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Keep the Vital Spark – burnout in lifeline services in the third sector
Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
Acknowledgements
This research was completed as one of the opportunities created by the Clore Social Leadership Programme which enables Fellows to explore third sector issues in depth during their fellowship. Paula Aldin Scott carried out fieldwork in Edinburgh’s third sector, focusing on services working with people with multiple and complex needs. Our thanks go to the third sector workers who gave up their time to complete a survey and to be interviewed. They had courage in revealing an area many of us in the third sector feel reluctant to expose: the emotional, physical and intellectual energy we put into our work, and what erodes this, which can help us all consider how we can remain resilient. However, the team here at Comas has taught me most about resilience. This year we worked through our transformation from a building site to a functioning hub of social activities and community support for people recovering from addiction, managed blips in short-term funding, tried new ideas relentlessly to explore what works, and remained steadfast in their commitment to helping people in recovery to overcome addiction, mental illness, physical health crises, financial need, family breakdown and repair. Their endurance instigated this research. Working with demanding, vulnerable people who have complex problems requires energy, and above all hope, that people’s lives can get better. And yet, workers providing this energy and hope are loyal to a small organisation which provides no luxuries: insecure funding, inelegant work environment, always making do, mending and giving more than their job description. Whilst we aim to continue to grow and provide more for our staff, the fact is, this work could be high burnout territory. But Comas is not alone in facing challenges. For all our staff throughout the third sector, who give so much energy, commitment and heart, this research can hopefully shine a positive light on their own needs in order that they can remain resilient.
Ruth Campbell Clore 2011 Social Fellow
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CEO, Comas
Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
Contents
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Introduction and recommendations
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Burnout, resilience and tipping point
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3
Factors affecting burnout – findings from this study
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The Work: The nature of the client group
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The approach to the work
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People:
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Gender
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Roles and time served
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Differences in characteristics of people experiencing burnout
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Individual responses to burnout
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The organisational context
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Preventing burnout
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Self-awareness and self-care
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Team
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Leadership
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Policy makers and commissioners
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Conclusion
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The study methodology
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References
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Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
1. Introduction and recommendations Burnout is not openly discussed in the third sector. This study explores an issue which many associate with shameful experiences of workers having ‘got something wrong’ in their relationship with beneficiaries – perhaps becoming ‘too emotionally involved’ – or of having some deficit in the qualities required to do difficult work with vulnerable people. Yet the best services which make the most impact on beneficiaries thrive on the vital spark within their workforce of passion, commitment and loyalty which helps them give their best. If we want this vital spark to endure, we have to become more open about burnout and more responsive to workers’ needs. The workers who contributed to this study – 48 by survey and 10 by in-depth interview – were candid in their experiences and clear in their motivation to share their views, to ‘encourage a culture where it can be talked about and it is recognised as something that does happen.’ Interview. All of the workers were involved in organisations working with people experiencing homelessness, addiction, mental illness and other issues making their client group vulnerable.
In calling for a more open attitude towards burnout and acceptance that, in our difficult work which requires emotional engagement, some level of burnout is likely, it is important to recognise that we can take steps to avoid, manage and repair burnout. Leading researchers on burnout (Kristensen et al, 2009) suggest that burnout is not necessarily ‘an unavoidable and negative process going from bad to worse’. It can be seen as a dynamic experience in which workers’ personal lives and working lives interact with our organisational cultures to shape the energy and commitment they can give to our work. This study explores what individuals working in the sector can do for themselves, as well as what leaders can do and what kinds of organisational systems can be effective, to prevent and respond well to burnout.
There are several dimensions prompting us to raise the profile of burnout and explore better practice in relation to burnout.
The first is a moral dimension. Several participants in this study pointed out that workers expected to show care and compassion for vulnerable beneficiaries should themselves expect to receive care and compassion from their employers. The front line in the third sector was seen as bearing the brunt of social welfare reforms and providing a ‘buffer’ between decision makers and the real impact of decisions on vulnerable people, which workers felt deserved greater recognition –
Ruth Campbell Clore 2011 Social Fellow
December 2012
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The second is a pragmatic dimension. Burnout costs money and creates further pressure. Staff absence and higher staff turnover stretch budgets to breaking point within the third sector so that teams which are already under-capacity are further burdened with carrying the work of colleagues who have burned out to the point of illness and absence. Shirom (2005) also suggests that burnout may transfer from one employee to another, either directly or indirectly. If burnout is contagious, then our best approach is to act quickly to contain it. The workers who participated in this study who had experienced burnout called for earlier intervention.
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‘I would go as far as to say that there is a duty of care from the local and national government to the 3rd sector. And if the 3rd sector isn’t here to support the people who are going to be horrendously hit by the welfare reforms there will be rioting on the streets... Let’s face it they need us here to keep everything at least manageable for them’. Interview.
Keep the Vital Spark – burnout in lifeline services in the third sector ‘That’s the thing about burnout, if it isn’t identified as burnout it just comes out in other health ways for yourself. That lack of recognition makes it harder to deal with and it can take a lot longer for people to process what has happened to them. I now understand why they feel the way they do, and I do believe there is something in putting your hand up sooner to say you’re struggling and this would hopefully help turn it around quicker’. Interview.
Importantly, there is the dimension of the ‘reality check’. In most organisations in the third sector, workers are being asked to do more with less. As vulnerable people are under more pressure from poverty, rising prices and welfare reform, our workers are trying to support people in increasingly complex systems. Many organisations are operating in a competitive tendering environment in which short term contracts, cost cutting and over-ambitious targets are becoming the norm. This study shows that this climate is impacting on our workforce and contributing to burnout. ‘With all the cuts and changes that are happening I could see that for some roles there will be inevitable burnout’. Interview.
This study explores burnout and calls for: Awareness and acceptance that burnout happens, to de-stigmatise the experience • •
Worker induction and training in self-awareness and self-management to avoid and manage burnout Leadership awareness to create team culture in which workers can discuss burnout and organisational practice which protects workers from burnout
Responsible funding and commissioning to protect workers from burnout •
• •
Awareness in the public sector that workforce development in the third sector is an essential investment in quality services for vulnerable people, which must include good practice to prevent burnout, when commissioning services Proactive encouragement to third sector organisations to care for their workforce through direct funding for initiatives to treat burnout when it occurs Recognition by funders interested in supporting work with survivors of abuse, violence and trauma that workers need additional support to sustain their efforts
Collaboration to create a consistent response to burnout The third sector is not alone in placing workers into challenging and emotionally demanding situations daily. The public sector emergency services, churches and caring services within, for example, educational institutions, all place workers into situations with a high risk of burnout and vicarious trauma. Together we can share ideas and resources to create a better response for all our workers in this situation
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Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
2. Burnout and resilience In this study the term burnout is used to embrace a range of experiences which in some more indepth research is specifically labelled compassion fatigue or the more serious experience of vicarious trauma. When study participants discussed their experiences, burnout, compassion fatigue and vicarious trauma were all terms they used. It is appropriate to discuss resilience alongside discussion of burnout. Study participants were asked what they felt were protective factors helping to prevent burnout. Resilience describes the presence of protective factors or personal resources which help people to face challenges and recover quickly. If we think of resilience alongside burnout, we may be less inclined to think of individuals as randomly susceptible to burnout, and more likely to think of how we can build resilience in our workforce rather than waiting and reacting to burnout when it occurs.
