Module 9 Outline: Employee-focused approaches to reducing burnout risk

In the previous module, we focused on organizational strategies to prevent burnout. We thought it was important to talk about those strategies first because we believe that burnout is not just a personal problem for people to solve alone. That said, there are evidence-based employee-focused strategies that, in conjunction with organizational efforts, can help to minimize burnout risk. These strategies are emphasized in this module.

As we introduced in Module 8, it is important to address burnout with a multi-level perspective. We walked through examples at each level of the IGLOO framework that are focused on changing the organization in the last module. We will now shift to changes focused on the individual.

Employee-focused interventions are primarily directed at individual workers.  Employee-focused interventions to reduce burnout might target intentional (or even natural) ways of behaving, thinking, feeling, and connecting with other people.

These interventions might also target personal practices that help keep demands and resources in balance. These practices are, in many cases, under the control of each individual worker. However, other people and the broader environment can facilitate or inhibit these practices.

As we acknowledged in the previous module, supervisors, leaders, and managers may be limited in the changes they can make in the workplace. However, our suggestions should provide several actionable strategies you can implement and other ideas you can suggest to higher-level leaders or collective bargaining groups that can change more formal policies and practices.

In this module we provide examples of employee-focused strategies to reduce burnout risk from different levels of the IGLOO framework (individual, group, leader, organization, and overarching context).

Starting at the individual level, employee-focused intervention efforts can obviously teach individual workers personal skills or strategies that can help to resolve demand-resource imbalances. These approaches are some of the most common that we see in burnout research.

The goal of most of these approaches is to increase knowledge and develop skills, mindsets, or other personal practices. These types of methods empower individuals to either reduce controllable demands, increase access to resources, or possibly both.

General examples of this type of intervention include training in stress management and/or self-care. These trainings tend to focus on how we respond to stressors and how we can minimize their impact. It may be through changing the way we appraise a stressor. For instance, we could think about a stressor as a challenge instead of a barrier. Or these trainings may target changes to the ways we cope, such as solving a problem versus just trying to suppress an emotion.

In self-care interventions, the focus is on helping individuals identify and develop plans to address personal resource recovery needs. This could be in terms of time, energy, and restoring a sense of control. Some of the examples we will work through next incorporate elements of self-care, but we will give additional attention to self-care toward the end of this module.

Here are a few specific examples of these types of interventions.

Enhancing individual coping skills
Stress inoculation trainings focus on how we appraise and respond to stressors. They can help workers to perform under stress and manage anxiety (Saunders et al., 1996). These trainings expose workers to low-level stressful situations to develop strong coping skills, and over time, apply these coping skills to progressively more stressful situations.

This type of training is often done by trained facilitators, but the practice could be fairly easily implemented in onboarding and training for public health workers. What stressful situations that are likely to occur could you practice avoiding or responding to in advance? How could workers start developing strong coping strategies so that stressful events are not as impactful when they do arise?

Encouraging restorative workday breaks
Interventions focused on self-care or self-regulation of your mood often use different types of restorative breaks during or after the workday. For instance, taking a 15-minute walk or participating in a deep-breathing exercise during a lunch break can help reduce tension and fatigue (de Bloom et al., 2017). These breaks are easy activities to encourage individuals to do during the workday that take relatively little time away from work.

Cultivating positive psychological states
Interventions can more directly focus on fostering positive psychological states, an important resource. One simple example of this is encouraging gratitude, which research shows can benefit worker well-being (Kaplan et al., 2014). These interventions can be simple reminders to stop and think about big and small things for which we are grateful.

Helping employees manage high demands
One last example is simply helping workers to plan how to address demands. This intervention can be helpful for both managing demands and restoring resources. One such planning intervention asked participants to think about the goals they did not accomplish at the end of the workday (Smit & Barber, 2016). These participants then created a plan for where, when, and how they would accomplish those unfulfilled tasks. Workers who did this were able to have better detachment and recovery even if they had high workloads.

