COUC 500 Week 6 Counselor Impairment Paper Example

Counselor Impairment Paper: Burnout, Compassion Fatigue and a Former Emergency Nurse's Plan to Stay Well

What Counselor Impairment Is

Impairment occurs when a counselor's own physical, mental or emotional problems reduce their ability to provide competent care to the point that clients could be harmed. The ACA Code of Ethics asks counselors to watch for signs of impairment in themselves, to seek help when problems reach that level, and to limit, suspend or end their professional responsibilities until they can practice safely (American Counseling Association, 2014). Impairment is not the same as having a hard week; it is a loss of competence.

Two conditions often come before it. Burnout develops from sustained strain in the work itself, such as heavy caseloads, poor support and low control, and is typically measured as emotional exhaustion, depersonalization and reduced accomplishment. Compassion fatigue, by contrast, arises from the work's emotional content, the cost of repeatedly entering into clients' suffering. A counselor can experience one without the other, and either can progress to impairment if ignored.

How Common the Problem Is

National studies of counselors show that burnout depends heavily on context. In a sample of 340 professional counselors, Lent and Schwartz (2012) found significantly greater burnout among community mental health outpatient counselors than among counselors in private practice or inpatient settings, and found that counselors with lower neuroticism and higher extraversion, agreeableness and conscientiousness reported less emotional exhaustion and depersonalization. Thompson et al. (2014), studying 213 mental health counselors, found that working conditions, mindfulness, coping strategies and compassion satisfaction together explained about two thirds of the variance in burnout, though far less of the variance in compassion fatigue; counselors who coped less maladaptively, were more mindful and found more satisfaction in their work reported less burnout. Puig et al. (2012) found that job burnout predicted a large share of the variance in counselors' personal wellness, showing that strain at work spills into the rest of life.

Signs to Watch For

Emotional signs include irritability, cynicism about clients, numbness, intrusive images from clients' stories and a sense of dread before sessions. Behavioral signs include withdrawing from family and friends, sleeping poorly, relying on alcohol or food to unwind and abandoning exercise. Professional signs include falling behind on notes, missing or shortening sessions, blurring boundaries and avoiding supervision. Any one sign may pass; several together, lasting for weeks, call for consultation. Because impairment can cloud the judgment needed to notice it, the signs are often seen first by others, which is why the ethics code also asks counselors to help colleagues recognize their own impairment and to consult when a colleague shows warning signs. Self-monitoring has blind spots, so I would ask a trusted peer and my supervisor, before any trouble starts, to tell me plainly if they see these signs in me.

My Personal Assessment

Eight years in an emergency department left me with strengths and risks. The strengths are real: I stay calm in crises, I am used to supervision and teamwork, and I know my own warning signs of exhaustion because I have seen them before. The risks are just as real. I have absorbed a great deal of trauma, from overdoses to child deaths, and I learned to keep working through it rather than process it. I am proud of my stamina, which tempts me to ignore fatigue. And I expect my first counseling job to be in a community agency, the setting where burnout appears highest. On a self-review of the warning signs, I recognize intrusive memories from emergency work and a tendency to withdraw after hard shifts, both of which I will watch closely. My protective factors include a supportive spouse, a church small group, regular running and a sense of calling to this work that has carried me through hard seasons before.

My Wellness Plan

The plan treats my history of trauma exposure as a risk to manage now, before clients' stories add to it.

• 1. Personal counseling: begin seeing my own counselor this semester to process the trauma I carried out of emergency work.
• 2. Mindfulness: ten minutes of guided practice each morning, since mindfulness was associated with lower burnout in counselors.
• 3. Supervision: each week, raise with my supervisor any case that has stirred something personal in me, and ask that supervisor to tell me directly if I seem depleted.
• 4. Limits: no more than one evening a week of work or study past 7 p.m., and one full day of rest each week.
• 5. Connection: a monthly lunch with two former nursing colleagues who understand what I carry, and a weekly small group at church.
• 6. Review: once a month I will score myself against the warning signs listed above; if three or more persist for two weeks, I will reduce my load and consult my supervisor.

Conclusion

The research is clear that burnout depends on setting, coping and support, and the ethics code is clear that monitoring oneself is a duty. My nursing years taught me to care for others under pressure; this plan is meant to teach me to care for myself so that I can keep caring for clients. Paul urged Timothy to keep a close watch on himself as well as on his teaching (English Standard Version Bible, 2001/2016, 1 Timothy 4:16), and that watchfulness is where wellness begins.

References

American Counseling Association. (2014). ACA code of ethics. Author.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Lent, J., & Schwartz, R. C. (2012). The impact of work setting, demographic characteristics, and personality factors related to burnout among professional counselors. Journal of Mental Health Counseling, 34(4), 355-372. https://doi.org/10.17744/mehc.34.4.e3k8u2k552515166

Puig, A., Baggs, A., Mixon, K., Park, Y. M., Kim, B. Y., & Lee, S. M. (2012). Relationship between job burnout and personal wellness in mental health professionals. Journal of Employment Counseling, 49(3), 98-109. https://doi.org/10.1002/j.2161-1920.2012.00010.x

Thompson, I. A., Amatea, E. S., & Thompson, E. S. (2014). Personal and contextual predictors of mental health counselors' compassion fatigue and burnout. Journal of Mental Health Counseling, 36(1), 58-77. https://doi.org/10.17744/mehc.36.1.p61m73373m4617r3