Burnout among the addiction counseling workforce: The differential roles of mindfulness and values-based processes and work-site factors

Journal of Substance Abuse Treatment

Volumn 40, Issue 4, 2011, Pages 323-335

  Vilardaga, Roger ^a   Luoma, Jason B ^b   Hayes, Steven C ^a   Pistorello, Jacqueline ^a   Levin, Michael E ^a   Hildebrandt, Mikaela J ^a   Kohlenberg, Barbara ^c   Roget, Nancy A ^d   Bond, Frank ^e  

^a UNIVERSITY OF NEVADA   (United States)

^b Research and Training Center ^*  (United States)

^c UNIVERSITY OF NEVADA SCHOOL OF MEDICINE   (United States)

^d Center for Application of Substance Abuse Technologies   (United States)

^e UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

Addiction counselors; Burnout; Cognitive fusion; Experiential avoidance; Values commitment; Work site factors

Indexed keywords

ADDICTION; ADULT; ARTICLE; BURNOUT; CROSS-SECTIONAL STUDY; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; MENTAL HEALTH CARE; MENTAL HEALTH CARE PERSONNEL; PATIENT COUNSELING; PRIORITY JOURNAL; SALARY; SOCIAL SUPPORT; SUBSTANCE ABUSE; WORK ENVIRONMENT; WORKLOAD;

ADULT; BURNOUT, PROFESSIONAL; COGNITION; COUNSELING; CROSS-SECTIONAL STUDIES; FEMALE; HUMANS; MALE; MIDDLE AGED; PROBLEM-BASED LEARNING; REGRESSION ANALYSIS; SUBSTANCE-RELATED DISORDERS; WORKPLACE;

EID: 79955103228     PISSN: 07405472     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jsat.2010.11.015     Document Type: Article

References (99)

