Professional Burnout

Recent Developments in Theory and Research

Wilmar B. Schaufeli, Christina Maslach, Tadeusz Marek, Wilmar B. Schaufeli, Christina Maslach, Tadeusz Marek

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351854733
• Edition: 1
• Topic: Business
• Subtopic: Business General
• Index: Business

A rapidly growing number of people experience psychological strain at their workplace. In almost all industrialized countries, absenteeism and turnover rates increase, and an increasing amount of workers receive disablement benefits because of psychological problems. This book, first published in 1993, concentrates on a specific kind of occupational stress: burnout, the depletion of energy resources as a result of continuous emotional demands of the job.

This volume presents theoretical perspectives that had been developed in the United States and Europe, discusses methodological issues, and examines organisational contexts. Written by an international group of leading scholars, this book will be of interest to students of both psychology and human resource management.

1

HISTORICAL AND CONCEPTUAL DEVELOPMENT OF BURNOUT

Christina Maslach

University of California, Berkeley

Wilmar B. Schaufeli

University of Nijmegen

“It is a critical time for the concept of burnout. Will burnout prove to be a concept of enduring value, useful in understanding and treating a class of work-related symptoms? Or will the concept itself ‘burn out’ from overuse, overextension, and lack of new direction?” (Farber, 1983b, pp. 17–18). It has been a decade since this “critical time” and in the intervening years there has been an extraordinary amount of work on this topic. In their recent bibliography, Kleiber and Enzmann (1990) listed nearly 1,500 publications that were published in the 7 years following Farber’s 1983 statement. This is even more than in the previous decade 1974–1983, when 1,000 books, journal articles, and dissertations on burnout were written. Although the early work on burnout was almost exclusively American in origin, the current contributions are truly international in scope.

What have we learned from this extensive empirical and clinical literature? Is burnout really a concept of enduring value that improves our understanding of the working world of many professionals? We believe that the answer is yes—an assessment that is well supported by the evidence documented in this volume. However, before beginning our tour through that territory, we first need to explore its definitional borders. In other words, how do we conceptualize, on various dimensions, the nature of burnout? To answer this question, we need to review the developmental history of the burnout concept and to trace the pattern of theoretical progress that has been made.

HISTORICAL DEVELOPMENT OF THE BURNOUT CONCEPT

Burnout first emerged as a social problem, not as a scholarly construct. Thus, the initial conception of burnout was shaped by pragmatic rather than academic concerns. In this pioneering phase of conceptual development, the focus was on clinical descriptions of burnout. Later on, there was a second, empirical phase, in which the emphasis shifted to systematic research on burnout and in particular to the assessment of this phenomenon. Throughout these two phases there has been increasing theoretical development in which the concern has been to integrate the evolving notion of burnout with other conceptual frameworks.

The Pioneer Phase

The first few articles about burnout appeared in the mid-1970s in the United States (Freudenberger, 1974, 1975; Maslach, 1976). The significance of these first articles was that they provided an initial description of the burnout phenomenon, gave it its name, and showed that it was not an aberrant response by a few deviant people but was actually more common.

The way in which the burnout phenomenon was identified and labeled illustrates its social origin. As a psychiatrist, Freudenberger was employed in an alternative health care agency. He observed that many of the volunteers with whom he was working experienced a gradual emotional depletion and a loss of motivation and commitment. Generally, this process took about a year and was accompanied by a variety of mental and physical symptoms. To denote this particular mental state of exhaustion, Freudenberger used a word that was being used colloquially to refer to the effects of chronic drug abuse: “burnout.”

At about the same time, Maslach, a social psychology researcher, was studying the ways in which people cope with emotional arousal on the job (see Chapter 2). She was particularly interested in such cognitive strategies as “detached concern” and “dehumanization in self-defense,” but soon discovered that both the arousal and the strategies had important implications for people’s professional identity and job behavior. When by chance she described these results to an attorney, she was told that poverty lawyers called this particular phenomenon “burnout.” Once Maslach and her colleagues adopted this term, they discovered that it was immediately recognized by their interviewees; thus, a new colloquial expression was horn.

Do these anecdotes about the “discovery” of burnout indicate that the phenomenon did not exist before? Obviously not. For instance, Burisch (Chapter 5) presents several examples of psychological states that have been described previously in the literature. These states match the current description of burnout but have been labeled differently (e.g., “exhaustion reaction”). In 1953, Schwartz and Will published a case study of Miss Jones, a disillusioned psychiatric nurse, who is probably the most prominent (and often cited) example of burnout. Moreover, essayists have portrayed fictional burned-out characters long before the concept was introduced in the mid-1970s. For instance, Thomas Mann’s description of the protagonist in Buddenbrooks (1922) includes the most essential features of burnout, such as extreme fatigue and the loss of idealism and passion for one’s job. Most famous, however, is Graham Greene’s A Burnt Out Case (1960), in which a spiritually tormented and disillusioned architect quits his job and withdraws into the African jungle. The symptoms displayed by this character fit quite well with current descriptions of burnout.

