Thursday, February 25, 2010

Pinis Check By Female

(Part II)

Phases Burn Out

Jerry Edelwich and Archie Brodsky (1980) define the burn out "as a progressive loss of idealism, energy and patterns experienced by people in the helping professions as a result of working conditions" .

propose four stages through which everyone passes to burn out:

• Stage idealism and enthusiasm.
The individual has a high energy level for the job, unrealistic expectations on him and still do not know what you can achieve with it. The person is involved too and there is an overload of volunteer work. Early in his career there intrinsic motivation enough. Hipervalorización is a professional capacity which leads to not recognize the internal and external boundaries, which can affect their professional duties. The failure of expectations aroused, at this stage, a feeling of disappointment that makes the worker go to the next stage.

stagnation stage.
involves a decrease in the activities when the individual finds the unreality of his expectations, going the loss of idealism and enthusiasm. The individual begins to recognize that your life needs some changes, which necessarily include the professional field.
• Stage
apathy and frustration.
is the central stage of burnout syndrome. The frustration of expectations leads the individual to the cessation of its activities, develop apathy and lack of interest. Begin to emerge, emotional, behavioral and physical. One of the common responses in this phase is the attempt to remove the frustrating situation. Avoiding contact with colleagues, is missing work and often there is the abandonment of this and the most extreme cases of occupation. These behaviors begin to become constants paving the way for the last stage of burn out, the distancing.

• Stage distance.
The person is chronically frustrated in their work, leading to feelings of total emptiness that can manifest in the form of emotional distance and vocational impairment. There are an investment of time spent at work compared to the first stage. In the place of professional enthusiasm and idealism the person happens to avoid challenges and patients is quite common and especially not to risk the job security. There is a cognitive and emotional collapse. Causes

The Burn out is a consequence of stressful situations that cause the individual is more prone to suffer. Stress often at work, primarily because the interaction that the individual has with the various conditions of work are key to the appearance of burn out.

The actions that trigger the onset of this syndrome are usually intense and / or long-lasting, because the burn out is conceptualized as an ongoing process that manifests itself in a gradual manner that will internalize the individual to have on it's own feelings syndrome.

There are certain factors which contribute to burn out:
• The nature of the task
• The organizational and institutional variable
• The interpersonal variable (colleagues, family, friends, social support networks)
• The individual variable (professional characteristics such as age, gender, experience, personality traits)

Below is a list of statistics from studies by various specialists that provide information on the influence of Burn out syndrome according to the profession.


Kyriacou (1980) Teachers 25%
Pines, Arason and Kafry (1981) Different professions 45%
Maslach and Jackson (1982) Nurses
20-35% Henderson (1984) Medical / as 30-40%
Smith, Birch and Marchant (1984) 12-40%
Library Rosse Johnson and Crow (1991) Police and medical personnel 20%
García Izquierdo (1991) Nurses
Jorgesen 17% (1992) Nursing students 39%
Price and Spence (1994) Police officers and staff 20%
health Deckard Meterko and Field (1994) Medical / as 50%

Consequences of Burn Out

The most important concept is that the Burn-out is a process (rather than a state) and is progressive (accumulation of intensive contact with consultants).
The process includes:
1. Gradual exposure to burnout
idealism wear 3. Lack of achievement

There are also a number of effects caused by this phenomenon:

- adversely affects the worker's resistance, making it more susceptible to compassion fatigue ( Compassion Fatigue).

- Favors Silent Response ( Danieli, 1984, Baranowsky 1997) which is the inability to address the experiences of the consultants, that are overwhelming.

- Gradually, the picture worsens in direct relation to the magnitude of the problem, initially adaptive processes protect the individual, but his repeated and often overwhelms them exhausted, creating feelings of frustration and sense of failure, there is a direct relationship between symptoms, seriousness and responsibility of the tasks performed.
- Feeling used, impaired or exhausted because of excessive energy demands
to, strength and personal resources, also creates intense impact on the individual and their family environment.

- states of fatigue or frustration are the result of devotion to a cause, lifestyle or relationship that failed while trying to get an expected reward.

- The progressive loss of idealism, energy and purpose experienced by many working professionals helping others are the result of their working conditions.

