Table 1.
Summary of data on burnout among psychotherapists.
| References | Year & country | Study design | Burnout measure | Burnout predictors | Sample (gender) | Sample (mean age in years) | Stable relationship (% of sample) | Workload hours week / experience years | Work setting (% of public sector) | Supervision/ personal therapy | Therapeutic modality | Main conclusions |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. Kahill (1986) | 1986, USA | Cross-sectional | “Tedium” burnout measure | Social Support, Professional Expectations | • M – 127 • F – 128 • Total – 255 | 36,2 | 71 % | 33,2 / 11,1 | 100% | N/A | CBT – 100% | Social support and professional expectations about the job were negatively related to burnout among psychotherapists. Burnout was not associated with professional experience or to other demographic factors in this sample of psychotherapists. |
| 2. Ackerley et al. (1988) | 1988, USA | Cross-sectional | Maslach Burnout Inventory | Age, Overinvolvement, Lack of control of therapy setting, Medical issues, Sexual Abuse, Sexual Dysfunction |
• M – 410 • F – 152 • Total – 562 | 44,15 | 79% | 39,22 / 13,8 | 39% | Yes / yes | • PD – 20 % • CBT – 9% • Hum – 6% • Int - 56% • Syst – 9% | Significant burnout predictors in this sample were: younger age, lack of control in the therapeutic setting, feeling overcommitted to clients, problems with physical health, history of sexual abuse and sexual dysfunctions. It was also found that lack of personal psychotherapy and lack of supervision correlated positively with burnout intensity. |
| 3. Huberty and Huebner (1988) | 1988, USA | Cross-sectional | Maslach Burnout Inventory | Job & Role definitions Time pressures (heavy workload) External pressures (superior pressure) Internal pressures (personality conflicts) Age |
• M – N/A • F – N/A • Total - 234 | 38,72 | N/A | N/A / 7,54 | N/A | N/A | CBT – 100% | Role definitions, time pressure (heavy workload), external and internal pressures were all related to burnout among psychotherapists. Younger psychotherapists declared higher burnout level. |
| 4. Raquepaw and Miller (1989) | 1989, USA | Cross-sectional | Maslach Burnout Inventory | Work load Work setting (public) |
• M – 26 • F – 42 • Total - 68 | N/A | N/A | N/A | N/A | N/A | Syst – 100% | Working for a public agency and perceived caseload were the strongest predictors of burnout among psychotherapists. Symptoms of urnout were related to intention to leave this job for other professions. |
| 5. van der Ploeg et al. (1990) | 1990 Denmark | Cross-sectional | Maslach Burnout Inventory | Age Work experience |
• M−69 • F – 29 • Total – 98 | 36,2 | N/A | 32,1/11,1 | 100% | N/A | CBT – 100% | Younger age, less experience in psychotherapy and working in a public sector (compared to private practice) were the strongest predictors of burnout among psychotherapists. |
| 6. Mills and Huebner (1998) | 1998, USA | Longitudinal | Maslach Burnout Inventory | Work experience, Perceived job stress, Neuroticism, Extraversion, Agreeableness, Conscientiousness |
• M – 60 • F – 165 • Total – 225 | 40,3 | N/A | N/A / 10,4 | 100% | N/A | Int – 100% | Less experience in psychotherapy, high level of perceived stress in job as well as personality traits (neuroticism positively, extraversion, agreeableness and conscientiousness negatively) were the most significant burnout predictors among psychotherapists. |
| 7. Wilkerson and Bellini (2006) | 2006, USA | Cross-sectional | Maslach Burnout Inventory | Emotion-Oriented Coping | • M – 22 • F – 56 • Total – 78 | 43,19 | 64,1% | N/A / 11 | 90% | N/A | Int – 100% | Emotion-oriented coping style was the strongest burnout predictor among psychotherapists. |
| 8. Wiseman and Egozi (2006) | 2007, Israel | Cross-sectional | Burnout Questionnaire | Personal Therapy | • M – 16 • F – 83 • O – 4 • Total – 103 | 41,2 | N/A | N/A / 10,6 | 100% | Yes / yes | • CBT – 50% • Int – 50% | Personal therapy occurred to be the strongest buffer against burnout symptoms among psychotherapists. |
| 9. Ben-zur and Michael (2007) | 2007, Israel | Cross-sectional | Maslach Burnout Inventory | Social Support, Problem-oriented coping | • M – 0 • F – 249 • Total – 249 | 41,66 | 73% | 37,62 / N/A | 100% | N/A | CBT – 100% | Appropriate social support at work as well as problem-focused coping with stress were the most important buffers against burnout among psychotherapists. |
