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Psychological distress and burnout in Australian employment service workers: two years on.

During 2001, 152 case managers providing intensive assistance to the unemployed completed the 12-item General Health Questionnaire (D. P. Goldberg, 1978) and the Maslach Burnout Inventory (MBI; C. Maslach, S. E. Jackson, & M. P. Leiter, 1996). Of the 152 case managers, 48% endorsed responses indicating psychological distress, and on emotional exhaustion, the core dimension of burnout on the MBI, the mean for these case managers was significantly higher than that published for other human service workers. The results confirm data from a 1999 longitudinal study and indicate significant levels of burnout and distress in employment service case managers in the Australian Job Network.

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The present study was conducted 3 years after Australia's national employment service industry was privatized in 1998. Historically, publicly funded employment services in Australia had been delivered directly by the Australian federal government through a national employment agency, the Commonwealth Employment Service. However, during the 1990s the Australian government privatized the delivery of services to the unemployed. The privatized national employment service that resulted from this change is now known as the Job Network, a term that encompasses a diverse range of welfare, community, and private sector organizations now competing with each other for financial incentives to assist the unemployed to find permanent employment. Within the Job Network framework, employment services that are delivered to the long-term unemployed, that is to individuals who have been continuously unemployed for 12 months or more, is accomplished through an individually focused service-delivery strategy referred to as intensive assistance. It is the well-being of the personnel who deliver intensive assistance to the long-term unemployed that was the focus of this study. Specifically, in our study, we used a cross-sectional survey methodology to investigate the current state of psychological well-being and burnout in the personnel whose job description requires them to enter into intensive one-to-one relationships with their unemployed clients to assist them to gain employment. These personnel are usually called case managers because the system of support and assistance that they offer their clients is in keeping with the case management models of service provision on which the current Australian employment services model was developed (Hagen, 1994).

In June of 2001, the Australian Job Network included 195 organizations that collectively had provided intensive assistance to 278,560 unemployed Australians in the previous year. The cost of these services to the Australian taxpayer has been estimated to be in the order of half a billion Australian dollars (Australian Council of Social Service, 2000). In the state of Queensland, 25 Job Network members had provided assistance to more than 59,000 individuals during the same period (Department of Employment, Workplace Relations and Small Business, 2001). At the commencement of this investigation, it was estimated that there were approximately 460 intensive assistance case managers who were operating from various locations and organizations throughout Queensland.

PSYCHOLOGICAL WELL-BEING AND BURNOUT

In contrast to the copious literature that details the effects of unemployment on the well-being of Australian and overseas occupational groups (e.g., see Allatt & Yeandle, 1992; Fryer & Payne, 1986; Leanna & Feldman, 1992; Murphy & Athanasou, 1999; Winefield, 1995), there is very little in the way of published work on the related topics of well-being and burnout in staff members who work directly with the unemployed. More than 16 years ago, Kelvin and Jarrett (1985) acknowledged this lack of focus on the individuals who delivered employment service relative to the individuals who were the recipients of the service. This is still the case today, despite the billions of dollars that are spent each year throughout the world in programs to support the unemployed. In Australia, publicly accessible details of well-being and burnout in employment service personnel generally, and within the case manager cohort in particular, are limited. In the few studies that have been conducted (e.g., see Goddard & Patton, 1998; Goddard, Patton, & Creed, 2000, 2001), researchers have repeatedly found high levels of emotional exhaustion (i.e., the core dimension of burnout) and high incidences of psychological distress in samples of Australian case managers.

