3.8 Case Studies

Lisa is a licensed mental health counselor with over 10 years of experience. She works in a busy community mental health clinic, seeing 30-35 clients per week, many of whom have severe mental health challenges, including trauma, addiction, and chronic depression. As the only counselor in her clinic with specialized trauma training, Lisa often feels pressured to take on the most complex cases. Despite feeling overwhelmed, she rarely declines new referrals, believing it’s her responsibility to help those in need.

Over time, Lisa begins to notice significant changes in herself. She feels exhausted, both physically and emotionally, before her workday even begins. She finds herself dreading client sessions and becomes increasingly irritable with colleagues and family. Lisa starts to lose her sense of fulfillment in her work and questions whether she’s making a difference with her clients. To cope with the stress, she begins canceling or rescheduling client appointments more frequently, and when in sessions, she feels emotionally disconnected from her clients, struggling to remain empathetic and present.

Lisa’s symptoms of burnout continue to worsen, and she begins making clinical errors, like missing important client details and feeling indifferent to her clients’ progress. One day, a long-term client confronts her, saying they feel she’s no longer engaged in their treatment. This prompts Lisa to realize that her burnout is negatively impacting her clients, her professional performance, and her own mental health.

Lisa is experiencing classic signs of burnout, which is now affecting her ability to provide effective and ethical care to her clients. This compromises her professional responsibilities and may lead to harm if not addressed. Lisa faces the ethical challenge of acknowledging her burnout, seeking support, and potentially reducing her caseload to maintain both her well-being and the quality of care she provides.

Discussion Questions:

1. What are the signs and symptoms of burnout that Lisa is experiencing?
2. How might burnout affect Lisa’s ethical responsibility to provide competent and effective care to her clients?
3. What steps can Lisa take to address her burnout and prevent further harm to herself and her clients?
4. How can counselors implement self-care practices and establish professional boundaries to prevent burnout?
5. What ethical guidelines address the counselor’s responsibility to monitor their own well-being and prevent burnout from compromising client care?

Evan is a licensed substance use disorder (SUD) counselor working at a busy outpatient treatment center. His primary role involves providing individual and group therapy to clients struggling with addiction. Many of Evan’s clients have co-occurring mental health disorders, which often complicates their treatment plans. In addition to his counseling duties, Evan is responsible for completing administrative tasks, such as writing detailed case notes, developing treatment plans, and coordinating care with outside agencies.

Recently, the treatment center experienced staff shortages, and Evan was asked to take on additional roles. These new responsibilities include supervising a caseload of newer counselors, leading community outreach initiatives to raise awareness about substance use treatment, and managing crisis interventions for clients in immediate need of care. Evan also conducts intake assessments for new clients, which significantly increases his workload. Though he enjoys his work, Evan is now juggling multiple responsibilities with little downtime between sessions or tasks.

Evan begins to feel overwhelmed as the demands from each role start to clash. His counseling sessions are becoming rushed due to the administrative work and constant interruptions for crisis management. His supervisory duties suffer as he has less time to mentor new counselors effectively. During group sessions, Evan finds it difficult to remain fully present with his clients, often distracted by emails and deadlines for reports. His stress level rises, and he feels guilty for not being able to provide the same quality of care that he used to.

Over time, Evan starts to experience symptoms of burnout—he feels emotionally drained, has difficulty concentrating, and begins to dread going to work. His supervisors continue to rely on him to manage the growing caseload, unaware of the toll this role strain is taking on his mental health and his ability to deliver quality care.

Evan’s experience of role strain is affecting his professional competence and his ability to meet the needs of his clients. As the demands of his different roles continue to increase, Evan is struggling to balance his counseling duties, administrative responsibilities, and supervisory role. This raises ethical concerns about his ability to maintain professional standards and ensure that his clients receive the care they need.

Discussion Questions:

1. How is Evan’s role strain affecting his ability to provide competent care to his clients with substance use disorders?
2. What ethical guidelines should Evan consider when balancing his multiple roles and responsibilities?
3. What steps can Evan take to reduce the impact of role strain on his professional duties and prevent burnout?
4. How should Evan communicate his concerns to his supervisors, and what role should the treatment center play in addressing staff role strain?
5. How might Evan’s role strain affect the therapeutic alliance with his clients and the outcomes of their treatment?