| 10. Deighton et al. (2007) | 2007, Germany, Austria, Switzerland | Cross- sectional | Maslach Burnout Inventory | Supervision in working with trauma clients Prevalence of psychotherapists own trauma history |
• M – 34 • F – 65 • O – 1 • Total – 100 | N/A | N/A | 24,7 / 7,7 | 100% | N/A | • PD – 17% • CBT – 14% • Hum – 8% • Int – 31% • Syst – 12% | Supervision and a low prevalence of psychotherapists own trauma history were related to lower burnout level among trauma psychotherapists. |
| 11. Rupert and Kent (2007) | 2007; USA | Cross-sectional | Maslach Burnout Inventory | Age Work load Administrative paperwork Negative client behaviors Overinvolvement Sense of control over work |
• M – 248 • F – 347 • Total – 595 | 51,98 | 75% | 39,19/17,19 | 42% | Yes, yes | • PD – 23 % • CBT – 32% • Hum – 0% • Int - 20% • Syst – 25% | The main important burnout risk factors among psychotherapists were: younger age, too much workload, negative client behaviors and work settings (higher burnout in public sector, with less subjective control over the therapeutic work). In addition it was found that females declared less burnout symptoms than males. |
| 12. Rupert et al. (2009) | 2009, USA | Cross-sectional | Maslach Burnout Inventory | Work-Family conflict, family-work conflict, workload, Sense of control over work, Family support | • M – 205 • F – 292 • Total – 497 | 54,1 | 96% | 35,2 / 19,6 | 39% | Yes / yes | • CBT – 30% • Int – 30% • Syst – 40% | The strongest predictors of burnout among psychotherapist were perceived conflicts on the dimensions work-family or family-work, as well as high workload. Buffers against burnout were family support and perceived sense of control over the job. |
| 13. Kim and Lee (2009) | 2009, South Korea | Cross-sectional | Maslach Burnout Inventory | Perceived job stress, Supervision |
• M – 110 • F – 101 • Total – 211 | 42,2 | N/A | N/A | 100% | Yes / N/A | Syst – 100% | Perceived job stress was positively related with burnout level among psychotherapists, while support received from supervision buffered against this syndrome in this sample of psychotherapists. |
| 14. Emery et al. (2009) | 2009, Australia | Cross-sectional | Maslach Burnout Inventory | Gender, Work setting, Personal resources, Sense of control over work | • M – 54 • F – 136 • Total – 190 | 34,5 | 75,3% | N/A / 7,1 | 45% | N/A | CBT – 100% | Significant burnout risk factors included: gender (females, but only when they work in public sector), public work sector, lack of personal resources and lack of feeling of control over the work. |
| 15. D'Souza et al. (2011) | 2011, Australia | Cross-sectional | Copenhagen Burnout Inventory | Perceived job stress Perfectionism |
• M – 12 • F – 75 • Total – 87 | 45,6 | N/A | N/A, 3,5 | 95% | N/A | CBT – 100% | There was a significant positive relationship between burnout level and the intensity of perfectionism and perceived stress at work. |
| 16. Kim et al. (2011) | 2011, USA | Longitudinal | Maslach Burnout Inventory | Physical health | • M – 62 • F – 223 • Total – 285 | 46,1 | N/A | N/A / 18,1 | 100% | N/A | CBT – 100% | Burnout symptoms predicted deterioration in psychotherapists' physical health (see headaches, gastrointestinal problems, respiratory infections) over three years period of observation. |
| 17. Acker (2012) | 2011, USA | Cross-sectional | Maslach Burnout Inventory | Perceived job stress | • M – 123 • F – 337 • Total – 460 | 41 | 57% | N/A / 11 | 100% | N/A | Int – 100% | Perceived job stress occurred to be the strongest burnout predictor among psychotherapists. |
| 18. Malinowski (2013) |
2013, USA | Cross-sectional | Maslach Burnout Inventory | Humor oriented coping | • M – 42 • F – 91 • Total – 133 | 53,5 | N/A | 26,1 / 19,5 | 54% | N/A | CBT – 100% | Self-enhancing humor, as coping style, was positively related with the level of perceived personal accomplishment among psychotherapists. |
| 19. di Benedetto and Swadling (2014) | 2014, Australia | Cross- sectional | Copenhagen Burnout Inventory | Mindfulness Work experience Career-sustaining behaviors |
• M – 22 • F – 145 • Total – 167 | 42,47 | 77,8 | N/A | 80% | N/A | N/A | Practicing mindfulness and more years of experience seemed to protect from burnout among Australian psychotherapists. |