Burnout One of the interview participants in this study described his impression of burnout as something affecting high-powered corporate executives, until his personal experience of burnout made him realise its relevance to his work in the third sector. Originally theorists of burnout described the condition as a specific kind of occupational stress among health care workers that results from demanding and emotionally charged relationships between caregivers and their recipients, a psychological syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment (Bakker et al, 2006). However, burnout researchers began to recognise that burnout presented a wider range of symptoms, including physical, emotional and spiritual exhaustion which over time accumulate (MacLaughan Fransden B; 2010). The spiritual facet of burnout is described by some burnout researchers as an erosion of values and beliefs and this is an important area to consider in the third sector, which places a strong emphasis on values and ethos within organisations. If burnout results in ‘disruptions to important beliefs, called cognitive schemas, that individuals hold about themselves, other people, and the world’ (Bell H; Kulkarni S; Dalton L; 2003) then we may find that the distinctiveness and added value of the third sector also becomes eroded. In this study, participants emphasised ‘energy’ as important to their concept of burnout, encompassing both physical and emotional energy: I think burnout is an issue in any job but for me it is particularly prevalent to the voluntary sector as a lot of the work is very stressful, so for me the way I would define it is the point where a worker has given so much, as in terms of physical energy and emotional energy, that they reach a point where they can no longer function the way they need to do their job. Interview. In this study, we used the term ‘stamina’ to describe feelings of being able to ‘carry on’ in work.
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The term resilience describes our positive adaptation to situations and circumstances in spite of adversity. Some people adapt more easily than others, and some may be adaptive in some situations and not in others (Bakker et al, 2006).
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Resilience
Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector Experts in resilience suggest three building blocks of resilience: a sense of security and attachment; good sense of self and awareness of the impact of self on others; and a sense of self efficacy – a belief that one can have some impact on what happens around oneself. This study revealed that people’s identification of the factors preventing burnout is strongly linked to the concept of resilience in the context of our work environments: the role of teams and supervisors in creating a sense of attachment, the importance of self-awareness in acknowledging burnout and feeling comfortable to discuss it, and the sense that workers can contribute meaningfully within their organisations.
Tipping point The tipping point, or ‘pile up’ described in resilience theory is particularly relevant to burnout. Even resilient people reach a point where enough is enough: ‘burnout [ ] causes us to waiver in our journey of the heart. The circumstances facing each of us in our jobs may be different, but we are all susceptible to that one additional event that brings us to the point of burnout.’ (MacLaughan Fransden B; 2010). An interesting example of the different levels of resilience people in this study experienced is that some people expected work with clients to be difficult and challenging and remained committed and feeling able to meet clients’ needs, perhaps part of their ‘psychological contract’ with their role, if you like. But they felt ‘ground down’ by the additional paperwork and bureaucracy they were experiencing in their organisations. For others, the current context of welfare reform was pushing them to tipping point. More negative financial impacts from the austerity cuts affecting ability to work with clients who are affected i.e. loss of benefits, impacting on recovery causing suicide, mental health, self-harm, isolation, humiliation etc. Which could all cause aggressive outbursts towards worker - signs already. Survey. In this study, there also appeared to be a difference between ‘challenge stress’ which people expected as part of their role, and ‘hindrance stress’ which some people identified as unnecessary hassles and hurdles that got in the way of their effective handling of the ‘real work’. One of the difficulties this study identifies for leaders is that the shame attached to burnout means that people may hide the fact they are reaching their tipping point. ‘I believe that people believing in what they are doing is really important and if people are able to express themselves, it takes quite a lot of emotional literacy in a high pressured environment. People can put up with a lot but not with it all. They might have a challenging job, or awkward colleagues, or low salary or awful working conditions but if they have 2 or more of these it can lead to them going off sick. Interview.
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We all deal with stressors in different ways but I do think that there are common threads which are about workload, sometimes about vicarious trauma and I think there is something not spoken about explicitly, we are kind of hiding it under the carpet and we are making it something that is a little shameful. Actually I think we just have to recognise that we work in stressful environments and people just need to be supported. An idea that people can just simply get on with it is naive. Interview.
Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
3. Factors affecting burnout This section of the report explores what the findings of the study can tell us about burnout in the third sector. The study explored different facets of burnout, including people’s experience of burnout symptoms (tiredness, weariness and loss of commitment) and work factors perceived to impact on people’s stamina at work. The findings fall into two areas: the nature of the work itself, and personal characteristics of workers.
The work In relation to the work in which participants were involved, this study explored the relationship between symptoms of burnout and: • • •
the nature of the client group (exposure to their distress, trauma and complex problems) the different settings in which people work any restrictions on time for working with beneficiaries
Nature of the client group You can’t work with vulnerable people, people with histories of neglect and/or abuse and not get stressed and frankly if you were I would be asking why you are in the job in the first place. Interview. It is to be expected that work with vulnerable people is stressful. All of the workers who participated in this study expected the work to be challenging but nevertheless held a strong commitment to helping people to change their lives. The purpose of exploring the relationship between the nature of the client group and burnout is partly to help set the context for exploring other factors which might influence burnout, on top of the existing ‘stress load’ of the work. It is also to explore whether specific aspects of working with vulnerable people impact on the experience of burnout, since some work may be more likely to lead workers to burnout. The survey questionnaire explored symptoms of burnout and three different aspects of working with vulnerable people (Table 1):
More survey participants reported that they experienced symptoms of emotional exhaustion and feelings of ‘I can’t take this anymore’ with ‘thankless’ clients than with clients with complex needs. Fewer survey participants who experienced clients engaging in positive activity experienced physical and emotional exhaustion, feelings of ‘I can’t take this anymore’ and susceptibility to burnout.
