ProblemPaperBurnout

A d d r e s s i n g B u r n o u t i n S o c i a l W o r k | 1

Addressing Utilization and Effectiveness of Burnout Strategic Plans in Social Work Occupations

Laura Casey

Tennessee Tech University


Introduction

Burnout is a worker’s negative experience of exhaustion of physical or emotional

energies as a reaction to work related stressors that are being handled in a maladaptive manner.

(Acker, 2010l; Felton, 1998) This is a major problem in social work occupations and can be

costly to the employee, employer, and clients by decreasing employee esteem and job

satisfaction, increasing employee depression rates, and increasing the rate of employee turnover.

With the employee-client relationship being a crucial factor in the field of social work, employee

depression and turnover directly negatively impacts clients. Depression decreases employee

productivity by offering the clients subpar services, and clients receiving services from multiple

professionals due to employee instead of from one professional with whom they can build a

trusting working relationship are not receiving the seamless structured services to which they are

entitled.

Communities as a whole are impacted negatively by the increase in employee burnout

because the increase in burnout in causing a decrease in social workers. With this absence of

helpers and incongruence between those needing help and those available to provide it, families

are experiencing higher rates of parental incarceration, child abuse, child neglect, elderly neglect

and numerous other detrimental factors. When individuals suffer the family suffers, and when

families suffer the community is weakened. Our social workers are needing assistance in the

area of burnout to keep them employed, happy and productive so to improve and empower our

communities.

Employers are also negatively impacted by the financial burden placed on them to hire

and train new employees hired to replace those that quit due to employee burnout. Employers


also suffer when clients leave to seek services from other companies who have less employee

turnover.

The United States offers few resources for social workers experiencing burnout, and it is

proposed that an increase in resources could lead to lowered turnover rates and greater

effectiveness in the field. (Daley, 1979; Lloyd, 2002; Adams, 2006) Although burnout has many

well documented, predictors and its dangers are known, the issue shows an increase over the last

two decades and many employers handle the issue retroactively focusing on damage control

rather than a proactive stance. (Jenaro,2007; Lloyd, 2002)

This phenomenon is experienced especially highly in the field of social work and mental

health work and even more so in positions dealing with severe mental illness. (Felton, 1998) A

study by Acker (1999) shows a positive correlation between workers who help severely mental

ill (SMI) clients and occupational exhaustion. Social workers providing services primarily to

adults experience greater depersonalization and burnout as compared to their colleagues who

have a mixed caseload of adults and children (Acker,1999). Burnout can have both mental and

physical symptoms such as recurrent illness, poor attendance, headaches, fatigue, lower self-

esteem, substance abuse, depression, countertransference towards clients, relationship problems

and more. (Acker, 1999; Schaufeli, 2004) While burnout can occur at any point in one’s career,

younger social workers in the beginning stages of their career are more susceptible. (Acker,

1999; Acker, 2010; Maslach, 1981)

This paper serves to research the issue of professional burnout and use the collaborated

findings in conjunction with innovative ideas to produce a potential solution and a detailed

description of how this solution may be successfully executed.


Literature Review

Burnout is a worker’s negative experience of exhaustion of physical or emotional

energies as a reaction to work related stressors that are being handled in a maladaptive manner.

(Acker, 2010l; Felton, 1998) Concepts to be addressed in this review of literature include

associated factors of professional burnout, intervention and prevention measures, stages of

burnout, and critiques of current employee assistance programs.

Factors Associated with Professional Burnout

Factors that can lead to professional burnout in social work include administrative and

organizational shortcomings, poor job training, fewer year of experience, lack of social support,

rigidity in work schedule, poorly identified role requirements of employees, and an increase in

legislation and administrative control limiting employee autonomy. (Felton, 1998; Lloyd, 2002).

