literature review found that less than 1% of 4430 papers reviewed contained scientifically rigorous data, and that the 14 well-designed studies collectively "showed that such [randomised control trial] interventions did not succeed in alleviating burnout symptoms." Lindsäter et al. in a 2022 literature review note the reported success of CBT, acceptance and commitment therapy (ACT), a multimodal rehabilitation program (MMR) program (involving group CBT, applied relaxation in a group, individual psychotherapy, physiotherapy, lectures, and medical treatment), physical exercise, cognitive training, consuming rhodiola rosea extract, and participating in an African dance program. However, overall they noted that "a multitude of interventions have been investigated for exhaustion disorder, but the evidence for any one type of intervention is limited." Burnout also often causes a decline in the ability to update information in working memory. This is not easily treated with CBT. One reason it is difficult to treat the three standard symptoms of burnout (exhaustion, cynicism, and inefficacy), is because they respond to the same preventive or treatment activities in different ways. Exhaustion is more easily treated than cynicism and professional inefficacy, which tend to be more resistant to treatment. Research suggests that intervention actually may worsen the professional efficacy of a person who originally exhibited low professional efficacy. Employee rehabilitation is a tertiary preventive intervention which means the strategies used in rehabilitation are meant to alleviate burnout symptoms in individuals who are already affected without curing them. Such rehabilitation of the working population includes multidisciplinary activities with the intent of maintaining and improving employees' working ability and ensuring a supply of skilled and capable labour in society. See also Motivational crowding Compassion fatigue Counterproductive work behavior Emotional exhaustion Employee engagement Meditation Spoon theory Writer's block Workaholism Karoshi Stress and the workplace Caregiver stress Industrial and organizational psychology Occupational health psychology Occupational Health Science Perceived organizational support Perceived psychological contract violation Workplace stress Teacher burnout Medical Acute stress disorder Adjustment disorder Chronic fatigue syndrome Depression Hypothalamic–pituitary–adrenal axis Mental disorder Pathological demand avoidance Posttraumatic stress disorder Stress Notes References Further reading External links Human resource management Occupational stress Organizational theory Motivation Organizational behavior