Cultivating Resilience to Combat Burnout in Emerging Professionals  

Child life specialists are frequently exposed to high-intensity and stressful situations in their work, which we know can put them at risk of developing emotional burnout and compassion fatigue. However, when compared to nurses who have similar risk levels of burnout, child life specialists have a significantly higher level of compassion satisfaction, making them more resilient to burnout (Lagos et al., 2022). It’s hypothesized this is because child life specialists typically have more intrinsic motivation, or “calling,” to the profession and fi nd immense satisfaction advocating for children (Lagos et al., 2022). We also know that entrance into the field of child life is becoming increasingly competitive due to limited internship availability, which can lead to one’s outlook of the field and self-perception becoming bleak. Many feel that the fight does not stop once they achieve certification; they then must change their stance and turn their fighting tactics into advocacy within the multidisciplinary team and to hospital leadership for a seat at the table. This early experience of competition, paired with a high-stress and potentially negative work environment, is a recipe for early burnout in our emerging professionals. Therefore, the necessity to cultivate resilience in child life specialists is imperative to promoting longevity in the field.

Resilience Strategies

Cultivating resilience in clinicians involves maintaining interest, developing self-awareness, accepting personal limitations, prioritization and balance, and having supportive relationships (Rakesh et al., 2017). The inability to regulate negative emotions can lead to generally empathic people losing their empathic responses in the work setting. Resilience building strategies, such as mindfulness, thought-stopping, seeking support, and establishing a personal mindfulness coping plan, can be used to mitigate this.

Both mindfulness and thought-stopping are forms of mental training to enhance awareness and the ability to disengage from maladaptive pathology (Shapiro et al., 2005). Mindfulness, or mindfulness-based stress reduction (MBSR) can be used to pay attention to one’s present experiences in a nonjudgmental way. With the practice of mindfulness, we can not only reflect on our own experiences, but also build empathy. In fact, the introduction of MBSR strategies increases the activation of brain regions involved with emotional regulation as well as empathy, encouraging strengthened emotional withstanding against burnout symptomology (Rakesh et al., 2017).

The practice of thought-stopping, an example of an MBSR strategy, is used to undermine negative thoughts and replace them with positive ones (Bakker, 2009). Thought stopping is the opposite of the acceptance quality of mindfulness and is an essential part of building self-awareness. With origins in Cognitive Behavioral Therapy (CBT), thought-stopping can help one shift the internal narrative surrounding emotional stress and dismiss negative internal stimuli. The CBT model addresses stimuli presentation, cognitive recognition, and emotional or behavioral response (Bakker, 2009).  Thought-stopping is a technique that is applied to block a response to stimuli at the cognitive level which encourages a positive change in attitude and responses to negative stimuli (Bakker, 2009).  Thought-stopping has been shown to be a worthwhile tool in combating depression, anxiety, and insomnia, symptomatology that can also be present in a burnout state (Rakesh et al., 2017).  However, a healthy balance between the reframing of thought-stopping and complete repression and compartmentalization needs  to be practiced. 

An acronym used in thought-stopping practice, S.T.O.P. (Stop, Take a breath, Observe, Proceed), can be helpful for clinicians to utilize in the moment (Liao et al., 2020).  For example, a child life specialist might choose to use S.T.O.P when a multidisciplinary team member questions a child life intervention as a way of self-regulating.  Instead of internalizing staff behavior as a negative reflection of self-worth or the efficacy of the intervention, the child life specialist pauses to breathe, recognizes and reframes negative thoughts, and redirects focus back to the needs of the patient while educating the team member on the intention of the intervention.

Many child life specialists may be familiar with the idea of avoidant coping, wherein an individual ignores or actively avoids a stressor in hopes of making it go away. When in a heightened stress state, it is easy to become lost in our mental noise. In these moments, it is important to utilize approach coping strategies rather than avoidant coping strategies to cultivate resilience and decrease the likelihood of experiencing compassion fatigue and burnout (Lagos et al., 2022). Approach coping strategies can include engaging in breathing exercises to bring our mental awareness back down to a calm baseline where we can then address the negativity to which we are being exposed. Other examples of effective approach coping strategies include crowdsourcing, reflection with members of the child life team, clinical supervision, and one-on one sessions with child life leadership (Lagos et al., 2022). Paired with approach coping strategies, one suggested MBSR technique is to engage in Body Scanning, a progressive focus of attention to the body, observing body sensations one experiences, and recognizing and reflecting on thoughts and feelings experienced during the exercise  (Moody et al., 2013).

Creating a Mindfulness Coping Plan

Clinicians are encouraged to build a coping plan to utilize in the moment when experiencing workplace stress. Following the model above and including MBSR and approach coping strategies, a suggested mindfulness coping plan for a child life specialist could include:

1. S.T.O.P. thought-stopping
◊ Recognizing negative thoughts
◊ Mindful breath-work
◊ Accepting reality and reframing focus

2. Body Scan
◊ Assess tension in body
◊ Gentle stretching for mindful movement and to decrease tension

3. Debriefing with supervisor or trusted team member

4. Journaling and privately reflecting on experiences

The identification of tools to use, such as thought-stopping, approach coping strategies, and developing a mindfulness coping plan, within the child life sphere is pivotal for establishing healthful coping strategies to combat the challenges of child life practice. When we create a personal mindfulness coping plan, similarly to how we do every day with our patients, we are setting ourselves up for resilience to continue to advocate for the role of child life within the interdisciplinary team and to lift each other up in solidarity.