Lloyd (2002) found that major proposed factors contributing to burnout include low work

autonomy, role ambiguity, difficulties in providing services to clients, low professional self-

esteem, and poor supervisory support. A study by Acker in 2009 set out to examine a correlation

between workers who interface with managed care organizations and burnout rates. The study

used questionnaires from 591 social workers practicing in New York State to assess potential

correlates to occupational burnout. Acker’s findings propose that higher levels of perceived

competence in one’s field of managed care correlated with lower levels of burnout. She also

notes that employees that interface with severely mental ill (SMI) patients are at risk for higher

rates of burnout during their career as well as younger, less experienced social workers. Her

findings on younger workers having a higher propensity toward burnout are consistent with her


findings in the literature. Ackler suggests that another study be done to focus on the younger

population of social workers and to include greater ethnic and racial diversity.

Another factor contributing to employee burnout was found by Acker (1999) in regards

to caseload structure. Questionnaires were administered which included three scales: an

involvement scale, a job satisfaction scale, and the Maslach Burnout Inventory (MBI). Acker’s

finding showed a high correlation between interfacing with clients with severe mental illness and

burnout rate. Also the findings show that a caseload consisting of only adults correlated with

higher levels of burnout as compared to mixed caseloads which include adults and children. Like

other research findings, this study shows evidence that younger practitioners are at greater risk

for exhaustion and burnout as compared to more veteran practitioners.

The Maslach Burnout Inventory mentioned above was created by Christina Maslach in

the 1980’s and remains one of the most commonly used inventories to assess occupational

burnout in social work. This inventory addresses a range of factors that may increase or decrease

a practitioner’s propensity toward burnout such as age, sex, marital status, education and more.

Adams, Boscarino, and Figley (2006) executed a study to examine compassion fatigue

and burnout in professionals working with traumatized clients in the mental health setting.

Adams and his colleagues used a 30-item Compassion Fatigue scale and a 12-item General

Health Questionnaire to assess compassion fatigue and psychological distress. Their results from

the survey and questionnaire responses indicated that work burnout, secondary trauma to

professionals and compassion fatigue are negatively correlated with social support.

The research by Boyle, Schaufeli, Jenaro and Felton supports common factors, predictors

and proposed strategies to combat occupational burnout. Factors and predictors for burnout in


the field of mental health and social work include: limited professional resources, emotional

exhaustion from interfacing with the mentally ill population, misunderstanding role

requirements, lack of autonomy in the workplace, schedule rigidity, work requirement overload,

high emotional demands, higher burnout and turnover rates in younger practitioners, poor job

training and lack of administrative support and organization.

To summarize, there are numerous factors to be found in the literature regarding

employee burnout. The main factors include: low work autonomy, misunderstood job

descriptions and role ambiguity, low professional self-esteem, poor supervisory support, low

social support, work requirement overload, poor caseload structure, facetime with severely

mentally ill clients, age of practitioner with the emphasis placed on issues of burnout among

young workers, and limited professional resources.

Preventative Measures

Preventative measures exist to combat occupational burnout which include, but are not

limited to: offering employees flexible work schedules, increasing social support and team

building within the company, cognitive-behavioral stress management, comprehensive job

training, ongoing communication between employees and administrative staff, periodic

employee review, regular group critical case review meetings, Critical Incident Stress

Debriefings (CISD), and the use of Employee Assistance Programs (EAPs). (Felton, 2002;

Schaufeli, 2004; Jenaro, 2007; Boyle, 1991) Employee Assistance Programs are among the most

commonly adopted resource for employees but it is underutilized and its availability and benefits

are unknown to many employees. These programs can offer a range of services such as


addictions treatment, counseling services, elder and childcare and legal services. (Felton, 2002;

Hartwell, 1996)

Schaufeli’s research emphasizes a unique approach using positive psychology to assess

and address burnout in social work settings. She proposes the use of stress management

programs as well as preventative measures such as job redesign, flexibility in work schedules,

and goal setting as possible aids in overcoming professional burnout. She emphasizes that the

positive psychology contrast to burnout is engagement and she focuses her research around

increasing these positive contrasting factors in the workplace. Jenaro (2007) also researches a

positive psychology factor called positive reinterpretation. This factor showed significant

correlations with lowered burnout and stress. The use of positive coping skills, acceptance and

employee’s personal religion or spiritual practice highly correlated with lower occupational

stress. In Felton’s research, he emphasizes group and staff discussion, Critical Incident Stress

Debriefing (CISD), employee autonomy and the utilization of Employee Assistance Programs as

main preventative and therapeutic factors to assist professionals experiencing burnout.

