Therapist Burnout, Vicarious Trauma, and the Science of Provider Wellbeing

Perfect. Hello and welcome back to Therapist Voices at Reach Link. Um, Reachink is a digital mental health counseling platform. My name is Jessica and I oversee our network of therapists. Joining me today, I'm so excited, is Dr. Joel Bennett, founder and CEO of Organizational Wellness and Learning System Systems, also known as Owls, O WLs, like like hoot hoot owls. And we do we give a hoot. Well, I was going to say you're also such a hoot, but I didn't know if I should be familiar, too. You are one of the funniest people that I know. Um, and that is a fact. So, I know that a big part, Dr. Bennett, of your work is focused on stressors that mental health providers face. Tell us all the things. What do you do? How did you notice the need for all these amazing things that you do that you'll tell us about?

What came first? What did you notice that was glaringly obviously missing? Oh, where does it begin? Um, you know, I mean, the probably the very first noticing was in the research literature because, you know, I have a very, you know, I'm a researcher was on the concept of vicarious trauma. Right. That was where and then shortly after that compassion fatigue. Yeah. Um and then after that moral strain and moral injury, right? All of these negative things, right? and and then after that with COVID um the total uh sort of reduction in workforce uh and the greater need for trained providers who have to do uh more with less. Okay, I mean I'm just stating you know what we all know and and at the same time all that's happening there's not a lot out there. Um that actually you know what I'll go even further back please.

The very first we did a study about 12 years ago. We had a grant from uh this was uh NITAA National Institute of Alcoholism and Alcohol Abuse. And we no it was NAIDA. Anyways, one of the NIH and we had one of our cohorts were providers uh EAP actually and what we noticed in the data was that they had some of the highest rates of stigma for help seeking that they themselves they these were mental health providers who thought they didn't need any help. Right. That's one. Yeah, of course. So okay now we have a syndrome here right so that's how it started with noticing those things what did you do were you like all right I need to start this program immediately how and you have so many programs though they're all incredible yeah it's not about the we always say it's never about the program or the content it's it's about the approach and the relationship right so it's just therap it's like taking therapy the therapeutic alliance to the organizational or client level, right?

So, um what did we do? Well, CO sort of I I hate to say it, ripped off the band-aid. And we had we had one uh state level uh behavioral health um uh I guess syndicate, you know, uh that really wanted to give their um provider members support. And so they asked me to do a series of webinars. Um and what I what I discovered I mean these are primarily female not only but primarily you know female uh also frankly um uh minority uh female and not all but um what I it was just amazing the number of them that shared their vulnerability and how much uh psychic pain they were in. Uh some of it of course was due to loss that was COVID related loss but some of it was just overwhelmed right with the amount of work that they had to do. So then another agency was listening to this and said let's work together and we uh we said well we have a lot of tools how can we package it to be uh an approach that would be sensitive to the the needs of people and not be overly dedactic.

We don't do dedactic. We don't when you know it's not death by PowerPoint ever. Uh and that's that's also part of the problem we'll get into. Anyway, so we created this program called you matter. This partic this is one of these. And what it is is we first start off by creating a care package, a physical box that has some of our, you know, self-care books in it, candles, uh, uh, incense, uh, essential oils, crossword puzzles, mandala book, you know, all these different pieces. And it is basically that's the first thing they get. And it comes from now it comes from the organizational client right but back so it's but we help with it you know we but it can't it's not coming from us it has to come from the organization the leader the supervisor and that's that sends a powerful message right that's huge yeah and it's not a big it's not a lot of cost it's not like you know what but the other thing I learned about that part is that When your heart is in supporting your people, you love putting these boxes together, you know, you know, it's like it's a thing.

Um, I'm a guy, you know, I don't know if people realize, but guys, I like to put boxes together. I love putting gift boxes together. Oh my god, don't even get me started. you know, you know, jelly jam, you know, I need you to wrap all my daughter's Hanukkah and Christmas and birthday presents then. So, we will discuss that. Yeah. No, I mean, don't even get me started. Anyway, uh but then we have what we decided to do was for the format to make it as efficient as possible is to do group coaching uh you know via Zoom and to do uh a key part of all of our work is supporting what we call paired or group really listening exercises. Okay? Because what we find is there's so much talking And we live in a, you know, Edgar Shine, who was sort of my hero as a consulting uh psychologist, we live in a culture of telling.

