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Making Time on a Busy Schedule

One thing that seems to run out quickly is time. After all, there are only so many hours in a day. How do I make time in my busy schedule to finish all work and school-related tasks? How do I fit in time to focus on my family and friendships? What if you are in a relationship, and they are wanting more of your time?

Ways to Successfully Balance a Full Caseload as a Therapist

By: Bridget Eickhoff, MA, Alison Dolan, Psy.D., LP, and Andrea Hutchinson, Psy.D., LP

Being a therapist can be a fulfilling and rewarding career. However, it can be hard to remember that therapists are humans who also experience anxiety, stress, and burnout. We took a survey of 30 clinicians at CARE Counseling asking what makes them feel successful and balanced at work. Here are the main points our amazing clinicians found that help them find balance when working with a full caseload.

  • Create Boundaries and Stick to Them
    • Let your clients know your boundaries for cancellations and follow through with the boundaries you’ve set or are set by your agency. Therapy should be a flexible time for the client to address topics that are important to them; however, aspects of structure are important in therapy to keep both your clients and yourself accountable. 
    • Start and end sessions on time so that you have time to complete documentation, grab something to eat or drink, use the restroom, consult with a colleague, and/or take a moment to regroup.
  • Manage your Schedule Proactively
      • Make your life easier by scheduling clients as recurring appointments and practice confirming the next appointment at the end of the session. 
      • You probably enjoy seeing clients and it can be heartbreaking to refer them out. However, back to that accountability point, close your clients who are not following the attendance policy (or use supervision and consultation if you need guidance) and give them referrals to help with barriers (e.g., closer to home, different hours, attending to a different piece of their difficulties, etc).
      • Proactively reach out and ask for more clients if you start to notice your caseload looking low or you have inconsistent clients. 
        • Keep in mind, being proactive will help keep the number of intakes in the same week lower and documentation will likely feel more manageable. 
      • Take advantage of cancellations and catch up on documentation or check-in with a co-worker. If you are finding yourself racing towards burnout remember:
        • You can use PTO and take a day or more to feel grounded again
        • Ask if you can have a temporary block off time in your schedule to help you gain some extra time to feel like things are more manageable again
        • Talk to management to see if there are ways to contribute to the team without as many client appointments. 
  • Try to NOT Take this Very Personal Job, Personally (easier said than done)
      • For both you and your clients, use your intuition for goodness of fit. As you know, a healthy therapeutic alliance is a key factor for the overall success of therapy. At times, especially as a new clinician, it can be difficult to decipher between your intuition and anxiety. Clinicians should utilize supervision and consultation to explore types of clients who are and are not a good fit. Supervision and consultation are also helpful when you feel stuck.
      • Sometimes, it can feel pretty personal when a client cancels often or ghosts us. Keep in mind, clients will cancel appointments for a multitude of reasons ranging from weather, illness, moving, and symptoms and this happens to the best of us. 
  • You’re Not Alone
    • Consult with your peers and use supervision to feel balanced and confident with your caseload.
    • While you are likely a compassionate person, remember you too may have times when you need to check-in on your own mental health. Remember everyone can benefit from therapy!

Diabetes Burnout

WRITTEN BY: Mark Heyman, PhD, CDE

Have you ever felt like you are just “done” with diabetes?

Are you sick and tired of doing everything you’re supposed to do, but feel like your blood sugar is still out of control? Do you feel like you don’t care anymore about managing diabetes and want to just give up? If any of these things sound familiar, you may be experiencing diabetes burnout.

Diabetes burnout is a state in which someone with diabetes grows tired of managing their condition, and then simply ignores it for a period of time, or worse, forever. Unfortunately, diabetes burnout is common, and most people with Type 1 diabetes (T1D) have experienced it at some point in their lives. After all, if you have T1D, you have to be “on” 24/7, and as much as we would like one, there are no breaks. People who experience diabetes burnout aren’t necessarily depressed and are certainly not lazy. In fact, almost everyone with diabetes, even those experiencing burnout, want to live long healthy lives. But sometimes diabetes can feel overwhelming and folks can get burned out from all the hard work.

What does diabetes burnout actually look like? While it may look different in people, there are some common signs and symptoms. These include:

  • Strong negative feelings (e.g., overwhelmed, anger, frustration) about diabetes
  • Feeling controlled by diabetes
  • Isolation, or feeling alone with diabetes
  • Avoidance of some, or all diabetes management activities and being unmotivated to change this behavior

If you have T1D and are feeling burned out, please know that there is hope! Diabetes is hard work, and until we have a cure, it will continue to be hard. However, there are some thing you can try that can help you overcome, and even prevent, feelings of burn out.

Manage your expectations

People with T1D tend to be really hard on themselves. They expect a lot from themselves, and when they don’t meet their own expectations, it can be frustrating. Anyone who lives with T1D knows that it is almost impossible to do everything “right” all the time. And even if you do everything “right”, your blood sugar can have a mind of its own and do some crazy things. If you expect perfection, and perfection is not possible, it’s normal to want to give up. Instead, try cutting yourself some slack. It’s ok to strive for perfection, but it’s important to cut yourself some slack sometimes and be ok with slipping up. And remember that sometimes, having wacky blood sugars is part of having diabetes.

Take small steps

Diabetes takes a lot of hard work and sometimes everything can seem overwhelming. When things get overwhelming, you may not even know where to start. Instead of tackling a big task all at once, try breaking it down into small steps that you know you can accomplish. For example, telling yourself you want to reduce your A1C from 8% to 7% may sound like a Herculean task. However, if that is your goal, identify the specific things you can do today to get there. For example, you can check your blood sugar at least 4 times a day and count carbohydrates at every meal and take insulin to cover. Taking small steps can make achieving big goals seem a lot more obtainable.

Get support

Feeling like you’re alone in your life with diabetes is a big risk factor for diabetes burnout. With diabetes, isolation is one the biggest risk factors for becoming burned out. If you feel that nobody understands what you are experiencing or that you are the only person with diabetes that feels this way, life with diabetes can be a lonely place. While feeling supported does not make T1D go away, it can make it easier to live with. Getting support, encouragement and empathy from others can be a critical part of staying motivated to manage your diabetes. Sometimes the people in your life may not know what kind of support you need. Be clear with these people what would be most helpful and what you want them not to do. Remember that other people with T1D can also be a great source of support. These are the folks who know exactly how you’re feeling, because, at some point, they have probably felt the same way. If you don’t know anybody else with T1D, there are resources that can help. Many communities have meet-ups for people with T1D and there is an active diabetes online community on social media.*

If you feel burned out with T1D, you are not alone. Just remember that many people have overcome their burnout and are able to live long, happy and healthy lives with T1D. If you are experiencing diabetes burn out and you feel like you can’t deal with it on your own, it’s important to get help from a mental health professional who understands diabetes. Talk to your endocrinologist to see if s/he can recommend one in your area.

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