Preventing rehabilitation counselor burnout by balancing the caseload.

Rehabilitation counselors, like all other human service professionals, are highly susceptible to burnout due to extensive client contact, caseload responsibilities, and positive or negative case outcomes. Even in the midst of success, constant stress stems from high expectations of self and others (Emener, 1979; Maslach, 1982; Maslach & Florian, 1988; Maslach & Jackson, 1984; Roessler & Rubin, 1982; Ursprung, 1986). For the rehabilitation counselor to be an effective helper, professional demands must be balanced with personal needs. Without careful management, rehabilitation counselors may want to stop helping others and may need serious help themselves.

In studies of many human service fields, Christina Maslach (1982) defined burnout as "...a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do people work' of some kind" (p. 2). The rehabilitation counselor's work can gratify and drain simultaneously. To enjoy life professionally and personally, the rehabilitation counselor must become an effective manager who can control rather than be controlled by responsibilities, risks, and rewards (Cassell & Mulkey, 1985; Emener, 1979; Roessler & Rubin, 1982; Ursprung, 1986; Wright, 1980). Balancing the rehabilitation caseload by management of self, management in setting, management through situations, and management toward solutions can prevent rehabilitation counselor burnout. their identities as people and counselors separate. The most vigorous visionary can become disillusioned when faced with increasing numbers of people with increasingly complex problems and fewer resources with which to help them. It is one thing to identify how it feels and quite something else to take on the identity of "walking in another person's shoes." Becoming personally involved rather than remaining professionally involved in a client's life can cause the counselor to feel inadequate in the solution of problems. Identity and Role

Personal identity and professional role delineation is essential for the rehabilitation counselor (Emener, 1979; Maslach, 1982: Roessler & Rubin, 1982; Wright, 1980). In his study of burnout among rehabilitation counselors, Emener (1979) stated:

"Many rehabilitation counselors enter the field of rehabilitation with the seeds of idealism which were cultivated in graduate school. It can be very disillusioning for them to realize, for example, that their senior colleagues' concerns for their jobs are actually related to their aspirations for upward mobility within the agency, that they cannot control as many of the variables that affect them to the extent that they thought they could, and that the techniques which once worked so well with a few practicum clients are not as successful with a caseload of 150 (p. 57)." Expectations and Realities

The rehabilitation counselor's expectations in several areas affect performance and satisfaction. Confusion usually comes from unclear, over-burdening, or non-challenging supervisory expectations (Maslach, 1982; Maslach & Florian, 1988). Because of role specificity in different environments, particularly in private and public rehabilitation organizations, counselors must know the ropes" of their roles in order to perform necessary responsibilities and to produce needed results (Rubin, Matkin, Ashley, Beardsley, May, Onstott, & Puckett, 1984).

Rehabilitation counselors must allow for and adjust to frequent discrepancies in outcome expectations and realities. The early years in any position shape realistic or unrealistic, as well as positive or negative, expectations that result in the beginning of long-term growth or burnout (Emener, 1979; Field & Van Seters, 1988; Maslach, 1982). A counselor's abilities and cooperation with others can determine whether a counselor manages or fails to manage large caseloads of real people with both real problems and real potential. The rehabilitation counselor must realize that mistakes and mishaps will occur, but also realize that a variety of methods exists to overcome difficulties (Bennis, 1989; Cassell & Mulkey, 1985; Wright, 1980). Counselors should adopt a similar compensation philosophy to overcome hurdles in their own performance just as clients with disabilities are expected to adopt in their lives and work. Management of self in relation to identity, role, and expectations provides the foundation for successful caseload management and burnout prevention.

Management in Setting

A rehabilitation counselor's management in setting focuses on priorities within the organizational system, individual functions, and time usage. Within the Organization

Professional control often causes the greatest conflicts within the organizational system. Consistent planning, prioritizing, and processing can alleviate pressure and promote individual and organizational accomplishments for clients, counselors, co-workers, and supervisors (Baldwin & McConnell, 1988; Cassell & Mulkey, 1985; Rubin et al, 1984). Case management planning with individual clients may be conducted uniquely according to client needs, but organizational requirements for success are fairly rigid. The counselor must decide not only how but when to meet with clients and other professionals, and how and when to provide clients with beneficial services that assist them in meeting goals. Wanting to provide quality personal and vocational counseling but needing time to do paperwork perplexes many counselors. The delicate balance between effective interaction and administration can be established by prioritizing counselor responsibilities with client responsibilities and needs (Livneh, 1989; Maslach, 1982; Maslach & Florian, 1988; Maslach & Jackson, 1984; Roessler & Rubin, 1982; Rubin et al, 1984; Ursprung, 1986).

