CBT Therapy Case Study - Burnout

Burnout

Background

Gemma* is a 42-year-old Senior Exec in Cheshire. She works in the Tech industry and has been gradually climbing the corporate ladder for the last 20 years. She was a high achiever all through school and university, and received lots of praise for her accomplishments and as a result now connects her sense of worth to her job.

She has been married for 12 years and has 2 primary school aged children. Outside of work she spends a lot of time as taxi driver running her kids to all their activities, and rarely has time for herself. She has had 3 previous episodes of sickness absence from work in the last 8 years.

She is currently off work again with Burnout.

Presenting problem

Gemma came to me via a recommendation from a friend. She was looking for an Online Therapist with experience in Therapy for Anxiety. Her friend had told her how CBT Therapy had massively helped them, so she wanted to see if it could help her too.

Gemma was feeling a bit lost and was frustrated at being back in this place again, the 4th sickness absence from work. She was feeling guilty for being off and concerned about the impact on her colleagues in her absence.

She wanted to get back to work as soon as possible but was struggling with even the basics of functioning and was feeling completely exhausted mentally and physically.

Assessment

This was Gemma’s 3rd experience of therapy.

She had experienced counselling following her 1st marriage breakdown, and had tried NHS Talking Therapy a few years ago.

She had gone to the Doctor the week before our appointment, and had been signed off work for 4 weeks and started on Fluoxetine medication.

Symptoms

Exhaustion
Hopelessness
Frustration
Feelings of guilt
Oversleeping and daytime naps
Achy muscles
No motivation or interest
Overwhelmed by people
Comfort eating
Eczema flare up

From the assessment discussion, we identified some tendencies and themes for Gemma

Doesn’t like to ask for help
Feels overly responsible both at work and within her family
Perfectionism and procrastination cycles at work
Difficulty delegating, prioritisation and decision making
Tried to do everything for her children that might benefit them
Often feels guilty and overcompensates
Expects a lot of herself but little of others
Cares a lot about being a good worker/wife/mother/daughter/friend
Struggles to say no to others
Puts everyone else’s needs before her own

We discussed the impact of all this

Had built up an unmanageable work load
Had become the go to yes person at work
Had become ineffective and inefficient at work
Had overcommitted herself with activities for the children (booked every night and Saturday)
Never had time for herself or enjoyable time with her children
Never feeling good enough and always feeling like she’s letting everyone down
Barely functioning and lost all enjoyment for life

We jointly agreed the following target areas for treatment

To better understand and challenge themes of guilt and responsibility
To adjust to more realistic expectations of herself
To learn skills for prioritising within her workload and delegating to juniors
To break the procrastination cycle
To reduce the activity commitments for the children
To challenge her beliefs about herself, her worth, and her needs
To start making time for herself, as well as reducing excessive work hours
To create a sustainable return to work plan

Treatment

CBT Therapy strategies were used across the course of 12 treatment sessions.

Outcome

After a period of rest, her sleep returned to normal, her eczema flare up ceased, and her comfort eating reduced
Following 3 weeks of her sickness leave she was no longer feeling burnt out or hopeless
Over the next couple of weeks she returned to being able to function at home
After 8 weeks she began a 4 week return to work plan and is now successfully back at work
She is now able to say no and prioritise, resulting in a more manageable workload
She has reduced her children’s activity commitments to 1 a week of their choice, and then 1 joint activity. This has now given her 2 evenings a week for them to enjoy together at home, and the weekends free to allow flexibility
She is now able to see that her worth isn’t defined by her job, or what she does for others. As a result she no longer works excessive hours or says yes to everything
She has adjusted her expectations of herself, and now allows herself to be a bit more human
She has learnt to speak up more for herself, and let others help at times
Most importantly she now responds to her sense of responsibility and feelings of guilt in a healthy way and is finding the intensity of these feelings is reducing as time goes on
She now feels confident in knowing how to prevent future burnout, and what signs to look for

* This is a fictionalised client that takes little elements from many clients I’ve worked with over many years to demonstrate an example of a client’s problems I work with and what therapy offers.