- The burnout syndrome is the last step in the progression of multiple failed attempts to manage and reduce a variety of negative social situations.
The list of psychological symptoms that can cause this syndrome is extensive and can be mild, moderate, severe or extreme.

One of the first symptoms of mild but serves Alarm Level I is the difficulty getting up in the morning or pathological fatigue, at a moderate distance is presented, irritability, cynicism, fatigue, boredom, progressive loss of idealism which make the individual emotionally exhausted with feelings of frustration, incompetence, guilt and negative self-assessment.
Serious expressed in the abuse of psychotropic drugs, absenteeism, abuse of alcohol and drugs, among other symptoms.

is the repetition of stressors that shapes the picture of chronic, low self-esteem produces a state of overwhelming frustration with melancholy and sadness, feelings of helplessness, loss, failure, state of neurosis, psychosis in some cases with distress and / or depression and feel that life is not worth it, reaching in extreme cases to ideas of committing suicide.

prevention measures

Most authors ( Byrne, Maslach, Huberman ..) agree that prevention is a key to remedy the effects produced by the Burn Out. Preventive work affects existing political and economic decision unrealistic positioning of administrations regarding the current situation of education.

prevention measures can be divided into three sections depending on the application form:

individual intervention strategies :

mitigation techniques focus on reducing the emotional experience of stress caused by various factors taken into account by acting on them. Within the education sector there are different methods:

- Cognitive-behavioral : teach off of work and personal life separate from work and family, using techniques to improve the performance of work trying to get the maximum effectiveness in the minimum possible time. Some authors propose training based on the withdrawal of attention, reinforcement, time out, control of contingencies, self-reinforcing and avoidance or the use of appropriate contingencies, task analysis, progressive strengthening and control of problems in class.

- psychodynamic orientation. This methodology is rarely used but should highlight the work of Andrianopoulos on psychoeducation and counseling. Also, in the literature of physical techniques that act on the physiological effects of stress and Burn out (insomnia, tachycardia, psychomotor restlessness and other psychosomatic responses characteristic of anxiety) such as proposal Travers and Cooper physical exercise, yoga, relaxation and travel.

These techniques are not used systematically nor with scientific rigor with groups of teachers, indeed, some piscológicas techniques presented in the literature as potentially reducing stress and anxiety to benefit from the results obtained with clinical populations however, there have been no serious studies that apply individually or in groups in teaching, perhaps because of methodological difficulties involved in its implementation.

• Intervention Strategies
• organizational intervention strategies

Can you try?

The main difficulty in treatment is the resistance of physicians to admit their own emotional problems and take the role of the patient (worst patients). Besides being special patients receive lower quality treatment and less time than the patients than health.
currently considered an occupational disease. Responsibility is shared, individual, collegial and institutional, the task of improving the working conditions of health personnel to perform the clinical task at an optimal level of quality and efficiency. A draft medical assistance program ill, channeled through the medical associations.
The two most effective treatment methods are known, techniques and cognitive behavioral psychotherapy. Both, in their complexity, require the psychiatrist and psychologist.

Treatment There is no specific treatment for the syndrome of "burnout", nor a simple strategy of prevention. Therapies that are used are designed to restore the psychological health and recovery of the affected job performance and are based on stress management, behavioral testing and empowerment self-control. Sometimes you need a short period of time off work and in severe cases we must resort to antidepressant medication.
The most effective solution to this syndrome would prevent the establishment of training courses aimed at enhancing psychosocial competence, emotional resources and strengthening professional psychological health of employees. The National Institute of Public Administration (INAP) is studying increasing its range of training courses for the treatment and control of stress and emotional intelligence in regard to work and other actions to enhance emotional resources public employees.

words to end

Finally, I tend to use the diagnostic label of "burnout syndrome." In Spain tend to popularize and introduce colloquial medical terms used in a short time young, old, educated and uneducated and lose their true meaning, content and diagnostic value. And what's worse, they "become fashionable" to ask for time off work as it was and remains a few years, neurasthenia, fibromyalgia, polymyalgia, chronic fatigue syndrome and the label on Burnout would not be calling soon down by "burnt." Thank

Miguel Pérez-Camacho Duque


The Need for an 'operational definition of burnout
Family and Community Health 1984. 6: 12 24.
Freudenberg, M, Staff burnout

