Secondary research objective 2: Common cultural and institutional factors that lead to low
self-esteem, high burnout and employee turnover intentions.
Cultural Factors
Results revealed that the cultural and institutional factors that lead to low self-esteem, high
burnout and turnover intentions can be classified in two themes namely: responsive factors,
which included aspirations, chronic disease, feedback, norms and rewards; and generic factors,
which included demographics, family issues, interpersonal issues and workplace issues.
This is congruent with a number of studies (Brown et al., 2009; Egan 2006; Heine 2001; Maslach
& Leiter 2005). Maslach and Leiter (2005) identified individual’s antecedents such as age,
gender, marital status and experience. Heine (2001) considered self and self-esteem as cultural
constructions. Brown et al. (2009) stated that self-esteem functions similarly in different cultures.
Egan (2006) explained extra-vigilant factors included life events experienced by the counsellor,
social support, and cultural context.
Institutional Factors
Regarding the workplace factors that lead to high burnout and turnover intentions, two themes
are derived from the results. Connectedness shortfalls and factors, which include client- induced
factors and interpersonal challenges, was the first theme analysed. This compares well with other
reported studies. For instance, Egan (2006) explained client factors to include the nature of client
clinical presentation and the impact of the counsellor’s case load. Cordes and Dougherty (1993)
presented three categories of factors that cause burnout namely: job and role characteristics,
personal characteristics and organisational characteristics.
The second theme to emerge is that of workplace deficits and workplace induced deficits which
includes benefits and rewards, employee motivation shortfalls, employee performance deficits,
management deficits, pressures of work and resources deficits. These findings are consistent with
other reported studies. White and Gaertner (2011) identified workplace factors that contribute to
counsellor turnover include: “ambiguity or organisational mission, inadequate salaries and
benefits, inadequate frequency and quality of clinical supervision, high workload, lack of
autonomy and control, lack of access to training and development, role mismatch and stress”
(p.57.) Maslach et al. (2001) stated that lack of work control contributes to reduced personal
accomplishment and higher levels of emotional exhaustion.
Management deficits were depicted as a factor that leads to turnover, burnout and low self-
esteem. The deficits mentioned in this study include lack of clear purpose for the institutions
existence, staff shortage, inadequate support, tight supervision-micro management, lack of
appraisal and motivation, lack of proper policy guidelines within the institution, no clear
strategies during employment and lack of support from management. These findings are
consistent with other reported studies. Egan (2006) listed the organisational factors that
influence burnout to include: organisational support to the counsellor, supervision and caseload.
Maslach and Leiter (2005) identified situational predictors of burnout and these include
workload, lack of control, awards, social network, job fairness and values. Pierce and Gardner
(2004) reported that the way in which a manager directs, communicates and behaves with their
employees’ influences the employees’ self-esteem and self-worth.
Secondary research objective 3: Common cultural and institutional interventions for
dealing with low self-esteem, high burnout and employee turnover intentions.
From the study findings, two major themes emerged on the common cultural and institutional
interventions for dealing with low self-esteem, high burnout and high turnover intentions
namely: developmental interventions and normative interventions.
Developmental Interventions
Developmental interventions articulated communication improvement strategies, institutional
procedures, policies and practices, and professionalism oriented strategies. Vorkapic and
Mustapic (2012) suggested changing troublesome conditions is a way of dealing with burnout at
the workplace. Hatinen et al. (2007) stated that the three burnout components, as proposed by
Maslach and Jackson (1981), seem to react differently to the same preventive or treatment
activities. They reported that at the individual level cognitive behaviour strategies have been
viewed as successful and at the organisational level reducing job stressors has been effective.
They argued that a combination of both is the best approach.
Many participants suggested communication improvement strategies as ways of intervening
against burnout and turnover. This theme was derived from responses that portrayed
opportunities for dissemination of information and modifications of workplace professional
relationships. Some of the interventions proposed included holding monthly team building
retreats, management listening to staff concerns and attending to them, improving
communication channels, holding regular meetings and annual general meetings, and receiving
feedback from satisfied customers. Kim and Lee (2009) reported that job relevant
communication and relationship communication reduce turnover intentions and burnout.
McNulty et al. (2007) reported that participatory management at the organisational level is a
strategy to reduce turnover.
The importance of institutional procedures, policies and practices as interventions was
highlighted by many participants. Some of the suggestions from this study included providing an
enabling working environment, setting clear guidelines for staffing, client intake and
professionalism, developing policy on work criteria and client intake, and motivating the
employee, and giving them management support. Young (2015) proposed improvement in areas
of work life namely: “adjustment of workload, increasing employees control over work and
decision making, adjusting organisational rewards to an employee’s expectations, developing a
sense of community, promoting fairness and aligning personal and organisational values” (p.682-
3).
Other suggestions from this study include setting up a job appraisal and reward system,
providing opportunities for promotions when qualified, reducing workload by having sufficient
number of workers; client worker ratio and increasing staff salaries. These findings are
consistent with Gallon et al. (2003) who reported a number of interventions to reduce turnover.
These included increasing salaries, improving benefits, reducing paperwork, providing ongoing
training, providing personal recognition, career development and shortening working hours.
Dunford et al. (2012) suggested that when managers plan interventions for employee burnout
they should consider career transitions.
Other proposals given by participants included: proper planning, provision of institutional
support systems and self help groups providing clear guidelines for staffing, client intake and
professionalism, motivating the employee and giving them management support. These findings
are consistent with Griffeth, Hom and Gaertner (2000) who proposed a number of workplace
interventions in dealing with counsellor turnover. These included enabling counsellor
independence and autonomy, training and skill building, team building and conflict management
training, succession planning and leadership training, clarifying boundaries and role
expectations. Xanthopoulou et al. (2007) noted that to deal with predictors of burnout,
organisations need to provide sufficient amount of job resources. Briner and Reynolds (1999)
argued that workplace based interventions aimed at reducing stress and burnout, and some of the
maladaptive responses to stress have little or no effect.
The findings in this study equally suggest interventions at the workplace; these suggestions
conform to other studies. Rupert, Miller and Dorociak (2015) explained that job control has been
associated with less emotional exhaustion, less depersonalisation and increased personal
accomplishment. A number of participants talked about increasing job control and autonomy in
dealing with burnout and turnover. Rupert, Miller and Dorociak (2015) stated that workplace
support is significant in dealing with burnout especially in promoting a sense of personal
accomplishment. In addition, more personal resources predicted less emotional
exhaustion and more personal accomplishment. White and Gaertner (2011) stated
a number of interventions including: increasing salaries, improving benefits,
reducing paperwork, ongoing training, personal recognition, participatory
management and strategic planning. The interventions proposed in this thesis are
quite similar to these. Knudsen et al. (2003) reported four practices of reducing
counsellor turnover namely long term strategic planning, participatory decision
making, improved benefits and increasing commitment to retention activities and
increasing salaries (Knudsen et al. 2003).
The study found that many counsellors proposed professionalism oriented
strategies. These are practices aimed at improving the counsellor’s expertness and
skilfulness. Some of the suggested strategies include: having motivation talks, on
the job training, providing clear job description, attending training and personal
therapy, holding team building activities, increasing remuneration and both sides
sharing objectives and expectations from the beginning. Silbiger and Pine (2014)
suggested that increasing the employees’ sense of their work importance could
reduce levels of burnout and lower turnover. Lewandowski (2003) suggested that
organisational support and worker’s control decrease employee burnout.
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