| 20. Rzeszutek and Schier (2014) | 2014, Poland | Cross-sectional | Oldenburg Burnout Inventory | Social Support, Briskness, Perseveration | • M – 89 • F – 111 • Total – 200 | 35,94 | N/A | 26,1 / 19,5 | 60% | Yes / yes | • CBT – 50% • Hum – 50% | The level of burnout symptoms among psychotherapists was positively related to perseveration and negatively linked to briskness and perceived social support. |
| 21. Steel et al. (2015) | 2015, UK | Cross-sectional | Maslach Burnout Inventory | Work demands Sense of control over work Perceived job stress |
• M - 20 • F – 74 • Total – 94 | 36,9 | N/A | N/A,1,9 | 100% | N/A | • CBT – 88% • Int – 12% | Significant predictors of burnout among psychotherapists were high work demands, perceived job stress and lack of control over the organization of work. |
| 22. Rasmussen et al. (2016) | 2016, Australia | Cross-sectional | Maslach Burnout Inventory | Age, Work demands, Work reward, Overinvolvement, Meaningfulness of work | • M – 66 • F – 351 • Total – 417 | 49,5 | N/A | 34,9 / 5,5 | 82% | Yes/ N/A | • CBT – 52% • Int – 17% • Syst – 31% | Significant predictors of burnout among psychotherapists were younger age, perceived high work demands, perceived low work efforts, over- involvement in therapeutic process and lack of sense of meaning in work. |
| 23. Kim (2017) | 2017, South Korea | Cross-sectional | Maslach Burnout Inventory | Work experience, Personal resources, Secondary Traumatic Stress, Workload |
• M – 59 • F – 120 • Total – 179 | 32,4 | N/A | 16,2 / 1,75 | 100% | N/A | • Int – 18% • Syst – 82% | Significant predictors of burnout among psychotherapists were little work experience, high work load, few personal resources, perceived high work demands, and high symptoms of secondary traumatic stress. |
| 24. Berjot et al. (2017) | 2017, France | Cross- sectional | Maslach Burnout Inventory | Work setting Type of work contract Age Seniority in workplace |
• M – 66 • F – 598 • Total – 664 | 35,44 | N/A | N/A | 54% | N/A | N/A | Working in a company, having multiple work contracts, younger age and seniority in the workplace all showed to be significant predictors of burnout among psychotherapists. |
| 25. Garcia et al. (2018) | 2018, USA | Cross-sectional | Maslach Burnout Inventory | Rule overload in work Vulnerability to oversight Politics influence on treatment methods Supervision |
• M – 143 • F – 338 • Total – 481 | 41,2 | N/A | N/A | 100% | N/A | • CBT – 69% • Int – 16% • Syst – 15% | Burnout was particularly associated with reports of “political influence” on treatment, feelings of vulnerability of complaints to leadership or government, and rule overload in a sample of trauma psychotherapists. Clinical supervision buffered the burnout symptoms in this sample. |
| 26. Simpson et al. (2019) | 2019, Australia | Cross-sectional | Maslach Burnout Inventory | Work demands, Abandonment, Mistrust/Abuse, Emotional Inhibition, Detached Protector | • M – 87 • F – 356 • Total – 443 | 42,93 | 52,8% | N/A | 54% | N/A | • PD – 7% • CBT – 68% • Int – 17% • Syst – 8% | Job demands, early maladaptive schemas and maladaptive coping modes significantly predicted burnout among psychotherapists. |
| 27. Lee et al. (2019) | 2019, South Korea | Cross-sectional | Maslach Burnout Inventory | Perceived job stress, Resilience | • M – 56 • F – 214 • Total – 270 | 35,5 | 52% | N/A | 100% | N/A | N/A | It was found that the level of perceived stress at work positively, and resilience negatively were associated with burnout among psychotherapists. |
| 28. von Hippel et al. (2019) | 2019, Australia | Cross-sectional | Copenhagen Burnout Inventory | Work satisfaction, Commitment to organization, Commitment to profession, Work engagement, Workplace wellbeing, Intentions to leave organization, Intentions to leave profession |
• M – 80 • F – 265 • O – 4 • Total – 349 | 35 | N/A | N/A / 5,65 | 100% | N/A | N/A | Burnout was significantly related to lower job satisfaction and lower job engagement, decreased workplace well-being, and increased turnover rates among psychotherapists. |
| 29. George-Levi et al. (2020) | 2020 Israel | Cross-sectional | Maslach Burnout Inventory | Sense of coherence | • M – 26 • F – 78 • Total – 104 | 37,4 | N/A | N/A6,5 | 100% | N/A | CBT – 100% | Sense of coherence buffered the burnout symptoms among psychotherapists and the perceived loneliness moderated this association. |