Journal of Social Issues 1974, 30: 159165.
Stress and work: burnout syndrome Ed
Channel editorial, 1998. Garcés de Los Fayos
Ruiz, EJ, Thesis on burnout
, 1996.
GIL-MONTE, PR and Peiró, JM,
psychic wear at work: the burnout syndrome
Madrid, Ed Summary, 1997.
burnout by work (Burn Out). Occupational disease in the welfare society. Madrid
Psychology Pyramid, 2005.
A social competence model of burnout
In: Farber, BA (Ed.), Stress and burnout in the human services professions (pp. 29-39). New York: Pergamon Press. (1983)
LAZARUS, RS & Folkman, S. Stress and cognitive processes

Ed Martínez-Roca. Barcelona, \u200b\u200b1986.
MIGNEE C, Raixa A, Proteau J. Medical Encyclopedia
surgical, psychiatry. E-37-886-A-10

The World Health Report 2000. Health systems: Improving performance
Available on the World Wide Web: http://www.who.imt/whr, 2000. PINES
AM, ARONSON, E. Carrer
burnout: Causes and cures
New York: Free Press., 1998.

Wednesday, February 3, 2010

Latin Kings And Nortenos

Part One: Burn out

"Origins and Consequences of Burnout Syndrome-Burn-Out"

What is the Burn Out or syndrome of "burnout"?

The term "Burn out" comes from the English and translated into Castilian by "burnt" . A mid-year 74 psychiatrist Herbert Freudenberger described Burn out syndrome, but not with that name, as a psychiatric disorder who were experiencing some practitioners working in any institution whose object of work are people.

The psychiatrist working in a clinic in New York and watched as the vast majority of the volunteers who worked with drug users in a given period, usually a year ago, suffered from progressive loss of power, until the exhaustion, anxiety and depression symptoms and as motivation in their work and patients aggressively.

Herbert Freudenberger defined it as "a sense of failure and an exhausting experience that results from an overload of energy demands, personal resources of the worker or spiritual force."

In the same dates (1974), the social psychologist Christina Maslach used the term Burn out, used previously by California law to describe the gradual process of loss of professional responsibility and cynical indifference among coworkers, to refer to a set of emotional responses to affect professional help.

determined that the victims suffered "emotional overload" syndrome or Burn out and called it "syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that can occur among individuals whose work involves the care or assistance people. "

Christina Maslach (1976) studied what he called " professional liability loss" and, from the psychosocial field, described the syndrome without stigmatizing psychiatrically the person. To Maslach burnout syndrome can be given only in the helping professions (eg, between health and educators who serve the public.) In 1986, Maslach and Jackson , define the syndrome as "a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that can occur among individuals who work with people."

In 1988, Pines and Aronson propose a broader definition, not restricted to the helping professions, " is the state of mental exhaustion, physical and emotional, produced Chronic involvement by working in situations with emotional demands. "

Brill, another researcher in this area, seen as a dysfunctional state related to work in a person who does not have other significant psychopathological disorder.

literature gives us at least seventeen different denominations in Castilian for the phenomenon, although some of them show a great similarity. Considering the degree of similarity, the names can be classified into three groups.

- A first group collect the names which refer to the name in Castilian the original Anglo-Saxon term burnout. In this group of names is spoken of:

• Burnout, work ( Gil-Monte & Peiró , 1997)
• burnout at work ( Salanova et al, 2000)
• Syndrome burning at work (Guillén and Santamaria , 1999; Manassero, 2000)
• burnout ( Da Silva et al, 1999)
• Burnout ( Chacón et al, 1999) • Being burned
(Olmeda et al , 2002)
• burnout ( Aluja, 1997)

- A second group includes those denominations that choose an alternative to the literal translation. Are names that are characterized by making reference to the semantic content of speech, or the content of pathology, rather than a more or less literal translation of the Anglo-Saxon:

• Wear work (García , and Llor Sáez, 2000)
• Occupational Wear ( López, 1996)
• Burnout ( Aron et al 2000)
• Burnout ( Belloch et al, 2000)
• professional fatigue syndrome ( Belloch et al, 2000)

Finally, a third group collect those studies are considered to Burn out syndrome is synonymous with work stress, and therefore it is possible to call it:

care • Chronic stress ( Manzano, 2001),
• Work stress care ( Arranz, Torres, Cancio and Hernandez, 1999),
• Professional stress ( Aluja, 1997)
• Work Stress ( Fuertes et al., 1997; García et al., 1999)

The number of names can be extended to nineteen to include the term "employee syndrome" offered on the website of the University of California (, and the term "disease or syndrome Tomás Tomás ( Meeroff , 1997 ; Mingote and Perez, 1999; Tarela , 2002).

