Burnout among community mental health (CMH) therapists has been associated with poorer therapist health, higher agency turnover, poorer client outcomes, and compromised quality of care. Recent mandates to learn and implement multiple evidence-based practices (EBPs) within CMH settings are intended to improve the quality of community care, yet there is mixed evidence concerning the impacts on workforce burnout. The current study sought to identify correlates of therapist emotional exhaustion, a key aspect of burnout, during the sustainment phase of a system-driven implementation of multiple EBPs in children’s mental health services. We hypothesized that high workload and unfavorable organizational climate would relate to therapist emotional exhaustion, but that positive experiences with EBPs adopted would relate to lower exhaustion. Although agency-level indices of organizational climate were unrelated to exhaustion, a multilevel model revealed that therapists’ weekly work hours, caseload, and number of EBPs delivered were associated with increased emotional exhaustion. Additionally, activities associated with the EBP implementation efforts (e.g., hours spent in EBP-related activities, supervision or consultation, or outcome monitoring), were not associated with emotional exhaustion. Therapists’ knowledge and confidence delivering EBPs and their positive perceptions of EBPs were protective against emotional exhaustion, but these perceptions did not buffer the risks associated with heavy workload. Findings point to implementation strategies to prevent burnout and associated turnover that compromise the returns on investments in EBP implementation.

中文翻译：

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在系统驱动的儿童心理健康多项循证实践的维持阶段，社区治疗师职业倦怠的预测因素。

社区心理健康 (CMH) 治疗师的倦怠与治疗师健康状况较差、机构更替率较高、客户结果较差以及护理质量下降有关。最近在 CMH 环境中学习和实施多种循证实践 (EBP) 的任务旨在提高社区护理的质量，但关于对劳动力倦怠的影响存在混合证据。当前的研究试图在系统驱动的儿童心理健康服务中实施多种 EBP 的维持阶段，确定治疗师情绪衰竭的相关性，这是倦怠的一个关键方面。我们假设高工作量和不利的组织氛围与治疗师的情绪耗竭有关，但采用 EBP 的积极体验与较低的耗竭有关。尽管机构层面的组织气候指数与疲劳无关，但多层次模型显示，治疗师的每周工作时间、案例量和提供的 EBP 数量与情绪耗竭增加有关。此外，与 EBP 实施工作相关的活动（例如，在 EBP 相关活动、监督或咨询或结果监测中花费的时间）与情绪衰竭无关。治疗师提供 EBP 的知识和信心以及他们对 EBP 的积极看法可以防止情绪衰竭，但这些看法并没有缓冲与繁重工作相关的风险。调查结果指出了实施策略，以防止倦怠和相关的人员流失，从而损害 EBP 实施的投资回报。