burnout - The Professional Counselor

Self-Care Through Self-Compassion: A Balm for Burnout

Apr 18, 2017 | Volume 7 - Issue 3

Susannah C. Coaston

Counselors are routinely exposed to painful situations and overwhelming emotions that can, over time, result in burnout. Although counselors routinely promote self-care, many struggle to practice such wellness regularly, putting themselves at increased risk for burning out. Compassion is essential to the helper’s role, as it allows counselors to develop the therapeutic relationship vital for change; however, it is often difficult to direct this compassion inward. Developing an attitude of self-compassion and mindfulness in the context of a self-care plan can create space for an authentic, kind response to the challenges inherent in counseling. This article expands beyond the aspirational aspects of self-compassion and suggests a variety of practices for the mind, body, and spirit, with the intention of supporting the development of an individualized self-care plan for counselors.

Keywords: self-care, self-compassion, burnout, mindfulness, wellness

Wellness, prevention, and human development compose the core of a counselor’s professional identity (Mellin, Hunt, & Nichols, 2011). This fundamental grounding is emphasized within the American Counseling Association’s (ACA) Code of Ethics (ACA, 2014), as well as by the Council for Accreditation of Counseling & Related Education Programs (CACREP; 2016). To fulfill their role in the change process, counselors depend heavily upon compassion, a key component of the therapeutic relationship that—paradoxically—counselors may seldom apply to themselves (Patsiopoulos & Buchanan, 2011). Whereas compassion means being with others in their suffering (Pollack, Pedulla, & Siegel, 2014), self-compassion can be understood as “being touched by and open to one’s own suffering, not avoiding or disconnecting from it, generating the desire to alleviate one’s suffering and to heal oneself with kindness” (Neff, 2003, p. 87). Higher levels of self-compassion can serve as a buffer against burnout (Barnard & Curry, 2011). Therefore, cultivating an attitude of self-compassion may assist counselors in employing self-care practices to refresh, rejuvenate, and recharge their bodies, minds, and souls. The purpose of this manuscript is to reimagine self-care as regular acts of self-compassion that benefit both clients and counselors.

Self-Compassion

Self-compassion, a construct from Buddhist thought, consists of self-kindness, common humanity, and mindfulness, and is characterized by gentleness with oneself when faced with a perceived sense of inadequacy or failure (Neff, 2003). Self-compassion is not based on an evaluation of the self; self-compassion becomes the path to positively relating to oneself (Neff & Costigan, 2014). The concept of self-compassion is consistent with the idea of self-acceptance in the humanistic tradition (Neff, 2003). Carl Rogers (1961) described a successful outcome of psychotherapy as an increase in positive attitudes toward self: “The client not only accepts himself . . . he actually comes to like himself. This is not a bragging or self-assertive liking; it is a rather quiet pleasure in being one’s self” (p. 87). The practice of self-compassion calls for a mindful awareness of emotions, and painful emotions are met with a sense of understanding, connection to our common humanity, and self-kindness (Neff, 2003). Neff and Costigan (2014) described self-compassion’s relationship with pain thusly: “Self-compassion does not avoid pain, but rather embraces it with kindness and goodwill that is rooted in the experience of being fully human” (p. 114). Self-compassion practices have been found to improve psychological functioning in both clinical and non-clinical settings (Neff, Kirkpatrick, & Rude, 2007; Schanche, Stiles, McCullough, Svartberg, & Nielsen, 2011).

Mindfulness is one of the core components of self-compassion and is critical for the awareness of suffering that precedes compassion (Germer & Neff, 2015). Mindfulness is the focusing on the awareness of pain in the present moment, and self-compassion becomes the act of taking that awareness and encouraging kindness toward oneself. The common humanity component of self-compassion becomes one of acknowledgment that, as humans, we are imperfect and make mistakes; recognizing our flawed condition allows for a broader perspective toward our difficulties (Neff, 2003). Adopting such a view of pain reduces the chance of over-identification or getting so wrapped up in one’s emotions that they become exaggerated (Neff & Costigan, 2014). When an individual can recognize pain as a universal occurrence, such a viewpoint then fosters a sense of connection with others who have felt suffering. Pain becomes an uncomfortable but acknowledged part of the human condition. When practicing self-compassion, the self-directed kindness is not done to change the circumstance of suffering, but done because there is suffering. The practitioner asks “What do I need now?” The individual then acts accordingly to provide comfort when experiencing the pain of inadequacy or failure (Germer & Neff, 2015). Learning self-compassion becomes a gift for both clients and the practitioner (Barnett, Baker, Elman, & Schoener, 2007). Making time for one’s self is one way counselors can practice self-care (Patsiopoulos & Buchana, 2011). That self-acceptance can prove vital for counselors, whose work often puts them at a risk for burnout (Yager & Tovar-Blank, 2007).

Counselor Burnout

Burnout is a multidimensional experience consisting of exhaustion, cynicism, and reduced professional efficacy that can result from dissatisfaction with the organizational context of the job position (Maslach, Schaufeli, & Leiter, 2001). Burnout can affect individuals in a variety of ways, with anxiety, irritability, fatigue, withdrawal, and demoralization as major examples (Schaufeli & Enzmann, 1998). Burnout can affect individuals at any point in their career and can hamper productivity and creativity, resulting in a reduction of compassion toward themselves and clients (Grosch & Olsen, 1994). “It is when counseling seems to have little effect that counselors reach despair because their raison d’être for choosing this work—to make a difference in human life—is threatened” (Skovholt, Grier, & Hanson, 2001, p. 171). Caring for others and caring for oneself becomes a difficult balance to achieve for both new and seasoned counselors alike. Carl Rogers (1980) wrote, “I have always been better at caring for and looking after others than I have in caring for myself. But in these later years, I made progress” (p. 80). Self-compassion can serve as a protective factor against such potentially debilitating effects of work-related burnout.

Historically, researchers examined the causes of burnout relating to demographic, personality, or attitudinal differences between individuals (Maslach et al., 2001). Today, burnout is viewed from an organizational standpoint and is concerned with the relationship, or fit, between the person and his or her environment, wherein mismatches can result in burnout over time (Maslach, Leiter, & Jackson, 2012). An individual’s perceptions have a reciprocal relationship with the work environment; how counselors make meaning of their work impacts their satisfaction, commitment, and performance in the workplace (Lindholm, 2003). Counselors experiencing work-related stress and burnout will construct meaning differently and require a tailored self-care plan that reflects their individual assessment of their own fit within their work environment.

Counselor Self-Care

Self-care can be defined as an activity to “refill and refuel oneself in healthy ways” (Gentry, 2002, p. 48). Self-care is vital if we are to remain effective in our role and avoid burnout; however, many counselors do not regularly implement the techniques they recommend to clients in their own lives (O’Halloran & Linton, 2000; Skovholt et al., 2001). Although self-care is widely promoted within the counseling literature, this author contends that inherent in many self-care plans and workplace improvement efforts is the idea that overwhelming work-related stress reflects an inadequacy of the individual. The message in the literature often reflects the view that a counselor’s distress hinges upon inadequate coping resources, poor health practices, or other kinds of personal failing, such as lacking assertiveness or not taking enough time off from work (Bradley, Whisenhunt, Adamson, & Kress, 2013; Killian, 2008; O’Halloran & Linton, 2000). As a result, self-care plans tend to take on the air of a New Year’s resolution, a strategy to get better. This narrow focus reflects the historical view of burnout that focused primarily on its individual dimension, without taking into consideration the organizational, interpersonal, or societal perspectives (Schaufeli & Enzmann, 1998). When self-care plans are written like self-improvement plans, the opportunities for criticism and judgment abound, particularly for new counselors who struggle with anxiety and self-doubt (Skovholt, 2012). When counselors are suffering, experiencing symptoms of burnout, struggling to maintain healthy professional boundaries (i.e., under- or over-involvement), or feeling as though they are not caring for themselves effectively, shame may cause them to be less likely to seek assistance (Graff, 2008). Some counselors may fear negative repercussions as a result of disclosure, such as being perceived as impaired or having professional competency problems (Rust, Raskin, & Hill, 2013).

Self-care is an ethical imperative (ACA, 2014), because utilizing self-care strategies reduces the likelihood of impairment (ACA, 2010). Issues in a counselor’s personal life, burnout in the workplace, mental or physical disability, or substance abuse can result in impairment (ACA, 2010). Sadly, in a survey completed in 2004, nearly two-thirds of participants knew a counselor that they would identify as impaired (ACA, 2010). Counselors who better manage their self-care needs are more likely to set appropriate boundaries with clients and less likely to use clients to meet their own personal or professional needs (Nielsen, 1988). Self-care education has been integrated into the accreditation standards for counselor training (CACREP, 2016), and there are multiple articles discussing how to incorporate the value of wellness and self-care into counselor education programs (Witmer & Young, 1996; Yager & Tovar-Blank, 2007). For counselor educators and supervisors, monitoring counselors-in-training for possible impairment is an important part of the responsibility of gatekeeping (Frame & Stevens-Smith, 1995). However, despite this attention, both students and practicing professional counselors still struggle to implement self-care (Skovholt et al., 2001; E. Thompson, Frick, & Trice-Black, 2011).

Bradley and colleagues (2013) suggested that many of the self-care suggestions in the literature are too general, focusing mainly on general health practices, such as eating healthily and getting enough sleep, or professional recommendations regarding seeking support from colleagues. A case can be made that a counselor would be better served by employing an overall approach to efforts that are based in a self-compassionate mindset. Therefore, actively seeking awareness of one’s own signs and symptoms that indicate suffering can not only help counselors recognize burnout, it also can provide clues toward the first step in soothing.

Mindfulness represents one possible means of increasing such awareness. Mindfulness allows the practitioner to be present in the moment non-judgmentally (Kabat-Zinn, 1994). To practice self-compassion, a counselor needs to be willing to attend to feelings of discomfort, pain, or suffering and acknowledge the experience without self-recrimination (Germer & Neff, 2015). Consider the experience of having a regular client stop attending sessions and returning calls or abruptly discontinuing services. Although common, the ambiguous loss of a connection with a client can be a source of stress and pain (Skovholt et al., 2001). It also can provide an opportunity. Covey (2010) shared the following quote that is often misattributed to Viktor Frankl: “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom” (p. VI). The space Covey describes is our opportunity to be mindful of the stimulus and choose to offer ourselves compassion in response. Choosing to deny, suppress, or distract to avoid these feelings may cause the counselor to miss the trigger to practice self-care. When such feelings are recognized, the counselor may act compassionately toward himself or herself by normalizing or validating the experience. Within self-compassion, the concept of common humanity becomes crucial to precluding the often-automatic tendency to become self-critical for experiencing discomfort (Neff, 2003). Thoughts such as, “I shouldn’t feel this way,” “Just snap out of it; it’s not so bad,” or “What’s wrong with me?” invalidate the sufferer and may cause the counselor to feel as though self-care is an act of indulgence rather than an essential, self-directed gift of kindness. Expressing kindness through self-care acknowledges that counseling can be both difficult and rewarding, a duality representative of the human condition.

When counselors choose to practice self-care, they enhance themselves and their practice. One participant in a narrative inquiry on self-compassion in counseling stated: “What’s so important about self-compassion? Three words: Avoidance of burnout” (Patsiopoulos & Buchanan, 2011, p. 305). Another participant noted, “When we come from a self-compassionate place, self-care is no longer about these sporadic one-time events that you do when you feel burned out and exhausted. Self-care is something you can do all the time” (Patsiopoulos & Buchanan, 2011, p. 305). The consequence of our job as counselors is working compassionately with suffering, and in doing so we suffer (Figley, 2002).

For someone to develop genuine compassion toward others, first he or she must have a basis upon which to cultivate compassion, and that basis is the ability to connect to one’s own feelings and to care for one’s own welfare. . . . Caring for others requires caring for oneself. (Germer & Neff, 2015, p. 48) Self-care, then, is a vital part of a counselor’s responsibilities to clients and to one’s self.

