how to cope with stress and prevent the burn out syndrome

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Transcript how to cope with stress and prevent the burn out syndrome

Agnieszka Kalbarczyk
When aiding is tiring:
how to cope with stress
and to prevent burn out syndrome
in work with the unemployed and the
job-seekers
Workshop title inspired by
Jörg Fengler’s book
„For therapists, physicians and nurses,
teachers, advocates, priests…..
- Helfen macht mude” (1996)
Relative terms and phenomena:
oJob Stress
oJob Depression
oJob Strain
Amount of demands,
Opportunity to Control,
Social Support
Burn out – basic concept
The term „burn out” in professional discourse
1974 - dr Herbert J. Freudenberger,
an American psychiatrist
1980 - with G. Richelson - book „Burnout:
How to Beat the High Cost of Achievement”
1976 - Christina Maslach – article in „Human
Behavior”
Definition
„breakdown of the psychological defense
(that) workers use to adapt and cope
with intense job-related stressors”
Herbert J. Freudenberger
The Staff Burnout Syndrome in
Alternative Institutions (1974)
Active vs passive burning out:
• An active burning out
– caused by institutional aspects, external
events and too many demands
• A passive burning out
– internal reaction to those external
factors, as a result of too little resilience
(some personality traits, lack of
distance toward oneself, beliefs)
What does it look like?
„Workers are conceding their time. They
are working longer hours. They are
taking work home, often continuing after
hours on computer equipment they have
purchased themselves.
They are devoting more time to tasks that
are not personally rewarding,
that is, that are not enjoyable and
psychologically
do not further their careers.”
Maslach & Leiter
The Truth About Burnout (1997)
So as a consequence...
„three things happen:
1. you become chronically exhausted;
2. you become cynical and detached
from your work;
3. and you feel increasingly ineffective
on the job.”
Maslach & Leiter
The Truth About Burnout (1997)
Burnout process
• begins from demands, pressure and amount
of work exceeding one’s ability
• trough the individual worker’s ineffective
attempts to manage
• the first burn out symptoms of an individual
whose coping capacity becomes insufficient
to the amount of stress one experiences
• but at the end one’s clients suffer as well,
because one is no longer able to give the
best to the clients one serves.
•
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1.
2.
3.
The nature of burnout
Occurs gradually
Processual - different number of stages
(from 3 to 12)
Lasting too long becomes chronic
Wrong coping strategies, when adopted,
make it deeper
Circle of
perceiving one’s job as a stressful
applying destructive coping strategies
stabilizing or even deepening of burnout
Maslach’s burn out concept
Psychological syndrome of
• emotional exhaustion – caused by emotional
overload
• sense of low personal achievement – feeling of
low competence and lack of success at work
• depersonalization expressed in negative
attitudes and reaction to recipients of one’s
service
that can concern
- some people,
- working in some professions
- in some special way…
Maslach Burnout Inventory (MBI) 1986
(together with Susan E. Jackson);
contains three general scales:
· of emotional exhaustion - assesses feelings
of being emotionally exhausted by one's
work
· of personal accomplishment - assesses
feelings of competence and achievement in
one's work
· of depersonalization - assesses an
unfeeling and impersonal response toward
recipients of one's service, care treatment,
or instruction
Burn out symptoms
differ among individuals dependant on
• individual physiological way of reacting
• one’s resources – cognitive, social,
material
• stage of burn out process
Different symptoms of burn out in
different professions – dependant on
the job specificity
(for example among medical staff: being
insincere, lying about patients chance of
recovery, black humour especially about
dying)
General burn out symptoms
Negative emotions
• feelings of frustration, anxiety,
• being angry, depressed, dissatisfied
• become chronic emotional fatigue
General burn out symptoms
Psychosomatic or even health problems:
• Chronic fatigue
• Probable increased vulnerability to illness:
colds,
headaches
backaches
• Frequent or prolonged illness
• Sleeping problems until insomnia
General burn out symptoms
Interpersonal problems
• increasing communication difficulty with
co-workers, friends and family members;
• family stress – less time spent together
• tendency to withdraw and neglect other
relationships – very probable among
„helping" professionals;
General burn out symptoms
Declining job performance:
- quality and quantity of your work
decrease
- rather subjective than objective
General burn out symptoms
Feelings of meaninglessness
• especially probable in the case of those,
who at the beginning were very
enthusiastic and dedicated to their job
• the enthusiasm is replaced by cynicism
Style of destructive coping
Substance abuse (so treated usually as
symptoms):
• more alcohol and drugs,
• poor eating, more or less than before,
• drinking more coffee
• if smoking - more cigarettes
Developing or worsening of bad habits instead of giving help and relief,
diminishes one’s physical resilience.
Style of destructive coping
Reacting emotionally
• in extreme, exaggerated ways
• not adequately to the situation – strong
reaction to minor problems
• misplaced
Getting away physically but not mentally
Style of destructive coping
• withdrawal from or even breakdown of
meaningful and important relationships and
friendships
• withdrawal from pleasant activities –
because of tiredness and lack of motivation
• working more but less effectively and
worse
Instead of helping, diminishes one’s
psychological resilience.
Burn out as an individual problem
„The conventional wisdom is that burnout
is primarily a problem of the individual.
That is, people burn out because of flaws
in their characters, behavior, or
productivity.
According to this perspective, people are
the problem, and the solution is to
change them or get rid of them …”
Maslach & Leiter
The Truth About Burnout (1997)
Proposals of reducing burn out at the
individual level:
Taking care of one-self:
practicing favorite (in the past) activities –
even without motivation
body exercise
relaxing - rest, relaxation and sleep
personal, individual methods of
improving one’s mood
Why just the so called „helping
professions” are especially vulnerable to
a job burn out?
