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Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout
Karolinska Inst, Sweden.
Karolinska Inst, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.ORCID iD: 0000-0002-9736-8228
Karolinska Inst, Sweden.
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2019 (English)In: Behavior Therapy, ISSN 0005-7894, E-ISSN 1878-1888, Vol. 50, no 3, p. 475-488Article in journal (Refereed) Published
Abstract [en]

Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017,95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 50, no 3, p. 475-488
Keywords [en]
clinical burnout; cognitive behavior therapy; exhaustion disorder; mediation
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:liu:diva-157533DOI: 10.1016/j.beth.2018.08.005ISI: 000467663600001PubMedID: 31030867Scopus ID: 2-s2.0-85053921900OAI: oai:DiVA.org:liu-157533DiVA, id: diva2:1328778
Note

Funding Agencies|Karolinska Institutet; Stockholm County Council

Available from: 2019-06-23 Created: 2019-06-23 Last updated: 2019-06-26Bibliographically approved

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Hesser, Hugo

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