1. Addiction and Technology Transfer Center (ATTC) National Office Understanding American's substance use disorders treatment workforce: A summary report. Kansas City: Missourri 2009.
2. Alotaibi A.G. Job burnout among employees in the Kuwaiti Civil Service and its relationship with type a personality and intention to leave. Journal of the Social Sciences 2003, 31:347-385.
3. Austad C.S., Sherman W.O., Morgan T., Holstein L. The psychotherapist and the managed care setting. Professional Psychology: Research and Practice 1992, 23:329-332.
4. Bach P., Hayes S.C. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology 2002, 70:1129-1139.
5. Balogun J.A., Titiloye V., Balogun A., Oyeyemi A., Katz J. Prevalence and determinants of burnout among physical and occupational therapists. Journal of Allied Health 2002, 31:131-139.
6. Blackledge J.T., Spencer R., Ciarrochi J. Initial validation of the personal values questionnaire 2007, May.
7. Bond F.W., Bunce D. Job control mediates change in a work reorganization intervention for stress reduction. Journal of Occupational Health Psychology 2001, 6:290-302.
8. Bond F.W., Bunce D. The role of acceptance and job control in mental health, job satisfaction, and work performance. Journal of Applied Psychology 2003, 88:1057-1067.
9. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Orcutt, H. K., Waltz, T. et al. (n.d.). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological flexibility and acceptance. Submitted.
10. Bowen S., Witkiewitz K., Dillworth T.M., Chawla N., Simpson T.L., Ostafin B.D., et al. Mindfulness meditation and substance use in an incarcerated population. Psychology of Addictive Behaviors 2006, 20:343-347.
11. Broome K.M., Knight D.K., Edwards J.R., Flynn P.M. Leadership, burnout, and job satisfaction in outpatient drug-free treatment programs. Journal of Substance Abuse Treatment 2009, 37:160-170.
12. Brown K.W., Ryan R.M. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003, 84:822-848.
13. Carpenter M.C. Job rewards and concerns for social workers: The impact of changes in funding and delivery of mental health services. Smith College Studies in Social Work 1999, 70:69-84.
14. Carrico A.W., Gifford E.V., Moos R.H. Spirituality/Religiosity promotes acceptance-based responding and 12-step involvement. Drug and Alcohol Dependence 2007, 89:66-73.
15. Chapman A.L., Gratz K.L., Brown M.Z. Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy 2006, 44:371-394.
16. Clarke P., Wheaton B. Addressing data sparseness in contextual population research-Using cluster analysis to create synthetic neighborhoods. Sociological Methods & Research 2007, 35:311-351.
17. Cohen G.L., Garcia J., Purdie-Vaughns V., Apfel N., Brzustoski P. Recursive processes in self-affirmation: Intervening to close the minority achievement gap. Science 2009, 324:400-403.
18. Cohen J. A Power Primer. Psychological Bulletin 1992, 112:155-159.
19. Cohen J., Cohen P., West S.G., Aiken L.S. Applied multiple regression/correlation analysis for the behavioral sciences 2003, Lawrence Erlbaum Associates, Mahwah, NJ. 3rd ed.
20. Crisp A.H., Gelder M.G., Rix S., Meltzer H.I., Rowlands O.J. Stigmatisation of people with mental illnesses. British Journal of Psychiatry 2000, 177:4-7.
21. Croy C., Novins D. Methods for addressing missing data in psychiatric and developmental research. Journal of the American Academy of Child and Adolescent Psychiatry 2005, 44:1230-1240.
22. Cushway D., Tyler P. Stress in clinical psychologists. International Journal of Social Psychiatry 1996, 42:141-149.
23. Ducharme L.J., Knudsen H.K., Roman P.M. Emotional exhaustion and turnover intention in human service occupations: The protective role of coworker support. Sociological Spectrum 2008, 28:81-104.
24. Elliot A.J., Harackiewicz J.M. Approach and avoidance achievement goals and intrinsic motivation: A mediational analysis. Journal of Personality and Social Psychology 1996, 70:461-475.
25. Epstein R.M. Mindful practice. Jama-Journal of the American Medical Association 1999, 282:833-839.
26. Festinger D.S., Rubenstein D.F., Marlowe D.B., Platt J.J. Relapse: Contributing factors, causative models, and empirical considerations 2001, Yale University Press, New Haven, CT, US.
