Staff Perspective: Helping the Helpers

Staff Perspective: Helping the Helpers

Christy Collette

As we wind down PTSD awareness month, I want to focus on us….the helpers. While we are all adept at identifying PTSD symptoms in our patients, we are less adept at recognizing our own struggles. We have the honor and privilege of hearing the stories our clients share with us, but with that comes some occupational stress that is unique to those in the helping profession.

While the world had to learn how to navigate life through the pandemic, therapists were placed in the role of helping patients navigate trauma while simultaneously experiencing the same trauma. The concept of collective trauma emerged after the attacks on 9/11 to describe this shared trauma (Holmes et al. (2021). After 9/11, the country came together against a shared enemy and with a common cause. While the impact of 9/11 was felt nationwide, its impact was more localized. Covid impacted everyone’s life in significant ways. Lockdowns, social isolation, financial stress, and fear of our own or loved one's physical health impacted us all.

For those in the helping professions, we are experiencing unprecedented levels of need for behavioral health care, while also experiencing a shortage of trained professionals. As we pivoted to telehealth sessions, we had to learn a new way of doing business, all while navigating other necessary pandemic related changes. We may have experienced frustration and guilt about limited resources and feeling like we should be doing more. Holmes et. al (2021) looked at well-being of 181 social workers during the first wave of the pandemic. The results are startling. The study found that 26.2% met the criteria for PTSD. When looking at grief, 16.2% reported severe symptoms of grief, and 49.6% reported symptoms of secondary traumatic stress. Maybe most surprising though, is that despite the negative effects of our work, 99.2% reported average to high levels of compassion satisfaction.

As I think about these findings in the context of behavioral health culture, I wonder if we are so used to being the helpers that we push our own needs aside to help those around us, in both our personal and professional lives. Similar to military culture, have we learned to push through struggles and to focus on what is best for others or the groups we belong to? Those groups may include our family, our work place, or our clients, and our communities. While this coping strategy may be effective for a while, it is not sustainable long term.

I recently piloted a provider sustainment for Star Behavioral Health Providers (SBHP). Attendance and interaction was low. The training was designed to be highly engaging rather than our typical didactic trainings. During our training, we often have engaging side conversations and attendees are generous in sharing clinical experiences related to the topics we are covering. This was different. We were talking about them. Asking them to be vulnerable about their own struggles. Asking them to assess their own levels of burnout and secondary traumatic stress. This can lead to discomfort.

As I was creating the training, I took the ProQOL (Stamm et al., 2009) to test to see if it would be a good fit for the training. As I answered the questions, I found myself struggling to answer the questions honestly, I found myself answering them the way I thought I “should” answer and feel. Being vulnerable to the negative aspects of our jobs as helpers can make us question whether or not we chose the right profession. Are we doing something wrong if we struggle?

The literature shows us that the majority of us feel at least some negative outcomes of the work we do. Normalizing the struggle and making meaningful changes towards self-care is critical for the health and ability to stay in the profession. During a recent live presentation, I was asked how I have stayed in the field for so long (27 years). I was a bit surprised by the question and it took me a moment to respond and I have been thinking about it ever since that training. A couple of these I identified immediately, others took more time to put into the context of self-care.

I will highlight some of the ways I have been able to sustain a long career in mental health.

  • Change jobs. We can outgrow workplaces. What was an ideal fit for a brand new therapist, but may not be such a good fit for a seasoned professional. Maybe leadership has changed and the direction the organization is moving doesn’t align with your career goals. Don’t be afraid of change.
  • Change the population you work with and seek out training to become an expert with that population. My first job was working with families involved in the child welfare system. Working first primarily with parents, I later moved to working with children and teens (with a lot of additional play therapy training!). That served me well for several years and I found my niche---play therapy and TRICARE. As my own family grew, I found that working with children was more challenging, and I began working with adults again.
  • Take a break from clinical work. While I recognize this might not be a viable option for everyone, it certainly allowed me to come back to clinical work with renewed energy and excitement. My career took a path I would never have expected, and has kept me on that road for 12 years. In summer of 2019, I transitioned full-time jobs and began a part-time clinical job at a local hospital. During the pandemic, I opened a virtual private practice. I have complete control over both of these part time gigs and it allows me to use my clinical skills and reminds me of my “why”.
  • Volunteer. After I closed my private practice, I found myself missing direct work, but didn’t want the responsibility for an ongoing caseload. I volunteered with the Red Cross through their Service to the Armed Forces division leading psychoeducational workshops. This was a great fit for that time in my career and personal life.
  • Don’t be afraid of growth opportunities. My very first clinical director, Nick, used that phrase when he had new (and potentially unwelcomed) tasks for me. My work with children was a growth opportunity, and thus began my love of play therapy. It is also how I learned that for me, working with non-offending parents of children who had been sexually abused was not my passion. I learned much from both of those unexpected opportunities.
  • Go to therapy and receive supervision. We should not be doing this alone. We shouldn’t expect our clients to be vulnerable with us without having experienced that vulnerability ourselves. Have your own therapist on speed dial. Call them. Even when you aren’t sure you need it. You do. My therapist recently retired and finding a new one is hard. Do it anyway.

As helpers get burnt out. We experience Secondary Traumatic Stress. Our work changes our worldview in amazing and negative ways. We can develop symptoms of PTSD and other related mental health concerns. But we also have the skills to navigate these challenges, we just need to apply what we know to ourselves…..we’re worth it. And the world needs us to be happy and healthy.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Christy Collette, LMHC, is a Program Associate for the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this capacity, she is coordinating the expansion of the Star Behavioral Health Providers into new states across the nation. SBHP trains civilian behavioral health providers to work with Service members, veterans and their families.

Holmes, M. R., Rentrope, C. R., Korsch-Williams, A., & King, J. A. (2021). Impact of COVID-19 pandemic
on posttraumatic stress, grief, burnout, and secondary trauma of social workers in the United
States. Clinical Social Work Journal, 49(4), 495–504.

Stamm, B. H., Higson‐Smith, C., Hudnall, A., & Stamm, H. (2009). Professional Quality of Life Scale
(ProQOL). I Can, 5(1).