Stress has been labelled the health epidemic of the twenty-first century and the effects of it on overall health can be disastrous. [1] It has been linked with “increased rates of heart attack, hypertension, obesity, addiction, anxiety, depression, and other disorders”. [2] One such condition has been labelled ‘burnout’. It has been defined as the result of “prolonged cumulative stress developed over time” [3] and is predominantly diagnosed among people working in the help-giving professions. The emotional stress produced by caregiving [4] “increases the risk of burnout for those working in other-focused positions”. [5] The pastorate is one such role. [6] Christian ministers face stressful work-related challenges similar to other human service professions, however, due to the ‘serve not to be served’ nature of Christian ministry “pastors are generally more susceptible”. [7] A 2008 survey of pastors found that “13% reported themselves as burned out, 23% as depressed and 45% rated themselves as high or moderate in emotional exhaustion”. [8] While many pastors continue to manage and function with symptoms of burnout, a large number leave the ministry altogether. [9] This paper seeks to understand this trend by examining the topic of pastoral burnout from a psychological and theological paradigm. First, an attempt is made to define ‘burnout’ using historical developments and psychological enquiry. Second, burnout within pastoral ministry is examined using theological reflection and the assessment of unique conditions, predictors and symptoms. Finally, individual and organisational evidence-based interventions are recommended and concluding comments offered.


‘BURNOUT’

 Historical Developments

The term burnout appeared with regularity during the 1970s, chiefly among professionals working within the human services sector. During this period, the burnout phenomenon was classed as “nonscholarly pop psychology” [10] largely due to its bottom-up or ‘grass-roots’ development (unlike other organisational research that utilised a top-down approach). Overtime though, theoretical models were developed and research studies appear to follow two distinct phases. The pioneering and empirical phases. [11] The pioneering phase in the mid-1970s, led by Freudenberger [12] and Maslach, [13] was exploratory in nature and began the articulation and definition of the burnout phenomenon. Burnout was named, popularised and researched using the experiences of professionals from caregiving occupations (human and healthcare services). Consequently, burnout became known as a condition that originates and is characterised by emotions as people related to stressors. [14] As a result of these concerns, immediate solutions were sought and, despite the elementary knowledge base, burnout workshops became the primary mode of treatment and prevention. It was these initial modes of intervention that provided an important testing ground for early burnout researchers. [15] The data collected in the 1980s provided the foundational statistics useful for the next phase, the empirical phase. “In the 1980s the work on burnout shifted to more systematic empirical research”. [16] Burnout was assessed in more detail, and as a result, a series of measuring tools were developed. “The scale that has had the strongest psychometric properties and continues to be used most widely by researchers is the Maslach Burnout Inventory (MBI)”. [17] As the empirical phase continued, interest and understanding into the burnout phenomenon broadened and more advanced methodology and statistical tools developed. These historical advances in burnout research that moved through pioneering to empirical phases has led to the emergence of key psychological theories.

Psychological Inquiry

Historical research described job burnout as a “psychological syndrome in response to chronic emotional and interpersonal stressors on the job” [18] and hence burnout is being defined as “three dimensions of exhaustion, cynicism, and professional inefficacy”. [19] The exhaustion component (the most widely reported aspect) refers to an individual’s sense of being emotionally and physically depleted. As a result of exhaustion, individuals distance themselves mentally and emotionally from their work (known as cognitive distancing), and in turn, can develop an “indifferent or cynical attitude when exhausted and discouraged”. [20] The cynicism (or depersonalization) factor of burnout can cause individuals to become negative, careless or extremely detached. This adds to the professional inefficacy aspect of burnout (the most complex factor) and causes a person to feel incompetent, incapable and lacking in achievement and productivity. As Maslach et al. suggest “a work situation with chronic, overwhelming demands that contribute to exhaustion or cynicism is likely to erode one’s sense of effectiveness … and it is difficult to gain a sense of accomplishment when feeling exhausted or when helping people toward whom one is indifferent”. [21]

