BURNOUT: WHO IS AT RISK?
Burnout has primarily been studied among persons in human service occupations such as education and health care (3). Persons in health and fitness careers often develop intense interpersonal contact with clients. These interactions can be positive and rewarding, yet they also can be demanding and draining. Feeling required to be motivational and compassionate, even while working with clientele who are more likely to relapse than succeed in their health and fitness goals, can be emotionally draining. Being nonjudgmental and accepting of clients when they have setbacks while demanding perfection in one’s own fitness goals can create a tremendous amount of strain (Table 1). In addition, research suggests persons with a Type A personality, an external locus of control, or an avoidant coping style are at an increased risk of experiencing burnout (5).
The organizational culture and practices where a person works also are key factors that affect an individual’s risk of feeling burned out. A host of organizational factors can contribute to burnout. Having uncertain work hours, limited flexibility/control over work, work overload (more work than allotted time allows), ambiguity about what needs to be done, and unresolved conflicts with coworkers or supervisors can increase feelings of ineffectiveness and lead to exhaustion (3,6) (Table 2). An inability to have any control over decisions that affect a person’s job, such as assignments, workload, or schedule, can decrease work-life integration and increase the risk of feeling burned out (3,6).
THE THREE DIMENSIONS OF BURNOUT
One of the leading researchers on burnout, Dr. Christina Maslach, wrote a book titled Burnout: The Cost of Caring in which she explained the three key dimensions of the burnout response (7) (Figure). The first aspect of the multidimensional theory of burnout is overwhelming emotional exhaustion. The second is feelings of cynicism, depersonalization, and detachment from one’s job. The third dimension is a sense of inefficacy or reduced feelings of accomplishment or productivity at work.
The exhaustion component of job burnout refers to feelings of being overextended and depleted of one’s emotional and physical resources (5). Emotionally exhausted persons may feel withdrawn and want to isolate themselves. A day spent working long hours, trying to motivate others to adopt healthy lifestyle changes, can leave a fitness professional feeling drained.
The depersonalization dimension can be described as having negative or inappropriate attitudes toward clients (5). Fitness professionals deal with a client population that has a high rate of relapse. As time goes on, this can easily make one cynical, which can lead to chronic irritability. One’s ability to have compassion for struggling clients may decline.
The component of reduced efficacy (called inefficacy) refers to feelings of incompetence and a lack of achievement and productivity at work (5). Professionals in the fitness field can begin to wonder if anything they say or do matters at all in terms of helping people get and stay active. This can lead to self-doubt and feelings of powerlessness. In the long term, a professional may begin to feel hopeless and ineffectual.
STRATEGIES FOR INDIVIDUALS TO COPE WITH JOB BURNOUT
Strategies proven to be effective in reducing burnout in individuals include mindfulness training, exercise programs, self-care efforts around stress management, and participation in small groups oriented around promoting community, connectedness, and meaning (8,9). Listed below are suggestions for addressing and reducing symptoms of job burnout (Table 3).
Create a Work-Life Balance
The key to preventing burnout is keeping a healthy balance between the time and energy one devotes to a career and life outside of work. What a work-life balance looks like is different for everyone. Once a person starts feeling emotionally drained and senses he or she is not getting ahead, even with increased effort, it is time to make time for activities and experiences that can build meaning away from work. Perform a values recalibration. On a piece of paper, write down the top 3 to 5 things of value in life, such as family, physical health, work, time spent in nature, and so on. In the same way a nutritionist might ask a client to perform a 7-day dietary recall, write down the number of hours spent each week in activities related to things identified as part of one’s core values. Examine the output to see how many hours are spent doing tasks that relate to work versus those that can give a sense of enjoyment and accomplishment outside of work.
Less than half of all workers in the United States who received paid vacation days used all (only 35%) or most (only 14%) of them (10). Spend some mental energy planning for a joyful life outside of work. Use up those vacation days. They do not have to be spent on expensive trips to far-flung locales or events that will make a splash on social media. Make a list of local attractions that are free, or schedule time for nurturing relationships that can provide much needed social support. Make a goal to spend time each day, each week, doing things or spending time with people that impart a sense of identity unrelated to the job.
