self-care

The Human in the Helper: It’s easier to prioritize our kids over ourselves

Jenny knows what it’s like to juggle many roles. At one point in the pandemic, she was running a small private practice, a second business of an online community, and working a full time job with a toddler at home. When her second child arrived, she was grateful for family to be present immediately after her son’s birth, an experience she didn’t get with her daughter who was born in September 2020. Jenny brought their son home, and days later noticed a rash developing on his tiny body but thought it was related to the 100 plus degree heat of Houston where they live. At her son’s check up, the doctor had concerns. “She calmly said, ‘you’re going to the emergency room now.’ I felt like I was in the dark as to what was going on but took him right away so they could run tests,” Jenny recalled. Her son was nine days old and remained in the hospital for three days as they waited for test results.

 

Jenny’s son had a staph infection. Although it was a relief to know the cause and receive treatment, Jenny found herself in self-blame. “Did I cause this to happen? Were there too many people around him at his birth? Should I have done something different?” Jenny isn’t alone in having these thoughts as a woman and mother. “I struggle to accept help. I tend to not rely on others and do things myself.” But as she stayed in the hospital with her son, relying on her spouse and others to keep things going at home was necessary.

 

A second opportunity to accept help from loved ones came when her son got a second staph infection at two months old while visiting family in Colorado. Jenny found herself telling clients about her son as she needed to cancel and reschedule appointments in order to address his needs. “It’s easier to prioritize our kids needs over our own,” Jenny reflected. She wants to operate from a ‘family comes first’ place but recognizes how that can feel challenging to herself and others when holding the role of primary earner in a household.

 

Figuring out our own needs as therapists and small business owners is a work in progress. Jenny had to learn how to slow down to meet her own needs. “Our bodies tell us when they’ve been ignored and neglected, and then we don’t have a choice in how to practice self-care.” As a mom, woman, and therapist who keeps others’ needs in mind, Jenny named the experience as “weaponized self-care, how are we supposed to do that?” She spoke to how it felt hypocritical to help clients and colleagues practice self-care when she wasn’t doing it well herself. Now she gives herself more grace and owns it when it happens. “I’m trying to model self-care but it’s not perfect,” she said.

 

Being a mom of two small children has also influenced her approach to self-care. “Our kids are purely living in the present, they model this for us. It’s also how we can recognize we aren’t taking care of ourselves in that present moment.” Jenny brings this insight into her online community for trauma therapists, who are working on their own journeys of balance and self-care. “We can join kids in the present moment, supporting healing and self-care through meaningful connection.”

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

Self-Care Isn’t Always About Slowing Down

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As a workaholic choosing balance on a daily basis, I know that if a stranger were to approach me tomorrow and say, “Khara, just slow down!” I’d politely acknowledge their suggestion without any desire to act on it. As a driven professional, I’ve heard this sentiment for years. From family, friends, and colleagues. Even briefly from my doctors. Yet like many of our clients, having someone suggest slowing down isn’t enough. Workaholics have to examine it, plan it, and justify it to avoid the resulting feelings of restlessness or guilt.

 

I saw a quote this week that said, “If you don’t make time for wellness, you’ll be forced to make time for illness.” Truth! To ignore the warning signs of burnout or write off self-care as frivolous isn’t an option. However, slowing down isn’t a comfortable option for driven professionals either, so what can we do?

 

I watched a respected colleague experience distress when exploring how to slow down her life. An extrovert and passionate business owner, she named that she had no desire to have unstructured weekends or embrace boredom. I can relate. I spoke to this in a previous blog called: What If Working Is Your Self-Care? My response to her distress was to share that self-care isn’t always about slowing down. It can be about pivoting and pouring our energy into something restorative and energizing instead. I watched her shoulders drop and a smile return to her face as she began exploring a new way to define her self-care strategy. Discovering what could support her in feeling restored without feeling bored.

 

People continue to think self-care is vacations, spa days, and bubble baths. All have an element of slowing down, which has value in certain situations. But what if we don’t like any of those things? What if these activities breed discomfort or resentment instead of joy? For workaholics and driven professionals, the abrupt change from 60 miles an hour productivity to full stop leaves them feeling like they’ve been hit by a truck.

