Conducting behavioural experiments

  The behavioural experiment (see p. 165) can be an extremely useful technique in the treatment of depression, since it provides additional evidence to challenge depressive predictions through the process of hypothesis testing. The individual is encouraged to challenge their negative predictions about future events with more positive alternative hypotheses. They are then encouraged to find out exactly what the outcome was to that given situation and how it compared with the predictions made. Invariably, because the predictions made are excessively negative and gloomy, as one would expect in depression, the outcome is more positive than the individual’s predictions and can be used as evidence to disconfirm their depressive thinking patterns. Consequently, most behavioural experiments will have the effect of weakening the individual’s original negative view of situations and events and at the same time strengthening alternative more positive explanations.

A note on the burnout syndrome

  The burnout syndrome has been included here because there are a number of researchers who argue that burnout is basically work related depression. However, others argue that burnout differs from depression because in classical depression, a person’s symptoms appear to manifest across all situations, whereas a person who is ‘burned out’ in the work sphere may function well in non-work spheres. Whatever the stance taken, the research literature indicates that there is a considerable overlap between burnout, depression and various elements of job satisfaction and that it is related to greater absenteeism, increased staff turnover and detrimental effects on work performance. Thus, burnout deserves a mention in the context of work related stress syndromes and it is most closely linked to the depression syndrome. It is found in occupations where there is a large amount of direct face-to-face contact with clients, particularly where resources are limited and inadequate. Some of the most common signs and symptoms of burnout include a high resistance to going to work every day, a sense of failure, anger and resentment, discouragement and indifference, isolation and withdrawal, feeling tired and exhausted all day, clock watching, loss of positive feelings towards clients, avoiding client contact, a more cynical and blaming attitude towards clients, avoiding discussion of work with colleagues, frequent colds and flu, frequent headaches, high absenteeism, poor sleep and increased use of drugs and alcohol.

The burnout syndrome is characterized by three main symptoms of emotional exhaustion, depersonalization and low personal accomplishment. It is thought to develop in three stages corresponding to these symptoms, the first being emotional exhaustion. As feelings of emotional exhaustion set in, the worker’s perception of their clients change. There is a gradual withdrawal of emotional involvement with them and an increasing perception that they have caused their own difficulties and are therefore less worthy of help. They often feel that they are being exploited by their clients and experience an increasing sense of depersonalization. As emotional exhaustion and negative attitudes towards clients increase, the worker becomes increasingly dissatisfied with themselves. They begin to feel that they do not understand the clients or accomplish much with their work with them. As the feeling of low personal accomplishment takes hold, the employee feels that they are not up to the job and ultimately experience a lowering of self-esteem.