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Burnout in Psychotherapists:: Incidence, Types, and Trends



Indicates that the incidence of burnout in psychotherapists is about 2–6%. Institutionally based and inexperienced therapists seem most at risk for burnout. The satisfaction of being in a position of helpful intimacy prevents most therapists from experiencing burnout. Three types of burned-out therapist are delineated: those who in response to frustration work increasingly harder; those who in response to frustration give up entirely; and those who perform their work perfunctorily, having lost interest in work they now find unchallenging. Trends that may increase the risk of burnout (e.g., the increasing number of individuals with character disorders that are presenting for treatment) are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
ED 303 741 CG 021 440
AUTHOR Farber, Barry A.
TITLE Burnout in Psychotherapists: Incidence, Types, and
NOTE 15p.; Paper presented at tte Annual Meeting of the
American Psychological Association (96th, Atlanta,
GA, August 12-16, 1988).
PUB TYPE Reports - Research/Technical (143) -- Viewpoints
EDRS PRICE MF01/PC01 Plus Postage.
DESCRIPTORS *Bqrnout; *Incidence; *Psychotherapy; *Stress
Variables; *Therapl.sts; *Trend Analysis
ABSTRACT Burnout among psychotherapists appears to be low;
most psychotherapists seem quite satisfied with their work and
untouched by the dysfunctional symptoms of burnout. Interviews with
60 therapists revealed that most considered "lack of therapeutic
success" to be the single most stressful aspect of therapeutic work.
Burnout was most often attributed to the nonreciprocated
attentiveness, giving, and responsibility demanded by the therapeutic
relationship. A survey of clinical psychologists suggests that
institutionally-based therapists, as opposed to those in private
practice, are more at risk of burnout. Three types of burnout which
have been identified among teachers can be used to construct profiles
of burned out psychotherapists. The most likely candidate for the
first type of burnout - frenetic overinvolvement - may be the young,
highly idealistic therapist. The second type, the worn-out therapist,
seems most prevalent among experienced therapists working in
institutions with oppressive bureaucratic structures. Finally, there
is the underchallenged, underestimated therapist. Trends which may
increase the risk of burnout among psychotherapists include the trend
toward health maintenance organizations, the trend for an increasing
number of individuals with difficult-to-treat character disorders
seeking treatment, and the tendency for psychotherapy to become more
of a business. (NB)
*Reproductions supplied by EDRS are the best that can be made *
*from the origir 1 document. *
Burnout in Psychotherapists: Incidence. Types. and Trends
Barry A. Farber, Ph.D.
Department of Psychology
Teachers College, Columbia University
New York, NY 10027
Paper presented at the Annual Convention: APA, Atlanta, August, 1988
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Therapist Burnout
- 10 1
Barry A. Farber, Ph.D.
Teachers College,
Columbia University
The problems with the term "burnout" have been well documented. It
has been overused, misused, adopted indiscriminately to describe
temporary states of disaffection with work, leisure activities,
relationships, and lives in general. But the word endures, for its essential
nature, its basic symptoms, resonate with a wide variety of workers,
including those who practice psychotherapy. Feelings of exhaustion, of
emotional and physical depletion, of inattention within the office and
irritability outside the office, of disillusionment and loss of belief in
one's effectiveness, of displacement of feelings onto one's family and
friends-these are phenomena that most of us have experienced, at least
occasionally. To label transient feelings of doubt or occasional bouts of
anger at borderline patients, "burnout", is, indeed to dilute the meaning of
the term. But the experience of these episodic feelings do enable us to
understand more fully the nature of thefull-blown syndrome, just as
fleeting feelings of sadness enable us to more fully empathize with those
with major depressive disorders.
Incidence and Risk Factors
While burnout in psychotherapists, then, is something many can easily
Therapist Burnout
relate to, the numbers of those who are actually burned out in this field is
relatively low. In comparison to teachers, for example, few therapists are
burned out. If we think of burnout as more than a transient state, we can
compare prevalence rates by noting the percentages of those in each group
whose responses on the Maslach Burnout Inventory (MBI) indicate that they
have "frequently" felt burned out from work during the last month. On this
basis, 10.3% of suburban public school teachers are burned out and a
startling 21.6% of urban teachers (Farber, 1984), but only 1.6% of the more
than 300 clinical psychologists who responded to a 1985 surv4 (Farber,
Another method of computing relative prevalence rates is to compare
these psychologists' scores on the three subscales of the MBI with Maslach
and Jackson's (1981) reported norms on a large and varied sample of human
service professionals. The Emotional Exhaustion subscale of the MBI
includes such items as "I feel emotionally drained from my work," and "I
feel used up at the end of the workday." On the intensity dimension of this
subscale, 75% of therapists in this sample scored in the "low" (lower
third) range of experienced burnout and only 6% scored in the "high" (upper
third) range. A second subscale of the MBI, Depersonalization, includes
such items as "I feel I treat some recipients as if they were impersonal
objects" and "I've become more callous toward people since I took this job."
