(PS7-C71) The Role of Supervision-related Factors in Reducing Community Mental Health Clinicians’ Burnout

Burnout is a significant and prevalent concern among community mental health (CMH) clinicians in which they feel emotionally exhausted by their work. Clinician burnout is associated with poorer quality of care and increased turnover, which is harmful to organizations and the clients they see. Factors contributing to clinician burnout include having a higher client caseload and low organizational resources and support. A growing body of work suggests that high quality clinical supervision may be protective against clinician burnout. However, it is unclear what aspects of supervision can reduce burnout. Therefore, the current study investigates whether multiple supervision-related factors are associated with reduced burnout in CMH clinicians.

Data came from a two-phased study examining supervision practices in Washington State CMH settings. In Phase I, supervision-as-usual practices were examined through observational coding. In Phase II (a randomized controlled trial), clinicians delivering Trauma-focused Cognitive Behavioral Therapy were randomized to one of two gold standard supervision practice conditions. This study uses data from Phase I only, including 152 clinicians and their supervisors (N = 40). Participants were predominantly Female, White, and held a master’s degree. Participating clinicians and supervisors completed self-report measures which were used for our analyses. Clinician-level measures included clinician burnout (9-item measure), supervisory working alliance (19-item measure with two factors: client focus and supervisor-clinician rapport), perceptions of organizational resources for supervision (7-item measure, i.e., availability and quality of supervision-related resources), caseload, and individual supervision frequency. Self-efficacy in supervising (13-item measure) was the only supervisor-level measure included. Descriptive statistics summarized participant characteristics. We employed a two-level multilevel model to examine the relationship between supervision-related factors, in addition to clinician caseload, and clinician burnout with random effects at the supervisor level due to the clustered nature of clinicians within supervisors. Our results revealed that higher clinician client caseload was associated with greater burnout (β = 0.02, 95% CI = [0.00, 0.04]), whereas more positive perceptions of organizational resources for supervision was associated with lower burnout (β = -0.52, 95% CI = [-0.79, -0.25]).

Our findings suggest that CMH clinicians’ caseload and perceptions of having the resources to receive adequate supervision are more closely associated with burnout than the supervisor-clinician working alliance or frequency of individual supervision. Thus, emphasis on improving the quality and availability of supervision in CMH settings may prevent clinicians from burnout and in turn enhance their ability to treat their clients effectively. Future research should study clinician-, supervisor-, and organizational-level moderators that may influence how certain factors affect clinician burnout. Additionally, future work should examine multilevel protective factors for burnout.