Moreover, research appears to suggest that resultant outcomes, arising from the three dimensions of burnout (exhaustion, cynicism and professional inefficacy), principally impact a person’s job performance and health. Research suggests that workers are likely to display job withdrawal, absenteeism and intentions on leaving the job. However, for those that manage their symptoms and remain on the job, burnout leads to decreased productivity and effectiveness at work. Subsequently, the negative dimensions of burnout may spill over into a person’s work and home life relationships, causing professional and familial conflict. [22] On the other hand, the exhaustion aspect of burnout appears to affect health more than job performance and can be “more predictive of stress-related health outcomes than the other two components”. [23] Research findings suggest a link between burnout and substance abuse, the personality dimension of neuroticism and the psychiatric profile of job related neurasthenia. [24] Although this may seem to categorise burnout as a form of mental illness, it appears more common to assume that burnout causes mental dysfunction (anxiety, depression, drops in self-esteem). “An alternative argument is that people who are mentally healthy are better able to cope with chronic stressors and thus less likely to experience burnout”. [25] This is also supported by Jenkins et al. in a study of people who worked in ‘helper’ type roles. They suggested that “people who were psychologically healthier in adolescence and early adulthood were more likely to enter, and remain in, such jobs, and they showed greater involvement and satisfaction with their work”. [26]

In addition, the particular work context in which burnout occurs has also been the subject of much research. Findings seem to suggest that excessive job demands (overload within time constraints), role conflict (conflicting job demands needing to be met) and role ambiguity (a lack of acceptable information to do the job well) cause stress. Also, studies suggest that the lack of social support (especially supervisory) contribute to the burnout phenomenon. [27] Work which is emotionally draining is also another factor consistently discovered in burnout research and has led to the assumption that “the emotional stressors of people-work were something uniquely related to burnout”. [28] In work context research, a variety of personality attributes have also been considered in an attempt to determine the type of person at greater risk form burnout. Kobasa suggests that “People who display low levels of psychological hardiness (involvement in daily activities, a sense of control over events and openness to change) have higher burnout scores”. [29] Burnout is also found to be higher in “people who have an external locus of control (attributing events and achievements to powerful others or to chance) rather than an internal locus of control (attributions to one’s own ability and effort)”. [30] Semmer combines these attributes and argues that “low levels of hardiness, poor self-esteem, an external locus of control, and an avoidant coping style typically constitute the profile of a stress-prone individual”. [31] Maslach et al. further the discussion by suggesting that individuals who have a neurotic and type-A personality (marked by competitive and controlling nature) are more prone to burnout. [32] Lehr makes further personality-burnout connections and provides useful information for the specific topic of this paper. In his book Clergy Burnout: Recovering from the 70-hour Work Week—and Other Self- defeating Practices, Lehr claims over that “over seventy percent of those in vocational church leadership have personality types drawn to co-dependent relationships and a personality type characterized by the need to fix and please”. [33] Hands et al. agree and further suggest that a co-dependent and fix and please mentalities make individuals prone to burnout. [34]Hauerwas et al. label this mentality as ‘limitless care’ and characterise it as the excessive investing of energy into congregational expectations to the exclusion of one health. [35] It appears that pastors are prone to burnout, an idea that informs the following section of this paper.

Pastoral Burnout

Theological Reflection

In various ways, the Bible addresses the demands, stressors and difficulties experienced by those in pastoral ministry. Paul the Apostle was no stranger to the hard work involved in pastoral ministry. Commonly accepted as one of the greatest Christian missionaries of all time, Paul recounts the physical, relational and spiritual hardships he endured on account of his ministry. In 2 Corinthians 11:25-28 he states:

Three times I was beaten with rods. Once I was stoned. Three times I was shipwrecked; a night and a day I was adrift at sea; on frequent journeys, in danger from rivers, danger from robbers, danger from my own people, danger from Gentiles, danger in the city, danger in the wilderness, danger at sea, danger from false brothers; in toil and hardship, through many a sleepless night, in hunger and thirst, often without food, in cold and exposure. And, apart from other things, there is the daily pressure on me of my anxiety for all the churches. [36]

Although it is unlikely that contemporary Western pastors will endure such danger, it is evident from scripture that pastoral ministry is deemed hard work – long days and late nights, emotional conversations, spiritual encounters and stressful situations. Paul highlights the effect of this by asserting that Christians (and pastors) often “become weary in doing good” [37] and face the temptation to “give up”. [38] In addition to Paul, the Bible offers several illustrations of individuals that appear to have experienced ministerial stress and possible burnout. One such example is Elijah. [39] In 1 Kings 19, after an intense emotional experience, Elijah appears to manifest characteristics consistent with burnout, namely, increased desire for isolation (v3), symptoms of depression and despair [40] (and possibly suicidal thoughts) (v4) and physical exhaustion(v5). [41] After three stressful years on the run from Ahab and having endured national drought, it appears that Elijah experienced the physical, relational and spiritual challenges many pastors face. Schaufeli et al. note that “this condition became known among priests as ‘Elijah’s fatigue’, and included symptoms such as intense but exhausting commitment to a cause, disappointment, and social disengagement, all of which strongly resemble modern descriptions of burnout”. [42]

