Paraprofessional behavioral health providers are employed across a variety of settings, many of which may expose them to high-stress situations. Stress within the workplace can result in high job turnover rates and negative mental and physical health outcomes for paraprofessionals, including burnout and premature death. The debilitating effects of stressful work environments also come at a financial cost, with demanding workloads accounting for $48 billion in U.S. health expenditures annually.

Resilience, or the capacity to recover from challenges, is a key factor for successfully navigating high-stress environments in which paraprofessionals work. Creating a culture of resilience in the workplace requires a multi-tiered approach of leadership engagement, creation of strong training programs, and building awareness of factors that impact provider stress levels and job satisfaction. Adoption of this approach may involve assessment and enhancement of teamwork, autonomy, work schedule flexibility, and availability of resources within the workplace.

This study will identify and examine the factors that contribute to the development of paraprofessionals’ resiliency to inform training mythology and development of strategies to best support this workforce. National Council researchers will utilize two strategies to collect and analyze primary and secondary data:

  1. Conduct a scoping review of literature to assess key concepts, data sources, available types of evidence, and gaps in existing research on factors that affect paraprofessional resilience, including high job turnover rates, burnout, mobility in the workforce, coping skills, and practice of self-care.
  2. Complete approximately nine key informant interviews with paraprofessional behavioral health workers to better understand factors that affect resilience in the workplace.


Findings from interviews revealed the existence of factors that influence the burnout experienced by paraprofessionals and factors that help support resilience. Results were organized around three main themes: 1) burnout protective factors, 2) burnout risk factors, and 3) facilitators to building resilience.

Results showed that mental health and substance use treatment paraprofessionals are exposed to multiple risk factors for burnout. Among many others, some of these factors include low compensation (a theme and current challenge throughout the mental health and substance use treatment workforce as a whole), workforce shortages, and lack of support for enhancing resilience. Findings revealed that practicing self-care and receiving support from coworkers and supervisors were some of the most effective ways in building resilience. Some individual practices to promote resilience were found to be effective, such as self-care and setting boundaries between work and personal life. However, findings also emphasized the need for organizational and systemic support in addition to personal practices to foster resilience, since systemic issues and lack of organizational support exacerbated burnout.


Yoon Hyung Choi, PhD
Emmanuella Amoako
Matt St. Pierre, MS
Caitlyn Wayment, MPH
Victoria Schoebel, MPH
Jessica Buche, MPH, MA