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ACQ Volume 11, Number 3 2009 177
Mental health
your stress is critical, along with employing coping strategies.
Positive workplace cultures allow optimal functioning. Clarification
of your role(s) and attendance at professional development
courses allow for new learning and support. Engage in one
or several of the following on a regular basis, particularly if
you are a clinician working in isolation or mental health:
debriefing, individual supervision, group supervision, peer
support, mentoring (regardless of your level of expertise).
Summary
Burnout is a reality for clinicians, but preventable by utilising
evidence-based skills and strategies. Workplaces are governed
by variables so often out of our control. With a greater under-
standing of burnout, we can empower ourselves, staff, and
colleagues to seek reassurance and support. Consequently,
we can engage with our clients, and the various roles we
undertake, feeling worthwhile and effective as clinicians.
References
Ben-Zur, H. (2009). Coping styles and affect. International
Journal of Stress Management, 16(2), 87–101.
Maslach, C., Jackson, S.E., & Leiter, M.P. (1996). Maslach
burnout inventory manual (3rd ed.). Palo Alto, CA: Consulting
Psychologists Press.
Michie, S., & Williams, S. (2003). Reducing work related
psychological ill health and sickness absence: A systematic
literature review. Occupational and Environmental Medicine,
60, 3–9.
Miller, S.D., Hubble, M and Duncan, B. (2008). Supershrinks:
What is the secret of their success? Psychotherapy in
Australia, 14(4), 14–22.
Ortqvist, D., & Wincent, J. (2009). Prominent
consequences of role stress: A meta-analytic review.
International Journal of Stress Management, 13(4), 399–422.
Peterson, U., Demerouti, E., Bergstrom, G., Asberg, M.,
& Nygren, A. (2008). Work characteristics and sickness
absence in burnout and non-burnout groups: A study of
Swedish health care workers. International Journal of Stress
Management, 15(2), 153–172.
Sauter, S.L., Brightwell, W.S., Colligan, M.J., Hurrell, J.,
Katz, T.M., Legrande, D.E., et al., (2002). The changing
organization of work and the safety and health of
working people. Cincinnati, OH: The National Institute for
Occupational Safety and Health.
Smith, M., Jaffe-Gill, E., Segal, J., & Segal, M. (2008).
Preventing burnout: Signs, symptoms, causes and coping
strategies. Retrieved 23 July 2009 from
mental/burnout_signs_symptoms.htm
“Who provides the therapy is a much more important
determinant of success than what treatment approach
is provided” (Miller, Hubble, & Duncan, 2008, p. 15).
High job stress and burnout among clinicians
has become a topic of interest due to its financial impact on
communities. Health and community services have undergone
changes to health-care delivery models, staff reductions and
longer working hours (Sauter et al., 2002). This is parallel to
high stress levels which directly affect health practitioners
(Michie & Williams, 2003). Stress is a well-established
phenomenon. We know that role-stress (conflict or ambiguity
of role) (Ortqvist & Wincent, 2009) and coping styles (Ben-Zur,
2009) are determinants of workplace stress. However, little
attention has been given to the notion of burnout.
What is burnout?
Burnout is a work-related stress, first observed in human
service workers and health care sectors (Maslach, Jackson, &
Leiter, 1996) and now recognised in all occupational groups. It is
composed of three primary elements: (1) feelings of exhaustion
(physical, cognitive, and affective strain), (2) disengagement:
distancing from work, work objects (including clients,
computers) or work content (providing your service); this is
seen as a way of distancing an individual from work, and (3)
reduced professional accomplishment or reduced professional
efficacy (Peterson et al., 2008). The causation for burnout is
multi-factorial including work, lifestyle and personality factors
which may overlap with mixed presentation.
Prevention of burnout
An inclusive approach to burnout is recommended. At the
individual level, adopting healthy eating, sleeping, and exercise
patterns are essential. Learning to understand and manage
Burnout in clinicians
Deborah Perrott
Factors contributing to burnout
Work-related factors Lifestyle causes Personality factors
Working in a high- Continuous work Perfectionist
pressured or chaotic tendencies
environment
Engaging in repetitive Poor sleep patterns Negative self-
work regimes evaluation and view
of others
Expectations of your Lack of leisure and A need for control
role are either beyond relaxation
attainable or unclear
A sense of lack of Poor relationships High achieving and
control with little with limited high expectations of
reward(s) supports self and others
Constant negative
feedback
Long hours of work
Lack of support/
supervision/professional
or personal development
Source: adapted from Smith, Jaffe-Gill, Segal, & Segal, 2008
Deborah Perrott is a speech pathologist and psychologist, and
is completing a PhD in linguistics at Monash University. She is a
psychologist in private practice and is currently the project officer
for Speech Pathology Australia for the review of the position paper
Speech Pathology in Child and Adolescent Mental Health Services.
Correspondence to:
Deborah Perrott
mobile: 0405 099 249
email:
Deborah Perrott