Counselors and supervisors must communicate within the organizational system. Counselors on the "client front" should be considered and consulted when new strategies are planned and implemented (Baldwin & McConnell, 1988; Schmid, 1986). With mutual strategies and priorities, supervisors and counselors can work together rather than against each other. Field and Van Seters (1988) observed:

"Authority should be delegated along with responsibility. It is necessary to clearly define both what objectives are to be achieved and also to give the member the authority and responsibility to determine how they will be achieved. Tasks should be assigned which are sufficiently difficult so as to be out of reach but not out of sight (p. 32). Individual Functions

The rehabilitation counselor's management in setting hinges upon individual functions within the organizational system. General functions include vocational testing and assessing, vocational and personal counseling, service coordinating, case recording and documenting, job placing, and following-up (Field & Van Seters, 1988; Holmes & Karst, 1989; Roessler & Rubin, 1982; Rubin et al., 1984; Wright, 1980). Counselors often become frustrated with too many responsibilities concerning too many people. With large caseloads, counselors must fight tendencies to develop mechanical methods in helping clients (Emener, 1979; Maslach & Florian, 1988). Continued management skill development and experience in planning, prioritizing, consulting, decision-making, delegating, negotiating, and recording will keep the rehabilitation counselor on top of rather than underneath the caseload (Carnevale, Gaines, & Meltzer, 1988; Cassell & Mulkey, 1985; Feuer, 1988; Gebelein, 1989; Holmes & Karst, 1989; Re & Cosse, 1989; Schmid, 1986). Time Usage

The rehabilitation counselor's time usage gives cohesion to management in setting. Time usage clearly reflects control. The diligent counselor plans and protects effective scheduling. Punctual planning balances people and paperwork and helps keep interruptions to a minimum. Effective time managers have found that one hour spent in effective planning time can reduce effective implementing time by 2-3 hours. Productive time with clients and various professionals in person and on the phone directly influences success and failure in caseload management. Because constant phone and personal interaction can drain hours from a day, time can be channeled by reserving certain periods for calls and appointments. Different client needs and situations will require different amounts of time, but the more effective planning in the beginning, the more likely planning will succeed in the end. Essential scheduling and planning ensures rather than erodes effective client-counselor relationships and results. Management in setting in relation to the organizational system, individual functions, and time usage provides the framework for successful caseload management and burnout prevention.

Management through

Situations

The rehabilitation counselor's management through situations focuses on interaction with clients and families, co-workers, supervisors, and other professionals. In dealing with multiple situations all of the time, the counselor can become burned out with work that never seems completed. The counselor must realize that it is not possible to solve everyone's problems, and that the counselor cannot solve any problem without the help of clients, co-workers, supervisors, and other professionals. Isolation creates a "sure-fire" atmosphere for burnout (Emener, 1979; Maslach, 1982; Maslach & Florian, 1988; Maslach & Jackson, 1984; Roessler & Rubin, 1982; Ursprung, 1986).

Management through situations centers around the counselor-client relationship. From the moment a client is determined eligible by the rehabilitation counselor, case management should not rest solely on the counselor, but should be shared mutually by the client. Concerning this mutual relationship, Rubenfeld (1988) believed:

"Co-management appears to be the strongest viable alternative to the more traditional helping relationship. Where the traditional mode stresses a hierarchical relationship, co-management insists on a team approach. Where the traditional mode tends to view the client as dependent, co-management relies on and nurtures active participation: the client is responsible and responsive (p. 41)."

The client's emotional maturity and adjustment to disability heavily impact the client-counselor relationship. Spouses, parents, and siblings who actively support the client should be included in cooperative planning and implementing indirectly, if not directly. Encouraging families to enhance client abilities rather than to enable client limitations frequently affects outcomes (Power, 1988; Szymanski, 1985). Facilitation with Clients

