Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
Front Public Health. 2024 Mar 6;12:1304345. doi: 10.3389/fpubh.2024.1304345. eCollection 2024.
Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health.
We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics ( = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand.
Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.
儿童心理健康临床医生的倦怠、二次创伤压力和高离职率不仅对个体治疗师和组织构成挑战，而且对循证实践的成功实施也是如此。然而，对于哪些以及如何与工作和实施相关的因素与儿童治疗师的倦怠、二次创伤压力和离职意向以及同情心满足感相关，人们知之甚少。在本研究中，我们旨在通过整合“职业生活质量”和“工作需求-资源”职业健康模型来探索这些因素和相关机制。
我们测量了挪威儿童和青少年心理健康诊所（共 256 名治疗师，其中 44 名）中实施创伤焦点认知行为疗法（TF-CBT）的全国性样本的感知职业生活质量和离职意向。还使用一般北欧心理和社会因素工作问卷和实施部分问卷测量了 17 个与工作和实施相关的资源和需求。路径分析用于检验倦怠和同情心满足感是否在工作需求和资源与二次创伤压力和离职意向之间的关系上起中介作用。
结果表明，两种工作资源，即工作中的积极挑战和对工作的掌握，是所有职业结果的重要预测因素。提出的模型仅得到部分支持。也就是说，虽然倦怠确实在一些工作需求（即工作-家庭干扰和角色冲突）与工作资源（即人力资源优势、积极挑战和对工作的掌握）与二次创伤压力和离职意向之间的关系上起中介作用，但同情心满足感并没有在工作资源与离职意向之间起中介作用。此外，除了通过倦怠的间接影响外，角色冲突和组织氛围（人力资源优势）也直接影响离职意向。这些发现表明，应优先考虑减少倦怠的干预措施，以提高儿童治疗师的职业生活质量和离职意向。从理论上讲，似乎同情心满足感和工作投入的作用不同。
