Psychological Flexibility, Coping, and Attachment Style in Predicting Secondary Traumatic Stress and Burnout In Forensic Inpatient Staff

Paper one is a literature review that explores predictors of burnout in forensic inpatient healthcare professionals (FHCPs). A systematic search of the literature identified 10 relevant studies. The review established 12 factors found to be predictive of levels of burnout in inpatient FHCPs. Factors that were consistently associated with staff burnout were younger age, number of hours worked, quality of supervision, work-related stress, negative attitudes towards clients who demonstrate aggressive behaviour, and avoidance of emotional expression. Factors associated with lower levels of burnout were older age, positive ward environment, trait empathy, dispositional mindfulness, trust in colleagues, and expression of emotions. The findings support the dominant models explaining burnout and provide recommendations to improve staff wellbeing.

The second paper describes a cross-sectional quantitative study investigating individual factors (psychological flexibility, coping style and attachment style) as predictors of secondary traumatic stress and burnout. The sample comprised 98 FHCPs recruited from two male medium secure inpatient hospitals in the UK. Multiple regression analyses were conducted. The results indicated that higher levels of maladaptive coping and lower psychological flexibility significantly predicted increased secondary traumatic stress and burnout, whilst increased adaptive coping predicted lower burnout. In terms of attachment, increased anxious attachment significantly predicted increased personal accomplishment. The findings suggest that practices and interventions which develop FHCP’s psychological flexibility and adaptive coping strategies may be useful approaches to help reduce levels of secondary traumatic stress and burnout.

The third paper is an executive summary of the research study described in paper two, written for those that participated or are interested in the study. It also aims to convey the recommendations of the study to those within forensic organisations in a position to act. FHCPs from within the participating services provided valuable feedback to ensure the paper’s accessibility.