On the last track, we discussed maturational crises in four transitional periods. These four transitional periods are young adulthood, adulthood, late adulthood, and old age.
On this track, we will discuss therapeutic crisis interventions for clients experiencing burn out.
As you are well aware, a burnout refers to a progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the conditions of their work. Burnout generally occurs in four stages; stagnation which specifically refers to the process of becoming stalled after an initial period of enthusiasm; frustration, characterized by the client realizing he or she is not doing what he or she set out to do’- ‘helping; apathy, which takes the form of progressive emotional detachment in the face of frustrationand hopelessness.
Charlie, 24, was a trainee in a crisis center. Initially enthusiastic, Charlie soon began appearing tired and less enthusiastic. He revealed that in addition to his five days at the crisis center, he was volunteering on the other two days for another center in order to gain experience. He had abandoned his hobbies and broken up with his girlfriend in order to devote his time to his work.
When it was suggested that Charlie give up his volunteering, he responded angrily that his clients needed him. Over the next two months, Charlie withdrew from his peers, and was poorly prepared to discuss his clients. When this was pointed out to him, Charlie stated, “I try to help them, but if they don’t want it… so what?” It was revealed that Charlie had not been taking client’s phone calls, and had received complaints about his performance.
Charlie’s crisis culminated in an emergency phone call. When informed he had an emergency call, Charlie told the therapist to take a message. Charlie’s supervisor overheard and insisted Charlie take the call. The call was from a local emergency room. One of Charlie’s clients, Denise, had committed suicide, and an appointment card with Charlie’s name had been found in the client’s hand. Charlie collapsed and fell to the floor, and for several minutes was completely uncommunicative. Charlie’s supervisor felt it was important for Charlie to obtain help from someone not connected to the crisis center, and referred Charlie to me for crisis intervention.
My immediate intervention with Charlie was to meet with his supervisor, Lawrence, and arrange for Charlie to take a temporary withdrawal from his training at the crisis center. I felt that it was necessary for Charlie to get away from the direct source of his job stress. Charlie’s supervisor arranged for Charlie to take a leave of absence.
In our initial session, Charlie stated, “It’s all my fault that Denise died. I just stopped caring… I must have missed something in talking with her! I don’t know who I’m kidding. I can’t help anybody! I am useless!” As an immediate intervention, I assisted Charlie in writing up exactly what his responsibilities in his job were.
I stated to Charlie, “you are only responsible for your own actions and responses. This does not mean that you do not become involved with clients or try to change the way the facility is run. It simply means you are responsible for your own actions regardless of what your clients do or do not do. Denise is the one who chose to end her own life.”
Technique for Social Work CEUs, Psychology CEUs, Psychologist CEUs,
Counselor CEUs, Addiction Counselor CEUs, and MFT CEUs
Technique: Magic Rescuer
As an immediate intervention for Charlie, I introduced the “Magic Rescuer Technique”. I asked Charlie to take some time to write responses to the following three questions:
Charlie's 3 Magic Rescuer Questions
1. If you could have a magic rescuer, what would that person do for you? Can you think of at least three things that person would do for you?
2. Can you do any of these things for yourself? Can anyone in your life right now do one of these things for you?
3. If you met yourself and tried to be your own magic rescuer, what could you do for yourself? What stops you from doing these things for yourself?
One of the things Charlie wished for his magic rescuer to do was to prove to him he could actually help someone. Through the Magic Rescuer technique, Charlie brought up the idea that he could remind himself of clients who he had successfully helped. I asked Charlie to spend fifteen minutes a day journaling about a time in which he had helped someone else, even if the event seemed very simple.
3-Step Burn-Out Intervention
My intervention with Charlie also included the following:
Step One. I encouraged Charlie to create a clear separation between work and the other areas of his life. This included limiting off-hours socialization with coworkers or friends in the same profession, and controlling Charlie’s tendency to extracurricular preoccupation with job-related issues. An important component of this intervention involved role-playing refusal to give friends and relatives free professional assistance with their personal problems.
Step Two. In later sessions, I practiced with Charlie skills for developing and maintaining social relationships with family and friends. With constant love and support from friends and family, the self is not at life or death risk if clients or supervisors do not express love and appreciation. This practice also involved encouraging Charlie to seek friends who were healthy, and well-functioning.
Step Three. Finally, I instructed Charlie in decompression routines which he could between leaving work and arriving home. I stated, “Engaging in a solitary, relaxing activity allows you to be more ready to be with people again, and separate your work stress from your loved ones.” Charlie purchased some Tai-chi self tapes, and began practicing tai-chi as a form of physical meditation for twenty minutes after returning home from work.
Think of your Charlie. Which of these interventions would be useful in helping her or him resolve a burnout crisis?
On this track, we have discussed four stages of burnout, and therapeutic crisis interventions for clients experiencing burn out. The four stages are stagnation, frustration, apathy, and hopelessness.
Online Continuing Education QUESTION 14
What are four stages of a burnout crisis?
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