Yeah. We don't live in a culture of listening. And beautiful as it is, therapists, counselors, providers, that's what they do, right? And um we need to listen to them too. We seem to have missed that along the way. But they but they need to know and this is a switch. They need to know that they deserve Yeah. to be listened to and to have a space to listen to. Yeah. So, I won't go into all the detail of what happens in the coaching, but it's all around emotional dysregulation, working, you know, kind of like coming clean on your on your vicarious trauma, compassion, fatigue, and moral injury, having a safe space to talk about that. Um, and and what I've Oh my god, there's so many stories, and we're presenting the results of some of this. All of them. I love all the Any stories you're willing to share.

Well, we're actually I don't know when this is coming out, but next month we're we have a panel at the Southwest Psychological Association in Frisco here in Texas, uh where we're going to present the results of our research because we always do research on it. And probably the most important thing, you know, if I had to give one story, what we originally found because we've now done close to a dozen cohorts of this and it's always limited, you know, 20 individuals per cohort and our coaches are amazing. Our, you know, providers are just really good at doing that laser. How can we get people in a group together to talk and provide them support? Anyway, one of the things we saw in the data which sort of like bothered me was we actually saw increases in some of these problems from pre to post assessment.

Huh. And this is over you know it's generally three week to four week period that we're doing it you know weekly. And I was like right figure I this was the quantitative data but the qualitative data they have to write these final essays and share was completely opposite. It was like much deeper emotional resonance, you know, uh a lot of release, you know, emotional release, a lot of gratitude. And what I what I learned, we started to ask different questions was that number one, providers are so overprotecting themselves that they don't have that opportunity or space to be vulnerable and it hurts them. In fact, that's one of the issues is it's a cardiovascular risk. Um and so what happens we find that one they become more aware of their stressor so you see an increase. They become more willing to admit what's going on so you see an increase and then they become more willing to share it.

So the analogy here is amazing with the occupational safety literature. So in occupational safety, you know, construction, manufacturing, uh some mining, when people do these safety climate interventions in in that literature, safety climate is, hey, it's okay to come forward if you see an injury. We're not going to, you know, it's okay if you do a little accident because we'd rather know about it. So there's often a climate of suppression and um what the literature suggests in that field this is total worker health occupational safety is that when you do those interventions you actually see an increase in injuries and accidents. That now makes sense. Yeah. But there it's not that you see an increase. is that people are more willing to come forward with it, which is great. It's great, but it's it's got repercussions if you're OSHA regulated.

So, people don't always do this. They just they I don't know if I want to do these kind of interventions, right? The parallel here, I think, is obvious that, you know, um what if I admit it? What do I have to do? And that's where the stigma comes in. So it's complex, it's nuanced, you know. So that's a short synopsis of that particular approach for providers and I can go into some detail on some of the tools that we use there and in our thriving informed practice program that we do with EPA. Yeah. You know, so I'm happy to do that. But I hope that, you know, kind of gives you No, that's that's great. And I would love I think we I would love to hear and I know I know about both of these pretty well. Um so anything about either of them thriving or whichever. Yeah. I mean there's so the thing is it's the tools are there right?

Yeah. Whether our tools or other tools, they're there. You know, mindfulness, you know, uh, uh, loving kindness, meditation, act therapy applied to oneself, um, you know, Bnee Brown, you know, whoever there the tools are there. They're just everywhere. Uh, and now with YouTube right now, you know, you can go on and do a 10-minute meditation to do an emotional reset, and there's probably a thousand of them. Yeah. Uh, tapping, you know, all the things that are out there. Um, so I want to I want to be clear that we're not saying that the tools that we use are the tools, right? Um, I'm a big fan of sematic work. you know, uh there are a lot of people now who are doing uh breathing types of exercises. Um so it's sort of like how do you use the tool and how do you incorporate it into your daily uh practice?

Uh for providers, you know, it's if you're doing therapy before you go into session and after you come out of a session, do you just go right to your notes? Do you just just condense everything or do you set things up? Does your employer allow you to set things up? And do you stand up for yourself and say, "Look, uh, we I know we're uh overworked. I know that the demands are great, but I'm going to burn out here." Yeah. So I can give you the tools but the most important tool is this selfefficacy the and and collective efficacy that the field as a whole has to recognize that um there's a a union aspect to this you know so we can get into the whole conversation of AI and uh how people have moved away from working within a a group practice and which is I think you know related to what you guys do.

