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The work environment and burnout among family and child care workers Sutton, James Henry 1987

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THE WORK ENVIRONMENT AND BURNOUT AMONG FAMILY AND CHILD CARE WORKERS by JAMES HENRY SUTTON .W., Royal Ottawa H o s p i t a l , Ottawa Ontario, 19 B.A., Carleton U n i v e r s i t y , 1982 B.S.W., U n i v e r s i t y of B r i t i s h Columbia, 1983 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK in THE FACULTY OF GRADUATE STUDIES SCHOOL OF SOCIAL WORK We accept t h i s t h e s i s as conforming to the required standard UNIVERSITY OF BRITISH COLUMBIA A p r i l 1987 ©James Henry Sutton, 1987 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of British Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 DE-6(3/81) i i ABSTRACT T h i s t h e s i s e x p l o r e s the r e l a t i o n s h i p between work environment and burnout by examining the q u e s t i o n : Do workers e x p e r i e n c i n g burnout see t h e i r work environment more n e g a t i v e l y than co-workers who are not burned-out? The g o a l i s t o e x p l o r e the p o t e n t i a l u s e f u l n e s s o f measures o f work environment and burnout t o guide e f f o r t s a t burnout i n t e r v e n t i o n and p r e v e n t i o n . T h i r t y - n i n e f a m i l y and c h i l d -c a r e workers from f i v e s i t e s i n the Vancouver area responded t o a survey t o t e s t hypotheses a d d r e s s i n g t h i s q u e s t i o n . The work environment and burnout were found t o be h i g h l y i n t e r a c t i v e w i t h the work environment v a r i a b l e s o f s u p e r v i s o r support and c l a r i t y i d e n t i f i e d as key f a c t o r s i n burnout. The Maslach Burnout Inventory and Moos (1981) Work Environment S c a l e were found t o be u s e f u l i n s t r u m e n t s f o r i n t e r v e n t i o n and f u t u r e r e s e a r c h . i i i T a b le o f Contents T i t l e Page page i A b s t r a c t page i i T a b l e o f Contents page i i i L i s t of T a b l e s page v i L i s t o f F i g u r e s page v i i Acknowledgement page v i i i Chapter I - I n t r o d u c t i o n page 1 A. Background to "Burnout" ... page 1 B. D e f i n i t i o n o f Burnout page 2 C. The I m p l i c a t i o n s of Burnout i n the S o c i a l S e r v i c e s page 4 D. Responses t o Burnout ...page 5 E. Purpose o f the Study page 7 H. L i m i t a t i o n s and Value Assumptions page 8 I. O r g a n i z a t i o n of the T h e s i s page 11 Chapter I I - L i t e r a t u r e Review page 12 A. O r i g i n s o f "Burnout" page 12 B. The M o r a l - R e l i g i o u s Paradigm page 13 C. M a r x i s t P e r s p e c t i v e s . . . page 18 D. An E x i s t e n t i a l P e r s p e c t i v e page 21 E. Burnout Research page 28 F. C o n c l u s i o n page 38 i v Chapter I I I - Research Problem page 41 A. Conceptual Framework page 41 Obi e c t i v e - I n d i v i d u a l page 48 Subi e c t i v e - I n d i v i d u a l page 48 Subi e c t i v e - E n v i r o m e n t a l page 49 Obi e c t i v e - E n v i r omental page 50 B. Research Issues page 60 Chapter IV - Research Design page 66 A. I n t r o d u c t i o n page 66 B. O p e r a t i o n a l D e f i n i t i o n s and Instruments...page 66 C. Sampling... page 71 D. Data C o l l e c t i o n page 74 E. Data A n a l y s i s P l a n page 75 F. E t h i c a l Issues page 78 Chapter V - F i n d i n g s page 79 A. Demographic Data page 79 B. Maslach Burnout Inventory ....page 79 C. Work Environment S c a l e page 83 D. Hypotheses T e s t i n g page 85 E. E x p l o r a t o r y Data A n a l y s i s page 92 R e s i d e n t i a l and Day Program Comparisons page 93 Comparison w i t h the S a v i c k i and Cooley F i n d i n g s page 99 V Chapter VI - C o n c l u s i o n page 102 A. C o n c l u s i o n s page 102 B. I m p l i c a t i o n s f o r I n t e r v e n t i o n and Research page 105 C. Summary page 109 B i b l i o g r a p h y page 111 Appendix A - Maslach Burnout Inventory page 117 Appendix B - Work Environment S c a l e page 119 Appendix C - Demographic Data Questions page 124 Appendix D - S t r u c t u r a l V a r i a b l e C h e c k l i s t page 127 v i L i s t o f Ta b l e s T a b l e I - page 80 Study Sample-Maslach Burnout Inventory S t a n d a r d i z a t i o n Sample Comparisons by S e l e c t e d Demographic V a r i a b l e s . T a b l e I I page 84 Sample Means-Work Environment S c a l e S t a n d a r d i z a t i o n Sample Means Comparisons (H o l l a n d S o c i a l O c c u p a t i o n a l C a t e g o r y ) . T a b l e I I I page 91 Within-Group Comparisons on Median Scores between Burnout and Work Environment. T a b l e IV page 94 Comparisons Between Burnout and Work Environment V a r i a b l e s S i g n i f i c a n t a t t h e P = .10 L e v e l U s i n g the Mann-Whitney U. Ta b l e V. ...... page 95 Comparisons Between Burnout and Work Environment V a r i a b l e s S i g n i f i c a n t a t the P = .10 L e v e l U s i n g the K r u s k a l - W a l l i s T e s t . T a b l e VI page 98 Mann-Whitney U T e s t f o r S i g n i f i c a n t D i f f e r e n c e s About t h e Median between t h e Day and R e s i d e n t i a l Programs on the Work Environment S c a l e . T a b l e V I I page 100 T o t a l Sample C o r r e l a t i o n s between Burnout and the Work Environment S c a l e a t P < .05 L e v e l o f S i g n i f i c a n c e . L i s t o f F i g u r e s F i g u r e 1 page A Two Dimensional Framework f o r Viewing Burnout F i g u r e 2 page A Three Dimensional View of Burnout I n c o r p o r a t i n g the Dimension o f Time F i g u r e 3 ... .page Hy p o t h e s i z e d Sequence of O v e r i d e n t i f i e d / D e p e r s o n a l i z e d Stages of Burnout Over Time Acknowledgement T h i s t h e s i s and r e s e a r c h was sparked by an i n t e r e s t i n work environments and a concern over r e c e n t developments i n B r i t i s h Columbia where the d e l i v e r y o f p r e v e n t a t i v e and r e s i d e n t i a l programs has i n c r e a s i n g l y been c o n t r a c t e d out t o the p r i v a t e s e c t o r . These s e r v i c e d e l i v e r y areas are known as o c c u p a t i o n s a t h i g h r i s k f o r burnout and few s t u d i e s have loo k e d a t s t a f f working i n these new " p r i v a t i z e d " environments. H o p e f u l l y t h i s study r e p r e s e n t s a f i r s t s t e p i n t h i s d i r e c t i o n . A number of c o l l e a g u e s have help e d make t h i s work p o s s i b l e . I w o u l d . l i k e t o thank my f e l l o w s t u d e n t s t h i s y e a r f o r t h e i r i n t e r e s t and feedback. A l s o the s t a f f of the S o c i a l Work L i b r a r y f o r t h e i r c h e e r f u l h e l p i n d i g g i n g up t h e m a t e r i a l f o r t h e r e s e a r c h . I want t o thank P r o f e s s o r C h r i s McNiven f o r her h e l p i n d e v e l o p i n g the t h e o r e t i c a l framework and her s u g g e s t i o n s f o r i n t e r v e n t i o n and P r o f e s s o r John Crane f o r h i s p a t i e n t m e t h o d o l o g i c a l feedback and guidance w i t h the r e s e a r c h technology. I a l s o want t o thank my w i f e , L o r a i n e L i t t l e f i e l d , f o r h e r e d i t i n g and support through t h i s e x c i t i n g and p r o d u c t i v e year. 1 C h a p t e r I - I n t r o d u c t i o n A. B a c k g r o u n d t o " B u r n o u t " O v e r t h e p a s t t w e l v e y e a r s , t h e t e r m " b u r n o u t " h a s e a r n e d a p l a c e i n t h e E n g l i s h l a n g u a g e and i s now u s e d by w o r k e r s i n many o c c u p a t i o n s t o c a p t u r e some d i f f i c u l t - t o -d e s c r i b e m a l a i s e o f w o r k e r s r a n g i n g f r o m d i s e n c h a n t m e n t w i t h t h e work s i t u a t i o n t o p h y s i c a l t i r e d n e s s . However, d e s p i t e i t s p o p u l a r u s a g e , b u r n o u t h a s most commonly been d e f i n e d a s a p r o b l e m f o r w o r k e r s i n s o c i a l s e r v i c e o c c u p a t i o n s . I t i s w i t h i n t h e s e o c c u p a t i o n s t h a t i n d i v i d u a l s c o m m i t t e d t o t h e i d e a l o f h e l p i n g o t h e r s and m a k i n g t h e w o r l d a b e t t e r p l a c e have most o f t e n s u f f e r e d t h e d i r e c t and a g o n i z i n g c o n s e q u e n c e s o f a l i e n a t i o n f r o m t h e i r work and f a c e d a s e l f -i n f l i c t e d l i t a n y o f g u i l t - p r o v o k i n g q u e s t i o n s . T y p i c a l l y t h e s e i n c l u d e d : "How c a n I f e e l t h i s b a d , I'm w o r k i n g a t what I'v e a l w a y s w a n t e d ? . . . . I d o n ' t d e s e r v e my p a y c h e c k , I w a l k a r o u n d l i k e a z o m b i e , I'm n o t h e l p i n g anyone What i f my s u p e r v i s o r f i n d s o u t ? " The c o n c e p t o f b u r n o u t h a s p r o v i d e d a l e g i t i m a t e e x p l a n a t i o n f o r t h e s e f e e l i n g s and c o n s e q u e n t l y r e d u c e d t h e a d d i t i v e c o n s e q u e n c e s o f i s o l a t i o n and g u i l t . I t h a s become an a c c e p t a b l e o c c u p a t i o n a l h a z a r d o f t h e s o c i a l s e r v i c e s and p e r c e i v e d a s a p r o b l e m on w h i c h b o t h e m p l o y e r s and e m p l o y e e s c o u l d w o r k . 2 N e v e r t h e l e s s , the acceptance of burnout has exceeded i t s development as e i t h e r a r e s e a r c h a b l e concept or an i d e n t i f i a b l e syndrome f o r treatment. T h i s study w i l l review the s u b s t a n t i a l l i t e r a t u r e on burnout with the aim of developing an conceptual framework that i s c o n s i s t e n t and apply t h i s theory to r e s e a r c h i n g an approach to i n t e r v e n t i o n u s e f u l t o f r o n t l i n e a d m i n i s t r a t o r s and s u p e r v i s o r s i n the s o c i a l s e r v i c e s . B. D e f i n i t i o n of Burnout The r e s e a r c h e x p l o r i n g burnout has been hampered by the lack of a s i n g l e accepted d e f i n i t i o n of the concept. Berkley Planning A s s o c i a t e s (1977) e x h a u s t i v e l y reviewed the l i t e r a t u r e on job s a t i s f a c t i o n and the p h i l o s o p h i c a l concept of a l i e n a t i o n and connected t h i s work with the concept of burnout. They concluded that the c l a s s i c concept of a l i e n a t i o n i s c l o s e s t to the modern concept of burnout. A l i e n a t i o n means "separated from" t h e r e f o r e , burnout means a l i e n a t e d or separated from the purpose of one's work. Karger (1981), a Marxist s c h o l a r , a l s o considered burnout to be a modern v e r s i o n of the c l a s s i c concept of a l i e n a t i o n . He argued that dominant p o l i t i c a l i d e o l o g y shapes the framing of r e s e a r c h q u e s t i o n s and the s p e c i f i c s of o p e r a t i o n a l i z e d d e f i n i t i o n s of concepts such as burnout. Most d e f i n i t i o n s of burnout place the phenomenon at the l e v e l of the i n d i v i d u a l and thereby conceal the r o l e played by the s t r u c t u r e d i n e q u i t i e s w i t h i n s o c i e t y . 3 Maslach (1982:3) considers burnout to be one type of job s t r e s s which i s unique i n that i t a r i s e s from the s o c i a l i n t e r a c t i o n between helper and r e c i p i e n t . Maslach b e l i e v e s burnout i s m u l t i f a c e t e d and c o n s i s t s of at l e a s t three f a i r l y independent components (Emotional Exhaustion, Personal Accomplishment, and D e p e r s o n a l i z a t i o n ) . Emotional Exhaustion r e f e r s to f e e l i n g s of being worn down and fa t i g u e d by work while Depersonalization describes the development of dehumanizing or c y n i c a l f e e l i n g s toward c l i e n t s . The Personal Accomplishment component of burnout i s the experience of f e e l i n g s of the l o s s of a sense of accomplishment in the work. Meier (1984) d e f i n e s burnout as a s t a t e r e s u l t i n g from repeated work experiences i n which i n d i v i d u a l s expect few rewards and considerable punishment i n t h e i r job, l i t t l e c o n t r o l of reinforcement, or l i t t l e personal competence i n obt a i n i n g reinforcement. Meier's d e f i n i t i o n i s a restatement of Maslach's d e f i n i t i o n i n behavioral terms. For t h i s study, burnout i s broadly defined as a c o n d i t i o n of disengagement from ones work a f f e c t i n g workers in p r o f e s s i o n a l helping r o l e s . Thus, burnout i s d i s t i n g u i s h e d from syndromes of occupational s t r e s s and job d i s s a t i s f a c t i o n by being s o l e l y a problem a f f e c t i n g " p r o f e s s i o n a l people-helpers". Secondly, burnout i s not simply p h y s i c a l or emotional f a t i g u e nor any other s i n g l e symptom but i s the l o s s of contact with the personal 4 a l t r u i s t i c i d e a l s which motivate those employed i n the helping p r o f e s s i o n s . C. The I m p l i c a t i o n s of Burnout i n the S o c i a l S e rvices Burnout has been acknowledged as a widespread (Borland, 1981), pervasive ( L e i t e r & Meechan, 1986), and se r i o u s (Daley, 1979) problem. Research has documented the prevalence of burnout among a d m i n i s t r a t i v e , d i r e c t - c a r e p r o f e s s i o n a l , and d i r e c t - c a r e p a r a - p r o f e s s i o n a l workers and has determined t h a t , at any given time, u s u a l l y about 15% are h i g h l y burned-out (Weinberg, Edwards, & Garove, 1983). These f i g u r e s are averages f o r large samples and are h i g h l y v a r i a b l e , d i f f e r e n t work s e t t i n g s vary widely i n l e v e l s of burnout (Weinberg et a l . , 1983). S t a f f working i n c h i l d welfare have repeatedly been i d e n t i f i e d as a group p a r t i c u l a r l y at r i s k f o r burnout (Daley, 1979; Falconer & Hornick, 1983; Harrison, 1980; Jayaratne, Chess, & Kunkel, 1986). For c h i l d welfare workers much of the s t r e s s leading to burnout stems from having to make complex, l i f e or death d e c i s i o n s with l i t t l e concrete information while f o r other s o c i a l s e r v i c e workers, the s t r e s s comes from having to deal with large numbers of c l i e n t s making extreme demands (Maslach, 1982). In a d d i t i o n to those d i r e c t l y s u f f e r i n g from i t s e f f e c t s , burnout has consequences f o r the consumers of s o c i a l s e r v i c e s , agency supervisors and a d m i n i s t r a t o r s , and s o c i e t y . As w e l l , burnout i s a s p e c i f i c occupational hazard 5 o f a l l t y p e s o f s o c i a l work and a s s u c h i s an i s s u e w h i c h c o n c e r n s e v e r y member o f t h e S o c i a l Work P r o f e s s i o n . C onsumers o f s o c i a l s e r v i c e s a r e one o f t h e s o u r c e s o f b u r n o u t and t h e g r o u p w h i c h s u f f e r s t h e g r e a t e s t h a r d s h i p a s a c o n s e q u e n c e . B u r n e d o u t c h i l d w e l f a r e w o r k e r s may a p p r e h e n d c h i l d r e n w i t h o u t i n v e s t i n g e x t r a e n e r g y t o f i n d d i f f i c u l t s o l u t i o n s o r f a i l t o i d e n t i f y t h e c h i l d t r u l y a t r i s k . B u r n e d o u t f i n a n c i a l a s s i s t a n c e w o r k e r s may grow c a l l o u s and c y n i c a l t o w a r d r e c i p i e n t s e r o d i n g a l r e a d y d i m i n i s h e d s e n s e s o f s e l f - w o r t h . B u r n e d o u t y o u t h c o u n s e l o r s may g i v e up on d i f f i c u l t c l i e n t s and so f o r t h . S o c i a l work s u p e r v i s o r s and a g e n c y a d m i n i s t r a t o r s a r e d o u b l y a f f e c t e d . They must t r y t o r e d u c e and p r e v e n t b u r n o u t i n t h e i r s t a f f w h i l e b e i n g a c t e d upon by t h e same f o r c e s ( s o m e t i m e s m a g n i f i e d ) w h i c h l e a d t o b u r n o u t i n t h e i r e m p l o y e e s . F i n a l l y , i n a t i m e o f d i m i n i s h i n g r e s o u r c e s and i n c r e a s i n g p u b l i c s c e p t i c i s m a b o u t t h e v a l u e o f s o c i a l s e r v i c e s , any o b s t a c l e t o e f f e c t i v e s e r v i c e d e l i v e r y p o s e s a t h r e a t w h i c h g o e s b e y o n d i m m e d i a t e c o n s e q u e n c e s . I n s h o r t , t h e s u r v i v a l o f p r e s e n t l e v e l s o f s o c i a l s e r v i c e s r e q u i r e d e m o n s t r a b l e , e f f e c t i v e s e r v i c e d e l i v e r y . D. R e s p o n s e s t o B u r n o u t The r e s p o n s e t o b u r n o u t a s a p r o b l e m i n s o c i a l s e r v i c e d e l i v e r y s y s t e m s h a s been d i v e r s e and m u l t i - f o c u s e d . The f o c u s f o r i n t e r v e n t i o n h a s been b a s e d on t h e assumed c a u s e . 6 I n i t i a l approaches to i n t e r v e n t i o n were d i r e c t e d at t r e a t i n g i n d i v i d u a l burnout v i c t i m s . Freudenberger (1982) i s the c h i e f spokesperson f o r t h i s l e v e l of i n t e r v e n t i o n which i s g e n e r a l l y reserved f o r workers i n severe stages of burnout. Most of the i n t e r v e n t i o n l i t e r a t u r e produced i n the l a t e 70's and e a r l y 80's explored the use of burnout workshops to t r e a t groups of s t a f f (Edelwich & Brodsky, 1980; Pines & Aronson, 1983). The proponents of workshops took a more preventative approach i n that the goal was not to t r e a t v i c t i m s but to equip workers to cope with work s t r e s s . An extension of t h i s preventative approach t r a i n e d neophyte c h i l d welfare workers before going o n - l i n e (Falconer & Hornick, 1983). Hunnicutt & MacMillan (1983) evaluated the e f f e c t i v e n e s s of burnout workshops and found that a c t i v e l y i n v o l v i n g workers i n program development and d e c i s i o n making was a more powerful preventative agent than workshops alone. The l a t e s t area of i n t e r v e n t i o n has focused on the environment. Environmental a t t r i b u t e s studied have included work r o l e s and r o l e c o n f l i c t (Harrison, 1980; Maslach, 1982; Ryerson & Marks, 1982); i n t e r a c t i v e and i n t e r p e r s o n a l f a c t o r s (Forman, 1983; Goroff, 1986; Pines, 1983; Randolph, 1982; S c u l l y , 1983); supervisory and management processes (Berkley Planning A s s o c i a t e s , 1977; Bramhall & E z e l l , 1981; Davis & B a r r e t t , 1981; Shapiro, 1982); and o r g a n i z a t i o n a l s t r u c t u r e s (Golembiewski, 1982; Golembiewski & Munzenrider, 7 1984a; Golembiewski, Munzenrider, & Ca r t e r , 1983; Karger, 1981; Pines, 1982; Woodsworth, 1983). The aspects of the work environment associated with burnout have ranged from o b j e c t i v e features such as hours, workload, and type of task (Berkley Planning A s s o c i a t e s , 1977) to broad i d e o l o g i c a l i n f l u e n c e s from the l a r g e r s o c i a l environment (Karger, 1981; Woodsworth, 1983). This study i s aimed at examining the a t t r i b u t e s of the perceived s o c i a l environment. This s o c i a l work-environment i s the immediate micro-environment created by co-workers involved i n s o c i a l i n t e r a c t i o n . Moos (1981) has devised an instrument, the Work Environment Scale (WES), f o r measuring the " s o c i a l c l i m a t e " of various environments i n c l u d i n g the work environment. The WES measures ten work environment v a r i a b l e s grouped i n t o three c a t e g o r i e s , r e l a t i o n s h i p dimensions, personal growth dimensions, and system maintenance and system change dimensions. By measuring the perceived work environment, the WES focuses on the immediate, experienced, s o c i a l micro-environment of the work p l a c e . E. Purpose of the Study Previous research (Berkley Planning A s s o c i a t e s , 1977; Golembiewski et al.,1983; Koran, e t . a l . , 1983; MacMillan & Hunnicutt, 1983; Parkes, 1982; Rosenthal, Teague, R e t i s h , West, & V e s s e l l , 1983; S a v i c k i & Cooley, 1987; Weinberg et al.,1983) has shown that l e v e l s of s t a f f burnout and 8 f e a t u r e s o f t h e work e n v i r o n m e n t a r e r e l a t e d . N e v e r t h e l e s s , t h e s e s e t s o f r e l a t i o n s h i p s have n o t been f u l l y e x p l o r e d i n t h e s e t t i n g s w i t h w h i c h t h i s s t u d y i s c o n c e r n e d . T h e r e f o r e , t h e g o a l o f t h i s s t u d y i s t o e x p l o r e t h e c o r r e l a t i o n b e t w e e n two m u l t i f a c t o r i a l m e a s u r e s , one o f b u r n o u t and t h e o t h e r o f d i m e n s i o n s o f t h e m i c r o s o c i a l w o r k i n g e n v i r o n m e n t t h o u g h t t o be r e l a t e d t o b u r n o u t . From t h i s e x p l o r a t o r y a n a l y s i s , i t i s hoped t o e x t r a c t two k i n d s o f i m p l i c a t i o n s : 1. P o s s i b i l i t i e s f o r i n t e r v e n t i o n i n t h e work e n v i r o n m e n t t o r e d u c e b u r n o u t . 2 . F e a s i b i l i t y o f u s i n g m e a s u r e s o f t h e s e two s e t s o f v a r i a b l e s f o r p e r i o d i c a s s e s s m e n t o f b u r n o u t i n t h e a g e n c i e s s t u d i e d . H. L i m i t a t i o n s and V a l u e A s s u m p t i o n s Two m a j o r c o n s t r a i n t s have l i m i t e d t h e s c o p e o f t h i s s t u d y . C h i e f among t h e s e was t h e s h o r t s p a n o f t i m e a v a i l a b l e . B u r n o u t r e s e a r c h h a s r e a c h e d a p l a t e a u where any s i g n i f i c a n t a d v a n c e s must come v i a t h o r o u g h l o n g i t u d i n a l w o r k . A l o n g i t u d i n a l m e t h o d o l o g y was u n f e a s i b l e i n t h e t e n months p e r m i t t e d t o c o n d u c t t h e s t u d y . H o p e f u l l y , t h e c r o s s - s e c t i o n a l d e s i g n u t i l i z e d i n t h i s s t u d y w i l l p r o v i d e a s o u n d s t a r t i n g p o i n t f o r f u t u r e l o n g i t u d i n a l r e s e a r c h . More t i m e w o u l d have a l l o w e d an e x a m i n a t i o n o f a t t r i b u t e s o f t h e work e n v i r o n m e n t a c c e s s i b l e o n l y t o a more i n - d e p t h , q u a l i t a t i v e m e t h o d o l o g y . T h i s i n f o r m a t i o n m i g h t have i n c l u d e d a b s e n t e e i s m , s i c k n e s s r a t e s , and e m p l o y e e p e r f o r m a n c e e v a l u a t i o n s . L i k e w i s e , a r i c h e r d e s c r i p t i o n o f b u r n o u t c o u l d have been o b t a i n e d by o b s e r v i n g w o r k e r s b e h a v i o r ( A r e t h e y t r e a t i n g c l i e n t s a s o b j e c t s and p r e s e n t i n g a s e m o t i o n a l l y e x h a u s t e d ? ) and w i t h i n t e r v i e w s (Where do you s t a n d i n r e l a t i o n t o y o u r c l i e n t s , e . g . , how r e s p o n s i b l e a r e you f o r t h e i r i m p r o v e m e n t o f f a i l u r e t o i m p r o v e ? ) . The l i m i t e d t i m e a v a i l a b l e t o c o n d u c t t h i s s t u d y p r e c l u d e d any a t t e m p t t o g e t a t c a u s a l r e l a t i o n s h i p s b e t w e e n work e n v i r o n m e n t and b u r n o u t . However, t h e f o c u s o f t h i s s t u d y i s t o e x p l o r e t h e r e l a t i o n s h i p b e t w e e n work e n v i r o n m e n t and b u r n o u t w i t h t h e g o a l o f p r o v i d i n g i n f o r m a t i o n t o g u i d e i n t e r v e n t i o n . C o n s e q u e n t l y , i f a p a r t i c u l a r work e n v i r o n m e n t c h a r a c t e r i s t i c i s shown t o be c o r r e l a t e d w i t h b u r n o u t and i s s u b j e c t t o m a n i p u l a t i o n , t h e n i t i s l o g i c a l t o work w i t h s t a f f on t h a t e n v i r o n m e n t a l c h a r a c t e r i s t i c a s a c o n s t r u c t i v e way o f r e s p o n d i n g t o b u r n o u t . A n o t h e r l i m i t a t i o n i s t h e r e l a t i v e l y s m a l l s a m p l e s i z e and t h e f a c t t h a t i t was n o t r a n d o m l y d r a w n . A d e c i s i o n was made t h a t i t was more i m p o r t a n t t o o b t a i n 100% r e s p o n s e r a t e s f r o m teams t o a l l o w w i t h i n - t e a m c o m p a r i s o n s t h a n t o o b t a i n a random s a m p l e o f t h e p o p u l a t i o n . A g a i n , t h e t i m e a v a i l a b l e p r e c l u d e d t h e s e l e c t i o n o f a l a r g e r s a m p l e . A f i n a l l i m i t a t i o n r e l a t e s t o t h e s t u d y m e t h o d o l o g y . R e s u l t s were s o u g h t f r o m c o m p l e t e teams o f w o r k e r s m e a n i n g t h a t t h e s i g n i f i c a n c e t e s t s u s e d i n t h e d a t a a n a l y s i s must 10 be v i e w e d w i t h c a u t i o n . T e s t s o f s i g n i f i c a n c e assume t h e " i n d e p e n d e n c e o f o b s e r v a t i o n s " and t h i s c a n n o t be g u a r a n t e e d when r e s u l t s f r o m w h o l e work teams a r e u s e d i n s t e a d o f a random s e l e c t i o n o f i n d i v i d u a l s . A number o f v a l u e a s s u m p t i o n s have g u i d e d t h i s r e s e a r c h . F i r s t among t h e s e i s an o p t i m i s m w h i c h r e f u s e s t o a c c e p t any human phenomena a s e i t h e r u n i f o r m l y o r s i m p l i s t i c a l l y n e g a t i v e . T h i s v a l u e , c o u p l e d w i t h p a s t e x p e r i e n c e s h e l p i n g w o r k e r s work t h r o u g h , i n t e g r a t e , and l e a r n f r o m t h e i r e x p e r i e n c e s o f b u r n o u t , p r e c l u d e d a v i e w o f b u r n o u t a s a s t a t i c , p u r e l y p o i n t l e s s e n d - s t a t e . B u r n o u t i s a l w a y s v i e w e d i n a d e v e l o p m e n t a l c o n t e x t ; a s a s t e p o r t r a n s i t i o n t o s o m e t h i n g e l s e w i t h a message f o r t h e w o r k e r m a k i n g t h e j o u r n e y . A s e c o n d v a l u e i n f l u e n c i n g t h i s s t u d y d e r i v e s f r o m t h e r e s e a r c h e r s e x p e r i e n c e w i t h g r o u p s . T h i s i s an i n t u i t i v e f a i t h i n t h e n o t i o n o f a s o c i a l g e s t a l t , t h a t i s , t h a t any g r o u p o f i n d i v i d u a l s f o r m i n g an i n t e r a c t i v e s o c i a l s y s t e m c o n s t i t u t e s a w h o l e g r e a t e r t h a n t h e sum o f i t s p a r t s . The i n f l u e n c e o f t h i s b i a s w i l l be o b v i o u s t h r o u g h o u t t h e t h e s i s . A f i n a l v a l u e a s s u m p t i o n i s r e f l e c t e d i n t h e s a m p l e c h o i c e . The r e s e a r c h e r h a s w o r k e d many y e a r s i n p a r a p r o f e s s i o n a l r o l e s a s a c h i l d c a r e and f a m i l y w o r k e r . I n g e n e r a l t h e s e o c c u p a t i o n s a r e l o w p a i d , l o w s t a t u s , and i n v o l v e a h i g h l e v e l o f i n t e n s i v e c l i e n t c o n t a c t . As s u c h , 11 t h e y a r e j o b s where b u r n o u t i s a d a i l y , o n g o i n g f a c t o f l i f e . I . O r g a n i z a t i o n o f t h e T h e s i s C h a p t e r I o u t l i n e s t h e p r o b l e m a r e a , d e f i n e s b u r n o u t , d e s c r i b e s t h e e x t e n t o f b u r n o u t and t h o s e a f f e c t e d , s t a t e s t h e p u r p o s e o f t h e s t u d y , n o t e s t h e l i m i t a t i o n s and v a l u e a s s u m p t i o n s i n t h e w o r k , and p r o v i d e s an o v e r v i e w o f t h e t h e s i s . C h a p t e r I I r e v i e w s t h e r e l e v a n t l i t e r a t u r e on b u r n o u t and d i s c u s s e s v i e w s o f b u r n o u t d e v e l o p e d f r o m m o r a l -r e l i g i o u s , M a r x i s t , and e x i s t e n t i a l p e r s p e c t i v e s . As w e l l , i m p o r t a n t r e c e n t r e s e a r c h i s r e v i e w e d . C h a p t e r I I I d e s c r i b e s t h e r e s e a r c h p r o b l e m and t h e t h e o r e t i c a l f o r m u l a t i o n u s e d t o g u i d e t h e r e s e a r c h , s t a t e s t h e h y p o t h e s e s , and d i s c u s s e s t h e l i m i t a t i o n s o f t h e s t u d y . A two and t h r e e d i m e n s i o n a l f r a m e w o r k f o r v i e w i n g b u r n o u t i s p r e s e n t e d d r a w i n g upon t h e a l t e r n a t e p e r s p e c t i v e s d e v e l o p e d i n C h a p t e r I I . C h a p t e r I V d e t a i l s t h e r e s e a r c h d e s i g n u t i l i z e d . R e s e a r c h m e t h o d o l o g y i s d e s c r i b e d i n c l u d i n g s a m p l i n g , d a t a c o l l e c t i o n , a nd d a t a a n a l y s i s . C h a p t e r V p r o v i d e s t h e r e s e a r c h f i n d i n g s and d i s c u s s e s t h e i r r e l e v a n c e t o t h e h y p o t h e s e s . C h a p t e r V I s u m m a r i z e s t h e s t u d y and c o n c l u s i o n s and d i s c u s s e s t h e i m p l i c a t i o n s f o r f u t u r e r e s e a r c h and i n t e r v e n t i o n . 