Content uploaded by Marcin Rzeszutek
Author content
All content in this area was uploaded by Marcin Rzeszutek on Aug 15, 2022
Content may be subject to copyright.
SYSTEMATIC REVIEW
published: 15 August 2022
doi: 10.3389/fpsyg.2022.928191
Frontiers in Psychology | www.frontiersin.org 1August 2022 | Volume 13 | Article 928191
Edited by:
Abanoub Riad,
Masaryk University, Czechia
Reviewed by:
Yi Huang,
Masaryk University, Czechia
Salmi Razali,
Universiti Teknologi MARA, Malaysia
Naeem Hayat,
University Malaysia Kelantan, Malaysia
*Correspondence:
Angelika Van Hoy
angelikahoun@psych.uw.edu.pl
Specialty section:
This article was submitted to
Psychology for Clinical Settings,
a section of the journal
Frontiers in Psychology
Received: 25 April 2022
Accepted: 23 June 2022
Published: 15 August 2022
Citation:
Van Hoy A and Rzeszutek M (2022)
Burnout and Psychological Wellbeing
Among Psychotherapists:
A Systematic Review.
Front. Psychol. 13:928191.
doi: 10.3389/fpsyg.2022.928191
Burnout and Psychological Wellbeing
Among Psychotherapists:
A Systematic Review
Angelika Van Hoy*and Marcin Rzeszutek
Faculty of Psychology, University of Warsaw, Warsaw, Poland
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.
Methodology: We 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.
Results: After 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.
Keywords: burnout, wellbeing, distress, psychotherapy, systematic review
INTRODUCTION
Although Freud (1937, 1964) highlighted several negative phenomena in therapeutic settings
constituting the danger of analysis for the analysts themselves, studies on the psychological health of
psychotherapists are lacking in psychotherapy, which has traditionally concentrated solely on the
clients of psychotherapy rather than on the psychotherapists (see systematic reviews: Simionato
and Simpson, 2018; Lee et al., 2020). Nevertheless, the psychotherapeutic occupation is associated
with multidimensional psychological distress, primarily including a high degree of emotional
strain and constant demands for empathy, which all pose a significant risk of burnout among
psychotherapists (Simionato and Simpson, 2018). Maslach et al. (2001) created one of the most
prevalent in the literature model of burnout, which defines this syndrome in terms of emotional
exhaustion, depersonalization, and reduced feelings of work-related personal accomplishment.
According to Maslach et al. (2001), burnout is particularly common in helping professions.
However, it is worth underlining the fact that in contrast to other helping occupations in the
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
health care field (e.g., physicians or nurses; Schaufeli et al., 2009;
Woo et al., 2020), burnout research among psychotherapists
is much less prevalent (Lee et al., 2020). However, existing
studies have demonstrated that psychotherapists who experience
burnout, are no longer able to manage therapeutic processes,
which may even endanger their clients (e.g., Farber and
Heifetz, 1982; Ackerley et al., 1988; Rupert and Morgan, 2005;
Berjot et al., 2013). They also suffer from several somatic
and psychological disorders, including back pain, headaches,
gastroenteritis, depression, and substance abuse (Raquepaw and
Miller, 1989; Rupert and Kent, 2007), and they frequently
express job turnover intentions (Rosenberg and Pace, 2006;
Garcia et al., 2014). 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). On the other hand, an insufficient
focus on psychotherapists’ intrapersonal variables (personality,
social support, and self-compassion) as burnout risk factors may
also be a reason for the aforementioned inconclusive findings
on burnout prevalence in this professional group (Rzeszutek and
Schier, 2014; Yip et al., 2017).
Compared to burnout studies, much less research has
investigated the issue of psychological wellbeing among
psychotherapists (Laverdière et al., 2018, 2019; Brugnera
et al., 2020). In other words, while there is a relative
consensus regarding why and how the psychotherapeutic
profession may be damaging to psychotherapists’ mental
health, very little is known about personal, social, and work-
related characteristics that can foster higher wellbeing and
quality of life among psychotherapists. To the best of our
knowledge, the existing literature does not contain a systematic
review on that topic. This latter issue is of fundamental
significance, as several classic reviews have noted that clients
choose to work with psychotherapists who they perceive
as psychologically healthy and satisfied with their own life
(Wogan and Norcross, 1985; Lambert and Barley, 2001). In
addition, some authors have observed that the poor quality
of life and associated mental difficulties of a psychotherapist
may significantly hamper their ability to forge a therapeutic
alliance (Enochs and Etzbach, 2004; Holmqvist and Jeanneau,
2006). Overall, the aforementioned results support a need
for further studies on psychotherapists’ mental health, both
from a negative (burnout), as well as a positive perspective
(wellbeing) as a crucial issue related to the overall process and
outcomes of psychotherapy.
OBJECTIVE
The general aim of this systematic review is to synthesize, analyze,
and critically review existing studies concerning the relationship
between intrapersonal and work-related factors and burnout and
psychological wellbeing among psychotherapists. We focused on
various theoretical models and associated measures of burnout
in the literature (see Methodology). Regarding the concept of
wellbeing, we concentrated on its vast operationalizations and
assessments, as suggested in the respective literature (Laverdière
et al., 2018, 2019; Brugnera et al., 2020), to better capture the
uniqueness of that phenomenon in that specific occupation.
More specifically, we included both positive (e.g., quality
of life, satisfaction with life, and satisfaction with job) and
negative dimensions of wellbeing among psychotherapists (e.g.,
depression, traumatic stress, and secondary traumatic stress).
Importantly, we wanted to clearly distinguish these latter factors
in particular, namely negative wellbeing indicators for burnout,
based on numerous authors indicating that they are two robust
and separate constructs (see e.g., Bakker et al., 2000; Maslach
et al., 2001; Schaufeli et al., 2009; Koutsimani et al., 2019).
METHODOLOGY
Systematic Review Protocol
The two authors of this review have performed the literature
search and review, which adhered to the standards of the
Preferred Reporting Items for Systematic Reviews and Meta-
analyses (PRISMA) statement (Moher et al., 2009; see Figure 1).
We then searched the following databases on 06 November 2021:
Web of Science, MedLine, Scopus, ProQuest, and PsyARTICLE.
We also focused on Google Scholar as an additional source of gray
literature (Bellefontaine and Lee, 2014). In Boolean algebra, the
query consisted of the following terms for burnout: (“burnout”
OR “fatigue” OR “job strain” OR “job stress∗” OR “exhaustion”
OR “occupational stress” OR “pressure” OR “cop∗” OR “manag∗”)
AND (“psychologist∗” OR “psychotherap∗” OR “mental health
professional∗” OR “mental health work∗” OR “social worker∗” OR
“counsel∗”). The respective search terms for wellbeing were as
follows: (“wellbeing” OR (“well” AND “being”) OR (“life” AND
“satisf∗”) OR “life-satisf∗” OR “wellness” OR (“life” AND “quality”)
OR “life-quality” OR “depress∗” OR “anxi∗” OR (“post-traumatic”
AND “stress”) OR (“posttraumatic” AND “stress”) OR “ptsd”)
AND (“psychologist∗” OR “psychotherap∗” OR “mental health
professional∗” OR “mental health work∗” OR “social worker∗” OR
“counsel∗”). In this review, we used the Covidence software to
screen references and undertake data extraction.
Study Selection Criteria
Despite the English-language criterion, eligible studies must also
meet the requirements enumerated below to be included in the
systematic review:
(1) Type of study: We included only peer-reviewed,
quantitative, empirical articles that assessed the relationship
between work-related, personal, and social factors and burnout,
as well as psychological wellbeing among psychotherapists. We
Frontiers in Psychology | www.frontiersin.org 2August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
FIGURE 1 | Flow diagram. Based on: Moher et al. (2009).
eliminated other systematic reviews and meta-analyses, as well as
editorials, letters, and qualitative studies.
(2) Participants: We included studies with samples of
psychotherapists, with no restrictions related to gender, age,
ethnicity, work experience, or therapeutic modality. We also
accepted studies with mixed representations of, broadly speaking,
mental health workers, which consisted of psychotherapists, as
well as psychologists, psychiatrists, coaches, etc. We excluded
studies that dealt with burnout or wellbeing among health care
workers outside of the mental health arena.
(3) Methodology: We only accepted studies with
psychometrically sound measurements of burnout and wellbeing
outcomes. We excluded studies with no psychometric burnout
or wellbeing measures.
(4) Quality of study: We based this on the Quality Assessment
Tool for Observational Cohort and Cross-Sectional Studies
(Shuang et al., 2015), which consisted of 14 criteria. Two
independent evaluators investigated the studies (see Results and
Figure 1). The evaluators were particularly interested in whether
the study utilized validated measures using psychometric data
and presented a clear operationalization of burnout and
wellbeing and their predictors. Moreover, if we encountered
articles by the same authors, we determined whether they used an
identical sample of participants more than once. If this happened,
only one of them was included in the final analysis.
RESULTS
Screening and Eligibility
Initially, we identified 1,632 titles and abstracts via the search of
the electronic databases, including 479 hits on Web of Science,
262 hits on MedLine, 506 hits on SCOPUS, 352 hits on Proquest,
20 hits on PsyARTICLES, and 13 hits on Google Scholar. After
removing duplicates, we pared them down to 656 potentially
eligible articles for further screening. After a comparison of two
independent coders, including the consistency of abstract and
full-text screening, as well as the quality assessment, 175 full
articles remained for the assessment. Using the exclusion criteria,
Frontiers in Psychology | www.frontiersin.org 3August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
we eliminated 123 papers. Ultimately, we accepted 52 articles for
systematic review, 38 for studies on burnout, and 14 for studies
on psychological wellbeing among psychotherapists.
