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Knight KE, Ellis C, Miller T, Neu J, Helfrich L. Does Where You Work and What You Do Matter? Testing the Role of Organizational Context and Job Type for Future Study of Occupation-Based Secondary Trauma Intervention Development. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1623-1648. [PMID: 38014684 PMCID: PMC10923160 DOI: 10.1177/08862605231211927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Organizational context (e.g., criminal justice, community-based, and healthcare) and job type (e.g., police, social workers, and healthcare providers) may impact the extent of occupation-based secondary trauma (OBST). Survey data collected from a multiphase community-based participatory research project were analyzed from a variety of professionals, who were likely to "encounter the consequences of traumatic events as part of their professional responsibilities" (n = 391, women = 55%, White = 92%). Results document high trauma exposure (adverse childhood experiences [ACEs] and workplace) and OBST-related outcomes (Maslach Burnout Inventory, Secondary Traumatic Stress Scale, post-traumatic stress disorder symptom checklist for DSM-5) for the entire sample with important differences across organizational context and job type. Using multivariate regression, the strongest determinants of suffering, however, were not related to a provider's specific profession but to their number of years on the job and their ACEs (e.g., adjusted R2 = 0.23, b = 2.01, p < .001). Likewise, the most protective factors were not profession specific but rather the provider's age and perceived effectiveness of OBST-related training (e.g., b = 2.26, p < .001). These findings inform intervention development and have implications for rural and other often under-resourced areas, where the same OBST-related intervention could potentially serve many different types of providers and organizations.
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Klingemann JI, Wieczorek Ł. A crisis of exhaustion in the game of escalation: a qualitative exploration of the consequences of occupational burnout among addiction therapists. POSTEPY PSYCHIATRII NEUROLOGII 2024; 33:18-25. [PMID: 38948685 PMCID: PMC11211912 DOI: 10.5114/ppn.2023.135054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/23/2023] [Indexed: 07/02/2024]
Abstract
Purpose Research shows that occupational burnout can affect health, the quality of personal relationships, and levels of job satisfaction and engagement. At the same time, the impact of individual burnout at the group and organisational levels has tended to be neglected. We aim to provide theoretical insights into the multidimensionality of burnout consequences at the individual, interpersonal and societal levels. Methods A theory-driven, computer-assisted qualitative data analysis was conducted, comprising a thematic analysis of 40 semi- structured telephone interviews with therapists working in alcohol treatment facilities in Poland. Maximum variation sampling was used to ensure the representation of participants with different characteristics. Results To theorise the implications of the collected data, the different viewpoints of addiction therapists on burnout and its consequences were interpreted through the lens of Rosa's resonance theory. Four interrelated sets of consequences were identified in the data: they related to (a) the therapists themselves, (b) their patients and the therapeutic process, and - in a broader sense - (c) the therapeutic team and (d) the treatment facility. Conclusions Occupational burnout in individual therapists has serious implications for their patients and colleagues. It can also lead to a reduction in the quality and ultimately the effectiveness of the treatment of alcohol use disorders leading to a negative social image of the treatment facility and thus creating a further barrier to treatment for people with alcohol-related problems. Furthermore, the complexity of the individual experience of occupational burnout and a cause-and-effect chain forms a loop, deepening the severity of its consequences.
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Affiliation(s)
- Justyna I. Klingemann
- Department of Health Sociology and Addiction Research, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Łukasz Wieczorek
- Department of Health Sociology and Addiction Research, Institute of Psychiatry and Neurology, Warsaw, Poland
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Klingemann J, Mokros Ł, Sienkiewicz-Jarosz H, Świtaj P. The prevalence of occupational burnout and its individual and situational predictors among addiction therapists. Alcohol Alcohol 2024; 59:agad074. [PMID: 37961919 DOI: 10.1093/alcalc/agad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
This study assesses the prevalence and individual and organizational predictors of occupational burnout among addiction therapists. A total of 452 addiction therapists from a representative sample of 184 Polish alcohol treatment facilities (outpatient and inpatient) participated in the study (facility response rate = 42%). The Oldenburg Burnout Inventory was used to measure occupational burnout, and 15 subscales of the Copenhagen Psychosocial Questionnaire II were administered to assess psychosocial work conditions. In addition, the Coronavirus Anxiety Scale, the Hospital Anxiety and Depression Scale and the abbreviated six-item De Jong Gierveld Loneliness Scale measured other important dimensions of addiction therapists' psychosocial functioning. Logistic regression was used for the analysis of the data. Occupational burnout was noticeably prevalent in the study group: 62% of respondents experienced exhaustion and 50% experienced disengagement from work, both to at least a moderate degree. Situational (organizational) variables were the most important predictors, explaining much more of the variance in both dimensions of burnout than the individual factors, of which only depression was significantly related to higher levels of exhaustion. Coronavirus anxiety played a marginal role in explaining the severity of burnout. The current study is one of the first attempts to assess the level of occupational burnout among addiction therapists and to comprehensively investigate the factors contributing to it. The findings provide useful information for the development of interventions aimed at preventing or reducing burnout in this professional group.
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Affiliation(s)
- Justyna Klingemann
- Department of Studies on Alcohol and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Łukasz Mokros
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Piotr Świtaj
- Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
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Watanabe T, Akechi T. The mediating role of psychological flexibility in the association of autistic-like traits with burnout and depression in medical students during clinical clerkships in Japan: a university-based cross-sectional study. BMC Psychiatry 2023; 23:302. [PMID: 37127557 PMCID: PMC10150344 DOI: 10.1186/s12888-023-04811-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/21/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Burnout and depression among medical students is linked to serious problems that require appropriate solutions. Subthreshold autism traits or autistic-like traits (ALTs) may be possible factors associated with burnout and depression. The effectiveness of acceptance and commitment therapy (ACT) for burnout and depression has been widely reported. The treatment aims to improve psychological flexibility, a concept indicating engagement in personal value-based behaviors without avoiding uncomfortable private experiences. This study examined whether ALTs were associated with burnout or depression among medical students during clinical clerkships in Japan, and then investigated what psychological flexibility processes might mediate these associations. METHODS A cross-sectional survey was administered to 284 medical students at Nagoya City University School of Medical Sciences who had been in clinical clerkships for 10 months or longer. Linear multiple regressions were performed with each burnout factor or depression as the outcome variable using validated tools measuring burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), ALT (Autism-Spectrum Quotient Japanese version-21), and psychological flexibility processes (Cognitive Fusion Questionnaire-7 and Valuing Questionnaire). Additionally, a mediation analysis was conducted using structural equation modeling. RESULTS A linear multiple regression analysis that controlled for age and gender found that ALTs were significantly associated with lower personal accomplishment, a factor of burnout, and depression. Lower personal accomplishment was also associated with males and lower progress toward values of the psychological flexibility process. Depression was also associated with males and higher cognitive fusion, lower progress towards values, and higher obstruction to values of the psychological flexibility process. Surprisingly, emotional exhaustion and depersonalization were not significantly associated with ALTs. The mediation analysis revealed that the relationship between ALTs and personal accomplishment was partially mediated by a process of progress toward values, while the relationship between ALTs and depression was partially mediated by both processes of progress toward values and cognitive fusion. CONCLUSIONS ALTs were significantly associated with lower personal accomplishment of burnout and depression among medical students in clinical clerkships. Consideration should be given to the psychological flexibility processes that focus on interventions targeting psychological flexibility for medical students with ALTs to reduce burnout and depression.
