(PS10-54) Client Experiences of Burnout in Dialectical Behavior Therapy

Abstract Text: Linehan and colleagues (2000) defined client burnout as feelings of emotional exhaustion and helplessness experienced in therapy. Extant literature review revealed limited research on client experiences of burnout as related to the therapeutic process across all treatment modalities and populations.
Dialectical behavior therapy (DBT) is a cognitive behavioral therapy originally developed as a treatment for individuals with borderline personality disorder (BPD). DBT requires a high level of commitment in time and effort from clients (Linehan et al., 2013). In addition, clients with BPD often come to DBT after previous experiences of unsuccessful treatments and misdiagnoses. Thus, client burnout may be especially prevalent in DBT and could be an important factor in understanding treatment processes with this population. Research is needed to better understand client experiences of DBT in hopes of optimizing treatment. This study aims to use exploratory analyses to examine the association between client burnout and other pertinent variables, including dropout and homework completion.
Data were collected from 38 individuals with BPD receiving 6-months of comprehensive DBT at a university-based research and training clinic. The sample had a mean age of 26 (SD = 11.20), was predominantly white (63%), female (84%), with a household income above $50,000 (63%). Participants and their therapists also rated their burnout levels after every individual therapy session on a scale of 1 to 5, with a higher score indicating higher burnout, using a modified version of the Copenhagen Burnout Inventory (Kristensen et al., 2005). Participants averaged a burnout score of 1.59 (SD = 0.77 ) across all sessions across treatment. Participants completed a battery of self-report questionnaires at intake, mid-point (3-months), and post-treatment (6-months), including the Borderline Symptoms List – Short Form (BSL-23; Bohus et al., 2009). Participants averaged a BSL-23 score of 2.07 (SD = 0.80) at intake and 18% (n = 7) were considered dropouts. Group homework completion was rated on a scale of 0 to 2 by group leaders after each group; homework completion scores will be averaged across all groups. Multiple linear regressions will be conducted to examine the association between client burnout, treatment engagement, and outcomes. Results have implications for determining if the construct of client burnout should be further studied to improve treatments to better help patients, both in DBT and other treatment modalities.