BREAKTHROUGH

PERSONAL & PROFESSIONAL DEVELOPMENT

Burnout Prevention & Wellness

BURNOUT
ASSESSMENT
An effective tool for measuring your personal
burnout risk & employee burnout within your
organization.
 How To Use The Burnout Assessment

The Burnout Assessment is based upon research findings across the globe.

The Burnout Assessment is comprised of two parts.

1. The Professional Profile looks at six work categories that can contribute to burnout. The following categories are
based upon the research of Christina Maslach and Michael P. Leiter. All questions are original content.

a) Workload - refers to the amount of work one is responsible for managing.

b) Control - refers to the level of autonomy one experiences at work.

c) Reward - refers to the intrinsic and intrinsic edification of one's work.

d) Community - refers to the quality of relationship with one's manager, co-workers and employer.

e) Fairness - refers to equity across economic, gender, and ethnic lines and the opportunity for upward mobility.

f) Values - refers to one's personal values in relation to the organization's values.

2. The Personal Profile looks at five categories of well-being that can be affected by your work.

a) Physical well-being.

b) Mental well-being.

c) Emotional well-being.

d) Spiritual well-being.

e) Relational well-being.

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 1

 How To Use The Burnout Assessment

Each category consists of ten questions, for a total of 110 questions altogether. Read each statement carefully and
answer on a scale of one to ten.

1 = Disagree & 10 = Agree. The scale is on a continuum, with five being neutral or unable to decide. Please avoid using
NA (not applicable) as much as possible for greater accuracy.

Example 1:
Disagree Neutral Agree

I spend time with close friends regularly. 1 2 3 4 5 6 7 8 9 10 NA

Example 2:
Disagree Neutral Agree

I do not think about unfinished work after leaving for the day. 1 2 3 4 5 6 7 8 9 10 NA

At the end of each category, calculate your score by adding the number you have chosen in each line.

Disagree Neutral Agree

I do not think about unfinished work after leaving for the day. 1 2 3 4 5 6 7 8 9 10 NA
My workplace invests in my professional growth. 1 2 3 4 5 6 7 8 9 10 NA
I enjoy working with my manager & co-workers. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: 17 / 30

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 2

 How To Use The Assessment At Work

The Burnout Assessment provides an effective tool for evaluating employee burnout risk, thereby providing a wealth
of information to help prevent burnout on your team.

Burnout is more than just a work-life balance issue. It reflects company culture priorities around workload, autonomy,
reward, connection, equity and values. Employee wellness incorporates both healthy workplace culture and personal
self-care.

The first step is opening the conversation with employees about burnout. This assessment provides you with essential
questions uncovering relevant information for understanding the strains and stress within your organization.

Learn what causes your employees the most significant stress so you can implement effective measures. This can
positively impact employee well-being and increase productivity. Further, you can prevent costly leaves of absence
and termination by stopping burnout before it happens.

Happy, healthy employees create healthy organizations that thrive.

If you have any questions, please reach out to us at https://www.break-through.ca/contact.

DISCLAIMER
The Burnout Assessment does not provide a diagnosis. The scores do not reflect any particular diagnosis or course of
treatment. The Burnout Assessment is a tool to help assess burnout potential using a series of questions. If you have
concerns about your health, well-being, mental health, or if you think you may be experiencing burnout, please
consult your medical doctor.

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 3

 Burnout Assessment
PROFESSIONAL PROFILE

Name: Department:
Date: Role:
Occupation: How long have you worked at this organization?
Organization: How long have you worked in your present position?

WORKLOAD Disagree Agree

1. I have the capacity to keep up with my work & do so with excellence. 1 2 3 4 5 6 7 8 9 10 NA

2. I have the training necessary to excel at my job. 1 2 3 4 5 6 7 8 9 10 NA
3. I do not feel burned out from my work. 1 2 3 4 5 6 7 8 9 10 NA
4. I am able to finish my responsibilities without working overtime. 1 2 3 4 5 6 7 8 9 10 NA
5. I have time to plan & prioritize my work. 1 2 3 4 5 6 7 8 9 10 NA
6. I have time to work on my most important responsibilities. 1 2 3 4 5 6 7 8 9 10 NA
7. I do not take work home to complete on evenings, weekends, or vacations. 1 2 3 4 5 6 7 8 9 10 NA
8. I do not think about unfinished work after leaving for the day. 1 2 3 4 5 6 7 8 9 10 NA
9. I have the support & resources needed to perform my job with excellence. 1 2 3 4 5 6 7 8 9 10 NA
10. My work does not take precedence over my personal interests. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

