top of page

Eight evidence-based approaches to beat burnout

Updated: Jul 18, 2022

Two years into coping with the pandemic, evidence-based tools and techniques to beat burnout are vital for our mental health.

Credit: Polina Zimmerman via Pexels

The COVID-19 pandemic changed life as we know it. On January 9th 2020 the WHO announced Coronavirus-related pneumonia in Wuhan, China. Two years later, the new Omicron variant of COVID-19 continues in circulation. How ever much we want it to be so, a clean ending to the pandemic looks unlikely.

By this point, fatigue has set in.

Burnout combines exhaustion with cynicism and a reduced sense of competence. It can result in serious physical and mental health consequences, including substance addiction, Type 2 diabetes, and insomnia (difficulty falling asleep or staying asleep). Unfortunately, as well as the health consequences, professionals experiencing burnout may be unable to return to work, depleting the workforce further, and in turn, the economy. This is a double blow, given that some of the workforce is already absent due to contracting or exposure to the virus.

Recently, Charlie Massey, Chief Executive of the General Medical Council stated:

“The danger is that, unless action is taken, workloads and wellbeing will continue to suffer, and future burnout rates could get even worse. As we move on from the pandemic, it is vital that doctors’ training and wellbeing needs are central to service recovery plans.”

Burnout in healthcare workers is a global phenomenon. Stressors include a high workload, insufficient Personal Protective Equipment (PPE), lack of knowledge, long working hours, and direct exposure with patients. A study among 3,100 nurses and 992 physicians working in Asian intensive care units in 16 countries in Asia found that nurses and physicians had high levels of burnout, 52 and 50.3%, respectively.

Whilst healthcare workers are particularly affected, the pandemic affects us all. Because burnout was already a major issue in healthcare jobs before the pandemic, a lot of the evidence of what works draws on studies with health care providers.

In general, for all professionals, if you have a heavy workload, work long hours, have difficulties maintaining work life balance, work in a helping profession and have limited control over your work, then you are at increased risk of burnout.

This blog is the final piece in a 3-part series on the topic of burnout for digital magazine, Inspire the Mind. As a recap, part one offered up an introduction to the science of burnout. Part 2 looked at the effects of Zoom in relation to burnout. In this final blog, I’ll share 8 evidence-based ways to prevent or recover from burnout.

As a researcher at the Evidence Based Practice Unit, I’m passionate about projects that are based on evidence of what actually works. I think that it’s important we refer to the evidence base before testing out programmes that sound great in theory but might not actually work. Most of us wouldn’t take a drug if it had not been scientifically tested, so perhaps it’s important to exercise a degree of caution with our mental health.

First, a quick recap on how psychologists define burnout.

Researchers, Maslach, Schaufel & Leiter, describe the concept of burnout as having 3 parts, that include:

  1. Emotional exhaustion, this means feelings of being emotionally overextended and depleted of emotional resources

  2. Depersonalization, refers to workers’ negative, callous, or excessively detached feelings towards their clients/customers

  3. Reduced personal accomplishment and equates to feelings of incompetence and lack of achievement at work (Maslach, Schaufeli, & Leiter, 2001).

As established by the World Health Organisation burnout is a workplace phenomenon.

Why is it important to draw on evidence-based interventions to tackle burnout?

It takes a lot of resources and time to deliver a programme across a whole organisation, or even within one department. Before embarking on solutions, checking existing research for evidence of if a program works in other settings increases the chances that it will “work” for employees in the organisation.

Evidence that a programme is really effective is most reliable when a trial has been conducted with a control group (a more or less identical group of people that have not received the programme to compare with the group that had the programme). If there are a number of different peer-reviewed studies (subject to critical examination by specialists in the field). Evidence-based programmes to defeat burn out need to be tested on a large group of people, ideally multiple times. Other factors that inform evidence-based interventions (and if a program might work) include a clinicians perspective and an individual’s values.

Disclaimer: this blog is only a rapid overview and a full systematic review is needed on this topic.


ONE. Cognitive Behavioural Therapy (CBT) to Reduce Stress

The good news is that there is lots of evidence that CBT can reduce stress, burnout and promote wellbeing.

CBT is one of the most widely used approaches to treat depression, anxiety and stress, here in the UK it’s available from the NHS for a range of mental health difficulties. CBT involves a technique that can be quickly applied to change thinking patterns that in turn have an effect on behaviour. CBT may be learned via a pre-recorded video or taught by a facilitator or therapist. CBT programmes often include:

  • Recognising unhelpful automatic thoughts and unhelpful beliefs. Automatic thoughts are those that just pop into our heads unfiltered that may not be based on facts. For example, “I’m terrible at choosing gifts”. Recognising them is like conducting “quality control” where we check that our thoughts are warranted. Unhelpful beliefs are things that we tell ourselves all the time but may not be true.

  • Setting goals — setting goals can help us to achieve what we want from life and work and from the therapy itself and provide greater meaning and a sense of achievement.

  • Understanding your attributional style — how we understand the meaning of events and what causes them.

  • Identifying thinking patterns such as — catastrophising, the tendency assume that the worst outcome might follow from a small event.

The challenge is that, whilst effects are seen after the intervention, these changes are not always maintained months after the intervention.

TWO. Coping interventions

Coping is key to managing stress.

Programs that teach coping strategies have found to be effective, for example, coping and support groups for nurses to increase coping with difficult situations and encourage positive coping strategies. Lee’s review of a range of studies found that coping interventions for 6 month to a year led to a reduction in emotional exhaustion, depression, and ultimately burnout among nurses.

Coping can involve confronting a problem head on, while avoidance is an aspect of burnout. A range of coping strategies may be used in a given situation that include confrontation, distancing, self-control, seeking social support from others, accepting responsibility, putting our head in the sand, avoidance, problem solving, and positive reappraisal (viewing the problem in different terms). Coping interventions often enable people to consider some of the disadvantages of their current range of coping strategies (e.g., watching Netflix) and provide them with new ones, (such as seeking support, exercise and meditation).

THREE. Novel approaches

There’s some evidence for novel approaches that are less widely researched. A study of Qi jong for physiotherapists found that emotional exhaustion decreased amongst participants that engaged in “White ball exercises”. Massage and touch therapy has had mixed results with some studies finding it effective and others not.

Workplace appreciation events were found to have a significant effect in increasing performance and reducing depression and burnout among nurses and physicians.

Some research finds that martial arts can help beat burnout. Caption: Credit- Herbert Santos

FOUR. Learning and skills training and professional id