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Aminihajibashi S, Jensen TK, Skar AMS. Exploring key job demands and resources in Norwegian child mental health services: a cross-sectional study of associations with and relationship between compassion satisfaction, burnout, secondary traumatic stress and turnover intention. Front Public Health 2024; 12:1304345. [PMID: 38528864 PMCID: PMC10961911 DOI: 10.3389/fpubh.2024.1304345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/15/2024] [Indexed: 03/27/2024] Open
Abstract
Background Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health. Methods We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics (n = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand. Results and discussion Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.
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Affiliation(s)
| | - Tine K. Jensen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ane-Marthe Solheim Skar
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Professional wellbeing and turnover intention among child therapists: a comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy. BMC Health Serv Res 2022; 22:1328. [DOI: 10.1186/s12913-022-08670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Poor professional wellbeing and job turnover is challenging for child mental health clinics and despite an increasing interest in implementing evidence-based practices (EBPs) in mental health services, little is known about if and how using EBPs may influence therapists’ professional wellbeing and turnover intention. To investigate this, we compare the average level of compassion satisfaction, burnout, secondary traumatic stress, and turnover intention between therapists trained in an EBP (Trauma-Focused Cognitive Behavioral Therapy – TF-CBT) and untrained therapists. We also explore the prevalence of and the associations between these personal and organizational outcomes.
Method
In this cross-sectional study, the data is collected from a national sample of 373 therapists 5 years after an implementation program began (i.e., in the sustainment phase). The variables were measured by the Professional Quality of Life and the Turnover Intention Scales. The Evidence-Based Practice Attitude Scale was also used to measure therapists’ attitudes toward EBPs.
Results
Over 70% of the respondents reported medium to high levels of burnout, secondary traumatic stress symptoms, and compassion satisfaction, whereas one-third of the respondents reported a high level of intention to leave their job in the current or near future. Higher ratings on burnout and secondary traumatic stress were significantly associated with lower compassion satisfaction and higher turnover intention. Finally, we found significantly lower degree of burnout and turnover intention along with higher compassion satisfaction among TF-CBT therapists (n = 96), compared to other therapists who were not trained in TF-CBT (n = 231). These differences could not be explained by between-group differences in age, job tenure, educational background, or therapists’ attitudes towards EBPs. However, mean differences in ratings on secondary traumatic stress symptoms were not statistically significant.
Conclusion
Although the prevalence findings are in general alarming, the present study provides the first empirical evidence for a potential positive effect of being trained in TF-CBT on therapists’ wellbeing and turnover intention. We discuss these findings in the light of self-efficacy theory and the job demands-resources model.
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Brend DM, Collin-Vézina D. Stronger together: Workplace social support among residential child welfare professionals. CHILD ABUSE & NEGLECT 2022; 130:105302. [PMID: 34511308 DOI: 10.1016/j.chiabu.2021.105302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Residential childcare workers (RCWs) in child welfare and youth-justice settings are at risk of secondary traumatic stress, burnout, and moral distress. Workplace support has been shown to be protective against work-related harms for some helping professionals and a lack of workplace support has been cited as a contributing factor toward workforce instability; however, little is known about what types or sources of support are effective for RCWs. PARTICIPANTS AND SETTING 81 RCWs from 11 residential units in 11 of the 16 territorial service centers across the province of Québec, Canada. METHODS This interpretive description study analyzed data extracted from transcripts of individual interviews guided by the Secure Base Interview protocol (Schofield & Beek, 2018). Responses to a single item were read for meaning, compared, contrasted, and then coded using the thematic analysis technique. The sources of support identified by participants as helpful were aggregated to reveal a common support system pattern. RESULTS Multiple sources of social support were described; the majority were interpersonal interactions with peers, unit managers, and various interdisciplinary team members. Informal individual supports without role overlap and teams with a common vision were most often cited, even when formal supports were available. CONCLUSIONS Implications of these findings include the need to conceptualize effective workplace social support for RCWs and to rethink the place of mutual-aid among trauma-exposed professionals in residential child welfare and youth-justice settings.