We managed to find articles dating from 1986 through 2021.
The total sample size was n =15,229, including 3,972 men, 11,005
women, 18 participants, who declared the “other” option, and 234
participants in a study that did not specify gender. Finally, 49/52
(94%) of the analyzed studies were cross-sectional.
Burnout and Wellbeing Measures
The most common measure of burnout was the Maslach
Burnout Inventory (MBI, Maslach and Jackson, 1986), which
measures three dimensions of burnout (emotional exhaustion,
depersonalization, and lack of personal accomplishment). Some
authors using this scale created the global burnout score
(see Table 1). Less utilized burnout measures were as follows:
the Copenhagen Burnout Inventory (Kristensen et al., 2005),
Oldenburg Burnout Inventory (Demerouti et al., 2001), and
Professional Quality of Life Scale (ProQOL; Stamm, 2010). These
all followed the global burnout scores. The most frequently
used wellbeing measures were Satisfaction with Life (Satisfaction
with Life Scale; Diener et al., 1985), Professional Quality of Life
Scale (Stamm, 2010), Job Satisfaction Survey (Spector, 1985), and
Psychological Wellbeing Scales (Ryff, 1989).
It is worth mentioning several remarks concerning burnout
and wellbeing assessment and operationalization. First, the vast
majority of studies adopted the Maslach et al. (2001) burnout
model. Second, in the eligible studies, the authors typically
performed statistical analysis using the global burnout/wellbeing
score. As the majority of studies used such a global burnout
and/or wellbeing score, the final conclusions were also drawn
from such global indicators. If more than one dimension of
burnout or wellbeing was mentioned in the study, the result with
the highest strength of associations with appropriate predictors
was selected, which was recommended by other authors as well
(Simionato and Simpson, 2018).
Tables 1,2summarize all the details related to the systematic
review of our 52 final studies related to burnout (n=38) and
psychological wellbeing (n=14) among psychotherapists.
SUMMARY OF FINDINGS AND MAIN
CONCLUSIONS
The primary goal of this systematic review was to synthesize,
analyze, and critically review already-existing research regarding
the relationship between intrapersonal and work-related factors,
burnout, and psychological wellbeing among psychotherapists.
In terms of burnout, the main focus was on various theoretical
models and measures that were associated with the construct,
although the Maslach et al. (2001) model was the most
prevalent (see further). Within that model, we observed that
the most common burnout dimension among psychotherapists
was emotional exhaustion, which was consistent with previous
reviews on that subject (Lee et al., 2020). The concept of wellbeing
was examined in relation to its numerous operationalizations and
assessments, specifically in the psychotherapeutic occupation.
Both positive and negative dimensions of wellbeing were
included. However, as was already underlined, we aimed to
clearly distinguish these latter negative wellbeing indicators from
burnout based on numerous authors indicating that they are
two robust and separate constructs (see e.g., Bakker et al., 2000;
Maslach et al., 2001; Schaufeli et al., 2009; Koutsimani et al.,
2019). Finally, after a careful selection process, we included 52
articles in the review, 38 for burnout and 14 for wellbeing,
published between 1986 and 2021. Selected papers satisfied the
selection criteria regarding the content and quality of the studies
(see Methods).
Sociodemographic, Intrapersonal, and
Work-Related Factors Related to Burnout
Among Psychotherapists
When it comes to sociodemographic correlates of burnout
among psychotherapists, it appears that, in particular, age and
gender play a significant role. Firstly, a total of nine relevant
studies (i.e., those which provided data on the age-burnout
association) revealed that younger psychotherapists tend to
report increased levels of burnout symptoms in comparison
to older and more experienced colleagues in that profession
(Ackerley et al., 1988; Huberty and Huebner, 1988; van der Ploeg
et al., 1990; Rupert and Kent, 2007; Rasmussen et al., 2016;
Berjot et al., 2017; Allwood et al., 2020; Tsai et al., 2020; Kotera
et al., 2021). This finding is consistent with the previous meta-
analysis concerning the aforementioned relationship in various
employment settings (Brewer and Shapard, 2004). In our specific
context, this is explained by the fact that young psychotherapists
often have excessively high and unrealistic expectations about
their role in this job, and the subsequent reality crash may
be a significant burnout catalyst for them (Rupert and Kent,
2007; Rasmussen et al., 2016; Berjot et al., 2017). Secondly, in
terms of gender, studies have yielded mixed findings. On the
one hand, higher burnout levels have been recorded among
women in comparison to men (Emery et al., 2009; Allwood
et al., 2020). This is consistent with gender role theory (Eagly,
1987), which suggests that women are more likely to express
negative feelings (e.g., emotional and physical fatigue) compared
to men, who typically conceal these emotions from others, which
does not mean that they do not experience them. Thus, this
could indicate an artificial overrepresentation of burnout among
females, which would correspond with Rupert and Kent (2007),
who reported contrasting evidence, with men experiencing more
burnout than women in their sample of psychotherapists. A
relevant meta-analysis on that topic demonstrated that men and
women can experience burnout in different ways. For instance,
women score higher on emotional exhaustion, whereas men
score higher on depersonalization (Purvanova and Muros, 2010).
In addition, it appears that the psychotherapeutic profession may
be especially conducive to burnout among men due to gender
differences in self-efficacy, which is usually higher among females
in helping professions (e.g., Roohani and Iravani, 2020). Gender
also moderates the effects of work stress and the association
between self-efficacy and health in various professions (Shoji
Frontiers in Psychology | www.frontiersin.org 4August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Summary of data on burnout among psychotherapists.
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
1. Kahill
(1986)
1986, USA Cross-
sectional
“Tedium”
burnout
measure
Social Support,
Professional
Expectations
M – 127
F – 128
Total – 255
36,2 71 % 33,2 / 11,1 100% N/A CBT – 100% Social support and professional
expectations about the job were
negatively related to burnout
among psychotherapists.
Burnout was not associated with
professional experience or to
other demographic factors in this
sample of psychotherapists.
2. Ackerley
et al. (1988)
1988, USA Cross-
sectional
Maslach
Burnout
Inventory
Age, Overinvolvement,
Lack of control of
therapy setting,
Medical issues, Sexual
Abuse,
Sexual Dysfunction
M – 410
F – 152
Total – 562
44,15 79% 39,22 / 13,8 39% Yes / yes PD – 20 %
CBT – 9%
Hum – 6%
Int - 56%
Syst – 9%
Significant burnout predictors in
this sample were: younger age,
lack of control in the therapeutic
setting, feeling overcommitted to
clients, problems with physical
health, history of sexual abuse
and sexual dysfunctions. It was
also found that lack of personal
psychotherapy and lack of
supervision correlated positively
with burnout intensity.
3. Huberty
and Huebner
(1988)
1988, USA Cross-
sectional
Maslach
Burnout
Inventory
Job & Role definitions
Time pressures (heavy
workload)
External pressures
(superior pressure)
Internal pressures
(personality conflicts)
Age
M – N/A
F – N/A
Total - 234
38,72 N/A N/A / 7,54 N/A N/A CBT – 100% Role definitions, time pressure
(heavy workload), external and
internal pressures were all related
to burnout among
psychotherapists. Younger
psychotherapists declared higher
burnout level.
4. Raquepaw
and Miller
(1989)
1989, USA Cross-
sectional
Maslach
Burnout
Inventory
Work load
Work setting (public)
M – 26
F – 42
Total - 68
N/A N/A N/A N/A N/A Syst – 100% Working for a public agency and
perceived caseload were the
strongest predictors of burnout
among psychotherapists.
Symptoms of urnout were
related to intention to leave this
job for other professions.
5. van der
Ploeg et al.
(1990)
1990
Denmark
Cross-
sectional
Maslach
Burnout
Inventory
Age
Work experience
M−69
F – 29
Total – 98
36,2 N/A 32,1/11,1 100% N/A CBT – 100% Younger age, less experience in
psychotherapy and working in a
public sector (compared to
private practice) were the
strongest predictors of burnout
among psychotherapists.
(Continued)
Frontiers in Psychology | www.frontiersin.org 5August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
6. Mills and
Huebner
(1998)
1998, USA Longitudinal Maslach
Burnout
Inventory
Work experience,
Perceived job stress,
Neuroticism,
Extraversion,
Agreeableness,
Conscientiousness
M – 60
F – 165
Total – 225
40,3 N/A N/A / 10,4 100% N/A Int – 100% Less experience in
psychotherapy, high level of
perceived stress in job as well as
personality traits (neuroticism
positively, extraversion,
agreeableness and
conscientiousness negatively)
were the most significant
burnout predictors among
psychotherapists.
7. Wilkerson
and Bellini
(2006)
2006, USA Cross-
sectional
Maslach
Burnout
Inventory
Emotion-Oriented
Coping
M – 22
F – 56
Total – 78
43,19 64,1% N/A / 11 90% N/A Int – 100% Emotion-oriented coping style
was the strongest burnout
predictor among
psychotherapists.
