The SPARKS approach to burnout prevention (with Danielle Graber)

[00:00:05] Bronwyn: Hey, mental workers. You're listening to The Mental Work Podcast, the podcast about working in mental health for early career mental health workers. As always, I'm your host, Dr. Bronwyn Milkins, and today we are talking about a really cool approach to burnout prevention. It's called the SPARKS and it's a no BS approach.

In this episode, we're gonna get real about burnout, why traditional self-care often misses the mark, and how you can stay well and thrive as a mental health worker with a practical, guilt-free approach that centers you without overwhelming you.

Here to help us out with this topic is our guest, Danielle Graber. Hi Danielle.

[00:00:37] Danielle: Hi. Thank you so much for having me back. It's so nice to be back and talking about SPARKS.

[00:00:41] Bronwyn: It is lovely to have you back. Listeners, if you haven't listened to Danielle's previous episode on the podcast, it was about animal assisted therapy, and I loved that because I love animals and I love talking with Danielle about that. It was a great episode, so I'll pop that in the show notes, and make sure you go back and listen to that.

But today, Danielle, you're here to talk to us about a model that you've created for burnout prevention. It's called SPARKS. Could you please tell listeners who you are and a SPARKS based activity you've recently undertaken?

[00:01:08] Danielle: Sure. Uh, I'm Danielle Graber. I'm a clinical psychologist and animal assisted therapist, board approved supervisor. Uh, I run 12 Point Psychology and training in Ferntree Gully in Melbourne, which is a psychology clinic plus a like an online training arm where we do professional development for therapists and have done for the last six years.

But over COVID, uh, and, and looking at the impact of that on all of the arms of the business, on the client, work on the supervisees, on their client, work on the, you know, the, the morale of the admin team, it became really obvious that we needed something different. Something was very, very broken and had been broken for a long time, long before COVID. It's just COVID really kind of, you know, the, the, the straw that broke the camel's back kind of thing.

So, I, I went back to the basics. Uh, I went into, into hyper focus, deep dive research mode and, and developed this, this new approach to not just, uh, definitely burnout prevention and recovery, but also just how to live and function and work as a human and as a therapist. Because that's something I don't think that we are terribly good at, naturally, and it's not something that's terribly encouraged.

[00:02:28] Bronwyn: Yeah, it's not, it's not really taught, like, you know, having done my training in 2017 and then doing the five plus one internship after that, it's not something that I covered in supervision. It's not something that I recall covering much in the content of what I listened to at university. It was kind of like, do self care, like as a one-liner.

[00:02:50] Danielle: Yes. That. Yeah, that was it.

[00:02:51] Bronwyn: It's like, it's probably a good idea that you self care. Um, but it was never described how to go about that, nor I think were I prepared for the realities of working as a therapist and how overwhelming that might be. It's like I took it on board as a trainee and I was like, oh yeah, this is probably important. I can just keep up the usual things that I do. And then you get this emotional overwhelm and this sense of responsibility that comes with being a therapist and it's like, oh, these strategies aren't gonna cut it.

[00:03:17] Danielle: It honestly feels to me a little gaslight that... because same, I mean, I did my initial training in 2000. I started in 2005 and yeah, do self-care, but that was the extent of it. And then every place that I worked and every organization that I worked within and all the jobs, their expectations went completely counter to the idea of looking after yourself in any way. And things are slightly better now. Mostly!

[00:03:47] Bronwyn: Yeah.

[00:03:48] Danielle: But not across the board. Uh, and, and a big part of SPARKS was learning that the, um, the early life traps and the early behaviors and, and beliefs that we took on board that often led us to become therapists in the first place. And then, you know, kind of made us prime candidates for, for, for burnout and, um, really being taken advantage of in a lot of ways.

Um, so the idea of, you know, just have a massage once a month and go to the gym, and that, that's gonna somehow counter all of the pressures and the expectations that we carry into the field and that continue to be expected of us once we're in the field. It's, it's, it's no wonder that we're in a little bit of a, in a little bit of a mess.

[00:04:34] Bronwyn: Mm. So with SPARKS, you created it during the COVID, and I'll contextualize it 'cause you're in Melbourne, aren't you?

[00:04:42] Danielle: I am, yes.

[00:04:42] Bronwyn: Yes. Whereas I'm in Perth and during COVID it was pretty crazy, but Perth had one of the least amount of lockdowns in the world. I think we had like two weeks 'cause we kept kicked everybody out of the state and we pretty much closed our state. Um, whereas Melbourne, you guys had several months and months and months on end of pretty intense lockdowns.

[00:05:03] Danielle: We ended up, um, I think we, I think we became the, the, the most lockdowns in the world, um, Italy and us were on par for a while, but, um, but no, I think we ended up beating them. It pretty much became two years off and on. The, the longest lockdown was six months, uh, in one go, and then we had two weeks out and we got locked down again.

 So I made it through 2020 just, and then I got about three months into 2021 and went, oh, no. Like I, I, I finally clicked something was really not well, and I, I burnt out, big time, uh, and, and started looking around and going, all of the stuff that they're recommending that I do is not helping, and I feel like it's making it worse. So what's, what's that about? And we, we need something different. And SPARKS really grew outta that.