 

It’s why I’ve talked in previous posts about redefining self-care as rest AND restoration. Maybe as a driven person, you like the idea of restoration more than rest. Maybe it fits your personality better, much like my colleague. Instead of binge watching a show and vegging out on the couch, maybe now you are walking in nature or cooking a nourishing meal. Perhaps you are painting or dancing or creating instead of embracing stillness. After all, a lot of entrepreneurs find stillness painful, worrying that it invites in stagnation. Moving and creating feel better to these folks.

 

So what would be on your self-care list if it wasn’t about slowing down? What would replace the naps, movie marathons, and pedicures if we wanted a self-care activity that was equally active and invigorating? Take that next step and watch how your work-life balance shifts for the better!

How to Stop Celebrating Noble Burnout

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What if we’ve received messaging that we are only as good as what we do for others? This is a common core belief for helping professionals. Subconscious or not, it has the potential to increase risks of poor boundaries, workaholism, and burnout.

 

If we choose a profession built on caring, responding, and helping, we tend to carry the weight of being vigilant, responsive, and always “on.”  As we work harder to help others and meet work demands, we pay less attention to our own boundaries for self-care and that superhero cape stays on way too long.

 

It’s a phenomenon I like to call Noble Burnout. The cape starts to weigh us down as we run the risk of forgetting our own needs entirely, which results in burnout. Yet we are praised for our sacrifices and our worth remains defined in what we do for others. While the effort to help so many people is noble, it’s not sustainable as we neglect our own self-care needs. Even superheroes need a break.

 

Finding Balance Over Noble Burnout

1) Learn to Say No, More. I’ve heard it called “acting your wage.” Stop working for free when what you offer has value! Having some prepared phrases or responses can help you hold your boundaries and practice of saying no.

 

2) Improve Your Relationship with Money. Exploring your money messages will help you identify a healthier relationship with your finances as a professional. What if you think poorly of people who are rich or well-off? What if you worry about becoming Scrooge? These internal beliefs may prevent you from meeting your full financial potential because you worry about the impression you make on others. Healing your money story is an important piece to the Noble Burnout puzzle.

 

3) Remember Your Values. If you are working within your values, you’ll enjoy the rewards of fulfillment and purpose at work and home. If your values are absent, how can you bring them back into the equation? If our values are identified and prioritized, we can utilize them as a healthy gauge for wellness rather than misplaced fuel for the Noble Burnout fire.

 

4) Embrace Authenticity. You are a person first and professional helper second. This means being able to honor your needs and take break. Being human, having limits, and saying no are all allowed.

 

Together we can stop subscribing to Noble Burnout as helping professionals and as a community! Just imagine what we could accomplish if we weren’t celebrating self-sacrifice and instead chose to celebrate self-care.

What if Working is Your Self-Care?

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I was bonding with other powerhouse business women in a working retreat recently and was asked to facilitate a goal-setting exercise. What do we want to accomplish in the next six months and how can we help one another achieve these goals? I’d had them narrow it down. Brainstorm. Prioritize. Share. Ask for help.

 

Then it was my turn. I jumped in with enthusiasm, rattling off my goals of book sales, the Amazon best-seller list, and a TED Talk. I was excited to share! To manifest, to make it more real. And then came the question. “Khara,” one of my colleagues said, “that sounds great. But, what’s the end goal?” I felt my excitement wheeze and deflate like an untied balloon. I felt confused, unsure, and started to sweat. Why couldn’t I come up with an answer for her? An answer for myself? I knew in my heart that I didn’t want to retire early and not have work. Working gives me a sense of direction. Work gives me purpose. More specifically, creating gives me purpose. And yet I didn’t know the end-result. Through a constricted throat, I claimed I’d have to get back to her, finding my mind going blank.

 

Soon after the retreat, she texted me. “Khara, I owe you an apology. My question to you was flawed from the beginning. It was a projection of societal expectations that there has to be a particular outcome more than just enjoying the process. Enjoying the process might be the point and that is actually really beautiful.” She proceeded to send me this quote:

 

“The fruits of a fulfilling life—happiness, confidence, enthusiasm, purpose, and money—are mainly the by-products of doing something we enjoy, with excellence, rather than the things we can seek directly.”    --Dan Miller

 

The tightness in my chest loosened, the panic of not having an answer and worrying about not having an answer, lifted. I felt seen. It lead me to a question of, “what if working is my self-care?” What if working is yours?

