It turns out though – that even though we are assisting people in finding their way – their choices and their desired outcomes aren’t up to us.  One of the main tenets of social work is self – determination.

The National Association of Social Workers states self-determination is an ethical principle of professional practice.

 “Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.”

It is imperative that a social worker is aware of their own value system and beliefs so they aren’t subconsciously or subtly moving the client to the clinician’s goals.  You want to act for your client’s best interest but who decides what that is?

Maybe you are a social worker providing case management to an individual in the community who is struggling with medical needs.  The client is diagnosed with diabetes and has dangerously high blood sugars because he isn’t interested in following the diet.  If he continues to disregard the diet it is possible his kidneys could fail and he will have to go on dialysis or he may lose a limb.  As the social worker you may be thinking the choice to follow the diet is obvious but the client doesn’t agree.  What could you do?  You would discuss with him the consequences of not following the prescribed diet and explore the barriers and his feelings.  However, if the client still says “I get it, I am not going to follow the diet.  It is just not important to me” then that is OK.  The social worker doesn’t get to say – let’s throw out all the unhealthy food or I’m not going to help you get assistance if you don’t follow the diet.  His choice may not be the same choice you or I might make but it is still his choice.

Clients often make life choices we wouldn’t choose for ourselves.  Sometimes people prefer to be homeless rather than live in an apartment.  Sometimes people will choose to cheat on their spouse.  Sometime people will stay in a job that seems to be completely unhealthy.  Someone could choose to not take psychotropic medication and still function in the community.   A client’s religious or other cultural values might feel abhorrent to you but it is not on the social worker to change them but to meet the client where they are at and let them live their own destiny.  It can be frustrating for a social worker because you want so much for your client’s to be successful.  Each of the clients we work with know themselves better than we know them.

I had a client once who left a destructive and abusive marriage and really struggled with self-confidence.  Almost immediately after the separation the client came in and said she met someone on an internet dating site.  She went on to share all these reservations she had regarding the man.  Within 2 months she was engaged to him.    In my head – I’m thinking “this seems like a really bad idea.”  She ended up being engaged for about a year and then married this man.  Now, they have been married about 4 years and this relationship seems to be the most stable and affirming that the client has ever been in.  I definitely wanted what I believed was in best for this client but if I had pushed her to what I thought was going to be better for her – I would have been wrong.  She knew herself better than I knew her.

Of course there are times when safety and well-being take precedence over self-determination.  A social worker will use their professional judgement to make that decision.  There are obvious situations such as when a client is suicidal with a plan or planning to cause destructive harm to another where the decision to act against the client’s choice is relatively.   However, deciding to limit a person’s self-determination is often not clear cut at all.

How can you make sure you are encouraging client self-determination?

• Start by asking the clients what they want for themselves? Ask those open-ended questions and see where it goes.
• Help them clarify their goals and set concrete hopes. Make sure they are the client’s goals – not what you think they should work on.
• Be cautious of having an agenda. There might be things you want to cover in a session but the client should determine where the conversation goes.
• Ask yourself – Is this what the client wants or is it me who thinks this is a good idea?
• Is what the client plans to do put them or someone else at imminent risk for harm.
• Consult with other social workers to get different perspectives.
• Remind yourself that your client’s reactions and their situation is not about you.
• Ask yourself – Is there a really good reason I am taking away this person’s right of choice?

As a social worker, self-determination is a value I have a huge affinity for. I have found there are times when I am in a room full of professionals and everyone is stating what they think will be best for the client regardless of what the client is saying they actually want.  As a social worker, I am sometimes the lone voice advocating for the individual’s choice.

Perhaps one of the reasons I became a social worker is that I want to choose my own path and I believe that each person should be able to choose theirs and this career gives me a way to fight for people.

So how can you recognize this sort of creeping burnout and intervene before it ruins your productivity, alters your personality and compromises your physical and emotional health? To get you started, we’ve put together this list most common burnout symptoms.