27. Flaxman P., Bond F.W. A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Behaviour Research and Therapy 2010, 48:816-820.
28. Frese M., Zaph D. Action as the core of work psychology: A German approach. Handbook of industrial and organizational psychology 1994, Vol. 4:271-340. Consulting Psychologists Press, Palo Alto, California. H.C. Triandis, M.D. Dunnette, L.. Hough (Eds.).
29. Gallon S., Gabriel R., Knudsen J. The toughest job you'll ever love; A Pacific Northwest Treatment Workforce Survey. Journal of Substance Abuse Treatment 2003, 24:183-196.
30. Ganster D.C., Fusilier M.R., Mayes B.T. Role of social support in the experience of stress at work. Journal of Applied Psychology 1986, 71:102-110.
31. Garner B.R. The impact of counselor burnout on therapeutic relationships: A multilevel analytic approach. Dissertation Abstracts International 2006, 67:581.
32. Gifford E.V., Kohlenberg B.S., Hayes S.C., Antonuccio D.O., Piasecki M.M., Rasmussen-Hall M.L., et al. Acceptance-based treatment for smoking cessation. Behavior Therapy 2004, 35:689-705.
33. Graham J.W. Missing data analysis: Making it work in the real world. Annual Review of Psychology 2009, 60:549-576.
34. Greco L.A., Heffner M., Poe S., Ritchie S., Polak M., Lynch S.K. Maternal adjustment following preterm birth: Contributions of experiential avoidance. Behavior Therapy 2005, 36:177-184.
35. Hackman J.R., Lawler E.E. Employee reactions to job characteristics. Journal of Applied Psychology 1971, 55:259-286.
36. Hayes S.C., Bissett R., Roget N., Padilla M., Kohlenberg B.S., Fisher G., et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behavior Therapy 2004, 35:821-835.
37. Hayes S.C., Follette V.M., Linehan M.M. Mindfulness and acceptance: Expanding the cognitive-behavioral tradition 2004, Guilford Press, New York.
38. Hayes S.C., Luoma J.B., Bond F.W., Masuda A., Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy 2006, 44:1-25.
39. Hayes S.C., Melancon S.M. Comprehensive distancing, paradox, and the treatment of emotional avoidance. Therapeutic paradox 1989, 184-218. Guilford Press, New York. L.M. Ascher (Ed.).
40. Hayes S.C., Strosahl K., Wilson K.G., Bissett R.T., Pistorello J., Toarmino D., et al. Measuring experiential avoidance: A preliminary test of a working model. Psychological Record 2004, 54:553-578.
41. Hayes S.C., Strosahl K.D., Wilson K.G. Acceptance and commitment therapy: An experiential approach to behavior change 1999, Guilford Press, New York.
42. Hayes S.C., Wilson K.G., Gifford E.V., Bissett R., Piasecki M., Batten S.V., et al. A preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts. Behavior Therapy 2004, 35:667-688.
43. Hayes S.C., Wilson K.G., Gifford E.V., Follette V.M. Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology 1996, 64:1152-1168.
44. Hardwood H.J. Survey on Behavioral Health Workplace. Frontlines linking alcohol services research & practice 2002, November, National Institute of Alcohol Abuse and Alcoholism in conjunction with Academy Health, Washington, DC.
45. Hubbard R.L., Flynn P.M., Craddock S.G., Fletcher B.W. Relapse after drug abuse treatment 2001, Yale University Press, New Haven, CT, US.
46. Ivey S.L., Scheffler R., Zazzali J.L. Supply dynamics of the mental health workforce: Implications for health policy. Milbank Quarterly 1998, 76:25.
47. Johnson J.A., Knudsen H.K., Roman P.M. Counselor turnover in private facilities. Frontlines: Linking alcohol services research and practice. 2002, National Institute of Alcohol Abuse and Alcoholism., Washington, DC.
48. Kaplan L. Substance abuse treatment workforce environmental scan. Substance Abuse and Mental Health Services Administration (SAMHSA) Retrieved on January 5, 2007 from. http://pfr.samhsa.gov/docs/Environmental_Scan.pdf.
49. Karasek R., Brisson C., Kawakami N., Houtman I., Bongers P., Amick B. The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology 1998, 3:322-355.
50. Knudsen H.K., Ducharme L.J., Roman P.M. Clinical supervision, emotional exhaustion, and turnover intention: A study of substance abuse treatment counselors in the Clinical Trials Network of the National Institute on Drug Abuse. Journal of Substance Abuse Treatment 2008, 35:387-395.