12 Chapter I I - L i t e r a t u r e Review A. O r i g i n s of "Burnout" The modern usage of "burnout" began in the mid 1970's when Freudenberger (1974) introduced the term to describe a c o n d i t i o n he observed among dedicated s t a f f working i n the free c l i n i c movement. He noticed that b r i g h t , e n t h u s i a s t i c volunteer s o c i a l s e r v i c e s t a f f were becoming f r u s t r a t e d and c y n i c a l and that many were e i t h e r working f r a n t i c a l l y and g e t t i n g nowhere or were "dropping out" and turning to drugs. He has continued to r e f i n e the concept and develop i n d i v i d u a l treatment s t r a t e g i e s from a psychoanalytic perspective (Freudenberger, 1975, 1977, 1980, 1982). Freudenberger (1982:174) has concluded that: burnout i s not a mental d i s o r d e r i n the usual sense; most burned-out p r o f e s s i o n a l s w i l l respond q u i c k l y to b r i e f , focused, r e a l i t y - o r i e n t e d c o u n s e l l i n g without drug therapy; and most cases of burnout are curable therefore i t i s cheaper to salvage than replace burned-out p r o f e s s i o n a l s . Maslach (1976, 1978a, 1978b, 1982) incorporated a broader a n a l y s i s than Freudenberger and i s g e n e r a l l y c r e d i t e d with intro d u c i n g an environmental p e r s p e c t i v e . While Freudenberger tended to look f o r a t t r i b u t e s of i n d i v i d u a l s which might predispose them to burnout, he d i d not emphasize environmental f a c t o r s even though "contact with people" was i m p l i c i t i n h i s concept. Other 13 p s y c h o l o g i s t s working in the f i e l d i n the e a r l y 70's (Pines & Kafry, 1978; Pines & Maslach, 1978) assumed an important r o l e f o r the environment but were mainly occupied with d e s c r i b i n g burnout and d e v i s i n g means to measure i t . Maslach was one of the f i r s t researchers to explore the underlying dimensions of burnout and conduct e m p i r i c a l work beyond the d e s c r i p t i v e l e v e l (Perlman & Hartman, 1981). B. The Moral R e l i g i o u s Paradigm Cherniss(1986) suggests a m o r a l - r e l i g i o u s paradigm as an a l t e r n a t i v e to the s c i e n t i f i c - t e c h n i c a l paradigm f o r understanding burnout. Viewed from t h i s p e r s p e c t i v e , "what we often r e f e r to as burnout i s r e a l l y a symptom of the l o s s of s o c i a l commitment" (Cherniss, 1986:219). A d i s t i n c t i o n i s made between "commitment" as i t i s u s u a l l y defined i n the burnout l i t e r a t u r e and the concept of " s o c i a l commitment". Freudenberger & Richelson (1980:20) use commitment in t h i s conventional context as a p e r s o n a l i t y t r a i t . People prone to burnout are the "overcommitted" who are "dynamic, c h a r i s m a t i c , g o a l - o r i e n t e d determined i d e a l i s t s " who want everything to be p e r f e c t . S o c i a l commitment from the m o r a l - r e l i g i o u s perspective i s defined as: . . . I mean b e l i e f i n a transcendent body of ideas and  strong i d e n t i f i c a t i o n with a group, i n s t i t u t i o n , or  method that i s based on those ideas. In other words, s o c i a l l y committed people b e l i e v e i n something greater 14 than themselves; and when work i s based on t h i s commitment, they are l e s s l i k e l y to experience the phenomena associated with burnout(Cherniss, 1986, p.219) . Cherniss (1986) gives two examples of s e t t i n g s where high l e v e l s of s o c i a l commitment i s associated with low burnout symptomatology. One was a r e s i d e n t i a l i n s t i t u t i o n f o r the mentally retarded run by an order of nuns. The s i s t e r s worked 7 days a week, 52 weeks a year in c o n t i n u a l contact with r e s i d e n t s while abiding by a p l e t h o r a of onerous, t r i v i a l , and f u n c t i o n a l l y unnecessary r u l e s imposed by the church. There was no d i v i s i o n of labor w i t h i n t h i s s e t t i n g and a l l menial and demanding tasks were shared without regard to t r a i n i n g or education. Despite t h e i r working under what would be c l e a r l y unacceptable working c o n d i t i o n s by the standards of most p r o f e s s i o n a l s o c i a l s e r v i c e care g i v e r s , these s i s t e r s not only d i d not show signs of burnout symptomatology but a c t u a l l y displayed joy i n t h e i r work. As w e l l , Cherniss provides a s e c u l a r example. A school f o r mentally retarded and emotionally d i s t u r b e d c h i l d r e n excluded from re g u l a r school as too d i f f i c u l t to teach operated i n the slums of Chicago with a s t a f f turnover rate of about 10%. This compared with s t a f f turnover rates near 50% i n other schools serving a s i m i l a r p opulation. The f a c t o r s which seemed to set t h i s school apart were p o s i t i v e charismatic leadership from the d i r e c t o r and a s t a f f 15 u n i v e r s a l l y t r a i n e d and c e r t i f i e d i n t h e M o n t e s s o r i t e a c h i n g m e t h o d . B a s e d upon t h e s e o b s e r v a t i o n s C h e r n i s s p r o p o s e s f i v e s o u r c e s o f s o c i a l commitment t h a t m i g h t be i n c o r p o r a t e d i n human s e r v i c e p r o g r a m s : I d e o l o g y — T o know t h a t t h e C a t h o l i c c h u r c h o r M o n t e s s o r i s a n c t i o n s a p a r t i c u l a r a c t i o n r e d u c e s much o f t h e a m b i g u i t y and s e l f - d o u b t t h a t can l e a d t o l o w e r e d m o t i v a t i o n a n d m o r a l e . T h u s a s t r o n g , c l e a r , e x p l i c i t i d e o l o g y seems t o be one way i n w h i c h i n s t i t u t i o n s s u c h a s human s e r v i c e p r o g r a m s c a n b u i l d s t r o n g s o c i a l commitment ( C h e r n i s s , 1 9 8 6 : 2 2 2 - 2 2 3 ) . G u i d a n c e — r e f e r s t o a s p e c i f i c p r o g r a m o f b e h a v i o r a l n o r m s , l i n k e d t o t h e g u i d i n g i d e o l o g y . The M o n t e s s o r i "method" p r o v i d e s a good e x a m p l e o f g u i d a n c e i n a human s e r v i c e c o n t e x t . The method i s b a s e d upon a c l e a r s e t o f v a l u e s and p r i n c i p l e s t h a t a r e t r a n s l a t e d i n t o an e l a b o r a t e , s t a n d a r d i z e d c u r r i c u l u m . . . t h e M o n t e s s o r i method e x i s t s i n a s o c i a l c o n t e x t t h a t i n f u s e s t h e c u r r i c u l u m w i t h m e a n i n g a n d makes i t a p o w e r f u l v e h i c l e f o r e n h a n c i n g s o c i a l commitment ( C h e r n i s s , 1986:223) C o m m u n i o n — r e f e r s t o p r a c t i c e s t h a t b r i n g "members i n t o m e a n i n g f u l c o n t a c t w i t h t h e c o l l e c t i v e w h o l e " . A n o t h e r p r a c t i c e u s e d i n t h e M o n t e s s o r i s c h o o l was r e g u l a r i z e d g r o u p c o n t a c t : e a c h m o r n i n g b e f o r e s c h o o l t h e t e a c h e r s w o u l d a s s e m b l e f o r c o f f e e and c o n v e r s a t i o n , g r o u p 16 e x e r c i s e , or some other kind of shared a c t i v i t y (Cherniss, 1986:223) Investment—"A process whereby the i n d i v i d u a l gains a stake i n the group, commits current and future p r o f i t s to i t , so that he must continue to p a r t i c i p a t e i f he i s going to r e a l i z e those p r o f i t s " . The Montessori school used t h i s mechanism i n r e q u i r i n g a l l s t a f f to r e t u r n to school and invest a considerable amount of time and e f f o r t toward securing Montessori t r a i n i n g and c e r t i f i c a t i o n (Cherniss, 1986:224). M o r t i f i c a t i o n — i n v o l v e s the "submission of p r i v a t e s t a t e s to s o c i a l c o n t r o l , the exchanging of a former i d e n t i t y f o r one defined and formulated by the community". The formal probationary period f o r novices used i n the r e l i g i o u s order would be a s p e c i f i c example of m o r t i f i c a t i o n (Cherniss, 1986:224). Cherniss argues that science has replaced r e l i g i o n with a new system of a u t h o r i t y . The new "Age of Psychology" i s e s s e n t i a l l y a n t i - r e l i g i o u s and a n t i - a u t h o r i t y . The s c i e n t i f i c - t e c h n i c a l paradigm f o s t e r s a mode of t h i n k i n g which a c t u a l l y increases burnout by weakening "our a b i l i t y to form strong commitment to any e x t e r n a l frame of reference by encouraging a c o o l , c r i t i c a l a t t i t u d e toward the world...and developing a c u l t u r e of p r o f e s s i o n a l i s m that weakens the bonds between car e g i v e r s and the s e t t i n g s i n which they work" (Cherniss, 1986:225). 17 Another way the s c i e n t i f i c - t e c h n i c a l paradigm c o n t r i b u t e s to burnout i s through i t s "strong emphasis on i n d i v i d u a l i s m and the i n s i s t e n c e that the p r a c t i t i o n e r be granted a high degree of autonomy. This has the e f f e c t of i s o l a t i n g the p r o f e s s i o n a l from others; s o c i a l support among members of a s e t t i n g i s weakened and thus everyone i s more l i k e l y to experience s t r e s s and burnout(Cherniss, 1986:226). Cherniss closes h i s d i s c u s s i o n by acknowledging that whatever b e n e f i t s p r o f e s s i o n a l i s m may have provided, i t nonetheless has drawbacks f o r both c l i e n t s and p r o f e s s i o n a l s . He s t a t e s : Conversely, human s e r v i c e workers who receive a t y p i c a l p r o f e s s i o n a l education, based on the s c i e n t i f i c -t e c h n i c a l paradigm, working i n s e t t i n g s with weak i d e o l o g i e s , l i t t l e guidance, minimal investment and m o r t i f i c a t i o n , and so f o r t h should be p a r t i c u l a r l y vulnerable to excessive demands and f r u s t r a t i o n s (Cherniss, 19 86:227-228). Cherniss urges the study of methods f o r introduc i n g s o c i a l commitment p r a c t i c e s i n human s e r v i c e programs. Cherniss' view represents a s i g n i f i c a n t step i n coming to terms with the concept of burnout. The value of the paper l i e s not i n any suggestion that the s o c i a l work pro f e s s i o n s should r e t u r n to p r e - s c i e n t i f i c t h i n k i n g but i n i t s i l l u s t r a t i o n of the i n s i g h t s an a l t e r n a t i v e frame of reference can generate by " j a r r i n g our t h i n k i n g " . Cherniss does not catalogue of the odious baggage that was l e f t 18 behind with the m o r a l - r e l i g i o u s paradigm although he had a l l u d e d to t h i s i n an e a r l i e r a r t i c l e (Cherniss & Krantz, 1983). These negative aspects would include the excesses of moral s e l f - r i g h t e o u s n e s s and the a p p l i c a t i o n of blame and g u i l t as change mechanisms. I t i s the release from g u i l t that the understandable concept of "burnout" provided to s e l f - c r i t i c a l workers with no acceptable explanation f o r t h e i r " i r r a t i o n a l " and "bad" f e e l i n g s that accounted f o r the immediate acceptance of the term. Some of the aspects important i n the concept of burnout that Cherniss has helped tease out are: the importance of "meaning" or meaningfulness i n ones work; the r o l e of strong c h a r i s m a t i c l e a d e r s h i p ; the a b i l i t y of a shared ideology to introduce c l a r i t y i n t o the work task; the importance of communion or peer support and sharing; the idea of "healthy investment" as opposed to "overcommitment"; the r o l e m o r t i f i c a t i o n or s i m i l a r l y , r i t u a l and " r i t e s of passage" may play ; and the concept of s o c i a l commitment. C. Marxist Perspectives M a r x i s t s tend to view burnout as a consequence of the inherent c o n t r a d i c t i o n s i n the s t r u c t u r e of l a r g e r s o c i e t y . In e f f e c t , burnout i s considered a symptom of a l a r g e r s o c i a l problem, c a p i t a l i s m . David Woodsworth a r t i c u l a t e s t h i s view: Burnout, I would argue, r e s u l t s from the imposition of bureaucratic impersonal r u l e s on p r o f e s s i o n a l p r a c t i c e 19 i n the i n t e r e s t of maintaining c o n t r o l of the population while s o c i e t y makes the necessary adaptations through c r i s e s of c a p i t a l i s m (Woodsworth, 1983:32). Although he does not i d e n t i f y himself as a Marxist s c h o l a r , the view Mclntyre (1987) puts forward i s c o n s i s t e n t with t h i s p e r s p e c t i v e . He argues that s o c i a l workers burn out because they s t r i v e to be " s i g n i f i c a n t change agents" i n a world with a b u i l t - i n and pervasive r e s i s t a n c e to change. The sources of s o c i a l worker " i n s i g n i f i c a n c e " are the b u r e a u c r a t i c o r g a n i z a t i o n of employing agencies, the s e l f -s e r ving goal of most p r o f e s s i o n a l a s s o c i a t i o n s , the co-opting i n f l u e n c e s of higher education, s o c i a l a t t i t u d e s f a v o r i n g the status-quo, and the lack of cooperation of c l i e n t s i n promoting change due to t h e i r i m p l i c i t awareness of the " s o c i a l c o n t r o l " f u n c t i o n of s o c i a l workers. Karger (1981) develops the Marxist view and argues that p o l i t i c a l p e rspectives i n f l u e n c e the framing of research questions. Researchers operating from a s c i e n t i f i c -t e c h n i c a l paradigm do so w i t h i n the l o g i c of l i b e r a l and conservative ideology. Their conservative i d e o l o g i c a l roots condemn them to a narrow view of burnout as a p r o f e s s i o n a l problem rather than a " s o c i a l phenomenon with i t s roots i n the s o c i a l view of the a c t i v i t y of production" (Karger, 1981:272). Karger c r i t i c i z e s the i n a b i l i t y of the current l i t e r a t u r e to analyze the causes of burnout, p r e d i c t i t s frequency or i n t e n s i t y , or adequately e x p l a i n and categorize 20 the problem. He s t a t e s : "the view of burnout as a phenomenon rather than as a p r e d i c t a b l e outgrowth of an a l i e n a t i n g work environment r e s u l t s i n the absence of a theory of burnout" (Karger, 1981:274). Karger notes the s i m i l a r i t y between the Marxist concept of a l i e n a t i o n and the concept of " p r o f e s s i o n a l burnout": In Marxian terms, burnout i s the o b j e c t i f i c a t i o n of the s o c i a l worker's means of production; h i s s k i l l s of human i n t e r a c t i o n become a market commodity. The transformation of those s k i l l s i n t o merely a means of production r e s u l t s i n the d i s t a n c i n g of a s o c i a l worker from the c l i e n t . This i n turn r e s u l t s i n the r e i f i c a t i o n of the c l i e n t r e l a t i o n s h i p i n t o an inanimate commodity. I t i s t h i s r e i f i c a t i o n , which a l i e n a t e s the worker from the authentic expression of hi s s k i l l s , that f i t s w i t h i n the reported symptoms of burnout (Karger, 1981:275). Norman Goroff (1986) takes a fresh and amusing approach to burnout and presents the "Love Paradigm" as an a n t i d o t e . His p o s i t i o n i s not s o l e l y M a r x i s t , he seems to operate from a broadly e c l e c t i c perspective but a l s o uses Marxist terminology. Goroff argues that workers must develop informal o r g a n i z a t i o n s w i t h i n the confines of repressive c a p i t a l i s t formal o r g a n i z a t i o n s that are based on a d i f f e r e n t set of assumptions. An informal o r g a n i z a t i o n based on the Love paradigm can c o n t r i b u t e much to the people involved to counter-act 21 the negative aspects of the h i e r a r c h i c a l s t r u c t u r e d o r g a n i z a t i o n . R e l a t i o n s h i p s based on c a r i n g and r e s p e c t p r o v i d e s an e s s e n t i a l n u r t u r i n g that a l l humans need (Goroff, 1986:198). G o r o f f ' s (1986) view s t r e s s e s the importance of peer support and c l o s e and supportive r e l a t i o n s h i p s with those one shares a task as a primary f a c t o r i n reducing the i n c i d e n c e of burnout symptoms. D. An E x i s t e n t i a l P e r s p e c t i v e I t seems l o g i c a l , that i f Cherniss (1986) can broaden our understanding of the communal aspects of burnout by a p p l y i n g an unconventional paradigm, that i t might be some p r o f i t a b l e to examine elements of e x i s t e n t i a l philosophy to gain a b e t t e r understanding the s u b j e c t i v e q u a l i t y of burnout. E x i s t e n t i a l i s m i s a 19th and 20th century branch of philosophy and e t h i c a l thought which emphasizes the s u b j e c t i v e or e x p e r i e n t i a l nature of human r e a l i t y . D i f f e r e n t p h i l o s o p h e r s have developed e x i s t e n t i a l i s m i n a v a r i e t y of d i r e c t i o n s and American humanistic p s y c h o l o g i s t s such as R o l l o May, E r i c h Fromm, E r i c E r i c k s o n , and Abraham Maslow have u t i l i z e d some of i t s concepts. The e x i s t e n t i a l i s t p e r s p e c t i v e u t i l i z e d i n t h i s study i s d e r i v e d from the North American schools which emphasize the p o s i t i v e , growth o r i e n t e d aspects over the European schools emphasizing the n e g a t i v e . I t i s important to bear i n mind 22 that e x i s t e n t i a l i s m i s not a u n i f i e d school of thought and, true to i t s " s u b j e c t i v e " underpinnings, i t i s d i f f e r e n t things to d i f f e r e n t s c h o l a r s . This s e c t i o n w i l l draw s e l e c t i v e l y on the l i t e r a t u r e to h i g h l i g h t the o n t o l o g i c a l and e p i s t e m o l o g i c a l dilemmas (eg. i s r e a l i t y e x t e r n a l to the i n d i v i d u a l or consciously created and i s knowledge hard, t a n g i b l e , and t r a n s m i t t a b l e or s o f t , s u b j e c t i v e , and transendental?) inherent i n the study of burnout. Maslow (1968:9) acknowledges that much of e x i s t e n t i a l i s t thought " i s too vague and too d i f f i c u l t to understand from a s c i e n t i f i c point of view (not confirmable or d i s c o n f i r m a b l e ) . " However the value i t has f o r t h i s e x e r c i s e (understanding the s u b j e c t i v e nature of burnout) stems from: .. i t lays great s t r e s s on s t a r t i n g from e x p e r i e n t i a l knowledge rather than from systems of concepts or a b s t r a c t c a t e g o r i e s or a p r i o r i s . E x i s t e n t i a l i s m r e s t s on phenomenology, i . e . , i t uses personal, s u b j e c t i v e experience as the foundation upon which a b s t r a c t knowledge i s b u i l t (Maslow, 1968:9). Maslow (1968) s y s t e m a t i c a l l y l i s t s the b e n e f i t s that can be derived from e x i s t e n t i a l i s t thought. The key concepts f o r t h i s d i s c u s s i o n are the emphasis upon the s u b j e c t i v e , the concept of " r e s p o n s i b i l i t y " and the s t r e s s placed upon "the u l t i m a t e aloneness of the i n d i v i d u a l " . About t h i s t h i r d concept, Maslow s t a t e s : 23 The e x i s t e n t i a l i s t s t r e s s on the ult i m a t e aloneness of the i n d i v i d u a l i s a u s e f u l reminder f o r us, not only to work out f u r t h e r the concepts of d e c i s i o n , or r e s p o n s i b i l i t y , of choice, of s e l f - c r e a t i o n , of autonomy, of i d e n t i t y i t s e l f . I t a l s o makes more problematic and more f a s c i n a t i n g the mystery of communication between alone-nesses v i a , e.g., i n t u i t i o n and empathy, love and a l t r u i s m , i d e n t i f i c a t i o n with others, and homonomy i n general. We take these f o r granted. I t would be b e t t e r i f we regarded them as miracles to be explained (Maslow, 1968:14). Apart from any preferences one may have f o r s c i e n t i f i c over s u b j e c t i v e - e x p e r i e n t i a l "ways of knowing", n e i t h e r of i t s e l f can f u l l y account f o r the whole of s o c i a l r e a l i t y . Harbert (1982:7), an e x i s t e n t i a l i s t philosopher, notes that "For the c o n t e x t u a l i s t , the whole i s not the sum of i t s p a r t s " . " S c i e n t i f i c theories...do not give us the f u l l t r u t h about persons i n the world but only a b s t r a c t i o n s thereof" (Harbert, 1982:8). French, Rodgers & Cobb (1974), a group of a n a l y t i c s c i e n t i s t s , s t a t e : There are two meanings f o r environment. Objective  environment that e x i s t s independently of the person's . perception of i t and s u b j e c t i v e environment as i t i s perceived and reported by the person (French, Rogers & Cobb, 1974:316). 24 The importance of the s u b j e c t i v e i s w e l l e s t a b l i s h e d i n the burnout l i t e r a t u r e . There i s simply no r e l i a b l e connection between the work and workers "burning out". As Karger(1981) points out, burnout i s i n c o n c l u s i v e i n i t s p r e d i c t a b i l i t y and assumptions and i s more a d e s c r i p t i o n of symptoms than an in t e g r a t e d theory of human behavior. I t i s the " s u b j e c t i v e environment" which i s as s i g n i f i c a n t as the o b j e c t i v e environment i n determining burnout. Hence i t i s the "meaning" a worker attaches to h i s work which i s important. Fra n k l (1965), the o r i g i n a t o r of logotherapy, a form of e x i s t e n t i a l psychotherapy, argues that the preeminent human dr i v e i s a will-to-meaning: the d e s i r e to give meaning to ones l i f e . This co n t r a s t s with psychology which i s based upon "status d r i v e " or the will-to-power and psychoanalysis, based upon "the pleasure p r i n c i p a l " or the w i l l - t o - p l e a s u r e . With regard to the meaning of work, Frankl notes "consciousness of r e s p o n s i b i l i t y a r i s e s above a l l out of awareness of a concrete personal task, a "mission" ( F r a n k l , 1965:117)." Mclntyre (1987:1) touches upon the importance of meaning i n h i s d i s c u s s i o n of how workers " s e l l out, burn out, or opt out" due to powerful s o c i a l f orces which condemn them to " i n s i g n i f i c a n c e and i r r e l e v a n c e " . S o c i a l workers d e s i r e s to be meaningful and s i g n i f i c a n t change agents are f r u s t r a t e d leading to burnout. 