Healing takes a ‘toll’ and how mental health providers cope matters
Florida Atlantic University
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With up to 85% of mental health providers facing compassion fatigue, the findings underscore the urgent need to reduce harmful coping and strengthen personal control to protect provider health, satisfaction and long-term effectiveness.
view moreCredit: Alec Dolce, Florida Atlantic University
Mental health providers are trained to guide others through trauma, yet their own exposure to clients’ suffering can take a significant toll. 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.
Researchers from 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.
Results, published in the Journal of Behavioral Health Services & Research, 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.
“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,” said David Simpson, Ph.D., senior author and an assistant professor in the Phyllis and Havery Sandler School of Social Work within FAU’s College of Social Work and Criminal Justice. “Additionally, 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.”
In summary, like many people, 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.”
Study co-authors are Marcheley Adam, Ph.D., an instructor in the Phyllis and Harvey Sandler School of Social Work; Morgan E. Cooley, Ph.D., an associate professor in the Phyllis and Harvey Sandler School of Social Work; Brittany Stahnke Joy, DSW, an assistant professor in the Department of Social Work, School of Clinical Sciences, East Tennessee State University; and Heather M. Thompson, Ph.D., a professor in the Phyllis and Harvey School of Social Work.
- FAU -
About Florida Atlantic University:
Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, Florida Atlantic serves more than 30,000 undergraduate and graduate students across six campuses located along the Southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, Florida Atlantic embodies an innovative model where traditional achievement gaps vanish. Florida Atlantic is designated as a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report, and holds the designation of “R1: Very High Research Spending and Doctorate Production” by the Carnegie Classification of Institutions of Higher Education. Florida Atlantic shares this status with less than 5% of the nearly 4,000 universities in the United States. For more information, visit www.fau.edu.
Journal
The Journal of Behavioral Health Services & Research
Method of Research
Survey
Subject of Research
People
Article Title
A Cross‑sectional Analysis Exploring Relationships Among Locus of Control, Coping, and Professional Quality of Life in Therapeutic Service Providers
CU Anschutz part of multi-state study: smartphone app cuts repeat suicide attempts by over half after hospital discharge
New research highlights how digital therapy can support mental health and prevent suicide in high-risk patients
AURORA, Colo. (August 19, 2025) – A nationwide study with researchers from the University of Colorado Anschutz Medical Campus, Yale School of Medicine and The Ohio State University, showed how a smartphone app reduced repeated suicide attempts by 58.3% among patients with a prior history of attempting suicide.
Each year, more than one million adults in the United States engage in nonfatal suicidal behavior and nearly 500,000 are hospitalized following a suicide attempt. These high-risk periods, especially just after discharge from inpatient psychiatric care, represent a critical window for intervention.
The study, published August 8th in JAMA Network Open, tested whether a smartphone-based digital therapy, grounded in proven talk therapy strategies, could reduce suicidal thoughts and behaviors after hospital discharge. The research followed 339 adult patients across six hospitals nationwide over several months.
“This study opens the door to a new generation of suicide prevention strategies that extend beyond the clinic or hospital room,” said study co-author Michael Allen, MD, professor of psychiatry at the CU Anschutz School of Medicine. “We are discovering that digital tools, when introduced at the right moment, can truly make a difference for people at high risk.”
Assistant Professor of Psychiatry Helena Winston, MD, and Professor of Psychiatry Scott Simpson, MD, MPH, of CU Anschutz also co-authored the study.
The app, called OTX-202, was developed by health tech company Oui Therapeutics.
It guided users through 12 short lessons focused on managing emotions, handling suicidal thoughts and building safety plans. Patients began using the app while still hospitalized and continued after discharge, alongside standard mental health care and follow-up.
To test its effectiveness, researchers compared OTX-202 with an active control app that also engaged patients but provided only general mental health support without the targeted therapeutic lessons.
Researchers said it significantly benefited those with a prior history of suicide attempts. In this group, users had fewer repeat suicide attempts, greater improvements in overall mental health and a sustained reduction in suicidal thoughts lasting up to 24 weeks after discharge. By contrast, patients using the control app showed early improvement but suicidal thoughts returned by week 24.