It is important to remember that counseling can be emotionally demanding for counselors in different ways (O’Halloran & Linton, 2000). Self-compassion encourages remembering the shared human experience (Neff, 2003), as the experience of being a professional counselor can be quite isolating, especially for those working in more independent environments (e.g., school counselors, private practitioners; Freadling & Foss-Kelly, 2014; Matthes, 1992). Using mindfulness, counselors can maintain an objective stance that can allow the counselor to view one’s work circumstances with a non-judgmental lens (Newsome, Waldo, & Gruszka, 2012), then act kindly to intervene with a self-care practice that is revitalizing to mind, body, and spirit. Using self-compassion tenets as a guide, self-care plans can be created that are authentic and kind, connect us to the human experience, and reflect a balanced state of self-awareness.

Creating a Self-Compassion–Infused Self-Care Plan

In wellness counseling, optimal functioning of the mind, body, and spirit is the goal for holistic wellness (Myers, Sweeney, & Witmer, 2001). The physical dimension is the most common focus for wellness intervention (Carney, 2007); however, this is quite limiting in a profession that is often sedentary, with long hours and pressure to meet productivity demands (Franco, 2016; Freadling & Foss-Kelly, 2014; Ohrt, Prosek, Ener, & Lindo, 2015). Maintaining one’s health is important but may not be enough to assuage the emotional demands of a high-touch profession in which a strong professional relationship is combined with the often-conflicting pressures of reimbursement; short-term, diagnosis-focused treatment; and behaviorally based outcomes associated with managed care (Cushman & Gilford, 2000; Freadling & Foss-Kelly, 2014). Developing a collaborative treatment plan is a common practice in counseling; it allows the counselor and the client to determine the possible direction and outcomes for their work together (Kress & Paylo, 2015). In the best case, this plan is individualized, specific, and open to revision when necessary. A good self-care plan can follow the same formula.

What follows are specific suggestions regarding self-care practices that stretch beyond the “should,” the “ought to,” and the New Year’s resolution language. When reading the interventions, consider the question Linder, Miller, and Johnson (2000) suggested for clients when encouraging self-care: “How do you reassure yourself?” (p. 4). The suggestions are organized into mind, body, and spirit; however, these are artificial divisions and some interventions may satisfy in multiple ways.

Interventions for the Mind

Mindfulness is a component of self-compassion, but it can also be used intentionally as a regular practice for self-care. Mindfulness can be described as a dispositional trait, a state of being and a practice (Brown, Ryan, & Creswell, 2007). The use of mindfulness has been integrated into many facets of counseling practice (I. Thompson, Amatea, & Thompson, 2014). For those attracted to the practice of mindfulness for self-care, non-judgmental awareness can be integrated as a practice (e.g., a set time for engagement in a particular mindfulness exercise) or as a way of being during particular activities within the day. Exercises such as mindful eating, maintaining sensory awareness while washing dishes, or mindful walking can be helpful for those who are looking for brief, everyday opportunities for self-care. Researchers I. Thompson and colleagues (2014) found that higher levels of mindfulness corresponded with lower levels of burnout. Mindfulness has been suggested as a beneficial way to teach self-care in counselor training (Christopher, Christopher, Dunnagan, & Schure, 2006), and also as a way to reduce stress and increase self-compassion in students training to be in helping professions (Newsome et al., 2012). For any number of reasons, not all counselors may find benefit in mindfulness practices; therefore, some may choose methods of self-care that are more mentally invigorating.

Intellectual stimulation in any endeavor is important to maintain engagement, interest, and enjoyment, but such motivation can be particularly helpful when a work position contains routine, mundane, or downright boring tasks. To create a stimulating work life, seasoned professionals find active ways to continue their professional development, which can decrease the boredom that can lead to burnout (Skovholt et al., 2001). Activities for growth and development can include learning something new within counseling or outside the profession, such as learning a new language, or how to make sushi, write code, or play a strategy game such as the ancient board game, Go.

The role of a counselor involves exposure to circumstances of human suffering, painful emotions, and heartbreaking situations, which increases the risk of burnout due to absorption of the clients’ pain (Ruysschaert, 2009). Finding a way to keep and maintain positive memories, cards and notes, compliments or successes—what this author terms warm and fuzzies—either personally or professionally, in a box, folder, jar, or bulletin board, can be a helpful response. Bradley and colleagues (2013) suggested tracking small changes made by clients when discouraged and sharing the progress with co-workers.

Writing can be a powerful intervention in a counseling setting and can benefit both mental and physical health (Pennebaker & Seagal, 1999; Riordan, 1996). Counselors can use the medium of writing in a multitude of ways. Whether through journaling, narrative, poetry, musical lyrics, or letters, the act of writing can reduce emotional inhibition (Connolly Baker & Mazza, 2004). Creative writing can be used to access the healing benefits of writing without worry about form or audience (Warren, Morgan, Morris, & Morris, 2010).

Warren et al.’s (2010) The Writing Workout is a way to express, validate, and externalize painful emotions. This wellness approach illustrates how creative writing for self-care can cultivate compassion. Narrative writing strategies can allow the writer to change the outcome of a lived experience or reframe a life experience (Connelly Baker & Mazza, 2004). Creating a narrative of an event can help the storyteller organize details and events, reflect and process thoughts and feelings, and derive meaning from experiences (Pennebaker & Seagal, 1999). A creative, mindful writing intervention could be used to examine a clinical situation that may not have gone as the counselor had hoped, or to creatively explore life lessons derived from a clinical encounter. For some clinicians, writing gives voice to emotions too raw to easily speak aloud (Wright, 2003).

Traditional journaling can allow for self-reflection, increased self-awareness, and growth (Lent, 2009; Utley & Garza, 2011). Journal writing can be inherently self-compassionate. Linder et al. (2000) discussed the use of a non-judgmental journaling practice in which there are no wrong words and writers are encouraged to use random sentences and words that do not make sense. Through almost nonsensical form, journaling offers a sense of safety and freedom, while creating a trusting relationship with the journal. Linder et al. (2000) stated, “Journaling finds the meaning in meaninglessness and negates the emptiness through creating writing from the heart. It is an outlet to tell the truth without being judged” (p. 7).

Beyond the traditional journal, counselors may find alternative ways to use journaling for emotional expression, such as use of bullet journaling or a personal blog online. Bullet journaling uses a rapid-logging approach, or a visual code, to represents tasks, events, and notes in a physical notebook (Bullet Journal, 2017). Keeping a bullet journal is a clever way of managing multiple arenas of one’s life in a single place, and the events and notes categories can be particularly helpful in the practice of journaling for self-care. Events are to be written down briefly and objectively despite the degree of emotional content they carry (Bullet Journal, 2017), offering an opportunity to practice the non-reactive skill of mindfulness (Kabat-Zinn, 1994). Once an event has been entered, the counselor can respond mindfully to it by writing at length on the following page. The notes category for bullet journaling consists of ideas, thoughts, or observations (Bullet Journal, 2017), which could include inspirational quotes, eureka moments, or other insights worth reviewing at a later date. The author can use signifiers (i.e., symbols) to create a legend to provide additional context for an event, note, or task. The bullet journal approach for self-expression exemplifies a creative twist on an old concept to better fit the preferences of the writer. Similarly, scrapbook journaling can be used to accommodate the types of expressive media that resonate with the counselor’s personal style or interests (Bradley et al., 2013). Counselors can use photos, poems, song lyrics, and quotes to reflect their emotional state, and then reflect on the emotional patterns or themes that arise. For counselors who prefer to share their thoughts on the Internet, an online blog can be a cost-effective, accessible medium to express oneself emotionally and share thoughts, feelings, and experiences with others (Lent, 2009). Counselors should consider the risks associated with the use of the Internet and maintenance of confidentiality in an online medium in accordance with the ACA Code of Ethics (2014).

Finally, a simple self-care intervention can involve writing oneself a permission slip or prescription for something. This could be the permission to be imperfect, to take a mental health day, or to run through a sprinkler on a hot day. A writing assignment of this sort expresses kindness in providing the very thing that is needed for an emotional recharge. In some cases, this may involve taking a quiet moment to allow one’s mind to wander. This can occur during a warm bath or shower at the end of the day or while savoring a warm cup of coffee or tea in the afternoon. Although mind-wandering can be a threat to effectiveness and productivity when it occurs at inopportune times, taking time for mind-wandering can relieve boredom, stimulate creative thoughts, and facilitate future planning (Smallwood & Schooler, 2015).

Interventions for the Body

Many self-care plans begin and end with a strong concentration on physical self-care, typically involving making nutritional changes and increasing physical activity (Bradley et al., 2013; E. Thompson et al., 2011). These therapeutic lifestyle changes (TLCs) can have a huge impact on health and well-being (Walsh, 2011). Although the mental health benefits of these types of changes are well documented (Walsh, 2011), a myopic focus on physiological wellness may be limiting, and self-care should include a broader range of ways to cope (E. Thompson et al., 2011). For individuals wishing to focus specifically on such changes, using the imagery of caring for oneself as one does a plant may increase self-awareness of bodily self-care needs (Bradley et al., 2013). Considering one’s needs in this metaphorical way may help counselors increase their own self-compassion by considering their unique needs and the changes they are ready and willing to make. A counselor may indicate they require shade from the sun, which could represent reducing over-stimulating environments; good spacing from other plants, indicating healthy boundaries or alone time; and water and nutrients, which may remind the counselor to keep a pitcher of water on the desk and a bag of almonds in a drawer. Externalizing in this way can be particularly helpful when learning self-compassion because often counselors find it easier to care for others than themselves (Patsiopoulos & Buchanan, 2011).

Although exercise has clear mental health benefits (Callaghan, 2004), for some the concept of exercise may lack appeal or may prove difficult to prioritize within a daily work schedule. The use of stretching, walking, or yoga for a short amount of time may be more easily integrated into a hectic schedule. Yoga has been found to be equivalent to exercise in many mental and physical health domains, but not all types of yoga have been found to improve overall physical fitness as compared to more rigorous exercise (Ross & Thomas, 2010). The practice of yoga has been found to increase acceptance of self and others and reduce self-criticism (Valente & Marotta, 2005). Further, the regular practice of yoga can “provide therapists with a discipline capable of fostering a greater sense of self-awareness and helping to develop a lifestyle that is conducive to their own personal growth and the goals of their profession” (Valente & Marotta, 2005, p. 79).

The benefits of movement go beyond improvements in cardiac and musculoskeletal health, while serving to benefit the mind and the spirit. Dance has been used for centuries as a healing practice (Koch, Kunz, Lykou, & Cruz, 2014) and reduces stress, increases stress tolerance, and improves well-being (Bräuninger, 2012). Marich and Howell (2015) developed the practice of dancing mindfulness, which utilizes dance as the medium for practicing meditation. Dancing mindfulness participants report improvement in emotional and spiritual domains, greater acceptance of self, and an increased ability to use mindfulness in everyday life (Marich & Howell, 2015). However, caring for oneself requires more than just nutrition and movement; self-care plans should metaphorically consider the environment.

Skovholt et al. (2001; Skovholt, 2012) uses the concept of a greenhouse to describe the characteristics for a healthy work environment. Plants flourish within a nurturing greenhouse environment. Likewise, counselors thrive within a work environment that is characterized by a sense of autonomy and fairness; growth-promoting and meaningful work; reasonable expectations and remuneration; and trust, support, and respect among colleagues (Skovholt, 2012). The metaphorical work “greenhouse” contains individualized supports and resources that allow for growth and rejuvenation, but can protect the counselor from the harshness that could characterize their work. Examining and adjusting factors that may be under the counselor’s control, such as breaks between clients; scheduling of clients engaged in trauma work; number of assessments, intakes, or group sessions in one day; or other malleable elements can help create a work day that best meets the needs of the counselor. Strategic planning and focused intentionality allows the counselor to engage fully in each client encounter.

Interventions for the Spirit

Religion and spirituality are important factors within the lives of many clients (Cashwell, Bentley, & Bigbee, 2007). Within the United States, 77% of adults identify with some religious faith (Masci & Lipka, 2016). However, the United States is growing in those who identify as spiritual, with 59% of adults reporting a regular “deep sense of ‘spiritual peace and well-being’” (Masci & Lipka, 2016, para. 2). To attend appropriately and fully to clients’ religious and spiritual needs, counselors also need to care for their own spiritual selves.

