In an industry faced with post-pandemic staffing shortages, the question of how to promote self-care and decrease burnout among autism service providers has become more critical than ever before. Burnout can be defined as a work-related illness that results from ongoing psychological stress (Leoni et al., 2020), and it is widely believed to lead to other illnesses and injuries. Given the potential impact of this work-related illness, significant research has been done on the factors contributing to it and what can be done to mitigate these. However, many identified factors that seem to lead to staff burnout and turnover, such as challenging behaviors and relatively low wages, often seem immovable (Leoni et al., 2020). In response, many autism service providers have increasingly focused on promoting self-care among their employees.
Self-care as a concept, though, is often difficult to define, let alone implement effectively, as an organization. One way to conceptualize self-care is as a collection of actions designed to promote physical and mental well-being (Dorociak et al., 2017). On an organizational level, autism service providers and other agencies often seek to enhance their employees’ self-care through various wellness initiatives. These initiatives may include various topics, such as yoga, mental health, and hydration. In some cases, wellness campaigns may be designed to increase awareness and provide connections to outside resources, while in other cases, companies may invest directly in employee health by subsidizing gym memberships and other health benefits. In addition to these health and wellness initiatives, many employers also invest in incentives or events designed to serve as rewards or “reinforcers,” increasing employee morale and decreasing burnout. Perhaps the most well-known of these types of rewards is the almost ubiquitous staff pizza party.
While this article is certainly not an indictment of pizza parties or yoga workshops, it is an invitation to reconsider the factors affecting burnout and the concept of self-care through the lens of motivation. In behavior-analytic terms, motivation describes the degree to which a particular outcome is reinforcing and the factors that establish that reinforcer as effective in the first place. A simple example often used is that food is particularly reinforcing to someone who is hungry, especially when they like the food being served. Human beings are complicated, though, and often have complex and competing motivations that are more difficult to detect than those related to basic human states, such as hunger.
In the workplace, where financial motivation and reinforcement often provide only a superficial lens of analysis, this is certainly true. Many studies have shown that what we assume is most reinforcing in the workplace, including increased compensation, is not always effective (Kuvaas et al., 2017). Some researchers in economic psychology have described this phenomenon by observing that intrinsic motivation appears to be more powerful than extrinsic motivation in improving job performance and decreasing turnover (Kuvaas et al., 2017). As a radical behavior analyst, though, I am hesitant to stop at the assumption that something is simply “intrinsic” and internal and, therefore, cannot be explained or addressed. Luckily, Acceptance and Commitment Therapy (ACT) provides an essential behavior analytic framework to understand intrinsic motivation as a matter of value alignment.
In the ACT framework, values are defined as deeply held beliefs which serve as guiding principles (Paliliunas, 2021). An individual whose goals are closely aligned with their short- and long-term values feels a greater sense of purpose and motivation. They also find it easier to engage in psychological flexibility when challenges arise. (Paliliunas, 2021). Individuals who engage in ACT actively work to identify and articulate their values to align their goals accordingly and decrease their burnout and associated avoidance behaviors. When seen through this lens, intrinsic motivation occurs when actions and goals align with an individual’s values.
Recently, researchers in the field of behavior analysis have pointed to this framework as a possible starting point in suggesting a value-based approach to self-care. Paliliunas (2021) suggested that while traditional self-care tools such as meditation may be useful in addressing burnout, people will ultimately experience less stress when living lives that align with their most closely held values and beliefs. The article suggests that the current focus on self-care as a restorative practice misses the opportunity to focus on what we can do proactively to reduce the occurrence of burnout and the need for many other self-care strategies in the first place.
What does all of this mean for organizations in regard to burnout and self-care? What role do organizations play in ensuring that individuals live value-driven lives? The answer, I believe, is quite a lot, especially in the field of autism services. First, we can and should have a vital role in providing value-driven work environments. This requires us as autism service providers to ensure that we are clearly articulating our mission, vision, and values at an organizational level. This goes beyond providing a statement of purpose or an organizational mission, which has become an established practice. Instead, a well-articulated mission includes not only a statement of purpose but the specific investments the organization is making to ensure that mission comes to fruition.
