Risk and Protective Factors for Burnout Among Psychologists: A Scoping Review

Labrecque, L., Larouche, A., Gauthier-Boudreau, J., & Lalande, D. (2024). Risk and protective factors for burnout among psychologists and neuropsychologists: A scoping review. Professional Psychology: Research and Practice, 55(4), 299–312. https://doi.org/10.1037/pro0000573

Rationale

This scoping review aimed to better understand the determinants of burnout among psychologists and neuropsychologists, as well as identify factors that allow these professionals to adapt and thrive at work despite occupational challenges. The rationale for conducting this review stems from several key factors:

1. High prevalence of burnout: Previous research has revealed high rates of burnout among health care professionals, including psychologists and neuropsychologists (Kumary & Baker, 2008; Lee et al., 2011; Maslach et al., 2001). A systematic review by Simionato & Simpson (2018) found that over 54% of psychologists experienced moderate to high levels of burnout symptoms.
2. Emotional demands of the profession: Psychologists and neuropsychologists work in emotionally demanding roles that require empathy and compassion, potentially increasing their risk for compassion fatigue and burnout (Figley, 1995; Freudenberger, 1974).
3. Impact of COVID-19: Recent studies have shown increased psychological distress among psychologists and neuropsychologists during the COVID-19 pandemic (Marra et al., 2023; Trombello et al., 2022), highlighting the need to understand factors influencing burnout in this population.
4. Lack of focused research: While many studies have examined burnout among health care workers broadly, fewer have focused specifically on psychologists and neuropsychologists (McCormack et al., 2018).
5. Need for protective factors: Identifying factors that contribute to job satisfaction and career success for psychologists and neuropsychologists is crucial for developing interventions to prevent burnout and promote well-being in this workforce.

Given these factors, a comprehensive review of recent literature on burnout, job satisfaction, and related factors among psychologists and neuropsychologists was warranted to synthesize current knowledge and identify areas for future research and intervention.

Method

This study employed a scoping review methodology, following the framework developed by Arksey and O’Malley (2005) and updated by Levac et al. (2010).

The researchers also utilized the Joanna Briggs Institute’s methodological guides for scoping reviews (Peters et al., 2015, 2020) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist (Tricco et al., 2018).

Search strategy and terms:

Two main databases were searched: PubMed and APA PsycInfo. The searches were conducted up to June 2022, with the final searches performed on June 1, 2022.

Search strategies were adapted for each database using thesauri and synonyms to ensure comprehensive results without adding irrelevant articles.

Additional methods to identify relevant articles included examining reference lists of included studies and searching for documents citing initially found articles.

Inclusion criteria:

• Scientific studies with available methodological data
• Published between 2012-2022
• Written in English or French
• Focused on psychologists and/or neuropsychologists
• Participants from Western cultures (North America, Europe, Australia)

Exclusion criteria:

• Experimental tools
• Studies where participants were patients
• Inappropriate subjects with no link to work or organization
• Unable to validate that participants were psychologists or neuropsychologists

The initial search identified 232 articles for screening. After title/abstract screening and full-text review, 27 articles were retained for final analysis.

Results

The researchers extracted and synthesized data from the included studies, focusing on qualitative analysis of themes and patterns across studies.

Burnout Prevalence and Determinants:

• Moderate to elevated levels of burnout were reported among psychologists and neuropsychologists across studies.
• Emotional exhaustion was the most prevalent dimension of burnout.
• Factors associated with increased burnout risk included younger age, fewer years of experience, female gender, working in public settings, high work demands, and certain personality traits like low extraversion and agreeableness.
• Protective factors against burnout included self-care behaviors, mindfulness, self-compassion, and greater perceived control over work.

Job Satisfaction and Career Success:

• Despite high burnout rates, psychologists and neuropsychologists generally reported high levels of job satisfaction.
• Factors contributing to job satisfaction included autonomy, teamwork, work-life balance, and perceived organizational support.
• Career success was conceptualized as both objective (salary, promotions) and subjective (job satisfaction, goal attainment).
• Personality traits like extraversion and agreeableness were positively associated with job satisfaction.

Self-Care and Work Environment:

• Self-care emerged as a critical factor in both preventing burnout and promoting job satisfaction.
• Key self-care behaviors included mindfulness, self-compassion, physical activity, and maintaining work-life balance.
• Work environment factors like control over scheduling, manageable administrative tasks, and supportive leadership were associated with lower burnout and higher job satisfaction.

