preventing burnout by improving relationships...burnout v exhaustion v depression 1 1.5 2 2.5 3 3.5...
TRANSCRIPT
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PROFESSOR MICHAEL P. LEITER, PHD
DEAKIN UNIVERSITY
Culture
Strengthening
Engage-ment
Respect
Preventing Burnout by
Improving Relationships
with and at Work
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Burnout as a Relationship Problem
People & Organizations have Expectations, Obligations, Demands
Key Areas of Worklife
Workload
Control
Reward
Community
Fairness
Values
Mismatches Drive Burnout
Exhaust Energy
Create Psychological Distance: Cynicism, Depersonalization
Discourage: Inefficacy, Low Accomplishment
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Burnout and Neighboring Profiles
• Unmanageable Demands
• Inadequate RecoveryExhaustion
• Value Conflicts
• Disrespect
• Emotional DistanceCynicism
• Lack of Recognition
• Impossible Standards
• Lack of ControlInefficacy Ineffective
Over-
Extended
Disengaged
Burnout
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Distributions Across Profiles
0
5
10
15
20
25
30
0.0
0.3
0.7
1.0
1.3
1.7
2.0
2.3
2.7
3.0
3.3
3.7
4.0
4.3
4.7
5.0
5.3
5.7
6.0
Pe
rce
nt
of
Re
spo
nse
s
Engaged
Exhaustion Cynicism Efficacy
0
5
10
15
20
25
30
0.0
0.3
0.7
1.0
1.3
1.7
2.0
2.3
2.7
3.0
3.3
3.7
4.0
4.3
4.7
5.0
5.3
5.7
6.0
Pe
rce
nt
of
Re
spo
nse
s
Disengaged
Exhaustion Cynicism Efficacy
0
5
10
15
20
25
30
0.0 0.3 0.7 1.0 1.3 1.7 2.0 2.3 2.7 3.0 3.3 3.7 4.0 4.3 4.7 5.0 5.3 5.7 6.0P
erc
en
t o
f R
esp
on
ses
Burned Out
Exhaustion Cynicism Efficacy
0
5
10
15
20
25
30
0.0
0.3
0.7
1.0
1.3
1.7
2.0
2.3
2.7
3.0
3.3
3.7
4.0
4.3
4.7
5.0
5.3
5.7
6.0
Pe
rce
nt
of
Re
spo
nse
s
Ineffective
Exhaustion Cynicism Efficacy
0
5
10
15
20
25
30
0.0 0.3 0.7 1.0 1.3 1.7 2.0 2.3 2.7 3.0 3.3 3.7 4.0 4.3 4.7 5.0 5.3 5.7 6.0
Pe
rce
nt
of
Re
spo
nse
s
Overextended
Exhaustion Cynicism Efficacy
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Contrast:
Overextended v Burnout
Burnout includes Exhaustion
But Burnout is More than Exhaustion
The Difference Matters
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Comparing Overextended to
Burnout
Physicians Hospital Employees
-1.20
-1.00
-0.80
-0.60
-0.40
-0.20
0.00
0.20
Overextended BurnoutD
iffe
ren
ce
fro
m S
td M
ea
nWorkload Control Reward Community Fairness Values
-1.00
-0.80
-0.60
-0.40
-0.20
0.00
0.20
Overextended Burnout
Diffe
ren
ce
fro
m S
td M
ea
n
Workload Control Reward Community Fairness Values
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Workgroup Culture and Profiles:
Canadian Hospital Employees
0%
10%
20%
30%
40%
50%
60%
70%
Civil Low Contact Coworker
Uncivil
FLM Uncivil All Uncivil
Pe
rce
nt
of
Re
spo
nd
en
ts
Engaged Ineffective Overextended Disengaged Burnout
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Profiles and Social Encounters:
Canadian Physicians
-0.25
-0.20
-0.15
-0.10
-0.05
0.00
0.05
0.10
0.15
0.20
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Profile re Positive Social Encounters
Community Mental Health Civility Psych Safety
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
0.80
1.00
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Profile re Negative Social Encounters
Doctor Uncivil Others Uncivil Instigated
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Burnout/Depression Distinction
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Burnout v Exhaustion v Depression
Item Exhaustion MHI P Efficacy Cynicism
MBIEx1 .88 .20 .02 .16
MBIEX3 .87 .16 .03 .22
MBIEX2 .86 .12 -.01 .14
MBICY1 .77 .16 -.07 .36
Downhearted .14 .85 -.05 .05
Happy -.11 -.84 .06 -.16
