Therapeutic burnout among borderline personality disordered clients and their therapists: Development and evaluation of two adaptations of the Maslach Burnout Inventory

Providers of psychotherapy services are likely to become emotionally exhausted, to depersonalize their clients, and to have diminished personal accomplishment as a consequence of treating "difficult" clients. This pattern, termed burnout, has recently received considerable empirical attention. Whereas previous researchers have explored burnout as an occupational phenomenon, we propose that both therapists and clients experience burnout reciprocally; that is, both providers and recipients can become burned out from the therapy process. We administered a modified client version of the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1986) to clients receiving psychosocial treatment for borderline personality disorder (BPD) both prior to therapy and 4 months into treatment and a modified therapist version of the MBI to their therapists. We predicted that client difficulty (depression, anger, and suicidality) would be related to therapist burnout, and that high expectancies of therapy would be related to increased burnout for both clients and therapists at 4 months. Whereas the first prediction was not supported, we did find some support for the relationship between expectancies and burnout. Post hoc analyses also revealed an interesting pattern: The most reliable predictor of therapist burnout at 4 months was client burnout at pretreatment. Implications of this interaction between client burnout and the therapists' responses are discussed.