How Do Psychologists and High Intensity Therapists Understand and Engage in Self-Care?

Background: The demanding nature of therapeutic work, along with associated stressors and risk factors, puts therapists at risk of stress and distress. If unchecked, this may affect their psychological wellbeing and professional competence (Wise & Barnett, 2016). Engagement in self-care has been suggested not only to be protective against such outcomes, but as therapists’ ethical responsibility (Wise, Hersh, & Gibson, 2012). Therapist self-care has not previously been studied in the context of the National Health Service (NHS), where increasing pressures may be a barrier to both compassionate care of others and practitioner psychological wellbeing (Francis, 2013).
Aims: This study sought to explore how psychologists and high intensity therapists working in the NHS understand and engage in self-care, and well as exploring what facilitates and hinders self-care.
Method: A critical realist approach was adopted. Four focus groups took place, each with four participants who were qualified National Health Service clinical psychologists, counselling psychologists, or high intensity therapists. Thematic analysis was used to analyse transcripts.
Results: Three main themes were generated: ‘Self-care as restorative activities’; ‘Self-care as a way of being’; and ‘The challenge of self-care in the NHS’. A description of these themes and associated subthemes is presented.
Conclusions: The study reflected the literature in concluding that self-care is complex, and can be understood as multifaceted. The study added to the literature by suggesting that these facets may be understood as restorative activities and ways of being, and that self-care can be proactive or reactive. Results suggested that facilitators and barriers to self-care can be understood in terms of individual factors (one’s own attitudes or stance towards self-care), relational factors (the influence of others), and systemic factors (the effect of wider pressures). The findings highlight the significant challenges of engaging in self-care in the context of the NHS, where pressures and expectations are high. Practical implications and directions for future research are discussed.