Ruth Campbell Clore 2011 Social Fellow
December 2012
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The complexity of their needs: the sense of so many interlinked problems to be resolved The sense that some beneficiaries are so disconnected from society they are ‘thankless’ and the sense of ‘reciprocity of regard’ is missing from the worker-beneficiary relationship The fact that many organisations work with the most challenging aspects of people’s lives and don’t see the beneficiary engaged in positive activities; so, exploring differences in burnout symptoms for those workers that do see their beneficiaries engaged with positive activity
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Keep the Vital Spark – burnout in lifeline services in the third sector
Table 1: Characteristics of clients affecting symptoms of burn out
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
35
50
12
38
24
15
60
40
60
20
30
20
10
60
18
36
5
18
9
9
Always / often tired by work %
Always / often physically exhausted by work %
Clients with complex needs Thankless clients
68
Clients engaged with positive activity
Always / often emotionally
Burnout researchers show that having a more diverse caseload with a greater variety of client problems, and other work opportunities such as participating in research, education, and outreach, appear to mediate the effects of traumatic exposure when working with beneficiaries with complex needs (Bell et al; 2003). This is important for third sector organisations to consider, as we are increasingly working less holistically with beneficiaries because services are more often commissioned to secure a relatively narrow range of outcomes. Inevitably, a section of our workforce will then be working in crisis-oriented work which requires them to ‘refer on’ clients who are ready to engage in positive activities, decreasing the opportunity for variety in their work and increasing the risk of burnout, requiring us to think carefully about the needs of workers involved in relentless chaos-management. Hearing trauma stories over and over and over again began to take its toll on me. I started to feel responsible for their safety, over recorded, was in constant contact with my clients, became obsessive about it. Interview. The job is very stressful and the clients you see have very troubled lives, you are seeing the underbelly of life, the bit that most people would shun and you see the human side. So that is quite a lot to take on and carry round … so I think it is important to talk to colleagues or your line manager just to off load. I think that would be the most important this – off loading because you hear some horrible stories and you have to get them out. Interview. The study also explored the effects on workers of changes in the life experience of beneficiaries (Table 2). The majority of survey participants identified that changes in benefits, employment opportunities and the cost of living are having a negative impact on workers’ stamina. Conversely, having the opportunity to see a beneficiary reach or pass a milestone has a very positive impact on workers’ stamina.
Somewhat positive impact %
Neutral / limited impact either way %
Somewhat negative impact %
Very negative impact %
Welfare reform
5
11
14
32
38
Unemployment / reduced opportunity for clients Rising cost of living for clients Client reaching/passing a milestone
5
3
18
37
37
0
3
17
50
31
60
35
5
0
0
Ruth Campbell Clore 2011 Social Fellow
December 2012
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Very positive impact %
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Table 2: Issues affecting clients affecting workers’ stamina
Keep the Vital Spark – burnout in lifeline services in the third sector Again, some front line workers dealing with crisis may rarely see the progress of their beneficiaries with which to balance their ongoing experience of their challenges. It is important for workers’ wellbeing that they get the opportunity to share their successes, no matter how small, as well as the challenges they face. Encourage staff to be reflective, and for me that is partly speaking to colleagues, partly speaking to your manager and partly taking the time to process in your own head what you have been doing with your practice. Interview.
Many workers identified that the content of beneficiaries’ crises contributed more to burnout than the number of cases they dealt with. It was certainly about emotional burnout and not workload burnout. I was taking home concerns for the young people I was working for, and at the time they were working in the sex industry and really found it hard I suppose emotionally to switch off when I’d get home. Interview. People who can’t stop themselves going over and over the situation that the client finds themselves in and can’t accept that they have done as much as they can, burn out. Interview.
Burnout researchers have also identified that burnout is associated with feelings of incompetence and low achievement in our work. Very challenging work therefore carries a higher risk of burnout. For front line workers in the third sector, ‘success’ may be hard to identify when working with beneficiaries with long term, chronic problems; but the work also carries uncertainty in many situations where there is no ‘right answer’ but where death, through frailty or suicide, is a very real possibility. 95% of survey participants said that client death would have a negative impact on their stamina at work. A lot of the nature of the work in the voluntary sector involves judgement calls and we are only human and we are not going to get all of those calls right. Despite all the right intentions and despite all the experience in the world you might have, you may still get it wrong, it needs to be treated as a learning experience. Don’t set ridiculous expectations of yourself and your abilities. Interview.
The approach to the work
Ruth Campbell Clore 2011 Social Fellow
December 2012
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More survey participants in this study who worked with beneficiaries in depersonalised environments (cubicles or shared meeting rooms) reported symptoms of burnout than those who were able to personalise the space in which they met beneficiaries with posters, photos or knickknacks. A sense of control and predictability arising from the setting also seemed to affect symptoms of burnout. Ironically, those meeting beneficiaries through streetwork contact appeared less prone to burnout symptoms than those who meet beneficiaries in social settings (e.g. cafes) possibly because workers in these settings will anticipate acting as a mediator between a beneficiary and the setting (e.g. managing upsetting conversations in public). Those who meet beneficiaries in their homes, where the chance of advance risk assessment is very limited, also seemed more prone to tiredness and physical exhaustion (Table 3). Workers who visit beneficiaries in their homes are also much more likely to be exposed to the upset of seeing clients’ desperate living conditions, which will also impact on their burnout symptoms.
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Burnout researchers have suggested that workers de-stress more easily if they have a personalised space in their work environment to work in and to retreat to after working with beneficiaries with difficult lives (Bell et al, 2003).
Keep the Vital Spark – burnout in lifeline services in the third sector Table 3: characteristics of work settings affecting symptoms of burn out
Workers who work in depersonalised setting with client Workers who work in personalised setting with client Workers engaging clients in streetwork Workers engaging client in social settings Workers engaging clients in clients’ homes
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
35
55
10
40
30
10
54
23
46
8
23
8
15
54
31
39
0
15
8
8
64
32
52
12
28
16
17
67
41
52
11
37
22
15
Always / often tired by work %
Always / often physically exhausted by work %
70
Always / often emotionally
Interview participants in this study commented on the impact of their office environment on their wellbeing. This is particularly pertinent information in the current trend towards hot-desking. City of Edinburgh Council social workers are gradually being re-accommodated in new buildings to replace worn and depressing environments, but are paying the price by being forced to hot-desk: returning from a distressing case without even the guarantee of a seat. The third sector has never been renowned for investing in positive office environments for fear funders will see this as ‘waste’, but the findings of this study support the view that where we work with beneficiaries, and where workers reflect and prepare for their practice, impacts on symptoms of burnout (Table 3). Savings on desk space may create costs in staff burnout. People are working in no natural light and the overhead lighting is poor or it has no heating in the winter and no air conditioning in the summer. And at the moment people are trying to streamline their office costs and aren’t maybe spending money on them to make them more suitable for their staff. Interview. Physical environment is important. I have recently found out that aesthetics are really important to the way I feel and feeling in a comfortable place, so yes for a place of work not to look like a building site. Interview.
Ruth Campbell Clore 2011 Social Fellow
December 2012
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Many third sector services are now committed by contract to work with a target number of beneficiaries, a target which can usually only be achieved on a limited budget by restricting how long we work with beneficiaries over time and maximising the number of beneficiaries we see in a given week. Survey participants who reported working in unrestricted appointments and for unrestricted time periods with clients were far more likely to report feeling their beneficiaries’ issues were resolved than those who worked in restricted appointments and restricted time periods (Table 4), helping to provide a greater sense of efficacy for workers.
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The sense of competence and efficacy identified by burnout researchers as important to workers’ wellbeing is important to explore. In the third sector, a further aspect of our approach to work which impacts on symptoms of burnout is our expectation of what can be achieved with beneficiaries with complex needs in a given timescale, or rather, what our service contracts require of us. Our sense of efficacy is affected when what is demanded of us, and what we want to achieve ourselves with our beneficiaries, is at odds with the time and resources available.
