Stress and burnout in Improving Access to Psychological Therapies (IAPT) trainees: a systematic review

Abstract

For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given. Key learning aims (1) To establish the current state of the literature regarding stress and burnout in IAPT trainees. (2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees. (3) To make recommendations regarding future research on the topic.

Practitioners’ experience of the working alliance in a blended cognitive–behavioural therapy intervention for depression: qualitative study of barriers and facilitators

“…Wisniewski & Torous 33 have proposed a new role within care teams called 'digital navigators' to reduce the time pressure on PWPs. This is particularly important considering that numerous studies have reported high rates of stress and burnout among PWPs, 34,35 which can lead to PWPs' avoidance of the patient-therapist alliance. 36 The digital navigator's role would involve setting up the programme, troubleshooting technological problems, reviewing patient data and producing data summaries, to provide PWPs with additional sights and time to effectively form a working alliance.…”

Stress, resilience and coping in psychological wellbeing practitioner trainees: a mixed-methods study

“…Owen, J., Crouch-Read, L., Smith, M., & Fisher, P. (2021). Stress and burnout in Improving Access to Psychological Therapies (IAPT) trainees: a systematic review.…”

“…A recent survey of UK psychological therapy practitioners also found evidence that lower workplace wellbeing was associated with a greater likelihood of wanting to leave the NHS, suggesting that workplace wellbeing may have an important relationship with high staff turnover in this population (Summers et al, 2020). Although research regarding trainee psychological therapists is comparatively scarce, existing evidence suggests that wellbeing may be further reduced during the training period, with trainees often reporting levels of stress and burnout that are greater than their qualified peers (Cushway, 1992;Cushway, 1997;Owen et al, 2021;Pakenham and Stafford-Brown, 2012).…”

“…In research to date, factors such as an excessive workload, hours of overtime, client characteristics and professional self-doubt have been associated with elevated levels of stress in psychological therapists (Hannigan et al, 2004;Westwood et al, 2017). Additional evidence suggests that for trainees, the competing demands of their academic workload, and the fact of holding dual roles as students and employees may exacerbate the stress experienced during this time (Owen et al, 2021;Pakenham and Stafford-Brown, 2012). Research into how psychological herapy practitioners and trainees cope with stress suggests that coping strategies such as talking to friends, using social support and exercise are common (Cushway, 1992;El-Ghoroury et al, 2012), with some limited evidence to suggest that high use of avoidance coping strategies such as denial may be associated with increased stress (Cushway and Tyler, 1996;Walklet and Percy, 2014).…”

“…This new workforce consists primarily of psychological wellbeing practitioners (PWPs), trained to use low-intensity CBT approaches to support people experiencing mild to moderate mental health problems, and high intensity therapists (HITs) who are trained to work clinically as cognitive behavioural psychotherapists. A recent systematic review found that research into stress and burnout in IAPT trainees is under-developed (Owen et al, 2021). To address this, further research using both quantitative and qualitative methods is required.…”