Stress and Burnout Among Rehabilitation Counsellors Within the Context of Insurance-Based Rehabilitation: An Institutional-Level Analysis

Abstract

Work stress and burnout are common problems in rehabilitation services. Usually, attempts to account for stress and burnout focus on the qualities of the individual and the demands of the organisational environment. However, the current paper has responded to recent demands in the occupational stress literature to examine burnout from a third perspective, namely the institutional level. This level of analysis transcends the boundaries of organisations and can be defined by the various political, economic, social and legal constraints that characterise a broad area. It is argued that the rapid growth of insurance-based rehabilitation in Australia has created a unique institutional context that has significant implications for the development of stress and burnout among rehabilitation counsellors. Rehabilitation counsellors in this context face a diverse array of conflicting demands within a system that often does not support the goals of rehabilitation. It is proposed that the development of strategies to reduce stress and burnout in this area would benefit from an institutional-level analysis. While individualised stress management training clearly has a role in the minimisation of stress and burnout, it is proposed in the current paper that this issue has human resource management and educational implications that must be addressed.

Ethical Dilemmas Experienced by Australian Rehabilitation Counsellors

“…The data illustrates that although rehabilitation counsellors form part of a network of professionals charged with providing rehabilitation services on behalf of insurers, the insurance industry often fails to appreciate the role of rehabilitation counsellors in protecting the welfare of clients, or to acknowledge their specialized skills and knowledge. This is similar to the findings of Buys and Kendall (1998), Lane et al (2012), andMurphy (2003). For participants in this study, the pressure to ignore the legitimate needs of clients in order to implement financially agreeable rehabilitation plans appeared to negatively influence their ability to uphold ethical standards and provide sufficient advocacy on behalf of their clients.…”

Rehabilitation Counselling Theory and Quality Practice Reported inThe Australian Journal of Rehabilitation Counselling

“…Many AJRC authors said or implied as much, but often acknowledged the impact of systemic or environmental factors. The tension between the desire to be proactive and the imperative to manage systemic and environmental factors is inherent in the work of RCs and requires further research (Buys & Kendall, 1998;Kearns et al, 1997;Mitchell, 1997;Mullins et al, 1997;Rumrill & Fitzgerald, 2001).…”

“…Papers included frameworks for assisting clients to negotiate with key stakeholders in various workers' compensation (Budd, 1997;Kearns, McCarthy 6k Sheehan, 1997;Nowland, 1997) and other rehabilitation systems (Crisp, 1995;Walker, 1999;Walker 6k Wiegmann, 1995). Several papers addressed the need for RCs to manage systemic barriers and/or stressors as part of their rehabilitation practice and professional self-care (Buys & Kendall, 1998;Chinnery et al, 1995;Kearns et al, 1997;Kenny, 1995Kenny, , 1998aMitchell, 1997). Data from Table 1 indicates that authors who wrote from a systems perspective advocated several methods of quality practice, these mostly being case management and relationship building; and to a lesser extent, assessment and self-care.…”

Time for a shift in Australian rehabilitation?

“…The third tension is created by the fact that rehabilitation providers have found themselves in an environment increasingly dominated by bureaucratic, legal, economic and political imperatives [7]. For individual practitioners, the humanistic values they espouse as a result of their training are juxtaposed sharply against these broad economic and legal pressures.…”