Once an organization clearly articulates its mission, vision, and values, it is important to consider how these are expressed and integrated at every level. A mission-driven organization is one in which every element of the organization’s strategic plan is aligned with the autism service provider’s mission and vision. Just as importantly, all of the action steps and goals that are set as part of the execution of that plan should be aligned with the values and core commitments of the organization. This key element can be in danger of becoming lost, in which the ends are allowed to justify the means. In a truly mission-driven organization, decisions at all levels should be made according to the articulated values of the company.
One way this is accomplished is by integrating the organization’s mission, vision, and values into the daily operations. At Melmark (a human service agency serving children and adults with autism across multiple states), for example, we begin every meeting throughout the organization with Mission Moments, in which we recognize recent examples of our Core Commitments. This has several functions, the first of which is keeping our mission and our commitment to it at the forefront of everything we do. The second important function is to provide concrete examples of how individuals can uphold the mission through our Core Commitments. Lastly, it allows us to highlight individuals or departments by celebrating how their actions exemplify our organizational values.
Creating a mission-driven focus as an autism service provider informs the organizational culture and places values front and center in every arena, including recruitment and onboarding. In fact, this is where the next crucial step to prevent burnout occurs, right at the beginning of the employee life cycle. If aligning your life with your values is the best way to practice self-care and decrease stress, as Paliliunas (2021) suggests, then hiring employees whose personal and professional values most closely align with your organization’s is one of the best ways to proactively preempt burnout in your workforce. Again, the only way to accomplish this is by leading with the mission first in all conversations and framing discussions of roles with new or potential employees according to the core commitments of the organization.
Honesty and transparency are key to this process’s success. For example, one of our Core Commitments is a Highly Skilled Workforce, and we are open with staff from the beginning about the degree of rigor in our training, the amount of feedback they will receive, and the high standards we set and maintain. Sometimes, this deters potential staff from pursuing interviews, accepting job offers, or even continuing in orientation, but this is simply part of the process. If becoming highly skilled in Applied Behavior Analysis is not a strong value for that new or prospective staff, then they would likely experience burnout in the long term due to the demands of the position. These hiring and onboarding principles are also especially important to consider for key leadership positions since these individuals will play a role in upholding the agency’s mission and recruiting and supporting individuals who will thrive in that environment.
As leaders of agencies providing autism services, we have a unique opportunity to set our workforces up for success. Our own science has given us the framework to approach self-care proactively, showing us that we experience less burnout when we align our goals and our daily lives with our core values and that doing so constitutes a profound form of self-care (Paliliunas, 2021). By providing mission-driven workplaces whose values are clearly articulated and diligently upheld and recruiting employees whose values align with our own, we give our workforce the best chance for a value-aligned life in the workplace. Personally, I will never turn down a pizza party or a yoga workshop, but neither of those is what gets me through the toughest days. What drives me is this form of radical self-care, in which the work itself is not something that needs to be escaped from, but which feeds my soul, keeping the mission first for every individual every day.
Katie Salvatore, MEd, BCBA, LABA, is Executive Director at Melmark New England.
References
Dorociak, K. E., Rupert, P. A., Bryant, F. B., & Zahniser, E. (2017). Development of the Professional Self-Care Scale. Journal of Counseling Psychology, 64(3), 325–334. https://doi.org/10.1037/cou0000206
Kuvaas, B., Buch, R., Weibel, A., Dysvik, A., & Nerstad, C. G. L. (2017). Do intrinsic and extrinsic motivation relate differently to employee outcomes? Journal of Economic Psychology, 61, 244-258. https://doi.org/10.1016/j.joep.2017.05.004
Paliliunas, D. (2021). Values: A core guiding principle for behavior-analytic intervention and research. Behavior Analysis in Practice, 15(1), 115–125. https://doi.org/10.1007/s40617-021-00595-3
