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Burnout of female executive directors in nonprofit organizations during COVID-19

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Burnout of female executive directors in nonprofit organizations during COVID-19

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Content Burnout of Female Executive Directors in Nonprofit Organizations During COVID-19
by
Brandy Eldridge
A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION
December 2022
Copyright 2022 Brandy Eldridge

© Copyright by Brandy Eldridge 2022
All Rights Reserved

The Committee for Brandy Eldridge certifies the approval of this Dissertation

Mary Andres, Committee Member Name
Alison Murazewski, Committee Co-Chair
Kimberly Hirabayashi, Committee Chair

Rossier School of Education
University of Southern California
2022

iv

Abstract
When the COVID-19 pandemic entered the workplace and employees were working from home,
well-being hit a low not seen since the Great Recession of 2008, and burnout became a concern
for employers. The pandemic has brought about a new host of challenges and opportunities for
women in the workplace, especially female leaders. Prior research has shown that stress and
anxiety are commonly experienced by many people working in the area of child protective
services. Yet, little research exists to demonstrate the extent of burnout experienced in the
workplace among female executive directors, and even less research has focused on burnout in
female executives in the area of nonprofit organizations during the global pandemic. This study
focused on understanding the extent in which the female executive directors experienced burnout
during the first year of the pandemic in nonprofit organizations specializing in child protective
services. This study followed a qualitative research design based on interviews from 10 female
executive directors in the Southern region of the United States. Based on the study findings,
recommendations for practice are provided that focus on what the board of directors of nonprofit
organizations can do to proactively reduce stress and burnout and retain female leaders working
in the area of nonprofit organizations specializing in child protective services.

v

Dedication
To my husband, Billy Eldridge, you gave your unwavering love and support each day so that I
could achieve my dream. You and I, we are not tied to the ground.

To my children, Hava, Liam, and Poppy Kate, everything I do is for you. You were so patient
and understanding when I was not around, never complaining but always encouraging. I am
thankful because you kept me going when I wanted to quit. You encouraged me with queso, Dr.
Pepper, low-fi study beats, hugs and kisses.

vi

Acknowledgements
First and foremost, I want to thank the executive directors leading their teams to serve and
protect the victims of child abuse. These women are mothers, caretakers, and business leaders
who are bringing hope to the world. Thank you. I want to express my deep appreciation to my
dissertation committee led by Dr. Kimberly Hirabayashi. Dr. H made me a better researcher and
writer. You were the perfect chair for me. This process has taught me grit and grace at the same
time. Dr. M was patient with me when I did not believe I could write anymore. Her guidance and
wisdom are invaluable. Thank you to Dr. Andres for agreeing to join this committee. Thank you
for asking the deeper questions. Thank you for your time, experience, and kindness. I also want
to thank Dr. Megan Krone, the greatest editor in the universe. You have a gift. Throughout this
program, I have been taught by the most accomplished and incredible professors. Thank you to
Dr. Lynch, Dr. Adibe, Dr. Grant, and Dr. Canny. Your classes were safe to learn, fun for us all,
and my favorite place to be on a Saturday. Finally, the “Saturday Breakfast Club,” has changed
my life forever. I am better because of each of you. Becoming a Trojan for life is only because of
the 16 people that carried me through this program. Fight On!

vii

Table of Contents
Abstract ........................................................................................................................................... iv
Dedication ........................................................................................................................................ v
Acknowledgements ........................................................................................................................ vi
List of Tables .................................................................................................................................. ix
Table of Figures ............................................................................................................................... x
Chapter One: Introduction to the Study ........................................................................................... 1
Context and Background of the Problem ................................................................................ 1
Research Purpose and Objectives ........................................................................................... 4
Importance of the Study .......................................................................................................... 4
Overview of Theoretical Framework and Methodology ......................................................... 5
Definitions ............................................................................................................................... 6
Organization of the Dissertation ............................................................................................. 7
Chapter Two: Literature Review ..................................................................................................... 8
Components of Burnout .......................................................................................................... 8
Causes of Burnout ................................................................................................................. 20
Measurement of Burnout ....................................................................................................... 28
Proposed Interventions .......................................................................................................... 33
Conceptual Framework ......................................................................................................... 45
Summary ............................................................................................................................... 48
Chapter Three: Methodology ........................................................................................................ 50
Research Questions ............................................................................................................... 50
Research Design Overview ................................................................................................... 50
Research Setting .................................................................................................................... 51
The Researcher ...................................................................................................................... 52

viii

Data Sources .......................................................................................................................... 53
Data Collection Procedures ................................................................................................... 54
Data Analysis ........................................................................................................................ 54
Validity and Reliability ......................................................................................................... 55
Research Ethics ..................................................................................................................... 56
Chapter Four: Findings .................................................................................................................. 57
Research Question 1: To What Extent Did Female Nonprofit Executive Directors
Experience Burnout During the COVID-19 Pandemic? ................................................... 58
Research Question 2: How Efficacious Did Participants Feel in Their Roles During the
COVID-19 Pandemic? ....................................................................................................... 73
Research Question 3: What Policies and Procedures Did Employers Implement During
COVID-19 That Impacted Work-Life Balance for Female Leaders? ............................... 76
Summary ............................................................................................................................... 82
Chapter Five: Recommendations .................................................................................................. 84
Discussion of Findings .......................................................................................................... 84
Recommendations for Practice ............................................................................................. 89
Limitations and Delimitations ............................................................................................... 95
Recommendations for Future Research ................................................................................ 97
Conclusion ............................................................................................................................. 97
References ..................................................................................................................................... 99
Appendix A: Recruitment Email ................................................................................................. 128
Appendix B: Interview Protocol ................................................................................................ 1289

ix

List of Tables
Table 1: Characteristics of Participants ......................................................................................... 58
Table 2: Participants Understanding of Burnout Based Maslach’s Three Dimensions of
Burnout ...................................................................................................................................... 60
Table 3: FWA: Centers Implementation During the Shutdown .................................................... 77
Table 4: Centers Implementation of Wellness Practices During the Shutdown ............................ 80
Table 5: Key Findings: Burnout in Female Leaders ..................................................................... 83

x

Table of Figures
Figure 1: Work Stressors ............................................................................................................... 23
Figure 2: Area of Worklife Scale .................................................................................................. 32
Figure 3: Triadic Reciprocity Influences Behaviors in Female Leaders During COVID-19 ........ 48

1

Chapter One: Introduction to the Study
In May of 2019, the World Health Organization (WHO, 2019) released a one-page press
release updating the definition of burnout as “resulting from chronic workplace stress that has
not been successfully managed” (para. 4). When the COVID-19 pandemic entered the workplace
and employees were working from home, well-being hit a low not seen since the Great
Recession of 2008, and burnout became a concern for employers (Wigert et al., 2021). Burnout,
or burnout syndrome, influences professionals, irrespective of age or gender (Aryankhesal et al.,
2019). When burnout occurs, it increases the risk of disease and leads to psychological
consequences (Ding et al., 2015; Sung et al., 2020). Working women reported symptoms of
burnout due to added responsibilities, such as caring for relatives and homeschooling children,
during the pandemic (McKinsey & Company, 2021). According to a McKinsey (2021), female
leaders have been doing more than ever to help team members navigate new challenges brought
on by the pandemic. These new challenges included ensuring workloads for employees were
manageable, creating new systems for employees to work from home, and checking in on
employees’ well-being. The purpose of this dissertation was to understand burnout in female
leaders through their lived experience during the COVID-19 pandemic.
Context and Background of the Problem
During the COVID-19 pandemic, burnout syndrome has increased, as jobs have been
redefined (Jesuthasan et al., 2020), with employees being forced to work from home to ensure
the safety of the individuals and follow the government guidelines. This change brought an
increase in occupational stress for working professionals, including female leaders. In an
academic study by Aldossari and Chaudhry (2020) on burnout among women, the shift during
the pandemic made it necessary for women to have used or developed coping mechanisms, such
2

as denial, disengagement, and energy conservation, to help with the increased responsibilities at
work and home. According to a study by Jick and Mitz (1985), women demonstrated a higher
psychological and physical stress manifestation, when compared to men’s manifestations.
Women are more likely to make use of emotion-focused mechanisms to cope with stress, rather
than making use of problem-focused mechanisms (Folkman & Lazarus, 1980).
The pandemic has brought about a new host of challenges and opportunities for women
in the workplace, especially leaders (McKinsey, 2021). The changing workplace structure has
created uncertainty for people, and the rate of unemployment has been increasing in many
developed countries, causing the increased need for intervention and help from nonprofit
organizations (NPOs; Albert, 2020). Albert (2020) posited people depend on NPOs to help
individuals in need, and the stress related to the increasing demand, while the growing regulation
limiting their accessibility. Thus, the reduction in the ability to deliver the required services and
barriers in connecting with the client has increased the challenges for NPOs. For this reason,
those working in nonprofits have seen increased burnout and stress (Albert, 2020).
Female leaders facing increased pressure in such conditions have caused women to leave
the workplace since the pandemic (McKinsey, 2021). Per the National Women’s Law Center
(2021a) statistics, around 2.3 million women had left the labor force in 2020, and the
participation level of women in the workplace as the lowest it has been since 1988. Nearly two
out of five women are experiencing high levels of anxiety and increased stress levels, while
25.3% of women reported being depressed, which was slightly higher than men who report it
(21.1%; National Women’s Law Center, 2021). Decades of gender equality progress decreased
significantly 1 month after the pandemic started, with the participation levels dropping heavily
and causing an increased level of financial and psychological stress among women. If left
3

unaddressed, there is a high chance that the progress made could be reversed (Coleman, 2020).
This study aimed to examine the female leader’s experience with burnout during the COVID-19
pandemic, so organizations can make decisions to ensure female leaders do not leave the
workplace.
As challenges have increased, it is critical to study and understand the impact that
burnout caused by COVID-19 on women leaders in NPOs. Nonprofit organizations in such times
are necessary, and the services they provide are invaluable. Studying the impact would help
establish systems to tackle the challenges faced. Aldossari and Chaudhry (2020) posited burnouts
are bound to happen at the individual level, and to analyze burnout in women, the researchers
considered interactions between work and home at the macro and meso levels, which are critical
to understanding the triggers that lead to burnout among women.
The Children’s Support Network (CSN) is a pseudonym for three different nonprofit
organizations serving child abuse victims, Children’s Advocacy Centers of Texas, Arkansas,
and Oklahoma, CASA of Texas, and Shelters of Louisiana, to protect the privacy of all persons.
The CSN provides services to improve the lives of children who have suffered from child abuse.
The CSN staff were considered essential workers during the COVID-19 pandemic, offering
services to families and children of child abuse. Executive directors of the area centers under the
CSCSR experienced unprecedented challenges with staff and services. The CSN is located in the
Southern United States and serves rural and urban populations. The CSN serves thousands of
children a year and has approximately 100 executive directors. This study will focus on the
experiences of the directors of the centers during COVID-19 pandemic.
4

Research Purpose and Objectives
This study aimed to examine the female leader’s experience with burnout during the
COVID-19 pandemic. This study also explored the existing literature. The following research
questions guided this study:
1. To what extent did female nonprofit leaders experience burnout during the COVID-
19 pandemic?
2. What is the relationship between self-efficacy and burnout within the context of the
COVID-19 pandemic?
3. What policies and procedures did employers put in place during COVID-19 that
impacted work-life balance for female leaders?
Importance of the Study
Organizations must understand the impact of burnout on female leaders to make
decisions to ensure female leaders do not leave the workplace. Women in leadership positions
have positively impacted the performance of the organization and motivated more women to
aspire to leadership roles (S. Burke & Collins, 2001). According to Hobbler et al. (2018), who
undertook a meta-analysis study of women in different organizations, women’s leadership
impacts the firm’s performance in general but has a particular impact on the firm’s sales
performance. Hobbler et al. asserted the constant need to redefine the parameters used to
measure the performance and effectiveness of female leaders in organizations.
The pandemic has created even more challenges for female leaders (Jesuthasan et al.,
2020). There was a general fear that the pandemic could lead to a global economic downturn
(McKinsey, 2021) and further increase the gender inequalities in the labor market. The National
Bureau of Academic Research cited a recession reduces the wage gap by 2%, while the current
5

pandemic recession may increase the wage gap by 5% (Tertilt et al., 2020). For the future of
women in organizations and leadership roles, women must not leave the workplace, making it
important to understand factors linked with the individual experience. In the height of the
pandemic, stress and burnout amplified challenges for the women leaders; thus, understanding
them and how to tackle them is important (Yildirim and Solmaz, 2020).
The research on burnout has focused heavily on the different human-service-oriented
professions, such as healthcare (Ben-zur & Michael, 2007; Pretty et al., 1992). Studies focused
on the impact of women leaders are limited, specifically in the nonprofit sector. In a survey of
1,000 working Swedish people between the ages of 25-64, researchers found women had a
higher level of burnout in comparison to men (Norlund et al., 2010). Burnout increased during
the pandemic due to increased home responsibilities or time additionally spent on chores
(McKinsey, 2021). Organizations hold responsibility for educating and creating policies that
protect and prepare employees to fight against the risks of burnout (O’Halloran & Linton, 2000).
The current study aimed to fill the existing gap in the literature with regard to the impact burnout
has on female leaders in NPOs and understanding factors affecting burnout during the pandemic.
The focus was to understand the factors associated with the experiences in the pandemic context
and how they relate to burnout.
Overview of Theoretical Framework and Methodology
The study focused on social cognitive theory (SCT), proposed by Albert Bandura (1977),
to help in addressing burnout. Social cognitive theory has explained how people regulate their
behavior (Bandura, 1977), which is often done through reinforcement and control to help achieve
goal-directed behavior. Social cognitive theory addresses the satisfaction and well-being of the
individual (Bandura, 1986). The theory emphasizes individuals’ beliefs about their abilities to
6

succeed in the current environment (Bandura, 1988). Bandura (1988) claimed individuals’
beliefs in themselves are the foundation on which emotional well-being is built. The study aimed
to understand the role of different factors that influence this burnout among women leaders and
help provide an understanding of how to tackle issues. Understanding these issues is critical in
reducing burnout (Bresó et al., 2011). Based on SCT, if stress becomes one of three fixed factors
and acts as motivation, one could have an optimistic sense of self-efficacy and also the ability to
persevere (Bandura, 1986).
According to Creswell and Creswell (2018), a qualitative research method relies on the
researcher as the instrument for data collection, employs multiple data collection methods based
on participants’ meanings, and includes researcher reflexivity. The study used a qualitative
method, with interviews as the instrument for data collection. Interview as a tool led to
increasing understanding of the meaning of participants’ narratives and combined the views of
the participants’ lives with that of the researcher’s inquiry design narrative (Creswell &
Creswell, 2018). The study used interviews designed to explore the female leaders and their
experiences during the pandemic.
Definitions
The following are key concepts that have emerged from the review process.
Burnout (burnout syndrome) is a psychological syndrome that involves a prolonged
response to the chronic interpersonal stressors related to the job (Maslach & Leiter, 2016b).
COVID-19 is a respiratory disease based on the SARA-CoC-2, a new coronavirus
discovered in 2019. The virus is spread from person to person through respiratory droplets
produced when an infected person sneezes, coughs, or talks (Centers for Disease Control and
Prevention [CDC], 2020).
7

Pandemic refers to an epidemic that spreads across different countries or continents,
impacting many people (CDC, 2020).
Self-efficacy refers to an0 individual’s belief in their capacity to execute the behaviors
necessary to produce specific performance attainments (Bandura, 1977, 1986, 1988). Self-
efficacy reflects the confidence of the individual in their ability to exert the required control over
their own emotion, social environment, and behavior.
Stressor are the events, force or condition that leads to physical or emotional stress. The
stressors could be internal or external forces that would require adjustment or coping strategies
on the part of the affected individual (Center for Studies on Human Stress, n.d.).
Work-life balance is the amount of time that is spent doing the job compared to the
amount of time spent with family or doing things that one enjoys (Hochschild, 2012).
Organization of the Dissertation
The researcher structured this study into five chapters. Chapter 1 provides the importance
of the study, the purpose of the research project along with the research questions, an overview
of the theoretical framework and methodology, the context and background of the problem, and
key definitions. Chapter 2 reviews the relevant literature and the conceptual framework for the
study. Chapter 3 comprises an overview of the design of the study and detailed research
methodology. Chapter 4 provides the results and findings of the study. Chapter 5 proposes
recommendations from the findings of the study.

