The timeliness of International Stress Awareness Day 2023 coinciding with Psychology Week 2023, and notably the latter’s theme “Make Self-Care Your New Superpower”, takes on profound significance in the field of psychology, particularly in the current climate.

The landscape of mental health services is evolving rapidly, driven by the challenges of increasing costs of living, global political and societal conflict, and the longstanding aftermath of the COVID-19 pandemic. This dynamic environment has placed intense pressure on psychologists to broaden and develop their expertise, ensuring mental health services remain accessible to a wider range of client populations.

Interestingly, the pathways to becoming a psychologist have also narrowed since the discontinuation of the 4+2 pathway in recent years and lacking compensation with limited and competitive Masters entries, furthering the demand on early career psychologists to fill gaps in the industry while simultaneously navigating personal and professional development, entering the workforce and increasing their exposure to a diverse clientele.

In this ever-changing scenario, the importance of self-care, particularly for early-career psychologists, has never been more apparent.

Why are stress awareness and self-care so critical?

Psychologists play a pivotal role in providing emotional and formal support to individuals facing a diverse spectrum of mental health challenges. Simultaneously, we, as psychologists, are not immune to the external pressures of our world. We too grapple with the rising costs of living and are affected by broader global and systemic issues. Concurrently, many early-career psychologists find themselves navigating a career path that demands increased tertiary education, mandatory internship or registrar requirements and placements, and workloads that surpass the expectations of a standard full-time job, sometimes unpaid. The combination of these factors, compounded by the emotional weight of our profession, makes early-career psychologists particularly susceptible to burnout.

This emphasises the pressing need to have open conversations about burnout and self-care, which align neatly with the core theme of Psychology Week and International Stress Awareness Day 2023. In our efforts to provide support to others, we must remember that self-care is not a luxury; it’s a superpower that enables us to thrive, both professionally and personally. So, the vital importance of self-care for psychologists, especially those starting their careers, remains an important topic of conversation throughout this significant week.

Recognising the dynamic trajectory of becoming a psychologist

Combatting stress requires self-awareness foremost, and it is important to recognise that the personal development of a psychologist is not linear, nor identical. A clear understanding of the developmental process and realistic demands of an early career psychologist may help to combat negative avenues that result in workplace stress, which can manifest as feelings of incompetence, burnout and disillusionment.

Research indicates that early career psychologists often feel threatened, anxious, and overwhelmed during their training, particularly when commencing work with clients. They may lack confidence, be unsure of how to handle clients or grapple with ethical dilemmas. The supervision process can also be a challenging dynamic to navigate, and a suboptimal supervisor relationship can hinder progress. As early career psychologists build their competence and increase their exposure to the field, shifts in their internal perspective of their abilities and personal and professional needs as developing practitioners occur.

During my own training, a dear supervisor introduced me to Rønnestad & Skovholt’s (2003) longitudinal study, which followed therapists throughout their professional trajectory to identify commonalities in their experiences as therapists in training. Their study identified six phases in a psychologist’s career, with the first four being most relevant to early career psychologists: the Lay Helper, Beginning Student, Advanced Student, and Novice Professional phases. This study became a familiar referenced piece I would seek out for validation and reassurance in times of uncertainty and self-doubt, and helped to normalise the experience of being an early career psychologist myself.

The Early Phases

Rønnestad & Skovholt (2003) found that before commencing their learning, early career psychologists often start as “Lay Helpers”, with a tendency to offer intuitive assistance rooted in personal beliefs to their informal supports, like peers and family. This was noted to often lead to boundary challenges, yet prompts a desire to channel their drive for helping others into a professional pathway.

Transitioning to the “Beginning Student” phase, where tertiary education and internship/registrar programs commence, intensifies anxiety and self-doubt where the realisation of needing to integrate personal belief systems with evidence-based and ethical practice elicits fear of failing or doing wrong by clients. This prompts an emergent need for mentorship and an open attitude to seeking input from senior psychologists on how they act, think, and feel in clinical practice for their own learning purposes and application.

Subsequent phases, namely the “Advanced Student” phase, reflect early career psychologists’ pursuit of excellence and conservative approach, often seeking external validation while critically assessing their own practice and evidence-based research, and focusing on both internal and external aspects of professional growth. We, in layman’s terms, reference this phase as “feeling consciously incompetent”; a difficult period to navigate given the pre-experienced emphasis on high performance and perfectionism during tertiary education and in pursuit of competitive post-graduate pathways. Tendencies to pursue high perfectionism and performance remain predictors for early burnout and may be considered as overcompensation for the phenomenon of “imposter syndrome”, a highly prevalent and universal experience for many early career psychologists.