On this subscale, 74% of the sample placed in the low range and only 2.3%
in the high range. The third subscale of the MBI, Personal Accomplishment,
is comprised of such items as "I feel I'm positively influencing other
Therapist Burnout
people's lives through my work," and "I have accomplished many
worthwhile things in this job." On this last subscale, 62% of therapists in
this sample had scores in the low range but somewhat surprisingly, 19.2%
of therapists scored in the high end of burnout-- a finding suggestive of
the fact that for a substantial minority of therapists psychotherapy
simply doesn't work as well as they would wish. As will be discussed
shortly, this somewhat disenchanted subgroup is probably
disproportionately represented by those working in institutional settings.
Overall, though, only 2% of therapists frequently feel emotionally drained
by their work, and only 2% frequently feel that working directly with
others puts too much stress on them. Most therapists then, seem quite
satisfied with their work, and except for perhaps 2-6% of the profession,
untouched by the dysfunctional symptoms of burnout.
What causes this small minority of therapists to burn out or causes
most of us to experience those transient feelings of despair? In-depth
interviews with 60 therapists have begun to provide answers to such
questions (Farber & Heifetz, 1982). Most of those interviewed cited "lack
of therapeutic success" as the single most stressful aspect of therapeutic
work; burnout per se was most often attributed to the nonreciprocated
attentiveness, giving, and responsibility demanded by the therapeutic
relationship. Other factors cited in accounting for burnout included
overwork, the general difficulty in dealing with patient problems,
discouragement as a function of the slow and erratic pace of therapeutic
work, the tendency of therapeutic work to raise personal issues in
Therapist Burnout
therapists themselves, the passivity oftherapeutic work, a -,d the isolation
often demanded by the work. The findings of this, and several other
studies, then, suggest that therapists expect their work to be difficult and
even stressful, but they also expect their efforts to "pay off." Constant
giving without the compensation of success apparently produces burnout.
Both patients and therapists art prone to burnout when they experience
their efforts as inconsequential.
Who among therapists is most likely to burn out? The survey of
clinical psychologists (Farber, 1985) suggests that institutionally-based
therapists, as opposed to those in private practice are more at risk. Both
on the Emotional Exhaustion and Personal Accomplishment subscales of the
Maslach Burnout Inventory, the scores of institutionally-based
practitioners as well as those with split practices are more indicative of
burnout. And less experienced therapists are also at greater risk for
burnout. First-order partial correlations indicate that number of years of
experience, even independent of age, is negatively and significantly re'ated
to scores on the Emotional Exhaustion and Depersonalization subscales.
Gender, however, does not seem to affect the tendency toward burnout.
Why are institutionally-based therapists more vulnerable to burnout?
Primarily because burnout is strongly mitigated by feelings of efficacy,
and such feelings are generally harder to come by for those whose hours
are dominated by chronic, resistant or seemingly untreatable patients. In
addition, those working in institutional settings are often faced with a
whole set of professional issues not encountered by those in private
Therapist Burnoue
practice. What immediately comes to mindilem is the issue of
"second-class" citizenship--deferring to those with medical degrees, even
when their knowledge of psychology is sorely deficient, having one's skills
go unrecognized (except for perhaps one's knowledge of testing), feeling
like "guests" in psychiatry's house. Administrative issues may also impair
one's sense of professionalism. In this regard, nearly half (48%) of
therapists working at institutional settings feel, at least to a moderate
extent ("4" on a 7-point intensity scale) that they have been frustrated by
administrative red-tape in their efforts to help patients. In addition,
59.7% feel to at least a moderate extent that they have been frustrated by
budgeting considerations in their efforts to help patients, and the identical
percentage feel at least to a moderate extent "disheartened" by the
working conditions at their setting. In short, in institutional settings,
therapists have less control over their practicesmany have excessive
caseloads or caseloads replete with difficult patients, and virtually all
must cope with the vagaries of organizational politics.