Unique Conditions

A recent analysis of Methodist ministers indicated that pastoral wellness still appears to be an area that requires improvement. Extensive effort is needed to help address the variety of unique conditions affecting the physical, mental and spiritual health of Christian ministers. [43] Pastors are at particular risk to burnout and many factors contribute to this fact. First, high consistently demands are placed upon ministry leaders time. [44] Second, role ambiguity contributes to work related stress, with pastor often fulfilling multiple simultaneous roles including, preacher, counsellor, coordinator, spiritual director, chief executive and fundraiser. [45] Third, success criterion plagues pastors, and as a result, ministers often experience feelings of incompetency or incapability (professional inefficacy). Sandford hypothesises that through functioning in a pastoral ‘persona’, ministers mask the inner effects of the success criterion, and instead, develop a narcissistic personality that craves admiration and appreciation. [46] Fourth, it appears that many pastors see their ministry training as insufficient, and as a result of the lack of resource, job role confidence is affected. [47] Fifth, inadequate relational networks and supervisory support lead to isolation. [48] Sixth, limitless care practices (the excessive investing of energy into congregational expectations to the exclusion of one’s health) can eventually lead to pastors neglecting their own spiritual development and devotional practices. [49] Given the unique conditions of pastoral ministry, it seems essential to evaluate burnout research and attempt to suggest common predictors and symptoms.

Predictors

First, following a survey of evangelical pastors, compassion fatigue was indicated as a significant factor in identifying pastors at risk from burnout. [50] It is suggested that compassion fatigue appears to arise due to the demand of pastors to regularly attend to peoples’ wide range of emotional and spiritual issues. Second, conflict management style has been found as a predictor to pastoral burnout. Beebe’s study of interfaith clergy showed that leaders who employ avoiding or accommodating styles of conflict management had higher levels of burnout than those utilising competing or collaborating conflict styles. [51] Third, the quality of a pastors familial, peer and mentor relationship appears to be a burnout predictor. Meek observes that  good family relationships are primary support systems amongst pastors. [52] Studies also indicate that regular contact with peers and mentors [53] and the effects of role model emulation help to lower emotional exhaustion, and therefore, prevent ministry burnout. [54] Additionally, Bährer-Kohler adds to the discussion by suggesting that the burnout process may be predicted by several other adverse factors including; high workload, time pressure, lack of control, demands for and/or lack of flexibility and work conflicts, problems of leadership and collaboration. [55]

Symptoms

For convenience, manifestations of burnout are commonly grouped into five major categories: affective, cognitive, physical, behavioural and motivational. [56] The five major burnout symptoms appear to be consistent across all help-giving professions, and therefore, psychological research can be applied directly to pastoral ministry. Using Schabracq et al. recommendations, this paper suggests a number of brief pastoral burnout symptoms. Affective manifestations may include a down and depressed mood and “although moods may change quickly, generally, spirits are low”. [57] Cognitively, individuals may feel helpless, hopeless and powerless. Work may lose its meaning and after being unsuccessful in influencing one’s work situation, the individual may now feel ‘trapped’. As a result, decreased interpersonal involvement may become the norm. [58] Physical health may also be impacted. There appears to be a consistent positive correlation between psychosomatic complaints and burnout. Melamed et al. found higher levels of cholesterol (a risk factor for cardiovascular disease) and cortisol (stress hormone) in burnt-out individuals. [59] As a result, an increase in physical illness and self-reported cold or flu episodes amongst burnout individuals has been reported. Behavioural changes also occur and are “mainly caused by a persons increased level of arousal”. [60] One study found more substance use (composite measures of alcohol, cigarettes, drugs, pain medication) among people who scored higher on depersonalisation. At an organisational level, there also appears to be an increase in absenteeism and impaired task performance. Also, typically, the burnout individual faces lower levels of motivation, with enthusiasm, interest and idealism often being lost. [61] Contrarily, disillusionment, disappointment and resignation set in, and physical as well as mental withdrawal from others is observed. [62]

