Who Therapizes the Therapists?

By Desiree Frain, Psy.D.

Many of us who pursue a mental healthcare profession do so because of personal experiences. For example, we may have witnessed a beloved family member or friend experience emotional or psychological pain, and we feel pulled to help.

For some, we’ve opted to become psychotherapists because we ourselves have experienced mental health concerns. We’ve seen firsthand the positive impact that a therapist can have on someone’s life, and we feel called to carry the torch and become a part of the next generation of mental health workers as a social worker, counselor, or psychologist.

My own story is no different; I am a clinical psychologist, raised in a family in which many mental health concerns were represented. I myself have lived experience of chronic mental health concerns, which have truly taught me to empathize with clients and prioritize my own mental health alongside my client’s.

A psychotherapist’s personal history of mental health problems doesn’t magically disappear when we earn our license. Classroom lectures on a vast number of therapeutic modalities, interventions, and treatment models don’t translate to immunity to mental health concerns.

In fact, some evidence suggests that being a psychotherapist can exacerbate or indirectly cause mental health concerns (Sherman, 1996). The high emotional tax of being present with others’ feelings, and joining them in their darkest moments, can take a toll on the most skilled psychotherapist.

A study by Laverdiere et al. (2018) of 240 psychotherapists found that a concerning percentage of psychotherapists experience mental health issues; 20 percent of therapists reported feeling emotionally exhausted, and 10 percent were experiencing “significant psychological distress” (p. 318). A meta-analysis by Bell et al. (2023) further reported high levels of occupational burnout and stress in psychologists across multiple studies.

In some cases, the psychological struggles can result in professional impairment, in which a therapist’s skill and ability are impacted (Sherman, 1996, p. 301; Bell et al., 2023). The data is concerning to those of us who are psychotherapists and want wellness for our fellow colleagues, longevity in our profession, and protection for the public.

What can we do to reduce the likelihood of mental health concerns impacting psychotherapists’ ability to provide quality care and experience personal and professional fulfillment? The question has diverse answers, many of which extend into systemic concerns beyond the control of the individual psychotherapist.

However, there are also individual and community-wide steps to be taken to promote wellness in our profession. Here are four.

First, by bringing to awareness the sobering statistics around the prevalence of mental health concerns in our field, psychotherapists can hopefully reduce the stigma associated with having a mental health diagnosis as a professional helper. Despite our efforts to reduce stigma in our clients, we often forget to do so for ourselves and our colleagues, who may worry that openly discussing our own mental health may lead to being labeled as unstable, unprofessional, or incompetent. By fostering more discussions in our field around provider mental health, we can better embody the value of destigmatization.

Second, the discussion around wellness, resilience, and burnout prevention should be emphasized during training. Training programs tend to focus on molding effective clinicians while neglecting to discuss what it means to be a well clinician. My supervisees have lovingly pointed this out to me, which has opened the door to many fruitful conversations about how to protect one’s own mental health while caring for others.

Third, we can support our fellow psychotherapists. This may mean explicitly offering mental health services to fellow mental health providers in an ethically appropriate manner. We can provide supervision and consultation to each other or simply be a listening ear. Community support is an important method of building resilience and preventing burnout (Sherman, 1996).

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To identify sources of peer support and consultation, psychotherapists can consult with local or national organizations or network within their local community. A good place to start is the American Psychological Association’s Advisory Committee on Colleague Assistance (ACCA), which has collected resources and strategies focused on the topic. Social media and Zoom have made it possible for therapists in even the most remote areas to seek peer support.

Last, I cannot stress enough the importance of seeking out personal therapy when indicated by increased stress, mental health symptoms, or impending burnout. Many of us already have our own therapist (clients like to jokingly refer to it as their “grandtherapist”), but some of us may have been procrastinating or prioritizing other matters. If you are an individuals who is struggling but hasn’t pursued treatment yet, I implore you gently to do so. We must practice what we preach regarding the skills and values we instill in clients—including self-compassion and self-care.

If we want longevity in our field, it is necessary for us to open the door (metaphorically and literally) into therapist mental health.