Burnout is a syndrome. The, the World Health Organization recognized it as a syndrome in 2022, finally, they, they fall short of calling it a medical syndrome. But there are physiological changes, there are neurological changes and obviously psychological changes. I don't know why that's not a medical syndrome. And if we don't address all areas of that, how, how do we expect it to get better?

So, so part of SPARKS was, all right, well how do we address all of those things when we're already in a place where our brain's not working properly, our body's just beyond exhausted and we're probably burnt out 'cause we're doing too much in the first place. So how are we going to, to make a change when we're already coming from such a, such a deficit place? Yeah.

[00:06:42] Bronwyn: It's, it's such a difficult place to be and how do we, how do we come back and reconnect when we're in a pretty dark space?

[00:06:48] Danielle: Yeah, yeah, yeah. And, and literally neurological changes that make it harder to connect that, you know, lower things like, like the, you know, oxytocin levels in your brain, so social reciprocity doesn't count for as much, and it, like, it's, it's designed to keep you isolated and feeling bad, um, so, so countering that by doing more, it just, that's, that's, nuts, that's

nuts.

[00:07:11] Bronwyn: And that's something the psychologists often do as well. We're like, I'm burnt out. I'm gonna take on five courses and do more work.

[00:07:17] Danielle: Yeah, yeah, yeah. Um, or, you know, I'm, I'm burnt out. I'm gonna take some time off from client work, and then I'm gonna develop an entire new approach to fixing burnout.

[00:07:27] Bronwyn: I'm not dubbing anybody in. Nobody in this room is implicated in that.

[00:07:33] Danielle: Idea. Look, I do not pretend for a second that I've got this stuff all sorted and done. Now either

[00:07:39] Bronwyn: Yeah.

[00:07:40] Danielle: SPARKS is incredibly helpful and has made such a big difference, but it's a work in progress and that's the good bit and the bad bit because I know we all want a checklist. We all want to do this, then do this, then do this, and you will feel fine and you won't burn out again, and that doesn't exist.

[00:07:59] Bronwyn: Yeah, I'm just like, that just really resonates with me because I totally do want a checklist. Nothing would delight me more if you gave me a bit of like laminated paper and was like, this is the checklist you follow to health. I'd be like, this is the best thing ever.

[00:08:14] Danielle: Yep. I know I would love to. I want one of those. I want one of those. But that doesn't work. I've tried that. It doesn't work because we do tend to, because we have those, you know, often perfectionistic, self-sacrificing schemas or you know, default beliefs and things that got us here in the first place. Then, yeah, you give us a checklist, we will follow it to the letter and, and one of the myths that I believed was if I, you know, I just have to exercise regularly and then that, you know, that's self-care, that's, that's burnout prevention, that's self-care... But then that got to the point where I'd be at the gym three or four times a week, sure. But I wouldn't rest if I was hurt or injured or sick. It was like, no, no, 'cause if I don't do that, then I'll burn out... when the thing that was burning me out was these rigid standards that I have to adhere to that aren't a choice. It's just a 'have to'.

This week I had a doctor's appointment, um, that was supposed to go for, well, that I'd, I'd sort of budgeted, you know, this much time for, and it finished early. The doctor was on time and everything went, went to plan and I ended up, uh, with like an extra hour. Previously, a hundred percent I would've gone, bonus, I'll get back to work and I've got an extra hour of work now I can work on this, this, and this. This time I went, I did my, did my SPARKS check in and went, you know what? It's quite a nice sunny day today and. I think I'm just gonna stop at the arboretum on the way back. And I sat, I stopped at the arboretum and got outta the car, and I went and I sat and I watched ducks in a pond and just, just, just chilled for, I think I, I think I was there for about 30 minutes or something, and previously, one, I would never have even considered doing that, but two, even if I did, I would've felt so guilty. Just like, no, you've got this bonus time. Why aren't you putting this to more productive use? Like, what are you doing? Just sitting watching ducks?

[00:10:16] Bronwyn: How did you give yourself permission to do that? Like what was the thought process going through your head?

[00:10:21] Danielle: Well, I mean, the thought process now is different 'cause we're, you know, I'm, I'm sort of, um, to three years into, to SPARKS work, but it, it's. Go something along the lines of, uh, if I was, if I was newer to it, there's an actual decision checklist. So-

[00:10:40] Bronwyn: Oh, okay.

[00:10:40] Danielle: -you know, I said there's no checklist. There is, there is the decision making. There is a decision making checklist. And you, you, you weigh up. It's, it's, um. Option A versus option B against the SPARKS domains. So, uh, I've got this extra hour, what am I gonna do with it? Well, I can go back to work and get some more work done, or I could do something else. I could go and get a, I could go and get a massage.

Like, I don't wanna knock massages in gym. Like, those things are awesome. It's just they're not the only thing. Uh, and, they're not the, they're not, it's not them that's going to fix the burnout or, or prevent the burnout. It's, it's your relationship to them and how you use them. But, so the decision becomes then against each of the SPARKS domains, um, which option is more true to the SPARKS? So which one is going to. Um, increase my feelings of emotional safety and containment, or help soothe my nervous system or be better for my body. Um, uh, which one's going to feel like more of an achievement? Which one's getting me more towards the path that I want to be walking rather than the old path that I'm trying to get off? Uh, which one is showing more kindness to myself, uh, and all of my parts, not just my work part, but, you know, my, my partner part and my dog mom part and my friend part and my inner vulnerable child part, whatever, you know, which one has, has the most to gain, the most to give to, to those parts. Uh, and which one's gonna be a bit more fun?

