While we know a lot about how patients’ well-being and emotional experiences affect psychotherapy processes and outcomes, much less is known about these effects on therapists. Some research suggests that therapists with poorer life satisfaction have greater difficulty establishing a therapeutic alliance. Other studies suggest that therapists who take better care of themselves provide better treatments. Therapists are susceptible to burnout and the negative effects of countertransference (feelings and reactions in the therapist triggered in part by their own unresolved issues) on themselves and their patients. Some factors, such as reflective capacities (mentalizing) may buffer therapists from these challenges. In this study, Rzeskutek and colleagues asked 296 therapists to fill out questionnaires about one of their patients after each of 10 therapy sessions. Therapists reported on their subjective well-being (satisfaction with life and positive/negative emotions), their responsiveness to patients (how attuned they were to the client during a session), and the quality of the session (how deep, smooth, and positive it was). Therapists also reported their demographics, experience, and personal therapy history. Therapists were on average 43.23 years old (SD = 8.40) with about 8.01 years of experience (SD = 7.67), 83% were women, and worked from a variety of therapeutic orientations. The authors found that therapists’ satisfaction with life was related positively to their helpfulness and responsiveness, as well as to the smoothness and positivity of sessions. Therapists’ positive affect enhanced their responsiveness to patients and the smoothness and depth of sessions. On the other hand, therapists’ negative affect hindered the smoothness and positivity of sessions. Older, more experienced therapists who had personal therapy reported being more self-accepting and helpful, and their sessions were more positive and deeper.
Practice Implications
The results of this study suggest that research and training should place greater emphasis on therapists' psychological well-being. This is important not only for therapists’ mental health but also for the quality of therapy they provide. Ongoing supervision that focuses on countertransference and the therapist’s subjective well-being can mitigate the challenges therapists face. In addition, personal therapy may help therapists manage their own unresolved issues, improve their reflective capacity, and place more emphasis on their personal lives and subjective well-being. This may be particularly important for younger, less experienced therapists, who may be more susceptible to the professional and personal uncertainties and challenges of clinical practice.
Rzeszutek, M., Lowicki, P., Szymon, S., Grabowska, M., Baginski, M… & Fijewski, P. (2026). The role of subjective well-being in therapist responsiveness and session evaluation: A 10-wave longitudinal study. Clinical Psychology & Psychotherapy, 33, e70269. https://doi.org/10.1002/cpp.70269.
The director of the Psychotherapy Practice Research Network (PPRNet) is Dr. Giorgio Tasca. Dr. Tasca is an Associate Professor with the School of Psychology, in the Faculty of Social Sciences at the University of Ottawa. His research is centered around psychotherapy process, mechanisms of change, and outcomes, as well as eating disorders.
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PPRNet Clinical summary: Therapists' Subjective Well-Being Affects their Responsiveness to Patients
While we know a lot about how patients’ well-being and emotional experiences affect psychotherapy processes and outcomes, much less is known about these effects on therapists. Some research suggests that therapists with poorer life satisfaction have greater difficulty establishing a therapeutic alliance. Other studies suggest that therapists who take better care of themselves provide better treatments. Therapists are susceptible to burnout and the negative effects of countertransference (feelings and reactions in the therapist triggered in part by their own unresolved issues) on themselves and their patients. Some factors, such as reflective capacities (mentalizing) may buffer therapists from these challenges. In this study, Rzeskutek and colleagues asked 296 therapists to fill out questionnaires about one of their patients after each of 10 therapy sessions. Therapists reported on their subjective well-being (satisfaction with life and positive/negative emotions), their responsiveness to patients (how attuned they were to the client during a session), and the quality of the session (how deep, smooth, and positive it was). Therapists also reported their demographics, experience, and personal therapy history. Therapists were on average 43.23 years old (SD = 8.40) with about 8.01 years of experience (SD = 7.67), 83% were women, and worked from a variety of therapeutic orientations. The authors found that therapists’ satisfaction with life was related positively to their helpfulness and responsiveness, as well as to the smoothness and positivity of sessions. Therapists’ positive affect enhanced their responsiveness to patients and the smoothness and depth of sessions. On the other hand, therapists’ negative affect hindered the smoothness and positivity of sessions. Older, more experienced therapists who had personal therapy reported being more self-accepting and helpful, and their sessions were more positive and deeper.
Practice ImplicationsThe results of this study suggest that research and training should place greater emphasis on therapists' psychological well-being. This is important not only for therapists’ mental health but also for the quality of therapy they provide. Ongoing supervision that focuses on countertransference and the therapist’s subjective well-being can mitigate the challenges therapists face. In addition, personal therapy may help therapists manage their own unresolved issues, improve their reflective capacity, and place more emphasis on their personal lives and subjective well-being. This may be particularly important for younger, less experienced therapists, who may be more susceptible to the professional and personal uncertainties and challenges of clinical practice.
By Dr. Giorgio Tasca
The director of the Psychotherapy Practice Research Network (PPRNet) is Dr. Giorgio Tasca. Dr. Tasca is an Associate Professor with the School of Psychology, in the Faculty of Social Sciences at the University of Ottawa. His research is centered around psychotherapy process, mechanisms of change, and outcomes, as well as eating disorders.Also Read