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#burnout #stressmanagement #cognitivebehavioral #ethics
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Ethics, Burnout & Self Care
Dr. Dawn-Elise Snipes, PhD, LPC-MHSP
Objectives
Identify signs and causes of burnout
Explore techniques for burnout prevention
Burnout is associated with suboptimal care and reduced patient safety. 1, 3, 4
High demands are associated with greater risk of burnout, regardless of level of other work supports. 2
Suboptimal care can negatively impact the public’s view of the profession and deter people from seeking treatment
26% of MAT counselors in one study reported burnout
Depersonalization is characterized by loss of empathy and
Your Brain on Stress
Even mild acute uncontrollable stress can cause
Prolonged stress exposure Anatomical changes in prefrontal nerve cells and amygdala enlargement
Focus, Attention
Self Control of Behavior and Speech
Plan and Organize
Perspective Taking
Cognitive Flexibility
Medical and other Decision Making
Ability to Defer Gratification
Estimating Time
Working Memory
Ethics
In 1996, the National Association of Social Workers updated the NASW Code of Ethics to cover issues of professional impairment (section 4.05).
Social workers who experience these problems should “immediately seek consultation and take appropriate remedial action” by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others”
Social workers with direct knowledge of another social worker’s impairment should, when feasible, consult with and assist the social worker in taking remedial action
Signs of Burnout
Physical and emotional exhaustion
Insomnia
Impaired concentration or memory
Physical symptoms (heart palpitations, HBP)
Appetite changes
Increased illness
Increases in depression and/or anxiety
Absence of positive emotions
Cynicism and disillusionment
Lack of patience
Lack of resilience (everything is a crisis)
Relationship deterioration
Substance abuse
Forgoing important personal activities
Malasch Burnout Inventory
The Maslach Burnout Inventory (MBI) is the most commonly used self assessment tool for burnout
The MBI explores three components: Exhaustion, depersonalization and personal achievement.
MBI pdf C. Maslach, S.E. Jackson, M.P. Leiter (Eds.), Maslach Burnout Inventory manual (3rd ed.), Consulting Psychologists Press (1996)
Abbreviated MBI from SAMHSA
Causes of Burnout
Excessive workload
Emotionally draining work
Lack of support
Lack of resources
Lack of rewards
Lack of a sense of control/say
Unclear or everchanging requirements
Severe consequences of mistakes
Work/life imbalance
Perfectionistic tendencies; nothing is ever good enough
Pessimistic view of yourself and the world
The need to be in control; reluctance to delegate to others
High-achieving, Type A personality
Poor work/person fit
Value conflicts
Lack of debriefing (See Restoring Sanctuary by Sandra L. Bloom)
Unpleasant environment
Cultural differences
Efficiency Audit
Morale Audit
Individual Interventions
Conduct periodic self-assessments
Engage in pleasurable activities
Exercise
Take breaks during workday
Reduce isolation by maintaining regular supervision and network with colleagues
Describe why you got into the field and visualize that intention (collage, etc)—money, help, adrenaline, status/power
Use psychological flexibility
Cognitive restructuring
Identify the strengths and resources you do have
Practice mindfulness
Journal
Limit your contact with negative people
Connect with a cause or a community group that is personally meaningful to you
Interventions (GODIVA)
Put the PIECES Together
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