In the “Novice Professional” phase, psychologists may experience newfound freedom but also confront unexpected challenges. They must navigate boundaries, responsibility, and the intricacies of therapeutic relationships, striving to integrate personal and professional elements effectively while establishing their reputation and practice in the field with less supervision and formal support than before.

These phases represent the dynamic and fluid internal and external experiences of early career psychologists, and highlight the complex co-occurring responsibilities of learning theoretical and practical foundations, applying these learnings to and building competence in diverse therapeutic modalities, assessments, and client populations, navigating the supervisor-supervisee and client-therapist relationship, ensuring the provision of ethical dilemmas and decision-making, and all the while completing additional course- or internship-related requirements and remaining cognisant of ensuring their clients receive the most optimal psychological care possible; a service they personally perceive they are largely incompetent in providing. Cue panic symptoms.

How does this relate to stress awareness and burnout?

Burnout is a state of physical, emotional, and mental exhaustion that often results from chronic workplace and professional stress, particularly in demanding or emotionally taxing professions like psychology. It can manifest as feelings of cynicism, detachment from work, reduced effectiveness, and an overall sense of depletion. Burnout is not merely feeling tired or stressed; it represents a deep sense of weariness that can have serious consequences for an individual’s well-being and professional performance.

In reference to early career psychologists, burnout is particularly evident in Rønnestad & Skovholt’s (2003) four phases of psychologists’ development. It is highlighted how psychologists are not immune to external pressures and the dynamic trajectory of a psychologist’s career is emphasised, where the phases highlight the unique demands and challenges faced by early career psychologists, such as feelings of self-doubt, dependency on mentors, new client interactions, and the need for feedback and validation. The additional factors of the pursuit of excellence, the emphasis on high performance, and tendencies towards perfectionism can also potentially lead to burnout where early career psychologists strive to excel in their profession before finally transitioning into later phases, which underscore the sense of newfound freedom, unexpected challenges, and the need for self-discovery and skill development while balancing personal and professional elements and refining boundaries.

Broadly, burnout can be particularly prevalent for psychologists due to the emotional and psychological demands of the job. We often work with clients who are experiencing distress and trauma, and this emotional labour can take a toll over time. Burnout in psychologists can lead to reduced empathy, increased errors in clinical judgment, decreased job satisfaction, and even ethical lapses in professional behaviour among more severe mental health issues. Personally and professionally, awareness and management of stress and burnout through self-care remain a high priority for sustainability in the profession and adequate client care yet is largely neglected due to the competing physical and emotional demands of the profession.

How can early career psychologists recognise burnout and workplace stress?

Self-awareness is key. Despite supporting others with recognising and intervening with signs of psychological distress or decline, psychologists often struggle with identifying signs of burnout within themselves. Beliefs regarding perfectionism and high standards interfere with the acknowledgment of burnout due to fear of being perceived as incompetent or because of personal desires to achieve general registration and/or endorsement in the minimal timeframes. Engaging in self-reflective practice is a core competency for any psychologist, and it can assist with increasing awareness and understanding of signs of burnout early.

So, how do we recognise burnout and workplace stress? Internally focusing on the core trio: thoughts, feelings, and behaviours. Our accessibility to resources that promote monitoring of internal and external experiences is plentiful and are the tools of the trade in servicing clients, but we must be our own clients too.

To monitor our internal and external experiences, mindfulness practice is a must. Being a conscious observer and non-judger of our experiences helps us to attune to the thoughts and emotions that intermittently and inevitably arise, and assists in identifying urges to engage in behaviours that function to combat negative internal dialogues or sensations. Proactive engagement in mindfulness can be effortful, yet simple. Make space to draw attention to and be non-reactive to sensations and thoughts that arise while pondering work-related questions:

 

“How am I doing? What do I need? What is the hardest part of my work, and what worries me the most about it? How have I changed, both positively and negatively? What is my sense of personal accomplishment? What came up for me in my last session with [X]? Where/when have I felt that before? Why?”.

 

Everyone’s experience of what arises for them will differ, though there are commonalities in trends of thoughts, feelings, and behaviours that are often linked to burnout and stress, and which may be elicited during mindfulness practice.

Relevant thoughts may have themes consisting of:

    • >> Questioning own competence.
    • >> Perfectionistic ideas and self-criticism.
    • >> Loss of hope and cynicism.
    • >> Challenging beliefs on safety, trust, esteem, and control.
    • >> Preoccupation with clients.
    • >> Tendency to fall into “thinking traps” of personalisation, black-and-white thinking, fortune-telling, jumping to conclusions and mind-reading regarding work-related situations.

Feelings common with stress and burnout may involve:

    • >> Anxiety in response to thoughts regarding work and performance.
    • >> Feelings of overwhelm.
    • >> Emotional exhaustion.
    • >> Compassion fatigue, or conversely, over-involvement with clients.
    • >> Feelings of isolation.
    • >> Bystander guilt and self-doubt.