Keep the Vital Spark – burnout in lifeline services in the third sector Table 4: Sense of efficacy and restricted / unrestricted working with beneficiaries
Workers day to day experience of beneficiaries’ problems being resolved %
Restricted appointments
Restricted time period
Unrestricted appointments
Unrestricted time period
18
28
50
47
Interview participants in this study were clear that ‘hindrance stress’ was an important factor when reporting on their time in the context of service contracts. The interview schedule in this study did not set out to explore the administrative burden on workers, so the level of response which identifies this as a factor in burnout is significant. Half of the interview respondents identified administration associated with justifying performance to targets set by contracts, as negatively impacting on their wellbeing, with an emphasis on the tensions this created in relation to taking time away from the job and reducing the sense of efficacy. We have to work to time slots of 15 minutes, everything we do must be in broken down into this, it can’t be less, which means people have to say that sending a text message took 15 minutes. A different example would be that I have clients in Kirkliston and a round trip can be as much as 3 hours but I can only claim for 30 minutes. This can lead to a culture of deceit as people don’t feel trusted and feel their time is being scrutinised. Interview. In the voluntary sector particularly when state funding is received there seems to be a large amount of paperwork/admin. This is the kind of stuff that usually results in you having to work late because you try to concentrate on supporting clients in the core 9-5 working hours. If something could be done to reduce this burden it would certainly make frontline staff/caseworkers more effective. Interview. Due to being audited to death team members would get into situations where they could be seen as being fraudulent e.g. signing peoples time sheets, attendance records, etc….With having to meet targets it got to the stage that we stopped meeting the needs of the people. Interview. I left before burnout. It was a great team, great manager, worked with young offenders and liked it. What made me leave was I couldn’t see what we were achieving, I had a massive case load but I couldn’t see how seeing someone once every 3 weeks would help… I felt like a fraud and I knew if I continued I would start to get depressed and upset. Interview.
People Many burnout researchers have focused on the personal characteristics of people who burnout, and others have focused on organisational characteristics which influence burnout including management styles. This study explored how experience of burnout symptoms related to: gender roles and length of time within the organisation the organisational culture Individual responses to burnout
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• • • •
Ruth Campbell Clore 2011 Social Fellow
December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector Gender On the whole, amongst frontline workers, women were less prone than men to symptoms of tiredness, physical tiredness, feeling worn out and susceptible to burnout. However women were slightly more likely than men to feel emotionally exhausted (Table 5). When this data is explored against the range of activities which represent emotional engagement with beneficiaries, women were more likely to share tea/coffee or eat with beneficiaries, and twice as likely to send birthday and Christmas cards to beneficiaries, which perhaps accounts for women’s higher emotional exhaustion. Table 5: gender differences in experience of symptoms of burnout
Always / often tired by work %
Always / often physically exhausted by work %
71 60
43 20
Men frontline workers Women frontline workers
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
43 50
14 15
43 35
29 20
14 15
Always / often emotionally
Roles and time served Symptoms of burnout were experienced by people in all roles in the third sector organisations in this study, however, symptoms closer to ‘tipping point’ (always / often think ‘I can’t take this anymore’) were less likely to be experienced by people in manager or team leader roles. However, burnout symptoms are experienced to a greater extent by team leaders across some symptoms and this may be because in many third sector organisations the team leader is expected to pick up slack, maintain some level of caseload, and absorb the stress of team members. Table 5: Position in organisation affecting symptoms of burnout
Manager or senior manager Team leader Front line worker
Always / often tired by work %
Always / often physically exhausted by work %
44.4 80 63
22.2 60 25.9
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
44.4 40 48.1
0 0 14.8
11.1 40 37
11.1 20 22.2
25 0 14.8
Always / often emotionally
Ruth Campbell Clore 2011 Social Fellow
December 2012
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People who have been in their role between 3 and 5 years are far more likely to experience burnout (Table 6), but symptoms appear to diminish amongst people who have been in their role more than 5 years. This may be because people learn to self-manage better over time, although the study data cannot discount the possibility that these workers are giving less to their roles.
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The study explored whether the length of time a person has been in their role is significant in terms of feeling symptoms of burnout. As might be expected, study participants who had been in their role less than a year experienced tiredness often, but reported no other symptoms of burnout. Over half of these participants attributed tiredness to staff shortages in their organisation.
Keep the Vital Spark – burnout in lifeline services in the third sector Table 6: Length of time in role affecting symptoms of burnout
Less than 1 year 1-3 years 3-5 years More than 5 years
Always / often tired by work %
Always / often physically exhausted by work %
22 77 88 43
0 41 50 14
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
0 59 75 43
0 12 13 14
0 41 63 14
0 24 38 14
0 6 38 29
Always / often emotionally
Differences in the characteristics of people experiencing burnout symptoms Burnout researchers have identified that some individuals are more prone to burnout than others. The literature (e.g. Alarcon et al, 2009) identifies that a range of personality factors are relevant to different aspects of burnout along these lines: Burnout Emotional exhaustion
Relevant personality traits Emotional stability Positive affectivity – expect to be happy Negative affectivity – expect to be sad Hardiness Depersonalisation Agreeable – co-operative, caring, trusting, sympathetic Emotional stability Positive affectivity – expect to be happy Negative affectivity – expect to be sad Hardiness Personal accomplishment Positive affectivity – expect to be happy General self-efficacy Hardiness There were mixed views amongst interview participants about the relevance of personality. Some participants challenged any individualisation of burnout and emphasised organisational responsibility; whilst others accepted that some individuals may be more prone to burnout. I think people don’t know themselves very well and they also have high expectations of themselves. This can lead to Burnout because they have high expectations so don’t ask for support. I don’t think all people are prone to burnout some people are more resilient and these people know they are in a crazy situation and they know they can talk about it. Interview. This is partly a combination of personality and how an individual approaches a job. Being professional is pacing yourself, training yourself, knowing yourself. Interview.
Ruth Campbell Clore 2011 Social Fellow
December 2012
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The survey data was explored to assess whether those experiencing more symptoms of burnout also had less positive attitudes towards team members, immediate boss and the organisation, as well as their clients. As would be expected, positive feelings are higher amongst people who seldom or never experience being susceptible to burnout, and negative feelings are higher amongst people who always or often feel susceptible to burnout. This study data does not suggest any causal
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If burnout is resulting from you being in the wrong job you need to be honest about that and deal with it. Interview.
Keep the Vital Spark – burnout in lifeline services in the third sector relationship in either direction but it does suggest that qualities such as feeling motivated, inspired and finding the work rewarding are most affected by burnout. These are also qualities inherent in people actively seeking solutions and improvements in their approach to their work, which suggests that once burnout sets in, people’s ability to move themselves towards a better experience become more limited. You feel like you’re caught in a stream that you can’t control and you see yourself being pulled further and further along. You don’t feel like there is anything you can do. Interview.
