Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-07-04T16:22:03.509Z Has data issue: false hasContentIssue false
  • English
  • Français

What about the therapist? – a quantitative exploration of the pathways from a therapist’s professional life to their personal well-being

Published online by Cambridge University Press:  20 May 2022

Sidrah Altaf Open the ORCID record for Sidrah Altaf [Opens in a new window]
Sidrah Altaf*
Affiliation:
Buckinghamshire New University, Buckinghamshire, UK Email: Sidrahaltaf1@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Occupational stress has been identified as one of the biggest contributors to therapists’ poor mental well-being; however, these ‘wear and tear’ effects are not universal. This study aimed to distinguish between these experiences, by exploring potential avenues through which a therapist’s professional life may impact their well-being. Previous research has highlighted four avenues: self-doubt, developmental depletion, developmental growth, and years of experience. A sample of 65 cognitive behavioural therapists were recruited from four Improving Access to Psychological Therapies (IAPT) services and a cognitive behavioural therapy training course at Buckinghamshire New University. A quantitative cross-sectional survey design was employed. Each participant completed a questionnaire consisting of subscales of the ‘Development of Psychotherapist Common Core Questionnaire’ to measure potential avenues (Orlinsky et al., 1999a), and the Warwick-Edinburgh Mental Well-being Scale to measure mental well-being (Tennant et al., 2007). A multiple regression and post-hoc mediation analyses were conducted. The multiple regression analysis found three significant direct pathways predicting well-being: self-doubt, developmental depletion, and developmental growth. The post-hoc mediation analyses found two significant indirect pathways between self-doubt and well-being mediated by developmental experience (growth and depletion). Years of experience had a non-significant direct and indirect pathway predicting well-being. The results suggested that therapists experiencing more growth, less depletion and less self-doubt experienced more positive mental well-being than those experiencing depletion and self-doubt, and less growth. When therapists experience high self-doubt, whether they also experience depletion or growth, they experience poor mental well-being. The implications for practice and future avenues of research are discussed.

Key learning aims

  1. (1) To understand the potential impact of therapists’ professional lives on their well-being.

  2. (2) To understand the role of developmental experience and self-doubt.

Keywords

CBTcognitive behavioural therapydevelopmentpsychological therapiestherapist self-doubttherapist well-being
Type
Original Research
Information
the Cognitive Behaviour Therapist , Volume 15 , 2022 , e24
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further reading

Nissen-Lie, H. A., Ronnestad, M. H., Høglend, P. A., Havik, O. E., Solbakken, O. A., Stiles, T. C., & Monsen, J. T. (2017). Love yourself as a person, doubt yourself as a therapist? Clinical Psychology & Psychotherapy, 24, 48–60.CrossRefGoogle ScholarPubMed
Thériault, A., & Gazzola, N. (2005). Feelings of inadequacy, insecurity, and incompetence among experienced therapists. Counselling and Psychotherapy Research, 5, 11–18.CrossRefGoogle Scholar
Thériault, A., & Gazzola, N. (2010). Therapist feelings of incompetence and suboptimal processes in psychotherapy. Journal of Contemporary Psychotherapy, 40, 233–243.CrossRefGoogle Scholar

