Burnout among therapists working with persons with autism after the 2009 earthquake in L'Aquila, Italy: a longitudinal comparative study

Accessible summary This study was the first attempt to evaluate burnout occurrence in mental health therapists working in a highly exposed setting, characterized by prolonged exposure to an autism-related work frame and a post-earthquake aftermath. Results strongly suggest that autism therapists exposed to a disruptive earthquake are at higher risk of burnout than caregivers working in typical conditions. In presence of high-risk exposures, burnout occurs rapidly (1 year) with respect to times to event described in the literature (4 years or later). Efforts are required to help mental health workers, including psychiatric nurses, to cope with the devastating situation determined by an earthquake. Assuming that return to good work conditions, supervision support, and natural adaptation are plausible determinants in reducing burnout risk, a periodical monitoring of mental health status is recommended in mental health works. The aim of this study was to follow up the occurrence of burnout in therapists of children and adolescents with autism experiencing the 2009 earthquake in L'Aquila, and to discuss implications for burnout prevention after disasters. A longitudinal study was carried out, measuring burnout outcomes according to the Maslach Burnout Inventory in 11 exposed and 53 unexposed therapists. Staff in the exposed group appeared to report significantly higher levels of emotional exhaustion after 1 and 2 years of follow-up than the unexposed staff. As to lack of personal accomplishment, the exposed groups shows increasingly lower scores with respect to the unexposed group, with personal accomplishment (PA) values falling from 41.0 [standard deviation (SD) 3.7] to 33.4 (SD 4.1) after 2 years, whereas PA values remain stable over time in the unexposed group. As to depersonalization, data show no significant difference between groups. Burnout occurrence is induced by the exceptional stressors related with natural disasters like earthquakes. Efforts are required to help mental health workers, including psychiatric nurses, to cope with the devastating situation determined by an earthquake. A periodical monitoring of mental health status is recommended in mental health works, especially with regard to help with post-traumatic stress disorder, coping with work and therapeutic relationships, family and social life and economic impact.