Recommendations for intervention

Two approaches to burnout intervention exist. On the one hand, burnout has been treated after it has occurred, on the other prevention often becomes the focus. Interestingly, most recommendations for burnout intervention focus on individual person-centred solutions (including educational intervention, training or the changing of one’s work behaviours). However, Maslach et al. think that this approach is “paradoxical given that research has found that situational and organizational factors play a bigger role in burnout than individual ones”. [63] It seems that individual-oriented approaches do not accurately resolve the two burnout components – the person within the context. In accordance with previously mentioned literature, “a focus on the job environment, as well as the person in it, is essential for interventions to deal with burnout”. [64] It appears that effective change arises when organisational management and individual intervention are combined. As Fink suggests, “personal and job characteristics need to be considered jointly within the context of the organizational environment”. [65] Recent studies lean this way and a number of personal and organisational recommendations can now be offered based upon previous psychological and theological observations. [66]

Personal – the individual

Physically: Rest-taking

Sanford suggests that physical overextension contributes to burnout. [67] Conversely, research shows that rest-taking, which often renews depleted physiological and psychological reserves, helps to prevent and reduce burnout. [68] Pastors must take careful note of this. Pastors are at particular risk from overextension due to a harmful view that driving overextension of both time and energy is a confirmation of godliness. [69] However, studies show that without adequate rest-taking and renewal the interconnecting, challenging and stressful ministry tasks often create conditions of spiritual, mental, physical and social exhaustion. [70] To counter this, Diddams et al. state that “practicing rest bolsters psychological resiliency and personal agency” [71] and this serves as a crucial tool for burnout resistance and resiliency. This is mainly due to the fact that adequate rest-taking, renews an individual not only physically, but also emotionally. Chandler’s empirical rest-taking and pastoral burnout study validate the idea that “feeling rested and renewed minimizes emotional exhaustion and contributes to vitality”. [72] Emotional exhaustion is a common cause of burnout and “the less time pastors are able to rest because of ministry involvement, the more they are apt to be emotionally exhausted and burned out”. [73]

Relationally: Social support systems

Relationally, burnout often abates our instinct toward community. [74] As a result of stress, individuals “withdraw into self” [75] and become increasingly relationally isolated. As Hands et al. suggest, the path to burnout is often marked by an escalating “estrangement from self, others and God”. [76] However, depersonalisation among pastors can be mitigated through the development of social support systems. Peer-based social support systems help to create a sense of belonging and provide opportunities for encouragement. In London et al. interview with Christian psychologist Archibald Hart, it was suggested that pastoral support groups offer safe spaces for healing and support. [77] Mentor relationships are also an important factor in burnout prevention and resilience. Research has shown that regular mentor contact helps lower emotional exhaustion, and therefore, prevent ministry burnout. [78] Also, findings suggest that family and marital relationships provide crucial social support systems. The positive impact of such relationships on a pastor’s quality of life, helps Christian ministers cope with job stress and avoid burnout.

Spiritually: Spiritual formation practices

“Research has shown that the average pastor works between fifty and sixty hours per week and spends limited time in personal spiritual formation activity”. [79] Often, pastors prioritise the spiritual wellbeing of others and neglect their own personal spiritual growth. [80] However, “a strong theme for all recent studies on clergy burnout and clergy resilience is the importance of spirituality”. [81] Spirituality, an individual’s connectedness to the transcendent, has been linked to positive coping and a decreased risk of burnout. [82] Conversely, the lack of spiritual formation practices, often described as ‘spiritual dryness’, has been found to be a primary predictor of emotional exhaustion among pastors. [83] These observations reinforce the premise that “pastors, by virtue of their calling, need to nurture an ongoing and renewing relationship with God to maintain life balance, reduce stress, and avoid burnout”. [84] Research shows that spiritual formation practices such as “prayer, worship, scripture reading and journaling” [85] add to a pastors health and wellbeing and act as a deterrent to burnout. Chandler thinks that “because spiritual dryness emerged as a primary predictor of emotional exhaustion, the need for on-going spiritual renewal, not only to replenish spiritual reserves but also to reenergize emotional energy, is strategic in the prevention of pastoral burnout”. [86] Jackson furthers this by suggesting that “becoming spiritually healthy is a primary focus in your recovery from burnout. Without this element, you can be physically fit, relationally graceful, and emotionally sturdy, but you will still be limiting the Holy Spirit’s ability to work in your life”.

