Burnout is a serious concern for Marriage and Family Therapists (MFTs) and for those in similar helping professions or who play other important roles in liaison with MFTs. Burnout is a common syndrome among MFTs, affecting over 50% of them at some point in their careers. Burnout is characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment as a result of continuous stressors as a result of the responsibilities that come with the profession. Society could minimize the efforts that MFTs encounter in that “talk therapy” is easy and comforting. However, the harsh reality is that there are many hats that MFTs wear beyond the dialogue that happens during therapy sessions with clients. In this article, we will explore the many causes of burnout that are inclusive of the many identities that MFTs encompass, including but not limited to having a lack of resources, lack of support from supervisors, lack of recognition for the work done, and the inability to meet high expectations from clients, supervisors, and other third-parties. It is vital for both MFTs and MFT supervisors to recognize the underlying factors that contribute to MFT burnout and ways to professionally remediate the effects of burnout among MFTs.
What is Burnout and Why is it Destructive?
Burnout is a state of physical, emotional, and mental exhaustion that can happen to anyone. Burnout is chronic and occurs when one feels either emotionally or physically exhausted, despite efforts to regain strength and passion for their profession. This chronic feeling of being drained can last for days or weeks at a time. In the worse or prolonged cases, it has been known to cause depression, anxiety, and other mood disorders. People with a history of obsessive-compulsive disorder or any other related mental health problems are also at a higher risk. The symptoms vary in severity, but in the most severe cases, OCD may cause sufferers to stop all normal activities and only perform compulsive behaviors. While MFTs are held to the responsibility of being systemic or relational experts, we are human and are not somehow invincible against mental health problems. Knowing what factors increase burnout and recognizing them before symptoms persist, is the first step. So, what are the factors that increase burnout among MFTs?
5 Factors that Increase MFT Burnout
1. Time Constraints: Having an excessive workload and working long hours contribute to burnout. The consequences of trying to complete a given task within limited timeframes only lead to continuous tasks and more limited timeframes. This is a never-ending story, like a hamster on a wheel, but realizing that the workload will never end because the therapy of any sort is a public service. Still, there has to be an internal stopping point that will all time to rest, rejuvenate, and reenergize.
2. Large Caseloads: Having a large caseload usually helps with productivity, especially when working at an agency. However, having a large caseload comes with many responsibilities and risks of spontaneous occurrences based on clients’ needs. MFTs are typically tasked to handle a large caseload with limited supervision. This can lead to burnout and ethical dilemmas. Maintaining a “high quota or productive” caseload has been shown to be an ineffective way to help beginner professionals develop their skills and provide quality service.
3. Meetings, Training, and Committees: Other clinical duties and responsibilities help MFTs to stay abreast and competent in the work that they do for certain populations or specialize in modalities. However, these responsibilities are time-consuming and can often take away from the clinical responsibilities that ensure quality services for clients. These may include clinical documentation, follow-up with clients, billing claims, marketing, supervision, and research. Though MFTs can wear many hats, we cannot be in the therapy room, bring an advocate, in supervisory and management roles, and be in training at the same time.
4. Deadlines and Crisis Combination: Meeting multiple deadlines such as documentation, billing, discharges, assessment renewals, treatment planning, and many others can impact the functioning of MFTs. When met with crises, which are often unplanned and unexpected can be challenging as this requires additional documentation and client follow-up in addition to the previous deadlines. The repetitive nature of these occurrences will result in a “deadlock” or when the MFT feels that “too much is happening with too little energy to handle the situations.” Therefore, the result is doing just enough to get by to not exacerbate burnout symptoms.
5. Work and Personal Life Balance: Between personal and professional pursuits, it can be difficult to spend eight to nine hours of the day or more having a dialogue with clients and then expecting to have a flourishing social life outside of the therapy room. In terms of romantic or more personal fulfilling relationships, it is difficult to manage when burnout is apparent. It becomes more of a quality-over-quantity issue as one person in a relationship may have been burned out. Being able to have a cut-off between the therapist's identity and the individual identity would be an additional key to having successful relationships outside of the therapy room.
Recommendations to Prevent Burn-Out and Maintain Resilience as an MFT
Prioritize Self-Care
There are many ways in which MFTs can prevent burnout and maintain resilience. Prioritizing self-care physically by eating well, exercising regularly, and getting enough sleep is a start. Another way would be to take care of your mental health by practicing self-compassion and self-love whenever you need it. Self-care is important for maintaining well-being and is also an important element of resilience in the face of adversities. Self-care can also be taking time off work to spend with loved ones instead of isolating yourself at work. Self-care can be maintained through practicing mindfulness and meditation, and spending time in nature or with pets/friends when feeling isolated or overwhelmed could be a vital approach to preventing burnout. Getting out of the office or therapy room and into the world, as much as possible is the goal. Scheduling time to yourself that is meaningful counterbalances silent symptoms of burnout. Still, MFTs must learn to practice resilience by surrounding themselves with positive and realistic support systems.
Actively Practice Gratitude
As an MFT, it is important to learn to practice gratitude and take time to reflect on the progress that you have made within your profession and personal life. It is also essential to reflect and keep momentous past successes and share them with others. Client success stories are inspiring and are a direct outcome of the change and healing that you have contributed to in some way. Showing gratitude is can promote grounding when you feel that tasks are not being done orderly, or when you lose passion for your work is done. There are many ways to practice gratitude. It might be as simple as taking a moment to notice the things that are going well in your life, from the people you love to the freedom of having choices in the food that you consume. You might also want to reflect on specific moments of progress (e.g., your partner spending more time with you) or past successes (e.g., leading a team to victory) and appreciate them. Doing a good deed for a colleague or family member can turn your focus to something meaningful, rather than something harsh. If you are having a difficult time finding gratitude, it might be helpful to think about what you would like your future to look like. For example, if you struggle with anxiety and worry, you might want to consider what would help bring peace into your life: understanding that whatever is happening is going to be okay or learning how to handle challenges through a protocol. Finding easy solutions that are repetitive and non-distractive is also vital. At any rate, learning that you have done your best, even when you are your own worst critic.
Seek Your Own Therapy
It is practically normal to seek your own individual therapy as an MFT, to ensure that you are being present in your own emotional development. Due to your own life experiences, and your experiences of your clients' experiences; seeking therapy is part of maintenance in all systems that you play a role in. MFTs are trained to be the "therapist" for their clients. We are often the ones who are “supposed” to have all the answers, and it is difficult and frustrating when we do not. We must not diminish the important roles that we play in the lives of clients and should not deny ourselves of the role that we play in relation to our “self.” Relational therapy with any population is demanding, no matter what platform or agency. Therapists have a tendency to be self-critical and cannot accept that we are not perfect. We are human and we need help too, in order to best help others. As therapists, we need to be able to provide help for ourselves and receive it from others. With that said, there is always more to learn in the field of relational doing and being relational in therapy. So, what will you choose? How will you be to recognize how burnout shows up in your professional identity as an MFT?