Humanistic counselors engage fully with clients to create a genuine connection and are most effective as helpers in areas in which they themselves are stronger and more grounded (Baldwin, 2013). Therefore, when addressing the spiritual concerns of a client, counselors need to be aware of where they are on their own spiritual path. Otherwise, there is no assurance their own religious or spiritual concerns will not create an obstacle for their client’s growth (Sori, Biank, & Helmeke, 2006). A counselor’s spiritual concerns can influence the therapeutic alliance in many ways. Influences can include increased reactivity to the spiritual concerns of the client, decreased recognition of how the client values personal spirituality, or inattention to how the client’s spirituality may be a therapeutic resource or contributing factor to distress (Sori et al., 2006). Sori and colleagues (2006) concluded that failure to be aware of spirituality as an aspect of the human condition can create potential boundary issues, limit a counselor’s understanding of the client due to unexamined beliefs rooted in one’s own spiritual background, and result in difficulty managing the emotional uncertainty and pain of clients due to the counselor’s own struggles with faith. Therefore, engaging in reflection, exploration, or a regular spiritual practice can benefit both the counselor and the client.

Spirituality in counseling has been defined as “the capacity and tendency present in all human beings to find and construct meaning about life and existence and to move toward personal growth, responsibility, and relationship with others” (Myers & Williard, 2003, p. 149). This definition conceptualizes spirituality as a central component of wellness that shapes one’s functioning physically, psychologically, and emotionally, not as separate parts of the whole being (Myers & Williard, 2003). Valente and Marotta (2005) asserted that a healthy spiritual life can be emotionally nourishing and keep burnout at bay. Further, greater self-awareness of one’s spirituality may allow practitioners to be more present with their own suffering and that of their clients. Chandler, Miner Holden, and Kolander (1992) stated that attending to spiritual health when making personal change toward wellness will increase the likelihood of self-transformation and greater balance in life. Because there are many expressions of spirituality, individuals wishing to incorporate spirituality into their self-care plan should consider choosing activities that align with personal goals and are consistent with their values (Cashwell et al., 2007).

A spiritual self-care practice can create an inner refuge (Linder et al., 2000) that can offer sanctuary for a counselor when overwhelmed by personal or professional suffering (Sori et al., 2006). Particularly for those in the exploration phase of their own spirituality, but beneficial for all, conducting a moral inventory can assess how individuals are living in accordance with personal beliefs and values (Sori, et al., 2006). Following the moral inventory, a counselor may create a short list of principles to live by (i.e., a distilled list of values consistent with religious and spiritual ideas that are particularly personally valuable; V. Pope, personal communication, August, 2016). Individual research or joining a spiritual community can be helpful for education, support, and guidance in learning more about a particular religious or spiritual tradition (Cashwell et al., 2007). Some religious traditions, such as Seventh-Day Adventists, offer guidelines for physical and mental exercises, as well as nutritional advice that can be translated into intentional counselor self-care practices. Seventh-Day Adventists have a strong focus on wellness and advocate a vegetarian diet and avoidance of tobacco, alcohol, and mind-altering substances (General Conference of Seventh-Day Adventist World Church, 2016). Further, self-reflection may be regularly incorporated into rituals associated with an important time of year such as Lent or the Days of Awe.

For many, prayer can be a powerful practice for connecting with a higher power. Prayer is an integral part of a variety of spiritual traditions and has been associated with a variety of improvements in health and well-being (Granello, 2013). Spending time in communion with a higher power can be integrated into a regular routine for the purpose of self-care. Meditation also can be a spiritual practice and has a long history of applications and associations with health improvement (Granello, 2013). Broadly speaking, there are two types of meditation: concentration, which involves focusing attention (e.g., repeating a mantra, counting, or attending to one’s breath), and mindfulness, which non-judgmentally expands attention to thoughts, sensations, or emotions present at the time (Ivanovski & Malhi, 2007). These quiet practices can allow the participant moments of silence to achieve various ends, such as relaxation, acceptance, or centering.

Connecting with the earth or nature also can be a practice of spiritual self-care. Grounding exercises such as massage, Tai Chi, or gardening can be helpful to encourage a reconnection with the body and the earth (Chandler, et al., 1992). Furthermore, spending time in nature has been found to be rejuvenating both mentally and spiritually (Reese & Myers, 2012).

Engaging in a creative, expressive art activity for the purposes of spiritual practice and healing can be incredibly powerful to heal mind, body, and soul (Lane, 2005). Novelist John Updike has said, “What art offers is space—a certain breathing room for the spirit” (Demakis, 2012, p. 23). Art can come in many forms. Expressive arts can be a powerful tool of self-expression (Snyder, 1997; Wikström, 2005) and provide many options that can easily be used as self-care interventions. Sometimes the inner critic, need for approval, fear of failure, or a fear of the unknown can create barriers to exploring one’s creative energy (N. Rogers, 1993). Maintaining a self-compassionate attitude can allow counselors to create a safe environment to practice self-care free of judgment.

Use of dance, music, art, photography, and other media can be used intentionally for holistic healing. Through the use of clay, paint, charcoal, or other media, the creator can become in touch with feelings, gain insight, release energy, and discover alternative spiritual dimensions of the self, as well as experience another level of consciousness (N. Rogers, 1993). Music has been found to be both therapeutic and transcendental (Knight & Rickard, 2001; Lipe, 2002; Yob, 2010). There are various ways to incorporate music into a self-care plan depending on interest, access, and preference. In many cultures, music and spirituality are integrally linked (Frame & Williams, 1996). Listening to a favorite hymn, gospel music, or other type of liturgical music can be one way to revitalize the spirit during the workday. Relaxing music has been found to prevent physiological responses to stress and subjective experience of anxiety in one study of undergraduates (Knight & Rickard, 2001). Singing is another way of expressing thoughts and feelings, and for some it can provide a vehicle for self-actualization, connection to a higher power, and self-expression (Chong, 2010). After a long day, singing in the office, in the car, or while cooking dinner can be particularly cathartic.

Conclusion

Counselors are routinely exposed to painful situations, traumatic circumstances, and overwhelming emotions. Consequently, they could benefit from creating a safe place for vulnerability, especially when emotionally overwrought after a long day or a particularly difficult counseling session. To thrive as a counselor, self-care is essential, yet many struggle to care for themselves as they care for their clients. To best achieve holistic wellness, counselors must incorporate interventions for the body, mind, and spirit. Counselors can apply self-compassion principles to the creation of an individualized self-care plan, one that functions to rejuvenate flagging professional commitment and soothe potentially debilitating stress. By cultivating an attitude of self-compassion, counselors may be more attentive to their own needs, reducing the risk of developing burnout and benefitting both clients and themselves. These counselors also may be more effective in assisting clients with overcoming their own barriers to self-care. Similarly, counselors who serve as educators or supervisors can model such principles and routinely ask students and supervisees, “What do you need now?” to increase awareness and the practice of tuning in. Consequently, the self-compassionate counselor learns to create a self-care plan that becomes a balm for burnout.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest or funding contributions for the development of this manuscript.

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Burnout, Stress and Direct Student Services Among School Counselors

Oct 15, 2016 | Article, Volume 6 - Issue 4

Patrick R. Mullen, Daniel Gutierrez

The burnout and stress experienced by school counselors is likely to have a negative influence on the services they provide to students, but there is little research exploring the relationship among these variables. Therefore, we report findings from our study that examined the relationship between practicing school counselors’ (N = 926) reported levels of burnout, perceived stress and their facilitation of direct student services. The findings indicated that school counselor participants’ burnout had a negative contribution to the direct student services they facilitated. In addition, school counselors’ perceived stress demonstrated a statistically significant correlation with burnout but did not contribute to their facilitation of direct student services. We believe these findings bring attention to school counselors’ need to assess and manage their stress and burnout that if left unchecked may lead to fewer services for students. We recommend that future research further explore the relationship between stress, burnout and programmatic service delivery to support and expand upon the findings in this investigation.

Keywords: burnout, stress, school counselors, student services, service delivery

The American School Counselor Association (ASCA; 2012) recommends that school counselors enhance the personal, social, academic and career development of all students through the organization and facilitation of comprehensive programmatic counseling services. Delivery of student services is part of a larger framework articulated by ASCA’s National Model (2012) that also includes management, accountability and foundation components of school counseling programs. However, ASCA notes that school counselors should “spend 80 percent or more of their time in direct and indirect services to students” (ASCA, 2012, p. xii). ASCA defines indirect student services as services that are in support of students and involve interactions (e.g., referrals, consultations, collaborations and leadership) with stakeholders other than the student (e.g., parents, teachers and community members). On the other hand, direct student services are interactions that occur face-to-face and involve the facilitation of curriculum (e.g., classroom guidance lessons), individual student planning and responsive services (e.g., individual, group and crisis counseling). In either case, ASCA charges school counselors with prioritizing the delivery of student services.

As a part of their work, school counselors often incur high levels of stress that may result from multiple job responsibilities, role ambiguity, high caseloads, limited resources for coping and limited clinical supervision (DeMato & Curcio, 2004; Lambie, 2007; McCarthy, Kerne, Calfa, Lambert, & Guzmán, 2010). In addition, burnout can result from the ongoing experience of stress (Cordes & Dougherty, 1993; Maslach, 2003; Schaufeli & Enzmann, 1998) and can result in diminished or lower quality rendered services (Lawson & Venart, 2005; Maslach, 2003). While research on burnout is common in the school counseling literature (Butler & Constantine, 2005; Lambie, 2007; Wachter, Clemens, & Lewis, 2008; Wilkerson & Bellini, 2006), studies have not focused on the relationship between burnout and school counselors’ service delivery. Yet, burnout has the potential to produce negative consequences for the work rendered by school counselors and could result in fewer services for students (Lambie, 2007; Lawson & Venart, 2005; Maslach, 2003). Therefore, the purpose of this research was to examine the contribution of school counselors’ levels of burnout and stress to their delivery of direct student services.

School Counselors and the Delivery of Student Services

Research on school counselors’ delivery of student services has produced positive findings. In a meta-analysis that included 117 experimental studies, Whiston, Tai, Rahardja, and Eder (2011) identified that, in general, school counseling services have a positive influence on students’ problem-solving and school behavior. Furthermore, in schools where school counselors completed higher levels of student services focused on improving academic success, personal and social development, and career and college readiness, students experienced a variety of positive outcomes, such as increased sense of belongingness, increased attendance, fewer hassles with other students, and less bullying (Dimmitt & Wilkerson, 2012). Moreover, researchers have shown that the higher occurrence of school counselor-facilitated services is beneficial for students’ educational experience and academic outcomes (Carey & Dimmitt, 2012; Lapan, Gysbers, & Petroski, 2001; Wilkerson, Pérusse, & Hughes, 2013). Overall, the services conducted by school counselors have a positive impact on student success. As such, research investigating the factors related to higher incidence of school counselors’ direct student services could provide significant educational benefits to schools.

Researchers have examined a variety of topics that relate to increased student services. Clemens, Milsom, and Cashwell (2009) found that if school counselors had a good relationship with their principal and were engaged in higher levels of advocacy, they were likely to have increased implementation of programmatic counseling services. Another study concluded that school counselors’ values were not associated with the occurrence of service delivery, but researchers did find counselors with higher levels of leadership practices also delivered more school counseling services (Shillingford & Lambie, 2010). Other factors related to increased levels of school counselors’ service delivery are increased job satisfaction (Baggerly & Osborn, 2006; Pyne, 2011) and higher self-efficacy (Ernst, 2012; Mullen & Lambie, 2016). These studies provided notable contributions to the literature; however, at this time no known studies have examined the relationship among school counselors’ burnout, perceived stress and direct student services.

Stress and Burnout Among School Counselors

Stress is a significant issue that relates to the impairment of work performance (Salas, Driskell, & Hughes, 1996) and is a likely problem for school counselors. The construct of stress has a rich history in scientific literature dating back to the 1930s (Cannon, 1935; Selye, 1936). Selye (1980) articulated one of the first broad definitions of stress by defining it as the “nonspecific results of any demand upon the body” (p. vii). Over time, various authors developed an assortment of definitions (Ivancevich & Matteson, 1980; Janis & Mann, 1977; McGrath, 1976), but Lazarus and Folkman’s (1984) definition of stress is common among scholars (Driskell & Salas, 1996; Lazarus, 2006). In their Transactional Model of Stress and Coping, Lazarus and Folkman (1984) defined stress as a “particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her wellbeing” (p. 19). Lazarus and Folkman conceptualized that stress results from an imbalance between one’s perception of demands or threats and their ability to cope with the perceived demands or threats. Consequently, one’s appraisal of demands and their assessment of their coping ability becomes a critical issue in relationship to whether or not the demand will trigger a stress response.

