Psychological therapist burnout, ACT and psychological flexibility

For a psychological therapist, burnout is a very real possibility. A recent study of CBT practitioners in the UK found that between 50-70% of therapists reported burnout symptoms (Westwood, Morison, Alt & Holmes, 2017). That’s a very high amount! Burnout is a phenomenon whereby we are no longer about to meet the demands of the job – it simply becomes too taxing.  As time progresses, we become emotionally fatigued, we lose our ability to empathise with our clients and our ability to enjoy our work and get a sense of achievement from it becomes stripped away. Jess, a high intensity therapist working in a London primary care service, describes her journey into burnout:

“A first I thought I was just going through a busy period at work and was sure I’d pop back out on top. After 6 months, the pressure kept building – clients to see, reports to write and targets to meet. I just couldn’t get my head above water. I took a 3 week holiday over Christmas but couldn’t climb down from the anxiety I felt. The dread I experienced going back after the break was like nothing I’d every felt before. In work, my colleagues annoyed me and I resented my clients. I was gutted by this – I’d come into the job to make a real difference, and I can honestly say I ended up hating my job and everything about it. After a week of coming home in tears every night, I knew something wasn’t right and I needed help”.

Given the experience is so common, what can we do about it? The first thing to say upfront is that research shows that a major contributor to burnout is the job itself – factors like low job control, workload, limited managerial support and organisational factors (Leiter & Maslach, 1999). Far from burnout being a sign of personal failing, it is almost always results from these job factors. It therefore may be the case that burnout symptoms are indicators it is time for a new job. Any approach to managing or preventing burnout needs to consider these job factors in order that interventions don’t simply end up being methods to keep practitioners in toxic work environments longer than is healthy.

While job factors are hugely important, the research does point to a number of individual difference factors that can increase the chances that early signs of burnout are ignored and and burnout occurs (Mäkikangas & Kinnunen, 2016). Targeting these can help practitioners respond quickly and effectively to either reduce the impact of the work environment, or to move out of the environment all together.

So what actually can be done to help? A number of studies have been published recently to show that Acceptance and Commitment Therapy (ACT) approaches are particularly helpful in reducing burnout (Frögéli et al. 2015Montaner et al. 2021Puolakanaho et al. 2020). ACT interventions work by increasing psychological flexibility, a skill that is exceptionally useful in the face of a demanding work environment. The evidence demonstrates that training psychological flexibility in the workplace helps people to:

Respond more skilfully to difficult thoughts and emotions


Stay centred and grounded in the present moment


Sharpen clarity on values, which can often easily become obscured in the face to work demands


• Facilitate actual steps towards chosen values


All of these factors help with self care and early identification of burnout symptoms, which are crucial to taking steps to mitigating burnout. These skills are also helpful for helping a person recover effectively from burnout once it has occurred.

If you are interested in finding out more, you might be interested in the work of Jim Lucas, CBT Therapist and Peer Reviewed ACT Trainer from Openforwards. Jim works with individuals and teams to develop practices that build psychological flexibility to increase workplace well being and prevent burnout. In February 2022, he delivered a day workshop on behalf of Contextual Consulting to the Mental Health Psychology Department,  Cwm Taf Morgannwg University Health Board. In the video below, you can watch a short segment of this workshop to get a taste of how ACT can be applied in this setting.

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