As professors of counselor education at three separate universities, we share a vested and common interest in counselor wellness. When COVID-19 hit, we began researching burnout in counselors. There is a consensus in the profession that burnout is the gradual onset of emotional, cognitive and physical exhaustion related to work. Often there is a sense of dread and avoidance with completing work-related tasks.
Our thinking was that due to the demands on counselors and the heightened health scare during COVID-19, counselors would begin to burn out. We wanted to understand the relationship between the new pandemic and counselors’ levels of stress, burnout, resilience and self-compassion during this time. We asked ourselves how we could better understand this unprecedented phenomenon so that we could better support our students, our supervisees, our colleagues and ourselves.
After conducting three independent research studies over the past year, we discovered some surprising results that could help us define — and rule out — what issues counselors may be facing and what can help keep us well during our parallel experiences with clients during the continued evolution of COVID-19.
Surprising Evidence of low burnout rates
In the past year, we have been inundated with anecdotal information from online sources and peer-reviewed manuscripts that communicate how counselors are experiencing high rates of burnout while seeing clients during the pandemic. This is a fair and seemingly clinically sound assumption, except that our current research isn’t supporting this claim. Three independent research studies that gathered data from counselors across the country in 2020 and 2021 indicate that burnout rates in counselors remain low, which is consistent with reports prior to the pandemic.
Three months into the pandemic, we sampled 211 counselors and found an average burnout rate of 20.85, which fits in the “low” category. According to Henry E. Stamm, developer of the Professional Quality of Life Scale, a score of 22 or less indicates low levels of burnout; a “moderate” score ranges from 23 to 41. Most participants in our first study scored low on burnout (67%), with the remainder displaying moderate levels (33%). No participants reported high levels of burnout. In this first study, we found self-compassion and resilience predictive of lower levels of burnout.
Eight months into the pandemic, we conducted two additional independent studies looking at other predictors of burnout. In the second study, 252 counselors reported an average burnout level of 20.99, again in the “low” category. This study found compassion for self and others predictive of resilience, whereas empathy was predictive of burnout.
The third study surveyed a national sample of 125 counselors who reported an average burnout level of 22.09, which again is consistent with that of the “low” burnout category. This study found that counselors’ negative perceptions of their working conditions, maladaptive coping styles, decreased levels of compassion satisfaction, higher caseload volumes of clients with trauma-related concerns, and lower levels of resilience were predictive of burnout.
Low burnout rates are surprising and, again, seem counterintuitive, even when we take our own experiences into consideration. This isn’t to say that counselors aren’t experiencing burnout, however, because they are. They just don’t seem to be experiencing it any more than they did before the COVID-19 pandemic.
Admittedly, it is hard to define an experience when it is one the current generation of counselors has yet to practice and live through completely. The trajectory of COVID-19 variants is still unknown, so further defining the struggle that counselors may be facing can be beneficial in increasing our ability to maintain personal wellness.
So, what is preventing counselors from experiencing higher burnout rates given the added stressors we have all faced this past year-plus, both at home and at work? Our research indicates that counselor resilience during the pandemic is moderately high. These findings suggest that counselors may be uniquely suited to cope with the additional pressures of a pandemic. By utilizing skills taught in counselor training programs and supervision — including maintaining adequate self-care, maintaining healthy boundaries, practicing ethical decision-making and responding to crises — counselors seem to be able to maintain enough resilience to keep burnout levels low.
Pandemic fatigue
If we aren’t experiencing burnout, then what are we experiencing? Here’s what we think: The phenomenon of providing counseling during a pandemic has produced an outcome unique to COVID-19 — pandemic fatigue. It is time that we talk about what this means for counselors.
The World Health Organization defines pandemic fatigue as “a reaction to sustained and unresolved adversity which may lead to complacency, alienation and hopelessness, emerging gradually over time and affected by a number of emotions, experiences and perceptions.” Pandemic fatigue is dissimilar to burnout in that the exhaustion being experienced isn’t related only to our work as counselors but is woven throughout the tapestry of our lives as a whole.
To us, this makes good sense. Counseling during a pandemic means that we cannot leave all of our clients’ material at the office. Because we are all experiencing the pandemic — clients and counselors alike — we, as counselors, carry our own experiences of the pandemic home with us. Often, we are transitioning from holding space for our clients’ concerns related to the pandemic to going home and doing the same for ourselves and our families. In this context, we can start to see that it’s not necessarily the tasks related to counseling that are increasing burnout but rather the increasing demands on our personal lives that are leading to pandemic fatigue.
Fortunately, counselors are trained to respond in crisis situations. When the pandemic hit, we continued to provide care to the growing numbers and needs of clients, most likely by shifting to a new telehealth business model to safeguard our health and the health of our clients. We prepared for a sprint instead of pacing ourselves for a marathon. Although access to vaccinations has provided some health care workers an increase in psychological resilience, counselors are still in the race with no known finish line in sight for themselves or their clients.
When humans are confronted with a crisis, they draw on short-term survival instincts and systems. When circumstances drag on, new coping strategies need to be implemented to prevent or reduce behaviors that cause fatigue and demotivation.
