Why Nonprofit Burnout Happens to Organizations—Not People, and How Naturopathic Medicine Can Help

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Nonprofit organizations exist to help make the world a better place. But what happens when nonprofit staff are so committed to their cause that they burnout? According to activist and naturopathic doctor Emily Bennett, Nonprofit burnout doesn’t happen to employees—it happens to organizations. We sat down with Dr. Bennett, ND, to find out what special health challenges nonprofit staff face, how naturopathic medicine can help, and how working on the organizational level can get to the root causes of nonprofit employee overwhelm. 

When Activism Takes a Toll

Bennett’s university days were chock-full of student activism. She spoke at rallies, started campaigns, and regularly burned the midnight oil—all in dedication to “the cause.” But by her fourth year at university, her activist lifestyle was starting to take a toll. “I started feeling like all the time I had put in over the past three years was pointless; nothing was changing,” Bennett recalls. “The work we were doing was not effective. I became really cynical.”

At that point, she was the Executive Director of a nonprofit organization while still in university. She was the only staff member, and soon she hit a wall. “I wasn’t sleeping; I was anxious. I was really unwell and wasn’t aware of how unwell I was because I was so anxious and in my head,” recounts Bennett. “I just abandoned the cause altogether.” 

This rapid shift away from everything that had ruled her life for the last several years brought on such strong feelings of shame and failure that she never spoke about it. She moved away after that final year of university and tried to put everything behind her.

From PCOS to a Naturopathic Career

Around this time, she found out that she had Polycystic Ovarian Syndrome (PCOS). When the medication prescribed by a specialist brought on a full-body reaction, she was told she had to keep taking the medication for the rest of her life. Coming from a family of Medical Doctors, she didn’t know where else to turn. But when a friend introduced her to a naturopathic doctor, she didn’t just get help for her own health condition; she found a new career direction. 

The ND walked her through how the endocrine system actually works and pointed out how Bennett—blaming herself for her activist ‘failures’—may have impacted her own health. “She really gave me hope and information, which is what I needed,” recalls Bennett. “I’d always considered being a medical doctor. But this felt so much more meaningful because of the time you get to spend with people, and the kind of journey you could take as you provide them with the information that they need to feel OK with what is happening to them.”

When Self-Care and Nonprofit Work Aren’t Compatible

When she started practicing as a naturopathic doctor, most of her patients were staff members of nonprofit organizations. She would work with patients to create a treatment plan and then schedule a follow-up appointment four to six weeks later.

But after six years of practice, she started to notice an alarming pattern. When nonprofit patients returned for the second appointment, many reported they had taken a stress leave from their job. They discovered their work lifestyle simply didn’t give them the space they needed to follow Bennett’s self-care recommendations. At first, Bennett considered this a positive development. These patients were not well, and she encouraged them to take time off. Patients would implement her treatment plan then head back to work a couple of months later revitalized and proud of their new self-care capabilities. 

But when Bennett saw them a month after they went back to work, many had quit their jobs altogether. “These are people who are facing what is difficult, what is unjust in our society,” explains Bennett. “And it’s extremely stressful. It was incompatible to work in these organizations for them and to maintain the level of care that they had developed during their time off and in their initial work with me.”

After Bennett had seen this pattern play out with eight patients, she took a closer look. Whether they left their jobs or not, nonprofit patients reported a serious mismatch between caring for themselves and their organizational culture. Nonprofit staff came in most commonly for stress-based symptoms such as anxiety, insomnia, digestive issues, and hormone concerns. But that wasn’t their only commonality. “It’s this idea that the work is tough, and so you have to tough it out. Often, there’s a culture of martyrdom and that has consequences for individual health,” explains Bennett. “This work often attracts people who care a lot. That leaves them vulnerable to taking on a workload that is too much and taking work home leaving them open to compassion fatigue.” 

Swapping Random Acts of Wellness for Organizational Basics

Bennett realized that to get to the root causes of nonprofit staff stress, she had to address what was happening within nonprofit organizations. While employee wellness programs that include yoga or meditation can be helpful, she knows that programs focusing solely on employees will only go so far. “Instead of these random acts of wellness, organizations need to go back to basics,” Bennett explains. “Things like how you create a sense of belonging for people in the workplace, how you communicate work-life boundaries, and how managers support their teams.”

When she delved into the work of burnoutresearch pioneers such as Christina Maslach, she made a discovery that confirmed her desire to work on the organizational level. “Burnout doesn’t happen to individuals; it happens in the context of a workplace,” Bennett explains. “Compassion fatigue happens to individuals. But for a person who is burnt out, you need to go all the way to the organization to find out why this is happening. It’s happening because of what is going on at work.”

research pioneers such as Christina Maslach, she made a discovery that confirmed her desire to work on the organizational level. “Burnout doesn’t happen to individuals; it happens in the context of a workplace,” Bennett explains. “Compassion fatigue happens to individuals. But for a person who is burnt out, you need to go all the way to the organization to find out why this is happening. It’s happening because of what is going on at work.”