At the group level, employee-focused interventions generally address norms and practices around balancing demands and resources. As discussed in module 8, an important strategy is to encourage a healthy culture which values well-being, rather than glorifying overwork (Mazzetti et al., 2016) and high levels of stress (Black & Britt, 2022). Additional interventions might include:

Encouraging workers to consider how they impact and are impacted by norms
It is important for individuals to think critically about how their behavior contributes to what is normal and expected. As one example, feeling like coworkers would treat you negatively if you said you had too much stress is related to burnout (Klinefelter et al., 2021).

One way to try to address and adjust norms that could be contributing to burnout is through open conversations among coworkers. How do coworkers treat one another when they are having difficulty balancing demands and resources? See the supplemental materials with this module for example discussion questions.

Working together to address common demands
Groups can also collaboratively problem- solve how to address and cope with common demands. One study created this opportunity with “health circles.” Remote workers were given opportunities to talk about common challenges they face at work and how to respond to them (Konradt et al., 2000). These workers benefited from talking as a group about common problems and sharing helpful coping strategies they could implement as individuals and in their teams.

At the leader, manager, and supervisor level, employee-focused interventions typically address leader-level decisions that support worker health. These types of interventions may also try to increase leader awareness of and intentions to respond to worker burnout risk.

Several interventions discussed in Module 8 can also apply here. For example, efforts to increase social support from leaders, and leaders’ awareness of how to support workers’ mental health, can provide important resources. Creating a healthy culture and realistic expectations for how much workers can take on is also critical to encourage workers to manage their burnout risk.

More broadly, some additional leader, manager, or supervisor level strategies to reduce the burnout risk for employees include:

Showing clear support for worker rest and recovery
Supervisor support for rest and recovery is generally helpful, but the influence of a leader can be complicated. For instance, workers with a high-quality relationship with their boss (obviously a good thing!) may have a harder time detaching from work (Bennett et al., 2016). In other words, feeling loyal to a leader could lead a worker to overexert themselves.

This issue points to the importance of clearly setting expectations for taking time to rest and recover. For example, encourage the worker still at their desk in the evening to go home and rest, avoid sending emails during off-work hours (or at least make it clear you do not expect a reply), and encourage workers to take their vacation days. This can be so important in a culture where rest and recovery are not always valued and among employees who are often willing to go the extra mile because they care about what they do. Reminding them that they will do their best work when they have sufficient resources can provide critical perspective to workers who need to take better breaks.

Being a positive role model
Model for yourself what good rest and recovery look like! Doing this, even when work is busy, will show workers the importance of prioritizing resource replenishment. This role-modeling will not only help you in your own self-care and burnout prevention, but also will help workers feel like they have permission to recover. When you experience challenging demands or find particularly helpful self-care, share it with the people on your team. Leaders, supervisors, and managers who are authentic, transparent, and skilled at developing relationships can build a culture of trust and make a difference in workers’ health (Alilyyani et al., 2018).

Supporting healthy work-life balance
A strong body of research emphasizes the importance of Family Supportive Organization Perceptions (Allen, 2001) and Family Supportive Supervisor Behaviors (Hammer et al., 2009). This research suggests that just having family-friendly policies in place is not sufficient. The culture of the organization and leaders need to also demonstrate support for managing family demands in order for workers to address work-life conflicts.

Family-supportive supervisor training is particularly helpful for promoting healthy work-life balance and enhancing perceptions of family support from the organization (Hammer et al., 2013; Odle-Dusseau et al., 2016). This type of training helps supervisors understand why work-family conflict is a problem and the resources that can reduce it. Family-supportive supervision can include emotional support and instrumental support for navigating work and non-work roles, role-modeling behaviors of healthy work-life balance, and creative solutions to help workers meet their demands outside of work (Hammer et al., 2013).

Cultivating positive psychological states
As a final example, leaders can create opportunities to build positive psychological and social resources during work. For instance, the National Association of County and City Health Officials (NACCHO) released resources based on the Institute for Healthcare Improvement’s “Joy in Work” program in 2022. It provides discussion tips for leaders in how to talk to workers about what matters in their work, how to promote joy, and how to address any “pebbles in their shoes.”

