Should psychotherapists limit their clinical work with trauma survivors to avoid being traumatized themselves? Vicarious traumatization (VT)—the symptoms similar to posttraumatic stress disorder and the disruption in cognitive schemas reported in clinicians who are exposed to the trauma material of their clients—was assessed in a national survey of 1,000 women psychotherapists. Therapists with higher levels of exposure to sexual abuse material reported significantly more trauma symptoms but no significant disruption of cognitive schemas. Spiritual well-being, a key area thought to be damaged by VT, was found to be higher for those clinicians who saw more sexual abuse survivors.

Research on childhood family environments of mental health professionals suggests that therapists are often raised in dysfunctional families and experience significant psychological distress in adult life. This study examined the prevalence of childhood trauma, family dysfunction, and current psychological distress among female mental health professionals (N= 340) and compared it with the prevalence among women working in other professions (N = 2,623). Psychotherapists reported higher rates of physical abuse, sexual molestation, parental alcoholism, psychiatric hospitalization of a parent, death of a family member, and greater family dysfunction in their families of origin than did other professionals. As adults, psychotherapists experienced less anxiety, depression, dissociation, sleep disturbance, and impairment in interpersonal relationships than did women in professions other than mental health.

A nationwide anonymous survey of 749 psychologists practicing psychotherapy was conducted to assess the impact of therapists' personal distress on the quality of patient care provided. A usable return rate of 44% was obtained (N = 318). An SPSS-X multiple discriminant analyses equation was used for the data analysis. A total of 74.3% reported experiencing "personal distress" during the previous 3 years; of those, 36.7% indicated that it decreased the quality of patient care, and 4.6% admitted that it resulted in inadequate treatment. A variety of factors were found to be associated with the experience of personal distress encountered, its impact on treatment, and the treatment interventions used.In a recent American Psychologist article, Pope, Tabachnick, and Keith-Spiegel (1987) reported the surprising finding that 62.2% of the Division 29 (Psychotherapy) psychologists surveyed admitted to "working when too distressed to be effective" at frequencies varying from "rarely" to "very often," even though 85.1% of these same individuals believed that it was unethical to do so. Such findings suggest that some clinical service may be provided by therapists who are themselves experiencing personal distress severe enough to raise questions about their competency and effectiveness.Unfortunately, relatively little is known about the impact of personal distress on the adequacy and quality of patient care JAMES D. GUY received his PhD from Fuller Graduate School of Psychology, Pasadena, California, in 1981. He is currently Associate Professor of Psychology at Rosemead School of Psychology, Biola University. He is a diplomate in clinical psychology of the American Board of Professional Psychology and maintains a private practice in Pasadena. His research focuses on the relation between the personal and professional lives of psychotherapists.

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The Waldrop anomaly score was used to assess the incidence of minor physical anomalies among 40 adult male Caucasian schizophrenics. This sample had a higher group mean anomaly score than that reported for the normal population (p less than .001). Those with higher anomaly scores evidenced poorer premorbid adjustment (p less than .05). A significant relationship also existed between anomaly scores and the subset of premorbid adjustment, Wechsler Adult Intelligence Scale Vocabulary scores, and the Neurological Impairment Index (p less than .05). These results suggest that first trimester developmental abnormalities, as reflected by the high incidence of anomalies, may parallel some form of central nervous system disturbance which may, in some cases, predispose toward the eventual development of schizophrenia. Implications of these findings, along with suggestions for further research, are considered.