8. Wiseman
and Egozi
(2006)
2007, Israel Cross-
sectional
Burnout
Questionnaire
Personal Therapy M – 16
F – 83
O – 4
Total – 103
41,2 N/A N/A / 10,6 100% Yes / yes CBT – 50%
Int – 50%
Personal therapy occurred to be
the strongest buffer against
burnout symptoms among
psychotherapists.
9. Ben-zur
and Michael
(2007)
2007, Israel Cross-
sectional
Maslach
Burnout
Inventory
Social Support,
Problem-oriented
coping
M – 0
F – 249
Total – 249
41,66 73% 37,62 / N/A 100% N/A CBT – 100% Appropriate social support at
work as well as problem-focused
coping with stress were the most
important buffers against
burnout among
psychotherapists.
10. Deighton
et al. (2007)
2007,
Germany,
Austria,
Switzerland
Cross-
sectional
Maslach
Burnout
Inventory
Supervision in working
with trauma clients
Prevalence of
psychotherapists own
trauma history
M – 34
F – 65
O – 1
Total – 100
N/A N/A 24,7 / 7,7 100% N/A PD – 17%
CBT – 14%
Hum – 8%
Int – 31%
Syst – 12%
Supervision and a low
prevalence of psychotherapists
own trauma history were related
to lower burnout level among
trauma psychotherapists.
11. Rupert
and Kent
(2007)
2007; USA Cross-
sectional
Maslach
Burnout
Inventory
Age
Work load
Administrative
paperwork
Negative client
behaviors
Overinvolvement
Sense of control over
work
M – 248
F – 347
Total – 595
51,98 75% 39,19/17,19 42% Yes, yes PD – 23 %
CBT – 32%
Hum – 0%
Int - 20%
Syst – 25%
The main important burnout risk
factors among psychotherapists
were: younger age, too much
workload, negative client
behaviors and work settings
(higher burnout in public sector,
with less subjective control over
the therapeutic work). In addition
it was found that females
declared less burnout symptoms
than males.
(Continued)
Frontiers in Psychology | www.frontiersin.org 6August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
12. Rupert
et al. (2009)
2009, USA Cross-
sectional
Maslach
Burnout
Inventory
Work-Family conflict,
family-work conflict,
workload, Sense of
control over work,
Family support
M – 205
F – 292
Total – 497
54,1 96% 35,2 / 19,6 39% Yes / yes CBT – 30%
Int – 30%
Syst – 40%
The strongest predictors of
burnout among psychotherapist
were perceived conflicts on the
dimensions work-family or
family-work, as well as high
workload. Buffers against
burnout were family support and
perceived sense of control over
the job.
13. Kim and
Lee (2009)
2009,
South
Korea
Cross-
sectional
Maslach
Burnout
Inventory
Perceived job stress,
Supervision
M – 110
F – 101
Total – 211
42,2 N/A N/A 100% Yes / N/A Syst – 100% Perceived job stress was
positively related with burnout
level among psychotherapists,
while support received from
supervision buffered against this
syndrome in this sample of
psychotherapists.
14. Emery
et al. (2009)
2009,
Australia
Cross-
sectional
Maslach
Burnout
Inventory
Gender, Work setting,
Personal resources,
Sense of control over
work
M – 54
F – 136
Total – 190
34,5 75,3% N/A / 7,1 45% N/A CBT – 100% Significant burnout risk factors
included: gender (females, but
only when they work in public
sector), public work sector, lack
of personal resources and lack of
feeling of control over the work.
15. D’Souza
et al. (2011)
2011,
Australia
Cross-
sectional
Copenhagen
Burnout
Inventory
Perceived job stress
Perfectionism
M – 12
F – 75
Total – 87
45,6 N/A N/A, 3,5 95% N/A CBT – 100% There was a significant positive
relationship between burnout
level and the intensity of
perfectionism and perceived
stress at work.
16. Kim et al.
(2011)
2011, USA Longitudinal Maslach
Burnout
Inventory
Physical health M – 62
F – 223
Total – 285
46,1 N/A N/A / 18,1 100% N/A CBT – 100% Burnout symptoms predicted
deterioration in psychotherapists’
physical health (see headaches,
gastrointestinal problems,
respiratory infections) over three
years period of observation.
17. Acker
(2012)
2011, USA Cross-
sectional
Maslach
Burnout
Inventory
Perceived job stress M – 123
F – 337
Total – 460
41 57% N/A / 11 100% N/A Int – 100% Perceived job stress occurred to
be the strongest burnout
predictor among
psychotherapists.
(Continued)
Frontiers in Psychology | www.frontiersin.org 7August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
18.
Malinowski
(2013)
2013, USA Cross-
sectional
Maslach
Burnout
Inventory
Humor oriented coping M – 42
F – 91
Total – 133
53,5 N/A 26,1 / 19,5 54% N/A CBT – 100% Self-enhancing humor, as coping
style, was positively related with
the level of perceived personal
accomplishment among
psychotherapists.
19. di
Benedetto
and Swadling
(2014)
2014,
Australia
Cross-
sectional
Copenhagen
Burnout
Inventory
Mindfulness
Work experience
Career-sustaining
behaviors
M – 22
F – 145
Total – 167
42,47 77,8 N/A 80% N/A N/A Practicing mindfulness and more
years of experience seemed to
protect from burnout among
Australian psychotherapists.
20. Rzeszutek
and Schier
(2014)
2014,
Poland
Cross-
sectional
Oldenburg
Burnout
Inventory
Social Support,
Briskness,
Perseveration
M – 89
F – 111
Total – 200
35,94 N/A 26,1 / 19,5 60% Yes / yes CBT – 50%
Hum – 50%
The level of burnout symptoms
among psychotherapists was
positively related to
perseveration and negatively
linked to briskness and
perceived social support.
21. Steel
et al. (2015)
2015, UK Cross-
sectional
Maslach
Burnout
Inventory
Work demands
Sense of control over
work
Perceived job stress
M - 20
F – 74
Total – 94
36,9 N/A N/A,1,9 100% N/A CBT – 88%
Int – 12%
Significant predictors of burnout
among psychotherapists were
high work demands, perceived
job stress and lack of control
over the organization of work.
22.
Rasmussen
et al. (2016)
2016,
Australia
Cross-
sectional
Maslach
Burnout
Inventory
Age, Work demands,
Work reward,
Overinvolvement,
Meaningfulness of work
M – 66
F – 351
Total – 417
49,5 N/A 34,9 / 5,5 82% Yes/ N/A CBT – 52%
Int – 17%
Syst – 31%
Significant predictors of burnout
among psychotherapists were
younger age, perceived high
work demands, perceived low
work efforts, over- involvement in
therapeutic process and lack of
sense of meaning in work.
23. Kim
(2017)
2017,
South
Korea
Cross-
sectional
Maslach
Burnout
Inventory
Work experience,
Personal resources,
Secondary Traumatic
Stress,
Workload
M – 59
F – 120
Total – 179
32,4 N/A 16,2 / 1,75 100% N/A Int – 18%
Syst – 82%
Significant predictors of burnout
among psychotherapists were
little work experience, high work
load, few personal resources,
perceived high work demands,
and high symptoms of
secondary traumatic stress.
24. Berjot
et al. (2017)
2017,
France
Cross-
sectional
Maslach
Burnout
Inventory
Work setting
Type of work contract
Age
Seniority in workplace
M – 66
F – 598
Total – 664
35,44 N/A N/A 54% N/A N/A Working in a company, having
multiple work contracts, younger
age and seniority in the
workplace all showed to be
significant predictors of burnout
among psychotherapists.
(Continued)
Frontiers in Psychology | www.frontiersin.org 8August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
25. Garcia
et al. (2018)
2018, USA Cross-
sectional
Maslach
Burnout
Inventory
Rule overload in work
Vulnerability to
oversight
Politics influence on
treatment methods
Supervision
M – 143
F – 338
Total – 481
41,2 N/A N/A 100% N/A CBT – 69%
Int – 16%
Syst – 15%
Burnout was particularly
associated with reports of
“political influence” on treatment,
feelings of vulnerability of
complaints to leadership or
government, and rule overload in
a sample of trauma
psychotherapists. Clinical
supervision buffered the burnout
symptoms in this sample.
26. Simpson
et al. (2019)
2019,
Australia
Cross-
sectional
Maslach
Burnout
Inventory
Work demands,
Abandonment,
Mistrust/Abuse,
Emotional Inhibition,
Detached Protector
M – 87
F – 356
Total – 443
42,93 52,8% N/A 54% N/A PD – 7%
CBT – 68%
Int – 17%
Syst – 8%
Job demands, early maladaptive
schemas and maladaptive
coping modes significantly
predicted burnout among
psychotherapists.
27. Lee et al.
(2019)
2019,
South
Korea
Cross-
sectional
Maslach
Burnout
Inventory
Perceived job stress,
Resilience
M – 56
F – 214
Total – 270
35,5 52% N/A 100% N/A N/A It was found that the level of
perceived stress at work
positively, and resilience
negatively were associated with
burnout among
psychotherapists.
28. von
Hippel et al.
(2019)
2019,
Australia
Cross-
sectional
Copenhagen
Burnout
Inventory
Work satisfaction,
Commitment to
organization,
Commitment to
profession,
Work engagement,
Workplace wellbeing,
Intentions to leave
organization, Intentions
to leave profession
M – 80
F – 265
O – 4
Total – 349
35 N/A N/A / 5,65 100% N/A N/A Burnout was significantly related
to lower job satisfaction and
lower job engagement,
decreased workplace well-being,
and increased turnover rates
among psychotherapists.
