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Burnout

Burnout

Oleksandr (Sasha) Kondrashov, and Ani Dingamtar. January 2020

What is burnout?

Maslach and Jackson (1986) defined burnout as “ a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do “people work” of some kind. . . .   Burnout can lead to a deterioration in the quality of care or service provided. . . . It appears to be a factor in job turnover, absenteeism, and low morale. …  It seems to be correlated with various self-reported indices of personal dysfunction, including physical exhaustion, insomnia, increased use of alcohol and drugs, and marital and family problems,   (pp. 1-2).

Maslach and Leiter (2016) state that burnout is a cronic problem. Muldary (1983) defined burnout as the “process by which a once-committed health professional becomes ineffective in managing the stress of frequent emotional contact with others in the helping context, experiences exhaustion, and, as a result, disengages from patients, colleagues, and the organization” (p. 12). Corcoran and Bryce (1983) defined burnout as the “loss of motivation for creative involvement with one’s client population and/or organizational setting” (p. 72). Brown (1984) reported that the problem of burnout among social service employees is “an increasing one” (p. 55).

All of the definitions, offered in the literature, involve negative reactions from and towards work. “Burnout is an individual experience that is specific to the work context” (Maslach, Schaufеli, & Lеitеr,  2001, p. 407; Maslach, 2017).

What does burnout mean for social work?

“Social workers are considered an occupational group at above-average risk for burnout.” (Soderfeldt & Soderfeldt, 1995, p. 638). Burnout not only affects the individual, but also can affect many others around that individual. In social work, burnout affects the quality of care, relationships, and effectiveness of care towards clientele (Wilson, 2016). Burnout also affects organizations by way of employment status, organizational reputation, and ultimately service provider numbers (i.e. having fewer employees to handle caseloads). This in turn indirectly affects clients as well. Although most of the research found that burnout is more a social or job situation than an individual issue (Soderfeldt, et al., 1995; Maslach et al. 2001; Maslach, 2017) there are some differences in who is susceptible and what type of burnout is experienced.

How you can recognize burnout (signs and symptoms)?

Certain demographic variables have been found to be related to the level of burnout. Marital status, age, level of education are some demographic factors identified in the literature as contributing to burnout in some form (Soderfeldt, et al., 1995; Maslach et al., 2001). Of all the demographic variables that have been studied, age is the one that has been most consistently related to burnout. Among younger employees the level of burnout is reported to be higher than it is among those over 30 or 40 years old. However, these findings should be viewed with caution because of the problem of survival bias—i.e. those who burn out early in their careers are likely to quit their jobs, leaving behind the survivors who consequently exhibit lower levels of burnout (Maslach et al. 2001).  

With regard to marital status, those who are unmarried (especially men) seem to be more prone to burnout compared with those who are married. Singles seem to experience even higher burnout levels than those who are divorced (Maslach et al. 2001).

Some studies have found that those with a higher level of education report higher levels of burnout than less educated employees. It is not clear how to interpret this finding, given that education is confounded with other variables, such as occupation and status. It is possible that people with higher education have jobs with greater responsibilities and higher stress. Or it may be that more highly educated people have higher expectations for their jobs, and are thus more distressed if these expectations are not realized (Maslach et al. 2001).

Avillion and Hamilton  (2018) from Wild Iris Medical Education lists physical, emotional and behavouiral signs and symptoms of burnout:

Physical

• Feeling tired and drained most of the time

• Lowered immunity, feeling sick a lot

• Frequent headaches, back pain, muscle aches

• Changes in appetite or sleep habits

Emotional

• Sense of failure and self-doubt

• Feeling helpless, trapped, and defeated

• Losing motivation

• Feeling alone in the world and detached from others

• Becoming increasingly cynical

• Decreased satisfaction and sense of accomplishment

Behavioral

• Withdrawing from responsibilities

• Isolating oneself from others

• Procrastinating, taking longer to get things done

• Using food, drugs, or alcohol to cope

• Taking out one’s frustrations on others

• Skipping work or coming in late and leaving early 

Maslach and Leiter (2016) provide some ideas on how to assess burnout by referencing Banishing Burnout: Six Strategies for Improving Your Relationship With Work book. For each item, think about how your current place employment matches up with your personal preferences using the following continuum: Just Right-Mismatch-Major Mismatch

Workload

The amount of work to complete in a day

The frequency of surprising, unexpected events

Control

My participation in decisions that affect my work

The quality of leadership from upper management

Reward

Recognition for achievements from my supervisor

Opportunities for bonuses or raises

Community

The frequency of supportive interactions at work

The closeness of personal friendships at work

Fairness

Management’s dedication to giving everyone equal consideration

Clear and open procedures for allocating rewards and promotions

Values

The potential of my work to contribute to the larger community

My confidence that the organization’s mission is meaningful

If everything is a match, you have found an excellent place of employment. However, if there is a lot of major mismatches that can lead to burnout.