Given these forerunners, why did the burnout syndrome not attract public attention until the mid-1970s? Several authors point to a specific constellation of economic, social, and historical factors. Farber suggests that “American workers have become increasingly disconnected and alienated from their communities, and increasingly insistent upon attaining personal fulfillment and gratification from their work. The combination of these two trends has produced workers with higher expectations of fulfillment and fewer recourses to cope with frustrations—a perfect recipe for burnout” (1983a, p. 11). Farber also points to a problematic development in the human services. Originally these services were based in the community, but after World War II social services work became more professionalized, bureaucratized, credentialized, and isolated. Governmental interference increased, and clients became needier and more entitled to services. Consequently, it became more difficult for people to find professional fulfillment in human services work, and disillusionment and burnout became increasingly common.

In addition, Cherniss (1980a) argued that the tendency toward individualization in modern society has led to increasing pressure on the human services. Because the traditional social fabric is disintegrating, more and more problems in living have to be solved by professionals instead of relatives, neighbors, or other members of the community. Furthermore, over the past decades, the government has cut back costs for many human service agencies, so that an increasing workload has to be managed by even fewer people. Cherniss (1980a) also points to the decline of the authority of professionals over the past decades and to the recent development of what he calls the “professional mystique.” The latter involves the public’s belief that professionals experience a high level of autonomy and job satisfaction, are highly trained and competent, work with responsive clients, and are generally compassionate and caring. This mystique is reinforced by the professionals’ education and leads to high and unrealistic expectations in young professionals that clash with the harsh everyday reality of the job.

Thus, the stage was set for the introduction of the burnout concept in the mid-1970s. There was a tremendous reaction to the first articles on this topic, and in the next 5 years there was a virtual flood of writing about burnout. Obviously, burnout was “in the air.” Not surprisingly, interest was particularly high among practitioners, as opposed to academic scholars, and thus much of the writing on burnout appeared in magazines or journals directed to this professional audience. These practitioners came from a variety of people-oriented, human services occupations where (1) the relationship between a provider and a recipient is central to the job and (2) the provision of service, care, or education can be fraught with emotional strain. Consequently, the greatest attention to burnout, and the most discussion of it in those first 5 years, occurred in the fields of education, social services, medicine, the criminal justice system, mental health, religion, and various other people-oriented occupations (see Maslach, 1982a for an annotated review).

This early burnout literature had several noteworthy characteristics, which in turn have had implications for the development of the burnout concept. First, what was meant by the term “burnout” varied widely from one writer to the next. As a result, these writers were sometimes talking about different phenomena rather than the same one. A second, and related, characteristic is that the concept of burnout was stretched and expanded to encompass far more than it did originally. Almost every personal problem that one can think of was described as “burnout” at some point. In some cases, burnout was a somewhat superfluous addition, as in “midlife crisis burnout.” In other cases, it was stretched to include opposite phenomena, such as overload and underload. The problem here is that a concept that has been expanded to mean everything ends up meaning nothing at all, an issue that has been discussed elsewhere (Maslach, 1982c; Maslach & Jackson, 1984).

A third characteristic of the early burnout literature is that it was largely nonempirical. Perlman and Hartman (1982) reviewed 48 articles that had been published between 1974 and 1981, all with many ideas, suggestions, and proposals about what causes burnout and what should be done about it. However, only five of these articles (i.e., 10%) had any empirical data beyond an occasional anecdote or personal case history. Instead, most of these early articles on burnout used a “clinical” approach. Thus, the authors tried to describe and understand the burnout syndrome by means of cautious (but unstandardized) observations and subsequent analyses of individual case studies. In particular, the focus was on symptoms that are found in burned-out individuals.

Most early articles on burnout followed a typical pattern. First, the stressful nature of the particular profession was described. Next, job stress in that profession was related to burnout, and one or more case studies or vignettes were presented to illustrate the issue. Finally, some preventive strategies were recommended. Thus, although much was being said about burnout, there was little evidence to either support or refute these statements. This relative lack of empirical evidence limited any attempts at intervention and led critics to disparage the concept or even dismiss it entirely.

One reason for the initial sparseness of research on burnout is that, as mentioned earlier, practitioners were far more interested in burnout than were academic scholars. This is not surprising, given that practitioners are more likely to be dealing directly with the problem of burnout on a daily basis. However, this fact has had some important ramifications. Most practitioners have had less training in research skills and thus are less likely to undertake major research projects. Furthermore, practitioners have different goals with respect to burnout than do academicians. Their primary concern is with intervention rather than theory, i.e., with how to solve the problem rather than with how to conceptualize it. Most academic scholars would argue that that is putting the cart before the horse and that one must first have a theoretical model about the phenomenon in order to know what to do about it. However, people who are actually dealing with the problem tend to view theory building as intellectual game playing, with no practical payoff. The argument is that we already know enough about burnout from direct experience, so now we should apply that knowledge to alleviate the problem.