Leaders, supervisors, and managers can easily incorporate these types of conversations into weekly meetings or other natural points. More information on this program is in the supplemental resources included with this module.

At the organization level, there are numerous ways to create an environment that supports individual worker’s abilities to manage burnout risk. In Module 8, we talked about broader organizational policies and procedures that could reduce burnout. Here we highlight examples of strategies that encourage individual workers to manage their demands and resources in a way that reduces burnout risk. These types of strategies include:

Creating an overarching culture that values well-being
A study of small businesses found employees reported better health when policies and procedures and a climate that supports health and safety were in place (Schwatka et al., 2021). This concept is emphasized from a Total Worker Health® perspective, where the whole worker is valued. This focus on worker health is clear throughout the organization’s policies, procedures, values, strategy, and culture.

Revising policies, procedures, and practices that threaten or undermine a culture of well-being
As one example, do promotion criteria and performance standards align with a value on well-being? Or do employees who self-sacrifice tend to end up on top?

Consider also whether the culture undermines the formal policies and procedures intended to support well-being. Is the worker who takes advantage of flexible work arrangements supported or ostracized? Are there groans, hesitations, or snide remarks about dumping work on others when an employee requests to use vacation time?

If inconsistencies are present, work to address them. Some of the group- and leader-level strategies can be helpful in diagnosing and addressing these types of disconnects. Discussions at the leader- and group- level will be especially helpful in observing when norms do not support formal values or practices.

As for the overarching context level of our guiding framework, the broader community in which public health workers serve can reduce resource drain and increase resources. Employee-focused interventions at this level might involve one or more of the following strategies:

Engaging community support for public health workers
While engaging this support is not something that may be in your immediate personal control, having more community resources can support employee efforts to reduce burnout. Anything from access to healthy foods, walkable neighborhoods, and quality community recreation areas can help to reduce demands and promote recuperation. We know public health workers are already passionate about community health. We simply want to point out that the community-building work you already do can also be a powerful resource for minimizing your own and your peers’ burnout risk.

Recognizing public health workers’ sacrifices
Knowing that meaningful work can be a powerful resource, create opportunities for meaningful community connections. As just one example, frontline healthcare workers were in the spotlight during the pandemic. However, there was less recognition of the sacrificial and difficult work carried out by public health workers. One public health leader we spoke with recounted the joy that came from letters of appreciation during the pandemic.

Because public health workers are often humble and work in the background, many community members may miss these opportunities to show support. Consider ways to be visible in the community. You may even solicit these “thank you” messages from time to time, especially when demands are high.

Sharing public health success stories
When you do hear stories of how people have benefited from the efforts of public health workers, be sure to share it! It could be through department meetings or social media networks. Savor those moments that remind you why you do what you do.

We hope you can see from these examples that employee-focused strategies for reducing burnout risk take many different forms. All of these employee-focused strategies can offer unique value and can be especially potent when linked to complementary organizational efforts (as discussed in Module 8).

To wrap up this module, we are going to spend a little more time exploring one of the most common employee-focused strategies for minimizing burnout: improving self-care.

Self-care has become a popular topic and buzzword, especially since the COVID pandemic. But what exactly is self-care?  We can use the demand-resource framework at the heart of this training series to understand self-care. Self-care is the process by which people at least temporarily reduce the demands they are experiencing and replenish spent resources. A wide variety of activities can be considered self-care.

Here it is important to remember that emphasizing employee self-care is a necessary, but insufficient, component to the formula to really reduce burnout risk. We cannot just promote “self-care” and expect a healthy and thriving workforce. However, encouraging good self-care is an important strategy that is complemented and reinforced by all of those examples we talked about at each level of the IGLOO framework.

