Psychological restoration among AIDS caregivers: Maintaining self-care.

Abstract

Burnout, although a popular theme in the caregiving literature, is not a well conceptualized construct. The present study recasts the challenges posed by caregiving in attentional terms, interpreting many of the symptoms associated traditionally with the burning out process as unnecessary but predictable outcomes of an uninterrupted cycle of mental fatigue. The study occupies an area at the convergence of coping research and clinical intervention. In addition to distinguishing some of the component parts of the fatigue experience, the study explores the potential for intervention within the context of leisure time and recreational activity. Findings identify different patterns of activities and approaches to recreational time that act to amplify or to mediate processes of fatigue. A number of modest--but powerful--possibilities for restoration are identified. The consequences of different approaches to use of recreational time are described. Escapist leisure engagements--those that involve high levels of distraction and allow little capacity for reflection--appear to be ineffective solutions to difficult life situations and actually appear to incur negative psychological effects. By contrast, restorative activities--that appear to be those that engage attention, but yet still provide room for reflection--influence functioning in a positive way and provide participants with a predictable resource for restoration and renewal. Leisure dysfunction, is identified as a critically important condition that acts to preclude restorative opportunities. Failure to acknowledge its presence has significant implications. It both hampers efforts to engage individuals in anticipating the costs of psychologically draining or challenging activities and impedes the development of plans to manage these costs. The restorative context is contrasted with more traditional psychotherapeutic approaches and suggestions are made regarding the inclusion of restorative experiences into explicitly therapeutic contexts. Directions for accessible interventions both at the individual and agency level are addressed and areas for further investigation outlined.