[00:12:29] Bronwyn: Yeah. 'cause the, the duck sounds nice. I like that idea of walking the, or not walk. I was gonna say walking the duck... of watching the ducks.

[00:12:39] Danielle: It was amazing. It was amazing and in large part because it was so different and I knew I was doing something that I would never have done a couple of years ago

[00:12:49] Bronwyn: Yeah.

[00:12:49] Danielle: That was, and I could take pride in that and take that. There was achievement in that as well, of doing something that felt good, that was good for me. Um, that I could feel my nervous system like resetting. Uh, and it just, you know, the rest of the day goes so much easier and so much better. And it's, it's, yeah. Such a, and this is sort of what I mean about with SPARKS. I talk a lot about doing versus being and doing differently, not doing more.

So I had that hour, I wasn't taking it away from anything else. It was, it was a, it was a bonus hour, if you like. Um, doing more, would've been using that hour to, you know, do something else that was in quotes, productive, you know, old, old pathway version of productive. This was allowing me to be, and, and allowing my nervous, allowing my nervous system to to, to rest and get more of what it needed. And. Um, and set me up for a much, much better evening and, and probably the rest of the week.

[00:13:54] Bronwyn: So it sounds like, yeah, really reconnecting with what, I guess your health and wellbeing and like centering that as a value and then making decisions based on that. How am I gonna help myself to help myself in the future. It's kind of like how, how can pass me help future me?

[00:14:10] Danielle: Yes. Yes, exactly. And that's like our tagline is Your Future Self Will Thank You.

[00:14:15] Bronwyn: Oh, nice one. Okay.

[00:14:17] Danielle: So, so perfect. The, the, yeah. It's, it's like what's going to be the, the, the biggest overall benefit right now. Um, and so that's when you've got like that, that sort of, um, in the moment decision making stuff.

[00:14:29] Bronwyn: So maybe this is a good time to talk about the domains of SPARKS, because we've said SPARKS a lot, but I just wanna go through the six domains. 'cause you mentioned it's integrative and it truly is. So I'll just say the domains out loud. So we've got safety and boundaries, physical health and body care, achievement and acknowledgement, relationships and connections, kindness and nurturance, and the last one is spontaneity entertainment. So it really is a holistic view of our health and wellbeing.

[00:14:58] Danielle: So, so Sparks is, comes from a, a, a very integrative, evidence base. There's, there's, there's principles in here from, from the neuroscience of chronic pain, from, um, biofeedback, from internal family systems and schema and ACT. There's, there's, there's a lot that goes into it.

But at its core, part of what we're doing is, yeah, absolutely. Looking at holistically at our overall health and wellbeing, mental, physical, all the rest of it. But we're also trying to heal some old ruptures. We're trying to heal some old unmet needs. So if you look at those and if you know anything about schema, you might recognize, you know, some parallels there with some of the core needs that we have as kids for optimal development, you know, the, that need for consistency, that need for safety, that need for, um, autonomy, um, say, uh, spontaneity play, all of that kind of thing. These are like the adult versions of those needs.

Because what I discovered when I started looking into this was 80 to 85% of therapists did not have these needs met consistently when they were kids. And that leads to huge numbers of perfectionism, people pleasing trauma responses, you know, whether it's T trauma, little T trauma. But that's, that's what it's, that's what it's cooked up. That's what it's resulted in.

You combine that with the fact that, like we were saying earlier with the self-care, since I've been doing these presentations and things, I do, um, we do surveys when, when we do the, the presentations for workplaces and things like that, uh, I think at the moment we've got 200 and something surveys completed, and 93% of respondents have never done any self-care training, learning, not at uni, not as part of their professional development. Nada. Which is terrifying. I knew- it's a lot

[00:17:00] Bronwyn: But like, you know, if I was to do that survey, I would say the same thing. I've never actually formally done, uh, a workshop or professional development on self-care.

[00:17:08] Danielle: Nope. And neither had I until, until-

[00:17:10] Bronwyn: Until you developed the approach. Yeah.

[00:17:12] Danielle: And the 7% who have done it was either paid for by a workplace, like, like, like me coming in to talk to them. or they just actually I, yeah, it's less than 1% paid for it themselves. but, but most were that 7% mostly where workplace had organized it or paid for it, uh, and of that 7%, none of them found it helpful.

[00:17:36] Bronwyn: I was just gonna say, um, I actually lied because I've just, it's triggered a memory in me that I have done a self-care course. I just didn't engage with it.

[00:17:44] Danielle: There you go.

[00:17:45] Bronwyn: So I downloaded it. I remember doing it and I was like, okay, this is nice, thanks. And then I like didn't do any of the activities and I just put it and I was like, tick. Which is a terrible way, obviously, to engage with professional development, and I wish I had actually done it.

[00:17:59] Danielle: But that tells you something. I think that tells us something really important that, that, that's been, that's been really, really lacking because it's not like those were hidden stats. Um, why, why is this not being kind of talked about and, and screamed from the rooftops? Why have we not seen any changes to the self-care research or literature or offerings in 50 years? Because it's obviously not working.

