Professional Health and Well

Professional Health and Well-being for Psychologists

by the Board of Professional Affairs’ Advisory Committee on Colleague Assistance

What Occupational Hazards Do Psychologists in Professional Practice Face?

The stress of our role, as professionals working with people in distress

The demands and importance of clinical and professional responsibility

Varied and often quickly shifting role demands

The challenge of managing the intimate, confidential and nonreciprocal nature of the client/therapist relationship

Isolation in the work context

Role characteristics that make psychologists prone to burnout (e.g., responsibility for people vs. things, limited control over outcomes, limited resources, high level of involvement)

Vulnerability to vicarious traumatization from empathic engagement with traumatized clients

The changing standards in the profession (e.g. decreased support for psychotherapy, an increased intrusion of legal and business concerns into therapeutic practice, increased documentation requirements)

The stress related to the business of practice (e.g. decreasing revenue and autonomy, managed care demands)

The interactions between personal stresses and the demands of our work

Utilizing the person of the therapist as a therapeutic tool

The heightened risk of suicide among male psychologists

Who Is Vulnerable to Occupational Stress?

We all are. Because of the nature of the work, every psychologist is at risk for occupational stress. Over the course of time, the interaction between events in the personal and professional life of a psychologist is certain to create stress, likely distress, and possibly impairment. This vulnerability to stress is not a reflection of pathology in the psychologist, but a reality of the challenge of our work.

What Increases Our Vulnerability to Occupational Stress?

Professional isolation

Inadequate consultation (e.g., regular clinical case consultation) or professional support for work that is challenging and complex

Poor self-care

Overwork (e.g., too many psychotherapy hours)

A paucity of leisure and non-work activities

Stigma within the profession for professionals who acknowledge distress or impairment

Unrealistic self-expectations, rigidity

A tendency to focus the needs of others while neglecting our own needs and personal problems

Poor boundaries, overinvolvement

Imbalance in caseload/professional responsibilities (e.g., working exclusively with trauma survivors, HIV, etc.)

What Are the Potential Consequences of Ignoring Occupational Hazards?

Damage to psychologists, including:

Depression

Social/professional isolation

Job dissatisfaction

Suicide Chemical abuse or dependence

Relationship conflicts (e.g., divorce)

Other addictions

Unprofessional behaviors

Ethical violations

Stress-related illnesses

Damage to clients, including:

Malpractice

Suicide

Boundary violations

Loss of faith in therapy

Symptom exacerbation

Guilt

Iatrogenic symptoms

Despair

Damage to the profession of psychology, including:

Loss of credibility

Lawsuits

Attrition

Negative media attention

Cynicism

Disillusionment

What Are Some Warning Signs of Occupational Stress?

Loss of pleasure in work

Depression (sleep or appetite disturbance, lethargy, negative mood)

Inability to focus or concentrate; forgetfulness

Anxiety

Substance use/abuse or other compulsive behaviors to manage stress

More frequent clinical errors

Less contact with colleagues

Workaholism

Persistent thoughts about clients and their clinical material

Intrusive imagery from clients’ traumatic material

Increased cynicism, overgeneralized negative beliefs

Increased isolation from or conflict with intimates

Chronic irritability, impatience

Increased reactivity and loss of objectivity and perspective in work

Suicidal thoughts

How Do We Protect Ourselves From the Consequences of Occupational Stress?

Take these risks seriously. Honestly assess your emotional, psychological and spiritual well being on a regular basis. Seek personal psychotherapy and other resources for health as needed.

Make and maintain professional connections that include opportunities to discuss the specific nature and stresses of our work. Model openness in such discussions for students and colleagues.

Seek consultation with knowledgeable peers and experts concerning specific clinical and professional challenges.

Understand that all psychologists are vulnerable to vicarious traumatization and other role-related risks and consult, limit caseload or make other accommodations or adjustments accordingly.

Pay attention to balance in work, rest and play. Make personal and professional self-care a priority. Attend to your physical and spiritual well being, as well as your emotional and psychological health. Pursue opportunities for intellectual stimulation including those outside the profession.

Challenge assumptions that stigmatize or demonize psychologists who acknowledge current or past experiences of distress, impairment or personal pain.

Develop reasonable and realistic expectations about workload, responsibilities and capabilities.

Become familiar with the literature on occupational risk for psychologists and pursue continuing education on these topics. (e.g., burnout, vicarious traumatization, compassion fatigue, colleague assistance and professionals in distress).

Identify sources of support for your work and use them.

Take regular vacations.

Incorporate topics of occupational vulnerability and professional well-being into graduate education, professional training and continuing education.

Who Is the Advisory Committee on Colleague Assistance (ACCA) and What Are Our Goals?

BPA’s Advisory Committee on Colleague Assistance (ACCA) focuses on the prevention of professional distress and impairment and on the consequences of impairment for the professional and the public. The committee believes that all psychologists are vulnerable to stress and can benefit from education about occupational hazards and vulnerabilities and reasonable steps toward prevention. Collecting, establishing and sharing resources and program models for state and provincial psychological associations are particularly important goals of the committee.

In addition to supporting state and provincial psychology association programming, our goals are to provide information about the universal vulnerability of psychologists to occupational stress, the need for preventive strategies to protect psychologists in the profession, the recognition of the continuum from stress to distress to impairment, and models of colleague assistance programs as developed by the state and provincial psychological associations.