The Copenhagen Burnout Inventory (CBI): Scoring, the 50-Point Cutoff, and What Scores Mean

The Copenhagen Burnout Inventory (CBI) was built at Denmark's National Institute of Occupational Health, now the National Research Centre for the Working Environment (NFA), for the PUMA study, a five-year project on burnout, motivation and job satisfaction. PUMA followed 2,391 employees in human-service work, in social security offices, a psychiatric prison, institutions for people with severe disabilities, hospitals and homecare, and 80.1% answered the baseline questionnaire (Borritz et al., 2006).

The authors put fatigue and exhaustion at the core of burnout and split it into three scales by what the person ties the exhaustion to: life in general, their work, or their work with clients (Kristensen et al., 2005). That makes it narrower than the best-known alternative, the Maslach Burnout Inventory, whose three subscales are emotional exhaustion, depersonalization and personal accomplishment (Maslach & Jackson, 1981).

NFA allows free use of the CBI, commercial use included, provided the PUMA baseline paper is cited (Borritz et al., 2006). You can take the free Copenhagen Burnout Inventory on this site. It scores in your browser, and nothing you answer is stored.

Personal burnout has six questions about exhaustion in general, such as "How often do you feel worn out?" Anyone can answer it, employed or not, and NFA's population figures include adults without jobs (Borritz & Kristensen, 2004).

Work-related burnout has seven questions about exhaustion the person ties to their job. The first three are answered by degree ("Do you feel burnt out because of your work?"), the last four by frequency. The last question, about having enough energy for family and friends in your free time, is scored in reverse.

Client-related burnout has six questions about exhaustion tied to working with clients, such as whether you feel you give more than you get back. NFA counts patients, students, children, inmates and other service recipients as clients, and suggests using whatever word fits the setting (Borritz & Kristensen, 2004). People who don't work with clients skip this scale.

Frequency answers score Always 100, Often 75, Sometimes 50, Seldom 25 and Never or almost never 0. Degree answers score To a very high degree 100, To a high degree 75, Somewhat 50, To a low degree 25 and To a very low degree 0. The reversed work question runs the other way, so Always scores 0.

Each scale's score is the average of the questions answered, from 0 to 100, and a higher score means more burnout. A scale gets no score if fewer than three of its questions are answered (four for the work scale). There is no total score: the three scales are reported separately (Borritz & Kristensen, 2004).

A worked example: someone who answers Often to all six personal questions scores 75 on personal burnout. On the work scale, Often to the first six questions and Often to the reversed seventh (25 points) gives (6 × 75 + 25) / 7, which rounds to 67.9.

The PUMA study defined high burnout as a score of 50 or more on a scale. Among its human-service workers, 22.2% scored that high on personal burnout, 19.8% on work-related burnout and 15.9% on client-related burnout (Borritz & Kristensen, 2004).

The line comes from a research study, and crossing it does not diagnose anything. Burnout is not a diagnosis in the DSM-5-TR. The World Health Organization's ICD-11 describes it as an occupational phenomenon, the result of chronic workplace stress that has not been managed well, and says it is not classified as a medical condition (World Health Organization, 2019). ICD-11 also limits the term to the work context, which is worth keeping in mind with the CBI's personal scale, since that scale asks about exhaustion from any source.

Danish adults aged 20 to 59 averaged 32.7 on personal burnout (SD 15.7, n = 1,498). Employed adults averaged 31.7 and adults without current employment 36.6 (Borritz & Kristensen, 2004).

Among the 1,917 PUMA participants in NFA's 2004 report, 83% of them women, the averages were 35.9 for personal burnout (SD 16.5), 33.0 for work-related burnout (SD 17.7) and 30.9 for client-related burnout (SD 17.6). Women scored higher than men on personal burnout (36.9 and 30.8), and men scored higher on client-related burnout (35.6 and 30.0) (Borritz & Kristensen, 2004).

These figures come from Danish samples measured around 2004. They give a score a reference point and work less well as a precise norm for a clinician in another country decades later.

