High Need Families

High Need Families + Unrealistic Expectations = Burn-Out By Jerry Wilde

Those of us in the helping professions have it tough! We are asked to perform minor miracles with little or no funding. People expect that we will somehow always have the magic solution. Many of our clients are less than thrilled to be our clients. Simply put, we spend an inordinate amount of time with high need families. All of these factors combine to place us at-risk for becoming burned out. Unless you take care of yourself (physically and emotionally) you’re pretty much lining up to be a statistic.

One of the best defenses against burn out is having optimistic, yet realistic, expectations for our clients and families. These families may have histories that include substance abuse, physical violence, sexual abuse or any number of other difficulties. After a home visit or families therapy session, social workers or other mental health professionals often feel drained. It is easy to become disheartened. A steady diet of high need families can lead to discouragement. Feelings of hopelessness can start to creep in. Eventually, professionals start questioning the value of social work altogether. The burn-out is starting.

Burn-Out or Rust-Out?
Let me correct something before we move on. I’ve always felt that the term “burn-out” is a misnomer. A more accurate expression would be “rust-out.” This processes, whatever it is called, is slow and insidious, not quick and observable. It doesn’t take one or two bad outcomes. Rather, it is the accumulation of multiple minor setbacks and disappointments that result in rust-out.

Other Defenses
Another defense against burn out is developing a healthy sense of patience. Families with long histories of dysfunctional behavior do not change overnight. While we all seem to know that intellectually, sometimes we forget it emotionally. Also, when and if the families do change, it is often change by degree. Said another way, look for small improvements because those can and do occur but we often miss them because our expectations are too high. We’ve got our eyes focused on the father getting the job rather than starting with being happy he made it to the job interview!

Our Thoughts and Beliefs
Professionally, my approach to counseling is rooted in rational emotive behavior therapy (REBT). For those of you unfamiliar with REBT, it is a school of therapy that focuses on irrational thinking as the cause of most emotional difficulties. The philosophy of REBT is actually a couple of thousand years old with philosophers such as Epictetus and Marcus Aurelius making the connection between thoughts and feelings. Epictetus stated, “Men are not disturbed by events, but by the views they take of them” and Marcus Aurelius echoed those sentiments by saying, “If thou art pained by an external thing, it is not this thing that pains thee, but thy own judgment about it. And it is in thy power to wipe out this judgment now.” Applying this logic to the topic at hand, “It is not the behavior of our clients that makes us angry, depressed, anxious, but our thoughts about it. And we have the power to change that those thoughts.” Albert Ellis, the founder of REBT, has written extensively about irrational beliefs and readers interested in learning more about REBT are encouraged to read some of his classic books on the topic.

How “Should” a High Need Family Act?
As previously stated, most high need families have a long-standing history of dysfunctional behavior. This pattern is precisely why they are high need. This behavior clearly reflects their value system, which is often in conflict with their worker’s value system.

I was working with a family that was about to be evicted and had little or no income now that the mother had broken up with the boyfriend. When I spoke to the mother my focus was on getting the rent paid or finding more affordable housing. Her concern was on getting the children a new Nintendo system for Christmas. I was angry, amazed, frustrated, and generally disbelieving of this common pattern of thinking among our clients. I kept thinking, “She shouldn’t be worried about a Nintendo system at a time like this.” In other words I was demanding, “She should not act the way she has always acted in the past.” It suddenly dawned on me that she “should” act exactly as she was acting. Yes, it would be better if she would act differently but to demand someone change a behavior pattern just because we want it to change is pretty unrealistic. I realized in that instance I was the one thinking irrationally, not the mother. The mother was acting the way she had typically acted and I was demanding she act differently. Who was being crazy?

Celebrate Your Victories
The last bit of “rust-out prevention” I’d like to share with you also revolves around our attitudes. In the helping fields, we seem to have a tendency to genuinely suffer the losses much more than we celebrate the victories. When there is a bad outcome with a family we often take that to heart much more so than when families are successful. We expect (there’s that word again) to be successful. Most of us have experienced a great deal of success in our lives and we expect to carry over that same success to the families we serve. When the families are not successful, we feel like we’ve failed.

On the other hand, when families improve, we typically accept that without a second thought. We often don’t even take a moment to feel happy. We just look at that pile of folders on the desk and immediately get on to the next case. This is a mistake. Celebrate your successes. That doesn’t mean you should schedule a parade but celebrate in small ways even if it nothing more than thanking the team and acknowledging the positive outcome. These celebrations often are few and sometimes are far between so enjoy them when they come. Keep up the important work that you do!

Jerry Wilde spent ten years as a school psychologist before his current academic appointment as assistant professor of educational psychology at Indiana University East. He is the author of “An Educator’s Guide to Difficult Parents” and can be contacted through the website http://www.angerchillout.com .

[ Home ] [ Career Resources ] [ Social Work Burnout Articles ]