Helping others manage pain, recover from injuries and improve their physical function can mean physiotherapists are putting their patients’ needs ahead of their own, says Ellen Lake APAM (pictured above), national chair of the APA Mental Health group.

The demands and stresses of the profession can take a significant toll on a physiotherapist’s own wellbeing, Ellen says, often leading to burnout, compassion fatigue and imposter phenomenon.

‘The World Health Organization defines burnout not as a medical condition but as an occupational phenomenon. 

'Burnout is characterised by emotional exhaustion, depersonalisation and a decreased sense of personal accomplishment,’ she explains. 

‘These elements can have a profound impact on a physiotherapist’s ability to provide the high-quality, compassionate care that is so central to our profession.’

Within the workplace, compassion fatigue and stress are more widely recognised. 

However, emerging evidence points to the impact of imposter phenomenon and perfectionism in contributing to physiotherapists’ self-perceived psychological distress.

A global systematic review conducted in 2024 and published in Physiotherapy reveals an eight per cent prevalence rate of burnout in the physiotherapy profession. 

A previous review from 2022 lists 53 factors as contributing to burnout among physiotherapists, with 49 deemed avoidable, including psychological and emotional elements. 

Organisational support and personal self-care strategies (eg, reflection, communication and seeking help) can help physiotherapists to manage the symptoms of burnout. 

With more than 30 years’ experience in the profession, Ellen is shining a light on these critical issues to empower physiotherapists to prioritise their own self-care and mental health.

‘It is important to be clear about what is and is not working. 

'The profession is growing and learning. We are becoming more aware that it empowers us, and those we work with, to look after ourselves.

‘With some self-care, you can identify the triggers of burnout and discover ways to achieve a work-life balance that doesn’t compromise your health and wellbeing.’

Drawing on her own personal journey and the growing body of research in this area, the clinical physiotherapist, counsellor and psychotherapist will share her tips on how to do this.

Her presentation, ‘Staying at work and flourishing: making friends with compassion fatigue, stress, imposter phenomenon
and perfectionism’, will be delivered at two sessions for the 2024 Tasmanian Summer Breakfast.

‘I know and understand burnout. I dropped out of being a physio for a couple of years. 

'I had my own practice, which included hospital visits. I also had three young children and I was balancing everything with clinical practice. 

'After 10 years or more, I felt disillusioned because I felt like I couldn’t contribute to the therapeutic space in the way that I wanted to.

'I didn’t enjoy what I was doing. So I stopped and I did other things for a couple of years.’ 

This included working in the personal development and coaching space.

Ellen returned to physiotherapy in 2016 when the national Mental Health group was just forming. 

‘I could see it was a good fit for me. I could work with my values and the way that I saw the world and bring all that to work to help others in the profession. 

'I had never felt that way before.’

With a strong commitment to mental health advocacy, Ellen volunteered to chair the Queensland branch of the APA Mental Health group from 2017 to 2021 and the national group from 2021. 

At the World Physiotherapy Congress 2023, she chaired the session on burnout and self-care and has written numerous articles on the importance of managing mental health and wellbeing.

She says there are several key factors that make physiotherapists particularly susceptible to burnout and other mental
health challenges, including high standards and perfectionism.

‘Physiotherapists are often driven by a strong desire for excellence and a commitment to achieving the best possible outcomes for our patients. 

'This can lead to unrealistic expectations and a tendency towards perfectionism, which can fuel imposter phenomenon and burnout.’

Ellen Lake.

Emotional involvement can also be a struggle to maintain. 

‘The nature of our work requires us to be deeply empathetic and emotionally invested in the wellbeing of our patients,’ Ellen explains. 

‘While the empathy we feel is a strength, it can also contribute to compassion fatigue and emotional exhaustion over time.’

From her own experience, in the early years of clinical practice patients would sometimes tell her, ‘What you said last time really helped me.’

However, Ellen would often respond with, ‘What did I say?’

She continues, ‘I couldn’t recall the specific details of our previous conversations and I started to realise that what I said was important. 

'Yet I felt a bit restricted because I couldn’t initiate those deeper conversations. I felt that it wasn’t within my scope and
I didn’t know how to manage that. 

'I just didn’t enjoy what I was doing. I felt like I was failing my patients and myself.’

In addition, the reliance on quantifiable results can produce extra stress for clinicians. 

‘Physiotherapy is a profession that places a strong emphasis on measurable outcomes, which can create additional pressure and a sense of failure when things don’t go as planned.’

Finally, the pathways for study and development are constantly evolving and expanding, adding to the feeling that there is always more that could be done to improve one’s clinical practice. 

‘The physiotherapy profession has seen a significant shift in recent years, with more opportunities for specialisation and advanced degrees. 

'While this is positive in many ways, it can also contribute to a sense of pressure to constantly improve and “succeed” in our careers.’

Ellen has identified several strategies for managing stress, imposter phenomenon and burnout.

1.    Embrace self-awareness and reflection 

‘The first step is to become more attuned to our own emotional responses and thought patterns. I encourage physiotherapists to regularly check in with themselves, reflect on their experiences and identify areas for growth.’

2.    Cultivate self-compassion 

‘Rather than being overly critical of ourselves, it’s important to practise self- compassion. This involves acknowledging our limitations, celebrating our strengths and treating ourselves with the same kindness and understanding that we would offer to a dear friend.’

3.    Seek support and mentorship

‘Reaching out to colleagues, supervisors or mental health professionals can provide valuable support and perspective. There are benefits in mentorship programs, where experienced physiotherapists can share their wisdom and guide younger professionals.’

4.    Prioritise work-life balance 

‘Maintaining a healthy work-life balance is crucial for preventing burnout. This may involve setting boundaries, taking regular breaks and engaging in activities outside of work that bring joy and fulfilment.’

In addressing the often invisible challenges facing physiotherapists, Ellen wants to empower her colleagues to find greater fulfilment and longevity in their careers. 

‘Prioritising mental health and wellbeing within the physiotherapy community can help physiotherapists to thrive both personally and professionally.

‘Looking after ourselves is a win-win. It works for us and it works for those we work with.’

Ellen Lake will present ‘Staying at work and flourishing: making friends with compassion fatigue, stress, imposter phenomenon
and perfectionism’ at the 2024 Tasmanian Summer Breakfast—Launceston on Thursday 28 November, 6.30–9 am, at the Peppers Silo Hotel, Launceston.

Ellen will also present this talk at the 2024 Tasmanian Summer Breakfast—Hobart on Friday 29 November, 6.30–9 am, at the Royal Yacht Club of Tasmania, Hobart.

Click here and here for more information and to book.