Here come the winter holidays. For many practices, the stretch from just prior to Thanksgiving to early February is the busiest – and most stressful- time of year. Case loads go up with new and returning patients. For our patients, the holidays bring out the worst of family dynamics, the memories and reminders of negative events in the past and anxieties about what will happen this year. For some trauma survivors especially, the holiday season may be fraught with emotional upheaval and difficult decisions about family get-togethers.
Meanwhile, the active therapist has her own holiday stresses to manage. Even in the best of circumstances, the holidays add a layer of responsibilities and expectations to what may already be a stressed life. Especially if you are a parent, the added layer of family activities and holiday tasks coupled with managing patients’ distress can be daunting.
Self-care becomes more important than ever during the winter holiday season if we are to avoid compassion fatigue or secondary trauma. Taking care of ourselves is the foundation for taking care of others – whether our patients or our family members. Here are some reminders of what you can do to keep your professional and personal life in balance.
Take Care of Yourself Professionally
Review your patient alumni list: If you’ve been in practice for a few years, you can probably predict who will be giving you a call. Prepare by reviewing their chart. Take some time to consider what you already know about them and what has been effective in the past. You’ll be more relaxed during the first session which will probably help them relax as well.
Add session slots to your schedule: It will add stress to your life if you need to “squeeze in” new patients or people who request extra sessions. If you know from experience that you are going to need more client hours, create those slots now.
Plan more breaks: Client distress around the holidays can be particularly intense. Build in a lunch break and/or a walk every mid day. You will be refreshed and more effective for the afternoon sessions.
Maintain boundaries: This is the time of year when some patients will be more likely to contact you between sessions. Be clear about what you are willing and able to do to avoid disappointing your patients and to avoid feeling over-burdened yourself. Stay true to your start and end times for sessions as well.
Arrange for coverage: Arrange for coverage for while you intend to be away or for during times you want to be unavailable so your time with your family won’t be disrupted by a client call. Inform your clients about who to call if they are in crisis. Make sure they have the phone number for your local crisis team entered into their phone or written down.
Maybe refuse new clients: It is often difficult for those of us in private practice to refuse to take on a new client. We think, “I may be over-busy today but what about the spring? Is it only wise to take on one or two more to ensure having a full practice in coming months?” Maybe. But not if it will leave you exhausted and unable to do your best work – or to enjoy your family when you get home.
Stay on top of record-keeping: You are tired. You want to go home. It may be tempting to put off doing case notes until another day. But it’s not a useful strategy. The task will still be there tomorrow and will only add to tomorrow’s stress. Build in some time at the end of the day to do whatever paperwork you need to do so you can come back to a clean desk the next morning.
Schedule extra supervision: Time with your supervisor is time for you to nurture your professional self. If you have patients who are especially difficult during the holidays or who have extra difficulty managing their traumatic history, meeting with your supervisor or a peer supervision group will provide you with helpful support.
Take Care of Yourself Personally
Make time for transitioning between work and home: Taking some time to transition to our home life is always important, but especially so during the winter. Before leaving the office do a mindfulness exercise, journal or just call a friend. If the end of the workday means time in the car, put on some soothing music and allow yourself to enjoy the alone time.
Nurture yourself: Remind yourself of the importance of doing what you regularly tell your clients to do: Eat right, get a full night’s sleep, exercise regularly and make sure you build in some time for relaxation. Most important, protect your own holiday time with family and friends.
Delegate: If you host the Thanksgiving or Winter Holiday meal for family and friends, by all means delegate some of the preparation to your guests. Really. Very few people mind being asked to bring the mashed potatoes or a dessert. These days, with so many dietary restrictions and demands, it is reasonable to ask the only lactose-free, gluten free, vegetarian coming to a meat-lovers’ feast to bring their own dish.
Do ahead: Early in my career, an older and experienced therapist in private practice gave me invaluable advice. “Do as much of your holiday list as you can before Thanksgiving,” she said. “Purchase and wrap gifts. Make the cookies or holiday bread and stash it in the freezer. Address those holiday cards or create your holiday letter. Put the lights on the house. Just don’t turn them on.– Whatever you can do ahead of time – do it before the holiday practice rush. That will help you stay centered for your clients. Even more importantly, it will guarantee that you can focus on your family when you get home instead of on your lists.” Good advice. I’ve followed it ever since.