Once the worker is affected, if not with foreign exchange intervention conditions that have motivated this change, protection, relief or by a labor adjustment will fail to regain their health. The burnout does not occur as a result of inadequate wages, or incompetence by lack of knowledge or because of physical difficulties or the result of any existing mental disorder.

In my opinion, these health workers have not been rewarded verbally by the company, organization, senior officials and relatives of patients not assessed its delivery, enthusiasm, performance and sometimes sacrifice. Conclusions

to define the concept of burnout:

• Burnout is a consequence of exposure to job stressors. This interaction of workers with certain risk working conditions can cause the syndrome, being, therefore, a consequence on health in the person's work derives.

• We need to work on the development of relational exchange is given an intense and lasting worker - client, worker-worker-patient or user. This response is characterized more work " Human Services" for assistance. However, has been identified in other professionals such as managers, middle managers, athletes, coaches, etc..

• The scientific community conceptually accepted empirical approach of three-dimensionality of the syndrome (Maslach and Jackson , 1981), which síntomatiza in emotional exhaustion, depersonalization and reduced personal accomplishment.

The concepts of stress and burnout are different constructs:

" The World Health Organization (WHO )
defines stress as the set of physiological reactions that prepare the body for action
" .

Y The notion of stress responses coordinated groups, and listed specific, physiological, and then eventually pathogenic not specific to the causative agent, the body produces when it is subjected to demands, requests, demands and environmental stimuli, this reaction
beyond the specific response associated with the nature and intensity of stimulus. "

This definition is not entirely satisfactory, some authors like himself Selye, recognizes that the definition of stress is problematic, as different viewpoints and often pragmatic and operational research for each course.

Selye states: " While stress is the sum of the changes
nonspecific produced in the body at a time
either, the general adaptation syndrome (EMS) covers all
nonspecific changes that develop over time during continuous exposure
attacks stressor. "

GHS develops gradually in three phases :

• Alarm Response • Phase resistance

• Exhaustion Phase

risk factors at the organizational level:

• Organizational Structure very hierarchical and rigid
• Lack of instrumental support the organization
• Excessive bureaucracy, "professionalized bureaucracy"
• Lack of employee participation
• Lack of coordination between units
• Lack of practical training staff in new technologies
• Lack of reinforcement or reward
• Lack of professional development
• conflict in the organization
• inappropriate management style perceived
• Inequality in the management of HR

Risk factors relating to job design:

• Work overload, emotional demands in the interaction with the patient
• Offset between responsibility and autonomy
• Lack of time to the attention of the user (patient, customer, subordinate, etc.).
• Role Dysfunction: conflict, role ambiguity, overload
• emotional load excessive
• Lack of control of the outcome of the task
• Lack of social support
• unfinished tasks which are endless decisional autonomy
• Little economic stressors

• • Dissatisfaction at work

Risk Factors Relating to interpersonal relationships:

• Treatment with difficult or problematic users
• conflict with customers
• Negative workflow
• Strained relationships, competitive, peer conflict and users
• Lack of social support
• Lack of collaboration between partners in complementary tasks
• Process social contagion of burnout
• Lack of reciprocity in social exchanges

Research on burnout increased dramatically in Spain during the nineties. Interest in the study of this phenomenon, which began in the psychological and psychiatric literature in the Attached to the mid of 1970 (Freudenberger , 1974, 1975), seem far from exhausted, projects into the new century.

The burnout is a process that arises in response to chronic stress and, therefore, is a phenomenon that is linked to the emergence of psychosocial risks at work. This phenomenon can be classified as the result of a process of psychological harassment at work.

There are two questions that often arise when talking about the origin of the term and the phenomenon of burn for the job:

a) Is a new or disease existed before of the seventies?

Does burnout occurs only in professional help or can also develop in other types of workers?

a) is true that burnout is sometimes characterized as an emerging pathology, and is referred to as one of the new risk psychosocial work, this phenomenon is not new to the workforce.

