Leadership Role in Preventing Burnout
Dr. Kelly Trevino OTR/L, OTD
The term “burnout” has become an increasingly common way to describe how those in healthcare are feeling toward their growing workload. Issues such as time constraints, increased workload, lack of control over the increasing workload, and conflicting roles and relationships with leadership directly impact the ability of healthcare professionals to provide quality care (Yap et al., 2025). Since the global pandemic the increase in demand for healthcare professionals in the workforce has had a large impact on the way allied health professionals experience work (American Hospital Association [AHA], 2021). Data suggests that by 2026 the US will face a shortage of 3.2 million healthcare workers (AHA, 2021). The COVID-19 pandemic alone has taken a heavy toll on health care professionals, reporting increased stress, trauma, burnout and behavioral health challenges. However, this growing understanding and prevalence of burnout reaches pre-pandemic, and continues to present issues that impact the overall healthcare system today (AHA, 2021).
Burnout is the gap between expectation and rewards, having feelings of being ineffective or feeling that one’s skills do not match key aspects of their job (Costa, 2018). Data suggests that occupational therapists have a significantly high rate of emotional exhaustion when compared to other areas of burnout (Costa, 2018). This could be supported by the fact that a big part of the occupational therapist skillset is the ability to connect with clients on an emotional level and empathize. Repeated exposure to secondary trauma, as is often the case between an occupational therapy practitioner and their clients, leads to an increase in compassion fatigue and reduced empathic capacity (Patole et al., 2024). Combined with resource disparities, specifically understaffing and its impact on workload and productivity expectations cause occupational therapists, like other health care workers, to feel overwhelmed by a perception that they are expected to deliver more and better services with fewer resources (Brown et al., 2016). Research suggests that compassion fatigue and burnout have long term negative consequences on health, including impaired cognition, cardiovascular disease, and psychiatric illness (Patole et al., 2024).
The growing needs of the medical landscape, and the continued demand placed on current healthcare workers are not expected to slow down in the coming years. Demand for healthcare workers, including occupational therapists, is anticipated to grow exponentially over the next decade (AHA, 2021). In order to prevent growth in the gap, occupational therapy management should take steps to prevent burnout and compassion fatigue and build infrastructure to assist in long-term solutions to support and grow the occupational therapy profession. Work overload, lack of control, insufficient reward, breakdown of community, notable value conflicts, and a poor fit between a person’s skills and their job responsibilities are the leading causes of burnout (Costa, 2018). Many of these factors can be directly addressed by the management team, taking a top-down approach in supporting skilled therapists in their work setting.
Patole et al. (2024) found that a variety of interventions to support allied health professionals’ mental health and to decrease burnout and compassion fatigue demonstrated some positive results. However, few of the studies included in their systematic review can be easily adapted to different healthcare settings. The use of acupressure, cognitive behavioral therapy, meditation, journaling, chromotherapy, and educational sessions on the use of stress-management techniques all demonstrated varied results but show poor generalizability to the population of healthcare professionals (Patole et al., 2024). Yap et al. (2025) found that after participation in a short mindfulness program, participants experienced increased introspection, improved emotional regulation and improved interpersonal relationships, which likely led to a reduction in emotional exhaustion. This mixed-method study, including standardized pre and post testing, as well as semi-structured interview is a good example of how the use of mindfulness progress, something that occupational therapists are highly skilled at, can support a decrease in burnout, and the subsequent negative results.
Management can take a proactive approach to preventing burnout by meeting the needs of the healthcare professionals that they support every day. The use of interventions such as mindfulness training or cognitive behavioral therapy has shown success in alleviating the symptoms of burnout and compassion fatigue (Yap et al., 2025; Patole et al., 2024; Costa, 2018). Toxic leadership is identified as one of the primary causes of burnout (Costa, 2018). Without awareness at an administrative and managerial level it is unlikely that the level of burnout among occupational therapists will decrease. The use of an effective leadership style can have a direct impact on worker satisfaction and staff retention. Research suggests that worker burnout is negatively correlated with transformational leadership (Park et al., 2024). Transformational leadership style is based on a collaborative approach to management, where management and staff collaborate to build a common overall goal (Northouse, 2019). A transformational leader will support someone to reach their fullest potential. Research has shown that there is a low likelihood of burnout among healthcare professionals who perceive their directors using transformational leadership (Park et al., 2024).
While individual practitioners can utilize different strategies to prevent and manage burnout and compassion fatigue, it is important to understand that the leadership style of management has a direct impact on the resources and strategies available to their team. Transformational leadership allows for the allocation of resources necessary to support staff and in turn prevent burnout and compassion fatigue. Transformational leadership supports a collaborative approach to the manager-practitioner relationship. These leaders have the ability to decrease unmanageable caseload, increase access to support resources, increase recognition, and provide time for a more consistent work-life balance. These changes in support structure for occupational therapists and other healthcare professionals have the potential to show a positive correlation with worker retention and a negative correlation to burnout and compassion fatigue.
References
American Hospital Association. (2021). Strengthening the healthcare workforce. www.aha.org.
Brown, C.A., Schell, J., Pashniak, L.M. (2016). Occupational therapists’ experience of workplace fatigue: Issues and actions. Work. 57. 517-527.
Costa, D. (2018). Better days at work: Identifying, preventing burnout in occupational therapy practice. OT Practice. (10-15). www.aota.org
Northouse, Peter G., 2019. Leadership 8th edition. Thousand Oaks, California. SAGE publications.
Park, T.K., Kim, J., Pierce, B., Lee, H. (2024). Transformational Leadership, Secondary Traumatic Stress, and Burnout of Child Welfare Workers: Multilevel Moderation Effects, Social Work, 69(3), 231–239, https://doi.org/10.1093/sw/swae017
Patole, S.; Pawale, D.; Rath, C. (2024). Interventions for Compassion Fatigue in Healthcare Providers—A Systematic Review of Randomised Controlled Trials. Healthcare. 12(171). https://doi.org/10.3390/healthcare12020171
Yap, S.W., Zainal, L.N.B., Yusoff, S.Z.B., Tan, X.R. (2025). Exploring the use of mindfulness for prevention of burnout in allied health professionals in Singapore. Work: A Journal of Prevention, Assessment, and Rehabilitation. 81(2). 2574-2581. DOI: 10.1177/10519815241313115.