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Section 34
Therapist Burnout

Question 34 | Test | Table of Contents

In the last section we discussed four key risk factors regarding the development of Secondary Traumatic Stress Disorder and five steps to alleviate the countertransference feelings for your supervisee.

This section will look at what I have found is the biggest trigger for STSD and possible burnout in supervisees. This trigger is the perceived inadequacies that result from a battered woman's cycle of leaving and returning, only to leave and return again and again.

Have you found, like I, it is often difficult to feel adequate as a helper when a battered woman continues to return to her battering spouse? In these cases, I find it helpful to remind my supervisee to maintain their perspective and remember that the average battered woman leaves 7 to 8 times before permanently leaving a relationship.

Case Study: Melissa & Adam
Melissa, age 32, met Adam, age 35, online. After about a year of dating they moved in together. Due to receiving numerous slaps in the face and punches, Melissa had left Adam three times. However, currently Melissa was living with Adam again. Melissa stated, "Adam accused me of stealing money from his wallet and started to slap me in the face for lying when I said I didn't do it. Then a few minutes later he found the money in his pocket. Instead of apologizing, he came back to slap me more. He yelled at me, 'You must have moved it!' That's how it always is with him, it's always someone else's fault. That's why I left him, but then I got so scared on my own. I just had to go back."

As with Melissa, there are many factors that determine if a woman will permanently leave her situation. To help my supervisee, Janelle cope with her feelings of inadequacy and burn-out, I find the information from Gelles (Gel-is) and Straus to be helpful. Gelles and Straus outlined four factors that distinguish between a battered woman who leaves her situation from a battered woman who stays. The following exercise and the 4 leaving vs. staying factors are written as if talking directly to the supervisee. Consider discussing these factors with your supervisee in your next session, if you think it would be a helpful exercise.

Exercise for the Supervisee
As you read the four factors of leaving vs. staying, think of a battered client whom your supervisee is treating returned to an abusive relationship. I asked Janelle, "Did this cause you to begin second-guessing? Did you find yourself saying to yourself things like, "If-only," "I could've," "I should've," "I would've?"" I find this self-questioning may stem from an earlier unresolved experience the supervisee may have with insecurity, self-esteem, and self-doubt. These unresolved issues may cause countertransference from the supervisee onto the supervisor or onto the client.

Four Leaving vs. Staying Factors
Below is a sample of four points I discussed with Janelle.
1. A battered woman who leaves seemed to have experienced more violence. Maybe your client who returned just hasn't "bottomed-out" yet and hasn't experienced that "last straw" syndrome. The violence she has experienced may be horrible, but not horrible enough for her to leave.

2. A woman who is more likely to stay in an abusive relationship grew up in a violent home.
As you may know, it seems that this past history gave her less hope of escape. For your client who returned to her batterer, ask yourself if the level of violence she is currently experiencing is a piece of cake compared to the level of violence she grew up with.

3. A woman with young children is more likely to stay.
As her children get older and they get hurt trying to protect her, she is more likely to leave. Did your battered client who returned have young children? Perhaps as they grow older your battered client will be more likely to leave to protect them.

4. A woman who is less educated is generally more likely to stay.
This may be because she has fewer job skills and is more likely to be unemployed. Essentially, she has fewer resources to help her leave. Consider a client you are currently treating. Did her level of education play any part in her decision to leave or stay?

Finding a Solution in Staying
When feeling inadequate as a helper for a battered woman, I also find it helpful to remember that leaving her battering partner is not the only way to stop the violence. As you know, there are, in some cases, battered women who manage to stop the violence with their husbands, and stay in the relationship. I often have to remind myself that the battered woman should decide what is best for her, and sometimes that is returning to her battering spouse.

This section has discussed the feelings of inadequacy and burnout that may occur when a battered woman enters the cycle of leaving and returning to her battered partner.

In the next section, we will look at countertransference and ways a supervisee can protect his or herself while treating battering relationships.

Peer-Reviewed Journal Article References:
Kim, J. J., Brookman-Frazee, L., Gellatly, R., Stadnick, N., Barnett, M. L., & Lau, A. S. (2018). Predictors of burnout among community therapists in the sustainment phase of a system-driven implementation of multiple evidence-based practices in children’s mental health. Professional Psychology: Research and Practice, 49(2), 132–141.

Nissen-Lie, H. A., Orlinsky, D. E., & Rønnestad, M. H. (2021). The emotionally burdened psychotherapist: Personal and situational risk factors. Professional Psychology: Research and Practice, 52(5), 429–438.

Simionato, G. K., & Simpson, S. (2018). Personal risk factors associated with burnout among psychotherapists: A systematic review of the literature. Journal of Clinical Psychology, 74(9), 1431–1456.

What four factors can determine whether a battered woman will leave her situation? To select and enter your answer go to Test.

Section 35
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