Literature review

The concept of burnout is first discussed in published journals in the 1970’s[1].

According to Maslach the term itself seems to have been coined in work relating to lawyers working with the poor in the USA, though she doesn’t give a reference to a specific date for the conversation.[2]

However in 1974 Herbert J Freudenberger used the term in his paper “Staff Burn-out”[3] where he describes it as relating to the negative feelings experienced by workers, particularly those working with people, as a result of long term exhaustion, diminished interest, and/or low feelings of personal satisfaction at work.

Initial work was based around identifying the varying ways individuals had of coping with difficult situations, such as doctors or nurses dealing with terminally ill patients. This was termed depersonalisation – the person in the caring profession considered the patient as “a case” rather than as a person with a terminal illness.

Freudenberger stated in his work mentioned above that burnout occurs when individuals expend too much effort and have insufficient recovery time.

Maslach and Jackson further developed this work and refined it into a multi-faceted concept including emotional exhaustion, depersonalisation and lack of personal accomplishment[4] initially including, and then abandoning a fourth element - “involvement”. This three element tool is known as the Maslach Burnout Inventory.[5]

Over the last 30 plus years studies have been conducted on various groups, including teachers[6], nurses[7], police officers[8], and others.

Dr Arch Hart[9] suggests that the symptoms for burnout include demoralisation, depersonalisation, detachment, distancing and defeatism which are generally in line with those stated by Maslach and Jackson.

In more recent years a number of studies have used the Maslach Burnout Inventory with members of the clergy in various parts of the world including Warner and Carter[10], Strumpfer and Bands[11], and Rogerson and Piedmont[12]

Warner and Carter studied 189 individuals, including 33 pastors and 28 pastor’s wives. One of their findings was that pastors’ wives scored more highly on the emotional exhaustion scale than other people, including their husbands – who scored at about the same level as non-pastors. Their conclusion was that pastors either developed coping mechanisms to help or deal with emotional exhaustion, or they would have left the ministry[13].

Strumpfer and Bands study used the Maslach Burnout Inventory  with 11 Anglican priests, and found that role conflict and high levels of workload correlated with burnout, although they declared that they could not conclude high levels of burnout in that sample.[14]

Leslie Francis, whilst Professor of Practical Theology at the University of Wales, Bangor participated in a number of studies with particular reference to members of the clergy in the United Kingdom,[15] and continues to do so across a variety of denominations.

There are a number of methods used to diagnose burnout including one by Freudenberger and Richelson[16] however the most widely used scientific method used to measure self diagnosed burnout is that devised by Christina Maslach and Susan Jackson⁵ known as the Maslach Burnout Inventory, already mentioned above, and which has been used in most of the studies already mentioned in this review.

Francis and Rutledge[17] however have questioned “the appropriateness of some of the individual items in relation to the way in which clergy care to speak of those within their pastoral charge”.

Initially this work produced a new modified version of the Maslach Burnout Inventory altering some of the wordings to relate with those in a parochial ministry with particular reference to language and experience which was then used in further studies to ensure reliability etc.

Francis, Kaldor, Shevlin and Lewis[18] generated a new Scale of Emotional Exhaustion in Ministry which was used as part of the National Church Life Survey in Australia with over 4,000 participants.

Francis, Kaldor, Robbins and Castle[19] tested further modifications of the Scale of Emotional Exhaustion in Ministry, and also constructed a new measure the Satisfaction in Ministry Scale. This work was done across denominations in Australia, New Zealand and the UK. These measures, now known as the Francis Burnout Inventory will be used in preference to the Maslach Burnout Inventory as they are more relevant to clergy, particularly in the UK.

The revised Scale of Emotional Exhaustion in Ministry (SEEM) contains 11 items, assessed on a 5 point Likert Scale[20], rather than the 6 point scale previously used.

The new Satisfaction in Ministry Scale (SIM) also contains 11 items, assessed by a 5 point Likert Scale with responses ranging from agree strongly to disagree strongly.

Fred Lehr in his book Clergy Burnout[21] summarises the issues well in his subtitle to the book: “Recovering from the 70 hour work week… and other self defeating practices”.

His work in counselling members of the clergy leads him to the conclusion that codependency is one of the key factors of burnout[22]. His definition of codependence includes the following:

“A set of maladaptive behaviours that a person learns to survive in an experience of great emotional pain ….. These behaviours and their accompanying attitudes are self-defeating and result in diminished capacity. Codependants do not take adequate care of themselves and are far too controlled by (or controlling of) other persons’ behaviours and attitudes.”[23]

He further goes on to explore the role of the church in creating this codependency giving various examples of the attitudes that are held by clergy. One of these is that of “hopelessness” where the clergy member has little, or no, self esteem or personal identity, and relationships with others is negative, painful and appears to be a failure. This also links in with Maslach’s emotional exhaustion, depersonalisation and reduced personal accomplishment.

Many writers simply end their studies with a conclusion and possible ideas for further future study into the causes of burnout, or how support can be offered. The second half of Lehr’s writing however seeks to provide “Hope and Healing” to those who suffer burnout and offers some assessment tools to help regain balance[24], to enable establishment of boundaries[25] as well as some study guides for clergy, and those in their churches to address the issues and plan the future[26].

The danger in Lehr’s writing is that the solution starts from a spiritual basis with the first two chapters of the second part being “Becoming Gospel Centred” and “Developing Spiritual Maturity”. There is little within other research which would indicate that a loss of spirituality is a cause, or indeed an effect, of burnout.

This approach may cause further distress to those experiencing burnout by increasing their sense of low personal accomplishment and sense of hopelessness by adding guilt that if they had been more spiritual things would have been OK.