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Affiliation(s)
- Takafumi Watanabe
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan.
| | - Tatsuo Akechi
- Department of Psychiatry and Coginitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi, Japan
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Unachukwu IC, Abrams MP, Dolan A, Oyekemi K, Meisel ZF, South EC, Aronowitz SV. "The new normal has become a nonstop crisis": a qualitative study of burnout among Philadelphia's harm reduction and substance use disorder treatment workers during the COVID-19 pandemic. Harm Reduct J 2023; 20:32. [PMID: 36906576 PMCID: PMC10008076 DOI: 10.1186/s12954-023-00752-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 02/07/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic worsened the ongoing overdose crisis in the United States (US) and caused significant mental health strain and burnout among health care workers (HCW). Harm reduction, overdose prevention, and substance use disorder (SUD) workers may be especially impacted due to underfunding, resources shortages, and chaotic working environments. Existing research on HCW burnout primarily focuses on licensed HCWs in traditional environments and fails to account for the unique experiences of harm reduction workers, community organizers, and SUD treatment clinicians. METHODS We conducted a qualitative secondary analysis descriptive study of 30 Philadelphia-based harm reduction workers, community organizers, and SUD treatment clinicians about their experiences working in their roles during the COVID-19 pandemic in July-August 2020. Our analysis was guided by Shanafelt and Noseworthy's model of key drivers of burnout and engagement. We aimed to assess the applicability of this model to the experiences of SUD and harm reduction workers in non-traditional settings. RESULTS We deductively coded our data in alignment with Shanafelt and Noseworthy's key drivers of burnout and engagement: (1) workload and job demands, (2) meaning in work, (3) control and flexibility, (4) work-life integration, (5) organizational culture and values, (6) efficiency and resources and (7) social support and community at work. While Shanafelt and Noseworthy's model broadly encompassed the experiences of our participants, it did not fully account for their concerns about safety at work, lack of control over the work environment, and experiences of task-shifting. CONCLUSIONS Burnout among healthcare providers is receiving increasing attention nationally. Much of this coverage and the existing research have focused on workers in traditional healthcare spaces and often do not consider the experiences of community-based SUD treatment, overdose prevention, and harm reduction providers. Our findings indicate a gap in existing frameworks for burnout and a need for models that encompass the full range of the harm reduction, overdose prevention, and SUD treatment workforce. As the US overdose crisis continues, it is vital that we address and mitigate experiences of burnout among harm reduction workers, community organizers, and SUD treatment clinicians to protect their wellbeing and to ensure the sustainability of their invaluable work.
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Affiliation(s)
- Ijeoma C Unachukwu
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. .,Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA.
| | - Matthew P Abrams
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Abby Dolan
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Kehinde Oyekemi
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA
| | - Zachary F Meisel
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Eugenia C South
- Urban Health Lab, University of Pennsylvania, Philadelphia, PA, USA
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Lu J, Brickham D, Jaeger BJ, Lo C. Vocational rehabilitation counselor burnout profiles and mindfulness. JOURNAL OF COUNSELING AND DEVELOPMENT 2023. [DOI: 10.1002/jcad.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Junfei Lu
- Department of Educational Studies in Psychology Research Methodology and Counseling The University of Alabama Tuscaloosa Alabama USA
| | - Dana Brickham
- Department of Health and Community Studies Western Washington University Bellingham Washington USA
| | - Brian J. Jaeger
- Department of Health and Community Studies Western Washington University Bellingham Washington USA
| | - Chu‐Ling Lo
- Educational Psychology and Special Services The University of Texas at El Paso El Paso Texas USA
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Rivas-García A, Míguez-Navarro MC, Ferrero-García-Loygorri C, Marañón R, Vázquez-López P. Burnout syndrome in paediatricians working in paediatric emergency care settings. Prevalence and associated factors: a multilevel analysis. An Pediatr (Barc) 2023; 98:119-128. [PMID: 36737361 DOI: 10.1016/j.anpede.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/20/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The aim of our study was to describe the prevalence of burnout syndrome (BOS) in paediatricians working in paediatric emergency care settings and to analyse its association with potential risk factors. MATERIAL AND METHODS Multicentre cross-sectional study through a survey of paediatricians working in paediatric emergency care settings in hospitals affiliated to the Research Network of the Spanish Society of Paediatric Emergency Medicine (SEUP) between September 2019 and January 2020. We analysed the association between social/family-related, demographic, occupational and satisfaction factors and the presence of BOS by means of multivariate and multilevel mixed-effects logistic regression models. RESULTS The estimated prevalence of BOS was 36.5% (95% confidence interval [CI], 31.7 %-41.2%). In the multivariate analysis, lacking a stable group of friends (OR, 2.57; 95% CI, 1.10-5.97), problems in and out of the work setting (OR, 3.06; 95% CI, 1.60-5.88) and a work experience of 9 years or less (OR, 2.31; 95% CI, 1.37-3.90) were identified as individual factors that increased the risk of SBO, while feeling acknowledged by coworkers (OR, 0.48; 95% CI, 0.30-0.79) and acknowledged by one's supervisor (OR, 0.62; 95% CI, 0.41-0.93) were protective factors. In relation to the hospital, the paediatric emergency unit being a subdepartment of the Department of Paediatrics (OR, 3.81; 95% CI, 1.85-7.85), the presence of an on-call emergency medicine specialist around the clock (OR, 3.53; 95% CI,1.62-7.73) and a volume of 28 or more paediatric emergency encounters a day to be managed per on-call physician (OR, 2.05; 95% CI, 1.01-4.16) were identified as independent risk factors for SBO. There was no variability in the prevalence of BOS attributable to differences between hospitals and autonomous communities, save for the described situations. CONCLUSIONS The prevalence of SBO among these providers is high. There are modifiable factors that we can intervene on to address BOS, independently of the hospital or region.
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Affiliation(s)
- Arístides Rivas-García
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | | | - Clara Ferrero-García-Loygorri
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Rafael Marañón
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Paula Vázquez-López
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Rivas-García A, Míguez-Navarro MC, Ferrero-García-Loygorri C, Marañón R, Vázquez-López P. Síndrome de burnout en pediatras con actividad asistencial en urgencias. Prevalencia y factores asociados. Análisis multinivel. An Pediatr (Barc) 2023. [DOI: 10.1016/j.anpedi.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Mavragani A, Knott B, Hodyl N, Horton G, Walker FR, Nilsson M. Medical Student Experiences of Engaging in a Psychological Flexibility Skill Training App for Burnout and Well-being: Pilot Feasibility Study. JMIR Form Res 2023; 7:e43263. [PMID: 36626191 PMCID: PMC9874998 DOI: 10.2196/43263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Medical students are at higher risk of burnout than the general population. Interventions that facilitate adaptive coping behaviors (eg, Psychological Flexibility) in the context of inherent stressors associated with medical training could mitigate burnout risk and improve well-being. Delivering these interventions using smartphone apps offers advantages such as accessibility, scalability, mitigation of time and stigma barriers, and facilitation of individual tailoring (individualization). There is a need for feasibility trials with medical students in this emerging field. Formal evaluations of user experiences of app-based psychological skill training are required to identify barriers to and facilitators of engagement and optimize intervention development before implementation in efficacy trials and real-world settings. OBJECTIVE This study aimed to assess the feasibility of delivering an individualized Psychological Flexibility skill training intervention (Acceptance and Commitment Training [ACTraining]) to medical students using an app-based delivery format. We further aimed to explore how formal evaluation of user experiences might inform and guide the development of this app before implementation in an efficacy trial and future research involving app-delivered psychological skill training for medical students. METHODS This single-arm study was an early-phase feasibility trial of a stand-alone ACTraining app conducted with a sample of Australian medical students (n=11). We collected app usability and user experience data across a broad range of domains (eg, perceived helpfulness and relevance, learning experiences, and self-efficacy) using self-report questionnaires (quantitative and qualitative) and behavioral engagement outcomes. RESULTS Behavioral engagement data demonstrated that the app delivered the assessment procedures and individualized ACTraining intervention to medical students as intended. The subjective feedback provided by students who actively engaged with the app was generally positive across several indicators, including usability, perceived relevance and helpfulness, accessibility, maintenance of privacy, and opportunity for self-reflection. Disengagement from the app was an identified challenge throughout the trial. Participant feedback identified several factors that may have affected engagement, such as time, expectations regarding app interface functioning, and individual differences in confidence and self-efficacy when implementing skills. CONCLUSIONS This study reports user experience data that have been largely absent from the literature on digital psychological interventions for medical students. Our findings demonstrate the preliminary feasibility of an app-delivered ACTraining intervention for medical student well-being and burnout and support the value of future assessment of the efficacy of this approach with larger samples. We consider subjective feedback from medical students in relation to observed engagement and propose how this information might be used to inform the development of this app and future research in this nascent field.
