Instructions
Black, indigenous, and people of color (BIPOC) often experience racial stress and trauma in our cu
ent society due to discrimination in institutions (school, work, government, etc.), microaggressions in day-to-day life, and the legacy of racism and oppression in American history. Children and teens are not removed from these stressors and may also experience race-based stress.
In an essay of 4-5 pages, you will explore and analyze how BIPOC (or a specific racial/cultural subgroup of) children and adolescents are likely to be impacted by a race- and/or culturally-based event or situation in our cu
ent U.S. society. To develop your essay, please do the following:
1. Choose an issue, event, or situation that can lead to racial stress or trauma for a child or adolescent of color. For example, you may focus on the killing of unarmed Black people by police, family separation or forced deportations of immigrants or refugees as a result of U.S. immigration policies and practices, or experiencing racial microaggressions in schools.
2. Describe how you think these experiences could be perceived by a child or teen. Consider both the experience of those who are directly involved in these events/situations (i.e. a child who is in an immigration detention center or who has been the target of racial aggression) AND the experiences of those who have witnessed such events either in person or through media exposure.
3. Drawing on and refe
ing to the required reading for module 8, Content Guides 1 and 2, and the podcast interview with Resmaa Menakem, provide an analysis of how a child or teen could be impacted by the events/situations you describe. How might a child perceive or understand the situation? What might make the experience of trauma better or worse for the child? And what stress or trauma symptoms might the child have?
4. Finally, apply what you have learned about how parents and professionals can help children cope with trauma to this situation. What can adults do, formally and informally, to support children and teens who experience the kind of racial stress or trauma that you have been discussing in your essay?
Your paper should be 4-5 pages in length and cite scholarly using APA formatting. You should rely primarily on scholarly sources but may use non-scholarly sources such as newspaper articles and reports from reputable organizations as well. To determine if a source is appropriate, please refer to this resource on the Empire State University online li
ary, Evaluating Information Sources.
Reading Assignments:
· Deangelis, T XXXXXXXXXXThe legacy of trauma. Monitor on Psychology, XXXXXXXXXXhttps:
www.apa.org/monito
2019/02/legacy-trauma
· Jernigan, M.M. & Henderson Daniel, J XXXXXXXXXXRacial trauma in the lives of black children and adolescents: Challenges and clinical implications. Journal of Child & Adolescent Trauma, 4.
· Transcript of a Podcast: Author and therapist Resmaa Menakem interviewed on On Being with Krista Tippett
https:
onbeing.org/programs
esmaa-menakem-notice-the-rage-notice-the-silence/#transcript
Dear Mental Health Practitioners, Take Care of Yourselves: a Literature Review on Self-Care
REVIEW ARTICLE
Dear Mental Health Practitioners, Take Care
of Yourselves: a Literature Review on Self-Care
Kirsten Posluns1 & Te
y Lynn Gall1
Published online: 23 May 2019
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Stress, burnout, and professional impairment are prevalent among mental health professionals
and can have a negative impact on their clinical work, whilst engagement in self-care can help
promote therapist well-being. This literature review examines the role of self-care in the
promotion of well-being among mental health practitioners. Specifically, empirical research
is presented in relation to specific domains of self-care practice, including awareness, balance,
flexibility, physical health, social support, and spirituality. Findings from this review under-
score the importance of taking a proactive approach to self-care and, in particular, integrating
self-care directly into clinical training programs and into the quality assurance processes of
professional organizations within the field of mental health.
Keywords Stress . Burnout . Professional impairment . Self-care . Therapist well-being
Introduction
Mental health practitioners (e.g., counselors; psychotherapists) work in a culture of one-way
caring (Guy 2000) in which they are required to demonstrate empathy, compassion and
patience, without the expectation of receiving such care in return from their clients
(Skovholt et al XXXXXXXXXXTo be effective in providing mental health services, practitioners must
develop a professional alliance or working relationship with clients that maintains appropriate
oundaries and levels of emotional or psychological involvement, and to do so consistently
from one client to another (Skovholt and Trotter-Mathison XXXXXXXXXXEstablishing and maintain-
ing these one-way working relationships takes significant effort and energy (Skovholt and
Trotter-Mathison 2011) placing practitioners at increased risk for negative outcomes such as
stress (El-Ghoroury et al. 2012), burnout (Wityk 2003), and professional impairment (Ha
ison
and Westwood XXXXXXXXXXIronically, while helping clients move toward well-being, practitioners
often can overlook their own needs (Barnett et al XXXXXXXXXXand indeed may not have Blearned
International Journal for the Advancement of Counselling XXXXXXXXXX:1–20
https:
doi.org/10.1007/s XXXXXXXXXXw
* Te
y Lynn Gall
XXXXXXXXXX
1 Saint Paul University, Ottawa, Canada
http:
crossmark.crossref.org/dialog/?doi=10.1007/s XXXXXXXXXXw&domain=pdf
http:
orcid.org/ XXXXXXXXXX
mailto: XXXXXXXXXX
how to take the time to care and to nourish [themselves], having been trained to believe that
this would be selfish^ (Sapienza and Bugental 2000, p XXXXXXXXXXAs a result, engaging in self-care
can often sit at the end of a practitioner’s to-do list, rather than being made a priority.
