“Burnout” and how to fight with that

“No More Victims”ConferenceMarch 2011

Presented by

Dr Jo ClarkeConsultant Forensic Psychologist

University of York

Setting the Scent: Pt 1

A Critical Occupation

One where there is a high risk of exposure to potentially traumatic events or material, that may, under

certain circumstances, exert critical impact on the psychological

well being of those within it

Paton & Violanti, 1996

What the early literature told us

• Consistently across studies between a fifth and a quarter of facilitators report negative effects (e.g. Farrenkopf, 1992;), broadly divided into:

– Cognitive– Emotional– Behavioural– Sexual

Examples of Cognitive Changes

• Increased difficulty making decisions (Bird Edmunds, 1997)

• Intrusive visual imagery about sexual violence (Jackson et al., 1997)

• Ruminating over offence details (Turner, 1993)

• Doubts about competence (Ellerby et. al., 1993)

• Increased cynicism and suspicion of others (Farrenkopf, 1992)

Examples of Emotional Changes

• Decreased sensitivity and dulling of emotion (Farrenkopf, 1992)

• Feelings of anger, frustration, disillusionment, depression, inadequacy and guilt (Ellerby et al., 1993)

• Heightened anxiety and fear (Jackson et al., 1993)

• Increased feelings of helplessness (Bird Edmunds, 1997)

Examples of Behavioural Changes

• Sleep disturbance,increased alcohol/drug use, increased absenteeism (Bird Edmunds, 1997)

• Deceased sense of humour (Farrenkopf, 1992)

• Avoidance of physical contact with children (Turner, 1993)

• Increased general irritability (Bird Edmunds, 1997)

• Depersonalising clients (Hill, 1995)

Examples of Changes in Sexual Behaviour

• Reduced interest in sex• Reduction in sexual behaviour• Avoidance of sexual behaviour• Distraction during sex

(Ellerby et al., 1993)

• Impotence• Intrusive sexual imagery

(Turner, 1993)

Shortcomings of what we know

• Symptoms made to fit existing conceptualisations

– Burnout (e.g. Farrenkopf, 1992)– Secondary Traumatic Stress (e.g. Ellerby)– Vicarious Trauma (Rich, 1997)– Compassion Fatigue (e.g. Figley, 1995)

• Based on poorly constructed and/or non-validated and/or general measures

• Most commonly used is the Maslach Burnout Inventory (MBI – Maslach and Jackson, 1981)

• 3 dimensions– Emotional Exhaustion– Depersonalisation– Reduced personal accomplishment

Shortcomings of Literature (cont’d)

• Based on cross sectional methodology

• Over reliance on self-report• Studies are generally descriptive• Assumption that effects should be attributed to nature of material

• No comparison with other mental health professionals

Caring about members of Critical Caring about members of Critical Occupations means working to Occupations means working to

ensure that “any damage is only ensure that “any damage is only temporary, and that they will temporary, and that they will succeed in their struggle to succeed in their struggle to restore their psychological restore their psychological

integrity”integrity”

Adapted from Adapted from Lazarus Lazarus (1999)(1999)

Setting the Scene: Pt 2Setting the Scene: Pt 2

The Rewards

• Kadambi and Truscott, 2003– Protection of the public– Offender change and wellness– Connection to colleagues– Enjoyment of counselling– Offender specific change– Socially meaningful curiosity– Professional benefits

Working with the Sex Working with the Sex Offenders: The Impact Offenders: The Impact

StatisticsStatistics About a quarter of people in About a quarter of people in Critical Occupations experience Critical Occupations experience negative impact (that they attribute negative impact (that they attribute to their work) at any given time.to their work) at any given time.

• About 75% don’tAbout 75% don’t

• People don’t feel bad People don’t feel bad all of the timeall of the time

• Probably, over time, Probably, over time, all of us experience all of us experience some sort of negative impactsome sort of negative impact

MOST OF US RECOVER!MOST OF US RECOVER!

Static Factors

Stable Factors

CriticalOccupation

Dynamic Factors

PositivePsychological

Outcome

NegativePsychological

Outcome

Model of Dynamic Adaptation (Clarke 2004)

The Person

About the FactorsAbout the Factors

• Static FactorsStatic Factors– Factors that are fixed or unchanging or change Factors that are fixed or unchanging or change in a highly predictable way, e.g. gender, in a highly predictable way, e.g. gender, qualifications, agequalifications, age

• Stable FactorsStable Factors– Factors that are potentially changeable but Factors that are potentially changeable but relatively stable; factors that under normal relatively stable; factors that under normal circumstances only change slowly, e.g. coping circumstances only change slowly, e.g. coping style, perspective taking skillsstyle, perspective taking skills

• Dynamic FactorsDynamic Factors– Factors that change rapidly and/or Factors that change rapidly and/or unpredictably, e.g. changes in organisational unpredictably, e.g. changes in organisational structure, events not under personal control structure, events not under personal control (accident)(accident)

About the factorsAbout the factors

• Critical OccupationCritical Occupation– This includes all the “on-the-job” type factors, This includes all the “on-the-job” type factors, such as types of unit/prisoners, colleague such as types of unit/prisoners, colleague relationships, policies and proceduresrelationships, policies and procedures

• Positive Psychological OutcomePositive Psychological Outcome– Anything rewarding about the job, from working Anything rewarding about the job, from working with a great team, to a previously highly with a great team, to a previously highly aggressive prisoner getting through the day aggressive prisoner getting through the day without hitting anyone!without hitting anyone!

• Negative Psychological OutcomeNegative Psychological Outcome– Any cost, such as feeling irritable, tired, Any cost, such as feeling irritable, tired, suspicious of others, anxious when alone, suspicious of others, anxious when alone, anxious around others etcanxious around others etc

AgeGender

Time in RoleEver a victimLiving status

ParentFacilitator Status

Coping stylePerspective takingEmotion control

Emotional sensitivitySocial Support

Skills - Modelling

ColleaguesEnvironmentFundingResources

Organisational policies, practices

and culture

Personal traumaHealthFamily

Management

Protection of the publicOffender change and wellnessConnection to colleaguesEnjoyment of counsellingOffender specific change

Socially meaningful curiosityProfessional benefits

Disrupted schemaIntrusive imagery

RuminationDifficulty making decisionsHeightened fear and anxietyFeelings of anger, guilt,

frustration, disillusionment, depression,

inadequacyDecreased sensitivity and

dulling of emotion…

The Model of Dynamic Adaptation (Clarke, 2004)

The Person

STATIC FACTORS

STABLE FACTORS

CRITICAL OCCUPATION

DYNAMIC FACTORS

POSITIVE OUTCOME

NEGATIVE OUTCOME

Hot off the Press

• The 3 most important MDA factors associated with resilience are:-

•Age (static)

•Organisational Culture (dynamic/critical occupation)

•Detached Coping (stable)Fox & Clarke, 2010

Static Factors

Stable Factors

CriticalOccupation

Dynamic Factors

PositivePsychological

Outcome

NegativePsychological

Outcome

Model of Dynamic Adaptation (Clarke 2004)

Intervention 4

Intervention 3Intervention 1

Intervention 2

Future Research?• Determine predictors of resilience and job satisfaction among European Union member states probation officers

• Identify good organizational practice in minimizing risk of negative outcome and maximizing likelihood of positive outcome for EU probation staff

• Develop a more detailed understanding of organisational culture and the impact of individual differences

• Evaluate of a range of interventions, including training in detachment (Roger, 2004)

• Implement a longitudinal study to develop a better understanding of the Process of Dynamic Adaptation