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Affiliation(s)
| | | | - Nicolette Hodyl
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,New South Wales Regional Health Partners, Newcastle, Australia
| | - Graeme Horton
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Frederick Rohan Walker
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Michael Nilsson
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singaport, Singapore
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Fentem A, Riordan R, Doroshenko C, Li X, Kasson E, Banks D, Winograd RP, Cavazos-Rehg P. Impact of the COVID-19 pandemic on burnout and perceived workplace quality among addiction treatment providers. Addict Sci Clin Pract 2023; 18:5. [PMID: 36670445 PMCID: PMC9854021 DOI: 10.1186/s13722-023-00361-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND This study examines the impact of the COVID-19 pandemic on work satisfaction, work-related stress, and perceived work quality among substance use treatment providers to better understand challenges faced among this group during the pandemic. METHODS Participants of this study were 91 addiction treatment providers (e.g., therapists, physicians, community support specialists, administrative staff) recruited from various treatment facilities (e.g., inpatient and outpatient settings). Mixed method analyses were conducted to assess self-reported burnout, sources of work-related stress, and perceived work quality during the pandemic. Responses from providers reporting COVID-19 related decreases in work quality were compared to responses from providers who reported their quality of work had increased or remained the same. RESULTS Results demonstrated half of providers (51%) reported their quality of work had decreased. This perceived decrease in quality of work was associated with higher levels of emotional exhaustion (M = 17.41 vs. M = 12.48, p = 0.002), workplace stress (M = 42.80 vs. M = 30.84, p = 0.001), as well as decreased enjoyment of work (83% vs. 51%, p = 0.001) and decreased personal accomplishment (M = 20.64 vs. M = 23.05 p = 0.001). Qualitative investigations further illustrated that increased hours, changes in work schedules, work-life balance challenges, difficulties with client communication, and increased client needs were contributing factors increasing stress/burnout and decreasing perceived work quality. CONCLUSIONS Addiction treatment providers experience high levels of burnout and workplace stress. Additionally, many individuals perceived a decrease in their quality of work during the COVID-19 pandemic. Addiction treatment facility administration should address these challenges to support the well-being of clinical staff and the clients they serve both during and after the COVID-19 pandemic.
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Affiliation(s)
- Andrea Fentem
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
| | - Raven Riordan
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
| | - Christine Doroshenko
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
| | - Xiao Li
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
| | - Erin Kasson
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
| | - Devin Banks
- grid.266757.70000000114809378Department of Psychological Sciences, University of Missouri – St. Louis, One University Blvd. 325 Stadler Hall, St. Louis, MO 63121 USA
| | - Rachel P. Winograd
- grid.266757.70000000114809378Missouri Institute of Mental Health, University of Missouri St. Louis, 43 Benton Court, St. Louis, MO 63121 USA
| | - Patricia Cavazos-Rehg
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110 USA
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Bredenberg E, Tietbohl C, Dafoe A, Thurman L, Calcaterra S. Identifying factors that contribute to burnout and resilience among hospital-based addiction medicine providers: A qualitative study. J Subst Abuse Treat 2023; 144:108924. [PMID: 36327617 DOI: 10.1016/j.jsat.2022.108924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/11/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Inpatient Addiction Consultation Services (ACS) fill an important need by connecting hospitalized patients with substance use disorders with resources for treatment; however, providers of these services may be at risk for burnout. In this qualitative study, we aimed to identify factors associated with burnout and, conversely, resilience among multidisciplinary providers working on ACS. METHODS We completed 26 semi-structured interviews with clinicians working on ACS, including physicians, social workers, and advanced practice providers. Twelve institutions across the country were represented. The study recruited participants via email solicitation to ACS directors and then via snowball sampling. We used an inductive, grounded theory approach to analyze data. RESULTS Providers described factors contributing to burnout and strategies for promoting resilience, and three main themes arose: (1) Systemic barriers contributed to provider burnout, (2) Engaging in meaningful work increased resilience, and (3) Team dynamics influenced perceptions of burnout and resilience. CONCLUSION Our results suggest that hospital-based addiction medicine work is intrinsically rewarding for many providers and that engaging with other addiction providers to debrief challenging encounters or engage in advocacy work can be protective against burnout. However, administrative and systemic factors are frequent sources of frustration for providers of ACS. Structured debriefings may help to mitigate burnout. Furthermore, training to enhance providers' ability to engage effectively in advocacy work within and between hospital systems has the potential to promote resilience and protect against burnout among ACS providers.
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Affiliation(s)
- Erin Bredenberg
- Division of Hospital Medicine, University of Colorado, Aurora, CO, USA.
| | - Caroline Tietbohl
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, CO, USA; Department of Family Medicine, University of Colorado, Aurora, CO, USA
| | - Ashley Dafoe
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, CO, USA
| | - Lindsay Thurman
- Division of Hospital Medicine, University of Colorado, Aurora, CO, USA
| | - Susan Calcaterra
- Division of Hospital Medicine, University of Colorado, Aurora, CO, USA; Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, CO, USA; Division of General Internal Medicine, University of Colorado, Aurora, CO, USA
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Murphy J, Kruis N. Emotional Exhaustion and Turnover Intentions among Counselors in Rural Substance Use Disorder Treatment Programs. Subst Use Misuse 2023; 58:180-187. [PMID: 36469610 DOI: 10.1080/10826084.2022.2151314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Counselor turnover is a serious problem for substance use disorder (SUD) treatment programs, especially in rural areas. This study examined the relationship between workload, workplace environment, and emotional exhaustion on turnover intentions among SUD treatment counselors in rural Pennsylvania. An online, anonymous survey was administered to rural SUD treatment counselors in Pennsylvania between October and December 2020. Completed surveys from 206 counselors were used for analysis. Variables included multi-dimensional measures of emotional exhaustion, intention to quit, workload, and workplace environment. Results showed age, perceptions of distributive justice, and management communication to be inversely related to emotional exhaustion and intention to quit. A subsequent analysis showed that the direct effects of these variables on intention to quit were reduced with the inclusion of emotional exhaustion in modeling, suggesting a potential mediation effect. Findings indicated that higher levels of emotional exhaustion were directly related to a greater intention to quit. A statistically significant indirect relationship was also found for distributive justice on intention to quit through emotional exhaustion, indicating a significant mediating effect. While counseling is a stressful occupation with high potential for burnout, these results show that organizations can adopt practices that help lower emotional exhaustion and turnover intentions for their counselors which could improve retention in the SUD treatment field. This is especially important for rural areas, where there is a high demand for SUD services and not enough treatment workers to meet that demand.
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Affiliation(s)
- Jennifer Murphy
- Criminal Justice, Penn State Berks, Reading, Pennsylvania, USA
| | - Nathan Kruis
- Criminal Justice, Penn State Altoona, Altoona, Pennsylvania, USA
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Zhang CQ, Li X, Si G, Chung PK, Huang Z, Gucciardi DF. Examining the roles of experiential avoidance and cognitive fusion on the effects from mindfulness to athlete burnout: A longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102341. [PMID: 37665822 DOI: 10.1016/j.psychsport.2022.102341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/05/2022] [Accepted: 11/17/2022] [Indexed: 09/06/2023]
Abstract
OBJECTIVES Athlete burnout is a maladaptive outcome that is potentially detrimental for performance and wellbeing. Cross-sectional evidence suggests that mindfulness might be associated with athlete burnout via experiential avoidance and cognitive fusion. In the current study, we extend knowledge of these hypothesized mediational pathways using a longitudinal design. METHODS Data was collected at three occasions with a three-month interval. A final sample of 280 elite Chinese athletes aged 15-32 years (Mage = 19.13; SD = 2.92; Female = 130) reported their mindfulness at Time 1, experiential avoidance and cognitive fusion at Time 2, and athlete burnout at Time 3. Structural equation modelling was adopted to examine the mediating roles of experiential avoidance and cognitive fusion on the effects from mindfulness to athlete burnout. RESULTS We found statistically meaningful directs effects from mindfulness (Time 1) to experiential avoidance and cognitive fusion (Time 2), which in turn influenced athlete burnout (Time 3). However, the direct effect from mindfulness at Time 1 to athlete burnout at Time 3 was non-significant. The indirect effects of experiential avoidance and cognitive fusion on the effects from mindfulness to athlete burnout were significant, providing longitudinal evidence that these two variables contribute meaningfully to the mindfulness-burnout pathway. CONCLUSION With initial evidence for the mediating effects of experiential avoidance and cognitive fusion, future studies could consider using experimental designs to examine the potential changing mechanisms of mindfulness on reducing athlete burnout.