Inexperienced therapists are simply less prepared to deal with the
inevitable stresses of therapeutic work, for example dealing with acting
out patients or working through their own countertransferential
difficulties. For better perhaps, but also for worse, they have not yet
learned to leave their work at work. Interview data suggest that they
continue to concern themselves with their patients after sessions, that
they experience difficulty in acclimating themselves to the different rules
and assumptions that govern social relations, and that they are more likely
Therapist Burnout
to bring home leftover feelings of frustration, anger, or bewilderment.
And many inexperienced therapists have not yet adapted entirely to the
nonreciprocal nature of the work, understanding intellectually this aspect
of the therapeutic relationship but nonetheless feeling a lack of gratitude
or appeciation. Finally, fcr somewhat understandable, if not entire
defensible reasons, it is the inexperienced therapists who, in
instiututional settings, are more likely to be assigned more difficult
patients, i.e., those who the more experienced, permanert staff would
prefer not to tre E.
What prevents most therapists from burning out? For most
therapists, the greatest satisfaction lies in helping people change.
Coupled with a sense of what might be called "intimate involvement"--of
being privy to personal, profound thoughts and feelings of another--
therapists are often in a unique position of helpful intimacy. Therapists
are compensated for the stresses of therapeutic work by other factors as
well, notably that therapeutic work promotes growth in oneself as well as
others, that it affords an opportunity for most therapists to utilize and gei
paid for an ability they enjoy and feel confident about, and that
psychotherapy is a high-status, professional career with somewhat of a
mystique surrounding it. The stresses of therapeutic work may also be
buffered by rewarding contact with one's colleagues. At least among
clinical psychologists, nearly 70% feel (to a moderate extent or more) that
they have a network of professional associatesto call upon for support;
only 3% feel this not at all to be the case.
Therapist Burnout
Types of Burnout
In general, burnout is caused when workers' exporience a significant
discrepancy between their input and expected output, between efforts and
rewards. Burnout is most often the consequence of feeling
inoonsequenlal. The typical symptoms of professional burnout include
feelings of ph, jcal and emotional depletion; increased irritability,
anxiety, and/cr sadness; and the development of negative attitudes toward
oneself clients, and work in general. In addition, burnout may lead to
psychosomatic symptoms (for example, insomnia, ulcers, headaches,
hypertension), alchohol or substance abuse, and increased family and social
conflicts. In therapists, burnout may mean caring less about patients and
giving less to them, feeling more easily frustrated by patients' resistances
or lack of progress, losing confidence in ono's skills or feeling
disillusioned about the healing powers of the field itself, being less
involved in or cynical about professional developmer', regretting the
decision to enter the field, or fantasizing about leaving the profession.
This is the general picture of a burned out therapist, but there
seems to be much variability in regard to both the process and nature of
this disorder. In teachers, for example, three variants of burnout have
been identified (Farber, in press): those who in response to frustration
work even harder in an attempt to produce the results they expect; those
who in response to frustration give up entirely and appear "worn out"; and
those who are relatively immune to frustration- -who neither work harder
nor give up but instead perform their work perfunctorily, having lost
Therapist Burnout
interest in work they now find unchallenging and unstimulating.
The first group, those frenetic individuals who refuse to acknowledge
failure until they have been completely exhausted by their efforts, were
first and most completely described by Herb Freudenberger. These are
people, said Freudenberger (1980), who have "pushed themselves too hard
for too lung, who have "started out with great (expectations and refused to
compromise along tho way" (p. 12) whose "inner resources [have been]
consumed as if by fire, leaving a great emptiness inside" (p. m(). These
individals risk their physical health and neglect their personal lives iJ
maximize the probability of professional success. For them, the
acknowledgement of failure is nearly impossible inasmuch as it reflects
on their personal worth as human beings. The job is an ex:ansion of 'heir
selves, their egos, and must be successfully performed. The second group
of burned out individuals, however, are not consumed by this degree of
passion; these "worn out" individuals are simply not as personally invested
in their work. Obsta:les to effectivework, therefore, are seen as
oppressive by these individuals and tend to dampen (rather than heighten)
their motivation. The third type of burned out individual is neither fired up
by unwanted obstacles, nor weighted .down and overwhelmed by them.
Obstacles are treated nonchalantly, worked around--the attitude in these
cases is that "there's a job to do and I'll do it reasonably well,but I won't
go out of my way to do it particularly well because the job isn't
sufficiently engaging or interesting."
