Burnout and Self-Care in Social Work

Burnout and Self-Care in Social Work: Second Edition

A Guidebook for Students and Those In the Mental Health and Related Professions

In the new edition, SaraKay introduces Societal Burnout as an essential component of burnout and illustrates its interaction with personal, professional, relational, and physical arenas of burnout. She also explores the impact of moral distress and dysfunctional leadership in families, work settings and society; addresses differences between depression and burnout from a psychosocial perspective; and shares vital information about our “inner-self” development. This innovative study can be beneficial to all seeking insight and balance in approaching their personal and professional responsibilities, as well as a reliable “emotional sense of direction” for themselves and their families.

Click here for SaraKay’s other books and reviews.
Click here for interviews & reflections about this book.
Click here for essential themes in Edition 2 of Burnout.

Latest Articles

THE ENEMY WITHIN: DONALD J. TRUMP

Like an abusive family member, the father of our country violates those who depend on him. His dangers must be recognized.

I’ve worked in the field of domestic violence for over 25 years, seeing horrific violations of the vulnerable. The violations by those their family relies upon and the violations of our 47th president, Donald J. Trump, are parallel in their inordinate need for domination, power, and control.

Please read on.

When domestic abuse within a family is suspected, the most urgent challenge in family therapy is for the consulted clinician to determine if a powerful family member is putting those who rely on them in harm’s way. When so, the abusive family member is often charismatic and appealing, and those who depend on their presence fear him deeply. With a carefully determined identification, even if this individual resists treatment (which is common) a healthy process can progress toward marginalizing ruthless power and control by strengthening other family members. When therapy is effective, family members face the truth, and the tyrant is left alone — isolated and powerless. But make no mistake, abusive family members do all possible to protect their power through all means possible to sabotage healing and maintain control.

What tactics are used to threaten the health of a family and society? In healthy family and societal systems, anxiety flows upward through questions and expressed concerns, always responded to. In dysfunctional systems anxieties are constantly imposed from the top, pitting individuals against each other, leading to animosity, angry division, and isolation from trusted friends and colleagues. In this way, mature problem-solving is thwarted, as individuals seek refuge in silent withdrawal. In these pathologic settings lies become truths through hypnotic repetition. Ridicule of others is used as entertainment to divert ultimate goals. Money for sustenance withers.

Without intervention, in both families and societies, there is submission to a violator’s will through a reign of terror. In societies, this includes the destruction of a free press and military control, with accompanying murder, arrest, and torture. In a family’s parallel, if not death itself, there is the imprisonment of the spirit and the soul.

What clearer evidence than our 47th president is a tyrannical lover of autocracy, devoid of concern for the well-being of those who rely on him, than what recently occurred in the Oval Office? In a scene beyond belief, our president and vice-president did all in their power to humiliate Volodymyr Zelenskyy, employing their well-honed pattern of lies — telling him and expecting us to believe that Zelenskyy was the one standing in the way of peace, not Vladimir Putin. This surreal exchange proved the tipping point for our long-time European colleagues, forced to confront the painful truth that America is no longer their trusted friend and ally.

Donald Trump’s long-range goals? The pieces of seeming ludicrous statements now fit. Our president’s plan, as is true of other dictators, is to slice and dice the world as we know it. Putin and Xi Jinping’s yearnings regarding Europe and Taiwan are clear. With the tyrants who attacked our Capitol on January 6th, 2020, whom he calls patriots, under his beck and call, and a replaced loyal Joint Chief of Staff at his side, Donald Trump’s endgame has become a possibility. His stated wish is to annex Canada, Greenland, and the Panama Canal. He also has spoken of invading Venezuela, annexing Mexico, and taking over the Gaza Strip. The painting of our 11th president, James K. Polk, who oversaw America’s greatest territorial expansion to date is now in Donald Trump’s Oval Office.

If Donald Trump’s grandiose statements and goals alarm you, your fears are well placed. Our president suffers from a dangerous, volatile psychiatric condition, megalomania. He believes and is ardently attempting to convince all that God saved him from assassination so that his wishes become reality and in this way, America will be great again.

As our 47th president moves forward to do all possible to meet his goals, through his saccharine voice, he will continue to present himself as a magnificent Father of our Country, diverting attention from his true nature with “good television” — such as the release of a long-imprisoned hostage or a child with cancer receiving a “Make-A-Wish” moment, as well as the humiliation of decent, ethical people.

Both our president’s illness and intent must be bravely confronted and halted. To survive, family members must face truths about the violation of body, spirit, and soul, and set themselves free from a tyrannical hold. In like manner, We the People are the only ones who can end the despotic violation that threatens all we hold dear. The first step is to recognize its disastrous intent and then, with deft precision, we must passionately, ardently confront lies with truth.