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Affiliation(s)
- Denise Michelle Brend
- Canadian Consortium on Child & Youth Trauma, Canada; École de travail social et de criminologie, Université Laval, Pavillon Charles-De Koninck, Bureau 6459, Québec, Québec G1V 0A6, Canada.
| | - Delphine Collin-Vézina
- Centre for Research on Children and Families, Canada; Canadian Consortium on Child & Youth Trauma, Nicolas Steinmetz and Gilles Julien Chair in Social Pediatrics in Community, Canada; School of Social Work & Associate Member, Department of Pediatrics, McGill University, 3506 University street, Room 321B, Montreal, Québec H3A2A7, Canada.
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Benuto LT, Yang Y, Bennett N, Lancaster C. Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11557-NP11581. [PMID: 33076751 DOI: 10.1177/0886260520967136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The extant literature has illustrated that protective service workers experience negative repercussions associated with their job (including the development of secondary traumatic stress; STS) and may utilize maladaptive coping mechanisms. Developing an improved understanding of factors that might explain the relationship between STS and the utilization of maladaptive coping mechanisms is warranted. This study sought to examine emotion regulation and distress tolerance as potential mediators between STS and the utilization of maladaptive coping mechanisms. Participants were 152 elder protective service workers and 105 child protective service workers who completed an online survey of self-report measures of emotion regulation, distress tolerance, STS, and coping behaviors. A parallel multiple mediator model was analyzed using structural equation modeling (SEM) to examine the hypothesis that distress tolerance and emotion regulation would mediate the relationship between STS and the utilization of maladaptive coping. Our hypothesis was partially supported as the effect of STS on maladaptive coping was mediated by emotion regulation but not by distress tolerance. The results from this study have both prevention and intervention implications. From a prevention perspective, efforts could be directed at teaching emotion regulation skills to those at risk for developing STS as a mechanism for decreasing the probability of denial, substance use, behavioral disengagement, and self-blame that may occur as a consequence of STS. From an intervention perspective, some of the negative sequelae of exposure to STS may be averted by teaching EPS and CPS workers who present with STS symptoms, emotion regulation skills.
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Affiliation(s)
- Susanna Alyce
- Health and Social Care, University of Essex Faculty of Science and Health, United Kingdom of Great Britain and Northern Ireland
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Campodonico C, Berry K, Haddock G, Varese F. Protective Factors Associated With Post-traumatic Outcomes in Individuals With Experiences of Psychosis. Front Psychiatry 2021; 12:735870. [PMID: 34912247 PMCID: PMC8666594 DOI: 10.3389/fpsyt.2021.735870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/04/2021] [Indexed: 01/28/2023] Open
Abstract
Trauma and trauma-specific mental health difficulties (e.g., post-traumatic stress disorder) are highly prevalent in people with psychosis. However, not everyone develops post-traumatic symptoms, and some people even experience post-traumatic growth (PTG) following trauma. It is important to identify which protective factors are associated with less severe trauma symptoms and/or positive outcomes to inform the development and implementation of interventions fostering these variables. Eighty-five patients with experiences of psychosis took part in a cross-sectional study. They were administered questionnaires measuring exposure to traumatic events, symptoms of PTSD and complex PTSD and potential protective factors assumed to be associated with lower vulnerability for post-traumatic symptoms and higher post-traumatic growth (trait resilience, secure attachment, social support, adaptive coping, optimism, general self-efficacy). Multiple hierarchical regression showed that some of these protective factors, in particular optimism, were associated with lower post-traumatic symptoms, explaining 21% of the variance in complex PTSD symptoms and 16% of the variance in PTSD symptoms. However, the hypothesized protective factors, in particular resilience and adaptive coping, explained a considerably larger proportion of variance in PTG (44%). Our results suggest that whilst these variables provide only moderate protection from the vulnerability to experience post-traumatic stress, they may play an important role in allowing people to find meaning despite multiple traumas and subsequently lead more fulfilling lives. Therapies targeting the emotional and psychological consequences of trauma in people with psychosis might benefit from the integration of intervention strategies to enhance these additional psychological protective factors, which in turn may lead to positive treatment outcomes beyond the mere reduction of post-traumatic stress symptoms.
