Overextending the Overextended: Burnout Potential in Health-Care Professionals, Psychologists, Patients, and Family Members

  • Lauren Woodward Tolle
  • Steve Graybar
  • A nurse providing care on the intensive care unit for children complains of debilitating headaches and is becoming increasingly socially isolated and detached from others.

  • A pediatrician is suffering from insomnia and days of vacation do not appear to alleviate symptoms of anxiety or sadness.

  • A mother of a child who survived a brain tumor is experiencing problems in her marriage and fears that the tumor will come back. She frequently worries about her child’s capacity to have meaningful relationships and a fulfilling career as an adult.

  • An adolescent living with type 1 diabetes for 8 years has become lax in his diabetes management and feels hopeless about the future.

  • A psychologist assisting families with chronically ill adolescents feels powerless to change behavior and improve outcomes outside of her control and frequently experiences intrusive thoughts about her patients.


Diabetes Care Emotional Exhaustion Chronic Health Condition Mindfulness Meditation Compassion Fatigue 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Adams, R. E., Boscarino, J. A. & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry 76(1), 103–108.CrossRefGoogle Scholar
  2. Alford, W. K., Malouff, J. M., & Osland, K. S. (2005). Written emotional expression as a coping method in child protective services officers. International Journal of Stress Management, 12(2), 177–187.CrossRefGoogle Scholar
  3. Allam, Z., & Ali, N. (2007). Job involvement, job anxiety and job burnout: A comparative study of bank employees. Social Science International, 23(1), 104–113.Google Scholar
  4. Berger, B. G., & Motl, R. (2001). Physical activity and quality of life. In R. N. Singer, H. A. Hausenblas, & C. M. Janelle (Eds.) Handbook of Sports Psychology. New York: Wiley.CrossRefGoogle Scholar
  5. Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring compassion fatigue. Clinical Social Work Journal, 35, 155–163.CrossRefGoogle Scholar
  6. Brosche, T. (2003). Death, dying and the ICU nurse. Dimensions of Critical Care Nursing, 22, 173–179.PubMedCrossRefGoogle Scholar
  7. Brown, R. T., Wiener, L., Kupst, M. J., Brennan, T., Behrman, R., Compas, B. E., et al. (2008). Single parents of children with chronic illness: An understudied phenomenon. Journal of Pediatric Psychology, 33(4), 408–421.PubMedCrossRefGoogle Scholar
  8. Bughi, S. A., Sumcad, J., & Bughu, S. (2006). Effect of brief behavioral intervention program in managing stress in medical students from two Southern California universities. Medical Education Online 11, 1–8.CrossRefGoogle Scholar
  9. Carlson, J. R., & Thomas, G. (2006). Burnout among prison caseworkers and correction officers. Journal of Offender Rehabilitation, 43(3), 19–34.CrossRefGoogle Scholar
  10. Chaffee, B. (2005). Implementing integrated behavioral health care in TRICARE. In N. A Cummings, W. T. O’Donohue, & M. A. Cucciare (Eds.). Universal healthcare: Readings for mental health professionals. Reno, NV: Context Press.Google Scholar
  11. Coffey, J. S. (2006). Parenting a child with chronic illness: A metasynthesis. Pediatric Nursing, 32, 51–59.PubMedGoogle Scholar
  12. Collins, S., & Long, A. (2003). Working with the psychological effects of trauma: Consequences for mental health professionals, a literature review. Journal of Psychiatric and Mental Health Nursing, 10, 417–424.PubMedCrossRefGoogle Scholar
  13. Conrad, D., & Kellar-Guenther, Y. (2006). Compassion fatigue, burnout, and compassion satisfaction among Colorado child protection workers. Child Abuse & Neglect, 30, 1071–1080.CrossRefGoogle Scholar