On the other hand, many researchers were not interested in burnout at first, even though (or maybe because) practitioners were. Initially, the academic world had a somewhat negative reaction to the concept of burnout. “Because it has a catchy ring to it, burnout is sometimes immediately dismissed as a fad or as pseudoscientific jargon that is all surface flash and no substance” (Maslach & Jackson, 1984a, p. 139). For instance, Maslach and Jackson’s psychometric article on the development of the Maslach Burnout Inventory (MBI) was returned by some journal editors with a short note that it had not even been read “because we do not publish ‘pop’ psychology.”

Because there was not an early emphasis on developing theories of burnout, there was no conceptual framework for integrating and evaluating the various findings and proposed solutions. Consequently, the field seemed somewhat scattered and chaotic. However, this lack of an initial theoretical model was not as serious a flaw as some have argued. To some extent, the lack of theory reflected the newness of the phenomenon—much had to be discovered about its parameters before a model could be developed. Also, a different process occurs when one starts with a real-world problem and works back toward a theoretical model rather than vice versa (starting with a theory and then deriving some implications for a particular social issue). Real problems tend to be messy and complex rather than clean and simple, and no single theory is going to be the obvious choice as a guiding model. Moreover, different people will work back toward different theoretical models for the same problem, depending on their particular perspective. For example, someone with a clinical perspective may conceptualize burnout in terms of depression, but someone with an organizational perspective may approach it as an issue of job satisfaction. Initially, it can be hard to compare and integrate these different perspectives (especially if there is definitional variation as well), and this may be one reason why the earlier burnout literature lacked theoretical coherence. However, as has been pointed out elsewhere, this rich diversity of theoretical perspectives, as well as of related methodological techniques, is one of the special virtues of the eclectic, problem-oriented approach that has typified the burnout field (Maslach & Jackson, 1984).

The Empirical Phase

During the next phase of the 1980s, the work on burnout entered a more focused, constructive, and empirical period. Many books and articles were written about burnout, in which the authors outlined their working models of the phenomenon, proposed various ideas and interventions, and presented various forms of corroborative evidence (survey and questionnaire data, interview responses, clinical case studies). Standardized measures of burnout were developed, thus providing researchers with more precise definitions and methodological tools for studying the phenomenon (for a review, see Chapter 12). In particular, the development and widespread acceptance of the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981a, 1981b, 1986) and the Tedium Measure (TM; Pines, Aronson, & Kafry, 1981) fostered systematic research on burnout, resulting in an increased number of articles published in scholarly journals (including several issues devoted entirely to burnout).

Up until the early 1980s burnout was studied exclusively in the United States. Gradually, the phenomenon drew attention in other countries as well, beginning with such English-speaking countries as Canada and Great Britain. Soon articles and books were being translated into other languages, and by the second half of the 1980s, research instruments (particularly the MBI) were also being translated into French, German, Italian, Spanish, Swedish, Dutch, Polish, and Hebrew, among others (see also Chapter 12). Soon, the first cross-national studies on burnout were carried out (for a review see Chapter 13).

Interestingly, in other countries burnout research started after the concept had been established in the United States, and after measurement instruments had been developed. Accordingly, what we have called the pioneer phase in the development of burnout was skipped in countries outside the United States. In these countries, burnout was conceptualized, from the very beginning, in operational terms that were implied by the measurement instruments. Thus, for researchers using the MBI, burnout was by definition a syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Hence, the initial conceptual debate on burnout was less broad, and alternative measures were rarely developed. Only recently have conceptual contributions been made by non-Anglo-Saxon authors (see Chapters 4–6, 9, and 10).

A general review of the more recent burnout literature indicates several trends. First, much of the work has continued to be done within people-oriented, human service occupations, although the variety of these occupations has expanded (e.g., police, correctional officers, prison guards, librarians). Although this is the general case, the burnout concept has also been extended to other types of occupations and other nonoccupational areas of life. For example, there has been discussion about burnout in the business world, in sports, in political activism, and within the family.

The empirical research on burnout has tended to focus more on job factors than on other types of variables. This is consistent with most of the conceptual models that have been proposed. Thus, researchers have studied such variables as job satisfaction, job stress (workload, role conflict, and role ambiguity), job withdrawal (turnover, absenteeism), job expectations, relations with coworkers and supervisors (social support on the job), relations with clients, caseload, type of position and time in job, agency 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 (locus of control, hardiness), 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.

The vast majority of the...