 

They say “if you do what you love, you’ll never work a day in your life.” That may be true for some, but it’s also one of the villains we blame for our current workaholic culture. Doing what we love is a privilege. Does the work invigorate you? Inspire you? Feed your soul?

 

I can tell you that creating for me brings feelings of happiness and joy. It’s as close as I get to contentment in knowing I’m producing things of value. I can also tell you that to the outside world, I’m churning things out at a breakneck speed. A speed which others might find unhealthy, believing I subscribe to workaholic culture, I am workaholic culture, and that I need to take it down a notch. That I’m steamrolling instead of stopping to smell the roses. They assume I don’t get enough sleep.

 

There’s a sweet spot for functioning in a productivity loop. For those creatives out there, you get it. We get ideas in the shower, while driving, and at 4am out of blue. We feel a rush to put our ideas into motion, creating something that can have a positive impact for ourselves and others. We do in fact maintain enough sleep to get to good ideas, the ahas that inspire action. So to tell us to slow down, stop our work, or accuse us of poor self-care is missing the mark. It’s once again operating from the flawed lens of society. The all or nothing thinking. Society which demands answers to the question, what’s the end goal? Why do it? What’s the point? Why?

 

Simon Sinek said it best when he said start with your why. If you embrace it, the rest will fall into place. If our why as women entrepreneurs is to make an impact and a meaningful difference in the world through our products and leadership, we can do that. We can work and have it be meaningful, fulfilling, and consider aspects of it as part of our self-care.

 

Self-care has been commercialized, having us thinking of vacations, massages, and manicures. In previous talks, I’ve invited others to redefine self-care as rest versus restoration. Rest is easy to measure. Taking brain breaks, vegging out, getting enough sleep. But what feels so enticing for creative entrepreneurs is restoration. What energizes you, invigorates you, inspires you? From this lens, it’s not surprising that parts of our business can restore us. Creativity. Leadership. Integrity and Purpose.

 

Adam Grant highlights the importance of creativity in the workplace by showing that employees who had 20% of their work hours carved out for creativity were more productive, were responsible for some of the latest innovations to change the world, and were more emotionally invested in their workplace. Does this not sound like a great recipe for burnout prevention and challenging our workaholic culture?

 

I’m asking you to change your beliefs about the churn. Creativity and enjoying the process in your work can be self-care. Creativity at work serves the dual purpose of encouraging feelings of productivity and contentment. Working may not be rest but it can be restorative. Therefore it can be part of your self-care practice. Do something you enjoy with excellence, and the fruits of a fulfilling life will follow.

To My Fellow Therapists, Let’s Slather on the Emotional Sunscreen

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Spring has been in full swing even as we feel like we’ve taken a pause in this pandemic. Although we may be staying in place, the weather is moving and shifting towards summer. For many of us, weather and the ability to get outside have been vital components to staying sane these last few months. The pleasure of feeling the sun on our faces, the breeze in our hair, inhaling fresh air, and experiencing the sounds of nature can almost transport us into feelings of normalcy.

 

Normalcy. Normal. A new normal. A phrase that has appeared to help us better articulate how COVID-19 has impacted our way of living and the ripple effects on our habits, behaviors, and mental health. With spring comes new energy, growth, and restlessness. We’ve seen this in the desire for stay-at-home orders to be lifted, the desire to get outside and have social gatherings, and the desire to go back to seeing clients in person. But what about restlessness as a sign of mental health? There are plenty of articles reporting that a mental health crisis will follow as the result of COVID-19 and will be long lasting. Our mental health communities have been working several months straight to support individuals and families with the changes and stresses that have come in waves. As therapists, we’ve prepared for this to some degree, having built practices working with people experiencing anxiety, depression, and trauma. Yet being human ourselves, we are also holding anxiety and dread for what’s to come simultaneously with holding onto hope that it will get better.

 

Spring Challenges

You see, COVID-19 wasn’t the only challenge to hit us hard in March. Springtime is considered a challenge because it’s known as a time for increased mental health crises. Spring is a time when those who experience the lows of winter and clinical depression related to the darker months start to shift to having more energy. With more energy comes more risks. For individuals experiencing suicidal thoughts, do they now have the energy to make an attempt? For individuals diagnosed with Bipolar disorder, are they experiencing a burst of energy that puts them at greater risk due to increased manic behaviors? Imagine how these worries each spring can combine with the anticipated increase in hopelessness related to COVID-19. For people who have lost jobs, houses, businesses, and loved ones, hopelessness and grief weighs heavy as the weeks accumulate. In fact, as we enter into another month of the pandemic, we may all be grieving the loss of anticipated events or perceived normalcy that summer could bring. The hopes for a planned vacation, a summer break, a slowing of referrals to allow us to regroup. Like a clenched muscle, we feel we must hold on and don’t yet have permission to relax. There continues to be so much that remains unknown about the future months, adding to the rollercoaster of mood as we struggle with not knowing what to plan for or what to look forward to in the ever-shifting weeks to come.