Yeah. So I first want to honor I want to say I it's honor to be here because I know you guys are really trying to create a culture that's related to what I just said. Would that be very much? Yeah. Very much. Thank you for saying that. Well that's why I'm here. I mean that's why we're talking. I I feel very strongly I know we're talking about much more than than this, but these days, people are probably so sick of hearing me say this in my life. What therapists are expected to be these days compared to I don't know when is just so wild to me. They have to be a great therapist, but also a tech wizard, their own IT person, their own everything. And I just refuse. I will never have a provider's name come across my desk or meet a provider where I feel like, nope, they can't use our our AI. They can't.

That's not an option. I will make it happen because the people that we're missing out on would be that would be extreme. These amazing therapists that had no idea they had to go to school to be, you know, to learn AI and all this stuff. It's just not fair. It's not fair. So say more about that. Like what are the boundaries there? What do you actually say? You know, well with providers, they always know from the start that they have any amount of support here. We are very firm on using AI, using automate automated systems, but there will always be a human. That is never going to go away. I wouldn't work here if that wasn't the case. So whether it's someone that I meet with on a video every other day and we look at things together, we share screens, we use another method, those things will not be a barrier.

So you're you're going to keep getting it. Say again. When providers might feel insecure about I don't know how to turn this video on. I probably didn't either. Like you're in good company. We will figure it out together. I just feel so strongly I refuse for there to be a provider outreach link that feels alone that feels like they have to figure it out. So when it comes to therapy So when it comes to technology you're going to take the time to support the provider in working through the use of that and and not putting also too much pressure on them to use it. Is that correct? 100%. 100%. We want them to to use it's for them. That's a huge thing here. All these tools are for are for them. And there are in fact a lot of tools that we offer providers that I as the person who's you know looking at their performance that I'm not even able to see.

They can see from a session different metrics about how much they talked which I don't even want to know if I had that for my own conversations. um how how much the client talked, pause time, all these really cool things that are just for them. Again, I can't even see them. It's just that is really the vibe. That's what we want people to understand that it's for it's for them. And they don't have to use everything, right? I would definitely use the AI note because it's great, but but you know, it's up it's up to people. We don't want people to be tied in to Yeah. So this this is an important this is a kind of a pivot in the conversation but it's it's important that um let's go back to burden on the provider and how much is technology adding to the burden uh how much is the technology removing the burden and what's the learning curve and What I think is most important given the what we call sociote techchnical interface you know the the human centered right the high-tech hightouch whatever you want to call it providers currently uh are at varying level of skill for that right and so there is uh another stressor you know I mentioned mentioned earlier, compassion fatigue, vicarious trauma, moral injury.

The other stressor here is what what I call in some of the research calls techno stress or Oh, I love that. I mean, I don't love that, but I love that it's a thing. Techno invasion. And what what's happening and even therapists and providers are seeing this is that in many other occupations people are experiencing job insecurity. Yeah. Uncertainty about the future because of AI. I mean just this week I think Google is investing $150 billion in AI, right? Wow. for uh and so but nobody is really thinking about what is the impact it has on the human centered occupational front of course so we're you know that's we've been in occupational psych our field there are a number of fields we work in but one of them is occupational health psychology and um I'm going to come back to the to the tool thing but you have to if in terms of your own, you know, commitment, your own ethical commitment is to navigate the business that you have with other competitors out there and recognize that there has to be this value ad of this is a place that I want to work in because it does show that it cares for me and that takes time.

Yeah, it takes human touch. Um, and it's not the predicted norm. You know, the norm is not humanentric. The the predicted norm is more AI, more techno, and more p uh efficiency. So, it's countercultural and but that's where empowering them in their own voice. That's one of the things that our work suggests is we can give people all these tools for self-care. You know, people talk about self-care. We can give them access to online asynchronous resources, YouTube. What we have found and fully believe is that putting people together in groups like you're where they can talk with each other, feel supported by each other, feel empowered, and feel that their employer cares about empowering them and their career and their growth. is the number one I think predictor of health and well-being. Feeling that you belong, connection, social capital, support, social support, supervisor support, the research is extremely overwhelming.

