Staff Empathy and Burnout in Forensic Mental Health Services: The Impact of Psychological Formulation

13 INTRODUCTION. 15 Burnout . 15 Empathy . 17 Burnout and Empathy: Is there a Relationship? 20 Rationale and Aims . 21 METHOD . 22 Information Sources . 22 Eligibility Criteria . 22 Outcomes. 22 Participants. 23 Search Strategy . 23 Data Extraction . 24 Methodological Quality (risk of bias in individual studies) . 24 Data Synthesis and Analysis . 25 RESULTS . 25 Study Selection . 25 Figure 1. Flow Chart of Literature Search Process . 26 Table 1 Data Extracted from Studies Pertaining to Study Characteristics, Participant Details, and Main Findings . 27 EMPATHY, BURNOUT, AND FORENSIC MENTAL HEALTH 4 Study Characteristics. 31 Participant Details . 32 Risk of Bias within Studies . 33 Reporting of Results in Individual Studies . 34 Evidence for Hypothesis One: Negative Association between Burnout and Empathy . 34 Evidence for Hypothesis Two: A Positive Correlation between Burnout and Empathy 36 DISCUSSION . 37 Clinical Implications . 40 Strengths and Limitations of the Review . 41 Suggestions for Future Research . 42 REFERENCES . 44 ABSTRACT . 57. 57 INTRODUCTION. 58 Empathy in Forensic Mental Health Services . 58 Empathy: State and Trait . 59 Formulation: Possible Effects on Empathy . 61 Burnout: The Potential Influence on Empathy . 62 Hypotheses . 64 METHOD . 64 Participant Characteristics . 64 Sampling Procedures and Ethics . 65 Sample Size and Power. 66 Measures and Covariates . 66 Interpersonal Reactivity Index (Adapted) (IRI-A; Davis, 1983). 67 The Empathy Quotient (short form) (EQ-SF; Wakabayashi et al., 2006). 68 Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981). 69 EMPATHY, BURNOUT, AND FORENSIC MENTAL HEALTH 5 Design . 69 Experimental Manipulations . 69 Case Vignette. 69 Data Analysis Procedure . 70 Figure 1. Flow chart indicating process of recruiting participants into the current study. 71 RESULTS . 71 Descriptive Statistics: Exploring Formulated and Unformulated Groups . 71 Table 1 Frequencies and percentages of participants in the unformulated and formulated groups according to demographic variable categories . 72 Independent Variables: Burnout (MBI) and Trait Empathy (EQ-SF) . 74 Table 2 Mean Scores, Standard deviations, and t-tests on the Maslach Burnout Inventory (MBI) subscales, and Empathy Quotient (EQ-SF) in the formulated and unformulated groups . 74 Dependent Variable: State Empathy (IRI-A). 75 Table 3 Mean Scores, Standard deviations, and t-tests on the adapted Interpersonal Reactivity Index (IRI-A) subscales in the formulated and unformulated groups . 75 Regressions . 75 Table 4 Linear model of predictors of IRI-A subscales: Empathic Concern and Perspective Taking . 76 DISCUSSION . 77 Exploring the Hypothesis . 77 Clinical Implications . 80 Strengths and Limitations . 81 Areas of Future Research . 82 REFERENCES . 83 EMPATHY, BURNOUT, AND FORENSIC MENTAL HEALTH 6 APPENDICES . 92 APPENDIX A AUTHOR GUIDELINES FOR THE JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE . 93 APPENDIX B BLANK COPY OF DATA EXTRACTION FORM . 94 APPENDIX C QUALITY ASSESSMENT TOOL FOR CROSS SECTIONAL STUDIES . 95 APPENDIX D QUALITY ASSESSMENT TABLE: RESPONSES FROM BOTH RATERS . 97 APPENDIX E RESULTS TABLE . 99 A