The World Health Organization (WHO, 2019) also stresses that burnout is an occupational phenomenon, not a medical condition. They define burnout as a syndrome “….resulting from chronic workplace stress that has not been successfully managed.” They point to three dimensions of burnout:

  1. Low energy or exhaustion
  2. Feeling negative, cynical, or mentally distant from one’s job
  3. Reduced professional efficacy

Rekindling the Organizational Fire

Now, Bennett uses evidence-based tools to help nonprofit organizations assess their burnout level. For example, the Areas of Worklife Scale (AWS) assesses how workload, control, reward, community, fairness, and values may factor into organizational burnout. Instead of telling nonprofits what they’re doing wrong, using such surveys helps Bennett provide evidence-based recommendations to improve organizational health and resilience. 

Bennett recalls one organization where experienced staff were resentful about how much time they had to spend training new staff. As it turned out, the lack of a new staff manual, standard training, and onboarding procedures were contributing to inefficiency and ill-feeling in the workplace. “It’s often these basics that are needed to reduce the workload burden and free up more energy for serving clients versus feeling negativity towards coworkers,” explains Bennett. “If they were not provided with adequate training at the outset, they won’t properly understand all the components of their job.”

Nonprofit organizations may focus so much on their cause, they risk losing sight of their greatest resource—their people. “Because of the focus on mission and vision, nonprofits sometimes lack the structures that support people feeling confident in their roles and responsibilities and on how they contribute to the mission overall,” explains Bennett. “I have so much to offer from the perspective of work-life balance and lifestyle. But people can’t achieve work-life balance when these basic organizational things are missing. That’s a big part of what is needed.”

The National Council of Nonprofits (Butkovich, 2019) points to five ways nonprofit organizations can bust burnout:

  1. Offer flexible work hours and locations
  2. Encourage taking time off
  3. Support logging off during non-work hours
  4. Offer mental health benefits
  5. Create a culture of compassion

This article is provided by the Institute for Natural Medicine (INM), a non-profit 501(c)(3) organization. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing healthcare systems and empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following  initiatives:

  • Education – Reveal the unique benefits and outcomes of naturopathic medicine
  • Access – Connect patients to licensed naturopathic doctors
  • Research – Expand quality research of this complex and comprehensive system of medicine

References

American Psychological Association. (2021), Speaking of Psychology: Why we’re burned out and what to do about it, with Christina Maslach, PhD, American Psychological Association, https://www.apa.org/news/podcasts/speaking-of-psychology/burnout

Butkovich, Sasha. (2019). Seeing Signs of Burnout at Your Nonprofit? 5 Tips to Help Your Team, National Council of Nonprofits, https://www.councilofnonprofits.org/thought-leadership/seeing-signs-of-burnout-your-nonprofit-5-tips-help-your-team

Maslach, C. & Leiter M.P. (2021), How to Measure Burnout Accurately and Ethically, Harvard Business Review, https://hbr.org/2021/03/how-to-measure-burnout-accurately-and-ethically

McClure, A., & Moore, M. (2021). Stress and Peer Support among Nonprofit Workers. Journal of Applied Social Science, 15(1), 151–156. https://doi.org/10.1177/1936724420982902

Moss, J. (2019), Burnout Is About Your Workplace, Not Your People, Harvard Business Review, https://hbr.org/2019/12/burnout-is-about-your-workplace-not-your-people

World Health Organization. (2019), Burn-out an “occupational phenomenon”: International Classification of Diseases, World Health Organization, https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases

More Resources

Cameron, K. (2012). Positive Leadership: Strategies for Extraordinary Performance. Berrett-Koehler Publishers.

Cameron, K. (2021). Positively Energizing Leadership: Virtuous Actions and Relationships That Create High Performance. Berrett-Koehler Publishers.

Connors, D. (2018). A Better Place to Work. Well-Advised Publishing.

Coyle, D. (2018). The Culture Code: The Secrets of Highly Successful Groups. Bantam Press.

Maslach, C. (2003). Burnout: The Cost of Caring. Malor Books. 

Maslach, C. & Leiter M.P. (2005). Banishing Burnout: Six Strategies for Improving Your Relationship with Work. Jossey-Bass.

Maslach, C. & Leiter M.P. (2000). The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It. Jossey-Bass.

Anna-Liza Badaloo is a writer and program consultant, working at the intersection of health, environment, and social justice. With over 10 years of experience at non-profit organizations, she brings a combination of content writing, copywriting, and journalism to her work. Using her strong storytelling ethic, Anna-Liza strives to amplify traditionally silenced voices such as BIPOC, youth, and 2SLGBTQIA+ communities.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

Get Involved!

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.