The enumeration of several discrete types of burnout may be useful in
1 6
Therapist Burnout
providing some degree of specificity to a disoroer that has to often been
described in rather general, all-purpose terms. On the other hand, as we
well know, individuals often defy easy categorization. Thus, in terms of
burnout, some, perhaps many, human service professionals vacillate among
these three types--at times feeling so energetic and optimistic that they
invest more than ever and more than is healthy in their work (frenetic
burnout), at times feeling so overwhelmed aAd pessimistic that they cut
back on their involvement (worn-out) ,and at times simply feeling
uninterested in and unstimulated by the problems and issues of their
profession. With this caveat in mind, it may be useful to construct
profiles of three different types of burned out osychotherapists.
Interviews with therapists suggest that the most likely candidate for
the first type of burnout--frenetic overinvolvement--is a young, highly
idealistic therapist either currently in a training program ur recently
graduated. Imbued with more than a healthy degree of narcisissm, such an
individual may become overly invested in curing either a specific pat'snt
or his or her entire caseload. This individual may, for example, get hooked
into the role of idealized savior for a borderline patient, or as the
nurturant, healing parent that a neglected child has never had. In the
movies (for example, Sybil, Ordinary People, David and Lisa), the
investment in such cases invariably pays off. In "real life", of course,
borderline patients don't get better so easily and autistic, schizophenic, or
abused children are rarely, if ever, cured by once or twice a week doses of
play therapy. The young therapist, therefore, who devotes him or herself
Therapist Burnout
to "curing" such individuals, who spends countless hour: digging through
files, reading pertinent case histories, searching his or her own psyche for
creative interpretations and explanations, imagining fame and fortune as a
result of a brilliant intervention, may, indeed, ultimately become
disillusioned, even burned out, by the lack of progress so frequently
encountered in these most difficult cases. Clinical lore recognizes the
potential of this scenario by advising even the most inexperienced young
therapists against taking on but one case.
The second type, that of the worn-out therapist, seems to be most
often manifest among more experienced individuals working in institutions
with particularly oppressive bureaucractic structures. These individuals
have been worn down by organizational politics, by seemingly petty rules
and demands, by low pay and low autonomy, and by often excessive
workloads. Interviews suggest that social workers and psychologists,
rather than psychiatrists, are more prone toward this type of burnout. For
these therapists, the setting in which work occurs seems to obliterate
much of the joy of the work itself--too much work, often with too many
difficult patients, in settings offering little opportunity for advancement
or recognition. We've all seen such therapists in large state or
Veterans-administration hospitals.
Lastly, there is the underchallenged, understimulated therapist. Here
the classic examples include the psychiatrist whose day is spent
prescribing or injecting psychotropic medications, the psychologist who
day in and day out prepares or supervises behavioral contracts for
Therapist Burnout
residents of group homes, the social worker whoseonly job in the
organization is to do intakes on alcoholic patients, the therapist who has
been pigeonholed by referral sources as the one willing work with
homebound agoraphobics--in short, individualswhose range of talents are
insufficently recognized or exercised in theirprofessional settings. Here
the stresses of work are not great but neither are the rewards- -
particularly those of a psychological nature.
Some individuals, of course, may appear to be a conglomeration of all
three types; some may manifest symptoms radically different from any of
these types. What is common to the experience of burnout is simply one
factor- -the felt discrepancy between what one puts into the job ar .the
rewards one takes out.
Althou,p, as noted above, burnout seems to be relatively uncommon in
our field, several trends may ba seen as potentially increasing the risk.
One is the trend toward HMOS where more bureaucracy and less
autonomy for therapists are the general rules. If a greater percentage of
therapeutic work is performed in HMOS over the next years--which seems
likely at this point--the number of wornout and underchallenged therapists
may well increase.
Another apparent trend is the increasing number of individuals with
character disorders that are presenting for treatment. As is well
documented, individuals with borderlineor narcissistic disturbances, or
those with aduictions to alcohol or other urugs, are quite difficult to treat.
Therapist Burnout
These patients are particularly likelyto engender frustrations, raise
expectations, and provoke fantasies of grandeur andomnipotence.