  14. Deighton, R. M., Gurris, N., & Traue, H. (2007). Factors affecting burnout and compassion fatigue in psychotherapists treating torture survivors: Is the therapist’s attitude to working through trauma relevant? Journal of Traumatic Stress, 20(1), 63–75.PubMedCrossRefGoogle Scholar
  15. Demerouti, E., Bakker, A. B., Vardakou, I., & Kantas, A. (2003). The convergent validity of two burnout instruments: A multitrait-multimethod analysis. European Journal of Psychological Assessment, 19, 12–23.Google Scholar
  16. Dyrbye, L. N., Thomas, M. R., Huntington, J. L., Lawson, K. L., Novotny, P. J., Sloan, J. A., et al. (2006). Personal life events and medical student burnout: A multicenter study. Academic Medicine, 81(4), 374–384.PubMedCrossRefGoogle Scholar
  17. Erickson, J. D., Patterson, J. M., Wall, M., & Neumark-Sztainer, D. (2005). Risk behaviors and emotional well-being in youth with chronic health conditions. Children’s Health Care, 34(3), 181–192.CrossRefGoogle Scholar
  18. Fahrenkopf, A. M., Sectish, T. C., Barger, L. K., Sharek, P. J., Lewin, D., Chiang, V. W., et al. (2008). Rates of medication errors among depressed and burnt out residents: A prospective cohort study. British Medical Journal, 336, 488–491.PubMedCrossRefGoogle Scholar
  19. Figley, C. R. (1995). Compassion fatigue: Secondary traumatic stress. New York: Bruner/Mazel.Google Scholar
  20. Figley, C. R. (1998). Burnout in families: The cost of caring. Boca Raton, FL: CRC Press.Google Scholar
  21. Figley, C. R., & Stamm, B. H. (1996). Psychometric Review of Compassion Fatigue Self Test. In B. H. Stamm (Ed), Measurement of Stress, Trauma and Adaptation. Lutherville, MD: Sidran Press.Google Scholar
  22. Freudenberger, H. J., & North, G. (1985). Women’s burnout: How to spot it, how to reverse it, and how to prevent it. Garden City, NY: Doubleday & Company, Inc.Google Scholar
  23. Galantino, M. L., Baime, M., Maguire, M., Szapary, P. O., & Farrar, J. T. (2005). Short communication: Association of psychological and physiological measures of stress in health-care professionals during an 8-week mindfulness meditation program: Mindfulness in practice. Stress and Health, 21, 255–261.CrossRefGoogle Scholar
  24. Granath, J., Ingvarsson, S., von Thiele, U., & Lundberg, U. (2006). Stress management: A randomized study of cognitive behavioral therapy and yoga. Cognitive Behavior Therapy 35(1), 3–10.Google Scholar
  25. Harbeck-Weber, C., Fisher, J. L., & Dittner, C. A. (2003). Promoting coping and enhancing adaptation to illness. In M. C. Roberts (Ed.). Handbook of pediatric psychology (3rd Ed.). New York: Guilford Press.Google Scholar
  26. Hartup, W. W. (1993). Adolescents and their friends. In B. Laursen (Ed.) Close friendships in adolescence. (pp. 3–22). San Francisco, CA: Jossey-Bass.CrossRefGoogle Scholar
  27. Hauenstein, E. (1990). The experience of distress in chronically ill children: Potential or likely outcome? Journal of Clinical Child Psychology, 19, 356–364.CrossRefGoogle Scholar
  28. Hayes, C. T., & Weathington, B. L. (2007). Optimism, stress, life satisfaction and job burnout in restaurant managers. Journal of Psychology: Interdisciplinary and Applied, 141(6), 565–579.CrossRefGoogle Scholar
  29. Holden, G., Bearison, D. J., Rode, D. C., Kapiloff, M. F., & Rosenberg, G. (2000). The effects of a computer network on pediatric pain and anxiety. Journal of Technology in Human Services 17(1), 27–47.CrossRefGoogle Scholar
  30. Iliffe, G., & Steed, L. G. (2000). Exploring the counselor’s experience of working with perpetrators and survivors of domestic violence. Journal of Interpersonal Violence 15(4), 393–412.Google Scholar
  31. Kahill, S. (1988). Symptoms of professional burnout: A review of the empirical evidence. Canadian Psychology, 29, 284–297.Google Scholar
