Table 1.
Study Characteristics and CCAT scores.
| Author(s) | Country | Design | Sample/specialty | Aim of paper | Theoretical Framework | Burnout dimensions measured | Predictors of burnout studied | Results | CCAT Quality score |
|---|---|---|---|---|---|---|---|---|---|
| Acker, 2012 | USA | 1 | 460 mental health service providers (social workers, psychologists and case managers) | Compare relationships in workplace conditions with role stress, burnout and intent to quit. | 2 | EE | Demographic variables. Work setting and work variables. Career satisfaction. | More than half (56%) of participants reported moderate to high EE, almost three quarters (73%) reported high role stress (RS), and half (50%) reported intention to leave the role. RS significantly predicted burnout. EE significantly predicted the intent to quit, over and above the effect of RS. Those working with patients with severe mental illness report higher levels of burnout and stress. EE is a mediating varibale rather than outcome varibale of burnout. | 25 |
| Ackerley et al., 1988 | USA | 1 | 562/ Licensed psychologists | Examining the correlates of burnout along with the instance of burnout in national sample. | 1 | EE, DP, PA | Demographic information. Case type. Work setting and variables. | Licensed psychologists have higher levels of burnout that other mental health workers. EE was the highest rated dimension of burnout. Age negatively related to burnout. Those in private practice experience less EE, DP and more PA than those in agency settings. PP workers less likely to experience burnout or it's correlates. No gender difference in experienced burnout. Psychologist-client relationship influences burnout. | 31 |
| Ballenger-Browning et al., 2011 | USA | 1 | 97 Civilians and active duty mental health providers in the US military. Psychologists made up the majority of participants (31.5%) | Assess levels and predictors of burnout among mental health providers in a military setting. | 1 | EE, DP, PA | Providers demographics, social support and situational variables. | 27 (27.8%) providers scored in the high level of emotional exhaustion, 18 (18.6%) had high depersonalization scores, and 4 (4.1%) reported a low level of personal accomplishment. Gender, profession and hours worked predicted burnout. Case type influences DP. Employment, experience and support increased PA. High case load decreased PA. | 26 |
| Ben-Zur and Michael, 2007 | Israel | 1 | 249/Social workers (55.8%), Psychs (20.5%) and Nurses (23.7%) all female. | Compare burnout and related characteristic between social workers, psychologists and nurses and assess effectiveness of appraisal, support and coping. | 3 | EE, DP, PA | Age, number of hours working, and origin. | High burnout is negatively correlated with support at work, challenge/control appraisals, and problem-focused coping. At the same time it is positively correlated to stress/load and emotion-focused coping. Social support is mediated by appraisal and coping | 24 |
| Boccio et al., 2016 | USA | 1 | 291 school psychologists | Role conflict, administrative pressure and their influence on burnout. | 1 | EE, DP, PA | Experience with administrative pressure to act unethically or illegally. | High instance of administrative pressure to act unethically and/or illegally. EE was the most highly experienced characteristic of burnout. Administrative power positive related to increased EE, decreased PA, decreased job satisfaction and increased intent to quit. | 27 |
| Carrola et al., 2016 | USA | 1 and/or 2 | 86 correctional counselors with a minimum masters levels qualification (professional counselors, 64%; licensed psychologists, 11.6%; social worker, 5.8%; 17.4% were not licensed; 1.2% did not specify). | Use of CBI among correctional counselors. Compare burnout rates as related to gender and workplace. | 1 | EE, DP,PA. Incompetence, negative work environment, deterioration in personal life. | Gender and experience | Higher burnout was experienced by those who work in maximum security environments. Case type correlated with burnout experienced. Gender and work setting also influenced type of burnout experienced. | 24 |
| Devilly et al., 2009 | Australia | 1 and/or 2 | 152 mental health workers: (125 or 82%) psychologists, (15 or 9.8%) psychotherapists, (6 or 3.9%) clinical social workers, 1 nurse, 1 psychiatrist and 4 other (all engaging in clinical therapeutic work) | Assess STS, VT and burnout among Australian mental health professionals in clinical practice. | 4 | PB, WB, CB | Satisfaction with work. Demographic information. Exposure to trauma. | Burnout contributes to therapists distress more highly than Secondary traumatic stress (STS) and Vicarious trauma (VT). Exposure to trauma patients did not influence burnout experienced. Both VT and burnout contribute significantly to affective distress. Burnout explains more variance in affective distress than VT. | 27 |
