Mental health professionals work in intensely stressful environments. Clients, organizations, policies, and in a broader sense, society, place high expectations on mental health practitioners. Students new to the profession, clinical practitioners, supervisors, and case managers alike, deal with difficult, stressful issues on a daily basis. For individuals who have difficulty coping, these stressors can take a heavy toll over time. As mental health practitioners, it is our responsibility to meet these challenges, to develop strategies to manage these stressors in positive ways lest we render ourselves ineffective. Not only do we suffer if we are unable to cope with our stress, so too do those with whom we work.
This module was designed to provide mental health practitioners with learning opportunities focusing on both self-care and stress. By recognizing the causes of stress in our life, we can then utilize or develop coping strategies to move forward. We demand this of our clients. So too should we demand it of ourselves.
“Self-care” can be understood in many different ways. In its simplest form, the term refers to our ability as human beings to function effectively in the world while meeting the multiple challenges of daily life with a sense of energy, vitality, and confidence. It also implies that we are active participants in that process. Self-care is not “other-care”. Rather, it is care that is initiated and maintained by us as individuals. It requires our active engagement.
The term “self-care” has been understood in many different ways. Its spans a full range of issues from the physical, the emotional, the intellectual, and the spiritual. Some conceptualize this construct by considering the dimensions of mind, body, and spirit. Others contend that it encompasses the dimensions of thinking, feeling, and behaving. It has also been broken down into personal and occupational aspects. It is referred to as “wellness”, a “healthy balance”, “resilience” and simply, mental health. It is important to note, though, that no matter how one breaks down the dimensions of self-care, in the end, all of these different aspects are interconnected. Failure to take care of oneself in one realm can lead to consequences in another.
There are many negative consequences that can result from an inability to take care of ourselves. Stress as the most prevalent issue is the focus of the following section.
Phil is a middle school counselor. At the beginning of the school year, Phil’s good friend, Jason, gets into a bad car accident. Someone runs a red light and hits Jason as he is driving through a busy intersection. As a result, Jason is hospitalized with a broken arm and leg and multiple lacerations. He is placed under observation for a possible head injury. Upon notification, Phil has an outpouring of emotions. He is sad for his friend, angry with the person who ran the red light, frustrated that he cannot make everything better. He goes to visit Jason in the hospital but does not share his feelings with Jason or anyone else. It is the beginning of the school year and there are a lot of things that have to be taken care of at work. He decides that he doesn’t have time to deal with the emotions brought on by his friend’s misfortune. He focuses on his work for the next few days visiting Jason in the hospital each night. The intensity of Phil’s feelings increases with each passing day, but he still does not reveal this to anyone. He begins to notice some sleep difficulties and a loss of appetite. Normally a regular at the gym, he skips his work out sessions at the end of the day in order to visit his friend.
On the third day after the accident, one of the teachers Phil has worked closely with for several years comes down to ask him for help with a student who is having some difficulties adjusting to school. Phil looks at the teacher and loses it: “You know what? Aren’t there more important things to worry about?! So this kid’s having a little difficulty. So what! Some things are a lot more important than a kid who can’t handle being in school!” The teacher is stunned.
By neglecting his emotional well-being, Phil is beginning to manifest new and negative behaviors in other areas of his life. This brief example illustrates how stress that manifests itself in one dimension can quickly lead to changes in other realms. This illustrates the importance of proper self-care.
As practitioners in the field of mental health, it is important for us to constantly ask the question, “How am I doing”? If we begin to neglect ourselves, our ability to care for others can rapidly become compromised.
This section looks at stress across two different life realms: the personal and the occupational.
Any understanding of self-care is incomplete without a concomitant understanding of stress; what it is, what it does, and how it is caused. It is important to note that stress in and of itself is not a bad thing. In fact, in manageable doses, it can serve as a motivating factor in our lives. It can push us to do more or to make changes with the things in our lives that are not working for us. It forces us to reflect on what is going on, to take stock. However, if left unchecked, it can also have negative impacts. While some of these impacts are quite minor, others can be far-reaching.
Stress can be viewed along four different dimensions : the cognitive, the affective, the behavioral, and the physical and can impact individuals in one or all of these areas. While human beings have a remarkable ability to self-regulate, in large enough doses stress can dramatically compromise functioning. This can result in compromised intra-personal and/or interpersonal health.