CONTROL Disagree Agree

1. I can handle the pace & my amount of work long-term. 1 2 3 4 5 6 7 8 9 10 NA

2. My work environment & tasks feel predictable. 1 2 3 4 5 6 7 8 9 10 NA
3. I am equipped to meet the challenges of my work. 1 2 3 4 5 6 7 8 9 10 NA
4. I have clarity regarding expectations & priorities. 1 2 3 4 5 6 7 8 9 10 NA
5. Communication in my organization is effective, authentic, clear & adequate. 1 2 3 4 5 6 7 8 9 10 NA
6. I feel positive about my job. 1 2 3 4 5 6 7 8 9 10 NA
7. I have influence within my team. 1 2 3 4 5 6 7 8 9 10 NA
8. I have control over where, when & how I do my work. 1 2 3 4 5 6 7 8 9 10 NA
9. I have a proper work set up to perform my responsibilities. 1 2 3 4 5 6 7 8 9 10 NA
10. I have adequate decision-making influence over my work. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 4

 Burnout Assessment
PROFESSIONAL PROFILE

REWARD Disagree Agree

1. I feel inspired & take pride in my work. 1 2 3 4 5 6 7 8 9 10 NA

2. I make a significant contribution at work. 1 2 3 4 5 6 7 8 9 10 NA
3. I feel my effort is noticed & rewarded. 1 2 3 4 5 6 7 8 9 10 NA
4. My manager or team encourages & appreciates my efforts. 1 2 3 4 5 6 7 8 9 10 NA
5. I feel fairly compensated monetarily for my work. 1 2 3 4 5 6 7 8 9 10 NA
6. I receive adequate health benefits to support myself & my family. 1 2 3 4 5 6 7 8 9 10 NA
7. I can save for the future rather than living paycheque to paycheque. 1 2 3 4 5 6 7 8 9 10 NA
8. My workplace invests in my professional growth. 1 2 3 4 5 6 7 8 9 10 NA
9. I feel appreciated for my contribution to my team or organization. 1 2 3 4 5 6 7 8 9 10 NA
10. I have sufficient time away from work & feel in control of my time off. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

COMMUNITY Disagree Agree

1. I enjoy working with my manager & co-workers. 1 2 3 4 5 6 7 8 9 10 NA

2. The culture of my organization is positive. 1 2 3 4 5 6 7 8 9 10 NA
3. I do not get irritated easily by my work or co-workers. 1 2 3 4 5 6 7 8 9 10 NA
4. I treat people at work with care & respect. 1 2 3 4 5 6 7 8 9 10 NA
5. I feel comfortable sharing my concerns with my manager. 1 2 3 4 5 6 7 8 9 10 NA
6. I feel heard & that my voice counts with my manager & team. 1 2 3 4 5 6 7 8 9 10 NA
7. I feel psychologically safe at work. 1 2 3 4 5 6 7 8 9 10 NA
8. I trust my co-workers. 1 2 3 4 5 6 7 8 9 10 NA
9. My co-workers do not adversely affect my work. 1 2 3 4 5 6 7 8 9 10 NA
10. My team is free from conflict. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

Notes

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 Burnout Assessment
PROFESSIONAL PROFILE

FAIRNESS Disagree Agree

1. I am fairly compensated relative to others in my organization & field. 1 2 3 4 5 6 7 8 9 10 NA

2. I have adequate opportunities to move upward in my organization. 1 2 3 4 5 6 7 8 9 10 NA
3. I feel respected regardless of my gender or sexual orientation. 1 2 3 4 5 6 7 8 9 10 NA
4. I have the same opportunities as people of other genders or orientations. 1 2 3 4 5 6 7 8 9 10 NA
5. I feel respected regardless of my spiritual orientation. 1 2 3 4 5 6 7 8 9 10 NA
6. I have the same opportunities as people of other spiritual orientations. 1 2 3 4 5 6 7 8 9 10 NA
7. I feel respected regardless of my ethnic identity. 1 2 3 4 5 6 7 8 9 10 NA
8. I have the same opportunities as people of other ethnicities. 1 2 3 4 5 6 7 8 9 10 NA
9. My organization wholeheartedly embraces diversity, equity & inclusion. 1 2 3 4 5 6 7 8 9 10 NA
10. I can climb the ladder at work while keeping my integrity. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

