A brief Acceptance and Commitment intervention for work-related stress amongst frontline homelessness staff: a single case experimental design series

Reeve, Andy (2020) A brief Acceptance and Commitment intervention for work-related stress amongst frontline homelessness staff: a single case experimental design series. DClinPsy thesis, University of Nottingham.

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Burnout – a syndrome resulting from chronic exposure to work-related stress – is a particular problem in health and social care contexts where it is understood to adversely impact the quality of care delivered and the health of the workforce. Although there has so far been scant research attention on the levels of, and effects due to burnout amongst frontline homelessness workers, the nature of the demands are equivalent and so this is an important population on which to focus. Additionally, burnout research has previously focussed on the deleterious aspects such as exhaustion rather than positive counter-part constructs such as work-engagement.

A focus on enriching an individual’s life – such as through increased work-engagement – is consistent with the therapeutic goal of Acceptance and Commitment Therapy (ACT), a third-wave behavioural intervention. Some research has found ACT to be useful for ameliorating burnout but as yet no research has investigated its role in enhancing work-engagement. A recent systematic literature review summarised these findings but also raised a number of questions, which this research project intended to answer. The literature review found mixed support for the use of ACT for reducing burnout, and a lack of support for intervention effects to operate through Psychological Flexibility (a key ACT construct).

This project used a staggered multiple baseline single case experimental design to test the usefulness of an individual one-to-one ACT intervention for reducing exhaustion, increasing work-engagement, and increasing psychological wellbeing. Furthermore, the relationship between changes in Psychological Flexibility and the outcome variables was assessed. Four participants were recruited from an organisation in the East Midlands which delivers support to those experiencing homelessness. ‘Full-form’ questionnaire measures were used to assess changes over the course of the intervention and at follow-up; ‘short-form’ versions of these were administered daily to provide a temporal measure of any changes relative to the introduction of the ACT-intervention sessions.

Overall, support was found for the effectiveness of the ACT-intervention reducing exhaustion and increasing work-engagement; some effect on overall wellbeing was found but it was not large enough to be considered reliable change. Additionally, the findings are tentatively supportive of the role of Psychological Flexibility in producing these changes. Finally, further support was found for there being interrelated yet distinguishable components of the ‘triflex’ model of Psychological Flexibility.

The findings are considered in terms of their implications for supporting frontline workers, the limitations of the study, and the relation to the extant research.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Moghaddam, Nima
Tickle, Anna
Keywords: Burnout, work-related stress, work-engagement, Acceptance and Commitment Therapy, Psychological Flexibility, homelessness
Subjects: W Medicine and related subjects (NLM Classification) > WA Public health
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 59229
Depositing User: Reeve, Andrew
Date Deposited: 14 Aug 2020 10:40
Last Modified: 14 Aug 2020 10:45
URI: https://eprints.nottingham.ac.uk/id/eprint/59229

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