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Occupational Therapist Burnout: What it is and How to Avoid it

Ari Ginsberg, PT, DPT, MSIOP

Occupational Therapist Burnout : Defining

Burnout is a reaction to prolonged or chronic job stress. It is comprised of 3 dimensions including exhaustion, cynicism, and feelings of reduced professional ability. 

  • Exhaustion refers to feeling tired either physically or emotionally. 
  • Cynicism is best explained by a lack of identification with one’s job. For example, if you were a lawyer and someone asked what you did for a living, if you were embarrassed to share that you were a lawyer that would be a sign of cynicism.
  • Finally, reduced professional ability describes the perception of a decline in effectiveness at a job. For instance, if a medical doctor started feeling like they weren’t helping their patients, that would reflect reduced professional ability.

Burnout is not a disease, but it is recognized in the medical literature as a medical condition. In this article I plan on discussing my own experience with physical therapy burnout. Occupational therapists also experience a high rate of burnout as well.

Occupational Therapist Burnout : Causes

There are many causes of burnout in the workforce at large. 

First, productivity demands contribute to burnout as it creates stress and feeling like there is not enough time in the day to accomplish goals. 

Another common cause of burnout is feeling like there is a lack of adequate reward from a job. There are 2 types if motivators in the world, internal and external motivators

Internal motivators exist when an activity itself motivates a person. From personal experience, I love road cycling and the activity of cycling is a motivator. Other times, people are motivated by getting something because of participating in an activity. If I was in a race, part of my motivation would be to win a trophy or prize money. Most of the activities we are involved in include both internal and external motivators, however internal motivators are far more powerful than external motivators. If a person is not internally motivated by their job, they will feel a lack of reward. If a physical therapist didn’t enjoy the process of treating patients, they would feel unrewarded. There are many other causes of burnout including company support and values alignment. Do you feel like your company is supportive of you when you need to take time off or need assistance with a task? Are the leaders at your company inspirational? If the answer is no, then you might be experiencing burnout. Also, do you feel as though your company’s values align with your values. If you value kindness and integrity, does your company value the same?

1. Productivity

Productivity demands have increased for physical and occupational therapists as reimbursement for services have declined. As a result, physical and occupational therapists often feel as though quality of care has decreased because of spending less time with patients than the past. 

Additionally, documentation requirements have increased putting more pressure on therapists to be productive. This is typically ranked by physical therapists as the primary cause of burnout. Occupational therapists also have mentioned productivity demands as being a critical cause of burnout.

2. Reward

There is a tremendously high debt to income ratio amongst physical and occupational therapists. Schooling was once a certificate program, but then evolved to a bachelor’s degree, master’s degree, and finally and doctorate. The evolution of the schooling is a byproduct of new research and techniques that have emerged. 

However, with each new year of school comes another year of tuition. Also, the evolution of physical and occupational therapy has not resulted in increased compensation. The stress over the extra debt is a factor in physical therapy burnout. Occupational therapists are just now dealing with that as well, because many programs have transformed into doctorate level programs.

3. Emotional Exhaustion

Physical and occupational therapists are particularly vulnerable to burnout due to emotional exhaustion. Emotional exhaustion occurs for 2 reasons, compassion fatigue and emotional dissonance. Compassion fatigue is due to the compromised nature of our patients and the strong identification clinicians feel with their patients. It compels clinicians to feel compassionate, but many clinicians are not designed to continuously feel and express compassion. 

Therefore, many clinicians feel exhausted at the end of the day, contributing to burnout. Another emotional reason for burnout is emotional dissonance. Emotional dissonance refers to situations in which a clinician must hold back from expressing their true emotions

For example, if a patient is rude, a clinician might want to retaliate and yell at the patient. Yet, because of a clinician’s professionalism, they hold back. That holding back leads to burnout. Occupational therapists and physical therapists encounter emotional dissonance on a daily basis.

4. Physical Breakdown

Another unique contributor to occupational therapist burnout is physical breakdown. When I first started my career, I worked with kids in a school setting. I am 6 foot 5 inches tall, and it became apparent to me that my back was hurting because I had to bend down consistently in treating these children. 

Then I transitioned to a geriatric population which was a little better, but I was consistently given heavier more involved patients requiring maximum assistance with mobility. The toll it took on my body strongly resulted in burnout. Occupational therapists do not necessarily have the same physical demands, but they too experience breakdown.

Avoiding Occupational Therapists Burnout

There are many different methods to avoid burnout, but the key is analyzing the reasons for your burnout. Once those reasons are isolated, then the appropriate intervention can be utilized to avoid or reduce burnout.

1. Productivity Interventions

If the primary reason for physical therapist burnout/occupational therapist burnout is productivity demands, then effort should be made to become more efficient, and therefore more productive. One of the areas that contributes to stress is documentation. If a clinician can improve documentation efficiency, they can become more productive, leading to greater work life balance. 

How do you improve documentation efficiency? 

You must embrace technology. Research suggests that using speech recognition software speeds up documentation. Also, using autofill to anticipate some to the words you will type is a great way to get faster at documentation. I created an acronym for a system I developed to increase documentation efficiency and it is called:

S – Strategize

M – Multitask

A – Assess

R – Relax

T – Timing

Strategizing means mentally planning and picturing a visit prior to the visit. It also implies having a consistent approach to evaluations and discharges. Always starting with the same questions and progressing in the same manner with each evaluation will help your documentation be more efficient. 

Additionally, learning how to type and talk is critical to improving documentation efficiency, and multitasking

You must also assess your patients’ reactions to determine whether you should continue documenting in a visit. If a patient is upset, try showing them what you are documenting and how it plays a role in their care. 

