Monday, August 12, 2019

Burn-out - decoding & tackling it!


Photo by Danylo Suprun on Unsplash

The acronym VUCA is commonly used to describe today's business environment. Volatility, Uncertainty, Complexity & Ambiguity are the order of the day. Burn-out, Anxiety, Stress, Work-life Balance, EAP (Employee Assistance Program), Counseling, Wellness programs etc are the buzz-words among HR & Management, across companies.

Burn-out as an occupational hazard is not limited only to corporate world, but seen in various people oriented professions such as human services, education & health care. The context varies, in Corporate sector the burn-out can be related to pressures of project timelines, product launch, productivity, demanding customer, while in Human services the prevailing norms are to be selfless & put other's needs first, the service providers  develop with the recipients an intense level of personal & emotional contact.Although such relationships can be rewarding & engaging, they can also be quite stressful, leading to burn-out in long-run.

In the recently published 11th edition of ICD (International Classification of Diseases), WHO (World Health Organisation) revised Burn-out as an Occupational phenomenon (previously it was categorized as a medical condition).

In online search engines, you will come across tons of scattered articles & papers on Burn-out, describing it's various facets. In this article, I have attempted to provide readers a simplified, consolidated, comprehensive coverage on the topic Burn-out, through a single reading.

List of topics we shall explore together:
  1. WHO definition of Burn-out
  2. Conceptual models of Burn-out
  3. Assessment/Measurement of Burn-out
  4. Causes of Burn-out
  5. Engagement
  6. Outcomes of Burn-out
  7. Intervention strategies
Definition

"Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
  • Feeling of energy depletion or exhaustion
  • Increased mental distance from one's job, or feeling of negativism/cynicism related to one's job
  • Reduced professional efficacy
Burn-out refers specifically to phenomena in the occupational context & should not be applied to describe experiences in other areas of life."

This three dimensional model, clearly places the individual's experience of Burn-out within a social context & involves the person's conception of both self & others. Therefore, Burn-out is a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job.

Conceptual models: 

The earlier theoritical models focused on the relationship between the three dimensions (exhaustion, cynicism & reduced efficacy) of burn-out & these were described in sequential stages.

More recently, burnout models have been based on theories of job stress & the notion of imbalances leading to strain. The first such model was the transactional one, which served as a conceptual bridge between sequential stages & imbalances. It's three stages are: a). job stressors, b). individual strain & c). defensive coping.

Subsequently, three models based on Demands-Resource Imbalance have emerged. There are:
Job Demands-Resources (JD-R), Conservation of Resource (COR) & Areas of Worklife (AW) models.

Job Demands-Resources (JD-R) -  Burn-out arises when individuals have inadequate resources at their disposal for meeting the increasing job demands.



Conservation of Resource (COR) - Burn-out arises when individuals strive to maintain their valued resources, which they perceive are under constant threat.

There are four basic kind of resources: Objects, Conditions, Personal characteristics & Energies.

Objects are physical entities such as transportation, house etc.

Conditions are social circumstances such as marriage, tenure, employment.

Personal characteristics include Skills (technical & social skills) & Personality Attributes (sense of mastery, self-esteem, optimism) that enable an individual to better withstand stressful conditions & achieve desired goals.

Energies are resources which are used to obtain other valued resources.

Areas of Worklife (AW) - This model identifies six key areas in which person-job imbalances arises. These areas of worklife are: Workload, Control, Reward, Community, Fairness & Values. 



The greater the mismatch between the person & the job, the greater the likelihood of burn-out. Conversely, the greater the match, the greater the likelihood of engagement. 

Assessment/Measurement:

Assessment of burn-out has evolved over the years. In 1980's, the focus was only for caregiving occupations such as healthcare & human services. The measures developed in 1980s tended to reflect the experience of those professions. Over the years, the scope expanded to encompass other professions & the assessment tests were broadened with more occupation-neutral wordings, to include experience of non-healthcare, human services professionals.
Other popular inventory tests are: Bergen Burnout Inventory (BBI), Oldenburg Burnout Inventory (OLBI), Shirom-Melamed Burnout Measure (SMBM), Copenhagen Burnout Inventory (CBI).
Causes of Burn-out

The organisational risk factors which lead to Burn-out can be categorised under Six key domains:
  1. Workload
  2. Control
  3. Reward
  4. Community
  5. Fairness
  6. Values
Workload: If overload becomes a chronic job condition then there is very little time for rest, recovery & restoring work-life balance.

 Control: The feeling of loss of autonomy, inability to take or influence decisions at work causes a feeling of lack of control at one's work place.

Reward:  Insufficient recognition, lack of positive reinforcement & lack of rewards (whether financial, institutional, or social) devalues the work & the employee, thereby causing a feeling of inefficacy.

Community: If there is lack of support, prevailing mistrust & conflict in the team, there is greater risk of burn-out.

Fairness: Fairness is the extend to which decisions at work are perceived as being fair & equitable. Cynicism, anger & hostility are likely to arise when people feel they are not being treated with respect & fairness.

Values: Values are the motivating connection between the worker and the workplace, which goes beyond the utilitarian exchange of time for money or advancement. When there is a values conflict on the job (gap between the individual's & organization's value), it leads to burn-out.  