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Affiliation(s)
- Chun-Qing Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China.
| | - Xin Li
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, China
| | - Gangyan Si
- Sport Psychology Center, Hong Kong Sports Institute, Hong Kong, China
| | - Pak-Kwong Chung
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Zhijian Huang
- School of Physical Education, Hubei University, Wuhan, China
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14
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Giovannetti AM, Messmer Uccelli M, Solari A, Pakenham KI. Evaluation of a program for training psychologists in an acceptance and commitment therapy resilience intervention for people with multiple sclerosis: a single-arm longitudinal design with a nested qualitative study. Disabil Rehabil 2022; 44:6926-6938. [PMID: 35100924 DOI: 10.1080/09638288.2022.2025926] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE This single-arm longitudinal study evaluated the effectiveness of a program for training psychologists in delivering an acceptance and commitment therapy-based program (REsilience and Activities for every DaY; READY) for people with multiple sclerosis (PwMS). MATERIALS AND METHODS The training encompassed three phases: (1) training workshop; (2) READY participation; (3) READY delivery to PwMS. Self-report data were collected immediately before the workshop, before and after participation in READY, and at 3- and 15-month follow-ups. RESULTS Forty psychologists successfully completed the training. The training was effective in fostering the acquisition of knowledge and skills for effective delivery of READY to PwMS. Participants improved over the course of training in resilience, positive affect, wellbeing, psychological flexibility, and associated processes. These improvements peaked during the participation in READY phase and continued to accrue at a slower rate three months later. Psychological flexibility mediated the improvements in resilience, positive affect, and wellbeing. Qualitative data confirmed the personal, professional, and multiple sclerosis (MS) psychologist community level positive training impacts. CONCLUSIONS The training fostered positive professional and personal development in trainees and consolidated the integration of READY into a frontline service for PwMS. To date, more than 50 READY groups for PwMS have been conducted in Italy.Implications for rehabilitationTraining psychologists in delivering an acceptance and commitment therapy (ACT)-based resilience intervention for people with multiple sclerosis (MS) is associated with positive personal and professional impacts for the trainees.The training program strengthened the sense of community among members of the professional network who attended as trainees.In ACT training, psychological flexibility plays a key role in improving resilience, positive affect, and wellbeing in trainees, and is therefore an important intervention target.ACT training for practitioners fosters the integration of ACT-based interventions into frontline services.
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Affiliation(s)
- Ambra Mara Giovannetti
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia.,Unit of Neuroimmunology and Neuromuscular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | | | - Alessandra Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Kenneth I Pakenham
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia
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15
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Exploring Mindful Self-Care as a Potential Mediator between Compassion Satisfaction and Compassion Fatigue among Student Services Professionals. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2040044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Higher education professionals are subject to high levels of stress as they support student populations at risk of trauma. Compassion fatigue, which represents dimensions of secondary traumatic stress and burnout, is associated with a poorer health-related quality of life (HRQOL) among those providing student services. Prior studies on helping professionals have found that mindful self-care mediates the relationship between compassion satisfaction, the positive aspects of helping others in one’s role, and compassion fatigue, but this has not been sufficiently explored in this population. A total of 559 respondents (faculty, students, and staff) who provide non-instructional support across 23 student service areas at 22 comprehensive regional universities completed a cross-sectional survey assessing mindful self-care, professional quality of life and HRQOL. Path analyses were conducted using EQS 6.4 software to test one model controlled for age, progressing from compassion satisfaction to mindful self-care, to compassion fatigue, to HRQOL. Mindful self-care, particularly supportive structure, mediated the relationship between compassion satisfaction and compassion fatigue. Compassion satisfaction was positively associated with HRQOL through mindful self-care and compassion fatigue. Institutions seeking to address compassion fatigue and promote well-being should implement policies to facilitate self-care by ensuring manageable workloads and balancing internal and external demands.
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16
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Muñoz-Martínez AM, Otto-Scheiber CS, Zuluaga-Jassir S, Medina-Díaz A, Pulido-Rozo J, Venegas-Ramírez M, Igua-Jojoa A. Scalability of an ACT-Based strategy for improving well-being in health care providers: A mix-method and preliminary evaluation of efficacy. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 25:136-144. [PMID: 35966007 PMCID: PMC9359768 DOI: 10.1016/j.jcbs.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 02/01/2023]
Abstract
The burden of the COVID-19 pandemic has been mainly carried by health care providers. Technology-Mediated Interventions (TMI) seem to be a feasible alternative to increase access to behavioral health resources in this population. However, scaling-up treatments into TMI requires developing user-friendly, accepted, and accessible formats. A two-stage study was conducted to assess scalability of an Acceptance and Commitment Therapy (ACT) based strategy (named FACE COVID) delivered using technology. First, a mix-method design connected qualitative and quantitative data from health providers and ACT experts by which changes were performed to enhance scalability. Second, a pretest-posttest study was conducted to preliminary evaluate the efficacy of FACE COVID intervention on well-being, psychological distress, and psychological flexibility. Results showed a positive impact on well-being, but not distress and psychological flexibility. While this intervention has promising results, changes in dose intensity, social support, and mental health literacy could improve retention as well as increase opportunities to target distress and psychological flexibility in future studies.
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17
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Mojallal M, Simons RM, Quevillon RP, Hatwan ML. Associations of experiential avoidance with burnout, wellbeing, and productivity loss among police officers: The mediating role of negative and positive affect. J Clin Psychol 2022; 78:2260-2280. [PMID: 35521677 DOI: 10.1002/jclp.23371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 03/31/2022] [Accepted: 04/23/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The current study aims to investigate the indirect associations between experiential avoidance (EA) and burnout, wellbeing, and productivity loss (PL) via the mediating role of positive and negative emotions among police officers. METHODS Data were collected on 187 officers (84% male) aged 21-64 years between 2019 and 2020. Participants completed online self-report measures. RESULTS EA was indirectly associated with burnout via positive and negative affect. EA was indirectly associated with wellbeing through positive affect, positive affect and burnout, and negative affect and burnout. Finally, EA was indirectly associated with PL via positive affect and burnout, and negative affect and burnout. CONCLUSION Results provide support for the role of EA in officers' wellbeing and job performance via increasing negative affect and decreasing positive affect. This highlights the importance of interventions, such as acceptance and commitment therapy that target acceptance and psychological flexibility.
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Affiliation(s)
- Mahsa Mojallal
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Raluca M Simons
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Randal P Quevillon
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Mason L Hatwan
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
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18
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Knight KE, Ellis C, Salois EM. Developing a Response to Secondary Trauma for American Indian and Rural Service Providers. INTERNATIONAL JOURNAL OF RURAL CRIMINOLOGY 2022; 6:252-272. [PMID: 36381496 PMCID: PMC9662949 DOI: 10.18061/ijrc.v6i2.8652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
How can victim service providers, the organizations they work for, and the communities they serve help respond to the issue of occupation-based secondary trauma? Over the last few years, federal agencies in the United States have spent millions in research and programming to answer this important scientific and policy question. The current study builds on this work by describing and evaluating a community-based participatory research project focused on finding manageable, effective, sustainable, and ethical ways to respond to occupation-based secondary trauma in two separate communities: a rural American Indian community, Blackfeet Tribal Nation, and a predominantly white county in Montana, Gallatin County, United States. Findings from evaluation questionnaires (n=178; 80.10% women; 64.60% American Indian; 29.14% White) representing a wide range of occupations document that: (1) the implementation of the project was successful; (2) toolkits created for the project were useful to both individual participants and organizations; (3) training outcomes improved significantly; and (4) findings were consistent across the two different community contexts. Contributions, lessons learned, and future directions are discussed.
