Motivation and emotion/Book/2023/Burnout

Burnout:
What is burnout and how can it be managed and prevented?

Multimedia presentation (3 min)

Overview

Figure 1. A worker suffers from burnout at their work.

Stress is an everyday occurrence that we all certainly experience all the time. We're accustomed to stress being presented negatively, however a moderate amount of stress can serve as motivation. Optimal stress levels can energize people to meet their goals in life as well as helping them complete tasks more effectively.

However, when you experience ongoing and high levels of stress, it feels like you are being weighed down, or trapped, and enveloped by chronic exhaustion that is preventing you from moving forward with your goals and enjoy your life. This feeling permeates your work, study, and social relationships. The time passes by while the overwhelming stillness persists, and you are paralyzed by inaction or reduced cognitive function to make decisions or perform in your daily duties. These "red flags" could be the signs of burnout (see Figure 1).

Case study Amy is a dedicated 35-year-old social worker. She has an innate passion for making a positive impact on her community by helping vulnerable people. To look after her own mental well-being, Amy regularly goes for walks and connects with her friends. For the last 8 years, Amy has been working hard at a local hospital and enjoying being a social worker. However, over the last few months, Amy noticed a significant change in her mental state and attitude towards her workload including several symptoms: Persistent fatigue and ongoing elevated stress levels. She found it difficult to be compassionate when engaging with her clients She has observed increasing levels of detachment when listening to her client's stories. The overwhelmingness pervaded her mental and physical states leading Amy to significantly decrease performance at work which led to several complaints from some clients.

Focus questions: What is burnout? What factors trigger burnout? What are the consequences of burnout? How to manage the burnout symptoms? How to prevent burnout?

What is burnout?

Burnout is known as a psychological phenomenon, defined as the final state of excessive, chronic stress which causes the individuals mentally and physically exhausted (McCormack et al., 2018). Although the burnout concept is defined by numerous research as a "work-related mental-health impairment, ongoing personal and environmental stressors such as major health issue, family hardships, or other persistent adversity are also the reasons to induce burnout (Khammissa et al., 2022).

Occupational burnout is defined as a syndrome that evolves from chronic workplace stress that has not been successfully managed (World Health Organization, 2019). The negative effects of burnout extends beyond an individual's professional and personal life. The World Health Organization (2019) recognized burnout in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational exposure, and not a medical condition, and one that should not be used to describe stressful experienced in other areas of life.

Burnout is characterized by 3 dimensions:

• Exhaustion: having sense of extreme fatigue or energy draining
• Depersonalization: increasing emotional detachment from one's job, or sensing negativity and cynicism towards it
• Reducing personal accomplishment in professional role.

Types of burnout

Burnout syndrome does not occur as a similar pattern to everyone, it can manifest in 3 variations which are influenced by the level of dedication workers have towards their job:

• Overload Burnout (Frenetic): typical type of workers who intensely work until energy drained.
• Under-Challenge Burnout: opposite to the overload type, occurs when the worker is not stimulated by the job, leading to a lack of motivation to keep on the workload
• Neglect Burnout (Worn-out): the individual is not given enough guidance in workplace, causing them to feel hopeless, uncertain and frustrated (Montero-Marín et al., 2009).

Emotions similar/ correlate with burnout Stress: the physiological and emotional reactions to stressor factor (Lloyd et al, 2009). While burnout occurs at the end state of chronic stress, some significant stress can be acute and be beneficial at some point (such as eustress), . Depression: the outcome of traumas and negative life events that is distinct from burnout. It contains the element of poor self-efficacy that share characteristics with burnout concept of diminishing personal accomplishment (Bakker et al., 2000) Anxiety: acts as a protective factor against threatening circumstances, that is correlated strongly with burnout features such as emotional exhaustion and cynicism (Koutsimani et al., 2019). Compassion Fatigue: "the cost of caring", when caring for others caused the feelings of helplessness and frustration, usually in professional role that prioritizing in taking care of clients (eg. nurses) (Gonzalez et al., 2019).

