Stress in clinical psychologists

Exploring the relationships among art therapy students' burnout, practicum stress, and teacher support

Introduction

This study examines how teacher support and practicum stress affect art therapy graduate students' burnout.

Methods

A total of 125 master's and doctoral students from art therapy graduate schools in Korea participated in the study. We conducted a correlation analysis and multiple regression analysis to explore the relationship between the variables.

Results

The correlation analysis results showed that burnout, practicum stress, and social support are significantly interrelated. The regression analysis results indicated that practicum stress increases burnout while social support decreases it. When we used the sub-factors of social support as independent variables, we found that professor support rather than the support of colleagues or family significantly reduced burnout. When we divided the perceived teacher support into emotional support and academic support, our analysis identified that academic support was more important than emotional support to reduce students' burnout.

Conclusion

Art therapy students' practicum stress can cause psychological burnout, while teacher support-especially academic support-can lower the possibility of experiencing such burnout.

Stress, resilience and coping in psychological wellbeing practitioner trainees: a mixed-methods study

In this study, a convergent parallel mixed-methods design was used to explore stress, resilience and coping in psychological wellbeing practitioner (PWP) trainees (n = 90) at the beginning of their training. Psychometric tests were used to measure levels of self-reported stress, resilience and dispositional coping styles. Open-text survey data regarding the perceived sources of stress at the beginning of training were also qualitatively analysed using thematic analysis (TA). Results indicated that in the early weeks of their training, trainees reported lower levels of resilience and higher levels of stress than those found in the general population. Statistically significant negative correlations were found between stress and resilience, and between stress and the coping styles ‘Planning’, and ‘Active Coping’. Statistically significant positive correlations were found between stress and the coping styles of ‘Denial’ and ‘Focus on and Venting of Emotions’. The qualitative findings provided a context within which to understand these quantitative results. The three themes ‘I can find the unknown quite unsettling’, ‘I question my competences’ and ‘Learning, consolidating and putting it all into practice’ were generated through the qualitative analysis. These themes were connected by an over-arching theme which suggests that the perceived responsibility of the role is an important source of stress for PWP trainees. Implications for future research and the training of PWPs are discussed.

Key learning aims

(1)

Work Stress, Mental Health and Validation of Professional Stress Scale (PSS) in an Italian-Speaking Teachers Sample

This study aimed validate the Italian version of the Professional Stress Scale (PSS). A questionnaire was translated into Italian and administered to two sample groups. The first group (n = 200) was the control group and the second (n = 1137) the experimental group. The participants in the study were students enrolled in a special needs training teacher course or a specialization course that aims to train support teachers. The study conducted two analyses; factor and reliability analyses. The factor analysis utilized the Kaiser-Meyer-Olkin (KMO) test which had a result of 0.925 for the scale; this was above the acceptable value of 0.7. The research studied 33 items and the BTS was significant for the 33 items scale (χ2 (528) = 4353.508, p < 0.001). Moreover, five eigenvalues greater than 1 were identified in the data, whereas the total variance explained was 63.7%. The reliability test utilized the Cronbach’s Alpha score (0.936) of the scale and the value is calculated based on the response of 1106 individuals. The value is well above the value of 0.80, which indicates a high internal consistency level of the different items of the scale. This study showed that the Italian version of the PSS is a reliable and valid measure that can be used for research and clinical purposes.

Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale

Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients. Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise. Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups. Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals. Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.

Mental Health, Work Engagement and Meaningful Work-Role Fit of Industrial Psychologists: A Latent Profile Analysis

The purpose of this study was to identify distinctive mental health profiles for industrial psychologists based on the Mental Health Continuum. Further, it aimed to determine how these profiles differ with respect to work-role fit, meaningfulness and work engagement. It also aimed to investigate whether industrial psychologists within managerial or specialist differ in respect of different types of mental health. An online cross-sectional survey design was employed to draw a census sample (n = 274) from all South African industrial psychologists. A biographical questionnaire, the Work-Role Fit Scale, the Psychological Meaningfulness Scale, the Work Engagement Scale, and the Mental Health Continuum–Short Form were administered. Descriptive statistics, correlations, latent profile analysis, MANOVAs and ANOVAs were computed. Three mental health profiles for industrial psychologists were identified: languishing, moderately mentally healthy and flourishing. Significant differences between the three mental health profiles and experiences of meaningful work-role fit and work engagement were found, but not between experiences of managerial roles. The results show that individuals with different mental health profiles, experience work and its related outcomes, differently. Therefore, in order to enhance meaningful work-role fit and work engagement of industrial psychologists, a one-size-fits-all model may not be appropriate.

