The value of psychological flexibility: Examining psychological mechanisms underpinning a cognitive behavioural therapy intervention for burnout

Abstract Little is known of the mechanisms by which interventions for burnout work. Employees of a UK government department were randomly assigned to either a worksite group-based CBT intervention called Acceptance and Commitment Therapy (ACT; n=43), which aimed to increase participants' psychological flexibility, or a waiting list control group (n=57). The ACT group received three half-day sessions of training spread over two and a half months. Data were collected at baseline (T1), at the beginning of the second (T2) and third (T3) workshops, and at six months' follow up (T4). Consistent with ACT theory, analyses revealed that, in comparison to the control group, a significant increase in psychological flexibility from T2 to T3 in the ACT group mediated the subsequent T2 to T4 decrease in emotional exhaustion in that group. Consistent with a theory of emotional burnout development, this significant decrease in emotional exhaustion from T2 to T4 in the ACT group appeared to prevent the significant T3 to T4 increase in depersonalization seen in the control group. Strain also decreased from T2 to T3 in the ACT group only, but no mediator of that improvement was identified. Implications for theory and practice in the fields of ACT and emotional burnout are discussed.