Contributors to and consequences of burnout among clinical genetic counselors in the United States

Abstract

Prior research has found that many genetic counselors (GCs) experience burnout.Studies of other clinicians have demonstrated that burnout can have significant detrimental consequences for clinicians, patients, and the healthcare system. We sought to explore the prevalence of, contributors to, and consequences of burnout among GCs. We performed a secondary data analysis of baseline data from Me-GC, a randomized controlled trial of meditation for GCs. We applied a systems model of burnout proposed by the National Academy of Medicine (NAM), which depicts burnout arising from a combination of contributors that include both work system and individual mediating factors, and then leading to consequences. Validated self-report scales were used to measure burnout and most contributors and consequences.Female and white GCs were over-represented in our sample. Over half (57.2%) of the 397 participants had Professional Fulfillment Index scores indicative of burnout.Multiple potential contributors were associated with burnout, consistent with its known multifactorial nature. Among work system factors, higher levels of burnout were associated with insufficient administrative support, lack of autonomy, and not feeling valued by non-GC colleagues. Individual mediating factors associated with greater burnout included higher levels of anxiety, depression, and stress. Participants with lower levels of burnout reported greater mindfulness, resilience, and use of professional self-care behaviors. Among variables categorized as consequences, higher levels of burnout were associated with lower levels of empathy, counseling alliance, and positive unconditional regard, as well as higher reactive distress, and a greater desire to reduce the amount of time spent on clinical care. Given the prevalence and potential consequences of burnout observed here, it is imperative that the field take steps to mitigate burnout risk.

Building a foundation in self‐awareness: Genetic counseling students’ experiences with self‐care, reflection, and mindfulness

“…Additionally, genetic counselors’ age, field experience, and/or comfortability in their professional role may impact their ability to benefit from mindful practices. Prior research indicates improved mindfulness has beneficial associations with burnout, compassion fatigue, work engagement, unconditional positive regard, and empathy among genetic counselors (Caleshu et al., 2021; Silver et al., 2018), suggesting genetic counseling students could also experience these benefits. These results demonstrate that there is a need for both increased self‐awareness and mindfulness levels in genetic counseling graduate students.…”

“…A recent publication by Caleshu et al. (2021) reported a significant correlation between stress and burnout among practicing genetic counselors. Additionally concerning, genetic counselors with reported high anxiety were also at risk for compassion fatigue, a state of feeling overwhelmed resulting from an overuse of empathy (Lee et al., 2015).…”

“…The positive association between mindfulness and empathy suggests that practice in mindfulness among genetic counselors could result in increased engagement with patients (Silver et al., 2018). Furthermore, the ‘acting with awareness’ component of mindfulness has been associated with lower levels of burnout, which is negatively associated with genetic counselors’ ability to practice empathy and unconditional positive regard (Caleshu et al., 2021). As empathy and unconditional positive regard are the other key attributes of genetic counselors, self‐awareness cultivated through mindfulness practices may help foster the empathic skills necessary to establish a quality counselor–patient connection.…”

“…It has been proposed that healthcare professionals could benefit from tools to improve their self‐reflection, self‐awareness, and mindfulness and that these tools should be introduced in either the professional or training level (Baker, 2002; Caleshu et al., 2021; Eckroth‐Bucher, 2010; Injeyan et al., 2011; Silver et al., 2018). As an integral time for personal and professional growth, incorporating self‐awareness practices during the graduate school period could instill in genetic counselors the ability to recognize emotional responses to patients, personal stress and anxiety triggers, and other barriers to the therapeutic relationship.…”

Influence of genetic counselor medical history on specialty and psychosocial practice in North America

“…Johnstone et al (2016) found that 40% of 353 surveyed genetic counselors considered leaving or did leave their jobs because of burnout. Other research describes how genetic counselors' interpersonal experiences can lead to burnout or compassion fatigue due to long-lasting emotional effects in the patient-counselor relationship (Caleshu et al, 2021;Lee et al, 2015;Udipi et al, 2008). Studies are needed to examine how the added layer of medical histories that parallel patient histories could affect genetic counselor burnout and compassion fatigue.…”