Calm -.08 -.82 .02 -.20
Nervous .14 .76 .00 -.06
Dumps .44 .57 -.09 .10
MBIPF3 .01 -.08 .85 -.14
MBIPF2 -.11 -.08 .83 -.19
MBIPF1 .05 .02 .77 .10
MBICY2 .32 .16 -.13 .84
MBICY3 .40 .12 -.10 .82
MBI-GS
Items with appropritate factor:
Except Cynicism 1:
Less enthusiastic
MHI
All items on MHI factor
Positive & Negative Coefficients
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Burnout v Exhaustion v Depression
1
1.5
2
2.5
3
3.5
4
4.5
5
Nervous Dumps DownHearted Happy Calm
Engaged Ineffective Overextended Disengaged Burned Out
Nervous: t(54)=0.18, p=.86
Dumps: t(54)=1.10, p=.28
Downhearted: t(54)=0.80, p=.43
Happy: t(54)=2.16, p=.036
Calm: t(54)=2.61, p=.012
Depression Symptoms Linked
Equally to Burnout & Exhaustion
Burnout with Distinct Low Scores on
Happy & Calm
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Social Profiles
Cluster Analysis
Five Profiles
Civil
Hi Positive: FLM & Cwk
Lo Negative: FLM & Cwk
Low Contact
Low + and –
FLM Civil
Hi Positive: FLM
Hi Negative: Cwk
FLM Uncivil
Hi Negative : FLM
Neutral: Cwk
All Uncivil
Lo Positive: FLM & Cwk
Hi Negative: FLM & Cwk
Civil
39%
Low
Contact
27%
FLM Civil
17%
FLM
Uncivil
13%
All
Uncivil
4%
CHART TITLE
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Civility Makes A Difference
-2.00
-1.50
-1.00
-0.50
0.00
0.50
1.00
1.50
2.00
2.50
Mental
Health
FLM Bully CWK Bully Sickness
Absense
Worked
Despite
Illness
QUIT Intent
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Civil Low Contact FLM Civil FLM Uncivil All Uncivil
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The Problem:
Problematic Social Encounters
People at Work Conundrum
People as Your Greatest Source of Support
People as Your Greatest Source of Distress
Problematic Social Encounters
Intensity
Intention
Power
Impact of Incivility
Administrative & Legal Demands: Complaints
Withdrawal: Nonparticipation, Absences, Quitting
Performance Problems: Errors, Limits, Gaps
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Workgroup Culture
Constructive Culture
Shared Mission
Smooth Information Flow
Civility & Respect
Acknowledgement
Assistance
Acceptance
Appreciation
Accommodation
Responsive Leadership
Dysfunctional Culture
Personal Agendas
Choppy Communication
Incivility & Disrespect
Ignoring
Gossiping, Undermining
Cliques and Exclusion
Taking for Granted
Rigidity
Constraining Leadership
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Domain of Negative Social
Encounters
Inte
nsi
ty
Intention
Abuse
Incivility
Annoying
Incivility
Low Intensity
Negative Social Behaviour
Of Ambiguous Intent
Rude
Contrary to Social Norms
Civility
Acknowledging
Accepting
Appreciating
Accommodating
Bullying
+ Power
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Costs of Incivility
Withdrawal
Less Engagement
Reduce Time at Work
Turnover Intention
Cynicism
Fewer Creative Ideas
Complaints
Grievances: 13% Mgmt Time
Internal Mediation etc.
Legal Action
Liabilities
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Positive and Negative Encounters
From Unit
Manager
From Coworkers
From Oneself
FLM Pos
82%
FLM Neg
18%
Cwk Pos
81%
Cwk
Neg
19%
Inst Pos
96%
Inst Neg
4%
Limits to Insight?
Intention
Self-Serving Bias
Justified
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Individual v Workgroup
Individual
Personal Initiative
Autonomy
Make Your Own Plan
Make Your Own Time
Leverage
One End of an Encounter
Subjective Evaluation
Workgroup
Shared Initiative
Cooperative
Negotiate the Plan
Agree upon the Time
Leverage
Both Ends of An Encounter
External Evaluation
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What Makes SCORE Effective?