| 30. Tsai et al. (2020) | 2020, USA | Cross-sectional | Maslach Burnout Inventory | Age, Ethnicity (Caucasian) | • M – 16 • F – 26 • Total – 42 | 39,6 | 36% | 42,9 / 4,7 | 100% | Yes / N/A | CBT – 100% | Significant predictors of burnout among psychotherapists were younger age and being white. |
| 31. Hricová (2020) | 2020, Slovakia | Cross-sectional | Maslach Burnout Inventory | Perceived job stress, Self-care | • M – 80 • F – 618 • Total - 698 | 43,9 | N/A | 20,34 / 13,12 | 100% | Yes / N/A | • CBT – 32% • Int – 41% • Syst – 27% | There was a significant association between perceived job stress and burnout and this relationship was also mediated by health self-care among psychotherapists. |
| 32. Allwood et al. (2020) | 2020, Sweden | Cross-sectional | Shirom-Melamed Burnout Questionnaire | Age, Ruminations: general, Ruminations: work, Family-work conflict, Work demands |
• M – 182 • F – 646 • Total – 828 | 42,1 | N/A | 38 / N/A | 100% | N/A | CBT – 100% | Burnout was significantly associated with younger age, tendency to ruminations (at work and in general) perceived work conflicts as well as high job demands among psychotherapists. Moreover, results showed that women experienced higher burnout levels than men. |
| 33. Kotera et al. (2021) | 2021, UK | Cross-sectional | Maslach Burnout Inventory | Age Workload Work-life balance |
• M – 23 • F – 83 • Total – 106 | 47,42 | N/A | 31,3/9,3 | 100% | N/A | • Int – 50% • Syst – 50% | Younger age, high workload and problems with work-life balance were found to significantly predict burnout among psychotherapists. |
| 34. Zarzycka et al. (2021) | 2021, Poland | Cross-sectional | Link Burnout Questionnaire | Therapeutic relationship: relational depth Therapeutic relationship: relational quality Psychological wellbeing |
• M – 75 • F – 26 • Total – 101 | 44,34 | 56% | N/A / 10 | 19% | Yes / yes | Hum – 100% | Aspects of therapeutic relationship (relational depth and relational quality) were the strongest buffers against burnout among psychotherapists. Burnout symptoms significantly hampered wellbeing of psychotherapists. |
| 35. Chang and Shin (2021) | 2021, South Korea | Cross-sectional | Professional Quality of Life Scale | Compassion satisfaction, Compassion fatigue, Adaptive emotion regulation, Maladaptive emption regulation, Perceived job stress, Negative client behaviors |
• M – 45 • F – 80 • Total – 125 | N/A | N/A | N/A | 100% | N/A | N/A | Burnout was positively related with compassion fatigue level, maladaptive emotion regulation, and experience of aggression by clients among psychotherapists. Conversely, compassion satisfaction and adaptive emotion regulation strategies buffered from symptoms of burnout in this sample. |
| 36. Smout et al. (2021) | 2021, Australia | Cross-sectional | Maslach Burnout Inventory | Resilience Work demands Coping style: detached protector |
• M – 82 • F – 343 • Total – 425 | 42,79 | 53% | N/A | 54% | N/A | • CBT – 89% • Int – 11% | Maladaptive coping (detached protector coping mode), high work demand seemed to be significantly associated with burnout among psychotherapists. Resilience acted as a buffer against burnout symptoms in this sample. |
| 37. McCade et al. (2021) | 2021, Australia | Cross-sectional | Copenhagen Burnout Inventory | Depression, Self-Compassion | • M – 44 • F – 203 • O – 1 • Total – 248 | 41,04 | 75% | N/A / 12,2 | 82% | N/A | • CBT – 50% • Int – 25% • Syst – 25% | Self-compassion may be treated as protective facto against burnout and depression among psychotherapists. |
| 38. Litam et al. (2021) | 2021, USA | Cross-sectional | Professional Quality of Life Scale | COVID-19 related distress Resilience Compassion fatigue |
• M – 24 • F −135 • O – 2 • Total – 161 | 39,1 | N/A | N/A | 68% | 1, N/A | • CBT – 50% • Int – 50% | COVID-19 related distress and high level of compassion fatigue were the strongest predictors of burnout among psychotherapists. Resilience acted as a buffer against burnout symptoms in this sample. |
Gender: M, Male; F, Female; O, Other; Therapeutic Modality: PD, Psychodynamic; CBT, Cognitive Behavioral Therapy; Hum, Humanistic; Int, Integrative; Syst, Systemic; N/A, Not Available.