Predictors of Burnout Among Community Therapists in the Sustainment Phase of a System-Driven Implementation of Multiple Evidence-Based Practices in Children's Mental Health
Predictors of Burnout Among Community Therapists in the Sustainment Phase of a System-Driven Implementation of Multiple Evidence-Based Practices in Children's Mental Health
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DOI：
10.1037/pro0000182
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发表时间：
2018-04-01
影响因子：
1.5
通讯作者：
Lau, Anna S.
中科院分区：
文献类型：
--
作者：
Kim, Joanna J.;Brookman-Frazee, Lauren;Lau, Anna S.
社区心理健康（CMH）治疗师的倦怠与治疗师健康状况较差，机构营业额较高，客户结果较差以及护理质量受损有关。最近的任务，学习和实施多种循证医学实践（EBP）CMH设置的目的是提高社区护理的质量，但有关于劳动力倦怠的影响的证据。目前的研究旨在确定相关的治疗师情绪衰竭，倦怠的一个关键方面，在维持阶段的系统驱动的实施多个EBP在儿童的心理健康服务。我们假设高工作量和不利的组织氛围与治疗师的情绪疲惫有关，但采用EBP的积极体验与较低的疲惫有关。虽然机构层面的组织气氛指数与疲惫无关，但多层次模型显示，治疗师的每周工作时间，案件量和EBP数量与情绪疲惫增加有关。此外，与EBP实施工作相关的活动（例如，花在EBP相关活动、监督或咨询或结果监测上的时间）与情绪衰竭无关。治疗师的知识和信心提供EBP和他们的积极看法EBP的保护情绪枯竭，但这些看法并没有缓冲与繁重的工作量相关的风险。调查结果指出，实施战略，以防止倦怠和相关的营业额，损害投资回报EBP实施。
Burnout among community mental health (CMH) therapists has been associated with poorer therapist health, higher agency turnover, poorer client outcomes, and compromised quality of care. Recent mandates to learn and implement multiple evidence-based practices (EBPs) within CMH settings are intended to improve the quality of community care, yet there is mixed evidence concerning the impacts on workforce burnout. The current study sought to identify correlates of therapist emotional exhaustion, a key aspect of burnout, during the sustainment phase of a system-driven implementation of multiple EBPs in children's mental health services. We hypothesized that high workload and unfavorable organizational climate would relate to therapist emotional exhaustion, but that positive experiences with EBPs adopted would relate to lower exhaustion. Although agency-level indices of organizational climate were unrelated to exhaustion, a multilevel model revealed that therapists' weekly work hours, caseload, and number of EBPs delivered were associated with increased emotional exhaustion. Additionally, activities associated with the EBP implementation efforts (e.g., hours spent in EBP-related activities, supervision or consultation, or outcome monitoring), were not associated with emotional exhaustion. Therapists' knowledge and confidence delivering EBPs and their positive perceptions of EBPs were protective against emotional exhaustion, but these perceptions did not buffer the risks associated with heavy workload. Findings point to implementation strategies to prevent burnout and associated turnover that compromise the returns on investments in EBP implementation.