Professional Ethics:Avoiding Burnout

Presented By

Chip Abernathy, LPC, MAC

Competence Is the Issue

Avoiding burnout and professionals’ self-care is Avoiding burnout and professionals’ self-care is often discussed in the area of professional often discussed in the area of professional ethicsethics

Competence to perform our work is the issueCompetence to perform our work is the issue

How well we take care of ourselves affects the How well we take care of ourselves affects the client who seeks our help client who seeks our help

Professionals

For the sake of consistency in this presentation, counselors will be the professionals noted in the examples given. However, any helping professional could be used in the examples, i.e. doctors, pharmacists, nurses, lawyers, etc.

Burnout Syndrome

Maslach and Jackson (1981) define burnout as a syndrome characterized by emotional

exhaustion, depersonalization, and reduced feelings of accomplishment that affects individuals in the helping professions

Emotional Exhaustion

Emotional exhaustion involves feelings of being emotionally drained by one’s job

Emotional Exhaustion – Patient PerceptionsWhat does emotional exhaustion look like or sound

like to patients? My counselor… Has mentioned changing careers Seems depressed Seems drained and fatigued Seems frustrated by his job Seems to be at the end of her rope

Depersonalization

Depersonalization involves the development of negative, cynical attitudes towards clients

Depersonalization – Patient PerceptionsWhat does depersonalization look like or sound

like to patients? My counselor… Doesn’t seem to care about me Seems to view patients negatively Blames me for my problems Cuts interactions short Doesn’t listen very closely to me

Reduced Personal Accomplishment

Reduced personal accomplishment is characterized by feelings of ineffectiveness in one’s professional role

Reduced Personal Accomplishment – Patient Perceptions What does reduced personal accomplishment look

like or sound like to patients? My counselor… Doesn’t seem very energetic Is tense during interactions Gets rattled easily by the problems I bring up Is sometimes sarcastic towards me Frowns, sighs, rolls his eyes at me Leans away from me and seems disinterested in

my problems

Expectations of the ProfessionalClients come to professionals with hope that Clients come to professionals with hope that

the the relationshiprelationship with the professional will help with the professional will help to make their lives betterto make their lives better

That is a reasonable expectationThat is a reasonable expectation

We are expected to be competent to do our jobWe are expected to be competent to do our job

Potential Consequences of BurnoutBurned out professionals provide ineffective

treatment

That ineffective treatment leads to High drop-out rates Lack of progress in treatment Legal and ethical liabilities Danger to health, safety and welfare of

clients

Burnout and Perception

Burnout affects how professionals view patients and themselves, and this affects how professionals interact with clients

Additionally, burnout affects how patients view professionals, view themselves, and view the therapeutic relationship

What Kind of Shape Are You In?Our ability to put forth the Our ability to put forth the energy, attentiveness, energy, attentiveness,

and best use of our skillsand best use of our skills towards helping a towards helping a client is largely determined by what kind of client is largely determined by what kind of shape we are in…shape we are in…

Physically Physically Mentally Mentally SpirituallySpiritually

We can reduce stress and enhance our We can reduce stress and enhance our effectiveness, both personally and effectiveness, both personally and professionally, by attending to all these life areas professionally, by attending to all these life areas

How Does Burnout Happen?

Helping professionals become burned out the same way people in other professions do…

We take on too much, We take on too much, We feel underappreciated, and We feel underappreciated, and We feel helpless to change thingsWe feel helpless to change things

We reach a state of mental exhaustion caused by We reach a state of mental exhaustion caused by the perception of being overwhelmedthe perception of being overwhelmed

Burnout is a reaction to stressBurnout is a reaction to stress

Warning Signs of Professional Burnout Some signs of burnout include…

Losing interest and meaning in your work Losing interest and meaning in your work

Distancing from others Distancing from others

Increasing irritability Increasing irritability

Reduced productivity Reduced productivity

Feeling trapped and unable to do anything about it Feeling trapped and unable to do anything about it

Cynicism, fatigue, feeling drainedCynicism, fatigue, feeling drained

Feeling “oppressed” by the system at workFeeling “oppressed” by the system at work

Job Burnout Symptoms Questions Are you more cynical,

critical and sarcastic at work?

