Academic journal article North American Journal of Psychology

Understanding Blame and Burnout in HIV/AIDS: Recommendations for Effective Practice

Academic journal article North American Journal of Psychology

Understanding Blame and Burnout in HIV/AIDS: Recommendations for Effective Practice

Article excerpt

HIV/AIDS has challenged the helping profession since the beginning of the epidemic. Now, thirty years since the discovery of HIV/AIDS, human service professionals are challenged with helping individuals cope with a chronic disease that society is still attempting to understand (Dorz, 2003). Current statistics indicate that 38.6 million people are living with HIV worldwide (UNAIDS, 2006). HIV has emerged as a chronic disease, where clients need support adjusting to a long-term illness that requires extensive medical management and coping with the uncertainty of problems that arise from being HIV positive. Due to advances in medication regimes, people with HIV/AIDS are living longer, but HIV continues to be a stigmatized disease in U.S. society. Societal views continue to impact policies, practices for diagnosing, treatment and prevention strategies for HIV (Maughan-Brown, 2006). The human service profession ensures that HIV positive individuals and their families have access to medical, psychological, social and educational services necessary to improve health outcomes. The shift in HIV to a chronic disease has put an increased demand on human service workers, which has subsequently place more strain on persons in the profession (Orner, 2006; Petersen & Swartz, 2002). This demand can consequently increase the risk of human services professionals placing blame and experiencing burnout (Bride, 2007; Brimlow, 2003; Pullium, 1993). A review of blame and burnout provides the basis for a possible connection between both perspectives. In the present paper I hope to demonstrate how an understanding of blame and burnout are helpful in effectively providing better services to those affected by HIV/AIDS.

Understanding Blame

The attribution process is about how individuals use information to arrive at an explanation or understanding for behaviors or an event. It's about how people answer questions beginning with "why" (Bowers, Edmonds & Canales, 1999; Gailey, Falk & Mizell, 2004)--in this instance, "Why is this person infected with HIV/AIDS?" Blaming is about explaining events and behavioral and emotional consequences of those explanations (Bowers, Edmonds & Canales, 1999; Heider, 1958; Mantler, Schellenburg & Page, 2003). Thus, prior beliefs or attitudes about HIV may influence the tendency to attribute blame as a justification of an individual's actions (Mantler, 1999; Mantler, et al., 2003).

Social motivation provides the basis for understanding the process of blame (Mantler, Schellenburg & Page, 2003). It starts after observing an event but prior to responding to it. Cognitively, the observer first makes several causal inferences to draw conclusions about controllability of the event. There are two phases in attributing blame for a negative event, the first being causal controllability and the second being the assignment of responsibility (Weiner, 1993).

The determination of causal controllability is based on three types of blame; internal, external, and societal blame. Internal blame associates the cause of the event with factors internal to the individual; physical traits, morals and lack of ability are examples of such. The actors' personal characteristics are viewed as the cause of their behavior or circumstances. External blame occurs when the perception of intent is assigned to situational variables. The behavior or circumstances are acknowledged, but the actor is not blamed. Societal blame associates the cause of an event or circumstances with societal factors such as lack of resources or discrimination. It could be conceptualized as a sociological variant of external blame. Consequently, the observer attributes no blame to the actor when external or societal attributions are made (Johnson, et al., 2002).

Unfortunately for AIDS victims, the fundamental attribution error that is so commonly made in our society results in attributions that are internal. Tetlock (1985) points out that there is a bias in the person-perception process, whereby the observer overestimates the (internal) personality or dispositional causes of behavior and underestimates (external) situational constraints on behavior. …

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