VALUES Disagree Agree

1. My personal values align with the values of my organization. 1 2 3 4 5 6 7 8 9 10 NA

2. My organization’s mission, vision, & values are authentically lived out. 1 2 3 4 5 6 7 8 9 10 NA
3. My responsibilities align with my organization’s values. 1 2 3 4 5 6 7 8 9 10 NA
4. I am treated with respect at work. 1 2 3 4 5 6 7 8 9 10 NA
5. Team successes are acknowledged & shared by the entire team. 1 2 3 4 5 6 7 8 9 10 NA
6. I make a positive contribution to my organization. 1 2 3 4 5 6 7 8 9 10 NA
7. I make a positive contribution to society through my work. 1 2 3 4 5 6 7 8 9 10 NA
8. I feel engaged in my role at work. 1 2 3 4 5 6 7 8 9 10 NA
9. My organization’s goals fit well with my career ambitions. 1 2 3 4 5 6 7 8 9 10 NA
10. I am growing personally & professionally within my organization. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

Notes

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 6

 Burnout Assessment
PERSONAL PROFILE

PHYSICAL WELL-BEING Disagree Agree

1. I sleep well & feel rested upon waking. 1 2 3 4 5 6 7 8 9 10 NA

2. I do not experience stress-related dreams or nightmares. 1 2 3 4 5 6 7 8 9 10 NA
3. I exercise at least three times per week. 1 2 3 4 5 6 7 8 9 10 NA
4. I generally feel healthy & well. 1 2 3 4 5 6 7 8 9 10 NA
5. I am satisfied with my level of health. 1 2 3 4 5 6 7 8 9 10 NA
6. I do not get sick more often than I used to. 1 2 3 4 5 6 7 8 9 10 NA
7. I rarely take sick days due to work-related stress. 1 2 3 4 5 6 7 8 9 10 NA
8. I do not feel physically run down or drained. 1 2 3 4 5 6 7 8 9 10 NA
9. I feel good about my current energy levels. 1 2 3 4 5 6 7 8 9 10 NA
10. I have the energy required to work at peak performance & feel good outside of work. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

MENTAL WELL-BEING Disagree Agree

1. The stress I experience feels manageable long-term. 1 2 3 4 5 6 7 8 9 10 NA

2. I do not feel mentally run-down or drained. 1 2 3 4 5 6 7 8 9 10 NA
3. My mind is calm & at rest most of the time. 1 2 3 4 5 6 7 8 9 10 NA
4. I feel hopeful & optimistic about the future. 1 2 3 4 5 6 7 8 9 10 NA
5. I do not think about my work during my time off. 1 2 3 4 5 6 7 8 9 10 NA
6. I have good boundaries between work & the rest of my life. 1 2 3 4 5 6 7 8 9 10 NA
7. I turn my cell phone notifications off at night. 1 2 3 4 5 6 7 8 9 10 NA
8. My thoughts toward both my job & life are positive. 1 2 3 4 5 6 7 8 9 10 NA
9. I know & utilize effective stress management techniques. 1 2 3 4 5 6 7 8 9 10 NA
10. I do not feel anxious or depressed due to work-related stress. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

