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Introduction
Recent years, researchers admit high rates of turnover among substance abuse counselors caused by burnout and emotional distress. The main problem is that their work demands empathic relationships and often a great deal of emotional involvement. They risk being emotionally drained, giving of themselves until they have nothing more to give. In many treatment programs, counseling serves as the primary mechanism for maintaining the treatment structure. The counselor explains the rules and procedures to the patient, monitors the patient’s performance, and participates in the use of sanctions to obtain patient compliance. Thus, researchers admit that burnout and turnover of substance abuse counselors is caused by work overload and inadequate policies and communication within the treatment facility.
The main functions of substance abuse counselors
Burnout and turnover of substance abuse counselors is caused by the nature of work itself. The main functions of substance abuse counselors involve development of plans and supervision of clients, work with families and psychological assessment of their emotional and physical progress (Shoptaw et al 2000). The client is expected to participate in counseling sessions once a week, minimum. The weekly counseling sessions serve to identify specific objectives and assign specific tasks to enable the client to successfully attain the established treatment goals. The counseling sessions also permit periodic review and revision of the individualized treatment plan as necessary and appropriate (Perkinson, 2001). The primary goal of the treatment is to maintain effective functioning rather than require detoxification. The counseling component of the mobile health service treatment program is behavior change as it relates specifically to drug-seeking and drug-taking. While the “high tolerance” philosophy of the treatment approach subscribes to a procedure that offers and encourages counseling, participation in drug abuse counseling is not an absolute requirement (Perkinson, 2001). Following Barnett and Thomas (1997): “Substance abuse therapists may be at higher risk for burnout than other therapists because they work with chronic and difficult clients”. The counseling situation needs to be viewed as a two-person interaction, where each individual is constantly influencing and being influenced by the other. So, it is not enough to merely hang a label on the client or the counselor. Rather, it is important to focus on the way in which the client’s style and behavior. Counseling is often mandatory and scheduled. The counselor also engaged clients in HIV risk reduction behaviors if HIV transmission is to be prevented (Perkinson, 2001). The engagement is most difficult for reasons such as denial, apathy, grandiosity, self-destructiveness, lack of information, difficulty in obtaining materials needed to practice safer sex or safer drug use, and lack of cultural and social support. It takes a special manager with special counseling skills to develop a relationship with these clients. The counselor does not act as a therapist but does participate in therapeutic activities that instigate client behavioral changes (Acker, 1999).
Substance abuse treatment can range from a few days of detoxification to a few months of drug-free outpatient counseling, to a year or more living in a therapeutic community. In each of these programs the focus is on providing medical, counseling, and psychological services to the client (Shoptaw et al 2000). Medical and psychological services are important, even primary, issues in treating drug abuse; however, case studies) have repeatedly highlighted the critical role of stressful life events (e.g., divorce, loss of job) in precipitating a relapse into drug use among recovering addicts. Integrating educational, vocational, and life skills management with more standard counseling treatment may more comprehensively address drug abuse symptoms. Following Perkinson (2001) providing after-care resources to assist and buffer the client from life stressors may be a more effective means of preventing relapse. The components of treatment during the intensive phase are designed to interrupt substance use behavior by providing individual, group, and family counseling aimed at breaking through denial and addressing issues that support the ongoing use of drugs (Brooks & Matthews, 2000) Education provides clients with information about the physical, emotional, behavioral, and spiritual effects of chemical use. AIDS education and support involving groups, discussion, and multi-media materials for clients and, if appropriate, their families lay the groundwork for further, individualized HIV prevention efforts Many counselors are constantly drowning in paperwork (Shoptaw et al 2000). They seem unable to get on top of their work. In this regard, they present much like clients whose emotional states – anxiety, depression, and anger – prevented them from focusing on and completing specific, concrete tasks (Stevens & Smith, 2004).
