Self-Awareness and Addiction Counseling

stress, coping strategies, and burnout among abuse-specific counselors Sam Loc Wallace Jayoung Lee Sang Min Lee

The purpose of this study is to investigate whether effective coping strategies play an important role to reduce burnout levels among sexual or substance abuse counselors. The authors examined whether coping strategies mediated or moderated relations between job stress and burnout in a sample of 232 abuse-specific counselors. Results indicated that self-distraction and behavior disengagement coping strategies medi- ated the relationships between 3 job stress variables (workload, role conflict, and job ambiguity) and burnout. Although venting and humor coping strategies positively moderated the relationship between role ambiguity and burnout, active coping strate- gies negatively moderated the relationship between workload and burnout.

Although the counseling profession can have many rewards, burnout can be a potential outcome of providing counseling and psychotherapy. Burnout is conceptualized as a psychological syndrome in response to chronic emotional and interpersonal stress on the job and is most widely defined by the dimensions of exhaustion, deperson- alization, and inefficacy (Maslach, Schaufeli, & Leiter, 2001). Much of the focus of burnout research has been with individuals who work in the human services field (Vredenburgh, Carlozzi, & Stein, 1999). There has been increasing recognition and study of this problem in the counselors who are working with sexual offenders and substance abuse clients. It is believed that burnout is a potential response to the emotional stress of working with others who are troubled (Everall & Paulson, 2004). Several studies (Pearlman, 1996; Pearlman & Saakvitne, 1995; Rich, 1997) reported that abuse-specific counselors working with sexual offenders and substance abuse clients would exhibit evidence of cognitive disruptions at levels higher than those of a criterion reference group of general mental health professionals. The impact on the counselor is believed to have direct adverse consequences to the clients they serve. Burnout may emerge in session as a loss of empathy, respect, and positive feelings for abuse-specific clients; more therapeutic gridlock; and boundary violations (Pearlman & Maclan, 1995; Skorupa & Agresti, 1993). When the mental health professional becomes burned out, she or he may exhibit behaviors that affect the quality of care

• • • • Sam Loc Wallace, Department of Rehabilitation, Human Resources and Communication Disorders, University of Arkansas, Fayetteville; Jayoung Lee and Sang Min Lee, Department of Education, Korea University, Seoul, Korea. Correspondence concerning this article should be addressed to Sang Min Lee, Department of Education, College of Education, Korea University, Anam-dong, Seongbuk-gu, Seoul, Korea (e-mail: [email protected]).

© 2010 by the American Counseling Association. All rights reserved.

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provided to clients (McCarthy & Frieze, 1999). Because the consequences of burn- out can ultimately impair clients, it is clearly an issue of professional and ethical behavior to develop awareness of burnout (American Counseling Association, 2005; Everall & Paulson, 2004).

The relationships between people and work have been recognized as a catalyst for potential problems (Maslach et al., 2001). Adverse emotional and behavioral sequelae of job satisfaction and burnout for helping professionals have been identified in several studies (Bingham, Valenstein, Blow, & Alexander, 2002; Kirk-Brown & Wallace, 2004; Malach-Pines & Yafe-Yanai, 2001). The importance of studying burnout within an organizational context has been suggested by several researchers (Emerson & Markos, 1996; T D. Evans & Villavisanis, 1997; Malach-Pines & Yafe-Yanai, 2001; McCarthy & Frieze, 1999). Job-related factors have been demonstrated to affect counselors' levels of burnout, with counselors in institutional settings being more vulnerable to burnout (Färber, 1990; Rosenberg & Pace, 2006; Trudeau, Russell, de la Mora, & Schmitz, 2001; Yu, Lee, & Lee, 2007). Higher rates of emotional exhaustion and depersonali- zation were found in counselors working in community agency settings versus those in private practice, where it is believed that counselors are able to regulate their job- related stress easier because of working outside of a bureaucratic hierarchical system (Rosenberg & Pace, 2006). These findings are consistent with the Job Demand-Control (JD-C) model (Karasek, 1979) that suggests that job control protects the individual from problematic and damaging work environments. Models of job environment and the subsequent work-life have been proposed to play a central role in the process of burnout (Maslach et al., 2001). The interaction of these factors and personal charac- teristics contribute to a rich matrix of considerations for developing burnout. Within the expanded conceptualization of burnout, the work—life and job stress framework can augment the understanding of burnout.

