Dr. Matt Hersh, founder of The Thriving Therapist

Dr. Hersh is a psychotherapist, Certified Energy Psychologist, mindfulness teacher, & founder of The Thriving Therapist, a site devoted to helping the helpers. Learn more about us and check out our free resources, online courses, and workshops on self-care, work-life balance, burnout prevention, your thriving practice, & much more.

You bring everything you have to your client sessions.  But the fact of the matter is that some clients simply will not make the progress you so desire or even get worse.

This post is all about how the practice of gratitude counteracts therapist burnout and fatigue. The morale-dampening effects of experiencing clients’ deep suffering and lack of progress are realities we must all face. We can explore how gratitude may be a salve to this humanistic injury.

Our training doesn’t emotionally prepare us for lack of therapeutic progress

Most of us aren’t really trained to think in this way because it reveals a very hard truth. Despite our every effort, some people will not change their lives for the better under our watch.  All our years of training, consultation, and skills-building may still not do the job we expect and hope.

In fact, some clients may even get much worse.

What do we do about this harsh reality? How do we prevent burnout or hopelessness when the very aspiration of our profession is called into question over and over again?

Take the example of a car mechanic who has trained for years and has really honed his craft. Let’s assume that the mechanic diagnoses and works on 80 cars per month.

How would it feel to the mechanic if every month he couldn’t adequately or accurately diagnose 40 of those cars. The cars are just too complicated or have a long-standing and complex history of difficulties. Or perhaps the mechanic hasn’t seen enough of certain types of cars to be considered a “true expert”.

And how would he feel if after running a series of diagnostics, he then labored away for days on several cars only to have the owners show up again and again. They would complain about the same problem but sometimes bring up entirely new issues.

Of course, human beings are not cars, and as therapists we are not interacting with static, inanimate objects. But if you put yourself in the mechanic’s shoes, you might feel pretty disillusioned pretty quickly unless you had a meaningful way to cope with the success rate alluded to above.

Gratitude counteracts therapist burnout and fatigue: A simple solution to a complex problem

Fortunately, we don’t have to look for very complicated solutions to a complicated problem. Part of the solution is already within our grasp – it’s all about the attitude and the act of gratitude.

I’m not suggesting, however, that gratitude “cures” all experience of emotional fatigue or hopelessness from a severely challenging case.

I am suggesting though that gratitude, in its various forms, can serve as a way to help transform hopelessness and disillusionment into appreciation for what is, what has been, and what could be.

Finding even the smallest of nuanced aspects of our work for which to be grateful is one key to preventing burnout and cultivating wellness. (One of the handful of successful programs on burnout prevention incorporates this very principle and practice.)

But how do we do this when our work can be so demanding and thankless?

Start where gratitude already flows

It’s far too easy for us to find our minds focusing on what isn’t going well or where we feel our competence is lacking.

So start with what is going well. For which clients can you easily feel warmth? Start with the therapeutic progress that is easily observed. What do you already feel competent doing?

Practice gratitude for the grind and the tough stuff

How do we muster the energy of gratitude when therapeutic progress is non-existent or when we are simply frustrated with a client or the way that client relates to us?

In these cases, you don’t have to force it. However, you likely are able to find, when you step back and really reflect, some elements of the therapeutic work on which you can shine a light of appreciation.

Maybe you can be grateful for how you handled client anger directed toward you or rode the waves of very intense emotion along with your client.

Integrate Gratitude into Everyday Practice

“Doing gratitude” would involve consciously and intentionally directing your mind to these positive elements and expressing your genuine appreciation.

  • You could do this in between sessions or on your commute home. You could do this right before you see a client. Or by internally expressing gratitude in the middle of a session, you may mindfully notice your client’s new insights or positive behavior change.
  • Keeping the gratitude active, alive, and fairly consistent are guiding principles that can help us reap the maximum benefits from a gratitude practice. In fact, calling it a gratitude practice can indeed increase our ability to manifest something that can too often remain latent and under-utilized.

(Lest we feel that this is yet another thing to accomplish or another form of self-care or burnout prevention that we must do, rest assured that it’s not necessary to practice gratitude 24/7 or with every single client at all times. Gratitude can be practiced a few times a week or every other day. We are much less likely then to “burn out” on gratitude practice. How ironic would that be?)

  • If you gravitate toward writing things down, then jot down 3 things for which you are grateful about a particular client or two. Doing this “often enough” will likely help you see the value in this brief practice.
  • If you would rather hear your own voice actually utter the sentiments of gratitude, pull out a small digital recorder or use your smart phone voice memo app. (Just be sure to de-identify the clinical information for ethical purposes – you could say something like “I’m so thrilled and honored that she finally made that phone call to her father. She found it so hard for so long. What a huge step.”)

Monitoring the Effects of Your Practice

Although we often are (or at least feel) too busy to even do a gratitude practice during our hectic workdays, tracking the effects of your practice can be a very valuable and worthwhile endeavor. But don’t overload yourself – just experiment.

So see if you might record how often you practice gratitude along with how you feel about work and your clients. You could even make/take a make-shift Maslach Burnout Inventory and rate yourself at regular intervals on a 5-point scale for each of three domains of burnout. They are emotional exhaustion, depersonalization (i.e., unfeeling, impersonal response to those you serve), and personal accomplishment (i.e., feelings of incompetence and lack of achievement).

Good luck with your gratitude practice!

I’d love to hear to how it’s going, so please drop a comment below. Your fellow therapists will benefit from knowing what positive effect gratitude practice might be having on you and your practice.

Be well,


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