References

Beck, A., Naz, S., Brooks, M., & Jankowska, M. (2019). BAME IAPT Black, Asian and Minority Ethnic Service User Positive Practice Guide 2019.Google Scholar
Békés, V., Doorn, K. A., Prout, T. A., & Hoffman, L. (2020). Stretching the analytic frame: analytic therapists’ experiences with remote therapy during COVID-19. Journal of the American Psychoanalytic Association, 68, 437–446.CrossRefGoogle ScholarPubMed
Bennett-Levy, J., Thwaites, R., Haarhoff, B., & Perry, H. (2014). Experiencing CBT from the Inside Out: A Self-Practice/Self-Reflection Workbook for Therapists. Guilford Press.Google Scholar
Bischoff, R. J., & Barton, M. (2002). The pathway toward clinical self-confidence. American Journal of Family Therapy, 30, 231–242.CrossRefGoogle Scholar
Brace, N., Snelgar, R., & Kemp, R. (2016). SPSS for Psychologists: And Everybody Else. Macmillan International Higher Education.CrossRefGoogle Scholar
Brady, J. L., Guy, J. D., Poelstra, P. L., & Brown, C. K. (1996). Difficult good-byes: a national survey of therapists’ hindrances to successful terminations. Psychotherapy in Private Practice, 14, 65–76.CrossRefGoogle Scholar
Chang, E. C. (2008). Self-Criticism and Self-Enhancement: Theory, Research, and Clinical Implications (pp. xvi–291). American Psychological Association.CrossRefGoogle Scholar
Connolly, S., Miller, C., Lindsay, J., & Bauer, M. (2020). A systematic review of providers’ attitudes toward telemental health via videoconferencing. Clinical Psychology: Science And Practice, 27. doi: 10.1111/cpsp.12311 Google Scholar
Cotton, E. (2017). Surviving Work in Healthcare: Helpful Stuff for People on the Frontline. Taylor & Francis.CrossRefGoogle Scholar
Delgadillo, J., Saxon, D., & Barkham, M. (2018). Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes. Depression and Anxiety, 35, 844–850.CrossRefGoogle ScholarPubMed
Deutsch, C. J. (1984). Self-reported sources of stress among psychotherapists. Professional Psychology: Research and Practice, 15, 833.CrossRefGoogle Scholar
Doorn, K. A., Békés, V., Luo, X., Prout, T. A., & Hoffman, L. (2021). What do therapist defense mechanisms have to do with their experience of professional self-doubt and vicarious trauma during the COVID-19 pandemic? Frontiers in Psychology, 12.CrossRefGoogle Scholar
Doorn, K. A., Békés, V., Prout, T. A., & Hoffman, L. (2020). Psychotherapists’ vicarious traumatization during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12, S148.CrossRefGoogle Scholar
Everitt, B., & Skrondal, A. (2010). Standardized mortality rate (SMR). The Cambridge Dictionary of Statistics, 409.Google Scholar
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.CrossRefGoogle Scholar
Hames, J. L., Bell, D. J., Perez-Lima, L. M., Holm-Denoma, J. M., Rooney, T., Charles, N. E., Thompson, S. M., Mehlenbeck, R. S., Tawfik, S. H., Fondacaro, K. M., Simmons, K. T., & Hoersting, R. C., (2020). Navigating uncharted waters: considerations for training clinics in the rapid transition to telepsychology and telesupervision during COVID-19. Journal of Psychotherapy Integration, 30, 348.CrossRefGoogle Scholar
Hayes, A. F. (2017). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Press.Google Scholar
James, K., Verplanken, B., & Rimes, K. A. (2015). Self-criticism as a mediator in the relationship between unhealthy perfectionism and distress. Personality and Individual Differences, 79, 123–128.CrossRefGoogle Scholar
Kannan, D., & Levitt, H. M. (2017). Self-criticism in therapist training: a grounded theory analysis. Psychotherapy Research, 27, 201–214.CrossRefGoogle ScholarPubMed
Keyes, C. L., & Haidt, J. (2003). Introduction: Human flourishing – the study of that which makes life worthwhile. In Flourishing: Positive Psychology and the Life Well-Lived, pp. 3–12.Google Scholar
Klostermann, K., Mignone, T., Steffan, S., & Mahadeo, M (2018). supervision in psychotherapy: clinical considerations and recommendations for improving the supervisory process and enhancing professional development. ARC Journal of Addiction, 3, 23–25.Google Scholar
Kottler, J. (2017). On being a Therapist. Oxford University Press.Google Scholar
Lopes, B. C. D. S., & Jaspal, R. (2020). Understanding the mental health burden of COVID-19 in the United Kingdom. Psychological Trauma: Theory, Research, Practice, and Policy.Google Scholar
Macdonald, J., & Mellor-Clark, J. (2015). Correcting psychotherapists’ blindsidedness: formal feedback as a means of overcoming the natural limitations of therapists. Clinical Psychology & Psychotherapy, 22, 249–257.CrossRefGoogle ScholarPubMed