What you can do to stay empowered (practical tips, strategies and tools)

Staying empowered can be difficult when you are facing with burnout. Maslach and Leiter (2016) suggest that when burnout is counteracted with engagement, exhaustion is replaced with enthusiasm, bitterness with compassion, and anxiety with efficacy” (p.44) there is a possibility to change.

Laura Biggart from The Centre for Research on Children and Families at the University of East Anglia in the Youtube video by Community Care (2017) offered the following tips for coping with burnout in social work

1. Use supervision opportunities

2. Aim to raise concerns with supervisors and team  leaders

3. Use your team as a resource for sympathy, advice and guidance

4. Remember that no social worker is invicible or all-knowing

5. Identify what you find emotionally rewarding at work and at home

Inspiration Quotes about Burnout

“Slowly you may have transformed from a helper to one in need of help. It’s important to talk about this, to identify the wounds you carry.”

― Jenn Bruer, Helping Effortlessly: A Book of Inspiration and Healing

“Dear Stress, I would like a divorce. Please understand it is not you, it is me.

–Thomas E. Rojo Aubrey”

― Thomas E. Rojo Aubrey, Unlocking the Code to Human ResiliencyMore quotes on Goodreads

Where you can learn more about burnout 

There are a number of resources available to learn about burnout. Below are resources that can help guide you move from burnout out back to engagement.

  • Read Petra Durianova research Burnout Syndrome: A Disease of the Modern Age. Durianova (2012) suggest that burnout syndrome intervenes in every aspect of your life and is capable of destroying it both physically and mentally. In Petra’s work there is a good review of Freudenberger’s 12 stages of burnout (p.25-27): 

A Compulsion to Prove Oneself

Working Harder

Neglecting One’s Needs

Displacement of Conflicts

Revision of Values

Denial of Emerging Problems

Withdrawal From Social Contacts

Obvious Behavioral Changes

Depersonalization

Inner Emptiness

Depression

Burnout Syndrome

Upon completion of module, you will be able to identify the causes, symptoms, stages, management, and prevention of job-related stress andcomponents of a healthy workplace. Specific learning objectives include:

• Describe the effects of stress on the human body and how to relieve such stress.

• Explain the types of job stress common in healthcare workers.

• Discuss the presentation and causes of job-related stress in healthcare.

• Summarize actions for responding to different forms of job-related stress.

• Describe individual and organizational strategies to minimize job-related stress.

  • Review Lauren’s video on 10 tips on how to stay well is social work. Lauren just celebrated 10 years of working in social work practices and the video is part of the social work scrapbook channel
  • Read SaraKay Smullens article in the new social worker What I Wish I Had Known: Burnout and Self-Care in Our Social Work Profession that focuses on burnout, compassion fatigue Vicarious Trauma and Secondary Traumatic Stress and self care tips as antitode to the above concerns.
  • Watch Ernst-Jan Pfauth and Frédéric Meuwly Ted Talks.  Ernst-Jan Pfauth shares ideas on how we can beat the burnout society. The video provides ideas on how to stay balanced while living in overachieving society. Frédéric Meuwly talk Burnout… A friend of a friend’s problem is based on a true story from a “burnout survivor”. This talk provides an overview how the exhaustion work and how to manage it effectively.

If you find any additional resources please share them in the comments.

Keep learning and sharing your knowledge.

Sasha and Ani.

References

Maslach, C, Jacksоn, S. Е. (1986). Thе Maslach Burnоut Invеntоry manual (2nd еd.). Palо Altо, CA, CоnsultingPsychоlоgists Prеss.

Muldary,  T. W.  (1983). Burnоut and hеalth prоfеssiоnals: Manifеstatiоns and managеmеnt. Nоrwalk, CT, ACapistranо Publicatiоn.

Cоrcоran, K.J., Brycе, A.K. (1983). Intеrvеntiоn in еxpеriеncе оf burnоut: Еffеcts оf skill dеvеlоpmеnt. Jоurnal оf Sоcial Sеrvicе Rеsеarch 7 (1),71–79.

Brоwn, L.N. (1984). Mutual hеlp staff grоups tо managе wоrk strеss. Sоcial Wоrk With Grоups 7 (2), 55–66.

Maslach, C., Schaufеli, W. B., & Lеitеr, M. P. (2001) Jоb burnоut. Annual Rеviеw оf Psychоlоgy, 52, 297-422.