29.
George-Levi
et al. (2020)
2020 Israel Cross-
sectional
Maslach
Burnout
Inventory
Sense of coherence M – 26
F – 78
Total – 104
37,4 N/A N/A6,5 100% N/A CBT – 100% Sense of coherence buffered the
burnout symptoms among
psychotherapists and the
perceived loneliness moderated
this association.
30. Tsai et al.
(2020)
2020, USA Cross-
sectional
Maslach
Burnout
Inventory
Age, Ethnicity
(Caucasian)
M – 16
F – 26
Total – 42
39,6 36% 42,9 / 4,7 100% Yes / N/A CBT – 100% Significant predictors of burnout
among psychotherapists were
younger age and being white.
(Continued)
Frontiers in Psychology | www.frontiersin.org 9August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
31. Hricová
(2020)
2020,
Slovakia
Cross-
sectional
Maslach
Burnout
Inventory
Perceived job stress,
Self-care
M – 80
F – 618
Total - 698
43,9 N/A 20,34 / 13,12 100% Yes / N/A CBT – 32%
Int – 41%
Syst – 27%
There was a significant
association between perceived
job stress and burnout and this
relationship was also mediated
by health self-care among
psychotherapists.
32. Allwood
et al. (2020)
2020,
Sweden
Cross-
sectional
Shirom-
Melamed
Burnout
Questionnaire
Age,
Ruminations: general,
Ruminations: work,
Family-work conflict,
Work demands
M – 182
F – 646
Total – 828
42,1 N/A 38 / N/A 100% N/A CBT – 100% Burnout was significantly
associated with younger age,
tendency to ruminations (at work
and in general) perceived work
conflicts as well as high job
demands among
psychotherapists. Moreover,
results showed that women
experienced higher burnout
levels than men.
33. Kotera
et al. (2021)
2021, UK Cross-
sectional
Maslach
Burnout
Inventory
Age
Workload
Work-life balance
M – 23
F – 83
Total – 106
47,42 N/A 31,3/9,3 100% N/A Int – 50%
Syst – 50%
Younger age, high workload and
problems with work-life balance
were found to significantly
predict burnout among
psychotherapists.
34. Zarzycka
et al. (2021)
2021,
Poland
Cross-
sectional
Link Burnout
Questionnaire
Therapeutic
relationship: relational
depth
Therapeutic
relationship: relational
quality
Psychological wellbeing
M – 75
F – 26
Total – 101
44,34 56% N/A / 10 19% Yes / yes Hum – 100% Aspects of therapeutic
relationship (relational depth and
relational quality) were the
strongest buffers against burnout
among psychotherapists.
Burnout symptoms significantly
hampered wellbeing of
psychotherapists.
35. Chang
and Shin
(2021)
2021,
South
Korea
Cross-
sectional
Professional
Quality of Life
Scale
Compassion
satisfaction,
Compassion fatigue,
Adaptive emotion
regulation, Maladaptive
emption regulation,
Perceived job stress,
Negative client
behaviors
M – 45
F – 80
Total – 125
N/A N/A N/A 100% N/A N/A Burnout was positively related
with compassion fatigue level,
maladaptive emotion regulation,
and experience of aggression by
clients among psychotherapists.
Conversely, compassion
satisfaction and adaptive
emotion regulation strategies
buffered from symptoms of
burnout in this sample.
(Continued)
Frontiers in Psychology | www.frontiersin.org 10 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 1 | Continued
References Year &
country
Study
design
Burnout
measure
Burnout predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relationship
(% of
sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
36. Smout
et al. (2021)
2021,
Australia
Cross-
sectional
Maslach
Burnout
Inventory
Resilience
Work demands
Coping style: detached
protector
M – 82
F – 343
Total – 425
42,79 53% N/A 54% N/A CBT – 89%
Int – 11%
Maladaptive coping (detached
protector coping mode), high
work demand seemed to be
significantly associated with
burnout among
psychotherapists. Resilience
acted as a buffer against burnout
symptoms in this sample.
37. McCade
et al. (2021)
2021,
Australia
Cross-
sectional
Copenhagen
Burnout
Inventory
Depression,
Self-Compassion
M – 44
F – 203
O – 1
Total – 248
41,04 75% N/A / 12,2 82% N/A CBT – 50%
Int – 25%
Syst – 25%
Self-compassion may be treated
as protective facto against
burnout and depression among
psychotherapists.
38. Litam
et al. (2021)
2021, USA Cross-
sectional
Professional
Quality of Life
Scale
COVID-19 related
distress
Resilience
Compassion fatigue
M – 24
F−135
O – 2
Total – 161
39,1 N/A N/A 68% 1, N/A CBT – 50%
Int – 50%
COVID-19 related distress and
high level of compassion fatigue
were the strongest predictors of
burnout among
psychotherapists. Resilience
acted as a buffer against burnout
symptoms in this sample.
Gender: M, Male; F, Female; O, Other; Therapeutic Modality: PD, Psychodynamic; CBT, Cognitive Behavioral Therapy; Hum, Humanistic; Int, Integrative; Syst, Systemic; N/A, Not Available.
Frontiers in Psychology | www.frontiersin.org 11 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 2 | Summary of data on wellbeing among psychotherapists.
Authors Year and
country
Study
design
Wellbeing
outcome and
measure
Wellbeing predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relation (%
of sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
1. Schlarb
et al. (2012)
2012,
Germany
Cross-
sectional
Satisfaction
with life
(Satisfaction
with Life Scale)
Workload, Job
demands, Insomnia
level
M – 193
F – 581
Total - 774
46,1 N/A 39,7/17,5 22% N/A PD – 40%
CBT – 40%
Int – 10%
Syst – 10%
Almost 45% of the studied
psycho therapists suffered from
insomnia symptoms. Workload,
specific job demands and
insomnia level were the strongest
negative predictors of life
satisfaction among
psychotherapists.
2. Puig et al.
(2012)
2012, USA Cross-
sectional
Wellness (The
Five Factor
Wellness
Inventory)
Devaluing client,
Deterioration in
Personal life,
Incompetence,
Exhaustion
M – 23
F – 106
Total – 129
40,67 N/A N/A 89% N/A Int – 53%
Syst – 47%
Significant predictors of wellness
among psychotherapists were
specific behaviors of clients
(devaluing client), problems in
personal life, subjective feeling of
incompetence and exhaustion by
the work.
3. Hardiman
and
Simmonds
(2013)
2013,
Australia
Cross-
sectional
Existential
wellbeing
(Spiritual
Wellbeing
Scale)
Severity of client
trauma, Emotional
exhaustion
M – 18
F – 71
Total – 89
49,69 N/A 20,48/16,4 21% N/A PD – 17%
CBT – 25%
Hum – 4%
Int – 48%
Syst – 6%
Psychotherapists declared high
level of existential wellbeing
coped better with highly
traumatized clients and avoided
emotional exhaustion at work.
4. Rzeszutek
et al. (2015)
2015,
Poland
Cross-
sectional
Secondary
traumatic
stress (PTSD
Questionnaire:
Factorial
Version)
Temperament:
Emotional reactivity,
Temperament: Sensory
Sensitivity, Social
Support
M – 21
F – 59
Total – 80
39,48 N/A 10,44/9,45 66% Yes / N/A PD – 11%
CBT – 44%
Hum – 36%
Int – 4%
Syst – 5%
The level of secondary traumatic
stress symptoms among trauma
psychotherapists was positively
related to emotional reactivity
and negatively linked to sensory
sensitivity and perceived social
support.
5. Roncalli
and Byrne
(2016)
2016,
Ireland
Cross-
sectional
Job satisfaction
(Minnesota
Satisfaction
Questionnaire)
Workload, Work
experience,
Supervision,
Team work with
co-workers
Satisfaction with work
with co-workers
M – 18
F – 59
Total - 77
37,8 N/A 11,3/6,7 100% Yes/ N/A CBT – 100% Supervision and satisfaction with
teamwork with colleagues
occurred to be the strongest
predictors of psychotherapists’
job satisfaction.
(Continued)
Frontiers in Psychology | www.frontiersin.org 12 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 2 | Continued
Authors Year and
country
Study
design
Wellbeing
outcome and
measure
Wellbeing predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relation (%
of sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
6. Yip et al.
(2017)
2017, China Cross-
sectional
Compassion
fatigue (The
Professional
Quality of Life
Scale)
Mindfulness,
Self-Compassion:
self-warmth,
Self-Compassion:
Self-coldness
M – 9
F – 68
Total – 77
35,2 N/A N/A /4,5 95% N/A CBT – 100% The relationship between
mindfulness and compassion
fatigue was mediated by
self-coldness (negative qualities
in self-compassion). Thus,
mindfulness may buffer the
compassion fatigue among
psychotherapists, but
self-compassion of therapists
matters.
7. Fleury et al.
(2017)
2017,
Canada
Cross-
sectional
Job satisfaction
(Job
Satisfaction
Survey)
Team work with
co-workers
Interdisciplinary
collabaration
M – 15
F – 53
Total – 68
40 N/A 22,45/6,1 72% Yes / N/A Int – 100% Team work, especially mutual
supervision and the frequency of
interdisciplinary collaboration
with colleagues representing
other psychotherapy
organizations occurred to be the
strongest predictors of
psychotherapists’ job
satisfaction.
