A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians

227 physicians who attended a counselling intervention for burnout at the Resource Centre Villa Sana, Norway in 2003-2005, were followed with self-report assessments at baseline, one-year, and three-year follow-up. Main outcome measures were emotional exhaustion (one dimension of burnout), job stress, coping strategies and neuroticism. Changes in these measures were analyzed with repeated measures ANOVA. Temporal relationships between changes were examined using structural modelling with cross-lagged and synchronous panel models.184 physicians (81%, 83 men, 101 women) completed the three-year follow-up assessment. Significantly reduced levels of emotional exhaustion, job stress, and emotion-focused coping strategies from baseline to one year after the intervention, were maintained at three-year follow-up.Panel modelling indicated that changes in emotion-focused coping (z = 4.05, p < 0.001) and job stress (z = 3.16, p < 0.01) preceded changes in emotional exhaustion from baseline to three-year follow-up. A similar pattern was found from baseline to one-year follow-up.A sequential relationship indicated that reduction in emotion-focused coping and in job stress preceded reduction in emotional exhaustion. As a consequence, coping strategies and job stress could be important foci in intervention programs that aim to reduce or prevent burnout in help-seeking physicians.The prevalence and predictors for the development of burnout in the medical profession have been explored to some extent [1-4], but we need follow-up studies after interventions for burnout to examine the role of coping strategies, job stress and personality traits for the reduction of burnout.Coping strategies have been defined as strategies used to reduce the possible harm of an event that is considered potentially dangerous to the person's psychological well-being [5], and they are usually grouped into (1) active, problem-focused and (2) emotion-focused or emotional ways of coping. Wishful thinking, an