Professional Psychology; Research and Practid Copyright 1997 by the American P

1997, Vol. 28. No. 1, 14-16

Psychotherapists' Personal Problems and Self-Care Patterns

Michael J. Mahoney
University of North Texas

Psychotherapy practitioners (/V = 155) responded to an anonymous self-report questionnaire focused

on their personal problems, their recent self-care patterns, and their attitudes toward personal therapy.
The most frequently reported personal problems clustered around emotional exhaustion and fatigue,
but these were concerns only among less than half of the sample. Personal therapy had been experi-
enced by almost 90% of participants, and their average ratings of its value were very positive. Cost
and accessibility were the most frequently noted concerns regarding personal therapy. These findings
afford a more positive image of the personal life of the psychotherapist than has been rendered by
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

previous surveys.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

The challenges of being a psychotherapist are considerable,
and at least some of those challenges are reflected in surveys
reporting the stress patterns and health concerns of practitioners
(Farber, 1983; Guy, 1987; Hellman, Morrison, & Abramowitz,
1987; Mahoney, 1995). In a survey of 264 psychotherapists, for
example, Deutsch (1985) found that relationship difficulties and
depression were commonly reported problems. Other surveys
of practitioners have also reported that anxiety, depression, sub-
stance abuse, and relationship problems are not uncommon (El-
liott & Guy, 1993; Thoreson, Miller, & Krauskopf, 1989). Esti-
mates of the frequency and seriousness of such problems have
been characterized by a number of limitations, however.
This article is a simple, descriptive report on the experiences
of 155 nonrandom psychotherapists about their methods of cop-
ing with their life stresses and personal problems. Information
on therapists' experiences of personal psychotherapy was also
gathered. This survey was conducted al a professional confer-
ence aimed at a broad spectrum of mental health service
providers.
The Descriptive Exploration
A brief self-report questionnaire was distributed to 325 men-
tal health professionals attending a conference on "briefer thera-
pies" and "treatment strategies for the 1990s." The conference,
which was held in San Francisco, included educational presenta-
tions on addictive behaviors, anxiety and stress, marital and
family therapy, depression, personality disorders, therapies with
children and adolescents, managed care, resistance, imagery,
metaphor, and psychotherapy integration. The questionnaire re-
quested basic demographic information as well as information
about personal problems experienced during the past year, self-
MICHAEL J. MAHONEY received his PhD from Stanford University in
1972. He is currently the executive director of the Society for Con-
structivism in the Human Sciences and professor of psychology at the
University of North Texas.
CORRKSPONDENCE CONCERNING THIS ARTICLE should be addressed to Mi-
chael J. Mahoney, Department of Psychology, University of North Texas,
Denton, Texas 76203-3587.
care practices during the past year, and opinions about personal
therapy. All items were presented in a 4-point Likert-type re-
sponse format in which 1 indicated strongly disagree and 4
indicated strongly agree.
Completed questionnaires were returned by 155 individuals,
yielding a response rate of almost 48%. The reporting sample
comprised 84 women (54.5%) and 70 men ( 1 respondent did
not report gender). Ages ranged from 24 to 83 years, with a
mean of 45.1 years. Most respondents had earned either a mas-
ter's degree (48%) or a doctorate (46%), with only 6% re-
porting the bachelor's as their highest degree. The men in this
sample reported having attained higher degrees than did the
women, F( I, 129) = 20.21, p < .001. The primary theoretical
orientations reported were eclectic (54%). psychodynamie
(19%), cognitive (15%), and behavioral (4%), and there were
no significant gender differences. The number of years of clinical
practice reported by this sample ranged from less than 1 to 48
years, with a mean of 12.9 years. Male respondents reported
significantly more clinical experience than did their female
counterparts, f ( l , 129) = 11.90, p < .001. There were no
significant gender differences in average current caseload, which
was reported as 18 clients.
Personal Problems and Concerns
The most common personal problems reported by this sample
of mental health practitioners clustered around emotional ex-
haustion and fatigue (Table 1). Problems with interpersonal
relationships and feelings of isolation, disillusionment about the
profession, anxiety, and depression were also reported. Somatic
and substance abuse problems were the least frequent com-
plaints among these practitioners. The only significant gender-
related difference in responding was in relation to concerns
about alcohol use, for which the men reported greater concern
than did the women, F(\, 142) = 8.16, p < .005. Doctoral-
level therapists reported less satisfaction with their sleep than
did nondoctoral therapists.
Patterns of Coping and Self-Care
Pleasure reading, physical exercise, hobbies, and recreational
vacations were the most common forms of self-care reported
 SPECIAL SECTION: THERAPISTS' PERSONAL PROBLEMS 15

