The Resilient Therapist

When the Work We Love Changes Us

You likely became a therapist to help people, to make a difference, and create a safe space for others. You went to graduate school, completed thousands of hours of supervised practice, learned about ethics and boundaries, and developed clinical skills necessary to support people through some of the most difficult moments of their lives. 

But... Did anyone teach you what to do when something happens that changes you? What happens when a client threatens your safety? When someone you've worked with for years dies unexpectedly? When a client dies by suicide? When a colleague betrays your trust, you're served a subpoena, or someone files a grievance against your license? These aren't hypothetical situations or "what ifs" for a lot of us. Rather, they are experiences that many mental health professionals have had to navigate, often without adequate (or any!) preparation, support, or permission to talk about what happened.

Introducing: The Resilient Therapist

In our book, The Resilient Therapist: Healing from Career-Altering Adverse Psychological Events, Khara and I focus on six Adverse Psychological Events (APEs):

1. Client Violence: Experiences involving threats, harassment, intimidation, verbal aggression, or physical violence from clients

2. Client Sudden Death: The unexpected death of a client due to an accident, overdose, medical event or illness, homicide, or other cause

3. Client Suicide

4. Professional Betrayal: Experiences of betrayal, manipulation, retaliation, or ethical violations involving colleagues, supervisors, or organizational leadership

5. Subpoenas: Being compelled to release records or provide testimony

6. Grievances: Formal complaints against a person with license or certification

These events are different but often share something important: The potential to disrupt a therapist’s sense of safety, competence, trust, and professional identity. Further, we explore the psychological, emotional, relational, mental, and spiritual impacts of APEs.

Burnout: Not Always a Slow Burn

When we talk about burnout, we often focus on large caseloads, administrative demands, productivity, low salaries, and the emotional complexities of being a therapist. These are important conversations but don’t capture the whole story. Sometimes, a therapist’s relationship with the profession changes because of one event; suddenly, the work that once felt meaningful feels unsafe, overwhelming, or impossible. Unlike burnout, which the World Health Organization (WHO) describes as an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed, an APE is usually a discrete, career-altering event with lasting consequences.

Resilience Doesn’t Mean Returning to Who You Were

We talk about resilience as the ability to bounce back, but what if returning to who you were before an event such as an APE is not possible? What if the experience changed how you understand yourself (personally or professionally), your profession, or the systems in which you work? Healing doesn’t necessarily mean returning to your previous professional identity; it may mean developing new boundaries, seeking different forms of support, reconsidering your professional values, or finding new ways to engage in clinical work. It may also mean recognizing that some things in our profession need to change.

Why Leadership Matters

We cannot discuss therapist resilience or APEs without taking a person-in-environment perspective; in other words, we have to discuss the environments in which therapists practice. When a therapist experiences an APE, the response of supervisors, colleagues, administrators, and organizations can influence whether that person feels supported or not - or even spirals. For example, a leader who responds with empathy, transparency, and support may help a therapist successfully navigate an extraordinarily difficult experience. Alternatively, a leader who responds with blame, avoidance, retaliation, or silence may compound harm, shame, or isolation. 

Resilience is not solely the responsibility of the individual clinician when organizational systems contribute to their distress. Because of this, The Resilient Therapist is not just about healing. It’s also about leadership, advocacy, and creating a profession in which therapists can be human.

Over the next six posts, I explore each APE, its potential impacts, strategies for healing, and what leaders can do differently. As you engage with this material, a question to consider: What is the worst thing that could happen in your therapy career? And if it happened tomorrow, who would you call?