acceptance and commitment therapy, burnout therapy, depth therapy, emdr, mental health basics, online therapy, text based therapy, trauma therapy

Systemic Factors Contributing to Burnout

I’ve been doing a bit of a research deep dive on burnout lately. (Don’t be surprised if my next several posts are all related to burnout!) One thing I noticed is that most of the research that gets quoted in the major news articles is related to nurses. While it’s great that we’re studying burnout in the medical field so well, this also means that a lot of the research and information on burnout doesn’t necessarily apply to therapists. With all this in mind, I was excited to find research on burnout among Occupational Therapists. I know, I know, that’s still different from a psychotherapist. But their systemic factors look a LOT more like ours. See if you can recognize a few:

Systemic Burnout Factors

  • High workload and time demands
  • Lack of resources at work
  • Lack of autonomy to make clinical decisions
  • Low satisfaction with income
  • Pressure to adopt a generalist approach
  • Under-recognized value of the profession
  • Lack of respect from colleagues
  • Feeling unsupported by colleagues and supervisors
  • Professional self-doubt
  • Lack of professional identity
  • Role conflict

Did you see yourself there?

I don’t know about you, but when I read that list, I felt it like a gut punch. This sounds like literally every agency and school-based job I had. Even in private practice, I still recognize a LOT of these factors.

So what do we do with this?

The study also identified three protective factors: feeling supported by colleagues or a supervisor, satisfaction with your income, and higher education attainment.

Burnout protection #1: Support from colleagues and supervisors

From the research, it looks like supervisor support is the most effective at creating protection against burnout. In agency work… you may not have much choice. While you’ll likely get the best outcomes from finding a job with an excellent supervisor, I know it’s not always realistic to leave your current job. This is where colleagues come in. You don’t need amazing support from all your coworkers, but even feeling supported by two or three close colleagues can help.

Burnout protection #2: Income satisfaction

This factor is also not totally in your control, especially if you’re working in an agency setting. Getting paid well is a systemic issue that needs more advocacy. We need to be paid well enough to afford to live while also making sure that services are available to more people. Serving low and middle income clients requires governmental and grant-based funding, mental health insurance parity, and reforms to the insurance system to increase coverage and minimize clawbacks. While some agency and nonprofit jobs are represented by a union, private practice therapists, therapy contractors, and non-union agency therapists have difficulty standing up against these systemic issues.

Until we resolve these systemic income issues for psychotherapists, there are some things you as an individual can do. First, don’t apply for or accept jobs that pay below the standard of the profession. Many therapist jobs pay barely over minimum wage which should not be acceptable for a professional with a master’s degree. Second, advocate for regular raises for yourself and your coworkers if your agency does not have a clear path for salary advancement in place. Finally, vote for measures that expand access to mental health services through government funding for low income clients. These allow the clients to have low-cost or free services while ensuring clinicians are paid adequately.

Burnout protection #3 : Higher education attainment

The study authors weren’t sure why more education would affect burnout, but I have a theory. Getting more educated in one area could possibly give you more confidence to specialize in a niche instead of feeling the pressure to be a generalist. Increasing your expertise will earn you more respect from colleagues as you dive deeper into one specialty. It might also help with professional identity and self-doubt as you practice your chosen modality or study new treatments.

Struggling to manage burnout?

I work with clients to manage burnout, overwhelm, and toxic work situations ALL. THE. TIME. Any helping field is at risk of burnout, but I have a special heart for walking with therapists to heal from burnout, compassion fatigue, and secondary traumas. Contact me for a free consultation to see how I can help you reignite your passion while holding to the boundaries that will help protect you from being overwhelmed.


Shin, J., McCarthy, M., Schmidt, C., Zellner, J., Ellerman, K., & Britton, M. (2022). Prevalence and Predictors of Burnout Among Occupational Therapy Practitioners in the United States. AJOT: American Journal of Occupational Therapy, 76(4), NA.

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