This has been one of those weeks where I feel completely emotionally and physically depleted. My back up well of energy is drying up and once again I am on my knees thanking God for carrying me through. It's the kind of week where the reality of my job is ever present and laying heavy on my heart. My dependence on God as my rock and my hope keeps my plugging through. The truth of Matthew 28:11--" Come to me all who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy and my burden is light."--has never spoken with such urgency to my heart.
Tonight was one of those nights, where I came home from work, and caved into the invitation of an early nap on my bed. I woke up, not feeling rested, but feeling the need to get out of the house and muster the strength to go about life. The dirty dishes, laundry to be put away, and unmade bed can wait tonight. Tonight---self-care mode is first priority. If I am going to be even the smallest bit useful to anyone the next two days--I have to take a step back.
Tonight, I pulled out a paper that I wrote at the end of grad school regarding burn out prevention. I have not looked at this since, but it is a good self-check to monitor how I am doing with self-care.
Burnout: A
Personal Prevention and Self-Care Plan
Audrey
Martin
Roberts
Wesleyan College
Burnout: A
Personal Prevention Plan
Once
a passionate and optimistic idealist, Mrs. Alexander, has recently found
herself disillusioned by the countless stories of trauma she hears daily
working as a social worker in a domestic violence shelter. After being at her current organization for
10 years, Mrs. Alexander finds herself cynical of her work, often questioning, what’s the point? I do my best, and my
clients still end up going back to their abusers. There is no hope. At one time, Mrs. Alexander was energized by the
prospect of new projects and areas of growth within the profession, but she now
feels bored and unfulfilled by the work. For the past several years, Mrs.
Alexander has thrown herself into her work, frequently cutting out lunch breaks
and working late in the evening to accomplish all she can for her clients. Even
her kids often sarcastically remark, “Mom, it’s good to see you are alive. We
were ready to send out a search party to look for you.” Mrs. Alexander begins to ponder, how did I get to this point of hopelessness
in a profession that once felt so rewarding? How can I extend hope to my
clients when I have no hope?
The
vignette above depicts a far too common story of well-intentioned individuals
in the helping professions confronting the reality of burnout. In the current day of economic hardship, with
frequent staff cuts and high caseloads, it is essential to begin to look at the
reality of burnout and preventative measures to ensure a resilient, satisfied,
and effective workforce who play a critical role in providing assistance to the
most vulnerable in society. As a
soon-to-be masters level social worker, it is important to develop a personal
self-care plan that will reduce the risk of future burnout in the field and
preserve one’s longevity in serving clients in need. This paper will aim to
address the definition and development of burnout, prevention and management
strategies, as well as my own personal plan for self-care and burnout prevention.
Burnout Definition and Development
At
times it seems paradoxical that the very reasons individuals enter the helping
profession, to utilize their skills of empathy and compassionate character, can
be the achilles’ heel that leads to the development of impairment and burnout.
Specifically, “48% of the total social work workforce in the United States
experiences high level of personal distress as a result of their work”
(Wharton, 2008). The very self-care procedures
helping professionals advise to clients can become void in their own
lives.
The
term “burnout” is common in the helping profession, but widely defined by many
sources. The Merriam-Websters Dictionary defines burnout as the, “exhaustion of
physical or emotional strength or motivation usually as a result of prolonged
stress or frustration” (Burnout, n.d.). Fruedenberger,
the father of the term burnout, defines this condition as, “a depletion or
exhaustion of a person’s mental and physical resources attributed to his or her
prolonged, yet unsuccessful striving toward unrealistic expectations,
internally or externally derived” (Keller & Ritt, 1984). Other similar terms have been designed in the
field of helping which address conditions that social workers and other helpers
are vulnerable to due to the nature of the job, such as compassion fatigue and
secondary traumatic stress (STS). Secondary
traumatic stress can occur for direct workers and their supervisors, who experience
distress and impairment after a client recollects their traumatic experiences (Barnett,
Elman, Baker, & Shroener, 2007). Figley, (2002) suggests however, that
these conditions differ from burnout stating,
Compassion
fatigue, in contrast to both burnout and countertransference, is associated with a sense of helplessness and confusion;
there is a greater sense of isolation from supporters.
The symptoms are disconnected from real causes and are triggered by other experiences. Burnout may require changing jobs or
careers. However, compassion fatigue is highly treatable once
workers recognize it and act accordingly (p. 1436).
The
factors contributing to burnout in the helping profession can vary widely from
person to person, but the literature suggests several common contributing
factors. Soderfeldt, Soderfeldt, & Warg (1995)
propose that burnout results in the helping profession from the involvement in
intricate social situations of clients, role ambiguity and conflict, and high
demands with limited resources. Social
workers can experience increased stress from combined pressures of work load,
covering for unmet staffing needs, organizational restructuring and retention
problems, and lack of adequate supervision (Weinstein, 2008). Additionally, low levels of compassion satisfaction were
found to be associated with high levels of burnout. Compassion satisfaction is
defined as feelings of competence and sense of calling to the helping vocation.