Table 1
A Comparison of Previous-Year Personal Problems, Self-Care, and Participation in
Personal Therapy Between Doctoral and Nondoctoral Therapists

Doctoral (n = 69) Nondoctoral (n = 86)

Experience pattern SD SD

Previous-year personal problems

Episodes of irritability or emotional exhaustion 2.41 1.00 42.6 2.47 0.90 46.5
Concerns about the size/severity of their caseload 2.23 1.02 37.9 2.40 1.08 48.2
Insufficient or unsatisfactory sleep* 2.38 1.06 43.5 2.27 0.91 39.5
Doubts about their own therapeutic effectiveness 2.36 0.82 42.2 2.34 0.86 40.7
Problems in their intimate relationships 2.26 0.98 37.7 2.27 0.96 41.2
Chronic fatigue 2.21 1.10 33.3 2.19 1.00 37.2
Feelings of loneliness or isolation 2.12 1.00 38.2 2.21 1.00 33.7
Episodes of anxiety 2.15 1.04 35.3 2.15 0.89 31.8
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Episodes of depression 2.12 1.05 34.8 2.00 0.81 25.3

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Feelings of disillusionment about their work 2.01 0.87 26.5 2.09 0.91 27.1
Concerns about their caffeine use 1.71 0.96 23.5 1.65 0.86 20.9
Gastrointestinal problems 1.68 0.94 17.6 1.64 0.84 16.3
Frequent headaches 1.41 0.78 11.8 1.65 0.97 20.9
Frequent colds or flu episodes 1.34 0.66 7.4 1.60 0.86 17.4
Concerns about their use of alcohol 1.47 0.78 14.7 1.39 0.78 10.7
Concerns about their use of drugs 1.07 0.31 1.5 1.08 0.31 1.2

Previous-year self-care patterns

Engaged in a hobby or reading for pleasure 3.42 183 87.0 3.22 0.96 79.1
Taken pleasure trips or vacations 3.42 X90 84.1 3.08 0.98 76.7
Attended movies, artistic events, or museums 3.43 3.85 85.3 3.17 0.90 79.1
Engaged in physical exercise 3.29 .03 78.3 3.29 0.83 83.5
Participated in peer supervision 2.82 ).98 63.6 2.89 0.94 64.7
Played recreational games 2.62 .15 50.0 2.68 1.08 56.5
Practiced meditation or prayer 2.50 .19 51.5 2.52 1.09 48.8
Engaged in volunteer work for a worthy cause 2.25 .23 42.6 2.13 1.21 40.0
Been a client in personal therapy* 1.85 .29 28.4 2.40 1.41 46.5
Received massage or chiropractic services* 1.79 .15 26.9 2.19 1.16 42.2
Attended church services 2.07 .23 33.8 2.04 1.24 30.6
Kept a personal diary 1.63 .01 23.9 1.62 0.93 19.0

Participation in personal therapy

Have concerns about the financial investment 2.16 1.05 41.3 2.44 1.12 50.0
Currently seeing a therapist regularly* 1.17 1.17 22.2 2.18 1.36 38.8
Wish it were more accessible to them 1.95 1.17 32.3 2.21 1.17 42.4
Have concerns about the emotional investment 1.67 0.88 20.6 .73 0.85 18.6
Wish they were more open to the idea 1.76 0.94 20.7 .80 0.99 20.7
Have concerns about its potential value for them 1.68 0.88 17.5 2.34 0.86 15.3
Have concerns about confidentiality 1.55 0.72 12.9 .53 0.91 16.5
(Would) feel embarrassed to be a client 1.51 0.80 15.9 .48 0.78 13.1
Reluctant due to previous negative experiences 1.35 0.68 7.9 .36 0.74 8.2