Stages of Burnout

Daley (1979) as well as Costello and Zalkind (1963) propose three stages of burnout: the

alarm state, the resistance state, and finally the exhaustion state. The alarm state may consist of a

professional attempting to cope with perceiving inadequacies, striving to maintain levels of

professional aspiration despite failures or stress, and a host of other internal conflicts. The

resistance stage is marked by the employee using his energy almost entirely to manage stress.

This gives way to exhaustion which is otherwise called “burnout”. Daley proposes that


preventative measures should be implemented in the workplace so that an employee does not

reach the resistance or exhaustion state.

Critiques of Current Employee Assistance Strategies

Hartwell (1996) and her colleagues discuss the benefits of employee resources but

criticize the availability and employee awareness of such resources. They propose that

Employee Assistance Programs are paramount in providing help to employees experiencing

hardship or burnout, yet employees are rarely made aware of the benefits to which they are

entitled. Benefits include addictions treatment, counseling, financial assistance, and more. Low

awareness and poor utilization of resources are main issues in solving the problem of

occupational burnout in social work. Hartwell proposes that an increase in awareness of these

resources is crucial in combatting employee burnout.

Strategy Review

Numerous interventions were found in the literature and these include workshops, peer

collaborated events, educational programs, and mindfulness trainings. For the purposes of this

paper, two intervention studies will be addressed including their purpose, research methodology,

results, and connection to professional burnout.

Cooley and Yovanoff (1996): Stress Management Workshop and Peer-Collaboration

The first study was conducted by Cooley and Yovanoff (1996), whose research examined

the effects of two interventions: a stress management workshop series and a peer-collaboration

program. There were 92 participants who were special education teachers and related staff. Of


these 92 participants, 66% were in their first five years of practice and the age range was 25-63

years.

The stress management workshop: this was a weekly two hour workshop held over a five

week period. It included small group discussions, real world applications, and practicing skills

between these weekly sessions and reporting on outcomes. Three main areas were the focus of

reducing stress and increasing employee empowerment:

1. Skills for changing the situation itself (generating positive coping skills)

2. Skills for changing one’s physical response to the situation (generating positive

psychological coping skills)

3. Skills for changing one’s thoughts about the situation (generating positive cognitive

coping skills)

Participants were also given homework to use in their work and were to report back with

completed assignments each week.

The peer-collaboration activity: This activity paired up participants and each pair took

turns with one being the initiator (one presenting a client related problem) and the other being the

facilitator (one who assists working initiator through the problem). They were guided through a

four step process which is listed below:

1. Clarifying: during this process (the most time consuming of the four stages), the

initiator presents the problem and answers all clarifying questions asked by the

facilitator. These are not just factual questions to gain knowledge, but include

presenting different ways of viewing the issue. Once the facilitator helps the initiator


to clarify the issue as well as other potential surrounding issues and alternative

viewpoints, the pair moves on to step two, summarizing.

2. Summarizing: in this stage the initiator frames the issue into three categories:

a. The problematic patterns of behavior present

b. The initiator’s typical responses to the issue

c. Specific aspects of the issue that fall under the initiator’s control

This stage is to reframe the issue in a more concrete way and address problematic

patterns of response on the initiator’s side and to determine what exactly is under his

or her control.

3. Intervention and Prediction: three possible action plans are created in this step and

positive and negative outcomes are predicted for each option. The initiator then

selects which option he or she believes to be best.