There are some important things to understand about how self-care helps to keep our demands and resources balanced. Some of the most basic self-care we can do are the basic things we know we need to be healthy – sleep, nutrition, exercise, etc. We also need other activities that can build personal and social resources. One example is playing a board game with family or friends. Another is reading a chapter of a good book before bed, instead of scrolling through social media (or worse, scrolling through work emails).

It is important to not overcomplicate self-care. You also do not want to compare your self-care practices and opportunities to others. Focus on what meets your needs and refills you within the constraints and general context of your daily life. It does not have to be a three-hour massage or a week-long vacation. Of course, those things can be replenishing, but if we assume that’s what we need to take care of ourselves, we may often feel disappointed when that does not fit into our reality. Even “micro breaks” or five-minute activities to break up demands can make a difference (Fritz et al., 2013).

Self-care often includes adding restorative activities to our days, but it can also include reducing our demands. For example, saying no to the thing that is going to push you out of balance. This might be an optional committee at work, a volunteer role at your child’s school, or an unexpected social event. If it is going to further deplete you, saying no can be a simple act of self-care, leaving more time for the activities that do refill you.

Similarly, strive to be more aware of things you regularly do that tend to be resource depleting more than resource replenishing. This also applies to people or groups with whom you regularly spend time. Scrolling through social media, do you tend to feel positive emotions or more negative ones? In a study we did, we found that women who feel negative emotions when using social media are at a greater risk of burnout (Black et al., 2022).

Consider what “recovery” activities you are participating in that are not fueling you. For instance, are you trying an exercise routine, like training for a marathon, that is overwhelming and not actually fun? Are you always working on overly complicated recipes that end up stressing you out?

A main point we have emphasized in this section is that people need to find self-care that is restorative for them personally. In other words, self-care needs and routines are not one-size-fits-all.

That said, research does suggest that there are some key “ingredients” to activities that tend to be more restorative than others (Bosch et al., 2017; Sonnentag & Fritz, 2007).

Psychological detachment is the ability to mentally disconnect from demands. It is one aspect of recovery activities that is most consistently related to better well-being (Sonnentag & Bayer, 2005; Sonnentag & Fritz, 2007). So, quite simply, try to do something that helps you to stop thinking about your demands!

We also tend to have better well-being outcomes when we have some control over when, how, and what we do to recover. Some people have non-work demands that make this difficult. For instance, you might feel your children’s activities dictate your time outside of work. But any way you can find to feel a little more in control of even some of your work or non-work breaks can help.

Activities that help us physically and mentally relax also tend to be restorative. Relaxation often involves opportunities for low effort activities, like watching TV or listening to music. But we do want to be clear that for many people some form of physical activity, like yoga or going for a walk, can also be relaxing (and have added benefits for health).

Mastery experiences are activities that help us feel like we are being challenged or acquiring a new skill. This feeling is why many people find hobbies restorative. Mastery experiences could include learning a new instrument or engaging in some form of crafting. Again, just remember to find something that you are doing because you want to, not for the sake of comparisons, competition, or motives that will not actually be restorative.

Finally, feeling a sense of connection or relatedness to others can be very restorative. Because humans have an innate desire for connection (e.g., Walton et al., 2012), making time for social activities is important. We can talk with others at work or spend time doing enjoyable activities with loved ones in non-work time.

Some people can naturally create opportunities to engage in restorative activities; others struggle to do create these opportunities. Even if this approach is difficult for you or for the people in your work group or team, remember that people can learn to engage in better recovery practices (Ebert et al., 2015).

Putting it all together, self-care is important but insufficient for workers to reduce their burnout risk.

Employee-focused strategies, in conjunction with sufficient and appropriate organization-focused strategies, can be a powerful tool for helping workers. It helps them to reduce controllable demands and build corresponding resources.

We focused on strategies that are primarily exercised by individuals, but we hope this module has shown the wide variety of things organizations can do to directly support these employee practices that benefit employee well-being.

Here is a quick reminder of the other content covered in this training course. We hope you have found this information helpful. Our final module will help you apply what you have learned.