 

Balance Over Burnout

There is some lightness to balance out the heavy. Mental health professionals are feeling the powerful beauty of connecting with clients on something they too are experiencing in real time. They are embracing raw emotions, vulnerability, and fear. They are expressing gratitude at being able to work via telehealth. They are standing in awe of their clients’ resiliency. 

 

Therapists are also feeling the burnout of working longer hours and struggling with work separation in working from home. We are human, we are helpers, and we are feeling called to assist others at the risk of caring for ourselves. In connecting with colleagues, it is not uncommon to hear that we feel obligated to help and to remain available. Maybe this would be doable if it was just our clients we were supporting, but for many of us, we are supporting the fear and anxiety of our loved ones, family, and friends as well. It’s a lot to hold, and more than two months in, it’s starting to wear us down.

 

Slather on the SunscreenWhat can we do to address the growing fatigue as first responders in this pandemic? It’s time to slather on the emotional sunscreen. Embrace this visual of shielding against negativity and practicing professional boundaries. Allow the application of sunscreen to be a gentle and important reminder to protect ourselves from the damage of poor boundaries at the risk of getting burned. Burned by the heavy. Burnt out by the demand. Burnt out by the constant holding of hope and compassion for others. Protecting our emotions. The fight against COVID-19 and its impact on mental health is not over and we are fighting to stay strong.

 

Reapply Every Two Hours 

So let’s take inspiration from BuzzFeed’s 10 Facts About Sunscreen Most People Don’t Know Due to Marketing Tricks. It is recommended we reapply sunscreen every two hours that we are in the sun. In this case, our metaphorical sun represents all the present stressors, glaringly bright and hard to ignore. They make us uncomfortable, irritable, and tired. So we must take precautions. How do we address the sleepiness and lethargy that too much sun brings? How do we step away, regroup, and restore our energy? How do we protect our empathetic skin from over-exposure to harmful elements that can hurt us, leaving us blistered, raw and achy? We must find a way to reapply our emotional sunscreen to fight off fatigue and feeling drained. Sunburn and burnout have discomfort in common.

 

More than ‘Make Do’

Discomfort is something we know well as therapists. We are masters at sitting in the discomfort of others to help them heal. We are skilled at compartmentalizing, successfully ignoring our own discomfort to help others. Recall the time you held your bladder so as not to interrupt a session? Or took a call after hours because you could? Or came to work with a head cold so as not to disrupt your client’s momentum? We make do in the face of discomfort, perhaps engaging in the bare minimum protective measures to keep it all moving along. Much like makeup with low SPF. It isn’t enough protection for longer exposure to the sun. Sure, it can serve for short spells or quick outings. But when it comes to sun (stress) exposure of the mental health crisis we are currently facing, minimal SPF isn’t going to cut it. We are in this for the long haul and we don’t want to get burned. We need more emotional sunscreen.

 

Check Your Expiration Date

More time. More stress. We need to check our own expiration dates when it comes to how much we can handle before we require a break. Last week and this week, I have seen an increase in therapists sharing how tired they are and expressing how they feel like they need a break. This is quickly followed by a disclosure that they cannot leave those they are trying to support during this pandemic out of obligation or guilt. I can relate to this thought process. I can relate to the obligation and responsibility we all feel. We’re helpers. However, I’m also going to champion that all of us take a much-needed break in the near future. Staggered it if need be and timing it to allow rest and restoration. It doesn’t have to be extravagant and it doesn’t have to be long. Sunscreen that has expired is no longer considered effective. If we push past our expiration date, we too are no longer effective. We must honor our own expiration dates and the physical and emotion signs of burnout. Notice the signs that we need to rest and restore in order to do right by ourselves and by our clients.