Sоdеrfеldt, M., Sоdеrfеldt, B., & Warg, L. (1995). Burnоut in sоcial wоrk. Sоcial Wоrk, 40, 638-646.

Maslach, C., & Leiter, M. P. (2016). Burnout. In Stress: Concepts, cognition, emotion, and behavior (pp. 351-357). Academic Press.

Maslach, C. (2017). Burnout: A multidimensional perspective. In Professional burnout (pp. 19-32). Routledge.

Wilson, F. (2016). Identifying, preventing, and addressing job burnout and vicarious burnout for social work professionals. Journal of evidence-informed social work13(5), 479-483.

Compassion Fatigue

Sierra Israel-Schned, Oleksandr (Sasha) Kondrashov, and Ani Dingamtar. December 2019

What is compassion fatigue?

Compassion is a “feeling of deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the pain or remove its cause” (webster’s, 1989, p. 229). Although professional boundaries should always be acknowledged and followed, the therapeutic alliance is built out of the client liking and trusting his or her therapist. Therefore, these feelings are directly related to the expression of empathy and compassion of the practitioner (Figley, 2002). Moreover, because the therapist/patient relationship is based on feelings of empathy, genuineness, and unconditional positive regard, the emotional and interpersonal bond is a unique but essential component to a healthy therapeutic alliance (Ardito & Rabellino, 2011). Therefore, it is important for the practitioner in these emotional therapeutic relationships to pay close attention to their own mental and physical health. 

What does compassion fatigue mean for social work?

Compassion fatigue is not limited to the social work profession, however as ‘caring professionals’ we work closely with individuals who have experienced trauma. Vicarious trauma often referred to as the “cost of caring” (Figley, 1982) is a phenomenon where counsellors/social workers are exposed to therapeutic dialogue where trauma survivors share their stories. Although this work is meaningful and necessary therapeutic partnerships can lead to emotional exhaustion, this is referred to as compassion fatigue (CF). Therefore, paying close attention to our emotional and physiological health is imperative for providing empathetic and compassionate allyship to those we work alongside. 

How you can recognize compassion fatigue (signs and symptoms)?

As mentioned above, It is important to pay close attention to your wellbeing when engaging in therapeutic conversations. The signs and symptoms of CF will vary from individual, however, bellow is a list of some signs and symptoms to look out for: 

  • Sadness and Grief 
  • Avoidance or dread of working with some clients
  • Reduced ability to feel empathy towards patients or families 
  • Somatic complaints 
  • Addictions
  • Nightmares
  • Frequent use of sick days 
  • changes in beliefs, expectations assumptions 
  • detachment
  • decreased intimacy 
  • Racing thoughts
  • numbness 
  • health concerns 
  • decreased creativity 
  • loneliness (transitional support, n.d)

What you can do to stay empowered (practical tips, strategies and tools)

Staying empowered can be difficult, however, you are not alone in your journey. There are ways to balance and even prevent compassion fatigue, which include:

  • Living more consciously
  • Knowing when to slow down
  • Reflection 
  • Physical activity 
  • healthy eating habits 

 It is important to know self and map out formal and informal supports to build resilience.  Understanding and recognizing your limits to your work is crucial for knowing when it is time to slow down. 

Inspiration Quotes about Compassion Fatigue

“Slowly you may have transformed from a helper to one in need of help. It’s important to talk about this, to identify the wounds you carry.”

― Jenn Bruer, Helping Effortlessly: A Book of Inspiration and Healing

“I discovered that compassion fatigue is a real thing. Emotions, so strong at first, can easily shift into apathy. The subsequent guilt is paralyzing; it can prevent us from ever doing anything and freeze us into inaction. No wonder some people live for themselves, unaware of or unengaged with those who desperately need help. When global problems overwhelm, the human tendency is to do nothing.”

― Chris Marlow, Doing Good Is Simple: Making a Difference Right Where You Are

More quotes on Goodreads 

Where you can learn more about compassion fatigue  

We are fortunate to live in a time where access to great resources is just a click away. Below are resources that can help guide you on the path of self-care and compassion fatigue prevention. 

The Compassion Fatigue Podcast with Jennifer Blough, LPC 

The Compassion Fatigue Podcast provides self-care tips, stress management techniques, and support to animal welfare professionals including shelter workers, veterinary staff, rescue workers, animal control officers, humane investigators, animal rights activists, wildlife conservationists, animal attorneys, pet sitters, dog walkers, groomers, volunteers, foster parents, ethical vegetarians and vegans, and all other animal lovers. Professional counsellor Jennifer Blough interviews experts on the best ways to combat compassion fatigue and burnout and cultivate compassion satisfaction

Click here  

The Figley Institute Website

Figley Institute offers cutting edge training and continuing education programs to those who provide relief to emotionally traumatized individuals, families, businesses, and communities. 