Individual responses to burnout The survey asked participants to identify how they would respond if they passed a tipping point and reached burnout at work. The differences in response from those already reporting susceptibility to burnout and those who seldom or never felt this way, show that those who have not already experienced it are far more optimistic about their coping strategies (Table 7). However, those already experiencing susceptibility say they are far more likely to take sick leave, leave their job or leave the third sector altogether. Table 7: Responses to burnout Quite likely to: Withdraw the ‘extra effort’ and do the minimum required Take annual leave and hope a holiday does the trick Take sick leave until the feeling passes Ask for help from your employer (e.g. counselling, external supervision) Ask for a change of role within your current workplace Look for promotion in your current work away from current responsibilities Start looking for a new job elsewhere in the sector Consider a change of career to leave the sector Consider taking legal action / compensation claim against your employer Look for improvements in your home life / leisure to lift you up Proactively seek external support independent of your employer Proactively seek support from your friends and family
People who seldom/never felt susceptible to burnout %
People who always / often felt susceptible to burnout %
25 81 6 50 6 6 50 31 0 81 31 88
46 91 27 64 0 5 68.2 55 0 82 64 91
Interview participants felt individuals needed to feel that taking time off from work was a positive strategy protecting both the worker and the client. that is quite dangerous to ignore burnout as it is happening, I decided to take time off because I wasn’t able to deal with people on a human to human basis. I was just sort of on auto pilot and I, apart from just the respect point of view I was wanting to speak to people in a real way, I felt that I wasn’t able to motivate people which a big part of my job. If you are at that point where you can’t genuinely care then you need to get out. Interview.
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However, participants also highlighted that individual responsibility needs to be matched by organisational responsibilities through management, systems and structures.
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Not be putting other people at risk, at the time of my burnout I had 2 clients who were having suicidal feelings and I realised that I could not be the person to motivate them, it was outside my remit but still I wasn’t happy that I could not help them to the standard I would have been happy with. I didn’t want to be the one putting them more at risk. Interview.
Keep the Vital Spark – burnout in lifeline services in the third sector The primary responsibility is with the individual and then the organisation has a role in helping them recognise the signs and provide them with techniques etc to help them but when it comes down to it is up to you as a person to take care of yourself. Be nice to yourself frankly, but most people aren’t very good at this. Interview. The management proactively cares for the workers and I think that makes people feel supported and secure. Interview. Its up to management to spot the signs and deal with it, it is not just the responsibility of the individual. Interview. I feel that there needs to be more than just a run of the mill S&S, it needs to be more robust and has to be able to recognise the signs of possible burn out and then have the resources, procedures which would allow you to be able to get counselling or some therapy. The 3rd Sector environment although supportive and caring for its clients isn’t geared up to provide the same care of duty to its employees and volunteers. Interview.
The organisational context This study showed a range of organisational factors contributed to symptoms of burnout and particularly, to people’s ‘tipping point’ in relation to burnout: supervision and management; pay and conditions; and team cohesion. The study also explored how people’s level of respect for their organisation affected symptoms of burnout. Study participants were asked in an open survey question what issues would push them to ‘tipping point’ in relation to burnout. Half of participants provided a narrative response. 26% of these participants identified poor management as a ‘tipping point’ issue. Lack of understanding from higher management of complexity of work and impact this has on a daily basis. Survey. Slack management. Lack of good communication. Lack of management support. Goal posts changing. Service users being let down and parked up in a support relationship for ease of funding with no real care plan in place. Survey. Lack of support and supervision. Survey. My line manager continuing to undermine my skills and experience. Survey. 23% of these participants identified pay and conditions as a ‘tipping point’ issue. Increased level of responsibility in my job as a result of growth within the organisation, but without having had a job review or any extra support/resources. Survey. Doing more for less- no change in pay scale is also a factor as the cost of living goes up. Survey Change in conditions/salary. Survey. Reducing salary, less job security, more responsibilities within role, external factors making clients more vulnerable and therefore more demanding. Survey
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One study participant highlighted an issue that is common in the third sector, where many organisations create part-time roles which are cheaper to sustain and provide a degree of flexibility for operational capacity. However, this means a significant number in the workforce piece together a living wage by taking on several part-time roles with different organisations, which she felt created risk of burnout.
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No annual cost of living increases/salary increases. Increasing demands within current role, for little or no incentive. Government welfare changes. Survey.
Keep the Vital Spark – burnout in lifeline services in the third sector The nature of part-time work in the voluntary sector is quite prevalent as people have more than one part-time job to try and make their hours up to a full time post. There is a challenge with parttime working and the juggling that goes with it that has potential to lead to burnout, having 3 jobs running at once. And I’m not suggesting they shouldn’t do that I am just saying that they need to be mindful of the added challenges this brings. They will be working for different organisations and I would say they themselves have to be aware of the pressures this brings. Workers in this position need time to reflect in terms of your own emotional resourcefulness to their work as a whole as they themselves are being split across these different roles. Interview.
Data was compared in this study to assess the differences in impact of having positive or negative feelings towards team members and immediate boss. Positive characteristics were any of ‘easy; motivating; rewarding; inspiring’ and negative characteristics were any of ‘difficult; frustrating; upsetting; thankless; repetitive’. As would be expected, positive feelings lead to slightly reduced experience of burnout symptoms, but positive feelings about an immediate boss appear to be a higher protection against experience of burnout symptoms than positive feelings about team members (Table 8) Not having the support from your staff team or the management, when you think you’re stuck, you can’t talk about some of the barriers you’re are facing or how you feel about it….Not being able to access that support due to team being busy, management not around etc can be damaging. Interview. Table 8: Positive or negative feelings about team and manager, and symptoms of burnout
Negative experience of team members Positive experience of team members Negative experience of immediate boss Positive experience of immediate boss
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
21
50
7
36
21
21
60
27
46
11
35
22
17
71
29
57
14
43
29
36
52
24
31
7
28
17
7
Always / often tired by work %
Always / often physically exhausted by work %
79
Always / often emotionally
Interview participants placed a lot of importance on the role of teams in protection against burnout.
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Having that security where you are able to say to team member of colleague that you are really struggling is vital. I would put more faith into talking with colleagues as managers have a set agenda. Interview.
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I feel that people in offices need a little bit of down time where the staff can chat and have a laugh without them feeling that the manager has to be included or that they are going to frown on it because they should be working. In fact this is often what allows people to re energise to go onto do the little bit more. There was a team I worked with who used to sit round a computer looking at animals, I have to say I found this rather disgusting until I realised that it gave them something to coo at, it was actually something pure, clean and beautiful – something different to their daily work or the life of their clients. They united under this life affirming image. Interview.
