Challenges to Therapist Self-Care with In-Home Work

Module Sections:

Introduction & Model One

In conceptualizing the multiple ways clinician self-care, or lack thereof, can affect the practitioner, an attempt was made to find models that encompassed the multiple variables and complexity often associated with self-care practices. The ABC-X Model will be introduced to reflect variables associated with stress, including perceptions and resources. Boss' Contextual ABC-X model expands upon the original model to include coping and adaptation that exist beyond the crisis event. This model provides a focus for discussing the components incorporated within a clinician's self-care strategies. While the Boss' model provides a framework for examining a clinician's experiences and responses to stress and potential crises, an additional framework is needed to address stress that appears in the form of therapist burnout. Further research revealed two additional models that address the effects of burnout within organizational contexts: the Leiter Model (Leiter, 1991) and the Burnout Contagion Model (Bakker et al., 2001). A unified framework, informing the application of clinician self-care throughout the work of therapy, will be discussed in the next section.

Model One: Double ABC-X Stress Model – Individual in Family and other Contexts

The ABC-X Model was originally developed to address the social stresses on the family (Hill, 1958). This model illustrates the interplay between the following variables:

A (stressor—event or situation) B (existing resources) C (perception of stressor or resources) X (degree of the crisis resulting from interplay between A, B, and C).

Figure 3. (Hill, 1958)Figure 3. (Hill, 1958)

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