  32. Kaplan, A., & Laygo, R. (2003). Stress management. In W. O’Donohue, J. E. Fisher, & S. C. Hayes (Eds.). Cognitive behavior therapy: Applying empirically supported techniques in your practice. Hoboken, NJ: John Wiley & Sons, Inc.Google Scholar
  33. Kazak, A. E., Alderfer, M., Rourke, M. T., Simms, S., Streisand, R., & Grossman, J. R. (2004). Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors. Journal of Pediatric Psychology, 29, 211–219.PubMedCrossRefGoogle Scholar
  34. Kazak, A. E., & Wilcox, B. (1984). The structure and function of social support networks in families with a handicapped child. American Journal of Community Psychology, 12, 645–661.PubMedCrossRefGoogle Scholar
  35. Kitaoka-Higashiguchi, K., Nakagawa, H., Morikawa, Y., Ishizaki, M., Miura, K., Naruse, Y., et al. (2004). Construct validity of the Maslach Burnout Inventory-General Survey. New York: John Wiley.PubMedCrossRefGoogle Scholar
  36. Kliewer, W., Sandler, I., & Wolchik, S. (1994). Family socialization of threat appraisal and coping: Coaching, modeling and family context. In F. Nestmann and K. Hurrelmann (Eds.) Social networks and social support in childhood and adolescence. (pp. 271–291). Oxford, England: Walter De Gruyter.PubMedCrossRefGoogle Scholar
  37. Kovacs, M., Goldstein, D., Obrosky, D. S., & Bonar, L. K. (1997). Psychiatric disorders in youths with IDDM: Rates and risk factors. Diabetes Care 20, 36–44..PubMedCrossRefGoogle Scholar
  38. Kovacs, M., Iyengar, S., Goldston, D., Obrosky, D. S., Stweart, J., & Marsh, J. (1990). Psychological functioning among mothers of children with insulin dependent diabetes: A longitudinal study. Journal of Consulting and Clinical Psychology, 58(2), 189–195.PubMedCrossRefGoogle Scholar
  39. Kushner, K., & Marnocha, M. (2008). Meditation and relaxation. In W. T. O’Donohue & N. A. Cummings (Eds.). Evidence-based adjunctive treatments. Burlington, MA: Academic Press.Google Scholar
  40. Kushnir, T., & Cohen, A. H. (2006). Job structure and burnout among primary care pediatricians. Work, 27, 67–74.PubMedGoogle Scholar
  41. Langballe, E. M., Falkum, E., Innstrand, S. T., & Aasland, O. G. (2006). The factorial validity of the Maslach Burnout Inventory-General Survey in representative samples of eight different occupational groups. Journal of Career Assessment 14(3), 370–384.Google Scholar
  42. Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
  43. Martell, C. R. (2003). Behavioral activation treatment for depression. In W. O’Donohue, J. E. Fisher, & S. C. Hayes (Eds.). Cognitive behavior therapy: Applying empirically supported techniques in your practice. Hoboken, NJ: John Wiley & Sons, Inc.Google Scholar
  44. Martinussen, M., Richardsen, A. M., & Burke, R. J. (2007). Job demands, job resources and burnout among police officers. Journal of Criminal Justice, 35(3), 239–249.CrossRefGoogle Scholar
  45. Maslach, C. (1982). Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  46. Maslach, C., & Jackson, S. E. (1986). The Maslach Burnout Inventory Manual (2nd ed.). Palo Alto: Consulting Psychologists Press.Google Scholar
  47. Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). The Maslach Burnout Inventory (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.PubMedGoogle Scholar
  48. Maytum, J. C., Heiman, M. B., & Garwick, A. W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families. Journal of Pediatric Health Care, 18, 171–179.PubMedGoogle Scholar
  49. McCrae, C. S., Nau, S. D., Taylor, D. J., & Lichstein, K. L. (2006). Insomnia. In J. E. Fisher & W. O’Donohue (Eds.). Practitioner’s guide to evidence-based psychotherapy. New York: Springer.Google Scholar
