Thursday, April 24, 2014

Preventing Burnout





That dreaded word: Burnout

Burnout is very real in this field, and is common among social service occupations in general.
The work that we do, while extremely rewarding, can also be challenging, frustrating, disappointing, and sometimes dangerous (such as with aggressive clients). Since we are all only human, we are not immune to burnout.

Staff who are experiencing burnout are sloppy at their work, they make careless mistakes, they “go through the motions” without actually trying to connect with their clients, or they are snippy and irritable where they should be patient and persistent.

Sometimes you can’t tell when you are burned out on a client, or on a job, and may think you are just temporarily tired, overwhelmed, or stressed. It’s important to regularly monitor and assess your emotional state, because you won’t be an effective professional when you are experiencing burnout and you also won’t draw satisfaction and joy from your work. Ideally, management/supervisors will be monitoring staff for signs and indications of burnout, and/or creating systems intended to minimize burnout (such as small caseloads). However, I recommend assessing yourself on a regular basis to be sure you aren't experiencing burnout.

I have learned over the years to monitor my own emotional state to make sure I am far away from reaching burnout levels. I know when to decline clients or refer out, I know when to seek out help or feedback from my colleagues, and I know how to maintain a healthy life/work balance…..but I didn’t start out in this field knowing all of that.

So what are some classic signs of Burnout?

  • Not wanting to go to work, constantly calling in or arriving late
  • Feeling constantly overwhelmed and/or chaotic at work
  • Feeling ill-equipped to perform your job, feeling like you don’t know what you are doing
  • Feeling that you aren’t making a difference….your job doesn’t “matter”
  • Being constantly annoyed or aggravated by your clients/co-workers
  • Productivity decreases…it takes you several minutes to start a task or you find it difficult to stay on task

Knowing yourself and your own preferences or needs as a professional will help you carve out a niche that works for you. Being mismatched in your career is an almost guaranteed way to rapidly slide into burnout. Let’s say I love working with adults in residential settings, but then I take a position working in a K-2 Autism classroom. See what a mismatch that is? I’m not doing what my preference is, I am not working within my skill set, and I may not enjoy my work. I would feel a lack of professional autonomy, or that I am not in control of my career and doing what I want to do. Over time, I may begin to feel that I hate my job……I dislike my clients……or what I do doesn’t matter anyway. These are all classic signs of burnout.

So what can be done to prevent the dreaded Burnout? Lots of things!

  1. Active parental involvement- I will continue to say this over and over on my blog, because it is so critical. When staff are working hard to bring about lasting behavior change in a client, only to have successes derailed or see gains disappear due to no parental carry over, that can be an extremely frustrating feeling. Staff can quickly grow to feel as if they are building sand castles on the shore, if after their session is over no one else is requiring the child to talk, to use the bathroom, to share with their siblings, etc.
  2. Supervision & Support- All ABA professionals need support, including BCBA’s. Having a few colleagues you can go to for venting purposes or to pick their brains is so important. Lack of quality and regular supervision is one of the biggest indicators I see that leads to staff burnout. ABA direct staff absolutely needs an experienced supervisor working with them to make sure they have the support and resources they need to do their job effectively.
  3. Effective training- This is probably the 2nd biggest issue I see that leads to staff burnout. When staff are quickly hired, thrown into the field, and given minimal ongoing supervision, they have no confidence in their abilities/skills. Lack of confidence leads to low job satisfaction, because no one wants to feel like they are bad at their job. Effective training is empowering. It makes people feel better equipped to do their job.
  4. Recognize your area(s) of expertise- This is something I definitely grew to learn over time, but knowing your ideal work setting and ideal client will increase job satisfaction. Not everyone enjoys working with small children. Not everyone enjoys working with high functioning teens. Working within your area of expertise doesn’t just help you to provide the best quality of service; it keeps you enjoying your work.
  5. Low pay- Ask for the level of pay that you need to support yourself, and your family. I see so many new ABA therapists accepting pay rates that are far below what they need, for fear of not being able to find something better. You have to know how to sell yourself in an interview and demonstrate competency in your work, which can often lead management to agree to higher pay rates. ABA therapy can be a physically and emotionally draining job. If on top of that you also can’t pay your bills… that’s a sure recipe for burnout.
  6. Toxic work environment- A toxic or negative work environment will severely impact how much you enjoy your work. I have had past experiences of working with verbally abusive families, or egotistical supervisors, and it really made me dislike my job. I had to be mature enough to realize that I can’t function properly in a toxic environment. If there is consistent dysfunction in your work place, it may be time to leave.
  7. Inconsistent management expectations/client expectations- When the supervisor or family you are working with are constantly demanding more and more of you, yet never satisfied with the work you are putting out, that’s a quick way to slide into burnout. It’s frustrating and defeating to feel that you can’t please someone no matter what you do.
  8. Poor or NO data collection- Some therapists don’t realize this, but consistent data collection can actually serve as positive reinforcement. You may FEEL like the child is not improving, or that what you are doing is not effective but when you can see on a data sheet or graph that small successes are happening, that can be a huge source of motivation. If your client used to scream for 11 minutes and now they scream for 9 minutes, that is progress. Clearly something that you are doing is working, and is having an impact on the problem behavior. I also personally recommend collecting data when dealing with resistant or uninvolved parents. This has helped me immensely in the past. If a parent who used to only respond to my emails 25% of the time now starts responding to my emails 45% of the time that could really make me feel increased job satisfaction. Sometimes little successes are all you have, and they can keep you from feeling defeated.