Depending on the setting at which 2 therapist works and depending too on
his o' her expectations and style of dealing with frustration, this trend
may increase the number of frenetically burned out as well as worn out
A final trend--though one for which there is limited supporting
data--is that psychotherapy seems to becoming more a "business" than
ever. At least in some individuals an original calling to help others has
been diluted, if not entirely replaced, with a new calling to make
ever-increasing amounts of money. Of course, there's the reality of
inflation, and the need to pay off higher mortgages, but all of us know too
individuals in this field whose priorities seem to have been lost--for
whom there seem to be no limits on the number of patients to be seen or
fees charged, for whom time spent with family or on their own
recreational activities is time spend reluctantly. For these therapists,
success is primarily measured by dollars rather thin by individuals helped.
"TV.ert- lc, iNc ,44ver,
-.9f-eettreert4iere% a middle ground, and skews% psychotherapy is,
whatever else it may be, also a business. But forthose who have lost sight
of their original motivation--presumably helping others--the endless,
frantic pursuit of money may lead to a burned out state if the expected
reward (i.e., affluence or financial security) fails to occur.
The true impact of these putative trends remains to be assessed by
future research. What is heartening, though, is that current studies (e.g.,
Therapist Burnout
Farber, 1985) indicate that the vast majority of therapists still view
"helping others" as the primary source cf satisfaction; morever, these
studies suggest that most therapists seem not to be burned out from their
work at all but rather gratified and fulfilled by it.
Farber, B.A. (1984). Teacher burnout: Assumptions, myths, and issues_
Teachers College Record. 86, 321-338.
Farber, B.A. (1985). Clinical psychologists' perceptions of
psychotherapeutic work. The Clinical Psychologist. 38, 10-13.
Farber, B.A. (in press). Sims and burnout in Americanleachers: Two
decades of blaming the helper. San Francisco: Jossey-Bass.
Farber, B.A., & Heifetz, L.J. (1982). The process and dimensions of burnout
in psychotherapists. Professional Psyrehology,ja, LJ3-301.
Freudenberger, H. (1980). Burn out. NY: Bantam.
Maslach, C., & Jackson, S.E. (1981). Burnout Research
Edition Manual. Palo Alto, CA: Consulting Psychologists Press, Inc.
... -1 which all pose a risk of psychological distress, impairment, or even burnout in this occupation (see e.g. Barnett, 2008;El-Ghoroury et al., 2012;Estacio, 2019;Farber, 1990;Farber & Heifetz, 1982;Luther et al., 2017;Skovholt & Trotter-Mathison, 2016). Several authors also underlined the role of contextual and environmental factors (e.g., working hours, caseload, and negative clientele), which are responsible for the risk of burnout among psychotherapists (e.g. ...
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The main goal of this study was to investigate the trajectories of the changes in burnout and subjective well-being (SWB) among psychotherapists in relation to social support, self-efficacy, sociodemographic, and work-related factors, with additional control for the subjectively experienced Covid-19 related distress. This study was carried out over a 1-year period during the critical time of the Covid-19 pandemic. We reached 226 Polish psychotherapists, of which 207 psychotherapists (91.6%) participated in all three measurements. The participants completed the following measurements: the Maslach Burnout Inventory-Human Service Survey, the Satisfaction with Life Scale, the General Self-Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and a questionnaire regarding sociodemographic, work-related factors and Covid-19 related distress. Several trajectories were observed for both burnout and SWB, which were differently associated with the level of social support, self-efficacy, and sociodemographic and work-related factors. We did not find a significant relationship between Covid-19 related distress and the inclusion of either burnout or SWB trajectories. This study calls for greater interest in the psychological health of psychotherapists. More specifically, our findings may entail some implications for the practice of psychotherapy by creating customized intervention programs to reduce burnout and enhance well-being in this specific occupation.
... No obstante, la falta de mayor difusión entre los profesionales sobre los factores de riesgo y los efectos perniciosos de determinados aspectos del trabajo clínico dificultan que estos se normalicen y se afronten de forma adecuada. Ligado a lo anterior, la ausencia de medidas preventivas o las expectati-vas inadecuadas sobre el trabajo clínico incrementan el riesgo de deterioro, burnout y discapacidad en los terapeutas (Farber, 1990). Por ende, sigue vigente la necesidad de promover que los psicólogos desarrollen de un modo activo, intencional y deliberado la conciencia sobre su estado de salud de cara a activar los recursos precisos en caso de tener que buscar posibles soluciones. ...