  50. McDaniel, S. H., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy: A biopsychosocial approach to families with health problems. New York: Basic Books.Google Scholar
  51. Meadors, P., & Lamson, A. (2008). Compassion fatigue and secondary traumatization: Provider self care on intensive care units for children. Journal of Pediatric Health Care, 22(1), 24–34.PubMedCrossRefGoogle Scholar
  52. Meltzer, L. J., & Moore, M. (2008). Sleep disruptions in parents of children and adolescents with chronic illness: Prevalence, causes and consequences. Journal of Pediatric Psychology 33(3), 279–291.CrossRefGoogle Scholar
  53. Miner, M. (2007). Burnout in the first year of ministry: Personality and belief style as important predictors. Mental Health, Religion & Culture, 10(1), 17–29.CrossRefGoogle Scholar
  54. Moran, C. C. (2002). Humor as a moderator of compassion fatigue. In C. R. Figley (Ed.). Treating compassion fatigue. New York: Brunner-Routledge.Google Scholar
  55. Motta, R. W., Chirichella, D. M., Maus, M. K., & Lombardo, M. T. (2004). Assessing secondary trauma. The Behavior Therapist, 27, 54–57.Google Scholar
  56. Naerde, A., Tambs, K., Mathiesen, K. S., Dalgard, O. S., & Samuelsen, S. O. (2000). Symptoms of anxiety and depression among mothers of preschool children: Effect of chronic strain related to children and child care-taking. Journal of Affective Disorders, 58, 181–199.PubMedCrossRefGoogle Scholar
  57. Nazarian, D., & Smyth, J. (2008). Expressive writing. In W. T. O’Donohue & N. A. Cummings (Eds.). Evidence-based adjunctive treatments. Burlington, MA: Academic Press.Google Scholar
  58. Norberg, A. L. (2007). Burnout in mothers and fathers of children surviving brain tumor. Journal of Clinical Psychology in Medical Settings, 14, 130–137.CrossRefGoogle Scholar
  59. Oh, S. H., & Lee, M. (2009). Examining the psychometric properties of the Maslach Burnout Inventory with a sample of child protective service workers in Korea. Children and Youth Services Review 31(2), 206–210.PubMedCrossRefGoogle Scholar
  60. Oliver, G., Wardle, J., & Gibson, L. (2000). Stress and food choice: A laboratory study. Psychosomatic Medicine 62(6), 853–865.PubMedCrossRefGoogle Scholar
  61. Oman, D., Hedberg, J., & Thoresen, C. E. (2006). Passage meditation reduces perceived stress in health professionals: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 74(4), 714–719.PubMedCrossRefGoogle Scholar
  62. Pfifferling, J., & Gilley, K. (2000). Overcoming compassion fatigue. Family Practice Management, 7, 39–45.Google Scholar
  63. Plante, W. A., Lobato, D., & Engel, R. (2001). Review of group interventions pediatric chronic conditions. Journal of Pediatric Psychology, 26(7), 435–453.PubMedCrossRefGoogle Scholar
  64. Quick, J. C., Quick, J. D., Nelson, D. L., & Hurrell, J. J. (1997). Preventive stress management in organizations. Washington D.C.: American Psychological Association.CrossRefGoogle Scholar
  65. Rudolf, J. M., Stamm, B. H., & Stamm, H. E. (1997). Compassion fatigue, a concern for mental health policy, providers and administration. Poster presented at the 13th annual meeting of the International Society for Traumatic Stress Studies, Montreal.Google Scholar
  66. Sabo, B. M. (2006). Compassion fatigue and nursing work: Can we accurately capture the consequences of caring work? International Journal of Nursing Practice, 12, 136–142.PubMedCrossRefGoogle Scholar
  67. Sarafino, E. P. (2002). Health psychology: Biopsychosocial interactions. New York: John Wiley & Sons, Inc.Google Scholar
  68. Schutte, N., Toppinen, S., Kalimo, R., & Schaufeli, W. (2000). The factorial validity of the Maslach Burnout Inventory-General Survey (MBI-GS) across occupational groups and nations. Journal of Occupational and Organizational Psychology, 73, 53–66.Google Scholar
