At California center, clinician self-care ingrained into culture

Addiction professionals know the weight of their caregiving responsibilities can become an undue burden if they don’t set aside time for self-care. At D’Amore Healthcare in Orange County, Calif., clinicians aren’t just encouraged to seek personal healing, they’re deliberately scheduled to participate in self-care retreats as a matter of course.

“The workshops are an opportunity to process, to be nurtured, cared for, seen, heard and acknowledged, as well as an opportunity to learn from a crisis as it occurs,” says Britten Devereux, MS, LAADC, MAC, chief executive officer.

About two dozen clinicians provide intervention, detox and residential care for dual-diagnosis patients at D’Amore, and Devereux says the quarterly retreats help employees work through the daily realities of compassion fatigue and vicarious trauma. She views the self-care program as a way to ensure employees arrive at work “with a full cup.” All D'Amore employees, not just clinical staff, attend the retreats.

On retreat days, staff members gather off-site at The Sanctuary in Tustin, Calif., a nearby holistic wellness center and yoga studio. For several hours, the D’Amore clinicians practice mindfulness and have dedicated time to express their thoughts in debriefing discussions—away from the emotional demands of patient care. By moving to a separate space, clinicians can assess their self-care needs authentically.

Breaking down burnout

Studies indicate that behavioral healthcare workers experience burnout at relatively high rates, ranging from 21 to 61%, according to the American Psychological Association. Among those treating trauma, more than 75% report feeling emotional exhaustion that affects the quality of care provided to their clients. Professional exhaustion can lead to errors, decreased empathy and a toxic workplace culture.

“Healthcare programs can make the mistake of overloading clinicians with clients,” says Sulabha Abhyankar, MSW, LCSW, an independent clinician who leads clinician workshops, including D’Amore’s program. “Providing therapy and processing client needs is an art.”

Abhyankar says maintaining a regular schedule for self-care is critical because, just like patients, behavioral health professionals need multiple opportunities to process their experiences. She says thanks to the continuity of the D’Amore program, she has seen participants transform over several workshop sessions from one quarter to the next.

Just giving clinicians the time and space to practice self-care can be empowering, Abhyankar says. If possible, organizations should dedicate as much as half of the time spent in team meetings to allow for weekly discussion of clinicians’ needs. Self-care is most effective if it’s an ongoing strategy rather than a rare occurrence, she says.

Company culture

Just a few years ago, in the ramp-up to launching D’Amore Healthcare, Devereux was putting in long hours, finding it hard to tear herself away from her phone and her to-do list, even at night. Eventually, she reached out to other professionals for therapeutic self-care and found the experience worthwhile. When D’Amore emerged in 2015, Devereaux was methodical about building in a self-care culture from day one.

For example, the quarterly clinician workshops at The Sanctuary are scheduled during regular shifts, so staff is on the clock, and no one needs to sacrifice family time (the organization also will pay overtime in cases where it is needed). Material includes practical tools, such as problem solving; peer support among clinicians who understand the emotional investment of treating those with substance use disorders and co-occurring conditions; and discussion of topics chosen specifically to address the concerns at hand.

Meghan Wheeler, ASW, clinical supervisor for D’Amore, who participates in the retreats, says professionals understand they must have the ability to model the behavior they’re recommending for their own clients. Likewise, corporate leaders must also model what they ask their staff to do, so the overall culture is integrated from the top down.

“Everyone has to be on board,” Wheeler says. “The clinical director can’t preach self-care [and] then work 100 hours a week and never take a lunch break.”

However, she notes that the employees attend the retreats in groups and their sessions don’t include their corporate managers, so the clinicians will feel more at ease and able to talk about their challenges openly.

Wheeler believes clinicians' toughest challenge today is simply not having enough hours in the day to do everything they want to do. Inevitably, some patients need more attention than expected, but behavioral health professionals can’t fall into the trap of believing that their own self-care is a selfish pursuit, contrary to high-quality patient care, she says.

“We need to remind ourselves that we are just as important as the people we work with and work for,” she says. “That involves us taking care of ourselves. It’s not being selfish. It benefits everyone involved in our lives in the long run.”

Positive experience

According to a study conducted by the U.S. Travel Association, 52% of Americans didn’t use all of their vacation days in 2017. Devereux says D’Amore is deliberate in tracking paid time off for employees, ensuring that everyone takes advantage of their well-deserved downtime. Full one-hour lunch breaks are mandatory, as are the quarterly self-care workshops.

And the result has been positive for the clinicians and the organization, Devereux says. Initially, she anticipated some clinicians would be “biting and scratching” to avoid such a personal self-care experience with their co-workers. Now they see the benefit and are grateful for it.

“They are better clinicians,” she says. “They’re kinder, they’re softer and more aware.”

The improvements translate to organizational advantages as well. As facilities across the nation compete to attract the best local clinicians, Devereux believes the self-care culture is a differentiator for D’Amore.

“Not only has it affected our retention of good clinicians and the development of clinicians, at the end of the day, they have a stronger commitment to their own care because we’ve modeled it to them,” she says.

Julie Miller is a freelance writer based in Cleveland.