Coping strategies are the ways in which individuals choose to respond to stressful situations (Welbourne, Eggerth, Hartley, Andrew, & Sanchez, 2007). Parkes (1994) suggested that personal characteristics such as coping strategies can mediate or moderate relations between job demands (stressors) and job strains (burnout symp- toms). Individual differences in coping strategies have been theorized to derive from traditional personality dimensions and have been supported in several studies (Armstrong-Strassen, 2004; Carver, Scheier, & Weintraub, 1989; McCormick, Dowd, Quirk, & Zegarra, 1998). Effective coping strategies may play an important role in reducing stress levels and increasing job satisfaction. Welbourne et al. (2007) reported that using nonavoidant coping strategies was associated with higher job satisfaction rates. Avoidant coping strategies have also been shown to be related to increased emotional exhaustion and decreased personal accomplishment (G. D. Evans, Bry- ant, Owens, & Koukos, 2004). Increasing the understanding of the role of various coping strategies on the relations between job stress and burnout can help identify effective coping skills to reduce exhaustion and depersonalization and increase a sense of personal competence and efficacy (G. D. Evans et al., 2004).

The purpose of this study is to examine the relationships among organizational job stress, coping strategies, and burnout. We examined whether the function of coping strategies mediated or moderated relations between job stress and counselor burnout.

112 journal of employment counseling • September 2010 • Volume 47

Specifically, using the Baron and Kenny's (1986) mediation and moderation model, we analyzed for identifying mediating and moderating relationships between coping strategies and counselor burnout as they relate to types and severity of job stress as perceived by abuse-specific counselors. This study is innovative in that it identifies the role and function of coping strategies as mediating and moderating factors in relation to job stress and counselor burnout.

METHOD

Participants

The participants were 232 abuse-specific counselors (i.e., either sexual abuse counselors or substance abuse counselors). Participants in the study were col- lected through a web-based survey or by mail. An e-mail containing a link to the survey and measures was sent to two electronic mailing lists; one with a focus on sex offender treatment and research (Association for the Treatment of Sexual Abus- ers electronic mailing list and one with a focus on maltreatment and victim issues [Prevent—Connect]). Additionally, e-mails were sent to substance abuse treatment facilities located on the Substance Abuse and Mental Health Services Administration facility locator webpage. Of the hard copy surveys, 120 were mailed to treatment facilities or individual practitioners that were identified to work in one of the three areas of treatment specialty. Facilities and practitioners were identified through a web search of programs and practitioners who were identified as having a treat- ment focus in one or more of the respective categories (e.g., certified sex offender treatment providers in Texas, rape crisis centers, substance abuse programs). Of the aforementioned surveys, 44 were returned for review making the response rate 36.67%. Included in the sample were participants from 35 states as well as seven other countries (Japan, France, India, Israel, Canada, Australia, and the United Kingdom; n - 21). The mean age of the sample was 42.96 years (SD = 11.94, range = 23—76 years). Of the 232 participants included in the study, 71.4% were women and 28.4% were men. The racial/ethnic composition of the participants was 93.5% European American, 3.9% Asian American, 1.3% African American, 0.9% Indian American, and 0.4% Hispanic American. These individuals had been working in their respective counseling organizations for an average of 10.71 years {SD — 7.51). Their main discipline fields were social work (32.1%), mental health (17.7%), counselor education (5.6%), rehabilitation counseling (1.9%), and others (42.1%). Also, this sample is composed of master-level counselors (63.6%), doctoral-level counselors (21.8%), graduate counselors (11.1%; i.e., nonlicensed counselors with a bachelor's degree), and specialist counselors (3.1%; i.e., counselors with an educational specialist's degree such as Ed.S.). (Percentages may not total 100% because of rounding.)

Instruments

Job Stress Scale (JSS; Caplan, Cobb, French, Van Harrison, & Pinneau, 1975). The JSS is a 13-item self-report questionnaire that measures the frequency with which

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an individual experiences four dimensions of job stress: (a) Workload, which measures the quantitative aspect of work overload resulting from time pressures (e.g., "How often does your job leave you with little or no time to get things done?"); (b) Role Conflict, which is a state in which rationally incompatible demands are made upon the individual by two or more persons whose jobs are functionally codependent with the individual's job (e.g., "How often do persons equal in rank and authority over you ask you to do things which conflict?"); (c) Role Ambiguity, which is a state in which a person has inadequate information to perform their role in an organization (e.g., "How often are you clear on what your job responsibilities are?"); and (d) Lack of Utilization, which is a stress factor related to underutilization of previously acquired skills in carrying out tasks required on the job (e.g., "How often can use the skills from previous training?"). Individuals respond to items using a 7-point Likert-type scale ranging from 1 {never) to 7 {always). The four-factor structure was confirmed in a study conducted by Hamel and Bracken (1986) and was additional support for the contention that job stress is a multidimensional phenomenon. In this study, Cronbach's alphas of .90, .81, .69, and .83 were obtained, respectively, for the Workload, Role Conflict, Role Ambiguity, and Lack of Utilization JSS subscales.

