Terry E. Waldren, Ph.D. LMFT-S LPC-S NBCC Lubbock Vet Center Wellness concepts are a holistic approach for working with individuals/couples and families. Characteristics of healthy individuals and families are different from our clinical populations – important to know these differences. Being physically and emotionally healthy are two key values for myself. I see myself as a model for patients and clients – if I’m not healthy then I believe I lack creditability as a professional – the ethical connection. Staying emotionally healthy working as therapist is a constant challenge – issue of burnout. Eliminating Self Defeating Behaviors – working with health issues since 1974 – critical issue is transforming identity from self defeating to healthy patterns/behaviors. Personal – going from smoker to smoke free person. Research on Academic Procrastination. Workshops on Burnout for Counselors. Workshops on Narcissistic and Borderline personality disorders – estimate ½ of participants showing signs of burnout. Interim Chair & Visiting Full Professor: Health Exercise and Sport Sciences (HESS). Became number one degree granted at TTU in 2008. Healthcare jobs are growing and are anticipated to grow in future. Many courses were focusing on how to build healthy lifestyles with children and adults. TTU Honors College Honors Seminar– Comparative healthcare issues between US and other countries. Critical issues for healthcare – going from procedures to wellness/prevention. Smoking as number one health issue world wide. Chronic diseases in the elderly increasing and the rapid increase of chronic diseases in young people as major sources of problems/healthcare costs – for younger people fast foods are a critical issue along with advertising. Diet/exercise/social support key ways to address issues of chronic illnesses. Grace Clinic – Working on resources for health prevention/weight loss resources – Issue is getting cost effective resources that work – Could not afford coaches as insurance pays very little for wellness. Dr. Bale – CME Ethics workshop about Heart Attack & Stroke prevention. Many physicians leaving practice because of burnout – talking about alternative ways of practicing medicine. Private medicine – concierge Once give up smoking and addictions then wellness becomes number one set of factors for being healthy. Physicians talking about not only physician assistants/nurse practitioners - health/exercise bachelor degree for nutrition/exercise awareness. Emotional depletion Isolation Working with people in pain is draining and demanding Confusion Therapist idealized and then devalued Repeated distorted projections each 50 minutes Depression, sadness and vicarious traumatization Often do not see immediate gains and/or sustained gains. Have not found user friendly measure of psychotherapy successes. Grandiosity and omnipotence Increasing numbers of laws, codes, and regulations regarding confidentiality. Often work when others are not working. Helplessness and sense of inefficiency Mainly working long hours in isolation Expected to give endlessly while expecting nothing in return except fee. Going from idealization to devaluation Constant worry Working with clients who maybe suicidal is draining Grief Cycle One way Intimacy and voyeuristic Attitudes: Endless cycle of new patients, hard work and then termination when patients are better. Therapist experiences deep intimacy from patients while not sharing about themselves. Distraction Focusing on others problems and losing track of our own needs/desires. Inability to Shut off the Therapeutic Stance Events that Affect Effectiveness Codes of ethics grow each time new ones are released and more and more there are contradictions within these codes. The threat of Lawsuits Our own life events (e.g. death, divorce, health provide challenges as these effect our effectiveness Conflicting Clinical, Ethical, and Legal Considerations: Therapy is a way of relating and can bring this into family/friend situations. Living in highly litigious society and working with disturbed people. Split Personality – Public vs. Private We have a very rigid separation between work and personal settings around issue of confidentiality. Burn out leading cause psychotherapists high rate of depression, drug and alcohol abuse and suicide. Health Indicators Fatigue and chronic exhaustion Frequent and prolonged colds Headaches Sleep disturbances: insomnia, nightmares, excessive sleeping. Ulcers Gastrointestinal disorders Sudden losses or gains in weight Flare ups of preexisting medical disorders: diabetes HBP, asthma, etc. Injuries from high-risk behaviors Muscular pain, particularly in lower back and heck. Increased premenstrual tension Missed menstrual cycles. Excessive Behavior Indicators Increased consumption of caffeine, tobacco, alcohol, over-the –counter medications, psychoactive prescription drugs, illicit drugs. High-risk-taking behavior: auto/cycle accidents, falls, “high-risk” hobbies, general proneness to accidents and injuries, gambling, extreme mood and behavior changes. Increased propensity for violent and aggressive behavior. Over and under eating. Hyperactivity Emotional Adjustment Indicators Emotional distancing Paranoia Depression: loss of meaning, loss of hope. Decreased emotional control. Martyrdom. Fear of “going crazy” Increased daydreaming/fantasizing. Constant feelings of being trapped. Nervous ticks. Undefined fears. Inability to concentrate. Intellectualization. increased tension. Relationship Indicators Attitude Indicators Isolation or over bonding with SO/friends. Responding in mechanical manner. Isolation from clients. Increased expression of anger and or mistrust. Increased interpersonal conflicts. Increased problems in marital and other interpersonal relationships. Social Isolation. Over involvement with clients/patient using clients to meet social needs. Value Indicators Sudden and often dramatic changes in values and beliefs. http://www.zurinstitute.com/burnout.html Site includes the aspects of counseling that influence burnout plus it talks about effects on therapist's family and ways to address burnout. Site includes an extensive bibliography of stress/burnout books and articles. http://helpguide.or/mental/burn_signs_wym ptoms.htm Additional resources for burnout. The Wheel of Wellness Counseling for Wellness: a Holistic Model for Treatment Planning. Good overview of utilizing a Wellness Counseling model with research support. Wellness Counseling: The Evidence Base for Practice. Reporting and describing research and ways to approach wellness research. Wellness of Counselor Educators: an initial Look. Study looking a wellness in Counselor Educators.