How to Prevent Burnout and Increase Professional Fulfillment Utilizing the BALANCE Framework

What is Burnout

The World Health Organization defines burnout as a state of being that occurs in response to prolonged stress at work (World Health Organization, 2022). It is a term inclusive of three primary characteristics, “emotional exhaustion, depersonalization, and reduced personal accomplishment” (Fred & Scheid, 2018). Emotional exhaustion is a feeling of being overextended and depleted of one's emotional and physical resources. Depersonalization is when someone exhibits a cynical attitude and detached feelings towards clients, colleagues, and the organization. Reduced personal accomplishment describes a sense of ineffectiveness and lack of accomplishment at work.

How to Implement Burnout Prevention and Achieve Professional Fulfillment

Mental health practitioners believe that burnout can be both treated and prevented. Professional fulfillment is often defined as the extent to which an individual finds their work rewarding, meaningful, and aligned with their personal and professional goals. Focusing on increasing professional fulfillment is preventive for burnout and is less costly to both employees and employers than treatment for burnout. For health and human service employees, professional fulfillment can be fostered through the 7 pillars of the BALANCE framework:

Behaviors. Behaviors are the evidence of the forces that are “behind the scenes” of the workplace and “below the surface” in the individual. In the workplace, this is the culture that is both stated in written procedures and unspoken in the understood norms. In the individual, this is the past painful experiences, thoughts and feelings (Dana & Porges, 2018).

The first step in avoiding burnout is to learn to notice and observe the problematic behaviors of yourself and others. Problematic behaviors are typically void of empathy and empowerment. Rather, they involve attempts to dominate and control others, lash out in anger and frustration, make assumptions before getting all the information, defensiveness, stubbornness, shutting down, or the like.

Observing behaviors provides the opportunity to understand the context surrounding the situation and activate a proactive, problem solving response. It also allows time to divert impulsive and emotionally charged reactions that perpetuate the toxic cycles that lead to burnout. This first step to commit to calmly observing rather than impulsively reacting is a critical ingredient of psychologically safe environments in which people can thrive and enjoy professional fulfillment.

Accepting Feelings. Accepting your own and others' feelings is essential for creating a safe and supportive environment. Often workplace cultures require that professionalism be synonymous with stoicism and that expressing feelings is a sign of weakness. However, both denying and/or stuffing your feelings is stressful and is problematic for the work culture and your physical and mental health.

Feelings are an authentic component of the human experience and are better regulated than denied. Accepting and expressing your feelings and allowing others to do the same creates the opportunity to learn and discover meaningful solutions for the conflicts that are compromising the wellbeing of yourself and others (Harris, 2021).

Limiting Beliefs. Learning to identify and challenge limiting beliefs is the key to growth, and development both for the individual and the workplace culture. For example, you could have beliefs that cause you to trust certain people more than others, or believe things about yourself and others that may or may not be true. Limiting beliefs are characteristically rigid and negative and unfortunately, the foundation for many of the organization policies that contribute to burnout.

Beliefs that are helpful are those that are flexible, optimistic and realistic. Recognizing and challenging limiting beliefs and the patterns and policies that reinforce them facilitates the opportunity for both individuals and workplace cultures to reach their full potential (Beck, 2020).

Activating Events. Events in the environment that trigger an emotionally charged response are the primary cause of burnout. Because the human body is wired for survival, reminders of past emotional pain are current threats that trigger the Fight, Flight or Freeze response (Dana & Porges, 2018). Becoming aware of the people, policies, duties, and types of interactions that trigger the survival response is probably the most important skill in building resilience in yourself and the workplace.

Simply stated, when either the activating event or the activation to the event can be avoided burnout will be eliminated.

Nurture Health. For several years, self-care has been the obvious burnout solution promoted by the vast majority of employee assistance programs. However, recent research is indicating a downside to this single minded focus (Hricová, 2020). Understanding that burnout is as much the responsibility of the workplace as the individual employee, is the heart of a successful wellness program.

Additionally, self-care or “health promotion” programs are most effective when offered as a voluntary and preventive measure allowing for autonomy and individual decision making in its use (Tetrick & Winslow, 2015). Nonetheless, self-care is essential for health and wellbeing and is the responsibility of each individual and each organization to promote (Jackson & Watkin, 2004).

Connections. Individuals and workplaces that foster a climate of inclusion and belonging create cultures that are safe, fun, and productive. Even workplaces that are especially demanding and that offer limited employee efficacy (a situation ripe for burnout) can offset the risk of stress through building opportunities for workplace relationships (Karesek & Theorell, 1990). Importantly, while allowing coworkers time to connect, reflect, and vent about their work has been found to reduce burnout risk; requiring social engagement through seemingly unnecessary meetings has been found to contribute to burnout (Tetrick & Winslow, 2015). Connection needs to be allowed to authentically occur in the workplace (Jackson & Watkin, 2004).

Additionally, reconnecting with your purpose, the reason why you do what you do and connecting with your passion, what you are good at, reinforces resilience in both the workplace and the individual. Rediscovering meaning and engagement with work in the helping professions can serve to reduce burnout risk (Hricová et al., 2020;Jackson & Watkin, 2004).

Efficacy. Studies have demonstrated that allowing employees increased autonomy in defining or “crafting” their jobs can reduce risk of burnout (Gabriel & Aguinis, 2022). Workplaces that promote autonomy and agency demonstrate respect for the dignity and self-worth of employees which provides opportunity for increasing confidence and motivation… the necessary ingredients for success (Jackson & Watkin, 2004).

Believing that professional fulfillment is possible is the motivation for both workplaces and individuals to commit to implementing the 7 pillars of the BALANCE framework.

Preventing burnout and fostering professional fulfillment in health and human services is not just beneficial—it's essential. It leads to healthier, happier employees who are more engaged and effective in their roles. As such, organizations need to prioritize these aspects not only to safeguard their workforce but to ensure high-quality care and service delivery. Through sustained efforts in these areas, health and human service professionals can achieve a rewarding balance that benefits everyone involved.