firm foundation in my recovery on which I can continue to build."
  Angelique J
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