Pacing ourselves
So, what can counselors do to pace themselves for the marathon we find ourselves in? Here are three suggestions:
1) Utilize parallel processes in supervision. Counselors shouldn’t be afraid to discuss fatigue, lack of motivation or other symptoms of pandemic fatigue with a clinical supervisor or colleague. Regardless of years of experience, talking about the exhaustion of providing care during the ongoing pandemic can have a dual benefit.
First, counselors can work with their supervisors to identify and discuss any guilt, demotivation, and lack of energy with clients, and ways of improving resilience in these areas. In doing so, the counselor participates in a parallel process that may trickle down to how the counselor identifies and treats pandemic fatigue in clients. Using the parallel process may increase new coping strategies and resilience in both counselor and client.
2) Practice compassion more and empathy less. According to neuroscientists Olga Klimecki and Tania Singer, empathy activates the pain network within the brain. In contrast, compassion activates nonoverlapping brain regions. In a subsequent study of counselors, increases in compassion (compared to increases in empathy) were associated with increases in counselor resilience. This means that counselors may benefit from practicing compassion to self and others. It also means identifying causes of suffering and working to alleviate them.
This contrasts with our practice of empathy. Empathy requires the counselor to take the perspective of the client by “trying on” their pain. When we practice empathy by putting ourselves in our clients’ shoes, our brains have difficulty distinguishing what is “ours” and what is “theirs.” Taking the client perspective requires an additional process of emotional regulation to distinguish others’ suffering from our own, which may add to counselor fatigue.
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Practicing self-compassion may also aid in identifying and decreasing guilt associated with the counselor’s inability to treat as many people in need as possible throughout the pandemic. Recent literature has captured the moral challenges of counselors when they are unable to provide more services to the increasing numbers (and overwhelming needs) of clients. When we practice self-compassion, we address our desire to help others and the guilt that arises when we cannot do so, while offering lovingkindness toward ourselves in the midst of that guilt.
By engaging in this self-compassionate process, counselors are better able to extend the same care and consideration to their clients. After all, we cannot effectively lead our clients to a place we have yet to discover or experience ourselves.
3) Define personal space and time. Remember, slow and steady wins the race. It looks like we are in a fluctuating pandemic that has the potential to affect us and our clients for some time to come. Intentionally carving out time and space to come back to center so that we can choose what we do with our time (instead of ceaselessly dedicating it to work) can provide balance.
No, this doesn’t necessarily mean taking a spa day, getting our nails done or binge-watching reruns. Those coping strategies are good only in the short term to distract from stress. They might have been effective coping strategies during the first months of COVID-19, but they can quickly turn into maladaptive behaviors that prevent us from being in our feelings and really assessing what we truly need. Instead, we are asking counselors to pay attention to their thoughts, bodies and feelings and prescribe leisure time (and purposeful aloneness) accordingly. Healthier coping strategies may enable us to remain resilient for the long haul.
Summary
Why is this important? Yes, we have available vaccinations and boosters, businesses are back up and running for the most part, many children and adolescents have returned to school for in-person learning, and more counselors are seeing clients face-to-face. Even so, we have such little information about how professional counselors remained well during pandemics and crises prior to COVID-19. Because little can be gleaned from the past, we hope to provide additional context centered on counselors’ experiences during global crises. Based on our research, we have a better understanding of what is keeping us well and what we may need to do to maintain that level of wellness.
As a profession, it is easy to focus on the needs of clients and not to focus on our own needs. The truth is that by keeping ourselves well, we are better positioned to help our clients reach and maintain their own wellness. Additionally, when we are well, we are more likely to make ethical decisions.
Our mental health is not separate from that of our clients. When they are suffering more, we are more likely to feel its effects, much like a shared experience. Conversely, when we are suffering more, our clients too are more likely to feel it. During the pandemic, when both counselors and clients are experiencing the same challenging phenomena, our symbiotic relationship needs to be addressed.
Given the ongoing nature of COVID-19, the unpredictability of its variants and an undetermined end point for the pandemic, understanding counselor wellness during this time is imperative. Counselors have described feeling burned out, and this is mirrored in current literature. When tested, however, we did not find counselors to have higher rates of burnout than before the pandemic. Instead, counselors may be experiencing pandemic fatigue marked by chronic stress that impacts perceptions of events, increased exhaustion and decreased motivation.
To mitigate these symptoms, counselors can use parallel processes in supervision to reinvigorate both the counselor and the client, practice compassion toward self and others, and carve out time for intentionally addressing needs. Using new coping strategies may help counselors to pace themselves during the COVID-19 marathon and mitigate pandemic fatigue.
Considering the gradual onset of burnout, it is plausible that counselor burnout rates will climb as the pandemic continues. However, many of the coping strategies we recommend using to reduce pandemic fatigue should also help prevent increases in burnout.
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Carrie L. Elder is a visiting assistant professor and clinical coordinator at Mercer University in Atlanta. She is a licensed professional counselor (LPC), national certified counselor (NCC), certified professional counselor supervisor and registered art therapist. Contact her at elder_cl@mercer.edu.
Elizabeth K. Norris is an assistant professor of counseling at Denver Seminary in Littleton, Colorado. She is an LPC, NCC and board certified telemental health provider (BC-TMH). Contact her at elizabeth.norris@denverseminary.edu.
Leann M. Morgan is core faculty in the School of Counseling at Walden University. She is an LPC, BC-TMH and certified career counselor educator. Contact her at leann.morgan@mail.waldenu.edu.
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