Denise Broholm Briggs
Degree of: Doctor of Philosophy
Department: Counselor Education and Counseling Psychology
Title: Therapist Stress, Career Sustaining Behavior, Coping and the Working Alliance
Committee: Dr. Patrick Munley, Chair
Dr. Alan Hovestadt
Dr. Ariel Anderson
Date: Monday, April 18, 2005 10:00 a.m. – 12:00 p.m.
Abstract: Psychotherapists face many challenges in their work and are prone to experiencing stress. Their ability to cope and manage their stress may have the potential to affect their work with clients. The purpose of this study was to examine the relationship between therapist stress, coping styles, career sustaining behaviors and therapist perceived working alliance. A sample of 160 psychologists, social workers, therapists and counselors primarily from the Midwest participated in this study. Participants completed a demographic questionnaire, which included a rating of the stress they experienced in their work as a psychotherapist, the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983), the Career Sustaining Behaviors Questionnaire (Kramen-Kahn, 1995), and the COPE (Carver, Scheier, & Weintraub, 1989). Participants also rated their working alliance with a single client they were currently seeing for individual therapy; a client with whom they experienced some stress. Participants completed an anonymous demographic questionnaire regarding the client, rated the stress they experienced in their work with their client and completed the Working Alliance Inventory (Horvath and Greenberg, 1989).
Pearson r correlations and hierarchical multiple regression analysis were used to investigate the relationships between the demographic variables, the three therapist stress variables, career sustaining behavior, approaches to coping and therapist perceived working alliance. Therapist working alliance scores demonstrated small magnitude negative correlations with each of the three therapist stress variables and showed small magnitude positive correlations with career sustaining behavior scores and active coping. In the multiple regression analysis, after controlling for therapist age, gender, years of experience, and number of clients seen each week, the therapist stress variables accounted for significant unique variance in working alliance. Higher levels of therapist stress were associated with lower working alliance scores. After controlling for demographic variables and the therapist stress variables, career sustaining behavior accounted for significant unique variance in working alliance. Career sustaining behaviors were associated with more positive working alliances. After controlling for demographic variables and the therapist stress variables, coping approaches accounted for significant unique variance in working alliance with active coping emerging a significant predictor. When Career Sustaining Behavior and COPE scores were entered together in the regression model after controlling for demographic variables and therapist stress, these variables together also accounted for significant unique variance in working alliance. In this model, career sustaining behavior scores and avoidant coping emerged as significant unique predictors. The current findings suggest that therapist stress, therapist approaches to coping with stress and the use of career sustaining behaviors may influence the working alliance in psychotherapy. This research suggests that the use of career sustaining behaviors and therapists' approaches to coping may be important variables that relate to the establishment of more positive working alliances with clients, even when clients are experienced as stressful. Findings and implications are discussed and recommendations are made for future research.
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