Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic

Craig S. Rosen; Adam N. Kaplan; David B. Nelson; Heidi La Bash; Kathleen M. Chard; Afsoon Eftekhari; Shannon Kehle-Forbes; Shannon Wiltsey Stirman; Nina A Sayer

doi:10.1016/j.jad.2022.09.141

Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic

Craig S. Rosen, Adam N. Kaplan, David B. Nelson, Heidi La Bash, Kathleen M. Chard, Afsoon Eftekhari, Shannon Kehle-Forbes, Shannon Wiltsey Stirman, Nina A Sayer

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Background: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. Method: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. Results: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. Limitations: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. Conclusion: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.

Original language	English (US)
Pages (from-to)	517-524
Number of pages	8
Journal	Journal of Affective Disorders
Volume	320
DOIs	https://doi.org/10.1016/j.jad.2022.09.141
State	Published - Jan 1 2023

Bibliographical note

Funding Information:
Dr. Rosen reported receiving grants from the U.S. Department of Defense and the U.S. Department of Veterans Affairs .

Funding Information:
This work was supported by a U.S. Department of Veterans Affairs , Health Services Research & Development [ IIR-17-178 ]. The opinions presented are those of the authors and do not necessarily represent the position of the U.S. Government or the U.S. Department of Veterans Affairs.

Funding Information:
Dr. Sayer is the PI of the U.S. Department of Veterans Affairs Health Services Research and Development grant that supported this work.

Funding Information:
Dr. Kehle-Forbes reported receiving grants from the U.S. Department of Veterans Affairs and the Patient-Centered Outcomes Research Institute .

Funding Information:
Dr. Wiltsey Stirman reported receiving grants from the U.S. National Institute of Mental Health and the Canadian Institutes of Health Research .

Publisher Copyright:
© 2022

Keywords

Burnout
COVID-19
Healthcare professionals
Implementation climate
Job demands-resources

PubMed: MeSH publication types

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.jad.2022.09.141

Find It

Find It at U of M Libraries

Cite this

@article{0eaead7e96fb451ebe5590baebad7ece,

title = "Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic",

abstract = "Background: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. Method: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. Results: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. Limitations: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. Conclusion: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.",

keywords = "Burnout, COVID-19, Healthcare professionals, Implementation climate, Job demands-resources",

author = "Rosen, {Craig S.} and Kaplan, {Adam N.} and Nelson, {David B.} and {La Bash}, Heidi and Chard, {Kathleen M.} and Afsoon Eftekhari and Shannon Kehle-Forbes and {Wiltsey Stirman}, Shannon and Sayer, {Nina A}",

note = "Funding Information: Dr. Rosen reported receiving grants from the U.S. Department of Defense and the U.S. Department of Veterans Affairs . Funding Information: This work was supported by a U.S. Department of Veterans Affairs , Health Services Research & Development [ IIR-17-178 ]. The opinions presented are those of the authors and do not necessarily represent the position of the U.S. Government or the U.S. Department of Veterans Affairs. Funding Information: Dr. Sayer is the PI of the U.S. Department of Veterans Affairs Health Services Research and Development grant that supported this work. Funding Information: Dr. Kehle-Forbes reported receiving grants from the U.S. Department of Veterans Affairs and the Patient-Centered Outcomes Research Institute . Funding Information: Dr. Wiltsey Stirman reported receiving grants from the U.S. National Institute of Mental Health and the Canadian Institutes of Health Research . Publisher Copyright: {\textcopyright} 2022",

year = "2023",

month = jan,

day = "1",

doi = "10.1016/j.jad.2022.09.141",

language = "English (US)",

volume = "320",

pages = "517--524",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic

AU - Rosen, Craig S.

AU - Kaplan, Adam N.

AU - Nelson, David B.

AU - La Bash, Heidi

AU - Chard, Kathleen M.

AU - Eftekhari, Afsoon

AU - Kehle-Forbes, Shannon

AU - Wiltsey Stirman, Shannon

AU - Sayer, Nina A

N1 - Funding Information: Dr. Rosen reported receiving grants from the U.S. Department of Defense and the U.S. Department of Veterans Affairs . Funding Information: This work was supported by a U.S. Department of Veterans Affairs , Health Services Research & Development [ IIR-17-178 ]. The opinions presented are those of the authors and do not necessarily represent the position of the U.S. Government or the U.S. Department of Veterans Affairs. Funding Information: Dr. Sayer is the PI of the U.S. Department of Veterans Affairs Health Services Research and Development grant that supported this work. Funding Information: Dr. Kehle-Forbes reported receiving grants from the U.S. Department of Veterans Affairs and the Patient-Centered Outcomes Research Institute . Funding Information: Dr. Wiltsey Stirman reported receiving grants from the U.S. National Institute of Mental Health and the Canadian Institutes of Health Research . Publisher Copyright: © 2022

PY - 2023/1/1

Y1 - 2023/1/1

N2 - Background: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. Method: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. Results: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. Limitations: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. Conclusion: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.

AB - Background: The first goal of this study was to assess longitudinal changes in burnout among psychotherapists prior to (T1) and during the COVID-19 pandemic (T2). The second objective was to assess the effects of job demands, job resources (including organizational support for evidence-based psychotherapies, or EBPs) and pandemic-related stress (T2 only) on burnout. Method: Psychotherapists providing EBPs for posttraumatic stress disorder in U.S. Department of Veterans Affairs (VA) facilities completed surveys assessing burnout, job resources, and job demands prior to (T1; n = 346) and during (T2; n = 193) the COVID-19 pandemic. Results: Burnout prevalence increased from 40 % at T1 to 56 % at T2 (p < .001). At T1, stronger implementation climate and implementation leadership (p < .001) and provision of only cognitive processing therapy (rather than use of prolonged exposure therapy or both treatments; p < .05) reduced burnout risk. Risk factors for burnout at T2 included T1 burnout, pandemic-related stress, less control over when and how to deliver EBPs, being female, and being a psychologist rather than social worker (p < .02). Implementation leadership did not reduce risk of burnout at T2. Limitations: This study involved staff not directly involved in treating COVID-19, in a healthcare system poised to transition to telehealth delivery. Conclusion: Organizational support for using EBPs reduced burnout risk prior to but not during the pandemic. Pandemic related stress rather than increased work demands contributed to elevated burnout during the pandemic. A comprehensive approach to reducing burnout must address the effects of both work demands and personal stressors.

KW - Burnout

KW - COVID-19

KW - Healthcare professionals

KW - Implementation climate

KW - Job demands-resources

UR - http://www.scopus.com/inward/record.url?scp=85139737733&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85139737733&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2022.09.141

DO - 10.1016/j.jad.2022.09.141

M3 - Article

C2 - 36191645

AN - SCOPUS:85139737733

SN - 0165-0327

VL - 320

SP - 517

EP - 524

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Implementation context and burnout among Department of Veterans Affairs psychotherapists prior to and during the COVID-19 pandemic

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this