Combating Burnout in Social Work

September 10, 2024

Case workers and social workers experience burnout at a higher rate than most professions, on par with police officers, lawyers, healthcare workers, EMT workers, and other high-stress jobs. How can you combat burnout in social work?

Editorial Note: The advice contained in this article is not a replacement for mental health treatment or medical advice.

In the United Kingdom, one survey of 2,000 frontline social workers and managers found that stress affected 80% of respondents. Human services is a sector all too familiar with high-stress situations. After all, secondary traumatic stress (STS) and extreme job demands can create an environment where burnout occurs. While job burnout has many definitions, it’s typically characterized by “emotional exhaustion, depersonalization, or a lack of personal accomplishment,” according to two longitudinal studies from researchers in the United States and Poland, which estimated 67% burnout rates among subjects in various fields like mental health, social services, etc.

One impact of this burnout is that human service organizations experience high turnover rates, sometimes as high as 40% in services like child welfare.

So what can human service organizations do to mitigate burnout? In this article, we’ll explore factors that contribute to case/social worker burnout and evidence-based strategies to alleviate its symptoms.

Every job has its trade-offs. And jobs with steep trade-offs (i.e., high stress, long hours, low wages) often come with other positive benefits (i.e., sense of purpose, positive impact, on-the-job training). So what are the trade-offs that often contribute to burnout for social workers?

Compassion Fatigue

Compassion fatigue is the idea that people who are frequently exposed to the suffering of other people can start to accumulate a sense of exhaustion over time, which can lead to a gradual lessening of empathy. It’s well known to affect people in certain areas of healthcare, law enforcement, social services, and other sectors centered on lessening the suffering of living beings.

Symptoms include:

Emotional numbness or feeling disconnected from clients
Irritability
Difficulty concentrating
Decreased job satisfaction

Moral Injury

Moral injury is the idea being forced to act or participate in something that goes against one’s personal values. One team of researchers defined it as, “when a professional identifies the ethically or morally correct action to take in a situation but is unable to perform this due to constraints.” It’s especially prevalent in military and law enforcement but can also extend to social work, in situations where case workers or managers are required to make utilitarian trade-offs (e.g., where resources are finite and can be allocated to only a few clients at a time).

Symptoms include:

Existential or spiritual crisis
Feelings of remorse, anger, or betrayal
Loss of meaning or purpose

Secondary Traumatic Stress (STS)

Secondary traumatic stress comes from indirect exposure to potentially traumatic events. While not everyone responds to these events the same way, it’s not uncommon for social care workers to experience STS because of the heavy subject matter they work with. Caring for clients who later overdose on fentanyl is one example, and so is performing repeated intakes where clients report exchanging sexual favors for food or money. While STS is sometimes hard to define, the main “clusters of symptoms” include:

Intrusion
- Unwanted or upsetting memories that repeatedly occur
- Nightmares
Re-experiencing
- Repetitive sensations, such as pain, sweating, feeling sick, or trembling
- Frequent rumination
- Flashbacks
Avoidance
- Self-isolation from social situations or discomfort
- Lower work attendance

Verbal Abuse

Combined with all those factors, clients of health and human services organizations understandably are experiencing “rock bottom” in many cases, which can contribute to distrust of institutions, difficulty navigating structured environments, and mental or behavioral health issues—which can contribute stressful interactions with frontline workers in social services. Verbal abuse is therefore a common experience for many case workers. Verbal abuse can include intentional insults, threats, yelling, and belligerence.

High Job Demands

It’s no secret that funding for social care coordination is limited, and administrative burden is extensive, as are heavy caseloads. Administrative burden includes legal documentation, compliance reporting, billing/reimbursement, case notes, and so on, which adds to the time pressure of interacting with clients, sometimes adding to long hours worked. Imagine all the time that could be saved if spreadsheets were a thing of the past!

Given all these potential factors that contribute to burnout, is it any wonder, then, that mental health is an issue for many social/case workers? To illustrate, one Scandinavian study found almost 25% of social workers were prescribed antidepressants in that region. Another UK study found a relation between burnout and addiction in healthcare professionals.

While depression and burnout are not exactly the same, there are significant overlapping symptoms. And while many of the factors contributing to emotional exhaustion listed above cannot be totally prevented, they can be mitigated at the organizational level and need to be addressed at the individual level. So let’s address methods for individuals and organizations to combat these symptoms.