Organisational – the context

Promoting workplace engagement

There is escalating interest in stress prevention within the workplace, [87] and as a result, researchers have “turned their attention to the positive antithesis of burnout, which has been defined as ‘engagement’”. [88] Engagement is defined in the same three terms as burnout, but with an emphasis on positive functioning, [89] and therefore, consists of “a state of high energy, strong involvement, and a sense of efficacy”. [90] Recent work burnout-engagement research [91] suggests that strategic planning to help promote workplace engagement “may be just as important for burnout prevention as strategies to reduce the risk of burnout”. [92] Findings suggest that organisations that develop and support energy, involvement, and effectiveness amongst its employees foster employee health by decreasing the likelihood of stress-based burnout. These findings have direct relevance for the pastor who works within the organisational framework of the church. Although churches are not solely organisations (they are also organisms), nevertheless, great benefit would arise from the promotion and development of strategies to help pastors engage with ministry work. Church systems and structures that lead to pastors having high energy, strong involvement and increased efficiency, in turn, decrease the likelihood of pastoral burnout.

Training

Equipping pastors with practical information relating to burnout would also be of value. Maslach advocates for training techniques such as self-monitoring, time management, work and private life balance, exercise, dieting and social skills. [93] It has also been suggested that preparatory training programmes that provide more realistic images of the chosen profession (in this case pastoral ministry) may help to prevent burnout by minimising the likelihood of wrong or inaccurate workplace expectations (a common cause of workplace burnout). [94]

On-going systems of support

Also, “since many burnout candidates feel ‘locked in’ to their careers, career development programmes and career counselling would be other organizational approaches to prevent burnout”. [95] It may be that, offering pastors advanced ministry training, developmental coaching and flexibility within their vocation, would help Christian ministers feel adequately equipped and able to progress (often a factor in the cause of burnout). Early research proposed an introductory mentorship system that helped avoid early workplace burnout. This concept may be of great use in the establishment of new churches and younger lesser experienced pastors. Also, sabbatical leaves (or time-outs) have also been shown to enhance individual renewal and recuperation. Ministerial, offering pastors ‘study leave’ or sabbatical breaks may be a step in the right direction, and in turn, decrease the likelihood of burnout stemming from prolonged stressors on the job. [96] Finally, researchers show support for on-going organisational support strategies that strengthen a workers “social network for participatory change through problem confrontation, group consolidation around problems, and building consensus for change”. [97] This collaborative approach may help reduce a pastors job demands and increase his or her control. In turn, this minimises the threat of workplace burnout and ensures that pastors are able to function efficiently over a long term tenure.

Conclusion

Although a large number of pastors manage the symptoms of burnout, however, a large number leave the ministry altogether. This paper has sought to understand that trend further. First, this paper has defined ‘burnout’ by utilising research from the field of psychology. Second, burnout within pastoral ministry has been examined and the assessment of unique conditions, predictors and symptoms has been offered. Finally, individual and organisational interventions have been recommended. Research citied in this paper shows that both psychology and theology have much to say about the topic of pastoral burnout and recommendations for intervention. Psychology helps to define burnout and offers great empirical insight. The three dimensions of burnout (exhaustion, cynicism and professional inefficacy) offer burnout measures and provide a basis for pastoral burnout evaluation. Theologically, it is clear that pastors are prone to Elijah fatigue and can “become weary in doing good” often facing the temptation to “give up”. Nevertheless, evidence-based findings support the hypothesis that burnout can be avoided and resilience developed. This paper agrees that individual-oriented approaches do not accurately resolve the two burnout components, and instead, advocates for a twin approach that targets individual and organisational change – the person within the context. Individually, pastors should develop physical, relational and spiritual strategies to help form burnout resistance and resilience. Rest-taking should become habitual, peer, mentor and familial support systems should be developed and spiritual formation practices must be prioritised. Organisationally, the church in which a pastor’s works and functions should promote workplace engagement, offer burnout and professional training and deliver on-going systems of support. This combination of individual and organisational change will help pastors develop burnout resistance and resilience and ensure that the valuable work of pastoral ministry continues to occur.