Do you drag yourself into work and have trouble getting started once you arrive?

Are you less patient and more irritable with co-workers?

Are you using food, alcohol/other drugs, or compulsive behaviors to feel better or to not feel?

Have your sleep habits or appetite changed?

Job Burnout Symptoms Questions (Continued) Do you feel

insurmountable barriers at work?

Do you lack the energy to be productive?

Do you have a hard time laughing at yourself?

Do you have unexplained headaches, neck pain or lower back pain?

A ‘yes’ could indicate burnout - or a mental health issue such as depression which needs professional attention

What I Can Do

In order to avoid or to recover from burnout, weIn order to avoid or to recover from burnout, weneed to look at need to look at

what we what we can can do do rather than whatrather than what

we cannot we cannot do to deal with our problemsdo to deal with our problems

Burnout Prevention

Taking steps to prevent burnout is the best way to Taking steps to prevent burnout is the best way to avoid itavoid it

Practice good stress management on a daily Practice good stress management on a daily basisbasis

Know the warning signs for burnout Know the warning signs for burnout Have management strategies in place should Have management strategies in place should

warning signs appearwarning signs appear

Management Strategies for Burnout –Professional Area of Your LifeProfessional Area Consult with colleagues and have clinical or peer

supervision regularly Have a variety of therapeutic approaches Belong to a professional organization Stay current on ethical standards and changes

in laws

Management Strategies – Professional Area (Continued)

Avoid dual relationships Document well Have continuing education Seek therapy as needed

Management Strategies for Burnout –Personal Area of Your LifePersonal Area Be aware of how you are doing physically,

mentally and spiritually Make the effort to take care of yourself when

concerns arise Pay attention especially to learning sound stress

management skills and practice those skills

Taking Care of Myself –PhysicallySome ways that I can take care or myself

physically are to Eat a nutritious diet Exercise Get plenty of rest Drink enough water Have regular checkups with my doctors and my

dentist - follow their advice – and see other practitioners as needed

Taking Care of Myself – MentallyI can take care of my mental health by Making time for family and friends Expressing my thoughts, feelings and needs Taking vacations, honoring time off planned Having hobbies Making fun a priority Doing enjoyable things Being open to new learning So many other ways – name a few of your own

Taking Care of Myself –SpirituallySome ways I can enhance my spiritual health are

to Be flexible Be honest Be curious – remain teachable Practice spiritual principles, esp. love, kindness,

open-mindedness, willingness Practice prayer and meditation Help others

It All Works Together

Body, mind, and spirit all work together

When I am taking care of my body, my mind and my spirit, I am less likely to become burned out and more likely to be effective and competent as a professional

Growth

In his book The Road Less Traveled (p. 11)

M. Scott Peck, M.D. asserts that there is “no distinction between the process of achieving spiritual growth and achieving mental growth. They are one and the same.”

Stress Management

Learning and practicing sound stress management skills are key factors in preventing and recovering from burnout. Some tried and true stress management skills include…

Exercising regularly Meditation Conscious contact with a Higher Power Connecting with people I enjoy Massage Changing my thinking and attitude

Balance

Creating balance in life enhances burnout prevention and management. Create balance between…

Giving and receiving Attention to family and attention to work Involvement and detachment Awareness of power and awareness of

powerlessness The client’s needs and my needs Time spent with people and time spent alone

References

Keith-Speigel, P., & Koocher, G.P. Ethics in psychology: Professional standards and cases. New York: McGraw-Hill, 1985, p. 241

McCarthy, W.C. Negative aspects of therapy: Client perceptions of therapists’ social influence, burnout, and quality of care. Journal of Social Issues, Spring, 1999

Maslach, C.,& Jackson, S.E. The measurement of experienced burnout. Journal of Occupational Behavior, 2(2), 99-113, 1981

Mayo Foundation for Medical Education and Research. Job burnout: Understand symptoms and take action. www.mayoclinic.com

References

National Institutes of Health. Stress management. www.medlineplus.gov, updated 2-6-08

Peck, M.S. The road less traveled: A new psychology of love, traditional values, and spiritual growth. New York: Simon and Schuster, p. 1, 1978

Zur, O. Taking care of the caretaker: How to avoid psychotherapists’ burnout. www.zurinstitute.com