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Keep the Vital Spark – burnout in lifeline services in the third sector The study explored whether participants’ views of their organisation also affected symptoms of burnout. Positive organisation characteristics were any of: ‘effective, makes a difference; efficient, does its best with the resources it has; courageous, makes a stand on things that matter; inspiring, tries new things to achieve more’; negative characteristics were any of: ‘not worthwhile, makes little or no difference; disorganised, don’t know how we get anything done; weak, agrees to systems and approaches that have negative impact; disappointing, doesn’t walk the talk’. A minority of participants identified negative characteristics in their organisation, however, it is clear that for those who do identify negative characteristics, this increases the experience of symptoms of burnout (Table 9). Some interview participants felt a match between personal and organisational ethos was essential to avoid burnout. If you don’t have the same values as the organisation or the organisation’s values are very different to yours don’t work for them. Make sure you or your organisation invests in your development – knowledge, skills, confidence, and competence. And just learn to say NO, be really clear and nicely assertive. Interview. Table 9: Perception of organisation and symptoms of burnout
Negative organisational characteristics Positive organisation characteristics
exhausted by work %
Always / often think ‘I can’t take this anymore’ %
Always / often feel worn out %
Always / often feel susceptible to burn out %
Always / often feel exhausted in the morning at the thought of another day’s work %
25
75
13
50
38
25
33
33
8
17
8
8
Always / often tired by work %
Always / often physically exhausted by work %
88 42
Always / often emotionally
The data from this survey suggests that people’s commitment and loyalty to organisations changes when they feel more negative towards their organisations and more symptoms of burnout. Not only do they feel more likely to ‘work to rule’ and take sick leave (Table 7), they are more likely to demand more incentives from their employers to compensate for their dissatisfaction (Table 10). Table 10: Impact of positive incentives on stamina at work
Positive about organisation – Impact of pay increase Negative about organisation – Impact of pay increase Positive about organisation – Impact of staff award scheme Negative about organisation – Impact of staff award scheme Positive about organisation – Impact of annual increment to holiday entitlement Negative about organisation – Impact of annual increment to holiday entitlement
Very positive impact %
Somewhat positive impact %
Neutral %
25 75 17 50 25 75
33 25 25 38 58 13
42 0 42 13 17 13
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Further, people who are positive about organisations and feel less susceptible to burnout feel more able to accept change and the external challenges facing the organisation (Table 11)
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Keep the Vital Spark – burnout in lifeline services in the third sector Table 11: Impact of change factors on stamina at work
Positive about organisation – Impact of internal organisational change Negative about organisation – Impact of internal organisational change Positive about organisation – Impact of changes to funding / sustainability Negative about organisation – changes to funding / sustainability
Neutral %
Somewhat negative impact %
Very negative impact %
50 13 9 25
25 50 27 13
17 38 46 50
However the current climate is impacting on how workers feel about their resilience in the workplace. One in five of the survey respondents who provided narrative responses about their tipping point mentioned job insecurity and funding insecurity. Interview participants were clear that the financial climate for the third sector is a factor in burnout. How can you plan your life when you know you won’t have a job in 9 months’ time. I have been in a situation over the last 3 years of not know where I would be, but this is also where I have a good example of a manager who has kept us in the loop and senior management have come in and shared information with us when they have gotten it. Interview. I think there are challenges in the 3rd sector around funding and that sometimes smaller teams have bigger workloads and in 20 years this only seems to be getting worse – less money, less resources and I think that those things absolutely put pressure on people. Interview. I feel that people are impacted on with having to find money, being accountable to various funders, being beholden to others for money/resources, I think all of this must have an impact on people in the sector. Salaries aren’t as much as what you would get in the statutory sector say. It’s short term funding, fixed term contracts. In the statutory sector I don’t worry about getting paid but in the 3rd sector it isn’t that simple. Interview. Worries about losing job if funding is withdrawn due to restrictions in the sector. Survey. Increasing work load and expectations from funders, staff and managers without any extra support or prep. Continually battling for funding to sustain services and staff salaries is a huge burden personally. Survey.
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Actually burnout is inevitable when you look at all that has to be dealt with. What is needed is long term funding that you can plan around and if this is not happening the 3rd sector is being tripped up, how can they meet their outcomes if funding gets tighter and tighter and accountability becomes more stringent while they can’t allow or cover for staff being ill or getting pregnant. Interview.
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Keep the Vital Spark – burnout in lifeline services in the third sector
4. Preventing burnout This section of the report is based on the findings of the study and suggests ways of preventing burnout in the third sector at different levels of the individual, team, leader and policy maker.
Self-awareness and self-care Although we have seen in this study that teams and organisations can influence and prevent burnout, burnout is experienced at individual level, and individuals can do a great deal themselves to prevent burnout. Study participants emphasised self-awareness as an important factor in burnout. Self-awareness is very important, being able to diagnose when you need to take a step back… I think the awareness about it is very important, the awareness that it can happen, noticing when you are starting to show signs of having taken it too far and so nipping it in the bud and nurturing yourself a little bit. Interview. Burnout researchers link effective practice preventing burnout with individuals as similar to any health promotion approach which enables individuals to evaluate and develop personal coping strategies (Kristensen et al, 2005). Each individual will experience burnout differently and will have different thresholds or tipping points. An individual’s personal resilience may change over time as their relationships, families and other circumstances change, in ways which may be invisible to their employer, so making people ‘expert’ in their own symptoms is an important strategy to take.
Information The first step is to provide information for employees. Information can help individuals to name their experience and provide a framework for understanding and responding to it (Bell et al, 2003), and it can help them support their peers effectively. Some of the people who had experienced burnout in this study had only become aware of the changes they were revealing through positive feedback from colleagues, so providing universal information to all employees is more positive than issuing information to individuals thought to be at risk. I think people should be aware that it is a particularly stressful line of work and that there are stop gap measures to identify that it is happening and allows you to try and stop it. Sometimes you just get caught up in the momentum and don’t even recognise that these things are happening, they can creep up on you. Interview. I think when people have a proper burnout it is really hard for them to admit that that is what has happened for them. Interview. Freudenberger and North identified 10 phases of burnout (MacLaughan Fransden; 2010) which resonate with the experiences of individuals in this study:
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A compulsion to prove oneself Working harder Neglecting one’s own needs Displacing conflicts by ignoring the root cause of the distress Revision of values in which friendships or hobbies are ignored Denial with emergence of cynicism or aggression Withdrawing from social contacts and/or using alcohol/substances to cope
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Keep the Vital Spark – burnout in lifeline services in the third sector 8. Inner emptiness 9. Depression 10. Burnout Develop good habits The next step is to develop good work habits. Bad habits are hard to break. If you get into a pattern of giving a little bit too much and not taking care of yourself it is very hard to break that way of being. Interview. The key good habits in burnout prevention are simple: talk and reflect. Support from your colleagues and if you are working in difficult circumstances having that emotional and practical support behind you knowing that there is someone there to talk to and that it is there on a regular basis is great. Having little cups of tea together, little chats where you are off loading. Interview. Learning how to sort all the information in your head out and not taking anything personal, if they are angry at you, shouting at you, they are not really shouting at you and you should not take it to heart. It’s alright to step back and reflect on what has happened and recognise that it’s not you that’s the problem. Interview.