25 The concept of r e s p o n s i b i l i t y and the o v e r r i d i n g relevance of the s u b j e c t i v e or "consciousness" are interwoven. Consciousness contains the word "conscience" which i m p l i e s r e s p o n s i b i l i t y ( F r a n k l , 1968). Likewise, the word r e s p o n s i b i l i t y breaks down i n t o the phrase " a b i l i t y to respond". Thus, the e x i s t e n t i a l concept of r e s p o n s i b i l i t y combines the notions of consciousness and responsiveness. In an e x i s t e n t i a l context, persons are responsible to one another rather than f o r one another. Assuming r e s p o n s i b i l i t y f o r others i s dehumanizing i n that i t turns the "other" i n t o an o b j e c t , a " t h i n g " whereby one can demonstrate personal s k i l l i f the " t h i n g " performs as one w i l l s or conversely a personal i n c a p a c i t y w i l l be h i g h l i g h t e d i f there i s a f a i l u r e to perform (Goroff, 1986:200). The relevance of the e x i s t e n t i a l concept of r e s p o n s i b i l i t y to burnout i s c l e a r . To lose s i g h t of the d i s t i n c t i o n between being responsible to c l i e n t s and becoming re s p o n s i b l e f o r them i s analogous to Freudenberger's (1980) s t a t e of overcommitment. Staying w i t h i n r e s p o n s i b i l i t y boundaries i s not the complete answer to burnout prevention but workers c l e a r on the degree of r e s p o n s i b i l i t y they own f o r c l i e n t s are c e r t a i n l y l e s s v u l n e r a b l e . The c o m p a t i b i l i t y with Maslach's(1982) progressive aspects of the burnout syndrome i s provocative. A worker shoulders the load of r e s p o n s i b i l i t y r i g h t f u l l y belonging to 2 6 the c l i e n t producing a s t a t e of Emotional Exhaustion; the dehumanizing o b j e c t i f i c a t i o n of the c l i e n t by assuming t h e i r r e s p o n s i b i l i t y f o r s e l f leads to D e p e r s o n a l i z a t i o n ; and by assuming the c l i e n t s r e s p o n s i b i l i t y f o r personal successes and f a i l u r e s , the workers sense of Personal Accomplishment becomes dependent upon the c l i e n t which, more often than not, leads to f a i l u r e and a reduced sense of accomplishment. The concept of the "ultimate aloneness of human existence" i s analogous to the systems concept of "boundaries". The breakdown of boundaries i n p a r e n t - c h i l d r e l a t i o n s h i p s describes a parent becoming "overinvolved" and assuming too much r e s p o n s i b i l i t y f o r the c h i l d . This i s s i m i l a r to the "overcommitted" worker who assumes too much r e s p o n s i b i l i t y f o r c h i l d l i k e c l i e n t s . The c l i e n t i s encouraged to remain c h i l d l i k e and the worker burns out. K r i l l (1978) has a p p l i e d e x i s t e n t i a l theory to s o c i a l work and describes a type of worker he terms the "impulsive helper". The "impulsive helper" i s rooted p r i m a r i l y i n f e e l i n g s . This commitment through f e e l i n g s i s p r i m a r i l y n a r c i s s i s t i c , f o r h i s helping behavior supports, shores up, reassures h i s own s e l f - w o r t h and sense of adequacy. He uses others (even under the guise of helping them) as a means to prove h i s own adequacy. He does not know how to l i s t e n to l i f e outside himself ( K r i l l , 1978:8). 27 He presents a range of " s o c i a l worker types" and h i s i d e a l , "the s o l i t a r y " i s based upon an e x i s t e n t i a l awareness of "ultimate aloneness". As the helping p r o f e s s i o n a l becomes disengaged from h i s personal a n x i e t i e s , s e l f - p i t y preoccupations, and hidden as w e l l as outspoken resentments, he a r r i v e s at an inner void that permits a more responsive and c r e a t i v e engagement with the complex tasks that confront him i n p r a c t i c e . P a r a d o x i c a l as i t may seem, the a p p l i c a t i o n of the e x i s t e n t i a l stance to our understanding of p r a c t i c e i n the helping p r o f e s s i o n s provides f o r a f l e x i b i l i t y , a detachment, an o b j e c t i v i t y s o r e l y needed today. The philosophy that had i t s b i r t h i n impersonal a l i e n a t i o n r e s u l t s i n an a c t i v e , r e l a t i o n a l engagement with the problems of l i f e ( K r i l l , 1978, preface xv). An e x i s t e n t i a l i s t perspective uncovers aspects of burnout not apparent from other p e r s p e c t i v e s . Frankl's (1965) idea that f o r work to have meaning a worker must have an awareness of "a mission" comes very close to a combination of the concepts of "ideology", "guidance" and "investment" that Cherniss (1986) develops from the moral-r e l i g i o u s paradigm. E x i s t e n t i a l i s m h i g h l i g h t s the c r i t i c a l r o l e played by s u b j e c t i v e "consciousness" i n a l l aspects of human phenomena. S o c i a l r e a l i t y i s always an i n t e r a c t i o n between 28 s u b j e c t i v e and o b j e c t i v e r e a l i t y . Any theory of burnout must attempt to get at both these aspects of the phenomenon. E. Burnout Research The most s i g n i f i c a n t research conducted i n the 70's was a massive three year study by Berkley Planning Associates (1977). This seminal three-year e x p l o r a t o r y - d e s c r i p t i v e study sought to gain a general understanding of the r e l a t i o n s h i p between burnout and worker c h a r a c t e r i s t i c s , management s t r u c t u r e s , and features of the o r g a n i z a t i o n a l s t r u c t u r e . The aims of the study were to: define o r g a n i z a t i o n a l and management aspects of the p r o j e c t s under study; e s t a b l i s h prevalence of worker burnout among s t a f f ; and determine the r e l a t i o n s h i p s between these f a c t o r s . The study was organized around a general hypothesis, that burnout i s d i r e c t l y a ssociated with personnel c h a r a c t e r i s t i c s and management processes and i n d i r e c t l y r e l a t e d to o r g a n i z a t i o n a l f a c t o r s (Berkley Planning A s s o c i a t e s , 1977:14). The study addressed s e v e r a l p r i n c i p a l questions: 1- How prevalent i s burnout i n c h i l d welfare workers? 2- Is burnout the same as lack of job s a t i s f a c t i o n ? 3- To what extent i s burnout r e l a t e d to worker c h a r a c t e r i s t i c s ? 4- To what extent i s burnout r e l a t e d to management processes? 29 5-To what extent i s burnout r e l a t e d to o r g a n i z a t i o n a l f a c t o r s ? (Berkley Planning A s s o c i a t e s , 1977:13) Data was c o l l e c t e d at seven s i t e s spread over the U.S. and included 162 s u b j e c t s . Both q u a n t i t a t i v e and q u a l i t a t i v e methodologies were employed using i n t e r v i e w s and q u e s t i o n n a i r e s . As w e l l data was c o l l e c t e d from subjects who had l e f t the agencies p r i o r and during the study. Data c o l l e c t i o n was done during three day v i s i t s to the s i t e s where a d m i n i s t r a t o r s were interviewed and agency records reviewed to obtain data on management p r a c t i c e s and o r g a n i z a t i o n a l s t r u c t u r e s . Data c o l l e c t i o n and design was thorough and comprehensive (Berkley Planning A s s o c i a t e s , 1977: 15) . The study produced a number of i n t e r e s t i n g f i n d i n g s . Worker c h a r a c t e r i s t i c s which emerged with s i g n i f i c a n t but not strong r e l a t i o n s h i p s to burnout were: younger i n age, l e s s experienced, male (small percentage of sample), f u l l time workers, and workers supervised by others. Management processes which were c l o s e l y associated with burnout were: q u a l i t y of l e a d e r s h i p , task o r i e n t a t i o n , c l a r i t y , c o n t r o l , and i n n o v a t i o n . The o r g a n i z a t i o n a l p r o p e r t i e s with s i g n i f i c a n t r e l a t i o n s h i p s to burnout were: high caseload, formalized r u l e observation, p r o j e c t s t a f f turnover r a t e , and c e n t r a l i z e d program d e c i s i o n making. P r o j e c t s with high turnover r a t e s tended to have the lowest burnout r a t e s suggesting t h e i r burntout s t a f f tended to leave. The r e l a t i o n s h i p between burnout and turnover was complex and 30 e n i g m a t i c . Many o f t h e c o n d i t i o n s a s s o c i a t e d w i t h h i g h l e v e l s o f b u r n o u t ( c a s e l o a d s i z e , f o r m a l i z a t i o n & c e n t r a l i z a t i o n ) d i d n o t l e a d t o t u r n o v e r . The i m p l i c a t i o n was t h a t some o f t h e most b u r e a u c r a t i c s e t t i n g s , w h i c h t e n d t o f a c i l i t a t e b u r n o u t , a l s o t e n d t o r e t a i n b u r n e d o u t w o r k e r s ( B e r k l e y P l a n n i n g A s s o c i a t e s , 1 9 7 7 : 2 7 - 4 1 ) . P e r h a p s t h e most i m p o r t a n t f i n d i n g o f t h i s s t u d y i s t h e i m p o r t a n c e o f l e a d e r s h i p as a f a c t o r i n b u r n o u t . " I n work e n v i r o n m e n t s where l e a d e r s h i p p r o v i d e d s t r u c t u r e and s u p p o r t , o n l y 27% o f w o r k e r s were b u r n e d o u t . I n a l l s i t u a t i o n s where l e a d e r s h i p was l o w o r i n a d e q u a t e , w o r k e r s were e i t h e r b u r n e d o u t o r m o d e r a t e l y b u r n e d o u t " ( B e r k l e y P l a n n i n g A s s o c i a t e s , 1 9 7 7 : 4 2 ) . The c r i t i c a l i m p o r t a n c e o f t h e s u p e r v i s o r y / l e a d e r s h i p r o l e f o r w o r k e r s i n j o b s w i t h h i g h p o t e n t i a l f o r b u r n o u t was h i g h l i g h t e d by t h e f i n d i n g t h a t " s u p e r v i s e d by o t h e r s " was s i g n i f i c a n t l y c o r r e l a t e d w i t h b u r n o u t . B e r k l e y P l a n n i n g A s s o c i a t e s (1977) were t h e f i r s t t o e x t e n s i v e l y r e l a t e b u r n o u t m e a s u r e d by s e l f - r e p o r t q u e s t i o n n a i r e s and i n t e r v i e w s w i t h c h a r a c t e r i s t i c s o f t h e work e n v i r o n m e n t a s m e a s u r e d by an a d a p t e d v e r s i o n o f t h e Moos (1974) S o c i a l C l i m a t e S c a l e s . Moos ( 1 9 8 1 , 1986) l a t e r r e v i s e d h i s S o c i a l C l i m a t e S c a l e s i n t o a v e r s i o n a d a p t e d s p e c i a l l y f o r work e n v i r o n m e n t s , t h e Work E n v i r o n m e n t S c a l e (WES). T h i s s c a l e c o n t a i n s t e n d i m e n s i o n s , I n v o l v e m e n t , P e e r C o h e s i o n , S u p e r v i s o r S u p p o r t , Autonomy, T a s k O r i e n t a t i o n , Work 31 Pressure, C l a r i t y , C o n t r o l , Innovation, P h y s i c a l Comfort, and has been used e x t e n s i v e l y to measure the environment i n burnout and occupational s t r e s s research (Koran, e t . a l . , 1983; Parkes, 1982; Weinberg et al.,1983). Several authors have developed instruments to measure burnout (Maslach & Jackson, 1981; Meier, 1984; Pines & Aronson, 1981) but the instrument which has been used most i s the Maslach Burnout Inventory (Maslach & Jackson, 1981). The MBI measures the frequency of three d i f f e r e n t dimensions of burnout, Emotional Exhaustion, D e p e r s o n a l i z a t i o n , and Personal Accomplishment. Golembiewski & Munzenrider (1981, 1983, 1984a 1984b) and Golembiewski et a l . , (1983) have done extensive work t e s t i n g the i n t e r r e l a t i o n s h i p s of the three MBI subscales and examining the p o s s i b i l i t y (suggested by Freudenberger, 1974) that burnout might have " a c t i v e " and "passive" b e h a v i o r a l symptoms. They have found that the Emotional Exhaustion subscale of the MBI i s the most s a l i e n t i n d i c a t o r of burnout. A number authors have used both the MBI and WES i n t h e i r research. Rosenthal et al.(1983) conducted an e x p l o r a t o r y c r o s s - s e c t i o n a l survey of a la r g e random sample (n = 414) of parks employees i n Iowa and M i s s o u r i and used a canonical a n a l y s i s to examine the i n t e r r e l a t i o n s h i p between burnout (dependent v a r i a b l e s ) and work environment (independent v a r i a b l e s ) . They found that the Emotional Exhaustion (EE) subscale of the MBI was s t r o n g l y c o r r e l a t e d 32 with the WES dimensions of Supervisor Support, Work Pressure, and C l a r i t y . Hunnicutt & MacMillan (1983) and MacMillan & Hunnicutt (1983) reported on a three year experimental study using the MBI and seven of the ten WES subscales ( P h y s i c a l Comfort, Innovation, and Peer Cohesion were omitted). The WES measures were included to estimate any changes i n the work environment over the three years of the study. A sample of mental h e a l t h agencies were d i v i d e d i n t o a c o n t r o l group (CG, 5 agencies, n = 90); an experimental group (EG1, 6 agencies, n = 70) which received s t a f f development workshops based on the research of Maslach (1978a, 1982b); and an experimental group (EG2, 5 agencies, n = 91) which received both the s t a f f development workshops and a s t r u c t u r e d opportunity f o r involvement i n program development with an o r g a n i z a t i o n a l development consultant. Their s t u d i e s (Hunnicutt & MacMillan,1983; MacMillan & Hunnicutt,1983) produced s e v e r a l important f i n d i n g s . F i r s t , the Emotional Exhaustion subscale of the MBI was found to be the most potent i n d i c a t o r of burnout. Second, a much stronger r e l a t i o n s h i p between the WES and burnout was found i n the t h i r d year than was expected. Levels of perceived Supervisor Support and Autonomy decreased s i g n i f i c a n t l y i n the c o n t r o l groups while C l a r i t y and Task O r i e n t a t i o n improved s i g n i f i c a n t l y i n the program development groups (EG2). T h i r d , members of the c o n t r o l groups showed s i g n i f i c a n t l y higher scores on the MBI Emotional Exhaustion 33 and Depersonalization subscales a f t e r three years. The workshops only (EG1) improved s l i g h t l y but not s i g n i f i c a n t l y i n l e v e l s of burnout while s t a f f i n the program development groups (EG2) showed a s i g n i f i c a n t decrease i n Emotional Exhaustion. Unfortunately the s t u d i e s do not i n d i c a t e whether the same i n d i v i d u a l s were tested over the three year p e r i o d . These work environments u s u a l l y have high r a t e s of s t a f f turnover so i t i s not c l e a r how to i n t e r p r e t the f i n d i n g s . Weinberg et a l . (1983) found that l e v e l s of burnout v a r i e d widely between d i f f e r e n t s e t t i n g s and was h i g h l y c o r r e l a t e d with s t a f f turnover, e s p e c i a l l y turnover at management and supervisory l e v e l s . Any turnover i n the sample groups over the three year period could have outweighed the i n f l u e n c e of the i n t e r v e n t i o n s . Hunnicutt & MacMillan, (1983:9) s t a t e : "The f i n d i n g s support the contention that patterns of management and decision-making provide a powerful mediating i n f l u e n c e upon the s t r a i n s of the d a i l y r o u t i n e which can lead to s t a f f burnout." Thus the authors suggest that i t i s p o s s i b l e to prevent burnout but not with workshops aimed at i n d i v i d u a l s as the focus of i n t e r v e n t i o n . S a v i c k i & Cooley (1987) examined the r e l a t i o n s h i p between burnout and environmental f a c t o r s using a design that permitted a comparison of the r e l a t i v e importance of se v e r a l environmental f a c t o r s . As w e l l , they examined the 34 r o l e of moderator v a r i a b l e s i n the burnout-environmental c o r r e l a t i o n s . These were defined as: Moderator v a r i a b l e s are those that i n f l u e n c e the r e l a t i o n s h i p between two other v a r i a b l e s . For example, i f there were a s i g n i f i c a n t c o r r e l a t i o n between years of employment and s a l a r y f o r male employees but not f o r female employees, then sex would be a moderator v a r i a b l e f o r the r e l a t i o n s h i p between years of employment and s a l a r y ( S a v i c k i & Cooley, 1987:249) Operational d e f i n i t i o n s of burnout and environment were provided by Maslach & Jackson's (1981) Maslach Burnout Inventory and Moos' (1986) Work Environment Scale. S a v i c k i & Cooley (1987) used "amount of d i r e c t c l i e n t contact" as t h e i r moderator v a r i a b l e . The study sample c o n s i s t e d of 94 mental heal t h workers from 10 agencies i n Oregon. These included two r e s i d e n t i a l treatment centers f o r emotionally d i s t u r b e d c h i l d r e n and youth, a r e s i d e n t i a l treatment center f o r delinquents, two day programs f o r d i s t u r b e d youth, four community mental health centers, and a court c o u n s e l l i n g s t a f f . Job t i t l e s ranged from: c h i l d - y o u t h care workers (29), mental h e a l t h s p e c i a l i s t (24), s u p e r v i s o r - a d m i n i s t r a t o r (17), f a m i l y worker ( 6 ) , p s y c h o l o g i s t ( 5 ) , nurse (2), p s y c h i a t r i s t ( 2 ) , and p a r a - p r o f e s s i o n a l (5). Ages ranged from 19 to 57 (mean = 33.5) and 55% of the sample were women. Levels of burnout were comparable with the normative sample f o r the MBI (Maslach & Jackson,, 1981). 35 S a v i c k i & Cooley used the frequency scores of the MBI and computed a "summary" MBI score from the three subscales (Emotional Exhaustion, D e p e r s o n a l i z a t i o n , & Personal Accomplishment). C o r r e l a t i o n s were run between these four MBI scores and the ten WES subscale scores. The m a j o r i t y of these MBI and WES c o r r e l a t i o n s were s i g n i f i c a n t (28 of 40, £ < .05), with the summary score of the MBI ( t o t a l frequency) c o r r e l a t i n g s i g n i f i c a n t l y with 8 of the 10 WES scales (Involvement, r = -.37; Peer Cohesion, r = -.38; S t a f f Support, r = -.32; Autonomy, r = -.31; Task O r i e n t a t i o n , r = -.28; C l a r i t y , r = -.32; C o n t r o l , r = .30; Innovation, r = -.25; a l l £ S < .01 ( S a v i c k i & Cooley, 1987:250). These f i n d i n g s must be viewed with c a u t i o n . Maslach & Jackson (1981) warn that MBI subscale scores measure d i f f e r e n t a f f e c t i v e s t a t e s and should not be combined. In a second a n a l y s i s , the overlap between WES sc a l e scores was c o n t r o l l e d by using a stepwise m u l t i p l e r e g r e s s i o n . High work pressure, low involvement, and low autonomy r e l a t e d to high l e v e l s of emotional exhaustion. Peer cohesion and p h y s i c a l comfort r e l a t e d to personal accomplishment and f i n a l l y , high c o n t r o l and lower task o r i e n t a t i o n r e l a t e d to d e p e r s o n a l i z a t i o n . Lower Peer Cohesion had the strongest r e l a t i o n s h i p with the summary MBI score while Task O r i e n t a t i o n and Control were a l s o r e l a t e d (at l e v e l s of £ < .05). 36 The moderator v a r i a b l e , percentage of c l i e n t contact, was examined by d i v i d i n g the sample i n t o high and low contact groups. The c u t o f f point was 50% of time spent i n d i r e c t contact with c l i e n t s . High contact workers (n = 53) and low contact workers (n = 24) d i d not d i f f e r on sex. Low contact workers were overrepresented i n a d m i n i s t r a t i v e and supervisory p o s i t i o n s and were older (mean age = 36.1 vs 32.1) than high contact workers. Comparing these subsamples using a d i s c r i m i n a n t a n a l y s i s of the WES s c a l e s showed high contact workers r e p o r t i n g higher c o n t r o l , higher autonomy, and lower innovation than low contact workers. High contact workers a l s o reported higher l e v e l s of Deperso n a l i z a t i o n ( S a v i c k i & Cooley, 1987:250). M u l t i p l e regressions were run f o r high and low contact groups to i d e n t i f y WES c o n t r i b u t o r s to the MBI frequency s c a l e s . Low contact workers (n = 24) had no WES dimensions c o r r e l a t i n g with Personal Accomplishment but Emotional Exhaustion was c o r r e l a t e d with Work Pressure, P h y s i c a l Comfort (£ < .001) and Innovation (p_ < .05). High contact workers (n = 54) had only one r e l a t i o n s h i p s i g n i f i c a n t at £ < .001, Peer Cohesion with Personal Accomplishment. R e l a t i o n s h i p s s i g n i f i c a n t at £ < .05 were: Supervisor Support, Task O r i e n t a t i o n , and Work Pressure with Emotional Exhaustion; Task O r i e n t a t i o n with D e p e r s o n a l i z a t i o n ; and Peer Cohesion and Task O r i e n t a t i o n with the summary MBI ( t o t a l frequency). 37 Their study confirms the importance of worker commitment, co-worker r e l a t i o n s h i p s , and supportive s u p e r v i s i o n f o r i n h i b i t i n g burnout. The f i n d i n g s are co n s i s t e n t with r e s u l t s produced by others (Barad, 1979; Berkley Planning A s s o c i a t e s , 1977; Pines & Kafry, 1978) using other instruments. As w e l l , S a v i c k i & Cooley (1987) reproduce previous f i n d i n g s demonstrating the r o l e of i n f l e x i b l e r e s t r i c t i o n of worker freedom, lack of worker input i n planning and c o n t r o l over the work, vague job expectations, management c o n t r o l v i a r i g i d l y imposed r u l e s and r e g u l a t i o n s , and i n h i b i t i o n of worker innovation as working environmental c o n d i t i o n s f o s t e r i n g burnout (Berkley Planning A s s o c i a t e s , 1977; Hunnicutt & MacMillan, 1983; Maslach, 1982; Maslach & Pines, 1977; Pines & Maslach, 1978). S a v i c k i & Cooley (1987:251) conclude that Emotional Exhaustion i s mostly r e l a t e d to the source of "push" or d r i v e to complete work. " I f the push comes from e x t e r n a l pressures to work, workers w i l l be more l i k e l y to report t h e i r emotional resources are depleted." This i s analogous to the concept of e x t e r n a l versus i n t e r n a l locus of c o n t r o l i n the therapeutic r e l a t i o n s h i p discussed by the authors i n a p r i o r a r t i c l e ( S a v i c k i & Cooley, 1983). Other p l a u s i b l e conclusions by S a v i c k i & Cooley (1987:251) are: Personal Accomplishment i s r e l a t e d to peer support because co-workers func t i o n as a reference group by which workers judge t h e i r competence; higher 38 Depersonalization stems from a r b i t r a r y i mposition of r u l e s and pressure on workers by management; lower Depersonalization i s associated with work environments where workers plan and have some c o n t r o l over t h e i r work; and that "The r e l a t i o n s h i p s between burnout and environmental c h a r a c t e r i s t i c s explored here are obviously complex." F. Conclusion The f a c t o r s which are repeatedly i d e n t i f i e d as c l o s e l y c o r r e l a t e d with burnout are: 1. A t t r i b u t e s of i n d i v i d u a l workers. These include o b j e c t i v e a t t r i b u t e s such as the workers age, l e v e l of experience and t r a i n i n g , sex, and m a r i t a l s t a t u s . These f a c t o r s alone f a i l to account f o r why s i m i l a r workers i n i d e n t i c a l jobs can vary so d r a s t i c a l l y i n t h e i r v u l n e r a b i l i t y to burnout. Consequently, there must be a s u b j e c t i v e component to burnout which includes such i n t a n g i b l e s as a workers outlook on l i f e , the meaning a worker attaches to t h e i r work, and the way events associated with work are i n t e r p r e t e d and experienced unique to the i n d i v i d u a l worker. This " s u b j e c t i v e " q u a l i t y of burnout has not been studied at a l l . 2. A t t r i b u t e s of the immediate, i n t e r a c t i v e , " s o c i a l "  working environment. The r e l a t i o n s h i p between the perceived s o c i a l environment and burnout has been examined i n a few s t u d i e s (Berkley Planning A s s o c i a t e s , 1977; Parkes, 1982; Rosenthal et a l . , 1983; Weinberg et a l . , 1983) and a 39 number o f r e g u l a r i t i e s have been o b s e r v e d . C l a r i t y i n t h e work t a s k and t h e q u a l i t y o f l e a d e r s h i p and s u p e r v i s i o n a r e g r o s s f a c t o r s w h i c h t e n d t o c o r r e l a t e w i t h b u r n o u t b u t t h e y a r e a l s o o b v i o u s c o m p o n e n t s o f good a d m i n i s t r a t i o n and a s s u c h do n o t p r o v i d e much s p e c i f i c g u i d a n c e t o s u p e r v i s o r s w a n t i n g t o i n t e r v e n e t o p r e v e n t b u r n o u t . The r e s e a r c h c o r r e l a t i n g work e n v i r o n m e n t w i t h b u r n o u t h a s n o t a t t e m p t e d t o e x a m i n e s p e c i f i c work e n v i r o n m e n t s . F i n d i n g s s u c h a s t h e i m p o r t a n c e o f c l a r i t y o f t a s k and q u a l i t y o f l e a d e r s h i p have been i d e n t i f i e d b y e x a m i n i n g l a r g e s a m p l e s o r w o r k e r s . One p r o b l e m w i t h t h i s i s t h a t n umerous w o r k e r s p e r c e p t i o n s o f many d i f f e r e n t s o c i a l m i c r o -e n v i r o n m e n t s have been lumped t o g e t h e r l o s i n g a n y i n f o r m a t i o n on s p e c i f i c e x p e r i e n t i a l e n v i r o n m e n t s . R e s e a r c h t o b e n e f i t p r a c t i t i o n e r s i n t h e f i e l d w i l l g e t a t t h e s p e c i f i c s o f t h e m i c r o w o r k i n g e n v i r o n m e n t s t h a t s u p e r v i s o r s a n d a d m i n i s t r a t o r s a c t u a l l y work w i t h . J u s t a s most r e s e a r c h on i n d i v i d u a l b u r n o u t a t t r i b u t e s h a s f a i l e d t o g e t a t t h e s u b j e c t i v i t y o f t h e phenomenon, most o f t h e work e x a m i n i n g t h e e n v i r o n m e n t h a s been b i a s e d t o w a r d t h e more o b j e c t i v e , macro a t t r i b u t e s o f t h e e n v i r o n m e n t . The i m p o r t a n c e o f C h e r n i s s 1 (1986) p r e s e n t a t i o n o f t h e " m o r a l - r e l i g i o u s p a r a d i g m " i s t h a t i t h i g h l i g h t s t h e n e e d f o r a b e t t e r u n d e r s t a n d i n g o f t h e l e s s t a n g i b l e , e x p e r i e n t i a l e l e m e n t s o f a w o r k e r s i m m e d i a t e s o c i a l e n v i r o n m e n t . 