NASW Social Work Talks - EP79: How Can Social Workers Avoid Job Burnout?

Episode Date: January 31, 2022

Guest SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD, is a certified group psychotherapist and family life educator, and author of NASW Press publication, "Burnout and Self-Care in Social Work." Visit the show notes to get related resources. And if you like this episode, be sure to subscribe so you'll know when new episodes are release. And please take a moment to leave us a review in Apple Podcasts.

This episode is brought to you by the National Council for Mental Well-Being. Welcome to Social Work Talks. I am Greg Wright. Social work is a rewarding profession. Each day, social workers positively touch the lives of millions of people. But the profession can also cause burnout. In fact, some studies indicate that at any given moment, 4 out of 10 social workers report that they feel burned out about their jobs. Here to talk about that is award-winning clinical social worker Sarah K. Smullins, who has a practice in the Philadelphia area. Sarah K. is author of the best-selling NASW press book, Burnout and Self-Care in Social Work.

Sarah Kay is here to talk about burnout, how social workers can avoid it, and why she decided to write a second edition of her book. Welcome to Social Work Talks, Sarah. It's a pleasure having you here. Thank you. It's a pleasure to be with you, Greg. Wonderful to be here. Yeah, thank you.

So at the top, there's a lot of confusion about what burnout is. And I was wondering if you could define it for listeners. There is indeed a great deal of misinformation, confusion about what burnout is and how it differentiates from depression. So just let me give you a capsule comment. I like to really talk to those who are here today in a way that they can not just understand intellectually, but feel what I want to try to share in the context of their experience. burnout is a state of mind where you're overwhelmed overloaded and feel like i just can't handle another thing it's an external force it comes from too much

pressure from too many places and too much overload most of the work that has been done with burnout concentrates on professional burnout. But my research shows an interactive flow between personal, professional, physical, relational, and societal burnout. It can start in any of these arenas because of overload. I can't carry anymore. My back is breaking. And one arena of burnout affects each of the others. So it's a progressional state. Many people who are burned out think that they're depressed. Depression is different, though there is a negativity in both and can be overlap. Depression is an internal force. And as a social worker, I don't see most forms of depression as illnesses. Depression happens because of life events, because of life realities, because of loss and sadness, illness, death, job discord, being treated poorly, connivance, betrayal. depression can also be of course a psychiatric illness when a black cloud descends and you don't know why when you wake up one morning and you say i'm not living the life i want and this is making

me sick or of course bipolar illness or um a psych uh a psychotic break uh but burnout is is much easier to address and prevent. Think of overload. And the self-care strategies that I've researched address and prevent burnout as long as they're integrated into life. Also, interestingly, the same self-care strategies that work with burnout work with depression. Even if depression cannot immediately be alleviated it it um it it makes it easier to live with depression when these strategies are part of your life so a lot of uh social workers like say that they um experience a vicarious trauma from like working with um individuals with a lot of issues how does i mean Is that like burnout? Is it like a cause of it? Is it a symptom of it? Could you kind of delve into that?

I absolutely, this is really important. And you are pointing to, now we're specifically talking about burnout now. You are talking to a cause, a primary cause of burnout, vicarious trauma. We take on things, we feel them so deeply that our clients talk to us, share with us. There's also compassion fatigue that's a cause of burnout. I give and I give and I give, but the cup is empty. I have no more to give. There's also counter-transference, which is a description that Freud, Sigmund Freud introduced, but more specifically to burnout, it means dealing with impossible situations and impossible people. I added in the second edition, which we'll talk about, moral distress and injury. We as social workers view so many things in our society, in our work setting, in our lives, that are morally unacceptable to any ethics that we live and breathe.

And moral distress and injury are also an enormous cause for burnout. So we've illustrated four psychosocial causes for burnout that with awareness and self-care strategies, we can address. So how does a social worker who has burnout behave? Like, what is a sign that I have burnout? A sign that I have burnout is a feeling that I want to withdraw from everything and everybody. A feeling that nothing that I am doing or can envision is worth anything anymore. And an absolute vehement turn off to the people who love you that begin slowly and without attention intensifies numbing oneself with drugs and alcohol until one can fall through the cracks

of life destroying everything that really keeps life meaningful personally and professionally i was like wondering um how did you get interested in that did you have a burnout issue yourself or were you like seeing it happening and so you said look um i want to uh investigate this a little bit further right you're getting to something really so important and of course i talked about physical burnout and um that's related to this story well this goes back to my first edition in 2015, when you so kindly interviewed me, I was blessed to work for President Kennedy. And it was he who suggested social work for me. And he suggested Catholic University. And you don't say to the President of the United States, Mr. President, what are you

smoking, but I'm from an Orthodox Jewish family in Baltimore. And I couldn't see myself at Catholic University. But it was one of the most extraordinary years of my life. I learned so much there. And I was treated very respectfully, despite my difference with my fellow students. When he died, I didn't want to stay in. I worked there for the department, it was then called the Department of Welfare. Again, to repeat, I just learned so much from my teachers, my supervisor. But when the president died, when President Kennedy died, I didn't want to stay in Washington any longer. I married very quickly. And I married a law student at Penn. And the University of Pennsylvania picked up my scholarship and stipend.