[00:18:22] Bronwyn: No. Yeah, because I remember, I remember the course I did now and it was like a few word docs, and I just remember finding it so boring, and as an ADHD, I really need engaging content. Don't give me like 50 pages of a word doc. It's not going to happen.

[00:18:36] Danielle: And if you're already burnt out or burning out, that's what, what is that? No, No. That's not gonna work.

[00:18:43] Bronwyn: So you've got this holistic approach which supports wellbeing, but it also helps to address past beliefs that have come maybe with unmet core needs. And I was gonna say as well, I actually went to a trauma-informed care workshop, and one of the questions that the presenters asked, the mainly psychologist audience was just how many people have experienced, and they put up the Adverse Childhood Experiences questionnaire. How many of you have experienced adverse childhood experiences? And it's like everyone was like, yes. Like two or more of these, so-

[00:19:15] Danielle: We score very highly.

[00:19:16] Bronwyn: Yeah, We actually do, yeah. And the presenter said that she's done surveys of psychologists, and when you look at the stats for exposure to adverse childhood experiences, it does seem to be a little bit higher than the general population, which was shocking to me. But yeah.

[00:19:30] Danielle: No, not shocking. Unfortunately not. Not shocking now. Yeah. 15 years ago I probably would've been shocked.

[00:19:37] Bronwyn: Yeah.

[00:19:38] Danielle: Because that, that those, and you, you tend to find those, lots of over parentification, uh, and lots of what I'm calling unsupported autonomy. So a core childhood need is for autonomy, and if you ask most therapists, how much autonomy did you have as a child? They'll say, I had lots, I had lots of independence and freedom, but it was not supported. It was a sink or swim kind of autonomy. It was a, it was an over parentification or it was a, you know, you are the mature one or you are the good girl or, or boy, or you are the, you know, there's a, there was a role and, and that, that served other people, but we took pride in it because we did it well and, and often did things.

I mean, I think about, I used to, I used to babysit for not just my siblings, but for other kids. I was like 11 doing overnight babysitting gigs. And I think about that now, I can work with kids. I think about some of my 11-year-old kids and I'm like, oh, dear God, no. No!

[00:20:37] Bronwyn: Yeah.

[00:20:38] Danielle: But I was incredibly proud of that. Uh, you, you, you develop this... really good at reading people, really good at tuning in and noticing and being hypervigilant to, to threats to how, how someone else is feeling. You get really, really good at suppressing your own needs in favor of everybody else's. And then you look around and you go, hey, look, there's this profession. And that's all they do!

[00:21:04] Bronwyn: Yeah. And then you're really good at it.

[00:21:06] Danielle: Yeah, then I'm really good at it, and I get praise for it, and the clients all like me and um, my organization loves the fact that I'll do six hours of overtime and not ask for pay.

[00:21:18] Bronwyn: Yeah. Yeah. What a team player.

[00:21:21] Danielle: And then you get, you know, for example, then you, you, you get fired because you say, actually, it's my birthday tonight and I really need to head off. They're having a party for me at this restaurant. Uh, well, we'll need to talk about this. I thought you were a team player.

[00:21:35] Bronwyn: Hmm.

[00:21:36] Danielle: And then you feel guilty about it and get depressed about it for, for quite a while because you feel like you did something wrong by saying, no, putting in a boundary and, yeah.

[00:21:47] Bronwyn: Yeah. So it sounds like therapist guilt is something that you've observed a lot, which comes up in the sparks, I guess, coaching and workshops that you do.

[00:21:55] Danielle: Yes, the therapist's guilt is, is terrifyingly real and strong. Uh, and this is not for everyone. This is not for every single therapist out there, obviously. Um, but you know, a good, 80% or so. It, it, it's pretty strong, and if we don't address that, then that, that's such a, that's such a big blind spot.

Um, a lot of what we do in SPARKS is trying to unearth some of those blind spots or traps that we fall into without even realizing it, that it's a trap. Uh, and, and, the number of times talking to supervisees, for example, and they might say, I'm feeling really, really stuck with this client, they're just not improving and I dunno where to go, and I just feel like we're not doing anything, and we talk about it. And they've had two sessions with this person who's got a really complex presentation and I'm like, what did you think was gonna happen in two sessions? Where do you think you should be in two sessions?

These internal expectations and drivers on, on what constitutes good therapy or, or a good therapist and, um, the, that, that unsupported autonomy tends to lead to what I think is one of the biggest risk factors for developing burnout and just generally being fairly miserable where, the, the, I dunno if you're familiar, it's a bit of an old term now, but the idea of the internal/external locus of control research, do you remember that from? Yeah. Yeah. So it used to be, you know, external locus of control, you're at life's whim, you, there's no self-efficacy, you just, whatever happens, happens.

But I think with therapists, what I've noticed is something, there's a split. So we tend to have an external locus of control when it comes to the good stuff, to the achievements. So if the client's doing really, really well, we say it's all them, or it was luck, or it was good timing, or they've worked really hard or, but it wasn't us. But when the client's not doing well or something's gone wrong, we have an internal locus of control.

[00:23:57] Bronwyn: It's so true. It's so true. I like can like, see myself in that image, 'cause like when a client is doing well, I'm like, oh, they had a really good environment. Their partner's so supportive. And then when they're, and then when they're not doing well, I'm like, why am I so awful? Like, how am I not supporting them well?

