Based on the prior literature reviewed above, the research question of our study was: How is the quality of life of psychotherapist trainees associated with their (1) current life situation; (2) personal characteristics; (3) family background; and (4) national and social origins?

This study reports on one aspect of a broader collaborative international longitudinal study of psychotherapy training that has been conducted by members of the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training (SPRISTAD; Orlinsky et al., 2019). From 2016 to the present, the SPRISTAD collaborative has collected information about psychotherapy training programs and trainees from different professions and theoretical orientations in many countries, in a conceptually organized exploratory and inductive study of the features of training programs, and the corresponding formative experiences, practices, and development of trainees. The study instruments focus mainly on trainees’ professional characteristics, activities, and development but also solicit information on aspects of their personal lives. Overall, the principal goals of the SPRISTAD study are: (1) identifying common and divergent features of psychotherapy training programs; (2) tracking progressive changes over time in trainees as therapists; (3) identifying factors that tend to facilitate or impede trainee development; (4) using quantitative and qualitative data gathered from a large number of psychotherapy trainees of varied types in a wide range of training programs.

Training centers and trainees collaborating in the study have been recruited through professional publications, workshops and conferences, professional societies and individual collegial networks. Training centers that participate in the SPRISTAD study have a local research coordinator who is a SPRISTAD member and must offer training programs of at least 12 months’ duration. Assessments with various instruments are made at the start of the trainee’s program, after 6 months, and after 12 months. Therapist trainees in the present study were informed about the study by their local research coordinators at the beginning of their training, and those who gave informed consent were provided online with the SPRISTAD questionnaires at the start of their training from the data collection center at Witten/Herdecke University in Germany; or, in the case of Finland, through the Finnish research coordinator; or, in the case of a subset of Italian participants, via a paper-and-pencil measure through the local research coordinator. The present study is based on data collected to date from countries that had at least 10 trainees who responded to the first SPRISTAD research measure.

The sample for this study comprises 1,214 psychotherapist trainees, whose demographic and professional characteristics are summarized in Table 1. Approximately three quarters of the total come from five European countries (Finland, Austria, Italy, Germany, and United Kingdom). About 85% are female. The average age of the group was 36 (M = 35.8, SD = 9.3) but the age range was substantial (19–71, with most between 27 and 45 years of age). About one in 10 identified with either a minority or immigrant status. Over four out of five trainees viewed themselves as training professionally in the field of psychotherapy, two-thirds at the initial level of professional training (0 to <2 years of practice) and one-third at an advanced level of training. All major therapy orientations were represented in the trainings.

Trainees’ current life status and family backgrounds are summarized in Table 2. About three fifths were in a committed adult relationship, with just over one-third married, another one-fourth living with their partner, and with the remainder as single, either unattached (17.7%) or in a relationship (17.9%). In terms of family background, 83.9% had siblings (mostly just one or two). Approximately a quarter of the trainees reported experiencing serious financial difficulty, but a majority had either no or only slight economic difficulties. A majority grew up in economically comfortable families, but over 1 in 7 experienced economic hardships in their childhood families.

Upon participating in the study, the local training centers addressed their respective research ethics committees and received ethical approval. All trainees were given written information about the study and signed an informed consent document.

Chi-square tests were used to determine the association between categorical variables. Non-parametric Pearson correlations (ρ) were calculated to determine the association between continuous measures for Personal Self and Adult Attachment and the Life Quality component variables (Life Satisfaction and Life Stress). This first exploratory investigation has assessed relationships with multiple independent variables, without an alpha-level adjustment, since detecting potential factors related to trainee life quality is the principal task, rather than hypothesis testing. Analyses were conducted using SPSS for Mac version 28.0.0.

With regard to the criterion variable, Table 3 shows that almost two-thirds of the trainees reported experiencing “great” or “very great” current life satisfaction, whereas just under one-fourth reported experiencing “great” or “very great” life stress. However, 50.3% of the trainees reported “some” or “moderate” stress in their lives, indicating that meaningful levels of stress were present for about three-fourths of them.