And my placement was the Society to Protect Children, where we work with neglect and abused children. And I learned from a rainbow coalition of devoted social workers how to help parents who got nothing have hope and the ability to care for their children. They taught me how to do it, Greg. But I thought it was the job, but it was really what the job was touching in me I developed flu-like symptoms and once I made I had a committed year to work for them and then I changed jobs and I went into therapy and I knew something wasn't right and what I learned there was it wasn't the job it was what the job was touching in me in my body in my physical arena about unfinished emotional business it was necessary to face. So I faced it.

And then when Lynn Abraham was DA in Philadelphia, I had known Lynn from the time she was a young DA. She gave me an extraordinary pro bono opportunity to work with first offenders in domestic violence, where there was no fatality, to let me offer intensive therapy in lieu of incarceration. So I called all my old mentors, who I had worked with at the Society to Protect Children, which then had been taken over by the city. And they said to me, Sarah Kay, we are burned the hell out and we are leaving social work greg i had never heard the term burnout and i thought my goodness and then i looked around me and others were leaving a a profession they cared vehemently about that they trained ardently for and that they did not want

to leave. You gave an alarming statistic in your intro. And it's worse now since the pandemic, obviously. And so I decided I'm going to do research into burnout. What is this? How is it different from depression? And that's where I learned that it isn't just professional burnout. It's personal, professional, physical, relational, and societal, and they interact. So that's a full response to your question. It was a progression that led to five years of research. So I have a question for you. Are some types of like social work more like prone to like burnout than like others?

I mean, I've heard it a lot from our social workers who are in a child welfare arena. But is it endemic across all, like, sorts of, like, social work? Yeah, Herbert Freudenberger, who worked in the kind of setting I described in 74 and 75, published and introduced the term burnout. And, yeah, yeah. When we see man's inhumanity to man, when we see children used as living ashtrays, chained to beds, starved, yes, you're in a situation where you're more prone to burnout. But I do want to say that all of us are prone to burnout today because 24-7 we see human violations of human beings all over the world. we see a disregard for human beings that often begins in leadership positions in families and in work settings, in communities, and of course, in society. And all of us, every living person today, because of the realities that are with us 24-7,

can be prone to burnout and in addition i mean even so i have a pro bono practice and i also have a regular practice and what you hear in your private regular practice is different than starving usually abused children battered children children whose eyesight is ruined starved, children who starve, until you can get in and do something. So it's different seeing that than, how can I say, deep intimacy and communication problems that are emotionally and often physically and sexually painful. That impacts on you too. There is vicarious trauma, counter-transference, compassion fatigue in that too.

So no matter what we do in a helping profession, we can, one of the core self-care strategies is ask yourself what this is touching in you. Once I saw why I kept getting the flu when I wasn't, flu-like symptoms when I wasn't sick, I knew that I had to do something about certain things in my personal life that had to change. So if we see in our work, wherever it takes us, if you're in a community setting and you have an impossible board member or an impossible executive director or CEO, what is this disregard touching in you and once you know you can figure it out you know it isn't the circumstance itself that overloads us what overloads us is what's touched in us and our ability to work toward change could you kind of like like delve um a bit more into um what is like touching us so

does that mean that the like the like situation um affects um an unresolved thing within our own psyches that we kind of need to like deal with in order to um address the burnout side of it yeah yeah for instance suppose you're dealing in a marital situation and the marriage is abusive um i i've done research in um arenas of emotional abuse that are always part of sexual and physical violence but deserve their own codification and when you deal in a family situation and you see abuse going on if you are abused in your present life or have been abused in your past life and you don't recognize it, you're going to be on overload and you're going to be burned the hell out. In a parallel way, if you're dealing with clients who really have a quality of love that