[1] George Fink, ed., Stress: Concepts, Cognition, Emotion, and Behavior, Handbook of stress volume 1 (Amsterdam: Boston : Academic Press, an imprint of Elsevier, 2016), xiii.

[2] Ibid.

[3] Anne Jackson, Mad Church Disease: Overcoming the Burnout Epidemic (Grand Rapids, Mich: Zondervan, 2009), 95.

[4] Jonathan Appel and Dohee Kim-Appel, “Family Systems at Work: The Relationship Between Family Coping and Employee Burnout,” The Family Journal 16, no. 3 (July 1, 2008): 231.

[5] Thomas M. Skovholt, Tabitha L. Grier, and Matthew R. Hanson, “Career Counseling for Longevity: Self-Care and Burnout Prevention Strategies for Counselor Resilience,” Journal of Career Development 27, no. 3 (2001): 167.

[6] H. B London, Neil B Wiseman, and H. B London, Pastors at Greater Risk (Ventura, Calif.: Gospel Light, 2003), 14.

[7] Ross S Chartrand, “Spiritual Energy Management: Avoiding Pastoral Burnout by Developing a Healthy Devotional Life (Doctoral Thesis)” (Wisconsin Lutheran Seminary, 2017), i.

[8] Diane J. Chandler, “The Impact of Pastors’ Spiritual Practices on Burnout,” Journal of Pastoral Care & Counseling64, no. 2 (June 1, 2010): 88.

[9] J Louis Spencer, Bruce E Winston, and Charles A Wickman, “Validating a Practitioner’s Instrument Measuring the Level of Pastors’ Risk of Termination/Exit from the Church: Discovering Vision Conflict and Compassion Fatigue as Key Factors,” Regent University (2009): 1–18.

[10] Christina Maslach, Wilmar B. Schaufeli, and Michael P. Leiter, “Job Burnout,” Annual Review of Psychology 52, no. 1 (2001): 398.

[11] Ibid., 399.

[12] Herbert J. Freudenberger, “The Staff Burn-out Syndrome in Alternative Institutions,” Psychotherapy: Theory, Research & Practice 12, no. 1 (1975): 73–82.

[13] C Maslach, “Burned-Out,” Human Behavior 5, no. 9 (1976): 16–22.

[14] Maslach, Schaufeli, and Leiter, “Job Burnout,” 399.

[15] Ayala Malakh-Pines, Elliot Aronson, and Ditsa Kafry, Burnout: From Tedium to Personal Growth (New York: Free Press, 1981).

[16] Maslach, Schaufeli, and Leiter, “Job Burnout,” 401.

[17] Christina Maslach and Susan E. Jackson, “The Measurement of Experienced Burnout,” Journal of Organizational Behavior 2, no. 2 (1981): 99–113.

[18] Maslach, Schaufeli, and Leiter, “Job Burnout,” 399.

[19] Fink, Stress, 351.

[20] Maslach, Schaufeli, and Leiter, “Job Burnout,” 403.

[21] Ibid.

[22] Esther R. Greenglass, Ronald J. Burke, and Lisa Fiksenbaum, “Workload and Burnout in Nurses,” Journal of Community & Applied Social Psychology 11, no. 3 (2001): 211–215.

[23] Maslach, Schaufeli, and Leiter, “Job Burnout,” 406.

[24] Ibid.

[25] Ibid.

[26] Sharon Rae Jenkins and Christina Maslach, “Psychological Health and Involvement in Interpersonally Demanding Occupations: A Longitudinal Perspective,” Journal of Organizational Behavior 15, no. 2 (1994): 101–127.

[27] Maslach, Schaufeli, and Leiter, “Job Burnout,” 407.

[28] D. Zapf et al., “Emotion Work and Job Stressors and Their Effects on Burnout,” Psychology & Health 16, no. 5 (September 2001): 527–545.

[29] Suzanne C. Kobasa, “Stressful Life Events, Personality, and Health: An Inquiry into Hardiness,” Journal of Personality and Social Psychology 37, no. 1 (1979): 1.

[30] Maslach, Schaufeli, and Leiter, “Job Burnout,” 410.

[31] Norbert Semmer, “Individual Differences, Work Stress and Health,” 2004, 99-121.

[32] Maslach, Schaufeli, and Leiter, “Job Burnout,” 411.

[33] J. Fred Lehr, Clergy Burnout: Recovering from the 70-Hour Work Week-and Other Self-Defeating Practices, Prisms (Minneapolis: Fortress Press, 2006), 22.