Brief COPE (Coping Orientations to Problems Experienced) Inventory (Carver, 1997). The Brief COPE Inventory is a 28-item self-report questionnaire that assesses an individual's cognitive and behavior coping strategies. It is an abbreviated ver- sion of the COPE Inventory (Carver et al., 1989), which has problems regarding the length and redundancy of the full instrument as well as the overall time burden of the assessment protocol. The Brief COPE Inventory produces distinct scores for each of the 14 coping strategies: (a) active coping, (b) planning, (c) use of instrumental support, (d) religion, (e) venting, (f) positive reframing, (g) humor, (h) acceptance, (i) use of emotional support, (j) self-distraction, (k) denial, (1) behavioral disengage- ment, (m) self-blame, and (n) substance use. Individuals respond to iems using a 4-point Likert-type scale ranging from 0 (/ haven't been doing this at all) to 3 {I've been doing this alot) to express the frequency of use for each of the coping behaviors. In this study, the Cronbach's alpha achieved for all items of the inventory was .78.

Counselor Burnout Inventory (CBI; Lee et al., 2007). The CBI is a 20-item self- report questionnaire that measures various levels of burnout. The CBI provides norm-referenced measures of a counselor's burnout syndrome on five factorially derived burnout dimensions: Exhaustion, Incompetence, Negative Work Environment, Devaluing Client, and Deterioration in Personal Life. Its focus on the counselor's work environment is unique to this inventory. This unique component corresponds with recent counseling burnout literature that accentuates the role one's workplace environment plays in promoting burnout (Azar, 2000; Maslach, 2005; Osborn, 2004; Savicki & Cooley, 1981; Thompson, 1999). In this study, the CBI total score was used to assess the overall level of a counselor's burnout. Individuals respond to items using a 5-point Likert-type scale (1 = never true; 5 = always true). The CBI contains items reflecting characteristics of feelings and behaviors that indicate various levels of burnout. Lee et al. (2007) reported alpha coefficient total scores of .88. Support for construct validity was obtained through exploratory factor analysis that identified a five-factor solution and a confirmatory factor analysis with all goodness-of-fit in-

114 journal of employment counseling • September 2010 • Volume 47

dexes also indicating an adequate fit to the data (Lee et al., 2007; Yu, Lee, & Nesbit, 2008). In this study, the Cronbach's alpha achieved for all items of the CBI was .88.

Data Analyses

In this study, 19 variables were investigated: four variables rating perceived severity of job stress, 14 variables rating coping strategies, and one variable rating level of counselor burnout. We analyzed the relationships among these variables by using multiple regression/ correlation analyses by the Baron and Kenny (1986) model (i.e., mediation and moderation analyses). Specifically, we examined whether the function of coping strategies mediated between job stress and counselor burnout. The test for mediation in this study involved evaluating if the influence of job stress on counselor burnout manifests itself through the types and severity of the counselor's coping strategies; also, we analyzed whether coping strategies moderated the relationship between job stress and burnout. The test for modera- tion in this study involved evaluating the 56 interactions between four subscales of the JSS (predictors) and 14 types of coping strategies (moderators) on counselor burnout (criterion variable). Namely, in our analysis, we identified mediating and moderating relationships between coping strategies and counselor burnout, as they relate to types, and severity of job stress, as perceived by abuse-specific counselors. All data were analyzed using SPSS (Version 15.0), and all significance values shown were based on two-tailed tests.

RESULTS

To test the hypothesis that 14 types of coping strategies would mediate the relationship between four types of job stress and counselor burnout, the three-step tests of media- tion suggested by Baron and Kenny (1986) were used. In this study, the three-step test for mediation involved (a) regressing the criterion variable (counselor burnout) on the predictor variables (subscales of the JSS), (b) regressing the mediators (scales of the Brief COPE Inventory) on the predictor variables (subscales of the JSS), and (c) regressing the criterion variable (counselor burnout) on both the predictors (subscales of the JSS) and mediators (scales of the Brief COPE Inventory).

First, the relationships between subscales of the JSS (predictor variables) and counselor burnout (criterion variable) were significant, F(4, 203) - 29.50,/> < .01. Significant main effects were shown for Workload (ß = .40,p < .01), Role Conflict (ß - .77, p < .01), Role Ambiguity (ß = .53, p < .05), and Lack of Utilization (ß = .60, p < .01) on counselor bum- out. These results fulfilled the mediation criteria in the first step of Baron and Kenny's (1986) model. Second, a correlation analysis was used to measure the relationship be- tween perceived severity of four types of job stress and 14 types of coping strategies. Nine mediators (i.e., self-distraction, active coping, denial, substance use, use of instrumental support, behavioral disengagement, planning, humor, and self-blame) were statistically significantly correlated with at least one of the predictor variables. However, five media- tors (i.e., use of emotional suppjort, venting, positive reframing, acceptance, and religion) were not statistically significantly correlated with any predictor variables. Additionally, a multiple regression analysis was used to test the relationship between significant variables in the second step (seK-distraction, active coping, denial, substance use, use of instrumen-

journal of employment counseling • September 2010 • Volume 47 115

tal support, behavioral disengagement, planning, humor, and seK-blame variables) and counselor burnout (the criterion variable). Among nine mediators, only seven mediators, self-distraction (ß = .16, p < .05), denial (ß = .12, p < .05), substance use (ß = .15, p < .05), behavioral disengagement (ß = .33, p < .01), planning (ß = .33, p < .01), humor (ß = .14,p < .05), and self-blame (ß = .13, p < .05), were statistically significant. Therefore, when considering these results, active coping and use of instrumental support of coping strategies were not considered for further analysis in the third step.

In the third step, a test of the additional variance explained by the mediators (seven • coping strategies: self-distraction, denial, substance use, behavioral disengagement, planning, humor, and self-blame variables) in addition to four job stress variables were significant, F(9,190) = 13.65, p < .01, AR^ = .16. As shown in Table 1, the follow-up tests indicated that greater workload, role conflict, and role ambiguity and greater self-distraction and behavioral disengagement uniquely predicted more counselor burnout, i(197) = 2.62,p < .05 and i(197) = 3.74,p < .01, respectively. More important, complete mediation was observed because the predictor variable (job ambiguity) was not significantly related to the criterion variable (counselor burnout) in the presence of the mediators (seK-distraction and behavioral disengagement). In addition, the re- lationship between two predictor variables (workload and role conflict) and criterion variable (counselor burnout) were partially mediated by two mediator variables (self- distraction and behavior disengagement) because the effect on counselor burnout of two job stress variables (workload and role conflict) was substantially decreased (see Table 1). When applying Sobel's (1982) mediation test to determine if the amount of mediation was significant, the self-distraction variable partially mediated the rela-

TABLE 1

Multiple Regression Anaiysis of Counselor Burnout (Criterion Variable) Predicted by Coping Strategies (Mediator Variables) and

Job Stress (Predictor Variables)

Variable Step 1

Workload^ Role Conflict" Role Ambiguity" Lack of Utilization"

Step 2 Workload" Role Conflict" Role Ambiguity" Lack of Utilization" Self-Distraction'= Denial Substance Use" Behavioral Disengagement" Planning" Humor* Self-Blame"

B

0.42 0.78 0.64 0.42

0.32 0.71 0.36 0.34 0.98 0.85 0.79 2.08 0.52 0.23 0.46

SE

.11

.27

.21

.21

.10

.24

.18

.19 - .37

.62

.45

.56

.32

.28

.38

ß

.25

.22

.23

.14

.19

.20

.13

.11

.15

.08

.09

.22

.09

.04

.07

f

3.71** 2.90** 3.13** 1.97

3.23** 3.02** 1.97 1.81 2.62* 1.36 1.77 3.74** 1.65 0.83 1.22

AFP .39

.16

fP .39

.55

AF 30.86

13.65

^Job Stress Scale subscale. "Brief COPE (Coping Orientations to Problems Experienced) Inventory scale. * p < . 0 5 . * * p < . 0 1 .

116 journal of employment counseling • September 2010 • Volume 47

tionship between workload and counselor burnout (Z = 2.25, p < .05). In addition, behavior disengagement partially mediated the relationship between workload and counselor burnout [Z = 3.49, p < .01) as well as the relationship between role conflict and counselor burnout {Z = 3.53, p < .01).

Next, we tested the altemative hypothesis that coping strategies moderated the relation- ship between job stress and counselor bumout. A moderator is a variable that changes the relationship between a predictor variable and a criterion variable (Frazier, Tix, & Barron, 2004). The main purpose for identifying and constructing moderators is to increase pre- dictive effectiveness (Abrahams & Alf, 1972). The moderator model tested the effects of four types of job stress (predictors) and the 14 types of coping strategies (moderators) as well as their interactions (e.g.. Workload X Active Coping) on counselor bumout (criterion variable). For these tests, both the amount of variance (/? :̂ effect size) accounted for by job stress and coping strategies and their interactions and the statistical significance of the change in F produced by entering the job stress and coping strategies and their interac- tions were considered. When the interaction increased the R^ by a statistically significcmt amount, the two variables were moderating each other's relationship with bumout. Table 2 summarizes only the significant moderating effects of coping strategies on the relationship between job stress (predictors) and counselor bumout (criterion variable). Specifically, ac- tive coping strategies moderated the relationship between workload and counselor bumout and increased the explained variance by a statistically significant amount (ß = - . 1 7 , F = 16.59, AR^ = .03,p < .01). In addition, venting coping strategies moderated the relationship between role ambiguity and counselor bumout and increased the explained variance by a statistically significant amount (ß - .14, AF = 25.00, AR^ = .02, p < .05). Humor coping strategies also moderated the relationship between role ambiguity and counselor bumout and increased the explained variance by a statistically significant amount (ß = .13, AF =

DISCUSSION

The findings of the current research contribute to an increased understanding of the relationship between coping strategies and counselor burnout as these processes relate to specific types of job stress among abuse-specific counselors. There are several

TABLE 2

Moderating Effects of Coping Strategies on Job Stress and Counselor Burnout

Variable

Workload" x Active Coping" Role Ambiguity" x Venting" Role Ambiguity" x Humor*

IE I ß

-.17*

.19**

.03*

I E 2 ß

.13*

.27**

.02*

I E 3 ß

.13*

.23**

.02*

Note. IE = interaction effect. "Job Sress Scale subscale. "Brief COPE (Coping Orientations to Problems Experienced) Inventory scale. *p< .05. **p< .01.

journal of employment counseling • September 2010 • Volume 47 117

significant implications for theory, training, and practice for the profession of abuse- specific counseling. In support of the Job Demand—Resource (JD-R) or JD-C models that were the widely known theories used to explain the worker burnout process (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001; Schaufeli & Bakker, 2004), the noteworthy outcome of the present research is that the job demand variables (e.g., JSS subscales) increased counselor burnout while the resource or control variables (e.g., active coping strategies) helped reduce job demand variables, thereby helping to decrease the feeling of burnout among abuse-specific counselors.

The JD-R or JD-C models conceptualize burnout not only as the result of a period of expending too much effort at work while having too little recovery (Osborn, 2004) but also as an erosion of engagement with the job (Schaufeli, Salanova, Gonzales- Roma, & Bakker, 2002). Results of the present study also indicated that avoidant emotional coping strategies, specifically self-distraction and behavior disengagement, mediated the relationship between three JSS subscales (Work Load, Role Conflict, and Job Ambiguity) and counselor burnout. In particular, the complete mediation effect was observed between job ambiguity and counselor burnout. That is, the job stress variables were positively related to greater levels of self-distraction and behavior disengagement coping strategies, and, in turn, greater self-distraction and behavior disengagement coping strategies were positively related to greater burnout among abuse-specific counselors. The interpretation of these findings suggests that the re- lationship between job stress and burnout is accounted for, in part, by the function of how negatively counselors cope with the stressful situation (i.e., avoidant coping strategies and erosion of engagement with the job).

In addition, the findings of the present study show some moderation effects. Emotional coping strategies, such as venting and humor, positively moderate the relationship between role ambiguity job stress and counselor burnout. Significant findings reflect that when abuse-specific counselors use venting and humor coping strategies and report higher role ambiguity, they have higher levels of burnout. Conversely, active coping strategies negatively moderate the relationship between work load stress and counselor burnout. Unlike emotional coping strategies, even when abuse-specific counselors reported higher work load in their jobs, if they used an active coping strategy, they reported lower levels of burnout. These findings sug- gested that investigating and discussing counselors' current coping strategies toward job stress may lead to preventing or alleviating their burnout symptoms.