THE PRESENT STUDY

As part of a larger study investigating the coping strategies that are preferred by employment service case managers, Queensland intensive assistance case managers were surveyed to ascertain whether or not the well-being levels of case managers were similar to the levels that had been observed in an earlier national survey. Since the privatization of the Australian employment services in 1998, the quality of the delivery of service to the unemployed generally and to the long-term unemployed specifically has been both applauded and criticized by different stakeholders (e.g., Australian Council of Social Service, 2000). In particular, the Australian government has claimed that the new privatized service had resulted in a more personalized service being delivered to the long-term unemployed by Job Network case managers than had been available when the service was delivered by the Australian public service (Department of Employment, Workplace Relations and Small Business, 2000). This last claim (i.e., that individuals who were experiencing long-term unemployment were receiving a more personalized service than they had received under the previous public employment service) was investigated in 1999. This 1999 study investigated burnout in a sample of Job Network case managers on two occasions between 1 year and 18 months after the Australian employment service was privatized, and high levels of emotional exhaustion and increasing levels of depersonalizing behavior by case managers toward their clients were found (Goddard et al., 2000). The results suggested that on these two dimensions of burnout, levels had not stabilized in the employment service that had been recently privatized. Consequently, any conclusions that were drawn at that time about whether the long-term unemployed were receiving a more personalized service than they would have received under the former, publicly run employment service might have been premature. The present study was undertaken a little more than 3 years after the commencement of Australia's privatized Job Network in May 1998. Its primary goal was to establish levels of psychological distress and burnout in Queensland Job Network case managers. A large survey, one that invited participation from all employment service case managers, was expected to establish referent burnout levels in this particular population. An additional aim of the study was to clarify whether emotional exhaustion and frequencies of depersonalizing behavior in Queensland case managers at this time were at levels similar to the emotional exhaustion and frequencies of depersonalizing behavior that had been observed in the national sample of case managers who were surveyed in 1999 (Goddard et al., 2000). Furthermore, given the dearth of literature available on the levels of burnout in employment service staff generally, this study is expected to make a significant contribution to the literature on both burnout and unemployment globally.

METHOD

Participants

Participants were employees of employment service organizations whose primary role was to provide intensive assistance to Australian individuals who had been unemployed for more than 12 months. Each organization was, at the time the survey was conducted, officially recognized as being a member of the national employment service currently operating in Australia, called the Job Network, and was delivering services in the northeastern Australian state of Queensland. The principal duties of all the participants who were involved in this study were to individually assist their unemployed clients to obtain employment, preferably permanent employment. A total of 152 case managers from 18 Job Network organizations took part in this study by completing and anonymously returning the survey instruments described in the following section. Participation in the study was voluntary. The case managers surveyed had an average age of 38 years (SD = 9.70) and had been employed for approximately 27.5 months (SD = 27.31) as case managers. Sixty-five percent (n = 99) of the case managers surveyed were female, a percentage that reflects the gender proportions typically found in this field. Table 1 provides a summary of the general demographic information from the Queensland case managers who took part in this survey.

Instruments

Psychological well-being. The current level of well-being was assessed by using the 12-item General Health Questionnaire (GHQ-12; Goldberg, 1978). This is a self-administered, point-in-time screening test that is designed to detect psychiatric disorders. This instrument has been extensively used in a variety of occupational and community settings as a screening measure for psychological ill health (see Banks et al., 1980; Boardman, 1987; Burvill & Knuiman, 1983; Warr, 1987) and has well-established reliability and validity credentials (Goldberg, 1978; Goldberg & Williams, 1988). Furthermore, the GHQ-12 has been validated for use with Australian respondents (Tennant, 1977). In the present study, we used both the binary and Likert methods of scoring responses. Binary scores of 2 or more from the 12 items were taken to represent cases of psychological distress or morbidity. This threshold score is commonly used and reported in the literature (e.g., Tennant, 1977). In the Likert scoring system, higher scores correspond to increasing psychological pathology. In the present study, coefficient alpha was found to be .84.

Burnout. We measured burnout using the Human Services Survey version of the Maslach Burnout Inventory (MBI; Maslach, Jackson, & Leiter, 1996). This is a 22-item, self-report instrument that is described in the literature as "the most widely used operationalization of burnout" (Lee & Ashforth, 1996, p. 124). The MBI consists of three subscales: Emotional Exhaustion (sample item: "I feel emotionally drained from my work"), Depersonalization (sample item: "I feel I treat some of my clients as if they were impersonal objects"), and Personal Accomplishment (sample item: "I feel I am positively influencing other people's lives through my work"). Participants responded on a 7-point rating scale, ranging from never (0) to every day (6). High scores on the Emotional Exhaustion and Depersonalization subscales and low scores on the Personal Accomplishment subscale are characteristic of burnout. Reliability coefficients published in the technical manual are .90 for Emotional Exhaustion, .79 for Depersonalization, and .71 for Personal Accomplishment (Maslach et al., 1996). In the present study, the corresponding reliability coefficients were .93 for Emotional Exhaustion, .82 for Depersonalization, and .82 for Personal Accomplishment.

In addition to the previously described instruments, respondents were asked a series of questions that investigated various demographic and work-related parameters. These data are summarized in Tables 1 and 2.