“This is a powerful example of how science can evolve to meet patients where they are,” said Neill Epperson, MD, professor and chair of the CU Anschutz Department of Psychiatry. “Digital tools like this won’t replace in-person care, but they can help fill in the gaps especially during those first few weeks after discharge when patients are most at risk. This is the future of mental health care, which is smarter, more accessible and tailored to the needs of each person.”
Researchers say the results offer hope for high-risk populations and mark an important step forward in personalized suicide prevention.
“Suicide remains one of the top 10 causes of death in the United States and rates have risen more than 30% since 1999,” said Allen. “For people with a history of suicide attempts, we urgently need new ways to offer support. Digital tools can help provide potentially life-saving help when it’s needed most.”
Allen noted that the current health system is not designed to support those with suicidal tendencies. People are often admitted to a hospital, feel better after a few days and sent home. Then suicidal thoughts return.
“This treatment is designed to be there during that critical transition after hospital discharge when immediate help may not be readily available,” he said.
Clinical sites included UCHealth University of Colorado Hospital in Aurora, Colo.; Ohio State University Wexner Medical Center in Columbus; Yale New Haven Hospital in Connecticut; the Menninger Clinic in Houston; Western Psychiatric Hospital in Pittsburgh; and Pine Rest Christian Mental Health Services in Grand Rapids.
About the University of Colorado Anschutz Medical Campus
The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado – which see more than two million adult and pediatric patient visits yearly. Innovative, interconnected and highly collaborative, the CU Anschutz Medical Campus delivers life-changing treatments, patient care and
professional training and conducts world-renowned research fueled by $910 million in annual research funding, including $757 million in sponsored awards and $153 million in philanthropic gifts.
Journal
JAMA Network Open
Method of Research
Randomized controlled/clinical trial
Subject of Research
People
Article Title
A Digital Therapeutic Intervention for Inpatients With Elevated Suicide Risk
Article Publication Date
18-Aug-2025
New research found that highly sensitive people are at higher risk of developing mental health problems
Press release
New research found that highly sensitive people are at higher risk of developing mental health problems
First ever systematic review and meta-analysis of its kind shows highly sensitive people are more likely to experience mental health problems
A new study from the University of Surrey and Queen Mary University of London, has found a correlation between high sensitivity and various mental-health conditions including depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), agoraphobia, social phobia and avoidant personality disorder.
People with high sensitivity tend to process sensory information more deeply, making them more easily overwhelmed and overstimulated, but also more prone to respond better to different psychological therapies compared to those who are less sensitive.
The research, a meta-analysis of 33 previous studies, which was published in Clinical Psychological Science, suggests that it’s key for mental health professionals to recognise this trait in their patients and customise their treatments in order to be more effective. Furthermore, the study suggests that future research should assess the efficacy of specific psychological therapies – e.g. cognitive restructuring, mindfulness, emotion-focused interventions - for patients with differing levels of sensitivity.
Professor Michael Pluess, Professor of Developmental Psychology at the University of Surrey and senior author of the study, said:
"This study provides compelling evidence that high sensitivity is a significant risk factor for a range of mental health issues.
“As highly sensitive individuals may be more vulnerable to certain conditions, they are also more likely to be more responsive to particular psychological therapies, which suggests that a one-size-fits-all approach to mental health care may be inappropriate.
“This isn't about pathologising sensitivity, it's about acknowledging its characteristics that require a more nuanced approach.”
Tom Falkenstein, Doctoral Researcher on Sensitivity and Mental Health at Queen Mary University of London , psychotherapist and lead author of the study said:
“Our findings suggest that sensitivity should be considered more in clinical practice, as it appears to represent a promising transdiagnostic risk factor.
“Given that about 31% of the general population can be considered highly sensitive, and that sensitive individuals seem to respond better to some psychological interventions than less sensitive individuals, sensitivity may be relevant not only for the etiology of psychological disorders but also for psychoeducation, treatment, and relapse prevention. ”
[ENDS]
Notes to editors
Professor Michael Pluess is available for interview, please contact mediarelations@surrey.ac.uk to arrange.
Tom Falkenstein is the author of the book "The Highly Sensitive Man"
The full paper is available at: https://journals.sagepub.com/doi/10.1177/21677026251348428
An image of Professor Pluess is available upon request.
Journal
Clinical Psychological Science
