Factors associated with professional identity, job satisfaction and burnout for occupational therapists working in eating disorders: A mixed methods study

Background: Occupational therapists employed within eating disorder services provide unique and valuable interventions. However, existing literature suggests that occupational therapists in this area may be at substantial risk of experiencing poor work-related wellbeing (e.g., high levels of burnout and low levels of job satisfaction). Despite these risks, no previous studies have explored the work-related experiences of occupational therapists in this specialist area of practice. Objectives: To explore challenges faced by occupational therapists working in eating disorders, their sense of professional identity, burnout and job satisfaction. Method: A mixed methods sequential design was adopted. Australian occupational therapists working in eating disorder services were invited to complete a survey exploring job challenges, burnout, professional identity and job satisfaction. Follow-up interviews were conducted and analysed using Braun and Clarke's method of thematic analysis. Results: Ten occupational therapists (representing approximately 50% of the workforce in this specialist area in Australia) participated. There were strong correlations between challenges from the client group and exhaustion (a component of burnout), and moderate correlations between stronger professional identity, pressure to adopt generalist approaches and exhaustion. Qualitative analysis suggested job challenges arose from structural, personal and client-related sources, especially underutilisation of occupational therapy and pressure to adopt non-occupation-based practices. Participants reported using strategies such as maintaining an occupation focus, supervision, professional interactions and maintaining work-life balance to mitigate job stress. Conclusion: Occupational therapists working in eating disorders do face challenges. These are particularly related to the lack of evidence base for occupational therapy in this area. Future research should focus on developing further evidence for occupational therapy in eating disorders and designing outcome measures that capture improvements in daily functioning. These efforts would strengthen the role of occupational therapy and may reduce the risk of burnout and improve job satisfaction and sense of professional identity.