Procedure

We approached all 25 Job Network organizations that employed case managers in Queensland at the highest level of state management to request permission for staff members to be given the opportunity to participate voluntarily and anonymously in the present study. Only two Job Network member organizations openly refused to permit their case managers to participate in the survey, and case managers from these two organizations were not approached. After gaining the approval of management, individual case managers were sent the survey instruments that have already been described and were asked to complete and return the surveys to us at their earliest convenience. Each case manager was provided with an envelope so that his or her survey responses could be mailed directly to us. In this manner, the survey instruments were administered by mail between July and October 2001.

RESULTS

Demographics, Workload Indicators, and Gender Differences

One hundred and fifty-two case managers from 18 Job Network organizations completed and returned surveys and satisfied the criterion that their principal occupation was undertaking case manager duties with unemployed individuals. An estimate, based on contact with participating organizations during the course of the investigation, of the total case manager population in Queensland was 460. Therefore, the response rate is thought to represent a third of all Job Network case managers who were working in Queensland at the time the survey was conducted.

The mean age of the case managers who responded, the average months employed as a case manager, and the mean case manager workload indicators are presented in Table 1. One-way analyses of variance (ANOVAs) indicated no significant gender differences on any of the workload measures presented in Table 1. Also, no gender differences were found on either the measure of well-being used in this study, the GHQ-12 (Likert scoring), or on any of the three MBI subscales used to estimate burnout. Only one gender difference was observed. Average female case managers were found to be significantly younger (37.8 years) than were male case managers (42.6 years) by almost 5 years, F(1, 149) = 7.51, p < .01.

The Psychological Well-Being of Queensland Case Managers

Using the binary scoring criteria and the 1/2 cutoff criterion described previously, 47.7% (i.e., n = 71) of the case managers who were surveyed endorsed responses on the GHQ-12 that indicated prevailing or imminent psychological ill health. When a much more conservative 3/4 cutoff criterion was applied, a threshold score normally applied to the longer 20-question version of the GHQ (Goldberg, 1978, p. 26), the case rate dropped only marginally to 42%.

Mean GHQ-12 Likert scores also reflected the high case rates that were revealed by the binary analysis. Table 1 presents mean GHQ-12 Likert scores for the total sample, and Table 2 presents means for various sample cohorts based on variables such as gender, work location, training history, and supervision responsibilities. Overall mean GHQ-12 Likert scores remained at statistically similar levels for most cohorts. Only on the question investigating case managers' perceptions of equity was a clear association with psychological distress observed. The case managers who believed that the effort that they were expending in their work was greater than the rewards they received for undertaking this work reported significantly higher GHQ-12 scores, corresponding to high levels of distress, than did the case managers who either believed the reverse was true or who perceived the effort-reward ratio as equitable, F(1, 142) = 17.24, p < .001.

Comparisons of the case rates and mean GHQ-12 Likert scores that were found in this study were made with the results of a longitudinal investigation that was conducted in 1999 of the well-being and burnout of Australian case managers. Comparisons were also made with other studies that have investigated psychological morbidity in both employed and unemployed Australian population cohorts. These comparisons are presented in Table 3. The mean GHQ-12 Likert score for case managers in the present study was not significantly different from the results that were obtained from the national sample of intensive assistance case managers who were surveyed twice in 1999 (Goddard et al., 2001), t(236) = 0.20, p > .05 and t(220) = 0.35, p > .05.

In a comparison with a study of a group of long-term unemployed Australian adults (Patton & Donohue, 1998), the mean GHQ-12 Likert score from the present study was significantly higher, corresponding to higher psychological distress, than the equivalent scores reported for the unemployed adults, t(122) = 2.29, p < .05.

In a third comparison with the results presented in Winefield, Tiggemann, and Winefield's (1991) comparative study of the psychological impact for young Australians who were engaged in satisfactory work with the impact for young Australians who were engaged in unsatisfactory work or who were unemployed, the mean GHQ-12 Likert score for Queensland case managers was found to be significantly higher than were the scores that were reported for the employed workers who found their work satisfactory, t(501) = 5.70, p < .001, and statistically equivalent for groups of dissatisfied workers and the unemployed, t(195) = 0.74, p > .05 and t(190) = 0.94, p > .05, respectively.