Insight

This scoping review provides several key insights into burnout and job satisfaction among psychologists and neuropsychologists:

1. Coexistence of burnout and job satisfaction: The findings reveal that high levels of job satisfaction can coexist with moderate to high levels of burnout. This suggests that burnout and job satisfaction are not simply opposite ends of a continuum, but rather distinct constructs that can occur simultaneously.
2. Importance of self-care: Self-care emerges as a critical factor in both preventing burnout and promoting job satisfaction. This highlights the need for psychologists and neuropsychologists to prioritize their own well-being and for organizations to support and encourage self-care practices.
3. Multidimensional nature of burnout: Emotional exhaustion appears to be the most prevalent dimension of burnout among psychologists and neuropsychologists. This suggests that interventions targeting emotional regulation and recovery may be particularly beneficial for this population.
4. Role of work environment: The review underscores the importance of work environment factors, such as autonomy, manageable administrative tasks, and supportive leadership, in influencing burnout and job satisfaction. This points to the need for organizational-level interventions to create more supportive work environments.
5. Individual differences: The findings highlight how factors like personality traits, years of experience, and gender can influence susceptibility to burnout and job satisfaction. This suggests the need for personalized approaches to burnout prevention and intervention.

These insights extend previous research by providing a comprehensive overview of factors influencing burnout and job satisfaction specifically among psychologists and neuropsychologist.

The review also highlights the complex interplay between individual, organizational, and professional factors in shaping these outcomes.

Future research directions could include:

• Longitudinal studies to examine the development of burnout and job satisfaction over time
• Intervention studies testing the effectiveness of self-care programs or organizational changes
• In-depth qualitative studies exploring how psychologists and neuropsychologists maintain job satisfaction despite experiencing burnout
• Comparative studies examining differences in burnout and job satisfaction between psychologists in different work settings or specialties

Strengths

The study had many methodological strengths including:

1. Comprehensive search strategy: The researchers used multiple databases and additional methods to identify relevant studies, increasing the likelihood of capturing all pertinent literature.
2. Adherence to established guidelines: The study followed well-established methodological guidelines for scoping reviews, enhancing its rigor and reproducibility.
3. Broad inclusion criteria: By including various study designs and both qualitative and quantitative research, the review provided a comprehensive overview of the topic.
4. Focus on recent literature: By limiting inclusion to studies published in the last 10 years, the review ensured that findings reflected current trends and issues in the field.
5. Multidisciplinary research team: The involvement of researchers with diverse expertise enhanced the quality of the review process and interpretation of findings.
6. Transparent reporting: The use of the PRISMA-ScR checklist ensures transparent and complete reporting of the review process.

Limitations

1. Geographical restrictions: The review focused on Western cultures, potentially limiting the generalizability of findings to other regions.
2. Language limitations: Only studies published in English or French were included, potentially missing relevant research published in other languages.
3. Lack of quality assessment: As is typical for scoping reviews, no formal quality assessment of included studies was conducted, which could impact the reliability of synthesized findings.
4. Potential publication bias: The review may be subject to publication bias, as it only included published studies.
5. Heterogeneity of included studies: The diverse range of study designs and measures used across included studies made direct comparisons challenging.
6. Lack of longitudinal data: Most included studies were cross-sectional, limiting our understanding of how burnout and job satisfaction change over time.

These limitations suggest that findings should be interpreted with caution and highlight the need for further research addressing these gaps.

Implications

The results of this scoping review have several significant implications for clinical psychology practice and organizational policy:

1. Emphasis on self-care: The strong association between self-care practices and reduced burnout risk suggests that self-care should be prioritized in professional training and continuing education for psychologists and neuropsychologists. Organizations should also consider how to support and encourage self-care among their staff.
2. Work environment interventions: Given the impact of work environment factors on burnout and job satisfaction, healthcare organizations should focus on creating supportive work environments. This could include providing greater autonomy, reducing administrative burdens, and fostering supportive leadership.
3. Tailored interventions: The findings suggest that burnout risk and job satisfaction are influenced by individual factors such as age, experience, and personality traits. This implies that one-size-fits-all approaches to burnout prevention may be less effective than tailored interventions.
4. Early career support: Given that younger and less experienced professionals appear to be at higher risk for burnout, organizations should consider implementing targeted support and mentoring programs for early career psychologists and neuropsychologists.
5. Work-life balance: The importance of work-life balance in promoting job satisfaction suggests that organizations should implement policies that support flexible working arrangements and respect for personal time.
6. Emotional regulation skills: Given the prevalence of emotional exhaustion, training in emotional regulation skills could be beneficial for psychologists and neuropsychologists.
7. Regular assessment: Organizations could benefit from regularly assessing burnout levels and job satisfaction among their staff to identify trends and implement timely interventions.

