Psychological flexibility as a predictor of professional quality of life in newly qualified psychological therapy practitioners

Garner, Emma Victoria (2022) Psychological flexibility as a predictor of professional quality of life in newly qualified psychological therapy practitioners. DClinPsy thesis, University of Nottingham.

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The professional quality of life of psychological therapy practitioners can be conceptualised within a compassion satisfaction and compassion fatigue framework. Compassion fatigue is purportedly separated into two components of burnout and secondary traumatic stress. Compassion fatigue can have detrimental impacts on therapy practitioners, organisations and patient care, whereas compassion satisfaction is associated with positive outcomes. Consequently, there is a need to explore factors that mitigate compassion fatigue and promote compassion satisfaction. This is particularly important for newly qualified psychological therapists who are reportedly at risk of compassion fatigue during the transition from pre- to post-qualified practice.

Psychological flexibility is the central tenet within Acceptance and Commitment Therapy (ACT) and is purportedly a key resilience process that is associated with higher levels of compassion satisfaction and lower compassion fatigue for healthcare professionals generally. However, the evidence base is dominated by cross-sectional research and there is a need to explore these associations over a longitudinal trajectory for healthcare workers and specifically newly qualified psychological therapy practitioners. Therefore, this study aimed to examine whether psychological flexibility prospectively predicts levels of compassion fatigue (inclusive of burnout and secondary traumatic stress) and compassion satisfaction in newly qualified psychological therapy practitioners.

The study employed a prospective cohort longitudinal design whereby fifty-six trainee psychological therapy practitioners (trainee Clinical Psychologists and Cognitive Behavioural Therapists) were recruited to complete an online survey of baseline measures pre-qualification. Participants completed the survey at two further timepoints post-qualification and data collection was completed over eight-months. The survey comprised a demographic questionnaire and measures of psychological flexibility, professional quality of life and wellbeing related to workplace factors.

Multilevel modelling was used to predict levels of compassion satisfaction, burnout and secondary traumatic stress, based on baseline levels of psychological flexibility. The results revealed that higher prospective levels of psychological flexibility predicted higher levels of compassion satisfaction and lower levels of burnout and secondary traumatic stress across all timepoints. Further analysis also revealed that psychological flexibility as a predictor exhibited causal predominance over professional quality of life as a predictor. However, contrary to theoretical suggestions regarding the buffering role of psychological flexibility, in this instance where time and workplace factors related to workplace wellbeing was found to have a significant detrimental effect on some professional quality of life outcomes, psychological flexibility did not moderate these effects.

Therefore, the study confirmed existing cross-sectional associations between psychological flexibility and professional quality of life for healthcare practitioners and goes further to provide insights regarding psychological flexibility as a prospective predictor of professional quality of life. Given existing evidence from interventional studies with alternative healthcare worker samples, it could be hypothesised that pre-qualification intervention to improve psychological flexibility would lead to positive post-qualification professional quality of life outcomes for therapy practitioners. This may potentially carry positive implications for practitioners, organisations and patient care.

It would be beneficial for future researchers to confirm the aforementioned hypothesis through interventional studies. Furthermore, it may be possible to observe the buffering role of psychological flexibility should future studies impose a longer time series. Finally, it is recommended that further longitudinal research is undertaken to examine similar predictive associations with other healthcare worker samples considering the dominance of cross-sectional research.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Golijani-Moghaddam, Nima
Sabin-Farrell, Rachel
Keywords: Psychological flexibility, Quality of life, Compassion fatigue, Compassion satisfaction
Subjects: W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 69007
Depositing User: Garner, Emma
Date Deposited: 15 Dec 2022 04:40
Last Modified: 30 Apr 2023 04:30

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