Occupational Therapy in mental health: Managing stress and burnout

Stress and burnout for human service workers has received increasing attention over a number of years. It has been suggested that health care professionals may be particularly at risk of stress and burnout because of the amount and type of direct client contact that makes up their work. For workers in the field of mental health, additional stressors are present owing to organisational restructuring and new models of care. Mental health occupational therapists may be vulnerable to stress and burnout owing to the nature of their work, the types of client they see, the changed work environment and professional issues. It is recommended that occupational therapists become aware of the factors contributing to stress and burnout and develop strategies to maintain their wellbeing in the workforce.

Techniques to determine ignition, flame stability and burnout of blended coals in p.f. power station boilers

The blending of coals has become popular to improve the performance of coals, to meet specifications of power plants and, to reduce the cost of coals, This article reviews the results and provides new information on ignition, flame stability, and carbon burnout studies of blended coals. The reviewed studies were conducted in laboratory-, pilot-, and full-scale facilities. The new information was taken in pilot-scale studies. The results generally show that blending a high-volatile coal with a low-volatile coal or anthracite can improve the ignition, flame stability and burnout of the blends. This paper discusses two general methods to predict the performance of blended coals: (1) experiment; and (2) indices. Laboratory- and pilot-scale tests, at least, provide a relative ranking of the combustion performance of coal/blends in power station boilers. Several indices, volatile matter content, heating value and a maceral index, can be used to predict the relative ranking of ignitability and flame stability of coals and blends. The maceral index, fuel ratio, and vitrinite reflectance can also be used to predict the absolute carbon burnout of coal and blends within limits. (C) 2000 Elsevier Science Ltd. All rights reserved.

Social work, stress and burnout: A review

Stress and burnout for health care professionals have received increasing attention in the literature. Significant administrative, societal and political changes have impacted on the role of workers and the responsibilities they are expected to assume. Most writers suggest that social work is a highly stressful occupation, with stress deriving in particular from role conflict between client advocacy and meeting agency needs. This article reviewed the social work literature with two questions in mind: Are social workers subject to greater stress than other health professionals? What factors contribute to stress and burnout among social workers? We found that most of the literature was either anecdotal or compared social worker stress with general population norms rather than with stress levels of workers in comparable professions. Such empirical research as is available suggests that social workers may experience higher levels of stress and resulting burnout than comparable occupational groups. Factors identified as contributing to stress and burnout included the nature of social work practice, especially tension between philosophy and work demands and the organization of the work environment. There was some evidence that supervision and team support are protective factors.

The relationship between extra-role behaviours and job burnout for primary school teachers: A preliminary model and development of an organisational citizenship behaviour scale

Recent research on teacher stress in primary schools (e.g. Leonard, Bourke & Schofield, 1999) has shown that higher levels of teacher exhaustion are associated with higher levels of student satisfaction. This paper seeks to explain this surprising finding by considering a construct discussed widely in the organisational literature known as extra-role or organisational citizenship behaviour (OCB). Teacher OCB may include extra efforts to make lessons enjoyable and interesting, organising extra-curricular activities and spending personal time talking with students. The proposed model of analysis also draws on literature relating to job burnout (Maslach, 1982), which generally suggests that the three components of chronic occupational stress - exhaustion, depersonalisation and reduced accomplishment - occur together. However, this paper proposes that although teachers who engage in more OCB experience more exhaustion, they may simultaneously increase their feelings of personal accomplishment and work identification, which may in turn help to avert burnout. It is argued that only with this particular set of job attitudes are the effects of exhaustion caused by high levels of OCB sufficiently buffered to avoid job burnout, and thus positively affect students' quality of school life. The development and piloting of an instrument to measure teachers' OCB will be discussed. The preliminary findings reported herein are part of a larger ongoing study investigating the consequences of stress and OCB in primary school teachers.

The moderating role of social support in Karasek's job strain model

This paper examines whether social support is a boundary-determining criterion in the job strain model of Karasek (1979). The particular focus is the extent to which different sources of social support, work overload and task control influence job satisfaction, depersonalization and supervisor assessments of work performance. Hypotheses are tested using prospective survey data from 80 clerical staff in a university setting. Results revealed 3-way interactions among levels of support (supervisor, co-worker, non-work), perceived task control and work overload on levels of work performance and employee adjustment (self-report). After controlling for levels of negative affect in all analyses, there was evidence that high levels of supervisor support mitigated against the negative effects of high strain jobs on levels of job satisfaction and reduced reported levels of depersonalization. Moreover, high levels of non-work support and co-worker support also mitigated against the negative effects of high strain jobs on levels of work performance. The results are discussed in terms of the importance of social support networks both at, and beyond, the work context.

