Staff Perspective: Reviewing Outcomes on Self-Care Training
Practicing self-care is vitally important for both personal and professional health. The topic of self-care has been receiving more attention due to the increased stress related to the COVID-19 pandemic. Given the importance of self-care, the purpose of this blog will be to review the latest findings regarding how self-care is being trained, outcomes of such efforts, as well as provide some recommendations and resources.
Although there is not a standard definition, self-care is generally considered to be a deliberate or conscious decision to engage in a behavior to specifically promote our well-being. Self-care behaviors can focus on a diverse range of needs to include physical, emotional, spiritual, intellectual, social, and safety needs. Self-care has been described as imperative for social work practice (Miller and Grise-Owens, 2020) and as an ethical standard for psychologists (Callan, Schwartz, & Arputhan, 2020). The National Association of Social Worker’s ethics code states in section 4.03 that social workers should not permit private conduct to interfere with their ability to fulfill their professional responsibilities (2020). Section 2.06 (b) of the American Psychological Association’s Ethics Code states that when psychologists become aware of personal problems that may interfere with professional responsibilities, they take appropriate steps for consultation or assistance (2000). Overall, the practice of self-care is broadly recognized within the healthcare field as being important to prevent impairment, avoid bad decision making, and enhance the quality of care provided to patients
Self-care has also been conceptualized as an important professional competency with specific behavioral developmental milestones during different stages of professional development. First, students learn why self-care is important, methods for practicing self-care, and demonstrate the ability to appropriately address those needs. As students advance in their training, they are expected to be able to monitor and incorporate feedback as appropriate about self-care practices from their respective supervisors. Finally, at an independent practice level, a healthcare professional is supposed to be able to self-monitor and make appropriate adjustments as needed (Callan et al, 2020).
Given the important ethical, professional, and personal consequences of self-care, Callen et al (2020) conducted a systematic review of the literature to examine how mental health training programs go about developing the competency of self-care for students. Specifically, the authors focused on doctoral counseling and clinical psychology training programs. Their review of the literature resulted in identifying 21 articles from 2009 to 2018 that meet their inclusion criterion. The researchers found 4 training approaches to develop the competency of self-care which included: 1) creating a positive climate or culture for self-care; 2) requiring the engagement in personal therapy; 3) delivering an intervention to improve self-care practices (i.e., didactic or experiential based learning activity, utilizing a workbook or training tool); and 4) the use of mentorship and or supervision. This blog will briefly summarize the findings for each of these training methods and end by highlighting suggestions and resources for improving self-care practices.
Culture of Self-Care within Organizations:
Studies have identified that perceptions about graduate training programs’ self-care emphasis are related to both self-care utilization and to quality of life (Callen et al., 2020). The culture of self-care of an organization has been assessed by examining looking at any written guidance related to the practice of self-care (e.g., program manual for students), and the example of those working within a given organization. A negative organizational climate can create barriers to engage in self-care and increase the stigma associated with practicing self-care (e.g., increase feelings of shame, guilt, or embarrassment over practicing self-care). The challenge can be attempting to shift a culture that can view self-care as a response to a problem versus promoting self-care as both proactive and preventive response (Zahniser, Rupert, & Dorociak, 2017).
Personal Therapy:
Some training programs require students to participate in personal therapy as a method of self-care training. The results from studies examining this particular approach found no significant relationships between personal therapy and perceived counselor competence, self-efficacy, and empathy (Callen et al., 2020). This does not mean that personal therapy is not a valuable resource to help address various challenges. However, for graduate mental health students it appears that there may be other approaches that may be more helpful in promoting the practice of self-care. Given the limited number of studies, additional research is needed to better understand these findings.
Interventions for Self-Care:
Callen et al. (2020) classified any study that provided didactic related training as an intervention. Various approaches to promoting self-care practices included using the Integral Practice Framework, a secondary traumatization perspective, stress reduction approach, and focusing practice techniques or utilizing a workbook or specific training tools. The majority of interventions focused on mindfulness-based techniques and ranged from a one-time two-hour didactic to weekly meetings over the course of five semesters. The workbooks varied in content emphasis ranging from self-compassion exercises to physical care activities. Results from research indicated that the interventions increased utilization of self-care behaviors and that the recipients rated their acceptability favorably. In particular, more positive outcomes were noted in training that was experiential versus purely didactic (i.e., greater utilization of self-care behaviors, higher perceptions of self-care competency).