Urges to engage or actual engagement in behaviours related to stress and burnout may include:

    • >> Declining attendance to self-care (diet, exercise, sleep).
    • >> Distancing and absenteeism.
    • >> Decreased productivity.
    • >> Unhelpful self-soothing (through binging food/TV/social media, alcohol and substance use).
    • >> Withdrawal from or avoidance of intimacy and relationships.
    • >> Difficulty boundary setting, including challenges separating personal and professional life/hours.
    • >> Over-compensation through preoccupations with study, learning and development that interferes with other life areas and appears uncontrollable.

What is self-care and what are key solutions to navigating it?

Self-care is a proactive and deliberate practice aimed at preventing burnout and promoting overall well-being. For psychologists, it involves a combination of strategies and activities designed to help psychologists maintain their mental and emotional health while effectively managing the demands of their profession. Regular supervision, self-reflection, and proactive self-care practices can help psychologists maintain their own well-being while continuing to provide high-quality care to their clients. Self-care oftentimes requires drawing on tools learned for and applied to clients, and applying them to ourselves.

Self-care should continue to incorporate mindfulness practice. Mindfulness is simultaneously a tool for building awareness and managing physiological arousal associated with stress. The research is clear that mindfulness helps humans improve their affect by remaining present (and thus supporting disentanglement from past and future work-related worries), reducing reactivity and promoting conscious responsivity to stress, and mediating judgment and negative evaluation of the self that perpetuates stress and feelings of incompetence. Mindful eating, walking, or movement (e.g., frequent yoga practice) may help, but simply incorporating a 10-minute mindfulness session two times per day over time is a good start.

Remind yourself of the importance of attending to your biological, psychological, and social needs in a balanced way. Diaphragmatic breathing, intense 30-minute exercise sessions, and daily exposure to natural environments are all noted to improve stress levels and are recommended to be incorporated into daily routines. Prioritise proper nutrition, adequate sleep, creativity, humour, social engagement, and spontaneity, and participate in healing activities that are disparate from your daily job, like journaling, artistic pursuits, gardening, and socialising, to rejuvenate.

Other reflective and personalised stress-management strategies may include:

>> Self-observation and intervention: Recognise the importance of early identification and treatment when you notice signs of burnout. Do not delay seeking help, whether it is from a supervisor, manager, peer, or professional. Speaking out is important.

> > Validation and normalisation: Understand that your own reactions are normal responses to the emotional toll of your work. Avoid self-shaming or guilt. There is a high likelihood your peers feel similarly (after all, Rønnestad & Skovholt developed their phases off commonalities identified in therapists’ experiences!).

>> Reframe self-doubt: View self-doubt as a reflection of your commitment and sensitivity as a psychologist in training, not as a weakness or sign of incompetence. Self-doubt is an indicator of self-reflective practice, a must-have competency to be an ethically practicing psychologist.

>> Debrief: The emotional toll of psychological practice is not to be ignored, and debriefing tough client sessions or interactions can help with processing any counter-transference, judgments, or feelings that arise during client engagement. Seek appropriate debriefing with your trusted manager or supervisor when needed.

>> Peer engagement: Assess and strengthen your support network. Engage in peer supervision, consult with trusted colleagues or family/friends, and discuss problems and ideas with your manager and supervisor.

>> Foster realism: Recognise that you are not alone in this journey. Set realistic expectations for yourself and your clients, avoiding wishful thinking. Establish achievable goals and challenge (or let go of) negative thought patterns.

>> Establish balance and set boundaries: Reflect on how to find the right balance between caring too much and too little, and how to balance your clients’ best interests with your own. Rituals and habits that assist in separating personal and professional hours can operate as a physical prompt to aid boundary setting, like taking a gym class straight after work or listening to non-educational podcasts on the drive home.

>> Develop action plans: Whether it be to-do lists, project maps, learning & development plans, or supervision agreements, developing action plans in collaboration with your trusted manager and supervisor can help to provide clarity and direction during feelings of overwhelm and uncertainty. Developing an action plan can oftentimes feel like “another task”, so seeking support from others in this process is important.

>> Have breaks: Ensure you take regular breaks and time off to recharge, rejuvenate, and disconnect from work. It does not need to be long holidays – think staycations, leaving your laptop at work where possible, or using your work leave effectively to make the most of upcoming public holidays.

>> Seek professional support: Understand that seeking your own psychologist is normal, valid, and okay. Who better understands the challenges of an early career psychologist than someone who has walked the same pathway and who is equipped with the tools to help? Book the time to see your GP for that Mental Health Care Plan (MHCP) and seek support when you need it.

Sarah Stewart

General Manager – Psychology

Clinical Psychologist, BA(Psych),BPsych(Hons) MClinPsych

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