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OBJETIVOS DEL CAPÍTULO • Informar sobre los problemas que pueden experimentar los terapeutas cuando trabajan bajo circunstancias estresantes, como en el abordaje de las personas con conductas suicidas. • Definir el concepto de autocuidado como competencia profesional y obligación ética, poniendo de relieve su importancia en la práctica clínica con problemas relacionados con las conductas suicidas. • Revisar las estrategias de autocuidado con apoyo empírico disponibles. • Estimular la integración del autocuidado en la práctica habitual de los terapeutas, los programas de formación y en las organizaciones de servicios asistenciales. ALBERTO GIMENO-PEÓN, JAVIER PRADO-ABRIL, JOAQUÍN PASTOR MORALES, FÉLIX INCHAUSTI GÓMEZ ©Ediciones Pirámide
... One exception was among clients receiving treatment in outpatient hospitals who reported lower levels of therapistprovided PR. Our sense here is that clinicians in these settings were (and still are) extremely over-burdened and prone to burnout (Ackerley et al., 1988;Farber, 1990;Morse et al., 2012;Thompson et al., 2014), especially during a global crisis, and thus less able to provide equivalent (or greater) levels of PR during the pandemic. Another exception to the general invariance of perceived changes in therapist PR was that respondents who were treated by therapists with an eclectic orientation reported higher levels of change. ...
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Objective: To investigate clients' perceptions of changes in their therapists' provision of positive regard (PR) following their transition from in-person therapy to teletherapy.Method A total of 2,118 clients, predominantly White, female, heterosexual, and in their mid-20s, who had been working with their therapist for an average of 20 months in-person and five months in teletherapy completed a Perceptions of Psychotherapy Process Scale (POPPS). This 42-item measure investigated, at a single time-point, the extent to which participants believed that specific therapist-related behaviors, statements, or attitudes changed since shifting to teletherapy. Results: An exploratory factor analysis revealed, among other factors, a factor comprised of six items related to therapist-provided PR (e.g., "my therapist makes me feel cared about"). Clients' scores on this factor indicated a marginal but significant increase in therapists' provision of PR over teletherapy; these scores also significantly predicted scores on a factor reflecting clients' engagement in teletherapy. Conclusions: Despite the challenges of an abrupt shift to teletherapy, clients perceive their therapists as communicating PR to the same or even slightly higher degrees as compared to in-person therapy pre-pandemic; therapists and clients have seemingly adapted to the new demands of technology to preserve important elements of the therapeutic relationship.
... However, the frequent exposure to narratives of distress, loss and trauma makes psychological therapists particularly vulnerable to developing occupational stress and burnout (Bearse et al., 2013;Simionato et al., 2019). Studies investigating the prevalence of burnout in psychotherapists show prevalence rates that range from 2-6% (Farber, 1990) to over 50% (Simionato and Simpson, 2018). Codes of conduct and professional guidelines for psychologists and psychological therapists, such as those published by the American Psychological Association (APA) and The British Psychological Society (BPS), have highlighted the risks of burnout and its potential impact on clinical work, thus recommending to also consider it from an ethical perspective (APA, 2017;BPS, 2018). ...
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Purpose Psychological therapists are vulnerable to developing burnout due to the frequent exposure to emotive narratives of distress. Several quantitative systematic reviews have provided an overview of the risk and protective factors associated with therapist burnout. To date, however, no qualitative systematic reviews on therapist burnout have been carried out. This systematic review aimed to explore the experiences and impact of burnout in psychological therapists, and the strategies they use to adapt to it. Design Systematic searches of three electronic databases (CINHAL EBSCO, Medline EBSCO and PsycINFO EBSCO) were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Papers were screened at title and abstract and full-text review stages. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to evaluate the methodological quality of the included studies. Results Nine peer-reviewed papers met the eligibility criteria. The findings stressed the severe professional and personal impact that burnout can have on therapists. The quality of the study designs of the included papers was overall good. The main limitations included risk of recruitment and selection bias, transparency and credibility issues due to lack of reporting on data saturation and reflexivity, and reduced transferability due to the qualitative methodologies and small sample sizes used. Conclusions Further research is needed to expand on these findings and develop a greater understanding of the experiences and management of burnout in psychological therapists. Future studies could use mixed-method designs and larger sample sizes to increase transferability. Theoretical implications and clinical recommendations are discussed.
... It may also be interesting to look at social mindfulness in psychotherapists not only with regard to their therapeutic effectiveness but also with regard to their mental hygiene. In this line of thought, Farber (1990) studied burnout among psychotherapists and found that it may be the nonreciprocated attentiveness as well as the unilateral giving in the therapeutic relationship that contributes to burnout the most. ...