One of the key signs of burnout is decreased productivity, working more and more while accomplishing less and less. Persons who work more than 50 hours a week are classified as workaholics (10). About one in five working adults fits in this category. In her best-selling book Lab Girl, geobiologist Hope Jahren describes how she learned, as an undergraduate student, that sitting down, and forcing herself to look at a blank screen for hours and write, was unproductive (11). If Professor Jahren took time initially to learn crucial information, she could then do something else and let her subconscious work out meaning and give it context. When that important work had been done, she could sit down and write page after page with much less effort. Challenge the assumption that working long hours means increased productivity. Spending time away from work, engaged in something non–work-related, can help improve efficiency and productivity when one comes back to work.
Learn to Say “No”
Experiment with saying no to more work when already at capacity. Saying no at work can feel risky. Fitness professionals do not want to turn down clients who provide them with income and referrals. Try to resist the urge to give a quick “yes” to the person asking for help. Practice communication that can allow for time to evaluate the new work requests without giving an immediate “yes.” For example, “Thanks for reaching out to me. Let me take a look at my workflow for the week and I will get back to you in 24 hours.” If the person making the request is a client, giving them a timely “no” is preferred over a “yes” that one cannot follow up on. Consider responding with something along the lines of “I cannot get you on my schedule for 2 weeks, but I am interested in working with you. Do you have 15 minutes right now to tell me how I can help?” or “I can put you on my cancelation list. If you are flexible with times, I will most likely be able to meet with you within 72 hours.”
Regular communication with coworkers and supervisors is key in providing a context for why you are unable to assist them with certain requests. Although initially, one may get pushed back when saying no to a colleague, over time, one will come to be seen as someone whose “yes” really means something. Consider regular meetings with supervisors as a way to get on the same page in terms of task prioritization.
Mindfulness is a coping skill that involves focusing one’s awareness on the present moment, building awareness of thoughts, feelings, and bodily sensations without judgment or forcing a change. A daily mindfulness practice such as a seated or walking meditation can help people recognize unhealthy ways of thinking (Table 4). A wandering mind is normal; notice the thoughts in your head and then gently bring them back into the moment. Notice. Do not judge. Do not try to force a change. Mindfulness teaches us to let go of “shoulds”: how one “should” act, how others “should” behave, what the outcome “should” be. A daily mindfulness practice can help people approach life with curiosity, flexibility, and compassion for oneself and others.
A daily mindfulness practice can help people approach life with curiosity, flexibility, and compassion for oneself and others.
Create a Support Team
Research consistently shows that a lack of social support is linked to burnout (5).
Research consistently shows that a lack of social support is linked to burnout.
Humans thrive in community. Small group activities that promote community, connectedness, and meaning are effective in preventing burnout (9). Many fitness professionals work one-on-one with clients, in isolation from peers. If this is the case, find a mentor, someone who is a good role model for having a work-life balance. Ask them if they will provide feedback and coaching. A mentor can help to recognize what individuals do well and identify opportunities for further training and collaboration. Professionals who work in an environment that does not provide needed support can reach out online or through conferences and trainings to connect with colleagues and build a community that is mutually supportive. Invest time, each day, in cultivating supportive personal and professional relationships. Remember to celebrate successes, no matter how small. Keep friends and family in the know about accomplishments at work. Ask a trusted coworker or supervisor to help acknowledge work triumphs. Do the same for them.
Find Meaningful Work
Health and fitness professionals know very well that both the physical and social environment can greatly impact an individual’s ability to make health promoting choices. Sometimes, to prevent or relieve job burnout, a change in work environment is necessary. There is only so much an individual can do, via self-care, to cope with the symptoms of burnout. Research has consistently shown that burnout is a response to work overload—too much work and too little time to do it (5). A lack of social support from supervisors and limited feedback on job performance is consistently related to all three components of burnout, as is low input in relevant decisions (5).