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19
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Habeger AD, Connell TDJ, Harris RL, Jackson C. Promoting Burnout Prevention Through a Socio-Ecological Lens. Dela J Public Health 2022; 8:70-75. [PMID: 35692986 PMCID: PMC9162404 DOI: 10.32481/djph.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There has been increased attention on the role of indirect trauma and the need for burnout prevention for behavioral health workers. Though frontline workers traditionally serve high needs and vulnerable populations, pandemic challenges have involved service delivery pivots to meet social distancing and safety guidelines, and have resulted in staff shortages and increased caseloads, increased use of maladaptive coping skills such as substance use, and increased mental health concerns within the workforce. Secondary traumatic stress and vicarious trauma within the workforce have often been linked with increased feelings of burnout. A socio-ecological model can provide a multilevel framework for addressing burnout and increasing resiliency among frontline workers. This article discusses recommendations for preventing burnout on an individual, interpersonal, organizational, community, and societal level. Prevention interventions include increasing training, mentorship, peer support, supervision, organizational culture, and interdisciplinary licensure efforts.
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Affiliation(s)
- Amy D Habeger
- Associate Professor, Social Work, Delaware State University
| | - Tana D J Connell
- Associate Professor, Social Work, Delaware State University
- Assistant Professor, Social Work, Delaware State University
- Opioid Outreach Specialist, NCALL Research, Inc
- FSCC Projects Director, Delaware Department Health and Social Services
| | - Rona L Harris
- Associate Professor, Social Work, Delaware State University
- Assistant Professor, Social Work, Delaware State University
- Opioid Outreach Specialist, NCALL Research, Inc
- FSCC Projects Director, Delaware Department Health and Social Services
| | - Chanda Jackson
- Associate Professor, Social Work, Delaware State University
- Assistant Professor, Social Work, Delaware State University
- Opioid Outreach Specialist, NCALL Research, Inc
- FSCC Projects Director, Delaware Department Health and Social Services
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20
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Murphy J. Improving the Recruitment and Retention of Counselors in Rural Substance Use Disorder Treatment Programs. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221080204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While access to drug treatment has increased in recent years, there is still a shortage of substance use disorder (SUD) treatment counselors in the United States, especially in rural areas. This study examined recruitment and retention issues for counselors in rural substance use disorder treatment programs. Qualitative interviews were conducted with 26 program, clinical, and/or human resource directors of SUD treatment programs. Almost all interviewees had problems recruiting high-quality counselors although only a small number saw retention as a significant issue. Improving educational opportunities and training related to addictions counseling could result in more people entering the SUD treatment field. Strategies for improving retention of counselors include more supportive and inclusive management practices. The stigma of SUD also contributed to recruitment and retention problems.
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21
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Ditton E, Knott B, Hodyl N, Horton G, Walker FR, Nilsson M. Assessing the Efficacy of an Individualized Psychological Flexibility Skills Training Intervention App for Medical Student Burnout and Well-being: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e32992. [PMID: 35119378 PMCID: PMC8857701 DOI: 10.2196/32992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical student burnout is a prevalent problem with adverse long-term outcomes. Incorporating psychological resource-building interventions into comprehensive burnout prevention approaches during medical training is an identified priority among educators. These interventions could reduce burnout risk by buffering students against nonmodifiable career stressors. However, there is a need for rigorous investigation into optimal intervention targets and methods. Psychological flexibility (PF) is an adaptive behavioral skill set that has demonstrated relationships with medical student burnout and well-being. More broadly, there is evidence that PF mediates burnout and well-being outcomes and may be a protective factor. Efficacy studies assessing the benefits of interventions targeting PF among medical students are needed. Research also supports the need to establish optimal methods for increasing intervention efficacy in the context of individual differences in burnout and PF by using individualized approaches. OBJECTIVE This study aims to assess whether an app-delivered PF intervention (Acceptance and Commitment Training) reduces burnout and improves well-being among medical students. We will examine whether changes in burnout and well-being are mediated by changes in PF. The potential benefits of an individualized version of the app versus those of a nonindividualized version will also be evaluated. METHODS In this 3-arm, parallel, randomized controlled study, a sample of medical students will be randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waiting list) by using a 1:1:1 allocation ratio. Participants in the individualized and nonindividualized intervention arms will have 5 weeks to access the app, which includes a PF concepts training session (stage 1) and access to short PF skill activities on demand (stage 2). Stage 2 will be either individualized to meet participants' identified PF training needs at each log-in or nonindividualized. RESULTS Burnout, well-being, and PF will be assessed at baseline and after the intervention. Quantitative analyses will include descriptive and inferential statistics. We hypothesize that the Acceptance and Commitment Training intervention app will be effective in improving burnout and well-being and that changes in these outcomes will be mediated by changes in PF. We further hypothesize that participants in the individualized intervention group will demonstrate greater improvements in burnout and well-being outcomes than those in the nonindividualized group. CONCLUSIONS The findings of this study could guide the development of burnout prevention and well-being initiatives for medical students. Identifying PF as a mediating process would provide support for the delivery of preventive intervention programs that train individuals to strengthen this psychological resource before burnout symptoms emerge. This would be an important step in addressing and potentially offsetting the significant costs of burnout among medical students and physicians. Demonstrating the superiority of an individualized version of the app over a nonindividualized version would have implications for enhancing intervention precision and efficacy by using scalable interventions. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ANZCTR 12621000911897; https://www.anzctr.org.au/ACTRN12621000911897.aspx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/32992.
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Affiliation(s)
- Elizabeth Ditton
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | | | - Nicolette Hodyl
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Graeme Horton
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Frederick Rohan Walker
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Michael Nilsson
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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22
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Towey-Swift KD, Lauvrud C, Whittington R. Acceptance and commitment therapy (ACT) for professional staff burnout: a systematic review and narrative synthesis of controlled trials. J Ment Health 2022; 32:452-464. [PMID: 35105253 DOI: 10.1080/09638237.2021.2022628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Staff working in people-oriented professions are vulnerable to burnout which is negatively associated with professional well-being and service-user care. AIM To investigate if interventions based on Acceptance and Commitment Therapy (ACT) are effective in reducing staff burnout. METHOD Systematic database and reference list searches were conducted resulting in the inclusion of 14 quantitative papers. A narrative synthesis, including extraction of individual effect sizes, was performed. RESULTS All studies were controlled trials. The settings for ACT delivery were varied across health, social care, and public services. The ACT interventions demonstrated statistically significant effects in favour of ACT on the outcome measure subscales across the majority of studies (n = 9). Thirteen studies demonstrated an effect in favour of ACT in at least one outcome measure subscale. Positive aspects of work engagement varied according to a professional role. CONCLUSIONS The findings suggest that ACT-based interventions using a wide range of formats may have the potential to decrease burnout across a range of professional groups. However, samples were small in the studies reviewed and the interventions were not always defined. Further research would benefit from larger studies, incorporating process measures, with explicit protocols.
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Affiliation(s)
- Kim D Towey-Swift
- Department of Clinical Psychology, The University of Liverpool, Liverpool, UK
| | - Christian Lauvrud
- Brøset Center for Research and Education in Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway
| | - Richard Whittington
- Brøset Center for Research and Education in Forensic Psychiatry, St. Olav's University Hospital, Trondheim, Norway.,Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Health Services Research, University of Liverpool, Liverpool, UK
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23
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Dhanani LY, Franz B, Hall TK. Revisiting the relationship between contact and physician attitudes toward patients with opioid use disorder. Addict Behav Rep 2021; 14:100372. [PMID: 34938833 PMCID: PMC8664778 DOI: 10.1016/j.abrep.2021.100372] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/26/2021] [Accepted: 08/31/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Prior research suggests that some physicians hold negative attitudes toward patients who misuse opioids and that this serves as a barrier which limits the availability and effectiveness of health care services. Interventions which improve physicians' attitudes have thus garnered attention, many of which have focused on increasing contact between physicians and patients who misuse opioids. However, drawing on recent literature on intergroup contact, the current paper argues that contact may not have uniformly positive effects on prejudice. METHODS We surveyed 408 board-certified physicians in the state of Ohio where many opioid overdose deaths have been concentrated. We used regression to test for interactions between contact and three focal variables, bias, burnout, and stress, on physician willingness to work with patients who misuse opioids. RESULTS The negative relationships between bias, physician burnout, and stress induced by working with patients who misuse opioids and physicians' willingness to work with this patient population are each exacerbated when contact with patients who misuse opioids is high. CONCLUSIONS Although intervention studies have shown promise for the role that increased contact may have in reducing stigma toward patients who misuse opioids, these interventions may not be appropriate for physicians who are experiencing strain or who hold preexisting negative attitudes toward this patient population. Future interventions may need to target bias, burnout, and stress, in addition to facilitating contact, to increase physician willingness to work with these patients.
