What’s New in Psychology
Clinical Work Can Take a Toll on Your Well Being
Jim Windell
If you have spent any number of years – or decades, as I did – working in clinics, courts and group practices, you undoubtedly witnessed how psychologists and other mental health professionals coped with stress.
Some of my colleagues would stop on the way home from work at a liquor store to grab a bottle of vodka or scotch, some chain smoked, and some continued to work long, grueling hours while denying they needed a vacation. I knew a few professionals who seemed to adapt well to the rigors of clinical life, maintaining a sense of humor and avoiding deviant behavior.
But there was no question that being a mental health professional was mentally draining and took its tool on clinicians who had to try to deal with depressed clients, long days of back-to-back therapy sessions, and the fatigue of trying to cope with billing and insurance issues.
These are not just my observations. Studies show that between 40% and 85% of providers experience compassion fatigue or secondary traumatic stress – key signs of reduced professional quality of life. These stressors are often ongoing and layered, and when combined with limited coping tools and a sense that they have little control over their circumstances, the impact can be even greater.
In a recent article published in the Journal of Behavioral Health Services & Research, researchers at Florida Atlantic University examined how different coping styles affect the relationship between a provider’s sense of control over life events and their professional quality of life. The goal was to better understand how the ways providers cope may either support or strain their well-being in the demanding work of helping others heal.
Using surveys from 172 providers with advanced degrees, researchers identified four types of coping: adaptive, such as problem-solving and seeking support; avoidant, such as trying to escape or ignore stress; religious; and substance use. They then analyzed whether the providers’ chosen coping strategies explain or influence the connection between their “locus of control” and professional well-being.
Locus of control is about how much people believe they can control what happens in their lives. If someone has an internal locus of control, they believe their personal choices and actions shape their future. If they have an external locus of control, they believe outside forces – like luck, fate or other people – are largely responsible for what happens to them.
The study also explored differences across agency settings such as private practices, community clinics, and hospital-based programs. Participants came from diverse clinical backgrounds including social work, counseling and psychology.
The results of the study reveal a powerful insight: avoidant coping plays a key role in lowering the quality of life for providers and is consistently linked to poorer professional outcomes. While the study found some relationships between coping, locus of control, and well-being, it did not find strong evidence that the other coping strategies change how locus of control affects quality of life. The results suggest that avoidance itself, regardless of other factors, is a critical risk for providers’ professional health.
According to David Simpson, Ph.D., “Mental health providers play a vital role in helping others heal, but the emotional weight of their work can leave them drained, overwhelmed and burned out.” Simpson is senior author of the study and an assistant professor in the Phyllis and Harvey Sandler School of Social Work within Florida Atlantic University’s College of Social Work and Criminal Justice.
“Additionally,” Simpson said, “the findings underscore how critical it is to reduce harmful coping habits and strengthen a sense of personal control – both of which are key to protecting the well-being, job satisfaction and long-term effectiveness of mental health professionals. When providers feel more empowered, they may be more willing and able to confront stress directly.”
Surprisingly, findings showed that clinicians in private practice, despite having more control and freedom, reported higher levels of avoidant coping, a higher likelihood of believing that outside forces control their lives, and lower professional well-being than clinicians working in community settings.
“This finding is striking because private practice offers independence and growth opportunities but also comes with heavy burdens like managing a business and juggling client demands, which may lead mental health providers to neglect their own well-being,” said Simpson.
Other coping strategies – like adaptive, religious or substance use coping – did not show clear effects in the study and neither did field of practice (e.g., counseling vs. social work). However, the number of years in clinical practice was associated with lower levels of secondary traumatic stress, suggesting that more seasoned professionals may be better equipped to manage job-related stress.
“One of the most important takeaways from our study is the clear and consistent link between avoidant coping and lower professional quality of life,” said Simpson. “This finding mirrors what’s been found in other fields – for example, research with teachers has shown that relying on avoidance is associated with lower well-being.”
To sum up, In summary, mental health providers who actively face stress and develop healthy coping strategies are more likely to feel in control and satisfied in their work. Furthermore, early and ongoing training in adaptive coping strategies – and fostering a stronger internal sense of control – can improve both provider well-being and client outcomes. While avoidant coping may offer short-term relief for those who feel powerless, avoidance tends to undermine resilience – highlighting the need for more intentional, skillful approaches to managing stress in mental health care.
“Evidence-based practices like mindfulness and cognitive behavioral therapy have been shown to reduce burnout and compassion fatigue,” said Simpson. “Professional organizations can make a real difference by offering training, setting standards and encouraging programs that strengthen coping skills and personal agency throughout a provider’s career.”
To read the original article, find it with this reference:
Simpson, D., Adam, M., Cooley, M.E. et al. (2025). A Cross-sectional Analysis Exploring Relationships Among Locus of Control, Coping, and Professional Quality of Life in Therapeutic Service Providers. Journal of Behavioral Health Services & Research. https://doi.org/10.1007/s11414-025-09958-y
