Intended for healthcare professionals


Counselling for burnout in Norwegian doctors: one year cohort study

BMJ 2008; 337 doi: (Published 12 November 2008) Cite this as: BMJ 2008;337:a2004
  1. Karin E Isaksson Rø, medical doctor12,
  2. Tore Gude, professor12,
  3. Reidar Tyssen, associate professor 2,
  4. Olaf G Aasland, director3, professor4
  1. 1Research Institute, Modum Bad, NO-3370 Vikersund, Norway
  2. 2Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
  3. 3Research Institute of the Norwegian Medical Association, PO Box 1152 Sentrum, NO-0107 Oslo, Norway
  4. 4Institute of Health Management and Health Economics, University of Oslo, Norway
  1. Correspondence to: K Isaksson Rø karin.roe{at}
  • Accepted 24 September 2008


Objective To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors.

Design Cohort study followed by self reported assessment at one year.

Setting Norwegian resource centre.

Participants 227 doctors participating in counselling intervention, 2003-5.

Interventions Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors’ situation and personal needs.

Main outcome measures Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression.

Results 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (β=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men “satisfaction with the intervention” (β=0.25, P=0.04) independently predicted reduction in emotional exhaustion.

Conclusions A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention.


  • We thank the participating doctors for their time and engagement in registering data. We also thank Per Vaglum, professor emeritus at the Department of Behavioural Sciences in Medicine, University of Oslo, for substantial and valuable comments during manuscript revision and John Boettiger, professor emeritus, for language revision.

  • Contributors: KEIR and TG conceptualised and designed the study, developed the construction of the questionnaire, analysed and interpreted data, and drafted the paper. RT contributed to data collection and analysis. OGA participated in the development and construction of the questionnaire. All authors revised the manuscript critically for important intellectual content and approved the final manuscript. KEIR is the guarantor.

  • Funding: The study was supported by the Norwegian Women’s Public Health Association and Modum Bad psychiatric hospital.

  • Competing interests: KEIR has been employed at the resource centre, Villa Sana, and was reimbursed for a presentation of preliminary results at an internal meeting at the Norwegian Medical Association.

  • Ethical approval: The study was approved by the data inspectorate through the Norwegian Social Science Data Services. The regional ethical research committee in the south of Norway did not consider consent necessary for this study. All doctors gave written informed consent.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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