8. Hitge and
van
Schalkwyk
(2018)
2017,
South Africa
Cross-
sectional
Psychological
wellbeing
(Mental Health
Continuum
Short Form)
Meaningfulness,
Resilience
M – 72
F – 182
Total – 254
43,2 N/A 7,5/13,4 53% Yes / N/A N/A Searching for meaning and
resilience as a personality trait
were the strongest predictors of
psychotherapist’s wellbeing.
9. Laverdière
et al. (2018)
2018,
Canada
Cross-
sectional
Satisfaction
with Life
(Satisfaction
with Life Scale)
Perceived stress, Work
experience, Workload
M – 53
F – 187
Total – 240
42,25 N/A 23,5/13,5 60% Yes / N/A PD−31%
CBT – 31%
Hum – 15%
Int – 22%
Syst – 1%
Perceived stress, high workload
and less years of experience
were predictors of poor life
satisfaction among
psychotherapists.
10. Rupert
and Dorociak
(2019)
2019, USA Cross-
sectional
Satisfaction
with Life
(Satisfaction
with Life Scale)
Self-Care, Perceived
job stress
M – 127
F – 295
Total – 422
50,48 76% 44,13/16,71 66% Yes/ N/A N/A Self-care enhanced
psychotherapists’ wellbeing and
the main mechanism in that
process was reducing the level
of perceived stress at work.
11. Yela et al.
(2020)
2019 Spain Longitudina; Psychological
wellbeing
(Psychological
Wellbeing
Scales)
Mindfullness
Self-compassion
M – 7
F – 54
Total – 61
25,6 N/A 11,3/1,1 100% N/A N/A Training in mindfulness and
self-compassion showed
significant improvement in
psychotherapist’ wellbeing over
time.
(Continued)
Frontiers in Psychology | www.frontiersin.org 13 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
TABLE 2 | Continued
Authors Year and
country
Study
design
Wellbeing
outcome and
measure
Wellbeing predictors Sample
(gender)
Sample
(mean age
in years)
Stable
relation (%
of sample)
Workload
hours week
/ experience
years
Work setting
(% of public
sector)
Supervision/
personal
therapy
Therapeutic
modality
Main conclusions
12. Müller
et al. (2020)
2019,
Germany
Cross-
sectional
Satisfaction
with Life (Life
Satisfaction
Questionnaire)
Work-related strain,
Supervision
M – 54
F – 56
Total – 110
51,4 N/A 41,6/ 13,7 25% Yes / N/A Int – 100% Supervision significantly
improved psychotherapists’ job
satisfaction when they
experienced a high amount of
work-related strain.
13. Brugnera
et al. (2020)
2021, Italy Cross-
sectional
Psychological
wellbeing
(Psychosocial
General
Wellbeing
Index)
Attachment anxiety,
Attachment avoidance,
Reflective Functioning,
Gender, Age
M – 84
F – 332
Total – 416
43,94 76% N/A / 10,1 N/A Yes / N/A PD – 13%
CBT – 11%
Int – 66%
Syst – 1%
Attachment anxiety and
attachment avoidance were
negatively related, while reflective
functioning was positively
associated with wellbeing among
psychotherapists. Older
psychotherapists declared higher
wellbeing.
14. Summers
et al. (2021)
2021, UK Cross-
sectional
Psychological
Wellbeing
Depressive symptoms
Harassment or bullying
Work experience
Age
M – 320
F – 1334
Total – 1654
46,2 N/A N/A / 4,3 96% Yes/ N/A CBT – 9%
Int – 52%
Syst – 39%
The strongest, negative
predictors of psychotherapists’
wellbeing were: being harassed,
feeling depressed, older age and
higher work experience.
Gender: M, Male; F, Female; O, Other; Therapeutic Modality: PD, Psychodynamic; CBT, Cognitive Behavioral Therapy; Hum, Humanistic; Int, Integrative; Syst, Systemic; N/A, Not Available.
Frontiers in Psychology | www.frontiersin.org 14 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
et al., 2016). Future research should also consider the “close-
to-zero” gender differences observed in this context, which may
explain discrepancies in this area of research, particularly when
using the Maslach model (Purvanova and Muros, 2010).
Secondly, eight studies have highlighted the significant
role of intrapersonal variables as burnout predictors among
psychotherapists, including predominantly personality traits
(Mills and Huebner, 1998; Rzeszutek and Schier, 2014; Lee et al.,
2019; George-Levi et al., 2020; Smout et al., 2021) and various
stress coping styles (Wilkerson and Bellini, 2006; Ben-zur and
Michael, 2007; Malinowski, 2013). Generally, traits related to
negative emotionality (e.g., neuroticism, emotional reactivity)
were burnout predictors, while those associated with emotional
stability and high levels of subjectively perceived resources (e.g.,
resilience) were buffers against this syndrome in this occupation.
Similarly, emotion-oriented coping was positively correlated,
while problem-focused coping or the use of humor to deal
with work-related stress were negatively linked to burnout
symptoms in this occupation. Although there are numerous
studies on the personality-burnout (Alarcon et al., 2009) and
coping-burnout association (Lee et al., 2016), this problem is still
highly understudied in this specific occupation and calls for more
research, ideally in the prospective methodological framework.
Alternatively speaking, one should remember that aside from
work-related characteristics, there are substantial intrapersonal
factors related to burnout in that occupation, which until now
were not sufficiently underlined in the contemporary reviews on
that topic (Simionato and Simpson, 2018; Lee et al., 2019).
Finally, concerning work-related covariates, workload, and/or
work experience, work settings and supervision/personal therapy
exerted relatively homogenous effects on burnout. Six studies
have revealed significant associations between high workload
and increased levels of burnout (Huberty and Huebner, 1988;
Raquepaw and Miller, 1989; Rupert and Kent, 2007; Rupert
et al., 2009; Kim, 2017; Kotera et al., 2021). Similarly, four
studies have suggested that less experienced psychotherapists
were particularly vulnerable to burnout compared to their more
experienced colleagues (van der Ploeg et al., 1990; Mills and
Huebner, 1998; di Benedetto and Swadling, 2014; Kim, 2017).
Specifically, these latter results generally corresponded with the
previously mentioned role of the younger age of therapists as a
significant burnout predictor in that job. Additionally, working in
the public sector seemed to be positively associated with burnout
levels, as highlighted by five studies (Raquepaw and Miller, 1989;
van der Ploeg et al., 1990; Rupert and Kent, 2007; Emery et al.,
2009; Berjot et al., 2017). This finding was usually explained
by a lack of control over their own work environment among
psychotherapists and an increased level of bureaucracy in such
workplaces compared to private psychotherapists’ offices, where
they may feel that they have more control over when, where,
and how they will be working with their clients. Lastly, personal
therapy and/or supervision act as a buffer against burnout, as
mentioned by five authors (Ackerley et al., 1988; Wiseman and
Egozi, 2006; Deighton et al., 2007; Kim and Lee, 2009; Garcia
et al., 2018), which is a highly important argument in the ongoing
discussion related to self-care behaviors among psychotherapists
(Norcross et al., 2008).
Sociodemographic, Intrapersonal, and
Work-Related Factors Behind
Psychological Wellbeing Among
Psychotherapists
First of all, it is worth mentioning that to the best of our
knowledge, no systematic review has investigated the problem
of wellbeing and quality of life among psychotherapists in the
literature thus far. This latter issue is of fundamental significance,
as psychotherapists’ poor quality of life and associated mental
difficulties among psychotherapists may significantly hamper the
entire psychotherapeutic process (Enochs and Etzbach, 2004;
Holmqvist and Jeanneau, 2006). However, as may be visible
when we compare the number of studies concerning burnout vs.
wellbeing among psychotherapists (see Tables 1,2), studies on
the latter issue are particularly scarce, as attention has still focused
mainly on negative aspects of psychotherapists’ functioning.
Thus, although we intended to fill this existing research gap, the
empirical evidence on that subject is minimal compared to that
concerning burnout among psychotherapists.
In the context of wellbeing among psychotherapists, the
only significant relationships with sociodemographic variables
were with age, but two studies presented contrasting results
(Brugnera et al., 2020; Summers et al., 2021). On the one hand,
older psychotherapists appeared to experience higher levels of
wellbeing. This is consistent with findings concerning the role
of age in the general population, which indicate that older adults
tend to be more satisfied with their lives and experience enhanced
psychosocial and economic conditions (Ulloa et al., 2013; Steptoe
et al., 2015). On the other hand, older age was also a negative
predictor of wellbeing; these results may be “time-specific,” as this
was one of the few studies conducted during the COVID-19 era
among this specific population. Perhaps older psychotherapists
experience greater difficulties organizing their work, mainly due
to the obligations inherent to online settings compared to their
younger counterparts, who are typically much more fluent in
new technologies.
Studies on intrapersonal variables related to psychotherapists’
wellbeing have confirmed the role of personality as well as
self-care behaviors, including self-compassion and mindfulness
practices, in maintaining a high quality of life in that profession
(Rzeszutek et al., 2015; Yip et al., 2017; Hitge and van
Schalkwyk, 2018; Rupert and Dorociak, 2019; Yela et al., 2020).
