What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic

Matthias Zerban*, Lara Marie Christine Puhlmann, Dana Lassri, Peter Fonagy, P. Read Montague, Natalia Kiselnikova, Nicolas Lorenzini, Alex Desatnik, Raffael Kalisch, Tobias Nolte

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic.

METHOD: We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample ( N  = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SR G) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SR S) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners.

RESULTS: Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SR G: 18/18 RFs, absolute βs = 0.16-0.40; SR S: 15/18 RFs, absolute βs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression.

DISCUSSION: Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.

Original languageAmerican English
Article number1272199
Pages (from-to)1272199
JournalFrontiers in Psychology
StatePublished - 2023

Bibliographical note

Publisher Copyright:
Copyright © 2023 Zerban, Puhlmann, Lassri, Fonagy, Montague, Kiselnikova, Lorenzini, Desatnik, Kalisch and Nolte.


  • adversity
  • compassion satisfaction
  • mental health practitioners
  • mental health professionals
  • mentalizing
  • positive reappraisal
  • self-compassion
  • stress


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