If one cannot alter their mindset about work issues, or affect a positive change in the work environment, finding a new job may need to be considered. Individuals may benefit from working with a therapist or life coach to determine if their current occupation is aligned with their core values. Seek out a position that 1) has a reasonable workload with resources available to help employees meet expectations, 2) allows for more autonomy over both day-to-day tasks and overall career trajectory, 3) cultivates a supportive social community at work, 4) exhibits an organizational culture in alignment with your values, and 5) enables a satisfactory work-life integration (6). Spend time looking at new employment opportunities with a clear sense of what is valued both in day-to-day tasks and long-term outcomes. No job is perfect, but one can find a situation that more closely aligns with the level of responsibility and production that is right for them.
HOW TO RECOGNIZE BURNOUT IN CLIENTS
There are no official medical or psychological diagnostic criteria for burnout. Burnout is not something that shows up quickly; it is the result of a slow burn. It is estimated that one in four workers experience symptoms of burnout (10). It is outside the scope of practice for health and fitness professionals to diagnose or counsel clients who are burned out. However, they can provide their clients with educational resources and encouragement to reach out for help.
Due to experiencing heavy workloads, a client who was always on time may start canceling appointments more frequently or arriving late. Someone who was usually optimistic and positive may begin to speak more negatively about their own clientele or coworkers. Unlike the efficient, productive sessions they used to have, an individual experiencing burnout may have difficulty getting started with a workout or finishing in the allotted time. If burnout is suspected in a client, talk with them about reaching out for help through an employee assistance program, a mental health professional, or a general practitioner.
The Maslach Burnout Inventory (MBI) was developed and published more than 35 years ago, and it is the most widely accepted instrument for assessing symptoms of burnout. There are versions developed for use by professionals in specific fields and a “general” version (MBI-GS). Individual assessments can be purchased online at https://www.mindgarden.com. After completing the assessment, individuals will receive a 15-page report that explains their scores, includes recommendations for reducing burnout, and provides a list of additional readings.
Work with the client who may be experiencing burnout symptoms to tailor their workout routine. Persons who work at a desk can take 5 to 10 minutes each morning and afternoon to stretch, perform some core exercises, or meditate. Encourage clients to think about walking to the office of a supervisor or coworker for a face-to-face chat instead of firing off another e-mail. Moderate exercise during a lunch break can be an effective way to fit movement into the day. Ask clients to consider working out with a friend or family member as a way to combine physical activity with socializing. Clients may benefit from exercising with a colleague who can offer social support.
Burnout is a particular type of work-related stress that is more common among professionals that work long hours in human services occupations. Fitness professionals may fit in this category. Chronic exposure to a stressful work environment can result in feelings of pessimism and job detachment, a sense of ineffectiveness at work, and overwhelming emotional exhaustion, known as the three dimensions of burnout. Understanding the symptoms and causes of burnout can help empower individuals to take steps to relieve stress. Individually, persons can practice mindfulness and strive to rebalance the time spent on work and non–work-related pursuits. Learning to say no when already at capacity can be useful in making time for a more holistic lifestyle. Research suggests that cultivating and maintaining strong social support is crucial in reducing symptoms of job burnout. Finally, if one cannot alter a stressful work environment, finding a new job may need to be considered. Being aware of symptoms of job burnout can also help fitness professionals recognize signs in their clients. They can then either change their expectations for their clients or bring it to their attention and encourage them to get help.
BRIDGING THE GAP
The main purpose of this article is to help fitness professionals identify and relieve symptoms of job burnout. Both individual self-care strategies and changes in the work environment have been proven to be successful in reducing the symptoms of burnout. It is also important to recognize burnout in clients, especially as it can negatively impact adherence, compliance, and goal achievement.
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Keywords:© 2019 American College of Sports Medicine.
Burnout; Multidimensional Theory of Burnout; Inefficacy; Work-Life Balance; Mindfulness