 

Maybe it’s a stretch to make a connection between sun, stressors, sunscreen, and burnout. Maybe it isn’t. There’s something reassuring about the idea of getting to a place where we can be mindful enough in our plans to remember to apply sunscreen. Can we apply the emotional sunscreen needed to help us engage in meaningful work without getting burned? Can we show up, remain authentic, and be healthy role models for our clients on taking breaks to avoid burnout? It may not be easy task, but it is doable with practice. They say it takes 30 days to make something a habit. Let’s slather on some emotional sunscreen by summer.

 

Check out Croswaite Counseling PLLC’s Balance Over Burnout, an online course that introduces 5 tools to prevent burnout for therapists and professional helpers.

 

Check out BuzzFeed’s full article on 10 Facts About Sunscreen Most People Don’t Know Due to Marketing Tricks here.

Strategies for Self-Care: Scheduling Intention

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Self-care is a word we hear a lot in our industry, not just for clients but for professionals as well. How does one define self-care? Is it true that we need to implement self- care in order to prevent burnout? To better understand fatigue, burnout, and the concept of self-care, let’s take a closer look at each of these elements and how they contribute to wellness.

 

Symptoms requiring Self-Care

For many professionals, self-care becomes something to explore when functioning declines. Our clients come to us because their lives are being disrupted and self-care may be needed to recover balance. We are our own worst clients in the idea that we can talk about the importance of self-care to others, but don’t always put it into regular practice for ourselves.  The result of limited or absent self-care is burnout, and burnout can be long lasting or pervasive as it spreads beyond our careers into our personal lives and beyond. In order to explore the impact of burnout for ourselves and our clients, we may find the following list helpful (adapted from Vital Hearts).

  • I don’t know how to relax.
  • I feel irritable more than I’d like.
  • I feel disconnected from my emotions.
  • I’ve isolated from my family.
  • Nothing makes me laugh anymore.
  • I take comfort in sweets.
  • I have no energy to listen to my family when I get home.
  • I escape by sleeping more.
  • I have no empathy at the end of my work day.
  • I’m ignoring my relationships.
  • I can’t seem to disconnect from work.
  • I am experiencing more anxiety.
  • I just want to get away sometimes.
  • I’m angry at my clients for asking so much of me.
  • I feel underappreciated.
  • I can’t read or watch the news anymore.
  • I don’t share my work with my friends, they just don’t get it.
  • I don’t socialize with friends much anymore.
  • I feel restless but don’t want to do anything.
  • I have lost confidence in myself.
  • I feel pessimistic as the result of my job.
  • I feel sadness.
  • I feel drained, I have no energy.
  • I feel angry.
  • My health has declined.
  • I feel like nothing I do makes things better.
  • I can’t concentrate.
  • I cry much easier than I used to.
  • My road rage has gotten worse.

For some, the list above starts the conversation about how much and to what degree life has been impacted by factors of our work as helping professionals.  Burnout untreated can lead to long lasting decline in quality of life and connection to others. Burnout can take away the passion of why you do this work. As we struggle to practice what we recommend to others, how do we change our patterns to support reduction of the negative impact of burnout? Below are some action steps.

 

Wellness Recovery Action Plan (WRAP)

Several organizations in Colorado see the importance of self-care, including the Colorado Mental Wellness Network. Selected by the Colorado Mental Wellness Network and endorsed by SAMHSA, the Wellness Recovery Action Plan (WRAP) is being utilized with various populations to support health and well-being. Colorado Mental Wellness Network supports change through peer to peer connection and wellness education. Through these efforts, they continue to implement WRAP plans within various communities, including those experiencing homelessness and within Department of Human Services caseworkers. What they found was that empowering individuals to notice wellness as well as health decline could support putting self-care into action. Below is an example of a wellness plan that can be used for both professionals and clients to best support their process of identifying and implementing self-care.

 

WRAP

 

Building in Boundaries

In addition to exploring and customizing self-care for meaningful change, boundaries may need to be re-evaluated to prevent burnout. For many helping professionals, long hours, after-hours texts, emails, or calls, client crisis, and urges to help, prevent successful disconnection from work. Technology makes it easy to check work emails 24 hours a day and calls may come in from various parties regarding client care. If there is flexibility to re-evaluate the schedule of work versus home life, it is encouraged. However, the schedule assigned may not be in your control. If this is the case, other means of implementing boundaries may be needed and can include the following:

  • Put an out of office message on email and voicemail to notify others of when you will respond.
  • Separate work and home phones to leave the work phone off during days off.
  • Identify a crisis coverage person to give to clients during vacations or other scheduled absences.
  • Schedule time off in your calendar(s) to support appropriate boundaries.
  • Schedule windows of self-care, even if just for 20 minutes, during your work week.
  • Be concrete with hours for yourself and your clients as to when and how they can reach you.
  • Find self-care you can commit to and put it in the calendar monthly or weekly.

