Chapter 5. Discussion, Implications, Conclusions
5.4. Implications for practice
The review of the literature suggests a three-pronged organizational approach to addressing burnout prevention and treatment in healthcare professionals. First, the development of resiliency-based skills that promote holistic wellness embedded in an educational curriculum (Haramati et al., 2017; Kreitzner & Klatt, 2017; Maslach & Leiter, 2017; Panagioti, Geraghy & Johnson, 2017). Second, organizational approaches that recognize the human aspects of health care provision focusing on workload, control, reward, community, fairness and values as outlined by Maslach and Leiter (2016). And third, individual lifelong development and practice of preventive skills related to
mindfulness meditation and group skills (Kreitzner & Klatt, 2017; Maslach & Leiter, 2017; Schrijver, Brady & Trockel, 2016).
Models describing the development of burnout fail to adequately address the complex ways in which humans manage strain and stress. Mindfulness-Informed group theory provides valuable insights related to the prevention and treatment of the burnout syndrome by introducing how a mindfully-informed group process helps members self-
regulate and co-regulate strain and stress. Using a mindfulness-informed group process allows both leaders and members of work groups to function in a more engaging
manner, using mindfulness meditation in their personal lives and the social engagement network at work to regulate their stress levels. Healthcare professionals need to
incorporate a holistic perspective in the management of burnout producing situations that include managing their stresses and needs, the small group dynamics, and the organizational demands (O’Connor et al., 2018; Patel et al., 2018; West et al., 2018).
Mindfulness-informed group theory suggests that leaders of work groups of healthcare professionals should actively construct work environments that increase the occurrence of interpersonal safety. They may do so by using mindful leadership, attention to the form of the group, and training the group members in interpersonal mindfulness to guide the group purpose and the exogenously determined goals of the organization. Leaders and organizations can harness the power of groups to produce interpersonal environments that encourage members to skillfully communicate their experiences in ways that signal safety and allow for the co-regulation of strain and stress. Mindfulness meditation promotes the self-regulation of strain and stress (Goleman and Richards, 2018). Mindfulness-informed groups shape work settings, appearing to increase the group’s co-regulating effect.
Mindfulness-informed group theory potentially addresses many of the concerns noted in the development of burnout. Frontline leaders and supervisors help direct the immediate workload, play a significant role in the development of teamwork and civility as well as fairness (Maslach & Leiter, 2017; Swensen & Shanafelt, 2017). Interpersonal mindfulness works with skillful communication to encourage member’s openness to other’s experiences and well as the genuine expression of their own experience.
Supportive supervisors and coworkers contribute to a positive work environment and act beneficially as a buffer to burnout (Leiter and Maslach, 1988). The mindfulness-informed group enriches this buffer through the genuine sharing of experiences.
Constraints of the mindfulness-informed work group lay in what can and cannot be shared. The idea is not to share “everything” but to share mindfully and genuinely what can be shared within the form of the work group. Member’s emotional experiences, as well as their interpersonal experiences, are often marginalized in work groups. In a safe group, the conscious, mindful and skillful expression of these experiences has a co-
regulating effect. But expressed unconsciously, unmindfully or unskillfully, they can have real and destructive consequences. The mindful leader needs to be ever vigilant with regard to the communication in a work group due to the inequalities of power between members, between members and the leader, and between the group and the
organization. Mindfulness-informed group theory respects the importance of these realities and asks the mindful leader to be ‘mindful’ of these dangers while modelling and encouraging this mindfulness with skillful communication in the group.
Van Bogaert et al. (2013) note that everyone contributes to the team
environment. Maslach & Leiter (2016) state that “the area of community has to do with the ongoing relationships that employees have with other people on the job. When these relationships are characterized by a lack of support and trust, and by unresolved conflict, then there is a greater risk of burnout” (p. 105). The form of the group and mindful leadership play an essential role in creating a group structure that encourages all members to play an active role in the management of the interpersonal field as well as being mindful of the needs of those in the group.
To conclude, mindfulness-informed group theory may play a role in preventing and treating burnout in healthcare settings, by regulating strain and stress through the mindful management of the interpersonal environment.
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