Therapists’ own family system experiences can trigger this, and all therapists will experience this to some extent at some point in their clinical work. Therapists may face times when their client’s presenting problem includes elements that remind therapists of their own experiences in childhood (Timm and Blow 1999). Self-of-the-therapist issues are reactions that therapists have to their clients that are related to family of origin experiences (McGoldrick 1982), similar to what might be called countertransference (Scharff 1992). We define these differing experiences here. Each of these potential issues has its own signs and symptoms, requires different attention to be managed or prevented, and likely derives from a different systemic influence. Emotional Risk for Mental Health ProfessionalsĪ career as a mental health professional can be an incredibly rewarding experience, but also comes with the potential for a variety of issues, including self-of-the-therapist issues (Timm and Blow 1999), compassion fatigue, secondary trauma, vicarious trauma, and professional burnout (Newell and MacNeil 2010), of which can arise when working with a long-term client. We will first present factors that could influence a therapist and affect their emotional experience, and then depict how to apply our adapted supervision approach within this context. As supervisors, we experienced this type of treatment bringing up emotional reactions with multiple supervisees. In order to provide a depiction of how multiple systems within the field can affect the emotional experience of a therapist, we will focus on experiences of compassion fatigue and professional burnout that can arise when working with long-term clients. In order to address the emotional impact from multiple systems on mental health professionals, we will present in this paper an approach to supervision adapted from Emotionally-Focused Therapy (EFT Greenberg and Johnson 1988). Such emotions should warrant processing in supervision prior to it becoming problematic in the therapist-client relationship (Watson 1993). We believe that emotional reactions to clients can happen with a variety of different clients, situations, or presenting problems, and can be the result of multiple systemic influences. On the other hand, where compassion fatigue and professional burnout acknowledge systemic influences on the therapist’s emotional experience, supervision in these approaches generally advises self-care first, and does not directly address emotionality in the context of the clinical system (Figley 2002b). For example, where supervision to process self-of-the-therapist issues recognizes the supervisee’s family system influences, and directly accesses emotion (Timm and Blow 1999 Wetchler 1999), it doesn’t move beyond those pieces to simultaneously address how the clinical system the therapist presently is in is contributing to the experience. Presently, most of the approaches to supervision for managing these normal responses have primarily been individually focused or lacking a direct focus on the emotional process. For therapists experiencing any of these reactions, seeking supervision to manage them is advised. These reactions that a therapist may experience with cases could be a variety of things, it could be a result of self-of-the-therapist issues (Lum 2002 Timm and Blow 1999), compassion fatigue, professional burnout (Newell and MacNeil 2010), or some combination of the above. Within the field, within an agency, or even within a therapy room, different experiences or messages are likely present that can deeply impact a therapist’s emotional reaction to any client or any presenting problem. What are your thoughts, feelings, or reactions? Were they positive or negative? Was your first feeling dread or excitement? Did you feel hope or worry? Did you first think about the client’s potential background or history or your past experiences with long-term clients? If your first reaction was fatigue or apprehension, you are not abnormal, and in fact may be reacting normally given your experiences within different systems. Or maybe, you are on your 43rd session with one of your clients, reflecting on the case and its progress. Or, perhaps you are having your first session with a new client at your private practice when you find out the client has been in treatment for 2 years and expects to see you continuously, and indefinitely. ![]() You arrive at your agency one morning with a new client scheduled to see you, one that been seen at the agency off and on for the past couple of years and is now scheduled with you.
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