For the past 25 years, counseling and psychology professional literature has examined the issues of stress on the job. Research and discussion initially identified burnout resulting from job stress as an important area for treatment and prevention. In the last decade, the focus has shifted from burnout to secondary traumatic stress due to the recognition of the specific challenges of working with traumatized individuals. Whether we are addressing the impact of working with others in general or those who have been traumatized, research agrees that we have a responsibility to maintain our own health and wellness as counselors (Iliffe & Steed, 2000; Miller, 1998; Savicki & Cooley, 1982; Sexton, 1999; Sherman, 1996).
The challenge lies in the fact that wellness is a concept that we as counselors often focus on more readily for our clients than ourselves. Counselors who are trained to care for others often overlook the need for personal self-care and do not apply to themselves the techniques prescribed for their clients. Therefore, this manuscript offers numerous resources for self-care that can be helpful in maintaining wellness. Following the advice Hippocrates might have made, "Counselor heal thyself," we recommend that counselors prescribe self-care for themselves. We provide recommended resources to do so below.
In the 1970s, the study of burnout in the counseling profession resulted in definitions of burnout, several instruments for its measure (Arthur, 1990), and recommendations for burnout prevention. Burnout has been defined as "to fail, wear out or become exhausted by making excessive demands on energy, strength, or resources" (Freudenberger, 1974, p.159). The Maslach Burnout Inventory assesses three symptom areas: emotional exhaustion, depersonalization of clients, and lack of feelings of personal accomplishment (Savicki & Cooley, 1982). Recommendations for dealing with burnout in the counseling profession included personal therapy, ample free private time (Watkins, 1983), stress-reduction techniques, development of an attitude of detached concern, and clarification of expectations and beliefs about counseling (Savicki & Cooley, 1982).
Common themes exist in the symptoms of burnout and secondary traumatic stress (STS). Both may result in depression, insomnia, loss of intimacy with friends and family, and both are cumulative (Arvay & Uhlemann, 1996). The key difference lies in the cause of the symptoms. STS is the direct result of hearing emotionally shocking material from clients, while burnout can result from work with any client group (Iliffe & Steed, 2000).
Secondary traumatic stress is defined as an outcome or risk that is related to engaging empathetically with another's traumatic material (Stamm, 1995). Symptoms, which are nearly identical to PTSD symptoms, include:
* Reexperiencing the traumatic events in recollections or dreams
* Avoidance or numbing of reminders of the event such as efforts to avoid thoughts, feelings and activities related to the situation, diminished affect, and loss of interest in significant activities
* Persistent arousal such as having difficulty sleeping and concentrating, hypervigilance, and exaggerated startle response
STS symptoms arise after being confronted with an event that involved death, injury, or extreme threat resulting in intense feelings of fear or helplessness. When symptoms last less than one month, they are considered normal reactions to crisis situations (Figley, 1995,1998). However, Figley (1995) suggests this cluster of symptoms becomes classified as a disorder, STSD, when experienced for more than 30 days following exposure to the traumatic event.
Counselors in community agencies, private practice, and schools work with clients of all ages who have directly experienced trauma. These include experiences such as sexual assault, domestic violence, violent crime, war, traumatic "natural" catastrophes (e. …