Abstract
BackgroundBurnout is a major societal issue adversely affecting employees’ health and performance, which over time results in high sick leave costs for organizations. Traditional rehabilitation therapies show suboptimal effects on reducing burnout and the return-to-work process. Based on the health-promoting effects of nature, taking clients outdoors into nature is increasingly being used as a complementary approach to traditional therapies, and evidence of their effectiveness is growing. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, however, impeding its systematic research.AimThe study aims to develop an intervention and evaluation model for outdoor therapy to understand and empirically evaluate whether and how such an outdoor intervention may work for rehabilitation after burnout.Methodological ApproachWe build on the exemplary case of an outdoor intervention for rehabilitation after burnout, developed by outdoor clinical psychologists in Netherlands. We combined the generic context, process, and outcome evaluation model and the burnout recovery model as an overarching deductive frame. We then inductively specified the intervention and evaluation model of outdoor therapy, building on the following qualitative data: semi-structured interviews with outdoor clinical psychologists and former clients; a content analysis of the intervention protocol; and reflective meetings with the intervention developers and health promotion experts.ResultsWe identified six key outdoor intervention elements: (1) physical activity; (2) reconnecting body and mind; (3) nature metaphors; (4) creating relationships; (5) observing natural interactions; and (6) experiential learning. The results further showed that the implementation of these elements may facilitate the rehabilitation process after burnout in which proximal, intermediate, and distal outcomes emerge. Finally, the results suggested that this implementation process depends on the context of the therapist (e.g., number of clients per day), therapy (e.g., privacy issues), and of the clients (e.g., affinity to nature).ConclusionThe intervention and evaluation model for outdoor therapy shows how key outdoor intervention elements may contribute to the rehabilitation process after burnout. However, our model needs to be further tested among a larger group of clients to empirically evaluate whether and how outdoor therapy can support rehabilitation.
Highlights
Employee Burnout and Rehabilitation ProgramsBurnout is defined as “a work-related state of exhaustion that occurs among employees, which is characterized by extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing
We showed that physical activity and experiential learning are essential elements of outdoor therapy for employee burnout, which makes sense as it is known that being physical active outdoors alleviates stress (Hartig et al, 2014) and that rehabilitation entails a process of “learning by experiencing” (Pijpker et al, 2021; Van Dam, 2021)
The present study aimed to develop an intervention and evaluation model of outdoor therapy for employee burnout
Summary
Burnout is defined as “a work-related state of exhaustion that occurs among employees, which is characterized by extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing. These four core dimensions are accompanied by depressed mood as well as by non-specific psychological and psychosomatic distress symptoms” Evaluations of the effectiveness of such burnout rehabilitation interventions reveal suboptimal results in terms of both reducing burnout complaints and facilitating the RTW process (Awa et al, 2010; Ahola et al, 2017; Perski et al, 2017; Pijpker et al, 2020); for example, Blonk et al (2006) showed that combining both CBT and a reduced workload only facilitated a partial RTW but did not fully alleviate burnout complaints. Theories explaining how the combination of general psychological support and outdoor-specific elements can trigger the rehabilitation process in outdoor therapy are often lacking, impeding its systematic research
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