[34] Donald R. Hands and Wayne L. Fehr, Spiritual Wholeness for Clergy: A New Psychology of Intimacy with God, Self, and Others (Washington, DC: Alban Institute, 1993), xii.

[35] Stanley Hauerwas and William Willimon, “The Limits of Care: Burnout as an Ecclesial Issue,” Word & World 10, no. 3 (1990): 251.

[36] 2 Corinthians 11:25-28 ESV

[37] Galatians 6:9a NIV

[38] Galatians 6:9b NIV

[39] Matthias Burisch, Das Burnout-Syndrom, 4th ed. (Heidelberg: Springer, 2010).

[40] Marc Schabracq, J. A. M. Winnubst, and Cary L. Cooper, eds., The Handbook of Work and Health Psychology, 2nd ed. (Chichester, West Sussex, England ; New York: J. Wiley & Sons, 2003), 389.

[41] Ibid., 390.

[42] Wilmar B. Schaufeli, “Burnout: A Short Socio-Cultural History,” in Burnout, Fatigue, Exhaustion: An Interdisciplinary Perspective on a Modern Affliction, ed. Sighard Neckel, Anna Katharina Schaffner, and Greta Wagner (Cham: Springer International Publishing, 2017), 111.

[43] Rae Jean Proeschold-Bell et al., “A Theoretical Model of the Holistic Health of United Methodist Clergy,” Journal of Religion and Health 50, no. 3 (2011): 700–720.

[44] Diane L. Ostrander, Carolyn S. Henry, and David G. Fournier, “Stress, Family Resources, Coping, and Adaptation in Ministers’ Families,” Journal of Psychology and Christianity 13, no. 1 (1994): 50–67.

[45] David Frisbie, Managing Stress in Ministry (Kansas City, Missouri: Beacon Hill Press of Kansas City, 2014).

[46] John A. Sanford, Ministry Burnout (Louisville, Ky: Westminster/John Knox Press, 1992).

[47] M Jinkins and K Wulff, “Clergy Burnout Survey,” Publication of the Alban Institute Congregations (May 2002).

[48] Hands and Fehr, Spiritual Wholeness for Clergy.

[49] Chandler, “The Impact of Pastors’ Spiritual Practices on Burnout.”

[50] Spencer, Winston, and Wickman, “Validating a Practitioner’s Instrument Measuring the Level of Pastors’ Risk of Termination/Exit from the Church: Discovering Vision Conflict and Compassion Fatigue as Key Factors,” Regent University (2009): 1-18

[51] Ronald S. Beebe, “Predicting Burnout, Conflict Management Style, and Turnover Among Clergy,” Journal of Career Assessment 15, no. 2 (May 1, 2007): 257–275.

[52] Katheryn Rhoads Meek et al., “Maintaining Personal Resiliency: Lessons Learned from Evangelical Protestant Clergy,” Journal of Psychology and Theology 31, no. 4 (December 1, 2003): 339–347.

[53] Benjamin R. Doolittle, “The Impact of Behaviors upon Burnout Among Parish-Based Clergy,” Journal of Religion and Health 49, no. 1 (2010): 88–95.

[54] Robert B. Mckenna, Tanya N. Boyd, and Paul R. Yost, “Learning Agility in Clergy: Understanding the Personal Strategies and Situational Factors That Enable Pastors to Learn from Experience,” Journal of Psychology and Theology35, no. 3 (September 1, 2007): 190–201.

[55] Sabine Bährer-Kohler, Burnout for Experts: Prevention in the Context of Living and Working (New York: Springer, 2013), 3.

[56] Schabracq, Winnubst, and Cooper, The Handbook of Work and Health Psychology, 398.

[57] Ibid.

[58] Ibid., 399.

[59] S. Melamed et al., “Chronic Burnout, Somatic Arousal and Elevated Salivary Cortisol Levels,” Journal of Psychosomatic Research 46, no. 6 (June 1999): 591–598.

[60] Schabracq, Winnubst, and Cooper, The Handbook of Work and Health Psychology, 400.

[61] Maslach, “Burned-Out.”

[62] Malakh-Pines, Aronson, and Kafry, Burnout.

[63] Maslach, Schaufeli, and Leiter, “Job Burnout,” 418.

[64] Ibid., 419.

