Global Burnout In The Workplace

Burnout has been defined in various ways since the construct was introduced in 1974. This state has historically been perceived as most prevalent among persons in the helping professions. Burnout thus indicates mental or physical depletion after a period of unrelieved job-related stress that can also culminate in physical illness. It is common among mental health providers in both civilian and military settings and in the U.S. and internationally. Burnout is also multidimensional in that it is a biopsychosocial syndrome of being overloaded that interacts with such work-related factors as type of duties and setting, types of clients served, provider gender, age, and other variables (de Oliveira Santos & Cardoso, 2010).

The main component of burnout is emotional exhaustion, the stress dimension; it involves feelings of being overextended affectively and a belief that one does not have adequate emotional resources to cope with and function in the work environment. Burnout is often experienced as “a state of physical, mental, and emotional exhaustion caused by long-term involvement in an emotionally demanding situation”, which is true of counselors, who must cope with complex life problems that are affecting job-related self-efficacy, while also adjusting to the demands of managed care and related limitations (Acker, 2010). For prevention purposes it is therefore crucial for counselors to fully understand the causes of burnout.

Recognizing the effects of work settings, counselors can advocate for a work environment that is more conducive to both productivity and their own mental health. First, cultivating organizational leadership willing to promote a healthy other-care/self-care balance is important. Second, receiving support from colleagues and mentors can aid with both catharsis and normalization of burnout-related experiences. Finally, mentoring others can bring renewed enthusiasm for one’s own work. It is important for counselors to balance other-care and self-care, but it can be a real struggle.

It may require professional help as well as personal self-care. Balancing four personal dimensions of wellness—physical, spiritual, emotional, and social—is important. Many counselors find that professional counseling enhances their focus on wellness. Supervisors can help by providing opportunities for supervisees to actively practice stress reduction techniques.

Work in health and social service settings has been shown to be particularly stressful. Health care workers also often experience workplace burnout, which is a gradual loss of emotional, cognitive, and physical energy that results from continuous exposure to job and life stresses. Daily spiritual experiences and job-specific training that might buffer workplace burnout among a particular at-risk population, namely medical and mental health personnel who work closely with dying and/or grieving clients. In mental health settings, it has also been shown that beginning counselors tend to experience substantially more discomfort when confronted with scenarios that involve death and loss compared to other serious presenting problems (Kirchberg & Neimeyer, 1991; Kirchberg et al., 1998).

Physicians have described their burnout as a profound sense of frustration and failure, and many of them report that the low success rate of treatments does significantly contribute to their level of burnout. It appears that health professionals cope more effectively with repeated exposure to trauma and death-related situations when they find ways to understand and consolidate their experiences into broader meaning structures. In many cases a sense of spirituality or religious conviction might help individuals coping with end-of-life issues frame from their experiences in a different and perhaps more positive light.

Training programs for doctors, nurses, and mental health professionals have steadily begun to recognize the importance of death, dying, and bereavement-specific education, and research studies suggest that this type of training can have a positive impact on health professionals in a variety of ways. It is possible that end-of-life practitioners who do not possess a sense of mastery or have an adequate knowledge base might feel overwhelmed by the cognitive as well as emotional demands of their work. Health care providers would be well advised to create a workplace atmosphere that allows for and encourages spiritual expression among employees. Although end-of-life staff might vary considerably in their spiritual beliefs and practices, memorial services and other rituals that promote a diversity of spiritual expression could prove to be helpful.

Training curricula that allow opportunities for personal value clarification, exploration of one’s own attitudes toward death and dying, and experiential learning could be especially important in amplifying the impact of end-of-life and grief education. Although the topic of burnout has been studied in a variety of health settings, little is known about the burden of treating mental health disorders in the military. A variety of workplace stressors have been shown to negatively impact healthcare workers and could potentially lead to burnout. Nurses report that inadequate staffing, relationships with co-workers, the emotional needs of the patient, shift working, and lack of reward and social support are common sources of stress.

Researchers also have concluded that providers’ personal beliefs about psychotherapy and pharmacotherapy can influence whether patients are adherent to treatment protocols, thereby affecting whether the provider experiences therapeutic success. Providers who have negative beliefs about treatment may therefore experience increased job stress if these beliefs affect the successful treatment of their patients. Severe distress is correlated with staff absenteeism, poor staff retention, ill health, and reduced job performance. Burn out medical practitioners experienced high rates of suicide, early retirement, increased substance use, and marital problems. It is of great importance to understand the unique stressors faced by active duty and civilian mental health staff at military hospitals.