In a study of child welfare workers, young, female workers were most vulnerable
experience of burnout (Van Hook and Rothenberg, 2009).
While
burnout can occur in many professions, but also one may ask why it so much
emphasis is placed on the helping field. Essentially, the answer is that
burnout not only impacts the helping professional, but impairs his or her
ability to serve clients and initiates a potential risk of harm to already
vulnerable clients. Social workers are
held to ethical standards to not only protect themselves from impairment, but
to protect the client’s of others by identifying and assisting fellow
professionals who are impaired to access resources in order to function
appropriately with clients (National Association of Social Workers, 1997). Peebles-Wilkins (2008), notes that,
Indications
of impairment include poor judgment, and unacceptable job performance characterized by tardiness, absenteeism,
dramatic mood changes, changes in hygiene and physical
appearance, boundary concerns or personal involvement with clients, inability
to recall what transpired in an
interview, and other difficulties may be indicators of impairment” (p. 1).
There
are a variety of symptoms associated with burnout, which can lead to
professional impairment. The symptoms can include cynicism, workaholism,
isolation, boredom, depletion, conflict, arrogance, and helplessness (Wicks,
2010). Additionally, “It is
characterized by feelings of depersonalization, emotional exhaustion, and a
lack of feelings of satisfaction and accomplishment, and it may result from
prolonged work with emotionally challenging clients” (Barnett, Elman, Baker, &
Shroener, 2007, p. 64). The symptoms of
burnout can progress gradually, when unresolved, through a variety of stages. In particular, Wicks (2010) suggests that
burnout progresses in three stages. In
the first stage, the symptom are inconsistent and with a lessened degree of
severity. Symptoms include mental exhaustion, resentment towards family and
coworkers, somatic complaints, as well as feeling overwhelmed and incapable of
keeping up with the pace and requirements of activities. In the second stage,
symptoms are prolonged and difficult to manage. Symptoms include feeling jaded
with one’s work consistently, anhedonia, rigid concern for schedule that loses
personal connection, loss of interest in professional development, and sporadic
periods of persistent irritation, depression, and stress that are unchanged by efforts to reduce
stressors. The third and most severe
level of burnout occurs when distress is chronic and manifests as illness.
Emphasizing the severity of the third level, Wicks (2010) writes, “Once the
threshold of the third level has been crossed, the burnout is severe and
remediation of the problem will likely take a good deal of time and effort.
This is why preventive measures are essential” (p. 33).
Preventing and Managing Burnout
With burnout threatening the
functioning and well-being of helping professionals, the prevention and
management of burnout become critical to preserving the vitality of the field. The literature suggests that the prevention
and management of burnout must occur on both a personal and organizational
level (Soderfeldt, Soderfelt, & Warg, 1995).
Personal
Level
On the personal level, a helping
professional can prevent themselves from burnout by disengaging from work, bolstering
his or her social supports, and utilizing a self-care plan to renew one’s own
sense of self. An important component of preventing burnout,
is for the helping professional to intentionally disconnect oneself from work
and client problems. One social worker noted that as part of her self-care
plan, she intentionally developed a ritual to disengage from her work. Each day
as the social worker would take off her work badge and place it in her glove
compartment; she would mentally imagine herself placing all of her work stress
and client scenarios in the glove box as well. She would not allow herself to
think about her work again, until she took her badge out of the glove box the
next day (M. George, personal communication, April 6, 2009). Figley (2002) explains this concept of
disengagement, as a practitioner’s purposeful decision, “that he or she must
“let go” of the thoughts, feelings, and sensations associated with the sessions
with the client in order to live their own life” (p. 1438).
Additionally,
it is critical that individuals in the helping profession have a well-developed
social support system. Wicks (2010), expresses one of the greatest burnout
deterrents and resilience builders, is the social support network. He states,
Burnout
is always around the corners when we don’t have people who are ready to encourage us, see our gifts clearly
and be there for us when our involvement with people, their sometimes unrealistic demands, and our own crazy
expectations for ourselves threaten
to pull us down (Wicks, 2010, p. 78).
He goes on to recognize the importance of having a
heterogeneous support system made up with four types of friends which include,
the prophet, cheerleader, harasser, and guide. Each of these people, help the
professional to develop different perspectives in life (Wicks, 2010). By
increasing the support system, the helping professional develops an identity
separate from the therapist persona (Figley, 2002).
