The National Institute on Drug Abuse has awarded a $1.1 M grant to University of Nevada, Reno to study burnout in addiction counselors. Housed in the Department of Psychology at UNR under Dr. Steven Hayes's direction, the three year study will examine the relative impact of various methods for alleviating stress and burnout. Co-investigators are UNR faculty Nancy Roget (Center for the Application of Substance Abuse Technologies), Barbara Kohlenberg (Psychiatry), and Jason Luoma (Psychology).
Substance abuse is one of the most difficult problems to treat, and addiction counselors are not immune to the negative attitudes and feelings that comes from working with difficult clients. Reducing providers entanglement with their own negative thoughts may be particularly important because there is evidence that these processes contribute to provider burnout, job turnover, and to decreased effectiveness in working with people in need.
There are few well developed methods for the alleviation of entanglement with negative attitudes toward recipients of care, however. This grant will evaluate two methods for the reduction of the harmful impact of thoughts of this kind: Multicultural Training and Acceptance and Commitment Training (ACT). Alone and in combination these will be compared to training in the biological processes that underlying addiction since it has been argued that understanding that addiction is a disease reduces bias toward people suffering from addition.
Multicultural Training is widely used to help providers be more aware of their biases and to see the world to the eyes of others. Usually this approach is applied to cultural or racial bias, but it seems equally applicable to appreciating the inside world of people with addictions.
ACT, developed here at UNR by Dr. Hayes, is an increasingly popular new form of therapy is based on mindfulness, acceptance, and values. In this study it will be used to teach providers to notice their difficult thoughts and feelings more the way a meditator might notice thoughts that comes up during meditation, and then to focus on what they can do with actual behavior to further their values.
Multicultural knowledge is known to be important when working with clients who comes from different cultural group, but there is also some evidence that providers sometimes feel guilty about their own biases when they learn to detect them. This study will see if the combination mindfulness and multicultural training can reduce this problem, allowing providers to use multicultural knowledge more effectively.
In workshops conducted across the country about 300 providers will be randomly assigned to the four conditions and will be trained in two day workshops. Pre, post, and follow-up measures will be taken on stress and burnout, and providers entanglement with negative thoughts about difficult clients, among other measures. It is expected that both treatments will have initially positive effects on stigma and burnout, but based on previous research it is expected that acceptance and mindfulness may have a longer term impact on the burnout provides feel as a result of working with such difficult cases.
This study is the largest randomized study ever done on multicultural training, It is also one of the larger randomized trials ever done on therapists burnout, and on mindfulness-based training. The study is funded by the National Institute on Substance Abuse, which has supported several other successful studies on ACT over the last decade.
For additional information, contact Steve Hayes at hayes@unr.edu