Yet self-care, or attending to one’s own holistic well-being, can be a pathway towards
preventing negative outcomes such as burnout (Barnett et al XXXXXXXXXXExperienced therapists
support including self-care as a primary objective for mental health practitioners (Jennings and
Skovholt 1999; Thériault et al XXXXXXXXXXand this should be recognized as a fundamental part of
functioning in a helping career (Guy XXXXXXXXXXThe practitioner is a Bpowerful but vulnerable tool
in the caring process^ that requires attention and care (Sansó et al. 2015, p. 204) in order to
prevent not only practitioner ill-health (Butler et al. 2017; Stebnicki 2007), but also negative
consequences for the clients they serve (Bearse et al XXXXXXXXXXIn fact, mental health practitioners
have an ethical duty to provide responsible caring, maximizing benefits and minimizing harm
for their clients. In order to provide effective care to their clients, practitioners must first be
well themselves (Norcross and Guy XXXXXXXXXXTo promote responsible caring, several regulating
odies have, therefore, included practitioner self-care in their code of ethics. For instance,
section II.12 of the Canadian Code of Ethics for Psychologists (Canadian Psychological
Association 2017) states that, in accordance with the Principle of Responsible Caring,
members are to Bengage in self-care activities that help to avoid conditions (e.g., burnout,
addictions) that could result in impaired judgment and interfere with their ability to benefit and
not harm others^. Regulatory bodies thus understand self-care as being an ethical obligation
for the mental health professional.
The purpose of this literature review was to examine the role of self-care within the context
of mental health professions (counseling, psychotherapy, etc.). Specifically, this review will
cover the following topics: negative health issues (e.g., burnout) for mental health practi-
tioners; definition of self-care; types of self-care (e.g., life balance, spirituality) and thei
empirical support; and implications for the integration of self-care within training programs
and professional organizations.
The Downside of Mental Health Professions
Stress among mental health professionals has been a known issue for decades, since Freud
(1937/1963) discussed the stressfulness of therapist uncertainty around the issue of therapeutic
success. For example, psychologists experience stressors in relation to the heavy emotional
demands associated with clients’ presentations including client lack of improvement, symptom
elapse, suicide ideation and attempts, aggressive or violent behaviours, as well as the practical
demands related to paperwork, ethical practice, licensing, malpractice complaints, and profes-
sional isolation (Barnett et al XXXXXXXXXXBettney XXXXXXXXXXalso identified the work-related issues of
large caseloads and negative team environments as being additional stressors for mental health
practitioners. Given the presence of such multiple stressors, it is no wonder that practitioners,
including graduate trainees, report a high level of stress and distress (El-Ghoroury et al. 2012;
McKinzie et al. 2006; Myers et al XXXXXXXXXXFor example, 73% of Australian psychology
postgraduate trainees reported clinically significant levels of distress (Pakenham and
Stafford-Brown XXXXXXXXXXTo complicate matters, mental health practitioners may not be fully
aware of the impact of these various profession-related stressors and so will be less likely to
see the need to engage in preventative measures (Barnett et al. 2007), or to seek treatment once
the stressors have taken a toll (El-Ghoroury et al XXXXXXXXXXResearch has shown that for trauma
2 International Journal for the Advancement of Counselling XXXXXXXXXX:1–20
therapists, work-related stress is related to their use of avoidant coping strategies, such as
denial (Killian XXXXXXXXXXUnfortunately, left unresolved, work stress can set the stage for more
serious issues, such as burnout and professional impairment to emerge (Barnett et al. 2007;
Clark et al. 2009).
Burnout is described in terms of emotional exhaustion, depersonalization (Killian 2008),
diminished self-efficacy (Stebnicki 2007), and reduced personal accomplishment (Clark et al.