Factors that induce and develop burnout

Jobs demands-resources model

The job demands-resources model proposes the cause of the individual's health and well-being depends on 2 factors: job demands and job resources.

• Job demands (negative): consist job factors (eg. workload, time pressure, emotional labor etc.) entail individuals sustained physical or mental ability which cause energy reduction, severe long-term mental illness, and lower the individuals' performance (Adil & Baia, 2018). If the individuals fail in efficiently managing their workload within the required timeline together with a lack of work-related resources accessible, they highly suffer from burnout. especially emotional exhaustion (Edú-Valsania et al, 2022).
• Job resources (positive): in contrast, job resources encompass the physical, social, organizational or psychological facets of work that are either: 1) effective in achieving work goals, 2) lessen job demands and their psychological and physical burdens, 3) foster individual growth, learning, and development (Adi; & Baia, 2018). These factors including organizational support (supervisor's feedback, skills development, autonomy, management support, etc.) and personal resources (resilience, comprehensive recovery process, etc.) (McCormack et al., 2018).

This model holds the idea that higher job demands and low work resources potentially cause burnout among individuals. Job demands are merely the job requirements and will turn into stressors when the individual has to put more effort into the job progress but are unsuccessful in handling high job demands. while job resources minimize the likelihood of depersonalization as a coping strategy (Edú-Valsania et al, 2022).

Social cognitive theory

Figure 2. The development of burnout through the SCT.

Social cognitive theory (SCT) maintains the significant role to individual variables such as self-confidence, self-efficacy and self-concept as key contributors to the development of burnout (Edú-Valsania et al, 2022), thus according to SCT, burnout is escalated when the individuals faces crises related to their professional role, they raise doubts about their own effectiveness or of their group in achieving the final goals.

The individuals highly feel doubt on their efficacy and confidence, including past failures, a lack of role model who successfully overcame similar challenges, limited reinforcement for their work, lack of feedback on completed tasks or excessive negative criticism and work related difficulties. As a result, these inefficacy expectations can diminish the job satisfaction, long-term emotional exhaustion, and as a coping mechanism, cynicism or depersonalization arises (see Figure 2).

Personality traits

Personality plays a vital role in the way individuals perceive their work environment, and, thus, how they cope with job demands and resources.

Type A personality

This personality represents individuals who are highly competitive, aggressive, impatient, impulsive can highly suffer from burnout, as this pattern is strongly associated with the depersonalization and emotional exhaustion dimensions of burnout (Edú-Valsania et al, 2022; Khammissa et al., 2022)

Neuroticism

This trait is characterized by emotions including low self-esteem, anxiety, pessimistic attitude, etc. Individuals with this personality will experience high levels of emotional exhaustion and depersonalization, since they will respond to a change within their work in a way that cause them emotionally drained or feel detached from the job (Maylor, 2018).

External locus of control

The higher the external locus of control (ELoC), the more likely burnout is to develop. People with this characteristics tend to believe that events happening around them are due to external factors such as luck, destiny, or by the decisions of others which indicates that they are not responsible for their actions or behaviors (Alfuqaha et al., 2021)

The risk of burnout

Figure 3. Leaving burnout unrecognized and untreated can cause various risk to the individual.

Burnout occurs when the symptoms are remained unnoticed for a long period of time, and this can lead to many dangerous consequences that affect the individual's physical health, mental well-being, physiological function, and behavioral responses (Gustafsson et al., 2018). Three stages of burnout are found to be occurred from when the distress started to arise to burnout syndrome escalated, leaving the individual struggling in their personal and professional life (need to rephrase) (see Figure 3).