| Di Benedetto and Swadling, 2014 | Australia | 1 and/or 2 | 167/ registered psychologists | Investigate burnout in Australian psychologists, work-setting and years of experience. | 1 | PB, WB, CB | Work -setting (private vs. public), length of experience, mindfulness. | Burnout did not differ between psychologists dependent on work-setting. The longer someone had worked, the less burnt out they would be. Mindfulness was negatively related to burnout. | 30 |
| Dreison et al., 2016 | USA | 1 and/or 2 | 358 staff from mental health agencies (Psychology was highest cited discipline. Social work, counseling, nursing, addictions, business and psychiatry) | To identify factors that might protect against burnout. | 4, 5 | EE, DP, PA | Age, education and discipline | Psychologists had significantly higher levels of emotional exhaustion. Education was sig. related to lower DP and lower PA. Men reported higher levels of PA. Age and length of time in the field were not sig. related to any burnout dimensions. Resources interact differently with the different dimensions of burnout. | 30 |
| D'Souza et al., 2011 | Australia | 2 | 87/ Clinical psychologists | Impact of personality on stress. | 1 | PB, WB, CB | Years of experience, work variables, access to peer support, client presenting problems, theoretical orientation. | Perfectionism and stress are related to burnout. Those who are highly stressed are more likely to experience different dimensions of burnout. Bunrout is a reflection of continued exposure to stress. | 26 |
| Emery et al., 2009 | Australia | 1 | 190/ Clinical Psychologists | Examine relationship between burnout, demographics and workplace variants. | 1 | OS, EE, DP, PA. | Age, gender, professional training, years of professional experience, work-status, client type, work setting, annual income, living arrangement. | Distress exacerbated burnout. Perfectionistic tendencies, therapeutic control contributed to stress. High levels of personal resources detract from EE and PA. Higher levels of EE were significantly associated with being female, working primarily for the government, having less personal resources, and endorsing more therapist beliefs related to control. Personal factors were strongest predictors of EE and PA. | 29 |
| Garcia et al., 2016 | USA | 2 | 137 (doctoral-level psychologists, psychology residents and interns, master-level counselors, both master- and doctoral-level social workers) | Examine predictors of burnout and intent to leave. | 1 | EE, DP, PA | Demographics, theoretical orientation, education and experience. Exposure to trauma. Workplace characteristics. | High levels of exhaustion and cynicism were reported, with low PA. Demographic variables not significant for burnout High EE impacted the quality of the service provided. Lack of control influenced exhaustion. Trauma characteristics not related to burnout. Malingering patients increased feelings of cynicism. | 26 |
| Hardiman and Simmonds, 2013 | Australia | 1 | 89 clinicians, counselors and psychotherapists | Relationship between spiritual well-being and burnout. | 1 | EE, DP, PA | Demographic information. Exposure to trauma. | Low levels of burnout reported. EE still came out as strongest indicator of burnout. EE scores weakly and negatively related to ratings of severity of client trauma. Age related to burnout. | 26 |
| Malinowski, 2013 | USA | 1 | 133/psychotherapists | Investigate the relationship between different types of humor and burnout. | 6,7 | EE, DP, PA | Work setting, age, number of years experience after being licensed, average hours worked per week. | Adaptive types of humor used twice as much as maladaptive humor. If looking at the severity levels of burnout as conceptualized by Maslach et al. (1996) therapists who experience EE were between low and moderate levels of severity of burnout. Therapists who experienced DP and decreased PA were on the low level of severity of burnout. | 25 |
| McCormack et al., 2015 | International | 3 | 30 Applied sport psychologists | Impact of social support on burnout and work engagement. | 8 | Qualitative investigation into the impact of social support and the causes of burnout. | Types of social support | All participants were able to recall easily, moments in their career when they felt burnt out. Often during high pressure situations with increased responsibility and/or high stakes. Burnout was experienced at a lower level than those who credited work based peer support as their main source of social support. | 27 |
