NCAD Spotlight: Proactive Self-Care an Ethical Practice for Clinicians

With responsibilities piling up, it can be an all-too-common refrain for practitioners to neglect taking care of themselves. But proactively making self-care an organizational priority for staff can go a long way toward maintaining quality of care for patients, says Tara Matthews, PhD, LPC, MAC.

At the virtual National Conference on Addiction Disorders, Matthews, an adjunct professor, integrative health coach, licensed professional counselor supervisor, writer, and owner of a small private practice, will discuss the ethics of self-care and help attendees formulate self-care plans while working through an ethical decision-making model. Recently, she spoke with Addiction Professional about why self-care is an issue of ethics, how leaders can change their organizational culture to make self-care a bigger priority for staff, and how the COVID-19 pandemic has made self-care an even bigger challenge for practitioners in recent months.

Editor’s note: This interview has been edited for length and clarity.

Why is self-care an issue of ethics in addiction treatment?

Self-care and ethics go hand-in-hand. As addiction professionals, we’ve chosen to help others in some of their most challenging times. That is going to have an impact on us as professionals and as people. Not only is self-care good modeling, it’s also essential in maintaining our health and well-being. We can’t be effective or ethical in helping others if we’re not caring for ourselves.

Why do clinicians neglect self-care, and how do leaders and executives change their organizational culture to make self-care a bigger priority?

Changing the conversation is important. When we think of the term self-care, we sometimes think of the word selfish. That’s an unfortunate translation we make in our head because as addiction professionals, we’re giving, we’re caring, we’re nurturing others, and we’re sometimes burning the candle at both ends. When we do that and we try to work with clients in a variety of capacities, we become more susceptible to vicarious traumatization. We become more susceptible to other unethical behavior, particularly things like self-disclosure or breaching boundaries. A lack of self-care makes us more vulnerable to breaking other ethical codes that we sometimes take for granted. Most of us think of ourselves as ethical professionals, and we focus on the ethics we think of in terms of taking care of others. My approach is taking the ethical codes and say not only is ethics about taking care of others, it’s about taking care of you.

How do you change that culture in a company as a supervisor? Sometimes, it’s about changing the conversation. It’s as simple as asking or instead of waiting until burnout exists with an employee, you proactively ask questions: What have you done for your self-care this week or today? You need to model that behavior as well. For example, when I work with supervisees, I say one of the things I enjoy doing for my self-care is making sure I spend an hour in nature every day, no matter the weather. Today, I had a great walk. Even though it was hot, it was great to be in the silence of nature. Just a casual comment I might say, then I go on with the topics we’re talking about in supervision, and then toward the end, I might say what are you going to do today to take care of your self-care? It needs to be a proactive activity, not a “now I’m burnt out and need to go on vacation.” It doesn’t work that way. We need to plug in our batteries every day.

Have you found that the pandemic we’re going through right now has caused a bigger strain and made self-care a bigger challenge in recent months?

Absolutely, however, in the example I just shared, it’s fulfilling to spend time in nature. That has not been taken. Part of it is about diversifying the self-care activities you use and not always depending on the one or two you’ve always done. Being creative is important as well. COVID has increased the stress and trauma clients are experiencing, and it also increases stress of those of us serving those clients or teaching those students. We’re getting more stories, more trauma, and to be perfectly honest, the number of people drinking and using is just increasing significantly because it’s the way a lot of people, though unhealthy, are caring for themselves. The addiction population is particularly vulnerable during this time. So, if you’re working with this population, you need to plug in your self-care at an even higher dose.