Therapist Stress, Career Sustaining Behavior, Coping, and the Working Alliance

Abstract

Psychotherapists face many challenges in their work and are prone to experiencing stress. Their ability to cope and manage their stress may have the potential to affect their work with clients. The purpose of this study was to examine the relationship between therapist stress, coping styles, career sustaining behaviors, and therapist perceived working alliance. A sample of 160 psychologists, social workers, therapists, and counselors primarily from the Midwest participated in this study. Participants completed a demographic questionnaire, which included a rating of the stress they experienced in their work as a psychotherapist, the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983), the Career Sustaining Behaviors Questionnaire (Kramen-Kahn, 1995), andthe COPE (Carver, Scheier, & Weintraub, 1989). Participants also completed an anonymous demographic questionnaire regarding a client they are currently seeing in therapy; they rated the stress they experienced in their work with this client and completed the Working Alliance Inventory (Horvath & Greenberg, 1989). Pearson r correlations and hierarchical multiple regression analysis were used to investigate the relationships between the demographic variables, thethree therapist stress variables, career sustaining behavior, approaches to coping, and therapist perceived working alliance. Therapist working alliancescores demonstrated small magnitude negative correlations with each of the three therapist stress variables and showed small magnitude positive correlations with career sustaining behavior scores and active coping. In the multiple regression analysis, after controlling for therapist age, gender, years of experience, and number of clients seen each week, the therapist stress variables, career sustaining behavior, and approaches to coping accounted for significant unique variance in working alliance. Lower levels of therapist stress and the use of career sustaining behaviors and active coping were associated with more positiveworking alliance scores. The current findings suggest that therapist stress, therapist approaches to coping with stress, and the use of career sustaining behaviors may influence the working alliance in psychotherapy. This research suggests that the use of career sustaining behaviors and therapists' approaches to coping may be important variables that relate to more positive working alliances with clients. Findings and implications are discussed and recommendations are made for future research.