Professionele zelfzorg voor psychische hulpverleners

Een ondergeschoven kindje in de ggz
01/07/2022
Patrick Adrichem
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Volume 57 , Issue 7

Samenvatting

Professional self-care for mental health
professionals
P. Adrichem
During the first Covid-19 outbreak the mental and physical health of mental health professionals deteriorated. However, emotional exhaustion and burn-out amongst mental health professionals is not a typical Covid-19 phenomenon. This article highlights the importance of professional self-care, mainly from a schema-focused perspective. Various vulnerability factors for developing emotional exhaustion and burn-out amongst mental health professionals, like the influence of common early maladaptive schemas, are discussed. The intense interpersonal nature of working in mental healthcare turns out to be an optimal breeding ground for re-enactments of these early maladaptive schemas, associated with occupational stress and work dysfunctions. A work culture that values self-awareness, openness and interpersonal connectedness is promoted. From a systemic perspective the vulnerability cycle is presented for use in supervision and intervision.

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  • Samenvatting
  • Uitputting in de ggz
  • Vatbare ggz-professionals
    • Gemeenschappelijke blauwdrukken
    • Discipline-specifieke schema’s
  • Adviezen voor verbetering
    • Verbinden: het zelf en de ander
    • Een gezonde werkcultuur
    • De kwetsbaarheidscyclus
  • Tot besluit
  • Literatuurlijst
  • Over de auteur
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In tijden van toegenomen regeldrukte en een hoge werkdruk, een zorgstelsel dat bij tijd en wijle piept en kraakt en daarboven op de naweeën van een coronapandemie, is goede zelfzorg door ggz-professionals noodzaak. Maar de praktijk blijkt weerbarstiger. Dit artikel belicht het onderwerp professionele zelfzorg in de ggz hoofdzakelijk vanuit het referentiekader van de schematherapie. Afsluitend wordt een model vanuit de systeemtherapie belicht om professionele zelfzorg binnen teams te bevorderen.

Tijdens de coronapandemie verschenen in de media steeds meer berichten over een hoge werkdruk in de gezondheidszorg en in toenemende mate ook in de geestelijke gezondheidszorg (ggz). Tijdens de eerste coronagolf deed het Trimbos-instituut onderzoek naar de impact van corona op psychische hulpverleners (Van Bon-Martens et al., 2020). De conclusies waren niet mals: een flink deel van de ggz-professionals kampte met een verminderde psychische en lichamelijke gezondheid.

Met name de psychische gezondheid ging erop achteruit; bijna een kwart van de hulpverleners voelde zich psychisch ongezond. Voor alle ggz-professionals (psychologen, verpleegkundigen, sociaal-maatschappelijk werkers en jeugdhulpverleners) steeg de gemiddelde werkdruk ten opzichte van vóór de crisis. Meer dan de helft van de ondervraagden kon niet de zorg leveren die nodig was. Bijna een derde van de hulpverleners rapporteerde (veel) meer slaapproblemen en meer dan de helft verlangde hulp en ondersteuning, onder andere bij het bewaken van de

