Having a Team Therapist Significantly Reduces Burnout Among Critical Care Nurses
In the high-stakes environments of intensive care units (ICUs), nurses are often the unsung heroes battling both the physical and emotional tolls of critical patient care. Recent groundbreaking research presented at the ATS 2025 International Conference in San Francisco highlights a promising intervention that could revolutionize how healthcare institutions support their nursing staff. Embedding a dedicated team therapist within critical care units has been shown to markedly reduce burnout rates, enhance resilience, and improve overall job satisfaction for ICU nurses. This novel approach is poised to alleviate mental health burdens that have long plagued nursing professionals and reshape organizational mental health strategies.
Burnout among critical care nurses is a pervasive and pressing issue, characterized by emotional exhaustion, depersonalization, and diminished personal accomplishment. The intense mental strain stems not only from managing medically complex patients but also from repeated exposure to trauma, ethical dilemmas, and chronic staffing shortages. Traditional support mechanisms, such as Employee Assistance Programs (EAPs) and peer support networks, have often fallen short in addressing these multifaceted stressors. EAPs, despite being readily available, tend to be underutilized by nursing staff, possibly due to stigma or a lack of immediacy in accessing support. Peer support models encounter challenges as the helpers may themselves be deeply affected by similar stressors, leading to constrained efficacy.
The innovative study spearheaded by Julie Graham, PhD, APRN, ACCNS-AG, assistant professor at San Diego State University School of Nursing, zeroed in on an embedded therapist model implemented at Sharp Chula Vista Medical Center, California, during the COVID-19 pandemic. This period is critical to consider, as the pandemic not only strained healthcare systems but also amplified psychological distress among frontline workers. Sharp Chula Vista experienced ICU nursing turnover rates reaching nearly 29%, reflective of the significant emotional breakdowns and mental health crises observed among staff.
In collaboration with hospital leadership and an affiliated mental health institution, the project established a full-time therapist position directly integrated within the critical care team. This embedded professional was not an external resource but rather an intrinsic team member, facilitating immediate, context-sensitive mental health support. By being onsite and continually present, the therapist could cultivate trust, offer real-time interventions, and attune therapeutic strategies to the evolving dynamics of the ICU environment. This contrasts with the episodic and often impersonal nature of traditional external counseling services.
Quantitative data from nurse surveys captured the intervention’s impact, revealing that engagement with the onsite therapist correlated with substantial improvements across key dimensions of nurse wellbeing. Job satisfaction indices increased, while burnout scores declined considerably. Nurses also reported enhanced resilience, an attribute crucial for withstanding prolonged stress without succumbing to despair. Another notable outcome was the elevation in nurses’ self-efficacy regarding mental health management, indicating that these professionals felt more competent in recognizing and addressing their own psychological needs after receiving consistent support.
One of the most striking institutional benefits was the dramatic reduction in nurse turnover following the therapist’s integration. After the therapist role became permanent, turnover plunged from a staggering 29% to as low as 1% at its nadir. While this ultra-low turnover rate was not entirely sustained over time, it remains significantly reduced compared to pre-intervention figures. From an organizational perspective, this translates to substantial cost savings, as the financial implications of recruiting and training replacement nurses are high. Dr. Graham emphasized that the salary of a single therapist could offset expenses incurred by multiple nurse departures, underscoring the intervention’s cost-effectiveness.
The embedded therapist model also addresses a core limitation of peer support systems. While peer supporters bring valuable empathy and relatability, their efficacy can be compromised when they are concurrently managing their own trauma or fatigue. Conversely, a professional therapist is trained in evidence-based psychotherapeutic techniques and maintains clinical boundaries that enable sustained, objective support. This distinction is critical in an ICU setting, where emotional contagion and cumulative trauma can quickly overwhelm informal support networks.
The embedded therapist supports a broad spectrum of mental health needs, employing strategies like cognitive-behavioral interventions, mindfulness-based stress reduction, and trauma-informed care tailored to frontline nursing staff. The immediacy of support not only mitigates acute distress but also fosters preventative mental health care, potentially reducing incidence of more severe psychopathology such as depression, anxiety, and post-traumatic stress disorder (PTSD). This proactive model contrasts with reactionary or crisis-only approaches prevalent in many healthcare systems.
As this model gains traction, the research team is expanding their inquiry through a prospective cohort study in partnership with San Diego State University’s School of Business. This follow-up research aims to quantitatively link the embedded therapist’s presence with additional outcomes including reduced absenteeism, sustained staff retention, and improved patient care metrics. These institutional indicators will provide a more comprehensive understanding of the model’s systemic value and scalability.
The implications of these findings extend beyond critical care nursing, highlighting a paradigm shift in occupational mental health support within healthcare environments. Integrating mental health professionals directly into clinical teams establishes a culture of wellbeing that normalizes psychological care and mitigates stigma barriers. It fosters a sustainable workforce capable of delivering high-quality patient care without succumbing to burnout. This is especially critical as healthcare systems worldwide confront nurse shortages and escalating demands exacerbated by global health crises.
Dr. Graham’s work calls for a reevaluation of traditional employee mental health support frameworks and advocates for widespread adoption of embedded therapist roles. The evidence presented not only argues for the humanitarian imperative to support those who care for the critically ill but also delineates a financially prudent strategy that benefits healthcare organizations holistically. As this intervention garners attention, it is poised to transform institutional approaches to nurse wellbeing, ensuring that these vital healthcare providers receive the support they urgently need in their challenging roles.
Subject of Research: Mental Health Support Interventions for Critical Care Nurses
Article Title: Having a Team Therapist Reduces Burnout in Critical Care Nurses
News Publication Date: May 19, 2025
Web References: https://www.atsjournals.org/doi/abs/10.1164/ajrccm.2025.211.Abstracts.A3142
Image Credits: Julie Graham, PhD, APRN
Keywords: Nursing, Stress management, Mental health, Burnout, Critical care, Therapist support, Nurse wellbeing, Occupational health
