Burnout is unfortunately prevalent in the ABA field. The work, while incredibly rewarding, can be equally exhausting. On top of that, clinicians are often met with large caseloads, minimal support, and loads of administrative or non-billable expectations.
The field has grown exponentially in the last several years. While this means more clinicians are available to support the increased need for applied behavioral therapy, the growth may also be working against us. Brand new BCBAs who have minimal applied experience are taking on major responsibilities once they pass the exam and add those four letters behind their name. We have to do a better job, as a field, in training and supporting our clinicians to avoid burnout. If you're finding yourself feeling burnout, read on as we review strategies to address this.
Antecedent Strategies
It is significantly easier to prevent burnout than to respond and recover from it. This is no different from our work with our clients. Antecedent strategies are implemented to arrange the environment in such a way that prevents the need for the targeted behavior. The primary focus of burnout in our field should be on prevention. What can agency owners and supervisors do to create an environment where burnout is unlikely or less likely to occur?
Antecedent strategies for burnout prevention are discussed in depth in this video. For the purposes of this article, however, we'll focus on reactive strategies to support those who are directly affected by burnout and are unsure of how to move forward.
Burnout in ABA Factors
Experimental research on behaviors associated with burnout is lacking. However, research has supported a few general factors that are correlated with burnout.
Age: Younger employees have been found to experience burnout at higher rates, compared to their elder peers (Maslach et al., 2001).
Workplace conflict: Conflicts may include disagreements with supervisors, coworkers, and/or clients. Caregiver interactions may fall under this category as well.
Lack of support: Leiter and Maslach (1988) found that negative workplace conflict may be moderated when coupled with other positive interactions. For example, challenging supervisory interactions may be buffered by coworker support. Those who do not have peer support or limited positive interactions, in general, may be more susceptible to burnout.
Prolonged job-related stress: Burnout does not occur overnight. High and unrealistic job expectations that are ongoing are common factors of burnout (Maslach, Schaufeli, & Leiter, 2001). I'm sure we have all experienced times when things get a bit overwhelming. Perhaps you have three treatment plans done within days of each other. However, you are able to work through that and it's back to smooth sailing. Generally, short-term stressors such as this do not lead to burnout.
Chime in below! If you are a BCBA who currently or at some point in your career felt high levels of burnout, which factor(s) most strongly led to this for you? Feel free to choose more than one option and share your thoughts in the comments.
If you are a BCBA who currently or at some point in your career felt high levels of burnout, which factor(s) most strongly led to this for you?
0%A large caseload and/or high work demands
0%Limited support or supervision
0%Personal feelings of ineffectiveness
0%Lack of control in job duties, company policies, etc.
You can vote for more than one answer.
Consequent Strategies
While antecedent manipulations are necessary, consequent strategies are often needed when agencies have not made the necessary antecedent manipulations. If you or a supervisee are feeling burnout, it is too late to implement antecedent strategies. So how should you respond? Do you take a day off and hope you're refreshed by the next day? There should always be more involved than that. Let's review a few strategies you can take to reduce and ideally eliminate burnout when you or a supervisee are experiencing it.
Self-Evaluate
First, take a step back to fully evaluate your experiences. Take a few days off, if this is at all an option for you. Mental health days should be honored and encouraged. This is especially true for a field like ABA which is known for high burnout rates. Burnout can lead to high turnover and poor job performance, affecting everyone in an organization, including the clients.
Consider a functional approach to your self-evaluation. For example, identify the antecedents and consequences of behaviors related to burnout.
One of the main characteristics of burnout is a feeling of ineffectiveness or lack of accomplishment. Let's use this in our example for an ABC analysis.
Imagine a BCBA is experiencing burnout. They identify feeling ineffective in their role. Using an ABC analysis, they define the behavior of interest as feeling and thinking "I'm a terrible behavior analyst". This feeling of ineffectiveness can be evaluated further by identifying antecedents that preceded that feeling. For example, they missed a treatment plan deadline, their client's treatment plan was returned or denied, and/or they received a poor quality assurance score. By identifying those antecedents, they can further evaluate the specific events that are leading to this feeling of ineffectiveness. Next, they would evaluate the consequences. In other words, what is occurring after these feelings of ineffectiveness? Are they provided support or reprimanded by management, for example?
Through analyzing the antecedents and consequences, we can determine the current variables resulting in our burnout (or the burnout in our staff members). From there, we can better assess what modifications can be made to reduce or eliminate this feeling of ineffectiveness, thus reducing burnout. An honest and objective evaluation is the first step in determining the following steps.
Assess your values
Have you evaluated your values recently? What is most important to you? Do your values align with your role and work environment? By no means should your immediate reaction be to quit your job or to quit the field altogether. However, there is a benefit in understanding what your values are and identifying whether your role and expectations are in line with those or not. For example, someone who values a supportive work environment may struggle in a solitary environment where peer or supervisor support is minimal. On the exact opposite side of the spectrum might be someone who values independence in their role and therefore prefers less supervision. For this person, a workplace environment with frequent meetings, supervisory overlaps, etc., may be aversive.
It is easy to see how our environment and values can be misaligned. When this misalignment is not corrected, burnout may continue to occur and/or get worse. Assessing your values can help you to identify whether your current environment is conducive to strong mental well-being or if it is likely to continue resulting in burnout.
Self-Advocate
Once you have identified the variables resulting in your burnout, you can advocate for modifications. Using the previous example of a BCBA who is experiencing feelings of ineffectiveness as a result of treatment plan issues, they may need more support in the area of treatment plans. They may also need caseload modifications or additional support in administrative tasks if deadlines are a common challenge. If your values are aligned with your role, then self-advocating for needed modifications would be the next best step.
Communicate with your supervisor about your concerns, ideally with some idea of what modifications are needed. Again, this does require some self-reflection. For example, you might explain the factors that are leading to burnout and request a reduced caseload or increased support.
Overcoming burnout
Burnout can be challenging to work through. Feeling exhausted and overwhelmed can take its' toll on many aspects of our lives. We all owe it to ourselves first and foremost to evaluate the factors leading to our burnout and take action to modify our environment accordingly. Of course, this is easier said than done. There are many factors that we may not have control over. It also takes an immense deal of introspection, which can be exhausting on its' own, much more when coupled with the exhaustion from burnout. However, it is possible. Overcoming burnout can have immense benefits for ourselves, our organization, and our clients. The number one thing you can do is seek support. You don't have to push through burnout alone.
While I hope this is not needed, please know that the Suicide and Crisis Lifeline is available if you are in emotional distress. You can call, chat, or text 988 for support. <3
References
Plantiveau, C., Dounavi, K., & Virués-Ortega, J. (2018) High levels of burnout among early-career board-certified behavior analysts with low collegial support in the work environment,European Journal of Behavior Analysis,19:2,195-207.
Kazemi, E., Shapiro, M., & Kavner, A. (2015). Predictors of intention to turnover in behavior technicians working with individuals with autism spectrum disorder. Research in Autism Spectrum Disorders, 17, 106–115.
Fiebig, J. H., Gould, E. R., Ming, S., & Watson, R. A. (2020). An Invitation to Act on the Value of Self-Care: Being a Whole Person in All That You Do. Behavior analysis in practice, 13(3), 559–567. https://doi.org/10.1007/s40617-020-00442-x
Maslach, C., & Goldberg, J. (1998). Prevention of burnout: New perspectives. Applied and Preventive Psychology, 7(1), 63–74.
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.
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