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Affiliation(s)
- Lindsay Y. Dhanani
- Department of Psychology, Ohio University, 22 Richland Avenue, Athens, OH 45701, United States
| | - Berkeley Franz
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Grosvenor 311, Athens, OH 45701, United States
| | - Taylor K. Hall
- Department of Psychology, Ohio University, 22 Richland Avenue, Athens, OH 45701, United States
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Listopad IW, Michaelsen MM, Werdecker L, Esch T. Bio-Psycho-Socio-Spirito-Cultural Factors of Burnout: A Systematic Narrative Review of the Literature. Front Psychol 2021; 12:722862. [PMID: 34925130 PMCID: PMC8672245 DOI: 10.3389/fpsyg.2021.722862] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/01/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Burnout is a widespread, multifactorial, and mainly psychological phenomenon. The pathogenesis of burnout is commonly described within the bio-psycho-social model of health and disease. Recent literature suggests that the phenomenon of burnout may be broader so that the three dimensions might not reflect the multifaceted and complex nature of the syndrome. Consequently, this review aims to identify the diversity of factors related to burnout, to define overarching categories based on these, and to clarify whether the bio-psycho-social model adequately describes the pathogenesis of burnout-holistically and sufficiently. Method: Five online databases (PubMed, PubPsych, PsychARTICLES, Psychology and Behavioral Sciences Collection, and Google Scholar) were systematically searched using defined search terms to identify relevant studies. The publication date was set between January 1981 and November 2020. Based on the selected literature, we identified factors related to burnout. We aggregated these factors into a comprehensible list and assigned them to overarching categories. Then, we assigned the factors to the dimensions of an extended model of health and disease. Results: We identified a total of 40 burnout-related factors and 10 overarching categories. Our results show that in addition to biological, psychological, and socio-environmental factors, various factors that can be assigned to a spiritual and work cultural dimension also play an important role in the onset of burnout. Conclusion: An extended bio-psycho-socio-spirito-cultural model is necessary to describe the pathogenesis of burnout. Therefore, future studies should also focus on spiritual and work cultural factors when investigating burnout. Furthermore, these factors should not be neglected in future developments of diagnosis, treatment, and prevention options.
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Affiliation(s)
- Ian W. Listopad
- Institute for Integrative Health Care and Health Promotion, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
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25
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Hage TW, Isaksson Rø K, Rø Ø. Burnout among staff on specialized eating disorder units in Norway. J Eat Disord 2021; 9:138. [PMID: 34706769 PMCID: PMC8555148 DOI: 10.1186/s40337-021-00473-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/12/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Burnout is commonly associated with low workplace wellbeing. Patients with eating disorders are frequently referred to as a particularly challenging group to treat. It is therefore important to study healthcare providers´ workplace wellbeing in settings which treat eating disorders. The aims of the current study were to (a) measure burnout among healthcare providers working on specialized eating disorder units in Norway, and (b) explore factors predicting burnout. METHODS 186 participants from 11 specialized eating disorder units in Norway completed an online survey including the Mashlach Burnout Inventory, and eating disorder-specific factors related to burnout, job satisfaction, work environment, emotional dissonance and stress. Multiple regression analysis was used to identify predictors of burnout. RESULTS Overall, low levels of burnout were found among the participants. Eating disorder-specific factors and emotional dissonance predicted the three central aspects of burnout, namely, emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment. CONCLUSIONS Findings suggest a relatively low level of burnout across age, gender, and professional categories working at specialized eating disorder units, contrary to commonly-held assumptions pertaining to the challenges involved in treating individuals with eating disorders.
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Affiliation(s)
- Trine Wiig Hage
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway.
| | - Karin Isaksson Rø
- LEFO - Institute for Studies of the Medical Profession, Oslo, Norway.,Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Rø
- Division of Mental Health and Addiction, Regional Department for Eating Disorders, Oslo University Hospital, Nydalen, P.O. Box 4956, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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26
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R-E-S-P-E-C-T: Psychosocial Factors Outdo Employment Conditions in Predicting Job Satisfaction and Turnover Intentions for AOD Nurses and Counsellors. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00676-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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27
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Mandarano P, Squatrito V, Mariotti A, Presti G. Second Line Volunteering in Lombardy Covid-19 Emergency as a Perspective on Medical Education and Psychological Distress. CLINICAL NEUROPSYCHIATRY 2021; 18:278-287. [PMID: 34984071 PMCID: PMC8696288 DOI: 10.36131/cnfioritieditore20210506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Healthcare personnel across Italy were called to arms during COVID-19 emergency beginning March 2020. Despite their medical training, not all of them were able to fight in first line. Volunteering for COVID-19 Lombardy ICU Network Coordination Centre (C19-LINCC) was an opportunity to volunteer without being under biological threat: a smart-working in direct phone contact with the ICUs. Our aim was to investigate if second line volunteering during the COVID-19 outbreak had an impact on stress levels and whether medical training could mitigate them, along with personality factors, namely psychological flexibility. METHOD Volunteers of the C19-LINCC self-rated their own medical education related to SARS-CoV-2 and psychological response to the emergency. The questionnaire included five psychological scales (PSS, IES, MBI, AAQ-II, GHQ-12) addressing burnout, stress, general health, attention, cognitive fusion, and psychological flexibility. RESULTS Psychological distress (GHQ p≤0,0001) and perception of personal achievement (MBI_p≤0,0001) change whether the subject is a volunteer or not, while perception of medical education does not have a significant impact between the two groups. No differences were found in acceptance, mindfulness, and psychological flexibility skills, however they inversely correlated with stress, burnout, and anxiety levels. CONCLUSIONS During this period of mandatory lockdown, trained and in-training doctors showed to benefit from this smart home-based volunteering in the C19-LINCC. In addition to volunteering, psychological flexibility, mindfulness, and acceptance skills can act as protective factors. Potentially, these are soft skills that could be added to medical education.
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Affiliation(s)
- Piergiorgio Mandarano
- Mandarano P. is an undergraduate student of Medicine and Surgery, Department of Medicine and Surgery, University of Parma, Italy, and a student member of the Academy of Medical Educators, GB
| | - Valeria Squatrito
- Squatrito V. is a Postdoc at the Department of Human and Social Science, University of Enna “Kore”, Italy
| | - Abigail Mariotti
- Mariotti A. is an intern at the Department of Human and Social Science, University of Enna “Kore”, Italy
| | - Giovambattista Presti
- Presti G. is Associate Professor of Psychology and Director of the Kore University Behavioral Lab (KUBE Lab), Department of Human and Social Science, University of Enna “Kore”, Italy, and former President of the Association for Contextual Behavioral Science
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Garner EV, Golijani-Moghaddam N. Relationship between psychological flexibility and work-related quality of life for healthcare professionals: A systematic review and meta-analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Prudenzi A, D Graham C, Flaxman PE, O'Connor DB. Wellbeing, burnout, and safe practice among healthcare professionals: predictive influences of mindfulness, values, and self-compassion. PSYCHOL HEALTH MED 2021; 27:1130-1143. [PMID: 33856236 DOI: 10.1080/13548506.2021.1898651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Poor wellbeing and burnout are significant issues among health-care professionals (HCPs) and may contribute to unsafe practice. In this exploratory study, we aimed to: provide the first investigation of the combined and unique influences of these psychological factors in predicting safe practice; confirm the role played by mindfulness in relation to wellbeing, burnout and safe practice; and investigate whether values and self-compassion predict additional variability above and beyond mindfulness skills. Ninety-eight NHS staff completed measures of wellbeing, burnout, perceived safety of practice, mindfulness, values and self-compassion. Practitioners with higher perceived safety of practice reported higher levels of mindfulness, but not values or self-compassion, particularly lower experiential avoidance and nonjudgmental attitude toward difficult thoughts. Mindfulness explained significant variability in psychological distress (20%), emotional exhaustion (8%), cognitive weariness (10%), patient safety related to oneself (7%), and related to work (8%). Values (obstruction) added unique variance for psychological distress (12%) and physical fatigue (10%). Moreover, self-compassion explained a small yet significant portion of variability in emotional exhaustion. These preliminary findings suggest that mindfulness processes may be associated with perceived safety of practice. The results also indicate that mindfulness-based interventions for HCPs may benefit from the inclusion of values-based action components and self-compassion practices.
