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

Film Review: The Roses — The Life or Death of a Marriage

I am very pleased that Linda Grobman assigned The Roses to me. It is not a film for everyone, but it does underline the importance of preserving love wherever it is found.

Read the full review of The Roses on socialworker.com

Image Credit: ©2025 Searchlight Pictures

Read the full review on socialworker.com

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

      Before I write a word about the 2025 exceedingly unsettling satirical comedy, The Roses, a remake of the 1989 film, War of the Roses, based on the 1981 novel of the same name, I must say how grateful I am that the marriage counselor consulted by the film’s protagonists is not portrayed as a social worker. You would have to go a long, long way to find a more poorly trained, clueless, and misdirected mental health professional. Whew!

     Of course, the therapist, Janice (Belinda Bromilow) cannot help herself—her words are written for her. This reality established, since any specific discussion about the plot of this film will lead to spoilers, I offer this for your concentration: Think about two highly successful, kind, talented people you care deeply for who marry, and have children—and then a domino of life upheavals hits hard, throwing their established societal roles and finances in complete disarray. Their story is then presented to viewers in the most exaggerated satire.

     This analogy established, back to the one and only marriage counseling session of Theo (Benedict Cumberbatch), an out of the box, uncompromising architect, and his wife Ivy Rose (Olivia Colman), a talented aspiring chef. Ivy and Theo are two Brits who fall madly, devotedly, supportively in love, marry, have twin children, Hattie (Hala Finley, Delaney Quinn as young Hattie ) and Roy (Wells Rappaport, Ollie Robinson as young Roy), and 10 years later leave their London home to settle in artistic, compelling Mendocino, California—pricey, but not to be confused with the more exclusive Montecito, where Prince Harry and his wife Meghan moved, joining Oprah Winfrey, Jennifer Aniston, Tom Cruise, Gwyneth Paltrow, and other media royalty.

What shaped a president

At a time when many of our vital, relied upon institutions are threatened, I am deeply grateful that the leaders of The Philadelphia Inquirer have refused to be intimidated. Although today understanding root causes of behaviors and decisions that threaten all we hold is devalued, the Inquirer printed my letter about how important this approach is in protecting our survival:

Julia Demaree Nikhinson/AP

To the editor:

Many Americans who aren’t in the MAGA camp often ask why our 47th president is attracted to despots, has contempt for our allies, and withdraws government resources from our fellow citizens in times of crisis and need.

I believe that addressing the “why” can be effectively answered by viewing Donald Trump’s childhood through a psychosocial lens — how someone’s psychological state is shaped by their environment and experiences - which is an area I’ve worked in for nearly six decades.

We have enough information about the Trump family’s history to know that unaddressed trauma dominated our president’s youth, dramatically impacting his leadership capacities today.

From his earliest years, Trump watched his older brother, Fred Jr., eight years his senior, assailed with shame and humiliation from his father and namesake, a ruthless real estate developer who demeaned his son’s ideas relentlessly. To buffer the pain of a sadistic father, Fred turned to alcohol, destroying himself, dying at age 42.

Engrained in the future president was a written-in-stone awareness: If he ever dared to question his father’s mindset, he, too, would be destroyed.

To survive, he became his father’s bullying, corrupt clone, believing that only those with the capacity for cruelty, disregard for ethical behavior, and contempt for law were real men.

Withheld respect for individual ideas and direction, a vital confidence-building aspect of our formative years, sheds light on our president’s continuous attempts to prove his strength and virility through what is, in essence, denied self-hate displaced on others — “acting out” by ridiculing those seen as weak, demonizing those with opposing views, tasteless references to his virility, compulsive womanizing, outlandish “endless gold” materialism, and incessant demands for praise and stroking.

And importantly, Trump — in an echo of his relationship with his father — reveres Vladimir Putin and other dictators, longs to emulate them, and is deathly afraid to oppose them.

As he continues trying to prove to himself, his country, and the world that he is not a coward, our president’s “acting out” could lead to disaster.

SaraKay Smullens
Philadelphia

Published in The Philadelphia Inquirer, Sptember 22, 2025

Philly Fringe 2025: Philly’s Medicare for All Movement presents Healthcare Is a Human Right!

Philly Fringe 2025: Philly’s Medicare for All Movement presents Healthcare Is a Human Right!

A lobby display at the Louis Bluver Theatre gives a preview of ‘Healthcare Is a Human Right!’ (Photo by Alaina Johns.)

By: SaraKay Smullens for the Broad Street Review

Three weeks before I walked into Healthcare Is a Human Right!, a Fringe show created by artists of Philly’s Medicare for All Movement (a grassroots healthcare advocacy group), I spent eight hours overnight in one of our city’s ERs. In the hopelessly crowded scene (thanks in part to the closure of Philly’s Hahnemann Hospital, whose ER served many Medicaid patients and uninsured people), I filled in for absent social workers and got splashed by vomit.

The US is the only country of its kind that doesn’t provide healthcare for its citizens, relying instead on a for-profit healthcare system and gouging insurance companies that produce rampant health disparities and disability injustice. So I was glad to enter the Louis Bluver Theatre for a Fringe show exposing the dangers of our cruel, discriminatory, totally broken healthcare system.

This moving and riveting interdisciplinary performance, featuring Genise Paige Deal, Aster Laevis, Oliver Jane Jorgensen, Tina Hulping Zhong, and Juniper Sweeney, used creative visuals and primitive yet effective sets. Incorporating actors, puppetry, audio, and projected video, the show introduces a cast of crawling animals, like roaches, ants, and caterpillars. Maimed and blinded by environmental conditions enhancing corporate wealth, these animals represent us.

In the following sequences, successfully inviting audience participation, We the People in the audience were encouraged to wave protest signs, sing along, cheer, yell, wave, hoot, and holler. Which we did.

A former Temple professor of emergency medicine in the audience, Dr. Joe Lex, volunteered for a sequence in which he advocated for an imaginary patient with the head of the Department of Go Fuck Yourselves (representing an insurance company), where he held his own with steely grit. In another segment, audience members shared their own experiences of care withheld, confusing insurance policies, and relentless forms.

Compounding the crisis, Congress has acted to further limit access to healthcare. It seems that our 47th president will do whatever possible to destroy the Medicaid that millions of Americans depend on.

In their materials, the show’s creators quote attorney Ady Barkan, a healthcare activist and cofounder of the Be a Hero PAC, who died in 2023 due to complications of ALS: “There is nothing more wildly expensive and wasteful than our current for-profit healthcare system. Private health insurers price-gouge, defraud taxpayers, and deprive patients of care at every level. We deserve #MedicareforAll.”

This reality and all we are up against make the bravery of the Healthcare Is A Human Right! artists even more noteworthy. They cry out for the necessity of humanity in our beloved, vulnerable democracy. Through tortured examples, veiled in humor and metaphor, they warn that our country will not survive without universal health care. Withholding vital, life-affirming services and protections is a death sentence to all but the exceedingly rich and powerful.

This group deserves a standing-room crowd! Give them an hour for their remaining performance on Saturday, September 6, and the reward will be yours. After their understated curtain call, speaking with the artists, I learned that they each have demanding jobs—in social work, street fundraising, flower arranging, concierge services, and graduate studies. Their gift to the Fringe, and to each of us, done in their spare time, offers not only hope, but opportunity for action. They urge us to join them.

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.

 
      
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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)