Burnout subtypes and their clinical implications: A theoretical proposal for specific therapeutic approaches

Abstract:  Burnout is associated with a poor perception of health status, psychosomatic disorders and physical illness. The aim of this study is to construct a comprehensive theoretical proposal for a therapeutic intervention that is sensitive to the different clinical manifestations of this state. In order to do this, the frenetic, under-challenged and worn-out subtypes of burnout are presented in a systematic manner, together with the interventions that may provide suitable management for each subtype. Said clinical profiles may represent different stages in the progression of burnout, and have specific dysfunctional mechanisms that require a choice of adjusted intervention strategies according to the characteristics of each particular case. Finally, the degree of dedication to work and its clinical repercussions are put forward as a hypothesis to explain the progressive impairment caused by burnout, and as a target on which primary, secondary and tertiary prevention strategies could be founded. Resumen:  Subtipos de burnout e implicaciones clinicas: Una propuesta teorica  basada en abordajes terapeuticos especificos.  El burnout se asocia con un peor estatus de salud percibida, trastornos psicosomaticos y enfermedades fisicas. El objetivo del presente trabajo es articular una propuesta teorica comprehensiva de intervencion terapeutica sensible a las diferen­tes manifestaciones clinicas de dicho estado. Para ello, se presentan de forma sistematica los subtipos de burnout frenetico, sin-desafios y desgastado, asi como las intervenciones que pueden proporcionar un adecuado manejo de cada subtipo. Dichos perfiles clinicos parecen representar momentos diferentes en la progresion del burnout, con mecanismos disfuncionales especi­ficos, que obligan a optar por estrategias de intervencion ajustadas a las caracteristicas de cada caso en particular. Finalmente, se propone el grado de dedicacion en el trabajo, y sus repercusiones clinicas, como hipotesis para explicar la progresiva erosion que supone el burnout, y como eje sobre el que fundamentar las estrategias de prevencion primaria, secundaria y terciaria.