2009). Burnout among mental health practitioners is more difficult to treat than general work
stress (Dreison et al. 2018), highlighting the need for prevention or early treatment. Unfortu-
nately, the prevalence of burnout among mental health professionals is significant. In one
study, 13% of behavioral health providers were at risk of compassion fatigue or burnout
(Sprang et al. 2007), while 49% of counselling or clinical trainees reported experiencing
urnout (Kaeding et al XXXXXXXXXXBurnout can lead to poor quality of life (Chang 2014) as it is
associated with a variety of mental and physical health problems, including headaches,
muscular pain, and depression (Ahola et al. 2007; Vlăduţ and Kállay XXXXXXXXXXIn turn, practi-
tioner burnout affects overall therapeutic effectiveness (Bearse et al. 2013), not only reducing
the level of care provided by the practitioner, but potentially leading to more serious inappro-
priate behaviours that can be harmful to clients. For example, Rupert and Kent XXXXXXXXXXfound
that psychologists’ emotional exhaustion and depersonalization of clients, two aspects of
urnout, were related to practitioner over-involvement with clients and clients engaging in
negative behaviours.
The cumulative effects of emotional, mental, and physical burnout thus can lead to
professional impairment in the provision of services (Figley XXXXXXXXXXThe potential for profes-
sional impairment is particularly increased for practitioners who work in the field of trauma,
and is known variously as Bsecondary victimization^ (Figley 1988), Bvicarious
traumatization^ (McCann and Pearlman 1990), Bcompassion fatigue^ (Figley 1995), and
Bempathy fatigue^ (Stebnicki XXXXXXXXXXVicarious traumatization, for example, has been recog-
nized as a distinct occupational hazard for mental health professionals (Buchanan et al. 2006),
as it can affect self-worth, identity, world view, basic beliefs, psychological needs, perception,
and memory (Saakvitne 2002) and hinder or impair the practitioner’s initiatives towards
professional development, personal growth, and holistic well-being (Stebnicki XXXXXXXXXXThis
type of counsellor impairment can significantly compromise therapeutic work, and pose harm
to clients (Johnson et al. 2018; Lawson XXXXXXXXXXGiven that both practitioner and client well-
eing are at risk when mental health professionals experience burnout, it is vital that steps are
taken to address this issue (Barnett and Cooper XXXXXXXXXXUnfortunately, research has shown that
interventions in reaction to practitioner burnout seem to demonstrate limited or no positive
impact on the mental health of practitioners (Van Dam et al. 2011), thus shifting the spotlight
toward preventative measures as a more desirable action.
The Upside: Self-Care as Prevention
There is substantial support for the beneficial effects of self-care practice in the reduction of
negative outcomes such as burnout for mental health practitioners. While a lack of self-care is
elated to higher levels of burnout and secondary traumatic stress symptoms, a greater risk of
health status decline, and the experience of stress (Butler et al. 2017; Mayorga et al. 2015;
Santana and Fouad 2017), engagement in self-care is associated with greater well-being
(Colman et al. 2016), lower levels of stress and negative affect, higher levels of positive
International Journal for the Advancement of Counselling XXXXXXXXXX:1–20 3
affect, flourishing, self-rated academic, and clinical performance (Zahniser et al. 2017),
compassion satisfaction (Butler et al. 2017), and quality of life (Goncher et al XXXXXXXXXXOverall,
engagement in career-sustaining behaviours is linked to a greater sense of personal accom-
plishment and a lesser tendency to depersonalize clients (Rupert and Kent XXXXXXXXXXIn fact,
experienced mental health practitioners, or those who might be called Bmaster therapists^, refe
to self-care as a key aspect of professional functioning. Jennings and Skovholt XXXXXXXXXXreport
that such master therapists prioritize self-care in their profession and take Bpreventative action
to protect what they consider [to be] their most important therapeutic tool: themselves (p.7)^.
Further, Dorociak et al. (2017b) found that more experienced practitioners engage in more self-
care behaviours and report less stress than practitioners who are early in their career.
What Is Self-Care?
Self-care refers to the Bability to refill and refuel oneself in healthy ways^ (Gentry 2002, p. 48),
including Bengagement in behaviours that maintain and promote physical and emotional well-
eing^ (Myers et al. 2012, p. 56) and that Blessen the amount of stress, anxiety, or emotional
eaction experienced when working with clients^ (Williams et al. 2010, p XXXXXXXXXXThe term self-
care refers not only to an engagement in various practices but also to having a caring attitude o
‘being’ caring toward oneself (Kissil and