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ŞANAL KARAHAN F, BAKALIM O. The Mindfulness Levels of Adults During the Covid-19 Pandemic: The Role of Solution Focused Thinking and Valuing. SPIRITUAL PSYCHOLOGY AND COUNSELING 2021. [DOI: 10.37898/spc.2021.6.1.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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A multiple case study of the personal values of counselor trainees from a psychological flexibility perspective: a sample from Turkey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01264-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hayes SC, Hofmann SG, Stanton CE. Process-based functional analysis can help behavioral science step up to novel challenges: COVID - 19 as an example. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020; 18:128-145. [PMID: 32864323 PMCID: PMC7445588 DOI: 10.1016/j.jcbs.2020.08.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/25/2022]
Abstract
Historically speaking, the behavioral tradition advanced functional analysis as a method of applying existing principles to novel situations. In the more than half a century since that idea was advanced, functional analysis has either fallen into disuse, as in most of applied psychology, or has been used but modified to a point that is virtually inapplicable elsewhere, as in applied behavior analysis work with severe developmental disabilities. In this paper we argue that the current challenges with COVID-19 present an ideal time to reinvigorate functional analysis by combining it with the growing body of evidence on processes of change, organized under an extended evolutionary meta-model. This new form of process-based functional analysis takes advantage of the strengths of contextual behavioral science, while opening avenues of fruitful interaction with other wings of intervention and evolutionary science more generally. Using the psychological flexibility model as an example, we show how this approach solves the key problems of classical functional analysis and helps professionals deal with novel challenges such as those posed by COVID-19. Humanity is now facing an extraordinary and unexpected situation. Behavioral science needs to rise to that challenge in a way that provides both immediate practical value and greater assurance of long-term benefits for our understanding of human complexity more generally. Process-based functional analysis can be a vehicle to do just that.
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Abu zied M, Fekry M, Mohsen N, Morsy M, El Serafy D, Salah M. Burnout syndrome among psychiatrists in Egyptian mental health hospital. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00028-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Burnout is a special type of work-related stress—a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity (Lancet 388:2272-2281, 2016).
Burnout is a syndrome of state of emotional exhaustion, depersonalization, and feelings of low personal accomplishment (Maslach C and Jackson S, Maslach burnout inventory manual, 1986).
Burnout syndrome leads to severe problems. It may cause psychosomatic problems, family and marital conflicts, and substance misuse and also may result in complications such as late coming and early leaving of employees, quitting, having frequent medical reports, and the lack of productive and constructive ideas and criticism in the occupational settings (Sayil et al, Kriz Dergisi, Cilt 5, Say 1:2 ss.71-77, 1997).
So, we aimed to estimate the rate of occurrence of burnout among a sample of psychiatrists in one of the governmental psychiatric hospitals in Egypt.
Results
Result shows that 56.2% of study sample were males and 43.8% were females. Their mean age was 32 ± 6, and 57.5% were married and 42.5% were single. Mean score of emotional exhaustion was 28.25 ± 10.45 (high). Mean score of depersonalization was 8.5 ± 6.1 (moderate). Mean score of personal accomplishment was 31.78 ± 8.5 (low)
Conclusion
Burnout rate among psychiatrists of Al-Abbassia Hospital is higher than in western countries. Marriage and sleeping in home have protective effects. There is a significant association between high number of working hours per week and quality of the relationship with seniors and burnout.
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Martinez JK, Dong S. An Investigation of Multicultural Counseling Competence Development among Graduate-Level Counseling Students through Mindfulness, Cognitive Complexity, and Cognitive Flexibility. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2020. [DOI: 10.1007/s10447-020-09400-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dir AL, Saldana L, Chapman JE, Aalsma MC. Burnout and Mental Health Stigma Among Juvenile Probation Officers: The Moderating Effect of Participatory Atmosphere. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:167-174. [PMID: 30392147 DOI: 10.1007/s10488-018-0902-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Despite high rates of mental health problems among juvenile justice-involved youth, mental health stigma among juvenile probation officers (JPOs) is under-studied. This cross-sectional study examined effects of job burnout and workplace participatory atmosphere on mental health stigma among JPOs across Indiana (n = 226). Participatory atmosphere moderated the relationship between JPO burnout-related cynicism and mental health stigma (interaction β = - 0.14, p = .04); burnout was related to greater mental health stigma at low levels of participatory atmosphere. Findings suggest participatory atmosphere mitigates effects of burnout on mental health stigma among JPOs. Organizational-level interventions might help to reduce mental health stigma and combat negative effects from burnout among JPOs.
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Affiliation(s)
- Allyson L Dir
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. .,Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
| | | | | | - Matthew C Aalsma
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.,Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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Østergaard T, Lundgren T, Zettle RD, Landrø NI, Haaland VØ. Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Front Psychol 2020; 11:528. [PMID: 32292369 PMCID: PMC7119364 DOI: 10.3389/fpsyg.2020.00528] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/05/2020] [Indexed: 01/05/2023] Open
Abstract
Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Tobias Lundgren
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Robert D. Zettle
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
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Farhoudian A, Baldacchino A, Clark N, Gerra G, Ekhtiari H, Dom G, Mokri A, Sadeghi M, Nematollahi P, Demasi M, Schütz CG, Hash-emian SM, Tabarsi P, Galea-Singer S, Carrà G, Clausen T, Kouimtsidis C, Tolomeo S, Radfar SR, Razaghi EM. COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine Practice and Policy Interest Group Position Paper. Basic Clin Neurosci 2020; 11:133-150. [PMID: 32855772 PMCID: PMC7368103 DOI: 10.32598/bcn.11.covid19.1] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/19/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations. People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).
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Affiliation(s)
- Ali Farhoudian
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Alexander Baldacchino
- Division of Population and Behavioral Sciences, St Andrews University Medical School, University of St Andrews, UK
| | - Nicolas Clark
- North Richmond Community Health, Victoria, Melbourne, Australia
- Royal Melbourne Hospital, Victoria, Melbourne, Australia
| | - Gilberto Gerra
- Drug Prevention and Health Branch, Division for Operations, United Nations Office on Drugs and Crime, Vienna, Austria
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium
| | - Azarakhsh Mokri
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Sadeghi
- Aftab Mehrvarzi Substance Abuse Treatment Center, Tehran, Iran
| | - Pardis Nematollahi
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryanne Demasi
- North Richmond Community Health, Victoria, Melbourne, Australia
| | - Christian G. Schütz
- Department of Psychiatry, University of British Columbia, Vancouver BC, Canada
| | - Seyed Mohammadreza Hash-emian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Susanna Galea-Singer
- Institute for Innovation and Improvement, IWaitematâ DHB, Centre for Addictions Research, University of Auckland, Auckland, New Zealand
| | - Giuseppe Carrà
- Department of Medicine and Surgery, Section of Psychiatry, University of Milan Bicocca, Milan, Italy
| | - Thomas Clausen
- Norwegian Centre for Addiction Research (SERAF); University of Oslo, Oslo, Norway
| | | | - Serenella Tolomeo
- Department of Psychology, National University of Singapore (NUS), Singapore
| | - Seyed Ramin Radfar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Integrated Substance Abuse Programs, University of California, Los Angeles, California, USA
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Puolakanaho A, Tolvanen A, Kinnunen SM, Lappalainen R. A psychological flexibility -based intervention for Burnout:A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2019.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Callender KA, Trustey CE, Alton L, Hao Y. Single Case Evaluation of a Mindfulness-Based Mobile Application with a Substance Abuse Counselor. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/21501378.2019.1686353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Karisse A. Callender
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Caroline E. Trustey
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Leslie Alton
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
| | - Yuan Hao
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, WI, USA
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Beitel M, Oberleitner L, Muthulingam D, Oberleitner D, Madden LM, Marcus R, Eller A, Bono MH, Barry DT. Experiences of burnout among drug counselors in a large opioid treatment program: A qualitative investigation. Subst Abus 2019. [PMID: 29522381 DOI: 10.1080/08897077.2018.1449051] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Little is known about possible experiences of burnout among drug counselors in opioid treatment programs that are scaling up capacity to address the current opioid treatment gap. METHODS Participants in this quality improvement study were 31 drug counselors employed by large opioid treatment programs whose treatment capacities were expanding. Experiences of burnout and approaches for managing and/or preventing burnout were examined using individual semi-structured interviews, which were audiotaped, transcribed, and systematically coded by a multidisciplinary team using grounded theory. RESULTS Rates of reported burnout (in response to an open-ended question) were lower than expected, with approximately 26% of participants reporting burnout. Counselor descriptions of burnout included cognitive, affective, behavioral, and physiological symptoms; and job-related demands were identified as a frequent cause. Participants described both self-initiated (e.g., engaging in pleasurable activities, exercising, taking breaks during workday) and system-supported strategies for managing or preventing burnout (e.g., availing of supervision and paid time off). Counselors provided recommendations for system-level changes to attenuate counselor risk of burnout (e.g., increased staff-wide encounters, improved communication, accessible paid time off, and increased clinical supervision). CONCLUSIONS Findings suggest that drug counselor burnout is not inevitable, even in opioid treatment program settings whose treatment capacities are expanding. Organizations might benefit from routinely assessing counselor feedback about burnout and implementing feasible recommendations to attenuate burnout and promote work engagement.