*Suggested Resources:

Wednesday, April 9, 2014

Program: Emotional Intelligence





Emotional Intelligence is defined as the ability to identify and manage your own emotions and the emotions of others. This includes emotional self-regulation, problem solving, and modifying your own behavior to impact the emotions of someone else (source: Psychology Today.com).

My Recognizing & Labeling Emotions post was about teaching individuals with Autism to receptively and expressively identify the basic human emotions.

So what about taking a step beyond just identifying a “happy” facial expression to associating events related to emotions, processing ones own emotions, thinking about how your own actions impacts what others feel, or moving into more complex/multifaceted emotions like  worry, guilt, disgust, jealousy, rage, contentment, suspicion, or courage?

As I said in my last emotions post, teaching emotions can get pretty complex!

This post is about programs I may write for my more higher functioning, Aspie kiddos, who often struggle mightily in the area of emotional intelligence. These kids are usually very bright, so (sadly) they are aware that they don’t get called for sleepovers, get picked first for teams at recess, or get invited to birthday parties. They just don’t understand the why.

Unfortunately, I often see higher functioning or older kiddos go without services or treatment because on paper, they seem fine. They don’t need to be toilet trained, they’re making straight A’s, they use Intraverbals all day long…their vocabulary is more expansive than mine! However, when social functioning is assessed that is typically where the deficits emerge.

What’s that? You’d like some examples? Sure, no problem :-)

  1. Therapist gives David a math worksheet to complete. David reaches a difficult problem, and promptly bursts into tears and shouts “I’m so stupid”, before ripping the paper in half.
  2. Therapist is at the park playing a game with Kayla when another child walks up to join their play. Kayla covers her nose with her hands and says “Wow, you smell”. The other child starts crying and walks off.
  3. Christopher is standing in the lunch line at school when a student accidentally bumps into him. The other child says “I’m sorry”. Christopher pushes the child to the floor. When the teacher later asks Christopher why he did that, he says “That kid picked a fight with me”.

Here are some suggested strategies for teaching emotional intelligence, with a resource at the bottom for teaching self-regulation:

(I would present large, color photographs to my kiddo and ask them questions about the photo. I would also work on generating discussion not just about the photo, but about the child’s recent experiences, so we can gently step into discussing THEIR emotions/feelings.)



What are these children doing? What games do you like to play with your friends?



Is that boy paying attention in class? How can you tell he isn’t? How do you think that makes the teacher feel?



How does this boy feel? How do you know that? Tell me about a time you felt sad/lonely. If you saw him what could you say to make him feel better?




What are they doing? How would you feel if some kids did that to you? Whats a good way to handle that?


How does the girl in the middle feel? What do you think the other two girls are saying? Tell me about a time you felt left out from the group. How did you handle it?



*Resource: The Incredible 5 Point Scale by Kari Buron & Mitzi Curtis is an amazing, super easy to read resource that uses a behavioral thermometer system to teach: how to recognize your emotional state, how to determine an appropriate reaction, how to identify triggers, and how to problem solve appropriate solutions to deescalate once you have been triggered. It has tons of visuals, and I have used it as a framework to write programs.