At the personal level, there is no way to provide a comprehensive list of the different stressors that people experience. Some examples however, might suffice. Personal issues like divorce, the death of a loved one, parenting stress, and national catastrophes can all have an impact on an individual’s level of stress. Other stressors might include increased family responsibilities or personal commitments outside of work. What is stressful for one person, however, may have little or no effect on another. This fact calls attention to the importance of self-awareness. By finding the time to monitor our own stress, we can better deal with things as they arise.
As already noted, mental health practitioners work in highly stressful environments. If allowed to escalate, stress can lead to many negative job-related outcomes including job dissatisfaction, a decreased commitment to organizational goals, lower performance evaluations, an increased sense of powerlessness, high turnover rates, increased absenteeism, decreased work productivity, and low job effectiveness. How we choose to negotiate these environments has a lot to do with whether or not our stress is alleviated. As is the case with personal stress, the causes of occupational stress are also many. Some identified factors are listed here:
While some people choose to deal with issues as they come up, others choose to avoid them. To some extent, our personal coping styles dictate these choices. Our coping style has certain implications for how we deal with stressful situations. Norman Endler and James Parker (1988) developed an inventory to assess individual’s coping styles. This 48-item inventory, the Coping Inventory of Stressful Situations, yields subscale scores along three different dimensions: task-oriented, emotion-oriented, and avoidance-oriented. People whose primary coping style is task-oriented tend to focus on the issues at hand. Those who deal with stress on an emotional level tend to immerse themselves in the feelings associated with the stressful situation. And finally, there are those who deal with stress by simply avoiding the situation altogether. All of us utilize each of these coping styles to different degrees. It is believed that people deal with mounting stress by resorting to their “primary” coping style. It is also possible, however, to develop multiple strategies for coping. Learning which coping strategy works best for a given situation is yet another way for individuals to deal with stress.
This section has presented information on stress and some of its possible causes. Click here if you would like to complete a very brief individual stress assessment. You will note that many of the previously mentioned stress concerns are included in the stress assessment. Are there other stressors in your life that are not reflected in the stress assessment? How have you been coping with them?
As discussed earlier, self-care can be understood as an individual’s ability to address personal and occupational issues in proactive, health-promoting ways. Any discussion of self-care, however, would be incomplete without a section on some of the actual skills and strategies for self-care maintenance.
Identifying the source (or sources) of stress in your life is often the first step towards change. A certain amount of self-awareness is implied if individuals are to do this for themselves. When sources of stress are properly identified, individuals can then begin problem-solving and developing strategies to address them.
All of the suggestions included in this section and many others might be components of a solution to deal with a stress-inducing situation. Sometimes, however, people are only able to notice that they feel stressed but cannot readily identify the reasons why. In this event, it may be wise to enlist outside help. In the most extreme case, people do not even recognize the symptoms of stress- they just think this is the way life is. This situation may also require the efforts of an outside source for assistance. Following, however, is a partial list of the different ways to address stress.
There is an underlying theme to each of these suggestions: each indicates the importance of self-awareness. In many ways, you may want to consider self-awareness as the single-most important key for fostering your own self-care. It is self-awareness that enables individuals to continuously monitor themselves and to make adjustments in their lives as things come up. Lacking self-awareness, small issues can grow larger thereby leading to increased stress. To the contrary, individuals who are highly self-aware have the ability to make more immediate decisions about how to deal with issues as they come up. This promotes stress reduction.
The skills utilized to deal with personal stress hold true in the workplace, too. Monitoring yourself and your responses to the work environment are key elements of professional self-care. Some of the following additional suggestions can prove beneficial in heading off professional stress as well as dealing with it once it occurs.
In order to effectively serve those with whom we work, it is important that we find ways to take care of ourselves in the process. The previous section provided an overview of self-care. Stress was defined and some of its causes were presented. As a result, readers hopefully have a more comprehensive understanding of the interrelationship between stress and self-care.
The following questions are designed to assess your understanding of the content in this module. Each question is linked to an appropriate page to assist you in locating the answers.
The following sections have been copied from the ACA Code of Ethics (eff. 1995). How do they apply to the issue of self-care as discussed in the module? Do you comply with additional professional codes? What do they say about the importance of counselor self-care?