Perhaps one of the most widely emphasized
practices to avoid burnout is the utilization of a self-care plan. In order to fully commit to self-care, it is
recommended that a self-care plan be written, public, specific and measureable.
An individual should set deadlines and attainable goals within the self-care
plan and practice frequent monitoring of progress (Greencross Academy of
Traumatology, 2010). The specific contents of the self-care plan will vary from
person to person. When identifying activities to include in a self-care plan, it
is critical for the helping professional to think, what activities energize and replenish me? (Wicks, 2010).
However, the plan should include activities
to care for both one’s physical and psychological well-being. For example, physical self-care activities
should include quality sleep, nutrition, exercise, and leisure activities and
psychological self-care activities could include planning time for laughter, evaluation
of values, discernment of control, self-appreciation, balanced involvement,
support group participation, spontaneous acts of creativity, and positive
self-talk (Wicks, 2010). More specifically, Van Hook & Rothenberg (2009),
found among a recent study of child welfare workers, common strategies for
dealing with work-related stress include; exercise, work breaks/leaving work
early, quality family time, hobbies, music, religious activities, conversations
with co-workers, reading, and watching TV or movies. Additionally, one can monitor his or her pace throughout
the day, contemplating what he or she is doing and how fast they are doing it
(Jones, 2001). During an interview with a current therapist in the field, she
stated that her self-care plan involves regular quiet time, planning events to
look forward to (besides vacation), time with friends, and walks after
work. She went on to emphasize the
importance of self-awareness, and a clinician’s ability to recognize his or her
own symptoms of burnout and especially pay attention to self-care when these
symptoms begin, to avoid spiraling downward. This may include seeking outside
assistance, as well (R. Elliott, personal communication, April 4, 2011).
Organizational
Level
The
work to prevent burnout can also go beyond the individual, and become an
initiative within the agencies and organizations that employ helping
professionals. In a survey of social
work professionals, many suggested the best ways for organization to aid the
fight against burnout are to, “reduce caseloads, implement less red tape,
increase staff, increase support from the administration, and offer incentives”
(Van hook and Rothenberg, 2009). Furthermore, organizations can aim to clarify
social workers roles, increase initiatives to promote social work safety,
provide adequate training, offer scheduling flexibility, and increase job
security (Soderfeldt, Seoderfeldt, & Warg, 1995). Because helping
professionals experience psychosocial stressors beyond the work environment in
addition to work-related stress, employee assistance programs can be an
additional resource to provide workers with counseling to address concerns
prior to evaluating to the highest stages of burnout (Cooper & Cartwright,
1998).
Individualized Self-Care Plan
Self-care
means more than eating a balanced diet and regularly visiting the doctor. Self- care means living the life God has intended
for you. You are God’s own creation.
Your task is to be yourself, the
person God has called you to be. This
includes creating a vision for your
life and then crafting a life that honors that vision. It includes caring for your body, mind, spirit, and the resources
God has given to you. Caring for yourself means
that in the next life, you will be able to say to God, “I was very much myself,
your own creation (Melander
& Eppley, 2002, p. XII).
Self-Care
Plan of Action
The
importance of self-care has never felt more relevant than now, as I approach
graduating. I feel the development of a
self-care plan is critical; to actively work at preventing burnout before it
starts. My burnout plan must be
tailored to the particular ways in which God intricately designed me. This means delving into an honest
self-evaluation of what in life rejuvenates and depletes my energy resources. Also, it is critical for me not to allow
myself to think of self-care as an option, but rather a necessity for surviving
and thriving in my work.
While
I enjoy spending time with people, I also need balance with alone time. Since I
hope to work in a clinical setting, where I will be working with the emotional
needs of others, I must be aware that this has the potential to drain me of my
energy. Thus, on exceptionally draining
days, I may need to spend some time alone in reflection listening to music or
journaling. I must be able to set boundaries with those around me, and let them
know that I need a specific period of time (1 hour), without the demands of
reacting to his or her emotional needs.
In
the past, running has been a great source of energy for me. In particular, I do best with running when I
have a goal to accomplish. Thus, it might be helpful for me to schedule to run
a half-marathon and find a friend to run the race with me. That way, I have the accountability of a
friend to keep up with my running and the pressure of needing to be ready for
race day will also keep me from neglecting my running schedule. Also, by scheduling a race in a fun location,
it will give me something to look forward to.
It may also be important to switch things up every now and then with
other forms of exercise such as swimming, tennis, a spinning class, or hiking. Additionally, finding other hobbies will be an
important piece too. I have always
wanted to take a painting class. Trying new activities is exciting and keeps
things from getting monotonous. Being
intentional about trying something new each week will be helpful for me. I love
the excitement of a new adventure. This could be as simple as trying a new
recipe for the week, taking a new path for my morning run, or starting a new
book.