For most of the subsequent analyses, high and low levels of life satisfaction and stress were combined to define four distinct life quality patterns (Table 3). A majority (54.3%) of the trainees evidently had Fortunate/Happy lives [great or very great satisfaction with no more than moderate stress. By contrast, just over one-fifth (21.7%) of the trainees’ seemed to be leading rather Low-Key/Subdued lives (no great satisfaction, and no great stress]. The remaining one-fourth of the sample was divided between two smaller patterns: Currently the lives of about one in 11 (8.7%) of the trainees could be described as Intense/Impassioned (having both great satisfaction and great stress), while even more (14.3%) of the trainees appeared to be living a Distressed/Troubled life (experiencing great stress and no great satisfaction). The next step was to determine which if any personal and life characteristics are associated with the trainees’ varied quality of life.

Personal SelfThe upper tier of Table 7 shows a number of significant correlations between trainees’ Personal Self dimensions and the components measures of Life Quality. (1) There was a moderate positive correlation (ρ = 0.26) of Genial/Caring (self-bestowal) with Current Life Satisfaction, and a small but significant inverse correlation (ρ = −0.12) with Current Life Stress. Practical/Determined (self-efficacy) also had a small but significant positive correlation (ρ = 0.13) with Current Life Satisfaction. (2) By contrast, Reclusive/Remote (self-protection) was modestly but significantly correlated (ρ = 0.19) with Current Life Stress, and negatively correlated (ρ = −0.16) with Current Life Satisfaction. Forceful/Exacting (self-assertion) also had a small but significant positive correlation (ρ = 0.11) with Current Life Stress.

First, happily, it should be observed that more trainees than not experienced their lives as Fortunate/Happy, characterized by great or very great life satisfaction and less than great life stress. While little previous research exists on therapist trainees’ life satisfaction, the findings fit broadly with a recent study that included measures of life satisfaction and distress, investigating relatively experienced therapists (practice experience level M = 13 years), and finding 52% characterizable as well-adapted or high functioning (Laverdière et al., 2018). The most worrisome group in the present study, the 14.3% of trainees in the Distressed/Troubled group, also broadly fit with the 10% of experienced therapists in the cited study who were characterized by significant psychological distress. The educationally and clinically relevant concern is obviously how such distress may affect trainees’ learning outcomes (Bücker et al., 2018) or therapy practice, in case they currently provide therapy (Beaumont et al., 2016).

Notably, a much higher prevalence has recently been reported for professional burnout, in both experienced therapists (Westwood et al., 2017) and trainees (Kaeding et al., 2017): in fact, in approximately every other professional. Given the divergence in constructs and measures, it is difficult to evaluate whether some degree of burnout—originally operationalized as involving experiences of emotional exhaustion, depersonalization, and low personal accomplishment (Maslach and Jackson, 1981)—may have been experienced by the 14.3% of Distressed/Troubled trainees (i.e., currently experiencing little satisfaction and much stress), who seem the likeliest to suffer work-related distress. Similar questions might be asked about the 8.7% Intense/Impassioned trainees (i.e., experiencing both notable life satisfaction and life stress) or the 21.7% Low-key/Subdued trainees (i.e., experiencing both little satisfaction and little stress). How may the greater stress experienced by the Intense/Impassioned trainees may affect their capacity for learning or focusing on their clients’ matters; and likewise, how might the little satisfaction experienced by Low-key/Subdued trainees affect their capacity to convey optimism, confidence, and hope to their clients (Orlinsky, 2022)? Indeed, this last question gives reason for looking more closely at what were shown to be the correlates of trainees’ life satisfaction and stress.