Physical or emotional exhaustion
The main problem is that counselors are emotionally involved in treatment and supervision activity. After a year or two, many of them admit that they are physically or emotionally exhausted, negative about themselves and their jobs, and increasingly less concerned about their clients. Counselors become depersonalized and emotionally withdrawn (Lewandowski, 2003). Burnout research focuses on the various causes and manifestations of such withdrawals and the resulting implications for work effectiveness, morale, and turnover (Brooks & Matthews, 2000). According to Barnett and Thomas (1997):
Recovering substance abusers employed as therapists in treatment facilities may have a higher risk of burnout than other therapists in the same facility because of their potentially greater identification and involvement with their clients.
Counselors are filled with or emptied of emotional resources in the course of their interactions with clients and other employees, which shape their abilities to perform their roles effectively.
Other problems
Many problems arise from a lack of staff development and professionalism in the program maintenance. The research shows that counselors unconsciously recreate the dynamics of the families with which they worked (Perkinson 2001). The components of treatment during the intensive phase are designed to. The social workers working closely with substance abusers took their anger at the fathers who in many cases had abandoned their families, and projected it onto the director, a likely candidate given his position of authority and his seeming absence from agency members. The counselors may express anger at the director both actively (e.g., blaming him for workloads) and passively (e.g., not completing necessary documentation) (Brooks & Matthews, 2000). Another closely related symptom that counselors might experience is that of feeling like they are on automatic pilot, as if their approaches and interventions get trotted out in a rather mechanistic fashion (Lewandowski, 2003). The counselor’s interventions lack the freshness, vitality, and originality that suggest that the counselor is actively and creatively engaged with the clients. Powell & Brodsky (2004) admit that counselors may feel distant from clients, like there is not much of a genuine relationship. Rather, the outplacement work begins to feel like a process of tinkering with externalities, but not really connecting to the strongly held dreams, interests, values, skills, and ideas of the client.
Also, counselors are responsible to both the sponsoring organization, who pays for the services, and to the individual candidate who receives them. This dual allegiance can create ethical problems from time to time. Decisions about progress reporting, for example, capture the dilemma, especially as it relates to the issue of confidentiality. Typically, outplacement counselors and their firm’s representative are asked to report to the sponsoring organization concerning client progress (Brooks & Matthews 2000). Outplacement counselors must walk the fine line between being responsive to the needs of the sponsoring organization, and being mindful of the sensitivities and trust of the clients who will not want certain personal information to be disclosed. The industry must continue to monitor this and other dilemmas that relate to the dual allegiance. According to Rotgers et al (2006) as further experience is accumulated, guidelines must continue to be formulated concerning the appropriate ways for outplacement counselors to respond.
Critical view
Critics (Rotgers et al 2006) single out different types of stressful situations influenced a counselor. Individual factors are those that are located within an individual. For example, those drawn to outplacement counseling and other forms of counseling often take pride in their commitment to helping others. However, working closely with others on a constant basis is emotionally demanding. In order to avoid becoming overly stressed, practicing professionals must develop consistent methods of stress reduction that work for them. Some counselors might find this difficult to do. It might be because they do not recognize their own symptoms of stress, or it might be that they respond to their stresses in a manner that is non-adaptive or not healthy. Another set of stressors are those that take place at the dyadic level. They emerge from the interactions of the counselor and client (Shoptaw et al 2000). Counselors have different styles and different sets of needs. The same is true for clients. Most experienced counselors know that there are certain types of clients who are more stressful than others for them. For example, a counselor can place great importance on his role as a helping professional, and can switches to outplacement from corporate human resources, where he does not feel like he has sufficient opportunity to be of genuine assistance to those he serves (Rotgers et al 2006).