MacKinnon, D. P., & Pirlott, A. G. (2015). Statistical approaches for enhancing causal interpretation of the M to Y relation in mediation analysis. Personality and Social Psychology Review, 19, 30–43.CrossRefGoogle Scholar
McBride, H. L., Joseph, A. J., Schmitt, P. G., & Holtz, B. M. (2020). Clinical recommendations for psychotherapists working during the coronavirus (COVID-19) pandemic through the lens of AEDP (Accelerated Experiential Dynamic Psychotherapy). Counselling Psychology Quarterly, 1–21.Google Scholar
Meehan, Z. (2019). Differences in Therapist Self-Doubt: Perceptions of Conduct Disorder.Google Scholar
Mesrie, V., Diener, M. J., & Clark, A. (2018). Trainee attachment to supervisor and perceptions of novice psychotherapist counseling self-efficacy: the moderating role of level of experience. Psychotherapy, 55, 216.CrossRefGoogle ScholarPubMed
Muran, J. C., & Eubanks, C. F. (2020). Therapist Performance Under Pressure: Negotiating Emotion, Difference, and Rupture. American Psychological Association.CrossRefGoogle Scholar
Nissen-Lie, H. A., Monsen, J. T., Ulleberg, P., & Rønnestad, M. H. (2013). Psychotherapists’ self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome. Psychotherapy Research, 23, 86–104.CrossRefGoogle ScholarPubMed
Nissen-Lie, H. A., Ronnestad, M. H., Høglend, P. A., Havik, O. E., Solbakken, O. A., Stiles, T. C., & Monsen, J. T. (2017). Love yourself as a person, doubt yourself as a therapist? Clinical Psychology & Psychotherapy, 24, 48–60.CrossRefGoogle ScholarPubMed
Norcross, J., & Guy, J. (2007). Leaving it at the Office: A Guide to Psychotherapist Self-Care. Guilford Press.Google Scholar
Odyniec, P., Probst, T., Margraf, J., & Willutzki, U. (2019). Psychotherapist trainees’ professional self-doubt and negative personal reaction: changes during cognitive behavioral therapy and association with patient progress. Psychotherapy Research, 29, 123–138.CrossRefGoogle ScholarPubMed
Oliveira, J. A., & Vandenberghe, L. (2009). Upsetting experiences for the therapist in-session: how they can be dealt with and what they are good for. Journal of Psychotherapy Integration, 19, 231.CrossRefGoogle Scholar
Orlinsky, D. E., & Ronnestad, M. H. (2005). How Psychotherapists Develop: A Study of Therapeutic Work and Professional Growth.CrossRefGoogle Scholar
Orlinsky, D. E., & Ronnestad, M. H. (2015). Psychotherapists growing older: a study of senior practitioners. Journal of Clinical Psychology, 71, 1128–1138.CrossRefGoogle ScholarPubMed
Orlinsky, D., Ambühl, H., Rønnestad, M., Davis, J., Gerin, P., & Davis, M. et al. (1999a). Development of psychotherapists: concepts, questions, and methods of a collaborative international study. Psychotherapy Research, 9, 127–153. doi: 10.1080/10503309912331332651 CrossRefGoogle Scholar
Orlinsky, D., Rønnestad, M., Ambühl, H., Willutzki, U., Botersman, J., & Cierpka, M. et al. (1999b). Psychotherapists’ assessments of their development at different career levels. Psychotherapy: Theory, Research, Practice, Training, 36, 203–215. doi: 10.1037/h0087772 CrossRefGoogle Scholar
Peto, J., Alwan, N., Godfrey, K., Burgess, R., Hunter, D., & Riboli, E. et al. (2020). Universal weekly testing as the UK COVID-19 lockdown exit strategy. The Lancet, 395, 1420–1421. doi: 10.1016/s0140-6736(20)30936-3 CrossRefGoogle ScholarPubMed
Piselli, A., Halgin, R. P., & MacEwan, G. H. (2011). What went wrong? Therapists’ reflections on their role in premature termination. Psychotherapy Research, 21, 400–415.CrossRefGoogle ScholarPubMed
Posluns, K., & Gall, T. L. (2020). Dear mental health practitioners, take care of yourselves: a literature review on self-care. International Journal for the Advancement of Counselling, 42, 1–20.CrossRefGoogle ScholarPubMed
Råbu, M., Moltu, C., Binder, P. E., & McLeod, J. (2016). How does practicing psychotherapy affect the personal life of the therapist? A qualitative inquiry of senior therapists’ experiences. Psychotherapy Research, 26, 737–749.CrossRefGoogle ScholarPubMed
Rauch, S. A., Simon, N. M., & Rothbaum, B. O. (2020). Rising tide: responding to the mental health impact of the COVID-19 pandemic. Depression and Anxiety.CrossRefGoogle Scholar
Ronnestad, M. H., Orlinsky, D. E., Schröder, T. A., Skovholt, T. M., & Willutzki, U. (2019). The professional development of counsellors and psychotherapists: implications of empirical studies for supervision, training and practice. Counselling and Psychotherapy Research, 19, 214–230.CrossRefGoogle Scholar