McCarthy et al. (2010) applied Lazarus and Folkman’s model of stress (1984) to school counselors using an instrument that measures the demands and resources experienced by school counselors called the Classroom Appraisal of Resources and Demands–School Counselor Version (McCarthy & Lambert, 2008). McCarthy et al. (2010) found that school counselors who reported challenging demands as a part of their job also had higher levels of stress. This finding is troubling considering that school counselors oftentimes encounter ambiguous job duties, inconsistent job roles and conflicts in their job expectations (Burnham & Jackson, 2000; Culbreth, Scarborough, Banks-Johnson, & Solomon, 2005; Lambie, 2007; Scarborough & Culbreth, 2008). An additional concern is that stress occurring over an extended period of time can lead to emotional and physical health problems (Sapolsky, 2004) along with increased likelihood of leaving the profession (DeMato & Curcio, 2004). Fortunately, prior research reveals that school counselors have reported low stress levels (McCarthy et al., 2010; Rayle, 2006). Still, research on school counselors’ stress and its effects on the services they provide is important.

An additional factor that we believe may have an impact on direct student services is burnout. Burnout was first recognized in the 1970s (Freudenberger, 1974; Maslach, 1976) and is considered to have significant consequences for counseling professionals (Butler & Constantine, 2005; Lambie, 2007; Lawson, 2007; Lee et al., 2007). The topic of burnout is common in the literature across many disciplines (Schaufeli, Leiter, & Maslach, 2009) and has been given particular attention in school counseling research (Butler & Constantine, 2005; Lambie, 2007; Wachter et al., 2008; Wilkerson & Bellini, 2006). Freudenberger (1974, 1986) suggested that burnout results from depleted energy and the feelings of being overwhelmed that emerge from the exposure to diverse issues related to helping others, which over time affects one’s attitude, perception and judgment. Pines and Maslach (1978) described burnout as an ailment “of physical and emotional exhaustion, involving the development of negative self-concept, negative job attitude, and loss of concern and feelings for clients” (p. 234). In 1981, the Maslach Burnout Inventory (MBI) was developed as a method to measure one’s experience of burnout in the helping and human service field (Maslach & Jackson, 1981).

More recently, Lee et al. (2007) expanded the measurement of burnout and presented the construct of counselor burnout, which they defined as “the failure to perform clinical tasks appropriately because of personal discouragement, apathy to symptom stress, and emotional/physical harm” (p. 143). Within their model, Lee and associates found that counselor burnout includes the constructs of exhaustion, negative work environment, devaluing clients, incompetence and deterioration in personal life. These constructs correlate with the factors measured by the MBI (Maslach & Jackson, 1981), but provide a definition consistent with the work of school counselors (Gnilka, Karpinski, & Smith, 2015).

Many researchers have explored factors related to school counselor burnout. Overall, scholars have found that school counselors report low levels of burnout (Butler & Constantine, 2005; Gnilka et al., 2015; Lambie, 2007; Wachter et al., 2008; Wilkerson & Bellini, 2006). Nonetheless, researchers also reported that higher collective self-esteem is associated with a higher sense of personal accomplishment and lower emotional exhaustion (Butler & Constantine, 2005), whereas higher levels of ego development are associated with higher personal accomplishment (Lambie, 2007). Moreover, Wilkerson and Bellini (2006) discovered that school counselors who handle stressors with emotion-focused coping are at a higher risk of experiencing burnout symptoms, and Wilkerson (2009) established that school counselors’ emotion-focused coping increases their likelihood of experiencing symptoms of burnout. Yet, there is no research on the connection between school counselors’ burnout and the direct student services they provide despite a high likelihood that burnout is the cause of fewer and deteriorated services for students (Maslach, 2003).

The purpose of this study was to build upon existing literature regarding school counselors’ stress, burnout and their facilitation of direct student services. The guiding research questions were: (a) Do practicing school counselors’ levels of burnout and perceived stress contribute to their levels of service delivery? and (b) Do practicing school counselors’ levels of stress correlate with their burnout? Consequently, the following research hypotheses were examined: (a) School counselors’ degree of burnout and perceived stress contributes to their facilitation of direct student services, and (b) School counselors’ degree of perceived stress correlates positively with their level of burnout.

Method

Procedures

To answer the research questions associated with this study, we employed a cross-sectional research design (Gall, Gall, & Borg, 2007). Furthermore, this study utilized online survey data collection procedures. Prior to any data collection, we received approval from the Institutional Review Board at the first author’s university. During the first step in the data collection process, we retrieved the name and e-mail address of every school counselor listed in the ASCA online directory of membership. Next, we generated a simple random sample of school counselors. Then, we sent the sample selected from the ASCA online directory a series of three e-mails that aligned with tailored design method (Dillman, Smyth, & Christian, 2009) recommendations for survey research. Each e-mail contained a brief description of the survey and a link to the online survey managed by Qualtrics (2013). If a participant wished to take the survey, he or she was directed to the Web site that posted the explanation of the study. If they agreed to participate, they would move forward and complete the survey. Participants were screened as to whether they were practicing school counselors or not (e.g., student, counselor educator or retired). Of the 6,500 participants sampled, 41 indicated they were not a practicing school counselor. In addition, 312 e-mails were not working at the time of the survey. Out of the 6,147 practicing school counselors surveyed, 1,304 (21.21% visit response rate) visited the survey Web site and 926 completed the survey in its entirety, which resulted in a 15.06% useable response rate. The response rate received for this study is high in comparison to studies using similar methods (e.g., 14%, Harris, 2013; 11.4%, Mullen, Lambie & Conley, 2014).

Participant Characteristics

Participants (N = 926) were practicing school counselors in private, public and charter K–12 educational settings from across the United States. The mean age was 43.27 (SD = 10.03) and included 816 (88.1%) female and 110 (11.9%) male respondents. The participants’ ethnicity included 50 (5.4%) African Americans, 5 (.5%) Asian Americans, 29 (3.1%) Hispanic Americans, 11 (1.2%) Multiracial, 2 (.2%) Native Americans, 4 (.4%) Pacific Islanders, 811 (87.6%) European Americans, and 13 (1.5%) participants who identified their ethnicity as “Other.” On average, participants had 10.97 (SD = 6.92) years of experience and 401.45 (SD = 262.05) students on their caseload. The geographical location of the participants’ work setting favored suburban (n = 434, 46.9%) and rural communities (n = 321, 34.7%) with fewer school counselors working in urban settings (n = 171, 18.5%). Most participants reported that they worked in the high school grade levels (n = 317, 34.2%) closely followed by elementary (n = 270, 29.2%) and middle school or junior high school (n = 203, 21.9%) grade levels, with 136 (14.7%) respondents working in another grade level format (e.g., grades K–12, K–8, or 6–12).

Measures

This study used the (a) Counselor Burnout Inventory (CBI; Lee et al., 2007), (b) the School Counselor Activity Rating Scale (SCARS; Scarborough, 2005), and (c) the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983). Participants also completed a researcher-created demographics form regarding their personal characteristics (e.g., age, gender and ethnicity) and work-related characteristics (e.g., location type, grade level, caseload, experience as a school counselor and percentage of time they directly work with students).

CBI. The CBI (Lee et al., 2007) is a 20-item self-report measure that examines counselor burnout across five domains. The domains that make up the CBI include: (a) exhaustion, (b) incompetence, (c) negative work environment, (d) devaluing client, and (e) deterioration in personal life. The CBI makes use of a 5-point Likert rating scale that ranges from 1 (never true) to 5 (always true) and examines emotional states and behaviors representative of burnout. Some sample items include “I feel exhausted due to my work as a counselor” (exhaustion), “I feel I am an incompetent counselor” (incompetence), “I feel negative energy from my supervisor” (negative work environment), “I have little empathy for my clients” (devaluing client), and “I feel I have poor boundaries between work and my personal life” (deterioration in personal life). Lee et al. (2007) demonstrated the construct validity of the CBI through an exploratory factor analysis that identified a five-factor solution in addition to a confirmatory factor analysis that supported the five-factor model with an adequate fit to the data.

Gnilka et al. (2015) found support for the five-factor structure of the CBI (Lee et al., 2007) with school counseling using confirmatory factor analysis, which supports the CBI as an appropriate measure for school counselor burnout. Lee et al. (2007) established convergent validity for the CBI based upon the correlations between the subscales on the Maslach Burnout Inventory-Human Services Survey (Maslach & Jackson, 198l) and the CBI. In prior research, the Cronbach’s alphas of the CBI subscales indicated good internal consistency (Streiner, 2003) with score ranges of .80 to .86 for exhaustion, .73 to .81 for incompetence, .83 to .85 for negative work environment, .61 to .83 for devaluing client, and .67 to .84 for deterioration in personal life (Lee et al., 2007; Lee, Cho, Kissinger, & Ogle, 2010; Puig et al., 2012). The internal consistency coefficients of the CBI in this investigation also were good (Streiner, 2003) with Cronbach’s alphas of .87 for exhaustion, .79 for incompetence, .84 for negative work environment, .79 for devaluing client, and .81 for deterioration in personal life.

SCARS. The SCARS (Scarborough, 2005) is a 48-item verbal frequency measure that examines the occurrence that school counselors actually perform and prefer to perform components of the ASCA National Model (2012). The SCARS measures school counselors’ ratings of activities based on the four levels of interventions articulated by ASCA (1999) and the ASCA National Model (2003). Unfortunately, a more recent version of the SCARS that articulates the new ASCA National Model (2012) does not exist. Nevertheless, this study utilized two SCARS scales (counseling and curriculum) that measure the incidence of direct student services. To the benefit of this investigation, the direct services measured on the SCARS have not changed in the new edition of the ASCA National Model (2003, 2012). Similar to Shillingford and Lambie (2010) and Mullen and Lambie (2016), this investigation utilized the actual scale, but not the prefer scale, on the SCARS (Scarborough, 2005) because this study sought to examine the frequency that school counselors delivered direct student services, not their preferences and not the difference between their preference and actuality. The subscales that measure direct student services used in this study included the counseling (e.g., group and individual counseling interventions; 10 items) and curriculum (e.g., classroom guidance interventions; 8 items) subscales, whereas the coordination, consultation and other activities scales were not used because they measure indirect activities.

The SCARS (Scarborough, 2005) assesses the frequency of school counselor service delivery with a 5-point Likert rating scale that ranges from 1 (I never do this) to 5 (I routinely do this). Scores on the SCARS can be total scores or mean scores. Some sample items from the counseling subscale are “Counsel with students regarding school behavior” and “Provide small group counseling for academic issues.” Some sample items from the curriculum subscale are “Conduct classroom lessons addressing career development and the world of work” and “Conduct classroom lessons on conflict resolution.” Scarborough (2005) examined the validity by investigating the variances in score on the actual scale based on participant grade level and found that participants’ grade level had a statistically significant effect across the scales with small to large effect sizes (e.g., ranging from .11 to .68[ω²]), which supported the convergent validity of the SCARS. Additionally, construct validity was supported using factor analysis. In prior research using the SCARS, the internal consistency of the counseling and curriculum scales was strong with Cronbach’s alphas of .93 for the curriculum actual scale and .85 for the counseling actual scale (Scarborough, 2005). The internal consistency coefficients of the SCARS actual subscales in this investigation were good (Streiner, 2003) with Cronbach’s alphas of .77 for the counseling scale and .93 for the curriculum scale.

PSS. The PSS (Cohen et al., 1983) is a 10-item self-report measure that examines the participants’ appraisal of stress by asking about feelings and thoughts during the past month. The PSS uses a 5-point Likert scale that ranges from 0 (never) to 4 (very often) and includes four positively stated items that are reverse coded. Some sample items include, “In the last month, how often have you felt that you were on top of things?” (reverse coded), and “In the last month, how often have you been upset because of something that happened unexpectedly?” The PSS has been shown to have acceptable internal consistency with Cronbach’s alphas ranging from .84 to .91 (Chao, 2011; Cohen et al., 1983; Daire, Dominguez, Carlson, & Case-Pease, 2014). The internal consistency coefficient of the PSS in this study also was acceptable (Streiner, 2003) with a Cronbach’s alpha of .88.

