Effects of writing-based interventions on self-compassion and job burnout among psychotherapists: a three-arm randomized controlled trial and mediation analysis

Job burnout is an important concern affecting psychotherapists’ occupational health and professional sustainability. Given the emotionally demanding nature of psychotherapy practice, identifying feasible approaches to support psychotherapists’ self-care and occupational well-being is of considerable importance. This study aimed to examine the effects of writing-based interventions on psychotherapists’ self-compassion and job burnout outcomes, and to explore the potential indirect role of self-compassion in this association. A total of 67 psychotherapists were randomly assigned to a self-compassion-oriented expressive writing (SCO-EW) group, a free writing (FW) group, or a control group for a 6-week intervention. Self-compassion and job burnout were assessed at pre-test, post-test, and follow-up using the Self-Compassion Scale-Chinese Version and the Maslach Burnout Inventory-General Survey-Chinese Version. Linear mixed-effects models and mediation analyses were conducted. Writing interventions were associated with increased self-compassion and improved job burnout outcomes. Compared with the control group, both writing conditions showed greater reductions in emotional exhaustion, whereas SCO-EW also showed reductions in cynicism. However, SCO-EW and FW did not differ significantly across most post-test outcomes, whereas SCO-EW showed greater improvements than FW in self-compassion and overall job burnout outcomes from pre-test to the 1-month follow-up. Mediation analyses indicated that post-test self-compassion was associated with follow-up job burnout outcomes, with significant indirect effects observed for both writing conditions compared with the control condition. This study extends expressive writing research to the occupational health context of psychotherapists. Self-compassion-oriented expressive writing may represent a feasible approach to supporting psychotherapists’ occupational well-being, with self-compassion serving as a potential psychological pathway underlying these associations.