The present study supports the importance of understanding coping strategies that may alleviate abuse-specific counselors' burnout when they are faced with the stressful demands of their particular field of work. The findings can be discussed within a supervisory relationship in which the counselor can be monitored and nur- tured. Supervision can guide abuse-specific counselors to understand their internal mechanisms by helping them identify their current coping strategies and by exploring alternative effective coping strategies, especially for novice abuse-specific counselors. Yu et al. (2008) also stressed that supervision contributes significantly in preventing and alleviating counselors' burnout. Thus, ongoing supervision is essential for both those who are just entering the counseling profession and for those who are more experienced counselors. Clinical supervision helps novice counselors to shape ap-

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propriate coping strategies (i.e., active coping strategies based on the results of the present study) and also helps experienced counselors reduce the existing ineffec- tive coping strategies (i.e., self-distraction, behavior disengagement, venting, and humor based on the results of the present study) in situations that are stressful in their jobs. In other words, supervisors could discuss the appropriate coping styles to help address unsettled role conflict and ambiguity in the work environment that could potentially result in professional impairment. Thus, identifying individual counselors' dysfunctional and functional coping strategies could be a valuable supplemental supervisory tool that could lead to productive discourse within the supervisory relationship.

The findings of this study lend support to the expanded conceptualization of burnout that includes organizational sources. The findings also increase explanatory research on conceptual development of job stress models. The social environment and functioning of the workplace play an important role in how people interact with one another and, ultimately, how they perform their jobs (Maslach, 2005). Organi- zational development strategies may be of interest when considering the role of the organization on job stress and burnout. Diagnostic models indicate that job design, or the value of the work, should be supported by job inputs, or organizational work environment and culture, in order to produce the most effective job outputs, or products and results (Cummings & Worley, 2005). The most salient organizational variable contributing to burnout in this study was job ambiguity. When abuse-specific counselors are not clear on what their job responsibilities are, what others in the workplace expect of them, or how to define their standard of performance, occupa- tional stress will likely occur. It is important for supervisors and administrators to understand that clarity in the role of the abuse-specific counselor is a key factor to consider in job design and role assignment. Special attention should be paid to the roles of abuse-specific counselors in some settings, such as residential treatment, where conflict may arise when interacting with other professionals who have different job functions (e.g., nurses, physicians, teachers, and direct care staff). These other professional staff members may place demands on the counselor that are contrary to counselors' training, thereby increasing role ambiguity and the likelihood for burnout. Additionally, counselors who work with sex offenders often have outside stakeholders such as probation officers and officers of the courts who may view the counselor as an extension of law enforcement, thereby potentially creating additional expectations and job ambiguity. Attention to these types of potential Stressors and organizational pitfalls as well as how counselors cope with these Stressors are im- portant considerations for those in supervisory roles. Clarifying the abuse-specific counselor's role and performance of duties should be a routine part of counselor job orientation and ongoing training.

It is important to note that statistical mediation and moderation were examined in this study, and, as such, no causal inferences may be drawn from this study (Skowron, Wester, & Azen, 2004). In addition, all measures were obtained by self-report questionnaires, and participants were anonymous and self-selected. Thus, abuse-specific counselors may have responded in ways that did not reflect their actual attitudes and beliefs for various personal reasons. Also, some abuse-

journal of employment counseling • September 2010 • Volume 47 119

specific counselors who did not identify any job stress within their work environment may have judged their participation in this study to have litue impact on them and chose not to participate. Thus, future research could use multiple measures (e.g., observation) to assess the variables, thereby giving a clearer picture of the long-term effects of job stress and coping strategies on burnout. Considering the sample of the current study, it is also important to know the limitations of the generalizability of the results. For example, the skewed distribution of sex and race (European American, female counselors) might have an effect on the variability of the results. Finally, further limitations of the study relate to cultural implications of construct definition and our sample selection. Healthy coping strategies are contextually and socially defined and may vary from culture to culture (Sue & Sue, 2003). Ultimately, coping strategies cannot be viewed apart from the influences of race, ethnicity, and culture. For example, in some cultures (e.g., African American and Hispanic), spiritual or religious coping may be strongly emphasized, whereas in others (e.g., European American), intrinsic sources of support (e.g., self-reliance) are highly valued. Also, although some cultures encourage open disclosure and expression of emo- tion (e.g., Hispanic), others discourage such displays (e.g.. Native American; Sue & Sue, 2003). Further research with more diverse counselors (in terms of sex and race) would allow counseling researchers to determine if significant similarities or differences exist in job stress, coping strategies, and burnout levels between male and female counselors and between European American counselors and minority counselors.

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