SUPPORTS for Therapist Burnout

(SUPPORTS Trial)

Overseen By Teresa Lind, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: San Diego State University

Disqualifiers: Children under 3, over 18

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a new strategy called SUPPORTS to assist therapists working with children exposed to trauma. The goal is to reduce therapist burnout and turnover, ensuring more consistent availability of mental health programs for these children. The trial will compare the SUPPORTS model to the methods agencies currently use. Therapists who have delivered Trauma Focused Cognitive Behavioral Therapy (TF-CBT) in the past six months are well-suited for this study. As an unphased trial, this study offers therapists the chance to contribute to innovative strategies that could enhance their professional well-being and improve mental health services for children.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the SUPPORTS implementation model is safe for reducing provider burnout?

Research has shown that the SUPPORTS model aims to reduce therapist burnout by enhancing social support and managing personal traits. Although specific data on negative effects from the SUPPORTS model itself is not available, it incorporates well-known methods such as burnout education, mindfulness exercises, and therapist involvement in decision-making. These methods are generally safe and well-tolerated.

Burnout is a common issue for therapists, often resulting from long work hours and heavy workloads. SUPPORTS addresses these challenges without introducing new risks. This suggests the model is likely safe, as it focuses on improving work conditions rather than introducing new drugs or medical procedures.

In summary, the SUPPORTS model relies on existing, safe practices aimed at reducing burnout, with no reports of serious negative effects from these strategies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the SUPPORTS implementation model because it focuses on reducing therapist burnout by directly addressing occupational health. Unlike traditional methods that may only tackle burnout through general stress management techniques, SUPPORTS incorporates psychoeducation, mindfulness training, and involves therapists in organizational decision-making. This holistic approach aims not only to reduce burnout but also to improve the overall organizational climate, potentially leading to better sustained evidence-based practices and lower turnover rates among therapy providers.

What evidence suggests that the SUPPORTS implementation model is effective for reducing therapist burnout?

Research shows that therapist burnout can reduce the effectiveness of treatments. This is significant because burnout correlates with poorer health for therapists, higher job turnover, and less success for clients. The SUPPORTS implementation model in this trial aims to reduce burnout and foster a safer, more supportive work environment for therapists. Although specific data on SUPPORTS is not yet available, studies have indicated that organizational strategies and support systems can help reduce burnout. Preventing burnout often involves taking breaks, enjoying leisure activities, and exercising regularly. This suggests that SUPPORTS could effectively maintain mental health programs by reducing therapist burnout. The trial will also compare outcomes with agencies using their usual implementation strategies without additional support. ^{1 2 4 6 7}

Who Is on the Research Team?

Teresa Lind, PhD

Principal Investigator

San Diego State University

Are You a Good Fit for This Trial?

This trial is for therapists who have been providing Trauma Focused Cognitive Behavioral Therapy (TF-CBT) in the last 6 months and children aged 3-18 receiving TF-CBT. Therapists new to their agency (<6 months) and children outside this age range cannot participate.

Inclusion Criteria

I am between 3-18 years old and getting TF-CBT from a study-enrolled therapist.

I have provided TF-CBT therapy in the last 6 months.

Exclusion Criteria

Therapists employed at their current agency for less than 6 months.

I am either under 3 years old or over 18 years old.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Needs Assessment

A needs assessment is conducted with programs involved with the multiple-EBP implementation efforts in California and Arkansas to inform the development of SUPPORTS.

4 weeks

Implementation Strategy Development

Development and piloting of the SUPPORTS implementation strategies aimed at reducing provider burnout and turnover and improving organizational climate.

8 weeks

Follow-up

Participants are monitored for changes in child trauma symptoms, therapist turnover intention, and therapist burnout.

12 months

Assessments at baseline, 3, 6, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• SUPPORTS

Trial Overview The study aims to test a set of strategies called SUPPORTS, designed to reduce therapist burnout and improve organizational psychological safety, with the goal of sustaining child trauma EBPs delivery.

