Understanding burnout in drug and alcohol workers

Abstract

Section A
Introduction: Burnout has been described as a global issue, and the empirical literature has not been reviewed within drug and alcohol settings, despite the high levels of stress these workers may have been exposed to. The aim of this critical review was to understand the prevalence and correlates of burnout in community drug and alcohol workers. Methods: A literature search of four databases yielded 1005 papers, 11 of which met the inclusion criteria for this literature review. The 11 papers were critiqued using the critical Appraisal Tool for Cross-Sectional Studies (AXIS). Data was synthesised using meta-analyses and narrative review. Results: From the quality appraisal, the 11 papers showed good quality in relation to the methods and discussions. However, similar areas of poor quality were found: non-responder bias and the limitations of cross-sectional studies. Meta-analyses found significance for organisational characteristics and length in service as possible correlates in burnout. Quantifying prevalence proved challenging due to inconsistencies in data reporting, specifically regarding omissions and lack of clarity. Discussion: The results from the quality appraisal found four constructs of burnout that were associated with drug and alcohol workers: organisational characteristics, demographic and professional background, health, and job satisfaction and therapeutic success. However, the cross-sectional designs were held in mind throughout the discussion. Strengths, limitations, and both clinical and research implications were considered.

Section B
Introduction: Drug and alcohol workers may be exposed to increased risk of burnout due to the nature of their work, which might increase their mentalisation load through uncertainty and anxiety, reflective effort and supporting service users with attachment difficulties. Mentalising is the ability to understand the mental states of oneself and others (Bateman and Fonagy, 2012). Previous research has found that mentalising ability might be associated to
burnout, finding the less one mentalises, the more burnout reported (Tarchi et al., 2025; Safiye et al., 2022, 2023). Therefore, this study, through several hypotheses, aimed to understand the relationship between mentalising and burnout and whether it is mediated through self-care and interpersonal workplace conflict. Methods: Staff were recruited from two drug and alcohol charities within the United Kingdom and asked to complete an online cross-sectional survey (N=138). Measures included Workplace Interpersonal Conflict Scale, Self-Care Inventory, Mentalisation Scale, Maslach’s Burnout Inventory, and
Multidimensional Scale of Social Support. Pearson correlation and mediation analysis was conducted. Results: Results suggest a total effect of mentalising and personal accomplishment, but no total effects were found for emotional exhaustion and depersonalisation. Analysis found a positive association with personal accomplishment statistically mediated through self-care. This finding continued to remain significant while controlling for social support. There did not appear to be any mediating associations between mentalisation and emotional exhaustion or depersonalisation. Discussion: Self-care mediates the association between mentalising and personal accomplishment. Discussions are held around the limitations of the study and the lack of significant mediation effect with emotional exhaustion and/or depersonalisation. Clinical implications are discussed, focusing on the need for self-care initiatives within the workplace. Research implications and areas of future research are discussed.

Date of Award	2026
Original language	English
Awarding Institution	Canterbury Christ Church University