Facilitation skills are valuable to the rehabilitation counselor in counseling clients. If the counselor can teach the client to overcome barriers throughout the referring, assessing, planning, coordinating, and placing stages, the counselor will have given the client a skin for life. Communicating and fostering positive expectations facilitate short- and long-term improvement (Feuer, 1988; Field & Van Seters, 1988; Gebelein, 1989; Rubenfeld, 1988). The rehabilitation counselor must discover the fine balance between caring and doing too much and caring and doing too little for clients. Learning to demonstrate critical empathy" (Wright, 1980, p. 58) or relating to clients with understanding while restraining personal emotion helps the rehabilitation counselor to manage rather than crumble under an often draining caseload. Over-attachment hinders both counselor and client. With too many dependent and demanding relationships, the rehabilitation counselor may tend to view clients negatively and to expect little responsible action from them. Greater satisfaction results from the counselor's facilitating the client's independence rather than his or her dependence (Emener, 1979; Maslach, 1982; Maslach & Florian, 1988; Maslach & Jackson, 1984; Rubin et al., 1984). Negotiation with Others

The rehabilitation counselor must think and act as negotiator to balance various relationships with varied needs. Negotiation is a critical skill for the rehabilitation counselor who meets both the needs of individuals with disabilities and the requirements of an organization. Financial disincentives, litigation, and emotional frustrations due to disability are only a few of the situations that may prevent the client's communication and cooperation with the counselor. Unless the client absolutely refuses to cooperate, the rehabilitation counselor must negotiate a compromise between client expectations and known realities that present oppressive barriers (Carnevale et al., 1988; Cassell & Mulkey, 1985; Re & Cosse, 1989; Schmid, 1986). Consistently identifying goals and desired outcomes, discussing significant issues, and responding to issues with necessary flexibility require both a negotiating attitude and definite action (Re & Cosse, 1989). Cooperation with Co-workers and Supervisors

Cooperation with co-workers enhances the rehabilitation counselor's management through situations. Collaboration increases competence rather than competition among counselors. Honest communication that includes helpful feedback and support creates an atmosphere in which co-workers become advocates rather than adversaries. Everyone's style of relating is unique, but co-workers who talk about situations, stresses, accomplishments, an failures are less likely to become burned out in their struggles for success (Ashforth & Mael, 1989; Carnevale et al., 1988; Emener, 1979; Maslach, 1982; Maslach & Jackson, 1984; Ursprung, 1986; Wright, 1980). Communication with supervisors critically influences the rehabilitation counselor's effective management and satisfaction. Supervisors can best motivate by clarifying, evaluating, and focusing on tasks managed correctly rather than focusing solely on tasks managed incorrectly. If the focus is always negative, the counselor win more likely be defeated by mistakes rather than learn from them (Emener, 1979; Maslach, 1982; Maslach & Florian, 1988; Maslach & Jackson, 1984; Miller et al., 1988; Ursprung, 1986). In their study of rehabilitation counselors and burnout, Maslach and Florian (1988) observed:

"There are too many clients, too little time, and an unworkable agency policy - and, not surprisingly, the counselors do not feel in control of what they are trying to do. There is more dissatisfaction with administrators, who are presumed responsible for these work conditions and policy. Working in such an environment may be especially upsetting if, despite all one's efforts, there are not many opportunities for promotion or other forms of recognition and reward (p. 92)."

Clear communication about job roles, functions, expectations, and requirements fosters mutual control and competence. Never being able to understand nor to please the boss leads to heavy resentment and likely burnout. Reciprocal rapport and respect among counselors and supervisors enhances effective planning, prioritizing, and implementing on the client's behalf Baidwin & McConnell, 1988; Bennis, 1989; Maslach & Florian, 1988; Maslach & Jackson, 1984; Miller et al., 1988; Rubin et al., 1984; Schmid, 1986; Ursprung, 1986). Cooperation with Related Professionals

Cooperation with medical, legal, vocational, educational, and other professionals, such as employers, fosters successful service provision. The broadening scope of rehabilitation services requires effective networking. Counselors in private sector rehabilitation, who often work independently, rely greatly on relationships with lawyers, physicians, vocational evaluators, and employers for successful outcomes (Rubin et al., 1984). Counselors working with youth in transition from school-to-work programs, such as supported employment, are only as effective as their connections (Wehman, Moon, Everson, Wood, & Barcus, 1988). Management through situations in relation to clients and families, co-workers, supervisors, and other professionals provides the focus for successful caseload management and burnout prevention.

