Emotional Stress and Coping Strategies in South African Clinical and Counselling Psychologists

Abstract

This study aimed to explore psychologists' emotional stress levels, as manifested in anxiety and depression, their coping strategies, and the relationship between stress and coping strategies. A stratified random sample of 238 South African clinical and counselling psychologists completed internet surveys that included a biographical questionnaire, the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Brief Coping Orientations to Problems Experienced (Brief COPE). According to category cut-off points in the manuals, results indicated that 56.3% of participants reported above average anxiety levels, while 54.2% were mildly depressed. A combination of the coping strategies of self-blame, behavioural disengagement, denial, a lack of humour, self-distraction, a lack of acceptance, venting, and substance use significantly predicted anxiety. A combination of substance use, self-blame, self-distraction, denial, and a lack of seeking instrumental support significantly predicted depression. The results suggest that South African psychologists fail to manage their emotional stress as manifested in depressive and anxiety symptoms. A coping programme for South African psychologists in practice and training is recommended. In addition, psychologists are encouraged to nurture their emotional health through psychotherapy and support groups. The limitations of sampling in terms of possible psychological sophistication and self-selection, as well as the need to further differentiate the work settings of psychologists, are discussed.

Keywords

anxiety coping depression psychologists stress

Get full access to this article

View all access options for this article.

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders–TR (4th ed.). Washington, DC: American Psychiatric Association.

Barnett

J. E.

Hillard

(2001). Psychologist distress and impairment: The availability, nature, and use of colleague assistance programs for psychologists. Professional Psychology: Research and Practice, 32, 205–210.

Basson

Rothmann

(2002, March 18–19). Sense of coherence, coping and burnout of pharmacists. Paper presented at the First Burnout Conference in South Africa, Potchefstroom, South Africa.

Beck

A. T.

Steer

R. A.

Brown

G. K.

(1996). Beck Depression Inventory (2nd ed.). San Antonio, TX: Harcourt Brace.

Beck

A. T.

Steer

R. A.

Garbin

M. G.

(1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100.

Beck

A. T.

Ward

C. H.

Mendelson

Mock

Erbaugh

(1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53–63.

Bifulco

Brown

G. W.

(1996). Cognitive coping response to crises and onset of depression. Social Psychiatry and Psychiatric Epidemiology, 31, 163–172.

Böhmer

A. C.

Spangenberg

J. J.

(2001). Depressie en angs onder predikante van die Nederduitse Gereformeerde Kerk in die Wes- en Suid-Kaap [Depression and anxiety among ministers of the Dutch Reformed Church in the Western and Southern Cape]. Nederduitse Gereformeerde Teologiese Tydskrif, 42, 6–14.

Bolger

(1990). Coping as a personality process: A prospective study. Journal of Personality and Social Psychology, 59, 525–537.

10.

Bowling

(2001). Measuring disease. Buckingham, UK: Open University Press.

11.

Carver

C. S.

(1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100.

12.

Carver

C. S.

Scheier

M. F.

Weintraub

J. K.

(1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.

13.

Case

P. W.

McMinn

M.R.

(2001). Spiritual coping and well-functioning among psychologists. Journal of Psychology and Theology, 29, 29–40.

14.

Cohen

R. J.

Swerdlik

M. E.

(2005). Psychological testing and assessment (6th ed.). New York: McGraw-Hill.

15.

Cushway

(1992). Stress in clinical psychology trainees. British Journal of Clinical Psychology, 31, 169–179.

16.

Cushway

Tyler

P. A.

(1994). Stress and coping in clinical psychologists. Stress Medicine, 10, 35–42.

17.

Cushway

Tyler

P. A.

(1996). Stress in clinical psychologists. International Journal of Social Psychiatry, 42, 141–149.

18.

Cushway

Tyler

P. A.

Nolan

(1996). Development of a stress scale for mental health professionals. British Journal of Clinical Psychology, 35, 279–295.

19.

De Bruin

G. P.

Taylor

(2005). Development of the Sources of Work Stress Inventory. South African Journal of Psychology, 35, 748–765.

20.

Derogatis

L. R.

Coons

H. L.

(1993). Self-report measures of stress. In Goldberger

Breznitz

(Eds.), Handbook of stress: Theoretical and clinical aspects (pp. 200–233). New York: Free Press.

21.