Professional burnout is a syndrome that affects employees in all occupations, but is especially prevalent among human service workers. Burnout has been conceptualized as a form of psychological distress related to work that is composed of three factors: emotional exhaustion, depersonalization, and feelings of low personal accomplishment (Maslach and Jackson, 1986). Emotional exhaustion is operationalized as feeling emotionally drained and depleted. Depersonalized refers to feeling emotionally distant from one’s client, and low personal accomplishment entails not meeting one’s work related goals.

Numerous studies have examined burnout in mental health workers of various fields. However, shelter workers and other crisis professionals have been somewhat neglected. Working closely with women and children in crisis and hearing their stories of repeated trauma on a daily basis can be stressful for shelter workers. Shelter workers also experience stress stemming from a lack of available resources or lack of support from the surrounding community. Only through continued research related to healthy functioning among these workers can we ensure that women in crisis receive the quality of services they deserve and so desperately need.

The term “crisis” is a very general term that evokes considerable emotion and interpretation. This is especially true with respect to mental health crisis situations. Inconsistency in operationalizing “mental health crisis” has complicated research efforts in the area of crisis intervention. There exists a need for greater clarity with respect to crisis programs, their components, coordination, and characteristics of the people they serve.

A second issue surrounding mental health crisis service definition is the lack of fundamental utilization, disposition, and outcome data. Crisis services have been developed and studied exclusively in urban and metropolitan areas. This raises important issues for crisis service development in rural areas where population density severely limits options. Certain components or models of crisis intervention may not be practical or cost effective.

Professional stress is used to mean the emotional stress that the therapist is subject to during psychotherapy. Depressive feelings are the most common reactions of therapists to stresses at work. Some therapists are able to relate these reactions to their early family dynamics. Research shows that the career choice of mental health profession correlated with early pathology in family, empathy, and therapeutic effectiveness. The internal locus of control buffers the effect of stressors. It helps the therapist to manage the possible professional stress more effectively.

Whether it is in the aftermath of a serious crisis or during an extended period of high stress, unrelenting demand for support may result in burnout for even the most seasoned crisis caregivers, particularly if they themselves are feeling vulnerable due to the circumstances. The risk may be even higher for teachers and other caregivers who are not trained crisis responders. Consequently all caregivers need to consider the following personal and professional suggestions to prevent burnout. Know your limitations and with what you feel reasonably comfortable or uncomfortable handling.

Recognize that your reactions are normal and occur frequently among many well-trained crisis professionals. To the extent possible, maintain normal daily routines (especially physical exercise activities, meal-time, and bed-time routines). Connect with trusted friends or family who can help take the edge off of the moment. Give yourself permission to do things that you find pleasurable (e.g., going shopping or out to dinner with friends). Be sure to maintain healthy eating habits and drink plenty of water. Be kind and gentle on yourself and others, as you have all shared exposure to a life-changing event.

Everyone needs time to process the impact of these events into their lives. Take time at the end of each day to process or debrief the events of the day with other caregivers or colleagues. As much as possible, try to get some restful sleep, preferably without the use of sleep aids or alcohol. Take periodic rest breaks at least every couple of hours. The importance to implement self-care daily in preventing burnout for yourself, in the workplace is essential. Your mental health is just as important as your physical health.

References

Baker, L. M., O'Brien, K.,M., & Salahuddin, N. M. (2007). Are shelter workers burned out?: An examination of stress, social support, and coping. Journal of Family Violence, 22(6), 465-474. doi:https://dx.doi.org/10.1007/s10896-007-9103-1

Ballenger-Browning, K., Schmitz, K. J., M.S., Rothacker, J. A.,N.C.U.S.N., Hammer, P. S.,M.C.U.S.N., Webb-Murphy, J., & Johnson, D. C., PhD. (2011). Predictors of burnout among military mental health providers. Military Medicine, 176(3), 253-60. Retrieved from https://search.proquest.com/docview/856118707?accountid=87314

Bonynge, E. R., Lee, R. G., & Thurber, S. (2005). A profile of mental health crisis response in a rural setting. Community Mental Health Journal, 41(6), 675-85. doi:https://dx.doi.org/10.1007/s10597-005-6427-2

Holland, J. M., & Neimeyer, R. A. (2005). Reducing the risk of burnout in end-of-life care settings: The role of daily spiritual experiences and training. Palliative & Supportive Care, 3(3), 173-81. Retrieved from https://search.proquest.com/docview/214843508?accountid=87314

Lent, J., & Schwartz, R. C. (2012). The impact of work setting, demographic characteristics, and personality factors related to burnout among professional counselors. Journal of Mental Health Counseling, 34(4), 355-372. Retrieved from https://search.proquest.com/docview/1114670345?accountid=87314

?????? Tiffany E. Gillis MA, B.S.