| Mills and Huebner, 1998 | USA | 4 | 225 at T1: 173 at T2/School psychologists | Prevalence and antecedents of burnout in school psychologists. | 9 | EE, DP, PA | Personality, demographics, number of schools, years of experience, job location, number of colleagues, student ratio. | 40% reported high levels of EE, 10.2% report high DP, and 18.7% reported low PA. Demographic info did not correlate with burnout. Nuroticism correlated all three burnout dimensions. EE sig. correlation with extraversion, agreeableness and conscientiousness. Depersonalization was related to agreeableness and reduced personal accomplishment was related to extraversion. | 31 |
| Proctor and Steadman, 2003 | USA | 1 | 31 in house/32 traditional school psychologists (63 total) | Work setting and it's influence on Burnout | 1 | General burnout | Demographics, job satisfaction, burnout, perceived effectiveness, preference of employment setting and activities. | In-house psychologists report higher job satisfaction and lower burnout. They also report perceived effectiveness. Looking at burnout alone and specifically between items, there are no differences between groups and only the conglomerate score shows a difference. Those serving a single school compared to those who serve multiple schools experience lower levels of burnout. However, overall burnout does not seem to be an issue for the population | 27 |
| Puig et al., 2012 | USA | 2 | 129 mental health professionals [mental health counselors (29%), psychologists (14.7%), counselor education (8.5%), marriage and family therapy (7%), social work (1.6%), rehabilitation counseling (0.8%) other disciplines (38%)] | Burnout in relation to personal wellness. | 1 | Exhaustion, incompetence, negative work environment, devaluing client and, deterioration in personal life. | Burnout and wellness | Exhaustion had the highest mean score from the CBI. Devaluing clients had the lowest mean score. The highest means score on the wellness question went to the social self-subscale, with the coping self-receiving the lowest mean score. Job burnout is negatively related to an individuals exercise and nutrition. | 29 |
| Rosenberg and Pace, 2006 | USA | 1 | 116/ Marriage and family therapists | Predictors and prevalence of burnout. | 1 | EE, DP, PA | Personal Characteristics. Goals and expectations. Demographics. Professional development. Work setting and work variables. | Some differences in demographics. Females reported lower levels of DP. Masters level had slightly higher levels of PA than doctoral-level. No difference between participants who engaged in professional development or professional support than those who did not. Work setting did influence dimensions of burnout experienced. | 23 |
| Rupert and Kent, 2007 | USA | 1 | 595/ practicing psychologists | Determine factors that relate to different levels of burnout. | 10, 8 | EE, DP, PA | Gender, work setting, work variables, resources, coping strategies. | Respondents matched the average or middle range of EE and DP for this population, and the lower range of PA. Age was significantly related to burnout. Gender and work-setting correlated to burnout. Men experience greater DP than women. Workload positively related to burnout. Personal resources have a role in preventing burnout. Solo practitioners reported less support. | 30 |
| Rupert and Morgan, 2005 | USA | 1 | 571/ practicing psychologists | Work setting and it's influence on Burnout. Resources | 1 | EE, DP, PA | Demographic information, work setting and variables, degree, and theoretical orientation. | Work setting and gender correlated with burnout. Age negatively related to burnout. Workload positively related to burnout. | 29 |
| Rupert et al., 2012 | USA | 1 | 595/practicing psychologists | Determine career satisfaction in practicing psychologists | 1 | EE, DP. PA | Career satisfaction. Demographic information, experience, work setting and variables, theoretical orientation, supervision. | Majority of practicing psychologists are satisfied with their work. Control has emerged as a resource related to lower levels of burnout. | 25 |
| Rupert et al., 2009 | USA | 1 | 487/421 practicing psychologists (those who were living with spouse/partner/children) | Determine difference in work-family conflict and it's contribution to burnout. | 8 | EE, DP, PA (MBI-HSS)/Control, Over involvement, Support, Negative clientele (PBI-R) | Family life, Gender, Work setting | Age is related to burnout. No sig difference between gender and work settings in relation to burnout. Control is negatively related to EE and DP while positively related to PA. Gender differences exist in family life and responsibility of care and exhaustion. | 28 |