8

Chapter Two: Literature Review
This review covers literature under four topic areas that emerged from the review. These
topic areas are (a) components of burnout, (b) causes of burnout, (c) measurement of burnout,
and (d) proposed solutions. Although the literature presented can be applied to a variety of
problems, this review focuses on the literature’s application to the problem related to burnout
among female leaders in NPOs during the COVID-19 pandemic.
Components of Burnout
The experience of burnout has been the focus of much research during the past few
decades (Leiter & Maslach, 2014). Developed definitions, theoretical models, measurement
tools, and research studies have contributed to the understanding of burnout (Leiter & Maslach,
2014). In this section, the following components of burnout explored: (a) the definitions of
burnout, (b) the history of burnout, (c) the symptoms of burnout, (d) COVID-19 in the context of
burnout, and (e) the impact of burnout on women.
Definitions of Burnout
Despite its relevance in society, burnout has been debated in psychology and psychiatry
(Heinemann & Heinemann, 2017). Scholars and practitioners do not agree on the definition,
symptoms, or whether burnout is a mental disorder. Halbesleben and Buckley (2004) defined
burnout as a psychological response to stress and as emotional exhaustion and loss of identity
and accomplishment. Maslach and Leiter (2016b) defined burnout as “prolonged responses to
chronic emotional and interpersonal stressors on the job” (p. 351). Maslach and Jackson (1981)
said burnout repeatedly occurs among individuals who do “people-work” of some kind. Fronek
and Brubaker (2019) referred to burnout as the “loss of soul” (p. 466) because of the disconnect
from one’s self. Freudenberger (1975) was possibly the first to use the term burnout, when
9

describing a mental condition he noticed in himself and his colleagues. Freudenberger is
considered the founding father of burnout (Heinemann & Heinemann, 2017). For this study,
burnout is defined as a psychological syndrome, resulting from a prolonged response to chronic
interpersonal stressors that build in an individual throughout their job (Maslach & Leiter, 2016a).
The history of burnout is central to understanding the components of burnout.
History of Burnout
Before Freudenberg (1975), masculine-dominated workplaces had harsh working
conditions. The term burnout was not coined until 1972, when social psychologist Herbert
Freudenberger introduced it to describe his own mental state and the exhaustion he noticed
among his colleagues. Freudenberger worked in the category of “intensely demanding, service-
oriented professions” (Maslach et al., 1996, p. 192). He found his emotional resources were
constantly being drawn on to help others, which was not reciprocated with the same level of
service. Freudenberger and Ginsburg first described burnout syndrome in two scientific articles
published in 1974. Freudenberger (1975) described burnout as “becoming exhausted by making
excessive demands on energy, strength, or resources (p. 159) in the workplace. He took a
qualitative approach in research, observing work that required significant empathy and personal
involvement. Freudenberg’s article on burnout was based on the working environment observed
at a free New York City, NY, clinic. He believed burnout was linked to working environments
and to personalities who were dedicated to helping.
Historical accounts of Freudenberger’s work in burnout impacted other studies and other
researchers, including known researcher Christina Maslach (Heinemann & Heinemann, 2017).
Unlike Freudenberger’s research, which focused on the lived narrative through qualitative
interviews, Maslach concentrated on the measurement of burnout. She developed the Maslach
10

Burnout Inventory (MBI) and the Areas of Worklife Scale (AWS), which are still used to
measure burnout. In 1993, Maslach and her partner wrote an internationally acclaimed book
called “The Truth about Burnout,” which was translated into 11 languages (Maslach & Leiter,
1997). They explained three stress reactions cause people to experience burnout. First, one
becomes cynical and critical toward others. Second, one feels physically and emotionally
exhausted. Finally, one becomes dehumanized, feeling apathetic toward others, often leaving
their jobs.
Ginsburg and Stutz (1977) studied the efficacy of therapeutic interventions with burnout
in physicians. They concluded burnout is not an acute syndrome but a chronic process.
According to Ginsburg and Stutz, there are three principal reasons why people get burnt out: (a)
seeing others suffer creates stress on health professionals; (b) people who work hard give back to
the community and make excessive demands on their energy; and (c) the job itself may put a
health professional at risk for burnout. Maslach and Leiter (2016) divided burnout into three
symptoms: (a) exhaustion, (b) cynicism, and (c) professional inefficacy. Employees suffering
from burnout experience exhaustion first, then depersonalization, and lastly, impact on personal
accomplishment.
Symptoms of Burnout
Emotional exhaustion is usually the first indicator of burnout and is considered the core
dimension of burnout (Leiter & Maslach, 2014; Swider & Zimmerman, 2010). Emotionally
exhausted employees feel fatigued and often become uncaring and develop negative attitudes
toward their job performance (Leiter & Maslach, 2014). Emotional exhaustion has been linked to
several negative work-related, physiological, and psychosocial outcomes. When considered in
the context of burnout, emotional exhaustion can lead to lower quality of self-care by staff, job
11

turnover, absenteeism, low morale, being physically exhausted, poor sleep, increased usage of
drugs or alcohol, and marital and family problems (Bianchi, 2018; Gascón et al., 2013). In the
Netherlands, Tijdink et al. (2014) performed an online nationwide survey of medical professors.
The medical professors took the MBI to provide demographic and job-specific data. Because
emotional exhaustion is considered the critical component of burnout, the researchers used
emotional exhaustion as the primary outcome measure and main variable to assess burnout. Out
of 437 participants, 23.8% scored above the cut-off used for the definition of emotional
exhaustion. The research also indicated a significant inverse correlation between emotional
exhaustion and the level of professional engagement. Their findings showed early career medical
professors have higher scores on emotional exhaustion and may be prone to developing burnout.
Cynicism was originally called depersonalization, described as negative or inappropriate
attitudes toward clients, irritability, loss of idealism, and withdrawal (Maslach & Leiter, 2016a).
Cynicism can be understood as a defensive, cognitive method of creating a protective distance.
Simha et al. (2015) used a self-report survey to measure levels of burnout and organizational
cynicism in 169 nurses working in a Taiwanese hospital. The results indicate several variables
acted as moderators in the relationship between emotional exhaustion and organizational
cynicism and in the relationship between depersonalization and organizational cynicism. Trust in
coworkers, perceived fairness, and conflict all were found to negatively influence the
relationship between a burnout component and cynicism. Leiter and Maslach (1988) noted high
levels of emotional exhaustion led to high levels of cynicism, stressful situation.
Professional inefficacy has high levels of exhaustion and cynicism and low levels of
efficacy (Maslach et al., 1996). Maslach and Jackson (1981) characterized professional
inefficacy as the inability to perform tasks as adequately as before. Employees experiencing
12

inefficacy may feel unproductive and lack the skills to be successful in their roles (Lin et al.,
2020). Employees may feel unproductive, and that feeling can lead to unproductive behaviors.
Furthermore, professional inefficacy can manifest as decreased morale and an inability to cope
with the job’s responsibilities (Maslach & Leiter, 2016b).
Freudenberger (1975) established physical symptoms of burnout: frequent headaches,
shortness of breath, feeling of exhaustion, sleep disturbances, frequent gastrointestinal problems,
and inability to recover from cold. These symptoms have remained identifiers for those who face
burnout (Maslach & Leiter, 2016b). There has been increasing research focused on burnout
syndrome due to COVID-19 (Khan et al., 2021).
Burnout During COVID-19
COVID-19 is a contagious disease that first emerged in Wuhan, China, in 2019 (WHO,
2019). The WHO coded the disease COVID-19, which stands for coronavirus disease 2019. On
March 11, 2020, the WHO characterized COVID-19 as a pandemic because of the alarming
levels of the spread and severity of the virus. According to the WHO (2020) COVID-19 timeline,
2 days later, President Donald Trump declared a national emergency and placed a travel ban on
non-U.S. citizens traveling from Europe. To reduce the spread of the virus, governments around
the world ordered people to stay at home and isolate themselves. California was the first state to
issue orders to remain at home, followed by many other states. In May 2020, the death toll was
over 100,000, and by June 2020, the United States reached two million confirmed cases of
COVID-19. According to Bloomberg Philanthropies (2022), at the end of 2021, the United States
surpassed 60 million confirmed cases and more than 1,000,000 deaths. The COVID-19 pandemic
also resulted in an increased surge of new cases of depression and anxiety, while intensifying the
existing mental health issues (Gewin, 2021).
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The WHO formally recognized mental health risks for health and social care
professionals, the need to manage anxiety and stress in this group, and the need to prevent
burnout, depression, and post-traumatic stress disorder (Ornell, 2020). The limited resources at
these times, coupled with longer shifts and disruption of sleep and also the work-life balance,
which was already on a thin thread, has increased the mental fatigue, stress, anxiety, and burnout
among professionals across the different sectors (Adams & Walls, 2020).
During COVID-19, increased stress was seen among women and was exhibited in
symptoms associated with emotional exhaustion, professional inefficacy, and cynicism in their
day-to-day lives and at work (Aldossari & Chaudhry, 2020; Augustus, 2021). There is not a
significant amount of research specifically on women in NPOs; however, burnout among helping
professions (e.g., teachers, social workers, police officers, healthcare workers) is well researched
(Shanafelt et al., 2017a, 2017b). Women physicians are more likely than men physicians to
experience depression, burnout, and suicidal ideation (Gold et al., 2016). The Canadian Institute
for Health Research issued a special call to address COVID-19 in mental health and substance
use issues to identify stress, burnout, and depression faced by women healthcare workers during
COVID-19 (Srihara et al., 2020). Because there had not been any previous research in this topic
area, the Canadian Institute for Health Research conducted a rapid scope review to provide
decision-makers with timely results. Srihara et al. (2020) reviewed articles and primary studies
that reported stress, burnout, and depression in healthcare workers, primarily focusing on
women. Of the 2,803 papers found, the researchers included 28 papers in the findings. They
found women healthcare workers have been at a higher risk for occupational stress, burnout, and
depression during the COVID-19 pandemic because of a combination of personal and
organizational factors.
14

A survey was given to internal medicine physicians at two academic hospitals in
Vancouver, Canada, to determine the prevalence of physician burnout during the pandemic and
differences by gender, ethnicity, and sexual orientation (Khan, 2021). The MBI was used to
assess burnout. Their findings showed burnout affected two of three internal medicine physicians
during the pandemic. Women, ethnic minority physicians, and those who felt that COVID-19
affects burnout were more likely to report components of burnout. Women were more likely than
men to report stress. The reasons underlying the high prevalence of emotional exhaustion in
women during the pandemic may include family stress, greater child-raising responsibilities,
increased risk of depression,
,
and less supportive work environments.

Working parents spent an
additional 6 hours a day caring for their children.
Nonprofit organizations during the pandemic are underexplored. Charitable Aid
Foundations chronicled the impact of the crisis on nonprofits worldwide, as the situation became
more complicated for the nonprofit sector, after the start of the pandemic (Albert, 2020). Most
studies about burnout have focused on the healthcare sector, which has been reported to have
increased stress levels during the pandemic. Workers in the helping professions are at greater
risk of burnout because of their constant and intense interactions with the patients who receive
their care (Schaufeli et al., 2017). More than 230,000 service opportunities planned between July
through December 2020 were unable to be met, due to the restrictions from the pandemic
(Albert, 2020).
The gap in service has impacted the people receiving services from nonprofit
organizations and the staff working in the nonprofit organizations, including the leaders at
various levels. Organizations have reported an increase in staff stress and burnout. Lamb (2015)
found 18% of U.S. nonprofits had a female CEO. Nonprofit leaders report that the stress levels
15

before the pandemic were five out of 10, but now it has reached a level 7. Nonprofit
organizations must focus on staff stress and create strategies to help with self-care.
In addition to staff stress, leaders face issues with funding, as 63% of the NPO leaders
believe funding will be the greatest challenge for these organizations in the next 6 months and
that they will lose revenue streams and volunteers. Revenues for nonprofits have fallen 75%,
while the demand for the services has increased (Luscher, 2021). Human service and helping
occupations involve large job demands and low levels of job resources, which can lead to
burnout, without acknowledging the disproportionately high numbers of women working in these
types of jobs (Bakker et al., 2005; Burnham, 2019; Morse et al., 2012).
Impact of Burnout on Women
There are few studies examining gender on burnout during the pandemic (Kahn et al.,
2021). Beauregard et al. (2018) found the environmental and individual paths to burnout were
well documented, but little was known about how gender may affect burnout. The researchers
evaluated relationships between age, gender, and burnout in Canadian workers. They conducted
a cross-sectional study of 2,026 workers from 63 workplaces from the province of Québec to
examine gendered pathways leading to burnout. The results suggested burnout symptoms varied
according to life stages of working men and women. Younger men and women aged 20 to 35 and
55 years and over were particularly susceptible to burnout. Burnout level reduced with increasing
age in men, but women between the ages of 20 and 35 and over the age of 55 showed the highest
burnout level.
Women have reported experiences of increasing stress and continued to exhibit
symptoms of emotional exhaustion, cynicism, and professional inefficacy in their daily lives,
including the workplace (Aldossari & Chaudhry, 2021; Augustus, 2021). To analyze burnout in
16

women, researchers must consider the ongoing interactions between work and home at the macro
and meso levels that may trigger burnout in women (Aldossari & Chaudhry, 2021, p. 828).
Existing research has left a gap in the literature on the differences between men’s and women’s
experiences of burnout and does not examine the complexities of gender at the individual level
considering the continuous interaction of work and home. Aldossari and Chaudhry (2021)
offered first-hand narratives of higher education women working full-time with children during
the COVID-19 pandemic. Aldossari and Chaudhry provided an account of one woman’s
experience with burnout addressing self-efficacy and coping strategies. The researchers chose a
midcareer female academic from a large professional network. The interviewee was a mother of
three. Intentionally, the researchers chose someone with a traditional family structure, where
caretaking was predominantly the woman’s responsibility. The participant’s lived experience
showed increased work stressors and increased home stressors. The participant experienced
burnout symptoms and coping mechanisms, such as disengagement, denial, and energy
conservation, as stressors increased at work and home. The findings highlight the participant’s
generated coping mechanisms in two areas: work and home (Aldossari & Chaudhry, 2021)
Hochschild (1989) introduced the idea that women are taking on more physical labor and
emotional labor, when she examined the increase of participation of working mothers in the
labor force since the mid-1900s. Hochschild found emotional labor has been linked to job-related
negative behaviors and adverse health outcomes, such as job dissatisfaction, memory loss,
depersonalization, job stress, hypertension, heart disease, emotional exhaustion, and burnout.
Hochschild defined emotional labor as “the management of feelings to create a publicly
observable facial and bodily display” (p. 7). Emotional labor is a job stressor that leads to
burnout.
17

A significant finding of Hochschild’s (1989) research was the family myth. The family
myth is a story that couples tell themselves to maintain harmony in the family. The family myths
of equal sharing describe arrangements partners make to create shared responsibilities. These
arrangements were less work for the husband and more work for the wife. Rodsky (2013) called
this unequal, emotional labor in a relationship invisible work. An example of a myth one husband
believed was housework and childcare were easier than men’s work. These inequalities at home
and the daily demands of work continue to impact the well-being of women and contribute to
burnout.
According to Hochschild (1989), working women perform a first shift in the workplace
and a second unpaid shift at home. Hochschild studied 50 heterosexual married couples with
full-time jobs and young children. Hochschild argued gender equality in the United States has
been blocked due to three factors: (a) women work an extra month of 24-hour days each year
compared with their husbands, as women do most of the housework and childcare; (b) there is
limited flexibility in the workplace for caregivers, and (c) there are limited benefits (e.g., parental
leave). Societal gender expectations and domestic responsibilities disproportionately fall on
women, causing stress and leaving women emotionally exhausted and experiencing burnout
(Hochschild, 1989). Suman and Chatterjee (2015) found working women scored lower in
emotional health and general health than nonworking women. Working women experience more
negative emotional management than nonworking women because of demands of home life and
responsibility of their work (Gupta & Rathore, 2021).
Women have been in the workforce for quite some time, but women in leadership roles
are still underrepresented across corporations, institutions of higher education, and the political
sector (Veihmeyer et al., 2015). In the United States, around 23% of chief executive offices are
18

women (Chin, 2011). According to Chin (2011), a review of the academic studies over the years
has supported women are more helpful in adopting cooperative, collaborative, and democratic
leadership than men are.
The number of women leaders has fallen, and recent years have shown a significant drop
(Warner et al., 2018). According to the Women’s Leadership Study, 64% of women have a lack
of confidence in their abilities to become leaders, and 70% of women mentioned they were more
likely to talk about their challenges with regard to their career and opportunities to a woman
leader (Veihmeyer et al., 2015). Around 80% of women mentioned having female leaders and
having access to networking with them would advance their careers, while also motivating them
to achieve such positions (Veihmeyer et al., 2015).
McKinsey (2021) showed a positive growth trend of women in senior positions between
January 2015 to January 2020. The representation of women in the role of senior-vice-presidents
grew from 23% to 28%, and those in C-suite (i.e., “chief” officer positions) grew from 17% to
21%. McKinsey mentioned the trend differs by race. They found White males have the largest
advantage for opportunity in C-Suite positions Women of color have the lowest representation,
while the percentage for men of color has not dropped drastically from one level to the other.
According to the McKinsey (2021), during the pandemic, companies had to take steps to
ensure support to employees. Few companies have taken the required steps to adjust expectations
and norms to address employee burnout and stress factors. One-third of companies have
performance review criteria that considers the impact of the challenges that have come to the
forefront due to the pandemic. Leaders are forced to choose between falling short of the
expectation levels before the pandemic or to keep unrealistic expectations and push themselves
to keep an unsustainable pace. In the survey, women in senior leadership positions reported
19

exhaustion and pressure to work more, contributing to women experiencing burnout more often
than men. More than 50% of women in senior level positions reported exhaustion, while 40%
claimed to be burned out. In contrast, 30% of men claimed to be burned out the senior level, and
40% of men mentioned exhaustion.
McKinsey (2021) noted race and ethnicity play critical roles in how women experience
stress. Based on the respondents’ experiences, women, in general, were reported to experience
more stress, exhaustion, and burnout than men were. In contrast, women with disabilities had the
worst experiences, followed by people in the LGBTQ+ community. Black women also reported
worse experiences, followed by Latinas (McKinsey, 2021).
Lyonette and Cropmton (2015) noted women continue to carry responsibility for most of
the housework, despite their increased responsibilities in the workplace. Based on analysis done
in households with dual-career couples, during the pandemic, the number of hours spent on
chores increased more for women than men (McKinsey, 2021). Men with children increased an
additional 1 to 2 hours daily, while women spent more than 5 hours daily on chores during the
pandemic.
Increased duties at home are another reason more women are considering leaving the
workspace or changing careers. McKinsey (2021) reported 23% of women with kids under 10
have been considering leaving the workplace, while only 13% of men have considered it. The
study found when women did not have children, the percentage of women who wanted to leave
the workforce was the same as that of men (10%). McKinsey claimed women leaders are 1.5
times more likely than men to downshift or leave their work and burnout is a main reason. The
impact of burnout for women increased in response to the heightened responsibilities at home
because of the COVID-19 pandemic (Aldossari & Chaudhry, 2020).
20

Causes of Burnout
The negative consequences of burnout have been the focus of various studies for over 30
years (Ghorpade et al., 2007). The question remains as to why it is some workers can flourish,
while others feel anxious and exhausted and perceive few personal accomplishments. The causes
for job burnout were found in both the job environment and within the individual (Leiter et al.,
2010). Two factors have been identified to categorize job burnout: (a) personal and (b)
organizational (Sonnentag et al., 2012). In this section, the literature review will include the role
well-being plays in burnout, the stressors which cause burnout, and personal and organizational
factors leading to burnout.
Well-Being
Burnout has been considered one of the most influencing factors in the development of
persistent stress and reducing the level of an individual’s positive well-being (Green, 2014;
Johnson et al., 2018). Poor well-being and moderate to high levels of burnout are negatively
associated (Hall et al., 2016; Pandey & Singh, 2016). Sprang (2011) asserted that job-related
well-being is a specific aspect of individual well-being and includes positive characteristics such
as work engagement, job satisfaction, and job morale. Poor job-related well-being includes
experiences such as job tension, depression, burnout, and alienation from work (Sprang et al.,
2011).
Parker et al. (2012) researched the well-being of 430 teachers in Australia to understand
how to retain qualified and experienced teachers and explored the role of burnout and
engagement. The researchers tested adaptive and maladaptive outcomes of teachers’ failure-
avoidant and mastery-oriented appraisal and coping patterns. The study found a strong
association between high burnout and low engagement. When there was a reduction in burnout
21

triggers, less failure avoidance, and maladaptive coping strategies, positive well-being was seen
in teachers.
To understand workplace experiences and the impact of well-being of professional
women, Opara et al. (2020) conducted online interviews with 20 British Black, Asian, and
minority ethnic professional women. The researchers defined professional job roles as those
requiring a minimum qualification of a university bachelor’s degree. The study found women
routinely experience identity impositions (i.e., the influence of the perception of race on social
interactions) at work (Franco & O’Brien, 2018). One main finding was women experienced
misperceived identity imposition, where social treatment had implications for participants’ well-
being. For example, women made extra efforts to stay late at work. If they left early, women felt
a sense of helplessness or burnout to avoid a particular individual, despite knowing this
individual was pertinent to their career success. Perceived identity and other organizational
inequalities represent systematic disparities in opportunities and difference in key well-being
outcomes, stress, and burnout (Opara et al., 2020; Tariq & Syed, 2018). van Dick and Haslam
(2012) found where individuals had a sense of shared identity with their work colleagues, they
were more likely to be protected from workplace stressors.
Stressors
Stressors are core predictors of job-related well-being and burnout and affect a person’s
physical and psychological state (Flaten & al’Absi, 2016). Lazarus and Folkman (1984) defined
stress as a “relationship between the person and the environment that is appraised by the person
as taxing or exceeding his or her resources and endangering his or her well-being” (p. 19). Work
stressors are obstacles, barriers, or hindrances in the work process. People who are continually
exposed to high levels of stress in their jobs can experience burnout (Sonnentag et al., 2012;
22

