When the Therapist Is Ill Navigating Vulnerability, Self-Care, and Self-Disclosure in Clinical Practice

Introduction  Internal Family System Glossary  Part 1: Dealing With Illness  1. The Diagnosis: Importance Of Personal Self-Care  2. Recognizing Our Personal Vulnerability: The Vulnerability Continuum  3. Recognizing Our Professional Vulnerability  4. Our Vulnerability: Therapist’s Trailheads For Inner Word  5. The Decision: Principles Of Self-Led Disclosure  6. Client Trailheads: How Self-Led Disclosure Fosters Client Growth  7. After Disclosure: Relational Trailheads Between Client And Therapist  Part 2: Roadmaps  8. A Roadmap For Disclosure: A Step-By-Step Guide  9. Scripts For Generating Real Conversations With Clients  10. The Professional Will: Preparing For The Unexpected  Part 3: Ethical Dilemmas And Decisions  11. The Importance Of Our Colleagues: Dilemmas And Best Practices  12. The Decision To Stop Working: Purpose, Loss And Ethics  13. When Time Is Of The Essence: Sudden Endings  14. The Good Goodbye: Navigating Relational Endings  15. What Now? Grief, Memorials, And New Therapists  Afterword  Conclusion  Endnotes  References

Biography

Roberta Rachel Omin, LCSW, provides workshops and consultations to therapists nationwide seeking assistance with decisions and dilemmas. Since 1985, her private practice has focused on individual and couples therapy, and people facing acute, chronic, and life-challenging illnesses. Roberta is certified in Internal Family Systems (IFS), Intimacy from the Inside Out (IFIO), and Gestalt Therapy.

"This brave, soulful, and deeply important book fills a profound gap in our therapeutic conversation. In a relationship grounded in trust, how do therapists navigate their own serious illness, and even impending death, with clients? Roberta brings extraordinary warmth, honesty, clinical wisdom, and ethical clarity to questions of vulnerability, self-disclosure, and the delicate boundary between the personal and the professional. This book is a gift to the field."

Patricia L. Papernow, Ed.D., psychologist, director, Institute for Stepfamily Education, author/co-author of three books on stepfamilies

 

"Therapists are emotionally and physically vulnerable. If you were seriously sick, would you know how to talk about it? Do you know how to sort professional responsibilities from a personal need for privacy? Roberta tackles these questions, reviews potential ethical dilemmas, shows options, and offers templates. We all can benefit by preparing for vulnerable moments, and if that vulnerability has already arrived, let this book take your hand."

Martha Sweezy, PhD, assistant professor, part-time in Psychiatry, Harvard Medical School, author/co-author of many books on Internal Family Systems Therapy

 

"When the Therapist Is Ill shines an unwavering and insightful light on a complex and unacknowledged issue in the world of mental health. Roberta honestly and courageously shares her own cancer journey and draws on her many years of professional practice, wisdom, and an amazing collection of deeply moving stories from other therapists and clients that advocate strongly for authenticity, truthfulness, and compassion - good medicine for our collective soul."

David Chernikoff, MDiv, author of Life Part Two: Seven Keys to Awakening with Purpose and Joy as You Age, guiding teacher of the Insight Meditation Community of Colorado

 

"We are all only a diagnosis away from the unmentionable. This book tenderly and fiercely meets that reality. Roberta Omin’s calming, resourceful voice supports therapists facing illness along the continuum toward dying. This reading offers a gift to therapists and clients: where the unspeakable becomes spoken, shared, and human, and brought back into the therapeutic frame."

Sarah Parad Rowen, LCSW, private practice, former Adjunct at Smith College School of Social Work.

"This book is an invaluable and overdue resource for mental health practitioners who are struggling head-on with one of the most difficult dilemmas clinicians ever have to face: what to do when they fall ill. With great courage and grace, Roberta shares her personal journey with illness, along with many others, profoundly enhancing the book’s rich theoretical and clinical exploration of this underexplored subject."

Laura Melano Flanagan, LCSW, private practice, Smith School for Social Work adjunct faculty, field faculty advisor, and co-author of Inside Out/Outside In

"Roberta Omin’s book tackles a challenging and therapeutically universal topic in a relevant and applicable manner.  She blends theory and real-life inside the therapy room, therapist and client stories, to give us direction in considering and addressing the much-needed topic of therapist illness or death.  Most of all, she encourages us to be brave as we consider both our needs and our clients’ needs in these conversations.  A must-have for therapists, new and experienced!"

Katie Devine, PhD, psychologist in private practice in New York, school psychologist, instructor at Adelphi University 

 

"In a culture that is grief illiterate and death phobic, Roberta’s When the Therapist Is Ill is a brilliant and needed contribution to therapists and health care providers, etc. The therapeutic relationship is a sacred one, built on love, trust, and encouragement. This book offers a voice to the complications, entanglements, and intricacies of being human, all within the acceptance of our vulnerability, fragility, and ultimately our mortality. You have given us the tools to make ourselves visible to ourselves and to the clients we love, who love us in return. To live and die well belongs to all of us. Thank you for the wisdom you have shared from “both sides of the couch” and the screen." 

Patricia Kuusisto, LCSW, in private practice, founder and director of the Diversity Center in White Plains and a clinical supervisor at the Lexington Center for Recovery

 

"When the Therapist Is Ill is an important book that virtually all mental health clinicians would benefit from reading, learning from, and considering. Almost all of us will be struggling with "aging bodies" and a range of biopsychosocial vulnerabilities. This book supports us in facing these issues with grace, wisdom, and care."

Jonathan Cohen, PhD, distinguished scholar, Center for Character & Citizenship, University of Missouri-St. Louis, USA; practicing clinical psychologist & psychoanalyst

 

"When the Therapist Is Ill brings the humanity of therapists into full view and examines the profound relational consequences of illness, disclosure, attachment, and loss within psychotherapy. As both a clinician living with significant health limitations and a former client whose beloved therapist became terminally ill, I have experienced these questions from both sides of the therapeutic relationship. Roberta Omin approaches this largely overlooked subject with compassion, courage, and an Internal Family Systems lens that honors the vulnerability, competing needs, and humanity of both therapist and client. This is an important contribution to a profession that has too often insisted therapists separate their innate humanity from their clinical role."

Stacey K. Wood, LMFT, IFS-trained psychotherapist, writer, and former adjunct faculty member at Sophia University (formerly the Institute of Transpersonal Psychology)

"As a psychiatrist, I not only admire Roberta’s brave and honest self-exploration, I appreciated how she addressed a very real situation for treating professionals. Her book made me reflect on my reactions to my experiences with patients who dealt with their therapists' terminal illnesses and how they handled the termination process. This book is an indispensable read for every practicing clinician. It provides insight and a practical framework for navigating self-disclosure and self-care during serious illness."

Alla Nirenberg, MD, board-certified psychiatrist