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

Trial Summary

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 data supports the effectiveness of the treatment SUPPORTS for reducing therapist burnout?

The research highlights the high prevalence of burnout among therapists, indicating a need for intervention programs to address this issue. Although specific data on the effectiveness of SUPPORTS is not provided, the studies suggest that organizational strategies and support systems could be beneficial in reducing burnout. ^{1 2 3 4 5}

Is the SUPPORTS treatment generally safe for humans?

Research on psychotherapy, which may include treatments like SUPPORTS, shows that safety data is often not standardized, and adverse effects are not consistently defined or reported. However, many studies do consider serious adverse events, suggesting that while there is awareness of potential harm, more standardized safety assessments are needed. ^{6 7 8 9 10}

How does the SUPPORTS treatment for therapist burnout differ from other treatments?

The SUPPORTS treatment for therapist burnout is unique because it focuses on enhancing social support and managing temperament traits, which are linked to reducing burnout symptoms. Unlike other treatments that may focus solely on workload or stress management, this approach emphasizes the importance of social connections and personal characteristics in preventing burnout. ^{11 12 13 14 15}

What is the purpose of this trial?

The majority of children exposed to early adversity and trauma do not have access to sustainably delivered evidence-based mental health programs (EBPs), despite the growing prevalence of large-scale multiple-EBP implementation efforts aimed at increasing access to these services. The objective of this proposal is to develop and test a package of implementation strategies designed to promote the sustained delivery of child trauma EBPs by reducing provider turnover through targeting the associated mechanisms of provider burnout and organizational psychological safety climate. Findings will have a significant public health impact by informing efforts to increase the sustained availability of child trauma EBPs, thereby improving outcomes for children exposed to trauma.

Research Team

Teresa Lind, PhD

Principal Investigator

San Diego State University

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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]

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 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]

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]

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Burnout among Occupational Therapists in Portugal: A Study of Specific Factors. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Exhausted but not cynical: burnout in therapists working within Improving Access to Psychological Therapy Services. [2015]

3. United States pubmed.ncbi.nlm.nih.gov

Prevalence and determinants of burnout among physical and occupational therapists. [2018]

4. Sweden pubmed.ncbi.nlm.nih.gov

Take charge: Patients' experiences during participation in a rehabilitation programme for burnout. [2018]

5. United States pubmed.ncbi.nlm.nih.gov

Burnout in occupational therapists. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Defining and assessing adverse events and harmful effects in psychotherapy study protocols: A systematic review. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

Multispecialty Physician Online Survey Reveals That Burnout Related to Adverse Event Involvement May Be Mitigated by Peer Support. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Work-related stress and occupational therapy. [2019]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Iatrogenic harm from psychological therapies--time to move on. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

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

12. United States pubmed.ncbi.nlm.nih.gov

Burnout among mental health professionals: special considerations for the marriage and family therapist. [2019]

13. United States pubmed.ncbi.nlm.nih.gov

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

14. Switzerland pubmed.ncbi.nlm.nih.gov

Psychosocial Factors Associated with Burnout and Self-Perceived Health in Spanish Occupational Therapists. [2023]

15. United States pubmed.ncbi.nlm.nih.gov

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