I try to frequently remind myself of these things, and follow my own advice as much as I can. Over the years these have stood the test of time — reading or hearing similar advice from authors / supervisors serves to underline the importance of perspective, and of self-care in this profession.
While this list is more suited for social workers in traditional roles, the majority of the tips remain valid for psychotherapy practitioners also.
1 — Remember that nothing you experience as you take on your client is your fault; these things were happening before you arrived, and will continue to happen if you leave — but if you do leave, someone else will fill your place. You are part of a large network of professions and helpers.
2 — Since you happen to be joining with people at this juncture in their lives, try to help — but also DO NO HARM. If you can help in some way, even the slightest (even by witnessing them), then your presence is needed.
3 — Remove your ego. Sometimes we are a signpost on the journey of people’s lives, it does not have to start and end with you — sometimes all we become is a little voice inside someone that rises in the future.
4 — Do not dishonor your importance in this moment. That might sound contradictory to point 3, but even if you are not the ‘savior’ of your client, you are there, and you must honor that. Do what you need to do, be diligent, be brave, and be the person they need you to be.
5 — Record and share. Write your notes on time, be clear with your content, give voice to your concerns, write a plan for the next stage and follow through with it. Communicate through email, ask questions that require responses, voice your concerns, catalogue your interventions and your evaluation of risk.
6 — Make use of your multidisciplinary team — talk to the school, the nurse, the police, the doctor. Share your information amongst them, don’t just wait for a review in 6 months. If you feel your voice is not being heard, then register a complaint — contact your representative, the union, HR, you can even call the police if there is sufficient concern and you feel it needs action.
7 — Acknowledge yourself for the things you do. Remind yourself of the good work, the little things, the attention you gave and the care you offered — these things are the fabric of your work.
8 — Self-care. Actually take time to identify what this is for you; make a routine and have a process. Make time for yourself and DO NOT compromise it. Learn to breathe in through your nose and out through your mouth, use this to ground you. Learn that breathing in and out through your mouth regulates your oxygen and carbon dioxide, instructing your body to center itself. Touch your middle finger to your thumb on your dominant hand while doing this — it will create a fast-track pathway in your brain to calm and focus you. Hold your shoulders back when you breathe, open your lungs. Allow your mind to open itself up as you focus on your breath. These are the beginning stage of mindfulness and of meditation. Think of meditation like a walk, you will see many sights along the way, but the view is not the initial-purpose, it is the action of the walk that matters — if your mind brings up thoughts or images then acknowledge them as if passing them by, and return your focus to the action (as if continuing on your walk). Practice these principles and study further if you wish, but use the breath and the finger-hold to ground yourself often. If you can take 1 minute ‘away’ then you have just joined with an eternal space inside you — when you open your eyes and return to the world you can choose how to interact with it.
9 — Exercise — it doesn’t matter what it is. It can be going to the gym, it can be dancing to music, it can be going for a walk, it can be moving whatever part of your body is able to move — but do it with conviction and attention. There is no winning or losing in this action, only the action, and the acknowledgment that you are doing it because you value yourself.
10 — Study CBT. I cannot stress this enough. Go and buy the book Mind Over Mood. It is really cheap and it will change the way you look at your life. It will change the way you interact with your clients. If you get a chance, take an actual training course. Using the principles of CBT will help you to examine your thought process, to identify your self-sabotage, to correct distorted thinking, to identify strengths, and to critically analyze your approach to situations. It will empower you to be an active force of constructive change in your life.
11 — Use more than the principles of CBT, identify a philosophical modality that works for you — CBT is a tool, it is not a singular mode of practice. Record and analyze what is working and what is not working in your practice — take this information to supervision and explore it from a strengths based perspective. Use systems theory to identify how you can reduce your stress and increase your efficacy — make use of your team, of resources, of referrals, and of the family themselves. Do not fall into the trap of believing it is just you. You are never alone in this role, and if you feel you are alone then it is a signifier to reach out and to gain support. If you cannot get support then it is a signifier that something is wrong, it is a signpost. Learn to read warning signs and act on them — remember to record such concerns in your notes, in emails, and in supervision notes.
12 — Allow yourself time to learn and to grow in your role. This will take you the rest of your career — be kind to yourself, but be diligent. If in doubt research it; Google Scholar is great. Invest in practice guides if you want, but don’t ever think you have to do this alone.