[00:24:15] Danielle: Yep. Yep. A hundred. Yeah. You are not alone in that one by any means. And it's, it's, it's, it's so bad!

[00:24:23] Bronwyn: Yeah. It's so true!

[00:24:25] Danielle: But it's, it's, it's so pervasive.

[00:24:28] Bronwyn: It's so self-defeating. 'cause it's like, as, as soon as you say it, as soon as I hear my, me say it, I'm like, yeah, of course, it's that's bad. Like, that's, it's so self-defeating. It's so senseless beating yourself up and it's so, it, it's so illogical.

[00:24:43] Danielle: But but that tells you that this is an old trap. This is an old schema, this is an old pathway. This is a, whatever we wanna call it. This is an old message that's coming through into the present, and it's a really, really good signal that you're looking at a trauma driven response rather than a values driven one, which is then something that you can, you can do something about because you learn that way. You learn that that was the case. You can learn different, it just takes a little bit of work.

[00:25:08] Bronwyn: Mm. So you mentioned in your ebook that SPARKS helps us to repair, not just bail. What does that mean in practice for someone on the verge of burnout?

[00:25:18] Danielle: So I, I used to use an analogy that, that I think spoke more to my, my medical days, which was that for a long time I felt that self-care was just like putting little bandaids on gaping wounds. You know, we we're gushing bloods and they're just like, have a massage, it's, it, no, mm.

But the, the blood analogy got a bit gross for some people. So we went with the boat, which was, which is fair. Which is fair. And that is the idea that, when we're born, we're given a row boat. And if our, if our mother was, really not stressed and had a wonderful pregnancy and there's no genetic history and uh, we've got a really nice supportive environment, then the rowboat's probably in pretty good shape.

Uh, we know for therapists that's generally not the case, that, uh, we're not generally born with a great looking rowboat and childhood usually makes it worse. Um, you know, every time there's another ACEs score, that's another hole in that rowboat. But you grow up thinking that's normal, that everyone's boats look like that and there's nothing you can do about it, 'cause no one tells you there's anything you can do about it.

You can have therapy and that can help for sure. But I think for therapists having therapy, this is something they don't consider, they don't look at this part of it. And you head out onto the big bad ocean and things are going fine for a while because you are used to bailing out that water that's always coming in. It's always been coming in. So you're used to just constantly bailing it out. Self care becomes like, maybe it gives you an extra bucket for a little while, or it gives you a bigger bucket or a prettier bucket, but it's just fundamentally doesn't change the fact that you are spending a lot of energy constantly bailing out all of this water that keeps gushing in. And it never even occurs to you that you can do something about the holes. Um, especially once you get into psychology and now suddenly you're in a massive ocean with all of these other people in equally leaky rowboats, all going, this is how you bail out faster. Come on, keep it up. Keep it up. You can do it.

[00:27:17] Bronwyn: Yeah.

[00:27:18] Danielle: So, um, when we talk about that sort of custom roadmap for people, it's identifying where your, um, where your leaks are and what do we need to do to, to change up in really, really, really, really small concrete ways to start with that, that might start, not just helping you feel a bit better, day to day, but actually start to address some of these leaks and, and, and repair them.

[00:27:45] Bronwyn: Something I really like about SPARKS and what you're doing is that you center self-care and wellbeing, whereas when you were talking before, I was like, when you start out as a psych, you have so much to learn, right? There is, there is so much to keep in mind. You're trying to keep in mind the techniques, and you're learning these modalities, learning how to work with these specific populations, keeping in mind your professional ethical obligations all your note taking, how do I do that? How do I manage these systems?

And then you've got self-care and it can just be a thing like, I'm just gonna watch a movie at home. But like you said, it's bailing out rather than actually fixing the holes. And I really like how you've given permission to center this, like, so thank you. Um, but I'm glad that you're doing it because I feel like we don't get that enough. It's like, I feel like we don't have enough permission to be able to center self care.

[00:28:36] Danielle: No, no, not at all. And, and we've got a really skewed idea of what self-care actually looks like because it, it, it has been bandaids on, on wounds up until now. It has been, you know, bigger or prettier buckets. It has been bail faster. Um, whereas, and the, and the, uh, is it the, the Jungian quote around, no, it's the Rogers quote, the, the more I accept myself, the more I can change.

[00:29:01] Bronwyn: Mm.

[00:29:02] Danielle: It's the same with SPARKS. So for a lot of particularly the early career psychs who are listening to this going, I don't have room for this, I don't have capacity for any more stuff. I am, I'm paying attention to the client and I'm doing this and I'm doing this, and it's such a steep learning curve.

But the ironic thing is, considering that this comes about because of the high degree of people pleasing and perfectionism and all of that kind of thing, is, if you need further permission, like ideally, I wanna get to the point where it's like, you are worth this all by yourself, but I'm being realistic, if you need further permission, think about it in this way. What do we know is the, the consistently proven, most important, single contributing factor to good client outcomes?

[00:29:52] Bronwyn: The relationship.

