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Stay calm and make tea – managing therapist reactivity

Working with clients who have experienced trauma is tough. As therapists, we work with clients who have experienced challenging life events from all forms of abuse and trauma. These therapy sessions can cause us to become dysregulated, unbalanced and emotionally reactive. We all experience it at one point or another.

I recently supervised an occupational therapy student who shared that they had become quite emotional during a therapy session they had observed. During the supervision session, they asked me how I look after myself in these difficult client interactions, and I answered honestly. The following are the tips I provided to help minimise our distress and reactivity as therapists working with complex trauma.

  1. Validate and accept you are human. There will be days when our vulnerabilities will make us more susceptible to being reactive to our client’s stories. Sometimes you may not even be aware that you are vulnerable. Maybe the client’s mannerisms remind you of someone from the past; maybe you have lived or shared a similar experience and haven’t had the time to reflect on the impact of these events on your life. That is okay. The important thing is to accept that you will need supervision and therapy support to become a better therapist. This leads to my next point.
  2. All mental health therapists need therapy. If you are not doing some form of therapy, I guarantee you will become more susceptible to burnout. Therapy is a way to stop and reflect on our current situations. This reflection helps us identify whether am I living my life as an integrated and whole person. Or am I hiding, parts of myself that feel uncomfortable away? It is these parts that will impact our clients and often without us even being aware.
  3. During sessions, take notes. One, it will put less anxiety on yourself to remember everything that is said and two, it is a way of imagining the client’s story and words leaving your human body and onto the paper. We are not to hold onto everything that clients tell us. Easier said than done. Rather we are allowed to let the words and experiences leave our bodies and be present outside of ourselves.
  4. Draw/ doodle. As you listen to your client’s story and notice that you are becoming emotionally reactive to their experience, I encourage you to draw. I draw during most of my client sessions. I make small scribbles. Why? Because by allowing my body to move, I am imagining that the tension and energy are leaving my body in one way or another. Better yet, if you can incorporate walk and talk therapy sessions in nature, this will improve your mood too.
  5. Walk-and-talk sessions and amazing yet not enough of us are using nature in our therapies. By walking, both you and your client are in an open space that is not confined to a built environment, Being in nature will soothe the sensors and allow for different input and interactions with the environment, which can offer a distraction or provide a grounding experience for you and your client
  6. Leave the room. If you notice yourself becoming distressed, give yourself permission to leave the room if possible. Perhaps pretend that you need to take a phone call and use this time to re-centre. If you are unable to recenter yourself, perhaps state that there has been an emergency and reschedule. Permit yourself to look after yourself. However, always ensure that it is safe to leave the client by themselves..
  7. Call your client if you are running late. I like to arrive to my client’s house 10 minutes early. If this is not possible, I will call and let my client know I am running later. Don’t enter a session feeling overwhelmed to start with.
  8. Arrive early, especially if you are doing a home visit for the first time. I try to use this extra time to recenter. Avoid checking your emails. Rather listen to a song on your phone and use that three minutes to focus on recentering yourself.
  9. Book emotionally challenging sessions according to your body’s needs. For example, I like to book complex conditions in the morning as I know that is when I am most efficient, I am most rested and regulated, and I have had a good meal.
  10. Finally, make tea. If you find yourself becoming distressed during a client session. Ask to pause. State something like, “I notice that this conversation has become quite heavy. Perhaps let’s take a 2-minute break and make a cup of tea”. You will be surprised how much just stopping, pausing, and making a cup of tea can do for you and your client.

Got any tips that you use? Please add them in the comments

Go Gently

Laura Ludowyke Occupational Therapist PhD Candidate

Need support? Laura provides support and training for therapists working with trauma. Please contact OT Trauma Tools at to reach out.

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