4. Evaluation: here a two part plan is created:

a. “Did I do it?” (was the plan executed)

b. “Did it work?” (what were the outcomes and were they expected)

Participants were encouraged to use these steps once returning to work and being confronted

with problems. Pairs continued to meet for a two hour session each week for four weeks

following the session.

The study evaluated outcome variables of burnout, job satisfaction, and organizational

commitment which were taken as pre/post measures as well as measurements throughout the

process. The researchers conducted follow up evaluations at the six month and one year points.


There was a significant difference found between those who received the interventions

and those who did not. These results indicate a positive option for employers looking to assist

employees experiencing job burnout and low job satisfaction. The literature appears to have a

theme of successful interventions that include workshops and peer collaboration activities.

Russell (1987): Rational-Emotive Education Program

The second study to be critiqued was by Russell (1987) at the University of Oregon. He

tested the effectiveness of a rational-emotive education program on teacher burnout by taking a

sample of 42 public-school teachers from grade levels kindergarten through high school. These

participants were divided into two treatment groups and those receiving the rational-emotive

education program partook in: emotion guessing exercises, role playing real world problems

from a negative emotion standpoint coupled with real-world problem role playing from a

positive emotional standpoint, class discussions on positive emotions and their impacts, as well

as exercises on how to self-check for negative patterns of thought and changing those thought

patterns.

Measurements were taken for pretesting, post-testing, and follow-up testing and the

instruments used were the Maslach Burnout Inventory, the Irrational Beliefs Test, and the

Teaching Events Stress Inventory.

Results showed that participants in the treatment group maintained lower levels of

burnout at the five week post-testing period than those in the control group. Analysis also shows

a correlation between teacher burnout and stressful teaching events but no correlation existed

between teacher burnout and irrational thinking.


This study informs the research topic of professional burnout by empirically researching

factors correlated to professional burnout. Limitations of this study would be small sample size

and an unbalanced gender proportion among participants. However, this study shows that

rational-emotive education has a positive impact of teachers experiencing professional burnout.

Solution

Professional burnout is an increasingly problematic issue in the field of social work.

Burnout can cause high rates of turnover, understaffed agencies, poor employee performance and

lowered job satisfaction. After assessing the research, the most beneficial solution would be a

combination of workshops, peer activities, and enhanced communication between employers and

employees which would combine to create a comprehensive program to prevent employee

burnout as well as offer assistance to those currently experiencing burnout.

The goals of this proposed project are:

1. Increase awareness of employee burnout.

2. Increase employee knowledge of intervention and prevention resources

3. Increase opportunities for employees to gain and practice intervention and prevention

skills on a regular basis

The project will contain the following elements:

- Semiannual workshops addressing burnout

- Quarterly peer-collaborated activity sessions

- On-site volunteer representatives

- On-site aid stations


- Web based aid station

Materials

Materials needed for this project to be successful include time, volunteers, money, and

technology as well as physical materials to crease the on-site aid stations which could include:

table: bulletin board, flyers, business cards, and positive reinforcement such as candy, flowers, or

other desired goods as indicated by the specific site’s employees.

Semi-Annual Workshops

Semi-annual workshops would be held by the company and could be administered by

supervisors and/or a hired workshop professional with experience in addressing employees on

the subject of burnout, motivation, job satisfaction, and communication. It would also be

appropriate to include rational-emotive education in these workshops as discussed in the strategy

review section.

Daley (1979) as well as Costello and Zalkind (1963) discuss recognizing the stages of

burnout and using this recognition to get early help. These workshops will include information

from these studies to help assess employees for burnout as well as teach self-assessment and the

process of seeking early preventative help.

This project element correlates with goals 1, 2, and 3. These workshops are designed to

get employees involved in learning about the factors of burnout and to assess their own personal

connection with it (goal 1) as well as teaching professionals about intervention and prevention

resources (goal 2) with the long-term goal of decreasing employee burnout rates. This strategy


does this by offering semi-annual opportunities to learn and practice skills to combat burnout

(goal 3).