Xanthopoulou et al., 2008). Stressors cause burnout through continuous psychological strain,
until they reach the point of physical and emotional and mental exhaustion (Anthony et al.,
2020). Oken et al. (2015) described stressors as situations considered to be a threat to the well-
being of an individual or their position in life, especially if the threat exceeds the individual’s
ability to handle the threat or perceived threat. Stressors can occur in various ways, while sharing
the qualities of a significant threat, challenge, demand, or constraint (Seery & Quinton, 2016;
Wheaton & Montazer, 2010). Threats are the possibility or expectation of potential harm.
Challenges question the assumptions with which a person implies that the usual response will not
meet the challenge. Demand refers to the burden of stressors. Constraints stand for less
opportunities, choices, or rewards (Crandall & Perrewe, 2020; Wheaton & Montazer, 2010).
Burman and Goswami (2018) reviewed 203 papers who researched work stress in multiple
countries from 1993 to 2017. The findings revealed major work stressors. The significant work
stressors have been provided as a summary in Figure 1.
Zapf et al. (2001) identified emotional labor as a new job stressor linked to burnout. Zapf
et al. felt an examination was needed to understand the relationship between emotional labor and
burnout. According to Zapf et al., most empirical studies on burnout have investigated the effects
of organizational or social variables, not the demands at work, referring to the concept of
emotional labor. The researchers studied research on emotion work, organizational and social
variables as predictors of job burnout. They hypothesized emotional labor would predict burnout
and measured negative effects on emotional exhaustion and depersonalization. The sample
consisted of employees working in hotels, banks, call-centers, children’s homes, and
kindergartens. Results showed emotional labor variables overlapped with organizational stressors
and resources. Emotional labor was predictive of all burnout variables. As hypothesized, emotion
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work variables could explain additional variance on top of task, organizational and social
stressors and resources for all burnout variables, with regard to emotional exhaustion and
depersonalization, two of three indicators of burnout.

Figure 1
Work Stressors

Note. Used with permission from “A Systematic Literature Review of Work Stress” by R.
Burman and T. Goswami, 2018, International Journal of Management Studies, 3(9), p. 112.
[https://doi.org/10.18843/ijms/v5i3(9)/15]. Copyright 2022 by docplayer.net
England et al. (2002) coined the term caring penalty, which means lower wages are
found in jobs requiring higher levels of caring, and most of these jobs were held by women.
Hirsch and Manzella (2015) revisited research by England et al. to examine wages for caring
jobs. They concluded women are still disproportionately employed in caring jobs and are
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penalized for doing so, receiving lower wages than they or similarly skilled workers would
receive in jobs not requiring care.
Emotional labor leads to emotional dissonance, which has negative consequences,
including job dissatisfaction, job burnout, work-family conflict, and hindering employees from
effective task and citizenship performance (Grandey et al., 2015). Biju and Pathak (2021)
identified the challenges women leaders faced in their intrapreneurial roles, including the impact
of emotional labor. The researchers interviewed 20 women leaders from seven large
organizations from the Indian information-technology industry. The women leaders interviewed
expressed their constant struggles to try to fit into the frame of masculinity. The women leaders
often resorted to deliberately projecting or faking masculine characteristics. They consciously
modified their behaviors, consciously suppressed their natural femininity, and tried to behave
like men. Suppressing emotions over time resulted in emotional exhaustion, and burnout (Biju &
Pathak, 2021).
Job stressors have an adverse impact on employee health (Nixon, 2011). When an
individual encounters a stressor, the body’s stress response leads to a series of physiological
changes helping the person tackle challenges or running from them (Flaten & al’Absi, 2016).
According to Nixon (2011), chronic stress has a significant effect on the immune system and
ultimately manifests as illness. Chronic stress can cause or exacerbate many serious health
problems, including mental health problems, cardiovascular disease, gastrointestinal problems,
and autoimmune disease. Therefore, there is a need to constantly observe symptoms of work that
cause burnout and other health risks (Burman & Goswami, 2018).
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Personal Factors
Personality types are related to burnout, including Type A personality and high
neuroticism, which has been linked to the exhaustion dimension of burnout (Rakovec-Felser,
2011). Bianchi (2018) researched how work factors and personality factors are associated with
burnout. The study used 1,759 participants to examine whether burnout was more strongly
associated with effort-reward imbalance in the job and job support than with personality traits,
neuroticism, and extraversion. The results suggested personality traits, most notably neuroticism,
play a major role in burnout. These findings are consistent with the view that neuroticism acts as
a negative filter in everyday life and magnifies the impact of adverse events (Bianchi, 2018).
The relationship between leadership styles and burnout differs for followers with
different traits (Aronsson et al., 2017). Tafvelin and Westerberg (2014) examined the
relationship between transformational leadership and employee burnout. Using a sample of
municipality workers in Sweden and their supervisors, employees responded a questionnaire
about their perceptions of resources in terms of vigor and peer support. The findings suggest
personal and contextual resources may help leaders engage in transformational leadership, which
is important in protecting employees from experiencing burnout.
Aldossari and Chaudhry (2021) asserted burnout happens when an individual’s identity is
excessively related to their achievement at work, as negative experiences produce negative
health consequences and lower psychological well-being. Johnson et al. (2018) recruited 486
Chinese university students, ages ranging from18 to 35 years and who were at risk for burnout
and low well-being. Researchers measured students’ risk of burnout using the MBI and the
Multidimensional Scale of Perceived Social Support. The findings suggest that social support
plays a significant role in the link between burnout and subjective well-being. One significant
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factor found to lower well-being for staff was emotional labor (Johnson et al., 2018). The study
also included organizational factors contributing to burnout such as excessive workload, poor
leadership, and lack of opportunity for skills development (Johnson et al., 2018). Lu and Guy
(2019) reported a significant relationship between emotional labor and the emotional exhaustion
dimension of burnout. Karimi et al. (2014) also linked physical and emotional labor, reducing
cognitive functioning skills, including decision making, memory, and attention to emotional
exhaustion. Therefore, workers suffering from burnout are more likely to make poorer decisions
and judgments in the organization.
Burnout is a leading cause of work-related problems for psychotherapists. A previous
study on psychotherapists revealed excessive caseloads, difficult clients, insufficient resources,
and lack of job support as precursors of high burnout (Simionato & Sipson, 2011).
Psychotherapists are inclined to develop burnout because of being exposed to consistently
emotionally taxing job demands and a high requirement for empathy (Simionato & Simpson,
2018). When showing signs of burnout, psychotherapists may detach or depersonalize from
clients. The findings identified multiple personal factors for burnout among psychotherapists,
including demographic variables, personality traits, coping mechanisms, social factors, personal
beliefs and attitudes, and involvement in work and leisure. Across all studies, younger age was
found to be the factor most commonly associated with high burnout, followed by having less
work experience, being over involved in client problems, and being female. The findings of the
study confirm personal factors play a role, alongside occupational factors, in the development of
burnout (Simionato & Simpson, 2018). Although individual factors are related to burnout,
organizational factors also play a role in burnout (Maslach & Leiter, 1997).
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Organizational Factors
Maslach and Leiter (1997) addressed the integration of individual and organizational
factors by proposing a model focused on the degree of match between individuals and six
domains of work environments: (a) workload, (b) control, (c) reward, (d) community, € fairness,
and (f) values. The greater the mismatch between the individual in one or more of the six
domains of work, the greater the risk for burnout was. The six areas of the work environment
come together in a framework that encompasses the major organizational qualifications of
burnout. Organizational risk factors have been identified in research across most occupations
(Maslach & Leiter, 2006).
Work overload is associated with feelings of exhaustion. If workers experience work
overload for a prolonged period, they may also experience tiredness, fatigue, stress, and burnout
(Maslach & Jackson, 2016a). Excessive workload has been expressed as a feeling that work-
related demands are beyond human limits (Maslach et al., 2001). The critical point occurs when
people are unable to recover from work demands. These individuals are more likely to suffer
from chronic exhaustion (Maslach & Leiter, 2016a).
Control is having the opportunity to make choices and decisions, including problem
solving (Leiter & Maslach, 2014). Control problems occur when workers have inadequate
authority over their work. A sense of efficacy is unlikely to happen when workers feel less
independence in the organization (Leiter & Maslach, 2014). A major control problem occurs
when people experience role conflict. Role conflict occurs when employees experience and
expectations are incompatible work demands. The greater the role conflict is experienced, the
greater exhaustion is experienced (Leiter & Maslach, 2014; Rakovec-Felser, 2011).
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Reward can be material rewards and opportunities for intrinsic satisfaction, such as
financial, organizational, or recognition for work (Leiter & Maslach, 2014). Lack of recognition
is closely related to feelings of inefficacy (Cordes & Dougherty, 1993). Inadequate reward
increased feelings of inefficacy and burnout (Gerich & Weber, 2020; McFadden, 2018).
Community relates to an organization’s social environment and the quality of social
relationships in the workplace (Maslach & Leiter, 2014). When demands chronically drain
energy and resources, exhaustion occurs. Jobs that isolate people from each other and have fewer
social interactions generate less community (McFadden, 2018). McFadden asserted the most
destructive factor of community is chronic and unresolved conflict with others on the job. Issues
related to conflict, team cohesion, and sense of community are all important factors related to
worker susceptibility to burnout (Maslach & Leiter, 2008).
Fairness refers to employees’ individual and collective evaluation about justice and
equality about decisions at work (Leiter & Maslach, 2014). Employees value fairness from
leadership and expect management will act equitably for all. The sense of injustice or inequity
can be a predictor of burnout (Demerouti et al., 2000; Laschinger, 2015).
Values are the connection between the worker and the workplace (McFadden, 2018).
Personal goals and meaningful contributions to an organization can take the place of money,
time, or advancement. When there is a conflict between personal aspirations for their career and
the organization’s values, a conflict of value can arise. Conflict in values is related to job burnout
(McFadden, 2018).
Measurement of Burnout
Most measures of burnout syndrome were developed in the early 1980s. This section of
literature focuses on reviewing models and tools used to measure burnout in individuals. This
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section focuses on the MBI, the Copenhagen Burnout Instrument (CBI), the Oldenburg Burnout
Inventory (OLBI), and the AWS.
Maslach Burnout Inventory
The first model of MBI was developed during the late 1970s and was based on research
in healthcare and human services (Maslach & Jackson, 1981). At that time, the only tool capable
of assessing the three dimensions (i.e., emotional exhaustion, depersonalization, and personal
accomplishment) was the MBI, which continued as the primary research tool through the 1990s,
as almost 93% of the research on burnout was carried out using the MBI (Schaufeli & Enzmann,
1998). The MBI has a set of 22 items that became known as the MBI Human Services Survey.
The second version was developed several years later and focused on educational settings
(Maslach & Jackson, 1986). The MBI General Survey was developed for all occupations,
irrespective of the sector or industry. In all three of the revised versions, it was found that MBI is
reliable, easy to use, and valid (Cartwright & Cooper, 2009).
Over the years, studies have confirmed the MBI is a valuable tool, and these studies have
also supported the three dimensionalities of the MBI (Greenglass et al., 2001; Hastings et al.,
2004). The three factors of the MBI have been conceptualized as three correlated dimensions of
one factor (Maslach & Jackson, 1986). Others have argued the tool was unidimensional and
relied heavily on the emotional exhaustion subscale of the instrument, considering emotional
exhaustion is strongest predictor of burnout (Aiken et al., 2002; Halbesleben & Buckley, 2004).
Over the years, there have been tools developed based on the limitations of the MBI, including
the CBI (Kristensen et al., 2005).
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Copenhagen Burnout Instrument
A team of researchers focused on developing the CBI (Kristensen et al., 2005). They
identified six limitations that prompted them to develop this tool to replace the existing MBI.
Kristensen et al. (2005) found no relationship between the MBI and burnout concept because the
three dimensions (i.e., personal burnout, work-related burnout, and client-related burnout) were
combined and given a single score. Changing the tool from the original MBI focus on human
service to a mixture of individual emotional states, coping strategies, and their impact,
Kristensen et al. scored the areas separately, instead of combined, giving the participant three
different levels of burnout, one for each of the three dimensions. They also found unacceptable
questions present in the MBI that have been known to trigger hostile responses from the
respondents. Unlike the MBI, the CBI is easily accessible to everyone (Kristensen et al., 2005).
The CBI questionnaire was designed to apply to three subdimensions: (a) personal
burnout, (b) work-related burnout, and (c) client-related burnout (Kristensen et al., 2005). First,
the questions on personal burnout were formulated on a generic scale, applicable to any person,
regardless of job type. Second, the work-related burnout questions were created to assume the
participant has a paid job. Finally, the client-related burnout questions used inclusive terms, such
as client, patient, student, inmate, and other terms specific to the participants. The three scales
successfully differentiated between multiple measures, such as fatigue and psychological well-
being. Likewise, the three scales predicted future sickness absence, sleep problems, use of
painkillers, and intention to leave a job. Analyses of changes over time showed that substantial
proportions of the employees changed about burnout levels. Kristensen et al. (2005) continued to
analyze reliability and validity for the CBI instrument. The CBI is used in several countries and
available in eight languages (Kristensen et al., 2005).
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Oldenburg Burnout Inventory
Not as popular as the CBI, the Oldenburg Inventory was also developed from limitations
of the MBI (Halbesleben & Demerouti, 2005). Similar to the CBI, the OLBI was based on the
MBI. Both instruments are designed to measure burnout with questions that apply to any job-
related group (Halbesleben & Demerouti, 2005). One difference between the two instruments is
the OLBI features only two scales: (a) exhaustion and (b) disengagement. The OLBI also has a
balanced amount of positive and negative wording to mitigate word biases (Demerouti et al.,
2001). Furthermore, the OLBI features questions designed to measure mental and physical
components of exhaustion, whereas the MBI focuses on mental components of emotional
exhaustion (Demerouti et al., 2001) The OLBI provides an alternative to the MBI, addresses the
word biases of the MBI, and expands the field of burnout beyond the component of exhaustion
(Tipa et al., 2019). The OLBI has not been used in an English-speaking sample. Consequently,
few studies of English-speaking samples use the OLBI because of a lack of evidence that the
English translation is acceptable (Halbesleben & Demerouti, 2005).
Area of Worklife Scale
With a focus on specifying work characteristics that predict burnout, a literature review-
based study was undertaken, which included studies on theoretical and empirical data on stress
and burnout (Leiter & Maslach, 1999). Leiter and Maslach (1999) developed primary themes of
burnout that fit into six areas of worklife: (a) control, (b) workload, (c) fairness, (d) values, ©
reward, and (f) community. The AWS was designed to assess the level of perceived balance
between the person and the job, in the context of organizational interventions, for researchers and
practitioners (Leiter & Maslach, 2003). The subsequent studies could identify the relevant
aspects of work-life for the burnout tool development and helped in the establishment of a
32

structural model known to have helped create and specify the relationship between the six work
areas and the three symptoms of the burnout (exhaustion, cynicism, and professional inefficacy)
which was identified under MBI. The model presented in Figure 2 illustrates the relationship
between the six work areas and the three facets of burnout (Brom et al., 2015).

Figure 2
Area of Worklife Scale

Note. Used with permission from “Areas of worklife as predictors of occupational health – A
validation study in two German samples” by Brom, S. S., Buruck, G., Horváth, I., Richter, P., &
Leiter, M. P., 2015, Burnout Research, 2(2-3) p. 12.
[https://doi.org/10.1016/j.burn.2015.05.001]. Copyright 2015 by S. S. Broma, G. Burucka, I.
Horvátha, P. Richter, & M. P. Leiter.