It appears that greater care for the personal emotional balance of
psychotherapists is a crucial, but highly understudied issue, both
in the empirical field, as well as in relation to psychotherapists’
training procedures involving various therapeutic modalities
(Laverdière et al., 2018).
Concerning work-related characteristics, only workload, work
experience, and professional support were significant. Workload
and amount of experience in the profession appeared to be
important in terms of psychological wellbeing (Schlarb et al.,
2012; Laverdière et al., 2018; Summers et al., 2021). Higher
workload was revealed to be a negative predictor of wellbeing,
while less experience seemed to be related to lower life
satisfaction, especially if both elements were present. This latter
finding is consistent with the previously mentioned data and
Frontiers in Psychology | www.frontiersin.org 15 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
socio-demographic and work-related factors behind burnout in
this profession. Moreover, three studies consistently proved that
supervision and general support from team coworkers played a
positive role in terms of wellbeing (Roncalli and Byrne, 2016;
Fleury et al., 2017; Müller et al., 2020). This is another argument
in favor of the significance of professional support in that
occupation (Norcross et al., 2008).
Strengths, Limitations and Future
Directions
So far, the focus of existing research has focused on the positive
(wellbeing) and negative (burnout) aspects of therapists’
functioning. This review adds to the literature concerning
these issues. Additionally, this brings awareness to the need
for implementing education about self-care practices in
psychotherapy training programs. These suggestions also extend
to current psychotherapists that have already completed their
initial training in the profession. Psychotherapists can benefit
from maintaining their wellbeing and taking action to decrease
risk for burnout. This can also positively affect their clients.
This systematic review is not free of limitations, which
should be delineated along with recommendations for potential
future research regarding burnout and wellbeing among
psychotherapists. First, we excluded studies that were conducted
in languages other than English and/or qualitative research,
which could be a valuable source of information related to
psychotherapists’ mental functioning. In the future, it would
be interesting to review qualitative studies on psychological
functioning among psychotherapists. Burnout is a global
phenomenon, thus, future research should include non-English
papers, as well.
Second, while preparing this review, we faced several
problems related to the operationalization and measurement of
burnout and wellbeing. More specifically, the burnout measures
were inconsistent across the included studies; some employed
the three scales of burnout (see MBI), while other studies
only included statistics based on the global burnout score.
The Maslach model and the MBI tool dominated most of the
reviewed studies, although this model has been the subject of
widespread criticism (Demerouti et al., 2001). In the context
of this review, one should underline that the use of MBI
cutoff values to screen “cases” of burnout is very problematic,
as it may be an insufficient way to diagnose the prevalence
of burnout in various samples. Another important criticism
concerns the fact that the MBI subscales all contain only one-
directional items, which may lead to the artificial clustering of
factors (Halbesleben and Demerouti, 2005). Analog problems
arose related to measures of psychological wellbeing; we found
a large variety of measurements and models of this theoretical
construct. Furthermore, there was also a high diversity in
burnout and wellbeing predictors. The aforementioned two
factors make it highly difficult to summarize these findings in
the form of a meta-analysis. Future studies should employ a
more unitary operationalization and measurement of burnout
and/or wellbeing in this specific sample. Regarding burnout,
different models from the Maslach model should be more widely
accounted for to avoid the criticism of a lack of theoretically
driven research in the burnout field (Demerouti et al., 2001).
New insights into the Job Demands–Resources theory may point
researchers in a promising direction regarding combating these
shortcomings (Bakker and de Vries, 2021).
Third, about 95% of the reviewed studies utilized a cross-
sectional design. Thus, no cause-and-effect conclusions can be
drawn. Further research should also include more longitudinal
studies to examine long-term relationships between burnout and
wellbeing and their predictors among psychotherapists. This
issue is especially crucial in this profession and its outcomes, with
it usually being a long-term process (Norcross et al., 2008).
Fourth, the reviewed studies consisted of heterogeneous
groups of psychotherapists, representing not only different
therapeutic modalities, but sometimes also those outside of the
pure psychotherapeutic occupation. This is related to the fact
that the psychotherapeutic occupation may be represented by
several occupational groups, as different regulations for the
psychotherapeutic profession exist in various countries. In the
future, it would be wise to focus on more homogeneous samples
of psychotherapists; for example, researchers could compare
whether and how different psychotherapy modalities differ
concerning psychological functioning (Rzeszutek and Schier,
2014).
Finally, more research should be conducted regarding
psychotherapists’ wellbeing, as we have noticed that there were
almost three times more studies concerning the negative aspects
of psychotherapists’ functioning compared to research focusing
on how to maintain high wellbeing and quality of life in this
professional group (Laverdière et al., 2018). Studies have shown
that clients often choose to attend therapy with psychotherapists
who are perceived as psychologically stable and seem satisfied
with their personal lives (Wogan and Norcross, 1985; Lambert
and Barley, 2001). Low quality of life among psychotherapists
can potentially deteriorate therapeutic alliances with clients as
well as the entire therapeutic process (Enochs and Etzbach, 2004;
Holmqvist and Jeanneau, 2006).
CONCLUSIONS
Our systematic review suggests that burnout and
wellbeing among psychotherapists may largely depend on
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, future
research is required, particularly studies that adopt more
advanced methodological models and burnout/wellbeing
operationalizations and assessments (Lee et al., 2019). Numerous
studies use various definitions of burnout and wellbeing. It
would be beneficial to find universal definitions of the terms
in order to address the vast discrepancies in existing research
(Simionato and Simpson, 2018).
From a clinical perspective, the overall problem of
psychological health among mental health workers remains
largely understudied. This topic is not only important for
psychotherapists, but also for the clients who receive their help,
as well as for the entire psychotherapeutic process. Thus, it
is recommended that training programs for psychotherapists,
Frontiers in Psychology | www.frontiersin.org 16 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
within various therapeutic modalities, should include a greater
focus on self-care behaviors among psychotherapists, to
teach them to better manage their work-related distress and
enhance their professional quality of life (McCormack et al.,
2018). Further, current psychotherapists should continue
to seek support within the profession as well as outside, in
order to maintain their wellbeing and decrease the risk of
experiencing burnout.
DATA AVAILABILITY STATEMENT
The original contributions presented in the study are included
in the article/supplementary material, further inquiries can be
directed to the corresponding author.
AUTHOR CONTRIBUTIONS
AV and MR contributed to conception and design of the study,
performed the statistical analysis, and wrote sections of the
manuscript. AV organized the database and wrote the first draft
of the manuscript. Both authors contributed to manuscript
revision, read, and approved the submitted version.
FUNDING
This project has received funding from the New Ideas
of POB V project implemented within the scope of the
Excellence Initiative - Research University Program (Number
PSP: 501-D125-20-5004310).
REFERENCES
Acker, G. (2012). Burnout among mental health care providers. J. Soc. Work 12,
475–490. doi: 10.1177/1468017310392418
Ackerley, G., Burnell, J., Holder, D., and Kurdek, L. (1988). Burnout
among licensed psychologists. Prof. Psychol. Res. Pract. 19, 624–631.
doi: 10.1037/0735-7028.19.6.624
Alarcon, G., Eschleman, K., and Bowling, N. (2009). Relationships between
personality variables and burnout: a meta-analysis. Work Stress 23, 244–263.
doi: 10.1080/02678370903282600
Allwood, C., Geisler, M., and Buratti, S. (2020). The relationship between
personality, work, and personal factors to burnout among clinical
psychologists: exploring gender differences in Sweden. Couns. Psychol. Q.
35, 324–343. doi: 10.1080/09515070.2020.1768050
Bakker, A., and de Vries, J. (2021). Job Demands–Resources theory
and self-regulation: new explanations and remedies for job burnout.
Anxiety, Stress Coping 34, 1–21. doi: 10.1080/10615806.2020.17
97695
Bakker, A., Schaufeli, W., Sixma, H., Bosveld, W., and Van Dierendonck,
D. (2000). Patient demands, lack of reciprocity, and burnout: a five-year
longitudinal study among general practitioners. J. Org. Behav. 21, 425–441.
doi: 10.1002/(SICI)1099-1379(200006)21:4<425::AID-JOB21>3.0.CO;2-%23
Bellefontaine, S., and Lee, C. (2014). Between black and white: Examining grey
literature in meta-analyses of psychological research. J. Child Fam. Stud. 23,
1378–1388. doi: 10.1007/s10826-013-9795-1
Ben-zur, H., and Michael, K. (2007). Burnout, social support, and coping at work
among social workers, psychologists, and nurses: the role of challenge/control
appraisals. Soc. Work Health Care 45, 63–82. doi: 10.1300/J010v45n04_04
Berjot, S., Altintas, E., Lesage, F., and Grebot, E. (2013). The impact of work
stressors on identity threats and perceived stress an exploration of sources
of difficulty at work among french psychologists. SAGE Open 3, 1–11.
doi: 10.1177/2158244013505292
Berjot, S., Altintas, E., Lesage, F., and Grebot, E. (2017). Burnout
risk profiles among French psychologists. Burnout Res. 7, 10–20.
doi: 10.1016/j.burn.2017.10.001
Brewer, E., and Shapard, L. (2004). Employee burnout: a meta-analysis of the
relationship between age or years of experience. Hum. Resour. Dev. Rev. 3,
102–123. doi: 10.1177/1534484304263335
Brugnera, A., Zarbo, C., Compare, A., Talia, A., Tasca, G. A., de Jong, K., et al.