It is with hope that we can create momentum from the talk of self-care into action steps as we continue in our roles as helping professionals. Modeling self-care is both in the benefit of our clients and ourselves as we navigate the busy world of demands in hope of positive change. May we all begin to develop quality self-care in order to find wellness in the path of hard work!

Geared towards Growth: Exploring Maslow’s Hierarchy of Needs

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Have you had a client come into your office wanting to work on their relationships? What about a client who wants to work on self-worth and self-esteem? These goals are valuable and achievable, and could greatly benefit your client in their functioning and connection in the world.  However, depending on your client’s stressors and current life events, basic needs may need to be attended to first in order to achieve the growth and progress desired within your therapeutic work.

 

Hierarchy of Needs

Abraham Maslow first introduced the concept of a Hierarchy of Needs in a paper published in 1943. The image found most often in reference to his concept is a pyramid with the bottom representing the building block or foundation for higher functioning. According to Maslow, every human being has needs that must be met and stable prior to advancement to another level of human need. The levels he identified begin with physiological needs, followed by safety needs, love and belonging, esteem, and finally, self-actualization. Below are some examples of needs for each level:

  • Physiological: food, water, oxygen, sex, sleep, excretion
  • Safety: security of shelter, employment, resources, health, body
  • Love & Belonging: family, friends, intimate partners
  • Esteem: confidence, self-esteem, respect by others, respect for self
  • Self-Actualization: Acceptance, lack of prejudice, enlightenment

 

Goals for Growth

So how do the levels of need impact your client’s therapeutic work? For many helping professionals, the awareness of the hierarchy manifest through client psychoeducation around basic needs. Perhaps your client wants to work fully on their relationships, but is impacted by the stress of not having a job to pay their bills. Maybe your client wants to strengthen self-esteem, but can’t identify housing in suffering from an eviction this month. The present crises will require therapeutic attention and intervention first prior to a client allotting mental energy to higher levels of functioning.

Within your work, it can be helpful to normalize and educate your clients on basic needs being the foundation for functioning. You may consider describing the imagery as basic needs being the foundation of a house. If the foundation is crumbling, the other parts of the house become low priority or unseen in trying to stabilize the problem due to risks of it all collapsing around them. With this analogy, clients can absorb the importance of a stable foundation of basic needs requiring their attention before other goals can be successfully met.

 

Accessing Needs

A stable foundation may require other resources outside of your office. As a helping professional, it is in your best interest to be aware of resources to provide additional support to your client. The databases in your state, (Colorado Crisis Services and Colorado 2-1-1 for example) can be helpful in identifying food, shelter, clothing, legal advice and more.  You may also consider coordination with helpful organizations that would warrant a release from your client in order to collaborate.

Assessing needs can also occur from a place of looking at client resistance. One way this may manifest is through your client’s capacity to work on homework or assigned tasks between sessions.  Although some clients don’t like homework out of personal choice, other clients may struggle to articulate the crises that prevent progress on the homework you assigned, including forgetfulness, loss of focus, or stressors demanding their attention instead. This attempt at juggling varying demands could even translate to cancelled sessions in trying to handle the stressors at home or work. By being aware of basic needs, it can help you as the professional to better understand contributing factors that may present like resistance as elements requiring attention to support client progress.

 

Maintenance and Motivation

With collaboration and stabilization of basic needs come the client’s motivation for maintaining the foundation.  It is the hope that client’s basic needs, once addressed, remain in good standing.  However, with clients experiencing poverty, trauma, or other adversity, the fluctuating circumstances of their life can delay progress on higher functioning goals. Encouraging ongoing boundaries and self-care can support the client in reaching higher goals around self-esteem and relationships. With awareness and effort, a client can harness a healthy sense of control and autonomy in their life. Remaining flexible to the stressors that may occur between sessions, it is important that you and your client continue to be mindful of what takes precedence to allow the deeper, meaningful work you both value to occur at the appropriate time.