Worker well-being:the vocational perspective of

'burnout'

Carl Fitzpatrick

University of South Australia

Overview

• Introduction

• Rationale

• Theories

• Assessments - try it out yourself

• Examples of an OT burnout study

• Case study

• Check your understanding

Introduction

• My view point article…

• Why my choice of topic?

• Why ‘burnout’ specifically?

Topic Rationale

• Holistic care - increase your awareness of vocational issues

• Planning a clients’ return to previous roles -

or planning new roles

• Growing prevalence of occupational stress?

• Can it be called a primary health care issue?

• Personal relevance to everyone here...

Definitions and theories

• ‘to fall wear out, or become exhausted by making excessive demands on energy, strength or resources’ (Freudenbauer in Brown & Pragner 1992)

• ‘characterised by a emotional exhaustion, a sense of depersonalization towards clients and a reduced sense of personal accomplishment’ (Maslach in Brown & Pragner 1992)

Definitions and theories continued...

Burnout develops over four stages:

enthusiasm

stagnation

frustration

apathy

‘ from one stage to the next there is a progressive loss of idealism, energy and purpose’

(Eldelwich & Brodsky in Brown & Pragner 1992)

Effects of burnout

• physical exhaustion

• increase susceptibility to illness

• sleep disorders

• psychosomatic symptoms - ulcers,

headaches and back pain

• use and abuse of alcohol and drugs

• accident proness

Effects of burnout - psychological

• decreased self-esteem

• depression

• feelings of helplessness

• emotional exhaustion

• negative self-evaluation

Effects of burnout - organisations

•increased absenteeism

•decreased quality of work

•increased employee turnover

•low staff morale

•increased stress on co-workers

Factors in burnout

personality traits - individuals prone to ‘burnout’

•unassertive

•anxious

•having difficulty setting limits

•lacking self confidence

•requiring an excessive need for control

•having low self-esteem

(Maslach in Brown & Pragner, 1992)

•work environment traits

Factors in burnout

Work environment factors

• low pay and long working hours• lack of opportunity for career advancement• inadequate training• lack of support from supervisors• insufficient ‘time-outs’ away from clients• lack of employee input into decision making

Burnout assessment toolsMaslach Burnout Inventory (1981)

measures the frequency and intensity of job related burnout on three scales:

• emotional exhaustion

• personal accomplishment

• depersonalization

Work environment scale (Moos 1981)

measures 10 different dimensions of work environment characteristics

Burnout Survey• Take a copy of the sample ‘burnout’ survey• Share with your neighbor if you need to• As a reflective tool, and to gain an appreciation of the types of questions asked, circle your responses based on your current part-time job or last placement.• Discuss the results and the apparent validity of this questionnaire between yourselves

15-20 minutes

Occupational therapy ‘burnout’ studies

• Brown & Pragner (1992) surveyed 130 Canadian occupational therapists working in psychiatric hospitals to examine the prevalence of burnout and the factor relationships in burnout.

• Primary predictors of burnout were found to be: large case load sizes, high levels of work

pressure, large percentages of clients with schizophrenia and large amounts of overtime worked

Brown & Pragner (1992) continued...

Recommendations:

Corrective and preventative measures

• decrease case load size

• participation in a stress management program and assertiveness training

• building in ‘time-outs’ away from clients

• limiting overtime

• encouraging diversity in work activities

• providing incentives for work well done

Case study - Homer SimpsonPROFILE:

Homer is a 38 year old obese man living with wife and 3 children in own house. Homer works more than 12 hours a day, 6 days a week at the nuclear power plant monitoring work place safety. Homer believes that his job involves too much

responsibility for his level of training. Hence, Homer is experiencing occupational stress.

Case study questions

Q1:

Based on the theory provided earlier, what are Homer’s likely symptoms (emotional and physical) resultant of his occupational stress?

Profile continued...Homer can’t quite work out why he doesn’t enjoy his job anymore.

When he first started he couldn’t wait to arrive at work everyday.

He settled into his role and cruised for a while and but eventually became bored with his work. Homer has since passed the stage where he cares and now he just feels like he needs to ‘ride things out’.

Case study questions

Q2:

Based on the process of burnout described earlier, what are the four stages of burnout that Homer Simpson experienced?

What is the likely outcome if Homer doesn’t do anything about his situation soon?

Profile continued...

Homer feels devalued as an employee. He finds himself insulted, humiliated and harassed frequently by his boss Mr Burns. Unlike other employees at Homer’s work-site, he will not stand up for himself. Hence, he continues to have his self-esteem shattered.

Case study questions

Q3:

What are the likely factors contributing to Homer’s unhappy work position?

Q4:

What would be your recommendations for Homer in this situation?

That’s the end...But first some conclusions…

• knowledge of ‘burnout’ issues may be useful in terms of increasing personal awareness

• a supportive work environment is a variable in burnout so be considerate and supportive of your coworkers

• personal development is also a variable - be aware that you may need to increase your assertiveness

• ultimately it’s an individual effort -

all in the attitude?