Mentorship/Supervision:
Another approach to promoting self-care was through participation in mentorship programs. No significant differences were found in the utilization of self-care behaviors for those participating in the mentorship programs versus those who did not.
Suggestions and Resources for Improving Self-Care Practice
- Create or contribute to a positive organizational climate that emphasizes proactive self-care to enhance both personal and professional functioning.
- Take time to complete a self-care inventory to identify potential areas that may need additional attention. https://www.nami.org/getattachment/Extranet/Education,-Training-and-Outreach-Programs/Signature-Classes/NAMI-Homefront/HF-Additional-Resources/HF15AR6SelfCare.pdf
- Make a plan using SMART goals (i.e., specific, measurable, attainable, relevant, and time-specific).
- Training on self-care should include experiential components and not rely just on didactic instruction.
- Resources for providers that can also be helpful:
- https://www.apa.org/monitor/2014/04/self-care
- https://www.apa.org/practice/resources/assistance/acca-toolkit.pdf
- https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus/S...
- Provider Resilience App allows you do conduct self-assessments, provides tools for self-care, inspirational thoughts, and tracks the amount of time until your next vacation.
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.
Timothy Rogers, Ph.D., is a Senior Military Internship Behavioral Health Psychologist and serves as the Associate Program Director for the Air Force Clinical Psychology Internship Program at Joint Base San Antonio-Lackland Texas.
Reference:
American Psychological Association. Ethics principles of psychologists and code of conduct. Retrieved November 13, 2020, from https://www.apa.org/ethics/code
Callan, S., Schwartz, J., & Arputhan, A. (2020, July 30). Training future psychologists to be competent in self-care: A systematic review. Training and Education in Professional Psychology. Advance online publication. http://dx.doi.org/10.1037/tep0000345
National Association of Social Workers. Code of ethics. Retrieved November 13, 2020, from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics- English
Zahniser, E., Rupert, P. A., & Dorociak, K. E. (2017). Self-care in clinical psychology graduate training. Training and Education in Professional Psychology, 11(4), 283-289. http://dx.doi.org/10.1037/tep0000172
Practicing self-care is vitally important for both personal and professional health. The topic of self-care has been receiving more attention due to the increased stress related to the COVID-19 pandemic. Given the importance of self-care, the purpose of this blog will be to review the latest findings regarding how self-care is being trained, outcomes of such efforts, as well as provide some recommendations and resources.
Although there is not a standard definition, self-care is generally considered to be a deliberate or conscious decision to engage in a behavior to specifically promote our well-being. Self-care behaviors can focus on a diverse range of needs to include physical, emotional, spiritual, intellectual, social, and safety needs. Self-care has been described as imperative for social work practice (Miller and Grise-Owens, 2020) and as an ethical standard for psychologists (Callan, Schwartz, & Arputhan, 2020). The National Association of Social Worker’s ethics code states in section 4.03 that social workers should not permit private conduct to interfere with their ability to fulfill their professional responsibilities (2020). Section 2.06 (b) of the American Psychological Association’s Ethics Code states that when psychologists become aware of personal problems that may interfere with professional responsibilities, they take appropriate steps for consultation or assistance (2000). Overall, the practice of self-care is broadly recognized within the healthcare field as being important to prevent impairment, avoid bad decision making, and enhance the quality of care provided to patients
Self-care has also been conceptualized as an important professional competency with specific behavioral developmental milestones during different stages of professional development. First, students learn why self-care is important, methods for practicing self-care, and demonstrate the ability to appropriately address those needs. As students advance in their training, they are expected to be able to monitor and incorporate feedback as appropriate about self-care practices from their respective supervisors. Finally, at an independent practice level, a healthcare professional is supposed to be able to self-monitor and make appropriate adjustments as needed (Callan et al, 2020).
Given the important ethical, professional, and personal consequences of self-care, Callen et al (2020) conducted a systematic review of the literature to examine how mental health training programs go about developing the competency of self-care for students. Specifically, the authors focused on doctoral counseling and clinical psychology training programs. Their review of the literature resulted in identifying 21 articles from 2009 to 2018 that meet their inclusion criterion. The researchers found 4 training approaches to develop the competency of self-care which included: 1) creating a positive climate or culture for self-care; 2) requiring the engagement in personal therapy; 3) delivering an intervention to improve self-care practices (i.e., didactic or experiential based learning activity, utilizing a workbook or training tool); and 4) the use of mentorship and or supervision. This blog will briefly summarize the findings for each of these training methods and end by highlighting suggestions and resources for improving self-care practices.
