DESCRIPTION (provided by applicant): Background: Unfortunately, there has been a serious lack of attention to reducing or preventing burnout and its associated problems. In particular, there is a paucity of intervention programs, especially those that are based on sound theory or research, and have been standardized and empirically evaluated. Our research team has conducted prior work to develop and test an intervention - BREATHE (Burnout Reduction: Enhanced Awareness, Tools, Handouts, and Education) - to reduce mental health provider burnout. In a quasi- experimental design, we found preliminary support for the program's effectiveness for reducing provider burnout and improving provider attitudes toward their consumer population. However, it has yet to be tested in a controlled design. In addition, we need to identify organizational factors that could help broader dissemination of the program if effective. Our long-term goal is to produce a user-friendly program that is effective not only for reducing provider burnout, but also for improving organizational/system outcomes, quality of care, and, ultimately, veteran outcomes. Objectives: This project includes several objectives. First, we will test the effectiveness of the basic BREATHE training in a randomized, controlled design. Second, we will examine organizational factors that impact burnout so that we can better design implementation supports for BREATHE in the VA. Methods: We will recruit 180 volunteer mental health providers in local VA and other facilities and randomly assign them to the day-long training or the control group receiving a day-long training in either person-centered treatment planning training or integrated dual disorders training. We will collect measures of provider burnout and attitudes toward veterans at baseline, 6-weeks post-training, and 6-months post-training. We will also collect qualitative data on organizational contextual factors that promote or reduce burnout. Burnout data will be analyzed using repeated measures analysis of covariance (ANCOVA) model to evaluate the intervention effect over time.

Minimizing burnout in mental health professionals constitutes a critical area for improving veterans' healthcare, particularly those receiving mental health services. Burnout of mental health providers and managers is highly prevalent and associated with a number of problems that may impact providers, the Veterans Health Administration as an organization, and the veterans they serve. At the provider level, burnout is associated with poor physical and mental health. At the organization and system levels, problems include higher absenteeism, lower productivity, higher costs, and a failure to retain trained and qualified professionals. Burnout is also linked with disruptions in the quality of care which may negatively affect veteran outcomes.