Notes

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 7

 Burnout Assessment
PERSONAL PROFILE

EMOTIONAL WELL-BEING Disagree Agree

1. I do not feel emotionally run-down or drained. 1 2 3 4 5 6 7 8 9 10 NA

2. I have fun & engage in restorative activities daily. 1 2 3 4 5 6 7 8 9 10 NA
3. I feel peaceful & calm most of the time. 1 2 3 4 5 6 7 8 9 10 NA
4. I feel positive about my work-life balance. 1 2 3 4 5 6 7 8 9 10 NA
5. I have designated screen-free time every day. 1 2 3 4 5 6 7 8 9 10 NA
6. I enjoy my job & do not feel like quitting. 1 2 3 4 5 6 7 8 9 10 NA
7. I have enough emotional reserves for family or friends. 1 2 3 4 5 6 7 8 9 10 NA
8. When I wake up in the morning, I feel excited about work. 1 2 3 4 5 6 7 8 9 10 NA
9. I engage in a creative outlet weekly. 1 2 3 4 5 6 7 8 9 10 NA
10. I have strong self-confidence. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

SPIRITUAL WELL-BEING Disagree Agree

1. I volunteer at something that feels fulfilling. 1 2 3 4 5 6 7 8 9 10 NA

2. I invest in personal growth weekly. 1 2 3 4 5 6 7 8 9 10 NA
3. I actively participate in a spiritual practice. 1 2 3 4 5 6 7 8 9 10 NA
4. I regularly enjoy inspiring texts, podcasts or music. 1 2 3 4 5 6 7 8 9 10 NA
5. I feel connected to a faith community. 1 2 3 4 5 6 7 8 9 10 NA
6. I know I have intrinsic worth outside of what I accomplish. 1 2 3 4 5 6 7 8 9 10 NA
7. I do not feel shame or guilt related to my work. 1 2 3 4 5 6 7 8 9 10 NA
8. I have time & energy to passionately engage in a cause outside of work. 1 2 3 4 5 6 7 8 9 10 NA
9. I find meaning in something greater than myself. 1 2 3 4 5 6 7 8 9 10 NA
10. I spend time in nature every week. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

Notes

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 8

 Burnout Assessment
PERSONAL PROFILE

RELATIONAL WELL-BEING Disagree Agree

1. I spend time with close friends regularly. 1 2 3 4 5 6 7 8 9 10 NA

2. I spend time with close family or people whom I identify as family. 1 2 3 4 5 6 7 8 9 10 NA
3. I have a rich & rewarding social life. 1 2 3 4 5 6 7 8 9 10 NA
4. My work hours make it easy to connect with loved ones on weekends & holidays. 1 2 3 4 5 6 7 8 9 10 NA
5. I make a positive contribution to another person’s life. 1 2 3 4 5 6 7 8 9 10 NA
6. I feel loved & appreciated. 1 2 3 4 5 6 7 8 9 10 NA
7. I feel physically & psychologically safe in my relationships outside of work. 1 2 3 4 5 6 7 8 9 10 NA
8. I rarely feel lonely or isolated. 1 2 3 4 5 6 7 8 9 10 NA
9. I have enough time for my family & friends. 1 2 3 4 5 6 7 8 9 10 NA
10. I have enough energy for my family & friends. 1 2 3 4 5 6 7 8 9 10 NA
Add up your score. Total: ______ / 100

Notes

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 Burnout Assessment
SCORING & INTERPRETATION

YOUR OVERALL SCORE

Add the category totals together. This total provides your overall score out of a possible score of 1100 (11 categories x
10 questions x a possible 10 points per question.)

900-1100 out of 1100 is ideal. You are doing well overall in terms of burnout risk.

700-890 out of 1100 means you have areas of concern that could lead to burnout. Now is the time to put prevention
measures in place.

1-600 out of 1100 means your burnout risk is high. The challenges you face may mean you are experiencing burnout
or lead to it. Now is the time to implement measures to prevent and overcome burnout.

YOUR OVERALL SCORE: _______ / 1100

CATEGORY SCORE
Beyond your overall score, it is important to note any category with a total of under 70 out of 100.

You may score 80 out of 100 in one category but only 30 out of 100 in another category.

You can begin implementing measures to prevent burnout for the low-scoring category.

CATEGORIES UNDER 70 /100:

RED FLAGS
Finally, note any individual question you scored at a 6 or under.

This signifies a red flag to pay attention to and begin implementing measures to improve this score.