| Rzeszutek and Schier, 2014 | Poland | 1 | 200 Gestalt and cognitive behavioral therapists | Severity of burnout in relation to temperament traits and social support. | 11 | Exhaustion and disengagement from work. | Burnout, temperament and aspects of social support. | No significant difference between Gestalt therapists and CBT therapists. Perceived social support and briskness were both negatively associated with burnout. Perseveration proved to be a significant positive predictor of burnout symptoms in the whole group of therapists | 26 |
| Senter et al., 2010 | USA | 1 | 203/Correctional psychologists (CR), Veteran's affairs (VA), Counseling Centers (CC), Public Psychiatric Hospital (PPH) | Burnout in correctional psychologists vs. other public sector psychologists. | 1 | EE, DP, PA | Job satisfaction, life satisfaction. | Correctional facility (CR) psychologists experience higher levels of burnout and report lower levels of job satisfaction. Greater professional identity predicted lower levels of burnout. | 29 |
| Sim et al., 2016 | USA | 3 | 14 staff psychologists at colleges and university counseling centers. | Experience in thriving, burnout and coping of psychologists in university counseling centers. | 4 | Qualitative comparison of ECPs vs. LCPs | Post-doctoral experience. | Recognition for achievement was typically identified as important by both ECPs and LCPs. Work setting correlated with thriving. Work variables correlated to thriving. Client improvement also contributed to thriving. Burnout was related to challenge, Non-clinical tasks and crisis work. Challenges in professional relationships contributed to burnout. Loneliness and isolation was only reported as a burnout factor by ECPs and not by LCPs Participants used interpersonal support for coping. Self-care, cognitive coping-strategies, behavioral strategies (creating boundaries and adjusting work schedules). Personal therapy only reported by ECPs. | 31 |
| Steel et al., 2015 | UK | 2 | 116 High Intensity Therapists (HITs) and Psychological Wellbeing Practitioners (PWPs). | Investigate levels and predictors of three burnout dimensions among therapists in IAPT services | 1 | EE, DP, PA | Predictors chosen from the GMB (General model of burnout): causal factors “demands” and lacking “resources.” Demographics, basic client data. | High levels of EE reported. Low levels of DP reported. Psychological job demands predict EE. Age and psychological job demands predict DP. Training significanlty predicted PA. Resources and feelings of in session flow predicted PA. Demographic variables and case type did not predict burnout. High demands and lack of autonomy predict EE. | 30 |
| Viehl and Dispenza, 2015 | USA | 2 | 189 mental health practitioners (licensed individuals e.g., psychologists 66.67%, and certified professionals 15.87%). Final sample size of 150. | Differences in coping and burnout among sexual identified minority MHP. | 1 | Exhaustion, incompetence, negative work environment, devaluing client and, deterioration in personal life. | Gender, sexual orientation. | Male sexual minority related to increased burnout. Sexual-minority identified MHPs engaged in less emotion-focused coping when compared to heterosexual-identified MHPs. Women engaged in more problem-focused coping than men. Sexual minority men in this sample are experiencing more exhaustion, frustration, stress, and not feeling effective as counselors when compared to heterosexual MHPs. | 30 |
| Vredenburgh et al., 1999 | USA | 1 | 521/counseling psychologists who had PhDs | Extent of burnout and relationships between work-setting, demographics and work-setting variables. | 12 | EE, DP, PA | Demographics, work setting and variables. | Reports of moderately low to medium level burnout. Practice setting has implications for burnout: lower level of PA and DP. Private practice lead to lower levels of burnout in general, probably due to autonomy and income. Client load is positively associated with PA but not related to EE or DP. There is an inverse relationship between age and burnout. Males have greater levels of DP than females. | 29 |
Study design: 1, Cross sectional survey on Paper; 2, Cross sectional survey via web; 3, semi structured interview; 4, 2-time prospective study.
Theoretical Framework: 1, N/A; 2, Role Stress Model; 3, Cognitive model of stress and coping; 4, JD-R; 5, SDT; 6, Theory of multidimensional humor; 7, Maslachs theory of job burnout; 8, COR; 9, Transactional model of burnout, personality and situational stressors; 10, Structural model of burnout; 11, Regulatory theory of temperament; 12, General Model of Burnout.
Bold numbers indicate papers which used a theoretical framework.