Learn from others Individuals can learn more about self-care from each other in a climate of acceptance that burnout is a normal occupational hazard. Several participants in this study described being initially judgemental of the tactics others used to look after themselves at work, until they began to experience burnout themselves and started to take their own self-care seriously. The overriding message from all study participants was ‘be nice to yourself’. I think that people just care so much that they want to give their best and they should be credited for that, but, they give so much that there comes a point where it is too much and they aren’t spending enough time taking care of themselves. Interview. One of my friends is a social worker and every now and again she will take a mental health day, she will take a day off because she recognises that it is coming to the point that she is going to be pushing herself too far. She takes the day off, she chills out and this works for her. I think in the long term this is a really good idea, even although when she first told me I thought that it was dreadful, you know taking a day off when you really don’t need too... but actually it makes a lot of sense, she could have pushed herself to the point that she might have need a week off and that obviously isn’t good. Interview.
Sharing experience helps people to avoid burnout by demystifying the experience (this is what burnout might look like and feel like) providing people with normative information (burnout can
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In most organisations, teams create the operational environment and culture shaping individual experience. A team which enables members to learn from each other and share experience is more likely to protect members from burnout.
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Team
Keep the Vital Spark – burnout in lifeline services in the third sector happen to anyone for lots of different reasons), and providing support for changes in attitudes about oneself and others, reducing isolation (Neitzel et al 1986).
Encourage caring and considerate behaviour The way that teams create a positive environment arises from the informal, day to day patterns of behaviour in teams in which people show care and consideration for each other. Teams which signify permission for colleagues to care for each other help guard against burnout. Social things like sharing a cake rota that are really simple things but are really significant to team spirit. Interview. We eat lunch together, made time for each other, made tea for each other, if someone was upset another would take them out for a coffee and a chat – no need to run it past the management. Interview. Celebrate when things have gone really well, praise one and other, thank one and other – not in a false way, make people cups of tea and say thank you when it happens. This all adds to the environment. Interview.
Protect time for reflection Many organisations are in danger of becoming warped by targets and accounting for time. Time spent on reflection is time well spent. It helps protect against burnout and it helps workers to feel their skills and experience are being fully used for the benefit of the organisation. Teams which spend time together on reflection also help ensure that ethos and values are discussed and shared, enhancing the sense for workers that they are ‘in synch’ with each other. Needs to be space for reflection within teams, reflect on practice on how we do things, don’t keep doing the things that aren’t working….I think it’s good relationships and space for reflection that will help prevent burnout. And the right staff, needs to be the right fit – compatible values, good work ethic. Interview. I think is important for individuals and teams to take a break and do an activity, get yourself into a different zone where your brain can have time to process information. Interview. We have what is called a ‘Reflective Practice Group’ … usually every 6 weeks practitioners from across the organisation come together to talk about some practice issue. The discussion is held around the table and it is chaired by a Manager who is there are a facilitator and not as someone laying down the Rock Trust law. It can also be about organisational procedures and systems, getting each other’s views on new ways of doing things. I find this really supportive and the conversations really productive. Interview.
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Leadership is critically important to burnout prevention. How we design organisations, involve employees in change and development, and how we model self-care and team working, creates the backdrop to the day to day work of the workers at the front line doing their best to help vulnerable people. It is important for us to think about burnout prevention when we consider how best to use limited resources, and it is down to leaders to ensure that Boards, policy makers and commissioners take the wellbeing of workers seriously.
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Leadership
Keep the Vital Spark – burnout in lifeline services in the third sector Recruit wisely Workers participating in this study felt that consideration of burnout starts at recruitment, when it is essential to ensure that workers are aware of the stresses involved in working with vulnerable people, and that new employees will ‘fit’ with the team they are joining. When recruiting you need to be looking for people that can get on board with that, people with their own moral compass, or however you would describe it, sit well within the ethos of the organisation so there is something about sitting within a group who are all aiming for the same thing. Interview.
Structure support into teams Although the findings of this study suggest that younger employees who have been in the job for a shorter time are less likely to experience symptoms of burnout, study participants also felt that wisdom comes with time served, and that a mixed team has benefits. Great staff team, great mix, oldest member 63 and youngest 28. Our experienced staff are more than happy to share their experiences and knowledge, chat with the new and younger members and mentor them. Interview. Study participants also felt that some approaches to work in the third sector potentially creates problems for employees and increases the risk of burnout: the high level of portfolio working (people juggling several part-time jobs across different organisations) and the fact that in many organisations single roles are created with limited project funding, creating isolated workers. I would say it is a lot easier if there are a number of people doing the same job so that people can really understand the pressure and strains that are on you. But if you have a job that other people don’t understand the day to day of it is harder to find someone to talk to when you’re having issues and it is a lot less likely if you’re over worked that someone is going to notice. Interview. Leaders have to be creative to ensure that part time workers and lone workers are provided with the same opportunities as other workers in relation to burnout prevention.
Build in protective systems and minimise hindrance stress Participants in this study described systems which they felt reduced the likelihood of burnout: a formal flexi-time system, which enabled managers to monitor over-working more easily; and formalised, regular support and supervision, with the caveat that this is about quality not procedure. Flexi time … it is much more likely if you are working too many hours and you are building up a lot of hours your manager is going to spot this and deal with it right away and have a conversation with you. Interview. …not the processes and procedures around S&S but about the relationship you have with your manager. Interview.
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Leaders also need to know the difference between challenge stress and hindrance stress. Many workers thrive on challenge and want to be stimulated. Workers which felt their skills were underutilised appeared more likely to experience symptoms of burnout in this study.
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Participants also wanted their leaders to ensure systems were workable and practical, enabling their work rather than hindering it. Participants who described fifteen-minute monitoring units felt badly let down by their organisations. Burnout researchers confirm that management which focuses on process and procedure rather than employee development actually increases the risk of burnout (Seltzer et al, 1988).
Keep the Vital Spark – burnout in lifeline services in the third sector A leadership style which gives you a lot of autonomy in your job and puts a lot of faith in you getting on with things but knowing to that there is back up support there is you need it. Interview.
Create a culture where we are all each others’ work environment Participants in this study felt that leaders could influence experience of burnout by the culture they create around them. They wanted leaders to respect workers’ autonomy but be accessible to their workers. They wanted a climate where discussion of burnout is positive and experience of burnout is accepted as a risk of working with vulnerable people in the sector. Kristensen (Shaughnessy, 2010) describes the concept of good organisational citizenship amongst employees which leaders create by being appreciative of workers’ experiences. Every now and again on a Friday about 4pm I gather the staff round and we open a bottle of wine and sit chatting for an hour or so, this helps with team dynamics in our office. Interview. Having an open door style so the staff feel comfortable to go in and off load and say my caseload is too much or I can’t deal with this client or whatever … Interview. Organisations need to be proactively looking for destressors for their teams that I suppose to me means having a culture that recognises that it happens but that as a team and an organisation you are going to do your best to make sure that it doesn’t happen. Interview.
Invest wisely Leaders also need to recognise the importance of investing in support for workers, such as therapeutic support, when they experience burnout. This is particularly important for workers who deal with beneficiaries who are recovering from abuse and trauma, even when their relationship with beneficiaries is not specialist (for example, many counsellors are provided with external supervision, but most ‘support workers’ are not). I was suffering from vicarious trauma and it was my manager who recognised it and sorted out her budget to find the money to send me to a therapist. At no time did she make me feel unable, or in need to take time off, or a failure, she just picked up on a change in my being with others and dealt with it. This helped and after attending the therapist I realised. Interview. Investment in support is more cost effective than providing staff cover for sick leave and replacing experienced, trained staff who burnout and leave the organisation.