RED FLAGS 6 /10 OR UNDER:

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 10

Burnout Prevention
Workshop

Bring our Burnout Prevention

Workshop to your organization.
Discover:
-The causes of workplace burnout.
-Common myths and misconceptions.
-The symptoms of burnout.
-The stages of burnout.
Learn how to identify potential burnout warning signs early in employees to
prevent burnout and foster wellness for greater productivity and longevity.
Gain practical tools and strategies to prevent employee burnout.
Receive resources for ongoing learning.
Create a healthy company culture with manager and employee training to
prevent workplace burnout.

Contact us to learn more about burnout

prevention training.
Learn more: https://www.break-through.ca/events

Contact: https://www.break-through.ca/contact

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 11

Mental Health
Workshop

Bring our Mental Health Workshop to

your organization.

Discover factors that create workplace mental health challenges.

Learn the risk factors for languishing and a lack of well-being.
Discover what triggers a fight, flight or freeze response in the modern
workplace.
Gain practical tools and strategies for fostering positive mental health.
Receive real-life interventions for overcoming stress and building resilience.
Learn the neuroscience behind how the brain reacts to harmful and helpful
messages and implement practical stress management strategies to support
mental health.
Receive resources for ongoing learning.

Contact us to learn more about mental

health training.
Learn more: https://www.break-through.ca/events

Contact: https://www.break-through.ca/contact

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 12

Stress Management
Workshop

Bring our Stress Management Workshop

to your organization.

Strategies for personal and professional stress management.

Discover the causes, symptoms, and effects of stress.
Experience powerful stress management exercises.
Learn how stress affects your mind and body through neuroscience.
Learn how to identify stress in your body in order to create constructive
thought processes and actions that will help you stop stress in its tracks.
Learn practical skills to overcome stress and live a more productive, effective,
and joyful life.

Contact us to learn more about stress

management training.
Learn more: https://www.break-through.ca/events

Contact: https://www.break-through.ca/contact

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 13

 About the Author

Bonita Eby
Burnout Prevention Strategist

Bonita Eby is a Burnout Prevention

Strategist, Executive Coach, and owner of
Breakthrough Personal & Professional
Development Inc., specializing in burnout
prevention and wellness for organizations
and individuals.

Bonita began in healthcare as a Registered Massage Therapy clinic in Kitchener,

Ontario, Canada working in her own clinic and a St. Mary’s Hospital multidisciplinary
team, rehabilitating survivors of traumatic motor vehicle accidents.

Next, Bonita transitioned to a leadership position at a non-profit organization in

Waterloo, Ontario, Canada, developing leaders, training teams, and coaching people
through complex challenges.

Having overcome burnout herself, Bonita spent years researching burnout from
healthcare and leadership perspectives. She supports organizations with burnout
prevention and wellness services through culture transformation, workshops,
consulting and Executive Coaching.

Bonita founded Breakthrough Personal & Professional Development Inc., the first
burnout prevention company at the intersection of healthcare and leadership
development. Bonita is on a mission to end burnout.

Learn more by visiting www.break-through.ca

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 14

 Let's Connect
Bonita Eby
Burnout Prevention Strategist
Breakthrough Personal & Professional Development Inc.

Serving Canada & USA

Request our Corporate Package

www.break-through.ca

bonita@break-through.ca

@Bonita Eby

@BreakthroughBurnout

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 15

Thank you for learning with Breakthrough Personal & Professional Development Inc. If you have any questions or would like to work further with Breakthrough
Personal & Professional Development Inc, please email us at www.break-through.ca/contact.

Disclaimer: The information contained herein is general in nature and for information purposes only. It is based on the author's personal experience. The author
assumes no responsibility whatsoever under any circumstances, for any actions taken as a result of the information contained herein.

The Burnout Assessment does not provide a diagnosis. The scores do not reflect any particular diagnosis or course of treatment. The Burnout Assessment is a
tool to help assess burnout potential using a series of questions.

The information contained herein is not offered as a substitute for professional mental health care or medical care and is not intended to diagnose, treat or cure
any mental health or medical conditions. Please consult with your physician or mental health care provider before making changes to your lifestyle.

Copyright © 2022. Breakthrough Personal and Professional Development Inc. All Rights Reserved.
No part of this document may be reproduced, copied, or shared without express, written consent from the author.

© COPYRIGHT 2022 BREAKTHROUGH PERSONAL & PROFESSIONAL DEVELOPMENT INC 16