" Refers to the percentage of respondents who answered the statement affirmatively.
*p < .05.

by respondents. Peer supervision, prayer or meditation, and vol-
unteer work were also frequently reported. Personal therapy,
attending church services, receiving massage or chiropractic
care, and keeping a personal diary were the least common among
the reported forms of self-care. Relative to their doctoral coun-
terparts, nondoctoral therapists were more likely to have been in
personal therapy during the preceding year and to have received
massage or chiropractic services.
Personal Therapy
A large majority of respondents (87.7%) reported having
been in personal psychotherapy, with women reporting this activ-
ity significantly more frequently than did men, F(l, 128) =
7.21, p < .01. This gender difference was also reflected in total
hours of personal therapy, F(l, 129) = 10.49, p < .002. There
were no significant gender differences in reported numbers of
different therapists or in the value of personal therapy. There
was, however, a significant gender difference in their reports of
having been a client in personal therapy during the past year,
F(l, 141) = 6.66, p < .01, with almost half of the female
respondents (46.5%) reporting having been in personal therapy
within the year, as compared with only 27.9% of the men.
Women were also more likely to have sought professional mas-
sage and chiropractic services during that time, F(\, 141) =
 16 MAHONEY
8.19, p < .005. Nondoctoral therapists were more likely than
doctoral ones to report being currently in therapy.
Discussion
The results of this survey corroborate those of previous inves-
tigations in documenting the fact that mental health practitioners
do, indeed, report experiencing personal problems. These results
differ from those previously reported, however, in that they sug-
gest substantially different base rates for psychological distress.
These data also provide clarifying information on how clinical
practitioners actively cope with the stresses of their work.
Focusing first on psychotherapists' personal problems and
concerns, emotional exhaustion was the most frequently re-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
ported personal problem, and yet it was expressed by less than
This document is copyrighted by the American Psychological Association or one of its allied publishers.
half the sample. About one third of the respondents reported
having experienced episodes of anxiety or depression during
the previous year. Somatic concerns were less frequently re-
ported. One out of 8 participants had been worried about their
alcohol consumption. This concern was significantly greater
among men than women. Drug use was the least common per-
sonal concern reported.
In the realm of self-care, half of the respondents reported
practicing meditation or prayer, and three out of four engaged
in regular physical exercise. Pleasure reading, vacations, hob-
bies, and artistic enjoyments were pursued by more than 80%
of the sample. More than 40% reported doing volunteer work,
and 1 out of 5 kept a personal diary.
Personal therapy had been experienced by a large majority of
these practitioners, and they generally rated it as a helpful or
very helpful undertaking. More than one third had been in ther-
apy during the previous year, and many reported wishing that
personal therapy were more accessible to them. The financial
and emotional investments required by personal therapy were
reported as concerns by a substantial minority of respondents.
Confidentiality and prior negative experiences in personal ther-
apy were less frequent concerns.
These findings and their interpretation require qualification
and caution, of course, given the self-selected nature of the
sample and the limitations of the self-report instrument used.
Nevertheless, these data suggest that the psychotherapy prac-
titioner may be less troubled and unhappy than has been sug-
gested by previous investigations. An image of the practitioner
as a generally happy and healthy individual who enjoys his or
her work is also encouraged by these data on previous-year self-
care patterns. Four out of 5 of the practitioners surveyed reported
reading for pleasure, engaging in a hobby, taking pleasure trips
or vacations, or attending movies, artistic events, or museums.
Three out of 4 were engaging in physical exercise and almost
as many reported getting together with peers for feedback and
support of their professional activities. More than half reported
an involvement in playful recreation, and exactly half said that
they practiced meditation or prayer.
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Received March 29, 1995
Revision received February 2, 1996
Accepted May 30, 1996 •