40 3. A t t r i b u t e s o f t h e m a c r o - e n v i r o n m e n t . T h i s l e v e l o f e n v i r o n m e n t a l i n f l u e n c e on b u r n o u t i s d i s c u s s e d by t h e M a r x i s t s . T h i s i s an i m p o r t a n t a r e a i n w h i c h l i t t l e c o n c r e t e r e s e a r c h h a s been d o n e . Though b e y o n d t h e s c o p e o f t h i s s t u d y , i t w o u l d be v a l u a b l e t o e x a m i n e b u r n o u t u s i n g a c r o s s - c u l t u r a l m e t h o d o l o g y d e s i g n e d t o i s o l a t e m a c r o -e n v i r o n m e n t a l v a r i a b l e s . F o r t h e p u r p o s e s o f t h e p r e s e n t s t u d y i t i s assumed t h a t a l l t h e w o r k e r s s a m p l e d a r e e x p o s e d t o r o u g h l y t h e same o b j e c t i v e macro e n v i r o n m e n t a l i n f l u e n c e s . C o n s e q u e n t l y , t h i s s t u d y w i l l a t t e m p t t o a d d t o t h e p r e s e n t l e v e l o f u n d e r s t a n d i n g o f b u r n o u t by e x p l o r i n g p r a c t i c a l ways t o i d e n t i f y p r o b l e m a t i c a t t r i b u t e s o f m i c r o w o r k i n g e n v i r o n m e n t s w h i c h a r e c o r r e l a t e d w i t h b u r n o u t i n t h e w o r k e r s i n t h a t s p e c i f i c work s i t e . The g o a l t h e n i s t o g a i n a f u l l e r u n d e r s t a n d i n g , n o t o f what g r o s s e n v i r o n m e n t a l c h a r a c t e r i s t i c s a r e g e n e r a l l y a s s o c i a t e d w i t h b u r n o u t , b u t how u s e f u l s p e c i f i c work e n v i r o n m e n t i n f o r m a t i o n c a n be o b t a i n e d w i t h w h i c h t o g u i d e e f f o r t s a t p r e v e n t i n g b u r n o u t . As w e l l , t h i s r e s e a r c h w i l l be t e m p e r e d w i t h an a p p r o a c h w h i c h t r i e s t o t a k e i n t o a c c o u n t t h e h i g h l y i n d i v i d u a l and s u b j e c t i v e n a t u r e o f t h e b u r n o u t phenomenon. 41 Chapter I I I - Research Problem A. Conceptual Framework Before d i s c u s s i n g s p e c i f i c models of burnout, i t i s u s e f u l to review some g l o b a l assumptions on human fu n c t i o n i n g that are i m p l i c i t i n any model. Marks (1977:926) argues that burnout i s a s u b j e c t i v e phenomenon of human beings and the simple organic analogies i m p l i c i t i n the concept cloud t h i s f a c t . A f i x e d energy or s c a r c i t y model of human energy f a i l s to e x p l a i n the f a c t that human resources are f l e x i b l e and can expand and contract depending upon many f a c t o r s . Maher (1983) notes that much of the burnout l i t e r a t u r e tends to be d e s c r i p t i v e and focuses on causes and cures. She b u i l d s upon Marks'(1977) arguments and suggests that there are two competing a n t i t h e t i c a l t h e o r e t i c a l approaches to e x p l a i n i n g human energy. The s c a r c i t y model l a r g e l y d e r i v e s from the work of Freud who saw humans with a l i m i t e d supply of l i b i d i n a l energy to be d i s t r i b u t e d through the body and psyche. I t s a n t i t h e s i s i s the "expansion approach", best ex e m p l i f i e d by the work of Durkheim (Maher, 1983:392). Marks (1977:926) p r e f e r s the Durkheimian view: "Some r o l e s may be performed without any net energy l o s s at a l l ; they may even create energy f o r use i n that r o l e or i n other r o l e performances". This view allows an explanation f o r the very r e a l human a b i l i t y to " r i s e to e x c e p t i o n a l 42 challenge" and the f a c t that c e r t a i n l e v e l s and types of s t r e s s act to optimize human performance. That the s c a r c i t y model and the expansion model both a c c u r a t e l y describe fragments of human f u n c t i o n i n g despite being opposites i l l u s t r a t e s one l i m i t a t i o n of applying organic analogies to describe human f u n c t i o n i n g . A number of authors have proposed models of burnout ( C a r r o l l & White, 1982; Harrison, 1983; Kamis, 1982; Perlman & Hartman, 1982) but few have been tes t e d e m p i r i c a l l y . C a r r o l l & White's (1982) model i s complex and derived from systems theory. While the model i s broad enough to encompass both environmental and i n d i v i d u a l burnout f a c t o r s , i t does not r e a d i l y lend i t s e l f to s i m p l i f i c a t i o n and p r e s c r i p t i v e c a t e g o r i z a t i o n of i n t e r v e n t i o n s . Like many models based on systems theory, i t tends to be vague and d i f f i c u l t to o p e r a t i o n a l i z e . C a r r o l l & White's ( 1982:46) model i s premised on 19 assumptions (eg. "burnout i s caused by prolonged exposure to s t r e s s and f r u s t r a t i o n ; i s not a disease or medical c o n d i t i o n ; and may lead to p r o f e s s i o n a l growth and development.") and contains the key components of: (1) the person; (2) the environmental components: the microsystem, the mesosystem, the exosystem, and the macrosystem. The microsystem i s the smallest u n i t of organized work (eg., the o f f i c e or department; the mesosystem the l a r g e r complex of smaller work u n i t s that comprise the company or i n s t i t u t i o n / a g e n c y ; the exosystem the non-work eco-systems which impact on the worker (eg., surrounding community); and the macrosystem the l a r g e r c u l t u r a l and world-wide complex ( C a r r o l l & White, 1982:47). Each of these components are amorphously "surrounded by the next l a r g e r system and assumed to be: "complex, dynamic, and unique." A l l elements i n t e r a c t to varying degrees, the consequence of a l l these i n t e r a c t i o n s are experienced throughout the e n t i r e system and are r e c i p r o c a l i n nature ( C a r r o l l & White, 1982:47)." The concept of the microsystem or the immediate s o c i a l work group i s a u s e f u l concept with a strong bearing on burnout. Cherniss (1986), i n presenting the m o r a l - r e l i g i o u s paradigm, has h i g h l i g h t e d the importance of a workers immediate, i n t e r a c t i v e , communal s o c i a l work-group to burnout. The concepts of exosystem, mesosystem, and macro system, while obvious and v a l i d from a systems p e r s p e c t i v e , are of l i t t l e use i n t h i s research. The r e l a t i o n s h i p s between these " l e v e l s of systemic o r g a n i z a t i o n " are too vague and v a r i a b l e to be of much p r a c t i c a l value. H a r r i s o n 1 s ( 1983) s o c i a l competence model i s simpler and based on b e h a v i o r a l p r i n c i p l e s . A workers motivation to help i s e i t h e r enhanced or reduced depending on whether b a r r i e r s or helping f a c t o r s are experienced i n the work. Helping f a c t o r s lead to high e f f e c t i v e n e s s , a sense of competence and enhanced motivation to help. B a r r i e r s lead to low e f f e c t i v e n e s s and burnout and hence, to reduced 44 motivation to help. Harrison's (1983) model may describe psychodynamic processes of burnout but o f f e r s l i t t l e promise f o r e x p l a i n i n g environmental f a c t o r s which are s i m p l i f i e d i n t o e i t h e r " b a r r i e r s " or "helping f a c t o r s " . Perlman & Hartman (1982:296) proposed a broad model which included a l l the s i g n i f i c a n t burnout v a r i a b l e s studied at that time. The model has three dimensions r e f l e c t i n g the three major symptom ca t e g o r i e s of s t r e s s : (a) p h y s i o l o g i c a l , focusing on p h y s i c a l symptoms ( p h y s i c a l exhaustion), (b) a f f e c t i v e - c o g n i t i v e , focusing on a t t i t u d e s and f e e l i n g s (emotional exhaustion, o v e r d e p e r s o n a l i z a t i o n ) , (c) b e h a v i o r a l , focusing on symptomatic behaviors ( o v r d e p e r s o n a l i z a t i o n , lowered job p r o d u c t i v i t y ) (Perlman & Hartman, 1982:296). Perlman & Hartman's (1982) model contains four stages: (1) the degree to which a s i t u a t i o n i s conducive to s t r e s s ; (2) the l e v e l of perceived s t r e s s ; (3) p h y s i o l o g i c a l , a f f e c t i v e / c o g n i t i v e , and b e h a v i o r a l responses to s t r e s s ; and (4) the outcome of the s t r e s s (e.g., job performance and s a t i s f a c t i o n l e v e l s , burnout, turnover, d i s m i s s a l ) . The f i r s t stage, the degree to which a s i t u a t i o n i s conducive to s t r e s s , i s mostly the r e s u l t of the o b j e c t i v e a t t r i b u t e s of the work environment and the i n d i v i d u a l worker moderated by i n d i v i d u a l coping a b i l i t i e s . The second stage i n v o l v e s "perceived s t r e s s " and i s the authors attempt to deal with the v a r i a b i l i t y and s u b j e c t i v i t y of burnout. Perlman & Hartman (1982:258) acknowledge that l i t t l e work 45 e x i s t s which reviews the t r a n s i t i o n between stages one and two. Stage three i s the response to s t r e s s (whatever i t s source, r e a l or perceived) and stage four i s the outcome of s t r e s s , burnout. Perlman & Hartman's (1982) model represents a s i g n i f i c a n t step forward i n burnout model c o n s t r u c t i o n as i t manages to incorporate a l l the major burnout v a r i a b l e s i s o l a t e d by research and a l s o attacks the issue of s u b j e c t i v i t y . The models major weakness i s i n i t s assumptions about the s e q u e n t i a l nature of burnout. There i s no evidence that a person must go through the four stages postula t e d by the authors to reach a s t a t e of burnout. As w e l l , the only explanation f o r a worker not reaching a s t a t e of burnout i n a high s t r e s s job i s reduced to " i n d i v i d u a l c h a r a c t e r i s t i c s " and "work and s o c i a l environments" which f a i l s to capture the richness that r e s u l t s from anal y z i n g these " i n f l u e n c e s " from C h e r n i s s 1 (1986) m o r a l - r e l i g i o u s paradigm and an e x i s t e n t i a l p e r s p e c t i v e . Kamis (1982) devised a model of burnout by transposing an e p i d e m i o l o g i c a l model from c l i n i c a l mental h e a l t h research. The model groups events and v a r i a b l e s i n t o three domains which represent pre d i s p o s i n g , p r e c i p i t a t i n g , and perpetuating f a c t o r s . Predisposing f a c t o r s are e i t h e r determined (e.g., type of c l i e n t or p h y s i c a l s t r u c t u r e of the workplace) or changeable (e.g., bad o f f i c e p o l i c i e s or lack of t r a i n i n g ) . P r e c i p i t a t i n g f a c t o r s are developmental (e.g., reaching a career summit) or s i t u a t i o n a l (e.g., 46 budget cuts or l a y o f f s ) . Perpetuating f a c t o r s are v a r i a b l e s which intervene or act upon predisposing and p r e c i p i t a t i n g f a c t o r s to discourage burnout. Perpetuating f a c t o r s are both personal s k i l l s — s t r e n g t h s and environmental supports. Kamis' (1982) and Perlman & Hartman's (1982) models are s i m i l a r and promising. Both are somewhat unweildly but they manage to incorporate most of the v a r i a b l e s research has determined as important i n burnout. Perlman & Hartman"s (1982) model allows f o r the s u b j e c t i v e q u a l i t y of burnout with the concept of "perceived s t r e s s " . Both authors at l e a s t s u p e r f i c i a l l y consider the importance of personal and environmental or o r g a n i z a t i o n a l f a c t o r s . Perlman & Hartman (1982:296) argue that models should "provide a b a s i s f o r v a r i a b l e s to study as researchers attempt to p r e d i c t who w i l l burn out." They ask the questions: What types of models best s t r u c t u r e burnout research? How d e t a i l e d or broad are the most u s e f u l models?" The answer i s the simplest model which i n c l u d e s the most d e t a i l . A simpler r e o r g a n i z a t i o n of Kamis' (1982) and Perlman & Hartman's (1982) models r e s u l t s from c o n s t r u c t i n g a two-dimensional framework which analyzes burnout along the continuums of: s u b j e c t i v e vs o b j e c t i v e and i n d i v i d u a l vs environmental. The four quadrants produced are the o b j e c t i v e - i n d i v i d u a l ; the s u b j e c t i v e - i n d i v i d u a l ; the subjective-environmental; and the objective-environmental dimensions. (see f i g u r e 1). 4 ? FIGURE 1 A Two D i m e n s i o n a l Framework f o r V i e w i n g B u r n o u t S UBJECTIVE OBJECTIVE E x i s t e n t i a l S c i e n t i f i c -T e c h n i c a l s e l f - p e r c e p t i o n / p e r s o n a l i t y t r a i t s I a w a r e n e s s N p e r s o n a l D p e r s o n a l i d e o l o g y c h a r a c t e r i s t i c s I l i f e s t y l e V p h i l o s o p h y o f l i f e I b e h a v i o r D s p i r i t u a l i d e n t i t y U r o l e f a c t o r s A e x p e r i e n t i a l k n o w l e d g e [ r o l e o v e r l o a d ] L c o n s c i o u s n e s s m i c r o E N e n v i r o n m e n t a l p e r c e p t i o n / w o r k p l a c e s t r u c t u r e V a w a r e n e s s - a u t h o r i t y I - w o r k l o a d R communal m e t h o d o l o g y / - b u r e a u c r a c y 0 i d e o l o g y r e l a t i o n s o f N p r o d u c t i o n M s p i r i t u a l c o m munity E s o c i o - e c o n o m i c N s t r u c t u r e T A macro L M o r a l - M a r x i s t R e l i g o u s 48 O b j e c t i v e - I n d i v i d u a l The o b j e c t i v e - i n d i v i d u a l q u a d r a n t i s d e s c r i b e d by C h e r n i s s (1986) a s t h e v i e w d e v e l o p e d f r o m t h e s c i e n t i f i c -t e c h n i c a l p a r a d i g m and i n c l u d e s P e r l m a n & H a r t m a n ' s (1982) n o n - s u b j e c t i v e p e r s o n a l v a r i a b l e s s u c h as b a c k g r o u n d  c h a r a c t e r i s t i c s a n d p h y s i c a l h e a l t h . I n K a m i s 1 (1982) m o d e l t h i s q u a d r a n t c o n t a i n s most o f t h e p e r s o n a l s k i l l s h a l f o f t h e p e r p e t r a t i n g v a r i a b l e s : i n t e l l i g e n c e , p r o b l e m s o l v i n g  c o p i n g a b i l i t y , s e l f e f f i c a c y , ego s t r e n g t h — t h e c h a n g e a b l e p r e d i s p o s i n g v a r i a b l e o f i n a p p r o p r i a t e t r a i n i n g — a n d t h e p r e c i p i t a t i n g d e v e l o p m e n t a l v a r i a b l e o f e a r l y n a i v e t e . I n g e n e r a l t h i s q u a d r a n t r e p r e s e n t s t h e r e l a t i v e l y s t a t i c o b s e r v a b l e o r m e a s u r a b l e c h a r a c t e r i s t i c s o f an i n d i v i d u a l s u c h as d e m o g r a p h i c s , p e r s o n a l i t y t r a i t s , a n d c o g n i t i v e a b i l i t i e s o r d i s a b i l i t i e s . S u b j e c t i v e - I n d i v i d u a l T h e s u b j e c t i v e - i n d i v i d u a l d i m e n s i o n r e f e r s t o t h e e x p e r i e n t i a l " l i f e - w o r l d " o f an i n d i v i d u a l w o r k e r . I t e n t a i l s h i s o r h e r s p i r i t u a l i d e n t i t y , p h i l o s o p h y o f l i f e o r p e r s o n a l i d e o l o g y , l e v e l o f s e l f - a c t u a l i z a t i o n , a n d s e n s e o f p e r s o n a l b o u n d a r i e s o r e x i s t e n t i a l a l o n e n e s s . T h e r e i s no h a r d and f a s t d e m a r c a t i o n b e t w e e n t h i s d i m e n s i o n a n d t h e o t h e r s ; t h e y merge i n t o e a c h o t h e r . P e r s o n a l v a r i a b l e s m e n t i o n e d b y P e r l m a n & H a r t m a n i n c l u d e d i n t h i s q u a d r a n t a r e o r g a n i z a t i o n a l / p r o f e s s i o n a l c o m m i t m e n t , commitment t o  c a r e e r , p e r s o n a l n e e d s / d y n a m i c s , p r o f e s s i o n a l i d e n t i t y a n d 49 perhaps tolerance of ambiguity. Factors mentioned by Kamis (1982) belonging to t h i s quadrant are s e l f - a c t u a l i z a t i o n and c l e a r and r e a l i s t i c values from the perpetuating s k i l l s category; a workers experience of a l l of the p r e c i p i t a t i n g -development f a c t o r s and the s i t u a t i o n a l f a c t o r of death of a  c l i e n t ; and the changeable predisposing f a c t o r of powerlessness (powerlessness may belong e q u a l l y i n the objective-environment quadrant). Subjective-Environmental C h e r n i s s 1 (1986) proposal of a m o r a l - r e l i g i o u s paradigm as an a l t e r n a t e view of burnout describes the s u b j e c t i v e -environmental aspects of burnout. This quadrant c o n s i s t s of the communal r e a l i t y that may or may not be present f o r a worker. I t describes both the c o g n i t i v e and emotional involvement a worker has with others. This shared communal r e a l i t y may be pegged to a methodology or some form of r e l i g i o u s or p o l i t i c a l ideology. This r e a l i t y may be shared with one other person, an immediate peer group, a p r o f e s s i o n a l a s s o c i a t i o n , or a n a t i o n . In some sense i t i s the i m p l i c i t l y agreed upon way of ordering experience that i s the substance of the i n t e r a c t i o n i s t , phenomenological, and ethnomethodological schools of s o c i o l o g i c a l thought. O r g a n i z a t i o n a l v a r i a b l e s from Perlman & Hartman's (1982) model included i n t h i s quadrant are work group norms, support from others, and colleagues's b e l i e f s and values. Factors from Kamis' (1982) model are most of those l i s t e d as 50 p e r p e t r a t i n g s u p p o r t v a r i a b l e s — s u p p o r t s y s t e m s , c o - w o r k e r s  s u p p o r t , f a m i l i a l , s o c i a l r e l i g i o u s and o r g a n i z a t i o n a l  a f f i l i a t i o n . Management s u p p o r t m i g h t be c o n s i d e r e d i n t h i s q u a d r a n t o r t h e n e x t . O b j e c t i v e - E n v i r o n m e n t a l The o b j e c t i v e - e n v i r o n m e n t a l q u a d r a n t c o n t a i n s a l l t h e s t r u c t u r a l a n d p h y s i c a l a t t r i b u t e s o f t h e work e n v i r o n m e n t a n d i n c l u d e s t h e l a r g e r i n s t i t u t i o n a l s t r u c t u r e s o f s o c i e t y d i s c u s s e d by t h e M a r x i s t w r i t e r s . I n c l u d e d a r e t h e s t r u c t u r e o f t h e work s u c h a s w o r k l o a d , f r e q u e n c y o f m e e t i n g s , pay and b e n e f i t s , s u p e r v i s o r - s t a f f r a t i o s , o t h e r h i e r a r c h i c a l and a u t h o r i t y r e l a t i o n s h i p s , l e v e l s o f b u r e a u c r a t i c o r g a n i z a t i o n , f o r m a l i z a t i o n o f r o l e s and r e l a t i o n s h i p s , r e l a t i o n s o f p r o d u c t i o n , w o r k e r c o n t r o l o v e r t h e w o r k , and s o o n . A t t h e more macro s c a l e o f t h e c o n t i n u u m a r e t h e i n f l u e n c e s on t h e w o r k e r o f d o m i n a n t s o c i a l , e c o n o m i c , a nd p o l i t i c a l i d e o l o g i e s ( t h i s b e g i n s t o o v e r l a p w i t h t h e s u b j e c t i v e - e n v i r o n m e n t a l ) . I n t h e m i c r o a r e n a a r e r e l a t i o n s h i p s w i t h f a m i l y a n d s o c i a l g r o u p s o u t s i d e o f work where t h i s q u a d r a n t b e g i n s t o f a d e i n t o t h e o t h e r s . V a r i a b l e s f r o m K a m i s ' (1982) m o del i n c l u d e d i n t h i s q u a d r a n t a r e : many o f t h e p r e d i s p o s i n g f a c t o r s , b o t h d e t e r m i n e d and c h a n g e a b l e , s u c h a s mundane t a s k s , upward  m o b i l i t y t h r u a d m i n i s t r a t i o n , b a d o f f i c e p o l i c i e s ,  i s o l a t i o n , s e g r e g a t i o n , s e x i s m & m i n o r i t y s t a t u s i n a d e q u a t e 51 funds, and so f o r t h ; some of the s i t u a t i o n a l p r e c i p i t a t i n g f a c t o r s such as changes i n work climate/ procedural changes,  programic changes, l a y o f f s , and budget cu t s . V a r i a b l e s such as powerlessness and management support may be shared with the s u b j e c t i v e - i n d i v i d u a l quadrant depending upon whether the "experience o f" or the " r e a l i t y of" these f a c t o r s are i n question. O r g a n i z a t i o n a l v a r i a b l e s from Perlman & Hartman's (1982) model included i n t h i s quadrant are: work l o a d ,  expected performance, s u p e r v i s i o n , opportunity f o r  advancement, pay, economic/market c o n d i t i o n s , and o r g a n i z a t i o n a l response to i n d i v i d u a l response. This four dimensional framework provides a u s e f u l way of o r g a n i z i n g important burnout v a r i a b l e s with the u l t i m a t e goal of suggesting theory. The d i v e r s i t y w i t h i n the very broad concept of burnout m i t i g a t e s against the development of a s i n g l e u n i f i e d theory. Most m i c r o - l e v e l t h e o r i e s proposed f o r burnout tend to describe burnout processes w i t h i n one or two quadrants. For example, Harrison's (1983) s o c i a l competence model reduces a l l environmental dimensions to "helping f a c t o r s " or " b a r r i e r s " and thus, i s d e s c r i p t i v e of processes w i t h i n the i n d i v i d u a l h a l f of the framework. Likewise, C a r r o l l & White's (1982) e c o l o g i c a l model describes burnout i n f l u e n c e s ( v a r i a b l e s ) ranging from the i n d i v i d u a l to macrosystem ( c u l t u r a l ) . While d e s c r i b i n g both i n d i v i d u a l and environmental i n f l u e n c e s , the e c o l o g i c a l 52 model f a i l s to account f o r the s u b j e c t i v e q u a l i t i e s of burnout. This two dimensional model represents only an a b s t r a c t i o n of the phenomenon of burnout. A f u l l e r and more d e s c r i p t i v e model i s generated with the i n c l u s i o n of the dimension of time. In e f f e c t , the in d i v i d u a l - e n v i r o n m e n t a l dimension becomes the X a x i s , the s u b j e c t i v e - o b j e c t i v e the Y a x i s , and time the Z a x i s . (see f i g u r e 2). Kamis 1 (1982) model makes no d i r e c t reference to time other than the i m p l i c a t i o n that predisposing v a r i a b l e s occur f i r s t , p r e c i p i t a t i n g v a r i a b l e s are events i n the present or about to occur, and p e r p e t r a t i n g v a r i a b l e s are f a c t o r s a c t i n g throughout. Outcomes are the b e h a v i o r a l consequences (burnout) of the preceding events but with no suggestion as to what comes a f t e r . 53 FIGURE 2 . A T h r e e D i m e n s i o n a l V i e w o f B u r n o u t I n c o r p o r a t i n g t h e D i m e n s i o n o f Time S u b j e c t i v e - I n d i v i d u a l q u a d r a n t X O b j e c t i v e - I n d i v i d u a l q u a d r a n t 71 S u b j e c t i v e - E n v i r o n m e n t a l q u a d r a n t O b j e c t i v e - E n v i r o n m e n t a l q u a d r a n t X a x i s = Y a x i s = Z a x i s = I n d i v i d u a l v s E n v i r o n m e n t a l f o c u s S u b j e c t i v e v s O b j e c t i v e q u a l i t y Time d i m e n s i o n 54 Perlman & Hartman's (1982) model has f o u r stages and i s s y s t e m i c a l l y based. I t s advantages are that i t allows f o r the dimension of time and an ongoing developmental view of burnout. The disadvantages are i t s complexity and the c o n s i d e r a b l e number of assumptions which must be made as to where and when a v a r i a b l e i s o p e r a t i v e . Perlman & Hartman (1982) s o l v e t h i s problem by r e p e a t i n g v a r i a b l e s at d i f f e r e n t stages but t h i s j u s t adds to the complexity of the model. I n c l u d i n g the dimension of time i n burnout models r a i s e s i n t e r e s t i n g q u e s t i o n s . Do people ever experience burnout more than once and i f they do, i s the experience the same the second time around? Common sense and experience would suggest that some people do experience burnout more than once i n t h e i r l i v e s and that i t could never be experienced the same way twice. Consequently, burnout must be c o n s i d e r e d i n a developmental c o n t e x t . To view burnout as a s t a t i c o b j e c t i v e c o n d i t i o n i s to r e i f y the concept and deny the c a p a c i t y of human beings to i n t e g r a t e p e r s o n a l experience, to grow and to develop. T h e r e f o r e , the q u e s t i o n a r i s e s : Could burnout be viewed as some negative extreme s t a t e of what i s a n a t u r a l developmental process? S a v i c k i & Cooley (1983) noted that the Maslach Burnout Inventory v a r i a b l e of D e p e r s o n a l i z a t i o n i s the p o l a r o pposite of " O v e r - I d e n t i f i c a t i o n " with c l i e n t s . The i d e a l f o r p r o f e s s i o n a l involvement with c l i e n t s i s a s t a t e of "detached concern" which i s somewhere between over-55 i d e n t i f i c a t i o n and a complete " l o s s of concern" with the welfare of the c l i e n t . The authors suggest that these burnout v a r i a b l e s e x i s t on a continuum of " o v e r - i d e n t i f i e d " -"detached concern" " l o s s of concern". Over-i d e n t i f i c a t i o n i s described as: " l o s s of o b j e c t i v i t y , personal involvement i n outcome, b l u r r i n g of d i s t i n c t i o n s between t h e r a p i s t and c l i e n t " ; d e p e r s o n a l i z a t i o n as " l o s s of empathy and c a r i n g , l o s s of o b j e c t i v i t y , and no personal involvement i n outcome"; and detached concern as "emotional detachment wit h no l o s s of o b j e c t i v i t y and empathy" ( S a v i c k i & Cooley, 1983:232). On t h i s " i d e n t i f i c a t i o n with the c l i e n t " continuum, e i t h e r of the extremes represent "negative consequences i n the helping r e l a t i o n s h i p . " S a v i c k i & Cooley (1983) a l s o suggest that an analogous continuum, Therapeutic Locus of C o n t r o l , d escribes the process by which "such i n d i v i d u a l s take upon themselves the onus of change." They " g l o r y i n success and agonize i n f a i l u r e . " This continuum ranges from " I n t e r n a l " (high l e v e l of perceived c o n t r o l over outcome, f u l l r e s p o n s i b i l i t y f o r outcome, emotional involvement i n outcome) to "Balanced" ( r e a l i s t i c assessment of t h e r a p i s t ' s r o l e i n change process) to " E x t e r n a l " (low l e v e l of perceived c o n t r o l , no r e s p o n s i b i l i t y f o r outcome, emotional detachment) ( S a v i c k i & Cooley,1983:232). In e f f e c t , S a i c i k i & Cooley have 56 i d e n t i f i e d s u b j e c t i v e v a r i a b l e s s i m i l a r to the concepts generated applying an e x i s t e n t i a l perspective to burnout. One i m p l i c a t i o n of S a v i c k i and Cooley's continuum i s the prospect that burnout may be a dynamic, developmental process which, i f managed i n a p o s i t i v e growth inducing way, might r e s u l t i n an inexperienced worker maturing i n t