Because the scales separate where the exhaustion is attributed, the pattern carries information. High personal and high work scores point to the job as a likely driver. A high personal score with a low work score suggests looking outside work: caregiving, health, sleep, grief or depression. A high client score with a lower work score puts the strain in client contact itself, which in a therapist's case means caseload mix, client acuity, boundaries and support.

Burnout and depression overlap heavily. A review of 92 studies found the distinction between them conceptually fragile, with recent studies casting doubt on burnout's distinctiveness (Bianchi et al., 2015). A high CBI score, especially a high personal score, is a reason to screen for depression as well, for example with the PHQ-9, and to ask about sleep, mood and physical health.

With clients: the CBI gives a short, structured way to talk about exhaustion that a client may describe only as being tired of everything. Repeating it every few months, or before and after a change such as a new role or reduced hours, shows whether things are moving. NFA's materials give no retest interval, so the schedule is a clinical choice.

For clinicians themselves: burnout is common in mental health work. A meta-analysis of 33 studies found that about 40% of mental health professionals reported high emotional exhaustion on the Maslach measure. Workload and relationships at work were key drivers, and role clarity, professional autonomy, fair treatment and regular clinical supervision appeared protective (O'Connor et al., 2018). A therapist who scores high, particularly on the client scale, has good reason to bring it to supervision or a consultation group.

For practices: a director can offer the CBI to staff as an anonymous check-in. Results belong to the person who answered, and a team-level picture should come from what staff choose to share.

Every answer is worth 0, 25, 50, 75 or 100, so a scale score translates back into a typical answer. A score of 25 means the person answered Seldom, or To a low degree, on average. A score of 50 means Sometimes, and 75 means Often.

Below 50: the score sits under the PUMA line for high burnout. Both Danish samples averaged in the 30s. A score in the 40s that has been climbing is worth watching.

50 or more: high burnout by the PUMA definition, with answers of Sometimes or more often on average. Rest and recovery time and changes to workload come first, along with a conversation with a professional if it has lasted for weeks or affects health, mood or work.

Close to 100: nearly every answer was Always or To a very high degree. A score this high calls for a conversation with a doctor or mental health professional soon, including a check for depression. If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline.

What is a normal score on the Copenhagen Burnout Inventory? Danish adults averaged 32.7 on personal burnout, and human-service workers in the PUMA study averaged about 31 to 36 across the three scales. Scores of 50 or more counted as high burnout in that study.

Is there a total CBI score? No. The three scales are scored and reported separately, so a person has a personal, a work-related and, if they work with clients, a client-related score.

Is the CBI free to use? Yes. NFA allows free use, commercial use included, as long as the PUMA baseline paper is cited: Borritz et al. (2006).

Can the CBI diagnose burnout? No. Burnout is not a diagnosis in the DSM-5-TR, and the 50-point line is a research definition. A high score is a reason for a conversation with a professional, who can also check for depression and medical causes of exhaustion.

Bianchi, R., Schonfeld, I. S., & Laurent, E. (2015). Burnout-depression overlap: A review. Clinical Psychology Review, 36, 28-41. https://doi.org/10.1016/j.cpr.2015.01.004

Borritz, M., & Kristensen, T. S. (2004). Copenhagen Burnout Inventory: Normative data from a representative Danish population on personal burnout and results from the PUMA study on personal burnout, work burnout, and client burnout. National Institute of Occupational Health.

Borritz, M., Rugulies, R., Bjorner, J. B., Villadsen, E., Mikkelsen, O. A., & Kristensen, T. S. (2006). Burnout among employees in human service work: Design and baseline findings of the PUMA study. Scandinavian Journal of Public Health, 34(1), 49-58. https://doi.org/10.1080/14034940510032275

Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19(3), 192-207. https://doi.org/10.1080/02678370500297720

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of Occupational Behaviour, 2(2), 99-113. https://doi.org/10.1002/job.4030020205

O'Connor, K., Muller Neff, D., & Pitman, S. (2018). Burnout in mental health professionals: A systematic review and meta-analysis of prevalence and determinants. European Psychiatry, 53, 74-99. https://doi.org/10.1016/j.eurpsy.2018.06.003

World Health Organization. (2019, May 28). Burn-out an "occupational phenomenon": International Classification of Diseases. https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases