Doctors as patients: how psychological therapists experience the opposing ideologies

Research suggests that doctors experience higher levels of stress and mental health problems than the general population. Doctors frequently experience difficulty seeking help, and also challenges during psychological treatment, due to role reversal and competing ideologies. Focusing specifically on the under-researched area of doctors as patients in a psychological context, this paper explores the processes underlying role transition as well as the therapeutic relationship that follows. Furthermore, therapeutic reactions and adaptions of practice to this dynamic is also explored. A qualitative approach was employed and seven psychological therapists who had worked extensively with doctors as their patients were interviewed. Subsequent interview data were thematically analyzed. Six themes were generated: fear and pressure; status and control; variation of ideologies; change in practice; temporal changes; and help seeking and support. The main barrier to recovery for doctors is difficulty in accessing services owing to the high-levels of stigma and shame that may be experienced. This research identifies some of the adaptions made by psychological therapists within their practice when working with doctors as patients. This is an Accepted Manuscript of an article which will be published by Taylor & Francis in the European Journal of Psychotherapy and Counselling. It will be available online: https://www.tandfonline.com/loi/rejp20