Mindfulness-, acceptance-, and value-based intervention for burnout : mechanisms of change and individual variation in outcomes

Abstract

The aim of these studies was to investigate the effects of a brief mindfulness-, acceptance-, and value-based (MAV) intervention on burnout during an eight-week intervention and 10-month follow-up. The mechanisms of change and individual variation in outcomes were focused on. The participants experiencing high burnout symptoms were divided to intervention group (n = 106) receiving the MAV intervention in addition to treatment-as-usual (TAU) and to control group (n = 96) receiving only TAU. Study I investigated whether the five separate mindfulness facets (observing, describing, acting with awareness, non-judging, and non-reacting) mediated the changes in burnout dimensions (exhaustion, cynicism, and reduced professional efficacy) during the intervention and 10-month follow-up. Study II investigated individual differences in intervention effects by identifying profiles of mindfulness skills and burnout during the intervention and 4-month follow-up. Furthermore, the profiles were compared in terms of practice quantity, frequency, and continuation, as well as learning experiences. Study III compared the profiles of Study II on the changes in subjective well-being during the 12-month study period (intervention and 10-month follow-up). The results of the three studies indicated that a brief MAV intervention could be a valuable addition to TAU for burnout since this approach could effectively and long-lastingly alleviate even severe burnout. Furthermore, the positive intervention effects were likely to spread to other areas of well-being. However, the intervention outcomes were not the same for everyone, and a minority of the participants did not benefit from the intervention. It is important to recognize these participants early, since the well-being gap between those who initially benefited and those who did not was likely to widen over time. Improvement in mindfulness skills was a mechanism of change. All mindfulness facets mediated the decreases in burnout dimensions, but improvement in non-judging was the most essential for burnout alleviation. Learning of non-judging skills could be emphasized in burnout interventions. Practice quantity and frequency during the intervention did not differentiate the profiles with differing intervention outcomes. However, positive learning experiences during the intervention and practice continuation after the intervention were associated to better outcomes. These could be emphasized in the MAV interventions to obtain long-lasting benefits.