How Is the Trial Designed?

Group I: SUPPORTS Implementation Model Experimental Treatment 1 Intervention

The SUPPORTS implementation model will consist of a package of implementation strategies aimed at improving EBP sustainment through reducing provider burnout and turnover and improving organizational climate. The content and structure of SUPPORTS will be informed by the occupational health literature (e.g., psychoeducation about burnout, mindfulness training, or changes involvement of providers in organizational decision-making) and from a needs and context assessment.

Group II: Implementation as Usual Active Control 1 Intervention

Agencies in the Implementation as Usual condition will have implementation strategies tied to the implementation of EBPs that these agencies in the community are already using (i.e., the study will measure the implementation strategies being used by the agency but will not provide any additional strategies). There will be no strategies related to reducing provider burnout and turnover and improving organizational climate.

Who Is Running the Clinical Trial?

San Diego State University

Lead Sponsor

Trials

182

Recruited

119,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

A systematic review of 115 psychotherapy study protocols revealed that while 77 protocols explicitly addressed harm, there was a lack of standardization in how harm was conceptualized and assessed, particularly regarding adverse events.

The review highlighted that although serious adverse events were defined consistently, the definitions and considerations for adverse events varied widely, suggesting a need for more standardized approaches in clinical research to effectively monitor and report harm.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review. Klatte, R., Strauss, B., Flückiger, C., et al.[2023]

Physicians involved in adverse events often experience emotional distress, which significantly increases their risk of burnout, with an adjusted odds ratio of 1.90 for those affected.

Peer support is a crucial factor in reducing burnout among physicians after adverse events, as those who received such support had a lower risk of burnout (adjusted odds ratio of 0.65), highlighting the importance of fostering supportive environments in healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multispecialty Physician Online Survey Reveals That Burnout Related to Adverse Event Involvement May Be Mitigated by Peer Support. Gupta, K., Rivadeneira, NA., Lisker, S., et al.[2023]

Approximately 45% of occupational therapists reported work-related burnout, while 44% experienced personal burnout, and 23% faced client-related burnout, indicating a significant prevalence of burnout in this profession among the 374 participants studied.

Burnout levels were found to increase with the age of the therapists and the number of years in practice, suggesting that targeted intervention programs are necessary to address and prevent burnout in occupational therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Burnout among Occupational Therapists in Portugal: A Study of Specific Factors. Reis, HIS., Vale, C., Camacho, C., et al.[2019]

Approximately 15.8% of Spanish occupational therapists experience burnout syndrome, with emotional exhaustion being the most prevalent issue at 38.7%.

Key psychosocial factors such as neuroticism, role conflict, and negative work-family interactions significantly contribute to higher levels of emotional exhaustion, indicating the need for strategies that enhance emotional management and social support to improve therapists' well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychosocial Factors Associated with Burnout and Self-Perceived Health in Spanish Occupational Therapists. Juy, R., Nieto, A., Contador, I., et al.[2023]

Burnout is a significant issue among psychotherapists, influenced by factors such as job control, caseload nature, and supervisory support, which can lead to emotional exhaustion and reduced job satisfaction.

The effects of burnout not only impact the well-being of psychotherapists but also negatively affect client engagement and outcomes in therapy, highlighting the need for effective prevention and intervention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Causes and consequences of burnout among mental health professionals: A practice-oriented review of recent empirical literature. Yang, Y., Hayes, JA.[2021]

Research on the adverse effects of psychotherapy has been acknowledged for many years, but there has been little progress in understanding their causes and how to prevent them.

The study highlights the need for a new framework to improve the systematic recording and reporting of psychotherapy-related harm, addressing the existing confusion in definitions and methodologies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Iatrogenic harm from psychological therapies--time to move on. Parry, GD., Crawford, MJ., Duggan, C.[2022]

A systematic review of 21 studies found a significant association between high levels of burnout among healthcare professionals and a decline in patient safety, indicating that burnout can negatively impact the quality of care.

