- LAST REVIEWED: 08 January 2021
- LAST MODIFIED: 26 May 2021
- DOI: 10.1093/obo/9780195389678-0136
- LAST REVIEWED: 08 January 2021
- LAST MODIFIED: 26 May 2021
- DOI: 10.1093/obo/9780195389678-0136
In recent years, various professions, such as social work, medicine, dentistry, pharmacy, nursing, law, and psychology, have paid increased attention to the problem of impaired practitioners. Impairment may involve failure to provide competent care or violation of a profession’s ethical standards. It may take such forms as providing flawed or inferior services to a client, sexual involvement with a client, or failure to carry out one’s duties as a result of addiction (substance abuse or gambling) or mental illness. Strategies for dealing with professionals whose work is affected by problems such as addiction, mental illness, and emotional stress have become more prevalent and visible. Professional associations and groups of practitioners have convened to examine impairment among colleagues and to organize efforts to address the problem. However, the social work literature contains relatively little discussion of impaired professionals. One can only speculate about why social work generally has paid less attention than have other professions to the problem of impaired practitioners. It is difficult to know whether the magnitude of the problem is smaller in social work than in other professions (and hence attracts less attention), whether there is greater denial of impairment in social work than in other professions, whether social workers have a higher threshold of tolerance for impairment in general (because of its prevalence among clients), or whether social workers simply write and publish less than do members of other professions. One of social work’s admirable hallmarks is its earnest focus on people’s strengths, as opposed to deficits. This, too, may contribute to social workers’ limited research on impaired practitioners. Further, social workers, compared with other groups of professionals, may be less confident about their status as professionals and are reluctant to draw attention to the profession’s limitations and weaknesses. Social workers who are interested in the subject of impairment must consult literature from other human service professions.
Nature and Extent of Professional Impairment
Scholars in a number of helping professions have investigated the nature and extent of impairment among practitioners. Several seminal discussions explore typical manifestations of impairment, common causes, and constructive responses. Deutsch 1985; Guy, et al. 1989; and Kilburg, et al. 1986 are among the earliest in-depth explorations of the various forms of impairment in the helping professions. Other publications focus on narrower topics related to impaired professionals. For example, Bryson 2012 discusses the nature of substance abuse among practitioners, and Mahoney 1997 explores the impact of personal distress on practitioners’ lives. Rosen, et al. 2009; Smith and Moss 2009; Williams, et al. 2010; and discuss impairment among psychiatrists and psychologists. Reamer 2021 explores the ways in which moral distress and moral injury among social workers may lead to impairment.
Bryson, Ethan. 2012. Addicted healers: 5 key signs your healthcare professional may be drug impaired. Far Hills, NJ: New Horizons Press.
Provides an in-depth discussion of the prevalence of drug impairment among health-care professionals, the causes of such addiction, ways that clients and patients can protect themselves, and sources of help for addicted health-care practitioners.
Deutsch, Connie. 1985. A survey of therapists’ personal problems and treatment. Professional Psychology: Research and Practice 16.2: 305–315.
One of the earliest discussions of the range of personal challenges encountered by psychotherapists and their experiences in treatment. This article reports on therapists’ reports of difficulties they have faced in their own lives and the benefits and limitations of their efforts to get help.
Guy, James, Paul Poelstra, and Miriam Stark. 1989. Personal distress and therapeutic effectiveness: National survey of psychologists practicing psychotherapy. Professional Psychology: Research and Practice 20.1: 48–50.
One of the earliest and most comprehensive surveys of psychologists’ personal impairment and their experiences in treatment. The authors summarize data from a large sample on the nature of psychologists’ impairment, their efforts to obtain help, and the benefits and limitations of available treatment options.
Kilburg, Richard, Peter Nathan, and Richard Thoreson, eds. 1986. Professionals in distress: Issues, syndromes, and solutions in psychology. Washington, DC: American Psychological Association.
This anthology is one of the earliest and most influential publications on impaired professionals. The authors explore the nature of impairment, causes, consequences, and treatment options.
Mahoney, Michael. 1997. Psychotherapists’ personal problems and self-care patterns. Professional Psychology: Research and Practice 28.1: 14–16.
Provides an overview of the range of personal challenges faced by psychotherapists and their efforts to address their impairment. Mahoney offers a brief summary of clinicians’ efforts to address personal problems that can affect their professional work.
Reamer, Frederic. 2021. Moral distress and injury in human services: Cases, causes, and strategies for prevention. Washington, DC: NASW Press.
This book includes an in-depth discussion of the ways in which moral distress and injury experienced by human service professionals may lead to impairment. The author includes case examples and prevention protocols and strategies.
Rosen, Alan, Andrew Wilson, Patte Randal, et al. 2009. Psychiatrically impaired medical practitioners: Better care to reduce harm and life impact, with special reference to impaired psychiatrists. Australasian Psychiatry 17.1: 11–18.
Reviews treatment outcomes for impaired practitioners and explores issues related to prevention, early intervention, and access to treatment. The authors offer recommendations to enhance prevention and treatment.
Smith, Penni, and Shannon Moss. 2009. Psychologist impairment: What is it, how can it be prevented, and what can be done to address it? Clinical Psychology: Science and Practice 16.1: 1–15.
This review of the psychologist impairment literature includes information about rates of impairment, collegial assistance efforts, barriers to treatment, and prevention strategies. The authors discuss the importance of professional education to prevent impairment.
Thoreson, Richard, Marinell Miller, and Charles Krauskopf. 1989. The distressed psychologist: Prevalence and treatment considerations. Professional Psychology: Research and Practice 20.3: 153–158.
One of the earliest and most influential discussions of the extent and nature of impairment among psychologists. The authors describe patterns of impairment and focus especially on treatment options.
Williams, Bailey, Andrew Pomerantz, Daniel Segrist, and Jonathan Pettibone. 2010. How impaired is too impaired? Ratings of psychologist impairment by psychologists in independent practice. Ethics and Behavior 20.2: 149–160.
Summarizes the opinions of psychologists in independent clinical practice concerning the point at which collegial impairment requires action. Respondents reviewed vignettes related to practitioner depression and substance abuse. The authors highlight practical and ethical implications.
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- Adolescent Depression
- Adolescent Pregnancy
- Adoption Home Study Assessments
- Adult Protective Services in the United States
- African Americans
- Aging out of foster care
- Aging, Physical Health and
- Alcohol and Drug Abuse Problems
- Alcohol and Drug Problems, Prevention of Adolescent and Yo...
- Alcohol Problems: Practice Interventions
- Alcohol Use Disorder
- Alzheimer's Disease and Other Dementias
- Anti-Oppressive Practice
- Asian Americans
- Asian-American Youth
- Autism Spectrum Disorders
- Baccalaureate Social Workers
- Behavioral Health
- Behavioral Social Work Practice
- Bereavement Practice
- Brief Therapies in Social Work: Task-Centered Model and So...
- Bullying and Social Work Intervention
- Canadian Social Welfare, History of
- Case Management in Mental Health in the United States
- Central American Migration to the United States
- Child Maltreatment Prevention
- Child Neglect and Emotional Maltreatment
- Child Poverty
- Child Sexual Abuse
- Child Welfare
- Child Welfare and Child Protection in Europe, History of
- Child Welfare Practice with LGBTQ Youth and Families
- Children of Incarcerated Parents
- Christianity and Social Work
- Chronic Illness
- Clinical Social Work Practice with Adult Lesbians
- Clinical Social Work Practice with Males
- Cognitive Behavior Therapies with Diverse and Stressed Pop...
- Cognitive Processing Therapy
- Cognitive-Behavioral Therapy
- Community Development
- Community Policing
- Community-Based Participatory Research
- Community-Needs Assessment
- Comparative Social Work
- Computational Social Welfare: Applying Data Science in Soc...
- Conflict Resolution
- Council on Social Work Education
- Counseling Female Offenders
- Criminal Justice
- Crisis Interventions
- Cultural Competence and Ethnic Sensitive Practice
- Culture, Ethnicity, Substance Use, and Substance Use Disor...
- Dementia Care
- Dementia Care, Ethical Aspects of
- Depression and Cancer
- Development and Infancy (Birth to Age Three)
- Differential Response in Child Welfare
- Digital Storytelling for Social Work Interventions
- Direct Practice in Social Work
- Disability and Disability Culture
- Domestic Violence Among Immigrants
- Early Pregnancy and Parenthood Among Child Welfare–Involve...
- Eating Disorders
- Ecological Framework
- Economic Evaluation
- Elder Mistreatment
- End-of-Life Decisions
- Epigenetics for Social Workers
- Ethical Issues in Social Work and Technology
- Ethics and Values in Social Work
- European Institutions and Social Work
- European Union, Justice and Home Affairs in the
- Evidence-based Social Work Practice
- Evidence-based Social Work Practice: Finding Evidence
- Evidence-based Social Work Practice: Issues, Controversies...
- Experimental and Quasi-Experimental Designs
- Families with Gay, Lesbian, or Bisexual Parents
- Family Caregiving
- Family Group Conferencing
- Family Policy
- Family Services
- Family Therapy
- Family Violence
- Fathering Among Families Served By Child Welfare
- Fetal Alcohol Spectrum Disorders
- Field Education
- Financial Literacy and Social Work
- Financing Health-Care Delivery in the United States
- Forensic Social Work
- Foster Care
- Foster care and siblings
- Gay Men
- Gender, Violence, and Trauma in Immigration Detention in t...
- Generalist Practice and Advanced Generalist Practice
- Group Work
- Group Work across Populations, Challenges, and Settings
- Group Work, Research, Best Practices, and Evidence-based
- Harm Reduction
- Health Care Reform
- Health Disparities
- Health Social Work
- History of Social Work and Social Welfare, 1900–1950
- History of Social Work and Social Welfare, 1950-1980
- History of Social Work and Social Welfare, pre-1900
- History of Social Work from 1980-2014
- History of Social Work in China
- History of Social Work in Northern Ireland
- History of Social Work in the Republic of Ireland
- History of Social Work in the United Kingdom
- HIV/AIDS Prevention with Adolescents
- Homelessness Outside the United States
- Human Needs
- Human Trafficking, Victims of
- Immigrant Integration in the United States
- Immigrant Policy in the United States
- Immigrants and Refugees
- Immigrants and Refugees: Evidence-based Social Work Practi...
- Immigration and Health Disparities
- Immigration and Intimate Partner Violence
- Immigration and Poverty
- Immigration and Spirituality
- Immigration and Substance Use
- Impact of Emerging Technology in Social Work Practice
- Impaired Professionals
- Implementation Science and Practice
- Indigenous Peoples
- Individual Placement and Support (IPS) Supported Employmen...
- In-home Child Welfare Services
- Intergenerational Transmission of Maltreatment
- International Social Welfare
- International Social Work
- International Social Work and Education
- International Social Work and Social Welfare in Southern A...
- Internet and Video Game Addiction
- Interpersonal Psychotherapy
- Intervention with Traumatized Populations
- Intimate-Partner Violence
- Juvenile Justice
- Kinship Care
- Korean Americans
- Latinos and Latinas
- Law, Social Work and the
- LGBTQ Populations and Social Work
- Life Span
- Mainland European Social Work, History of
- Major Depressive Disorder
- Management and Administration in Social Work
- Maternal Mental Health
- Measurement, Scales, and Indices
- Medical Illness
- Men: Health and Mental Health Care
- Mental Health
- Mental Health Diagnosis and the Addictive Substance Disord...
- Mental Health Needs of Older People, Assessing the
- Mental Illness: Children
- Mental Illness: Elders
- Middle East and North Africa, International Social Work an...
- Military Social Work
- Mixed Methods Research
- Moral distress and injury in social work
- Motivational Interviewing
- Native Americans
- Native Hawaiians and Pacific Islanders
- Neighborhood Social Cohesion
- Neuroscience and Social Work
- Nicotine Dependence
- Occupational Social Work
- Organizational Development and Change
- Pain Management
- Palliative Care
- Palliative Care: Evolution and Scope of Practice
- Pandemics and Social Work
- Parent Training
- Philosophy of Science and Social Work
- Physical Disabilities
- Podcasts and Social Work
- Police Social Work
- Political Social Work in the United States
- Positive Youth Development
- Postmodernism and Social Work
- Post-Traumatic Stress Disorder (PTSD)
- Practice Interventions and Aging
- Practice Interventions with Adolescents
- Practice Research
- Primary Prevention in the 21st Century
- Productive Engagement of Older Adults
- Profession, Social Work
- Promoting Smart Decarceration as a Grand Challenge
- Psychiatric Rehabilitation
- Psychoanalysis and Psychodynamic Theory
- Psychopathology and Social Work Practice
- Psychopharmacology and Social Work Practice
- Psychosocial Framework
- Psychosocial Intervention with Women
- Psychotherapy and Social Work
- Qualitative Research
- Race and Racism
- Readmission Policies in Europe
- Redefining Police Interactions with People Experiencing Me...
- Religiously Affiliated Agencies
- Reproductive Health
- Research Ethics
- Restorative Justice
- Risk Assessment in Child Protection Services
- Risk Management in Social Work
- Rural Social Work in China
- Rural Social Work Practice
- School Social Work
- School Violence
- School-Based Delinquency Prevention
- Services and Programs for Pregnant and Parenting Youth
- Severe and Persistent Mental Illness: Adults
- Sexual and Gender Minority Immigrants, Refugees, and Asylu...
- Sexual Assault
- Single-System Research Designs
- Social Development
- Social Insurance and Social Justice
- Social Intervention Research
- Social Justice and Social Work
- Social Movements
- Social Planning
- Social Policy
- Social Policy in Denmark
- Social Security in the United States (OASDHI)
- Social Work and Islam
- Social Work and Social Welfare in East, West, and Central ...
- Social Work and Social Welfare in Europe
- Social Work Education and Research
- Social Work Leadership
- Social Work Luminaries: Luminaries Contributing to the Cla...
- Social Work Luminaries: Luminaries contributing to the fou...
- Social Work Luminaries: Luminaries Who Contributed to Soci...
- Social Work Regulation
- Social Work Research Methods
- Social Work with Interpreters
- Solution-Focused Therapy
- Strategic Planning
- Strengths Perspective
- Strengths-Based Models in Social Work
- Supplemental Security Income
- Survey Research
- Sustainability: Creating Social Responses to a Changing En...
- Syrian Refugees in Turkey
- Systematic Review Methods
- Task-Centered Practice
- Technology Adoption in Social Work Education
- Technology for Social Work Interventions
- Technology, Human Relationships, and Human Interaction
- Technology in Social Work
- Terminal Illness
- The Impact of Systemic Racism on Latinxs’ Experiences with...
- Transdisciplinary Science
- Translational Science and Social Work
- Transnational Perspectives in Social Work
- Transtheoretical Model of Change
- Tribal child welfare practice in the United States
- United States, History of Social Welfare in the
- Universal Basic Income
- Veteran Services
- Vicarious Trauma Redefining PTSD
- Victim Services
- Virtual Reality and Social Work
- Welfare State Reform in France
- Welfare State Theory
- Women and Macro Social Work Practice
- Women's Health Care
- Work and Family in the German Welfare State
- Workforce Development of Social Workers Pre- and Post-Empl...
- Working with Non-Voluntary and Mandated Clients
- Young and Adolescent Lesbians
- Youth at Risk
- Youth Services