51. Knudsen H.K., Ducharme L.J., Roman P.M. Turnover intention and emotional exhaustion "at the top": Adapting the job demands-resources model to leaders of addiction treatment organizations. Journal of Occupational Health Psychology 2009, 14:84-95.
52. Knudsen H.K., Ducharme L.J., Roman P.M. Counselor emotional exhaustion and turnover intention in therapeutic communities. Journal of Substance Abuse Treatment 2006, 31:173-180.
53. Knudsen J., Gabriel R. Advancing the current state of addictions treatment: A regional needs assessment of substance abuse treatment professionals in the pacific northwest 2003, Danya Institute, Portland, OR.
54. Landis R., Earp B., Libretto S. Unpublished report on the state of the substance abuse treatment workforce in 2002: Priorities and possibilities 2002, Danya International, Inc.
55. Lee R.T., Ashforth B.E. A meta-analytic examination of the correlates of the three dimensions of job burnout. Journal of Applied Psychology 1996, 81:123-133.
56. Leigh J., Bowen S., Marlatt G.A. Spirituality, mindfulness and substance abuse. Addictive Behaviors 2005, 30:1335-1341.
57. Luoma J.B., Hayes S.C., Twohig M.P., Roget N., Fisher G., Padilla M., et al. Augmenting continuing education with psychologically focused group consultation: Effects on adoption of group drug counseling. Psychotherapy 2007, 44:463-469.
58. Luoma J.B., Kohlenberg B.S., Hayes S.C., Bunting K., Rye A.K. Reducing self-stigma in substance abuse through acceptance and commitment therapy: Model, manual development, and pilot outcomes. Addiction Research & Theory 2008, 16:149-165.
59. Manderscheid R.W., Henderson M.J., Witkin M.J., Atay J.E. The U.S. mental health system of the 1990s: The challenges of managed care. International Journal of Law and Psychiatry 2000, 23:245-259.
60. Marx B.P., Sloan D.M. Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behaviour Research and Therapy 2005, 43:569-583.
61. Maslach C., Jackson S.E., Leiter M.P. Maslach Burnout Inventory 1996, Consulting Psychologists Press, Palo Alto, CA. 3rd ed.
62. Maslach C., Schaufeli W.B., Leiter M.P. Job burnout. Annual Review of Psychology 2001, 52:397-422.
63. Masuda A., Hayes S.C., Sackett C.F., Twohig M.P. Cognitive defusion and self-relevant negative thoughts: Examining the impact of a ninety year old technique. Behaviour Research and Therapy 2004, 42:477-485.
64. McCracken L.M., Yang S. A contextual cognitive-behavioral analysis of rehabilitation workers' health and well-being: Influences of acceptance, mindfulness, and values-based action. Rehabilitation Psychology 2008, 53:479-485.
65. McGovern M.P., Xie H.Y., Segal S.R., Siembab L., Drake R.E. Addiction treatment services and co-occurring disorders: Prevalence estimates, treatment practices, and barriers. Journal of Substance Abuse Treatment 2006, 31:267-275.
66. Mulvey K.P., Hubbard S., Hayashi S. A National Study of the Substance Abuse Treatment Workforce. Journal of Substance Abuse Treatment 2003, 24:51-57.
67. Muto, T., Hayes, S.C., Jeffcoat, T. (In press). The effectiveness of Acceptance and Commitment Therapy bibliotherapy for enhancing the psychological health of Japanese College students living abroad. Behavior Therapy.
68. National Association of Alcoholism and Drug Abuse Counselors (NAADAC) Practitioner Services Network: Report 2003.
69. National Evaluation Data Services (NEDs) Profile of Clinicians in the National Treatment Improvement Evaluation (NTIES) 2001.
70. Ogborne A.C., Braun K., Schmidt G. Working in addictions treatment services: Some views of a sample of service providers in Ontario. Substance Use & Misuse 1998, 33:2425-2440.
71. Osborn C.J. Seven salutary suggestions for counselor stamina. Journal of Counseling & Development 2004, 82:319-328.
72. Ost L.G. Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy 2008, 46:296-321.
73. Ostafin B.D., Marlatt G.A. Surfing the urge: Experiential acceptance moderates the relation between automatic alcohol motivation and hazardous drinking. Journal of Social and Clinical Psychology 2008, 27:404-418.
74. Pedhazur E.J., Pedhazur Schmelkin L. Measurement, design, and analysis. An Integrated Approach 1991, Lawrence Erlbaum, New Jersey.