Results

Preliminary Analysis

Initial screening of the data included the search for outliers (e.g., data points three or more standard deviations from the mean) using converted z-scores (Osborne, 2012), which resulted in identifying 21 cases that had at least one variable with an extreme outlier. To accommodate for these outliers, the researchers utilized a Windorized mean based on adjacent data points (Barnett & Lewis, 1994; Osborne & Overbay, 2004). Next, the assumptions associated with structural equation modeling (SEM) were tested (e.g., normality and multicollinearity; Hair, Black, Babin, Anderson, & Tatham, 2006; Tabachnick & Fidell, 2007). Multicollinearity was not present with these data; however, the data violated the assumption of normality of a single composite variable (e.g., devaluing clients scale on the CBI). Researchers conducted descriptive analyses of the data using the statistical software SPSS. Table 1 presents the means, standard deviations and correlations for the study variables.

Model Testing

This correlational investigation utilized a two-step SEM method (Kline, 2011) to examine the research hypothesis employing AMOS (version 20) software. The first step included a confirmatory factor analysis (CFA) to inspect the measurement model of burnout and its fit with the data. Then, a structural model was developed based on the measurement model. The measurement model and structural model were appraised using model fit indices, standardized residual covariances, standardized factorial loadings and standardized regression estimates (Byrne, 2010; Kline, 2011). Modifications to the models were made as needed (Kline, 2011). Both the measurement and the structural models employed the use of maximum likelihood estimation technique despite the presence of non-normality based on recommendations from the literature (Curran, West, & Finch, 1996; Hu, Bentler, & Kano, 1992; Lei & Lomax 2005; Olsson, Foss, Troye, & Howell, 2000).

Table 1 Correlations among measures of direct student services, perceived stress, and burnout
	M	SD	1	2	3	4	5	6	7	8	9
Counseling	3.02	.60	–
Curriculum	2.77	1.16	.44	–
Percent of Time	59	78	.36	.27	–
Perceived Stress	1.56	.63	-.15	-.11	-.14	–
Exhaustion	3.04	.86	-.15	-.11	-.11	.61	–
Incompetence	2.29	.68	-.31	-.14	-.18	.49	.44	–
NEW	2.56	.87	-.23	-.19	-.22	.46	.53	.39	–
DC	1.39	.50	-.20	-.17	-.14	.32	.28	.45	.64	–
DPL	2.39	.80	-.19	-.12	-.16	.58	.66	.41	.47	.30	–
Note. N = 926. All correlations (r) were statistically significant (p < .001). Counseling = frequency of direct counseling services, curriculum = frequency of direct curriculum services, percent of time = percent of time in direct services to students, NEW = negative work environment, DC = devaluing client, DPL = deterioration in personal life.

Multiple fit indices were examined to determine the goodness of fit for the measurement model and structural model (Hu & Bentler, 1999; Kline, 2011; Weston & Gore, 2006). The fit indices that were used include: (a) chi-square, (b) comparative fit index (CFI), (c) goodness of fit (GFI), (d) standardized root mean square residual (SRMSR), and (e) root mean square error of approximation (RMSEA). Furthermore, we consulted the normed fit index (NFI) and Tucker-Lewis index (TLI) because they are more robust to non-normal data as compared to other indices (Lei & Lomax, 2005). For a detailed description of these fit indices, readers can review the works of Hu and Bentler (1999), Kline (2011), and Weston and Gore (2006). We used these fit indices to establish a diverse view of model fit.

Measurement model. First, we employed a CFA model to examine the latent variable representing burnout (Lee et al., 2007). The research team totaled each subscale on the CBIs to develop a composite score for each domain. The initial measurement model for burnout produced acceptable standardized factor loadings ranging from .41 (devaluing client) to .57 (incompetence), .62 (negative work environment), .77 (deterioration in personal life), and .82 (exhaustion). Furthermore, all fit indices for the measurement model indicated an adequate fitting model except chi-square, RMSEA, and TLI: χ2 (df = 5, N = 926) = 107.07, p < .001; GFI = .96; CFI = .92; RMSEA = .15; SRMR = .06; NFI = .92; TLI = .85. Therefore, we consulted the modification indices and standardized residual covariance matrix and tested a new CFA based upon these consultations.

The modifications indices indicated the need to correlate the error terms for incompetence and devaluing client. The resulting model produced a model in which all fit indices indicated an adequate fitting model: χ² (df = 4, N = 926) = 12.03, p = .02; GFI = .99; CFI = .99; RMSEA = .05; SRMR = .02; NFI = .99; TLI = .99. Further inspection of the standardized factor loadings for the model indicated they were all acceptable except for the factor loading for devaluing client, which dropped to .36 (below .40; Stevens, 1992). While these modifications improved the overall fit of the CFA, the correlation of incompetence and devaluing client has no theoretical justification (Byrne, 2010). In addition, the correlation of the error terms for incompetence and devaluing client produced a standardized factor loading below the noted standard of .40 (Kline, 2011; Stevens, 1992). Subsequently, we removed the subscale of devaluating client given: (a) the low factor loading produced after modification of the initial model, and (b) the lack of normality in the composite score.

Next, we examined the new modified measurement model that included the removal of the subscale devaluing client. The resulting model (see Figure 1) produced a model in which all fit indices indicated a good fitting model: χ² (df = 2, N = 926) = 8.25, p = .02; GFI = .99; CFI = .99; RMSEA = .06; SRMR = .02; NFI = .99; TLI = .98. The modified measurement model for burnout produced acceptable standardized factor loadings ranging from .53 (incompetence) to .63 (negative work environment), .77 (deterioration in personal life), and .85 (exhaustion). In review of the model fit indices and standardized factor loadings, we deemed the measurement model acceptable for use in the structural model.

Structural model. We developed the structural model (see Figure 1) based on a review of the literature, and it was theorized in this model that school counselors’ perceived stress correlates to school counselors’ burnout and contributes to the frequency with which they provide direct student services. In addition, this model tested the hypothesized model that school counselors’ burnout contributes to their frequency of direct student services. The structural model includes the measurement model previously tested that consisted of the latent variable of burnout. School counselors’ perceived stress and burnout were defined as exogenous or independent variables. Perceived stress was a manifest variable consisting of participants’ composite scores on the PSS (Cohen et al., 1983).

Additionally, we defined the manifest variables of percentage of time at work providing direct services to students, direct curriculum activities, and direct counseling activities as the endogenous or dependent variables that measure participants’ facilitation of direct student services. The variable of percentage of time at work providing direct services to students was a single demographic item reported by participants, while direct curriculum activities and direct counseling activities were the participants’ composite scores derived from subscales on the SCARS (Scarborough, 2005). In addition, the error terms of the direct student services variables—percentage of time at work providing direct services to students, direct curriculum activities and direct counseling activities—were correlated given that they measure similar constructs.

An examination of the structural model indicated a strong goodness of fit for all fit indices except for chi-square: χ² (df = 14, N = 926) = 108.37, p < .001; GFI = .97; CFI = .96; RMSEA = .07; SRMR = .04; NFI = .95; TLI = .91. The researchers deemed the structural model as suitable with these data despite the significant chi-square (Henson, 2006; Kline, 2011; Weston & Gore, 2006). A closer examination of the standardized regression weights identified that school counselors’ burnout scores contributed to 12% (β = -.35, p < .001) of the variance in their direct counseling activities and 5% (β = -.22, p < .001) of the variance in their direct curriculum activities. Furthermore, school counselors’ burnout scores contributed to 6% (β = -.24, p < .001) of the variance in percentage of time at work providing direct services to students. Perceived stress did not contribute to direct counseling activities (β = .11, p = .04), direct curriculum activities (β = .06, p = .31), and percentage of time at work providing direct services to students (β = .04, p = .51). In addition, perceived stress and burnout produced a statistically significant correlation (β = .75, p < .001; 56% of the variance explained).

The structural model (Figure 1) indicates that school counselors’ level of counselor burnout had a negative contribution to the frequency of their direct counseling activities, direct curriculum activities and percentage of time at work providing direct services to students. However, it should be noted that the effect sizes of these findings were small to medium (Sink & Stroh, 2006). An additional finding from this investigation was that the perceived stress correlated with burnout with a large effect size (Sink & Stroh, 2006); however, perceived stress did not have a statistically significant contribution to school counselors’ direct counseling activities, direct curriculum activities, and percentage of time at work providing direct services to students.

Figure 1. Final hypothesized structural model depicting the relationship between school counselors’ (N = 926) perceived stress, burnout, and direct student services.

Discussion

This study examined the relationship between school counselors’ reported burnout, perceived stress and frequency of direct student services. The findings indicated burnout was a statistically significant contributor to the frequency of direct counseling services (β = -.35; medium effect size) and direct curriculum services (β = -.22; small to medium effect size). Furthermore, the findings identified that burnout was a significant contributor to the participants’ report of the percentage of time they spend on their job working directly with students (β = -.24; small to medium effect size). Although the results should be interpreted with some level of caution, we found that burnout also had a statistically significant relationship to frequency of direct student services with increased levels of burnout relating to lower levels of direct student services. Nonetheless, these findings are not surprising considering the literature on burnout emphasizes the important role burnout plays on the effort one places on their job, with individuals presenting with higher burnout typically having lower investment interest in their job (Garman, Corrigan, & Morris, 2002; Landrum, Knight, & Flynn, 2012; Maslach, 2003). While the findings support the literature on the role of burnout, they also bring attention to the possibility that burnout does not have a strong relationship to school counselors’ facilitation of direct counseling services as noted by the small effect size.

An interesting finding was that school counselors’ degree of perceived stress did not contribute to the direct student services variables and yet did correlate with burnout. In fact, the relationship between perceived stress and counselor burnout had a large effect size, with 56% of the variance among these variables explained by their relationship. This finding accentuates the difference between the constructs of burnout and stress because burnout had a statistically significant relationship with the direct student services variables and stress did not, despite the strength of the relationship between burnout and stress. One interpretation of this finding is that school counselors’ ability to manage and cope with stress permits them to complete their job functions, whereas burnout may be more challenging to overcome. Furthermore, scholars state that prolonged exposure to stress worsens or cultivates burnout (Cordes & Dougherty, 1993; Schaufeli & Enzmann, 1998). This finding is logical given the theory behind burnout (Lee et al., 2007; Maslach, 2003); yet, this is one of only a few studies (McCarthy et al., 2010; Wilkerson & Bellini, 2006) in the school counseling literature to examine this relationship. However, these results need further exploration. As McCarthy et al. (2010) noted, the construct of stress is multidimensional (includes appraisal of resources and demands) and the PSS (Cohen et al., 1983) is a single-dimension scale. Therefore, a scale that examines stress in a multifaceted manner may produce different results.

An additional finding worth discussion involves the measurement model of the CBI (Lee et al., 2007). Specifically, this study found that the construct of devaluing client did not fit with the data. Furthermore, participants reported low scores regarding the devaluing client scale, as indicated by the descriptive statistics. The devaluing client subscale also was the only subscale on the CBI that was not normally distributed. These results were similar to Gnilka et al.’s (2015) findings that indicated school counselors are likely to maintain high levels of empathy and positive regard for their students. These findings may indicate that the devaluing clients subscale may not reflect symptoms of burnout for school counselors. This is a promising finding as it suggests that school counselors do not develop a negative perspective of students because of the negative consequences of their job.

The descriptive statistics from this investigation also provide some noteworthy information. First, participants reported moderate to low levels of burnout across the five factors of the CBI (Lee et al., 2007), with exhaustion having the highest mean score. These results are consistent with prior research (Butler & Constantine, 2005; Lambie, 2007; Wachter et al., 2008; Wilkerson & Bellini, 2006) on burnout and indicate that, overall, school counselors report low levels of burnout. An additional finding was that school counselors reported a low level of perceived stress, which is surprising given the challenge of role ambiguity, confusion and conflict (Burnham & Jackson, 2000; Culbreth et al., 2005; Lambie, 2007; Scarborough & Culbreth, 2008). However, school counselors have reported low levels of stress in other research (e.g., McCarthy et al., 2010; Rayle, 2006). The last noteworthy finding from the descriptive statistics was the measures of direct student services. This investigation was one of the first to focus specifically on the topic of direct student services versus other aspects of school counselors’ roles. This study found that school counselors reported that, on average, they spend over half their time working directly with students. In addition, they reported high frequencies for facilitating both curriculum and counseling activities. These findings are promising and consistent with other research examining these constructs (Mullen & Lambie, 2016; Scarborough & Culbreth, 2005; Shillingford & Lambie, 2010). Overall, the results from this study provide new and novel information for the school counseling discipline.

