In 2019, the World Health Organization included occupational burnout in the 11th Revision of the International Classification of Diseases and classified it as a phenomenon related to prolonged exposure to chronic, unsuccessfully managed workplace stress [1]. The term burnout first appeared in the academic literature in the 1970s as a social psychology construct, resulting from research conducted by pioneers in industrial organizational psychology who were interested in job stress [2,3,4]. To develop the original theory, qualitative exploratory research was conducted in the human health care services industry, due to its association with emotion and interpersonal stressors [5,6]. This led to a three-dimensional theoretical framework of burnout [2] which, decades later, remains the gold standard for conceptualizing it [7].

Burnout is widely accepted as a unique multidimensional psychological construct [8]. It is a maladaptive response to occupational stressors that, when left untreated, may decrease well-being by negatively affecting both mental and physical health [9]. Burnout also causes persistent interpersonal and emotional strain [2] since it is not only an individual experience, but also carries social implications related to conceptions of the self and others [10]. It is situation-specific (i.e., work-related) [4] and not generally associated with psychopathology or other types of organic illness [2,11].

In recent years, an updated and rigorously tested conceptualization of burnout has emerged [12]. This has confirmed that burnout is a single unified construct, but with core symptoms categorized across four dimensions, that are all related to occupational performance [13]. Exhaustion is severe energy depletion, defined as feeling physically tired, mentally drained, and worn-out to the extent that the regulation of cognitive and emotional processes is impeded [13]. Cognitive impairment is reduced performance due to difficulties with memory, attention, and concentration [13]. Emotional impairment is feeling overwhelmed by intense emotional reactions, often expressed as frustration, irritability, anger, or feeling sad at work without the ability to control emotions [13]. Mental distance is an attempt to decrease exhaustion through psychological detachment from work, denoted by indifference and cynicism [13]. These four dimensions constitute the primary domains of burnout, along with two sets of secondary burnout symptoms, psychological distress, which is a nonphysical complaint like difficulty sleeping, excessive worrying, or feeling tense and anxious; and psychosomatic distress, which is a physical complaint like chest or stomach pain or headaches that are exacerbated by a psychological problem and not attributable to a physical disorder [7].

All professionals are vulnerable to burnout based on various types of organizational stressors, but burnout is of particular concern for health care service providers who may need to adopt a stance of detachment, or emotional distance, as relief from intense workloads, with clients [2]. This is especially true for mental health practitioners (MHPs), a population of workers defined as persons with current, appropriate licensure in a mental health profession who are permitted to evaluate and care for patients within the scope of professional practice [14]. Burnout has a high prevalence for psychotherapists [15]. It is estimated that burnout affects 40% of MHPs, based on a systematic review of 62 studies that presented data on the “prevalence and determinants of burnout” for MHPs across 33 countries [16].

The risk of developing burnout can begin early in one’s career, as soon as during an internship [3,17], due to external factors like unrealistic workloads [18], lack of professional training, stressful work environments [1], or inconsistent expectations about work performance, in addition to the emotional demands of the profession [19]. Internal risk factors for burnout include age, years of experience, personal characteristics, and coping styles; thus, younger or less experienced MHPs may not have the training or resources available to help meet the challenges of the profession [6,20]. Additional contributing factors include perfectionism, anxiety, low self-efficacy, and interpersonal characteristics like shyness [12,21]. Although personal vulnerability and/or problems outside of work may facilitate the development of burnout, research demonstrates that it is tied etiologically to an imbalance between high job demands and insufficient job resources [22]. It is an individual reaction to persistent work stress and professional demands, with a progressive developmental trajectory, as opposed to being simply a personal problem [23].

The effects of burnout are concerning for health care service providers, since empathy (without sympathetic emotional distress) and compassion are critical facets of high-quality patient care and are closely related to feelings of work satisfaction and meaning [24,25,26]. For example, compassion satisfaction, the opposite of compassion fatigue, is the pleasure or positive effects experienced when helping people cope with suffering, and the perception that one’s work is contributing positively to society [20]. MHPs are particularly vulnerable to compassion fatigue (a relational source of stress associated with helping others) [5] and burnout since the very nature of their work is to help clients recover from the effects of trauma and suffering [27]. Burnout is also consistently related to poor employee retention, higher service costs, and suboptimal client care [26,28].

Self-care is a known antidote to burnout because it is a preventive action, intended to promote well-being, harmony, and balance in a person’s life [29,30]. Self-care is the ability to maintain personal health, prevent disease, and cope with illness or disability either with, or without, a supportive health-care provider [31]. It is used by MHPs to nurture the self, manage anxiety, and maintain optimal performance [32]. Domains of self-care practice include actions that promote physical health, social support, and spirituality [33]. Self-care is a necessity for all employees in the helping professions [33,34], but it is considered essential for MHPs who are ethically obligated to assume responsibility for preserving personal health [31].

Most MHPs can skillfully articulate the benefits of self-care to their clients, even as they lack vigilance regarding their own [35,36]. Research has repeatedly revealed that many MHPs personally experience a disconnect between knowledge of self-care and utilizing personal self-care actions [37]. This may be due in part to being unskilled at personal self-care strategies that reduce burnout [28,38] or simply as there are barriers that prevent them from taking the necessary steps to mitigate it [39]. The demands of the profession can create challenges due to a lack of training, resources, supervision, time, or finances [40]. Fortunately, there is growing interest in promoting self-care strategies during MHP training programs and in mental health work settings [35,36,41]. This may address the urgent need to identify risk factors and protective measures to help protect MHPs’ psychological well-being [28,42,43], especially by educating MHPs about self-care actions that are within their individual control.

Research has shown that mindfulness-based practices are effective in treating burnout because they help improve therapeutic and stress-management skills by instructing individuals on how to shift their perspective and cope adaptively [37]. Mindfulness is the moment-to-moment awareness of experience, coupled with acceptance and a non-judgmental attitude [44,45]. Benefits of mindfulness-based practices include improvements to self-efficacy [46], job satisfaction and resilience [18,47], burnout prevention [29,48], and self-awareness through self-compassion [49,50,51]. Therapists’ self-awareness is critical since it is correlated with resilience, which helps defend against burnout [52].

Self-compassion practice, as a component of mindfulness, is rooted in the principles of Buddhist psychology [53]. According to this framework, self-compassion is a function of a caring, kind, and nonjudgmental attitude toward oneself especially as related to feelings of inadequacy and failure [53]. Self-compassion practices appear to be effective in alleviating burnout when incorporated as self-care [50], and self-compassion training reduces burnout symptoms [54]. Adopting a mindful, self-compassionate perspective is beneficial for MHPs not only because it helps regulate negative emotions, but also because it may kickstart positive feelings toward oneself without the need to falsely inflate self-concept or to avoid or repress feelings that are painful [53]. Self-compassion means accepting the reality that failure and disappointment are natural parts of the human condition, which negates the need to evaluate personal performance in relation to others or ideal standards [53]. In turn, this may lead to a greater sense of compassion toward others [53,55,56] while boosting emotional resilience [57,58], personal resilience [59], and clinician resilience [60]. Randomized follow-up studies have shown the positive effects of mindfulness training on coping skills, self-care, and stress management as many as six years later [61]. There is abundant research on the benefits of mindful self-compassion for other types of healthcare workers [62], including protection from the negative effects of burnout [31,35].