Burnout is the stress-related condition that represents the effects of persistent pressure. Anyone in a “high-touch” (as opposed to high-tech) occupation, where care for others is central to the role, is at risk. That means those working in the field of Applied Behaviour Analysis and also parents of children with developmental disabilities may end up finding themselves paying what has been termed the “cost of caring”. However, burnout is not inevitable, and there is plenty professionals and parents can do to safeguard themselves against the risk of burnout. In this blog, we focus specifically on how Acceptance and Commitment Therapy (ACT) can help to prevent burnout.
Psychologist Herbert Freudenberger was first to use the term “Burnout” in 1974. It is now a widely recognised phenomenon that describes the physical, emotional, mental and behavioural negative impacts of sustained stress and cumulative pressure without respite or support. Whilst the World Health Organization now classifies burnout as an “occupational phenomenon”, it is clear that parents of children with developmental disabilities are also at risk of burnout as well as professionals who work with families.
Risk factors for burnout can be grouped into external and internal factors. The greater amount of contact we have with people impacted by trauma, the more at risk we are. Heavy caseloads, professional isolation and inadequate supervision also contribute to raise our risk. Parents of children with developmental disabilities may be particularly at risk in that, unless they manage to tap into local peer and other support networks, they are unlikely to receive supervision or much in the way of respite from their caring role.
Internal risk factors include stress in our personal life and being a carer or a giver in other areas of our life and within other relationships: particularly if we practice poor levels of self-care. It’s also known that it we hold a strong sense of idealism or perfectionism, or seek validation of self through caring or supporting others
So, how can Acceptance and Commitment Therapy (ACT) help to prevent burnout? ACT is an empirically supported behavioural intervention that can support both professionals within the field of and also parents of children with developmental disabilities. ACT is a branch of clinical behaviour analysis and along with Mindfulness-Based Cognitive Psychotherapy (MCBT), it is used to positively treat anxiety, depression, OCD, addictions, and substance abuse, among other conditions. ACT focuses on accepting those things which are outside of your personal control and committing to action that improves and enriches your life, according to your own personal values. ACT does not encourage shying away from emotion and difficult feelings. Indeed, ACT recognises that suffering is a natural and inevitable condition for humans. Instead, mindfulness skills allow for unpleasant thoughts and feelings to be acknowledged and accepted in such a way that they have less impact and influence over you, resulting in increased psychological flexibility.
Three key components of ACT are defusion, acceptance and contact with the here-and-now. Defusion relates to finding ways to take the power and the energy out of unhelpful thoughts, beliefs and memories. Acceptance means to allow space for, without becoming overly attached to, painful feelings, urges and sensations, and allowing these to come and go without a struggle. It also involves accepting your own values and regaining their potential for guiding, inspiring and motivating you to change your life for the better. And, contact with the here-and-now involves engaging fully with your present experience, with an attitude of openness and curiosity.
Much of our own suffering and pain is caused by trying to change or control things outside of our circle of influence. We may well find ourselves caring so much for children with developmental disabilities, that we try to move heaven and earth to change the structures and the current realities that seem to make life difficult. We may find ourselves cross and self-critical at our tiredness, lack of stamina or inability to effect the change we want. ACT reminds us that attachment to perfection is not helpful. It offers us a chance to become mindful, in the here-and-now, of the feelings of frustration, anger and sadness that we may be experiencing, among other things. ACT encourages us to drill into our own core values, and to commit to accepting these as guiding forces for our own life well lived, restoring a sense of “compassion satisfaction” to our work and contact with children: demonstrated to be a protective factor against burnout. ACT allows us to take time for self-care, self-reflection and the space that acts as a buffer to burnout.
So, whilst professionals and parents of children with developmental disabilities are at higher risk of developing burnout, it is not inevitable. The skills learnt in ACT – particularly when supported by an effective therapist – equip parents and professionals to accept the very real challenges they face without becoming overwhelmed by them. These skills are a fabulous support for adults working or living alongside children and are fantastic to role model to those children within our care. To prevent burnout, ACT could well be a very smart choice for you and for the children you support.
Blackledge, J.T.& Hayes , S.C. (2006) Using Acceptance and Commitment Training in the Support of Parents of Children Diagnosed with Autism, Child & Family Behavior Therapy, 28:1, 1-18
Figley, C. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology, 58(11): 1433–1441
Freudenberger, H.J. (1974), Staff Burn‐Out. Journal of Social Issues, 30: 159-165
Skovholt, T., & Trotter-Mathison, M. (2011). The resilient practitioner: burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals. (2nd ed.). New York: Routledge.
Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the Compassion Satisfaction and Fatigue Test. In C. R. Figley (Ed.), Psychosocial stress series, no. 24. Treating compassion fatigue (p. 107–119). Brunner-Routledge