Social mindfulness has been described as the socially relevant disposition of being attentive to and considerate of other people's needs and acting accordingly. However, previous studies have not included actual other people. The goal of the present study is to test the hypothesis that people high versus low in social mindfulness are perceived as different by and have different impacts on the people in their personal environments. In our study, we used caregivers as primary participants and two types of other rater. First, primary participants were rated by their private long-term contacts (e.g., closest friend or significant other) on empathy, agreeableness, and honesty/humility. Second, patients provided satisfaction ratings of the care they received from their caregivers (i.e., primary participants). We found small associations between social mindfulness and other-rated empathy but no associations with other-rated agreeableness or honesty/humility. By contrast, the association between caregivers' social mindfulness and patients' satisfaction with their received care was large. The findings are interpreted with regard to differences in levels of acquaintanceship. We speculate that social mindfulness may be more relevant in formal settings than in close relationships.
... Previous systematic reviews on burnout among psychotherapists (Simionato and Simpson, 2018;Lee et al., 2020) have concentrated almost entirely on homogeneous groups of predictors (work-related or sociodemographic factors, e.g., caseload, years of experience, age, or gender) and the burnout measures used (mostly Maslach Burnout Inventory and its scales: emotional exhaustion, depersonalization, and reduced personal accomplishment; Maslach et al., 2001). Nevertheless, it is not entirely clear why there are so many discrepancies in burnout prevalence among psychotherapists from various countries, ranging from 6% to as high as 54% (Farber, 1990;Hannigan et al., 2004;Berjot et al., 2017). On the one hand, this may be related to overlooking other burnout measures in this occupational group and alternative theoretical burnout models (e.g., Demerouti et al., 2001). ...
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Objectives The general aim of this systematic review is to synthesize, analyze, and critically review existing studies concerning the relationship between sociodemographic, intrapersonal, and work-related factors and burnout, as well as psychological wellbeing among psychotherapists.MethodologyWe performed a structured literature search utilizing the PRISMA framework in the following databases: Web of Science, Scopus, MedLine, PsyARTICLES, ProQuest, and Google Scholar. The most relevant inclusion criteria were quantitative and peer-reviewed articles published in English.ResultsAfter the selection process, we accepted 52 articles for further systematic review. Thirty-eight studies examined burnout among psychotherapists, while the other 14 studies focused on psychological wellbeing in this sample.Conclusions Burnout and wellbeing among psychotherapists are related to numerous sociodemographic (e.g., age, gender), intrapersonal (e.g., coping, personality), and work-related characteristics, including work settings and professional support in this profession (e.g., supervision or personal therapy). However, the high heterogeneity observed between studies in terms of burnout and wellbeing operationalization and measurement warrants more consistent and advanced methodological models of these theoretical constructs in the future in this specific sample.
The main goal of this study was to investigate the trajectories of the changes in burnout and subjective well‐being (SWB) among psychotherapists in relation to social support, self‐efficacy, sociodemographic, and work‐related factors, with additional control for the subjectively experienced Covid‐19 related distress. This study was carried out over a one‐year period during the critical time of the Covid‐19 pandemic. We reached 226 Polish psychotherapists, of which 207 psychotherapists (91.6%) participated in all three measurements. The participants completed the following measurements: the Maslach Burnout Inventory‐Human Service Survey, the Satisfaction with Life Scale, the General Self‐Efficacy Scale, the Multidimensional Scale of Perceived Social Support, and a questionnaire regarding sociodemographic, work‐related factors and Covid‐19 related distress. Several trajectories were observed for both burnout and SWB, which were differently associated with the level of social support, self‐efficacy, and sociodemographic and work‐related factors. We did not find a significant relationship between Covid‐19 related distress and the inclusion of either burnout or SWB trajectories. This study calls for greater interest in the psychological health of psychotherapists. More specifically, our findings may entail some implications for the practice of psychotherapy by creating customized intervention programs to reduce burnout and enhance well‐being in this specific occupation. This article is protected by copyright. All rights reserved.