(2020). Self-reported reflective functioning mediates the association between
attachment insecurity and well-being among psychotherapists. Psychother. Res.
31, 247–257. doi: 10.1080/10503307.2020.1762946
Chang, J., and Shin, S. (2021). A path model for burnout in community
mental health professionals. Int. J. Environ. Res Public Health 18, 9763.
doi: 10.3390/ijerph18189763
Deighton, R., Gurris, N., and Traue, H. (2007). Factors affecting burnout and
compassion fatigue in psychotherapists treating torture survivors: Is the
therapist’s attitude to working through trauma relevant? J. Trauma. Stress 20,
63–75. doi: 10.1002/jts.20180
Demerouti, E., Nachreiner, F., and Schaufeli, W. (2001). The job
demands–resources model of burnout. J. Appl. Psychol. 86, 499–512.
doi: 10.1037/0021-9010.86.3.499
di Benedetto, M., and Swadling, M. (2014). Burnout in Australian psychologists:
Correlations with work-setting, mindfulness and self-care behaviours. Psychol.
Health Med. 19, 705–715. doi: 10.1080/13548506.2013.861602
Diener, E., Emmons, R., Larsen, R., and Griffin, S. (1985). The Satisfaction with
Life Scale. J. Pers. Assessment 49, 71–75. doi: 10.1207/s15327752jpa4901_13
D’Souza, F., Egan, S., and Rees, C. (2011). The relationship between perfectionism,
stress and burnout in clinical psychologists. Behav. Change 28, 17–28.
doi: 10.1375/bech.28.1.17
Eagly, A. (1987). Sex Differences in Social Behavior: A Social-role Interpretation.
Hillsdale, NJ: Lawrence Erlbaum.
Emery, S., Wade, T. D., and McLean, S. (2009). Associations among therapist
beliefs, personal resources and burnout in clinical psychologists. Behav. Change
26, 83–96. doi: 10.1375/bech.26.2.83
Enochs, W., and Etzbach, C. (2004). Impaired student counselors:
ethical and legal considerations for the family. Fam. J. 12, 396–400.
doi: 10.1177/1066480704267240
Farber, B. (1990). Burnout in psychotherapists: Incidence, types, and trends.
Psychother. Priv. Pract. 8, 35–44. doi: 10.1300/J294v08n01_07
Farber, B., and Heifetz, L. (1982). The process and dimensions of burnout in
psychotherapists. Prof. Psychol. 13, 293–301. doi: 10.1037/0735-7028.13.2.293
Fleury, M., Grenier, G., and Bamvita, J. (2017). A comparative study of
job satisfaction among nurses, psychologists/psychotherapists and social
workers working in Quebec mental health teams. BMC Nurs. 16, 4225.
doi: 10.1186/s12912-017-0255-x
Freud, S. (1937). Analysis terminable and interminable. Int. J. Psycho-Anal. 18,
373–405.
Freud, S. (1964). The Standard Edition of the Complete Psychological Works of
Sigmund Freud, eds J, Strachey (London: Macmillan).
Garcia, H., McGeary, C., McGeary, D., Finley, E., and Peterson, A. (2014). Burnout
in Veterans Health Administration mental health providers in posttraumatic
stress clinics. Psychol. Serv. 11, 50–59. doi: 10.1037/a0035643
Garcia, H. A., Benzer, J. K., Haro, E., and Finley, E. (2018). Occupational burnout
among PTSD specialty clinic providers in the Veterans Health Administration:
Perceptions of bureaucratic and political oversight. Ment. Health Prev. 12,
42–49. doi: 10.1016/j.mhp.2018.09.001
George-Levi, S., Schmidt-Barad, T., Natan, I., and Margalit, M. (2020). Sense of
coherence and burnout among school psychologists: the moderating role of
loneliness. Curr. Psychol. 29, 1–8. doi: 10.1007/s12144-020-00766-5
Halbesleben, J., and Demerouti, E. (2005). The construct validity of an alternative
measure of burnout: Investigating the English translation of the Oldenburg
Burnout Inventory. Work Stress 19, 208–220. doi: 10.1080/026783705003
40728
Frontiers in Psychology | www.frontiersin.org 17 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
Hannigan, B., Edwards, D., and Burnard, P. (2004). Stress and stress management
in clinical psychology: findings from a systematic review. J. Ment. Health 13,
235–245. doi: 10.1080/09638230410001700871
Hardiman, P., and Simmonds, J. (2013). Spiritual well-being, burnout and trauma
in counsellors and psychotherapists. Ment. Health Relig. Cult. 16, 1044–1055.
doi: 10.1080/13674676.2012.732560
Hitge, E., and van Schalkwyk, I. (2018). Exploring a group of South African
psychologists’ well-being: competencies and contests. South Afr. J. Psychol. 48,
553–566. doi: 10.1177/0081246317722931
Holmqvist, R., and Jeanneau, M. (2006). Burnout and psychiatric
staff’s feelings towards patients. Psychiatry Res. 145, 207–213.
doi: 10.1016/j.psychres.2004.08.012
Hricová, M. (2020). The mediating role of self-care activities in the stress-burnout
relationship. Health Psychol. Rep. 8, 1–9. doi: 10.5114/hpr.2019.89988
Huberty, T., and Huebner, E. (1988). A national survey of burnout among school
psychologists. Psychol. Sch. 25, 54–61.
Kahill, S. (1986). Relationship of burnout among professional psychologists to
professional expectations and social support. Psychol. Rep. 59, 1043–1051.
doi: 10.2466/pr0.1986.59.3.1043
Kim, H., Ji, J., and Kao, D. (2011). Burnout and Physical Health among
Social Workers: a three-year longitudinal study. Soc. Work 56, 258–268.
doi: 10.1093/sw/56.3.258
Kim, H., and Lee, S. (2009). Supervisory communication, burnout, and turnover
intention among social workers in health care settings. Soc. Work Health Care
48, 364–385. doi: 10.1080/00981380802598499
Kim, Y. (2017). Secondary traumatic stress and burnout of North
Korean refugees service providers. Psychiatry Investig. 14, 118–125.
doi: 10.4306/pi.2017.14.2.118
Kotera, Y., Maxwell-Jones, R., Edwards, A., and Knutton, N. (2021). Burnout
in professional psychotherapists: relationships with self-compassion, work–
life balance, and telepressure. Int. J. Environ. Res. Public Health 18, 5308.
doi: 10.3390/ijerph18105308
Koutsimani, P., Montgomery, A., and Georganta, K. (2019). The relationship
between burnout, depression, and anxiety: a systematic review and meta-
analysis. Front. Psychol. 10, 284. doi: 10.3389/fpsyg.2019.00284
Kristensen, T., Borritz, M., Villadsen, E., and Christensen, K. (2005). The
Copenhagen Burnout Inventory: a new tool for the assessment of burnout.
Work Stress 19, 192–207. doi: 10.1080/02678370500297720
Lambert, M., and Barley, D. (2001). Research summary on the therapeutic
relationship and psychotherapy outcome. Psychother. Theory Res. Pract. Train.
38, 357–361. doi: 10.1037/0033-3204.38.4.357
Laverdière, O., Kealy, D., Ogrodniczuk, J., and Morin, A. (2018).
Psychological health profiles of Canadian psychotherapists: a wake
up call on psychotherapists’ mental health. Can. Psychol. 59, 315–322.
doi: 10.1037/cap0000159
Laverdière, O., Ogrodniczuk, J., and Kealy, D. (2019). Clinicians’ empathy
and professional quality of life. J. Nerv. Ment. Disord. 207, 49–52.
doi: 10.1097/NMD.0000000000000927
Lee, H., Kuo, C., Chien, T., and Wang, Y. (2016). A meta-analysis of the effects
of coping strategies on reducing nurse burnout. Appl. Nurs. Res. 31, 100–110.
doi: 10.1016/j.apnr.2016.01.001
Lee, M., Kim, E., Paik, I., Chung, J., and Lee, S. (2020). Relationship
between environmental factors and burnout of psychotherapists: Meta-analytic
approach. Couns. Psychother. Res. 20, 164–172. doi: 10.1002/capr.12245
Lee, Y., Lee, J., Kim, J., Shin, I., Yoon, J., and Kim, S. (2019). A comparative study
of burnout, stress, and resilience among emotional workers. Psychiatry Investig.
16, 686–694. doi: 10.30773/pi.2019.07.10
Litam, S., Ausloos, C., and Harrichand, J. (2021). Stress and resilience among
professional counselors during the COVID-19 pandemic. J. Couns. Dev. 99,
384–395. doi: 10.1002/jcad.12391
Malinowski, A. J. (2013). Characteristics of job burnout and humor among
psychotherapists. Humor 26, 117–133. doi: 10.1515/humor-2013-0007
Maslach, C., and Jackson, S. (1986). Maslach Burnout Inventory Manual, 2nd ed.
Palo Alto, CA: Consulting Psychologists Press.
Maslach, C., Schaufeli, W., and Leiter, M. (2001). Job Burnout. Annu. Rev. Psychol.
52, 397–422. doi: 10.1146/annurev.psych.52.1.397
McCade, D., Frewen, A., and Fassnacht, D. (2021). Burnout and depression in
Australian psychologists: the moderating role of self-compassion. Aust. Psychol.
