Creating a Sustainable Rhythm in Your Practice

If someone asked you to name the core tool of your clinical practice, what Would you say? EMDR? CBT? Your favourite assessment measure? Your EHR?

What if were none of these, and the one tool you need may be a key to preventing burnout?

We talk about clinician burnout like it's a personal problem. You know the platitudes, “Have better boundaries”, “Take time for self care”, “No is a complete sentence".

These are all important but it's like trying to use a hammer to change a tire and it misses more than it hits. That's because the problem isn’t that you are bad at taking care of yourself, it's that you need a different tool.

And that is the Cycle of Caring.


Skovholt and Trotter-Mathison (2016) mapped the four phases that make up the life of a helping professional that is not only the span of a therapeutic relationship or career trajectory, but can happen several times a day each time we come in contact with the people we provide a service to.

This is the Cycle of Caring. The phases are:

1. Empathic Attachment.
2. Active Involvement.
3. Felt Separation.
4. Re-Creation.

The first two are where we lean in by building rapport and investing in our clients' goals. They're other-oriented by design. When people think of therapy, these are the two phases that come to mind. But the last two are where we come back to ourselves by processing the letting go and returning to start the cycle again.

Most clinicians live in attachment and involvement. Felt separation and re-creation are the first to disappear when caseloads are high and breaks are short.  Felt separation becomes a 90-second walk to the bathroom and re-creation becomes a weekend where you spend more time recovering than restoring.

Before you add more certifications, assessments, or self care apps to your toolbox, reach for felt separation and re-creation first.

Naming the phase you're in, even just once a day, is in itself a regulatory act.

It moves you from being on auto pilot to acting intentionally. That space between re-creation and when the cycle starts again at empathic attunement?

It is where sustainable practice begins.