Psychotherapy is a complex activity that requires a comprehensive training. Because of the emotional specificities of this job, supervision ensures the quality of the practice and psychological health for both the patient and the therapist. Alternative therapists can sometimes have difficulties with the transference that can occur in the therapeutic relationship with their clients. The supervision that can be offered by a clinical psychologist may be helpful in such cases, but presents particular stakes inherent to the fact of dealing with exceptional experiences. Two clinical situations from the CIRCEE, a French center dedicated to exceptional experiences, are presented below to illustrate the challenges of such a work. The psychodynamic analysis of these situations leads to a discussion about the interests and limitations of supervision and therapy. These two situations show that the profession of alternative therapist can sometimes find its origins in a process of traumatic progression. Exceptional experiences are attempts to symbolise traumatic events. Accompanying these therapists between supervision and psychotherapy opens the way to treat traumas. The therapist’s personal development, whether through supervision or psychotherapy, seems important to avoid secondary trauma due to the transferential processes.
Medical personnel is constantly exposed to a variety of stressful events, starting from work overloading, to threats to one’s own health or personal integrity, disruptions in personal relationships due to high stress in the professional environment, continuous need to keep in touch with the advances of medical science and therapeutic guidelines etc. Structured evaluation of work-related stress disorders (WRSD) is important both for screening purposes in a vulnerable population like the medical personnel, and for the monitoring of the overall status evolution during individual or organizational interventions. Beside burnout syndrome, major depressive episodes, anxiety disorders, acute stress reactions, posttraumatic stress reactions, substance use disorders, adjustment disorders are also included in the category of WRSD. A specific instrument has been designed for the purpose of screening for WRSD in this specific population, i.e. the Work-related Stress Inventory for Medical Personnel, structured as a 20 items, self-administered instrument (WRSIMP-20). This inventory evaluates three main dimensions- (1) mood symptoms and somatic equivalents, (2) work and professional environment-related discomfort, and (3) interpersonal relationship-associated distress. The results of online administration of WRSIMP-20 in 81 health care workers and 52 individuals not related in any way to health care professions (control group) were consistent with the premises, as this inventory has been proven valid for the targeted population. Larger trials and test-retest evaluation are needed in order to complete the psychometric properties of WRSIMP-20, but this instrument seems promising in the detection of individuals vulnerable to WRSD
Compassion fatigue is often experienced by helping professionals, especially psychologists and counsellors. The goal of this chapter is to reflect how self-care strategies and techniques can be used to combat compassion fatigue among psychologists/psychology professionals when dealing with different stressors at the workplace front. Psychology professionals/therapists treating trauma patients have been shown to undergo indirect trauma, which can result in changes in emotions, cognitions, and behaviors. The first section of this chapter discusses compassion fatigue, including its causes, symptoms, and progression. It entails the creation of the notion of compassion fatigue, as well as how it is stated in the literature and comprehended by psychologists. The second part explores the resilience skills of the psychology professionals in order to mitigate distress, discomfort, and anxiety caused due to compassion fatigue. Implications for practice as well as future research are discussed in this chapter.
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Conducted 2-hr semistructured interviews with a heterogeneous group of 60 psychotherapists to investigate their experiences of therapeutic practice. According to the Ss, professional satisfaction derives from the ability to promote a helpful therapeutic relationship; dissatisfaction stems primarily from lack of therapeutic success; and burnout is primarily a consequence of the nonreciprocated attentiveness, giving, and responsibility demanded by the therapeutic relationship. Other reasons for burnout included overwork, isolation, and discouragement as a function of the slow pace of the work. Most Ss felt that support systems were essential to resisting burnout. The data suggest that although therapists expect their work to be difficult and even stressful, they also expect their efforts to be rewarding. Burnout is not only psychologically debilitating to therapists, it also critically impairs the delivery of mental health services. (48 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Investigated clinical psychologists' perceptions of psychotherapeutic work by gathering background information and a modified version of the Maslach Burnout Inventory from 314 members (mean age 50.9 yrs) of the clinical psychology division of a large state psychological association. Ss were 99% White. Results show that Ss seem gratified and fulfilled by their work and their professional relationships. While up to one-third of Ss felt moderately affected by the stresses of their work, only 2–6% perceived themselves as greatly affected by work-engendered stress. It is suggested that clinical psychologists in general, and private-practicing clinical psychologists in particular, enjoy and respect their work. Findings show that greater clinical experience was associated with a reduction in the perceived vulnerability to the inevitable stresses of therapeutic work. Results are consistent with findings of J. C. Norcross and J. O. Procaska's (see PA, Vol 68:1987, 6571, and 13544) national survey of clinical psychologists. (19 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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