408 - Ethics - Self Care And Burnout

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Ethics, Burnout
& Self Care
in Human Service Professions

Dr. Dawn-Elise Snipes, PhD, LPC-MHSP
Counselor Toolbox Podcast
Objectives
 Identify signs and causes of burnout
 Explore techniques for burnout prevention

Is Self Care an Ethical Issue
 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 a rapid and dramatic loss of prefrontal cognitive abilities.
 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 should not allow personal problems, psychosocial distress, or mental health difficulties to interfere with their professional judgment, performance, or responsibilities to clients
 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)
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