Career versus motherhood? A case study describing a cognitive-existential approach to the dilemma

The present paper reports a case study concerning a professional woman in her 30s, who presented to the Occupational Health department of a metropolitan hospital with work stress stemming from accelerating work demands and marital problems related to the decision about whether to start a family or continue her career. No clinical diagnosis was warranted; however, Maslach Burnout Inventory Scores indicated a high degree of emotional exhaustion and moderate levels of depersonalisation, offset by a high sense of personal accomplishment in her work role. The client also demonstrated severe stress and moderate depression on the Depression-Anxiety-Stress Scale (DASS-21). The case was conceptualised from a combined cognitive-existential perspective. The woman's cognitions about her work, relationship, and prospective motherhood roles were identified, as well as underlying existential issues such as finding a meaning in life and a fear of being alone and unloved. Eight sessions of therapy incorporated components of cognitive and existential therapies, aimed at managing stress and improving marital adjustment. Posttreatment results showed substantial reductions in all the measures of distress, while personal accomplishment remained high. The woman and her husband decided to defer starting a family until other issues had been addressed.

Prediction of carbon monoxide in fires by conditional moment closure

Carbon monoxide is the chief killer in fires. Dangerous levels of CO can occur when reacting combustion gases are quenched by heat transfer, or by mixing of the fire plume in a cooled under- or overventilated upper layer. In this paper, carbon monoxide predictions for enclosure fires are modeled by the conditional moment closure (CMC) method and are compared with laboratory data. The modeled fire situation is a buoyant, turbulent, diffusion flame burning under a hood. The fire plume entrains fresh air, and the postflame gases are cooled considerably under the hood by conduction and radiation, emulating conditions which occur in enclosure fires and lead to the freezing of CO burnout. Predictions of CO in the cooled layer are presented in the context of a complete computational fluid dynamics solution of velocity, temperature, and major species concentrations. A range of underhood equivalence ratios, from rich to lean, are investigated. The CMC method predicts CO in very good agreement with data. In particular, CMC is able to correctly predict CO concentrations in lean cooled gases, showing its capability in conditions where reaction rates change considerably.

Mood states as an indication of staleness and recovery

Elite athletes repeatedly completed the Profile of Mood States (POMS) during a six month training season to determine whether athletes who are stale show different values from those who are intensely trained but not stale. Nineteen elite male and female swimmers were studied at five time points: three times during training (early-, mid-, and late-season), during tapering prior to, and then shortly after, major competition. Of the 14 subjects who completed the entire monitoring program, three were classified as stale based on several criteria including poorer performance and prolonged high level of fatigue. Two of the stale swimmers showed higher scores for several of the POMS measures throughout the season compared with the remainder who were classified as non-stale. However, the third stale swimmer showed similar scores to those of the non-stale swimmers. Several POMS measures were significantly correlated with training intensity but not with training volume. It was concluded that stale athletes may not always demonstrate different mood scores from non-stale athletes but that the total mood disturbance score (TMD) as evaluated by the POMS may be used to indicate those athletes predisposed to the condition long before the symptoms of poor performance and prolonged fatigue are observed. TMD scores were chosen to monitor staleness since they represent a synthesis of the six specific mood states measured by the POMS.

Work-related stress and occupational therapy

Occupational stress and burnout have been studied extensively in the human services. It has been suggested that healthcare professionals in particular are at risk of stress owing to the caring nature of their work. Articles related to occupational therapy and work-related stress were reviewed in regard to practice in Australia, Canada, the United Kingdom, the United States and Sweden. Although the empirical literature is relatively weak for occupational therapy, it has been argued that occupational therapists in health care share risk factors with other healthcare professionals. These risk factors include repeated exposure to distress and difficult behaviour, prolonged interventions and uncertain outcome. Issues such as professional status, staffing issues and the nature of the profession have been identified as additional risk factors for occupational therapists. However, empirical studies that enable burnout rates of occupational therapists to be compared with those of related occupational groups suggest that this may not be the case. Occupational therapists may in fact be protected from some stress and burnout factors. Further research is recommended to clarify the nature of stress experienced by occupational therapists and to identify both risk and protective factors characteristic of the profession. Copyright © 2001 Whurr Publishers Ltd.