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SCORE Process
Establishing Psychological Safety
Facilitator Involvement
Clear Ground Rules
Recognising Existing Culture
Taking a Problem-Solving Perspective
Behaving Differently
Intuitively
Inconsiderate
Rational Problem Solving
Intuitively
Considerate
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1. Acknowledging Respect
5 Sessions
90 Minutes
2-4 Weeks Apart
SCORE Sessions
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Pilot Results: October 2018
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Method
Control SCORE
Before 68 48
After 44 39
Social Contact Scale (Leiter 2018)
Behaviors
Civility
Incivility
Intimidation
Sources
Supervisor
Coworker
Instigated
Maslach Burnout Inventory GS
Exhaustion, Cynicism, Efficacy
Mental Health Index—5
Between Groups MANOVA
Before and After 5-Session SCORE
Waiting List Control
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Improving the Positive
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Supervisor Civility
Control SCORE
-0.80
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Coworker Civility
Control SCORE
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Reducing the Negative
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Supervisor Incivility
Control SCORE
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Coworker Incivility
Control SCORE
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Reducing Bullying
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Supervisor Bullying
Control SCORE
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Coworker Bullying
Control SCORE
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Improving Wellbeing
-0.80
-0.60
-0.40
-0.20
0.00
0.20
0.40
0.60
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Mental Health Index
Control SCORE
-0.30
-0.20
-0.10
0.00
0.10
0.20
0.30
0.40
0.50
Before After
Std
Diffe
ren
ce
fro
m A
ve
rag
e
Cynicism
Control SCORE
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Change During Score
Civility Profile nearly Doubles
Low Contact Remains at Half of
the Sample
FLM Civil Increase from 12% to 29%
FLM Uncivil Decreases from 12% to
0%
All Uncivil Decreases from 12% to
3%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
T1 SCORE T2 SCORE
16%
29%
49%47%
12%
21%
12%
0%
12%
3%
Civil Low Contact FLM Civil FLM Uncivil All Uncivil
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Perspective
1. Pilot Level
2 Treatment Groups
50 Participants
2. Between Groups Analysis
Insufficient individual matches
Non-Random Assignment: Most Problematic Groups
Non-Blind Assignment: Participants Actively Involved in the Project
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Going Forward
Wave 2
October through December 2019
3 Units
Survey: March 2019
Assess Wave 2
Follow-up Wave 1
Baseline for Wave 3
Interviews
What Made a Difference?
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Sustaining Gains
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Sustaining Gains
Monitoring
Count What Matters
Include Critical Dimensions
Authority: Differentiate manager and peer, upward and downward
Include Both Giving and Receiving Respect & Disrespect
Training
Manager Initiatives to Promote Respect
Responsive Leadership
Policies
Effective and Usable Mistreatment Procedures
Active Recognition for Success
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Readiness:
What’s Needed to Do SCORE?
Respect as a Core Value
A Motivated Workgroup
Resources
Staff Time in Sessions (1.5 X 5 = 7.5 hours)
Surveys: 2 X 0.25 = 0.50 hours
Co-Facilitator:
Training (3 hr)
Sessions: Prep, Session, Debrief (3.5 X 5 = 17.5 hours)
Staff Attending on non-Work Days
Space, Snacks, Materials
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Conclusion
Burnout is More then Exhaustion
Important to Address Work Overload
But More Needed for an Engaging Worklife
Action: Improve Areas of Worklife: Community
Two Strategies
Individual Action
SCORE: Workgroup Process
mpleiter.com
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References & Readings
Porath, C. & Conant, D. R. (October 2017). The Key to Campbell
Soup’s Turnaround? Civility. Harvard Business Review
Leiter, M. P. (2012). Analyzing and theorizing the dynamics of the workplace incivility crisis. Amsterdam: Springer.
Leiter, M. P. & Maslach, C. (2005). Banishing Burnout: Six Strategies for
Improving Your Relationship with Work. San Francisco: Jossey Bass.
Maslach, C. & Leiter, M. P. (1997). The truth about burnout. San
Francisco: Jossey Bass.