Burnout and retention among psychological practitioners : a qualitative investigation into the influence of organisational factors

Saddington, David and Hodge, Suzanne (2021) Burnout and retention among psychological practitioners : a qualitative investigation into the influence of organisational factors. PhD thesis, Lancaster University.

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Abstract

The wellbeing of the mental health workforce both internationally and within the NHS is an area of concern. Problems with staff burnout and retention are of particular concern, and research has highlighted how organisational issues can play a role. This thesis comprises a literature review, research paper, and critical appraisal. In the literature review, a meta-ethnography reviewing eight qualitative studies of mental health practitioners’ experiences of burnout was conducted following methodology outlined by Noblit and Hare (1988). A line of argument was developed which suggested that burnout experience can compromise practitioners’ physical and mental wellbeing, and sense of self-efficacy; that mental health practitioner self-knowledge and boundaries can contribute to or protect against burnout, and; that organisational culture and values can create a workplace that can be protective against practitioner burnout or contribute to it. The research paper explores how organisational factors can influence clinical psychologists’ decisions to leave the NHS. Seven participants were interviewed, and grounded theory methodology was used to identify organisational processes perceived to influence decisions to leave the NHS consisting of: trying to achieve the impossible, cycle of imposed change, and shifting organisational valuing. Psychologist categories were also identified, describing participant experience and coping in relation to organisational processes with impacts contributing to decisions to leave. These consisted of: striving for autonomy and integrity, valuing people, trying to make things better, seeking sustainability and growth, and a push to leave / pull to return. The findings highlight how organisational factors influenced participant decisions to leave the NHS, and a tentative conceptual model was presented. The critical appraisal extends the discussion of the research strengths and limitations and expands the discussion of opportunities for further research and implications. Reflections are offered around reflexivity and the personal journey as a new meta-ethnographer and grounded theorist through the research.