Uh and so this profession needs it more than ever. And um so now having said that I think that your leadership right the reach link I'm sorry I've got to make sure I don't that there's no more techno invasion here right oh god I love I love that term again I hate it but I love it I love that it's well what it is so sematics so let me come back to that so we know that uh internet technology uh social media even this is a screen right we're on a screen here does not support uh broadened attentiveness and focus it it supports fragmentation and more and more younger people who are coming into the field have less attention span are are less able to focus are more you know we used to call it multitasking it's just basically uh a culture that supports not paying attention And what I believe from my own work the counter to that is somatic presencing.

You know you'll see here it says quest for presence is our other piece. So what I prefer to do now is to just do a tool like let's just do a tool right now you know. Oh I love it please. instead of talking about it, you know. So, because Okay, so let's just close our eyes for a moment. This may take 3 minutes, please. And really let that, you know, that sense of, oh gosh, I can actually not have to listen to more and just relax for a moment. You can't make me laugh during it. I'm always going to laugh. No, you got to laugh. It's good for laugh. You have to okay la laughter yoga is another sematic modality um in fact I have I always say I have a book of dirty limmericks here but I won't read them out loud okay anyway uh take a deep breath feel your feet wherever they are resting is your foot flat on the floor or is your heel just there let both feet come to rest on the Or are your hands fidgeting?

Are they connected? Let them separate and put them on your lap and you likely will feel some warmth. Let that warmth contact you. Inhale as deeply as you can without strain. Let it go. Inhale again. And straighten your back a little bit. You know, don't overdo it. And inhale again. You might feel your belly. And you may be judging yourself. Oh my god, I feel my belly. I'm a little overweight. Maybe I'm a lot overweight. Okay, let that go. That's not fair. I wouldn't be able to you wouldn't be I wouldn't be able to do it with you. Okay, come back to your breath. Quiet the mind a little bit. And just notice for a moment that all of this is a rhythm. The breathing is a rhythm. Breathe it, sense it, feel it. The heartbeat is a rhythm. You might feel the pulsing somewhere in your hands or neck or torso.

That's a rhythm. Breathe into that. Sense it and feel it. Whatever comes up is fine. This meeting is a rhythm. The conversation is a rhythm. The technology is there, but it's way in the background. What's most important right now is your body and you're being in tune, breathing, sensing, feeling, rhythm. And just let your mind go for a moment and sense your day. What brought you here, the rhythm of sleeping and waking up, of having whatever food you may have had. What happened just before this meeting? You're being here listening to this. What's about to happen next? And come back to the moment. and tell yourself briefly to sense it. It's all unfolding. I'm okay with it. It's all unfolding. I'm good. And then when you're ready, feel your feet on the ground or maybe move your hands and wiggle wiggle your toes, wiggle your fingers, and come back and open your eyes when you're ready.

Well, I liked that. You know what? I really liked that you said when you said I think you said and I'm okay with that that's great cuz at first it's challenging like wait what am like am I letting go of all this stuff okay Dr. Bennett said, "I am. I am." There you go. That's great. Yeah. So hopefully that and of course that could take longer. This was just a small sample, right? So um what's next? I love that. Well, now how who's supposed to go to work now? Very grounded. Well, that's a great question. Who Who is going to work? Who which Jess? You never know. You ne seriously you never know. I never know. Truly truly. But it's going to be a really productive one, I think. Yeah. I hope. And I'll I'll let you know. I will circle back and give the feedback. So quick note before we finish you know productive efficient present in sync in rhythm we know that productivity can kill us.

Yeah. So I will say please take your time. Did everyone hear that? Because truly please do. The truth is you can't help but doing it. It's you will it will come out. You know the best-selling book is the body keeps the score. Um you know it's because we don't pause and slow down. is going to come out some way. So, it's what do you value? You know, people go, "Well, money. I value money. I need to make money. I've got to feed the kids." Okay, it's always a balancing act, right? But that's where rhythm comes in. When you're in tune with your rhythm, um it's much easier to balance. If you're struggling to be productive in balance, that's why the body uh sematic work is so important. That's all. I love that. I I'm always going to tie seatic to you, to your company. That's amazing. Well, you've really set me up for the day.

Set me up for success. Thank you so so much truly for doing this. This We're going to have to have a part two. Are you up for a part two? as much as you want. So, reach link providers, if anyone is listening right now, um you may be hearing more about Dr. Bennett and his programs in the near future. Wink wink. Hopefully, it's a good wink. So, stay tuned for some cool things for you guys. Thank you so much, Dr. for Bennett.