Professional Ethics: Avoiding Burnout

1. Professional Ethics:Avoiding Burnout Presented By Chip Abernathy, LPC, MAC

2. Competence Is the Issue Avoiding burnout and professionals’ self-care is often discussed in the area of professional ethics Competence to perform our work is the issue How well we take care of ourselves affects the client who seeks our help

3. 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.

4. 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

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

6. Emotional Exhaustion – Patient Perceptions What 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

7. Depersonalization Depersonalization involves the development of negative, cynical attitudes towards clients

8. Depersonalization – Patient Perceptions What 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

10. Reduced Personal Accomplishment Reduced personal accomplishment is characterized by feelings of ineffectiveness in one’s professional role

11. 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

12. Expectations of the Professional Clients come to professionals with hope that the relationship with the professional will help to make their lives better That is a reasonable expectation We are expected to be competent to do our job

13. Potential Consequences of Burnout Burned 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

14. 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

15. What Kind of Shape Are You In? Our ability to put forth the energy, attentiveness, and best use of our skills towards helping a client is largely determined by what kind of shape we are in… • Physically • Mentally • Spiritually We can reduce stress and enhance our effectiveness, both personally and professionally, by attending to all these life areas

16. How Does Burnout Happen? Helping professionals become burned out the same way people in other professions do… • We take on too much, • We feel underappreciated, and • We feel helpless to change things We reach a state of mental exhaustion caused by the perception of being overwhelmed Burnout is a reaction to stress

17. Warning Signs of Professional Burnout Some signs of burnout include… • Losing interest and meaning in your work • Distancing from others • Increasing irritability • Reduced productivity • Feeling trapped and unable to do anything about it • Cynicism, fatigue, feeling drained • Feeling “oppressed” by the system at work

18. 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

19. 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 Job Burnout Symptoms Questions (Continued)

20. What I Can Do In order to avoid or to recover from burnout, weneed to look at • what we can do • rather than what we cannotdo to deal with our problems

21. Burnout Prevention Taking steps to prevent burnout is the best way to avoid it • Practice good stress management on a daily basis • Know the warning signs for burnout • Have management strategies in place should warning signs appear

22. Management Strategies for Burnout –Professional Area of Your Life Professional 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

23. Management Strategies – Professional Area (Continued) • Avoid dual relationships • Document well • Have continuing education • Seek therapy as needed

24. Management Strategies for Burnout –Personal Area of Your Life Personal 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

25. Taking Care of Myself –Physically Some 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

26. Taking Care of Myself – Mentally I 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

27. Taking Care of Myself –Spiritually Some 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

28. 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

29. 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.”

30. 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

31. 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

32. 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

33. 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