{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:05:55Z","timestamp":1792112755800,"version":"4.4.0"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Clinician burnout has been associated with clinician outcomes, but the association with patient outcomes remains unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the association between clinician burnout and the outcomes of patients receiving of guideline-recommended trauma-focused psychotherapies for posttraumatic stress disorder (PTSD).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study was set at the US Veterans Affairs Health Care System and included licensed therapists who provided trauma-focused psychotherapies and responded to an online survey between May 2 and October 8, 2019, and their patients who initiated a trauma-focused therapy during the following year. Patient data were collected through December 31, 2020. Data were analyzed from May to September 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Therapists completing the survey reported burnout with a 5-point validated measure taken from the Physician Worklife Study. Burnout was defined as scores of 3 or more.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was patients\u2019 clinically meaningful improvement in PTSD symptoms according to the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic> (Fifth Edition<\/jats:italic>). Patient dropout, therapist adherence, and session spacing was assessed through electronic health records. Multivariable random-effects logistic regression examined the association of therapist burnout and clinically meaningful improvement, adjusted for case-mix.<\/jats:p><\/jats:sec>Results<\/jats:title>In this study, 165 of 180 (91.7%) therapists (89 [53.9%] female) completed the burnout measure and provided trauma-focused psychotherapies to 1268 patients (961 [75.8%] male) with outcome data. Fifty-eight (35.2%) therapists endorsed burnout. One third of patients (431 [34.0%]) met criterion for clinically meaningful improvement. Clinically meaningful improvement in PTSD symptoms was experienced by 120 (28.3%) of the 424 patients seen by therapists who reported burnout and 311 (36.8%) of the 844 patients seen by therapists without burnout. Burnout was associated with lower odds of clinically meaningful improvement (adjusted odds ratio [OR],0.63; 95% CI, 0.48-0.85). The odds of clinically meaningful improvement were reduced for patients who dropped out (OR, 0.15; 95% CI, 0.11-0.20) and had greater session spacing (OR, 0.80; 95% CI, 0.70-0.92). Therapist adherence was not associated with therapy effectiveness. Adjusting for dropout or session spacing did not meaningfully alter the magnitude of the association between burnout and clinically meaningful improvement.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this prospective cohort study, therapist burnout was associated with reduced effectiveness of trauma-focused psychotherapies. Studying when and how burnout affects patient outcomes may inform workplace interventions.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.6858","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T15:06:55Z","timestamp":1713366415000},"page":"e246858","source":"Crossref","is-referenced-by-count":25,"title":["Clinician Burnout and Effectiveness of Guideline-Recommended Psychotherapies"],"prefix":"10.1001","volume":"7","author":[{"given":"Nina A.","family":"Sayer","sequence":"first","affiliation":[{"name":"Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota"},{"name":"Department of Medicine, University of Minnesota, Minneapolis"},{"name":"Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Center for Care Delivery and 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