Literatuurlijst

  1. Aronsson, G., Theorell, T., Grape, T., Hammarström, A., Hogstedt, C., Marteinsdottir, I., Skoog, I., Traskman-Bendz, L. & Hall, C. (2017). A systematic review including meta-analysis of work environment and burnout symptoms. BMC Public Health, 17(1), 1–13.
  2. Bakker, A.B., Demerouti, E. & Euwema, M.C. (2005). Job resources buffer the impact of job demands on burnout. Journal of Occupational Health Psychology, 10(2), 170–180.
  3. Bamber, M. R. (2006). CBT for occupational stress in health professionals: introducing a schema focused approach. London and New York: Routledge.
  4. Bamber, M. & McMahon, R. (2008). Danger – Early maladaptive schemas at work!: the role of early maladaptive schemas in career choice and the development of occupational stress in health workers. Clinical Psychology and Psychotherapy, 15(2), 96–112.
  5. Bamber, M. & Price, J. (2006). A schema focused model of occupational stress. In M. R. Bamber (Ed.), CBT for occupational stress in health professionals: introducing a schema focused approach (pp. 149-161). London and New York: Routledge.
  6. Bennett-Levy, T., Thwaites, R., Haarhoff, B. & Perry, H. (2015). Self-practice/self-reflection guides for psychotherapists. Experiencing CBT from the inside out: a self-practice/self-reflection workbook for therapists. Guilford Press.
  7. Bennett-Levy, J., Turner, F., Beaty, T., Smith, M., Paterson, B. & Farmer, S. (2001). The value of self-practice of cognitive therapy techniques and self-reflection in the training of cognitive therapists. Behavioural and Cognitive Psychotherapy, 29(2), 203–220.
  8. Bierings, H. & Mol, M. (2010). Burn-out: de rol van werk en zorg. Centraal Bureau Voor de Statistiek, 10.
  9. Bon-Martens, M. Van, Doesum, T. Van, Leone, S., De Beurs, D., Kroon, H. & Shields-Zeeman, L. (2020). Impact van de coronacrisis op het werk en welzijn van professionals voor psychische hulp: eindrapport. Trimbos Instituut.
  10. Crawford, M.J., Adedeji, T., Price, K. & Rutter, D. (2010). Job satisfaction and burnout among staff working in community-based personality disorder services. International Journal of Social Psychiatry, 56(2), 196–206.
  11. Cushway, D. & Tyler, P.A. (1994). Stress and coping in clinical psychologists. Stress Medicine, 10(1), 35–42.
  12. Delgadillo, J., Saxon, D. & Barkham, M. (2018). Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes. Depression and anxiety, 35(9), 844–850.
  13. Di Benedetto, M. & Swadling, M. (2014). Burnout in Australian psychologists: correlations with work-setting, mindfulness and self-care behaviours. Psychology, Health and Medicine, 19(6), 705–715.
  14. Farrell, J.M. & Shaw, I.A. (2018). Experiencing Schema Therapy from the Inside Out: a Self-Practice/Self-Reflection Workbook for Therapists. Guilford Publications.
  15. Geuzinge, R. (2015). Concrete zelfzorgstrategieën voor de psychotherapeut Compassie versus empathie. Tijdschrift Cliëntgerichte Psychotherapie, 53(3), 197–212.
  16. Glassburn, S., McGuire, L.E. & Lay, K. (2019). Reflection as self-care: models for facilitative supervision. Reflective Practice, 20(6), 692–704.
  17. Gonot-Schoupinsky, F.N., Garip, G. & Sheffield, D. (2020). Laughter and humour for personal development: a systematic scoping review of the evidence. European Journal of Integrative Medicine, 37. 1-57
  18. Haarhoff, B. & Thwaites, R. (2016). Reflection in CBT. Los Angeles: SAGE.
  19. Haarhoff, B., Thwaites, R. & Bennett-Levy, J. (2015). Engagement With Self-Practice/Self-Reflection as a Professional Development Activity: the Role of Therapist Beliefs. Australian Psychologist, 50(5), 322–328.
  20. Hiebler-Ragger, M., Nausner, L., Blaha, A., Grimmer, K., Korlath, S., Mernyi, M. & Unterrainer, H. F. (2021). The supervisory relationship from an attachment perspective: Connections to burnout and sense of coherence in health professionals. Clinical Psychology and Psychotherapy, 28(1), 124–136.
  21. Howard, F. (2008). Managing stress or enhancing wellbeing? Positive psychology’s contributions to clinical supervision. Australian Psychologist, 43(2), 105–113.
  22. Kapoulitsas, M. & Corcoran, T. (2015). Compassion fatigue and resilience: a qualitative analysis of social work practice. Qualitative Social Work, 14(1), 86–101.
  23. Killian, K.D. (2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Traumatology, 14(2), 32–44.
  24. Kim, H., Ji, J. & Kao, D. (2011). Burnout and physical health among social workers: a three-year longitudinal study. Social Work, 56(3), 258–268.