Policy makers and commissioners Burnout is a matter for public policy and decision making. The third sector is a vital resource in meeting the needs of vulnerable people in our society and our workforce is as important as public sector emergency services. Indeed, when public sector emergency services have done all they can for vulnerable individuals, they invariably pass the baton to the third sector.
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Organisations struggling to survive are being forced to make unrealistic tenders for services. Commissioners can take steps to ensure that employers take the care and welfare of their employees seriously.
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Commission responsibly
Keep the Vital Spark – burnout in lifeline services in the third sector Positive action could include asking organisations to provide details of their safeguards against staff burnout alongside the policies organisations are invariably required to provide on equalities and care and protection of vulnerable people and children. The most positive action, however, would be to respect organisations’ worker support costs as an essential part of tendering for services for vulnerable people. Commissioners should also ensure that procurement is managed by someone who actually has experience of delivering front line services to the target beneficiaries. The specialisation of procurement in many public sector organisations carries a high risk that organisations making unrealistic proposals win tenders and then burnout the staff trying to deliver the contract – no-one is the winner here, least of all the beneficiaries. …a sort of corporate bullying where targets that have been agreed at tender are passed down the line and at each stage the measures to reach the targets have been agreed.... Because of the tendering situation people promise more than is easily achievable, that’s for sure and perhaps is even not reasonable to expect. Interview. …because they are competing and are desperate to win the tenders they will end up winning a tender at a low price but have to deliver a quality service. This adds pressure. Interview.
Cross-sector collaboration The third sector is not alone in caring for a workforce which deals with distressing problems. It is a challenge we share across all sectors. Policy makers should recognise the importance of burnout prevention and make this integral to workforce development initiatives across the health and social care sectors. However, participants in this study also suggested that small scale approaches could also be encouraged.
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…some sort of partnership across a part of the sector in Edinburgh. To have the more experienced practitioners there as a kind of pool of mentors and maybe having meetings once every 6 months or once a quarter. Interview.
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5. Conclusion This study opened the lid on an issue we are all aware of and hope happens to someone else in some other workplace: burnout. The study shows that burnout can be experienced by workers and for many different reasons. Accepting burnout and bringing it into the open can help our organisations continue caring for vulnerable people by ensuring we care for our staff. The study also suggests that there are particular challenges facing the third sector right now which are increasing the threat of burnout for our workers. Struggling organisations need strong workers. Vulnerable people need caring, consistent services. If we are to lead our workforce through tough times and sustain their energy and commitment, we have to bring burnout into the open and respond to it positively.
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No it really matters, really bad burn out can make people never work again, can also make people really cynical and not see the best in humanity. Really bad burnout blames other people for their problems. So in the work I’m in if I got badly burnt out I’d blame the women who are being abused, for getting themselves into abusive relationships. You’d blame homeless people for not getting their act together. Really bad burnout creates reactionary behaviours, you stop taking responsibility and start blaming other people, this is toxic to our society. If we want our society to be a better place we need not to have burnout. Interview.
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6. The study This fieldwork for this study was carried out between September and December 2012 in the City of Edinburgh.
Literature review • • • •
Focus on public and voluntary sector Literature on burnout, compassion fatigue and vicarious trauma in health, mental health and social service sectors Published journals Relevant professional magazines
Scoping discussions •
Three interviews with managers of services in the third sector
Online survey sample • • • • • •
Sent to all organisations concerned with homelessness, addiction, mental illness and poverty in the third sector in Edinburgh 30 questions including multiple choice, rating and open-ended for narrative response 48 respondents 33 women, 15 men 61% front line workers, 15% team leaders, 23% managers /senior managers Core questions asked participants to rate their experience of symptoms of burnout, with other questions designed to explore variables which may influence experience of symptoms
Interview sample One hour semi-structured interview 10 workers recruited via the online survey 6 women, 4 men 9 front line workers and one manager Interviews explored participants’ views on burnout, factors in individuals and organisations influencing burnout, and effective responses to burnout
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• • • • •
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7. References Alarcon G; Eschelman K J; Bowling N A; 2009; Relationships Between Personality Variables and Burnout: a Meta-analysis; WORK & STRESS; 23(3) 244-263
Bakker A; Van Der Zee K I; Lewig K A; Dolard M F; 2006; The Relationship Between the Big Five Personality Factors and Burnout: a Study Among Volunteer Counsellors; THE JOURNAL OF SOCIAL PSYCHOLOGY; 146(1) 31-50
Bell H; Kulkarni S; Dalton L; 2003 Organizational Prevention of Vicarious Trauma; FAMILIES IN SOCIETY • Volume 84, Number 4
Kristensen T S; Borritz M; Villadsen E; 2005; Christensen K B; The Copenhagen Burnout Inventory: a new tool for the assessment of burnout; WORK & STRESS; 19(3); 192-207
MacLaughan Fransden B; 2010; Burnout or Compassion Fatgue? LONG TERM LIVING MAGAZINE; May 50-52
Neitzel M T; Guthrie P R; Susman D T; 1986; Utilization of Community and Social Support Resources IN Kanfer FH, Goldstein AP, ed: Helping People Change: a Textbook of Methods. New York: Pergamon Press
Paris M Jr; Hoge M A; 2010; Burnout in the Mental Health Workforce; THE JOURNAL OF BEHAVIOURAL HEALTH SERVICES AND RESEARCH; 37(4) 519-527
Seltzer J; Numerof R E; 1988; Supervisory Leadership and Subordinate Burnout; ACADEMY OF MANAGEMENT JOURNAL; 31 (2): 439-446
Shaughnessy M S; Moore T-L; 2010; An Interview with Tage S Kristensen about Burnout; NORTH AMERICAN JOURNAL OF PSYCHOLOGY; 12(3) 415-420
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Shirom A; 2005; Reflections on the Study of Burnout; WORK & STRESS; July-September; 19(3): 263270 Taylor & Francis
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December 2012
Keep the Vital Spark – burnout in lifeline services in the third sector
Ruth Campbell is CEO of Comas, an organisation she founded which uses community development approaches to involve people affected by our toughest social problems in finding solutions that work for them. Comas initiated the Serenity Café, the first recovery café in the UK developed with and for people recovering from addiction. The café has been copied throughout Scotland and the UK, and has influenced decision makers and commissioners to take recovery community development seriously. Comas is now designing new approaches to working with young people with social, emotional and behavioural difficulties to find alternative learning opportunities that suit their needs in the Invention Shed.
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Comas is also exploring micro-enterprise projects with people living on the margins of the economy.
Ruth Campbell Clore 2011 Social Fellow
December 2012
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Keep the Vital Spark – burnout in lifeline services in the third sector
Ruth Campbell Clore 2011 Social Fellow
December 2012