Finally, in a comparison with Graetz (1993), who reported GHQ-12 case rates and mean Likert scores for very large subgroups of Australian youth, the case rates that were observed in the present study were significantly higher than were the case rates for the employed and student cohorts and statistically equivalent to the unemployed cohort surveyed in the first wave of the Australian Longitudinal Study conducted during the 1980s, [chi square](2, N = 151) = 28.97, p < .001; [chi square](2, N = 151) = 5.99, p < .05; and [chi square](2, N = 151) = 1.36, p > .05, respectively.

Case Manager Burnout

Summary data for the MBI are presented in Table 1. When sample means were compared with normative data presented in the MBI technical manual (Maslach et al., 1996, p. 6) for human service workers generally, two significant differences were noted. First, the mean case manager Personal Accomplishment score was found to be significantly higher, corresponding to a lower level of burnout, than the norms reported in the technical manual, t(149) = 5.60, p < .001. In contrast to the previous finding, the mean Emotional Exhaustion score that was reported by case managers was found to be significantly higher, corresponding to a higher level of burnout, than the normative data, t(149) = 2.55, p < .05. The mean case manager score on the MBI's Depersonalization subscale was not significantly different than Maslach's norms, t(148) = 0.20, p > .05.

The means of the MBI subscales for the various sample cohorts that were investigated in the present study are presented in Table 2. Most emphatically, on the question investigating case managers' perceptions of equity, a clear association between perceived inequity and all three MBI subscale scores was found. The case managers who believed that the effort that they were expending in their work was greater than the rewards that they were receiving for undertaking this work reported significantly higher Emotional Exhaustion and Depersonalization scores, corresponding to higher levels of burnout, than did the case managers who perceived a more equitable or favorable equation of effort to reward, F(1, 141) = 39.90, p < .001, and F(1, 140) = 14.34, p < .001, respectively. Similarly, the case managers who indicated that the effort that they were expending was greater than the rewards that they were receiving reported significantly lower Personal Accomplishment scores, corresponding to higher levels of burnout, than did the case managers who perceived a more equitable or favorable equation, F(1, 141) = 4.52, p < .05.

On the question pertaining to supervision duties, the group of case managers who were required to supervise two or more other staff members reported higher levels of Emotional Exhaustion and Depersonalization than did the group of case managers who were not required to undertake supervision duties, F(1, 137) = 4.44, p < .05, and F(1, 136) = 4.54, p < .05, respectively. No significant difference between supervisors and nonsupervisors was evident on the Personal Accomplishment subscale, F(1, 137) = 0.02, p > .05.

Finally, mean MBI subscale scores from the present study were compared with the corresponding scores from two earlier investigations of burnout experienced by employment service case managers--the 1999 Job Network investigation that has been described previously in this article and a 1995 investigation into public service case manager burnout. Only on the Personal Accomplishment subscale was a significant difference found. The mean Personal Accomplishment score from the present study was significantly higher, corresponding to lower burnout, than was the corresponding mean for a sample of public sector employment service case managers surveyed in 1995, t(203) = 3.93, p < .001. This comparison is shown in Table 4, which presents MBI subscale means for all available published studies that have investigated the burnout experienced by employment service case managers. No significant differences were observed between the present study's mean Emotional Exhaustion and Depersonalization subscale scores and the corresponding mean scores in either the 1999 or 1995 investigations.

DISCUSSION

Psychological Distress in Australian Case Managers

It should be noted that the GHQ-12 enjoys wide acceptance as a reliable screening tool to detect respondents who currently have or who are likely to develop a psychological or psychiatric illness. Using the GHQ-12 in this study, we have identified significant levels of psychological morbidity in the Queensland case managers who participated in this study. This finding is highly consistent with the results that were obtained from a national sample of employment service case managers who were surveyed in 1999 (Goddard et al., 2000). Taken together, the results of the 1999 national investigation and the present Queensland-focused investigation leave little doubt that servicing large caseloads of unemployed individuals can be, for some individuals, a very stressful and psychologically distressing activity. This picture is most clearly presented by the results ensuing from the standard binary scoring methodology. These results suggest that for approximately half (48% in the present study) of the case managers surveyed, significant work-related pathologies are likely to arise. Even after modifying the criterion for determining psychiatric morbidity to a more conservative level, the distress experienced by case managers remained high (42%) relative to other studies that have reported case rates for employed respondents. For example, Graetz (1993) has reported maximum case rates of 28% for 2,647 employed Australians who were surveyed in the Australian Longitudinal Survey that was conducted by the Department of Employment, Education and Training between 1985 and 1988 (see Table 3). Similarly, the mean case manager Likert score found in the present study corresponded more closely to the levels of distress that were observed in individuals employed in stressful occupations (such as community-based mental health staff [M = 14.4]; Prosser et al., 1996), in the unemployed themselves, and in dissatisfied workers (Winefield et al., 1991), rather than to the levels of distress that were observed in employed adults who were satisfied with their employment. Table 3 provides details of these comparisons.