you yearn for and don't see, don't want to face is missing in your life, they're having what you long for is going to also put you on overload and so basically the bottom line is whatever the path of reality in your world and in society regardless of how stony face it and don't be passive and activate yourself toward the self-respect and mutual respect you and all deserve toward attaining that. 68% of youth surveyed in a national assessment identified providers as the most trusted messengers for sensitive conversations on alcohol and other drug prevention, highlighting the critical role of providers in preventing substance abuse. Yet engaging young people can be challenging, even for trained professionals. The National Council for Mental Well-Being created

a simple message guide to support providers in these difficult conversations. Download the free guide now at thenationalcouncil.org slash getting-candid. That's thenationalcouncil.org slash getting-candid. I want to talk about your book, but before that, I want to ask you, do our social work schools teach our students how to deal with this? Now, I have a daughter. um she earned um her master's in like social work last year um she like has um a passion to be um a forensic social worker um who works with um a lot of foster children and i am like petrified that she'll get burnout from it but um are they like teaching our students about this that it's um a reality of the profession? I was really, yeah, that's such an essential question.

And as I've told you in personal conversation, I was blown away at the success of the 2015 book NASW published. And because of that, before the pandemic, I was invited to meet with young social workers and newly minted social workers really all over the United States. And I would go personally, I've been to Europe, I've been to Canada. And then once the pandemic hit, I met with them through technology. And here's what they tell me. They tell me we know about the injustices.

We know about the pathologic isms, all of the hatred. that drains you. So we know about the immigration problems. We know about our environment going to hell. And we want to work on that. And that's essential to being a social worker. Children need love. And children need respect. And through the ages, a community and a school compensate for what parents can't or don't or aren't able to give children, which was, of course, the job at Society to Protect Children. I told you where I was so blessed to be and learn from committed social workers who understood this. We start with the human hurt in development. And this shows that our schools must improve and of course our communities must have vital resources

a child needs at birth to begin to develop a state of dignity and a state of dignity begins with love. A child who is loved develops internally a feeling of pride. As one grows, I deserve good things and humility. I am not the center of the universe. Those children who grow chronologically, but not with internal needs met, cannot grow into healthy parents, healthy community leaders. They may be even very bright and charming, but internally they're missing something. They can lead an organization where we work, but not understand how to really relate compassionately to others, and they can be in elected office. And my research showed me also that rejection, abandonment, rage, enmeshment, where the family must be one big blob and people

can't become who they really know in a, how can I say, in an emotional sense, with an emotional sense of direction, which I know was so important, who they really need to grow to become in order to be satisfied, and who they really need permission from parents who are so important to become. Severe neglect impedes development, and extreme overprotection and overindulgence leads to people who don't understand the necessary give-take compromise in life. And these people have emotional deficits. So, you know, I would ask anybody who is listening to our discussion, Greg, to think about people who are so impossible to deal with on any level, society, personally,

professionally. And if you study their backgrounds and developmental years, you will see often more than one of these grave limitations in how they grew to chronological adulthood. Gotcha. So your first book was out in the year 2015. So here we are, a second edition is like out um with seven years um after that we've like um had um a pandemic we've like had um a recession we've had um a lot of racial strife going on uh we've had um a political um environment that that is um a divisive one so how did you like weave um all those things into um a second um edition that like offers like social workers advice on how to avoid burnout you've covered why um i saw from 2015 on uh divisiveness rage pathological expression

pitting people against each other from from those who are supposed leaders and i added another arena i think um we were the first to do this um societal burnout and 24 7 exposure to man's in humanity to man which was the societal overwhelming experiences that we're all sharing together exacerbated burnout in the other arenas because our energy was eaten up it's important to understand that in every healthy setting personally professionally in our relationships and in our society, anxiety filters up. There is somebody to talk to who will respect you and cares about your concern. In dysfunctional settings, personally, professionally societally anxiety filters down as a control method to pit you against each other

so you're burned the hell out withdraw and and the so-called leaders can control you yeah um yeah so i i i with the proposal wrote itself i wanted to do research into what's a dysfunctional, what's a functional leader in all aspects of life. I wanted to add more about internal healthy development. I wanted to add more about why social workers aren't as respected as we should be and why we are an impossible profession. I wanted to show that the personal is the professional, is the political, that that's an interactive chain. When we have societal leaders who don't care about our children, especially our children who are suffering so much. That is quintessential societal burnout. And I wanted to do my best to research

what the hell we could do about it together. And with other people who I call natural social workers, those who whatever their professions, share our values and our passion. So that's why i did it that's why i did it that's why i did it and i'm so grateful that um my proposal was accepted and i had an excellent editor rachel myers and um yeah i've been yeah and julie guten who's the project manager i and of course cheryl bradley for believing in my work from the first book from the first edition i'm very grateful i'm very grateful that people found my book Oh, yeah, they have. So I'm a PR person who works for social workers. So what I've learned to avoid burnout is that I only watch the news for like an hour or so. That's it. I can't have it on all day, every day. I get burnt out with it. um we want people to actually read your book but i was wondering if you could offer a few tips to

