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Section 10
Predictors of Burnout in Therapists

Question 10 | Test | Table of Contents

Burnout is conceptualised as “a syndrome of emotional exhaustion (EE), depersonalisation (DP), and reduced personal accomplishment (PA) that can occur among individuals who do people work of some kind” (p.3) (Maslach, 1982). EE is defined as the central quality representing the basic stress dimension of burnout (Leiter & Maslach, 2001), including feelings of being emotionally overextended and depleted of emotional resources (Maslach, Schaufeli & Leiter, 2001). The DP or cynicism component depicts the interpersonal context dimension of burnout (Schaufeli & Enzmaan, 1998), and refers to a negative, callous, excessively detached response to clients (Aarogones, 2001). The component of reduced PA represents the self-evaluation dimension of burnout (Leiter & Maslach, 2001). It connotes feelings of inefficacy, lack of achievement and productivity at work (Maslach et al., 2001). There has been a dearth of research on burnout in UK clinical psychologists, despite US psychologists reporting burnout levels of up to 40% (Fortener, 1999; Hann, 1999; Persing, 2000) and mental health workers being identified as a high risk group for burnout (Onyett, Pillinger, Muijen, 1997). This neglect is disquieting, especially as the only national study on UK clinical psychologists indicated that 29.4% were highly stressed (Cushway & Tyler, 1994). Although stress is an insufficient marker for burnout as it does not incorporate lowered PA or DP in its parameters, it is a significant predictor of EE (Kaden, 1999; Wertz, 2000). Therefore, UK clinical psychologists could be at risk of burnout and it is imperative that the nature, extent and correlates of burnout in this population are investigated.

Research Summary

Objectives
To examine the nature and extent of burnout in a national sample of UK clinical psychologists, together with the individual and organisational variables associated with the three dimensions of burnout.

Design
This study utilised a cross sectional survey design.

Method
Clinical Psychologists (336) recruited from the Register for Chartered Clinical Psychologists completed a postal survey, including a Demographic Questionnaire, the Big-Five Mini Markers Scale (Saucier, 1994), the Therapists Role Stress Inventory (Hellman, 1984), the Facet Free Job Satisfaction Questionnaire (Quinn & Staines, 1979), and the Maslach Burnout Inventory (Maslach, Jackson & Leiter, 1996).

Results
UK clinical psychologists displayed higher scores on emotional exhaustion, lower scores on depersonalisation and personal accomplishment as compared to their US counterparts. Psychologists appeared to be working an average of 35 hours per week, and reported moderate therapeutic role stress, moderate levels of job satisfaction and high scores on agreeableness and conscientiousness. Professional doubt emerged as a key stressor and correlated with all three burnout dimensions. Logistic regression analyses indicated that 70.54% of cases for EE were correctly classified by conscientiousness, perception of workload, perception of being burnt out, resource depletion and professional doubt. For DP, 80.30% of cases were correctly classified by years post qualification, conscientiousness, agreeableness, total hours worked and professional doubt. For PA, administrative work, extroversion, openness to change and professional doubt correctly classified 72.02% of cases. The association of specific individual, organisational and stress appraisal variables with EE, DP and PA also lent weight to the multidimensional conceptualisation of burnout.

Conclusions
Significant proportions of UK clinical psychologists are burnt out, and 47% of clinical psychologists in this study indicated a high likelihood of leaving their job. The high levels of burnout also suggest that a proportion of these burnt out, unsupported psychologists may be providing an unethical, poor quality of care to their clients. Thus, these findings have implications for the individuals, their clients, the profession and the NHS. It is hoped that this research will raise awareness and positively impact on the individual psychologists’ level of self-care, clinical practice and facilitate the development of intervention and preventative strategies for burnout.

Self-Care Through Self-Compassion: A Balm for Burnout

- Coaston, S. C. (2017). Self-Care Through Self-Compassion: A Balm for Burnout. The Professional Counselor, 7(3), 285-297. doi:10.15241/scc.7.3.285

Personal Reflection Exercise #3
The preceding section contained information about burnout in clinical psychologists. Write three case study examples regarding how you might use the content of this section in your practice.

Update
Predictors of Burnout among Us
Healthcare Providers: A Systematic Review

- Meredith, L. S., Bouskill, K., Chang, J., Larkin, J., Motala, A., & Hempel, S. (2022). Predictors of burnout among US healthcare providers: a systematic review. BMJ open, 12(8), e054243.

Peer-Reviewed Journal Article References:
Brown, T. J. (2021). Ethics, burnout, and reported life and job attitudes among board-certified behavior analysts. Behavior Analysis: Research and Practice.

Kim, J. J., Brookman-Frazee, L., Gellatly, R., Stadnick, N., Barnett, M. L., & Lau, A. S. (2018). Predictors of burnout among community therapists in the sustainment phase of a system-driven implementation of multiple evidence-based practices in children’s mental health. Professional Psychology: Research and Practice, 49(2), 132–141.

Warlick, C. A., Van Gorp, A., Farmer, N. M., Patterson, T., & Armstrong, A. (2021). Comparing burnout between graduate-level and professional clinicians. Training and Education in Professional Psychology, 15(2), 150–158.

QUESTION 10
What is the basic stress dimension of a burnout? To select and enter your answer go to Test.


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