Justices must continue to speak out, even more vehemently than Justice Roberts’s recent rebuke when Donald Trump disrespected the court order to return two flights of men denied due process, sent to an inhuman Venezuelan prison. In addition to our courts, each member of Congress who cherishes democracy must call town halls to point to America’s menacing “enemy within” as prep not only for our next election but beyond.

Further, never in our lifetimes has a free press been more essential. While other newspapers have caved, the March 20th, 2025 editorial warning of my hometown Philadelphia Inquirer was fearless: “Donald Trump continues to trample the Constitution with reckless abandon, while sadly most other Republican and Democratic leaders do nothing.”

It is up to We the People to act. Outreach to the White House and Republican elected officials must unceasingly convey our president’s malevolence. We must demonstrate that we are not afraid to call out lies and destruction — that we refuse to continue to be pitted against each other or terrified into retreat. We must do so as if our very lives and the lives of our loved ones depend on it. For most assuredly, they do.

Originally Published on Medium March 20, 2025

Letter to the Editor: Power of Love

Ryan Kang / NFL

To the editor:

My husband proposed during halftime of the 1979 Super Bowl. I had been sitting next to him absorbed in my work when he entered the room with Champagne and roses. Everyone I was close to knew I had to be deeply in love, for I had always steered clear of football. To me, real life was dangerous enough. Games offered no diversion, only fear a player would be badly injured. But my husband is a loyal fan. Through the years, I sat next to him doing work, loving that he would hoot and holler, cheering his beloved Eagles on in their wins, and sure they would turn things around when they were losing — even hopelessly so.

As time passed, when the cameras focused on Philly fans, or players, coaches, and owners were interviewed, Stan would nudge me to put down my work to watch and listen. It struck me, as my husband and I sipped Champagne last Sunday, toasting our team to victory (and our anniversary), that President Donald Trump, who sat in the Chiefs’ box, left during halftime when his support, regardless of the outcome, would have meant so much. Our fans would never, ever do that. What does our Super Bowl championship mean to me? The grit and determination of our soaring Eagles, the unwavering love and loyalty of their fans, and my gratitude to live in my adopted city.

Published in The Philadelphia Inquirer February 19, 2025

Film Review: A Real Pain Exposes Isolation and Trauma Through a Two-for-the-Road Dramedy

Image Credit: 2024 Searchlight Pictures

Read the full review on socialworker.com

by SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD

     A Real Pain is essential film for those in the social work and related professions to experience and to recommend, brilliantly written and directed by Jesse Eisenberg, and starring Eisenberg and Kieran Culkin. With uncommon insight, A Real Pain gently addresses myriad examples of intergenerational trauma that run the gamut from a lack of self-respect to self-loathing, leading to an inability to connect with others and the devastation of failed relationships. It offers the opportunity to address questions we as social workers are asked again and again: Why am I hated? Why do “they” want to kill us?

     Social workers know that burying our pain, pushing it toward oblivion, is a major cause of failure in all aspects of life. A Real Pain reveals the cost of personal isolation and the importance of connection. We learn that even if the intensity of connection between two who love and trust may seem frightening and overwhelming, refusing to walk away leads to mutual compassion and broader insights and vision that uplift in remarkable ways. The film also affirms that, with unshakable hope, we can endure what is necessary, leading to inner strength.  

     Through these messages, A Real Pain begs the question: Why are we so afraid to face difficult emotions? For once we do, we can decide if, when, and how to share with others. When we decide to wisely share, the experience itself is the highlight. This process of deep, respectful listening, coupled with doing all possible to rid ourselves of bias, can lead to closeness and calm, allowing the give and take of problem solving. Compromise then becomes an act of love, not submission.

     Billed as a two-for-the-road dramedy, your laughter will draw you closer to serious examination of the inner worlds and outer manifestations of two cousins, raised more as brothers, who have lost touch with each other. Benji Kaplan (Culkin), is devoid of any semblance of boundary between his Self and events in the real world. His breathtaking, passionate, emotionally crippling insights have put his direction at a standstill. David Kaplan (Eisenberg) is a devoted husband and father who cannot access emotion. He is tied to a NYC tech job that offers little satisfaction and suffers from an anxiety disorder and OCD.  

Events

SaraKay has presented her findings and spoken regularly at many conferences and conducted many workshops through the years. She has also been invited to book clubs and private gatherings. Additionally, she has appeared on television and radio shows.