Table. Three stages of burnout and its consequences (Hozo et al., 2015)

Stage	Occurrence of symptoms in each stage
Stage 1: Initial stage, tension stress occurs	Psychological reaction: constant irritability, anxiety, focus issues, memory lapse Physiological reaction: insomnia, teeth grinding during sleep, gastrointestinal issues, high blood pressure episodes, etc. This phase is not usually recognized as the start of burnout. It is often unnoticed due to the complicate job requirement, environment factors, etc. Experiencing at least 2 symptoms can be considered as the first stage of exposure to stress
Stage 2: Stress response by conserving energy reactively	Behavioral reactions: late to work, delay remaining tasks, unwilling to accept new tasks, excessive and frequent alcohol/ smoking/ cigarette consumption, attempt to solve issues with drugs and psychoactive substances Functional reactions: reduced sexual desire, fatigue, isolate self from friends and family, increase cynicism and bitterness Characterized by the self-demand to stay calm, retreat and conserve energy as much as possible Changes in behaviors and functioning are noticed by the environment yet the symptoms are ignored, which can lead to stage 3. At least 2 symptoms present indicated the burnout existence in second phase.
Stage 3: Burnout	Individuals begin to feel something is wrong Health-related problems: seeing work as a load, job dissatisfaction, chronic depression, prolonged mental fatigue, desire to withdraw from society, family, friends, persistent suicidal afterthoughts Physical health symptoms: chronic stomach and intestinal disorders, prolonged physical exhaustion, long-term headaches or migraines Any emergence of 2 out of these symptoms is a clear sign of third stage of burnout.

Test yourself Take a few minute to test yourself with this burnout quiz: https://psychcentral.com/quizzes/burnout-quiz Disclaimer: The quiz can help you identify frequent signs of burnout, it is not meant to advise you on how to manage burnout yet is advisable to ask for help from professional healthcare if you are experiencing this syndrome.

How to manage burnout?

According to Kaschka et al. (2011), the treatment for burnout should concentrated on three R:

• Relief from stressors,
• Recovery via relaxation and exercise
• Reconnecting with the real world by letting go of external ideals of perfection

Cognitive behavioral therapy (CBT)

CBT helps the individual tackling on their intrusive, negative thoughts and emotional processes that related to their working, studying stressors, as how the physical and mental maladaptive replies to these thinking patterns.

Prevention for burnout

As we have seen the aforementioned risk of burnout and its management, it is crucial to consider the prevention of its onset for the Supervision and team support as protective factors

https://www.tandfonline.com/doi/pdf/10.1080/09638230020023642?casa_token=jc9D-hOLu-EAAAAA:fdyhveOXfdBkyma_LAWJY54CSeGWW9IehZCFxRFp9Tg73bz63a-YZgtPAU6itZyBjKm9hiA-cqU talking about social workers sense the support from team to prevent burnout

Dealing with burnout in personal life

If burnout syndrome is getting severe, it is recommended to

Case studies

• Case studies describe real-world examples of concepts in action.
• Case studies can be real or fictional.
• A case study could be split into multiple sections throughout a chapter to illustrate different theories or stages.
• It is often helpful to present case studies using feature boxes.

Feature boxes

• Important content can be highlighted in a feature box. But don't overuse feature boxes, otherwise they lose their effect. There are several ways of creating boxes. Recommended: Pretty boxes).
• Consider using feature boxes for:
  • Focus questions
  • Case studies or examples
  • Quiz questions
  • Take-home messages

Box

Take-home messages "Almost everything will work if you unplug it for a few minutes... including you" - Anne Lamott "Resting is not laziness, it's medicine" - Glennon Doyle

Quizzes

• Using one or two review questions per major section is usually better than a long quiz at the end
• Quiz conceptual understanding, rather than trivia
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• Different types of quiz questions are possible; see Quiz

Example simple quiz questions. Choose your answers and click "Submit":

1 Quizzes are an interactive learning feature:

	True
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2 Long quizzes are a good idea:

	True
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Conclusion

• The Conclusion is arguably the most important section
• The Conclusion is typically 150 to 330 words
• What are the take-home messages likely to be?
• It should be possible for someone to only read the Overview and the Conclusion and still get a good idea of the problem and what is known based on psychological science

Suggestions for this section: What is the answer to the sub-title question based on psychological theory and research? What are the answers to the focus questions? What are the practical, take-home messages?