Case Manager Burnout

The aforementioned results have indicated that significant levels of emotional exhaustion were occurring in the sample of case managers surveyed. These levels were significantly higher than were Maslach et al.'s (1996) norms for this core dimension of burnout. This finding is both consistent with the results obtained from the administration of the GHQ-12 and is worrisome, because high levels of emotional exhaustion have repeatedly been associated with a wide range of social, emotional, and behavioral pathologies in both individuals and organizations (Cordes & Dougherty, 1993; Kahill, 1988; Maslach & Goldberg, 1998; Maslach & Leiter, 1997; Schwab, Jackson, & Schuler, 1986).

The concurrent finding that case managers' perceptions of personal accomplishment, on average, were significantly higher than Maslach et al.'s (1996) norms for other occupations indicated that many case managers in Queensland's Job Network were experiencing high levels of personal satisfaction. This pattern (i.e., high average emotional exhaustion, corresponding to high burnout levels, coexisting with high average personal accomplishment levels, corresponding to low levels of burnout) is consistent with the theory that emotional exhaustion and personal accomplishment develop independently. The same pattern of results was also found in the national survey of 1999 and is in keeping with the modified process model of burnout proposed by Leiter in 1993 (Maslach & Goldberg, 1998).

The Perception of Equity

In the present study, we found that case managers who considered that they were putting more into their work than they were getting back were reporting significantly more psychological distress and significantly higher burnout than did case managers who believed that the work environment was more equitable. This finding is notable for its significance across all the dependent variables that were investigated in the present study and is consistent with a growing number of studies that have demonstrated an association between perceived inequity in the service provider-recipient relationship and burnout (Schaufeli & Janczur, 1994; van Dierendonck, Schaufeli, & Sixma, 1994; van Horn, Schaufeli, & Enzmann, 1999; Van Yperen, Buunk, & Schaufeli, 1992). This finding is also consistent with Seigrist's recent proposal that the perception of equity is a significant predictor of work stress (Seigrist, 1996) and suggests that perhaps Adams's (1965) equity theory, a well-established and influential theory of social exchange, may provide a fruitful theoretical foundation from which to launch future empirical studies regarding the well-being of employment service personnel. Similarly, equity theory may provide helpful direction for the design and evaluation of the remedial interventions that the results of the present study suggest will be required for Australian employment services. For example, the results suggest that organizational interventions that increase the frequency and/or visibility of rewards, whatever these may be, may be influential in reducing levels of psychological distress and emotional exhaustion in personnel who work closely with the unemployed. However, caution must be exercised in the interpretation of the data regarding equity that are presented here, because the cross-sectional design of the present investigation cannot impute either cause or direction to the observed relationship.

The Impact of Supervision

The higher Emotional Exhaustion and Depersonalization subscale scores for supervisors who are required to supervise two or more personnel in addition to undertaking their case manager duties are unsurprising. The results are consistent with Maslach et al.'s (1996) theory that emotional exhaustion and depersonalization are most sensitive to job demands and lack of inner resources and suggest that the demands of supervision may have an additive effect with the work demands that are associated with carrying out intensive assistance case management with large caseloads of unemployed clients.

Limitations and Recommendations

In particular, it should be noted that the findings of the present study are based on the responses of approximately one third of the total population of employment service case managers who were working in Queensland at the time the survey was conducted. Although this participation rate improves marginally (to approximately 50%) when the number of case managers who worked for the two organizations that declined to participate are subtracted from the overall total, caution is warranted when considering the implications that the results may have for other cohorts of case managers. Given the paucity of research that has been conducted in this area, it is difficult to judge if an overall response rate of 50% is typical of the occupational group being investigated. Indeed, the large caseloads and high work pressures that have been found in other studies (e.g., Goddard & Patton, 1998) suggest that it may be difficult for case managers to engage in well-being surveys of this type simply because of time pressures. On this point, the current survey is possibly the largest single survey of employment service case managers published to date, and, given the paucity of research available elsewhere, there is no reason to believe that markedly different results would be found elsewhere in the world if case managers had similar work caseloads. Indeed, as the case management approach has been adapted as the vehicle for delivering billions of dollars of services (Department of Employment, Workplace Relations and Small Business, 2000, 2001) to the unemployed in Australia and a number of other countries (e.g., the United Kingdom, the United States, Canada, Sweden, and New Zealand), the findings of the present study should be a strong recommendation to researchers to investigate the well-being and burnout of employment service case managers in countries other than Australia. Finally, it was noted that the strongest association identified in this study was the relationship between perceived inequity and psychological distress. In our study, we did not attempt to make any determination about whether the perception of inequity was influenced more by the case manager's relationship with his or her unemployed clients or by the relationship with his or her employing organization. An answer to this question could be helpful for the design and implementation of initiatives to address the distress and burnout that were observed in the present study, and this question should be considered in future research.

