O R I G I N A L A R T I C L E Burnout among people working with intellectually disabled persons: a theory update and an example Siw Tone Innstrand 1 MSc, Geir Arild Espnes 1,2 RN, MPsych, PhD, Professor andReidar Mykletun 1 PhD, Professor, Psychol 1 Department of Social Work and Health Sciences and 2 Department of Sport Sciences, Faculty of Social Science and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway Scand J Caring Sci; 2002;16;272–279 Burnout among people working with intellectually disabled persons: a theory update and an example The paperoffersan overview of the burnout literature connected to work stress and is specially aimed at profes- sionals with responsibilities for persons with intellectual disabilities. In the paper different important key concepts in the burnout literature are both discussed in general terms, and also connected to the different instruments used to assess burnout. The effect of stress and burnout intervention procedures is also discussed thoroughly. At the end of the paper there is an example of an intervention study among staff working with persons with intellectual disabilities. The paper concludes that future progress is to be dependent on empiricaltests oftheory-based models using research designs that permit causal inferences. In addition there is a growing need for longitudinal designs reporting effects of differentintervention approaches, especially among the staff working with persons with intellectual disabilities. Keywords: burnout, stress, strain, interventions. Submitted 5 December 2000, Accepted 3 April 2002 Introduction Most jobs and many life experiences generate some degree of stress and strain but it seems that this problem may be exacerbated among individuals working in emotionally demanding environments (1). It is obviousthat profes- sional and paraprofessional staff working with persons with intellectual disabilities are faced at various times with highly disturbed and agitated individuals (2). Burnout is a metaphorthat is commonly used to describe a state or process of mental exhaustion, similar to the smothering of a fire or the extinguishing of a candle (3). Burnout does not only affect the staff member’s moral and psychological well-being but also the quality of care and treatment provided to clients (4). The importance of increasing our understanding of the causes,impactand consequences of burnout among staffworking with per- sons with intellectual disabilities, and what to do with it, is therefore essential not only to protect the health of indi- vidual workers,but also to ensure the promotion and ongoing health of the clients to whom service is provided. In Norway the responsibility for personswith intel- lectual disabilitieswas transferred from the county to each municipality in 1991, and most of the central institutionswere dissolved (called ÔtheHVPU-reformÕ). Since then several studies have been carried out where the relation between the organization of services and the interests of the recipients have been the main focus (e.g. 5–9). Less attention has been devoted to the conse- quences ofthe reform on the working environment for staff working with persons with intellectual disabilities (10). This paper will therefore discuss the burnout conceptin general, its relationship to work stressand differentintervention approaches to stress and burnout. At the end of the paper a Norwegian intervention study among staff working with persons with intellectual disabilitieswill be presented and discussed according to the preceding literature. Methods This overview is based on both manual journal searches and electronic literature searcheson key words like ÔBurnoutÕ, ÔStressÕ, ÔBurnout and stressÕ, ÔInterventionsÕ and ÔWorking with intellectually disabledÕ in PsychInfo and MedLine.Combinations ofthe above listed search terms were also used. As we were able to locate only one study concerning burnout and stress among people working with intellectually disabled in Norway, most of the literature is based on burnout and stress in general. Correspondence to: Geir Arild Espnes, Department of Social Work and Health Sciences, Faculty of Social Science and Technology Management, Norwegian University of Science and Technology, 7094 Trondheim, Norway. E-mail: geirae@svt.ntnu.no 272 Ó 2002 Nordic College of Caring Sciences, Scand J Caring Sci