A mixed methods exploratory evaluation of burnout in frontline staff implementing dialectical behavior therapy on a pediatric eating disorders unit

Jennifer Couturier,Liah Rahman,Zechen Ma,Cheryl Webb

doi:10.1186/s40337-021-00453-1

Jennifer Couturier, Liah Rahman + Show 2 more

Open Access

https://doi.org/10.1186/s40337-021-00453-1

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Abstract

BackgroundEating disorders are life-threatening illnesses that commonly affect adolescents. The treatment of individuals with eating disorders can involve slow treatment progression and addressing comorbidities which can contribute to staff burnout. Dialectical behavior therapy (DBT) has emerged as a viable treatment option and has reduced staff burnout in several other settings. Our aim was to describe frontline staff burnout using mixed methodology on a DBT-trained combined inpatient/day hospital unit for pediatric eating disorders.MethodFrontline staff were trained to provide DBT skills for adolescents with eating disorders. Twelve months following the training and implementation, they completed the Copenhagen Burnout Inventory (CBI) and a qualitative interview. Directed and summative content analyses were used.ResultsEleven frontline staff including nurses, child life specialists and child and youth workers participated. The CBI revealed that only one staff member experienced high personal burnout, while another experienced high client-related burnout. Qualitative data indicated that all frontline staff felt DBT had the potential to reduce burnout.ConclusionQualitative data indicate that staff believe that DBT may hold promise in reducing burnout for pediatric frontline staff who treat children and adolescents with eating disorders. Further study is needed.Plain English summaryUnderstanding burnout is particularly important for nursing staff in inpatient and day hospital settings for eating disorders, as nursing staff generally have the most frequent patient contact; thought to be a risk factor for burnout. The reduction of burnout can prevent detrimental effects on job performance, personal well-being, and patient outcomes. Our exploratory study shows that frontline staff believe that DBT may have the potential to reduce burnout in staff treating children and adolescents with eating disorders in a combined inpatient/day hospital setting. Further study is needed in this area.

Highlights

Eating disorders (ED) are the third most common chronic illness that affect adolescents [1]
The Copenhagen Burnout Inventory (CBI) revealed that only one staff member experienced high personal burnout, while another experienced high clientrelated burnout
Qualitative data indicated that all frontline staff felt Dialectical behavior therapy (DBT) had the potential to reduce burnout

Summary

Introduction

Eating disorders (ED) are the third most common chronic illness that affect adolescents [1]. These illnesses can be life threatening, with anorexia nervosa having the highest mortality rate of any psychiatric illness [2]. Patients with ED frequently experience comorbid psychiatric diagnoses such as depression, anxiety, obsessive–compulsive disorder, personality disorders, and substance abuse disorders [3, 5]. Behaviors such as self-harm in this group of patients are perceived as very stressful to treatment providers [6, 7]. Our aim was to describe frontline staff burnout using mixed methodology on a DBT-trained combined inpatient/day hospital unit for pediatric eating disorders

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