Burnout is a type of prolonged response to chronic emotional and interpersonal stressors on the job. It has been conceptualized as an individual stress experience embedded in a context of complex social relationships, and it involves the person’s conception of both self and others. As such, it has been an issue of particular concern for human services occupations where:
(a) the relationship between providers and recipients is central to the job; and
(b) the provision of service, care, treatment or education can be a highly emotional experience. There are several types of occupations that meet these criteria, including health care, social services, mental health, criminal justice and education. Even though these occupations vary in the nature of the contact between providers and recipients, they are similar in having a structured caregiving relationship centred around the recipient’s current problems (psychological, social and/or physical). Not only is the provider’s work on these problems likely to be emotionally charged, but solutions may not be easily forthcoming, thus adding to the frustration and ambiguity of the work situation. The person who works continuously with people under such circumstances is at greater risk from burnout.
The operational definition (and the corresponding research measure) that is most widely used in burnout research is a three-component model in which burnout is conceptualized in terms of emotional exhaustion, depersonalization and reduced personal accomplishment (Maslach 1993; Maslach and Jackson 1981/1986). Emotional exhaustion refers to feelings of being emotionally overextended and depleted of one’s emotional resources. Depersonalization refers to a negative, callous or excessively detached response to the people who are usually the recipients of one’s service or care. Reduced personal accomplishment refers to a decline in one’s feelings of competence and successful achievement in one’s work.
This multidimensional model of burnout has important theoretical and practical implications. It provides a more complete understanding of this form of job stress by locating it within its social context and by identifying the variety of psychological reactions that different workers can experience. Such differential responses may not be simply a function of individual factors (such as personality), but may reflect the differential impact of situational factors on the three burnout dimensions. For example, certain job characteristics may influence the sources of emotional stress (and thus emotional exhaustion), or the resources available to handle the job successfully (and thus personal accomplishment). This multidimensional approach also implies that interventions to reduce burnout should be planned and designed in terms of the particular component of burnout that needs to be addressed. That is, it may be more effective to consider how to reduce the likelihood of emotional exhaustion, or to prevent the tendency to depersonalize, or to enhance one’s sense of accomplishment, rather than to use a more unfocused approach.
Consistent with this social framework, the empirical research on burnout has focused primarily on situational and job factors. Thus, studies have included such variables as relationships on the job (clients, colleagues, supervisors) and at home (family), job satisfaction, role conflict and role ambiguity, job withdrawal (turnover, absenteeism), expectations, workload, type of position and job tenure, institutional policy and so forth. The personal factors that have been studied are most often demographic variables (sex, age, marital status, etc.). In addition, some attention has been given to personality variables, personal health, relations with family and friends (social support at home), and personal values and commitment. In general, job factors are more strongly related to burnout than are biographical or personal factors. In terms of antecedents of burnout, the three factors of role conflict, lack of control or autonomy, and lack of social support on the job, seem to be most important. The effects of burnout are seen most consistently in various forms of job withdrawal and dissatisfaction, with the implication of a deterioration in the quality of care or service provided to clients or patients. Burnout seems to be correlated with various self-reported indices of personal dysfunction, including health problems, increased use of alcohol and drugs, and marital and family conflicts. The level of burnout seems fairly stable over time, underscoring the notion that its nature is more chronic than acute (see Kleiber and Enzmann 1990; Schaufeli, Maslach and Marek 1993 for reviews of the field).
An issue for future research concerns possible diagnostic criteria for burnout. Burnout has often been described in terms of dysphoric symptoms such as exhaustion, fatigue, loss of self-esteem and depression. However, depression is considered to be context-free and pervasive across all situations, whereas burnout is regarded as job-related and situation-specific. Other symptoms include problems in concentration, irritability and negativism, as well as a significant decrease in work performance over a period of several months. It is usually assumed that burnout symptoms manifest themselves in “normal” persons who do not suffer from prior psychopathology or an identifiable organic illness. The implication of these ideas about possible distinctive symptoms of burnout is that burnout could be diagnosed and treated at the individual level.
However, given the evidence for the situational aetiology of burnout, more attention has been given to social, rather than personal, interventions. Social support, particularly from one’s peers, seems to be effective in reducing the risk of burnout. Adequate job training that includes preparation for difficult and stressful work-related situations helps develop people’s sense of self-efficacy and mastery in their work roles. Involvement in a larger community or action-oriented group can also counteract the helplessness and pessimism that are commonly evoked by the absence of long-term solutions to the problems with which the worker is dealing. Accentuating the positive aspects of the job and finding ways to make ordinary tasks more meaningful are additional methods for gaining greater self-efficacy and control.
There is a growing tendency to view burnout as a dynamic process, rather than a static state, and this has important implications for the proposal of developmental models and process measures. The research gains to be expected from this newer perspective should yield increasingly sophisticated knowledge about the experience of burnout, and will enable both individuals and institutions to deal with this social problem more effectively.