o an e f f e c t i v e , balanced, helping p r o f e s s i o n a l able to work with "detached concern". Figure 3 introduces the dimension of time to S a v i c k i & Cooley's (1983) o v e r i d e n t i f i e d - d e p e r s o n a l i z e d continuum to i l l u s t r a t e how the burnout process might occur f o r a new worker s t a r t i n g out over-committed, i d e a l i s t i c , a l t r u i s t i c , and with a strong personal need to help others i n order to f e e l adequate as a worker. The v e r t i c a l s cale ranges from O v e r - i d e n t i f i c a t i o n at the top to the n e u t r a l s t a t e of Detached Concern i n the middle to the burnt-out s t a t e of Depersonalization at the bottom. The h o r i z o n t a l a x i s represents time. 57 F i g u r e 3 H y p o t h e s i z e d S e q u e n c e o f O v e r i d e n t i f i e d / D e p e r s o n a l i z e d S t a g e s o f B u r n o u t O v e r T ime O v e r i d e n t i f i e d D e t a c h e d C o n c e r n D e p e r s o n -a l i z e d > t i m e • > The g r a p h p i c t u r e d i n f i g u r e 3 d e s c r i b e s a w o r k e r s t a r t i n g o u t v e r y h i g h l y o v e r - i d e n t i f i e d w i t h c l i e n t s w h i c h l e a d s s h a r p l y t o a s t a t e o f D e p e r s o n a l i z a t i o n . The w o r k e r r e c o v e r s , r e g a i n s m o t i v a t i o n , and r e t u r n s t o an o v e r i d e n t i f i e d s t a t e l e s s i n t e n s e t h a n b e f o r e due t o e x p e r i e n t i a l l e a r n i n g , m a t u r i t y , o r d e v e l o p m e n t . T h i s p r o c e s s i s r e p e a t e d u n t i l t h e w o r k e r a t t a i n s a h e a l t h y s t a t e o f d e t a c h e d c o n c e r n . This i s postulated as a t y p i c a l s i t u a t i o n with a p o s i t i v e outcome. Other scenarios are p o s s i b l e such as a worker progressing s t e a d i l y to a s t a t e of detached concern without experiencing burnout or the worker whose swings up and down the continuum from o v e r - i d e n t i f i e d to depersonalized with no l e s s e n i n g of i n t e n s i t y u n t i l l e a v i n g the f i e l d . The obvious l i m i t a t i o n of t h i s model i s the i m p l i c a t i o n that a worker passes through a p o s i t i v e s t a t e o detached concern on the way from o v e r - i d e n t i f i c a t i o n to d e p e r s o n a l i z a t i o n . S a v i c k i & Cooley's (1983) continuum f a l l s e n t i r e l y w i t h i n the i n d i v i d u a l side of the three dimensional model discussed p r e v i o u s l y . Levels of o v e r - i d e n t i f i c a t i o n , detached concern, and d e p e r s o n a l i z a t i o n r e f e r to s u b j e c t i v e and o b j e c t i v e s t a t e s of the i n d i v i d u a l . However, i s d e p e r s o n a l i z a t i o n the only outcome f o r an o v e r - i d e n t i f i e d neophyte worker becoming burned out? Depersonalization i m p l i e s an i s o l a t e d , p r i v a t e experience of withdrawal from ones c l i e n t s . Could a worker becoming burned out begin to act-out negative behavior instead t u r n i n g inward? Edelwich & Brodsky (1980) report the case of Roger F., an a d d i c t i o n counselor working i n a s i t u a t i o n where the norms of h i s work group condoned buying s t o l e n goods from, and taking sexual advantage of a d d i c t - c l i e n t s such that he e v e n t u a l l y engaged i n the same behavior. C e r t a i n l y more than simple d e p e r s o n a l i z a t i o n i s involved i n t h i s instance. A model which incorporates the subjective-environmental 59 i n f l u e n c e of a workers communal work team i s more u s e f u l i n t h i s case. Minnehan & Paine (1982:100) assessed the economic and l e g a l consequences of burnout and l i s t employee t h e f t and  sabotage as a d i r e c t e f f e c t on employers. In t h i s case the employee may or may not have withdrawn from c l i e n t s but i s a c t i n g out the c o n d i t i o n of burnout i n the workplace against the employer. In a s i m i l a r v e i n , Goroff (1986) argues that agency requirements f o r record keeping are dehumanizing f o r c l i e n t s and workers and a way of maintaining i n s t i t u t i o n a l c o n t r o l over both. This i n s t i t u t i o n a l requirement i s an i n s i d i o u s source of d i s i l l u s i o n m e n t and disappointment (burnout) f o r workers who must choose between helping c l i e n t s or keeping records. A l l t h i s suggests another continuum of i d e a l i s m vs d i s i l l u s i o n m e n t where the outcome i s an a n t i - s o c i a l type of burnout which i n v o l v e s acting-out negative behaviors i n the work place. The d e s c r i p t i v e quadrant i n the three-dimensional model i s the objective-environmental. The burnout outcome i n t h i s instance i s angry a n t i - s o c i a l or anti-establishment behavior rather than the inward desperation of d e p e r s o n a l i z a t i o n . This formulation of a three dimensional model of burnout i n terms of i n d i v i d u a l - e n v i r o n m e n t a l , s u b j e c t i v e -o b j e c t i v e , and time i s n e i t h e r complete nor f u l l y comprehensive. The model needs e m p i r i c a l t e s t i n g before i t s value can be determined. As a framework or h e u r i s t i c 60 d e v i c e , t h e f o u r q u a d r a n t s c r e a t e d by t h e s u b j e c t i v e -o b j e c t i v e a nd i n d i v i d u a l - e n v i r o n m e n t a l a x e s seem a b l e t o encompass t h e m a j o r i t y o f s i g n i f i c a n t b u r n o u t v a r i a b l e s i s o l a t e d i n p r i o r r e s e a r c h . The r e l a t i o n s h i p o f b u r n o u t t o t h e d i m e n s i o n o f t i m e i s t h e l e a s t u n d e r s t o o d . Numerous a u t h o r s ( E i n s i e d e l & T u l l y , 1982; P e r l m a n & H a r t m a n , 1982; S a v i c k i & C o o l e y , 1983) have commented on t h e l a c k o f l o n g i t u d i n a l r e s e a r c h i n t o b u r n o u t . I m p o r t a n t q u e s t i o n s n e e d t o be a n s w e r e d . I s b u r n o u t c y c l i c a l ? I f w o r k p l a c e s t e n d t o have a r e l a t i v e l y s t a b l e p e r c e n t a g e o f h i g h l y b u r n e d o u t w o r k e r s ( W e i n b e r g e t a l . , 1983 f o u n d 15% t o be t h e n o r m ) , t h e n a r e t h e same i n d i v i d u a l s r e m a i n i n g c h r o n i c a l l y b u r n o u t o u t o r i s t h e r e t u r n o v e r i n t h i s h i g h b u r n o u t g r o u p ? T h e s e and many o t h e r q u e s t i o n s c a n o n l y be a n s w e r e d w i t h l o n g i t u d i n a l r e s e a r c h d e s i g n s . A l t h o u g h t h e p r e s e n t s t u d y r e l i e s on t h e f o u r q u a d r a n t f r a m e w o r k t o g u i d e t h e r e s e a r c h , t h e l i m i t e d t i m e a v a i l a b l e r u l e d o u t a l o n g i t u d i n a l d e s i g n . C o n s e q u e n t l y , t h i s s t u d y s u f f e r s f r o m t h e same l i m i t a t i o n o f most b u r n o u t r e s e a r c h ; i t i s c r o s s - s e c t i o n a l and a d d s l i t t l e t o t h e u n d e r s t a n d i n g o f p r o c e s s o f b u r n o u t o v e r t i m e . B. R e s e a r c h I s s u e s The g o a l o f t h i s s t u d y i s t o e x p l o r e t h e f e a s i b i l i t y o f u s i n g b u r n o u t and work e n v i r o n m e n t m e a s u r e s t o g e t h e r t o d i a g n o s e a n d i n t e r v e n e t o p r e v e n t b u r n o u t . The k e y q u e s t i o n 61 i s : What work environment v a r i a b l e s are most s i g n i f i c a n t l y c o r r e l a t e d with higher l e v e l s of burnout i n s t a f f ? To provide u s e f u l i n f o r m a t i o n , s p e c i f i c c o r r e l a t i o n s between burnout and a range of work environment v a r i a b l e s must be generated. This information would allow supervisors and a d m i n i s t r a t o r s to target i n t e r v e n t i o n more e f f e c t i v e l y and economically. Many s t u d i e s (Berkley Planning A s s o c i a t e s , 1977: Macmillan & Hunnicutt, 1983; Rosenthal, et a l . , 1983; S a v i c k i & Cooley, 1987; Weinberg, et a l . , 1983) have demonstrated that burnout and the work environment are h i g h l y i n t e r a c t i v e and burnout has been i d e n t i f i e d as a v a l i d concept with a strong r e l a t i o n s h i p to depression (Meier, 1984). Weinberg et a l . (1983) noted the considerable v a r i a b i l i t y i n l e v e l of burnout between i n s t i t u t i o n s and between occupational c a t e g o r i e s w i t h i n i n s t i t u t i o n s . A f i n d i n g of t h i s study i s that l e v e l s of burnout are s t r o n g l y associated with micro-environments. The authors s t a t e : Consequently, t h i s i d i o s y n c r a t i c nature (of burnout) s i g n i f i c a n t l y decreases the l i k e l i h o o d of f i n d i n g v a r i a b l e s which act as "common causes" of burnout. Since burnout and s t r e s s can r e s u l t from d i f f e r e n t sources f o r d i f f e r e n t i n d i v i d u a l s , no one plan of attack w i l l be s u c c e s s f u l even f o r the majo r i t y of o r g a n i z a t i o n s and i n d i v i d u a l s w i t h i n those o r g a n i z a t i o n s . Instead, attempts to minimize or reduce 62 burnout and job s t r e s s must take i n t o account the unique aspects of the i n d i v i d u a l s t a f f member, the unique environment of the i n d i v i d u a l work s e t t i n g , and the way i n which these two i n t e r a c t to create or act as bu f f e r s against unnecessary and d e b i l i t a t i n g l e v e l s of job s t r e s s (Weinberg et a l . , 1983:252). Large random samples are good f o r d e s c r i p t i v e purposes such as showing which general c h a r a c t e r i s t i c s of a work environment are c o r r e l a t e d most h i g h l y with burnout. Most s t u d i e s have r e l i e d on l a r g e samples and have not t r i e d to focus on the c h a r a c t e r i s t i c s of s p e c i f i c work s i t e s . Weinberg et a l . (1983) and Rosenthal et a l . (1983) measured burnout and the work environment i n larg e samples (n = 724 and n = 414 r e s p e c t i v e l y ) with response r a t e s of 84% f o r the f i r s t study and 70% f o r the second. What t h i s means i s that l e v e l s of burnout i n respondents was compared with the averaged scores of i n d i v i d u a l s perceptions of numerous d i f f e r e n t micro-environments. The data a n a l y s i s design lumps a l l these micro-environments i n t o one l o s i n g any information on the unique features of each. Supervisors intervene i n work teams or micro-environments and need a t o o l u s e f u l f o r t h i s purpose. Paine (1982:16) suggests that model b u i l d e r s must create two sets of models. "On one l e v e l are generic models of the BOP (burnout process) which casts i t as a general response to work s t r e s s o r s . This needs to be supplemented by models 63 which d e l i n e a t e the f a c t o r s operating w i t h i n s p e c i f i c work s e t t i n g s . " For measures of burnout and work environment to provide u s e f u l information to guide i n t e r v e n t i o n , they must be able to i d e n t i f y s p e c i f i c problematic a t t r i b u t e s of the work environment and connect t h i s information with workers and types and degrees of burnout. Toward the goal of e x p l o r i n g the u t i l i t y of using burnout and work environment measures together to enable more e f f e c t i v e and economical i n t e r v e n t i o n , the f o l l o w i n g hypotheses are proposed: 1. Workers who perceive t h e i r work environment n e g a t i v e l y w i l l score higher on burnout than workers who do not perceive t h e i r work environment n e g a t i v e l y . 2. Workers who perceive t h e i r work environment n e g a t i v e l y w i l l score higher on burnout than co-workers (working i n the same environment) who do not perceive t h e i r work environment n e g a t i v e l y . 3. Work environment v a r i a b l e s s i g n i f i c a n t l y r e l a t e d to l e v e l s of burnout i n workers w i l l vary by s p e c i f i c work environment. The f i r s t hypothesis compares the work environment r a t i n g s between respondents i n the t o t a l sample sc o r i n g h i g h l y on burnout and those s c o r i n g low to moderate. This approach r e p l i c a t e s that taken by most s t u d i e s which have compared work environment and burnout (Rosenberg et a l . , 1982; S a v i c k i & Cooley, 1987; Weinberg et a l . , 1982). This 64 s i m p l e w h o l e - s a m p l e c o r r e l a t i o n c o m b i n e s w o r k e r s p e r c e p t i o n s o f s e v e r a l work e n v i r o n m e n t s ( t h e number o f w o r k s i t e s i n t h e s a m p l e ) i n t o o n e . I n o t h e r w o r d s , s i g n i f i c a n t d i f f e r e n c e s i n p e r c e p t i o n s o f t h e work e n v i r o n m e n t b e t w e e n h i g h a n d l o w b u r n e d - o u t w o r k e r s c o u l d be t h e r e s u l t o f d i f f e r e n c e s b e t w e e n s i t e s i n t h a t h i g h b u r n o u t r e s p o n d e n t s m i g h t p e r c e i v e t h e work e n v i r o n m e n t d i f f e r e n t l y f r o m w o r k e r s i n o t h e r work e n v i r o n m e n t s b u t n o t s i g n i f i c a n t l y d i f f e r e n t f r o m c o - w o r k e r s ( w o r k i n g i n t h e same m i c r o - e n v i r o n m e n t ) . The s e c o n d h y p o t h e s i s e l i m i n a t e s v a r i a t i o n i n o b j e c t i v e m i c r o - e n v i r o n m e n t s by c o m p a r i n g p e r c e p t i o n s o f t h e work e n v i r o n m e n t b e t w e e n h i g h and l o w - m o d e r a t e l y b u r n e d - o u t s c o r e s w i t h i n teams o f w o r k e r s . The i m p o r t a n c e o f t h i s c o m p a r i s o n i s t h a t t h e y a r e b e t w e e n i n d i v i d u a l s p e r c e p t i o n s o f t h e same work e n v i r o n m e n t . T h i s r e p r e s e n t s an a t t e m p t t o g e t a t b o t h s u b j e c t i v e a n d o b j e c t i v e a s p e c t s o f t h e work e n v i r o n m e n t . I n e f f e c t , s i m i l a r r a t i n g s o f t h e same o b j e c t i v e work e n v i r o n m e n t r e p r e s e n t i n t e r - o b s e r v e r r e l i a b i l i t y . The t h i r d h y p o t h e s i s a s k s w h e t h e r t h e same v a r i a b l e s a r e i m p o r t a n t i n e a c h o f t h e e n v i r o n m e n t s . I f b o t h h i g h and l o w b u r n o u t w o r k e r s w o r k i n g i n d i f f e r e n t m i l i e u s t e n d t o r a t e t h e i r work e n v i r o n m e n t s s i m i l a r l y , t h e n t h e r e i s l i t t l e s u p p o r t f o r t h e i d e a t h a t t h e work e n v i r o n m e n t m e a s u r e w i l l p r o v i d e u s e f u l i n f o r m a t i o n . A u s e f u l work e n v i r o n m e n t m easure must be s e n s i t i v e e n o u g h t o d e t e c t s u b t l e d i f f e r e n c e s i n t h e e n v i r o n m e n t and t h i s w o u l d be r e f l e c t e d by e x p l a i n a b l e v a r i a t i o n s a c r o s s d i f f e r e n t s e t t i n g s . 66 Chapter IV - Research Design A. I n t r o d u c t i o n A n a t u r a l i s t i c c r o s s - s e c t i o n a l study design was s e l e c t e d to t e s t the hypotheses i n t h i s research. The research i s e x p l o r a t o r y - d e s c r i p t i v e and examines the i n t e r a c t i o n between the v a r i a b l e s of l e v e l s of burnout (independent) and perceptions of the work environment (dependent). The study examines a number of i n t e r v e n i n g v a r i a b l e s derived from the the two dimensional framework described i n chapter three. These include demographic v a r i a b l e s , age, sex, experience, education ( o b j e c t i v e -i n d i v i d u a l ) ; objective-environmental v a r i a b l e s such as pay, b e n e f i t s , vacation time, and hours; and the s u b j e c t i v e -environmental v a r i a b l e s of shared ideology/methodology and s p e c i a l c e r t i f i c a t i o n . A q u a n t i t a t i v e methodology was i m p l i c i t as the goal i s to explore the use of e f f i c i e n t and economical means f o r supervisors to gain information about the work micro-environment. Consequently, r e l i a b l e measures of burnout and work environment which re q u i r e l e s s than 15 minutes to complete were s e l e c t e d . B. Operational D e f i n i t i o n s and Instruments The o p e r a t i o n a l d e f i n i t i o n of burnout used research i s provided by Maslach & Jackson (1981) i n t h i s who have 67 developed the Maslach Burnout Inventory (MBI) and demonstrated i t s r e l i a b i l i t y f o r measuring l e v e l s of burnout i n i n d i v i d u a l s . Burnout i s conceptualized as i n v o l v i n g three r e l a t i v e l y independent symptom p a t t e r n s : Emotional Exhaustion ( f a t i g u e d and worn down), Depersonalization (cynicism toward c l i e n t s ) , and Personal Accomplishment ( l o s i n g a sense of accomplishment i n one's work). The Maslach Burnout Inventory i s a 22-item questionnaire asking respondents how f r e q u e n t l y they experience c e r t a i n f e e l i n g s . Each item i s rated on a s c a l e of 0 to 6 where 0 = never and 6 = every day. Emotional Exhaustion (EE) i s assessed with 9 items (e.g., " I f e e l e m o tionally drained from my work."); Depersonalization (DP) by 5 items (e.g., "I don't r e a l l y care what happens to some r e c i p i e n t s . " ) ; and Personal Accomplishment (PA) by 8 items (e.g., " I have accomplished many worthwhile things i n t h i s j o b . " ) . The MBI was standardized on samples of over 1,500 helping p r o f e s s i o n a l s and has shown i n t e r n a l r e l i a b i l i t y (Cronbach's alpha, from .71 to .90 with a mean of .79) (Maslach & Jackson, 1981). In terms of the two dimensional model, the l e v e l of burnout i s viewed as the independent v a r i a b l e and i s a component of both the s u b j e c t i v e - i n d i v i d u a l and o b j e c t i v e -i n d i v i d u a l quadrants. As such, i t measures workers f e e l i n g s about t h e i r work (s u b j e c t i v e ) but i n as o b j e c t i v e a manner as p o s s i b l e . The MBI was s e l e c t e d both because i t i s 68 e f f i c i e n t and economical to use and i s a r e l i a b l e measure of burnout. Work environment i s assessed using the Work Environment Scale (WES) developed by Moos (1981). The WES i s a 90-item t r u e - f a l s e questionnaire containing 10 nine-item s c a l e s and has been standardized on a sample of over 3,000 s t a f f . The WES d i s p l a y s an i n t e r n a l consistency (Cronbach's alpha) of from .86 to .69 f o r the 10 s c a l e s (Moos, 1981). A d e s c r i p t i o n of the ten s c a l e s i s provided below: WES Subscales and Dimension D e s c r i p t i o n s  R e l a t i o n s h i p Dimensions 1. Involvement—the extent to which employees are concerned about and committed to t h e i r jobs. 2. Peer Cohesion—the extent to which employees are f r i e n d l y and supportive of one another. 3. Supervisor S u p p o r t — t h e extent to which management i s supportive of employees and encourages employees to be supportive of one another. Personal Growth Dimensions 4. Autonomy—the extent to which employees are encouraged to be s e l f - s u f f i c i e n t and make t h e i r own d e c i s i o n s . 5. Task O r i e n t a t i o n — t h e degree of emphasis on good plan n i n g , e f f i c i e n c y , and g e t t i n g the job done. 6. Work P r e s s u r e — t h e degree to which the press of work land time urgency dominate the job m i l i e u . 69 S y s t e m M a i n t e n a n c e a n d S y s t e m C h a n g e D i m e n s i o n s 7. C l a r i t y — t h e e x t e n t t o w h i c h e m p l o y e e s know what t o e x p e c t i n t h e i r d a i l y r o u t i n e a n d how e x p l i c i t l y r u l e s and p o l i c i e s a r e c o m m u n i c a t e d . 8 . C o n t r o l — t h e e x t e n t t o w h i c h management u s e s r u l e s and p r e s s u r e s t o k e e p e m p l o y e e s u n d e r c o n t r o l . 9 . I n n o v a t i o n — t h e d e g r e e o f e m p h a s i s on v a r i e t y , c h a n g e , l a n d new a p p r o a c h e s . 1 0 . P h y s i c a l C o m f o r t — t h e e x t e n t t o w h i c h t h e p h y s i c a l s u r r o u n d i n g s c o n t r i b u t e t o a p l e a s a n t work e n v i r o n m e n t . ( M o o s , 1 9 8 1 , 1 9 8 6 : 2 ) T h e WES i s a s sumed t o m e a s u r e b o t h s u b j e c t i v e a n d o b j e c t i v e a s p e c t s o f t h e work e n v i r o n m e n t . I t i s n e c e s s a r i l y a m e a s u r e o f an i n d i v i d u a l s s u b j e c t i v e p e r c e p t i o n o f t h e e n v i r o n m e n t a n d as s u c h i t r a t e s e l e m e n t s o f t h e communal makeup o f a work e n v i r o n m e n t . P e e r C o h e s i o n i s a n a l o g o u s t o t h e c o n c e p t o f Communion d e v e l o p e d b y C h e r n i s s ( 1 9 8 6 ) . A n o n - c o h e s i v e work g r o u p c a n n o t f u n c t i o n a s a " c o l l e c t i v e w h o l e " . T h e WES v a r i a b l e o f C l a r i t y i s r e l a t e d t o t h e c o n c e p t o f s h a r e d I d e o l o g y w h i c h " r e d u c e s a m b i g u i t y a n d s e l f - d o u b t " . T h e m o r a l - r e l i g i o u s p a r a d i g m c o n c e p t o f G u i d a n c e r e l a t e s t o t h e WES s u b s c a l e s o f S u p e r v i s o r S u p p o r t , P e e r C o h e s i o n , T a s k O r i e n t a t i o n , C l a r i t y , a n d A u t o n o m y . G u i d a n c e c a n come f r o m s u p e r v i s o r s , c o h e s i v e p e e r s , g o o d p l a n n i n g , a n d e x p l i c i t r o u t i n e s a s w e l l a s f r o m r e l i g i o u s f a i t h . A u t o n o m o u s a c t i o n i s o n l y p o s s i b l e when a l l t h e s e " g u i d i n g " s u p p o r t s a r e i n p l a c e . C h e r n i s s 1 70 (1986) c o n c e p t o f I n v e s t m e n t , "whereby t h e i n d i v i d u a l g a i n s a s t a k e i n t h e g r o u p " , i s a l m o s t i d e n t i c a l t o t h e WES s c a l e o f I n v o l v e m e n t , " t h e e x t e n t t o w h i c h e m p l o y e e s a r e c o n c e r n e d a b o u t and c o m m i t t e d t o t h e i r j o b s " . The WES S y s t e m M a i n t e n a n c e and S y s t e m Change D i m e n s i o n s o f C l a r i t y , C o n t r o l , I n n o v a t i o n , a n d P h y s i c a l C o m f o r t a r e v a r i a b l e s d e s c r i b i n g t h e o b j e c t i v e - e n v i r o n m e n t a l q u a d r a n t . A team o f c o - w o r k e r s r a t i n g t h e i r work e n v i r o n m e n t s i m i l a r l y on t h e s e d i m e n s i o n s a r e p r o v i d i n g an o b j e c t i v e m e a s u r e o f t h a t e n v i r o n m e n t b a s e d on i n t e r - o b s e r v e r r e l i a b i l i t y . C o n v e r s e l y , a s i n g l e d e v i a n t o b s e r v e r i n a team o f c o n s i s t e n t r a t e r s may be p r o v i d i n g a s u b j e c t i v e m e a s u r e o f s o m e t h i n g o t h e r t h a n t h e o b j e c t i v e e n v i r o n m e n t . On a r e s e a r c h team t h i s i s a s o u r c e o f v a r i a b i l i t y and e r r o r , on a s o c i a l s e r v i c e team t h i s m i g h t be a c a s e o f an i s o l a t e d " b u r n o u t " . A d e m o g r a p h i c d a t a q u e s t i o n n a i r e d e t e r m i n e d s e x , a g e , r a c e , r e l i g i o n d e g r e e o f r e l i g i o s i t y , m a r i t a l s t a t u s , l e n g t h m a r r i e d , number o f c h i l d r e n , l e v e l o f s c h o o l c o m p l e t i o n , e d u c a t i o n a l a t t a i n m e n t , work a r e a , p o s i t i o n , h o u r s p e r week, y e a r s i n p r e s e n t j o b , and y e a r s i n f i e l d . T h e s e v a r i a b l e s a s s e s s o b j e c t i v e a t t r i b u t e s o f i n d i v i d u a l r e s p o n d e n t s and a l l o w a c o m p a r i s o n o f t h e s a m p l e w i t h o t h e r s i n t h e l i t e r a t u r e . T h i s d a t a d e s c r i b e s p a r t o f t h e o b j e c t i v e -i n d i v i d u a l q u a d r a n t . 71 C. Sampling Non-profit agencies i n the lower mainland area of B r i t i s h Columbia employing teams of d i r e c t - c a r e s o c i a l s e r v i c e d e l i v e r y s t a f f were contacted by l e t t e r and i n v i t e d to p a r t i c i p a t e i n the study. Five agencies were included i n the sample; one from North Vancouver, three from Vancouver, and one from Richmond. To be e l i g i b l e f o r the study a team of workers had to have more than four and l e s s than 12 s t a f f working face to face a minimum of bi-weekly. The assumption upon which t h i s d e c i s i o n was made can be summarized as: 1- The work environment i s a s o c i a l environment made up of co-workers i n frequent i n t e r a c t i o n with each other. 