First, the standard pathways between the three dimensions of the burnout identified under
the MBI were proposed. Leiter and Maslach (1999) found exhaustion predicts cynicism, which is
negatively predicts efficacy. Secondly, from the conceptual perspective, a proposal was made
which all six work characteristics or key domains are directly related to the three burnout factors.
33

The workload links directly to exhaustion. In the AWS, control relates to workload, reward,
fairness and community. Control was considered to have the central role, based on the
assumption employees shape their work-life around the level in which they could participate in
the practice of professional autonomy. This tool has been used to measure the outlook or
investigate the opinion of the employees about the workplace and measure the burnout from the
six factors (Brom et al., 2015).
Proposed Interventions
The need to develop interventions to reduce burnout and to test their effectiveness has
long been acknowledged (Gewin, 2021; Johnson et al., 2018). Personal and organizational
factors have been associated with causes of stress and burnout. Taking steps to minimize the risk
of burnout before it happens is the primary prevention strategy. Prevention, in which steps are
taken to minimize the risk of burnout before it happens, is better than treating it after symptoms
occur (Maslach, 2017). This section focuses on mitigating worksite stressors through two
prevention categories: (a) fixing the person and (b) fixing organization.
Fixing the Person
Programs that seek to fix the person have been more prominent in research and in
practice, possibly because of a belief that burnout is due to personal issues or it is easier to
change individuals than to change an organization (Maslach, 2017). In a study to determine the
effectiveness of occupational-stress-reducing interventions, four intervention types were
distinguished: (a) cognitive behavioral interventions, (b) relaxation techniques, (c) multimodal
programs, and (d) organization-focused interventions (Morse et al., 2012). The study determined
stress management interventions are effective, and cognitive-behavioral interventions are more
effective than the other intervention types are. Cognitive-behavioral interventions appeared to be
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effective in improving perceived quality of work life, enhancing psychological resources and
responses, and reducing complaints (Morse et al., 2012). Maslach (2017) summarized the most
popular interventions to burnout in six categories: (a) health and fitness, (b) relaxation strategies,
(c) self-understanding, (d) coping skills, € changes in work patterns, and (f) social support.
Health and fitness has been the most common recommendation (Maslach, 2017). Healthy
people are more resilient and can better handle any kind of stress and burnout (Bretland &
Thorsteinsson, 2015). The recommendations for becoming healthier include eating more
nutritious food, losing excess weight, engaging in regular exercise, and quitting smoking.
Exercise has potential to be an effective burnout intervention. In a study conducted by Bretland
and Thorsteinsson (2015), 49 participants completed a 4-week exercise program of either
cardiovascular, resistance, or no exercise. Different types of exercise may assist employees in
different ways. After 4 weeks of exercise, participants showed more positive well-being and
personal accomplishment, less psychological distress, less perceived stress, and less emotional
exhaustion than when the participants started. Cardiovascular exercise was found to increase
well-being and decrease psychological distress, perceived stress, and emotional exhaustion.
Resistance training increased well-being and personal accomplishment and reduced perceived
stress (Bretland & Thorsteinsson, 2015).
Another key approach to coping with stress has been to use relaxation techniques
(Maslach, 2017). Some techniques include meditation, biofeedback, naps and a longer night’s
sleep, hot baths, and massages (Smith, 2014). Mindfulness meditation is a popular and well-
researched type of meditation and has been shown to be a successful way to handle stress. Smith
(2014) conducted a critical literature review that explored the current state of the science on
mindfulness-based stress reduction (MBSR) on the stress levels of nursing leaders. Nurses’ use
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of MBSR may be a key intervention to help improve nurses’ abilities to cope with stress and
improve the quality of patient care. The findings suggest MBSR helped nurses, healthcare
professionals, and health science students’ deal with stress. Smith also found MBSR decreased
anxiety, improved moods, increased empathy, and a positive impact on self-improvement and
self-acceptance (Smith, 2014). Similarly, another study on mindfulness found developing a
mindfulness practice decreased stress-related responses in African American women. African
American women have broader exposure to stressors that influence stress responses and coping
behaviors, due to sociohistorical and cultural experiences related to race and gender. Woods-
Giscombé and Black (2010) found MBSR a key intervention to reduce stress and burnout. The
practice of mindfulness can enhance awareness of habitual patterns of responding to stress
coping skills. Practicing MBSR can give African American women restorative time to quiet the
mind.
Self-understanding refers to the ability to have better knowledge of one’s personal
strengths and weaknesses. A person will have a more realistic assessment about why they are
experiencing burnout when they have a better understanding of their own personality, needs, and
motives (Maslach, 2017). People who have a better understanding or can understand their
weaknesses and strengths can tackle the issues before symptoms of burnout occur, while also
setting goals accordingly (Maslach, 2017). Self-knowledge can then be used to change behavior
for positive outcomes. There are many techniques that can be used to generate more self-insight,
including mindfulness, counseling, and therapy. Mindfulness-based stress reduction can also be
used to promote self-understanding and reduce stress. Counseling provides strategies to reduce
burnout in the workplace. A study in Shanghai evaluated the potential physical activity and
counseling intervention effects on health outcomes of working women over a 12-week period. A
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total of 121 participants were randomly divided into three groups: a control group and two
intervention groups. The results revealed physical activity and counseling interventions reduced
stress and burnout and improved health-related quality of life among the working women, when
compared to the results of control groups (Wang et al., 2021).
Preventive coping strategies are designed to change a person’s response to work
stressors. Coping strategies, such as time management and conflict resolution, are characterized
by cognitive restructuring, such changing one’s job expectations, reinterpreting other people’s
behavior, and imagining new goals and next steps (Maslach, 2017). Evaluations of individual
interventions suggest coping skills programs are effective for reducing burnout, especially
emotional exhaustion (Simionato & Simpson, 2018). These programs generally seek to develop
coping skills in an individual to assist in dealing with the stress and occasionally the programs
reduce emotional exhaustion (Shin et al., 2014). Reilly and colleagues (2021) conducted a study
which examined the perceived effectiveness of various coping strategies implemented by mental
health practitioners during the COVID-19 pandemic and found behavioral coping strategies
effective. Surveys were given to 888 participants who then selected applicable coping strategies.
The most frequently chosen coping strategies were behavioral strategies, which included
engaging in enjoyable activities, spending time with loved ones, and engaging in physical
exercise (Reilly et al., 2021).
Changes in work patterns are known to be an important solution, considering the link
between burnout and work overload, and there is a recommendation to work less when under
stress (Maslach, 2017). Morse et al. (2012) recommended focusing on time management, such as
taking a break, changing routines, and avoiding overtime. The option to work remotely can also
reduce the stress of time management for employees. Work redesign is a key tool to decrease
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employee workload (Leiter & Maslach, 2014). A sustainable workload stops the cycle of
exhaustion that is a driving force in the experience of burnout for many people (Maslach, 2017).
Some common strategies for working less include more breaks in one’s work routine, avoiding
overtime work, and taking more time off or more vacations. Vacation may alleviate burnout, but
working while on vacation may contradict the benefits (Marshall et al., 2021). In an online study
of 498 members of the Physician Women in Leadership Facebook group, participants self-
reported work patterns while on vacation and the perceived impact of working during vacation
on burnout (Marshall et al., 2021). Participants were also asked about the impact of the COVID-
19 pandemic on these behaviors. About 94% of respondents reported engaging in some level of
work-related behavior while on vacation. They also reported that working on vacations was
detrimental to their mental health. The researchers suggested using tools to disengage from work
while on vacation, for example, using out-of-office messages, declining meetings during
vacation time, and removing work email from personal phones (Marshall et al., 2021).
Maslach’s (2017) last recommendation was to turn to other people for social support to
help in dealing with burnout. Support from mentors, friends, and family helped tackle burnout
issues and challenges (Mattke, 2013). Social support helps one manage uncertainty, increases
one’s perception of personal control over one’s life experiences, and helps one toward goals (Foy
et al., 2019). Foy (2019) also noted that positive relationships of support correlate to higher job
satisfaction and productivity. Long-term care nursing staff have reported high levels of burnout.
Woodhead et al. (2016) conducted a study to examine burnout and the relationship between job
resources and job demands in nurses working in a long-term care facility. The findings revealed
job demands were associated with more emotional exhaustion, more depersonalization, and less
personal accomplishment than job resources. Nurses who had support from job resources,
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supervisors, friends, family members, reassurance of worth, and opportunities for nurturing had
less emotional exhaustion and higher levels of personal accomplishment than the nurses who did
not receive support (Woodhead et al., 2016). While the reduction of emotional exhaustion should
lead to reductions in depersonalization and increase perceptions of personal accomplishment,
another approach to the reduction of burnout has been to attempt to make changes to the
environment in which the employees work (Jain et al., 2013; Lloyd et al., 2013).
Fixing the Job
The effort to reduce burnout was targeted at specific organizational stressors believed to
be causing burnout. Organizational burnout is the result of a unique combination of stressors
specific to each workplace; therefore, a single burnout intervention is unlikely to be universally
effective (Bretland & Thorsteinsson, 2015). To prevent and reduce burnout, organizations have
introduced initiatives designed to reduce stress and improve employee health in the workplace by
addressing person-job (P-J) fit and organizational climate. Organizational climate includes
workplace bullying, employee and supervisor relationships, workplace programs and workshops,
and organizational policies that meet the needs and demands of the workforce (de Beer et al.,
2016; Xanthopoulou et al., 2007).
A strategy for organizational intervention is to change qualities of the work environment
with strong links to enhanced employee engagement (Maslach et al., 2012). Burnout is often the
result of a mismatch between person and job (Gabriel et al., 2012). The demands of the job can
be too great for an individual to handle effectively. The person-environment fit (P-E) or P-J fit
describes the demands-and-resources relationship between individuals and their work. In cases
when fit is high, the demands of the workplace are balanced in what the individual brings to the
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workplace and the demands of the work itself. When fit is low, demands deplete resources, or
resources are insufficient against the demands of the workplace. (Maslach & Leiter, 2017).
The AWS is a model used to measure and understand the imbalances or mismatches of
the P-J fit (Gregory & Menser, 2015). Gregoory and Menser (2015) used the AWS in a study to
develop and test the theory for burnout in the primary care setting to improve physician
engagement or reduce the level of burnout. The findings demonstrated effective intervention
efforts in three areas: (a) workload, (b) values, and (c) control. The researchers recommended
increasing resources to match increases in workload, aligning and communicating organizational
values with those of the physician workforce, and creating joint decision-making mechanisms
involving organizational and physician leaders (Gregory & Menser, 2015).
Organizational climate has been defined as a meaningful and shared perception derived
from a body of interconnected experiences with organizational policies, practices, procedures,
and observations (Schneider et al., 2017). Studies have identified socially toxic workplaces,
which are characterized by unresolved conflicts, lack of trust and support, and destructive social
relationships, such as bullying, as factors that influence burnout in the organization (Leiter,
2013). The workplace climate is essential to well-being, but working is problematic when people
experience workplace bullying (MacIntosh et al., 2010).
To extend understanding, from the perspective of women, of how workplace bullying
affects their work, a study was conducted in eastern Canada with 36 women who had
experienced psychological bullying in the workplace. The problem identified was that women
could not continue working at the same level as before the workplace bullying. Becoming aware
of bullying earlier would enable earlier interventions. Women who tried to access workplace
resources too late often found little support, prompting women to quit their job. Participants
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believed employers who develop organizational cultures that foster listening, offer impartial
advice, and engage in advocacy are more likely to address bullying effectively. Third-party
advocates can be useful in aiding communication and resolving bullying. Early intervention
could significantly influence the process for women, those bullying, and coworkers. Providing
job orientation and training at all levels, especially education about an employee’s specific
responsibilities and performance evaluation expectations and what constitutes acceptable
workplace behavior and relevant policies and protocols are recommended to reduce stress
(MacIntosh et al., 2010).
The quality of relationships impact employees’ levels of burnout and overall health and
well-being (Leiter & Maslach, 2014). One study found positive relationships with supervisors
and coworkers in nonprofits were associated with less work stress (Quinn et al., 2019). The
purpose of the study was to investigate the impact risk and protective factors relevant to the
experiences of social workers in nonprofit organizations. The clinical supervisory relationship
was found to be a statistically significant, inverse predictor of risk factors of burnout. This result
suggests a clinical supervisor who can provide a genuine, open, understanding, and accepting
environment for the supervisee may contribute an important protective factor for reducing
secondary trauma symptoms among clinical social workers.
Groups’ perceptions of how their supervisors handle conflict can also impact burnout (Way &
Bordia, 2020). In Australia, 972 teachers answered a questionnaire based on supervisors’
handling of conflicts. Supervisor-collaborating climate was found to be negatively associated
with collective employee burnout. In this study, the positive association between supervisor
flexible climate and overall employee burnout was evident when supervisor emotion recognition
skills (identifying human emotion) were low but absent when supervisor emotion recognition
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skills were high. Groups with high high supervisor emotion recognition skills experienced lower
group burnout,
Workplace programs have been created to target burnout issues and create a positive
environment (Leiter & Maslach, 2014.) Workplace flexibility is a work-life strategy that can be
used to meet changing personal needs, especially needs of women who are caregivers (Goldin &
Katz, 2011; Kim et al., 2020). To examine the associations between workplace flexibility and
workers’ well-being, Kim et al. (2020) researched reasons for working at home and gender
differences. The study found benefits of flexible schedules for work-related well-being. The
ability to take time off during the workday to attend to personal or family matters was especially
important and beneficial to workers and was associated with greater job satisfaction and lower
job stress, daily fatigue, and work-to-family conflict. Having the ability to adjust start and end
times of work and working at home to catch up on work were associated with elevated work-to-
family conflict, particularly for women workers.
Peer support groups elevate self-esteem and mental well-being and reduce risks of
burnout (Leiter & Maslach, 2014). Levy-Tzedek et al. (2016) started an all-women peer
mentoring support group to meet the needs of young women faculty members. The purpose was
to provide new members with concrete advice for coping with the challenges of academic life
and running a research group. Participants discussed approaches to leadership, solved problems
women face frequently, and created a sense of camaraderie. They worked together to use
emotional intelligence when dealing with colleagues and students and were encouraged to
embrace the diversity of approaches and management styles. They used the peer-coaching
approach to address and resolve an issue or a problem per requests from the group. Participants
said the group was beneficial and had continued to use the tools of peer support (Levy-Tzedek et
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al., 2018). A pilot study was conducted to examine the feasibility, acceptability, and
effectiveness of brief, 5-minute interventions on nurses’ burnout (Copeland, 2021). Nurses were
randomized into five groups: (a) meditation, (b) journaling, (c) gratitude, (d) outside, and €
control. Many participants expressed a desire to continue the practice after the 6-week
intervention period. The findings showed actively encouraging nurses to engage in some form of
reflective, refocusing, or positive practice each shift and fostering a commitment to making it
happen each day while at work showed can decrease burnout.
Interventions designed for the entire organization, especially when the interventions take
place for an extended period of time, are more likely to demonstrate successful outcomes (Leiter
& Maslach, 2014). Evidence indicates wellness programs are successful in improving the health
status of employees (Harris, 2016). Wellness can be considered a lifestyle approach that pursues
elevated states of physical and psychological well‐being (Lloyd, 2019).
Researchers conducted a study to examine the link between health communication and
health behaviors in workplace wellness programs among 169 employees (T. J. Burke et al.,
2017). Participants were recruited from a large southwestern university and its local school
district. They were part of a workplace wellness program that offered daily group fitness classes,
cooking classes, and other educational programs for faculty and staff. The study found as
individuals’ perceived health-related social influences from their coworkers increased, their
perceived health-related social support from their coworkers increased. People felt more
supported in an environment in which their coworkers engaged in health-related social influence.
Another study was conducted on employees at a university to evaluate the effects of
physical activity on employees’ levels of burnout (Ginoux et al., 2019). Employee assistance
programs (EAPs) provide counseling and consulting services that focus on the prevention and
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remediation of personal problems experienced by employees or members of their families.
Employee assistance programs are considered a main vehicle for occupational stress
management and have been evolving into providers of holistic well-being programs in the
workplace (Richmond et al., 2017).
A study was done on employees who receive EAP counseling services in Colorado. The
researchers hypothesized reductions in absenteeism, increased productivity, and less workplace
distress in response to the participants receiving EAP counseling services (Richmond et al.,
2016) The EAP reduced absenteeism for the participants in the study who began with lower
severity of depression and anxiety at baselines. The findings confirmed the value of EAPs
helping employees address personal and work-related concerns that affect job performance.
Stress management workshops may include self-assessment, stress management,
relaxation and meditation, cognitive and behavioral techniques, time management, peer support,
and the promotion of healthy lifestyles. Stress management workshops combine many individual
strategies to combat burnout for the organization (Burman & Goswami, 2018; Leiter & Maslach,
2014). Research suggests stress management workshops should be conducted on a regular basis,
educating employees about sources of stress, harmful consequences on their health, and how
they can reduce stress effectively. Stress management workshops should be backed by practical
stress reduction techniques that workers can use on and off the job (Burman & Goswami, 2018).
A study of 256 physician residents was done to examine a stress management workshop
to improve physician residents’ stress management behaviors and outcomes. The participants
attended a one-day stress management workshop. The objectives were to help residents identify
stressors, identify early warning signs of stress, and practice intervention techniques. Participants
completed a precourse survey, a course evaluation, and a 1-month-postcourse survey. The
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findings revealed that residents improved in three of the four burnout constructs: emotional
exhaustion, depersonalization, and satisfaction with their job (Ghannam et al., 2020).
Programs for the workplace generally seek to develop coping skills for individuals,
assisting in dealing with stress that has resulted in burnout. Mindfulness training can target
emotional reactions to systemic psychosocial stressors through the development of self-
awareness and self-compassion (Woods-Giscombe´ & Black, 2010). A study was conducted at
the University of Kansas School of Medicine to investigate whether workplace, group
mindfulness-based yoga intervention could help manage burnout among 43 healthcare
professionals (Ofei-Dodoo et al., 2020). After 8 weeks of a program, consisting of group
discussions, mindfulness activities, and yoga practices, the researchers found significant
reductions in measures of burnout, depression, anxiety, and stress and improvement in resilience
and compassion. The findings suggest a convenient, short, workplace, mindfulness-based yoga
intervention of weekly 1-hour sessions over 8 weeks provided a collegial and time-efficient way
to improve personal accomplishment, resilience, and compassion and reduction in depression,
anxiety, and stress among healthcare professionals (Ofei-Dodoo et al., 2020).
Bartlett et al. (2019) conducted a meta-analysis review and synthesized evidence from
workplace-delivered training for changes in mindfulness, stress, mental health, well-being, and
work performance outcomes. The findings showed training increased mindfulness and had
significant positive effects for perceived stress, psychological distress, anxiety, well-being, and
sleep.
As further studies are conducted to validate the benefits of MBSR for practicing nurses
and to investigate the impact on patient care, justification may be found for policy changes in the
workplace leading to MBSR being routinely offered to nurses (Smith, 2014). System-wide health
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policy changes are needed to solve the social determinants of health and that focus on person-
centered interventions places an unfair burden on individuals to change, despite obvious
structural odds (Bias et al., 2020). Smith (2014) reviewed 25 primary intervention studies.
Unlike health-policy related interventions that seek to change the underlying social causes of
health disparities, mindfulness is person-centered and helps individuals examine and adapt
emotional reactivity that might influence behavioral responses and produce undesirable health
outcomes. Smith found intervention programs that include refresher courses resulted in longer
lasting positive effects on burnout. For example, a reduction in emotional exhaustion lasted over
2 years, when implementing refresher courses.
Organizations should recognize the need for and make burnout intervention programs
available to employees. Work policies in organizations should focus on creating an environment
that provides employees with support and access to information for early signs of burnout
(Carnevale & Hatak, 2020). Burnout can be reduced, but there is a need to develop appropriate
programs (Sonnentag, 2015). When the context of occupational stress is considered, self-efficacy
represents the confidence, skills, and resources necessary for dealing with challenges, stress, and
consequences of the job (Shoji et al., 2016).
Conceptual Framework
As the researcher, I chose SCT, originated by Bandura in 1977, as a means of further
examining this topic. This study aims to examine the female leader’s experience with burnout
during the COVID-19 pandemic, so organizations can make decisions to ensure female leaders
do not leave the workplace. This study will primarily use Bandura’s (1977) SCT to address
practice. This section focuses on the role SCT plays in the development of the individual
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experiences which include the stressors causing burnout, and personal and organizational factors
leading to burnout (Bandura, 1977, 1986).
Bandura (1977) stated a person’s behavior influences and is influenced by personal
factors and the social environment. Internal factors, such as self-concept; external factors, such
as cultural influences and COVID-19; and organizational systems and structures contribute to
burnout. When the context of occupation stress is considered, self-efficacy represents the
confidence, skills, and resources necessary for dealing with challenges, stress, and consequences
of the job (Shoji et al., 2016). Self-efficacy is measured by using a domain-specific construct: the
ability of an individual to cope with a broad range of challenges and stressful demands in the
organization (Luszczynska et al., 2005). In SCT, self-efficacy determines stress-related
outcomes, and burnout is one outcome. Employees who show low self-efficacy harbor
pessimistic thoughts about future accomplishments and personal development (Salanova et al.,
2011). Indicators of self-efficacy and stress outcomes are conceptually distinct. The construct of
personal accomplishment is considered to be of a retrospective character and represents action
outcomes, while self-efficacy beliefs are considered to be prospective and operative
characteristics of an individual and their action in the future (Bandura, 1986).
Ventura et al. (2015) analyzed the role of professional self-efficacy as a predictor of
burnout to understand how professional self-efficacy plays in the perception of challenge.
Female leaders with higher self-efficacy experienced less burnout symptoms when they faced
challenging demands with more confidence in her abilities to take on complex challenges. On the
contrary, female leaders with lower levels of self-efficacy experience heightened levels of stress
when facing occupational challenges and environmental factors.
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Reciprocal determinism is a central concept of SCT (Bandura, 1977). Reciprocal
determinism (also known triadic reciprocity) is a model composed of three factors that influence
behavior: (a) the individual, (b) their environment, and (c) the behavior itself (Bandura, 1977).
Reinforcement is the internal or external response to an individual’s behavior that affects the
likelihood of either continuing or discontinuing the behavior. According to SCT, self-efficacy
refers to individuals’ beliefs in their capabilities to exercise control over challenging demands
(Bandura, 1997). In the context of occupational burnout, self-efficacy represents the confidence
that one can employ the skills necessary to deal with job-specific tasks and cope with job-
specific challenges, job-related stress, and its consequences.
The model presented in Figure 3 is based on Bandura’s triadic reciprocity model showing
the relationship between person, behavior, and environment. The figure represents the
bidirectional influence of the environment—(a) women, (b) leadership, and (c) nonprofit—and
the three burnout dimensions: (a) emotional exhaustion, (b) cynicism, and (c) efficacy. Culture,
social norms, and community influence internal motivational factors such that an individual
frames her actions against what is possible and expected, and the consequences of going against
the internal factors. Personal factors of self-efficacy determine a female’s behavior and the
actions that she assumes. Furthermore, organizational support structures and processes influence
her behavior. The model also illustrates the causal relationship between all three factors
impacting behavior simultaneously. The result of burnout is a triadic reciprocal causation of a
system of interaction with the environment, behavior, and a person, which negatively affects the
female leader.

