Compassion Training for Hospital Chaplain Residents: A Pilot Study Public

Abstract

Objective: Healthcare providers experience high rates of burnout. Provider burnout includes feelings of emotional exhaustion and ineffectiveness associated with prolonged exposure to patients’ suffering. Hospital chaplains are relied on to provide spiritual, social, and emotional support to acutely distressed patients, and may be particularly susceptible to burnout. The purpose of the current study is to examine the effectiveness of incorporating compassion meditation training into a clinical pastoral education (CPE) curriculum to reduce burnout and negative emotional symptomology among hospital chaplain residents.                                                                   

Methods: A longitudinal, quasi-experimental design was used to examine the impact of Cognitively-Based Compassion Training (CBCT^®), a group-delivered compassion meditation intervention in reducing adverse mental health outcomes, including burnout. Hospital chaplain residents (n = 15) were assigned to participate in a CBCT intervention in the fall of their CPE program or a waitlist comparison group that received CBCT in the spring of their CPE program. We assessed depression, anxiety, stress, burnout, secondary trauma stress, and compassion satisfaction at four-time points: baseline, immediately after the intervention group received CBCT, 4-month follow-up before the waitlist group received CBCT, and after the waitlist group received CBCT.

Results: Compared to the waitlist comparison group, chaplains assigned to CBCT reported significant decreases in burnout and anxiety; though, the effect was not maintained at 4-month follow-up. Other outcomes did not differ significantly post-intervention but were trending in the expected direction. Secondary analyses that collapsed the intervention and waitlist group into a single group pre-post design indicated that CBCT training was associated with significant decreases in depression, anxiety, burnout, and secondary trauma stress, and increases in compassion satisfaction. 

Conclusions: Findings support the hypothesis that group-delivered compassion meditation training incorporated into CPE is effective for reducing burnout and anxiety among hospital chaplain residents, although it may be necessary to continue CBCT throughout residency to sustain effects. 

Table of Contents

Chapter 1: Introduction................................................................................................................ 1

Chapter 2: Literature Review...................................................................................................... 5

The Role of Hospital Chaplains............................................................................................... 5

Chaplain Wellbeing................................................................................................................. 8

Compassion Training................................................................................................................ 9

Chapter 3: Methods.................................................................................................................... 13

Participants.............................................................................................................................. 13

Study Design and Procedures................................................................................................ 13

Intervention............................................................................................................................. 14

Measures.................................................................................................................................. 15

Data Analysis Methodology.................................................................................................... 17

Student Contributions............................................................................................................ 18

Chapter 4: Manuscript............................................................................................................... 19

Introduction............................................................................................................................. 21

Materials and Methods........................................................................................................... 23

Results...................................................................................................................................... 27

Discussion................................................................................................................................ 29

Conclusions............................................................................................................................. 31

Manuscript References........................................................................................................... 33

Tables and Figures................................................................................................................... 40

Figure 1: Study Schedule.......................................................................................................... 40

Table 1: Demographics........................................................................................................... 41

Table 2: Main Outcomes......................................................................................................... 42

Table 3: Follow-up Results...................................................................................................... 42

Table 4: Secondary Analyses (Non-Parametric)...................................................................... 43

Table 5: Secondary Analyses (Parametric).............................................................................. 43

Chapter 5: Public Health Implications..................................................................................... 44

Discussion................................................................................................................................ 44

Strengths and Limitations..................................................................................................... 46

Public Health Implications.................................................................................................... 47

Conclusion............................................................................................................................... 52

References.................................................................................................................................... 53

Appendices................................................................................................................................... 69

Appendix A: CBCT Integrative Model.................................................................................. 69

Appendix B: CBCT Skills and Outcomes............................................................................. 70

Appendix C: CBCT Practice Overview................................................................................. 71

Appendix D: Study Schedule.................................................................................................. 72

Appendix E: Cronbach’s Alpha Scores by Measure............................................................. 73

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Public Health Education Psychology, Behavioral Sciences
Mot-clé	Secondary Trauma Stress Compassion Chaplains Burnout
Committee Chair / Thesis Advisor	Walker, Elizabeth, Emory University DiClemente, Ralph, New York University
Committee Members	Mascaro, Jennifer, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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