56, 111–122. doi: 10.1080/00050067.2021.1890979
McCormack, H., MacIntyre, T., O’Shea, D., Herring, M., and Campbell, M.
(2018). The prevalence and cause(s) of burnout among applied psychologists: a
systematic review. Front. Psychol. 9, 1897. doi: 10.3389/fpsyg.2018.01897
Mills, L., and Huebner, E. (1998). A prospective study of personality characteristics,
occupational stressors, and burnout among school psychology practitioners. J.
Sch. Psychol. 36, 103–120. doi: 10.1016/S0022-4405(97)00053-8
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., and PRISMA
Group (2009). Preferred reporting items for systematic reviews and
meta-analyses: the PRISMA statement. PLoS Med. 6, e1000097.
doi: 10.1371/journal.pmed.1000097
Müller, A., Kotte, S., and Möller, H. (2020). Coach and no regrets about it: On the
life satisfaction, work-related mental strain, and use of supervision of workplace
coaches. Coaching 13, 16–29. doi: 10.1080/17521882.2019.1636841
Norcross, J., Bike, D., Evans, K., and Schatz, D. (2008). Psychotherapists who
abstain from personal therapy: Do they practice what they preach? J. Clin.
Psychol. 64, 1368–1376. doi: 10.1002/jclp.20523
Puig, A., Baggs, A., Mixon, K., Park, Y. M., Kim, B., and Lee, S. (2012). Relationship
between job burnout and personal wellness in mental health professionals. J.
Employ. Couns. 49, 98–109. doi: 10.1002/j.2161-1920.2012.00010.x
Purvanova, R., and Muros, J. (2010). Gender differences in burnout: a meta-
analysis. J. Vocat. Behav. 77, 168–185. doi: 10.1016/j.jvb.2010.04.006
Raquepaw, J., and Miller, R. (1989). Psychotherapist burnout: a componential
analysis. Prof. Psychol. Res. Pract. 20, 32–36. doi: 10.1037/0735-7028.20.1.32
Rasmussen, V., Turnell, A., Butow, P., Juraskova, I., Kirsten, L., Wiener, L.,
et al. (2016). Burnout among psychosocial oncologists: an application and
extension of the effort-reward imbalance model. Psychooncology 25, 194–202.
doi: 10.1002/pon.3902
Roncalli, S., and Byrne, M. (2016). Relationships at work, burnout and job
satisfaction: a study on Irish psychologists. Ment. Health Rev. J. 21, 23–36.
doi: 10.1108/MHRJ-01-2015-0002
Roohani, A., and Iravani, M. (2020). The relationship between burnout and self-
efficacy among Iranian Male and Female EFL Teachers. J. Lang. Educ. 6,
173–188. doi: 10.17323/jle.2020.9793
Rosenberg, T., and Pace, M. (2006). Burnout among mental health professionals:
special considerations for the marriage and family therapist. J. Marital Fam.
Ther. 32, 87–99. doi: 10.1111/j.1752-0606.2006.tb01590.x
Rupert, P., and Dorociak, K. (2019). Self-care, stress, and well-being
among practicing psychologists. Prof. Psychol. Res. Pract. 50, 343–350.
doi: 10.1037/pro0000251
Rupert, P., and Kent, J. (2007). Gender and work setting differences in career-
sustaining behaviors and burnout among professional psychologists. Prof.
Psychol. Res. Pract. 38, 88–96. doi: 10.1037/0735-7028.38.1.88
Rupert, P., and Morgan, D. (2005). Work setting and burnout among
professional psychologists. Prof. Psychol. Res. Pract. 36, 544–550.
doi: 10.1037/0735-7028.36.5.544
Rupert, P., Stevanovic, P., and Hunley, H. (2009). Work-family conflict and
burnout among practicing psychologists. Prof. Psychol. Res. Pract. 40, 54–61.
doi: 10.1037/a0012538
Ryff, C. (1989). Happiness is everything, or is it? Explorations on the
meaning of psychological well-being. J. Pers. Soc. Psychol. 57, 1069–1081.
doi: 10.1037/0022-3514.57.6.1069
Rzeszutek, M., Partyka, M., and Gołab, A. (2015). Temperament traits,
social support and secondary traumatic stress disorder symptoms in
a sample of trauma therapists. Prof. Psychol. Res. Pract. 46, 213–220.
doi: 10.1037/pro0000024
Rzeszutek, M., and Schier, K. (2014). Temperament traits, social support, and
burnout symptoms in a sample of therapists. Psychotherapy 51, 574–579.
doi: 10.1037/a0036020
Schaufeli, W., Leiter, M., and Maslach, C. (2009). Burnout: 35 years of research and
practice. Career Dev. Int. 14, 204–220. doi: 10.1108/13620430910966406
Schlarb, A., Reis, D., and Schröder, A. (2012). Sleep Characteristics, Sleep
Problems, and Associations to Quality of Life among Psychotherapists. Sleep
Disord. 2012, 806913. doi: 10.1155/2012/806913
Frontiers in Psychology | www.frontiersin.org 18 August 2022 | Volume 13 | Article 928191
Van Hoy and Rzeszutek Burnout and Psychological Wellbeing
Shoji, K., Cieslak, R., Smoktunowicz, E., Rogala, A., Benight, C., and Luszczynska,
A. (2016). Associations between job burnout and self-efficacy: a meta-analysis,
Anxiety Stress Coping 29, 367–386. doi: 10.1080/10615806.2015.1058369
Shuang, F., Hou, S., Zhu, J., Ren, D., Cao, Z., and Tang, J. (2015).
Quality assessment tool for observational cohort and cross-sectional studies.
PLoS ONE. 9, e111695. doi: 10.1371/journal.pone.0111695.t001
Simionato, G., and Simpson, S. (2018). Personal risk factors associated with
burnout among psychotherapists: a systematic review of the literature. J. Clin.
Psychol. 7, 1431–1456. doi: 10.1002/jclp.22615
Simpson, S., Simionato, G., Smout, M., van Vreeswijk, M. F., Hayes, C., Sougleris,
C., et al. (2019). Burnout amongst clinical and counselling psychologists: The
role of early maladaptive schemas and coping modes as vulnerability factors.
Clin. Psychol. Psychother. 26, 35–46. doi: 10.1002/cpp.2328
Smout, M. F., Simpson, S. G., Stacey, F., and Reid, C. (2021). The
influence of maladaptive coping modes, resilience, and job demands on
emotional exhaustion in psychologists. Clin. Psychol. Psychother. 1, 1–14.
doi: 10.1002/cpp.2631
Spector, P. (1985). Measurement of human service staff satisfaction: Development
of the job satisfaction survey. Am. J. Community Psychol. 13, 693–713.
doi: 10.1007/BF00929796
Stamm, B. (2010). The Concise ProQOL Manual, 2nd Edn. Pocatello: Eastwoods,
LLC.
Steel, C., Macdonald, J., Schröder, T., and Mellor-Clark, J. (2015). Exhausted
but not cynical: Burnout in therapists working within Improving
Access to Psychological Therapy Services. J. Ment. Health 24, 33–37.
doi: 10.3109/09638237.2014.971145
Steptoe, A., Deaton, A., and Stone, A. (2015). Subjective well-being, health, and
ageing. Lancet 385, 640–648. doi: 10.1016/S0140-6736(13)61489-0
Summers, E., Morris, R., Bhutani, G., Rao, A., and Clarke, J. (2021). A survey of
psychological practitioner workplace well-being. Clin. Psychol. Psychother. 28,
438–451. doi: 10.1002/cpp.2509
Tsai, J., Jones, N., Klee, A., and Deegan, D. (2020). Job burnout among
mental health staff at a veterans affairs psychosocial rehabilitation center.
Community Ment. Health J. 56, 294–297. doi: 10.1007/s10597-019-0
0487-5
Ulloa, B., Møller, V., and Sousa-Poza, A. (2013). How does subjective well-
being evolve with age? A literature review. J. Popul. Ageing 6, 227–246.
doi: 10.1007/s12062-013-9085-0
van der Ploeg, H., van Leeuwen, J., and Kwee, M. (1990). Burnout among Dutch
psychotherapists. Psychol. Rep. 67, 107–112. doi: 10.2466/pr0.1990.67.1.107
von Hippel, C., Brener, L., Rose, G., and von Hippel, W. (2019). Perceived inability
to help is associated with client-related burnout and negativex work outcomes
among community mental health workers. Health Soc. Care, 27, 1507–1514.
doi: 10.1111/hsc.12821
Wilkerson, K., and Bellini, J. (2006). Intrapersonal and organizational factors
associated with burnout among school counsellors. J. Couns. Dev. 84, 440–450.
doi: 10.1002/j.1556-6678.2006.tb00428.x
Wiseman, H., and Egozi, S. (2006). Personal therapy for Israeli school counsellors:
prevalence, parameters, and professional difficulties and burnout. Psychother.
Res. 16, 332–347. doi: 10.1080/10503300500532663
Wogan, M., and Norcross, J. C. (1985). Dimensions of therapeutic skills and
techniques: Empirical identification, therapist correlates, and predictive utility.
Psychother. Theory Res., Pract. Train. 22, 63–74. doi: 10.1037/h0088528
Woo, T., Ho, R., Tang, A., and Tam, W. (2020). Global prevalence of burnout
symptoms among nurses: a systematic review and meta-analysis.