A cognitive behavioural model for maintaining processes in burnout

The Mediation Chain Effect of Cognitive Crafting and Personal Resources on the Relationship between Role Ambiguity and Dentists' Emotional Exhaustion

Based on Job Demands-Resources (JD-R), Conservation of Resources (COR) and self-regulation theories integration, this study investigated the association between role ambiguity and emotional exhaustion among 191 Romanian dentists, as well as the chain mediating role of cognitive crafting and three personal resources (resilience, optimism, and self-efficacy). Three conceptual models which included, separately, the three personal resources were proposed. PROCESS macros were used to verify the hypotheses related to the testing of the path mediation models. The results indicated that role ambiguity was directly and positively associated with dentists' burnout. More importantly, the sequential indirect effect of role ambiguity on burnout via mediators in chains (cognitive crafting and resilience for the first model; cognitive crafting and optimism for the second model; cognitive crafting and self-efficacy for the third model) was significant. The findings provide a direction for dentists' health intervention because it reveals how the negative impact of role ambiguity on emotional exhaustion increasing can be buffered by the cumulative effect of cognitive crafting and different personal resources, as a result of their chain reinforcement.

Associations between therapists' occupational burnout and their patients' depression and anxiety treatment outcomes

BACKGROUND

Occupational burnout is common in mental health professionals, but its impact on patient outcomes is as yet uncertain. This study aimed to investigate associations between therapist-level burnout and patient-level treatment outcomes after psychological therapy.

METHODS

We used multilevel modeling using depression (PHQ-9) and anxiety (GAD-7) outcomes data from 2,223 patients nested within 49 therapists. Therapists completed a survey including the Oldenburg Burnout Inventory (OLBI) and a job satisfaction scale (JDSS).

RESULTS

After controlling for case-mix, around 5% of variability in treatment outcomes was explained by therapist effects (TE). Higher therapist OLBI-disengagement and lower JDSS scores were significantly associated with poorer treatment outcomes, explaining between 31 and 39% of the TE estimate. Higher OLBI scores were also correlated with lower job satisfaction ratings.

CONCLUSIONS

Therapist burnout has a negative impact on treatment outcomes and could be the target of future preventive and remedial action.

Coping with stress and types of burnout: explanatory power of different coping strategies

Background

Burnout occurs when professionals use ineffective coping strategies to try to protect themselves from work-related stress. The dimensions of ‘overload’, ‘lack of development’ and ‘neglect’, belonging to the ‘frenetic’, ‘under-challenged’ and ‘worn-out’ subtypes, respectively, comprise a brief typological definition of burnout. The aim of the present study was to estimate the explanatory power of the different coping strategies on the development of burnout subtypes.

Methods

This was a cross-sectional survey with a random sample of university employees, stratified by occupation (n = 429). Multivariate linear regression models were constructed between the ‘Burnout Clinical Subtypes Questionnaire’, with its three dimensions –overload, lack of development and neglect– as dependent variables, and the ‘Coping Orientation for Problem Experiences’, with its fifteen dimensions, as independent variables. Adjusted multiple determination coefficients and beta coefficients were calculated to evaluate and compare the explanatory capacity of the different coping strategies.

Results

The ‘Coping Orientation for Problem Experiences’ subscales together explained 15% of the ‘overload’ (p<0.001), 9% of the ‘lack of development’ (p<0.001), and 21% of the ‘neglect’ (p<0.001). ‘Overload’ was mainly explained by ‘venting of emotions’ (Beta = 0.34; p<0.001); ‘lack of development’ by ‘cognitive avoidance’ (Beta = 0.21; p<0.001); and ‘neglect’ by ‘behavioural disengagement’ (Beta = 0.40; p<0.001). Other interesting associations were observed.

Conclusions

These findings further our understanding of the way in which the effectiveness of interventions for burnout may be improved, by influencing new treatments and preventive programmes using features of the strategies for handling stress in the workplace.

Clinical supervision in a UK military Department of Community Mental Health

OBJECTIVES

Recent service developments in the NHS on the provision of talking therapies such as the Improving Access to Psychological Therapies (IAPT) initiative have made the compliance with clinical supervision (CS) inherent among its service guidelines. This paper presents the findings of an audit, measuring compliance with CS among clinicians providing psychological therapies within a military Department of Community Mental Health.

METHOD

Adherence to the recommended monthly supervision and the presence of an indate CS contract were audited on two separate occasions over 2 years by analysing the departmental electronic CS database.

RESULTS

Compliance rates were found to be lower than the Defence guidelines, which are already modest in their expectations compared with IAPT CS standards.

DISCUSSION

Potential reasons are hypothesised including high levels of staff rotation, other military commitments, clinicians not keeping up-to-date records and the pressures of meeting performance indicators on other clinical issues. Proposals for improving the uptake of CS are suggested along with areas for further research.

Cognitive behavioural therapy for occupational trauma: a systematic literature review exploring the effects of occupational trauma and the existing CBT support pathways and interventions for staff working within mental healthcare including allied professions

This study performed a systematic literature review to examine existing and recommended CBT support for staff working within mental healthcare, who experienced occupational traumatization. The following questions were posed: (1) What are the effects of differing levels of occupational trauma on the individual and/or organization? (2) Are there any current CBT-specific models, or treatment pathways, aimed at supporting those experiencing the effects of occupational trauma? Conclusions showed the effects of occupational trauma are significant, varied and predominantly negative to both employees, and the organizations where they work. There were no CBT-specific models or pathways sourced to address occupational trauma; however, interventions were highlighted which may form parts of a larger pathway. Reviewed evidence suggests that development of a stepped CBT pathway for occupational trauma will be beneficial.