Limitations and Implications for Future Research

Readers should interpret these findings within the context of their limitations. Some limitations from this study include: (a) associational research using correlation statistics does not establish cause and effect relationships; (b) the response rate, although high as compared to other studies with similar methods, is low; and (c) the generalizability of these findings is limited by the sampling procedures (e.g., only sampled ASCA members; Gall et al., 2007). In addition, participants who respond to surveys may have different characteristics as compared to those school counselors who chose not to participate (Gall et al., 2007).

The findings from this study have implications for future research. A prominent direction for future research is the examination of the relationship between stress and programmatic service delivery, including direct student services. This study identified that perceived stress has no relationship with direct service delivery, but a multidimensional measure of stress (McCarthy & Lambert, 2008) may produce different results. Similarly, this study found that perceived stress relates to higher levels of burnout and supports the theory that chronic stress relates to increased burnout. Future research might further confirm these findings.

Another relevant future research implication is exploring factors that prevent or mediate the contribution of burnout to school counselor service delivery, considering this investigation found a significant relationship between these constructs. A variety of mechanisms may serve as buffers between burnout and programmatic service delivery, such as coping skills, career-sustaining behaviors, emotional intelligence, grit, or self-efficacy. Nonetheless, the identification of preventative skills or personal traits that inhibit the effects of burnout may lead to interventions to support school counselors’ work. Future research also can examine training interventions that target school counselors’ susceptibility to burnout or stress. A final research implication is the need to replicate and confirm our findings. Researchers might consider replicating this study with similar or different measures and data collection methods.

Implications for School Counseling Practitioners and Supervisors

The degree of perceived stress for participants in this study had a positive correlation with their degree of burnout. Furthermore, participants’ burnout negatively contributed to their level of direct student services. While this study included several limitations, these findings provide more evidence for the positive relationship between stress and burnout, in addition to the negative contribution burnout can have on the job functions of school counselors. In an effort to support direct student services, it would behoove school counselors to take steps to increase their awareness about their well-being, including symptoms of burnout, and seek support to address concerns as they arise. Additionally, school counselors’ failure to address burnout is an ethical concern (American Counseling Association, 2014). School counselors could utilize a self-assessment (i.e., Counselor Burnout Inventory [Lee et al., 2007] or Professional Quality of Life Scale [Stamm, 2010]) to examine their level of burnout and subsequently address their work functions and lifestyle to alleviate symptoms.

As Moyer (2011) pointed out, supervision plays a vital role in school counselor development and can be a way to alleviate burnout. Thus, supervisors can provide opportunities for school counselors to learn ways to assess their well-being with the aim of developing career-sustaining behaviors to prevent burnout. For example, supervisors can inform school counselors of available screening measures and provide resources to aid in the development of career-sustaining behaviors. Similarly, supervisors can create activities (Lambie, 2006) that assess school counselors’ well-being, which allows counselors to address negative feelings. Efforts made to prevent burnout may increase the chances of school counselors performing direct student services. Higher rates of direct student services, such as individual and group counseling, also may lead to better educational outcomes for students (Lapan, 2012).

In an effort to reduce school counselors’ burnout and potentially increase their delivery of direct student services, practitioners and supervisors can initiate wellness-related activities. Butler and Constantine (2005) noted that peer supervision or consultation along with social support from colleagues and administrators might be helpful for reducing the effects of burnout. Furthermore, Lawson and Myers (2011) reported on the highest rated career-sustaining behavior, which provides potential to support the wellness of school counseling practitioners. As Meyer and Ponton (2006) noted, counselors as a whole tend to put their own wellness to the side in order to provide services to their clients. Therefore, another consideration for school districts and school counseling organizations is to offer wellness-focused training that could raise attention to counselors’ level of stress and burnout and provide strategies to enhance their wellness. Additionally, school counselors should remember to advocate for the profession and for themselves (Young & Lambie, 2007). It is important that administrators understand the critical wellness needs of school counselors, and school counselors should be among the first to advocate for this cause. As these findings indicate, there is a relationship between burnout and the quality of services offered by school counselors. Therefore, it is important that counselors “learn to be their own advocates and help dysfunctional workplaces become well” (Young & Lambie, 2007, p. 99).

In summary, this study examined the association of practicing school counselors’ degree of burnout, perceived stress and frequency of direct student services. The findings indicated that higher levels of burnout contribute to a decreased frequency of direct student services. Furthermore, school counselors’ perceived stress does not contribute to their facilitation of direct student services, but was positively associated with burnout. Overall, these findings are encouraging because the descriptive statistics indicate that school counselors operate at a low level of burnout and perceived stress and provide a moderate to high frequency of direct student services.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest

or funding contributions for the development

of this manuscript.

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Patrick R. Mullen, NCC, is an Assistant Professor at the College of William and Mary. Daniel Gutierrez, NCC, is an Assistant Professor at the University of North Carolina – Charlotte. Correspondence can be addressed to Patrick Mullen, School of Education, P.O. Box 8795, College of William & Mary, Williamsburg, VA 23188, prmullen@wm.edu.

Counselor-in-Training Perceptions of Supervision Practices Related to Self-Care and Burnout

Sep 7, 2014 | Article, Volume 1 - Issue 3

E. Heather Thompson, Melodie H. Frick, Shannon Trice-Black

Counselors-in-training face the challenges of balancing academic, professional, and personal obligations. Many counselors-in-training, however, report a lack of instruction regarding personal wellness and prevention of personal counselor burnout. The present study used CQR methodology with 14 counseling graduate students to investigate counselor-in-training perceptions of self-care, burnout, and supervision practices related to promoting counselor resilience. The majority of participants in this study perceived that they experienced some degree of burnout in their experiences as counselors-in-training. Findings from this study highlight the importance of the role of supervision in promoting resilience as a protective factor against burnout among counselors-in-training and provide information for counselor supervisors about wellness and burnout prevention within supervision practice

Keywords: counselors-in-training, wellness, burnout, supervision, resilience

Professional counselors, due to often overwhelming needs of clients and heavy caseloads, are at high risk for burnout. Research indicates that burnout among mental health practitioners is a common phenomenon (Jenaro, Flores, & Arias, 2007). Burnout is often experienced as “a state of physical, mental, and emotional exhaustion caused by long-term involvement in emotionally demanding situations” (Gilliland & James, 2001, p. 610). Self-care and recognition of burnout symptoms are necessary for counselors to effectively care for their clients as well as themselves. Counselors struggling with burnout can experience diminished morale, job dissatisfaction (Koeske & Kelly, 1995), negative self-concept, and loss of concern for clients (Rosenberg & Pace, 2006). Clients working with counselors experiencing burnout are at serious risk, as they may not receive proper care and attention to often severe and complicated problems.

The potential hazards for counselor distress in practicum and internship are many. Counselors-in-training often begin their professional journeys with a certain degree of idealism and unrealistic expectations about their roles. Many assume that hard work and efforts will translate to meaningful work with clients who are eager to change and who are appreciative of the counselor’s efforts (Leiter, 1991). However, clients often have complex problems that are not always easily rectified and which contribute to diminished job-related self-efficacy for beginning counselors (Jenaro et al., 2007). In addition, counselor trainees often experience difficulties as they balance their own personal growth as counselors while working with clients with immense struggles and needs (Skovholt, 2001). Furthermore, elusive measures for success in counseling can undermine a new counselor’s sense of professional competence (Kestnbaum, 1984; Skovholt, Grier, & Hanson, 2001). Client progress is often difficult to concretely monitor and define. The “readiness gap,” or the lack of reciprocity of attentiveness, giving, and responsibility between the counselor-in-training and the client, are an additional job-related stressor that may increase the likelihood of burnout (Kestnbaum, 1984; Skovholt et al., 2001; Truchot, Keirsebilck, & Meyer, 2000).

Counselors-in-training are exposed to emotionally demanding stories (Canfield, 2005) and situations which may come as a surprise to them and challenge their ideas about humanity. The emotional demands of counseling entail “constant empathy and one-way caring” (Skovholt et al., 2001, p. 170) which may further drain a counselor’s reservoir of resilience. Yet, mental health practitioners have a tendency to present themselves as caregivers who are less vulnerable to emotional distress, thereby hindering their ability to focus on their own needs and concerns (Barnett, Baker, Elman, & Schoener, 2007; Sherman, 1996). Counselors who do not recognize and address their diminished capacity when stressed are likely to be operating with impaired professional competence, which violates ethical responsibilities to do no harm.

Counselor supervision is designed to facilitate the ethical, academic, personal, and professional development of counselors-in-training (CACREP, 2009). Bolstering counselor resilience in an effort to prevent burnout is one aspect of facilitating ethical, personal, and professional development. Supervisors who work closely with counselors-in-training during their practicum and internship can promote the hardiness and sustainability of counselors-in-training by helping them learn to self-assess in order to recognize personal needs and assert themselves accordingly. This may include learning to say “no” to the demands that exceed their capacity or learning to actively create and maintain rejuvenating relationships and interests outside of counseling (Skovholt et al., 2001). Supervisors also can teach and model self-care and positive coping strategies for stress, which may influence supervisees’ practice of self-care (Aten, Madson, Rice, & Chamberlain, 2008). In an effort to bolster counselor resilience, supervisors can facilitate counselor self-understanding about overextending oneself to prove professional competency to achieve a sense of self-worth (Rosenburg & Pace, 2006). Supervisors can help counselors-in-training come to terms with the need for immediate positive reinforcement related to work or employment, which is limited in the counseling profession as change rarely occurs quickly (Skovholt et al., 2001). Counselor resiliency also may be bolstered by helping counselors-in-training establish realistic measures of success and focus on the aspects of counseling that they can control such as their knowledge and ability to create strong therapeutic alliances rather than client outcomes. In sum, distressing issues in counseling, warning signs of burnout, and coping strategies for dealing with stress should be discussed and the seeds of self-care should be planted so they may grow and hopefully sustain counselors-in-training over the course of their careers.

Method

The purpose of this exploratory study was to investigate counselor-in-training perceptions of self-care, burnout, and supervision practices related to promoting counselor resilience. The primary research questions that guided this qualitative study included: (a) What are master’s-level counselors-in-training’s perceptions of counselor burnout? (b) What are the perceptions of self-care among master’s-level counselors-in-training? (c) What, if anything, have master’s-level counselors-in-training learned about counselor burnout in their supervision experiences? And (d) what, if anything, have master’s level counselors-in-training learned about self-care in their supervision experiences?
The consensual qualitative research method (CQR) was used to explore the supervision experiences of master’s-level counselors-in-training. CQR works from a constructivist-post-positivist paradigm that uses open-ended semi-structured interviews to collect data from individuals, and reaches consensus on domains, core ideas, and cross-analyses by using a research team and an external auditor (Hill, Knox, Thompson, Williams, Hess, & Ladany, 2005; Ponterotto, 2005). Using the CQR method, the research team examined commonalities and arrived at a consensus of themes within and across participants’ descriptions of the promotion of self-care and burnout prevention within their supervision experiences (Hill et al., 2005; Hill, Thompson, & Nutt Williams, 1997).

Participants

Interviewees. CQR methodologists recommend a sample size of 8–15 participants (Hill et al., 2005). The participants in this sample included 14 individuals; 13 females and 1 male, who were graduate students in master’s-level counseling programs and enrolled in practicum or internship courses. The participants attended one of three universities in the United States (one in the Midwest and two in the Southeast). The sample consisted of 10 participants in school counseling programs and 4 participants in clinical mental health counseling programs. Thirteen participants identified as Caucasian, and one participant identified as Hispanic. The ages of participants ranged from 24 to 52 years of age (mean = 28).