Addressing Emotional Exhaustion and Depersonalization

Emotional exhaustion often includes feelings of anxiety, apathy, depression, irritability, or lack of motivation and focus. Of course, many things can contribute to it, and emotional exhaustion is not unique to social work or even high-pressure jobs. It’s a normal human experience. But its severity can vary by degree and frequency, leading to intense mood swings or bouts of clinical depression. As explained by above-cited research, “Recent meta-analyses indicated that such modifiable beliefs about one’s own ability to deal with stress and its consequences are linked to lower levels/a reduction of job burnout.”

Individual Practices for Emotional Exhaustion

There’s no one-size-fits-all approach to addressing emotional exhaustion, obviously, and the general advice contained here is no replacement for working with a professional therapist or psychiatrist. With that in mind, here are some approaches that have been reported to help, some rooted in contemplative/therapeutic practices, and some rooted in behavior.

Resist projecting your past experiences onto clients. It can be the case, in many human services, that providers are passionate about the work because of their own experiences with trauma, homelessness, domestic abuse, and so on. In one interview with an expert of our own at Eccovia, an HMIS administrator said:

I think most of us go into social work or case management for a specific reason, and to help people with traumas we have experience with. It’s easy to project those things onto the client and unintentionally harm the client in a way because the attitude becomes, “This is what I did to get through,” instead of asking, “What do you need?”
Source: Brett Rawl, HMIS Administrator, Eccovia.

Many practices in cognitive behavioral therapy (CBT). A common practice in CBT is that of cognitive distancing. In practice, this would involve taking a beat to distance ourselves from our thoughts and feelings to examine them closely, and even argue with them. “Is this situation really as bad as it feels? Is there anything I can do about it? Will worrying about the situation make it any better, in reality?”

Psychotherapist and philosophy historian Donald Robertson explains this concept:

[Cognitive distancing] doesn’t mean distancing ourselves from events emotionally, by suppressing our feelings or distracting ourselves, but rather something more subtle and fundamental: distancing our thoughts from reality by viewing them as merely mental representations. . . Normally we view the world “through” the lens of our . . . judgments, like someone looking at the world through “rose-tinted” spectacles. . . We may forget we’re wearing glasses, though, and assume that’s just the way external things [are]. Cognitive distancing is like the process of taking off the glasses and looking at them, rather than through them. . . [It’s the] practice of treating [our] own thoughts as if they were hypotheses that deserve to be evaluated rationally and tested empirically, rather than simply facts about the world.
Source: Donald Robertson, Stoicism and the Art of Happiness. 2018. Hodder & Stoughton: Great Britain. p 178–179.

For example, a case worker who has a heavy caseload might feel as though she is bound to work ridiculously long hours to compensate for the backlog of clients, or she might feel obligated to constantly worry over her clients she hasn’t gotten to yet. However, there isn’t any point in worrying over something you can’t control directly. Of course, this will take time to train your mind this way; there’s no way to just flip a switch to stop worrying. But over time, while accepting the situations we’re in, we can find relief in viewing our thoughts merely as thoughts and rationally understanding what is true about them and what isn’t.

This means viewing the ways in which we catastrophize, think in black-and-white terms, or expect unrealistic control over the unfolding of events, all with a compassionate, non-self-judgmental lens.

Meditation practice (but not in the way you think). It’s common to be thinking without knowing we’re thinking, almost like being lost in a dream. This self-identification with thought is thought by many who study behavior and neuropsychiatry to be a source of additional, unnecessary suffering we can sometimes avoid if we pay close attention to the nature of our experience, often through meditation. While there are many forms of meditation in varied spiritual communities, many of which help with stress reduction, the most prominent form of meditation is often described as mindfulness.

This term is hard to define scientifically, but meditative practice can include a lot of different activities than just sitting in silence or walking while listening to a meditation track. It can include fidget toys (especially helpful for neurodivergent people with ADHD or autism), hiking, listening to music (while doing nothing else), taking a walk, yoga, or worry stones. The point is to do something as an end unto itself.

To quote our HMIS admin from above, “I cross-stitch now, but a lot of people knit and crochet and do other things like that. Repetitive motions and creating something can be an outlet to unplug for a bit.”

In Nature, one team of researchers write:

Mindfulness meditation can lead to a calming of attitudes, help people to modulate their attention, and guide them to focus on their feelings in the present moment. People can increase their self-awareness when practicing mindfulness meditation, which helps them to better comprehend their own emotions and states, thus increasing flexibility of thought and driving positive thoughts.
Source: Fu, Y.; Song, Y.; Li, Y.; et al. “The effect of mindfulness meditation on depressive symptoms during the COVID-19 pandemic: a systematic review and meta-analysis.” Sci Rep 14, 20189 (2024).