These implications underscore the need for a multifaceted approach to promoting well-being and job satisfaction among psychologists and neuropsychologists, involving both individual-level strategies and organizational policies.

References

Primary reference

Labrecque, L., Larouche, A., Gauthier-Boudreau, J., & Lalande, D. (2024). Risk and protective factors for burnout among psychologists and neuropsychologists: A scoping review. Professional Psychology: Research and Practice, 55(4), 299–312. https://doi.org/10.1037/pro0000573

Other references

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32.

Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.

Freudenberger, H. J. (1974). Staff burn-out. Journal of Social Issues, 30(1), 159-165.

Kumary, A., & Baker, M. (2008). Stresses reported by UK trainee counselling psychologists. Counselling Psychology Quarterly, 21(1), 19-28.

Lee, J., Lim, N., Yang, E., & Lee, S. M. (2011). Antecedents and consequences of three dimensions of burnout in psychotherapists: A meta-analysis. Professional Psychology: Research and Practice, 42(3), 252-258.

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69.

Marra, D. E. C., Simons, M. U., Schwartz, E. S., Marston, E. A., & Hoelzle, J. B. (2023). Burnt out: Rate of burnout in neuropsychology survey respondents during the COVID-19 pandemic, brief communication. Archives of Clinical Neuropsychology, 38(2), 258-263.

Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52(1), 397-422.

McCormack, H. M., MacIntyre, T. E., O’Shea, D., Herring, M. P., & Campbell, M. J. (2018). The prevalence and cause(s) of burnout among applied psychologists: A systematic review. Frontiers in Psychology, 9, 1897.

Peters, M. D. J., Godfrey, C., McInerney, P., Soares, C. B., Khalil, H., & Parker, D. (2015). Methodology for JBI scoping reviews. In E. Aromataris (Ed.), The Joanna Briggs Institute Reviewers manual 2015 (pp. 3-24). Joanna Briggs Institute.

Simionato, G. K., & Simpson, S. (2018). Personal risk factors associated with burnout among psychotherapists: A systematic review of the literature. Journal of Clinical Psychology, 74(9), 1431-1456.

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., … & Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467-473.

Trombello, J. M., David, N. S., Robbins, M. A., & Ruchinskas, R. A. (2022). Burnout during the COVID-19 pandemic: Descriptive and predictive data from a survey of psychologists at a single academic medical center. Academic Psychiatry, 46(6), 718-722.

Keep Learning

Here are some Socratic questions for a college class to discuss this paper:

1. How might the coexistence of high job satisfaction and high burnout rates among psychologists and neuropsychologists be explained? What implications does this have for how we conceptualize and measure occupational well-being?
2. Given the importance of self-care in preventing burnout, what barriers might psychologists and neuropsychologists face in implementing self-care practices? How could these barriers be addressed at individual, organizational, and professional levels?
3. How might the finding that emotional exhaustion is the most prevalent dimension of burnout inform interventions or training programs for psychologists and neuropsychologists?
4. Considering the impact of work environment factors on burnout and job satisfaction, what specific changes could healthcare organizations implement to create more supportive work environments for psychologists and neuropsychologists?
5. How might the relationship between burnout and job satisfaction differ for early-career versus experienced psychologists and neuropsychologists? What implications does this have for professional development and support across the career span?
6. Given the limitations of the current research, what study designs or methodologies would be most valuable for advancing our understanding of burnout and job satisfaction in this population?
7. How might cultural differences influence experiences of burnout and job satisfaction among psychologists and neuropsychologists? How could future research address this question?
8. Considering the high rates of burnout despite high job satisfaction, what ethical implications arise regarding psychologists’ and neuropsychologists’ ability to provide effective care to their clients?