CONCLUSION

This study investigated the incidence of burnout and psychological distress in personnel who work directly with the unemployed and, in doing so, has continued to address the worldwide dearth of literature in this area. The results of this Queensland-focused study are highly consistent with the results that were obtained in a previous Australian national study and are indicative of significant levels of emotional exhaustion and psychological distress in the fraternity of employment service case managers. The present study confirms that burnout and psychological distress in personnel who work in one-to-one relationships with unemployed individuals are significant phenomena, ones that have potentially serious health consequences for Australian case managers and ones that have workplace health and safety implications for employment service administrators.
TABLE 1
Demographic, Workload, Well-Being, and Burnout Scores
Reported by Case Manager Respondents From 18 Job Network
Organizations Offering Intensive Assistance in Australian
State of Queensland During 2001

Variable                           n (a)     M      SD      Range

Demographics
 Age last birthday (years)          149    38.01   9.70  21 to 54
 Experience as case manager
  (months)                          146    27.53  27.31  1 to 100
Workload variables
 Average weekly working hours       143    35.97   9.52   4 to 60
 Total caseload                     138   109.64  53.92  15 to 500
 Active caseload                    124    83.23  31.14  12 to 170
Well-being
 GHQ-12 (Likert scoring)            151    12.52   6.05   0 to 34
Burnout (MBI)
 Emotional Exhaustion subscale      150    23.58  12.42   0 to 54
 Depersonalization subscale         149     8.85   7.00   0 to 28
 Personal Accomplishment subscale   150    37.71   6.84  12 to 48

Note. GHQ-12 = 12-item General Health Questionnaire. MBI = Maslach
Burnout Inventory.

(a) n reflects the actual number of respondents answering
each question or completing all items on a measure.

TABLE 2
Well-Being and Burnout Comparisons for Various Respondent
Cohorts, Two-Tailed Significance

                              GHQ-12              MBI Subscale

Demographic                 n (a)     M      EE M      DP M     PA M

Sex
 Men                         51   13.29     23.61      8.98     36.67
 Women                       99   12.13     23.55      8.75     38.20
Work location
 Rural                       46   11.72     22.70      7.91     38.20
 Urban                       96   13.11     24.35      9.48     37.81
Skills training
 Any training undertaken     37   12.62     21.76      7.86     38.62
 No relevant training       113   12.60     24.29      9.19     37.44
Well-being
 program/activity
 Engaged in any program      56   12.30     23.49      7.89     39.18
 Not in a support program    94   12.78     23.61      9.31     36.80 *
Supervision
 Supervises two or more      37   14.14     27.27     11.03     38.03
 Does not supervise         102   12.04     22.32 *    8.21 *   37.85
View of workload equity
 Effort is greater
  than rewards               83   14.24     28.37     10.49     36.87
 Rewards are greater than
  or equal to effort         61   10.16 **  16.54 **   6.18 **  39.28 *

Note. GHQ-12 = 12-item General Health Questionnaire; MBI = Maslach
Burnout Inventory; EE = Emotional Exhaustion; DP = Depersonalization;
PA = Personal Accomplishment.

(a) n reflects the number of respondents answering each question.

* p < .05. ** p < .001.

