Proposition d’un modèle descriptif et thérapeutique du rapport au travail : le modèle AIRE

Abstract

Mental-health professionals are increasingly solicited for work-related suffering problems. If considered alone, the difficulty of the tasks in the workplace cannot explain the phenomena of exhaustion and suffering, and the increase in the impact of these troubles requires the use of functional and descriptive models. Various ones have been suggested and are utilized: Seyle's general adaptation syndrome model; Lazarus and Folkman's stress adaptation model, which focuses on the transactions between the subject and their environment and the strategies (coping) used to adapt; Karasek's model, confronting the pressure of demands with the self-sufficiency abilities and the social support; Siegrist's model, assessing the scale between the efforts demanded to the subject and all the reinforcements drawn from work; Finally, Demerouti's model, for whom there are two essential dimensions: the demands, and the resources, source of engagement and achievement. Starting from Albert Bandura's works, we suggest describing the relationship to work through the feeling of the self-efficacy perceived (or not) by a subject in their professional activity. The feeling of efficacy is a subjective perception, linked to one particular activity (for example, a sport), different from self-esteem or self-confidence, and supposedly constitutes the main source of motivation and dedication for this activity. It interacts with the expectations from the environment perceived by the subject for the given activity. The interaction between a strong feeling of efficacy and perceptions of high expectations supposedly leads to a proper commitment and a feeling of satisfaction. Hence a fulfilling relationship to work is seemingly based on an adequate feeling of efficacy and suitable for the professional activity, interacting accordingly with actual but not excessively high expectations. To complete the description of the relationship to work, we suggest adding two parameters: the commitment of the subject in the professional activity and the reinforcements received through this activity. It really is a matter of cognitive notions, corresponding to the subject's vision and perception in each area. This description is schematized by four parameters as follows Expectations – Commitment – Reinforcements – Efficiency, represented by a quadrilateral, with these 4 parameters as vertexes. The relationship to work is represented by each one of the sides: The EC segment Expectations – Commitment refers to the subject's desire and initial willpower for his work; The CR segment Commitment – expected Reinforcements represents the persistence and motivational aspect: rewards are implicitly expected depending on the provided commitment. The segment RE perceived Reinforcements–feeling of Efficiency represents the most intimate aspect experienced by the subject in their work time and one's attachment to a professional environment. The EE segment (Expectations–feeling of Efficiency) refers to the way the subject approaches the task to do. In a balanced relationship to work, the quadrilateral is regular, rectangular or square, with an “average” surface area. On the contrary, imbalances are represented by an irregular quadrilateral, and/or a too small or big surface area. Some of the typical clinical pictures (Burn-Out, Bore-Out, impostor syndrome, etc.) will lead to easily identifiable cases: thus the Burn-Out is characterized by expectations perceived as high, an initially conserved commitment which then collapses (linked to cynicism), reinforcements perceived as insufficient and a low feeling of efficiency. During a consultation with a patient, it is particularly useful for them to establish their own representation of their relationship to work and to share it with the therapist. If suffering is experienced, the goal is to get balance back, firstly by talking about the rationality of their perception of in each of these dimensions, on a standard model of cognitive therapy, then in a more behavioral approach, by leading to the required practical modifications, when it is possible, in each dimension. The perception of one's relationship to work is indeed targeted, aiming at a short therapy, and not a global psycho-therapeutic effort on personality aspects. In this experience, this model facilitates the usual collaborative link in behavioral therapy, and the implementation of changes. In order to try out the validity of this model, it would be interesting to evaluate the reproducibility of its usage among several therapists, and to suggest a structured treatment program by assessing the results.