Another technique is to relax and be ok with not completing your full note while in a patient visit. 

Finally, make sure you are documenting at the appropriate times. Don’t document when a patient requires balance training, as it is dangerous. The best time to document is when the patient is resting

Physical therapists can reduce burnout, occupational therapists burnout can reduce burnout by becoming more efficient with documentation.

2. CBT and Mindfulness Interventions

Cognitive Behavioral Therapy (CBT) is a great way to reduce some of the feelings of burnout tied to feeling unsupported by an organization. Sometimes we allow our emotions to cloud the accuracy of our judgments. 

For example, if a boss was constantly assigning you difficult patients it could be construed in 2 possible ways. 

1 would be that the boss was trying to punish you because of they dislike you. Another approach would be that the boss respects you and that is why they have assigned you some difficult patients. 

CBT helps a clinician see the way in which a situation is interpreted and how it affects their emotions. Mindfulness involves an awareness of a situation and pausing to experience that situation. It also demands more deliberate thinking on the part of the practitioner. Meditation is a tool used in mindfulness to help a person focus and become immersed in awareness.

3. Change

Sometimes a physical or occupational therapist requires a change of scenery to combat burnout. Occupational therapists and physical therapists are lucky, there are so many practice settings in physical and occupational therapy. A physical or occupational therapist can work in a school, outpatient clinic, hospital, or in a patient’s home. Sometimes challenging the status quo by changing settings is key to recharging a physical or occupational therapist’s batteries. There are also instances where a physical or occupational therapist should consider a new career. Try thinking about your passions outside of physical or occupational therapy and see if those passions can fit in with physical or occupational therapy. For example, if you loved golf, then focus your physical therapy practice on rehabbing golfers. 

Also, be aware of the skills that you have used as a physical or occupational therapist and see if they translate to other fields. It is a challenge to change, but it is not worth feeling unhappy and stuck, because of the fear of change. If you need any coaching on what you should do next, reach out to me via

  ari.ginsberg@psychologyforthebody.com and we can set up a chat.

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Let's Get Ethical: Ethical Boundaries for PTs/OTs

A 2.5 hour webinar approved for CEUs by the

AOTA – # 02517 

NY Board of Physical Therapy

The Ohio Physical Therapy Association # 21S2571

The NJ Board of PT # 2110-14

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, PA, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition of approval from another state chapter of the APTA (Ohio PTA)

or another state board of PT (NY, NJ)

Objectives to facilitate clinician ethical practice

 

1. Define ethics and the Code of Ethics of the APTA/AOTA to practice in an ethical manner

2. Analyze the boundaries of ethical priniciples for PTs/OTs to solve ethical dilemmas

3. Apply APTA ethical principles to professional practice through case studies

4. Apply AOTA ethical principles to professional practice through case studies

A posttest/survey will be give after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

Optimizing the Patient Experience

A 1 hour webinar approved for CEUs by the

AOTA – #02034

NY Board of Physical Therapy

Pending Approval by the NJ Board of PT – 2022 – 2024

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, WA, WI

Objectives related to professional development

1) Identify the components of bedside manner/ patient satisfaction and their link to healthcare outcomes

2) Apply strategies using social psychology to optimize the patient experience

3) Implement an organizational approach to improve patient satisfaction scores

A posttest/survey will be given following live and on-demand webinars. After purchasing the on-demand webinar you will be redirected to a webpage with the webinar and posttest links A CE certificate will be emailed following posttest completion

Improving Patient Adherence to Home Exercise Programs

 1 hour webinar approved for CEUs by the

AOTA – #02036

NY Board of Physical Therapy

The NJ Board of PT # 2111-80

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, UT, WA, WI

Objectives to facilitate patient/client goal achievement

1. Identify the benefits of home exercise programs

2) Define differing theories of motivation/influence

3) Apply social psychology to HEP prescription/plan

A posttest/survey will be given following live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

The Science of Bedside Manner and Patient Satisfaction

A 2 hour webinar approved for CEUs by the

AOTA – #02037

NY Board of Physical Therapy

Ohio Physical Therapy Association # 21S2565

The NJ Board of PT # 2110-15

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, PA, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition of approval from another state chapter of the APTA (Ohio PTA)

or another state board of PT (NJ, NY)

Objectives to facilitate patient/client goal achievement

1. Develop and improve empathy skills

2. Identify the link between bedside manner/patient satisfaction and health outcomes

3. Measure patient satisfaction in a valid/reliable manner

4. Apply social psychology techniques to improve patient satisfaction

5) Integrate organizational strategies to improve patient satisfaction scores

A posttest/survey will be give after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

Effective Leadership and Communication in Rehab

A 1 hour webinar approved for CEUs by the

AOTA – #02299

NY Board of Physical Therapy

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, WA, WI

Objectives related to professional development

 

1. Define leadership and various leadership styles

2. Identify successful leadership styles in healthcare/rehab

3. Implement effective leadership communication strategies in rehab

A posttest/survey will be given after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

The New World of Rehab: Addressing Burnout

A 1-hour webinar approved for CEUs by the

AOTA – #02035

NY Board of Physical Therapy

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition by another state board of PT (NY)

Objectives related to professional development

 

1. Identify the causes of rehab burnout

2. Recognize the signs of rehab burnout

3. Apply strategies to prevent/reduce rehab burnout

A posttest/survey will be given after live and on-demand webinars. After on-demand purchase you will be redirected to a webpage with the video link/posttest link. A CEU certificate will be emailed following post-test completion