Culture of Self-Care within Organizations:
Studies have identified that perceptions about graduate training programs’ self-care emphasis are related to both self-care utilization and to quality of life (Callen et al., 2020). The culture of self-care of an organization has been assessed by examining looking at any written guidance related to the practice of self-care (e.g., program manual for students), and the example of those working within a given organization. A negative organizational climate can create barriers to engage in self-care and increase the stigma associated with practicing self-care (e.g., increase feelings of shame, guilt, or embarrassment over practicing self-care). The challenge can be attempting to shift a culture that can view self-care as a response to a problem versus promoting self-care as both proactive and preventive response (Zahniser, Rupert, & Dorociak, 2017).
Personal Therapy:
Some training programs require students to participate in personal therapy as a method of self-care training. The results from studies examining this particular approach found no significant relationships between personal therapy and perceived counselor competence, self-efficacy, and empathy (Callen et al., 2020). This does not mean that personal therapy is not a valuable resource to help address various challenges. However, for graduate mental health students it appears that there may be other approaches that may be more helpful in promoting the practice of self-care. Given the limited number of studies, additional research is needed to better understand these findings.
Interventions for Self-Care:
Callen et al. (2020) classified any study that provided didactic related training as an intervention. Various approaches to promoting self-care practices included using the Integral Practice Framework, a secondary traumatization perspective, stress reduction approach, and focusing practice techniques or utilizing a workbook or specific training tools. The majority of interventions focused on mindfulness-based techniques and ranged from a one-time two-hour didactic to weekly meetings over the course of five semesters. The workbooks varied in content emphasis ranging from self-compassion exercises to physical care activities. Results from research indicated that the interventions increased utilization of self-care behaviors and that the recipients rated their acceptability favorably. In particular, more positive outcomes were noted in training that was experiential versus purely didactic (i.e., greater utilization of self-care behaviors, higher perceptions of self-care competency).
Mentorship/Supervision:
Another approach to promoting self-care was through participation in mentorship programs. No significant differences were found in the utilization of self-care behaviors for those participating in the mentorship programs versus those who did not.
Suggestions and Resources for Improving Self-Care Practice
- Create or contribute to a positive organizational climate that emphasizes proactive self-care to enhance both personal and professional functioning.
- Take time to complete a self-care inventory to identify potential areas that may need additional attention. https://www.nami.org/getattachment/Extranet/Education,-Training-and-Outreach-Programs/Signature-Classes/NAMI-Homefront/HF-Additional-Resources/HF15AR6SelfCare.pdf
- Make a plan using SMART goals (i.e., specific, measurable, attainable, relevant, and time-specific).
- Training on self-care should include experiential components and not rely just on didactic instruction.
- Resources for providers that can also be helpful:
- https://www.apa.org/monitor/2014/04/self-care
- https://www.apa.org/practice/resources/assistance/acca-toolkit.pdf
- https://www.socialworkers.org/Practice/Infectious-Diseases/Coronavirus/S...
- Provider Resilience App allows you do conduct self-assessments, provides tools for self-care, inspirational thoughts, and tracks the amount of time until your next vacation.
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.
Timothy Rogers, Ph.D., is a Senior Military Internship Behavioral Health Psychologist and serves as the Associate Program Director for the Air Force Clinical Psychology Internship Program at Joint Base San Antonio-Lackland Texas.
Reference:
American Psychological Association. Ethics principles of psychologists and code of conduct. Retrieved November 13, 2020, from https://www.apa.org/ethics/code
Callan, S., Schwartz, J., & Arputhan, A. (2020, July 30). Training future psychologists to be competent in self-care: A systematic review. Training and Education in Professional Psychology. Advance online publication. http://dx.doi.org/10.1037/tep0000345
National Association of Social Workers. Code of ethics. Retrieved November 13, 2020, from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics- English
Zahniser, E., Rupert, P. A., & Dorociak, K. E. (2017). Self-care in clinical psychology graduate training. Training and Education in Professional Psychology, 11(4), 283-289. http://dx.doi.org/10.1037/tep0000172