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Figure 3
Triadic Reciprocity Influences Behaviors in Female Leaders During COVID-19

Summary
The literature review identified and defined burnout and its causes, while also examining
the role burnout plays in organizations. The literature shows the impact of burnout on women,
components related to burnout, theories on and measures for burnout, and the use of each tool.
The chapter presented a conceptual framework of self-efficacy and burnout components on
49

which the research was based. The chapter included studies that have shown the impact of
burnout and self-efficacy and have explored the impact of burnout on women and leaders.
The literature review identifies and defines burnout along with causes and factors leading
to burnout while also examining the role that burnout plays in the organization. The literature
that shows the impact of burnout on women, the components that are related to burnout, the
different theories and measures used in burnout, and how each tool can be used. The chapter also
goes through a conceptual framework developed on self-efficacy and burnout components that
would form the base on which the research would be carried out. The paper has also gone
through some past studies which have shown the impact of burnout and self-efficacy, as well as
studies that explore the impact of burnout on women and leaders.
In summary, this literature review synthesizes the research surrounding burnout. The
aforementioned literature offers a valuable insight into the components of burnout related to
nonprofit female leaders during COVID-19. Furthermore, the review of literature points to areas
of workplace burnout that may be linked to female leaders. The constructs presented will be used
to inform the development of the qualitative interviews and research hypotheses.

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Chapter Three: Methodology
This chapter begins with a discussion of the research design used to explore variables,
research questions, and constraints of the study. Next, the population, sampling procedures,
recruitment, participation, and data collection are explained. Then, the instrumentation,
operationalization of constructs, and reliability and validity are discussed. Finally, ethical
procedures of the study are addressed.
Research Questions
The following research questions are posed to understand the experience of burnout and
guide this study.
1. To what extent did female nonprofit leaders experience burnout during the COVID-
19 pandemic?
2. What is the relationship between self-efficacy and burnout within the context of the
COVID-19 pandemic?
3. What policies and procedures did employers put in place during COVID-19 that
impacted work-life balance for female leaders?
Research Design Overview
Qualitative research focuses on the phenomenon and relates to quality. In this study, the
focus was on understanding burnout in female leaders through their lived experiences.
Underlying motives and desires are often targeted through this type of research, and for this,
there are different techniques used, including in-depth interviews. Qualitative research is most
suitable for exploratory research, as this study is, and is used to understand individual
experiences, opinions, thoughts, and trends to identify the problem and help to understand the
extent of the problem at hand (Arghode, 2012). For this research, the qualitative methods were
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the most suitable, considering that the research questions are focused on understanding the
impact factors, emotions, and experiences that lead to burnout among the female leaders during
the pandemic (Arghode, 2012; Smith, 2018).
Research Setting
Participants initially received an email about participation in this study (see Appendix A).
Participants who expressed an interest in participating in the study emailed the researcher. The
selection criteria included the following three components: (a) female executive director, (b)
experienced burnout during the global pandemic in 2020, and (c) length of time in the workplace
predated COVID-19. Participants varied in age, race, and region of origin. The purposive sample
consisted of ten participants who met the criteria.
The qualitative researcher collects data themselves through interviewing participants by
using open-ended questions (Creswell & Creswell, 2018). This study followed a qualitative
research design based on interviews. This approach was chosen to gain insight from the lived
experiences of the participants (Merriam & Tisdell, 2016). Prior to the interview, a list of 12
predetermined questions, along with probes, was developed so that each interviewee responded
to a similar series of prompts based on the three research questions. The questions were open
ended to elicit as much detail and meaning from the interviewee as possible. The interviews took
place over a 2-month period (February 2022-April 2022). All interviews lasted between 30 to 60
minutes. The Zencastr platform was chosen as the video conferencing tool. The Zencastr
platform allowed for the sessions to be recorded and transcribed.
The sample came from the membership at the Children’s Support Network (CSN) in the
southern region of the United States, covering multiple states. The pseudonym was selected as a
general term for the three different types nonprofit organizations supporting and serving children
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who have experienced child abuse. The headquarters of the CSN has an estimated 100 executive
directors. Each executive director has their NPO located in one of the state’s counties. Centers
have a varied number of employees based on the population of the county and number of
children served. The CSN supports children who have suffered from child abuse or neglect.
Centers employ staff specifically trained to offer multiple services to the victims and their
families who have experienced child abuse, including mental health, medical, and social
development. During COVID-19, these were considered essential services. The organizations
stayed open and continued to serve children and families, thus relative to the study of burnout
during the pandemic.
The Researcher
Constant reflective practices throughout the research process raise awareness of the
influence on the researcher’s interpretation of the data collected (Merriam & Tisdell, 2016). I
acknowledge I am a female nonprofit executive director (FNED) with over 15 years of
leadership experience. As I engaged in this study, I was aware of my preconceived knowledge,
experiences, and barriers faced, as a woman who experienced burnout during COVID-19. To
engage in self-reflective practices, I requested feedback from classmates, professors, and
committee chairs during the entire process to limit bias. Based on past experiences and
individual work experiences, there is a belief that women leaders face increased burnout
compared to their male counterparts, and women leaders are heavily scrutinized for their
performance. My findings could conflict with the findings of other studies, and the focus was on
understanding the issues based on real-life experiences and learning the difference between
reality and studies. Thus, whether the findings matched my own beliefs, the results were
presented as intended by the participants. Interviews have been transcribed and, so readers can
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see if there is any bias in the reporting and ensure the report’s reliability.
Data Sources
Data was sourced from semi-structured interviews of FNEDs. Participants provided
detailed stories and information on their views of the topic.
Participants
The research was carried out through interviews of FNEDs. Participants worked in the
CSN, and the executive directors from the Southern region were the sample frame. This study
used a direct email approach to recruit FNEDs. The CSN includes an estimated 100 executive
directors. The participant email ensured selection of participants from diverse backgrounds from
different areas of the region. This study also used snowballing recruitment technique. The
directors of the CSN identified other potential candidates. The criteria for selection included
current FNEDs who had been in that position since January 2020 and who had experienced
burnout in 2020. The selection of the individuals was critical for the researcher as these are
women in an executive director role in NPOs, and the focus of the study is on understanding
burnout during the pandemic and how it has impacted them.
Instrumentation
Qualitative analysis allows for different tools to be used in gaining the required data.
Semi-structured interviews were the most suitable option, as they allowed participants to provide
detailed stories and information on their views of the topic. Interview questions were based on
the three research questions and SCT, focused on the pandemic, and were framed for female
leaders of NPOs.
Following the guidelines for qualitative research questions, 12 sequential questions were
developed, along with probing questions to address this study’s conceptual framework (see
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Appendix B; Merriam & Tisdell, 2016). Two mock interviews were conducted. Following the
mock interviews, questions were arranged in sequential order and reworded for clarity.
Data Collection Procedures
A qualitative research method relies on the researcher as the instrument for data
collection and employs multiple data collection methods based on participants’ meanings
(Creswell & Creswell, 2018). The researcher sent an initial email with an overview of the study
to interview participants. Following the initial email, additional correspondence with chosen
participants was made to schedule the interviews. Then the researcher corresponded with the
chapter director for further possible candidates. The researcher conducted semi-structured
interviews of 10 participants. Each interview took 45 to 60 minutes and was conducted through
Zencastr. Zencastr allowed recording, participant consent, and transcriptions of the interviews.
All interviews were guided by 12 questions. The interview began with time to develop rapport
with each participant and then shifted to how the participants began their work in NPOs.
Data Analysis
After the collection of data utilizing interview videos and audio recordings, analysis and
interpretations of the participants’ responses, using semi-structured interviews as the design of
inquiry for this study allowed the researcher to use the coding process to generate a description
of the participants and categories or inductive themes for analysis (Creswell & Creswell, 2018;
Merriam & Tisdell, 2016). The interview data will be coded and categorized based on their
relevance to the three research questions. Interview transcripts were analyzed to identify themes
for each open-ended question and analyzed separately to identify comments and important points
to provide answers to the research questions.
Analytic memos were written after each interview and each observation. I documented
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thoughts, concerns, and initial conclusions about the data, in relation to the conceptual
framework and research questions. Interviews were transcribed and coded. In the first phase of
analysis, open coding was used, looking for empirical codes from the conceptual framework. In
the second phase of analysis, empirical and prior codes were aggregated into analytic codes. The
third phase of data analysis included the identification of patterns and themes that emerge in
relation to the conceptual framework and research questions.
Interview transcriptions, observations of nonverbal reactions, and interpretations of the
participants’ narratives were analyzed. The data were coded and categorized based on their
relevance to the three research questions (Merriam & Tisdell, 2016). The codes were
independently analyzed and combined into themes emerging from the data.
Validity and Reliability
Establishing validity and reliability was first done by acknowledging my own reasons for
the interview and what the interview would be used for was explained to participants to ensure
trustworthiness and credibility (Merriam & Tisdell, 2016). I provided participants with
transcripts and findngs on the interpretation to clarify or change anything they felt being
misinterpreted. Confirmability occurred through the use of participants’ responses and avoiding
my own biases. Using narrative research as the design of inquiry for this study allowed the
researcher to use the coding process (dependability) to generate a description of the participants
and categories or inductive themes for analysis (Creswell & Creswell, 2018). By explicitly
acknowledging the elements of the researcher’s positionality and identities concerning the
participants’ roles and interpretation of data collected, the presentation of the findings of the
study will help ensure trustworthiness (Merriam & Tisdell, 2016). If another person wants to
replicate the study, they should have enough information from the report to do so and obtain
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similar findings to establish dependability.
Research Ethics
Several ethical considerations ensure compliance with the International Review Board
and an obligation to the study participants that the information shared is used with the utmost
confidentiality and integrity. After receiving approval from the Institutional Review Board
(IRB), the researcher approached the CSN groups through email to obtain permission to use the
listserv to email participants. Upon obtaining permission, the participants were contacted by e-
mail and were requested to participate in the research. The participants were informed ahead of
time of the topic, the topics to be explored, and the time required. Participants were told they
would not be forced = to be a part of the study. The participants’ names and organizational
information has been kept confidential for all participants. Interviews took place over Zoom, and
the contact was kept to a minimum to ensure that the participants did not feel pushed or
disturbed. I followed these guidelines and only included the open and willing participants.

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Chapter Four: Findings
The purpose of this dissertation was to understand burnout in female leaders through their
lived experiences during the COVID-19 pandemic. The WHO (2019) defined burnout as a
“syndrome conceptualized as resulting from chronic workplace stress that has not been
successfully managed” (para. 4). The problem addressed in this study concerned FNEDs’
challenges that could increase perceived occupational stress levels and burnout symptoms. The
research questions were
1. To what extent did female nonprofit leaders experience burnout during the COVID-
19 pandemic?
2. What is the relationship between self-efficacy and burnout within the context of the
COVID-19 pandemic?
3. What policies and procedures did employers put in place during COVID-19 that
impacted work-life balance for female leaders?
This qualitative study consisted of 10 participants who provided the researcher with a
pseudonym to protect confidentiality. The work locations of participants are not disclosed in the
research, but all participants were in the Southern United States. Table 1 annotates the
demographic makeup of the selected participants. The remainder of this chapter presents the
seven findings in alignment with burnout studies, highlighting the impact of female leadership in
nonprofit organizations during COVID-19.

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Table 1
Characteristics of Participants
Name
(Pseudonym)
Age Marital Status Children at
Home
Years in
Position
Ethnicity
Alice 39 Divorced 2 6 Native American
Amy 38 Married 1 4 White
Carrie 40 Married 3 8 White
Ellen 46 Married 2 5 White
Kate 61 Widowed 0 15 White
Nicole 39 Married 4 9 White
Ruth 43 Married 0 10 White
Sasha 32 Married 3 4 Hispanic
Tammy 45 Married 2 12 White
Valerie 54 Married 2 12 Black

Research Question 1: To What Extent Did Female Nonprofit Executive Directors
Experience Burnout During the COVID-19 Pandemic?
This first research question sought to explore the perceptions of FNEDs, as they
experienced burnout. Research Question 1 laid the foundation for the interview questions. The
study included FNEDs who experienced burnout symptoms during 2020. The researcher focused
on Interview Questions 3—How would you describe burnout?—and 4—Can you take me back
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to a time when you felt overwhelmed or stressed during the pandemic?—to gather thoughtful
responses that led to the participants sharing their experience. The research discovered three key
findings regarding the extent in which FNEDs experienced burnout during COVID-19: (a)
FNEDs demonstrated understanding of burnout and symptoms of burnout; (b) FNEDs had
similar descriptions of experiencing burnout during COVID-19; and (c) FNEDs felt isolated
during the pandemic. In the following sections, the findings are contextualized to gain a deeper
understanding of their lived experiences during the pandemic,
Finding 1: Female Nonprofit Executive Directors Expressed a Common Understanding of
Burnout
Maslach and Leiter (2016b) divided burnout symptoms into dimensions: (a) feelings of
emotional exhaustion (fatigue and overwhelmed), (b) depersonalization (cynicism) and (c)
reduced professional efficacy (low personal accomplishment). Table 2 categorizes the 10
participants’ descriptions of burnout and their understanding of burnout into Maslach’s three
dimensions. Using their initial description of burnout, emotional exhaustion was inferenced six
times; depersonalizations was referenced seven times: and reduced professional efficacy was
referenced five times.
From the start of the interviews, participants used terms that described occupational
stressors interchangeably with the term burnout. Tammy described her definition of burnout and
added she felt there are levels of burnout: “I think there are levels of burnout. On one end, you
can see a light at the end of the tunnel. Then there is a point for people that there is no turning
back.” Tammy said she “definitely experienced extreme burnout” for a time but did not come to
the point of quitting her job.

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Table 2
Participants Understanding of Burnout Based Maslach’s Three Dimensions of Burnout
Emotional Exhaustion Depersonalization Reduced Professional
Efficacy
Alice Learned hopelessness. You feel like you get to a
point where you have
suppressed your feelings
so many times that you
no longer want to go the
extra mile because you
automatically assume
there’s no reward. It’s
not going to be fruitful.
I can see that I end up just
doing the bare
minimum.

Amy Burnout to me was when I
hated doing my job.
Burnout for me was when
the staff was mad at me
because they thought I
didn’t know what I was
doing. I didn’t know
what I was doing.
Carrie It is related to the
professional’s inability
to do the work and to do
quality work.
Ellen

Burnout is really two-
fold. It is getting more
frustrating instead of
finding joy in what I’m
doing.
Burnout is personally
seeing my own
frustrations and getting
to the level of not being
able to do my job.
Kate It can be an overwhelming
feeling.

Burnout is whenever you
are walking the walk,
but you’re not feeling it.

Nicole I think the best way I can
describe it is like
depression, less social,
and just feeling tired all
of the time.

Burnout is finding
yourself avoiding
something that you had
once found a lot of joy
and passion in, just
losing your zest.

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Emotional Exhaustion Depersonalization Reduced Professional
Efficacy
Ruth I view burnout as
cumulative. It is like
you’re just so beat down.
It is not that you don’t
believe in the mission
but that you can’t do the
mission anymore. Like
your why isn’t there
anymore.

Sasha It is not having that open
heart that you usually
have towards the kids
and families that we
serve. You’re kind of
going through the
motions you don’t have
any sense of motivation,
purpose, or passion to be
there.