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Affiliation(s)
- Carolina Campodonico
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Katherine Berry
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Filippo Varese
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Page J, Robertson N. Extent and predictors of work-related distress in community correction officers: a systematic review. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 29:155-182. [PMID: 35755153 PMCID: PMC9225775 DOI: 10.1080/13218719.2021.1894259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research indicates that indirect exposure to trauma can have a detrimental psychological impact on professionals working within, and interfacing with, law enforcement and the criminal justice system. This systematic review aimed to explore the extent and predictors of work-related distress amongst community corrections personnel. A search of five databases identified 19 papers eligible for inclusion; 16 addressed burnout, and the remainder investigated secondary trauma, vicarious trauma and compassion fatigue. Synthesis revealed that community corrections personnel reported burnout at levels akin to those of other professions working in forensic contexts, though reports of secondary trauma appeared higher. Predictive factors encompassed personal, role-based and organisational factors. Research reporting work-related distress in correctional officers is focused on burnout but uses divergent models of stress, reveals methodological weaknesses, and to date has little examined responses to indirect trauma. The limitations of this review are discussed, alongside clinical implications and areas for future research.
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Affiliation(s)
- Jessica Page
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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Greenberg N, Rafferty L. Post-traumatic stress disorder in the aftermath of COVID-19 pandemic. World Psychiatry 2021; 20:53-54. [PMID: 33432762 PMCID: PMC7801831 DOI: 10.1002/wps.20838] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Neil Greenberg
- Health Protection Research Unit, King's College London, London, UK
| | - Laura Rafferty
- King's Centre for Military Health Research, King's College London, London, UK
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Louison Vang M, Shevlin M, Hansen M, Lund L, Askerod D, Bramsen RH, Flanagan N. Secondary traumatisation, burn-out and functional impairment: findings from a study of Danish child protection workers. Eur J Psychotraumatol 2020; 11:1724416. [PMID: 32166006 PMCID: PMC7054954 DOI: 10.1080/20008198.2020.1724416] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/11/2020] [Accepted: 01/22/2020] [Indexed: 11/08/2022] Open
Abstract
Background: Child-protection workers are at elevated risk for secondary traumatization. However, research in the area of secondary traumatization has been hampered by two major obstacles: the use of measures that have unclear or inadequate psychometric properties and equivocal findings on the degree of associated functional impairment. Objective: To assess the relationship between secondary traumatization and burnout using exploratory structural equation modelling (ESEM) and to assess the relationship between secondary traumatization and functional impairment. Methods: A survey of Danish child-protection workers was conducted through the Danish Children Centres (N = 667). Secondary traumatization was measured using the Professional Quality of Life-5 (ProQoL-5) and burnout using the Oldenburg Burnout Inventory. Results: A three-factor ESEM model provided the best fit to the data, reflecting factors consistent with the structure of secondary traumatization and burnout. The factors were differentially related to trauma-related and organizational variables in ways consistent with existing evidence. All factors were significantly related to functional impairment. Conclusion: The findings supported the discriminant validity of secondary traumatization and burnout while highlighting methodological issues around the current use of sum-score approaches to investigating secondary traumatization. The current study supported the clinical relevance of secondary traumatization by linking it explicitly to social and cognitive functional impairment.