Burnout amongst clinical and counselling psychologist: The role of early maladaptive schemas and coping modes as vulnerability factors

Psychologists are subject to multiple competing emotional demands that increase the risk of burnout. Research has demonstrated that burnout arises from both organizational and personal factors, including psychologists' personal beliefs and coping. Preliminary research indicates that early maladaptive schemas (EMS) are associated with high burnout, yet, to date, the role of EMS and associated coping responses (maladaptive coping modes [MCM]) in predicting high burnout amongst psychologists has not been investigated. Four hundred forty-three psychologists completed a self-report online questionnaire comprising the Maslach Burnout Inventory-emotional exhaustion scale (EE), Young Schema Questionnaire, and Schema Mode Inventory. The two most common EMS amongst psychologists were unrelenting standards and self-sacrifice. There was substantial indication of burnout, with 18.3% in the high range and 29.6% in the moderate range of EE. The most common MCM were detached protector and detached self-soother. Controlling for demographics and job demands, EMS accounted for an additional 18% variance in EE. MCM accounted for an additional 6% beyond the variance explained by demographics, job demands, and EMS. Practical recommendations are suggested to reduce psychologist burnout.

Emotional Stress and Coping Strategies in South African Clinical and Counselling Psychologists

This study aimed to explore psychologists' emotional stress levels, as manifested in anxiety and depression, their coping strategies, and the relationship between stress and coping strategies. A stratified random sample of 238 South African clinical and counselling psychologists completed internet surveys that included a biographical questionnaire, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Brief Coping Orientations to Problems Experienced (Brief COPE). According to category cut-off points in the manuals, results indicated that 56.3% of participants reported above average anxiety levels, while 54.2% were mildly depressed. A combination of the coping strategies of self-blame, behavioural disengagement, denial, a lack of humour, self-distraction, a lack of acceptance, venting, and substance use significantly predicted anxiety. A combination of substance use, self-blame, self-distraction, denial, and a lack of seeking instrumental support significantly predicted depression. The results suggest that South African psychologists fail to manage their emotional stress as manifested in depressive and anxiety symptoms. A coping programme for South African psychologists in practice and training is recommended. In addition, psychologists are encouraged to nurture their emotional health through psychotherapy and support groups. The limitations of sampling in terms of possible psychological sophistication and self-selection, as well as the need to further differentiate the work settings of psychologists, are discussed.

Systematic Review of Mindfulness Practice for Reducing Job Burnout

OBJECTIVE

A systematic search and critical appraisal of interdisciplinary literature was conducted to evaluate the evidence for practicing mindfulness to treat job burnout and to explore implications for occupational therapy practitioners.

METHOD

Eight articles met inclusion criteria. Each study was assessed for quality using the Physiotherapy Evidence Database scale. We used the U.S. Agency for Health Care Policy and Research guidelines to determine strength of evidence.

RESULTS

Of the studies reviewed, participants included health care professionals and teachers; no studies included occupational therapy practitioners. Six of the 8 studies demonstrated statistically significant decreases in job burnout after mindfulness training. Seven of the studies were of fair to good quality.

CONCLUSION

There is strong evidence for the use of mindfulness practice to reduce job burnout among health care professionals and teachers. Research is needed to fill the gap on whether mindfulness is effective for treating burnout in occupational therapy practitioners.

Recovery of Work-Related Stress: Complaint Reduction and Work-Resumption are Relatively Independent Processes

PURPOSE

The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the association between predictors and work-resumption.

METHODS

Seventy-one patients on sickness-leave because of work-related stress complaints were followed over a period of 13 months. Predictors comprised personal (demographics, coping, cognitions), work-related (job-characteristics, social support), and illness-related (complaint duration, absence duration) variables. Dependent variables were distress complaints, burnout complaints, and work-resumption.

RESULTS

Complaints reduced considerably over time to borderline clinical levels and work-resumption increased to 68% at 13 months. Predictors of stronger reduction of distress complaints were male gender, less working hours, less decision authority, more co-worker support, and shorter absence duration. Predictors of stronger reduction of burnout complaints were male gender, lower age, high education, less avoidant coping, less decision authority, more job security, and more co-worker support. Predictors of work-resumption were lower age and stronger reduction of burnout complaints. No indication for a mediating role of burnout complaints between the predictor age and work-resumption was found.

CONCLUSIONS

Complaint reduction and work-resumption are relatively independent processes. Symptom reduction is influenced by individual and work-related characteristics, which holds promise for a multidisciplinary treatment approach for work-related stress.

The effectiveness of an ACT informed intervention for managing stress and improving therapist qualities in clinical psychology trainees

OBJECTIVES

Clinical psychology trainees (CPTs) are vulnerable to high stress, which can adversely affect their personal and professional functioning. This study evaluated the effectiveness of a group acceptance and commitment therapy (ACT) informed stress management intervention for CPTs.