TABLE 3
Comparison of Case Manager Psychological Morbidity Estimated by
the GHQ-12 With Statistics Reported in Other Australian Studies

                                   Level of Psychological Morbidity

                                                GHQ-12 Likert Scale
                                         Case
                                         Rate
Study                               N      %         M            SD

The present study
 Queensland Case Managers-
  2001                             151  48         12.52         6.05
Goddard et al. (2001)
 Australian Case Managers
   Surveyed-autumn 1999             86  51         12.25         6.85
   Surveyed-spring 1999             70  57 * (a)   12.83         6.38
Graetz (1993)
 Australian Longitudinal Data,
  Wave 1-1985
    Employed full-time           2,647  28 ** (a)   9.19         --
    Studying                       459  38 * (a)   10.14         --
    Unemployed                      76  43         10.83         --
Winefield et al. (1991)
 Young Australians (mean age
  22.6 years)
   Satisfied with employment       417  --          9.27 ** (b)  4.03
   Dissatisfied with employment     45  --         11.74         6.59
   Unemployed                       40  --         11.49         6.32
Patton & Donohue (1998)
 Unemployed Australian Adults       38  --         9.34 ** (b)   7.06

Note. GHQ-12 = 12-item General Health Questionnaire. Dash indicates
that data were not reported. Significance levels pertain to differences
from GHQ-12 scores observed in the present study.

(a) asymmetrical significance. (b) two-tailed significance.

* p < .05. ** p < .001.

TABLE 4
Comparison of Maslach Burnout Inventory (MBI) Subscale Scores for
Queensland Intensive Assistance Case Managers Surveyed in 2001
With Earlier Studies in 1995 and 1999 of Australian Employment
Service Case Managers

                                      National Surveys
                                           1999
                           Public                       Queensland
                           Sector
                            1995     Time 1    Time 2   Survey 2001
Item                      (N = 55)  (N = 86)  (N = 70)   (N = 150)

MBI subscales
 Emotional Exhaustion      23.42     22.31     24.56       23.58
 Depersonalization          9.58      8.05      9.56        8.85
 Personal Accomplishment   33.65 *   37.35     37.51       37.71

Note. Significant differences are observed only on the Personal
Accomplishment subscale (i.e., between the 1995 survey and all
subsequent surveys).

* p < .001, two-tailed significance.


REFERENCES

Adams, J. S. (1965). Inequity in social exchange. In L. Berkowitz (Ed.), Advances in experimental social psychology (pp. 267-299). New York: Academic Press.

Allan, P., & Yeandle, S. (1992). Youth unemployment and the family: Voices of disordered times. London: Routledge.

Australian Council of Social Service. (2000, August). Is the Job Network working? ACOSS analysis of the first stage of the official evaluation (ACOSS Paper 108). Strawberry Hills, New South Wales: Australian Council of Social Service.

Banks, M. H., Clegg, C. W., Jackson, P. R., Kemp, N. J., Stafford, E. M., & Wall, T. D. (1980). The use of the General Health Questionnaire as an indicator of mental health in occupational studies. Journal of Occupational Psychology, 53, 187-194.

Boardman, A. P. (1987). The General Health Questionnaire and the detection of emotional disorder by general practitioners: A replicated study. British Journal of Psychiatry, 151, 373-381.

Burvill, P. W., & Knuiman, M. W. (1983) Which version of the General Health Questionnaire should be used in community studies? Australian and New Zealand Journal of Psychiatry, 134, 508-515.

Cordes, C. L., & Dougherty, T. W. (1993). A review and integration of research on job burnout. Academy of Management Review, 16, 621-658.

Department of Employment, Workplace Relations and Small Business. (2000). Job Network evaluation, stage one: Implementation and market development (EPPB Report 1/2000). Canberra, Australian Capital Territory: Australian Government Publishing Service.

Department of Employment, Workplace Relations and Small Business. (2001). Annual report 2000-01. Canberra, Australian Capital Territory: Australian Government Publishing Service.

Fryer, D. M., & Payne, R. L. (1986). Being unemployed: A review of the literature on the psychological experience of unemployment. In C. L. Cooper & I. Robertson (Eds.), International review of industrial and organisational psychology (pp. 235-278). Chichester, England: Wiley.

Goddard, R. C., & Patton, W. (1998). A comparison between burnout levels of case management staff and non-case management staff working directly with the unemployed. In E. Carson, A. Jamrozik, & T. Winefield, (Eds.), Unemployment: Economic promise and political will (pp. 227-236). Brisbane, Queensland: Australian Academic Press.

Goddard, R. C., Patton, W., & Creed, P. (2000). Burnout in the Australian Job Network. Journal of Applied Health Behaviour, 2, 1-6.

Goddard, R. C., Patton, W., & Creed, P. (2001). Psychological distress in Australian case managers working with the unemployed. Journal of Employment Counseling, 38, 50-61.