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Affiliation(s)
- M Louison Vang
- School of Psychology and Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom.,The CONTEXT-consortium.,ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,The Danish Children Centres, Region Southern Denmark and Central Region, Denmark
| | - M Shevlin
- School of Psychology and Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom.,The CONTEXT-consortium
| | - M Hansen
- The CONTEXT-consortium.,ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - L Lund
- The CONTEXT-consortium.,The Danish Children Centres, Region Southern Denmark and Central Region, Denmark
| | - D Askerod
- The CONTEXT-consortium.,The Danish Children Centres, Region Southern Denmark and Central Region, Denmark
| | - R H Bramsen
- The Danish Children Centres, Region Southern Denmark and Central Region, Denmark
| | - N Flanagan
- The CONTEXT-consortium.,ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,SPIRASI, National Centre for the Rehabilitation of Victims of Torture in Ireland, Dublin, Ireland
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Dornelles TM, Macedo ABT, Souza SBCD. PROFESSIONAL QUALITY OF LIFE AND COPING IN A REFERENCE HOSPITAL FOR VICTIMS OF SEXUAL VIOLENCE. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2019-0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to verify the relationship between professional quality of life scores and coping strategies in the multidisciplinary health team that assists children and adolescents victims of sexual violence. Method: a cross-sectional study carried out in a public hospital of Porto Alegre, Brazil. Data collection took place from July to October 2018, using the Professional Quality of Life Scale and the Inventory of Coping Responses at Work. The analysis was performed using the Kruskal-Wallis test and Pearson's Correlation Coefficient. Regression was used for independent variables with p ≤ 0.05 in the bivariate analyses. Results: the professionals showed a medium level in the compassion satisfaction dimension (54.2%), medium level for secondary traumatic stress (50.8%), and medium level for Burnout (61%). Regarding the coping strategies, the decision-making strategy showed a weak correlation with the compassion satisfaction dimension (0.261), and the emotional extravasation strategy showed a moderate correlation with secondary traumatic stress (0.485) and Burnout (0.399). The female gender was associated with secondary traumatic stress (p=0.002). Conclusion: the identification of coping strategies such as decision-making can help the professionals to increase the levels of compassion satisfaction. In situations of suffering in daily work, management to avoid emotional extravasation should take place, preventing high levels of compassion fatigue. Such information is important to support public policies on occupational health, as well as programs to promote occupational health.
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. Protecting the psychological wellbeing of staff exposed to disaster or emergency at work: a qualitative study. BMC Psychol 2019; 7:78. [PMID: 31823824 PMCID: PMC6905092 DOI: 10.1186/s40359-019-0360-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Disasters are becoming more prevalent across the world and people are frequently exposed to them as part of their occupational groups. It is important for organisations to understand how best to support employees who have experienced a trauma such as a disaster. The purpose of this study was to explore employees’ perceptions of workplace support and help-seeking in the context of a disaster. Methods Forty employees in England took part in semi-structured interviews. Thematic analysis was used to extract recurring themes from the data. Results Participants reported both positive and negative psychological outcomes of experiencing a disaster or emergency at work. Most had little training in how to prepare for, and cope with, the psychological impact. They perceived stigma around mental health and treatment for psychological issues which often made them reluctant to seek help. Many reported that the psychological support available in the workplace was insufficient and tended to be reactive rather than proactive. Interpersonal relationships at work were viewed as being important sources of support, particularly support from managers. Participants suggested that psychosocial training in the workplace could be beneficial in providing education about mental health, encouraging supportive workplace relationships, and developing listening skills and empathy. Conclusions Organisations can take steps to reduce the psychological impact of disasters on employees. This could be done through provision of training workshops incorporating mental health education to reduce stigma, and team-building exercises to encourage supportive workplace relationships.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
| | - Rebecca Dunn
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science & Technology, Health Protection Directorate, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
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Sweeney A, Taggart D. (Mis)understanding trauma-informed approaches in mental health. J Ment Health 2018; 27:383-387. [PMID: 30345848 DOI: 10.1080/09638237.2018.1520973] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Angela Sweeney
- a St George's, University of London, Population Health Research Institute , Cranmer Terrace , London , UK
| | - Danny Taggart
- b School of Health and Social Care , University of Essex , Essex , UK
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