What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic

Matthias Zerban; Lara Marie Christine Puhlmann; Dana Lassri; Peter Fonagy; P Read Montague; Natalia Kiselnikova; Nicolas Lorenzini; Alex Desatnik; Raffael Kalisch; Tobias Nolte

doi:10.3389/fpsyg.2023.1272199

What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic

Front Psychol. 2023 Dec 18:14:1272199. doi: 10.3389/fpsyg.2023.1272199. eCollection 2023.

Authors

Matthias Zerban^#¹, Lara Marie Christine Puhlmann^#^{2

3}, Dana Lassri^#^{4

5}, Peter Fonagy^#^{4

6}, P Read Montague^#⁷, Natalia Kiselnikova^#⁸, Nicolas Lorenzini^#⁴, Alex Desatnik^#^{4

9}, Raffael Kalisch^#^{1

2}, Tobias Nolte^{4

6}

Affiliations

¹ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
² Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
³ Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁴ Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
⁵ The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Jerusalem, Israel.
⁶ Anna Freud National Centre for Children and Families, London, United Kingdom.
⁷ Virginia Tech Carilion Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Roanoke, VA, United States.
⁸ Department of Psychosocial Studies, Birkbeck College, University of London, London, United Kingdom.
⁹ Open Door Young People's Service, London, United Kingdom.

^# Contributed equally.

Abstract

Introduction: Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic.

Method: We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SR_G) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SR_S) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners.

Results: Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SR_G: 18/18 RFs, absolute βs = 0.16-0.40; SR_S: 15/18 RFs, absolute βs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression.

Discussion: Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.

Keywords: adversity; compassion satisfaction; mental health practitioners; mental health professionals; mentalizing; positive reappraisal; self-compassion; stress.

Grants and funding

WT_/Wellcome Trust/United Kingdom