Quarterly Peer-Collaborated Activity Sessions

These activity sessions would be designed and administered by volunteer employees in

collaboration with the on-site project representative. These sessions will include experiential

discussions such as role-play and case-review to include employees’ subjective personal

experiences. This sharing of information created and led by the employees is meant to foster

community and communication within the company as well as surface any possible or definite

indicators of employee burnout. These sessions should closely model the study done by

Cooley and Yovanoff (1996) to include their stress reduction activities as well as the peer

collaboration practices and four-step model.

Adams, Boscarino, and Figley (2006) found a correlation between employee burnout and

lack of social support. These findings informed the creation of these activity sessions, which are

designed specifically to increase awareness of burnout, resources available, and the social

supports that are in place for employees.

These sessions will address goals 1, 2, and 3 by increasing communication and awareness

of burnout (goal 1), promoting employee resources (goal 2), and offering regularly scheduled

opportunities for peers to learn and practice their skills (goal 3) which will assist in decreasing

overall employee burnout rates.

On-site Representatives


On-site representatives would be selected on a self-volunteering basis. Monetary benefits

may be possible depending upon the individual company’s financial flexibility, but it is preferred

that this job be on a volunteer basis preferably led by employees with a special interest in

preventing employee burnout. These representatives will liaise with supervisors and company

administrators while also coordinating workshops, peer collaborated activities, and tending to aid

stations as needed. A site may have one or multiple representatives, but at least one must have

technological knowledge of creating and maintaining a website for the web-based aid station. If

none are available with those skills, the company will need to offer a brief but comprehensive

training.

The representatives role will aid in fulfilling goals 1 and 2 by increasing employee

knowledge of burnout through promotion of awareness (goal 1) and by increasing awareness of

specific intervention and prevention resources by word-of-mouth as well as the promotion of the

on-site and web-based aid stations (goal 2). Representatives will have an active part in all

project elements, but they will be most useful in connecting employees with available resources.

Aid Stations

Aid stations will be both on-site and web based so that employees may have access to

information and support 24/7. The on-site station will include flyers with Employee Assistant

Program and employee benefits information, current reviews of research on burnout, positive

psychology tidbits, contact information for employee burnout support staff, positive

reinforcements such as candy, fresh flowers or other incentives preferred by the site’s staff.

The web based aid-station website will include all the information that the on-site station

has, but will include hyperlinks to websites, quizzes on burnout and employee satisfaction, as


well as positive motivational information such as quotes, pictures, hyperlinks to relevant positive

psychology websites and other resources. The on-site stations will also have cards with the web

based station’s website URL and the contact information for the website’s maintenance

representative.

The rationale for including positive psychology elements such as quotes, candy, flowers

and other positive implementations comes from Schaufeli (2004) and Jenaro (2007), whose work

indicates how impactful positive psychology is on decreasing employee burnout levels as well as

increasing positive employee traits such as higher self-esteem.

Aid stations are the tools used by the representatives. These stations will provide

tangible support to assist representatives in providing resources to employees. These on-site and

online stations will impact all three stated goals, but most directly correlate with goals 1 and two

by providing information on employee burnout (goal 1) as well as promoting intervention and

prevention resources (goal 2). They will fulfill goal 3 by promoting quarterly and semi-annual

opportunities for employees to learn and practice coping skills and strategies.

Pilot Program

A potential pilot program site for this project would be at Lifecare Family Services in

Cookeville, Tennessee under the approval and advisement of Omni Community Health. This is a

relatively small site with an established Employee Assistance Program and high levels of

employee/employer communication. This would be a prime location to test the Employee

Burnout Project and address problematic areas as needed.

