The Ethics of Rest: Why Therapists and Caregivers Must Prioritize Wellness

The Conflict Between Self-Care and Professional Duty

I often remind my clients that self-care is not a luxury but a necessity. Yet, when I tested positive for COVID-19 recently, I found myself struggling with an internal conflict I’ve seen echoed in the lives of many helping professionals. The guilt of canceling or rescheduling appointments was immediate and heavy. I had to wrestle with a deeply rooted value—“showing up no matter what”—versus the professional and ethical imperative to care for my own health. This is a familiar pattern among therapists, teachers, nurses, and other direct service professionals. We are trained to be present, to hold space for others, and to prioritize the needs of our communities. But what happens when our own health is compromised?

Unique Stressors in Mental Health Professions

The mental health profession carries a unique set of stressors. Emotional labor, constant exposure to trauma, high caseloads, and systemic challenges all contribute to burnout. The World Health Organization classifies burnout as an occupational phenomenon, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment (World Health Organization 2019). In helping roles, burnout is not just a risk—it is a frequent reality.

This is not just a psychological burden. Chronic stress and burnout have been linked to a higher risk of cardiovascular disease, gastrointestinal disorders, and compromised immune function (Melamed et al. 2006). For those of us in health and mental wellness fields, the irony is clear: in our efforts to support others, we often neglect our own well-being, becoming more vulnerable to the very conditions we work to prevent in others.

The Cultural Stigma of Rest

One of the biggest challenges I face—and I hear this echoed across the professions—is the internal narrative that taking time off is a sign of weakness or failure. For example, during my recent illness, I felt a strong reluctance to rest, despite knowing that continuing to work while sick could harm both my clients and myself. This mindset is reinforced by organizational cultures that reward overwork and penalize vulnerability. In environments marked by staffing shortages and limited budgets, the expectation of being constantly available is heightened.

Systemic and Individual Solutions

Best practices in health and mental wellness must include systemic and individual strategies. On the organizational level, municipalities should implement mandatory wellness days, regular supervision focused on practitioner well-being, and policies that normalize mental health leave. For clinicians, boundary-setting is critical. I have learned to incorporate structured breaks, limit my caseload, and engage in regular peer consultation. I also maintain a relationship with my own therapist, which helps me process the emotional demands of the work.

The Role of Mindfulness and Interventions

I recognize that incorporating mindfulness practices would benefit me, yet even as a therapist, I sometimes forget to draw on the tools in my own toolbox. Research consistently supports the value of evidence-based interventions such as mindfulness-based stress reduction (MBSR) and cognitive-behavioral techniques in lowering stress and strengthening practitioner resilience (Shapiro, Astin, Bishop, & Cordova, 2005). To support my own well-being, I integrate grounding exercises into my daily routine, often pausing between sessions to recalibrate my nervous system. These small but intentional practices help me remain present with clients while also protecting my own sense of balance and well-being.

Actionable Steps for Preventing Burnout

For municipal leaders, department heads, and practitioners alike, addressing burnout and promoting mental wellness must become a strategic priority. Here are several actionable steps to consider:

• Normalize self-care within organizational culture. Leaders should model wellness behaviors and actively encourage staff to take breaks, use mental health days, and disconnect after hours.

• Invest in mental health resources for staff. This includes access to confidential counseling services, wellness stipends, and regular workshops on stress management and self-regulation.

• Implement reflective supervision practices. Supervisors should be trained to hold space for emotional processing and professional development, not just compliance and productivity.

• Use data to drive change. Regular staff surveys on burnout, job satisfaction, and workload can help identify patterns and inform resource allocation.

• Foster community among professionals. Peer support groups, mentorship, and interdisciplinary forums can reduce isolation and promote a sense of shared purpose.

The data is sobering. According to a 2023 report by the National Association of Social Workers, 39% of social workers report high levels of emotional exhaustion, and nearly one in four consider leaving the profession within the next two years due to burnout (NASW 2023). Among teachers and healthcare workers, similar patterns exist. A 2022 survey by the American Psychological Association found that 59% of healthcare professionals and 52% of educators reported feeling burned out, with many citing lack of support and unmanageable workloads as key drivers (APA 2022).

The cost of inaction is too high. Burned-out professionals are more likely to make errors, experience health problems, and leave their positions—leading to increased turnover, reduced service quality, and greater strain on already limited municipal resources. If we expect our workforce to show up for communities, we must first ensure they can show up for themselves.

References

1. American Psychological Association. 2022. “Stress in America 2022: Concerned for the Future, Beset by Inflation.” APA. https://www.apa.org/news/press/releases/stress/2022/report.

2. Melamed, Samuel, Arie Shirom, Shlomo Toker, David Berliner, and Shmuel Shapira. 2006. “Burnout and Risk of Cardiovascular Disease: Evidence, Possible Causal Paths, and Promising Research Directions.” Psychological Bulletin 132 (3): 327–53. https://doi.org/10.1037/0033-2909.132.3.327.

3. National Association of Social Workers. 2023. “Workforce Trends and Burnout in the Social Work Profession.” NASW Research Brief. https://www.socialworkers.org/Research/Workforce-Studies.

4. Shapiro, Shauna L., John A. Astin, Scott R. Bishop, and Mark Cordova. 2005. “Mindfulness-Based Stress Reduction for Health Care Professionals: Results from a Randomized Trial.” International Journal of Stress Management 12 (2): 164–76. https://doi.org/10.1037/1072-5245.12.2.164.

5. World Health Organization. 2019. “Burn-out an ‘Occupational Phenomenon’: International Classification of Diseases.” WHO Newsroom. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.