With burnout happened something similar to what happened with obesity. The phenomenon has always been there, you may always have been people living with burnout, and it is not surprising that this is so since the work was configured as a collective and social phenomenon.

Over the last century were descriptions of the phenomenon, both in the scientific literature (Schwartz and Hill, 1953) and in the popular literature of non-scientist, who even called it the scientific term that is currently ( Greene, 1961). It has taken a series of social, cultural and organizational, in the world of work, as discussed below, that the phenomenon "out of the closet" and that has been given the epithet, often exaggerated, of " epidemic. "

b) Regarding the second question that often arises, I must say that burnout is not a disease exclusive to professional help, or the service sector.

When reviewing the literature on burnout, it is found that most studies have been conducted with samples of professional educators and health professionals.

If we further consider that burnout can become infected (eg, through social learning processes or any mechanism of social influence), in all likelihood the spread of the phenomenon will be greater than between other groups with fewer individuals, or where they are more scattered within the organization. However, there are studies which conclude on the presence of significant levels of the syndrome in groups such as women workers ( Westman, Etzion and Danon, 2001), sellers ( Klein and Verbeke, 1999), engineers and technicians and athletes.

even versions of questionnaires have been developed to estimate the syndrome outside the professional services sector.

Any professional or worker with a great vocation, which comes to his profession, with high levels of professional idealism and to develop their research on the treatment of others may develop burnout. One could argue that "any worker who goes on with their work can lead to burnout.

The interest that the phenomenon has aroused in the academic world is reflected in the frequency with which they are organized scientific meetings to discuss the issue, or the frequency with which studies are presented in international and national congresses. These studies with indicator has achieved prominence within psychology and even medicine.

The emergence of companies dedicated to the study stress (eg the English Society for the Study of Anxiety and Stress, SEAS), which in its conferences and publications (for example, the journal Anxiety and Stress) devote considerable attention to the study of burnout is also a significant indicator of this situation.

According to studies Freudenberger this syndrome would be contagious, since workers who have it can affect others with their disgust, despair and cynicism, which in a short period of time the organization as entity, may fall into despair widespread. Other authors such as
Savicki, Seidman and Zager made possible to generate epidemic effects.

aspects manifested in the Burn Out


- Mental Manifestations: feelings of emptiness, exhaustion, failure, helplessness, low self-esteem and poor personal. It is also common state of nervousness, restlessness, difficulty concentrating, and low frustration tolerance, with paranoid behavior and / or aggressive towards students and their families, colleagues and family.

- Manifestations Physical: headaches, insomnia, musculoskeletal pains, gastrointestinal disturbances, tachycardia. Behavioral

- Prevalence of addictive habits (snuff, alcohol, drugs) as well as tactics to avoid unpleasant situations that often lead to poor performance and as extreme as in the absenteeism. Violent behavior can be very frequent.


- emotional distancing as a means of protection ego, boredom and cynical attitude, impatience and irritability, disorientation, feelings of helplessness, inability to concentrate and feelings of depression. Weather


- lower labor productivity and declining quality of services provided to customers, increased hostile interactions, frequent interpersonal conflicts in the workplace and within their own family, poor communications.


Gillespie differentiated two types of Burn arising out precisely because of the ambiguity in the conceptualization syndrome:

active Burn out

• It is characterized by the maintenance of affirmative conduct. Relates to organizational factors or elements external to the profession.

Burn out passive

• Predominantly feelings of withdrawal and apathy. It has to do with internal psychosocial factors. Remember

dimensional syndrome characterized by emotional exhaustion, depersonalization and reduced personal accomplishment of Maslasch and Jackson.

emotional and physical exhaustion is characterized by an absence or lack energy, enthusiasm and a sense of scarcity of resources. These feelings can be added the frustration and tension among workers who realize that are no longer able to spend more energy.

- The depersonalization or dehumanization is characterized by treating customers, colleagues and the organization as objects. Workers can demonstrate emotional numbing, a psychological state in the prevailing cynicism and emotional deception, fueled criticism of your entire environment and all the others.

- The decline of personal fulfillment at work is characterized as a tendency of workers to self-evaluate negatively. People unhappy with themselves dissatisfied with their professional development, experienced a decline in the sense of competence and success in their work and their ability to interact with people.