[65] Fink, Stress, 354.

[66] Elizabeth Ann Jackson-Jordan, “Clergy Burnout and Resilience: A Review of the Literature,” Journal of Pastoral Care & Counseling 67, no. 1 (March 1, 2013): 1.

[67] Sanford, Ministry Burnout.

[68] Diane Chandler, “An Exploratory Study of the Effects of Spiritual Renewal, Rest-Taking, and Personal Support System Practices on Pastoral Burnout” (January 1, 2006).

[69] London, Wiseman, and London, Pastors at Greater Risk.

[70] Chandler, “An Exploratory Study of the Effects of Spiritual Renewal, Rest-Taking, and Personal Support System Practices on Pastoral Burnout,” 275–276.

[71] Margaret Diddams et al., “Implications of Biblical Principles of Rhythm and Rest for Individual and Organizational Practices” (n.d.): 317.

[72] Chandler, “An Exploratory Study of the Effects of Spiritual Renewal, Rest-Taking, and Personal Support System Practices on Pastoral Burnout,” 283.

[73] Ibid.

[74] Jackson, Mad Church Disease, 156.

[75] Stephen P. Daniel and Martha L. Rogers, “Burn-out and the Pastorate: A Critical Review with Implications for Pastors,” Journal of Psychology and Theology 9, no. 3 (1981): 232–249.

[76] Hands and Fehr, Spiritual Wholeness for Clergy, 13.

[77] London, Wiseman, and London, Pastors at Greater Risk.

[78] Mckenna, Boyd, and Yost, “Learning Agility in Clergy.”

[79] “Great Expectations, Sobering Realities: Reflections on the Study of Clergy Burnout,” Congregations 28, no. 3 (May 2002).

[80] Todd W. Hall, “The Personal Functioning of Pastors: A Review of Empirical Research with Implications for the Care of Pastors,” Journal of Psychology and Theology 25, no. 2 (June 1, 1997): 240–253.

[81] Jackson-Jordan, “Clergy Burnout and Resilience,” 3.

[82] Jonathan Golden et al., “Spirituality and Burnout: An Incremental Validity Study,” Journal of Psychology and Theology 32, no. 2 (June 1, 2004): 115–125.

[83] Diane Chandler, “Pastoral Burnout and the Impact of Personal Spiritual Renewal, Rest-Taking, and Support System Practices,” Pastoral Psychology 58 (June 1, 2008): 273–287.

[84] Chandler, “An Exploratory Study of the Effects of Spiritual Renewal, Rest-Taking, and Personal Support System Practices on Pastoral Burnout,” 284.

[85] Chandler, “Pastoral Burnout and the Impact of Personal Spiritual Renewal, Rest-Taking, and Support System Practices,” 7.

[86] Chandler, “An Exploratory Study of the Effects of Spiritual Renewal, Rest-Taking, and Personal Support System Practices on Pastoral Burnout,” 283.

[87] Schabracq, Winnubst, and Cooper, The Handbook of Work and Health Psychology, 415.

[88] Fink, Stress, 353.

[89] Wilmar Schaufeli, Marisa Salanova, and Vicente González-Romá, “The Measurement of Engagement and Burnout: A Two Sample Confirmatory Factor Analytic Approach,” Journal of Happiness Studies 3 (February 1, 2002): 71–92.

[90] Christina Maslach and Michael P Leiter, The Truth about Burnout: How Organizations Cause Personal Stress and What to Do about It, 2013.

[91] Hely Innanen, Asko Tolvanen, and Katariina Salmela-Aro, “Burnout, Work Engagement and Workaholism among Highly Educated Employees: Profiles, Antecedents and Outcomes,” Burnout Research 1 (June 1, 2014): 38–49.

[92] Fink, Stress, 353.

[93] Christina Maslach, Burnout: The Cost of Caring (Cambridge, MA: Malor Books, 2003).

[94] Schabracq, Winnubst, and Cooper, The Handbook of Work and Health Psychology, 415.

[95] Ibid., 415–416.

[96] Lee M. Marcus, “Coping with Burnout,” in The Effects of Autism on the Family, ed. Eric Schopler and Gary B. Mesibov, Current Issues in Autism (Boston, MA: Springer US, 1984), 311–326.

[97] Schabracq, Winnubst, and Cooper, The Handbook of Work and Health Psychology, 415–416.

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