Dillman

D. A.

Phelps

Tortora

Swift

Kohrell

Berck

(2001). Response rate and measurement differences in mixed mode surveys using mail, telephone, interactive voice response and the Internet. Retrieved August 28, 2002, from http://survey.Sersc.wsu.edu/dillman/papers/Mixed%20Mode%20ppr%20_with%20Gallup_%20POQ.pdf.

22.

Dooley

(1995). Social research methods (3rd ed.). Upper Saddle River, NJ: Prentice Hall.

23.

Elman

B. D.

Dowd

E. T.

(1997). Correlates of burnout inpatient substance abuse therapists. Journal of Addictions and Offender Counseling, 17, 56–65.

24.

Field

(2000). Discovering statistics using SPSS for Windows. London: Sage.

25.

Flynn

H. A.

(1997). An investigation of the relationship between depression and coping using time series analysis [Abstract]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 57, 5324.

26.

Gilat

(2004). MATLAB: An introduction with applications (2nd ed.). New York: Wiley.

27.

Gilbert

Miles

J. N. V.

(2000). Sensitivity to social put-down: Its relationships to perceptions of social rank, social anxiety, depression, anger and self-other blame. Personality and Individual Differences, 29, 151–714.

28.

Gilroy

P. J.

Carroll

Murra

(2001). Does depression affect clinical practice? A survey of women psychotherapists. Women and Therapy, 23, 13–30.

29.

Gilroy

P. J.

Carroll

Murra

(2002). A preliminary survey of counselling psychologists' personal experiences with depression and treatment. Professional Psychology: Research and Practice, 33, 402–407.

30.

Goldberg

(1978). Manual of the General Health Questionnaire. London: nferNelson.

31.

Good

G. E.

Thoreson

R. W.

Shaughnessy

(1995). Substance use, confrontation of impaired colleagues, and psychological functioning among counseling psychologists: A national survey. The Counseling Psychologist, 23, 703–721.

32.

Haenninen

Aro

(1996). Sex differences in coping and depression among adults. Social Science and Medicine, 43, 1453–1460.

33.

Kerlinger

F. N.

Lee

H. B.

(2000). Foundations of behavioral research (4th ed.). Orlando, FL: Harcourt College.

34.

Koeske

G. F.

Kirk

S. A.

Koeske

R. D.

(1993). Coping with job stress: Which strategies work best? Journal of Occupational and Organizational Psychology, 66, 319–335.

35.

Kramen-Kahn

Hansen

N. D.

(1998). Rafting the rapids: Occupational hazards, rewards, and coping strategies of psychotherapists. Professional Psychology: Research and Practice, 29, 130–134.

36.

Lazarus

R. S.

(1999). Stress and emotion: A new synthesis. New York: Springer.

37.

Mahoney

M. J.

(1997). Psychotherapists' personal problems and self-care patterns. Professional Psychology: Research and Practice, 28, 14–16.

38.

Beach

Malone E. E.

Zarit

S. H.

(1995). Dimensions of social support and social conflict as predictors of caregiver depression. International Psychogeriatrics, 7, 25–38.

39.

Maslach

(1986). Stress, burnout, and workaholism. In Kilburg

R. R.

Nathan

P. E.

Thoreson

R. W.

(Eds.), Professionals in distress: Issues, syndromes, and solutions in psychology (pp. 53–75). Washington, DC: American Psychiatric Association.

40.

Moller

A. T.

Spangenberg

J. J.

(1996). Stress and coping amongst South African dentists in private practice. Journal of the Dental Association of South Africa, 51, 347–357.

41.

Mosley

T. H.

Perrin

S. G.

Neral

S. M.

Dubbert

P. M.

Grothules

C. A.

Ointo

B. M.

(1994). Stress, coping, and well-being among third-year medical students. Academic Medicine, 69, 765–767.

42.

Mostert

(2004, March 25–26). Occupational stress, coping and burnout in the South African Police Service. Paper presented at the 2nd South African Work Wellness Conference, Potchefstroom, South Africa.

43.

Murtagh

M. P.

Wollersheim

J. P.

(1997). Effects of clinical practice on psychologists: Treating depressed clients, perceived stress, and ways of coping. Professional Psychology: Research and Practice, 28, 361–364.

44.

Nemeroff

C. B.

(2002). Comorbidity of mood and anxiety disorders: The rule, not the exception? American Journal of Psychiatry, 159, 3–4.

45.

Novy

D. M.

Nelson

D. V.

Goodwin

Rowze

R. D.

(1993). Psychometric comparability of the State-Trait Anxiety Inventory for different ethnic subpopulations. Psychological Assessment, 5, 343–349.

