The May/June 2015 edition of Psychotherapy Networker had a great article on preventing burnout, called “Burnout Revisited.” This series of posts will be based on that article. In this post, I describe “bunting” as a means of sacrificing professional pride for the good of the client.
Bunting
In the last post, I discussed the importance of outcome research and focusing on results as a way of preventing burnout. But how do we focus on results when we have an impossibly resistant client? When we’ve done everything we know how to do and it’s all failed? When neither our colleagues or our supervisor have any useful suggestions? What if we are out of options?
We bunt.
OK, time for a disclaimer. I am not giving you direct professional advice; I am not your supervisor. This post is meant to stimulate thinking and ideas. It is not meant as a substitute for clinical judgement, peer evaluation or supervision.
Now, back to bunting.
In baseball, players bunt when they know they will probably lose. They sacrifice their own chance to score points to benefit the team. In the same way, we can bunt in counseling.
We can have the hard conversation about moving on.
Here’s a case example:
An agency is in trouble: a backlog of clients, high client drop-out rates, underfunding, burned-out clinicians. What did they do? They instilled outcome measurement, and “bunted” when progress wasn’t being made. The result? Staff turnover and sick days were reduced significantly, while client improvement rate increased by 21%. Consumer complaints also dropped dramatically.
What did they do, exactly? They measured outcomes at every visit: one for the quality of the work and another for the outcome of the service. This can double the probability of improvement by identifying clients that aren’t being helped (for more information, visit whatispcoms.com). Then, they traded cases or referred out when they were ineffective.
This wasn’t always easy. For example, Joe, a 20-year veteran of a rural counseling center, knew he wasn’t helping a female client based on this outcome research. However, the client could not accept this and would beg him to continue, telling him he was “the only one that could help”. Rather than succumb to this appeal to his professional pride, he stuck to his guns, firmly but gently. When the client finally did visit another therapist, she improved.
Summary
Not only can we prevent burnout by caring more effectively, our clients will benefit as well. A win-win! (Sorry for the corporate lingo, but it fits). In the end, therapists fulfill their professional calling by doing the things that objectively help clients. Caring is part of the process, but it is never a means to the end. Rather, it’s all about measuring outcomes, and letting go when progress isn’t being made.
Yours in the Joy of Knowledge,
Dr. Barbara LoFrisco