  69. Seaburn, D. A. (2001). Chronic illness. The American Association for Marriage and Family Therapy: Clinical Update, 3(4), 1–6.Google Scholar
  70. Seeman, T. E., Dubin, L. F., & Seeman, M. (2003). Religiosity, spirituality and health: A critical review for the evidence of biological pathways. American Psychologist, 58, 53–63.PubMedCrossRefGoogle Scholar
  71. Sloan, D. M., & Marx, B. P. (2004) A closer examination of the structured written disclosure procedure. Journal of Consulting and Clinical Psychology, 72, 165–175.PubMedCrossRefGoogle Scholar
  72. Smyth, J. M., & Greenberg, M. A. (2000). Scriptotherapy: The effects of writing about traumatic events. In P. R. Duberstein and J. M. Masling (Eds.). Psychodynamic perspectives on sickness and health. (pp. 121–160). Washington D.C.: American Psychological Association.Google Scholar
  73. Spirito, A., Brown, R. T., D’Angelo, E. J., Delamater, A. M., Rodrigue, J. R., & Siegel, L. J. (2003). Training pediatric psychologists for the 21st century. In M. C. Roberts (Ed.). Handbook of pediatric psychology (3rd ed.). New York: Guilford Press.Google Scholar
  74. Sprang,G., Clark, J. J., & Whitt-Woosley, A. (2007). Compassion fatigue, compassion satisfaction, and burnout: Factors impacting a professionals quality of life. Journal of Loss & Trauma, 12(3), 259–280.CrossRefGoogle Scholar
  75. Stamm, B. H. (2002). Measuring Compassion Satisfaction as Well as Fatigue: Developmental History of the Compassion Fatigue and Satisfaction Test. In C. R. Figley (Ed.), 107–119. Treating Compassion Fatigue. New York: Brunner Mazel.PubMedCrossRefGoogle Scholar
  76. Steele, R., Long, A., Reddy, K., Luhr, M., & Phipps, S. (2003). Changes in maternal distress and child-rearing strategies across treatment for pediatric cancer. Journal of Pediatric Psychology, 28, 447–452.PubMedCrossRefGoogle Scholar
  77. Stoeber, J., & Renner, D. (2008). Perfectionism in school teachers: Relations with stress appraisals, coping styles and burnout. Anxiety, Stress & Coping: An International Journal, 21(1), 37–53.CrossRefGoogle Scholar
  78. Storm, K., & Rothmann, S. (2003). A psychometric analysis of the Maslach Burnout Inventory-General Survey in the South African police service. South African Journal of Psychology, 33, 219–226Google Scholar
  79. Swedish National Board of Health and Welfare. (2003). Syndrome of exhaustion. Stress-related psychological ill health. Swedish 123(18), Stockholm: AuthorGoogle Scholar
  80. Tichron, J. G.,& Shapiro, M. (2003). With a little help from my friends: Children, the internet and social support. Journal of Technology in Human Services, 21(4), 73–92.CrossRefGoogle Scholar
  81. Thomas, N. (2004). Resident burnout. Journal of the American Medical Association, 292(23), 2880–2889.PubMedCrossRefGoogle Scholar
  82. Vela-Bueno, A., Moreno-Jimenez, B., Rodriguez-Munoz, A., Olavarrieta-Bernadino, S., Fernandez-Mendoza, J., De La Cruz-Troca, J. J., et al. (2008). Insomnia and sleep quality among primary care physicians with low and high burnout levels. Journal of Psychosomatic Research, 64(4), 435–442.PubMedCrossRefGoogle Scholar
  83. Wardle, J., Steptoe, A., Oliver G., & Lipsey, Z. (2000). Stress, dietary restraint and food intake. Journal of Psychosomatic Research 48(2), 195–202.PubMedCrossRefGoogle Scholar
  84. Weiss, M. J. (2002). Hardiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism, 6(1), 115–130.PubMedCrossRefGoogle Scholar
  85. Wysocki, T., Greco, P., & Buckloh, L. M. (2003). Childhood diabetes in psychological context. In M. C. Roberts (Ed.) Handbook of Pediatric Psychology 3rd ed. New York, NY: Guilford.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of NevadaRenoUSA

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