Selected Presentations Include:
  • Presentation for Temple University Osher Lifelong Learning Institute
  • Speaker: SSWLHC 2021
  • Webinar: PA Patient Safety Authority (PAPSA): “Examination and Addressing Healthcare Professional Burnout, From Burnout to Resiliency”
  • Webinar: American College of Medical Quality (ACMQ): “Examination and Addressing Physician Burnout, From Burnout to Resiliency”
  • Webinar: Hospital Association of Rhode Island (HARI): “From Burnout to Resiliency”
  • SKMC Faculty Quality Leadership (QIPS): “Examination and Addressing Physician Burnout”
  • SKMC Student Physician Leadership (PEL): “Avoiding Burnout: Reigniting the Fire”
  • Webinar Connecticut Hospital Association: “From Burnout to Resiliency”
  • “Beyond Burnout: The Creation of a Fulfilling Marriage Between Self-Care and an Emotional Sense of Direction,” The Inaugural Mary Ann Komaran Symposium, Royal Alexandria Hospital of Alberta, Canada
  • Webinar: Child Hub for South East Europe, “The Journey From Compassion Fatigue to Compassion Satisfaction”
  • Care Gathering at the Philadelphia County Medical Society (to highlight the   epidemic of suicides among physicians and medical students)
  • The National Meeting of the National Association of Social Workers
  • “From Compassion Fatigue to Compassion Satisfaction: A Concentration on the Development of a Reliable Emotional Sense of Direction,” Tuttleman Educational Seminar, Magee Rehabilitation Hospital
  • “Beyond Burnout, Its Prevalence and Toll: The Creation of a Fulfilling Relationship Between Self-Care and an Emotional Sense of Direction,” NASW-PA
  • “Beyond Burnout, Its Prevalence and Toll: The Creation of a Fulfilling Marriage Between Self-Care and an Emotional Sense of Direction,” 30th Annual Social Work Symposium, Mayo Clinic, Rochester Minnesota
  • “The Overlooked “Self” in Self-Care: Alleviating and Preventing Burnout in Group and Therapist with Common Sense and Individualized Creativity,” AGPA
  • “A Committed and Fulfilling Marriage Between Self-Care and An Emotional Sense of Direction,” NASW-PA
  • “Achieving an Emotional Sense of Direction: A Response to Pervasive Societal Burnout,” NASW National Conference
  • The William J. Neff, Sr. Symposium: Prevention of Crimes Against Older Adults: Avoiding Burnout of Care Givers
  • “Safety and Self-Care.” NASW-PA Philadelphia Division at the University of Pennsylvania School of Social Policy and Practice
  • Webinar: “Facing the Demons Head-On: The Impact of Burnout” NASW
  • Suicide and Depression in the Medical Profession, Pennsylvania Medical Society
  • Numerous discussions on the film, The Tale, with Jennifer Fox
  • Webinar for students at California’s Brandman University: focus individual, professional, and societal burnout
  • The Athenaeum
  • Jewish Family and Children’s Service
  • Goucher College Book Fair
  • Jewish Family and Children’s Service Viewing of THE TALE: with Jennifer Fox
  • American Group Psychotherapy Association Presentation: with Jennifer Fox
  • Rhode Island Hospital Association, With Stanton Smullens
  • American Council of Graduate Medical Education, With Stanton Smullens
  • Pennsylvania Patient Authority, With Stanton Smullens
  • Jefferson Medical School Students, With Stanton Smullens
  • Jefferson Hospital Departmental Quality Improvement Directors, With Stanton Smullens
  • SP2 Celebrates Inaugural Inductees at Alumni Hall of Fame Ceremony
  • NASW 2018 Conference: Intensive: From Compassion Fatigue to Compassion Satisfaction: The Road to An Emotional Sense of Direction
  • Panel Discussion With Jennifer Fox, writer and director of THE TALE
  • "The Meaning of Friendship" at Penn’s Village
  • An Introduction to the LiveWell Program: A Peer-Led, Guided Self-Care Wellness Program for Depression
  • The National Meeting of the National Association of Social Workers
  • The University of Pennsylvania School of Social Work (now the School of Social Policy and Practice)
  • The American Group Psychotherapy Association
  • Care Gathering at the Philadelphia County Medical Society (which highlighted the suicides of physicians and medical students)
  • The William J. Neff, Sr. Symposium: Prevention of Crimes Against Older Adults
  • Pennsylvania Chapter Of The National Association Of Social Workers 
  • Various Book Clubs, Organizations, and Living Rooms discussions
  • Child Hub for South East Europe, The journey from compassion fatigue to compassion satisfaction: addr essing burnout with an emphasis on the self in self-care
  • The American Group Psychotherapy Association Annual Meeting
  • Mayo Clinic, Full-day Symposium on Burn Out and Self-Care
  • AmeriCorps Alums: Philadelphia Chapter
  • Royal Alexandra Hospital System, Edmonton, Alberta, Canada
  • Magee Hospital
  • Dr. Guy Freed Educational Seminar: Tuttleman Family Foundation, Magee Hospital
  • Discussion Group: The Positive Agers: for those over age 50
  • Various book clubs and discussion groups
A photo of Sarakay Smullens