Researchers. An informed understanding of the researchers’ attempt to make meaning of participant narratives about supervision, counselor burnout, and self-care necessitates a discussion of potential biases. This research team consisted of three Caucasian female faculty members from three different graduate-level counseling programs. All three researchers are proficient in supervision practices and passionate about facilitating counselor growth and development through supervision. All members of the research team facilitate individual and group supervision for counselors-in-training in graduate programs. The three researchers adhere to varying degrees of humanistic, feminist, and constructivist theoretical leanings. All members of the research team believe that supervision is an appropriate venue for bolstering both personal and professional protective factors that may serve as buffers against counselor burnout. It also is worth noting that the three members of the research team believed they had experienced varying degrees of burnout over the course of their careers. The researchers acknowledge these shared biases and attempted to maintain objectivity with an awareness of their personal experiences with burnout, approaches to supervision, and beliefs regarding the importance of addressing protective factors, wellness and burnout prevention in supervision. This study also was influenced by an external auditor who is a former counselor educator with more than 20 years of experience in qualitative research methods and supervision practice. As colleagues in the field of counselor education and supervision, the research team and the auditor were able to openly and respectfully discuss their differing perspectives throughout the data analysis process, which permitted them to arrive at consensus without being stifled by power struggles.

Procedures for Data Collection

Criterion sampling was used to select participants in an intentional manner to understand specified counseling students’ experiences in supervision. Criteria for participation in this study included enrollment as a graduate student in a master’s-level counseling program and completion of a practicum experience or participation in a counseling internship in a school or mental health counseling agency. Researchers disseminated information about this study by email to master’s-level students in counseling programs at three different universities. Interested students were instructed to contact, by email or phone, a designated member of the research team, who was not a faculty member at their university. All participants were provided with an oral explanation of informed consent and all participants signed the informed consent documents. All procedures followed those established by the Institutional Review Board of the three universities associated with this study.

Within the research team, researchers were designated to conduct all communication, contact, and interviews with participants not affiliated with their respective universities, in order to foster a confidential and non-coercive environment for the participants. Interviews were conducted on one occasion, in person or via telephone, in a semi-structured format. Participants in both face-to-face and telephone interviews were invited to respond to questions from the standard interview protocol (see Appendix A) about their experiences and perceptions of supervision practices that addressed counselor self-care and burnout prevention. Participants were encouraged to elaborate on their perceptions and experiences in order to foster the emergence of a rich and thorough understanding. The transferability of this study was promoted by the rich, thick descriptions provided by an in-depth look at the experiences and perceptions of this sample of counselors-in-training. Interviews lasted approximately 50–70 minutes. The interview protocol was generated after a thorough review of the literature and lengthy discussions about researcher experiences as a supervisee and a supervisor. Follow-up surveys (see Appendix B) were administered electronically to participants six weeks after the interview to capture additional thoughts and experiences of the participants.

Data Analysis

All interviews were audio-taped and transcribed verbatim for data analysis. Transcripts were checked for accuracy by comparing them to the audio-recordings after the transcription process. Participant names were changed to pseudonyms to protect participant anonymity. Participants’ real names and contact information were only used for scheduling purposes. Information linking participants to their pseudonyms was not kept.

Coding of domains. Prior to beginning the data analysis process, researchers generated a general list of broad domain codes based on the interview protocol, a thorough understanding of the extant literature, and a review of the transcripts. Once consensus was achieved, each researcher independently coded blocks of data into each domain code for seven of the 14 cases. Next, as a team, the researchers worked together to generate consensus on the domain codes for the seven cases. The remaining cases were analyzed by pairs of the researchers. The third team member reviewed the work of the pair who generated the domain coding for the remaining seven cases. Throughout the coding process, domains were modified to best capture the data.

Abstracting the core ideas within each domain. Each researcher worked independently to capture the core idea for each domain by re-examining each transcript. Core ideas consisted of concise statements of the data that illuminated the essence of the participant’s expressed perspectives and experiences. As a group, the researchers discussed the wording of core ideas for each case until consensus was achieved.

Cross analysis. The researchers worked independently to identify commonalities of core ideas within domains across cases. Next, as a group, the research team worked to find consensus on the identified categories across cases. Aggregated core ideas were placed into categories and frequency labels were applied to indicate how general, typical, or variant the results were across cases. General frequencies refer to findings that are true for all but one of the cases (Hill et al., 2005). Typical frequencies refer to findings that are present in more than half of the cases. Variant frequencies refer to finding in at least two cases, but less than half.

Audit. An external auditor was invited to question the data analysis process and conclusions. She was not actively engaged in the conceptualization and implementation of this study, which gave the research team the benefit of having an objective perspective. The external auditor reviewed and offered suggestions about the generation of domains and core ideas, and the cross-case categories. Most feedback was given in writing. At times, feedback was discussed via telephone. The research team reviewed all auditor comments, looked for evidence supporting the suggested change, and made adjustments based on team member consensus.

Stability check. For the purpose of determining consistency, two of the 14 transcripts were randomly selected and set aside for cross-case analysis until after the remaining 12 transcripts were analyzed. This process indicated no significant changes in core domains and categories, which suggested consistency among the findings.

Results

A final consensus identified five domains: counselor burnout, counselor self-care, faculty supervision, site supervision, and improvements (see Table 1). Cross-case categories and subcategories were developed to capture the core ideas. Following CQR procedures (Hill et al., 1997, 2005), a general category represented all or all but one of the cases (n = 13–14); a typical category represented at least half of the cases (n = 7–12); and a variant category represented less than half but more than two of the cases (n = 3 – 6). Categories with fewer than three cases were excluded from further analysis. General categories were not identified from the data.

Counselor Burnout

Experiencing burnout. Most participants reported knowledge of or having experiences with burnout. Participants identified stressors leading to burnout as a loss of enthusiasm and compassion, the struggle to balance school, work, and personal responsibilities and relationships, and difficulty delineating and separating personal and professional boundaries.

Participants described counselor burnout as no longer having compassion or enthusiasm for counseling clients. One participant defined counselor burnout as, “it seems routine or [counselors] feel like they’ve dealt with so many situations over time that they’re just kind of losing some compassion for the field or the profession.” Another participant described counselor burnout as no longer seeing the unique qualities of individuals seen in counseling:
I wouldn’t see [clients] as individuals anymore…and that’s where I get so much of it coming at me, or so many clients coming at me, that they’re no longer an individual they’re just someone that’s sitting in front of me, and when they leave they write me a check….they are not people anymore, they’re clients.
Participants often discussed a continual struggle to balance personal and professional responsibilities. One participant described burnout as foregoing pleasurable activities to focus on work-related tasks:
I can tell when I am starting to get burned out when I am focusing so much on those things that I forgo all of those things that are fun for me. So I am not working out anymore, I am not reading for fun, and I am putting off hanging out with my friends because of my school work. There’s school work that maybe doesn’t have to get done at that moment, but if I don’t work on it I’m going to be thinking about it and not having fun.
Another participant described burnout as having a hard time balancing professional and personal responsibilities stating, “I think I don’t look forward to…working with…people. I’m just kind of glad when they don’t show up. And this kind of sense that I’m losing the battle to keep things in balance.”

Boundary issues were commonly cited by participants. Several participants reported that they struggled to be assertive, set limits, maintain realistic expectations, and not assume personal responsibility for client outcomes. One participant described taking ownership of a client’s outcome and wanting to meet all the needs of her clients:
I believe part of it is internalizing the problem on myself, feeling responsible. Maybe loosing sight of my counseling skills and feeling responsible for the situation. Or feeling helpless. Also, in school counseling there tends to be a larger load of students. And this is frustrating to not meet all the needs that are out there.

Participants reported experiences with burnout and multiple stressors that lead to burnout. Participants defined counselor burnout as a loss of compassion for clients, diminished enthusiasm, difficulty maintaining a life-work balance, and struggles to maintain boundaries.

Counselor Self-Care

Self-care is purposeful and proactive. Participants were asked to describe self-care for counselors and reported that self-care requires purposeful efforts to set time aside to engage in activities outside of work that replenish energy and confidence. Most participants identified having and relying on supportive people, such as family, friends, and significant others to help them cope with stressors. Participants also identified healthy eating and individualized activities such as exercise, reading, meditation, and watching movies as important aspects of their self-care. One participant described self-care as:
Anything that can help you reenergize and refill that bucket that’s being dipped into every day. If that’s going for a walk in the park…so be it. If that’s going to Starbucks…go do it….Or something that makes you feel good about yourself, something that makes you feel confident, or making someone else feel confident….Whatever it is, something that makes you feel good about yourself and knowing that you’re doing what you need to be doing.

Participants reported that self-care requires proactive efforts to consult with supervisors and colleagues; one of the first steps is recognizing when one needs consultation. One participant explained:
I think in our program, [the faculty] were very good about letting us know that if you can’t handle something, refer out, consult. Consult was the theme. And then if you feel you really can’t handle it before you get in over your head, make sure you refer out to someone you feel is qualified.

Participants described self-care as individualized and intentional, and included activities and supportive people outside of school or work settings that replenished their energy levels. Participants also discussed the importance of identifying when counselor self-care is necessary and seeking consultation for difficult client situations.

Faculty Supervision

Faculty supervisors directly promote counselor resiliency. More than half of the participants reported that faculty supervisors directly initiated conversations about self-care. A participant explained, “Every week when we meet for practicum, [the faculty supervisor] is very adamant, ‘is everyone taking care of themselves, is anyone having trouble?’ She is very open to listening to any kind of self-care situation we might have.” Similarly, another participant stated, “Our professors have told us about the importance of self-care and they have tried to help us understand which situations are likely to cause us the most stress and fatigue.” One participant identified preventive measures discussed in supervision:
In supervision, counselor burnout is addressed from the perspective of prevention. We develop personal wellness plans, and discuss how well we live by them during supervision….Self-care is addressed in the same conversation as counselor burnout. In supervision, the mantra is good self-care is vital to avoiding burnout.

Faculty supervisors indirectly promote counselor resiliency. Participants also reported that faculty supervisors indirectly addressed counselor self-care by being flexible and supportive of participants’ efforts with clients. Participants repeatedly expressed appreciation for supervisors who processed cases and provided positive feedback and practical suggestions. One participant explained, “I know that [my supervisor] is advocating for me, on my side, and allowing me to vent, and listening and offering advice if I need it….giving me positive feedback in a very uncomfortable time.”

Further, participants stated they appreciated supervisors who actively created a safe space for personal exploration. One participant explained:
[Supervision] was really a place for us to explore all of ourselves, holistically. The forum existed for us for that purpose. [The supervisors] hold the space for us to explore whatever needs to be explored. That was the great part about internship with the professor I had. He sort of created the space, and we took it. It took him allowing it, and us stepping into the space.
Modeling self-care also is an indirect means of addressing counselor burnout and self-care. Half of the participants reported that their faculty supervisors modeled self-care. For example, faculty supervisors demonstrated boundaries with personal and professional obligations, practiced meditation, performed musically, and exercised. Conversely, participants reported that a few supervisors demonstrated a lack of personal self-care by working overtime, sacrificing time with their families for job obligations, and/or having poor diet and exercise habits.
Participants reported that faculty supervisors directly and indirectly addressed counselor burnout and self-care in supervision. Supervisors who intentionally checked in with the supervisees and used specific techniques such as wellness plans were seen as directly affecting the participants’ perspective on counselor self-care. Supervisors who were present and available, created safe environments for supervision, provided positive feedback and suggestions, and modeled self-care were seen as indirectly addressing counselor self-care. Both direct and indirect means of addressing counselor burnout and self-care were seen as influential by participants.
Site Supervision