In a talk by meditation teacher and author Jack Kornfield, he recalled an experience: “I remember once when I was walking with my teacher Ajahn Chah, he pointed to a boulder in a field and asked, ‘Is that heavy?’ I replied, ‘Yes, of course.’ Ajahn Chah smiled and said, ‘Not if you don’t pick it up.’“

There are a few ways to interpret this parable-like lesson, but here’s one that’ll help, which Kornfield later explained: trying to prevent suffering or fight against a feeling is like trying to lift that heavy boulder. You will only strain against it, and it will remain. Mindful meditation is the practice watching thoughts, feelings, and sensations come and go, accepting them without judgmental thoughts, like, “I shouldn’t be having this experience.”

For example, try telling yourself to not think about a specific subject. Guess what happens—you tend to think about it even more.

Autobiographical journaling. Remember that cognitive distancing we talked about earlier? It’s much easier to do when you write it all down by hand. When we write something out by hand, we are more likely to remember it, as suggested by recent brain imaging studies. We take the time to slow down, think honestly about what we are experiencing, and write about our experiences, we understand them differently and find a kind of separation from them so we can study them.

However, it’s important to avoid writing just complaints; expressing things we are grateful for, even if it doesn’t feel genuine in the moment, can have a stress-reduction effect. Bestselling author and teacher, Mark Matousek, who coaches people on journaling for personal insights, said in an audio essay, “Journaling can help you become more aware of how you see [things], since many of us move through our lives with scant knowledge of our subjective lenses and their impact on moment-to-moment experience.” After all, it was William James, one of the founders of modern psychology, who said that our lives are basically the sum of what we pay attention to.

Rigorous physical exercise. As the saying goes, the best form of exercise is the one you’ll actually do. It’s important not to pressure yourself into a revolutionary routine—or the most “optimized”—if you’re new to regularly working out. James Clear wrote in his bestseller, Atomic Habits, about a client of his who started going to the gym for literally 5 minutes at a time. He would walk into the gym and walk right back out. Then, after a few days, he would go for 15 minutes, then 30 minutes after a few more days, then 60. The point is that he made the habit sustainable and easily doable at first, which gave him an internal sense of encouragement and accomplishment. The point is to get your heart rate above your rest rate.

Finding community. We know that we’re a social species that thrives best in groups. It’s noted in anthropology, modern psychology, sociology, and every other field of study that studies human well-being, that we are best served when we find a sense of belonging in a group of individuals, even if they’re not like us in every other way. At Eccovia, for example, we encourage communities to learn from each other and find community through our ClientConnect platform, a series of webinars, events, and educational pieces that help communities learn from each other.

Of course, individual behavior can only go so far. It’s clear that burnout can and should be addressed at a higher level, too.

Organizational Practices for Emotional Exhaustion

Human services organizations can help their employees address emotional exhaustion through a few methods, but be careful: any intervention may appear to work at first, if people know they’re being observed for certain outcomes. These observer effects take on many names, but if you survey employees and volunteers who know they’re being observed for specific items, it’s easy to create a self-reporting bias that skews the data. For more information, check out our article on mitigating self-report bias!

With all that in mind, here are some ways organizations can help their social/case work employees prevent or mitigate burnout:

Providing mental health benefits or resources. Do you provide your employees with a meditation app, the right to unplug after hours, or mental healthcare? Those are a good start. Maybe they’re necessary, but not they’re not sufficient. Anne Helen Petersen wrote in a now-famous article:

You don’t fix burnout by going on vacation. You don’t fix it through “life hacks,” like inbox zero, or by using a meditation app for five minutes in the morning, or doing Sunday meal prep for the entire family, or starting a bullet journal. You don’t fix it by reading a book. . . vacation. . . or “anxiety baking” . . .
Source: Anne Helen Petersen, Buzzfeed News, “How Millennials Became The Burnout Generation.” January 5, 2019.

Providing technology that eases administrative burdens. Giving organization members, like case managers and workers, the ability to manage their caseloads with client database technology is a surefire way to help them help others more efficiently, thereby experiencing a lighter workload and lower probability of burnout. When case managers can share case notes in a uniform way, or when case workers can perform intakes knowing that their data will be synced with the system automatically, or when reports can be pulled more easily than having to know Excel formulas inside and out, administrative burden decreases. After all, how much time do you spend on compliance already?

Partnering with similar organizations to pool resources. There are many organizations out there like MACC, the Metropolitan Alliance of Connected Communities, which provides shared administrative services at a scale that allows service providers to worry more about their mission instead of things like data services, IT infrastructure, insurance billing, and finances. The network is held together not just through personal relationships, which can prove to be a fragile foundation, but also shared missions. That’s one reason many refugee resettlement agencies, for example, coordinate care with shared ClientTrack environments.