[00:29:53] Danielle: There we go! Yes. Okay. Now where are we putting all of our concentration, all of our training, all of our time, all of our money, all of our effort. Which side of the relationship is getting all of that attention? We focus on the client and their needs and their wants and what's good for them and, and I'm not saying we shouldn't do that. I'm saying if it's a relationship, then there are two people in that relationship. If you ignore one altogether, that's not good. That's that, that doesn't, that's not a reciprocal, genuine relationship.

[00:30:25] Bronwyn: So true.

[00:30:26] Danielle: And the more you... because it is all that, it helps you to get out of the mindset of doing and overdoing, you are much more likely to be present in that room, to pick up on a, on a shift in the client, to be more comfortable being another human in the room. And when you do that, then the specific technique for that specific client in this specific moment becomes less important than just being there and being another human and concentrating on the relationship.

So you actually stress less because I don't have to know the, I dunno, the manualized approach to binge eating disorder in in 21 year olds with this kind of history. I just need to know that this is how this person's feeling right now. And I don't have to come up with something brilliant to say. I can just be here with them. It makes it so much easier and so much less stressful.

And then afterwards Yeah, you go and you, you can look up some of the specific things. But the question that I always, it's harder to ask these days 'cause everything's online, but in the old days when we had our paper files and you used to be able to really freak out a therapist by saying, imagine the client shows up and you can't find their file and you've just gotta go in and you can't read what happened last session and you don't know what's happened and all your face, yeah.

[00:31:49] Bronwyn: Well, it's happened. It's happened even like, 'cause I use iPad and it's like iPad like ran outta battery.

[00:31:54] Danielle: It won't. Yeah, exactly. It happens. And, and most therapists. Yeah, freaks in the hell out.

[00:31:59] Bronwyn: -freak Oh, freak out. Yeah.

[00:32:02] Danielle: 'cause you're concentrating. Because you're concentrating on the doing. You're concentrating on what we have to do here instead of the being. So this is, this is, this is how we can sort of. Use our self-sacrificing people pleasing stuff against us to say, if you really wanna help the client and really genuinely be there for them, and really give them a solid, authentic, genuine, therapeutic relationship, you have to look after yourself.

[00:32:28] Bronwyn: Mm, it's so true. I find that very convincing. I think that's a convincing way of putting it, and it's something that I've said to myself over the years to help myself. I think that like if I'm an electrician, I've got my tools that I can use as an, as an electrician. I can rely on my tools. I'm like in therapy, I am the tool. Like there's only me, there's me here in the room. I need to look after me.

[00:32:49] Danielle: A hundred percent. A hundred percent. You are the most important tool that you have. Your, your ability to connect, your ability to relate, your ability to attune, your ability to think on your feet, all of that stuff is super important, but nothing is as important as being another human in the room.

[00:33:06] Bronwyn: So true. And I think we get a lot of respect from clients when that does happen. I noticed, um, when one of the, uh, strategies I put in to prevent burnout is I take regular time off. And at one point in my practice I was taking a week off every six weeks. So I'd have six weeks of practice and then I'd take a week off. And that was just what I needed at the time. And I remember, clients querying this and being like, oh, did you not just take off some time? And I told one of them, I was like, this is part of my burnout prevention strategy. And they were like, oh, wow, that's awesome. I'm gonna do that.

[00:33:37] Danielle: Yes, yes, yes, exactly. There's a really, really, I, a really nice idea, um, we're talking about it a bit in a, well, I talked about it recently in a video that we did on with a couple of other therapists who work in sort of burnout prevention space, but that compassionate friend stance from the point of view of the clients as well. How do you think your clients would like you to be treating yourself?

[00:34:01] Bronwyn: Yes.

[00:34:02] Danielle: And I think some of, some of them would be horrified if they knew the way that we talk to ourselves or the way that we, the way that we treat ourselves, or the staying up till late to finish a resource for them or you know, whatever it might be. I think some of them would be horrified if they knew.

[00:34:16] Bronwyn: I think they would. They totally would. Yeah. Like, yeah, imagine a client discovering that their therapist beats themselves up and is like, oh, how terrible am I? That kind of thing. They'd be mortified.

[00:34:27] Danielle: Yeah. And they would say, are you kidding? That was like the best session we've ever had.

[00:34:31] Bronwyn: Yes. Yeah.

[00:34:32] Danielle: Uh, it's, it's, yeah, it's, it's useful. I think, again, ultimately I want us to be doing this for our own sake, but realistically we've got some pretty big leaks to patch up here. And so starting from a place of this is actually beneficial to the client. Like, client outcomes get better when their therapist is doing this stuff. It's, it's, it's ironic, but also makes perfect sense and you become such a, it just, it just makes life so much easier. I can't even tell you.

[00:35:06] Bronwyn: Yeah. So we are kind of coming up towards the end of our conversation, but I wanted to ask you if there are any common signs that a mental health worker might be slowly burning out, even though there's still air quotes functioning on the surface. Just in case there are any listeners who are like, I'm not sure if this is resonating with me, and maybe there are some things that is happening for them that you see commonly.

[00:35:27] Danielle: Absolutely. Yes. I think it's useful to think about it. So with burnout, we've got three pillars. We've got the organizational side of things, which can be things like just, you know, the admin, the, the behind the scenes parts of being a therapist. You know, getting your registration, getting your pd. Um, it might be the organization that you work for and policies within that. You know, a place where I worked where you had to see five clients a day in, in the, in the eight hours, which would normally be okay, except they required you to complete all of the paperwork and triplicate. And it wasn't just like, you know, it wasn't a carbon copy or something you could cut and paste. You had three different systems you had to enter this information into for every single client. And that's annoying!

