U.S. Army photo by Sgt. Jang, Young Jae 

Felisha Garcia, Psy.D., Olivia Bentley, Ph.D., LPCC-S, Lt. Cmdr. Dierdra Oretade-Branch, DSW, LCSW, BCD, U.S. Public Health Service
June 18, 2024

Do you ever feel frustrated or worried about patients who refuse to leave their abusive partners? Does the worry, fear, or stress come home with you and disturb your peace? Do you feel yourself becoming increasingly distrustful of your own interpersonal relationships? You are not alone. It may be helpful to recognize there are many ways to engage in self-care and embrace a healthy work-life balance, while continuing to support your patients.

Listening to Trauma Experiences of Others Can Take a Toll on You

Listening day-in and day-out to the details of patients who have experienced intimate partner violence, or other types of traumas can take its toll, even though assisting patients in these circumstances can be rewarding. Providers working with patients who have experienced trauma report various impacts to their physical and psychological well-being.¹ Providers have shared symptoms of vicarious trauma, secondary traumatic stress, compassion fatigue, and post-traumatic stress disorder.^1,2 Research findings indicate that providers may be at an elevated risk of harm as a result of their work.^1,2 Despite the continual exposure to the trauma of others, many providers still expressed positive growth and appreciation for their work.¹ 

Self-Care Strategies and Tips to Prevent Burnout

An important component of trauma-informed care is that providers take care of themselves so that they can continue taking care of others. In fact, engaging in self-care is considered an ethical obligation by most helping professionals.^3-7 Providers may use a multitude of self-care practices that can be categorized into the following areas: awareness, balance, flexibility, physical health, social support, and spirituality.⁸ The American Psychological Association recently recommended the following self-care tips for providers:⁹

Daily Balance: Take breaks throughout the workday, practice relaxation and avoid overcommitment to work responsibilities.^8,9 Engage in regular exercise, a balanced diet and adequate sleep hygiene.⁸

Cognitive Strategies: Be aware of your feelings and needs and be mindful of your triggers.^8,9 Proactively manage the challenges of your work and set realistic goals and expectations.^8,9

Life Balance: Spend time with family or friends.^8,9 Seek activities or people that are comforting to foster social connection and belonging.^8,9 Practice mindfulness, gratitude and self-compassion.³

Professional Development: Connect with professional organizations and maximize time spent engaging in professional activities that you enjoy.^8,9 Take part in work-related social and community events.^8,9 Find ways to stay current in professional knowledge.^8,9

Professional Support: Cultivate a professional support system and avoid workplace isolation.^8,9 Share work-related stressors as well as positive work experiences with colleagues.^8,9

We All Need Support

Did you know self-care can be practiced in community with others? Engaging with your professional community through peer consultation, supervision, and continuing education is an important component of self-care that is sometimes overlooked.¹⁰ Practicing self-care by seeking support is an embodiment of the trauma-informed care principles of collaboration and mutuality.¹¹ Professional supervision and training are crucial to better preparing and coping with exposure to trauma.² Many providers have experienced supervision and peer-to-peer consultation as vital forms of professional and personal self-care, especially while providing treatment in conditions of danger and turmoil.¹² Instead of isolating when experiencing distress from clinical work, reach out for support from others who have shared experiences.¹⁰ Peer support with trusted colleagues should be regularly scheduled as a preventive strategy, so that it is easily accessible when needed.¹⁰ Regular check-ins can be particularly helpful when it is difficult to recognize psychological distress or the need for additional help.¹⁰

Growth is Always Possible

Self-care practices may change over the course of a provider’s lifetime, just as personal and professional needs change.¹⁰ Try new self-care strategies if yours are no longer working. Attend that conference on the topic of self-care that you may have neglected in favor of a more “clinical” one. Embrace lifelong learning and seek opportunities that energize you. Most importantly, protect the time you set aside for self-care by remembering that creating a more-balanced life will fuel the longevity needed to continue serving your patients well.

For additional resources on provider self-care, see list below. 

Provider Self-Care Resources

Provider Resilience and Self-Care Toolkit: Learn more about some DHA resources to address provider resilience.

Provider Resilience Desktop App: Measure your level of burnout or professional quality of life, explore strategies for self-care or set a vacation countdown.

Understanding Burnout: Individual, Organizational, and System Factors: Visit this site for information about burnout and self-care strategies to reduce risk for burnout.

Provider Self-Care When Working with Trauma Survivors: Review blog for self-care strategies when working with trauma survivors.

Psychological Health Resource Center: Contact by phone, email, or live chat for free answers to questions about psychological health in the military. Click link for contact information.

References

1. Brend, D. M., Krane, J., & Saunders, S. (2020). Exposure to trauma in intimate partner violence human service work: A scoping review. Traumatology, 26(1), 127–136. https://doi.org/10.1037/trm0000199
2. Tarshis, S., & Baird, S. L. (2019). Addressing the indirect trauma of social work students in intimate partner violence (IPV) field placements: A framework for supervision. Clinical Social Work Journal, 47(1), 90–102. https://doi.org/10.1007/s10615-018-0678-1
3. American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=55ab73d0_1
4. American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
5. American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
6. National Association of Social Workers. (2021). Code of ethics of the national association of social workers. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English 
7. American Medical Association. (2001). AMA principles of medical ethics. https://code-medical-ethics.ama-assn.org/principles
8. Posluns, K., & Gall, T. L. (2020). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International journal for the advancement of counseling, 42(1), 1–20. https://doi.org/10.1007/s10447-019-09382-w
9. APA Member Services. (2023, November 30). Helping ourselves: Self-care for psychologists. American Psychological Association. https://www.apa.org/members/content/secure/self-care
10. Barnett, J. E. & Homany, G. (2022). The new self-care: It’s not all about you. Practice Innovations, 7(4), 313-326. https://doi.org/10.1037/pri0000190 
11. National Mental Health and Substance Use Policy Laboratory. (2023). Practical guide for implementing a trauma-informed approach (SAMHSA Publication No PEP23-06-05-005). U.S. Department of Health and Human Services, Substance Abuse & Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/pep23-06-05-005.pdf 
12. Yevlanova, E. (2023). Professional supervision as therapists’ self-care during wartime. Psychoanalytic Psychology, 40(4), 257–260. https://doi.org/10.1037/pap0000486 

Dr. Olivia Bentley is a licensed professional clinical counselor and contracted subject matter expert at the Psychological Health Center of Excellence who specializes in trauma-informed care.

Dr. Felisha Garcia is a licensed clinical psychologist and contracted subject matter expert for the Defense Health Agency, PHCoE. She specializes in forensic psychology with extensive experience in the treatment of trauma.

Dr. Dierdra Oretade-Branch is a board certified clinical social worker and Lieutenant Commander in the Commissioned Corps of the United States Public Health Service. She is a subject matter expert at the PHCoE and specializes in military and forensic social work within the civilian, veteran, and active-duty service member populations.