2- Teams l a r g e r than 12 are f u n c t i o n i n g s y s t e m i c a l l y as smaller sub-teams and those smaller than 4 are not l i k e l y to represent a true ( r e l a t i v e l y complex) s o c i a l environment. This assumes that there i s a f u n c t i o n a l l i m i t to the s i z e of ones s o c i a l working environment. The assumption i s that once the number of i n d i v i d u a l s i n a work group exceeds about ten to twelve, then s o c i a l l y and f u n c t i o n a l l y , the group i s operating as two or more sub-systems. The s e l e c t i o n of ten to twelve as the upper l i m i t f o r a f u n c t i o n a l s o c i a l system i s somewhat a r b i t r a r y but i s based on sound p r i n c i p l e s . A f u n c t i o n a l s o c i a l system i s assumed to be one where the members of that system maintain some frequent and d i r e c t communication. A dyad has only one of these " l i n e s of communication" and a group of three has 72 three. As the group s i z e increases, the number of l i n e s of communication increase e x p o n e n t i a l l y . The mathematical formula to determine the number of r e l a t i o n s h i p s to be maintained where X i s the number of members i n the group and R i s the number of r e l a t i o n s h i p s produced i s : R = X + [(X - 3) x 2] + (X - 4) + [X - (X - 1)] Consequently, the number of r e l a t i o n s h i p s f o r a group of f o u r , s i x ; f o r a group of e i g h t , twenty-eight; and f o r a group of twelve, s i x t y - s i x . To gain a v i s u a l concept of the complexity involved when group s i z e i n c r e a s e s , draw a s e r i e s of dots i n a c i r c l e and draw a l i n e between each dot. The dots represent the i n d i v i d u a l s i n a group and the l i n e s the number of f u n c t i o n a l channels of communication necessary f o r the group to operate as a cohesive, i n t e r a c t i v e s o c i a l -whole . Whether work environment measures estimate features of t h i s immediate, i n t e r a c t i v e social-work environment, fea t u r e s of the l a r g e r , more impersonal ( l e s s - i n t e r a c t i v e ) work environment, or both, has important i m p l i c a t i o n s f o r both i n t e r p r e t i n g p r i o r research and t h i s study. F i r s t , past s t u d i e s have e i t h e r sampled l a r g e work groups such as whole i n s t i t u t i o n s composed of wards and u n i t s (Weinberg et a l . , 1983) or have used random s e l e c t i o n s of respondents from many d i f f e r e n t s i t e s (Rosenthal et a l . , 1983). These perceptions of the work environment were then c o r r e l a t e d with l e v e l s of burnout and g e n e r a l l y found to be h i g h l y i n t e r a c t i v e with c e r t a i n v a r i a b l e s such as q u a l i t y of s u p e r v i s i o n and c l a r i t y i n the work task. The problem i s , i f work environment measures are accurate, then these s t u d i e s are comparing an i n d i v i d u a l phenomena, burnout, with perceptions of d i f f e r e n t o b j e c t i v e micro work environments. R e l a t i o n s h i p s between burnout and s p e c i f i c work environments are l o s t when micro-environments are c o l l a p s e d i n t o the t o t a l sample. For example, a team of 10 h i g h l y burned out workers from an unusual work environment could produce s i g n i f i c a n t c o r r e l a t i o n s i n a l a r g e r sample where there were no other r e l a t i o n s h i p s between burnout and the work environment v a r i a b l e s i d e n t i f i e d as s i g n i f i c a n t . Of the f i v e teams p a r t i c i p a t i n g i n t h i s study, two contained 9 members, two with 8, and one with 5 producing a t o t a l sample of n = 39. Respondents could occupy any p o s i t i o n i n the agency as long as they were i n d a i l y , d i r e c t contact with c l i e n t s or were s u p e r v i s i n g those who were. Three teams were operating day programs to a s s i s t disadvantaged parents of pre-school age c h i l d r e n to l e a r n parenting s k i l l s while the other two were r e s i d e n t i a l centers f o r teens. One of the r e s i d e n t i a l teen programs was treatment o r i e n t e d while the other was a short term assessment center. Both the teen programs were s t a f f e d on a 24 hour, 7 day b a s i s . The day programs are the only programs p r o v i d i n g t h e i r s e r v i c e i n the lower mainland while the the r e s i d e n t i a l programs represent 1/4 to 1/3 of the programs p r o v i d i n g s i m i l a r s e r v i c e i n the same area. The two l a r g e r day programs and the teen assessment program were formerly p r o v i n c i a l l y run but had been contracted out i n 1984. D. Data C o l l e c t i o n A p r e - t e s t was conducted using the s t a f f of an non-p r o f i t agency not s e l e c t e d f o r the sample. No remarkable problems were encountered and the respondents completing the pre - t e s t confirmed the ease and short time necessary to complete the data c o l l e c t i o n instruments. The p r e - t e s t enabled the researcher to provide prospective sample teams a r e a l i s t i c estimate of the demands on t h e i r time. The data c o l l e c t i o n instruments were administered at r e g u l a r l y scheduled s t a f f meetings on the program s i t e . This ensured that responses were received from 100% of the members of the teams. Completion of the ques t i o n n a i r e s took from 20 to 30 minutes and the major i t y of respondents completed a l l the items. P a r t i c i p a t i o n was volun t a r y with the q u a l i f i c a t i o n that teams unanimously volunteer to take p a r t or not at a l l . Team supe r v i s o r s were asked to provide information f o r a 6-item s t r u c t u r a l v a r i a b l e c h e c k l i s t . These v a r i a b l e s c o n t r o l l e d f o r objective-environment dimension f a c t o r s discussed i n the s e c t i o n on Marxist p e r s p e c t i v e s and subjective-environmental v a r i a b l e s o u t l i n e d by Cherniss' (1986) m o r a l - r e l i g i o u s paradigm. The c h e c k l i s t included work week (9-5, monday to f r i d a y to s h i f t work), s a l a r y 75 l e v e l s , p a i d a n n u a l l e a v e , b e n e f i t s , f r e q u e n c y o f s t a f f m e e t i n g s , a n d w h e t h e r team members u t i l i z e d a s p e c i f i c w o r k i n g m e t h o d o l o g y o r i d e o l o g y ( e . g . M o n t e s s o r i t r a i n i n g ) o r were r e q u i r e d t o h o l d any s p e c i a l c e r t i f i c a t i o n ( e . g . c h i l d c a r e d i p l o m a ) . None o f t h e teams r e q u i r e d a n y s p e c i a l c e r t i f i c a t i o n o r u s e d a s e t m e t h o d o l o g y o r i d e o l o g y . As w e l l , s a l a r i e s , b e n e f i t s , and p a i d b e n e f i t s were r e l a t i v e l y u n i f o r m a c r o s s t h e g r o u p s . M e e t i n g f r e q u e n c y v a r i e d , e s p e c i a l l y b e t w e e n t h e day and r e s i d e n t i a l p r o g r a m s . A l l day p r o g r a m s had two o r more s t a f f m e e t i n g s w e e k l y w h i l e none o f t h e r e s i d e n t i a l p r o g r a m s met more t h a n o n c e a week. E. D a t a A n a l y s i s P l a n A l l d a t a o b t a i n e d i n t h i s s t u d y a r e c o d e d and s t o r e d i n an MTS f i l e i n t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a m a i n f r a m e c o m p u t e r . A l l d e s c r i p t i v e and s t a t i s t i c a l o p e r a t i o n s use e x i s t i n g p r o g r a m s i n t h e M i c h i g a n I n t e r a c t i v e D a t a A n a l y s i s S y s t e m ( M I D A S ) . D e m o g r a p h i c and b a c k g r o u n d d e s c r i p t i v e d a t a i s p r o v i d e d f o r t h e t o t a l s a m p l e o f r e s p o n d e n t s . T o t a l s a m p l e means and v a r i a n c e s a r e c a l c u l a t e d f o r t h e M a s l a c h B u r n o u t I n v e n t o r y a n d c o m p a r e d w i t h t h e i n s t r u m e n t s t a n d a r d i z a t i o n s a m p l e . Work E n v i r o n m e n t S c a l e means and v a r i a n c e s a r e c o m p a r e d w i t h s t a n d a r d i z a t i o n s a m p l e means and v a r i a n c e s f o r s t a f f i n t h e H o l l a n d " S o c i a l " o c c u p a t i o n a l c a t e g o r y . The f i r s t h y p o t h e s i s i s t e s t e d b y d i v i d i n g t h e s a m p l e i n t o h i g h E m o t i o n a l E x h a u s t i o n , D e p e r s o n a l i z a t i o n , a n d 76 Personal Accomplishment versus low to moderate scorers on these MBI subscales. D i f f e r e n c e s i n perceptions of the work environment between the two subsamples are analyzed using the Mann-Whitney U t e s t f o r d i f f e r e n c e s about the median. The Mann-Whitney i s used due to the d i f f e r e n c e s i n the s i z e s of the subsamples. This s i z e d i f f e r e n c e creates a s i g n i f i c a n t d i f f e r e n c e i n degrees of variance between the subsamples n e c e s s i t a t i n g the use of a non-parametric t e s t . Jayartne et a l . (1986) tested s e v e r a l hypotheses l i n k i n g burnout and symptomatology and manipulated t h e i r sample by d i v i d i n g respondents i n t o equal high versus low burnout subsamples at the mean. The problem with such an approach i s that other researchers (Weinberg et a l . , 1983) examining l a r g e samples have determined that approximately 15% of workers surveyed at any point i n time w i l l be h i g h l y burned out. Simply d i v i d i n g the sample at the mean on burnout d i l u t e s the "high burnout" sample with 35% of average to moderately burned out workers. Burnout i s simply not a p r e c i s e enough concept to r e l y on applying to anyone except those claiming to experience the most gross of i t s symptoms. Consequently/ f o r a s t r i c t t e s t of the hypotheses, only the workers scoring i n the high range on burnout (as determined by Maslach & Jackson, 1981) are compared with the r e s t of the sample. To f u r t h e r explore the o v e r a l l i n t e r a c t i v i t y between the MBI and the WES, the sample i s d i v i d e d i n t o high, moderate, and low l e v e l s of burnout f o r each of the three 77 MBI s u b s c a l e s u s i n g t h e c u t - o f f p o i n t s p r o v i d e d by M a s l a c h & J a c k s o n ( 1 9 8 1 ) . The K r u s k a l - W a l l i s , a m u l t i - s a m p l e , n o n -p a r a m e t r i c t e s t f o r v a r i a t i o n a b o u t t h e m e d i a n on t h e t e n WES d i m e n s i o n s i s r u n . The s e c o n d h y p o t h e s e s i s t e s t e d u s i n g t h e same r e g i m e n e x c e p t t h a t s e p a r a t e c o m p a r i s o n s a r e made w i t h i n e a c h team. Not a l l teams c o n t a i n e d h i g h s c o r e r s on t h e t h r e e MBI s u b s c a l e s , c o n s e q u e n t l y , a n a l y s e s on a l l t h e i n d e p e n d e n t v a r i a b l e s f o r a l l teams i s i m p o s s i b l e . The t h i r d h y p o t h e s i s i s t e s t e d b y e x a m i n i n g o v e r a l l r e s u l t s f r o m t h e p r e v i o u s t e s t s f o r h y p o t h e s e s . The s p e c i f i c i t y and i n d e p e n d e n c e o f t h e WES and MBI w o u l d be s u g g e s t e d b y a v a r i e t y o f WES f i n d i n g s b y t y p e a nd d e g r e e o f b u r n o u t ( e g . EE, DP, and PA) and w i t h v a r i a t i o n b e t w e e n s e t t i n g s . F i n a l l y , e x p l o r a t o r y a n a l y s e s a r e r u n t o e x a m i n e p a t t e r n s o f r e l a t i o n s h i p s s u g g e s t e d b y i n i t i a l f i n d i n g s on t h e t e s t s o f t h e t h r e e h y p o t h e s e s . S i g n i f i c a n t r e l a t i o n s h i p s b e t w e e n b u r n o u t and work e n v i r o n m e n t a r e p r e s e n t e d i n t a b u l a r f o r m t h r o u g h o u t . Two c a u t i o n s a r e n e c e s s a r y t o q u a l i f y t h e s t u d y f i n d i n g s . F i r s t , t h e s e m u l t i p l e r e p e t i t i o n s o f s t a t i s t i c a l t e s t s a r e bound t o p r o d u c e some s p u r i o u s l y s i g n i f i c a n t f i n d i n g s a s w e l l a s s i g n i f i c a n t o n e s . T h e r e f o r e , r e s u l t s must be t a k e n o n l y a s p r e l i m i n a r y . R e p l i c a t i o n i s r e q u i r e d t o f i r m them up. 78 S e c o n d , t h e d e c i s i o n t o use r e s u l t s f r o m w h o l e teams o f w o r k e r s mean t h a t t h e s t u d y r e s u l t s a r e n e i t h e r i n d e p e n d e n t n o r r e p r e s e n t a t i v e o f t h e t o t a l p o p u l a t i o n o f w o r k e r s . The v a r i a n c e w i t h i n g r o u p s s u g g e s t t h a t t h e r e i s some d e g r e e o f i n d e p e n d e n c e b u t t h e r e s u l t s p r o b a b l y u n d e r e s t i m a t e t h e " r e a l " d i f f e r e n c e s amongst p e r s o n s . F. E t h i c a l I s s u e s B e c a u s e t h e o v e r a l l g o a l o f t h e r e s e a r c h i s t o e n a b l e more s p e c i f i c and h o p e f u l l y more e f f e c t i v e i n t e r v e n t i o n t o p r e v e n t b u r n o u t , e a c h team was o f f e r e d t h e o p t i o n o f r e c e i v i n g f e e d b a c k on t h e r e s u l t s o f t h e s t u d y . T h i s was an e t h i c a l d e c i s i o n by t h e r e s e a r c h e r b a s e d on a b e l i e f t h a t a l l t y p e s o f i n t e r a c t i o n ( i n c l u d i n g o b t a i n i n g d a t a f o r r e s e a r c h p u r p o s e s ) c o n t a i n an e x c h a n g e w h i c h s h o u l d be b e n e f i c i a l t o a l l i n v o l v e d . P a r t i c i p a n t s i n t h i s s t u d y have a r i g h t t o know how t h e t i m e t h e y d o n a t e d t o c o m p l e t i n g t h e q u e s t i o n n a i r e s was u s e d . H o p e f u l l y t h o s e i n t e r e s t e d i n t h e f i n d i n g s w i l l d e r i v e some b e n e f i t i n t h e i r p e r s o n a l d e v e l o p m e n t a l e n c o u n t e r s w i t h b u r n o u t . 79 Chapter V - Findings A. Demographic Data The sample contained 15 men and 24 women (37%-63%) ranging i n age from 27 to 51 (mean = 34.5). Fourteen were never married, 16 p r e s e n t l y married, and 8 were divorced or separated. A l l the sample were Caucasian with the exception of one Asian-Canadian male and one Native-Canadian male. A l l but three had received education beyond the high school l e v e l . Three were r e g i s t e r e d nurses and 27 had earned c o l l e g e diplomas or u n i v e r s i t y degrees. The sample contained one student, a cook i n d a i l y i n t e r a c t i o n with r e s i d e n t s , 28 f r o n t l i n e s t a f f , and 9 supervisors or a d m i n i s t r a t o r s working an average of 34.5 hours per week. The average length of time i n the present job was 2.8 years with 9.1 years the average time spent i n the f i e l d . The mean f o r time i n present job i s depressed because three of the four large programs had been contracted out to p r i v a t e agencies by the p r o v i n c i a l government approximately three years ago. B. Maslach Burnout Inventory T o t a l sample means f o r the MBI subscales were Emotional Exhaustion-18.8, Depersonalization-6.1, and Personal Accomplishment-36.6. These averages place the sample at the c u t t i n g points between low to average l e v e l s f o r the MBI subscales. Comparisons between the study sample MBI means and the MBI s t a n d a r d i z a t i o n sample by demographic categories are given i n Table I . TABLE I Study Sample-Maslach Burnout Inventory S t a n d a r d i z a t i o n Sample Comparisons by Selected Demographic V a r i a b l e s — s t u d y sample / s t a n d a r d i z a t i o n sample (means) SD = standard d e v i a t i o n V a r i a b l e N Emotional Depersonal- Personal Exhaustion i z a t ion Accomplishmen SEX male 15/2247 18.5/19.9 6.5/7.4 35.7/36.2 SD 7.9/10.5 4.3/5.99 7.2/6.76 female 24/3421 18.9/20.9 5.8/7.0 37.2/36 .5 SD 9.4/10.7 3.7/7.02 6.3/6.56 AGE <31 9/1044 23.2/23.8 5.4/9.3 36.5/35.9 SD 9.5/11.4 3.3/9.36 7.5/6.58 31-40 21/1197 19.6/22.2 6.8/8.2 37.6/37.2 SD 8.7/10.8 4.7/6.05 6.1/6.63 41-50 6/641 12.5/20.2 5.5/6.6 35.1/38.9 SD 3.2/11.1 2.3/5.56 5.5/7.67 MARITAL STATUS Sing l e 14/732 20.0/24.2 7.5/9.3 37.2/35.8 SD 9.1/11.2 5.2/6.43 7.6/6.71 Married 17/2017 18.8/19.9 5.6/7.0 34.9/38.4 SD 7.7/10.6 2.9/6.02 5.6/6.74 Divorced 6/478 17.8/22.2 4.8/7.7 38.6/37.2 SD 12.3/11.2 1.7/5.97 7.0/6.73 EDUCATION No C o l . 3/269 13.6/22.9 2.3/8.5 34.6/36.5 SD 3.5/11.8 1.5/6.86 5.1/6.97 Some C o l . 10/664 17.2/21.3 6.5/8.0 33.0/35.3 SD 7.1/11.3 4.0/6.54 7.4/6.66 Col.Grad 12/664 24.5/19.8 8.5/7.5 36.9/31.4 SD 6.76/9.97 4.3/5.70 5.7/6.95 Postgrad 13/1878 16.3/21.1 4.4/7.3 40.1/37.8 SD 10.4/10.74 2.6/5.67 5.8/6.42 81 The most c o n s i s t e n t d e v i a t i o n of the study sample from the norms of the s t a n d a r d i z a t i o n sample was on Depersonalization where the scores were lower (except f o r c o l l e g e grads who were marginally h i g h e r ) . Much of t h i s v a r i a t i o n was from the three day-programs whose mean DP scores were 3.6 (n = 5), 5.6 (n = 9), and 5.8 (n = 8). The r e s i d e n t i a l teen programs were more i n l i n e with the norms with 7.1 (n =8) and 7.2 (n = 9). I t i s l i k e l y that the study sample v a r i a t i o n on DP stems from two sources. One discussed p r e v i o u s l y i s that the majority of the sample (n = 22) deals with a r e l a t i v e l y appealing c l i e n t group (disadvantaged parents and pre-schoolers vs r e b e l l i o u s teens). The other source of b i a s might be due to s o c i a l d e s i r a b i l i t y e r r o r . The MBI was completed i n a group s e t t i n g i n the presence of the researcher and t h i s may have i n h i b i t e d some respondents from acknowledging frequent f e e l i n g s such as: "I t r e a t some r e c i p i e n t s as i f they were impersonal o b j e c t s . " and "I've become more c a l l o u s toward people since I took t h i s job." Other notable d i f f e r e n c e s were the tendency f o r the 41-50 age group and post-graduate educated groups to r a t e lower on Emotional Exhaustion. These groups are l i k e l y overlapping and are over-represented by supervisors and a d m i n i s t r a t o r s i n these s t a f f groups of p a r a - p r o f e s s i o n a l d i r e c t - c a r e workers. That c o l l e g e graduates were somewhat higher than the norm i n both EE and DP may i n d i c a t e higher l e v e l s of f r u s t r a t i o n due to o v e r - q u a l i f i e d s t a f f i n para-82 p r o f e s s i o n a l r o l e s . The extremely low l e v e l s of EE and DP i n the no c o l l e g e group would be the t r a n s p o s i t i o n of t h i s assumption but the numbers are too small to draw any f i r m c o n c l u s i o n s . Six s t a f f scored at 27 or over on the Emotional Exhaustion subscale. This represents j u s t under 16% of the t o t a l sample s c o r i n g i n the high range on EE. This percentage i s i d e n t i c a l to the percentages found i n a large sample (n = 724) of s i m i l a r s t a f f (demographically and o c c u p a t i o n a l l y ) from r e s i d e n t i a l f a c i l i t i e s i n the US (Weinberg et al.,1983). Four s t a f f scored i n the high range on Depersonalization and only one of these was a l s o i n the high range on EE. Seven respondents scored below the c u t o f f point on Personal Accomplishment which i s scored i n the opposite d i r e c t i o n ( i . e . , low PA means high burnout). One low PA score was a l s o a high DP and two were high EE. No respondent scored as high burnout on a l l three s c a l e s . Maslach & Jackson(1981) recommend that the three s c a l e s be t r e a t e d s e p a r a t e l y . However, to allow comparisons with the S a v i c k i & Cooley study, a combined MBI measure was c a l c u l a t e d f o r each respondent by adding the EE and DP to the remainder of the PA score minus the maximum p o s s i b l e on the PA s c a l e (due to the reverse s c o r i n g on t h i s s c a l e ) . This c a l c u l a t e d MBI score i d e n t i f i e d as high i n burnout, a l l s i x high EE respondents, the one respondent s c o r i n g high on both the other s c a l e s , and two respondents s c o r i n g i n the high-moderate range on a l l three s c a l e s . 83 The l i t e r a t u r e confirms the Emotional Exhaustion subscale of the MBI as the most potent i n d i c a t o r of burnout r e l a t i v e both to the other two subscales (Golembiewski & Munzenrider, 1981) and to other burnout instruments (Hunnicutt & MacMillan, 1983). These f i n d i n g s are co n s i s t e n t with r e s u l t s i n the study sample. A l l high EE were included i n the high composite MBI and make up the majority of respondents i n that category. C. Work Environment Scale Sample means on the WES are compared with standardized sample (n = 86) means f o r s t a f f i n the Holland occupational category of S o c i a l i n table I I (Moos, 1981). TABLE I I Sample Means-Work Environment Scale (WES) Sta n d a r d i z a t i o n Sample Means Comparisons (Holland S o c i a l Occupational Category) WES STANDARD MEANS SAMPLE MEANS (n = = 84) (n = 39) Innovation 61 67 Peer Cohesion 55 63 Supervisor Support 59 68 Autonomy 59 66 Task O r i e n t a t i o n 58 59 Work Pressure 49 50 C l a r i t y 64 62 Con t r o l 43 37 Innovation 52 60 P h y s i c a l Comfort 66 59 The study sample perceived t h e i r work environments as: higher i n Involvement, Peer Cohesion, Supervisor Support, Autonomy, and Innovation; lower i n Control and P h y s i c a l Comfort; and about the same i n Task O r i e n t a t i o n and Work Pressure as the standardized sample. O v e r a l l , the non-p r o f i t agency employed workers i n the study sample tend to average l e v e l s of burnout and see t h e i r work environments more p o s i t i v e l y than the norm. 85 D. Hypotheses Testing The f i r s t hypothesis, that workers who perceive t h e i r work environment more n e g a t i v e l y would score higher on burnout, was tested by d i v i d i n g the sample i n t o high vs average-low EE, DP, PA, and composite MBI sub-samples. The c u t - o f f point f o r high burnout i s given i n the t e s t manual (Maslach & Jackson, 1981). The Mann-Whitney U was c a l c u l a t e d to t e s t that no s i g n i f i c a n t d i f f e r e n c e e x i s t s about the median f o r the two sub-samples. No r e l a t i o n s h i p between EE and any WES sub-scales at a l e v e l of s i g n i f i c a n c e of £ < .05. High EE (n = 6) respondents saw l e s s Task O r i e n t a t i o n i n t h e i r work environments than low-average (n = 33) respondents at a l e v e l of s i g n i f i c a n c e of £ = .0601 (U = 67.5). The Mann-Whitney t e s t of high (n = 5) vs low-average (n = 34) Depersonalization found high DP s t a f f p e r c e i v i n g l e s s Involvement at a l e v e l of £ = .0202 (U = 50.0) and greater C o n t r o l at a l e v e l of s i g n i f i c a n c e of £ = .0457 (U = 46.0). No other r e l a t i o n s h i p s were s i g n i f i c a n t at a £ < .1 l e v e l . As w e l l , no s i g n i f i c a n t r e l a t i o n s h i p s (£ < .1) were found between high (n = 7) vs low (n = 32) Personal Accomplishment and the WES. With the sample d i v i d e d by high composite MBI (n = 9) vs low-average composite MBI (n = 30), h i g h l y burntout s t a f f perceived l e s s supervisor support at a s i g n i f i c a n c e l e v e l of £ = .0361 (U = 73.0). As w e l l , the high MBI respondents rated t h e i r work environments as lower on C l a r i t y (U = 86 100.0) and Task O r i e n t a t i o n (U = 45.5) than low-average workers at a l e v e l of s i g n i f i c a n c e of £ = .0797 on both v a r i a b l e s . A t e s t f o r the s t a t i s t i c a l a s s o c i a t i o n of burnout and work environment was made by d i v i d i n g the sample i n t o high, average, and low sub-samples by EE, DP, and PA (PA reversed). The c u t - o f f points f o r these c a t e g o r i e s are taken from the t e s t manual (Maslach & Jackson, 1981). The K r u s k a l - W a l l i s , a non-parametric t e s t f o r s i g n i f i c a n t v a r i a t i o n about the median, was run due to the d i f f e r e n c e s in within-sample variance between the two sample groups. With Emotional Exhaustion as the dependent v a r i a b l e , a s i g n i f i c a n t r e l a t i o n s h i p (£ = .0342) was found with the WES subscale of C l a r i t y (Degrees of Freedom = 2, K r u s k a l - W a l l i s s t a t i s t i c = 6.75). The higher respondents scored on EE, the l e s s C l a r i t y they perceived i n t h e i r work environment. No other s i g n i f i c a n t r e l a t i o n s h i p s were found. With D e p e r s o n a l i z a t i o n , respondents scor i n g higher on t h i s burnout measure perceived s i g n i f i c a n t d i f f e r e n c e s i n Peer Cohesion (£ = .0404, DF = 2, K-W s t a t = 6.41) and Innovation (£ = .0210, DF = 2, K-W s t a t = 7.73). On the burnout measure of Personal Accomplishment, no s i g n i f i c a n t d i f f e r e n c e s were found on the WES subscales. K r u s k a l - W a l l i s t e s t s on the sample d i v i d e d by high (n = 9), average (n = 13), and low (n = 17) composite MBI found higher burntout workers p e r c e i v i n g l e s s C l a r i t y i n t h e i r work environment at a l e v e l of s i g n i f i c a n c e of £ = .0076 (DF 87 = 2, K-W s t a t = 9.76). No other r e l a t i o n s h i p s s i g n i f i c a n t at a £ < .1 were found. The second hypothesis, that workers viewing t h e i r work environments more n e g a t i v e l y w i l l score higher on burnout than co-workers, was test e d by d i v i d i n g the samples as described above and analyzing them by work group using the Mann-Whitney. In a follow-up a n a l y s i s , the K r u s k a l - W a l l i s was run f o r EE and composite MBI. Too few respondents f e l l i n t o the high DP and PA to permit comparable w i t h i n group a n a l y s i s by these v a r i a b l e s . Work group 1 (large day program, n = 8) had 4 workers sc o r i n g i n the low range on EE, 2 i n the average range, and 2 i n the high range. No r e l a t i o n s h i p s s i g n i f i c a n t at a £ = .1 l e v e l were found using the Mann-Whitney t e s t to compare the two high EE respondents with t h e i r remaining seven co-workers . The K r u s k a l - W a l l i s produced no r e l a t i o n s h i p s s i g n i f i c a n t at a l e v e l of £ < .05 on any WES s c a l e . Higher EE tended to see l e s s Supervisor Support (£ = .0771, DF = 2, K-W s t a t = 5.12) and greater Work Pressure (£ = .0695, DF = 2, K-W s t a t = 5.33) at a l e v e l of s i g n i f i c a n c e of £ < .1. Group 1 had no respondents scoring i n the high range of De p e r s o n a l i z a t i o n . Mann-Whitney comparisons of high composite MBI (n = 2) vs those i n the low-average range (n = 6) produced no r e l a t i o n s h i p s s i g n i f i c a n t at £ < .1 with the WES. However, the K r u s k a l - W a l l i s showed those s c o r i n g i n the average range rated t h e i r work environment as s i g n i f i c a n t l y 88 (p = .0253, DF =1, K-W s t a t = 5.0) lower on Innovation than low DP respondents. No s i g n i f i c a n t r e l a t i o n s h i p s were found between DP and the other WES s c a l e s and no r e l a t i o n s h i p s were noted between Personal Accomplishment and WES w i t h i n t h i s group. No workers i n the small day program (n = 5) scored high on any of the burnout measures and tended as a group to have very s i m i l a r perceptions of t h e i r work environment. There were no s i g n i f i c a n t r e l a t i o n s h i p between any MBI and WES v a r i a b l e s at £ < .1. This work group displayed very l i t t l e v a r i a t i o n on any of the MBI or WES measures. Therefore, i t i s l i k e l y that the lack of any r e l a t i o n s h i p s was simply due to the small numbers i n v o l v e d . Group 3 (day program, n = 9) had 3 s t a f f low i n EE, 4 average EE, and 2 high EE. The Mann-Whitney produced no s i g n i f i c a n t r e l a t i o n s h i p s between high EE and the WES. On the composite MBI, the high burntout s t a f f (n = 3) rated t h e i r work environments as lower i n Supervisor Support than low-average MBI (n = 6) at a £ = .0476 (• = .501evel of s i g n i f i c a n c e . They a l s o perceived l e s s Task O r i e n t a t i o n (U = 1.5) and l e s s C l a r i t y (U = 1.5) at £ = .0833 i n both cases. With the K r u s k a l - W a l l i s , no r e l a t i o n s h i p s s i g n i f i c a n t at £ < .05 were found but higher EE was associated with higher perceived C o n t r o l at £ = .0786 (DF = 2, K-W s t a t = 5.08). This group had no respondents scoring i n the high Depersonalization range and there were no r e l a t i o n s h i p s 89 between DP and the WES s i g n i f i c a n t at £ < .05. Average DP respondents saw t h e i r work environment as lower i n Task O r i e n t a t i o n at £ = .0528 (DF = 1, K-W s t a t = 3.75) and lower i n Supervisor Support at £ = .0933 (DF = 1, K-W s t a t = 2.81). No s i g n i f i c a n t r e l a t i o n s h i p s between Personal Accomplishment and WES were found i n group three. Group 4, a teen assessment centre (n = 9), had one respondent scor i n g i n the high EE range, 5 i n the average range, and 3 i n the low range. Group 4 had too few cases f o r a high EE vs low-average comparison using the Mann-Whitney. D i v i s i o n of t h i s group i n t o high vs low-average composite MBI produced no s i g n i f i c a n t r e l a t i o n s h i p s with work environment. Using the K r u s k a l - W a l l i s , no r e l a t i o n s h i p s between Emotional Exhaustion and the WES were s i g n i f i c a n t at a £ < .05 but higher EE respondents perceived l e s s C l a r i t y at a l e v e l of £ = .0671 (DF = 2, K-W = 5.40). No r e l a t i o n s h i p s between e i t h e r DP or PA were s i g n i f i c a n t at a £ < .1 l e v e l . Group 5, the teen treatment center (n = 8), had one s t a f f high i n EE, 4 i n the average range, and 3 low i n EE. This group had too few cases f o r a Mann-Whitney comparison by EE and no s i g n i f i c a n t r e l a t i o n s h i p s were found between composite MBI and WES with t h i s t e s t . This group had 2 s t a f f scoring high i n D e p e r s o n a l i z a t i o n , one i n the average range and 5 i n the low range. The K r u s k a l - W a l l i s showed no s i g n i f i c a n t r e l a t i o n s h i p s between Personal Accomplishment and any Work Environment Scale items at a l e v e l of £ < .1. One r e l a t i o n s h i p was s i g n i f i c a n t at a l e v e l of £ < .1; higher DP s t a f f perceived l e s s Innovation i n t h e i r work at a l e v e l of £ = .0907 (DF = 2, K-W s t a t = 4.8). A l l of these s t a t i s t i c a l l y s i g n i f i c a n t within-team f i n d i n g s are summarized below i n t a b l e IV. These r e s u l t s must be viewed as t e n t a t i v e since m u l t i p l e s i g n i f i c a n c e t e s t s of the r e l a t i o n s h i p between two v a r i a b l e s w i l l count some "chance" r e l a t i o n s h i p s as " s i g n i f i c a n t " . This i s due to type I e r r o r . 