In terms of changing immediate behavior, counselors can stop certain behaviors within the counseling relationship that are stressful, limiting, and emotionally draining. For example, counselors who are overly invested in being an expert at all times can pull back from that stance. They can strive to be more comfortable not having all the answers (Stevens & Smith, 2004). They can do a better job of drawing on other resources, identifying other sources who can be of assistance to the client. Specifically, there might be professional colleagues who are more knowledgeable about information resources or industry information, to whom a client can be referred. Also, counselors can do a better job of regularly recharging their batteries. Each counselor will do this differently. For some it might be spending the lunch hour quietly, reading or reflecting (Stevens & Smith, 2004). Counselor experience painful feelings: fear about matching youths with potentially abusive volunteers, fear of being overwhelmed by the youths’ neediness, and hopelessness about the enormity of substance abusers need help.
Counselors may seek to defend themselves against the anxiety generated by their primary tasks. They simplify their emotional experience in order not to deal with disturbing ambiguities, ambivalences, and other sources of emotional confusion. Counselors increasingly find themselves attending to issues of professional development. There are certain historical and sociological factors that contribute to this trend. Professional development is especially important for outplacement practitioners in order to prevent counselor burnout. There are wide assortment of activities that promote professional development (Stevens & Smith 2004). In addition, there are a variety of approaches for promoting long-range career development among outplacement professionals. According to Knudsen et al (2006):
Perceptions among counselors that managers will listen to their opinions and will apply decisions fairly across workers are strongly associated with emotional exhaustion and intentions to quit. Program managers may be able to address, in part, problems of high turnover within their organizations through social interactions with their counseling staff.
These activities and approaches are important to counteract the stresses of outplacement practice. This follows a psychological premise: when people are unwilling or unable to change behaviors that are clearly irrational, given the goals they articulate, it is often because unconscious, irrational needs are holding sway.
Summary
In sum, high turnover rates and burnout among substance abuse counselors are caused by emotional distress and inability to overcome stressful situations at work. Many counselors act in irrational ways, given their ostensible goals. Their breakdowns may often be traced to irrational purposes that members have collectively, unconsciously substituted for organizational goals. The creation of appropriate collaborations across organizations thus depends on establishing regular settings in which unit members can address their own practices and experiences. Insight and understanding will help to integrate their work and avoid emotional distress. Collaborations, like relationships, cannot be truly healthy unless each party has the maturity to examine and develop their own behaviors separate from those of the other. In the context of such differentiation, people are not forced into simplified emotional experiences.
References
- Acker, G. M. (1999). The Impact of Clients’ Mental Illness on Social Workers’ Job Satisfaction and Burnout. Health and Social Work, 24 (2), 112.
- Barnett, E. D., Thomas, D. (1997). Correlates of burnout in inpatient substance abuse treatment therapists. Journal of Addictions & Offender Counseling, 17 (2), 56-65.
- Brooks, C.W., Matthews, CH. O. (2000). The Relationship among Substance Abuse Counselors’ Spiritual Well-Being, Values and Self-Actualizing Characteristics and the Impact on Clients’ Spiritual Well-Being. Journal of Addictions & Offender Counseling, 21 (1), 23-26.
- Knudsen, H. K., Ducharme, L. J., Roman, P. M. Counselor emotional exhaustion and turnover intention in therapeutic communities. Journal of Substance Abuse Treatment, 31 (2006), 173– 180.
- Lewandowski, C. A. (2003). Organizational Factors Contributing to Worker Frustration: The Precursor to Burnout. Journal of Sociology & Social Welfare 30 (4), 175.
- Perkinson, R. R. (2001). Chemical Dependency Counseling: A Practical Guide. Sage Publications, Inc.
- Powell, D.J. Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods. Jossey-Bass.
- Rotgers, F., Morgenstern, J. Walters, S.T. (2006). Treating Substance Abuse, Second Edition: Theory and Technique. The Guilford Press.
- Shoptaw, S. Stein, L. A., Rawson, R. A. (2000). Burnout in substance abuse counselors Impact of environment, attitudes, and clients with HIV. Journal of Substance Abuse Treatment, 19, 117–126.
- Stevens, P., Smith, R. L. (2004). Substance Abuse Counseling: Theory and Practice. Prentice Hall.
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