Additionally,
faith and spirituality are important pieces for my self-care. Spending daily time
in scripture and prayer has been a way for me to rejuvenate before and after a
long day. In the beginning of the day, starting with prayer and asking the Lord
for guidance with my clients, will help me to start my day focused on
purposeful interactions. I often journal a “Letter to god” each night, laying
before Him my fears, frustrations, hopes, prayer requests and dreams. Even
after a busy day, simply laying out under the stars or spending time outdoors
in the sunshine, I feel reenergized by God’s creation.
At
the same time, it is important for me to develop strong social supports within
and outside of work. As I look for a
social work job, it will be critical for me to find out the type of supervision
provided. I know that I work best with a
supportive supervisor, whom I feel comfortable asking for help. Socially, this
will also include involvement in a small group at church, spending time with
friends and family, and simply calling friends to catch up. By having a wide range of friends and
supports from many areas, I can draw on different friends for support when needed.
Also, I am energized when I am volunteering my
time for an organization that I am passionate about. Depending on my work schedule, this may mean
that I lead a small group for youth at my church or volunteer at the local
homeless shelter. As I am a therapist, I get paid for my work. While that is
not the only reason I do what I do, it is helpful to help others not as my job,
but because it is something that I genuinely want to do without the time
restraints of work.
I recognize that I tend to be a very task
oriented person. I find crossing an item off of my to-do list, exceptionally
empowering. As a therapist though, we
are working with people. People are never done growing. There is always more
work that can be done. Thus, there is
never really an end to our work. Of course there are goals for the client, but
these take lengths of time and largely depend on the client to work towards
them. Thus, it will be important for me
to incorporate tasks that I can successfully complete in a given day. For
example, it may be as simple as getting my laundry done. This is a task with an end. While it something simple, each day I need to
feel like I have accomplished something.
This is especially critical when I feel overwhelmed by the “never
ending” demands of work. And after I
complete these items on my “to-do” list, I can check them off and know that
they are done for the week.
Personal Identifiers
of Impending Burnout & Measures of Self-Reflection
Acknowledging
the signs and symptoms of stress will be critical for me, to make sure that I take
extra care during these times to avoid going to a point beyond repair. I recognize myself being stressed, when small
tasks begin to feel overwhelming and I start cutting out social activities or
feel uninterested in the activities that I once enjoyed. I should also
acknowledge when I am feeling overly anxious, frustrated, and negative. I know
that I have too much stress, when I stop dreaming about the future or lose
hope. During these times, I will need to seek others for support and
acknowledge that these symptoms are my body’s cry for restoration and action. Hopefully,
through self-care, these symptoms will be rare and manageable.
In
order to keep myself from experiencing these symptoms, asking myself the following questions can be
an important skill in knowing when changes need to be made in my level of
self-care. For example, I can ask myself using the following measures:
·
How am I feeling emotionally? Emotion:
________________
Scale of Emotional Intensity (1 a
little bit -10 intensely)___________
·
What was one way I saw God in this day? What
could God be teaching me out of my experiences today?
·
How did I take care of myself physically today?
Emotional? Socially? Spiritually?
·
What did I do well today? What could I improve? What actions can I take to make this
improvement?
·
How well did I do with following through on
previous attempts at improvement? What are my barriers to greater self-care?
How can I confront these barriers?
If find
myself neglecting self-care through my assessment, these tools will help me
critically evaluate the steps to get back on track. The biggest trick will be
to not just think about making changes, but actually taking action and
initiative before burnout is beyond repair.
A proactive approach, is always far better than a reactive plan.
Conclusion
As
the literature suggests, awareness of the symptoms, management and prevention
of burnout are critical steps in protecting a helping professional’s
well-being. My self-care plan is a
reflection of my developing self-awareness of the person God created me to be.
It is my hope that as I learn to accept my limits and embrace self-care, I will
be better suited to reflect the character of God to my clients and respond to His
call in my life. Inevitably, when a helping
professionals models their own self-care and boundaries, they liberate their
clients to do the same. Scripture
states, “I praise you because I am fearfully and wonderfully made; your works
are wonderful, I know that full well” (Psalm 139:14, New International
Version). As I embrace this truth, I
will respond to God with thanks and praise, by preserving the helping
professional he designed me to be, through acts of self-care.
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I feel like I have actually truly followed my burnout prevention plan. But, I think the one area that I am learning more now that I am in the field, is that as much as I can try to prevent burnout, my efforts are futile if I am not letting God carry the load and burden. He is the one who meets me in those moments where I don't know where the energy will come from. He is the one who motivates me with His love and His eyes for others. I cannot prevent burnout on my own, but luckily I have a God who gently walks with me and carries the load that I can't carry alone.