The Figley Institute: Basics of Compassion Fatigue Work Book Click here

To provide each participant with the knowledge and skills necessary to reduce the secondary impact of working with traumatized populations.’

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review click here

Compassion Fatigue Awareness Project (CFAP) website

CFAP Founder Patricia Smith recently gave a presentation at the TEDx SanJuanIsland event. Check it out Here !  

If you find any additional resources please share them in the comments.

Keep learning and sharing your knowledge.

Sierra, Sasha and Ani.

References

Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103-108. doi:10.1037/0002-9432.76.1.103

Ardito, R.B, Rabellino D. (2011) Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Front Psychol. 2011;2:270.:10.3389/fpsyg.2011.00270

Blough, J. (n.d.) The compassion fatigue podcast. Retrieved from https://www.stitcher.com/podcast/the-compassion-fatigue-podcast 

Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International journal of environmental research and public health, 13(6), 618. doi:10.3390/ijerph13060618

Compassion Fatigue Awareness Project (n.d.). Retrieved from http://www.compassionfatigue.org/index.html

Figley Institute (2012).  Workbook. Retrieved from http://www.figleyinstitute.com/documents/Workbook_AMEDD_SanAntonio_2012July20_RevAugust2013.pdf

Figley, C. R. (Ed.). (2002). Treating compassion fatigue. Routledge.

Good therapy (n.d.). Compassion fatigue. Retrieved from https://www.goodtherapy.org/blog/psychpedia/compassion-fatigue

Smith, P. (2017). How to manage compassion fatigue in caregiving | Patricia Smith | TEDxSanJuanIsland. [Video file]. Retrieved from https://www.youtube.com/watch?v=7keppA8XRas

Transitional Support (n.d). Burnout vs. compassion fatigue. Retrieved from: http://transitionalsupport.com.au/transitional-phase/compassion-fatigue-trauma/ 

Additional Resources

Boyle, D. A. (2015). Compassion fatigue: The cost of caring. Nursing2019, 45(7), 48-51. Retrieved from https://journals.lww.com/nursing/Fulltext/2015/07000/Compassion_fatigue__The_cost_of_caring.15.aspx

Coetzee, S. K., & Laschinger, H. K. (2018). Toward a comprehensive, theoretical model of compassion fatigue: A n integrative literature review. Nursing & health sciences, 20(1), 4-15.

Diaconescu, M. (2015). Burnout, secondary trauma and compassion fatigue in social work. Revista de Asistenţă Socială, (3), 57-63. Retrieved from https://pdfs.semanticscholar.org/03b1/b5fc11bb545a9e61f0baf2cb5420df9daf52.pdf

Hamilton, S., Tran, V., & Jamieson, J. (2016). Compassion fatigue in emergency medicine: the cost of caring. Emergency Medicine Australasia, 28(1), 100-103. Retrieved from https://www.researchgate.net/profile/Jennifer_Jamieson2/publication/290963237_Compassion_fatigue_in_emergency_medicine_The_cost_of_caring/links/5a711231aca272e425ed3b0a/Compassion-fatigue-in-emergency-medicine-The-cost-of-caring.pdf

Kapoulitsas, M., & Corcoran, T. (2015). Compassion fatigue and resilience: A qualitative analysis of social work practice. Qualitative Social Work, 14(1), 86-101. Retrieved from http://vuir.vu.edu.au/24738/1/QSW%20final.pdf

Lynch, S. H. (2018). Looking at compassion fatigue differently: Application to family caregivers. American Journal of Health Education, 49(1), 9-11.

Pehlivan, T., & Güner, P. (2018). Compassion fatigue: The known and unknown. Journal of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi, 9(2). Retrieved from https://www.journalagent.com/phd/pdfs/PHD-25582-REVIEW-PEHLIVAN%5BA%5D.pdf

Pelon, S. B. (2017). Compassion fatigue and compassion satisfaction in hospice social work. Journal of social work in end-of-life & palliative care, 13(2-3), 134-150.

Sheppard, K. (2016). Compassion fatigue: Are you at risk. American Nurse Today, 11(1), 53-55. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2016/01/ant1-Compassion-Fatigue-1222.pdf

Wagaman, M. A., Geiger, J. M., Shockley, C., & Segal, E. A. (2015). The role of empathy in burnout, compassion satisfaction, and secondary traumatic stress among social workers. Social work, 60(3), 201-209.