Are they special people or special
professions?
Both.
Maslach conceptualizes a burn out as a
process which combines the key
relationships between personal, social,
and contextual variables.
Special people –
An individual risk factors
• Primary personality predispositions as
factors of burn out risk - Type A of
personality
• Some personal needs - of being
- outstanding
- special or
- popular and liked by everyone
An individual risk factors
• Some elements of one’s self image
I should always manage
I am indispensable
I have to do this or everything will fall apart
I should do everything by myself
I must finish jobs with accuracy and
perfection
An individual risk factors
• Some primary attitudes towards the job
and clients:
Being extraordinarily enthusiastic, optimistic,
devoted and ……. unrealistic
Putting the focus on personal adequacy
instead of organizational roles and
responsibilities
An individual risk factors
• Personal beliefs producing burn out
syndrome:
I am not allowed to neglect somebody
asking for help
I am a person with a mission
I feel personally responsible for my
clients’ progress
Success of clients’ carriers depends on my
efforts
Counsellors’ attitudes towards relationship with
the unemployed client
• Understanding help as reaching
concrete result – „objectively good”
• Projecting the counsellor's value system
on the client
• Not respecting the client as an
independent person with free will
• Taking responsibilities for the client
Unemployed clients’ attitudes towards
relationship with counsellors
Some clients don’t understand
• that
- to succeed in their carrier they must decide
by themselves;
- they need time to reach success in their
carrier;
- real help needs time, their involvement and
activity.
and demand to be helped directly and
immediately.
Some advice for counsellors – to take as soon
and as often as possible
1. Be aware of your own expectations and
assumptions
2. Learn to set limits and learn to say NO –
negotiate new/ temporary job schedule
3. Don’t hesitate to ask for help: be more willing
to ask for help and share ideas with someone
else
4. Recognize priorities and delegate tasks
5. Appreciate your co-operators’ competence:
use their knowledge and experience
Some advice for counsellors – to take as
soon and as often as possible
7. Don’t bear somebody else’s stress
8. Notice positive side of your job and
even smaller successes in job
9. Recognize when you need help in
coping with yourself
10.……?
Burn out as an organizational problem
„burnout is not a problem of the people
themselves
but of the social environment in which
people work ...”
Maslach & Leiter
The Truth About Burnout (1997)
An institutional risk factors
„..burnout in individual workers says more
about the conditions of their job than it
does about them.
Contrary to popular opinion, it's not the
individual but the organization that
needs to change …”
Maslach & Leiter
The Truth About Burnout (1997)
What is so special
about vocational counsellors work?
• People with problems as typical recipients
of service – unemployed seeking for a job
• Frequent contact with their negative
emotions, behavior
• Demand of being in a psychological contact
with clients as they are
• Persistent contact with clients burned out
because of unemployment
What is so special
about vocational counsellors work?
• Help and assistance as a basic form of a
job
• Expected behavior - requiring the control
and use of one’s own body, verbal and non
verbal expression in an „appropriate way” to meet goals oriented to client needs
• Goals of clients - being employed - rarely
reached
Burn out as a result of a relationship
between job and a person – result of
mismatching
„Burnout is the index of the dislocation
between
what people are and
what they have to do.”
Maslach & Leiter
The Truth About Burnout (1997)
Primary conditions of burn out
• on the stage of selection for the counsellor’s
job: being
- badly educated
- too optimistic about the counsellor’s job
- not prepared for job conditions
- not prepared for job difficulties and troubles
- not informed about real job conditions or
informed inadequately
• at work
- not being trained further
- being underpaid
At organizational level
„Contrary to popular opinion, it's not the
individual but the organization that
needs to change …”
Maslach & Leiter
The Truth About Burnout (1997)
The My Relationship with Work Test
(by Maslach) evaluates :
• Workload:
working alone or with others, amount of work to
be completed, deadlines
• Control:
authority, decision making, professional judgment
• Reward:
salary, benefits, perks, recognition of achievement
• Community:
organizational communication, employee
interaction
My Relationship with Work Test
• Fairness:
diversity, cultural sensitivity, disciplinary
procedures, management's treatment of staff
• Values:
management's commitment to the
organization's values and mission, justice,
honesty
Leiter & Maslach (2005)
Banishing Burnout: Six Strategies for
Improving Your Relationship with Work
What is the relation of „helping professionals”
i.e.
social workers, medical staff or vocational
counsellors
to their job?
Some general features of bad job
description
overloaded work schedule
no opportunity to control
treatment of workers perceived as unfair
or unjust
weakness of community
conflict of values
Research has demonstrated that lack of
control is extremely stressful
Some general features of good job
description
participation in the setting of goals
clarity of goals, demands, instructions,
feedback on progress, meeting
deadlines
acknowledgement for job performance
Basic ways and methods of coping with
and prevention of job burning
Different proposals for diminishing job burn out
• more self-management,
• stress control,
• building social support network and using it,
• developing skills:
professional as well as social and coping skills
• job adapting,
• changing jobs,
• neutral thoughtfulness – „detached
concern” – keeping emotional distance but
behavioral involvement
Change of thinking
Do you want to be helping?
If you appreciate help as a virtue, let other
people be helpful for you
If you forget, that you are a human being,
consider:
you use your own body and mind to help
others, so you are kind of helping tools
– you take care of your machines and
domestic tools, don’t you?
To cope or to prevent?
Programs were quite successful for less
burned out participants.
Those with stronger symptoms of burn out
syndrome didn’t take as big an
advantage.
Especially difficult to reduce and change is
depersonalization – core dimension of
burn out at the counsellor’s job
Conclusions:
• It is absolutely necessary to prevent burn
out syndrome, before it occurs,
• It is too difficult to cure or at least
reduce it.