Ronnestad, M. H., & Skovholt, T. M. (2013). The Developing Practitioner: Growth and Stagnation of Therapists and Counselors. Routledge.Google Scholar
Scharff, A., Breiner, C. E., Ueno, L. F., Underwood, S. B., Merritt, E. C., Welch, L. M., Litchford, G. B. et al. (2021). Shifting a training clinic to teletherapy during the COVID-19 pandemic: a trainee perspective. Counselling Psychology Quarterly, 34, 676–686.CrossRefGoogle Scholar
Schroder, T., Orlinsky, D., Ronnestad, M. H., & Willutzki, U. (2015). Psychotherapeutic process from the psychotherapist’s perspective. In Psychotherapy Research (pp. 351–365). Vienna: Springer.Google Scholar
Simionato, G. K., & Simpson, S. (2018). Personal risk factors associated with burnout among psychotherapists: a systematic review of the literature. Journal of Clinical Psychology, 74, 1431–1456.CrossRefGoogle ScholarPubMed
Sodeke-Gregson, E. A., Holttum, S., & Billings, J. (2013). Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients. European Journal of Psychotraumatology, 4, 21869.CrossRefGoogle ScholarPubMed
Stewart-Brown, S., & Janmohamed, K. (2008). Warwick-Edinburgh Mental Well-Being Scale. User guide. Version, 1.Google Scholar
Stewart-Brown, S., Platt, S., Tennant, A., Maheswaran, H., Parkinson, J., & Weich, S. et al. (2011). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a valid and reliable tool for measuring mental well-being in diverse populations and projects. Journal of Epidemiology & Community Health, 65, A38–A39. doi: 10.1136/jech.2011.143586.86 CrossRefGoogle Scholar
Stoltenberg, C. (1981). Approaching supervision from a developmental perspective: the counselor complexity model. Journal of Counseling Psychology, 28, 59.CrossRefGoogle Scholar
Strean, H. S. (1993). Resolving counterresistances in psychotherapy. New York, USA: Brunner/Mazel.Google Scholar
Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., & Weich, S. et al. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health and Quality of Life Outcomes, 5, 63. doi: 10.1186/1477-7525-5-63 CrossRefGoogle ScholarPubMed
Thériault, A., & Gazzola, N. (2006). What are the sources of feelings of incompetence in experienced therapists? Counselling Psychology Quarterly, 19, 313–330. doi: 10.1080/09515070601090113 CrossRefGoogle Scholar
Thériault, A., & Gazzola, N. (2010). Therapist feelings of incompetence and suboptimal processes in psychotherapy. Journal of Contemporary Psychotherapy, 40, 233–243.CrossRefGoogle Scholar
Thériault, A., Gazzola, N., Isenor, J., & Pascal, L. (2015). Imparting self-care practices to therapists: what the experts recommend. Canadian Journal of Counselling and Psychotherapy, 49.Google Scholar
Thériault, A., Gazzola, N., & Richardson, B. (2009). Feelings of incompetence in novice therapists: consequences, coping, and correctives. Canadian Journal of Counselling and Psychotherapy, 43.Google Scholar
Tracey, T. J., Wampold, B. E., Goodyear, R. K., & Lichtenberg, J. W. (2015). Improving expertise in psychotherapy. Psychotherapy Bulletin, 50.Google Scholar
Tracey, T. J., Wampold, B. E., Lichtenberg, J. W., & Goodyear, R. K. (2014). Expertise in psychotherapy: an elusive goal?. American Psychologist, 69, 218.CrossRefGoogle Scholar
Wampold, B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. Routledge.CrossRefGoogle Scholar
Watson, J. C., & Greenberg, L. S. (2000). Alliance ruptures and repairs in experiential therapy. Journal of Clinical Psychology, 56, 175–186.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Westwood, S., Morison, L., Allt, J., & Holmes, N. (2017). Predictors of emotional exhaustion, disengagement and burnout among improving access to psychological therapies (IAPT) practitioners. Journal of Mental Health, 26, 172–179.CrossRefGoogle ScholarPubMed
Winter, T., Riordan, B., Pakpour, A., Griffiths, M., Mason, A., Poulgrain, J., & Damian, S. (2020). Evaluation of the English version of the Fear of COVID-19 Scale and its relationship with behavior change and political beliefs.CrossRefGoogle Scholar
World Health Organization (2018). Mental health: strengthening our response. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response Google Scholar
Ziem, M., & Hoyer, J. (2020). Modest, yet progressive: effective therapists tend to rate therapeutic change less positively than their patients. Psychotherapy Research, 30, 433–446.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.