75. Perrewe P.L., Ganster D.C. The impact of job demands and behavioral control on experienced job stress. Journal of Organizational Behavior 1989, 10:213-229.
76. Peterson K.H. Occupational stress and burnout among addictions counselors. Dissertation Abstracts International 1990, 50:2781-2782.
77. Plumb J., Stewart I., Dahl J., Lundgren T. In search of meaning: Values in modern clinical behavior analysis. Behavior Analyst 2009, 32:85-103.
78. Plumb J.C., Orsillo S.M., Luterek J.A. A preliminary test of the role of experiential avoidance in post-event functioning. Journal of Behavior Therapy and Experimental Psychiatry 2004, 35:245-257.
79. Podsakoff P., MacKenzie S., Lee J., Podsakoff N. Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology 2003, 88:879-903.
80. Polusny M.A., Rosenthal M.Z., Aban I., Follette V.M. Experiential avoidance as a mediator of the effects of adolescent sexual victimization on negative adult outcomes. Violence and Victims 2004, 19:109-120.
81. Powers M.B., Vording M.B.Z.S., Emmelkamp P.M.G. Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics 2009, 78:73-80.
82. RMC Research Corporation Advancing the current state of addiction treatment. A regional needs assessment of substance abuse treatment professionals in the pacific northwest 2003, RMC Research, Portland, OR.
83. RMC Research Corporation Kentucky Workforce Survey 2002. Results of a statewide needs assessment of substance abuse treatment professionals 2003, RMC Research, Portland, OR.
84. Rubin D.B. Multiple imputation for nonresponse in surveys 1987, Wiley and Sons, New York.
85. Sarata B.P. Burnout workshops for alcoholism counselors. Journal of Alcohol and Drug Education 1983, 28:34-46.
86. Sargent L.D., Terry D.J. The effects of work control and job demands on employee adjustment and work performance. Journal of Occupational and Organizational Psychology 1998, 71:219-236.
87. Schafer J. Multiple imputation: A primer. Statistical Methods in Medical Research 1999, 8:3-15.
88. Schaufeli W.B., Bakker A.B. Job demands, job resources, and their relationship with burnout and engagement: A multi-sample study. Journal of Organizational Behavior 2004, 25:293-315.
89. Shapiro S.L., Brown K.W., Biegel G.M. Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology 2007, 1:105-115.
90. Sheldon K.M., Elliot A.J. Goal striving, need satisfaction, and longitudinal well-being: The self-concordance model. Journal of Personality and Social Psychology 1999, 76:482-497.
91. Sheldon K.M., Kasser T., Smith K., Share T. Personal goals and psychological growth: Testing an intervention to enhance goal attainment and personality integration. Journal of Personality 2002, 70:5-31.
92. Smith C.S., Tisak J., Hahn S.E., Schmieder R.A. The measurement of job control. Journal of Organizational Behavior 1997, 18:225-237.
93. Substance Abuse and Mental Health Services Administration. Alcohol and Drug Services Study (ADSS) The National Substance Abuse Treatment System: Facilities, clients, services, and staffing 2003, Office of Applied Studies, Rockville, MD.
94. Tabachnick B.G., Fidell L.S. Using multivariate statistics 2007, Allyn & Bacon, Boston. 5th ed.
95. Terry D.J., Jimmieson N.L. Work control and employee well-being: A decade review 1999, Wiley & Sons, New York, NY, US.
96. van Dierendonck D., Schaufeli W.B., Buunk B.P. The evaluation of an individual burnout intervention program: The role of inequity and social support. Journal of Applied Psychology 1998, 83:392-407.
97. Varra A.A., Hayes S.C., Roget N., Fisher G. A randomized control trial examining the effect of acceptance and commitment training on clinician willingness to use evidence-based pharmacotherapy. Journal of Consulting and Clinical Psychology 2008, 76:449-458.
98. Wilson K.G., Hayes S.C., Gregg J., Zettle R.D. Psychopathology and psychotherapy. Relational frame theory: A post-Skinnerian account of human language and cognition 2001, 211-237. Kluwer Academic/Plenum Publishers, New York. S.C. Hayes, D. Barnes-Holmes, B. Roche (Eds.).
99. Zettle R.D., Hayes S.C. Dysfunctional control by client verbal behavior. The Analysis of Verbal Behavior 1986, 4:30-38.