Burnout, dismissed by some as a faddish, 1960s-era concept, just will not go away. Despite its lack of official DSM-IV status, it continues to be studied empirically, described theoretically, and discussed extensively by mental-health professionals and the general public. Perhaps most importantly, it continues to be a defining focus for many patients, particularly those who work in the human-service professions. These patients come to therapy complaining of work overload, "time famine," resentment over the innumerable and unrelenting demands in their lives, interpersonal problems, family difficulties, irritability, emotional and physical exhaustion, cynicism, and the belief that there is no way out of their situation. Many do well financially and feel that, although they barely can tolerate their work, coworkers and/or clients, and barely feel they have a life for themselves, they still cannot afford to leave and look elsewhere for employment. They are stuck, angry, and disillusioned, and often come to us desperate for help-even as they believe that no solutions are possible.
Many definitions of burnout have been proposed; most tend to rely on Maslach and Jackson's (1981) delineation of three central factors-emotional exhaustion, lack of personal accomplishment, and depersonalization (recently reconceptualized as "cynicism"). Shirom (1989), for example, views burnout as a combination of physical fatigue, emotional exhaustion, and cognitive weariness. My own sense is that burnout is essentially about "inconsequentiality"-a perception on the part of human-service professionals that their efforts to help others have been ineffective, that the task is endless, and the personal payoffs for their work (in terms of accomplishment, recognition, advancement, or appreciation) have not been forthcoming (Farber, 1991).
The contributors to this issue offer several visions of working with clients who are burned out or on the brink of becoming so. For Friedman, who has done extensive empirical work on the nature of burnout in schoolteachers and principals, treatment resides in healing the discrepancy between unrealistic expectations and self-perceived results.