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Area Counselor’s Facing Burnout Amid Substance Abuse in Dayton

Sarah Collinsworth and Kaleb Barrows | The Wright State Guardian


When the consequences are life and death, the hardest part of Sarah Collinsworth’s job as a substance abuse clinician is when she has to leave it. 

Collinsworth is a program coordinator at McKinley Hall, a non-profit substance abuse recovery agency. She also works in her private practice, Lighthouse Counseling and Wellness, as a therapist. 

Addressing Burnout

Substance abuse clinicians including Collinsworth cite burnout as a major problem in the profession. The job boasts an annual estimated average turnover rate of 33 percent for counselors and 23 percent for supervisors, concluded a 2010 study, and this was before the opioid epidemic started gaining momentum. On a bad year, annual turnover can be up to 50 percent in some areas. 

Collinsworth has 15 years of experience in the substance abuse and addiction field. She describes burnout as feeling depleted. 

“Montgomery County was in the paper, actually, like, across the country, because they had so many overdoses,” Collinsworth said while recounting a particularly hard time during the height of the opioid epidemic in Montgomery County 2017 through 2018. 

There were 548 deaths in Montgomery County by November 2017. 

“It just got so overwhelming thinking about: is everybody safe, how do we get people in treatment? What do we need to do? Weeks would go by, and you just- you’re just depleted,” said Collinsworth.

Kaleb Barrows is the COO for DeCoach Rehabilitation Centre, a private substance abuse clinic based in Xenia, Ohio. The center provides both inpatient care, medication-assisted treatment, and sober housing.

Barrows sees on average 12 percent turnover a year among his 100 employees. Turnover costs between 5,000 and 7,000 dollars per person at DeCoach, due to recruiting costs and new hire training. Turnover costs, as well as recruiting efforts, add even more stress on Barrows.

He believes that many of his employees leave due to burnout and see a less stressful opportunity elsewhere.

“I hear time and time again, why would I work here when I can make just as much at Menards? I can make just as much at Costco or more,” he says. “You can go to the Target distribution center, and make more money and have a less stressful position.”

Stress and passion

Collinsworth consistently had to juggle stress with her passion while working at Mckinley Hall and the Weekend Intervention Program, from 2011 to 2016. Her work week totaled at nearly 70 hours. Forty hours at McKinley Hall and nearly 30 hours at the program. She worked to provide as much care as she could.

“I called in sick three days in 11 years; I just had to power through,” recounts Collinsworth. It was then she realized she was burned out. “There’s this thought that if I can’t do it, nobody else can.”

The three-day-long Weekend Intervention Program was aimed at individuals who were charged with an OVI or Operating a Vehicle Impaired. The program includes group substance abuse therapy, information seminars, and individual substance abuse counseling. 

Collinsworth worked at the program for 22 years, dedicating her weekends to the program throughout college and nearly her entire career in substance abuse.

“I mean, one of the things that I love so much about that program is that it was just an intimate weekend,” Collinsworth reminisces. “To see the change firsthand was phenomenal. You could just create this perfect space for people to say, okay, like everybody else is in this with me.”

At a certain point, the weekend program job started to take too much. Collinsworth began to feel a familiar depleted feeling. 

“I was not doing the things I wanted to do. It’s like my life was just going on,” Collinsworth emphasized. “When I left [the Weekend Intervention Program], it was one of the hardest things that I had to do, but I knew that I had to do it.”

Self care

Collinsworth began practicing self-care, which she describes as creating a better environment, “[taking a day off] is really great in the moment, but you’re still going back to a crazy, chaotic life,” Collinsworth argues. “You really want to create this environment that you don’t want to run away from.”

Barrows attempts to create that environment at DeCoach by holding events, offering competitive benefits, and capping employees at 40 hours a week. Each staff member also receives on average three weeks of vacation per year. 

“We promote self-care. We promote them taking their time off and just really utilizing the benefits that are offered to them,” Barrows asserts.

Both Barrows and Collinsworth said they recognize setting boundaries is not always easy and it takes time to find a balance. For Collinsworth, it took seven years to set boundaries for herself. Barrows notices tenured staff have stronger boundaries. 

Collinsworth said the most important boundaries are not seeing patients on the weekend, journaling or taking time to reflect every day. She also caps her personal clients at 12, on top of some cases at McKinley. However, Collinsworth acknowledges not all clinician’s boundaries are the same. 

Clinicians at DeCoach, depending on their department, can have up to 55 patients at a time. Despite the gap, this can still be a workable caseload, due to the wide range of treatment offerings at DeCoach in multiple stages of recovery. 

Barrows said that lower caseloads are better for the outcome of the patient. His solution is to hire more therapists and to increase trainings for current staff. Sometimes though, in Barrows’ words, “you do your best with what you’re given.”

Collinsworth believes it is the responsibility of the clinician and the organization to work together to set appropriate boundaries because there will always be a need for their line of work. 

“This idea of going, going, going, because there’s always something else to do is very strong with young clinicians,” she argues. “You just want to give and give and give and you don’t always recognize when you are completely depleted.”

Reclaiming balance

Collinsworth argues the importance of developing a plan to prevent burnout, which must be purposeful and pay attention to all aspects of life. 

Now that Collinsworth has reclaimed her work-life balance, she takes scheduled vacation time and using it to reflect. She recently returned from a backpacking trip to Vermont with a close friend. She took the time to be alone with her own thoughts.

“Something about being out there, with just alone time, was very challenging, but good for my mental health,” she said. “There were times when I hit a wall and I had to sit down and like, nope get yourself back up.”

“Be ‘purposeful’ that’s the word that always comes to my mind, because if you don’t, it will slip away,” said Collinsworth.   

Sarah Collinsworth can be reached through her website at lighthousedayton.com. Kaleb Barrows works for DeCoach Rehabilitation Centre, who can be reached through their website at decoachrehabctr.com


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