The Before 

For those of us in group practice, there was a time when we embarked on our hour-long commute to an office full of quirky furniture, sound machines and tissues, gearing up for a full day of sessions, minimal breaks and a lack of sunshine. The interplay of friendly exchanges with clients and water cooler talk with colleagues were small moments of connection we could count on day after day.

For most of our careers, this was our work routine until the abrupt halt of 2020. When office walls full of artwork were replaced with blurred out backgrounds and the occasional pet sightings. When body language became limited to facial expressions. When we lost the ability to make small bids of connection over coffee between sessions and hear about what was going on in each other’s lives, both professionally and personally.

A New Era 

Three years later, we are seeing more abandoned offices as clinicians choose to stay remote. Of course, there are many perks. Sessions are more accessible to clients, the ability to share info quickly in screen shares and the use of the chat function for resources. Not to mention the benefits for the therapist. However, it comes at the cost of our immediate access to a community, which many in private practice have already known. 

For all professionals in the mental health field, our new “normal” has shifted to a paradigm of increased isolation. The work alone has always navigated the bounds of physical and emotional isolation but in a post-COVID era, we are only seeing these effects heightened. Research supports that among the leading complaints of experienced independent practitioners, isolation and loneliness rank at the top (Tryon, 1983; Gündoğan, 2017).

Long Term Effects of Isolation 

What do we know about the long term effects of isolation? A study in 2015 found evidence linking perceived social isolation with adverse health consequences including depression, poor sleep quality, impaired executive function and impaired immunity, among others over the course of a lifespan (Hawkley, Capitanio, 2015).

Unchecked, this perceived physical, emotional and social isolation can quickly spiral to burnout. An alarming rate of 21-67% of all mental health professionals are already experiencing it, according to many studies (more on that here). We are well beyond a need for action.

Combating Isolation

One way we can combat isolation is through a professional support system of colleagues. ‘Competence constellations‘ is a term coined from the research by Johnson, Barnett, Elman, Forrest, and Kaslow (2012). It refers to, “a psychologist’s network or consortium of individual colleagues, consultation groups, supervisors, and professional association involvement that is deliberately constructed to ensure ongoing multisource enhancement and assessment of competence” (p. 566).

The benefits of these competence constellations are vast, improving not only the therapist’s efficacy but improving the client’s wellbeing. Mental Health professionals have a place to provide feedback and share information with colleagues, whether the topic is on ethical dilemmas or self-care strategies. In turn, as the research supports, when therapists reach out for help from other mental health professionals, the capacity for empathetic behavior is increased and directed towards both oneself and towards clients (Macran & Shapiro, 1998; Macran, Stiles, & Smith, 1999; Norcross, 2005).

Power of Community 

While we can’t expect to go back to the way things operated before, it is essential to ensure we are building our own competence constellations and that our connection to a community is still being met. Some examples of this might look like: 

As mental health professionals, it’s important to practice what we preach to our clients. We can’t go at this work alone and to continue to do so would be a hindrance to ourselves and those we serve. With a focus on competence constellations, we can combat the pervasive isolation and loneliness and continue to thrive in our professional and personal lives. 

Sources:

Gündoğan, H. (2017). Meaning-making process of psychotherapists on feelings of incompetence through the framework of the professional self-development: Sources, consequences, and defense mechanisms(Doctoral dissertation, Middle East Technical University, Ankara, Turkey). Retrieved from https://open.metu.edu.tr/handle/123456789/26931

Hawkley  C, Capitanio J. P. (2015) Perceived social isolation,evolutionary fitness and health outcomes: a lifespan approach.Phil. Trans. R. Soc. B 370: 20140114. https://doi.org/10.1098/rstb.2014.0114

Johnson, W. B., Barnett, J. E., Elman, N. S., Forrest, L., & Kaslow, N. J. (2013). The competence constellation model: A communitarian approach to support professional competence. Professional Psychology: Research and Practice, 44(5), 343–354. https://doi.org/10.1037/a0033131.

Macran, S., & Shapiro, D. A. (1998). The role of personal therapy for therapists: A review. British Journal of Medical Psychology, 71(1), 13–25. https://doi.org/10.1111/j.2044-8341.1998.tb01364.x.

Macran, S., Stiles, W. B., & Smith, J. A. (1999). How does personal therapy affect therapists’ practice? Journal of Counseling Psychology, 46(4), 419. Retrieved from https://psycnet.apa.org/buy/1999-11962-001–431.

Norcross, J. C. (2005). The Psychotherapist’s own psychotherapy: Educating and developing psychologists. American Psychologist, 60(8), 840–850. https://doi.org/10.1037/0003-066X.60.8.840.

Rokach, A., Boulazreg, S. The COVID-19 era: How therapists can diminish burnout symptoms through self-care. Curr Psychol 41, 5660–5677 (2022). https://doi.org/10.1007/s12144-020-01149-6

Tryon, G. S. (1983). The pleasures and displeasures of full-time private practice. The Clinical Psychologist, 36, 45–48. Retrieved from https://psycnet.apa.org/record/1983-21953-001.