Tammy It’s numbness from
exhaustion like you’re
tapped out. You carry
the emotional weight of
the work.
We deal with human
systems in this work,
and burnout is when you
don’t care anymore
because it’s just too
much to care.

Valerie Burnout is beyond
physical exhaustion. It is
mental and emotional
exhaustion. You have
reached your capacity.
You don’t have the
capacity for any
additional ounce of
energy.
Whatever that mission or
cause is, you become
immobilized and
rendered ineffective to
yourself.

One incongruence of the understanding came from two participants, Sasha and Alice.
They explained symptoms of burnout but believed burnout happens when a person can longer
work and quits their job. Sasha did not feel she suffered from burnout, even though she
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expressed symptoms of burnout. She explained, “There was nothing in place for our mental
health. We were at our wit’s end and so exhausted. We just did what we did and went home.”
She described the stress she felt at home: “It was stressful at home with my kids having online
school. I didn’t know what they needed and I was trying to complete my work from home too,”
Alice had a similar understanding of burnout. She also felt burnout meant quitting her job. She
described her experience with burnout:
I felt overwhelmed and stressed before the pandemic, but not burnout. I felt it
even more in 2020 at work. I can see that I ended up just doing the bare
minimum. I felt 100% of burnout symptoms, still did my job and came to work
every day.
Finding 2: Female Nonprofit Executive Directors Revealed High Levels of Perceived Stress
The interview questions related to RQ1 led to responses where participants identified one
or more instances in which they experienced or perceived burnout during the pandemic. The
pandemic forced immediate changes on serving child abuse victims in person during the
shutdown. Female nonprofit executive directors were tasked with keeping their centers open
during the pandemic. In some states, employees were considered frontline workers. Those states
were given more help from governors than those not deemed frontline workers were. The states
not considered frontline workers were still expected to keep the centers open and serve children
and families, putting a considerable amount of work on the FNEDs. Participants provided
examples of the levels of stress they experienced. Nicole had been an executive director for 8
years when the pandemic began. She described her experience:
At first, we were passive about it, like it wasn’t real. And then everybody
panicked and fell apart at the same time and looked at me like, “You better have
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some answers here. How are we going to operate?” I knew that everyone
depended on me to figure it all out. I started to see a lot of conflict with our
leadership team and felt almost ganged up on. I had to figure this out at home and
at work all at the same time. I crashed emotionally and physically. It was one of
the hardest times in my life.
When Valerie reflected on the experience, she felt burnout happened when things started
to get back to normal. She said, “I felt that if I didn’t take a break, I knew I was going to
implode. When the adrenaline started to subside, I realized I was not in control of what was
happening to me.” She stated, “It was pandemic on top of pandemic.”
Amy said she knew it was burnout when she started hating her job. She described making
staffing decisions, where she experienced an incredible amount of stress. “There was a time
when we had to make staffing decisions and who would cover what and when,” Amy said. She
continued, “Half the staff was scared to death of COVID, and half fought me on wearing masks.
I had children that needed to receive services and adults acting like children.” At this point, Amy
said she experienced burnout for the first time. She added, “I didn’t want to go to work. I didn’t
care what happened at that place anymore.”
Kate remembered how running out of toilet paper was the moment she felt the
accumulating stress at once: “I remember standing there and feeling like I was Dorothy in the
Tornado. Everything was swirling around, and people were making comments to me, but I
wasn’t hearing it.”
Carrie felt a sense of urgency during the start of the pandemic. “I needed to get
everything. I had to get everything done. I wasn’t sleeping. I was handling phone calls, emails, a
pandemic, and trying to teach my children. I was losing my mind towards the beginning.”
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Alice said she had felt burnout in other jobs before the pandemic as well. Ruth said, “If
you’ already burnt out on clients and seeing clients and dealing with clients knowing that they
could be bringing a pandemic to your door isn’t going to help matters so it doesn’t make you
want to
The findings revealed stress came from factors outside of work during this time. All
FNEDs were mothers, and some were also caretakers of their parents. Eight of the 10
participants had children at home who were attending online school during the shutdown. The
FNEDs addressed the added stress of caring for children during the pandemic. Tammy said, “My
biggest concern was my kids and their schoolwork. How was I going to stay on top of it?” Sasha
shared a similar concern, “My stress was also my kids at home and doing online school. I didn’t
understand what they needed. I was still trying to do my own work too.” Natalie’s entire
leadership team is made up of entirely women. She said they were all struggling during the
pandemic with added stress: “The role of being a mom is stressful, but the role of being a mother
during the pandemic while trying to run an organization takes it to a whole new level.” Although
Kate’s children were no longer in her home, her employees had children who were sent home for
online school. She had a difficult time thinking of her female employees’ stress levels. She
explained:
I realized for those that had children in school, they had suddenly become an
educator who was accountable for their kids 24 hours a day, with no relief. Then I
was going to ask them to be at work at least 8 hours out of their day to be
accountable to me. This situation was not a gradual change. I was stressed about
how I was going to stress all of the mothers out.
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Valerie had two children at home and was concerned for their well-being, and she
was also caring for both of her parents during the pandemic: “It was my role as mom to
be the nurturer. I made ways to give them a sense of peace and security so that their
mental health was intact.” In addition to taking care of her children, she was taking care
of her ailing parents. Valerie lost both of her parents within 4 months of each other. One
parent died from COVID-19. She remembered, “My father’s belief was that I would take
care of him. So, for me failing at that would have been the most devastating thing for me.
But layer caring for my dad and caring for my mother, too.”
The first year of the pandemic seemed more stressful for the FNEDs than the second
year. When participants were asked to describe a time, they experienced burnout or
overwhelming stress during COVID-19, all participants referenced the beginning of the
pandemic. According to nine out of 10 participants, the rapidly changing updates from CDC and
state guidelines created stress. Additionally, the difficulty of finding proper personal-protective
supplies (e.g., Lysol, toilet paper, masks, sanitizer) to continue services became difficult during
this time. Ellen said her first experience with stress during the pandemic was because she was
trying to find masks: “We were navigating through something we’ve never done before. Finding
masks was the biggest issue. We couldn’t serve child abuse victims without them. We had to find
masks, but we couldn’t find them anywhere.”
Sasha was one of 10 participants who did not discuss personal-protective supplies. She
also did not distinguish between stress in the first or second year of the pandemic.
Ruth recalled the stress of the state mandates to wear masks:
I remember having children in our center for interviews and the governor mandating
masks. Of course, you couldn’t find masks anywhere. I could do basic sewing. So, I made
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masks and brought them to work. We could conduct our forensic interviews with
homemade masks. Otherwise, we would have had to shut down until we found masks.
There was a new sense of urgency the FNEDs felt: to find PPP equipment and
because of new challenges presented to the success of serving victims of child abuse. The
nature of the FNEDs jobs was already linked to stress prepandemic. Carrie expressed a
mental load she was not prepared to handle: “I cannot let myself think about it still. All
the kids being abused during the shutdown were stuck at home. I remember thinking, we
can’t crash. We have to help these kids.” Tammy felt the emotional burden of child abuse
even heavier during the pandemic. Similar to Carrie, Tammy recalled:
We’ve dealt with sexual abuse for so long, but physical abuse cases or cases of severe
neglect where these kids I don’t have food was so difficult. No one has seen these
children for weeks or sometimes longer. They have been beaten so badly. But to hear
these kids tell their story. It was so hard. Just so hard.
The findings indicated there was no clear parallel between levels of burnout and
perceived efficacy at work. Seven of the 10 participants described their burnout as equal to or
higher during the COVID-19 pandemic, compared to prepandemic levels. Ruth said, “The
pandemic made burnout 10 times harder.” Three of the 10 participants—Amy, Nicole, and
Kate—described their burnout as unmanageable at times during the pandemic.
Sasha and Valerie perceived themselves to be effective during the pandemic. They were
the two participants with a different understanding of burnout; the caveat for the two was their
belief that burnout also meant quitting one’s job when the stress became too much to handle.
Additionally, they believed their effectiveness was significantly higher, when compared to
effectiveness in prepandemic levels. While burnout did not impact efficacy, participants
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discussed having more stressors and symptoms of burnout than they did prepandemic. Sasha
said, “It was hard, but we did what we were supposed to do. I just really pushed.” Valerie shared
a similar attitude:
I think every leader will tell you that we are set on “go” mode. I am the leader. I
am the rock. I have the answers, and so I did not give myself the space and time to
burnout because I wasn’t afforded the space and time to get weary. I had to pull
my administrative team together to say here’s the roadmap. We’re going to follow
it, and I don’t know if it’s the right roadmap or not, but this is what we’re going to
do. In the midst of a storm, you can’t stop the car. You can’t stop driving. I think I
held my breath for 2 years to be very honest. I kept one foot in front of the other.
Of the 10 participants, Alice remained neutral, citing she had experienced burnout
at times before and during pandemic. She had also experienced burnout in other jobs
prepandemic. She added, “For a lot of people, burnout during the pandemic hasn’t ended.
I feel like I’m coming out on the other side of it now, but I know lots of people that have
not made it out yet.”
Finding 3: Female Nonprofit Executive Directors Lacked Support, Contributing to
Burnout
When participants were asked if anyone was checking on their well-being or stress levels,
100% of participants answered that no one checked on them at work during the first year of the
pandemic. Two participants answered that their spouses checked on them during the pandemic.
Amanda and Carrie said both of their partners checked in on them, but it was to schedule
logistics with work and family. Alice said she would talk with her partner about cases before the
pandemic because he was in a similar type of work. Sasha said no one from work checked on her
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during the first year, but when things started to normalize, her board members asked if she
needed help. Carrie said, “I think my board retracted into handling their lives, and their worlds
were crashing too. I was not a priority to them. I understand that.” Valerie recalled a lack of
support she felt at home:
After 24 years of marriage, my husband looked at me and asking how we were going to
handle all of this. He said, “Well, how do we do this? What do we do?” I’m thinking to
myself, “Oh my God! Are you serious? I’m caring for my mom and my dad and the kids
and here’s my husband asking me what are we going to do?”
Nicole described a similar experience. She recalled the stress of the first year of the pandemic
and her lack of support she experienced:
No aspect of my life during that time was calm. There was nothing fueling me. I
wasn’t taking care of myself during that time, and nobody was checking on me to
be sure I was taking care of myself. I didn’t feel good about myself as a person, as
a leader, or as a mom. It was one of the hardest times of my life. When I hinted to
my board that I was overwhelmed, I got a weird response that let me know it was
not safe to show weakness. As a female, I need to act like I have it together, even
if I don’t. My husband didn’t contribute to that conversation at all. He was like,
“You got this, right?” We were not in it together.
Amy felt that even if a member of her board of directors or a staff member would have to
asked about her well-being, she would not be truly honest about her feelings for fear of
repercussions or a loss of trust with her board of directors or her employees. Ruth had a similar
response. Ruth said if someone had checked on her, she would have had a difficult time sharing
her emotions. During the pandemic, Ruth had to put her mother into hospice care. Ruth believed
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her mom would have been the person checking on her, but she was in kidney failure and had
dementia. She described her experience with isolation:
I definitively don’t remember anybody saying, “Hey, this is hard. This pandemic
is crazy. How are you doing? Do you need help?” I’m still the boss, so it makes it
lonely and hard. There is this emotional piece of myself that I can’t share. I didn’t
want to break down at work.
The participants who described a lack of support described a lack of support specifically
from board members. A few participants said board members called to check on the
organization’s staff and financial standing but not them personally. Kate said she was alone. She
asked herself, “Do I even matter?” She continued, “I am not a selfish person. We get into this
business to help. I was helping everyone on my staff. It would have been nice if someone had
checked on me.”
Carrie felt her husband thought she was fine and could handle everything. Like Carrie,
Nicole said, “I was not okay.” Valerie, a Black woman, remembered the feeling of loneliness.
She described her experience:
Black women are not oftentimes given the buffers and the latitude or the graciousness.
Graciousness means a word from anybody. Anybody to just look at you and say, “You’re
tired” kind-of grace. Not even a word from my board of saying, “Hey, what do you
need?” There was never the grace extended. There was never a moment when somebody
even asked.
Two participants shared feelings of resentment towards others who were not under the
same amount of stress. Ruth shared how she felt she was the only one in her situation, “I saw
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people posting about planting gardens and binge-watching Netflix. I was trying to find Lysol so
that we could serve abused children.”
Tammy shared how alone she felt being in the South during this time: “Covid hit in
March, and people had strong opinions about masks and about COVID-19.” She shared how the
murder of George Floyd and the protests became even more complex in her center. Tammy
continued, “I have a very diverse staff in age, race, politics, and religion. Most centers in our
state are not diverse and were not experiencing the depth of what was happening. I felt so alone
during that period.”
Finding 4: Female Nonprofit Executive Director Lacked Self-Care, Contributing to
Burnout
Ellen stated a contributing factor to her burnout was “feeling the burden of your staff and
trying to navigate kids and life at home.” Nicole highlighted, “There are a lot of mom aspects to
what I do at work. I want the staff to feel supported by me.” Several participants shared pressures
to maintain employees’ emotional stability to serve children. One participant felt her executive
director position during COVID-19 had an “immense level of responsibility accountability” on
her alone. She added that trying to keep her team happy contributed to her burnout: “The team’s
attitude was the hardest for me.” Amy stated, “I didn’t take a day off in 2020. I should have
sought therapy and given myself permission to be more flexible, but there was always a fire to
put out, and nobody else could do it but me.” Carrie recalled, “I was working nonstop and not
sleeping. My husband and I were taking shifts with the three kids so that I could work. I was
losing my mind.”
One out of the nine participants said exercise mitigated burnout symptoms. Ellen started
exercising with her family to relieve stress and help her maintain gratitude during a trying time:
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“We consistently worked together. We made an effort to get outside. Sometimes I would do it
twice a day.” Ellen had two teenagers who were at home. She continued, “I didn’t have the
pressure other directors had. I could come home and relax because my children were self-
sufficient.” Other directors expressed lack of time to allow for regular exercise. Carrie was an
avid runner for years, but during the pandemic she didn’t have time to exercise anymore: “I was
getting up at 4:00 a.m. to begin work. I had young children at home. I was working when they
went to sleep. Something had to give.”
Nicole reflected on the unrealistic expectation of women in leadership and who are also
mothers. She said, “I think women in leadership have to work harder. We have expectations at
home too. We wear masks and let people think we can do it all.” She explained how in the
beginning, she felt she had to keep it all together. Toward the end of the first year, she felt she
was not equipped for her role: “We don’t teach women leaders grounding techniques and give
them opportunities to recenter and refocus. And because it’s just assumed that they can do that
all by themselves, which is just not true or even realistic.”
As all participants are mothers. Ruth, Tammy, Nicole, and Kate all shared their job had
similar responsibilities to being a mother. As Nicole said, “I am a mother. I am used to doing
everything.” The participants did not address self-care as a priority for themselves during the
first part of the pandemic. All participants encouraged their employees to practice self-care, but
not a priority for themselves.
Several FNEDs expressed feeling disconnected from their teams. The FNEDs tried to
implement social connections for their staff to feel supported. Tammy said she knew her team
needed face-to-face time and created time to spend with each member. Ellen made weekly
wellness calls. She also created monthly “coffee talks,” using Zoom to connect with staff
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members. Carrie implemented a similar program. She said, “I did like a coffee and conversation.
I had opportunities to connect with people, and that was helpful to me.” Ruth said her staff
decided to plant a garden. Sasha encouraged her staff to continue with office talk using safe
distancing. She said, “Go over to a staff member’s office and small talk. Ask them what’s going
on. Continue to talk to one another.” Sasha thought it was essential to create time to talk about
stress: “In those discussions, we decided to do a book study together. We read through a few
books.” Amy tried to have an after-work happy hour to connect the group. She stated, “I tried,
but it didn’t last more than once or twice. I knew we needed it, but it was difficult to schedule. I
know because I was trying around my daughter and husband’s schedule.” Natalie had a similar
experience. She expressed that social interaction and connection was needed during this time. “It
would have been nice to hear from other people. It would have felt good to talk with people. I
didn’t know how much I needed that until I didn’t have it.” Natalie says in December of 2020,
her staff of 28 wanted to have a Christmas party because they missed the social aspect of their
job. She explained her experience:
The team wanted a Christmas party. Then they didn’t want a Christmas party. Then they
wanted one again. So, I had to figure out how to do a Christmas party during a pandemic,
and only six people showed up. I was just like, why even try?
The FNEDs tried to implement social connections for their staff to feel supported. In two states,
the state-level organizations also created monthly gatherings for the executive directors. Two
participants mentioned they attended the state-wide meetings. One FNED found it helpful. The
other FNED said it was mandated and felt like more work.
In summary, RQ1 focused on the extent FNEDs experienced burnout related to their job
in nonprofit organizations. The research discovered one key finding. While FNEDs demonstrated
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an understanding of burnout and symptoms of burnout, they FNEDs had similar descriptions of
experiencing a high level of perceived burnout during COVID-19. The findings also revealed a
theme of lack of personal self-care. The participants worked longer hours and made frequent
decisions to change with CDC guidelines and state requirements, while continuing to serve
victims of child abuse. While participants understood their roles, they felt overworked, alone,
and uncertain of their decision-making abilities during the pandemic. Unpacking each finding
provided useful descriptions exploring their lived experiences of burnout as FNEDs.
Research Question 2: How Efficacious Did Participants Feel in Their Roles During the
COVID-19 Pandemic?
The lack of support was seen in taking emotional responsibility for others and feeling
solely responsible for work and home and neglecting exercise. The questions provided a deeper
understanding of the relationship between self-efficacy and burnout during COVID-19 and the
factors influencing stress and well-being. The research uncovered one key finding in the
relationship between self-efficacy and burnout: FNEDs doubted their decision-making abilities
during the pandemic.
Finding 1: Female Nonprofit Executive Directors Doubted Their Decision-Making Abilities
During the Pandemic
RQ2 focuses on the relationship between self-efficacy and the extent to which
participants felt burnout. Participants expressed the inability to make sound decisions at the
beginning of the pandemic. The CDC often gave updated information, and organizations had to
change with new guidelines. The FNEDs were tasked with serving children of abuse in person,
keeping staff safe, finding resources, personal-protective equipment, and working with local
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agencies, such as Child Protective Services, law enforcement, and local courts. Policy and
procedures were changing rapidly.
Seven out of 10 participants experienced self-doubt during the pandemic. There was no
pattern of responses for the years of experience in leadership and low self-efficacy. The seven
participants who shared doubt in their abilities to make sound decisions had been in their
positions between 3 and 15 years. The three participants who did not show low self-efficacy had
been in their position from 2 to 12 years.
Ruth felt she was “second-guessing” every decision: “It was really hard keeping everyone
happy. I saw others not freaking out, so I had to be fine and balance it all. I didn’t know what I
was doing more than they did.” Amy hated her job and said, “The staff looked at me for answers
and were mad at me because I didn’t know what I was doing. And I didn’t.” Carrie recalled a
specific time when she was having difficulty with how she would navigate the finances of her
organization:
I had feelings that may not have been completely true or rational. That’s what I felt. I was
uncertain of how I was going to get funding sources. I had this weight of uncertainty, and
I didn’t know what I was going to do. I cried like three times that night.
Ellen described a similar experience regarding uncertainty at the beginning of the pandemic:
I was just not confident in decisions because I had never done this before. It was all new.
We had to find resources, and new policies were changing almost daily from the CDC or
the state. Sometimes different information from the government and the state. Who do we
follow? What do we do if someone is sick? Do we close down a center? It became
overwhelming.
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Valerie shared, “There was no time to think about how you felt. I had the responsibility of caring
for families, children, and staff. It was just go time.” Valerie felt that being a woman in
leadership in the southern United States was already a challenge. She added, “There’s a different
responsibility and liability that rests with women of color in leadership positions. We have a
responsibility to our greater community in which we serve.” Referring to the beginning of the
pandemic, Valerie was trying to figure out how to handle all the changes and take care of her
organization. She described her experience: “Just take all of the pieces to every board game and
dump it in the middle of the floor. I didn’t know which pieces went to which game. I just had to
figure it out.” Kate had a similar experience. She shared, “I didn’t know what next steps to take. I
just knew I had to figure out the best and safest way to serve kids. I tried to make that the
priority.” She explained it was challenging to navigate employee health issues: “I didn’t know
how to handle employees with underlying health conditions. How would they interact with staff
and children?”
Nicole reflected on the unrealistic expectations of women in leadership who are also
mothers. She said, “I think women in leadership have to work harder. We have expectations at
home too. We wear masks and let people think we can do it all.” She explained how in the
beginning, she felt she had to keep it all together. Toward the end of the first year, she felt she
was not equipped for her role. She added, “We don’t teach women leaders grounding techniques
and give them opportunities to recenter and refocus. And because it’s just assumed that they can
do that all by themselves, which isn’t true.”
Two FNEDs did not make any comments on their abilities to make decisions or reach
goals. However, one participant was the outlier in self-efficacy. Participant, Tammy, had a
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positive outlook at the beginning of the pandemic. She saw the constant change as a new goal
and a chance to use your strength as a leader. She describes her experience with new changes:
I don’t believe in like hardcore rules. I knew we were going to mess this up, and then
we’re going to figure out how to fix it. We’re going to respect each other and understand
that everyone is in a different place right now. Then the next day something would
change. Like, now we have to wear a mask, or we are not supposed to wear cloth masks.
We can’t all constantly be right. Initially, there was something exciting about stretching
myself. I was like, we can roll with this. I felt pretty good. I think one of my skill sets is
my flexibility.
In summary, the overall findings for RQ2 demonstrated the relationship between self-
efficacy and the extent to which participants felt burnout. Participants expressed the inability to
make sound decisions at the beginning of the pandemic. While participants understood their
roles, they felt overworked, alone, and uncertain of their decision-making abilities during the
pandemic. The FNEDs also recognized that they needed connections with others at work and
created unique ways to boost morale, again whether the staff utilized the resource or not.
Research Question 3: What Policies and Procedures Did Employers Implement During
COVID-19 That Impacted Work-Life Balance for Female Leaders?
For the FNEDs, rules quickly shifted during processes. The challenge for the FNEDs was
to keep the center staffed and safely serve child abuse victims. When it came to helping
employees balance work and life, FNEDs had to react quickly. Many staff members had
challenges in their personal lives, such as having children at home, becoming caregivers to sick
relatives, or staff becoming sick. All contributed to the need to modify policy and procedures
during the pandemic. The findings for RQ3 showed a consistent theme regarding the changes in
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policies and procedures to ensure a balanced work-life. The research discovered two findings the
FNEDs established during COVID-19 that impacted work-life balance: (a) implementing flexible
work arrangements (FWA) and (2) developing wellness plans.
Finding 1: Implementing Flexible Work Arrangements
The pandemic forced FWA into policy in all FNEDs centers. Although each FNED
handled FWA differently, all FNEDs implemented a form of FWA during the shutdown. All
participants were mothers, and eight of the 10 women had children sent home to continue school
during the pandemic. During the first year of the pandemic, centers implemented a variety of
FWAs, which ranged from a week of remote work to a permanent hybrid workplace. Table 3
shows the FNEDs FWA plans for each center.