91 TABLE I I I Within-Group Comparisons on Median Scores between Burnout (MBI) and Work Environment (WES) Va r i a b l e s S i g n i f i c a n t at the .10 l e v e l  using the Mann-Whitney U t e s t Group 3 v a r i a b l e s U £ Composite MBI <Supervisor Support 750 .0476 <Task O r i e n t a t i o n 1.5 .0833 <C l a r i t y 1.5 .0833 V a r i a b l e s S i g n i f i c a n t at the .10 l e v e l using the K r u s k a l - W a l l i s t e s t Group 1 v a r i a b l e s K -W* £ DF** Depersonal-i z a t i o n (no high) <Innovation 5 .0 .0253 1 Emotional Exhaustion <Supervisor Support >Work Pressure 5 5 .12 .33 .0771 .0695 2 2 Group 3 v a r i a b l e s K' -W* £ DF** Emotional Exhaustion >Control 5 .08 .0786 2 Depersonal i z a t i o n (no high) <Task O r i e n t a t i o n <Supervisor Support 3 2 .75 .81 .0528 .0933 1 1 Group 4 v a r i a b l e s K--W* £ DF** Emotional Exhaustion < C l a r i t y 5 .40 .0671 2 Group 5 v a r i a b l e s K--W* £ DF** Depersonalization <Innovation 4 .8 .0907 2 note. K-W* = Kruskal-DF** = degrees -Wallis s t a t i s t i c of freedom 92 E. Exploratory Data A n a l y s i s Exploratory analyses were suggested by i n i t i a l d e s c r i p t i v e f i n d i n g s . They should be viewed as suggestive of hypotheses, not as t e s t s of hypotheses, since they are based on p r e l i m i n a r y f i n d i n g s . F i r s t , a l l the high Depersonalization respondents were found to be from the two r e s i d e n t i a l programs. This f i n d i n g i s not s u r p r i s i n g as the r e s i d e n t i a l centers deal with d i s t u r b e d , r e b e l l i o u s , or acting-out teens. As such, s t a f f i n these f a c i l i t i e s are t a r g e t s f o r t h e i r c l i e n t s angry behaviors, a s i t u a t i o n p l a c i n g extreme demands on s t a f f s a b i l i t y to maintain an empathic stance toward c l i e n t s . C l i e n t s f o r the day programs are disadvantaged (needing t r a i n i n g f o r parenting s k i l l s ) parents and and t h e i r preschool aged c h i l d r e n . C e r t a i n l y some of these c l i e n t s are considered " d i f f i c u l t " but on the whole they must be l e s s l i k e l y to engender depersonalized a t t i t u d e s i n s t a f f than the teen group. The second suggestive f i n d i n g was that the small day program (n = 5) contained no respondents scoring as high i n any MBI category. As w e l l , s t a f f i n t h i s program tended on the whole to perceive t h e i r work environment more uniformly p o s i t i v e than other groups. Some of t h i s lack of variance may a t t r i b u t a b l e to t h e i r lower numbers (5 versus 8 or 9). Nevertheless the notable d i f f e r e n c e s between t h i s program and the others along with the d i f f e r e n c e s between the target c l i e n t groups suggested a day versus r e s i d e n t i a l program comparison excluding the small s t a f f group. Consequently, 93 the procedures described above were r e p l i c a t e d w i t h i n subsamples of lar g e day (n = 17) versus r e s i d e n t i a l (n = 17) programs. R e s i d e n t i a l and Day Program Comparisons The two day programs were i d e n t i c a l contracted programs run by d i f f e r e n t agencies serving separate parts of town. Both had been p r o v i n c i a l l y run u n t i l 1984. One contained nine respondents, the other had e i g h t . One r e s i d e n t i a l program (n = 9) was a short term assessment and r e f e r r a l f a c i l i t y contracted out i n 1984. The other r e s i d e n t i a l program (n = 8) had been a p r i v a t e contract f o r s e v e r a l years but had experienced a r e o r g a n i z a t i o n and change of i t s parent n o n - p r o f i t agency i n 1982. Background d i f f e r e n c e s between r e s i d e n t i a l and day program respondents were: day program s t a f f were married longer; had more c h i l d r e n l i v i n g w ith them, and were s l i g h t l y higher i n educational attainment. Day program s t a f f were more l i k e l y to describe t h e i r area of work " s o c i a l s e r v i c e " while r e s i d e n t i a l s t a f f were more l i k e l y to describe t h e i r work area as " c o u n s e l l i n g " . R e s i d e n t i a l s t a f f had s i g n i f i c a n t l y more annual leave, worked longer hours (36.4 v 33.8), and attended fewer weekly s t a f f meetings than day program s t a f f . Mean age between the groups was s i m i l a r (R = 35.2 / D = 35.4) as was r e l i g i o u s i t y (4.1 v 4.5) and years i n the f i e l d (9.8 v 9.1). The greatest v a r i a t i o n between the groups was i n sex 94 composition. Day programs were s t a f f e d with 71% women while women made up 47% of the s t a f f i n r e s i d e n t i a l programs. The Mann-Whitney t e s t f o r s i g n i f i c a n t d i f f e r e n c e s about the median was run comparing high versus moderate and low scorers on Emotional Exhaustion, D e p e r s o n a l i z a t i o n , and Personal Accomplishment f o r r e s i d e n t i a l , day program, and the t o t a l group (n = 34, minus the small day program). Results are tabulated below: TABLE IV Comparisons Between Burnout (MBI) and Work Environment (WES) Va r i a b l e s S i g n i f i c a n t at the P = Using the Mann-Whitney .10 Level U f o r t o t a l r e s i d e n t i a l & day program (n = MBI v a r i a b l e s WES 34) U £ Depersonalization >Control 45.5 .0222 Emotional Exhaustion <Task O r i e n t a t i o n 60.5 .0703 f o r r e s i d e n t i a l program (n = 17) MBI v a r i a b l e s WES U £ Personal <Physical Comfort Accomplishment 4.5 .0147 f o r day program (n = 17) MBI v a r i a b l e s WES U £ Emotional Exhaustion <Supervisor Support 7.5 .0987 <Task O r i e n t a t i o n 13.0 .0525 Personal >Work Pressure Accomplishment 12.0 .0824 As i n the e a r l i e r f i n d i n g s , the most notable aspect of these d i f f e r e n c e s i n perceptions of the work environment between high burnout workers those s c o r i n g low i s the lack 95 of consistency i n r e s u l t s when workers are compared with the t o t a l sample and when compared with t h e i r smaller reference groups. That r e s i d e n t i a l workers r a t i n g lower on Personal Accomplishment perceived lower l e v e l s of P h y s i c a l Comfort i s enigmatic and l i k e l y represents a spurious f i n d i n g . The K r u s k a l - W a l l i s t e s t f o r d i f f e r e n c e s about the median between between low, moderate, and high scores on the MBI was d u p l i c a t e d . The r e s u l t s are presented i n the t a b l e below. TABLE V Comparisons Between Burnout (MBI) and Work Environment (WES) Va r i a b l e s S i g n i f i c a n t at the P = .10 Level Using the K r u s k a l - W a l l i s Test t o t a l r e s i d e n t i a l & MBI v a r i a b l e s day programs (n = WES 34) K-W* £ DF** Depersonalization <Peer Cohesion 6.78 .0336 2 <Innovation 6.25 .0439 2 r e s i d e n t i a l program MBI v a r i a b l e s (n = 17) WES K-W* £ DF** Emotional Exhaustion <Involvement < C l a r i t y 6.08 6.28 .0476 .0432 2 2 Personal Accomplishment <Physical Comfort 6.97 .0305 2 day program (n = 17) MBI v a r i a b l e s WES K-W* £ DF** Emotional Exhaustion <Supervisor Support 4.81 .0899 2 Depersonalization <Peer Cohesion 2.91 .0875 2 note. K-W* = K r u s k a l - W a l l i s s t a t i s t i c DF** = degrees of freedom The Kruskal-Whitney exposes more i n t e r - a c t i v i t y between the MBI and WES by t e s t i n g f o r d i f f e r e n c e s across a broader range of burnout l e v e l s . The lack of consistency between t o t a l sample r e s u l t s and reference group r e s u l t s i s repeated. The r e s u l t s are stronger i n the above comparisons. The sample i s grouped i n t o two subsamples each cont a i n i n g two work groups with very s i m i l a r environments. The v a r i a t i o n between the subsamples (n = 17) i s r e l a t i v e l y minor and known; c l i e n t group, sexual composition, s h i f t work versus nine to f i v e , m a r i t a l s t a t u s , frequency of s t a f f meetings, and annual leave. The i m p l i c a t i o n i s that the d i f f e r e n c e s i n perceptions of work environments are narrowed down to these v a r i a b l e s . The r e s i d e n t i a l s t a f f contained a l l respondents s c o r i n g high on Depersonalization yet no s i g n i f i c a n t d i f f e r e n c e s i n perceptions of work environment were revealed between high, moderate and low co-workers on the Kruskal-Whitney. I t i s c l e a r that "type of c l i e n t group" has an important r e l a t i o n s h i p to f e e l i n g s of a l i e n a t i o n from c l i e n t s (DP). Low (n = 6), moderate (n = 9), and high (n = 2) Emotional Exhaustion respondents from the r e s i d e n t i a l programs d i f f e r e d on Involvement .(£ = .0476) and C l a r i t y (£ = .0432). On both v a r i a b l e s most of the variance was from the moderate category where f i v e of the nine rated these environmental f a c t o r s lower than e i t h e r high or low EE respondents. I t i s important to note that there i s no 97 l i n e a r r e l a t i o n s h i p where t h e h i g h e r t h e EE t h e l o w e r t h e p e r c e i v e d I n v o l v e m e n t and C l a r i t y . S i g n i f i c a n t d i f f e r e n c e s (£ = .0305) i n P h y s i c a l C o m f o r t w i t h i n t h e r e s i d e n t i a l g r o u p were r e p e a t e d w i t h t h e K r u s k a l -W a l l i s . I n t h i s i n s t a n c e , t h e h i g h e r t h e w o r k e r s c o r e d i n P e r s o n a l A c c o m p l i s h m e n t , t h e h i g h e r t h e y r a t e d t h e i r p h y s i c a l e n v i r o n m e n t . T h i s i s t h e o n l y f i n d i n g w h i c h m i g h t s u g g e s t a l a c k o f d i s c r i m i n a t i o n b e t w e e n t h e WES and MBI. P e r h a p s t h e l e s s s a t i s f a c t i o n and a c c o m p l i s h m e n t w o r k e r s f e e l t h e more l i k e l y t h e y a r e t o c o m p l a i n a b o u t t h e d e c o r , l i g h t i n g , h e a t i n g , and v e n t i l a t i o n . The a p p a r e n t s p e c i f i c i t y o f t h e WES i n d i s c r i m i n a t i n g b e t w e e n r e s i d e n t i a l a n d day p r o g r a m work e n v i r o n m e n t s s u g g e s t e d a c o m p a r i s o n o f t h e two s u b s a m p l e s a c r o s s a l l t h e MBI and WES v a r i a b l e s . C o n s e q u e n t l y , t h e M ann-Whitney U was r u n t o t e s t f o r s i g n i f i c a n t d i f f e r e n c e s a b o u t t h e m e d i a n on a l l t h e WES and MBI v a r i a b l e s b e t w e e n t h e r e s i d e n t i a l a n d d a y p r o g r a m s . No d i f f e r e n c e s were f o u n d i n MBI s c o r e s . The d i f f e r e n c e s i n WES s c o r e s a r e t a b u l a t e d b e l o w . 98 TABLE V I M a n n-Whitney U T e s t f o r S i g n i f i c a n t D i f f e r e n c e s A b o u t t h e M e d i a n b e t w e e n t h e Day (n = 17) and R e s i d e n t i a l P r o g r a m s (n = 17) on t h e Work E n v i r o n m e n t S c a l e WES V a r i a b l e R e s u l t £ U I n v o l v e m e n t day p r o g r a m h i g h e r £ = .0019 <u = 60 .0) Autonomy day p r o g r a m h i g h e r £ = .0194 (u = 78 .0) Work P r e s s u r e day p r o g r a m h i g h e r £ = .0174 (u = 76 .0) C o n t r o l day p r o g r a m l o w e r £ = .0006 = 47 .5) I n n o v a t i o n d a y p r o g r a m h i g h e r £ = .0103 = 71 .0) T h e s e r e s u l t s a r e c o n s i s t e n t w i t h e x p e c t e d d i f f e r e n c e s b e t w e e n t h e two t y p e s o f p r o g r a m s . W o r k e r s i n r e s i d e n t i a l p r o g r a m s f o r y o u t h work i n a day t o d a y , l i v i n g s i t u a t i o n w i t h t h e i r c l i e n t s and d e a l w i t h f e w e r numbers o f c l i e n t s t h a n w o r k e r s i n t h e day p r o g r a m s . C o n s e q u e n t l y , t h e work p r e s s u r e w o u l d be e x p e c t e d t o be l o w e r t h a n i n t h e day p r o g r a m s where l a r g e r numbers o f p a r e n t s and c h i l d r e n a r e d e a l t w i t h i n a s h o r t e r s p a n o f t i m e . W o r k i n g i n a r e s i d e n t i a l p r o g r a m means t h a t b r i e f p e r i o d s o f c o u n s e l l i n g t a k e p l a c e w i t h i n l o n g p e r i o d s o f c u s t o d i a l c a r e . T hus l o w e r r a t i n g s on I n v o l v e m e n t , Autonomy, and I n n o v a t i o n a r e t o be e x p e c t e d f o r t h e r e s i d e n t i a l w o r k e r s . The h i g h e r r a t i n g on C o n t r o l f o r r e s i d e n t i a l w o r k e r s i s l i k e l y r e l a t e d t o t h e r i g i d demands o f s h i f t work and t h e 99 importance of s t a f f consistency i n working with c h i l d r e n . The n e c e s s i t y of a f i r m r u l e s t r u c t u r e i n r e s i d e n t i a l centers places c o n s t r a i n t s on the a b i l i t y of s t a f f to e x e r c i s e autonomy and experiment with c r e a t i v e s o l u t i o n s ; i n other words, they are as governed by the "house r u l e s " as the c h i l d r e n . Comparison with the S a v i c k i & Cooley Findings Because of the s i m i l a r i t y i n both instruments and type of sample between t h i s research and a study published e a r l i e r by S a v i c k i & Cooley (1987), some comparisons are made between the f i n d i n g of the present study and the e a r l i e r research. S a v i c k i & Cooley (1987) had examined the r o l e of the moderator v a r i a b l e of "amount of d i r e c t c l i e n t contact" i n an examination of the r e l a t i o n s h i p between work environment and burnout. Amount of d i r e c t c l i e n t contact i s not a v a r i a b l e i n t h i s research but i s simulated by d i v i d i n g the sample i n t o l i n e versus a d m i n i s t r a t i v e and supervisory s t a f f . S a v i c k i & Cooley (1987:251) had noted that "The d i s t i n c t i o n between high and low contact workers was p r i m a r i l y one between the r o l e of "on l i n e " workers versus the r o l e of supervisors and a d m i n i s t r a t o r s . " S a v i c k i & Cooley (1987) c o r r e l a t e d the composite MBI score with WES and found a s i g n i f i c a n t (£ < .05) r e l a t i o n s h i p with 28 of the 40 p o s s i b l e and with 8 of the 10 (£ < .01) WES subscales using the MBI composite. The only s c a l e s not c o r r e l a t i n g s i g n i f i c a n t l y were P h y s i c a l Comfort 100 and Work Pressure. Using the t o t a l study sample (n = 39), only 7 of the 40 r e l a t i o n s h i p s were s i g n i f i c a n t at £ < .05 and only one r e l a t i o n s h i p , with C l a r i t y (£ < .01) was noted with the composite MBI. In t o t a l , f i v e of the ten WES s c a l e s c o r r e l a t e d s i g n i f i c a n t l y w i t h the four MBI measures. No s i g n i f i c a n t r e l a t i o n s h i p s were found with Personal Accomplishment. These r e s u l t s are given i n table V I I I below. TABLE VII T o t a l Sample C o r r e l a t i o n s between Burnout and the Work Environment Scale at P < .05. Maslach Burnout Inventory - R - Work Environment Scale Composite MBI Emotional Exhaustion Depersonalization -.4302 -.4288 .3879 -.3318 -.3616 -.3384 -.3293 C l a r i t y C l a r i t y Work Pressure Supervisor Support Innovation Peer Cohesion C l a r i t y Note. For a l l items: N = Degrees of Freedom = R @ .0500 = 39 37 .3160 101 The most notable d i f f e r e n c e between the r e s u l t s of the two s t u d i e s i s on the composite MBI score. In the S a v i c k i & Cooley sample (1987), t h e i r "summary MBI" was apparently more h i g h l y c o r r e l a t e d with the WES. The a r t i c l e d i d not s p e c i f y how the three MBI scores were t r a n s l a t e d i n t o t h i s summary score. They may have used a d i f f e r e n t formula accounting f o r some of the d i f f e r e n c e . Otherwise, the d i f f e r e n c e i n sample s i z e s may be r e s p o n s i b l e . S a v i c k i & Cooley (1987) ran a stepwise m u l t i p l e regression with EE, DP, and PA against WES sc a l e s and then ran separate m u l t i p l e regressions of MBI against WES f o r high and low contact workers. The small sample s i z e of t h i s study d i d not allow f o r a r e p l i c a t i o n of these procedures however the Mann-Whitney U t e s t f o r s i g n i f i c a n t d i f f e r e n c e s about the median between l i n e workers (n = 26) and super v i s o r s and a d m i n i s t r a t o r s (n = 8) was run. The Mann-Whitney U found no s i g n i f i c a n t d i f f e r e n c e s between these subsamples on work environment. 102 C h a p t e r V I - C o n c l u s i o n A. C o n c l u s i o n s The f i n d i n g s o f t h i s r e s e a r c h s u g g e s t t h a t b u r n o u t i s c o m p l e x l y r e l a t e d t o t h e work e n v i r o n m e n t . E i g h t o f t h e t e n WES s u b - s c a l e i t e m s were i d e n t i f i e d i n a n e g a t i v e d i r e c t i o n by w o r k e r s e x p e r i e n c i n g h i g h e r l e v e l s o f b u r n o u t a t £ < .10 o r b e t t e r l e v e l s o f s i g n i f i c a n c e . N e g a t i v e d i r e c t i o n on t h e WES i s c o n s i d e r e d t o be l o w e r on t h e s c a l e s o f i n v o l v e m e n t , p e e r c o h e s i o n , s u p e r v i s o r s u p p o r t , t a s k o r i e n t a t i o n , c l a r i t y , i n n o v a t i o n , and p h y s i c a l c o m f o r t , and h i g h e r on t h e s c a l e s o f work p r e s s u r e and c o n t r o l . T h i s c o m p l e x i t y i s f u r t h e r s u g g e s t e d by t h e f a c t t h a t t h e K r u s k a l - W a l l i s t e s t e x a m i n i n g t h e s a m p l e by h i g h , a v e r a g e , and l o w l e v e l s o f b u r n o u t f o u n d no r e s u l t s i n common a t £ < .05 w i t h t h e Mann-W h i t n e y t e s t c o m p a r i n g h i g h w i t h a v e r a g e - l o w s u b - s a m p l e s . The t e s t o f t h e f i r s t h y p o t h e s i s , t h a t h i g h l y b u r n e d o u t w o r k e r s w i l l r a t e t h e i r work e n v i r o n m e n t more n e g a t i v e l y , i s n o t c o n c l u s i v e . U s i n g t h e s t r i c t e s t i n t e r p r e t a t i o n , t h a t i s , o n l y c o m p a r i n g h i g h E m o t i o n a l E x h a u s t i o n o r C o m p o s i t e MBI ( t h e most s a l i e n t b u r n o u t i n d i c a t o r s ) w i t h t h e r e s t o f t h e s a m p l e (Mann-Whitney t e s t o f h i g h v s l o w - a v e r a g e ) a t a £ < .05 s i g n i f i c a n c e l e v e l , p r o d u c e s t h e r e s u l t : h i g h l y b u r n e d o u t w o r k e r s i n t h e s t u d y s a m p l e p e r c e i v e l e s s S u p e r v i s o r S u p p o r t t h a n l o w - a v e r a g e 103 w o r k e r s . C o n s e q u e n t l y , h y p o t h e s i s 1 i s n o t s u p p o r t e d f o r a l l WES s u b s c a l e i t e m s e x c e p t S u p e r v i s o r S u p p o r t . T a k i n g D e p e r s o n a l i z a t i o n a s t h e b u r n o u t i n d i c a t o r p r o d u c e s t h e f i n d i n g t h a t " w o r k e r s w i t h h i g h e r l e v e l s o f DP see t h e i r work e n v i r o n m e n t as l o w e r i n I n n o v a t i o n and h i g h e r i n C o n t r o l . " T h e s e h i g h DP r e s p o n d e n t s (n = 4) were a l l s t a f f members i n t h e r e s i d e n t i a l p r o g r a m s w h i c h had much h i g h e r means on DP t h a n t h e day p r o g r a m s ( p e r h a p s due t o a l e s s a t t r a c t i v e c l i e n t g r o u p ) . C o n s i d e r i n g t h a t t h e h i g h DP were i n r e a l i t y a s u b - s a m p l e o f g r o u p s f o u r and f i v e o n l y , t h i s v a r i a t i o n on I n n o v a t i o n and C o n t r o l by c o m p a r i n g h i g h DP w i t h t h e t o t a l s a m p l e must be v i e w e d w i t h c a u t i o n . ( B e t t e r t o compare h i g h DP a g a i n s t t o t a l g r o u p s 4 and 5.) T o t a l s a m p l e c o m p a r i s o n s u s i n g t h e K r u s k a l - W i l l i s ( a t £ < .05 & d i s r e g a r d i n g DP f o r t h e r e a s o n s d i s c u s s e d a b o v e ) were s u g g e s t i v e . B o t h E m o t i o n a l E x h a u s t i o n and c o m p o s i t e MBI were a s s o c i a t e d w i t h p e r c e p t i o n s o f l e s s C l a r i t y i n t h e work e n v i r o n m e n t . ( T h i s i s n o t r e a l l y a " d o u b l e f i n d i n g " a s h i g h EE and h i g h c o m p o s i t e MBI r e s p o n d e n t s were a l m o s t i d e n t i c a l . ) The f i n d i n g i s " t h e h i g h e r a s t a f f p e r s o n p l a c e d a l o n g l o w - a v e r a g e - h i g h EE, t h e more l i k e l y t h e y were t o r a t e t h e i r work e n v i r o n m e n t a s l o w e r i n C l a r i t y ." C l a r i t y r e f e r s t o t h e p r e d i c t a b i l i t y o f d a i l y r o u t i n e s and how e x p l i c i t l y r u l e s and p o l i c i e s a r e c o m m u n i c a t e d . S t u d i e s u s i n g t h e MBI and t h e WES c o n s i s t e n t l y i d e n t i f y C l a r i t y a s an i m p o r t a n t c o r r e l a t e o f b u r n o u t b u t a r e m i x e d i n t h e e m p h a s i s p l a c e d on i t s i m p o r t a n c e . B e r k l e y P l a n n i n g 104 Associates (1977) and Rosenthal e t . a l . (1983) found C l a r i t y h i g h l y associated with burnout while MacMillan & Hunnicutt (1983) and S a v i c k i & Cooley (1987) place a low p r i o r i t y ( r e l a t i v e to other WES) on t h i s dimension. Applying the same s t r i c t t e s t to the second hypothesis, that h i g h l y burned out workers w i l l perceive t h e i r work environment more n e g a t i v e l y , produces the r e s u l t : h i g h l y burned out workers i n group 3 perceive l e s s Supervisor Support than co-workers. Therefore, hypothesis 2 i s not supported f o r a l l the co-worker groups except group 3 where the hypothesis i s r e j e c t e d f o r a l l WES items except Supervisor Support. Both the f i n d i n g s f o r Supervisor Support were produced using the v a r i a b l e , composite MBI. Maslach & Jackson (1981) warn against combining the MBI subscales so these r e s u l t s must be i n t e r p r e t e d with c a u t i o n . Numerous st u d i e s have i d e n t i f i e d the important r o l e s upervisors play in e i t h e r preventing or f a c i l i t a t i n g burnout i n t h e i r s t a f f (Berkley Planning A s s o c i a t e s , 1977; Daley, 1979; Brady e t . a l . , 1980; Borland, 1981; Rosenthal e t . a l . , 1983; MacMillan & Hunnicutt, 1983; S a v i c k i & Cooley, 1987). Supervisor Support i s one aspect of the work environment that i s more r e l a t e d to an i n d i v i d u a l r e l a t i o n s h i p (the respondent and t h e i r supervisor) than to the general group m i l i e u . The i m p l i c a t i o n i s that two workers on the same team could be experiencing very d i f f e r e n t q u a l i t i e s of s u p e r v i s i o n . 