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Affiliation(s)
- Mark Beitel
- a Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA.,b Pain Treatment Services , The APT Foundation , Inc., New Haven , Connecticut , USA
| | - Lindsay Oberleitner
- a Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA
| | - Dharushana Muthulingam
- c Department of Internal Medicine , Yale School of Medicine , New Haven , Connecticut , USA
| | - David Oberleitner
- d Department of Psychology , University of Bridgeport , Bridgeport , Connecticut , USA
| | - Lynn M Madden
- a Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA.,b Pain Treatment Services , The APT Foundation , Inc., New Haven , Connecticut , USA
| | - Ruthanne Marcus
- c Department of Internal Medicine , Yale School of Medicine , New Haven , Connecticut , USA
| | - Anthony Eller
- b Pain Treatment Services , The APT Foundation , Inc., New Haven , Connecticut , USA.,f Yale School of Public Health , New Haven , Connecticut , USA
| | - Madeline H Bono
- b Pain Treatment Services , The APT Foundation , Inc., New Haven , Connecticut , USA.,e Department of Psychology , New York University, New York , New York , USA
| | - Declan T Barry
- a Department of Psychiatry , Yale School of Medicine , New Haven , Connecticut , USA.,b Pain Treatment Services , The APT Foundation , Inc., New Haven , Connecticut , USA
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Johnson RLL. A Brief History of Mindfulness in Addictions Treatment. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2019. [DOI: 10.1007/s10447-019-09372-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Penwell-Waines L, Ward W, Kirkpatrick H, Smith P, Abouljoud M. Perspectives on Healthcare Provider Well-Being: Looking Back, Moving Forward. J Clin Psychol Med Settings 2019. [PMID: 29536320 DOI: 10.1007/s10880-018-9541-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Recognizing the impact of healthcare professional (HCP) burnout has led to vigorous interest from organizations and individuals regarding how to most effectively promote HCP well-being. The present paper reviews the literature on HCP well-being and describes factors that impact well-being at various levels (i.e., system, institution, program, interpersonal, and individual). We propose that change must occur at all levels to have the greatest impact. Further, we highlight opportunities to advance research on HCP well-being (e.g., being more inclusive regarding study populations and designing longitudinal intervention studies).
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Affiliation(s)
| | - Wendy Ward
- Department of Pediatric, UAMS College of Medicine, Little Rock, AR, USA
| | | | - Patrick Smith
- University of Mississippi Medical Center, Jackson, MS, USA
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Gutierrez D, Butts CM, Lamberson KA, Lassiter PS. Examining the Contributions of Trait Emotional Intelligence on Addiction Counselor Burnout. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2019. [DOI: 10.1002/jaoc.12056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Daniel Gutierrez
- Department of School Psychology and Counselor EducationCollege of William & Mary
| | - C. Missy Butts
- Department of CounselingUniversity of North Carolina at Charlotte
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Acceptance and commitment training focused on repetitive negative thinking for clinical psychology trainees: A randomized controlled trial. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Patterson Silver Wolf DA, Linn BK, Dulmus CN. Are Grittier Front-Line Therapists More Likely to Implement Evidence-Based Interventions? Community Ment Health J 2018; 54:959-966. [PMID: 30083831 DOI: 10.1007/s10597-018-0305-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Abstract
Substance use disorder remains a pervasive problem in the U.S. and elsewhere. Recent scholarship has explored therapist characteristics and evidence based intervention implementation in an attempt to improve client outcomes. One such construct that has received considerable attention is grit. People with high levels of grit tend to remain determined despite setbacks. This study sought to elucidate the relationship of grit to therapeutic alliance and attitudes towards evidence-based interventions in a sample of front-line therapist (n = 240). Grit was found to be positively associated with therapeutic alliance and correlated with favorable attitudes towards using proven practice. Findings suggest that gritty therapists may sustain the use of evidence based interventions in their usual services and have better client outcomes.
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Affiliation(s)
| | - Braden K Linn
- School of Social Work, University at Buffalo, 685 Baldy Hall, Buffalo, NY, 14260, USA.
| | - Catherine N Dulmus
- Buffalo Center for Social Research, School of Social Work, University at Buffalo, 221 Parker Hall, Buffalo, NY, 14214-8004, USA
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46
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Puolakanaho A, Tolvanen A, Kinnunen SM, Lappalainen R. Burnout-related ill-being at work: Associations between mindfulness and acceptance skills, worksite factors, and experienced well-being in life. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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47
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Development of Professional Identity for Counseling Professionals: A Mindfulness-Based Perspective. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2018. [DOI: 10.1007/s10447-018-9338-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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48
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Hofer PD, Waadt M, Aschwanden R, Milidou M, Acker J, Meyer AH, Lieb R, Gloster AT. Self-help for stress and burnout without therapist contact: An online randomised controlled trial. WORK AND STRESS 2017. [DOI: 10.1080/02678373.2017.1402389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Patrizia D. Hofer
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Michael Waadt
- insas Institut für Arbeit und Seelische Gesundheit, München, Germany
| | - Regula Aschwanden
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Marina Milidou
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Jens Acker
- insas Institut für Arbeit und Seelische Gesundheit, München, Germany
| | - Andrea H. Meyer
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Roselind Lieb
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Andrew T. Gloster
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
- Department of Psychology, Division of Clinical Psychology and Intervention Science, University of Basel, Basel, Switzerland
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Kroska EB, Calarge C, O’Hara MW, Deumic E, Dindo L. Burnout and depression in medical students: Relations with avoidance and disengagement. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Adimando A. Preventing and Alleviating Compassion Fatigue Through Self-Care: An Educational Workshop for Nurses. J Holist Nurs 2017; 36:304-317. [DOI: 10.1177/0898010117721581] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Though various authors have refined and described the concept of compassion fatigue (CF), the overarching features, predisposing factors, and potential consequences remain relatively consistent. Available literature demonstrates that caregivers caring for patients who are chronically ill and/or traumatized are at highest risk for developing CF. Potential consequences for unmitigated CF include physical, emotional, and work-related consequences, all of which can have negative effects on the quality and safety of care and degree of engagement with one’s employer. CF is further exacerbated by exposure to cumulative, unresolved stress and neglect of one’s own emotional needs over time. Caregivers must be knowledgeable on CF’s risk factors, symptoms, and management strategies to decrease its incidence and negative impacts. This article details the creation, execution, and evaluation of an evidence-based practice change project implemented with the goal of increasing knowledge needed to prevent, identify, and alleviate CF in high-risk nurses. The project involved a series of educational workshops containing information on CF’s risk factors, symptoms, and consequences, with a strong emphasis on self-awareness, self-care, and stress management. Pre- and postknowledge tests showed a significant increase in knowledge was achieved via the workshops, and qualitative surveys indicated a high level of participant satisfaction with the program contents, format, and impact.
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