See also

• Burnout (Book chapter, 2013)

• Burnout (Book chapter, 2022)

• Cognitive behavioural therapy (Wikipedia)

• Occupational burnout (Wikipedia)

Suggestions for this section: Present in alphabetical order Use sentence casing Include the source in parentheses

References

Adil, M. S., & Baig, M. (2018). Impact of job demands-resources model on burnout and employee's well-being: Evidence from the pharmaceutical organisations of Karachi. IIMB management review, 30(2), 119–133. https://doi.org/10.1016/j.iimb.2018.01.004

Alfuqaha, O. A., Al-Olaimat, Y., Abdelfattah, A. S., Jarrar, R. J., Almudallal, B. M., & Abu ajamieh, Z. I. (2021). Existential vacuum and external locus of control as predictors of burnout among nurses. Nursing Reports, 11(3), 559. https://doi.org/10.3390/nursrep11030053

Bakker, A. B., Schaufeli, W. B., Demerouti, E., Janssen, P. P., Van Der Hulst, R., & Brouwer, J. (2000). Using equity theory to examine the difference between burnout and depression. https://doi.org/10.1080/10615800008549265

Demerouti, E., Bakker, A. B., Peeters, M. C., & Breevaart, K. (2021). New directions in burnout research. European Journal of Work and Organizational Psychology, 30(5), 686–691. https://doi.org/10.1080/1359432X.2021.1979962

Edú-Valsania, S., Laguía, A., & Moriano, J. A. (2022). Burnout: A review of theory and measurement. International journal of environmental research and public health, 19(3), 1780. https://doi.org/10.3390/ijerph19031780

Gustafsson, H., Madigan, D. J., & Lundkvist, E. (2018). Burnout in athletes. Handbuch stressregulation und sport, 493. http://dx.doi.org/10.1007/978-3-662-49322-9_24

Hozo, E. R., Sucic, G., & Zaja, I. (2015). Burnout syndrome among educators in pre-school institutions. Materia socio-medica, 27(6), 399. https://doi.org/10.5455%2Fmsm.2015.27.399–403

Khammissa, R. A., Nemutandani, S., Feller, G., Lemmer, J., & Feller, L. (2022). Burnout phenomenon: neurophysiological factors, clinical features, and aspects of management. Journal of International Medical Research, 50(9). https://doi.org/10.1177/03000605221106428

Koutsimani, P., Montgomery, A., & Georganta, K. (2019). The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Frontiers in psychology, 10, 284. https://doi.org/10.3389/fpsyg.2019.00284

Lloyd, C., King, R., & Chenoweth, L. (2002). Social work, stress and burnout: A review. Journal of mental health, 11(3), 255–265. https://doi.org/10.1080/09638230020023642

Maylor, S. A. (2018). The relationship between big five personality traits and burnout: A study among correctional personnel (Doctoral dissertation, Walden University).

McCormack, H. M., MacIntyre, T. E., O'Shea, D., Herring, M. P., & Campbell, M. J. (2018). The prevalence and cause (s) of burnout among applied psychologists: A systematic review. Frontiers in psychology, 9, 1897. https://doi.org/10.3389%2Ffpsyg.2018.01897

Montero-Marín, J., García-Campayo, J., Mera, D. M., & Del Hoyo, Y. L. (2009). A new definition of burnout syndrome based on Farber's proposal. Journal of occupational medicine and toxicology, 4(1), 1–17. https://doi.org/10.1186/1745-6673-4-31

Pines, A. M., & Keinan, G. (2005). Stress and burnout: The significant difference. Personality and individual differences, 39(3), 625–635. https://doi.org/10.1016/j.paid.2005.02.009

World Health Organization. (2019). Burn-out an "occupational phenomenon": International Classification of Diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

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External links

Provide up to 6 external links to relevant resources such as presentations, news articles, and professional sites. Use sentence casing. For example:

• A guide to burnout (healthline.com)
• Burn out to brilliance. Recovery from chronic fatigue (TEDx Talk)

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