Management toward

Solutions

Management toward solutions focuses on the rehabilitation counselor's self-expression and self-satisfaction. Without a thriving professional life the rehabilitation counselor's personal life may suffer, if not deteriorate. Professional life may be smothering and dissatisfying without a personal life. Work cannot fiR the role of play, and play cannot fill the role of work. Finding a meaningful, manageable balance between both lives can drown sparks of burnout before they cause damage. It would be unrealistic to believe that the rehabilitation counselor will never face frustrations, pressures, and failures. Due to these realities, management solutions must be planned and implemented in anticipation of self, setting, and situation struggles (Emener, 1979; Maslach, 1982: Maslach & Florian, 1988; Maslach & Jackson, 1984; Miller et al., 1988; Ursprung, 1986). Balance through Self-Expression

The rehabilitation counselor's self-expression balances management of self with excessive caseload demands and prevents burnout. The fundamental attitude behind self-expression is simply perceiving and expressing oneself as first a person and then a counselor. Literal actions that exude this mental attitude include separating personal and professional living and working locations, hours, activities, and phone calls. Burnout begins and grows very quickly without precautionary prevention. Planning hours around personal demands and needs can stir energy and steer efforts during professional hours (Maslach, 1982).

Foundational associations in self-expression build on social relationships with family and friends. Clients may meet some social needs for counselors but are much less likely to meet the counselor's support needs. If clients are meeting too many social needs, the counselor-client relationships may be imbalanced for many reasons and should probably be realigned (Emener, 1979). Most studies show that personal relationships prove more refreshing than frustrating (Maslach, 1982; Maslach & Jackson, 1984). Investments into family and friends shape a healthier perspective. Real tragedy transpires when a weary counselor cannot draw from or give support to family and friends but instead neglects, withdraws, or lashes out at them (Maslach, 1982). Time and energy must be balanced between personal and professional relationships in order for the rehabilitation counselor to function as a whole person and an effective helper (Emener, 1979; Maslach, 1982; Maslach & Jackson, 1984).

Foundational activities in self-expression rest in leisure time. Without some leisure, work becomes drudgery. Enjoying hobbies and recreation makes work more desirable and endurable. The rehabilitation counselor who prioritizes a few daily hours and/or entire days for relaxation restores energy for work (Emener, 1979; Maslach, 1982; Maslach & Jackson, 1984; Miller et al., 1988; Roessler & Rubin, 1982; Ursprung, 1986; Zemke, 1988). Balance through Self-Satisfaction

The rehabilitation counselor's self-satisfaction balances management in setting and situations with excessive self-criticism and prevents burnout. Effective management evolves from realistic expectation and evaluation. Determining attainable goals, planning and implementing long- and short-term objectives, and learning from failures and successes keeps the counselor thriving on possibilities rather than throbbing with burnout.

In addition to client successes and failures, the rehabilitation counselor's self-satisfaction may depend on increased challenges, salaries, and promotions. Realistically, counselors cannot be concerned only with their clients' welfares, but must also be concerned with their own. Lack of recognition, promotion, and remuneration causes the counselor to consider whether all the efforts are worth the stresses. In fact, burnout often roots in lack of recognition and reward in addition to other stresses (Maslach, 1982; Maslach & Florian, 1988). The best managed caseloads should benefit both clients and counselors. Adjusting to the reality of not making a great deal of money must be balanced by the counselor's greater motivation to help people with disabilities overcome handicaps. Self-satisfaction and recognition from clients, co-workers, and supervisors should outweigh and outlast remuneration rewards in public or private rehabilitation (Emener, 1979; Maslach, 1982).

Along with expectations, evaluations can encourage or erode self-satisfaction. Without deliberate self-evaluation based on organizational and self-imposed priorities, the rehabilitation counselor has no accurate way to judge strategies, failures, or successes. Reviewing goals and objectives, case records and documentation along with requesting objective feedback can ensure realistic self-evaluation. Some counselors evaluate themselves too harshly by client failures and must identify significant failure factors rather than totally blaming themselves. Both creative solutions and successful closures should satisfy rehabilitation counselors (Holmes & Karst, 1989; Livneh, 1989; Maslach & Florian, 1988). Management toward solutions in relation to self-expression and self-satisfaction provides the fuel for successful caseload management and burnout prevention.

Conclusion

Balancing the rehabilitation caseload by management of self, management in setting, management through situations, and management toward solutions can prevent rehabilitation counselor burnout. With effective management skills, the motivated rehabilitation counselor continues giving to clients; cooperating with co-workers, supervisors, and others; accomplishing objectives; and enjoying life. By balancing professional demands and personal needs, the rehabilitation counselor produces results and prevents burnout.