Addressing Lack of Accomplishment

There will always be too much to do. While there are many non-work-related factors that can contribute to this experience of being unable to focus, there’s one possible explanation that tends to pervade high-pressure jobs: constant urgency.

In the bestselling book Four Thousand Weeks, psychology journalist Oliver Burkeman makes a few interesting observations:

The harder you struggle to fit everything in, the more of your time you’ll find yourself spending on the least meaningful things. . . The reason for this effect is straightforward: the more firmly you believe it ought to be possible to find time for everything, the less pressure you’ll feel to ask whether any given activity is the best use for a portion of your time. . . because you’ll assume you needn’t sacrifice any other tasks or opportunities in order to make space for it.
Source: Source: Oliver Burkeman, Four Thousand Weeks: Time Management for Mortals. Farrar, Straus and Giroux: New York, 2021. p 48.

Does this mean we’re doomed to be overwhelmed with our too-large caseloads? Well, yes and no, he argues in the book:

The more you confront the facts of finitude instead—and work with them, rather than against them—the more productive, meaningful, and joyful life becomes. I don’t think the feeling of anxiety ever completely goes away; we’re even limited, apparently, in our capacity to embrace our limitations. But I’m aware of no other time management technique that’s half as effective as just facing the way things truly are.
Source: Ibid., p 32.

So what does it mean to “face things the way they truly are”? It means a few things, in his estimation.

Letting go of the illusion of getting it all done, and instead focusing on what counts. In the appendix of Four Thousand Weeks, Burkeman argues for keeping only three items at a time on your to-do list, so you’re not spreading yourself too thin on getting progress on all fronts—which will inevitably lead to progress on no fronts, he says. After all, how much context-switching do you do in a day, and how long does it take you to really dive into a task once you’ve been asked to do it? It often takes people a few minutes to remember what was done on a project, what remains to be done, and how you’re going to do it.

Making hard sacrifices among all the things we deem important. Burkeman also argues for doing one big project at a time so you can really see it to completion before moving on to the next one. After all, it’s well known that multitasking is a myth, in cognitive science. That means you have to learn to say no to things you think are actually really important, like “clearing the decks” and answering every single email. (After all, if you quickly answer all emails and messages, what do you get? Just more emails and messages in a never-ending treadmill.)

Decide what you’ll procrastinate on or fail at, in advance. There will inevitably things that fall through the cracks when caseloads are high and deadlines for reporting loom near. That means there will be some things that will fall short of your perfect fantasies of achievement (aren’t there always?). There’s a kind of freedom in that, because it releases you to focus on a few things that you can excel at. Burkeman writes, “Loss is a given. That ship has sailed—and what a relief.”

Keep three lists: open, closed, and on deck. Keep no more than three items on your “open” (to-do) tasks at a time, and keep your “closed” list (done list) as long as you want, as a way to motivate yourself: “See how much I got done this last week?” You can focus on what you have accomplished just as much as what you haven’t.

Organizational Practices for Time Management and Accomplishment

Human service organizations and networks can mitigate burnout by helping social workers, case workers, and case managers in a few key ways.

Find data reporting tools that make it easy and intuitive. When reporting to stakeholders (i.e., CoC board members, regulators, and funders), reporting needs to be something that can be done in a matter of hours or minutes, not days or weeks. Fortunately, ClientTrack offers reporting for all levels of organizational needs, including enterprises.

Make intakes uniform across the network. When intake questions and access points are disparate and repetitive, it discourages would-be clients for many reasons: secondary trauma, reporting fatigue, and issues with navigating structured environments. Also, your data quality suffers when intake questions are asked in similar yet different ways. ClientTrack’s Designer Toolset makes this process much easier.

Have strict non-work hours for all involved. During the pandemic, many reported the lines blurring between work and home life due to the accessibility of work computers at home. “I’ll just check my email really quick,” became the common refrain. In any job, it’s important to maintain boundaries and protect your work/life balance; in social work, it’s essential. It’s natural and good to feel empathy and the drive to help others, but there will never be a point where the work is “done,” and if we’re not careful, it can encroach on our personal lives. Wherever possible, help foster a working environment that helps maintain that work/life balance and allows social workers to leave their work at the office.

There will probably always be issues with high caseloads, heavy administrative burdens, compliance reporting, and social ills. The least we can do as organizations is make things easier on each other and ourselves. Combating social worker burnout is a multilayered, multitiered process that can be done with many different methods. Some of our efforts will fall short, and some will succeed.

But we have to at least make it easier for those on the frontlines of social services.

If you agree and want to see how technology can help in that fight, please schedule a demo with one of our experts or subscribe to our monthly newsletter for further information!