If all elements of this solution are put into practice, then the stated goals for decreasing

employee burnout will be achieved. This means that there will be an increased awareness of


what employee burnout is, intervention and prevention strategies will be made known, and there

will be numerous regularly scheduled opportunities for employees to learn and practice coping

skills and strategies which they can incorporate into their fieldwork. When these goals are

achieved, there will be a decrease in employee burnout as well as a decrease in employee

turnover, lower rates of employee depression, lower costs to employers, higher job satisfaction

rates for professionals and greater work efficiency. Other benefits include an increase in client

satisfaction, greater client success in treatment goals, decreased amounts of client and parent

incarceration, lowered rates of incarcerations and probation violations, less cases of substance

use and abuse for both client and employee, and increased standards of living for all parties

involved.

Overall, the utilization and success of this solution strategy will create stronger

individuals, families and communities, which is cornerstone of the helping professions.


References

Acker, G. (1999). The impact of clients' mental illness on social workers' job satisfaction and

burnout. Health & Social Work, 24(2), 112-119.

Acker, G. (2010). The Challenges in Providing Services to Clients with Mental Illness: Managed

Care, Burnout and Somatic Symptoms Among Social Workers. Community Mental

Health Journal, 46(6), 591-600. doi:10.1007/s10597-009-9269-5

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

Boyle, A., Grap, M., Younger, J., & Thornby, D. (1991). Personality hardiness, ways of coping,

social support and burnout in critical care nurses. Journal Of Advanced Nursing, 16(7),

850-857. doi:10.1111/j.1365-2648.1991.tb01767.x

Cooley, E., & Yovanoff, P. ( 1996). Supporting professionals-at-risk: Evaluating interventions to

reduce burnout and improve retention of special educators. Exceptional Children, 62,

336– 355.

Costello, T.W., & Zalkind, S.S., (1963). Psychology in administration: A research orientation.

Englewood Cliffs, NJ: Prentice-Hall.

Daley, M. R. (1979). 'Burnout': smoldering problem in protective services. Social Work, 24(5),

375-379.

Felton, J. S. (1998). Burnout as a clinical entity—its importance in health care

workers. Occupational medicine, 48(4), 237-250.


Hartwell, T. D., Steele, P., French, M. T., Potter, F. J., Rodman, N. F., & Zarkin, G. A. (1996).

Aiding troubled employees: the prevalence, cost, and characteristics of employee

assistance programs in the United States.American Journal of Public Health, 86(6), 804-

808.

Jenaro, C., Flores, N., & Arias, B. (2007). Burnout and coping in human service

practitioners. Professional Psychology: Research And Practice, 38(1), 80-87.

doi:10.1037/0735-7028.38.1.80

Lloyd, C., King, R., & Chenoweth, L. (2002). Social work, stress and burnout: a review. Journal

Of Mental Health, 11(3), 255-265.

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of

Organizational Behavior, 2(2), 99-113.

Russell, T.T., (1987). THE EFFECTIVENESS OF A RATIONAL-EMOTIVE EDUCATION

PROGRAM FOR THE TREATMENT AND PREVENTION OF TEACHER

BURNOUT (Order No. 8712992). Available from ProQuest Dissertations & Theses Full

Text. (303592504). Retrieved from http://search.proquest.com/docview/303592504?

accountid=28833

Schaufeli, W. B., & Bakker, A. B. (2004). Job demands, job resources, and their relationship

with burnout and engagement: A multi-sample study. Journal of Organizational

Behavior, 25(3), 293-315.

Wilkinson, S., Perry, R., Blanchard, K., & Linsell, L. (2008). Effectiveness of a three-day

communication skills course in changing nurses' communication skills with


cancer/palliative care patients: a randomized controlled trial. Palliative Medicine, 22(4),

365-375.

Yu, M. C., Lin, C. C., & Hsu, S. Y. (2009). Stressors and burnout: The role of employee

assistance programs and self-efficacy. Social Behavior and Personality: an international

journal, 37(3), 365-377.

Documents

ProblemPaperBurnout