Table 3
FWA: Centers Implementation During the Shutdown
Name FWA
Alice Flexibility to work from home
Amy Remote for 2 weeks, then the flexibility to work from home and in shifts with teams
Carrie Remote for 1 week, then the flexibility to work from home and in shifts with teams
Ellen Remote for 2 weeks, then staff returned with new safety protocols
Kate Remote for 1 week, then the flexibility to work from home and in shifts with teams
Nicole Remote for 1 week, then the flexibility to work from home and in shifts with teams
Ruth Remote for 2 weeks, then the flexibility to work from home and in shifts with teams
Sasha Remote for 6 months and then the flexibility to work from home
Tammy Flexibility to work from home and in shifts with teams
Valerie Flexibility to work from home and in shifts with teams
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The ability to check on their children relieved stress. Ellen said, “Flexibility of working
from home alleviated some stress. It helped to be able to check on my kids and still work.”
Tammy felt developing an FWA routine helped her feel as normal as possible during the
pandemic. “I would go to work about 10:00 a.m. I got the kids settled and then call and check in
on them.” She felt school offered structure for her teenagers and made it easier for her to go to
the office.
Alice’s center already had FWAs in place before the pandemic hit. “FWA saved me. We
already knew how to handle this. Our problem came when working with local agencies, which
were still adjusting.” Flexible work arrangements provided time for Sasha and Valerie, who
assisted in the caretaking of dying parents. Amy implemented FWA at her workplace and still
felt stressed. She described her experience with FWA:
I just stayed overwhelmed all the time because of my daughter. My husband and I would
work from home every other day. I couldn’t hire a babysitter at that time, so I guess there
was that. People were scared to come to your house. It was so stressful working from
home, but there was no other option.
Finding 2: Developing Wellness Practices
The emotions from the pandemic affected the well-being of the staff and FNDEs. Seven
of the FNDEs implemented wellness practices, specific to the needs and wants of their center.
Three FNDEs did not feel the need to implement wellness practices.
The small size of Sasha’s center led her to believe wellness practices were not reasonable
expectations. Still, she recommended using the Headspace application and continuing with an
open-door policy, if anyone needed to talk. Sasha said, “I started focusing more on myself of
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what I need versus what everybody else needs around me, because I felt that if I wasn’t 100%
with myself, then how was I going to give.”
Seven out of the 10 FNDEs felt wellness needed to be a priority, with five FNEDs
specifically citing mental health services as part of a well-being plan. The CDC (2021) included
emotional, physical, and social well-being included under term mental health. Amy knew she
needed mental health services during the pandemic. She tried implementing mental health
services to her staff prior to the pandemic, but it was expensive. Amy offered EAP, but neither
she nor her employees used it. She shared, “The board says they want to support me. Then put
your money where your mouth is. We needed mental health services, and I couldn’t get them
together on a Zoom meeting to approve it.” Alice shared a similar experience about mental
health services. Alice felt FWA was enough for her staff but wanted mental health services
provided. She had a small organization and did not think she could afford mental health services:
I think that boards need to know that if you are not supporting your executive director
before a pandemic, you definitely won’t support them during a pandemic. If we are going
to pull through, the foundation of the organization is what the board does every day. We
needed mental health services available before the pandemic. We needed it during the
pandemic, and we will need it after. The policy changes are critical to our well-being.
Kate felt a significant piece of wellness is having an accessible EAP: “We wanted to use
our EAP, but it wasn’t easy to access. We had an in-house therapist. I think we overwhelmed
her.” Ellen incorporated mindfulness practices and made well-being calls to her employees. She
also changed a policy for time off: “We updated policies on wellness and wellness for our office.
We offer an extra day if people just need it for their mental health or whatever they need.” Carrie
created a mental health committee to gain insights on how to help staff during the pandemic.
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Table 4 depicts all well-being practices by each FNED. Other well-being practices were
put into policy. Amy organized a sick bank for extra leave days for those who had COVID-19 or
if her team just needed a day off. Ruth added two mental health days during the year. She also
believed FWA was a significant wellness practice. Ruth said, “Employees can work from home
or the office. Depending on the schedule, they can take care of whatever they need during that
time, like working out. It is up to the individual.” Toward the beginning of 2021, Nicole added
medical, physical, and nutritional benefits: “This is the first time we have offered medical
benefits, but we are also giving physical and nutritional options too. A real well-being plan.”
Nicole offered mental health days and flexible working arrangements.

Table 4
Centers Implementation of Wellness Practices During the Shutdown
Name Wellness Practices
Alice FWA
Amy Sick bank for employees; Offered employee assistance program
Carrie Personally stopped exercising; created mental health committee; offered employee
assistance program for employees
Ellen Exercised at home with family; mindfulness practices; well-being calls for
employees; offered employee assistance program
Kate Used in house therapist; offered employee assistance program
Nicole Offered employee assistance program; medical, fitness, and nutritional benefits
Ruth FWA; mental health days
Sasha Headspace application; open-door policy
Tammy Offered employee assistance program; mental health days; board interaction
Valerie Shifted workloads; implemented financial literacy classes

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Tammy believed person-to-person interaction is well-being and a way to fight burnout.
She explained:
We have mental health days, but something we have enacted is taking a personal interest
in another person’s well-being. It’s not formal, but you need those kinds of policies too.
We have board members stop by and get us stuff when we are having a bad day. We
actually have board members that talk to staff about stories that they’re dealing with.
Having somebody else that cares about what you’re doing and to support you in the
agency is important and you are able to reset.
Valerie believed her employees were already well taken care of at work. Her budget did
not allow for “extras.” She continued, “Wellness is shifting some of the workloads and sharing
the workloads. I tried to do that. That’s a real wellness plan.” Valerie believed financial well-
being alleviated stress for her organization. She offered financial literacy to her staff and the
families she served in her organizations. She explained what she did differently with her
organization:
Some people take advantage of, let’s say, a yoga membership. Some people don’t like
that option. But financial planning and financial literacy are essential to everyone,
especially during the pandemic. Financial literacy is critical to well-being. If you don’t
want to feel like you cannot support or sustain your family, you don’t have to worry if
your family won’t be able to eat. That’s been one of the most important things that we’ve
done. How powerful is it to give them the tool so that they can begin to plan for their
financial well-being. If the agency were not able to pay our employees every 2 weeks,
would they still be okay? That is very important to me.
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In summary, the overall findings for RQ3 showed a consistent theme regarding the
changes in policies and procedures to ensure a balanced work-life. All FNEDs changed some
policies and procedures to incorporate FWA. Largely, FWA was seen as the most beneficial
policy change. In addition, most participants provided resources to increase the organizations’
well-being practices, whether they use them or not. Most FNEDs changed policy to include
wellness practices.
Summary
This chapter provided an overview of the findings supporting this study’s three research
questions. It shared the experiences of 10 FNEDs who experienced burnout during the pandemic.
The participants’ narratives highlighted the complexities of ensuring their employees’ safety and
well-being, delivering services to children who have suffered from child abuse, and managing
their personal lives during a pandemic. The interviewees shared their weaknesses and strengths,
while overseeing their nonprofit communities in the southern regions of the United States. The
study generated seven key findings identifying the complexities surrounding the possession of
multi-dimensional bodies as they traverse the employment cycle. Table 5 summarizes the seven
key findings of this study.

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Table 5
Key Findings: Burnout in Female Leaders
RQ 1: To what extent
did female non-
profit leaders
experience burnout
during the COVID-
19 pandemic?
RQ 2: What is the
relationship between
self-efficacy and
burnout within the
context of the COVID-
19 pandemic?
RQ 3: What policies and
procedures did employers
put in place during Covid-
19 that impacted work-life
balance for female
leaders?
Key
Finding
FNEDs shared an
understanding of
burnout
FNEDs doubted their
decision-making
abilities during the
pandemic.
FNEDs implemented
flexible work
arrangements
Key
Finding
FNEDs experienced a
perceived level of
high-stress