Site supervisors did not directly address burnout or self-care. Participants reported that site supervisors rarely initiated conversations about counselor burnout or self-care. One participant reported that counselor burnout was not addressed and as a result she felt a lack of support from the supervisor:
[Site Supervisors] don’t ask about burnout though. Every time I’m bringing it up, the answers I’m getting are ‘well, when you’re in grad school you don’t get a life.’ You know, yeah, I get that, but that’s not really true, so I get a lot of those responses, ‘well, you know, welcome to the club.’
One participant stated that her site supervisor did not specifically address counselor burnout or self-care, stating “I think that is less addressed in a school setting than it is in the mental health field….I think that because we see such a small picture of our students, I think it is not as predominantly addressed.” Some participants, however, reported that their site supervisors indirectly addressed self-care by modeling positive behaviors. One participant stated:
[My site supervisor] has either structured her day or her life in such a way that no one cuts into that time unless she allows it. In that sense, she’s great at modeling what’s important…She just made a choice….She was protective. She made her priorities. Her family was a priority. Her walk was a priority, getting a little activity. Other things, house chores, may have fallen by the wayside. She had a good sense of priorities, I thought. That was good to watch.
In summary, participants reported that counselor burnout and self-care were not directly addressed in site supervision. Indeed, some participants felt a lack of support when feeling overwhelmed by counseling duties, and that school sites may address burnout and self-care less than at mental health sites. At best, self-care was indirectly modeled by site supervisors with positive coping mechanisms.
Improvements for Counselor Supervision and Training

Improvements for counselor supervision. More than half of the participants reported wanting more understanding and empathy from their supervisors. One participant complained:
A lot of my class mates have a lot on their plates, like I do, and our supervisors don’t have as much on their plate as we do. And it seems like they don’t quite get where we are coming from. They are not balancing all the things that we are balancing….a lot of the responses you get demonstrate their lack of understanding.
Another participant suggested:
I think just hearing what the person is saying. If the person is saying, I need a break, just the flexibility. Not to expect miracles, and just remember how it felt when you were in training. Just be relatable to the supervisees and try to understand what they are going through, and their point of view. You don’t have to lower your expectations to understand where we’re at…and to be honest about your expectations…flexible, honest, and understanding. If [supervisors] are those three things, it’ll be great.
Participants also suggested having counselor burnout and self-care more thoroughly addressed in supervision, including more discussions on balancing personal and professional responsibilities, roles, and stressors. One participant explained:
What would be really helpful when the semester first begins is one-on-one time that is direct about ‘how are you approaching this internship in balance with the rest of your life?’ ‘What are any issues that it would be worthwhile for me to know about?’ How sweet for the supervisor to see you as a whole person. And then to put out the invitation: the door’s always open.
Improvements for counselor training programs. More than half of the participants wanted a comprehensive and developmentally appropriate approach to self-care interwoven throughout their counselor training, with actual practice of self-care skills rather than “face talk.” One participant commented:
Acknowledge the reality that a graduate-level program is going to be a challenge, talking about that on the front end….[faculty] can’t just say you need to have self-care and expect [students] to be able to take that to the next level if we don’t learn it in a graduate program….how much better would it be for us to have learned how to manage that while we were in our program and gotten practice and feedback about that, and then that is so important of a skill to transfer and teach to our clients.
Most of the participants suggested the inclusion of concrete approaches to counselor self-care. Participants provided examples such as preparing students for their work as counselors-in-training by giving them an overview of program expectations at the beginning of their programs, and providing students with self-care strategies to deal with the added stressors of graduate school such as handling administrative duties during internship, searching for employment prior to graduation, and preparing for comprehensive exams.
Discussion

Findings from this study highlight the importance of the role of supervision in promoting resilience as a protective factor against burnout among counselors-in-training. The majority of participants in this study perceived that they experienced some degree of burnout in their experiences as counselors-in-training. Participants’ perceptions of experiencing burnout are a particularly meaningful finding because it indicates that these counselors-in-training see themselves as over-taxed during their education and training. If, during their master’s programs, counselors-in-training are creating professional identities based on cognitive schemas for being a counselor, then perhaps these counselors-in-training have developed schemas for counseling that include a loss of compassion for clients, diminished enthusiasm for counseling, a lopsided balance of personal and professional responsibilities, and struggles to maintain boundaries. Counselors-in-training should be aware of these potential pitfalls as these counselors-in-training reported experiencing symptoms of burnout which were rarely addressed in supervision.

In contrast to recent literature, which suggests that counselor burnout is related to overcommitment to client outcomes (Kestnbaum, 1984; Leiter, 1991; Shovholt et al., 2001), many counselor trainees in this study did not perceive that their supervisors directly addressed their degree of personal commitment to their clients’ success in counseling. Similarly, emotional exhaustion is commonly identified as a potential hazard for burnout (Barnett et al., 2007); yet, few participants believed that their supervisors directly inquired about the degree of emotional investment in their clients. Finally, elusive measures of success in counseling are often indicated as a potential factor for burnout (Kestnbaum, 1984; Skovholt, et al., 2001). The vast majority of participants interviewed for this study did not perceive that these elusive measures of success were addressed in their supervision experiences. Supervisors who are interested in thwarting counselor burnout early in the training experiences of counselors may want to consider incorporating conversations about overcommitment to client outcomes, emotional exhaustion, degree of emotional investment, and elusive measures of success into their supervision with counselors-in-training. In an effort to promote more resilient schemas and expectations for counseling work, supervisors can take an active role in helping counselors-in-training understand the importance of awareness and protective factors to protect against a lack of compassion, enthusiasm, life-work balance, and professional boundaries, similar to the way a pilot is aware that a plane crash is possible and therefore employs purposeful and effective methods of prevention and protection.
Participants in this study conceptualized self-care as purposeful behavioral efforts. Proactive behavioral choices such as reaching out to support others are ways that many counselors engage in self-care. However, self-care cannot be solely limited to engagement in specific behaviors. Self-care also should include discussions about cognitive, emotional, and spiritual coping skills. Supervisors can help counselors-in-training create a personal framework for finding meaning in their work in order to promote hardiness, resilience, and the potential for transformation (Carswell, 2011). Because of the nature of counseling, it is necessary for counselors to be open and have the courage to be transformed. Growth and transformation are often perceived as scary and something to be avoided. Yet, growth and transformation can be embraced and understood as part of each counselor’s unique professional and personal process. Supervisors can normalize and validate these experiences and help counselors-in-training narrate their inspirations and incorporate their personal, spiritual, and philosophical frameworks in their counseling. In addition, supervisors can directly address misperceptions about counseling, which often include: “I can fix the problem,” “I am responsible for client outcomes,” “Caring more will make it better,” and “My clients will always appreciate me” (Carswell, 2011). While these approaches to supervision are personal in nature, counselors-in-training in this study reported an appreciation for time spent discussing how the personal informs the professional. This finding is consistent with Bernard & Goodyear’s (1998) model of supervision which emphasizes personal development as an essential part of supervision. Models for personal development in counselor education programs have been proposed by many professionals in the field of counseling (Myers, 1991; Myers & Williard, 2003; Witmer & Granello, 2005).
Counselors-in-training in this study reported an appreciation for supervision experiences in which their supervisors provided direct feedback and positive reinforcement. Counselors-in-training often experience performance anxiety and self-doubt (Aten et al., 2008). In an effort to diminish counselor-in-training anxiety, supervisors may provide additional structure and feedback in the early stages of supervision. Once the counselor-in-training becomes more secure, the supervisor may facilitate a supervisory relationship that promotes supervisee autonomy and higher-level thinking.
The majority of participants interviewed reported a desire for supervisors to place a greater emphasis on life-work balance and learning to cope with stress. These findings suggest the importance of counselor supervisors examining their level of expressed empathy and emphasis on preventive, as well as remedial, measures to ameliorate symptoms and stressors that lead to counselor burnout. Participants expressed a need to be more informed about additional stressors in graduate school such as administrative tasks in internship, preparing for comprehensive exams, and how to search for employment. These findings suggest the need for counselor educators and supervisors to examine how they indoctrinate counselors-in-training into training programs in order to help provide realistic expectations of work and personal sacrifice during graduate school and in the counseling field. Moreover, counselor educators and supervisors should strive to provide ongoing discussions on self-care throughout the program, specifically when students in internship are experiencing expanding roles between school, site placement, and searching for future employment. As mental health professionals, counselor educators and supervisors may also struggle with their own issues of burnout; thus, attentiveness to self-care also is recommended for those who teach and supervise counselors in training.
Limitations

Findings from this study will benefit counselor educators, supervisors, and counselors-in-training; however, some limitations exist. One limitation is the lack of diversity in the sample of participants. The majority of the participants identified as Caucasian females, which is representative of the high number of enrolled females in the counseling programs approached for this study. The purpose for this study, however, was not to generalize to all counselor trainees’ experiences, but rather to shed light on how counselor perceptions of burnout and self-care are being addressed, or not, in counselor supervision.

Participant bias and recall is a second limitation of this study. Recall is affected by a participant’s ability to describe events and may be influenced by emotions or misinterpretations. This limitation was addressed by triangulating sources, including a follow-up questionnaire, reinforcing internal stability with researcher consensus on domains, core ideas, and categories, and by using an auditor to evaluate analysis and prevent researcher biases.
Conclusion

Counselors should be holders of hope for their clients, but one cannot give away what one does not possess (Corey, 2000). Counselors who lack enthusiasm for their work and compassion for their clients are not only missing a critical element of their therapeutic work, but also may cause harm to their clients. Counseling is challenging and can tax even the most “well” counselors. A lack of life-work balance and boundaries can add to the already stressful nature of being a counselor. Discussions in supervision about the potential for emotional exhaustion, the counselor-in-training’s degree of emotional investment in client outcomes, elusive measures of success in counseling, coping skills for managing stress, meaning-making and sources of inspiration, and personalized self-care activities are several ways supervisors can promote counselor resilience and sustainability. Supervisors should discuss the definitions of burnout, how burnout is different from stress, how to identify early signs of burnout, and how to address burnout symptoms in order to promote wellness and prevent burnout in counselors-in-training. Counselor educators and supervisors have the privilege and responsibility of teaching counselors-in-training how to take care of themselves in addition to their clients.

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E. Heather Thompson is an Assistant Professor in the Department of Counseling Western Carolina University. Melodie H. Frick is an Assistant Professor in the Department of Counseling at West Texas A & M University. Shannon Trice-Black is an Assistant Professor at the College of William and Mary. Correspondence can be addressed to Shannon Trice-Black, College of William and Mary, School of Education, PO Box 8795, Williamsburg, VA, 23187-8795, stblack@wm.edu.

Appendix A

Interview Protocol

1. What do you know about counselor burnout or how would you define counselor burnout?
2. What do you think are possible causes of counselor burnout?
3. As counselors we often are overloaded with administrative duties which may include treatment planning, session notes, and working on treatment teams. What has this experience been like for you?
4. Counseling requires a tremendous amount of empathy which can be emotionally exhausting. What are your experiences with empathy and emotional exhaustion? Can you give a specific example?
5. How do you distinguish between feeling tired and the early signs of burnout?
6. As counselors, we sometimes become overcommitted to clients who are not as ready, motivated, or willing to engage in the counseling process. Not all of our clients will succeed in the way that we want them to. How do you feel when your clients don’t grow in the way you want them to? How has this issue been addressed in supervision?
7. What is your perception of how your supervisors have dealt with stress?
8. How has counselor burnout been addressed in supervision?
prompt: asked about, evaluated, provided reading materials, and how often
9. How have specific issues related to burnout been addressed in supervision such as: (a) over-commitment to clients who seem less motivated to change, (b) emotional exhaustion, and (c) elusive measures of success?
10. How could supervision be improved in addressing counselor burnout?
prompt: asked about, evaluated, provided reading materials, modeled by supervisor
11. What do you know about self-care or how would you define self-care for counselors?
12. What are examples of self-care, specifically ones that you use as counselors-in-training?
13. How has counselor self-care been addressed in supervision?
14. Sometimes we have to say “no.” How would you characterize your ability to say “no?” What have you learned in supervision about setting personal and professional boundaries?
15. What, if any, discussions have you had in supervision about your social, emotional, spiritual, and/or physical wellbeing? What is a specific example?
16. How could supervision be improved in addressing counselor self-care?
prompt: asked about, provided reading materials, modeled by supervisor
17. How could your overall counselor training be improved in addressing counselor burnout and counselor self-care?

Appendix B

Follow-Up Questionnaire

How would you describe counselor burnout?
How has counselor burnout been addressed in supervision?
How could supervision be improved in addressing counselor burnout?
How would you describe self-care for counselors?
How has counselor self-care been addressed in supervision?
How could supervision be improved in addressing counselor self-care?
How could your overall counselor training be improved in addressing counselor burnout and counselor self-care?

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