A clinical perspective on burnout:Diagnosis, classification, and treatment of clinical burnout

In clinical psychology, burnout is regarded as a mental disorder assessed in patients who apply for psychological treatment and no longer work because of their symptoms or experience of serious problems in functioning at work. This definition of burnout is mostly referred to as ‘clinical burnout’. The purpose of this article is to provide insight into how clinicians in The Netherlands establish a diagnosis of clinical burnout and how they fit it in their classification systems. An outline is given on how psychological interventions for burnout are applied in therapies. The different phases in the treatment of clinical burnout – crisis, recovery, prevention, and post burnout growth, as well as their accompanying interventions are described. It may be relevant for work and organizational psychologists to realize that biological processes may play a role in the development of clinical burnout. For the physiology of stress, it does not matter whether the stress is work-related or the result of stress in private life or both. Central to understanding clinical burnout is the lack of recovery of the (physiological) stress system. It is also argued that the relevance of questionnaires, for detecting who is at serious health risk, is limited

Explaining the willingness of clinicians to work with patients with antisocial personality disorder using the theory of planned behaviour and emotional reactions

Many clinicians seem to experience negative emotions towards patients with antisocial personality disorder (ASPD), resulting in the exclusion of patients in many treatment programmes. The behaviour of individuals with ASPD has a significant impact on society, which affects ASPD patients and their environment, and therefore, the exclusion from programmes is a serious concern. Relatively, little is known about why some clinicians are willing to work with ASPD patients and others are not and what factors contribute to an increase in the motivation to do so. In this study, clinicians (n = 130) working in a regular and forensic mental health service in the Netherlands completed a questionnaire based on the theory of planned behaviour (TPB) and the Feeling Word Checklist and questions about the relevant experience gained and education received. The current study confirms the limited willingness to work with ASPD patients, especially in regular mental health care. Experience working with ASPD patients, education on cluster B personality disorders and having experienced verbal and/or physical violence in clinical practice did not fully explain whether or not clinicians were motivated to provide treatment to ASPD patients. TPB appeared to predict the intention to provide psychological therapy to ASPD patients adequately. The impact of positive emotions towards ASPD patients on providing treatment appeared to be stronger than negative emotions. This study provides more insight into why so few clinicians are willing to work with ASPD patients and what may increase motivation to include this group in treatment programmes

De maatschappij komt de spreekkamer binnen:Aandacht voor complotdenken en anti-overheidssentimenten in de GGZ

Corona heeft geleid tot een toename aan diverse psychische klachten onder de bevolking, de werkdruk onder hulpverleners is gestegen. De gevolgen zullen in de ggz waarschijnlijk nog lang voelbaar zijn, betogen Arno van Dam en collega’s. ‘Door de polarisatie in de samenleving van de afgelopen jaren is de buitenwereld veel nadrukkelijk de behandelkamer binnengekomen.

Spousal Assaulters in Outpatient Mental Health Care:The Relevance of Structured Risk Assessment

This study examined whether a typology of perpetrators of intimate partner violence (IPV) could be replicated in a Dutch sample (N = 154) of self-referred IPV perpetrators using a structured risk assessment tool for relational violence (Brief Spousal Assault Form for the Evaluation of Risk [B-SAFER]). Our findings support the previous IPV perpetrator subtypes: low-level antisocial (LLA), family only (FO), psychopathology (PP), and generally violent/antisocial (GVA). The subtypes differed on the descriptive dimensions general criminality, substance use, and mental health problems. The prevalence rates for each subtype were roughly comparable with those in previous studies. Contrary to expectation, the prevalence of the GVA subtype was relatively high in our self-referred sample compared with court-referred samples. Our findings suggest that structured risk assessment should be an integral part of the intake procedure for IPV perpetrators entering treatment, to assess their level of risk and to arrive at a tailored risk management strategy, regardless of setting or referral source

Including personal boundaries scale: development and psychometric properties of a measurement for nurses' self-efficacy toward intimate and sexual behavior in dementia care

BackgroundPerson-centered nursing home care recognizes the intimate and sexual needs of residents with dementia but lacks guidance for nurses to address them while effectively respecting their personal boundaries. The Including Personal Boundaries (IPB) scale was developed to complement clinical and scientific efforts to support both nurse and resident wellbeing.MethodsThrough a co-creative process, theoretical principles, day-to-day experiences, and expert knowledge were integrated into an initial nineteen-item version of the IPB scale. The pilot sample comprised 297 Dutch (vocational) nurses in dementia nursing care.ResultsAfter Principal Component Analysis, nine items with strong factor loadings (>0.6) were retained. Internal reliability measures supported the item selection, such as high internal consistency (α = 0.866) and adequate corrected item-total correlations (0.532–0.781).ConclusionThe presented IPB scale, a nine-item scale, is a short, robust measure to assess nurses' self-efficacy in their capabilities to include personal boundaries (physical and emotional) when confronted with the intimate and sexual behaviors of residents with dementia. Further validation is recommended. The IPB scale could provide valuable insights for research, clinical practice, and education

A critical analysis of the utility and compatibility of motivation theories in psychiatric treatment

The TransTheoretical Model (TTM), Self-Determination Theory (SDT), and the Integral Model of Treatment Motivation (IM) provide distinct but not incompatible conceptualisations of motivation. We discuss the utility of these theories as a basis for the improvement of psychiatric treatment engagement and treatment outcomes in patients with severe mental illness. It appears that all three theories have gained support for their predictions of outcomes in patients with severe mental illness, but important questions remain unanswered, such as which of these theories provides the best prediction of treatment engagement and treatment outcomes. We explain how these three theories could complete each other, based on their strong and unique assets. It is imperative that the theories are empirically tested and compared to confirm their utility, and to this end we propose several important research questions that should be addressed in future research. Theory comparisons can advance what is currently known about intrapersonal changes and interpersonal differences in treatment engagement and outcomes in severely mentally ill patients