SaraKay Smullens

Social Worker, Life Activist, Educator, Psychotherapist

SaraKay Smullens, LCSW, ACSW, BCD, DCSW, CGP, CFLE, whose private and pro bono clinical social work practice is in Philadelphia, is a certified group psychotherapist and family life educator. In addition to her clinical emphasis, a long-standing professional priority has been to bring social work awareness and psychological insights to the public at large, and through this process join those devoted to addressing and alleviating divisiveness and rage in families, work settings, and society through education, advocacy, and activism.

SaraKay's activist roots began in her hometown, Baltimore, where as a child she witnessed the evils and degradation of the Jim Crow laws. While in undergraduate school at Goucher College, then a women’s college located in Baltimore, she successfully led a two-year campus coalition to end segregation in Towson, Maryland, the Baltimore suburb where Goucher College is located. A graduation award for this initiative led to an introduction to John F. Kennedy at the Democratic Convention in 1960, and subsequent employment at the Democratic National Committee, where she became a regional coordinator for young Democrats. It was President Kennedy who recommended social work to her as a profession.

In graduate school at Catholic University’s National Catholic School of Social Service in Washington, DC when President Kennedy was assassinated, she transferred to the University of Pennsylvania to complete her degree, where her scholarship and stipend were continued. The enormous impact of this year at Penn is documented in her fourth book, a second edition of Burnout and Self-Care in Social Work: A Guide for Students and Those in Mental Health and Related Professions, Work (publication date, October, 2021, NASW Press). The edition adds the dangers of societal burnout to the concentration on the personal, professional, relational, physical, and societal arenas in our lives where burnout is found — and the causes, warning signs, and evidence based self-care approaches to alleviate their danger and toll, The second edition also offers a fuller explanation of the differences between burnout and depression; and the impact of dysfunctional leadership in every facet of our lives, and democracy as a whole.

When Lynne Abraham became Philadelphia’s first woman District Attorney, she offered SaraKay an extraordinary pro bono opportunity: With the input of psychiatric consultation, she worked with staff to carefully select first offenders in domestic violence cases where there were no fatalities. In lieu of incarceration individuals and their families were offered intensive group psychotherapy, augmented by individual, couple, and family therapy and family life education. Her pro bono practice continues.

A best selling author. SaraKay’s articles and commentaries have appeared in peer-reviewed journals, newspapers, magazines, and blogs. Her articles about domestic abuse contributed to the reform of brutal, archaic Pennsylvania divorce laws. Her investigation of invisible patterns of emotional abuse, always part of physical and sexual violence, led to their independent codification. It also led to the founding of the Sabbath of Domestic Peace, an initiative focused on the involvement of Philadelphia clergy, identified as “a missing link,” in addressing the epidemic of domestic abuse and violence.

SaraKay’s professional papers and memorabilia are divided between the Archives of the University of Pennsylvania, Goucher College, and the John F. Kennedy Presidential Library. A recipient of numerous awards, in 2019 SaraKay was one of five graduates of the University of Pennsylvania School of Social Policy and Practice inducted into its Inaugural Hall of Fame.

 
      
The outline of a trophy encased in a circle

Awards and Honors

  • Society for Social Work Leadership’s 2021 Kermit B. Nash Award
  • Lifetime Achievement Award from the Pennsylvania chapter of NASW
  • NASW Media Award
    Best Magazine Article
  • Woman Leader of Distinction Award The Eastern Region Women's Ministry Pennsylvania Baptist State Convention
  • Honored Author, Diamond Jubilee Borrowers Ball
    The Free Library of Phildelphia
  • Louise Waterman Wise Award
    American Jewish Congress,
    Pennsylvania Region
  • Peace Medal, Women’s International
    League for Peace and Freedom
    Maryland Chapter
  • NASW Media Award
    "What I Wish I Had Known: Burnout and Self-Care In our Social Work Profession."
    The New Social Worker
 
   
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Professional Credentials and Memberships

  • Academy of Certified Social Workers
  • Authors Guild
  • Fellow, Pennsylvania Society for Clinical Social Work
  • National Association of Social Workers (NASW)
  • Pennsylvania Chapter, NASW
  • National Council on Family Relations (Certified Family Life Educator)
  • American Group Psychotherapy Association (AGPA), Certified Group Psychotherapist
  • Pennsylvania Chapter, (AGPA)