105 The l a c k o f s u p p o r t f o r t h e f i r s t two h y p o t h e s e s s u b s t a n t i a t e s t h e c o n c e p t u a l and e x p e r i m e n t a l i n d e p e n d e n c e o f t h e WES and MBI and h e n c e , s u p p o r t t h e t h i r d h y p o t h e s i s , t h a t work e n v i r o n m e n t v a r i a b l e s s i g n i f i c a n t l y r e l a t e d t o l e v e l s o f b u r n o u t i n w o r k e r s w i l l v a r y by s p e c i f i c work s i t e . O v e r a l l , t h e two i n s t r u m e n t s a p p e a r t o m e asure q u i t e d i f f e r e n t s u b j e c t i v e p e r c e p t i o n s o f r e s p o n d e n t s . A u n i v a r i a t e a n a l y s i s o f v a r i a n c e r u n on t h e t h r e e MBI and t e n WES v a r i a b l e s by g r o u p s u p p o r t t h i s c o n t e n t i o n . None o f t h e g r o u p s d i f f e r e d s i g n i f i c a n t l y on t h e MBI i t e m s y e t t h e r e was v a r i a n c e a t p < .01 on s i x o f t h e 10 WES s u b s c a l e s . I n v o l v e m e n t , S u p e r v i s o r S u p p o r t and C l a r i t y v a r i e d by g r o u p a t p = .0310, £ = .0774 and £ = .0735 r e s p e c t i v e l y . V a r i a n c e b e t w e e n g r o u p s on P e e r C o h e s i o n was s i g n i f i c a n t a t £ = .1079. D i f f e r e n t work e n v i r o n m e n t s w o u l d be e x p e c t e d t o p r o d u c e a r a n g e o f r e s u l t s on a s c a l e v a l i d l y m e a s u r i n g t h o s e e n v i r o n m e n t s w h i l e s i m i l a r l e v e l s o f b u r n o u t w o u l d be e x p e c t e d i n w o r k e r s d o i n g s i m i l a r j o b s . As i t w e r e , when WES i t e m s were a s s o c i a t e d w i t h MBI s c o r e s , i t was s e l e c t i v e l y by g r o u p and t y p e o f b u r n o u t ( i . e . EE, DP, & PA) . B. I m p l i c a t i o n s f o r I n t e r v e n t i o n and R e s e a r c h U s i n g t h e WES and MBI t o g e t h e r c a n p r o v i d e a v e r y s p e c i f i c d i a g n o s t i c p i c t u r e f o r b o t h i n d i v i d u a l s and t e a m s . A work team s c o r i n g u n i f o r m l y h i g h on an MBI i t e m w i t h s i m i l a r p e r c e p t i o n s o f an e n v i r o n m e n t a l d e f i c i e n c y w o u l d 106 provide a very s p e c i f i c p r e s c r i p t i o n . In t h i s case the targ e t f o r i n t e r v e n t i o n would be improvement of the environment a t t r i b u t e . Various means could be employed to use the WES and MBI i n working to prevent burnout i n teams of workers. At one l e v e l , i n d i v i d u a l s might s e l f - a d m i n i s t e r and score the s c a l e s to gain an understanding of t h e i r l e v e l of burnout and t h e i r f e e l i n g s toward the work environment. I d e a l l y , teams would work together and pool t h e i r r e s u l t s on the MBI and WES perhaps f o l l o w i n g a "nominal group process" as described by Johnson & Richards (1983). This i s a small group decision-making process o f f e r i n g a s t r u c t u r e d method f o r problem i d e n t i f i c a t i o n and r e s o l u t i o n and i n v o l v e s p a r t i c i p a n t s i n d e f i n i n g and s o l v i n g t h e i r own problems. Using a method such as a nominal group process has obvious b e n e f i t s based on p r i o r research f i n d i n g s . Berkley Planning Associates (1977) were the f i r s t to note that " c e n t r a l i z e d d e c i s i o n making" was s i g n i f i c a n t l y r e l a t e d to burnout. Hunnicutt & Macmillan's (1983) f i n d i n g that "involvement i n program development" was an important causal f a c t o r i n reducing l e v e l s of burnout supported the e a r l i e r f i n d i n g and points out the need f o r work teams to be a c t i v e l y involved i n e x e r c i s i n g c o n t r o l over t h e i r work environment to prevent burnout. Using a methodology l i k e a nominal group process to involve workers i n ongoing program development to prevent burnout i s described by the "environment" h a l f of the two 107 dimensional framework. Engaging i n an i n t e r a c t i v e group process i s one means of f o r g i n g a shared, communal group r e a l i t y discussed under the subjective-environmental quadrant. When such a group has as an option making i n t e r v e n t i o n s i n t h e i r o b j e c t i v e work environment, then they are i n t e r v e n i n g i n the objective-environmental quadrant. The development of an e x i s t e n t i a l perspective on burnout has a l s o been productive i n suggesting avenues f o r i n t e r v e n t i o n . None of the burnout i n t e r v e n t i o n research has deal t with working with the s u b j e c t i v e , e x p e r i e n t i a l l i f e -world of workers. Forman (1983) has come close with a suggestion f o r " c o g n i t i v e - b e h a v i o r a l programs" to develop coping s k i l l s i n i n d i v i d u a l s . C o g n i t i v e - b e h a v i o r a l approaches are developed from b e h a v i o r i s t psychology and involve a conscious attempt to modify ones own behavior through a form of s e l f - d i a l o g u e . Despite i t s s c i e n t i f i c t h e o r e t i c a l f o r m u l a t i o n , t h i s approach i s i n r e a l i t y a form of "refraining" where subjects are taught to view events, i n the work i n a d i f f e r e n t p e r s p e c t i v e . In e f f e c t , the worker i s provided with a "new c o g n i t i v e framework" f o r understanding s t r e s s f u l s t i m u l i from the work environment. This amounts to working with a workers s u b j e c t i v e l i f e - w o r l d to a l t e r the way they i n t e r p r e t experience and provides a means of in t e r v e n i n g i n the s u b j e c t i v e i n d i v i d u a l quadrant. A d d i t i o n a l l y , t h i s study has reaffirmed the connection between le a d e r s h i p and s u p e r v i s i o n and l e v e l s of burnout i n s t a f f . Every study on burnout which has examined the r o l e 108 o f s u p e r v i s i o n h a s f o u n d t h a t i t i s a k e y c o r r e l a t e o f b u r n o u t r e g a r d l e s s o f what method o r i n s t r u m e n t was u s e d t o e x a m i n e t h e work e n v i r o n m e n t . D e s p i t e t h e m e t h o d o l o g i c a l l i m i t a t i o n s o f t h e p r e s e n t s t u d y , l o w e r p e r c e p t i o n s o f s u p e r v i s o r s u p p o r t was c o n s i s t e n t l y a s s o c i a t e d w i t h h i g h e r l e v e l s o f b u r n o u t . T h i s s t u d y h a s d e m o n s t r a t e d t h e a t t r a c t i v e p o t e n t i a l o f u s i n g t h e work e n v i r o n m e n t and b u r n o u t m e a s u r e s t o g e t h e r t o g u i d e i n t e r v e n t i o n i n work t e a m s . More work i s n e e d e d t o e x p l o r e t h e f u l l r a n g e o f p o s s i b i l i t i e s and l i m i t a t i o n s b u t t h e p o t e n t i a l a p p l i c a t i o n s t o b u r n o u t i n t e r v e n t i o n a r e p r o m i s i n g . P e r h a p s t h e most i m p o r t a n t i m p l i c a t i o n f o r f u t u r e b u r n o u t r e s e a r c h i l l u s t r a t e d by t h e p r e s e n t s t u d y i s s i m p l y t h e r e l i a b i l i t y , e f f i c i e n c y , and a c c u r a c y o f b o t h t h e M a s l a c h B u r n o u t I n v e n t o r y and t h e Work E n v i r o n m e n t S c a l e . T h e s e i n s t r u m e n t s a r e p o w e r f u l m e a s u r e s o f b u r n o u t and work e n v i r o n m e n t w h i c h p r o v i d e r e s e a r c h e r s w i t h e x c e l l e n t , e a s i l y a d m i n i s t e r e d t o o l s f o r r e s e a r c h . The a b i l i t y o f t h e WES t o g e n e r a t e a c c u r a t e p i c t u r e s o f t h e work e n v i r o n m e n t r e l a t i v e l y u n c o n t a m i n a t e d by l e v e l s o f b u r n o u t i n r e s p o n d e n t s i s e s p e c i a l l y i m p o r t a n t f o r b o t h r e s e a r c h and i n t e r v e n t i o n . The two d i m e n s i o n a l f r a m e w o r k f o r v i e w i n g b u r n o u t d e v e l o p e d i n t h i s s t u d y may a l s o some p r o m i s e f o r f u t u r e b u r n o u t r e s e a r c h . V i e w i n g b u r n o u t a s e x i s t i n g a l o n g c o n t i n u u m s o f i n d i v i d u a l - e n v i r o n m e n t a l and s u b j e c t i v e -109 o b j e c t i v e d o e s n o t c o n s t i t u t e a " m o d e l " o f b u r n o u t i n t h e u s u a l s e n s e . The c o n c e p t o f b u r n o u t a s i t i s p r e s e n t l y d e f i n e d and d e v e l o p e d i s s t i l l v e r y b r o a d and d i v e r s e . As s u c h , i t d e f i e s a t t e m p t s a t e x p l a n a t i o n u s i n g s i m p l e c a u s a l m o d e l s and t h e b r o a d m o d e l s w h i c h have been d e v e l o p e d a r e c l u t t e r e d w i t h v a r i a b l e s . The two d i m e n s i o n a l f r a m e w o r k o f f e r s a g e n e r a l p a r a d i g m f o r o r g a n i z i n g b o t h b u r n o u t v a r i a b l e s , t h e o r e t i c a l p e r s p e c t i v e s , and s i m p l e c a u s a l m o d e l s . As s u c h , t h e fr a m e w o r k o f f e r s a s i m p l e r way o f c a t e g o r i z i n g b u r n o u t r e s e a r c h w i t h t h e p o t e n t i a l o f l e a d i n g t o a u n i f i e d model o r p e r h a p s p a r t i a l m o d e l s d e s c r i b i n g one o r two q u a d r a n t s . And f i n a l l y , t h e p r e s e n t s t u d y h a s h i g h l i g h t e d t h e n e e d f o r more s t u d i e s e x a m i n i n g b u r n o u t o v e r t i m e . B u r n o u t r e s e a r c h h a s r e a c h e d a p l a t e a u where any i m p o r t a n t a d v a n c e s must come f r o m l o n g i t u d i n a l s t u d i e s . The q u e s t i o n s w h i c h s t i l l n e e d a n s w e r i n g a r e : Do a l l w o r k e r s b u r n o u t and t o what d e g r e e ? How c a n b u r n o u t be u n d e r s t o o d i n a d e v e l o p m e n t a l c o n t e x t and c a n i t have a p o s i t i v e , e d u c a t i v e i m p a c t on w o r k e r s ? I s t h e a v e r a g e 15% o f h i g h l y b u r n e d o u t s t a f f a s t a b l e g r o u p , do t h e same w o r k e r s t e n d t o b u r n o u t o v e r and o v e r , and i s b u r n o u t a c h r o n i c o n g o i n g c o n d i t i o n f o r a few w o r k e r s ? And F i n a l l y , do e n v i r o n m e n t a l f a c t o r s r e l a t i n g t o b u r n o u t c h a n g e o v e r t i m e a n d , i f s o , how? 110 C. Summary T h i s s t u d y h a s r e v i e w e d t h e e x t e n s i v e l i t e r a t u r e on b u r n o u t and t r a c e d t h e o r i g i n s and d e v e l o p m e n t o f t h e c o n c e p t . A number o f d i f f e r e n t t h e o r i e s and p e r s p e c t i v e s were e x a m i n e d and a two d i m e n s i o n a l f r a m e w o r k f o r o r g a n i z i n g b u r n o u t v a r i a b l e s and t h e o r y was d e v e l o p e d and p r e s e n t e d . T h i s f r a m e w o r k c l a s s i f i e s b u r n o u t a l o n g c o n t i n u u m s o f s u b j e c t i v e v e r s u s o b j e c t i v e a nd i n d i v i d u a l v e r s u s e n v i r o n m e n t a l and was u s e d t o o r g a n i z e and g u i d e t h e r e s e a r c h . The r e s e a r c h component o f t h i s s t u d y s o u g h t t o e x p l o r e t h e p o s s i b i l i t i e s f o r i n t e r v e n t i o n i n t h e work e n v i r o n m e n t t o r e d u c e b u r n o u t and t o i l l u s t r a t e t h e f e a s i b i l i t y o f u s i n g t h e M a s l a c h B u r n o u t I n v e n t o r y and t h e Work E n v i r o n m e n t S c a l e f o r t h e a s s e s s m e n t o f b u r n o u t and t h e d i r e c t i o n o f e f f o r t s f o r i n t e r v e n i n g i n t h e work e n v i r o n m e n t s o f t h e a g e n c i e s s t u d i e d . A l t h o u g h t h e r e s u l t s o f t h e s t u d y a r e l i m i t e d i n s c o p e and g e n e r a l i z a b i l i t y , t h e o v e r a l l i n d i c a t i o n i s t h a t u s i n g r e l i a b l e m e a s u r e s o f b u r n o u t and work e n v i r o n m e n t t o g e t h e r i s a p r o d u c t i v e a p p r o a c h f o r i n t e r v e n i n g i n m i c r o -work e n v i r o n m e n t s t o p r e v e n t b u r n o u t . I l l BIBLIOGRAPHY Barad, C. B. (1979). Study of burnout syndrome among S o c i a l S e c u r i t y A d m i n i s t r a t i o n f i e l d p u b l i c contact employees. Unpublished r e p o r t . Washington, DC: S o c i a l S e c u r i t y A d m i n i s t r a t i o n . Berkley Planning A s s o c i a t e s . (1977) Evaluation of C h i l d Accuse and Neglect Demonstration P r o j e c t s . V o l . IX, P r o j e c t Management and Worker Burnout. N a t i o n a l Technical Information S e r v i c e , S p r i n g f i e l d , VA. Report #PB-278 446, December 1977. 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Jones (Ed.) The Burnout Syndrome: Current  Research, Theory, I n t e r v e n t i o n s , (pp. 166-171). Park Ridge IL: London House. 116 Rosenthal, D., Teague, M., R e t i s h , P., West, J . & V e s s e l l , R. (1983). The r e l a t i o n s h i p between work environment a t t r i b u t e s and burnout. Journa l of  Leis u r e Research, 15, 125-135. Ryerson, D. & Marks, N. (1982). Career burnout i n the human s e r v i c e s : S t r a t e g i e s f o r i n t e r v e n t i o n . In J.W. Jones (Ed.) The Burnout Syndrome: Current  Research, Theory, I n t e r v e n t i o n s , (pp. 151-163). Park Ridge IL: London House. S a v i c k i , V.. & Cooley, E. (1983). T h e o r e t i c a l and research c o n s i d e r a t i o n s of burnout. C h i l d r e n and  Youth Services Review, 5, 227-238. S a v i c k i , V.. & Cooley, E. (1987). The r e l a t i o n s h i p of work environment and c l i e n t contact to burnout i n mental h e a l t h p r o f e s s i o n a l s . J o u r n a l of  Coun s e l l i n g and Development, 65, 249-252. S c u l l y , R. (1983). The work-setting group: A means of preventing burnout. In Faber, B.A. (Ed.). Stress  and Burnout i n the Human Service P r o f e s s i o n s (pp. 188-197). New York: Pergamon Press. Shapiro, C.H. (1982). Creative s u p e r v i s i o n : An u n d e r u t i l i z e d a n t i d o t e . In W.S. Paine (Ed.), Job  Stress and Burnout: Research, Theory, and  In t e r v e n t i o n P e r s p e c t i v e s (pp. 213-228). Beverly H i l l s : Sage. Weinberg, S., Edwards, G. & Garove, W.E. (1983). Burnout Among Employees of State R e s i d e n t i a l F a c i l i t i e s Serving Developmentally Disabled Persons. Chi l d r e n s and Youth Services Review, 5, 239-253. Woodsworth, D. (1983). S o c i a l work: A dying chameleon: Comments on an a r t i c l e on burnout. The  S o c i a l Worker, 51(1), 31-32. Appendix A Maslach Burnout Inventory (Maslach & Jackson, 1981, 1986) HOW OFTEN: 0 = Never 1 = A few times a year o r l e s s 2 = Once a month or l e s s 3 = A few times a month 4 = Once a week 5 = A few times a week 6 = Every day Statements: Answered as t o how o f t e n you f e e l about your  nob. 1. I f e e l e m o t i o n a l l y d r a i n e d from my work. 2. I f e e l used up a t the end of the workday. 3. I f e e l f a t i g u e d when I get up i n t h e morning and have t o f a c e another day on the j o b . 4. I can e a s i l y understand how my r e c i p i e n t s f e e l about t h i n g s . 5. I f e e l I t r e a t some r e c i p i e n t s as i f they were impersonal o b j e c t s . 6. Working w i t h people a l l day i s r e a l l y a s t r a i n f o r me. 7. I d e a l e f f e c t i v e l y w i t h the problems of my r e c i p i e n t s . 8. I f e e l burned out from my work. 9. I f e e l I'm p o s i t i v e l y i n f l u e n c i n g o t h e r peoples l i v e s through my work. 118 10. I've become more c a l l o u s toward people s i n c e I took t h i s j o b . 11. I worry t h a t t h i s j o b i s hardening me e m o t i o n a l l y . 12. I f e e l v e r y e n e r g e t i c . 13. I f e e l f r u s t r a t e d by my j o b . 14. I f e e l I'm working too hard on my j o b . 15. I don't r e a l l y c a r e what happens t o some r e c i p i e n t s . 16. Working w i t h people d i r e c t l y puts too much s t r e s s on me. 17. I can e a s i l y c r e a t e a r e l a x e d atmosphere w i t h my r e c i p i e n t s . 18. I f e e l e x h i l a r a t e d a f t e r working c l o s e l y w i t h my r e c i p i e n t s . 19. I have accomplished many worthwhile t h i n g s i n t h i s j o b . 20. I f e e l l i k e I'm a t the end of my rope. 21. In my work, I d e a l w i t h emotional problems v e r y calmly. 22. I f e e l r e c i p i e n t s blame me f o r some of t h e i r problems. (s c o r e s equal sum of t o t a l frequency) Emotional E x h a u s t i o n = items: l , 2, 3, 6, 8, 13, 14, 16, & 20. D e p e r s o n a l i z a t i o n = items: 5, 10, 11, 15, & 22. P e r s o n a l Accomplishment = items: 4, 7, 9, 12, 17, 18, 19, & 21. 119 Appendix B Work Environment S c a l e (Moos, 1981, 1986) ( a l l q u e s t i o n s answered t r u e or f a l s e ) Involvement 1. The work i s r e a l l y c h a l l e n g i n g . 11. There's not much group s p i r i t . 21. A l o t of people seem t o be j u s t p u t t i n g i n time. 31. People seem t o take p r i d e i n the o r g a n i z a t i o n . 41. People put q u i t e a l o t of e f f o r t i n t o what they do. 51. Few people ever v o l u n t e e r . 61. I t i s q u i t e a l i v e l y p l a c e . 71. I t ' s hard t o get people t o do any e x t r a work. 81. The work i s u s u a l l y v e r y i n t e r e s t i n g . Peer Cohesion 2. People go out of t h e i r way t o h e l p a new employee f e e l c o m f o r t a b l e . 12. The atmosphere i s somewhat impersonal. 22. People take a p e r s o n a l i n t e r e s t i n each o t h e r . 32. Employees r a r e l y do t h i n g s t o g e t h e r a f t e r work. 42. People are g e n e r a l l y f r a n k about how they f e e l . 52. Employees o f t e n eat l u n c h t o g e t h e r . 62. Employees who d i f f e r g r e a t l y from o t h e r s i n the o r g a n i z a t i o n don't get on w e l l . 72. Employees o f t e n t a l k t o each o t h e r about t h e i r p e r s o n a l problems. 82. O f t e n people make t r o u b l e by t a l k i n g behind o t h e r s backs. S u p e r v i s o r Support 3. S u p e r v i s o r s tend t o t a l k down t o employees. 13. S u p e r v i s o r s u s u a l l y compliment an employee who does something w e l l . 23. S u p e r v i s o r s tend t o di s c o u r a g e c r i t i c i s m s from employees. 33. S u p e r v i s o r s u s u a l l y g i v e f u l l c r e d i t t o i d e a s c o n t r i b u t e d by employees. 43. S u p e r v i s o r s o f t e n c r i t i c i z e employees over minor t h i n g s . 53. Employees g e n e r a l l y f e e l f r e e t o ask f o r a r a i s e . 63. S u p e r v i s o r s expect f a r too much from employees. 1 73. Employees d i s c u s s t h e i r p e r s o n a l problems w i t h s u p e r v i s o r s . 83. S u p e r v i s o r s r e a l l y stand up f o r t h e i r people. Autonomy 4. Few employees have any important r e s p o n s i b i l i t i e s . 14. Employees have a g r e a t d e a l o f freedom t o do as they l i k e . 24. Employees are encouraged t o make t h e i r own d e c i s i o n s 34. People can use t h e i r own i n i t i a t i v e t o do t h i n g s . 44. S u p e r v i s o r s encourage employees t o r e l y on themselve when a problem a r i s e s . 54. Employees g e n e r a l l y do not t r y t o be unique and d i f f e r e n t . 64. Employees are encouraged t o l e a r n t h i n g s even i f they are not d i r e c t l y r e l a t e d t o the j o b . 74. Employees f u n c t i o n f a i r l y i ndependently of s u p e r v i s o r s 84. S u p e r v i s o r s meet w i t h employees r e g u l a r l y t o d i s c u s s t h e i r f u t u r e work g o a l s . Task O r i e n t a t i o n 5. People pay a l o t of a t t e n t i o n t o g e t t i n g work done. 15. There's a l o t of time wasted because of i n e f f i c i e n c i e s 25. Things r a r e l y get "put o f f t i l l tomorrow." 35. T h i s i s a h i g h l y e f f i c i e n t , work-oriented p l a c e . 45. G e t t i n g a l o t of work done i s important t o people. 55. There's an emphasis on "work b e f o r e p l a y . " 65. Employees work v e r y hard. 75. People seem t o be q u i t e i n e f f i c i e n t . 85. There's a tendency f o r people t o come t o work l a t e . Work P r e s s u r e 6. There i s aconstant p r e s s u r e t o keep working. 16. There always seems t o be an urgency about e v e r y t h i n g . 26. People cannot a f f o r d t o r e l a x . 36. Nobody works too hard. 46. There i s no time p r e s s u r e . 56. I t i s v e r y hard t o keep up w i t h your work l o a d . 66. You can take i t easy and s t i l l get your work done. 76. There are always d e a d l i n e s t o be met. 86. People o f t e n have t o work overtime t o get t h e i r work done. 122 C l a r i t y 7. Things are sometime p r e t t y d i s o r g a n i z e d . 17. A c t i v i t i e s are w e l l - p l a n n e d . 27. Rules and r e g u l a t i o n s are somewhat vague and ambiguous. 37. The r e s p o n s i b i l i t i e s of s u p e r v i s o r s are c l e a r l y d e f i n e d . 47. The d e t a i l s of a s s i g n e d jobs are g e n e r a l l y e x p l a i n e d to employees. 57. Employees are o f t e n confused about e x a c t l y what they a r e supposed t o do. 67. F r i n g e b e n e f i t s are f u l l y e x p l a i n e d t o employees. 77. Rules and p o l i c i e s are c o n s t a n t l y changing. 87. S u p e r v i s o r s encourage employees t o be neat and o r d e r l y . C o n t r o l 8. There's a s t r i c t emphasis on f o l l o w i n g p o l i c i e s and r e g u l a t i o n s . 18. People can wear w i l d l o o k i n g c l o t h i n g w h i l e on the job i f they want. 28. People are expected t o f o l l o w s e t r u l e s i n doing t h e i r work. 38. S u p e r v i s o r s keep a r a t h e r c l o s e watch on employees. 48. Rules and r e g u l a t i o n s are p r e t t y w e l l e n f o r c e d . 58. S u p e r v i s o r s are always checking on employees and s u p e r v i s e them v e r y c l o s e l y . 68. S u p e r v i s o r s do not o f t e n g i v e i n t o employee p r e s s u r e . 78. Employees are expected t o conform r a t h e r s t r i c t l y t o the r u l e s and customs. 123 88. I f an employee comes i n l a t e , he can make i t up by s t a y i n g l a t e . I n n o v a t i o n 9. Doing t h i n g s i n a d i f f e r e n t way i s v a l u e d . 19. New and d i f f e r e n t ideas are always b e i n g t r i e d out. 29. T h i s p l a c e would be one of the f i r s t t o t r y out a new i d e a . 39. V a r i e t y and change are not p a r t i c u l a r l y important. 49. The same methods have been used f o r q u i t e a l o n g time. 59. New approaches t o t h i n g s are r a r e l y t r i e d . 69. Things tend t o s t a y j u s t about the same. 79. There i s a f r e s h , novel atmosphere about the p l a c e . 89. Things always seem t o be changing. P h y s i c a l Comfort 10. I t sometimes gets too hot. 20. The l i g h t i n g i s extremely good. 30. Work space i s a w f u l l y crowded. 40. T h i s has a s t y l i s h and modern appearance. 50. T h i s p l a c e c o u l d stand some new i n t e r i o r d e c o r a t i o n s . 60. The c o l o r s and d e c o r a t i o n s make the p l a c e warm and c h e e r f u l t o work i n . 70. I t i s r a t h e r d r a f t y a t times. 80. The f u r n i t u r e i s u s u a l l y w e l l - a r r a n g e d . 90. The rooms are w e l l v e n t i l a t e d . 124 Appendix C Demographic Data Questions Your sex: male-female-Your age: y e a r s -Are you (check o n l y one group) A s i a n B l a c k L a t i n o , H i s p a n i c N a t i v e American, I n d i a n White Other (please s p e c i f y - ) What i s your r e l i g i o n ? P r o t e s t a n t ( s p e c i f y denomination-) Roman C a t h o l i c Jewish Other (please s p e c i f y - ) None, no r e l i g i o n How r e l i g i o u s do you c o n s i d e r y o u r s e l f t o be? ( C i r c l e the a p p r o p r i a t e number.) 1 2 3 4 5 6 7 (1 = v e r y r e l i g i o u s ; 7 = not a t a l l r e l i g i o u s ) M a r i t a l s t a t u s : s i n g l e m a r r ied d i v o r c e d widowed ot h e r (please s p e c i f y - ) I f m a r r i e d , f o r how l o n g have you been m a r r i e d t o your c u r r e n t spouse? years I f you have c h i l d r e n , how many of lthem ae now l i v i n g w i t h you? c h i l d r e n l i v e w i t h me I have no c h i l d r e n What was the h i g h e s t l e v e l you completed i n school? (Check o n l y one answer.) completed h i g h s c h o o l some c o l l e g e completed f o u r years o f c o l l e g e some postgraduate work or degree o t h e r (please s p e c i f y - ) P l e a s e check the h i g h e s t degree you have r e c e i v e d : B.A./B.S. B.S.W. R.N. M.A./M.S. M.S.W. B.S.N. Ph.D. 1 year C o l l e g e Diploma 2+ y e a r s ( s ) C o l . Diploma. o t h e r (please s p e c i f y - ) 1 2 6 What i s the primary area i n which you work? (Check o n l y one answer.) mental h e a l t h e d u c a t i o n s o c i a l s e r v i c e s c o u n s e l i n g o t h e r (please s p e c i f y - ) What i s the l e v e l of your primary p o s i t i o n ? (Check o n l y one answer.) s t a f f member s u p e r v i s o r / manager a d m i n i s t r a t o r o t h e r (please s p e c i f y - ) How many hours per week do you work at the job i n d i c a t e d above? hours per week How l o n g have you been a t your p r e s e n t job? years How l o n g have you been employed f o r t h i s g e n e r a l type of work? years Appendix D S t r u c t u r a l V a r i a b l e C h e c k l i s t work week nin e t o f i v e , monday t o f r i d a y n i n e t o f i v e , monday t o monday s h i f t work y e a r l y s a l a r y $18,000 or l e s s $18,001 t o $24,000 $24,001 t o $30,000 over $30,000 annual l e a v e 2 weeks or l e s s 2 t o 3 weeks over 3 weeks b e n e f i t s none p a i d medical i n s u r a n c e extended medical d e n t a l p l a n s t a f f meeting frequency l e s s than weekly weekly t w i c e weekly more than twice weekly 128 methodology / i d e o l o g y no yes s p e c i a l c e r t i f i c a t i o n no yes sample w o r k s i t e number ( f i v e s i t e s numbered s e q u e n t i a l l y ) 

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