Yi, J., Kim, J., Akter, J., Molloy, J. K., Ah Kim, M., & Frazier, K. (2018). Pediatric oncology social workers’ experience of compassion fatigue. Journal of psychosocial oncology, 36(6), 667-680. Yi, J., Kim, M. A., Choi, K., Kim, S., & O’Connor, A. (2018). When does compassion fatigue hit social workers? Caring for oncology patients in Korea. Qualitative Social Work, 17(3), 337-354.

@EMPR SOCIAL WORK

Sasha Kondrashov and Ani Dingamtar

What is “empowerment”?

Empowerment originated from the Latin verb for power, potere, which means, ‘to be able’ and is also linked to the word ‘potent’ meaning powerful, cogent, persuasive and having or exercising a great influence (Rodwell, 1996). Its prefix ‘em’ means ‘cause to be or provide with’ (cited in Abdoli et.al, 2011). The suffix ‘ment’ is defined as a result, act or process and thus by adding the suffix ‘ment’ to the verb ’empower’, empowerment becomes a noun defined as the process or result of empowering (Rodwell, 1996). Empowerment is individually determined (McIntosh, 2016), and can be seen as a helping process, a partnership valuing self and others, mutual decision making, and freedom to make choices and accept responsibility (Rodwell, 1996).

How can social workers empower themselves?

Empowerment is a process. When one understands how the process works, they can empower themselves daily (Salzman, 1994). Social workers can empower themselves individually and collectively through the use of support groups, caucuses of professional organizations, social media and other forms of groups to process their experiences, build coalitions with each other, strategize for the next steps, and/or to take actions to fight against oppression and discrimination (Sakamoto, 2005).

What is the Empower Social Worker Campaign? #EMPRsocialwork

Similar to the mission of the Wikimedia Foundation ‘‘to empower and engage people around the world to collect and develop educational content under a free license or in the public domain, and to disseminate it effectively and globally’’ (Botella et.al, 2012) Empower Social Worker campaign’s mission is to engage social workers and allies around the world to collectively create a list of individual empowerment tools through the use of images and story-telling  and to disseminate them effectively among social work communities of practice.

We plan to achieve our mission by running the social media campaign to introduce some very successful empowerment tools that social workers and allies use around the world to empower themselves. Those tools can assist current social work students and future social workers to practice social work and stay empowered. Empowerment tools are personal growth activities that are used over time to create a sense of self-worth, personal and professional accountability, and generate power within an individual.

Why Empower Social Worker (ESW)?

Empowerment on an individual level should be considered an important step to strengthening social work practices, connecting with communities, reducing the sense of powerlessness, which, in turn, would help social workers and allies to link their critical consciousness and self-actualization to work toward social justice (Sakamoto, 2005).

We argue that #EMPRsocialwork campaign is crucial because it helps social workers and allies to maintain personal and professional power to effectively perform their multiple roles in different practice contexts. Empowered social workers are more effective in challenging oppression and privilege and affecting positive changes at different levels (Sakamoto, 2005).

How to join the campaign and share what empowerment means to you as a professional social worker?

#EMPRsocialwork is a space to encourage social workers and allies to share their stories and tools that empower them in their fields of practice.

Join the campaign in 4 steps:

  1. Find and Follow us on TwitterInstagram, and Facebook
  2. Think about the tool that empowers you to practice social work
  3. Share an image and provide the brief story of that tool on social media using #EMPRsocialwork
  4. Invite your social work friends and allies to follow the campaign  and challenge them to share their empowerment tools

References

Abdoli, S., Ashktorab, T., Ahmadi, F., Parvizy, S., & Dunning, T. (2011). Religion, faith and the empowerment process: Stories of Iranian people with diabetes. International journal of nursing practice17(3), 289-298.

McIntosh, D. (2016). Empowering clients means empowering ourselves first. Retrieved from http://www.socialworker.com/extras/social-work-month-project-2016/empowering-clients-means-empowering-ourselves-first/

Botella, C., Riva, G., Gaggioli, A., Wiederhold, B. K., Alcaniz, M., & Baños, R. M. (2012). The present and future of positive technologies. Cyberpsychology, Behavior, and Social Networking, 15(2), 78–84.

Rodwell, C. M. (1996). An analysis of the concept of empowerment. Journal of Advanced Nursing, 23(2), 305–313.

Sakamoto, I. (2005). Use of critical consciousness in anti-oppressive social work practice: Disentangling power dynamics at personal and structural levels. British Journal of Social Work, 35(4), 435–452.

Salzman, J. (1994). Self-empowerment: Achieving your potential through self-awareness. Women in Business, 46(3), 24-27.