Burnout is particularly prevalent among physicians and nurses, often linked to factors like heavy workloads and poor interpersonal relationships, suggesting that improving work conditions could enhance patient safety outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Garcia, CL., Abreu, LC., Ramos, JLS., et al.[2020]

Eighteen patients with burnout reported that participating in a one-year rehabilitation program, which included cognitive behavioral therapy and Qigong, helped them regain control over their lives, highlighting the importance of group support in the recovery process.

The study identified key factors such as positive encounters, affirmation, and group cohesiveness as essential for fostering behavioral change and personal development during rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Take charge: Patients' experiences during participation in a rehabilitation programme for burnout. Fjellman-Wiklund, A., Stenlund, T., Steinholtz, K., et al.[2018]

A study of 99 registered occupational therapists found that using general norms from the Maslach Burnout Inventory may underestimate burnout levels specific to this profession, indicating a need for tailored norms.

Significant correlations were identified between burnout levels and factors such as age, education, years of experience, and hours of direct patient contact, providing insights into the factors contributing to work-related stress in occupational therapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Burnout in occupational therapists. Rogers, JC., Dodson, SC.[2019]

Occupational therapists face unique stressors similar to other healthcare professionals, such as exposure to distressing situations and prolonged interventions, but empirical evidence suggests they may be less affected by burnout compared to other groups.

The current literature on occupational stress in occupational therapy is limited, highlighting the need for further research to better understand the specific stressors and protective factors that influence burnout in this profession.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Work-related stress and occupational therapy. Lloyd, C., King, R.[2019]

A study of 116 therapists in IAPT services revealed high levels of Emotional Exhaustion (EE) and low levels of Depersonalisation (DP) and Personal Accomplishment (PA), indicating significant burnout among mental health professionals.

Key predictors of burnout included service-related factors like work demands and autonomy, as well as therapists' in-session feelings of anxiety, suggesting that addressing these issues could help prevent burnout.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exhausted but not cynical: burnout in therapists working within Improving Access to Psychological Therapy Services. Steel, C., Macdonald, J., Schröder, T., et al.[2015]

A study of 116 marriage and family therapists (MFTs) found that they generally experience low-to-moderate levels of burnout, with variations depending on their job settings.

Key predictors of burnout among MFTs include the number of hours worked per week and the specific job setting, and the Maslach Burnout Inventory (MBI) was confirmed as a suitable tool for assessing burnout in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Burnout among mental health professionals: special considerations for the marriage and family therapist. Rosenberg, T., Pace, M.[2019]

A study of 307 physical therapists and occupational therapists in New York City found high levels of emotional exhaustion (EE), depersonalization (DP), and low personal achievement (PA), indicating significant burnout among these professionals.

Only a few factors, such as support from supervisors and colleagues, number of children, and religious affiliation, were linked to emotional exhaustion, suggesting that workplace support is crucial in addressing burnout in therapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prevalence and determinants of burnout among physical and occupational therapists. Balogun, JA., Titiloye, V., Balogun, A., et al.[2018]

Family therapists can reduce burnout by balancing their own responsibilities with those of the families they work with, which helps manage stress and expectations.

Focusing on clear role definitions, open communication about feelings, and realistic therapeutic goals can significantly alleviate the pressure on therapists.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Making family therapy easier for the therapist: burnout prevention. Friedman, R.[2019]

In a study of 200 therapists in Poland, common burnout symptoms included feeling tired before work, loss of commitment, and lack of energy, highlighting the significant emotional toll of their profession.

The study found that certain temperament traits, like briskness, can help reduce burnout symptoms, while traits like perseveration can increase them; additionally, higher perceived social support is linked to lower burnout levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Temperament traits, social support, and burnout symptoms in a sample of therapists. Rzeszutek, M., Schier, K.[2015]

Citations

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Psychologists' Role in Addressing Healthcare Provider ... Health service psychologists are often key members of interprofessional teams and may be asked to intervene with colleagues exhibiting signs of burnout.