like like social workers to deal not only with um a professional burnout but like societal level as well so just a few things right right it's my pleasure and that is what i was asked to do recently when I was in Tucson at the Society of Social Work Leadership and Healthcare Conference. And this is what they asked me to do as the keynote. So let me give you that capsule comment that I tried to give to them. We know that gratitude is important. We know that mindfulness is important. We know that journaling is important. What a lot of people don't understand is varying a caseload is important. But most important of all, in our professional settings, in our personal settings, and in our society and community, there must be self-respect that comes

from a feeling of dignity. And there must be mutual respect. Without that, we will be burned out. There are boundaries that can help us in our work. We must know we are not our clients. Our clients' lives are their lives. We have ours. A relationship is essential. And so many of our societal problems have exacerbated because many have forgotten how important it is to form relationships even with those we don't agree with. And that leads to give, to take, to compromise, and to respect. I mean, look at Uncle Tom's cabin. That story awakened the world, awakened the United States led to the Civil War, really, I think, because we talked about real things and real suffering and horror, and we could get on a page to fix it. We must also ask always, and this is

what we said earlier, what is this situation in my society, in my home, in my work that is upsetting me so much. Let me face it. And what can I do about it? This leads to the necessity, sometimes, even in a personal relationship with people who cherish each other, sometimes we have to be able to say no, personally, professionally, I wish I could. But right now, I don't have the time or energy to do that. We must face realities, no matter how stony the path. Get involved with the social determinants of health. God bless us. We all know that. Listen as we work together to address what's necessary. Never demoralize a person. Be as kind as possible when you're dealing with someone with a character disorder, however, who cannot love. Learn to be tough and

hold your ground and process with people you trust and understand they don't have your best interested heart they don't have anyone's best interested heart other than their own listen to your bodies your bodies will speak to you always of course consult um a medical expert if you're ill but if if if you um if your neck hurts and there's no medical reason uh what is it you can't carry? If your back, who's a pain in the neck? If your back hurts, what's breaking your back? What can't you stomach? What can't you swallow? Your body talks to you. What are you itching for? We talked about the inner world development earlier. Understand what in one psychological makeup is overwhelming you. What are they missing? And maybe what you need to fill in

for yourself. No matter the hell, no matter what hell we are going through, no matter, we can rise above it. We have to remember, I love Amazing Grace, we all have such limitations. And that speaks to how much we need each other. And together, there's absolutely nothing we can't achieve. Robert Kennedy said, we can break down the mightiest mountains. E.M. Forster wrote, an aristocracy of the compassionate and the plunky and those capable of caring for each other. This is the aristocracy I think that we as social workers are blessed to have together with the natural social workers who join us. John Lewis, don't be passive. Get into good trouble, with the issues that matter to you and save the soul of America. And take pride,

take pride in our profession. Despair is never an option. We cannot afford to give up hope. There is always hope. And we absolutely can't tell our children that hope is dead, Because it isn't. We can learn from our mistakes. We can have grassroots efforts. We can get involved with the Brennan Center. United States is the only democracy in the earth, in the world, where voting districts are determined by the politicians who benefit from this manipulation. In every other democracy, these lines are decided by independent commissions of bipartisan citizenry. That's why involvement in the Brennan Center is essential. We have to have a dream in our work life and we have to have a dream in our professional life. and we need to think out of the box and the dream we have may not be with the dream that a person parents would have or even a person we're committed to in life we're entitled to our own dreams we

must be creative and think out of the box and allow ourselves our dreams and if one dream doesn't come true there's only one thing to do find another thank you so much miss sarah k smullins author of the second edition of burnout and self-care and social work that's at naswpress naswpress.org um i want to thank you um for all of your like time and once this pandemic is like over with and like easing. I hope to see you in person again. That'll be lovely, Greg. Thanks for this opportunity. Thanks very much. You have been listening to NASW Social Work Talks, a production of the National Association of Social Workers. We encourage you to visit NASW's website for more information about our efforts to enhance the professional growth and development of our

members, to create and maintain professional standards, and to advance sound social policies. You can learn more at www.socialworkers.org. And don't forget to subscribe to NASW Social Work Talks wherever you get your podcasts. Thanks again for joining us. We look forward to seeing you next episode. This podcast was produced by Heartcast Media.