FNEDS developed a
wellness practice
Key
Finding
FNEDs lacked self-
care

Key
Finding
FNEDs lacked social
support

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Chapter Five: Recommendations
This study examined FNEDs’ lived experiences of occupational burnout during the
COVID-19 pandemic. This study used Bandura’s (1977) SCT to address practice. This study
also investigated the data from existing literature. The following research questions guided this
study.
1. To what extent did female nonprofit leaders experience burnout during the COVID-
19 pandemic?
2. How efficacious did participants feel in their roles during the COVID-19 pandemic?
3. What policies and procedures did employers put in place during COVID-19 that
impacted work-life balance for female leaders?
This chapter discusses recommendations to support the findings identified in Chapter 4.
The recommendations were constructed from scholarly literature centered on the theoretical
framework for this study. This chapter includes a discussion of the findings, recommendations
for practice, limitations and delimitations, recommendations for future research, and the study’s
conclusion.
Discussion of Findings
This section discusses the study findings elicited during the data analysis process. From
the seven findings in the study, three themes were found that directly supported the literature
review. The themes in the research aligned with the conceptual framework, Bandura’s (2001)
SCT, which combines human agency, self-efficacy, and individuals’ beliefs that influence
behavior and the environment.
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Based on the findings, SCT influences the complexity of the FNEDs’ relationships with
burnout. This theory describes the influence of individual experiences, the actions of others, and
environmental factors on individual behaviors. Also, SCT provides opportunities for social
support through instilling expectations and self-efficacy and using observational learning and
other reinforcements to achieve behavior change (Luszczynska & Schwarzer, 2015). Through
SCT, this study found the belief in one’s ability to succeed in the current environment. As
individuals’ lifestyles and patterns change, their self-efficacy levels and participation levels vary,
based on preconceived perceptions (Wilkerson et al., 2017). Triadic reciprocity is a central
concept of SCT. According to Bandura (1977), the triadic reciprocity model is comprised of
three factors influencing behavior: (a) the individual, (b) their environment, and (c) the behavior
itself. The environment affects how a person thinks and feels, which influences their behavior,
which impacts the environment. In this study, the environment influences a person’s thinking,
but their subsequent behavior affects their environment.
All participants were women who worked in the area of child abuse in NPOs. Before the
pandemic, it was widely acknowledged that providing services to traumatized populations
negatively impacted those employees’ mental health (Simionato & Simpson, 2018). Child
protective professionals are susceptible to burnout, compassion fatigue, and secondary traumatic
stress (Lizano et al., 2017). They also experience high levels of burnout and turnover (Tullberg
& Boothe, 2019). During the shutdown of the pandemic, the organizations in this study remained
open to provide services to the children who experienced physical and sexual child abuse and
neglect. Remaining open came with unique challenges executive directors had not faced before
the pandemic and contributed to new stress. Executive directors in child protection organizations
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are responsible for protecting their employees’ well-being. Workplace experiences that threaten
child welfare workers’ affective well-being present a threat to the entire organization (Lizano &
Barak, 2015).
The first finding revealed all participants experienced high levels of perceived stress
during COVID-19 in relationship to burnout. As discussed in Chapter 2, there is an ongoing
discussion among scholars as to the definition of burnout. Although the participants volunteered
to be interviewed with the understanding of the study, it was essential to have a foundational
knowledge of burnout. The participants used similar phrases and words in relation to burnout
(see the discussion of RQ1 in Chapter 4). The only outlier was from two participants who
believed true burnout meant leaving their current jobs. After the participants provided their
understandings of burnout, they described times they felt what they described as burnout. All
participants perceived high levels of stress during the pandemic. All but one participant
described their experiences at the beginning of the pandemic, between March and July of 2020.
These factors could influence their understanding of burnout.
The second finding demonstrated how the lack of self-care contributed to burnout. As
discussed in Chapter 4, the participants reported a lack of self-care during the pandemic. All
participants encouraged their employees to practice self-care, but not a prioritize self-care for
themselves. At the pandemic’s beginning, only one FNED exercised with her family, while the
other nine had difficulty scheduling exercise. The FNEDs encouraged employees to seek mental
health therapy but did not take advantage of mental health services in the first year of the
pandemic. Two FNEDs mentioned provided a stipend to make health and wellness more
personal. Self-care behaviors have also predicted less than 85% burnout and higher compassion
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satisfaction in previous studies (Salloum et al., 2015; Sanso et al., 2015). Self-care affects one’s
performance of self-care behaviors, including energy levels, perseverance, resilience, stress,
anxiety, and the decision-making processes involved in self-care (Buck et al., 2012).
Self-efficacy is portrayed as a type of self-reflection regarding determining one’s
capabilities. It develops, as individuals observe environmental constraints, examine their
achievements, and consider their psychological states and self-perceptions (Bandura, 1977).
Perceived self-efficacy affects managing intense stressors and how well people cope with them
(Benight & Bandura, 2004). As highlighted in the literature review, self-efficacy plays an
essential role in how one evaluates perceived stress and copes with stress in threatening
situations (Bandura, 1997).
The third finding from the research showed the lack of support felt by the FNEDs
contributed to their burnout. When participants were asked if anyone was checking on their well-
being or stress levels, 100% of participants answered that no one checked on them at work
during the first year of the pandemic. When the FNEDs noticed their employees needed social
support, they created opportunities for social connection with others in their office. Though the
FNEDs created opportunities for their employees to connect, still leaving a need for support for
the FNEDs. This process of thought patterns became apparent during the interviews when
Participants described feeling burnout and then created practices for their staff. The FNEDs did
not want their employees to experience what they were feeling during the pandemic. Social
support reduces vulnerability to stress and burnout (Bandura, 1986). The environmental factors
contributing to their lack of support include the organizational expectations from their board of
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directors, the absence of support structures pre-pandemic, and the FNEDs experiences during
COVID-19.
The subsequent finding that emerged from the research was that the FNEds doubted their
ability to make sound decisions during the pandemic. While participants understood their roles,
seven out of 10 FNEDs felt overworked, alone, and uncertain of their decision-making abilities
during the pandemic. At the beginning of the pandemic, the FNEDs were tasked with many
changes to serve children who were victims of child abuse. While participants doubted their
abilities and felt uncertain about the decisions, they kept their centers from closing and served
children during the pandemic.
Bandura (1989) stated self-efficacy beliefs affect thought patterns that may be helpful or
hurtful. Self-efficacy influences how you engage when stress occurs (Bandura, 1982). Leaders’
confidence in their abilities, knowledge, and skills is needed to lead others effectively (Ford et
al., 2021). People with high self-efficacy also put in the work necessary to achieve the given
goal. The major influences on self-efficacy are mastery-building opportunities, vicarious
experiences, intrinsic motivation/emotional arousal toward bettering performance, and verbal
persuasion or encouragement from others (Bandura, 1997).
The following findings revealed FWAs relieved stress for FNEDs during the pandemic.
The findings show all participants implemented a form of FWA for themselves and their
employees. Implementation of FWA resulted in the reduction of stress for FNEDs. This allowed
participants to be home with their children and care for their ailing parents. While this did not
alleviate all stress, the data from this study showed this was the most often used strategy the
FNEDs used across their centers.
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In Bandura’s (1978) reciprocal determinism, the environment includes physical
surroundings. According to Bandura, human behavior is controlled and influenced through
cognitive processes and environmental factors. According to Bandura (2000), individual agency
autonomy is the process that guides behavior within the immediate environment. The
environment, personal characteristics, and behavior work together to cause human action and
changes in behavior.
The final finding from the research showed that implementing wellness practices in the
organization reduced stress during the pandemic. While seven of FNDEs said they implemented
wellness practices specific to the needs and wants of their center, most FNDEs did not participate
in wellness practices at the beginning of the pandemic. Three FDNEs implemented forms of
well-being. Mental health was mentioned eight times. Six FDNEs offered EAP, but none
mentioned use of current EAP. While EAPs are mental health services, the EAPs offered seemed
hard to use. FWA was seen as part of well-being according to four FNEDs. There is no clear
definition of well-being among FNEDs, so all forms of wellness practices were collected.
Bandura (1982) asserted that unlike personality traits, self-efficacy is a situation-specific
construct that can be encouraged and developed. Self-efficacy plays a role in adopting wellness
behaviors. People with high efficacy persist in pursuing goals. The literature in Chapter 2
revealed poor well-being practices are strongly related to burnout.
Recommendations for Practice
The problem of practice is the COVID-19 pandemic created high-stress levels for
FNEDs, causing burnout. This section includes recommendations based on the study’s findings
and the literature to address areas that can decrease the stress in FNEDs’ workplaces, thus
lowering the stress resulting in burnout. These recommendations are directed to the board of
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directors of nonprofit organizations because the executive directors have no direct supervisor.
The following recommendations hinge on board of director approval before policy and practices
can be implemented in the organizations. Furthermore, it becomes increasingly important to
explore and identify the characteristics associated with well-being to identify support and
resources to best meet the needs of the FNEDs. The implications are drawn from the study’s
findings highlight areas for consideration within the organizations to help guide subsequent
efforts toward supporting the well-being of FNEDs.
Recommendation 1: Provide Board Education and Training
The first recommendation from this study was to provide education and training for
boards of directors of nonprofit organizations. The findings revealed the lack of support from the
board of directors contributed to their burnout. While only asking general support questions, the
FNEDs felt support from their board of directors was essential to their well-being. Executive
directors are more likely to have a positive sense of well-being and lower perceptions of burnout
when the board of directors is seen as an enhancement (Olinske & Hellman, 2017). These
findings emphasize the need for effective governance of the organization to protect the executive
director and the organization from the destructive effects of burnout (Kenney, 2018).
The leadership of executive directors is critical to the success an effectiveness of the
organizations (Meyer Foundation, 2022). The executive director’s role can have little energy
recovery in the mental, emotional, and physical areas, leading to burnout and impacting focus,
performance, and quality of decision making. With the addition of being a female in leadership
during a global pandemic, the added stressor can also create low self-efficacy, with leaders
questioning where they can be supported and if asking for support is safe. The board of directors
needs to be educated on burnout in general. Still, there should be ongoing training around
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burnout, specifically for women in executive leadership and women in NPOs. The board should
articulate and model desired behaviors that reduce and mitigate burnout (Kenney, 2018).
The board of directors of nonprofit organizations already have to compete with large
businesses to find and retain top talent, and for this reason, they should invest in training
(Chemmanur & Fedaseyeu, 2018). Boards should also be concerned with the financial gains
of retaining an executive director. Factors that contribute to the true cost of hiring a new
executive director include recruitment costs, onboarding costs, and training costs. Chemmanur
and Fedaseyeu (2018) also asserted that aside from costs, the cultural impact of an executive
director leaving should be considered in retaining quality leaders. The board of directors should
create an ecosystem of support by utilizing available resources through the state’s chapter.
Burnout prevention can be added to the board of directors annual training. Ongoing training on
burnout ensures the boards commitment to improving their knowledge about burnout (Davidescu
et al., 2020). The board also should develop a burnout prevention plan. The plan should utilize
confidential assessments that measure a leader's wellbeing. Interventions aimed at improving
self-efficacy can positively affect self-care behavior (Patel & Ghosh, 2017). The board of
directors needs to create an ecosystem of support for ongoing support. The board should
encourage confidential assessments that measure a leader’s well-being. This should include
vacations, mental health days, building time for physical activity, and other well-being priorities.
The board of directors also needs to engage in candid conversations around the well-being
assessments. The board should articulate and model desired behaviors (Kenney, 2018). Boards
are responsible for being more involved in the health and welfare of employees, their
preservation, and management to adopt a more strategic approach to wellness (Washington &
Ray, 2021). The board of directors also has a fiduciary obligation to create policies to ensure
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funding for multi-year support. Further recommendations rely on the education and training of
board members.
Recommendation 2: Develop Comprehensive Wellness Plans
The second recommendation from this study was to develop a comprehensive wellness
plan. This study revealed wellness practices were created and implemented to relieve stress in
seven out of ten centers in the first year of the pandemic. According to the CDC (2020), job-
related stress is the nation’s leading workplace health problem. Workplace wellness programs
are intended to reduce medical spending, increase productivity, and improve well-being (Jones &
Reif, 2019). Forty-six percent of U.S. worksites have a workplace health program. Employees
feel valued when companies invest in their well-being by offering a wellness program (Gubler et
al., 2018). Healthier employees can perform better physically and mentally in the short term,
becoming more health-conscious, efficient, productive, satisfied, and motivated (Ozminkowski
et al., 2016; Szabo & Juhasz, 2019).
The health and well-being of the workforce directly impact work performance (Litchfield
et al., 2016). An investment in employee health may lower health care costs and insurance
claims. Employees with more risk factors, including being overweight, smoking, and diabetes,
cost more to insure and pay more for health care than people with fewer risk factors (Haddon,
2018).

A workplace health program has the potential to keep healthy employees when promoting
health maintenance and targeting employees in the higher-risk categories (Gubler et al., 2018).
Workplace health programs can increase productivity. In general, healthier employees are
more productive. Healthier employees are less likely to call in sick or use vacation time due to
illness. Companies that support workplace health have a more significant percentage of
employees at work every day (Gubler et al., 2018; Haddon, 2018). Because employee health
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frequently carries over into better health behavior that impacts the employee and their family,
employees may also miss less work caring for ill family members. The workplace health and
wellness program must contain a combination of individual and organizational level strategies
and interventions to influence health, including benefits and support (Mytton et al. 2016). Most
people experiencing mental health problems do not seek help, and the stigma of mental illness is
considered a significant barrier to seeking appropriate treatment (Hanisch et al., 2016). Hanisch
et al. (2016) found evidence indicating the positive impact of antistigma interventions on
participants’ general mental health. Improved knowledge of signs of mental illness and treatment
options leads employees to seek help earlier. Health education suggests that an attitude towards
mental health can change behavior through expertise.
A wellness plan should encompass physical and mental health, along with preventative
strategies. During the interviews, several FNEDs emphasized the need for mental health. Half of
the centers had an EAP in place, but only one program took advantage of the prepandemic
program. According to Harris (2016), less than 10% of U.S. works take advantage of their EAPs.
An EAP is paid for by the organization for the employees and offers free and confidential
assessments, short-term counseling, referrals, and follow-up services to employees (Cowell et al.,
2012). An EAP can be expensive, but many services are offered online, significantly reducing
the cost per employee (Joseph et al., 2018). Many EAPs offer online meditation, yoga,
counseling, and financial literacy.
The most common focus of these programs is physical activity, nutrition, and stress
reduction. Many organizations offer incentives to help manage their employees’ health and
wellness. Some organizations offer to pay for gym memberships, if a gym is unavailable at work.
Organizations may provide incentives to cycle to work or car-sharing to encourage physical
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activity (Haddon, 2018). The organization pays an employee wellness program designed to
support employees as they adopt and sustain behaviors that reduce health risks, improve quality
of life, enhance personal effectiveness, and benefit the organization’s bottom line (Mytton et al.,
2016). Some employers run their own employee wellness programs, whereas others opt to
contract with third-party companies to provide and run their employee wellness programs (Szabó
& Juhász, 2019).
Recommendation 3: Implement Flexible Work Arrangements
The third recommendation from the research is to implement FWAs in organizations. The
findings presented in Chapter 4 show all participants implemented a form of FWA during the
pandemic. During the pandemic, the shutdown forced FWA, and each participant discussed the
importance of implementing FWAs into policy and practice. Implementation of FWAs resulted
in the reduction of stress and allowed the flexibility needed for the FNEDs to care for children
and parents. Flexible work arrangements have positive outcomes across domains, including
increased work-family conflict, improved mental health, and job morale (Shifrin & Michel,
2022). Workplace practices that can reduce employee work-family conflict have become a topic
of considerable interest to researchers and practitioners (SHRM, 2010). Flexible work
arrangements have been vital in helping employees manage work and non-work responsibilities.
Flexible work arrangements is generally defined as work options that permit flexibility when and
where work is completed (Rau & Hyland, 2002). Such practices have become widespread in
organizations and are often part of a central strategy to attract, motivate, and retain key talent
(SHRM, 2019). With the growing attention on flexible working arrangement initiatives, a more
accurate understanding of the relationship between flexibility and work-family conflict is needed
(Masuda, 2012).
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Work-life conflict happens when the pressure from work is incompatible with the
pressures outside of work (Boamah & Laschinger, 2016). Work-life conflict is associated with
higher turnover intentions and higher job dissatisfaction. Organizations offering FWAs show
they care about their employees’ well-being and, more significantly, psychological commitment.
Policies can influence turnover intentions when people perceive these policies as a sign that the
organization cares for their well-being. (Masuda, 2012; Eisenberger et al., 2002).
As with a wellness program, FWAs reduce employee absenteeism and add costs to
organizations (Weideman & Hofmeyr, 2020). Depending on the organizational structure,
absenteeism may need to pay for overtime work or substitute workers to replace absent workers,
thus incurring additional expenses temporarily. Apart from direct costs, diminished productivity
is a high indirect cost that the organizations pay due to sickness absence (Foy et al., 2019). The
U.S. Bureau of Labor Statistics (2020) reported 2% of working time is lost due to sickness.
Boards of directors should work with the executive directors and staff to create a wellness
plan specific to the organization. The board should conduct surveys to understand the needs and
risks of wellness programs. There should be a set budget according to the assessments. The goal
of holistic corporate wellness programs is to promote overall well-being and improve quality of
life. The focus of the program should include the total health of the employees. The areas
involved in the process include improving fitness, nutrition, mental health, and stress
management (SHRM, 2022).
Limitations and Delimitations
According to Creswell and Creswell (2018), limitations are conditions or influences that
cannot be controlled by the researcher. I will approach the study knowing my own limitations in
order to be transparent in the research process. The online recruitment strategy will help ensure
96

participants from diverse backgrounds from different regions of the two states. A limitation to
this strategy is that the study’s findings may not be generalizable to the greater non-profit
network population and, therefore, may be limited to the context of the study sample. First, as a
white woman conducting the interviews, the responses of minorities may be affected.
Interviewees may not feel comfortable because of my age, experience, or appearance. Second,
the lack of previous research in nonprofit executive directors experiencing burnout, specifically
during a global pandemic, creates a limitation to the research. As an insider to these experiences
of burnout and a female executive director, the participants may feel comfortable sharing similar
experiences.
Delimitations are the boundaries based on the researcher’s decision on what to include
and exclude to make the study more relevant to the problem of practice (Creswell & Creswell,
2018). This study will examine whether COVID-19 increased existing burnout or caused burnout
to current executive directors in non-profit work. Due to the limitations of a small population of
women executive directors of nonprofit organizations, the women interviewed are not
necessarily representatives of the entire population. The number of interviews could create more
research around burnout and women leaders in non-profit organizations. This study does not
cover the experiences of men or female caretakers. The scope of research would become too
problematic to define an end point of this study. The experiences of the employees (not in
leadership) of CSN have been excluded from this study. While there is limited research on
executive burnout in nonprofit organizations, there is however research on employee burnout.
Using Bandura’s social cognitive theory as the conceptual framework limits what is being asked
in the interview questions. The pandemic brought unforeseen changes during the planning of the
study. As a result, the impact on the female leaders’ work environment, roles, and
97

responsibilities continued to change. The long-term effects of the pandemic are still shifting.
Therefore, the study’s findings may not have reflected the widespread impact of COVID-19 felt
by FNEDs. This study might not have entirely captured the overall effects of COVID-19 on the
work of nonprofit leaders and their entire experience.
Recommendations for Future Research
Future research could employ and compare the strategies proposed by the participants in
this study to determine which are successful in decreasing burnout. Also, it could investigate the
impact of the interventions and reduced burnout on the FNEDS, as this study’s goal is to reduce
burnout. This study only considered FNEDs in which the focus was on child abuse and
participants were recruited through snowball sampling. There is a growing body of literature on
the need to address the retention of female leadership, but there is little on leadership in
nonprofits (Beckwith et al., 2016). The final recommendation is to expand the study beyond
executive directors to middle management for females in NPOs. In summary, there are
limitations in the research, but the study can serve as a gateway for future research. The
recommendations for future research serve to expand the study’s current findings. In addition,
various perspectives can further address strategies to mitigate burnout and provide efficient
resources.
Conclusion
This study aimed to explore burnout in female leaders during COVID-19 and the most
effective strategies and interventions to reduce the problem. This study focused on the
perspectives of female executive directors who worked during the first year of the pandemic
within the southern region of the United States. Participants experienced a heightened sense of
burnout during COVID-19. The participants’ views offered insight from multiple states and
98

NPOs, specifically working in child abuse on how to best address the issue of burnout. Female
leaders of nonprofits faced new challenges brought on by the pandemic. If left unaddressed, there
is a high chance that the progress made could be reversed (Coleman, 2020). This study aimed to
examine the female leader’s experience with burnout during the COVID-19 pandemic for
organizations to make decisions to ensure female leaders do not leave the workplace. It is critical
to study and understand the impact of burnout caused by COVID-19 on women leaders in non-
profit organizations. Nonprofit organizations have an opportunity to not only retain female
representation in leadership positions but create a workplace where female leaders are healthy
and thriving.

99

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128

Appendix A: Recruitment Email
To Whom It May Concern:
My name is Brandy Eldridge, and I am also a doctoral candidate in the Rossier School of
Education at the University of Southern California, conducting a research study as part of my
dissertation. I am examining burnout in female leaders through their lived experience during the
COVID-19 pandemic. This research has been approved by the Institutional Review Board (IRB).

You are invited to participate in the study, if you meet the following criteria:

(a) female executive director
(b) experienced burnout during the global pandemic in 2020
(c) length of time in the workplace predated COVID-19

The interview is anticipated to last approximately 45 to 60 minutes. I will use a video
conferencing platform. Participation in this study is entirely voluntary. Your identity as a
participant will remain confidential at all times during and after the study.

If you agree to participate in the interview or you have any further questions, please feel free to
contact me at beldridg@usc.edu.

Thank you in advance for your participation.

Brandy Eldridge
Doctoral Candidate - Rossier School of Education
University of Southern California
129

Appendix B
Interview Protocol
Interview Questions Potential Probes RQ Addressed
I would like to break the ice by first getting to know
you…
1. Tell me about yourself and the work you do.
*How long have you worked in your job?
What roles have you had in nonprofit?
Rapport
2. Can you tell me about your role as a leader? *What led you to work in the nonprofit sector? Rapport
3. How would you describe burnout? *How did you come to this understanding? RQ1
4. Can you take me back to a time when you felt
overwhelmed or stressed during the pandemic?
What was happening?
*What work factors contributed to your burnout? RQ1
5. How was your experience different or similar to
other women in the organization?
*How do you think other women were feeling? RQ1
6. Do you feel differently when you are not at
work?
*Interesting. I think I understand what you mean.
Can you elaborate on what you mean by that?
RQ2
7. Are there other factors outside at work that
contributed to burnout?
*What kept you going? RQ2
8. Describe a barrier or challenge you that
contributed to burnout during COVID-19? How
did you navigate the challenge?
*What assumptions do you think people have made
about your leadership, supportive or critical, during
this time?
RQ3
9. Tell me about the support you received during
COVID-19 that helped relieve burnout?
* Who, if anyone, was checking in on your well-
being or stress levels?
RQ3
130

Interview Questions Potential Probes RQ Addressed
10. What would you want people to know about
burnout during the pandemic?
*Can you tell me more about how it made you
feel?
RQ3
11. What would you need and want that would
address burnout in your organization?
*What resources might have been helpful? RQ3
What would the perfect well-being plan look like for
your organization?
*What are you doing differently?
*What, if anything, would you have changed to
help yourself?
RQ3

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Asset Metadata

Creator Eldridge, Brandy (author)

Core Title Burnout of female executive directors in nonprofit organizations during COVID-19

School Rossier School of Education

Degree Doctor of Education

Degree Program Nonprofit Leadership and Management

Degree Conferral Date 2022-12

Publication Date 09/09/2022

Defense Date 09/09/2022

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag burnout,Child abuse,COVID-19,executive directors,Female,leaders,nonprofit organizations,OAI-PMH Harvest,qualitative research,social cognitive theory

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Andres, Mary (committee chair), Hirabayashi, Kimberley (committee chair), Muraszewski, Alison (committee chair)

Creator Email beldridg@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC111939845

Unique identifier UC111939845

Legacy Identifier etd-EldridgeBr-11195

Document Type Dissertation

Format application/pdf (imt)

Rights Eldridge, Brandy

Type texts

Source 20220909-usctheses-batch-979 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

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Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu