Exploring psychologists’ attachment style, compassion fatigue and satisfaction, and use of self-care within forensic settings

Abstract

Background: Attachment styles involve perceptions of the self and others and influence how individuals relate to other people. Insecure attachment styles have been strongly associated with the life experiences, criminal behaviour and mental health presentations common to patients in forensic settings. Therefore, challenging interactions associated with patients’ insecure attachment styles and contact with traumatising material are considered common for psychologists working within these settings. However, previous research has also indicated that a significant number of psychologists may also have insecure attachment styles. Forensic settings have been associated with stress and burnout amongst health care professionals. However, no previous research has explored how psychologists’ attachment styles may impact their levels of compassion fatigue and compassion satisfaction or influence their self-care in this setting. Aims: This is an exploratory study which addresses a gap in the literature. It aims to explore the attachment styles and prevalence of compassion fatigue (burnout and secondary traumatic stress) and compassion satisfaction amongst psychologists in forensic settings. It will also qualitatively explore how psychologists manage negative feelings that arise in relation to their work and their use of self-care strategies in a range of situations. Finally, it will explore differences in the self-care strategies used by psychologists with different attachment styles. Methodology: An online survey was used to gather data from 66 psychologists currently working in forensic settings in the United Kingdom. Quantitative measures of attachment style, compassion satisfaction and compassion fatigue were combined with qualitative questions regarding psychologists’ self-care strategies. This provided data which was analysed using a mixed methodology, including correlational statistical analysis and qualitative content analysis. Attachment style groups were identified from the quantitative data and qualitative content analysis was applied to explore group similarities and differences in psychologists’ self-care strategies. Results: The results indicated that participating psychologists had a range of attachment styles. Compassion fatigue was not found to be as prevalent as suggested by previous research. Positive correlations were found between attachment related anxiety and burnout, and attachment related avoidance and burnout. Compassion satisfaction was found to be common within the present sample. A negative correlation was found between attachment related avoidance and compassion satisfaction. Similarities and differences in psychologists’ self-care were highlighted between different attachment style groups. Implications: A potential vulnerability was identified for psychologists with insecure attachment styles, in relation to burnout and reduced compassion satisfaction. Furthermore, there appeared to be a lack of knowledge and understanding of attachment theory and how this applies to clinical work. Therefore, a key implication is the development of training for psychologists in relation to this topic. Use of multiple self-care strategies was common and self-care was perceived as important to clinical practice by the majority of the present sample. However, a training need for skills to be taught early in the psychologists’ career and a need for self-care to be more widely supported at an organisational level regardless of stage of career was identified. The study concludes with a review of methodological considerations and the limitations these may present to the current findings.