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Introduction: What I Wish I Had Known

Burnout and Self-Care in Social Work

A Guidebook for Students and Those in Mental Health and Related Professions

The training to become a social worker is arduous, demanding, and complex. My concentration was clinical social work, which, during my graduate education, was known as casework. I well remember studying my basic curriculum; taking more electives than were required; receiving excellent supervision of my clinical work with individuals, couples, families, and groups; and, before it was required, taking many continuing education classes.

I learned a great deal, but what it seemed that no one shared with me during these years, or seemed to discuss among themselves, was the sheer exhaustion experienced in every concentration of social work as we do our very best to meet our clients’ needs day after day, year after year. When one of my deeply trusted supervisors died, and I met his wife for the first time, she told me that sometimes he would return home too exhausted to even speak and that a frequent statement she heard from a man who obviously treasured his clinical work, teaching, and writing was: “They feel better, but I surely do not.” How well I understood this feeling, I thought. How well so many in our field must understand this feeling. And yet many of us lack the attendant knowledge that can assess and direct this feeling, which is called “burnout” in the literature— or knowledge of the necessary practices to heal and soothe ourselves, which are collectively known as “self-care.” What I have learned over the years is the necessity of addressing this complicated exhaustion before the feeling of depletion leads to dysfunction or more serious disintegration. With this in mind, I share the precise information that I wish I had known about burnout and self-care in the early years of my work.

The term “burnout” was first applied by Freudenberger (1974) to describe what happens when a practitioner becomes increasingly “inoperative.” According to Freudenberger (1975), this progressive state of inoperability can take many different forms, from simple rigidity, in which “the person becomes ‘closed’ to any input” (p. 79) to an increased resignation, irritability, and quickness to anger. As burnout worsens, however, its effects turn more serious. An individual may become paranoid or self-medicate with legal or illegal substances. Eventually, a social worker afflicted with burnout may leave a promising career that he or she has worked very hard to attain or be removed from a position by a forced resignation or firing.

Various studies have reported figures of moderate burnout on the part of social workers ranging from 47 percent (Maslach, Jackson, & Leiter, 1996) to as high as 71 percent (Martin & Schinke, 1998). The research accompanying these studies points to a direct correlation between burnout and the desire to leave one’s job (Lloyd, King, & Chenoweth, 2002). Gibson, McGrath, and Reid (1989) found that 73 percent of respondents had thought of leaving social work at some point. Yet even with the signs of burnout all around us, social workers may still not pay full attention to the reality of that possibility until suddenly everything seems overwhelming. At such times, we may lack the knowledge of what is transpiring or the critical faculties to assess our experience objectively that will enable us to take proper measures to restore balance to our lives. To explore and understand the phenomenon of burnout before it is too late, researchers have found it useful to introduce several components of the term or attendant syndromes; in this work, I have made use of three of them specifically: compassion fatigue, countertransference, and vicarious trauma.

Just as burnout is associated with personal and professional factors, adjustment to those factors prevents future or further burnout from occurring. Further, it can reverse burnout that has occurred. In other words, there is a cure for burnout; not a permanent cure, or a cure-all, but a process that can restore balance in our personal and professional lives. That cure is self-care, a practice that can be actively committed to in four arenas: the professional, including organizational, supervisory, and peer strategies; the personal, including the psychological, emotional, and religious/spiritual dimensions; the social, including one’s partner, immediate family, and circle of friends and acquaintances; and the physical, the care of one’s own body.

Lately, increased attention has been given to the concept of self-care, the balancing activities in which social workers can engage to preserve personal longevity and happiness, their relationships, and their careers. These activities span a wide range and can include receiving support from mentors or a peer group, the importance of relaxation (including vacations), the pursuit of personal hobbies and interests, and the need to balance wellness with one’s professional life. By engaging in self-care, we can assert our right to be well and reintroduce our own needs into the equation. Self-care is not merely one of those “nice-to-haves”: Among the many consequences of burnout is poor-quality client care. Organizations thus must take note: We cannot simply give lip service to self-care and then get social workers back on a demanding treadmill without compromising client care and staff well-being.

In this book, you will find the examination of burnout and self-care communicated through four distinct dimensions. First, there is the research; since the concept of burnout was first introduced by Freudenberger, there have been scores of important thinkers engaged in an intensive qualitative and quantitative discussion of the aspects of burnout and self-care. The second dimension comes from a qualitative case study I have conducted over the past two years: Drawing from over 200 prospective candidates, 40 social workers were selected to complete an anonymous, extensive questionnaire. Their responses pointed to the exact problems of burnout and blessings of self-care in a unique way, and because of their efforts, we are able to hear authentic voices of those on the front lines of social work and mental health practice. In addition, there are the case studies of individuals (with identifying features altered) whose stories I have known intimately through my 30-plus years of practice and who aptly represent the tremendous challenges of burnout and the very real possibilities of self-care. Finally, there are questions at the conclusion of most chapters, designed for personal examination and understanding. It may be that these opportunities for reflection will also have value to those important to you, either in social work and related professions or not. Hopefully, new areas of self-awareness can lead to clearer individualized direction as well as more meaningful and fulfilling sharing and communication with others. Authentic, trusting contact is a gift synonymous with self-care.

In social work and related mental health professions, although we are surrounded by people all day long, there is not a balanced give and take. The concentration is on clients, not ourselves. In the truest sense, we are alone: We are the givers, and our professional fulfillment comes from seeing the growth, hope, and new direction in those with whom we are privileged to work. The fulfillment of our professional commitment demands that we do our best and give as much as possible in the ethical ways that are the underpinnings of our social work profession. With this awareness, common sense predicts that burnout is a potential threat waiting for us in the wings. However, as we all know, common sense and clear thinking can be eroded when our own “unfinished emotional business” (Scarf, 1995) propels us.

My life and work have taught me that the strongest lesson in avoiding burnout through self-care is to accept that we are human, and in that, we are each limited and, yes, flawed. Despite best intentions and very hard work, we will each experience failure, and our losses and the losses of those dear to us will bring the most unbearable pain imaginable.

Yet, with all of the pain and loss of life, we can, if we will it, grow, learn, and move forward in our life journey. If we hold on to this, we can understand how important self-care is. It will give us the strength to claim the joys of living and endure what we must. And it will help us to ensure that our clients are able, whenever possible, to do the same.

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