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

Abstract

Background Eating 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. Method Frontline 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. Results Eleven 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. Conclusion Qualitative 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 summary Understanding 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.

Child life specialist services, practice, and utilization across health care: a scoping review

“…The evidence revealed that research involving CLS took place in hospitals and health centers (eg, inpatient hospital services), with 93 of the 105 studies conducted in this context representing 89% of the research (Figure 3). 7,12–14,17,19–21,33–117 Other contexts included ambulatory clinics (n = 4; 4%), 25,122–124 multicontext (n = 3; 3%), 23,120,121 community health (n=2; 2%), 24,118 dental office (n=1; 1%), 119 multi-context (n=3; 3%), 23,120,121 rehabilitation facility (n=1; 1%), 22 and proton treatment (n=1; 1%) 16 . These results suggest that the CLS’ workforce is most prevalent in hospitals and health centers.…”

“…Research involving CLS was most prevalent in the USA (n = 84) representing 80% of the evidence 7,12–14,16,17,19–25,34,37–40,42,44,45,47–51,53–55,58–68,72,74–80,82,83,85–92,94–96,98,100–105,107–109,111–113,115–124 with research in Canada a distant second place (n=10) with 10% of the research 35,36,46,52,56,73,81,84,110,114 . The remainder of the evidence was from Australia, Europe, Mexico, and Taiwan with 1 to 2 articles from each country and 3 multicountry studies (Figure 5).…”

“…Physicians were most commonly named as first author in 42% (n=44) of the research studies included, 13,19–22,34,38,39,44,51,52,54,56,58–60,66–68,71–73,77,80,82,86,88,90–95,99–102,104,105,108–110,114,118 whereas CLS were first authors in 18% (n = 19) of studies (Figure 7). 7,16,17,25,42,45,48,62–65,69,84,98,107,111,120–122 Remaining first authorship was divided, with non-clinician researchers as first authors in 16% (n = 17) of studies, nurses in 11% (n = 12) of studies, clinicians in 10% (n = 11) of studies, and 2 studies where first authorship categorization could not be determined.…”

“…The geographical spread of studies is captured in the review findings. See Appendix IV for a full list of included studies 7,12–14,16,17,19–25,33–124 …”

“…2001 USA Health care professionals Hospitals and health centers Participant, researcher/author Corwin et al 51 2012 USA Pediatric patients Hospitals and health centers Implementation Couturier et al 52 2021 Canada Health care professionals Hospitals and health centers Participant Crawford et al 53 …”