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

Abstract

IntroductionAlthough 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.MethodWe 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 (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners.ResultsFactors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute βs = 0.16–0.40; SRS: 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.DiscussionOur 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.

Comparative investigation of appraisal style measures in their predictive potential for stress resilience and implications for predictive modeling of resilience

“…In agreement with previous work Veer et al, 2021;Zerban et al, 2023) and to prepare all prediction analyses, the associations between the socio-demographic covariates and the main SR outcome in each sample (MARP and LORA: SR(B0-B2), DynaM-OBS: SR(B0-9 months); cf. Table 1) was tested in separate univariate regressions, to retain all covariates surviving a likelihood ratio test at p<0.2 for further analyses (Supplementary Tables S1-S3).…”

“…As a consequence, PAS should be a better predictor of resilience than instruments assessing biases in single appraisal dimensions. While initial studies have found associations between PAS and resilience Veer et al, 2021;Zerban et al, 2023), this specific claim remains untested. Alternatively, it could also be that a bias in a single dimension, or in just two dimensions, may be dominant in shaping resilience.…”

“…Specifically, we ask whether the predictor-outcome relationship is mediated by a self-report measure of optimal stress response regulation. For this purpose, we use a battery questionnaire that assesses how easily individuals cope with, and recover from, stressful events (in short: 'good stress recovery') (Smith et al, 2008), which has already been confirmed as a mediator between PAS and resilience in the initial studies Veer et al, 2021;Zerban et al, 2023).…”