[00:36:13] Bronwyn: Yeah. Yeah. Yep.

[00:36:17] Danielle: And you're like, and especially for an ADHD, like can you imagine by the third time you're doing this, just like, ah, so you know, organizations where there's huge amounts of responsibility but no autonomy whatsoever and things like that. So there can definitely be organizational issues and if that's sort of the primary driver, you might see things like, um, you're someone who's usually, even if you're not incredibly punctual, but you, you're there in time and you know you, you're sitting down and you're ready to go at your desk by your first client. Suddenly you get this kind of late creep kind of sneaking in and you're five minutes late and then you're 10 minutes late and you couldn't necessarily say why, but it's just this, this, this, yeah, this quiet, sneaky creep, lateness.

You might suddenly start taking a lot more sick days, um, and you, 'cause you might genuinely be just getting a lot more illnesses. Again, a physiological process, your immune system gets screwed up when you're burning out. So, you know, if you are someone who has key sign in this domain is definitely, um, if you're someone who get sick every time you take a holiday, you need to look at that, because that's saying that your, your HPA, that hypothalmic pituitary axis is under chronic stress conditions, which is, which is a key indicator that we're heading for burnout or already burnt out.

If you... what should we say? Well get a little bit more on the judgmental side. You know, a a, a colleague has a bad day or, you know, or, or drops a coffee cup and in your head you are just like, stupid cow. And, and then you're like, whoa. That was, oh, okay. That was, that was a bit, you bit more judgmental. You lose that generosity of spirit. Like people are doing the best they can do. It's just like she's doing that just to piss me off now.

In the professional domain, that tends to be more related to the clinical work itself. You might notice, just dreading, just dreading the days, the sessions, you might notice that previously... a big one for me was previously, no matter how I was doing in general, if I was, if I was having physical health problems, if I was, you know, I'd, I'd had some bouts of depression in the past, it just, whatever was going on, the therapy space was still my space. I still, I felt the most me there, I felt the most comfortable and I still felt really useful and productive. And it was, it was, it was a refuge... and it really stopped being a refuge. And I became something that I started to dread, uh, which was, which was a huge thing for me.

Resenting the clients, um, feeling more judgmental. Um, you know, starting to have the really, you think that's a problem? You should have heard my four o'clock, or that comparison thing is, is, is a, is a, is a big sign. Uh, and it, and actually in another really good example there of, of a simple SPARKS intervention to look at your caseload and identify your red light, green light clients who are the clients when I see their name and I feel awesome. Yay. I get to, you know, I get to work with this. And who are the clients that make you go, oh God, oh, I really, or why are those two people back to back? Oh, God. Looking at the balance, and it's not necessarily complexity or presentation, it's, it's the fit. How well that client fits with how you work and how much effort you are putting into the sessions and that kind of thing.

[00:39:43] Bronwyn: Hmm.

[00:39:44] Danielle: The professional domain, those are the kinds of things to look for. And then the personal domain, it's withdrawing from friends, changes to sleep, appetite, all of the kind of normal stuff that you might look at for, for depression. But underlying that more than guilt is shame. Just a, just a really pervasive sense of shame. I can't do anything right. And- in- a, in a, a loss of connection to, meaning, loss of connection in general, but loss of connection to meaning as well. So lot of helplessness, that kind of thing.

[00:40:17] Bronwyn: Yeah, so there's a lot of signs there. And I guess like on the flip side, I didn't wanna end the episode on a bit of a downer, I guess, by identifying all these like sad signs. So I wanted to point out something, which is you sent me an ebook of the SPARKS program, and I was really delighted to see in the program that you've measured. How effective the SPARKS program has been. So you've given participants pre and post questionnaires. Some of them have been like the dust 10, which measures depression, anxiety, stress. Um, the ProQual, which is professional quality of life, and one measure of self-efficacy as well.

And you found that it looks like all of these things pretty much increased. So there was less self-doubt, less burnout, boasted confidence, no more self-care, ba- band-aids, less distress, more satisfaction. Um, which I think is really cool because it's like. If there's, if there's a listener listening who is experiencing those things that you just described, there are ways to get out of that, essentially. Like there are ways to change that. It doesn't have to be the end point.

[00:41:15] Danielle: No. No, and it's not inevitable. One of the biggest myths, I think, is if you care about your job, if you care about your clients, if you like your job, if you're good at it, then burnout is inevitable. It's the cost of caring and it's, that's not true. I used to think that was true, but no, it's, it's not. It's the cost of caring disproportionately. Caring more about them than you do about yourself. And I wanna even that a little bit. Um.

[00:41:39] Bronwyn: Yeah.

[00:41:40] Danielle: And the, the lovely thing has been that, uh, I mean the, the quantitative data at this point, I don't have huge numbers, so I can't sort of, you know, say, oh, this proves that this and all the rest of it, I can say it's trending that way, which is nice.

[00:41:54] Bronwyn: That's nice.

