Self-Care Techniques: Prevention Techniques
B. Prevention Techniques to apply during therapy
Friedman, R. (1985) in "Making family therapy easier for the therapist: Burnout prevention" Presented a position on the relation among the degree of responsibility undertaken by the family therapist, the outcome of the therapy and burnout. Some specific techniques for reducing the strain on the therapist while maintaining effective treatment were also outlined. A few of the techniques will be discussed:
- Awareness that responsibility to change is on the family Friedman (1985) established that family therapists be aware that the major responsibility for positive outcomes rests with the family and not the therapist. Although as a home therapist you are responsible for providing a setting for growth and change, you are not responsible for rescuing the family from pain and suffering (Exceptions being: extreme situations like suicide , child abuse, spousal abuse etc). While dedication to your work and interest in your clients needs are important aspects of your work, it is also essential to know that "exaggerated ego needs, unrealistic self-expectations, and excessive energy output can lead to burnout" (p.550).
- Role definitions (client vs. therapist) As a home therapist be cautious in order not to assume the role of "all-knowing" or "all powerful" expert. In fact withstanding the tendency for the family deify you will go a long way to emphasize the families responsibility in the process and make your work easier. Remember, you are not "rescuing the family from pain and suffering". In as much as it is tempting to answer all questions and give advice freely, doing so will make the family take a passive stand and avoid responsibility of change. For example, questions asked by parents about the reasons for a child's behavior can be redirected to the child. That way the child is held accountable for the specific behavior, and the family is involved to take responsibility in the process. Note however that in cases like crisis intervention where your expertise is necessary for constructive crisis resolution, your role as an expert is very important.
- Expressing feelings It is not uncommon to feel irritated, annoyed, baffled, confused, overwhelmed, anxious or discounted during therapy session. When such feelings occur it is important to share it in an open, nonhostile way in order to relieve the pressure on you and to be more objective. After all you are a real person who also has real problems and real feelings. Letting the family be aware of your feelings is a polite and appropriate way of allowing the family to cope with your feelings and clarifying interactions between you and the family and making issues such as transference and countertransference explicit.
- Humor Utilizing humor during therapy is an important way of easing the strain of situation where there is heightened tension which may otherwise not be clinically productive. This enhances spontaneous interaction. For example the use of cartoons where clinical point is made in a humorous context is an effective way of reducing stress. However this technique must be used judiciously and wisely.
- Flexibility Flexibility in therapy schedule is also an important way to relieve stress and burnout. Sometimes mere anticipation of appointments may be stressful for you as a therapist. However adding a little bit of flexibility in your schedule may go a long way to have a positive effect on treatment. After all this should not be a ritual. Involve the family in scheduling for the next visit. This way the family is given the opportunity to influence the therapy arrangements as well as take responsibility in the process.