Goldberg, D. P. (1978). Manual of the General Health Questionnaire. Slough, England: National Foundation for Education Research.

Goldberg, D. P., & Williams, P. (1988). A user's guide to the General Health Questionnaire. Windsor, England: National Foundation for Education Research.

Graetz, B. (1993). Health consequences of employment and unemployment: Longitudinal evidence for young men and women. Social Science and Medicine, 36, 715-724.

Hagen, J. L. (1994). JOBS and case management: Developments in 10 states. Social Work, 39, 197-205.

Kahill, S. (1988). Symptoms of professional burnout: A review of the empirical evidence. Canadian Psychology, 29, 284-297.

Kelvin, P., & Jarrett, J. E. (1985). Unemployment: Its social psychological effects. Cambridge, England: Cambridge University Press.

Leanna, C. R., & Feldman, D. C. (1992). Coping with job loss: How individuals, organizations, and communities respond to layoffs. New York: Lexington Books.

Lee, R. T., & Ashforth, B. E. (1996). A meta-analytic examination of the correlates of the three dimensions of job burnout. Journal of Applied Psychology, 81, 123-133.

Leiter, M. P. (1993). Burnout as a developmental process: Consideration of models. In W. B. Schaufeli, C. Maslach, & T. Marek (Eds.), Professional burnout: Recent developments in theory and research (pp. 237-250). Washington, DC: Taylor & Francis.

Maslach, C., & Goldberg, J. (1998). Prevention of burnout: New perspectives. Applied and Preventative Psychology, 7, 63-74.

Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach Burnout Inventory manual (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.

Maslach, C., & Leiter, M. P. (1997). The truth about burnout: How organizations cause stress and what to do about it. San Francisco: Jossey-Bass.

Murphy, G. C., & Athanasou, J. A. (1999). The effect of unemployment on mental health. Journal of Occupational and Organizational Psychology, 72, 83-99.

Patton, W., & Donohue, R. (1998). Coping with long-term unemployment. Journal of Community & Applied Social Psychology, 8, 331-343.

Prosser, D., Johnson, S., Kuipers, E., Szmukler, G., Bebbington, P., & Thornicroft, G. (1996). Mental health, burnout and job satisfaction among hospital and community-based mental health staff. British Journal of Psychiatry, 169, 334-337.

Schaufeli, W. B., & Janczur, B. (1994). Burnout among nurses: A Polish-Dutch comparison. Journal of Cross-Cultural Psychology, 25, 95-113.

Schwab, R. L., Jackson, S. E., & Schuler, R. S. (1986). Educator burnout: Sources and consequences. Educational Research Quarterly, 10, 14-30.

Seigrist, J. (1996). Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27-41.

Tennant, C. (1977). The General Health Questionnaire: A valid index of psychological impairment in Australian populations. Medical Journal of Australia, 2, 392-394.

van Dierendonck, D., Schaufeli, W. B., & Sixma, H. J. (1994). Burnout among general practitioners: A perspective from equity theory. Journal of Social and Clinical Psychology, 13, 86-100.

van Horn, J. E., Schaufeli, W. B., & Enzmann, D. (1999). Teacher burnout and lack of reciprocity. Journal of Applied Psychology, 29, 91-108.

Van Yperen, N. W., Buunk, A. P., & Schaufeli, W. B. (1992). Imbalance, communal orientation and the burnout syndrome among nurses. Journal of Applied Social Psychology, 22, 173-189.

Warr, P. B. (1987). Work, unemployment and mental health. Oxford, England: Oxford University Press.

Winefield, A. H. (1995). Unemployment: Its psychological costs. In C. L. Cooper & I. T. Robertson (Eds.), International review of industrial and organizational psychology (pp. 169-212). Chichester, England: Wiley.

Winefield, A. H., Tiggemann, M., & Winefield, H. R. (1991). The psychological impact of unemployment and unsatisfactory employment in young men and woman: Longitudinal and cross-sectional data. British Journal of Psychology, 82, 473-486.

Wendy Patton and Richard Goddard, School of Learning and Professional Studies, Queensland University of Technology. Correspondence concerning this article should be addressed to Wendy Patton, School of Learning and Professional Studies, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld, 4059 Australia (e-mail: w.patton@qut.edu.au).
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Author:Patton, Wendy; Goddard, Richard
Publication:Journal of Employment Counseling
Geographic Code:8AUST
Date:Mar 1, 2003
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