Applying integrative therapeutic approaches across organisational and clinical settings

This study used a sequential, primarily explanatory, mixed methods analysis to investigate the relationships between Psychological Inflexibility (the central concept of Acceptance and Commitment Therapy, ‘ACT’), Early Maladaptive Schemas (a key concept of Schema Therapy) and Burnout, and how these factors might inform appropriate interventions. The first component of this study used an online survey combining the Maslach Burnout Inventory–General Survey (MBI-GS, Maslach et al., 1996), the AAQ-ii (Acceptance and Action Questionnaire, Bond et al., 2011) and the Young Schema Questionnaire (YSQ-S3, Young, 2005), along with additional demographic items. A total of 506 participants completed the survey. Quantitative results demonstrated significant relationships between Psychological Inflexibility, a number of Early Maladaptive Schemas, specific demographic variables, and Burnout. Based on these relationships, a number of regression models were created to explain variance in the three dimensions of Burnout measured (Emotional Exhaustion, Cynicism and Professional Efficacy). Additionally principal components (‘factor’) analysis was used to create a single burnout factor, used in additional regression-modelling. The second component of this study used thematic analysis to analyse data collected from interviews with six therapists experienced in working with symptoms of burnout, three identifying themselves as ACT Therapists and three as Schema Therapists. The analysis of the ACT Therapist data resulted in four superordinate themes: 1) Key ACT Concepts and Burnout, 2) Clinical Observations, 3) Assessment and Intervention Principles, and 4) Intervention Specifics. The analysis of the Schema Therapist data also resulted in four superordinate themes: 1) Coping styles, 2) Schema Modes, 3) Understanding Burnout - The Clinician’s Perspective, and 4) Formulation and Intervention. The results from both components are discussed in the context of published literature, relevance to counselling psychology, potential interventions and opportunities for future research.