GARY R. SCHOENER
In this chapter I will review the concept of professional impairment in the psychotherapy professions. It is a concept that has undergone some changes and reformulation over the past two decades. Although at one time it was synonymous with substance abuse or alcoholism, today it connotes a wide range of personal problems. As such, the treatment of professionals in the psychotherapy fields who are experiencing some impairment in their ability to perform their duties may take many forms. I will examine a variety of approaches to treatment of the impaired professional and also discuss a number of challenges when one is seeking to help a wounded healer.
In the 1980s the field of psychology became concerned with the distressed practitioner (Kilburg, Nathan, & Thoreson, 1986; Thoreson, Miller, & Krauskopt, 1989) as well as the impact of stress on clinicians (Guy, Poelstra, & Stark, 1989). In other health care fields, such as medicine and nursing, the focus had traditionally been on practitioners who were alcoholic or substance addicted, and impairment was often synonymous with addictions. Impaired practitioner programs and colleague assistance committees in these professions focused on addictive disorders (Schwebel, Skorina, & Schoener, 1991). A substantial literature evolved concerning treatment approaches geared for health care professionals (e.g., Bissell & Haberman, 1984; Crosby & Bissell, 1989).