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 journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)517-524
Number of pages8
JournalJournal of Affective Disorders
Volume320
DOIs
StatePublished - 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

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