• Exhaustion: This is probably the most obvious of the symptoms.  People affected feel drained and exhausted, overloaded, tired and low, and do not have enough energy. Physical exhaustion symptoms, however, can even include pain or problems with the stomach or bowel. Additionally, when you suffer from chronic stress, your body’s immune system is actually weakened and you’ll become more vulnerable to infections, colds, flus, and other immune system disorders. This often leads to individuals calling in sick because they don’t feel well. Workers suffering from burnout are often late for work, frequently call in sick and procrastinate on the job.
• Inability to concentrate: Ongoing physical and mental exhaustion can lead to various cognitive problems, such as an inability to concentrate, hold attention, and remember things. You’ll find that it’s harder to get things done and you simply can’t keep up the way you used to.
• Frequent mood changes: Burnout may cause emotional exhaustion and a loss of a sense of personal accomplishment, and therefore lead to depersonalization, alienation and depression. With this, you might notice that you feel more generally pessimistic than you used to. While everybody experiences some negative emotions from time to time, it’s important to know when these are becoming unusual for you.
• Lack of motivation: When you don’t feel enthusiastic about anything anymore or you no longer have that internal motivation for your work, there’s a good chance you’re experiencing burnout; it can be harder to get going in the morning and more difficult to drag yourself into work every day. You may also feel like you have too much on your plate and cannot get it all done.
• Social isolation: The depression and mood changes often associated with burnout can lead individuals to isolate themselves from others which leads to yet more depression; this can create a vicious cycle. When individuals feel they are not accomplishing all that they should, they start feeling ashamed and guilty about the poor job they’re doing. This leads to not wanting to let others down and individuals often decrease the number of social interactions they’re involved in. Moreover, this often causes people to entirely detach themselves from the world around them and makes them become totally isolated, further worsening the problem.
• Unhealthy coping habits: When suffering from burnout, some people engage in unhealthy coping strategies like drinking too much, smoking, being too sedentary, eating too much junk food, not eating enough or not getting enough sleep. Self-medication is another issue and could include relying on sleeping pills to sleep, drinking more alcohol at the end of the day to de-stress or even drinking more coffee to summon up the energy to drag yourself into work in the morning.

Well now you’re probably saying, “Okay. That’s great. But how do I fix this problem?” Well we’ve got that taken care of too! Here are some great tips for you to follow:

• Relax: Many find relaxation through meditation, yoga, or exercise to be the perfect anecdote to a stressful day. When your workday is done, you need to leave the stresses of it and the rest of your life behind, even if only for fifteen minutes. Relaxation and meditation can rejuvenate the body and the spirit. Right now you can begin by just closing your eyes and telling each of your body parts to relax as you sink further into your seat. Then focus on your breathing. If you only did this for five minutes each day, you would see a big difference in your own stress levels.
• Exercise: Human bodies have not evolved thousands of years to spend ten hours a day hunched over a keyboard staring at a screen or pouring over class books.  To stave off burnout, do something physical that makes you sweat, and do it at least three times a week. Regular physical activity, like walking or biking, can help you to better deal with stress. It can also help get your mind off work and focus on something else.
• Eat healthy foods: Eat more. We don’t mean donuts and pizza, though. We mean low-calorie green food that you eat throughout the entire day. Adding food with lots of antioxidants, water, fiber, and other nutrients can calm you and help your body relax.
• Learn when to say “no”: You’re busy – really busy, and everyone wants a little bit of your time.  If you don’t learn how to say no to people you are only going to do more damage. Saying “no” is something you need to be able to do to accomplish what you want to in life.
• Adjust your attitude: If you’ve become cynical at school or work, consider ways to improve your outlook. Rediscover enjoyable aspects of what you do. Recognize the valuable contributions your peers make or congratulate them on a job well done. Take short breaks throughout the day. Spend time away from stressful work to do the things you enjoy.
• Seek support: Whether you reach out to co-workers, classmates, friends, loved ones or others, support and collaboration may help you cope with job stress and feelings of burnout. If you have access to a health center at your school or near your work, take advantage of the available services.  Here are some of our favorite resources to help:

1. MindTools has created a neat, 15-question burnout self-test to score and evaluate exactly how worn out you are
2. MayoClinic – Job burnout: How to spot it and take action
3. Forbes Article – 12 Ways To Eliminate Stress At Work
4. National Institute of Health‘s Stress page
5. Stress Management Society – stress tips and how to manage stress in the workplace
6. American Institute of Stress – information on stress reduction, stress in the workplace, effects of stress and various other stress related topics

(NOTE: If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not self-diagnose.)