[00:41:55] Danielle: It's the qualitative stuff as well that's been really, really, really lovely. Like the, the, the past participant who emailed heading into Christmas and went, I've been going to this particular family Christmas thing for a decade and I hate it and I do it because I'm the good girl and I'm supposed to, I didn't even realize that's why I was still doing it. And you know, that's the only contact that we have with them. They don't even know my daughter's name, they like, they care that little about about us and I just canceled. I just called and said, I'm not coming this year, and my heart's still going pretty fast, but, feeling pretty good and we're gonna create our own little tradition, uh, on Christmas Eve instead. And this is what we're gonna do. And it was so gorgeous. And I checked in with her afterwards to sort of see how she'd gone and she's like, it's great. The sky didn't fall in. Nobody seemed to, I don't, I'm not sure Half of them noticed. And, and I didn't go into it feeling this horrible sense of dread and obligation and then feel crappy for a week afterwards. And it, it was life changing.

[00:42:58] Bronwyn: That's awesome.

[00:43:00] Danielle: So simple. Really. I mean, so simple, just paying attention and going, oh, why? Why am I still doing this?

[00:43:07] Bronwyn: Yeah, so really that permission to put in boundaries and prioritize yourself.

[00:43:12] Danielle: Yeah. Yeah. I'm allowed to have a want here. I'm allowed to have a need and I'm allowed to ask for it to be met, and if it's not, I'm allowed to walk away.

[00:43:19] Bronwyn: Yeah, that's really awesome. So there's been a lot of great qualitative feedback. And I mean, it makes sense when you practice something deliberately like this self-care approach. You can see changes and you really do emphasize those small intentional changes. So it doesn't surprise me that people see benefits there. Um, and it's much more engaging, like, as opposed to the course I was talking that I, that I took before on self-care where it was like, read this 50 page document and I was like, yeah, that's nice.

[00:43:44] Danielle: No! No, no, Even, even the Sparks mini book, I tried so hard to keep that down.

[00:43:52] Bronwyn: yeah, it's very engaging. I like it.

[00:43:54] Danielle: Thank you.

[00:43:54] Bronwyn: There's lots of pictures in there. I really appreciate pictures.

[00:43:59] Danielle: I too, so yeah, of course. I'm gonna include pictures.

[00:44:01] Bronwyn: Yeah, pictures are fun.

[00:44:03] Danielle: It's much easier now. I can use chat, GPT and everything to do the pictures 'cause I'm

terrible.

[00:44:07] Bronwyn: Oh yeah, totally. Yeah. No, it's, it's helpful. Um, so Danielle, I've really appreciated this conversation today. It's been really awesome hearing your perspective and your work in this area. What do you hope listeners will take away from our conversation most of all?

[00:44:21] Danielle: I would love them to take away that burnout is not, not inevitable, it's not a moral failing. Um, it's a very predictable result to, a certain configuration, a certain pattern of of, of life experiences, behaviors, and, um, and a system that that benefits from- and I, I don't, I don't mean that everyone who's in psychology business, business, business or organizations is exploiting on purpose. But you know the system, there's a lot of holes in the system as well. And as long as they know that we'll keep filling them because we've got this people pleasing, perfectionistic thing going on, they don't have to change it.

So you, if you make these, these little changes, if you start looking at... You start looking at your day differently. If you start looking at these, these small actions differently, the potential for a really like a, there's a really good ripple effect potential there for you, for your clients, for your family, and potentially for the system in general. Because as long as we keep plugging the holes in the system, then that's not gonna change either.

[00:45:31] Bronwyn: 100%. Yeah. And like I always think as well, it's like we're so concerned with helping people in our community, there is such great community need for mental health support, but psychologists we're important too. Like we're humans too.

[00:45:44] Danielle: Yes, and, and we're better therapists when we are humans first.

[00:45:48] Bronwyn: 100%. Danielle, thank you so much for joining me on the Mental Work podcast. I really appreciate it. If listeners wanna learn more about you or get in touch or take one of your fabulous courses, where can they find you?

[00:46:00] Danielle: Oh, they can find me on my website, which is 12points.com.Au. There's a, the clinic section, 12 points psychology and the training section, and there's sections on SPARKS and, uh, it, honestly is a little bit of a reflection of my ADHD or brain on the website. So if you have any trouble navigating, send me an email, danielle@twelvepoints.com.Au or you can find me on Instagram and there's like little, you know, SPARKS tips and tricks, including our new SPARKS theme song, which I'm very excited about.

[00:46:29] Bronwyn: Wow, that's a really exciting, I wanna see this. Did you write it or is this like an AI

jingle?

[00:46:34] Danielle: I did well, I, I wrote the lyrics and then AI like created it. I'll send you a link.

[00:46:39] Bronwyn: I'd love to see the link. I, I love this. This is so cool. Wow. I've never, um, I, I love the innovation here is what I'm thinking.

[00:46:48] Danielle: That was, that was some massive spontaneity and achievement and just, just, just, yeah, that was, that was a lot of fun.

[00:46:56] Bronwyn: That is so much fun. That is really cool. Um, thanks, Danielle.

Listeners, if you found this episode helpful, please consider following Mental Work. Give us a rating or review on your favorite podcast app and share this episode with a friend or a colleague who needs to hear it. That's a wrap. Thanks for listening to Mental Work. I'm Bronwyn Milkins. Have a good one, and catch you next time. Bye!