Self-Care  |  Working in Essential Services

Therapists Need Support Too

BY SHANE TAN

24 December 2021  |   5 min read

Growing up, Joachim Lee was in mental anguish from depression and low self-esteem as a teenager, but he didn’t have anyone to turn to and talk about what he was going through. Feeling lost and confused, Lee found a lifeline through reading and writing letters to therapists, who surprised him when they replied.

The kindness of these therapists who didn’t know him made him realise how important access to professional mental health support is. His personal lived experience with mental health inspired him to want to help others as a career.

“Not having anyone to turn to nor have anyone to talk to attuned me to the needs of others besides myself. Knowing first-hand how my past struggles affected my life and how professional support was important, I decided to dedicate my life to walking alongside those who may be experiencing this similar struggle,” said Lee.

Today, Lee is a Senior Psychotherapist at Promises Healthcare.

Being attuned to the needs of others is an essential and beneficial trait for therapists, but it can also lead to burnout when it comes at the expense of their own needs. “Therapists prefer to give rather than to receive. They can be too myopic and focus solely on the welfare of their clients while neglecting their own. In other words, therapists tend to give a lot to their clients and do not take the time to focus on themselves until it is too late,” Lee explained.

Lee was burned out himself in his early years as a therapist. “I was providing support to six active suicidal cases simultaneously without realising that I was mentally exhausted,” he said. Lee was on the verge of giving up in despair, before his supervisor noticed and helped him through it.

Therapists prefer to give rather than to receive. They can be too myopic and focus solely on the welfare of their clients while neglecting their own.

Burnout among mental health professionals is on the rise in Singapore amidst the COVID-19 pandemic, as counsellors and therapists face an uptick in cases from more people seeking help to cope with various mental health concerns that have come up, such as stress and anxiety. “There is a spike in depression and anxiety related cases due to the isolation imposed by COVID measures,” Lee agreed.

According to The Straits Times, five local counselling firms reported an average of 20 per cent increase in the number of new cases from pre-pandemic years , with one firm reporting that its client numbers had tripled between August last year and last month, compared with the same period over 2018 and 2019.

Therapists are more susceptible to burning out when they do not have the support of their peers or a clinical supervisor to help them process the accumulation of emotion from their day-to-day work. As such, Lee emphasised that aside from ensuring there are sufficient therapists available to meet the demand, resources for self-management for therapists need to made easily accessible and avenues to seek support need to be expanded as well.

“Perhaps the best way to mitigate this is to create a culture of support within the agency and within their own peers so that support is easily present when needed,” Lee advised.

Lee offered the following practical tips for mental healthcare workers to practise self-care, maintain boundaries in their work, and prevent burnout:

  1. Many well-meaning therapists fail to set boundaries and tend to give their time away — Lee had a client who scolded him and accused him of not being sincere in wanting to help him, because he did not want to see the client for a session at 3 a.m. Set clear session working hours (e.g. 10 a.m. – 2 p.m., 4 – 6 p.m., 8 – 10 p.m.) and set aside 1–2 days free from any therapy work.
  2. Have at least 15 minutes of mental/physical break between each session.

  1. Keep each therapy session time to under 75 minutes.
  2. Keep your personal mobile phone number private.
  3. Practise deep breathing and regulate your body to be calm. (Using an analogy from The Avengers, be in Bruce Banner mode and not Hulk mode!)
  4. Exercise 2-3 times per week to release stress in your body.
  5. Appoint a fellow professional as your Clinical Supervisor to check in on you regularly.
  6. When affected by a case, always consult a peer/clinical supervisor. It is never wise to keep it to yourself.

Lee said that experiencing burnout in his early years made him deeply cognisant of the importance of self-care. “Now, when I notice a change in my physiology and mood, I immediately contact a friend and ground myself. Never be afraid to ask for help, even if you are an experienced therapist,” he emphasised.