  25. Latha, K.S. (2004). Work-related stress among health professionals and coping mechanisms. Indian Journal of Social Work, 65(2), 190–212.
  26. Lichner, V. & Lovaš, L. (2016). Model of the Self-Care Strategies Among Slovak Helping Professionals. Qualitative Analysis of Performed Self-Care Activities, 5(1), 107–111.
  27. Lloyd, C., King, R. & Chenoweth, L. (2002). Social work, stress and burnout: a review. Journal of Mental Health, 11(3), 255–265.
  28. Luther, L., Gearhart, T., Fukui, S., Morse, G., Rollins, A.L. & Salyers, M.P. (2017). Working Overtime in Community Mental Health: associations with Clinician Burnout and Perceived Quality of Care. Psychiatry Rehabiltation Journal, 40(2), 252–259.
  29. Manning-Jones, S., De Terte, I. & Stephens, C. (2016). Secondary traumatic stress, vicarious posttraumatic growth, and coping among health professionals; a comparison study. New Zealand Journal of Psychology, 45(1), 20–29.
  30. Maslach, C. (1993). Burnout: a Multidimensional Perspective. In W. B. Schaufeli, C. Maslach & T. Marek (Eds.), Professional Burnout: Recent Developments in Theory and Research. Philadelphia, PA: Taylor & Francis.
  31. Morse, G., Salyers, M.P., Rollins, A. L., Monroe-DeVita, M. & Pfahler, C. (2012). Burnout in mental health services: a review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39(5), 341–352.
  32. Nelson, J.R., Hall, B.S., Anderson, J.L., Birtles, C. & Hemming, L. (2017). Self–Compassion as Self-Care: a Simple and Effective Tool for Counselor Educators and Counseling Students. Journal of Creativity in Mental Health, 13(1), 121–133.
  33. Oprel, D. (2013). Wie zorgt er voor de psychotherapeut? Tijdschrift Voor Psychotherapie, 39(2), 124–126.
  34. Råbu, M., Moltu, C., Binder, P.E. & McLeod, J. (2016). How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists’ experiences. Psychotherapy Research, 26(6), 737–749.
  35. Rokach, A. & Boulazreg, S. (2020). The COVID-19 era: how therapists can diminish burnout symptoms through self-care. Current Psychology, (1997).
  36. Rupert, P.A. & Kent, J.S. (2007). Gender and work setting differences in career-sustaining behaviors and burnout among professional psychologists. Professional Psychology: Research and Practice, 38(1), 88–96.
  37. Rupert, P.A. & Morgan, D.J. (2005). Work setting and burnout among professional psychologists. Professional Psychology: Research and Practice, 36(5), 544–550.
  38. Scanlan, J.N. & Still, M. (2019). Relationships between burnout, turnover intention, job satisfaction, job demands and job resources for mental health personnel in an Australian mental health service. BMC Health Services Research, 19(62), 475–476.
  39. Schaufeli, W.B. & Greenglass, E.R. (2001). Introduction to special issue on burnout and health. Psychology & Health, 16(5), 501–510.
  40. Scheinkman, M. & Fishbane, M.D. (2004). The vulnerability cycle: working with impasses in couple therapy. Family Process, 43(3), 279–299.
  41. Scott, J., Yap, K., Bunch, K., Haarhoff, B., Perry, H. & Bennett-Levy, J. (2021). Should personal practice be part of cognitive behaviour therapy training? Results from two self-practice/self-reflection cohort control pilot studies. Clinical Psychology & Psychotherapy, 28(1), 150–158.
  42. 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.
  43. Simpson, S., Simionato, G., Smout, M., Vreeswijk, M. F. van, Hayes, C., Sougleris, C. & Reid, C. (2019). Burnout amongst clinical and counselling psychologist: the role of early maladaptive schemas and coping modes as vulnerability factors. Clinical Psychology and Psychotherapy, 26(1), 35–46.
  44. Taris, T., Houtman, I. & Schaufeli, W. (2013). Burnout: de stand van zaken. Tijdschrift Voor Arbeidsvraagstukken, 29(3), 241–257.
  45. Thompson, E.H., Frick, M.H. & Trice-Black, S. (2012). Counselor-in-Training Perceptions of Supervision Practices Related to Self-Care and Burnout. The Professional Counselor, 1(3), 152–162.
  46. Vereniging voor Schematherapie (2021, 1 juni). Overzicht schema’s en modi. Geraadpleegd op 10 januari 2022, van http://www.schematherapie.nl/document/overzicht-schemas.pdf
  47. Vinkers, C., Tijdink, J., Gerritse, F., Pattyn, T., Wit, L. de & Visscher, A. (2020). De Psychiaterthermometer. 1–22.
  48. Wilkinson, H., Whittington, R., Perry, L. & Eames, C. (2017). Examining the relationship between burnout and empathy in healthcare professionals: a systematic review. Burnout Research, 6, 18–29.
  49. Young, J.E., Klosko, J.S. & Weishaar, M.E. (2016). Schemagerichte therapie: handboek voor therapeuten (P. van der Kaaij, Vert.). Houten: Bohn Stafleu van Loghum.