What Do Therapist Defense Mechanisms Have to Do With Their Experience of Professional Self-Doubt and Vicarious Trauma During the COVID-19 Pandemic?

Abstract

This is the first study to examine psychotherapists' levels of defense mechanisms, their concurrent relationship with professional work-related stress (professional self-doubt and vicarious trauma), and how their levels of defense mechanisms predict the changes in these professional stresses over the course of 3 months since the start of the COVID-19 pandemic. Data from two online studies (Study 1; N = 105 and Study 2; N = 336), using two self-report measures of therapists' defense mechanisms (Defense Style Questionnaire-40 in Study 1 and Defense Mechanism Rating Scales Self-Report-30 in Study 2), are presented. Therapists reported higher levels of mature defense mechanisms, and lower levels of immature defense mechanisms, compared to published community and clinical populations assessed before and during the pandemic. Therapists' lower level of mature defense mechanisms and higher levels of neurotic and immature defense mechanisms were related to higher concurrent levels of vicarious trauma and professional doubt. Therapists who reported higher levels of mature defense mechanisms at 3-month follow-up showed less vicarious trauma and professional self-doubt at follow-up, after controlling for these professional stressors at baseline. Implications for clinical supervision and training are discussed. The context and professional challenges during the pandemic are unique and future replications of the results outside the pandemic context are warranted.

The complexity of teletherapy: Not better or worse, but different.

“…Indeed, recent empirical studies appear to confirm the multitude of teletherapy experiences; not better or worse per se, but different. Patient and therapist responses in international longitudinal surveys and in-depth interviews that we conducted (Aafjes-van Doorn, Aafjes-van Doorn, Békés, Luo, Prout, et al, 2021;Békés et al, 2021Békés et al, , 2022 suggest that the teletherapy process reflects a complex amalgamation of potentially helpful and unhelpful therapeutic experiences. Many therapists and patients reported difficulties with emotional connection, distractions, and privacy when they transitioned to teletherapy.…”

“…As Lin and Anderson pointed out, it is worth noting that, in spite of the documented successes of teletherapy many therapists continue to doubt its efficacy. Many still continue to report preference for, and greater competency in, in-person therapy (Aafjes-van Doorn, Békés, Luo, Prout, et al, 2021). This suggests that besides the “objective” measurements of efficacy and effectiveness of teletherapy outcomes, it might also be important to examine therapists’ and patients’ attitudes towards teletherapy technology.…”

Assessing patients' attitudes towards telepsychotherapy: The development of the unified theory of acceptance and use of technology‐patient version

“…Since the beginning of the COVID‐19 pandemic, several studies have reported on the therapists' attitudes towards telepsychotherapy (Aafjes‐van Doorn et al, 2020, 2021; Békés et al, 2021; Cataldo et al, 2021) and found that most psychotherapists identified a somewhat positive attitude towards telepsychotherapy, suggesting they were likely to use telepsychotherapy in the future (Békés & Aafjes‐van Doorn, 2020). However, compared to the many studies that report on therapists' perspectives, patients' attitudes towards telepsychotherapy have received relatively little attention.…”

The Relationship of Mental Health and Resilience with Posttraumatic Growth through the Mediating of Defensive Styles in the COVID-19 Survivors

“…The developed defensive style is an adaptive, normal, and efficient coping strategy. The immature and neurotic defensive styles include maladaptive and inefficient coping strategies [17,18].…”