46.

Nutt

(2004). Anxiety and depression: Individual entities or two sides of the same coin? International Journal of Psychiatry and Clinical Practice, 8(Suppl. 1), 19–24.

47.

O'Connor

M. F.

(2001). On the etiology and effective management of professional distress and impairment among psychologists. Professional Psychology: Research and Practice, 32, 345–350.

48.

Pope

K. S.

Tabachnick

B. G.

(1994). Therapists as patients: A national survey of psychologists' experiences, problems, and beliefs. Professional Psychology: Research and Practice, 25, 247–258.

49.

Radeke

J. T.

Mahoney

M. J.

(2000). Comparing the personal lives of psychotherapists and research psychologists. Professional Psychology: Research and Practice, 31, 82–84.

50.

Roux

G. B.

(1992). Stressore in die bediening en die effek daarvan op spesifieke persoonlikheidsaspekte van die predikant [Stressors in the ministry and the effect thereof on specific aspects of the personality of the minister]. Nederduitse Gereformeerde Teologiese Tydskrif, 33, 225–231.

51.

Rupert

P. A.

Baird

K. A.

(2004). Managed care and the independent practice of psychology. Professional Psychology: Research and Practice, 35, 185–193.

52.

Sadock

B. J.

Sadock

V. A.

(2003). Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences, clinical psychiatry (9th ed.). Philadelphia: Lippincott Williams & Wilkins.

53.

Schlebusch

(2004). The development of a Stress Symptom Checklist. South African Journal of Psychology, 34, 327–349.

54.

Schonlau

Fricker

R. D.

Elliott

M. N.

(2001). Conducting research surveys via e-mail and the web. Santa Monica, CA: RAND. Retrieved August 28, 2002, from http://www.rand.org/publications/MR/MR1480/MR1480.ch6.pdf.

55.

Schoup

(1995). Perspectives of therapist impairment in women psychologists [Abstract]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 56, 2885.

56.

Shaughnessy

J. J.

Zechmeister

E. B.

(1997). Research methods in psychology (2nd ed.). New York: McGraw-Hill.

57.

Sherman

M. D.

Thelen

M. H.

(1998). Distress and professional impairment among psychologists in clinical practice. Professional Psychology: Research and Practice, 29, 79–85.

58.

Skorupa

Agresti

A. A.

(1993). Ethical beliefs about burnout and continued professional practice. Professional Psychology: Research and Practice, 24, 281–285.

59.

Spangenberg

J. J.

Theron

J. C.

(1999). Stress and coping strategies in spouses of depressed patients. The Journal of Psychology, 133, 253–262.

60.

Spangenberg

J. J.

Theron

J. C.

(2001). Stress and coping in parents of children with Down Syndrome. Studia Psychologia, 43, 41–48.

61.

Spielberger

C. D.

Gorsuch

R. L.

Lushene

R. E.

Vagg

P. R.

Jacobs

G. A.

(1983). Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto, CA: Consulting Psychologists Press.

62.

Statistical Package for the Social Sciences (SPSS, 2001) for Windows (Release 11.0). Chicago, Ill: SPSS.

63.

Storm

Rothmann

(2003). The relationship between burnout, personality traits and coping strategies in a corporate pharmaceutical group. South African Journal of Industrial Psychology, 29, 35–42.

64.

Te veel depressielyers is nog nooit behandel. [Too many depression sufferers have never been treated] (2000, September 4). Die Burger, p. 6.

65.

Wamsley

L. M.

(1996). Stress, stress related depression, and burnout: Their effects on nurses and holistic patient care [Abstract]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 56, 5412.

66.

Warner

Carter

J. D.

(1984). Loneliness, marital adjustment, and burnout in pastoral and lay persons. Journal of Psychology and Theology, 12, 125–131.

67.

Wheaton

(1996). The nature of chronic stress. In Gottlieb

B. H.

(Ed.), Coping with chronic stress (pp. 43–73). New York: Plenum Press.

68.

Wiese

Rothmann

Storm

(2003). Coping, stress and burnout in the South African police service in Kwazulu-Natal. South African Journal of Industrial Psychology, 29, 71–80.

69.

Zemirah

N. L.

(2000). Burnout and clinical psychology graduate students: A qualitative study of students' experiences and perceptions [Abstract]. Dissertation Abstracts International: Section B: The Sciences and Engineering, 60, 5237.