Let's think about Burn-out & Engagement as two opposite poles on a continuum. 
Burn-out <-----------------------------------------------------------------------------------------> Engagement
The Positive state of Burn-out is Engagement.

    Engagement consists of a state of high energy (Vigor), strong involvement (Dedication) & a sense of efficacy (Absorption). 

    So what are the interventions which can be made in these Six key domains of organisational risk factors for promoting engagement?

    Workload: A sustainable & manageable workload, provides opportunities to use & refine existing skills as well as to become effective in new areas of activity.

    Control:  When employees have the perceived capacity to influence decisions that affect their work, to exercise professional autonomy & to gain access to the resources necessary to do an effective job, they are more likely to experience job engagement.

    Reward: Consistency in rewards & recognition, between the person & the job offers both material rewards & intrinsic satisfaction.

    Community: Team work, social connect & support, enhances the experience of job engagement.

    Fairness: Practice of mutual respect, fairness, empathy enhances the experience of job engagement.

    Values: Greater the overlap & congruence between employee's & organisation's values, stronger would be the cognitive-emotional experience of job engagement.

    Outcomes of Burn-out: 

    There are many undesirable outcomes of burn-out at psycho-somatic & cognitive-emotional levels, such as:
    • Job withdrawal
    • Job dissatisfaction
    • Low organisational commitment
    • Absenteeism, more than usual sick leave
    • Turnover
    • Cynicism
    • Lowered productivity
    • Impaired Quality of Work
    • Increased personal conflicts
    • Physical ailments (exhaustion, headaches, chronic fatigue, GI disorders, hypertension, cold/flu episodes, sleep disturbances)
    • Work related anxiety, low mood & depression
    • Alcoholism 
    Intervention strategies to counter Burn-out:

    Intervention strategies can be have two broad approaches:
    1. Prevention of burn-out & Treatment of burn-out, once it has set in
    2. Individual level actions & Work-group/Team/Organisation level actions
    Let's explore them in some details:
    1. A. Prevention of burn-out: 
    Prevention on any given day, is better than Cure. So what proactive steps an individual can take to prevent Burn-out?
    • Make your own health & Well-being a priority. Eating right, regular exercise, proper sleep, meditation, having a channel to share/vent out are all the right steps towards self-preservation. 
    • Have good role models who have been successful in striking harmony in their life & emulate their actions in your daily life.
    • Develop life skills: Stress management, Coping skills, Time management, Problem solving skills.  
    • Nurturing social support (both from2 colleagues & family)
    • Developing a better self-understanding 
    1. B. Treatment of burn-out, once it has set in:
    • Changing work-patterns (taking break times, avoidance of over-time work, balancing work with the rest of one's life)
    • Utilizing relaxation strategies
    • Seek help form a Counselor (counseling sessions; CBT - Cognitive Behaviour Therapy)
       2. A. Individual level actions:

    An individual should take responsibility of their own health & well-being. The self-realisation that outsourcing one's health & well-being to government or corporation is being irresponsible & laid-back, is the first step towards being responsible. This self-realisation then needs to be put into action by practicing preventive steps (listed above in 1.A).

    2. B. Work-group/Team/Organisation level actions:

    Team Leader, has a very important role to play in tackling burn-out:

    • In the daily grind of work, it is easy for people to forget what drew them to their career & organisation in the first place. They start experiencing burn-out by getting disconnected from their values & work at hand. As a Leader, one needs to 'develop a shared sense of WHY' in the team. Remind them why this work important for the organisation, for the customer & for them. When a team has shared values & connection, they are more likely to feel positively about their work.   
    • If the team is reeling under chronic heavy workload, it is the Team Leader's responsibility to get to the root cause to break the vicious cycle. It could be work-resource imbalance, skill-gap, process inefficiency, process breakdown, lack of teamwork, project planning & project management issues. Addressing the root cause in a time-bound manner, monitoring & controlling the situation on an ongoing basis, can significantly improve the situation. 
    • Be a role model for the team. Being humane, spreading positivism & optimism, exhibiting empathy, compassion, understanding, active listening, goes a long way in re-energizing the team.
    • Plan regular short breaks through the day's work & take out time to celebrate team success, milestones & personal occasions.
    • Help team members, wherever possible by redesigning their jobs (job-enrichment, job rotation).
    • Nurture a good team culture, social connect & social support. Team Well-being, should be put into practice & not remain just a philosophy.   
        At an Organization level, following initiatives can be run for employee well-being:

    • A good work culture, is always a top-down approach. Senior management has a very big say, in driving this organisational culture. 
    • Initiatives like EAP (Employee Assistance Program - Counseling), Wellness program, Planned Celebrations/Outings breaks down monotony & facilitates team bonding. 
    • Two-way communication, Trust building measures between management-employee, employee surveys & addressing the issues, goes a long-way in setting the right tone for the organisational culture. 
    Burn-out can be kept at bay. Tackling burn-out is a collective responsibility of an individual, of a leader & of the organisation. With burn-out Out! one's work-life becomes far more rewarding, enriching, fulfilling & meaningful. Let us all collectively strive, for making our work-place better!