Burnout and compassion fatigue An area receiving increasing attention is that of burnout and compassion fatigue. The consequences of burnout and compassion fatigue (or any other form of professional impairment) include the risk of malpractice action. Resulting from the effects of day-to-day annoyances, overburdened workloads, crises, and other stressors in the workplace, burnout and compassion fatigue can be serious and may be considered similar in many ways to acute stress and post- traumatic stress disorder. Burnout According to Maslach and Leiter (2016), burnout is “a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job.” This syndrome is characterized by “overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment.” Burnout occurs when gradual exposure to job strain leads to an erosion of idealism with little hope of resolving a situation. In other words, when mental health practitioners experience burnout: ● Their coping skills are weakened. ● They are emotionally and physically drained. ● They feel that what they do does not matter anymore. ● They feel a loss of control. ● They are overwhelmed. Burnout manifests as “physical and emotional exhaustion,” “cynicism and detachment,” and “feelings of ineffectiveness and lack of accomplishment” (Carter, 2013). Within these overall symptoms are feelings of apathy and detachment, which are disastrous for anyone in a helping profession and for his or her clients. According to the Mayo Clinic (2018), causes of job burnout include: ● Lack of control : Being left out of decision making that directly affects the individual’s schedule or workload, for example. ● Unclear job expectations : Feeling unclear about what is expected or one’s degree of authority. ● Dysfunctional workplace dynamics : Bullying and micromanagement or feeling undermined by colleagues. ● Extremes of activity : Encountering monotony or chaos. ● Lack of social support : Feeling isolated at work and at home. ● Work-life imbalance : Too much time spent working and not enough enjoying other aspects of life. The Mayo Clinic puts working in a helping profession in a list of risk factors for job burnout. Other risk factors are: ● Identifying so strongly with work as to create a work-life imbalance. ● Having a high workload. ● Trying to be “everything to everyone.” ● Feeling of having little or no control over the work. ● Monotony. They recommend evaluating one’s options by discussing specific concerns with one’s supervisor and setting realistic goals, seeking support, being sure to get enough sleep, and practicing such activities as yoga or mindfulness. Burnout and its attendant symptoms are relevant to the ethics of helping professions. According to Bray (2018), counselors who fail to realize that they are suffering from burnout are “playing with fire.” When they are “detached Dealing with burnout and compassion fatigue A professional mental health practitioner can take steps to increase her or his ability to cope and achieve balance in life. Maintaining a healthy lifestyle balance and recognizing the signs of burnout and compassion fatigue are important.
from their work and not taking steps to address burnout (or missing its indicators) [they] are entering a danger zone rife with ethical pitfalls.” Bray recounts the warnings of certified counselor Monica Band, who cautions that exhaustion can lead to indifference and cynicism, possibly leading to the blurring of practitioner-client boundaries, incompetent decision making, and an inability to build rapport. Bray reminds helping professionals that “the prevention of burnout – and the commitment to seek help if it occurs – is both a best practice and an ethical mandate.” Compassion fatigue A newer definition of worker fatigue was introduced late in the last century by social researchers who studied workers who helped trauma survivors. This type of worker fatigue became known as compassion fatigue, or secondary traumatic stress (STS). Burnout is gradually acquired over time and recovery can be somewhat gradual. Compassion fatigue surfaces rapidly and diminishes more quickly. Both conditions can share symptoms such as emotional exhaustion, sleep disturbance, or irritability. According to Cocker and Joss (2016), compassion fatigue is a kind of vicarious traumatization: Characterized by exhaustion, anger and irritability, negative coping behaviours including alcohol and drug abuse, reduced ability to feel sympathy and empathy, a diminished sense of enjoyment or satisfaction with work, increased absenteeism, and an impaired ability to make decisions and care for patients and/or clients. Compassion fatigue shares many symptoms with posttraumatic stress disorder, and another name for compassion fatigue is secondary stress disorder (Administration for Children and Families, n.d.). Symptoms of compassion fatigue include: ● Feelings of isolation. ● Anxiety. ● Dissociation.
● Physical ailments. ● Sleep disturbances. Among the cognitive symptoms are: ● Lowered concentration. ● Apathy. ● Rigid thinking. ● Perfectionism. ● Preoccupation with trauma.
Among the behavioral symptoms are hypervigilance and an elevated startle response. According to the Administration for Children and Families (n.d.), an impaired immune system can be a physical symptom of this condition. According to Harr and colleagues (2014, citing Forster, 2009), a contributor to compassion fatigue is the “moral stress caused by the various ethical and value conflicts social workers often encounter in practice.” Moral stress can result from situations such as being unable to provide adequate care because of a client’s inadequate health insurance or the urge to skip reporting child abuse for fear of causing more harm than good or the urge to give money to a destitute client (Fried, 2016). These scenarios can place the practitioner in ethical and legal jeopardy, as the wrong choice can lead to conflicts with ethical codes, state laws, and other rules.
The responsible mental health clinician will take action, which can range from a vacation break to a change in schedule or job duties. Practitioners also need to be aware, not only of the signs and symptoms of burnout and
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