DESIGN

Outcome measures were work-related stress, distress, life satisfaction, counseling self-efficacy, self-compassion, and therapeutic alliance. A cohort-controlled design, where an experimental group (n = 28) was compared with a waitlist control group (n = 28), was utilized, with a 10-week follow-up.

RESULTS

Group comparisons showed statistically significant intervention effects for the main outcome measures, which were maintained at follow-up. Mediational analyses showed that changes on most outcomes were mediated by ACT mindfulness and acceptance processes.

CONCLUSIONS

Findings support the effectiveness of a group ACT program for CPTs regarding stress reduction and improving therapist qualities.

Burnout among the addiction counseling workforce: the differential roles of mindfulness and values-based processes and work-site factors

Although work-site factors have been shown to be a consistent predictor of burnout, the importance of mindfulness and values-based processes among addiction counselors has been little examined. In this study, we explored how strongly experiential avoidance, cognitive fusion, and values commitment related to burnout after controlling for well-established work-site factors (job control, coworker support, supervisor support, salary, workload, and tenure). We conducted a cross-sectional survey among 699 addiction counselors working for urban substance abuse treatment providers in six states of the United States. Results corroborated the importance of work-site factors for burnout reduction in this specific population, but we found that mindfulness and values-based processes had a stronger and more consistent relationship with burnout as compared with work-site factors. We conclude that interventions that target experiential avoidance, cognitive fusion, and values commitment may provide a possible new direction for the reduction of burnout among addiction counselors.

Sources of stress experienced by occupational therapists and social workers in mental health settings

This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists.

A influência de fatores de personalidade e de organização do trabalho no burnout em profissionais de saúde

O presente estudo investigou a relação de fatores de personalidade e de fatores ligados à organização do trabalho com a síndrome do burnout. As características de personalidade examinadas foram padrão tipo A de personalidade e traço de ansiedade. Os fatores da organização do trabalho investigados envolveram o significado do trabalho, a percepção de controle e o suporte da chefia imediata. Participaram do estudo 239 profissionais de saúde. Eles responderam a cinco medidas para avaliação de dados sócio-demográficos, personalidade tipo A, traço de ansiedade, fatores do trabalho, burnout total e suas dimensões (exaustão emocional, despersonalização e realização pessoal com o trabalho). As análises de regressão múltipla (Stepwise) indicaram que as variáveis traço de ansiedade, suporte da chefia e tipo A de personalidade foram preditores significativos do burnout total e da exaustão emocional, enquanto as variáveis traço de ansiedade e tipo A de personalidade predisseram significativamente a despersonalização. Nenhuma das variáveis do estudo predisse significativamente a dimensão realização pessoal com o trabalho.

The relationship between support and stress in forensic community mental health nursing

AIMS OF THE STUDY/PAPER: This paper reports the results of a survey of forensic community mental health nurses (FCMHNs) in England and Wales which aimed to ascertain the level of stress and burnout experienced by this group.

BACKGROUND/RATIONALE

Several studies have identified that mental health nursing is a stressful activity and the relationship between factors such as age, experience, support, caseload size and perceived stress have been explored. However, until recently, no studies have examined the situation of FCMHNs and this paper extends the analysis of studies completed by the main author, considering issues related to coping abilities and support systems.

DESIGN/METHODS

The survey involved respondents completing a demographic questionnaire and a range of standardized validated measures (Maslach Burnout Inventory, General Health Questionnaire and Community Psychiatric Nurse Stress Questionnaire). The population for the study was all identified FCMHNs attached to the 26 National Health Service (NHS) Medium Secure Units in England and Wales (n=104).

RESULTS/FINDINGS

A high response rate of 77% (n=80) was achieved. The results identified that a number of respondents were experiencing burnout. Statistically significant associations were found between caseload size and level of stress. The results also suggest that support from managers and colleagues were an important factor in ameliorating the experience of stress and show that individuals in this study experiencing high levels of stress adopted palliative behaviours such as use of alcohol.

CONCLUSIONS

The paper concludes by suggesting that such findings should be considered when delivering stress management programmes and reinforce the potential benefit of effective clinical supervision as a means of staff support.

Factor structure of the Mental Health Professionals Stress Scale (MHPSS) among clinical psychologists in India

This study examined the factor structure of the Mental Health Professionals Stress Scale (MHPSS) and its reliability and validity in a sample of 116 clinical psychologists in India. Principal component analysis of the MHPSS identified four factors that accounted for 42.2% of the total variance. These 4 factors reflected 6 of the 7 original subscales. The subscale 'Client-related difficulties' did not emerge as a distinct factor. The authors attribute this to cultural differences in the therapist-patient relationship. The MHPSS correlated negatively with measures of professional role satisfaction and subjective well being. It was concluded that the MHPSS is a reliable and valid tool to measure sources of occupational stress experienced by mental health professionals.