First, gender differences were essentially non-existent for life satisfaction, in line with prior literature (Diener et al., 1999; Geerling and Diener, 2020). Previous research has also found life satisfaction to often follow a U-shaped curve with age, with happiness levels reaching a low sometime in the 40s (Diener et al., 2018). Our results supported that partially, in that older therapists were most often Fortunate/Happy; and perhaps mirroring also cross-cultural studies on personality development, indicating that people tend to become lower in neuroticism (or negative affectivity) as they age (McCrae et al., 1999, 2000).

In line with early meta-analyses (Haring-Hidore et al., 1985; Wood et al., 1989), the findings also showed married trainees to be happier, although some research suggests that as people adapt to marriage, long-term life satisfaction may be little different than before it (Luhmann et al., 2012). At any rate, however, the freedom of single or unattached trainees did not seem to add to their life quality but rather vice versa, in line with prior studies (Myers, 2000). Another finding in line with prior literature (Diener et al., 2018) was that trainees’ current economic circumstances were an unequivocal correlate of life satisfaction. Of the trainees experiencing moderately to very difficult finances, one of two were either Distressed/Troubled or Low-key/Subdued. These findings are important from a policy perspective, as they underline how societal factors such as availability of affordable student loans and employment situation contribute to life satisfaction and stress (Diener et al., 2018).

Aspects of personality, as expressed in close personal relationships, also correlated significantly, and in expectable ways, with trainee life quality. The strongest correlate was for Genial/Caring style (ρ = 0.26), which corresponded in size with the second-strongest Big 5 personality trait correlate of life satisfaction from meta-analyses, Extraversion (r = 0.28; Steel et al., 2008). Indeed, a Genial/Caring or self-bestowing self-experience may overlap (1) with Extraversion in terms of a generally friendly and open disposition toward others, and (2) with another Big 5 personality correlate of life satisfaction, i.e., Agreeableness (r = 0.14), a warm, kind, and cooperative disposition (Steel et al., 2008). The capacity for trusting relationships emerged as significant but somewhat less important correlates both life satisfaction and stress, as Life Satisfaction was associated negatively (ρ = −0.16) and Life Stress positively (ρ = 0.19) with being Reclusive/Remote or self-protective in close personal relationships. Greater Anxious attachment and Avoidant attachment were also linked to greater Life Stress (ρ = 0.25 and 0.13) and lower Life Satisfaction (ρ = −0.26 and − 0.18). Recalling that Secure attachment is the opposite of anxious and avoidant attachment, these correlations show how much a capacity for more Secure attachment (e.g., as reflected in marital status) may help individuals attain a positive quality of life.

While the findings above are in line with studies indicating the contribution of (perceived) social relationships and support for life satisfaction (Geerling and Diener, 2020), it should be noted that the mechanisms linking personality and life satisfaction are still not well understood (Diener et al., 2018). For instance, given that self-report measures are often used for assessing both constructs, as also in the present study, it is not clear whether more open, sociable, or trusting people are better able to form relationships and that increases their life satisfaction; or, whether certain people have an overall tendency to see their life, personality, and relationships in more positive terms (Steel et al., 2008; Diener et al., 2018). The observed associations in the present and prior studies nevertheless suggest that creating a trusting and positive group atmosphere in therapist training might benefit both trainees’ life satisfaction but also their learning outcomes (Clément et al., 1994; Bücker et al., 2018; Reschke et al., 2021).

It is important to recognize how current adult life quality may also be influenced by earlier life circumstances. In the present study, trainees’ poorer life quality was notably associated with poorer family economic background as well as poorer family psychological and emotional functioning. This fits well with large-scale longitudinal studies showing adverse childhood experiences—including both financial strain as well as psychological and emotional dysfunction—predict severely reduced life quality (Nurius et al., 2015; Mosley-Johnson et al., 2019). From an intervention perspective, the important question then is which resilience resources may counteract these risks—such as having a sense of community, social integration, and emotional and social support, which have been found to beneficially moderate the effects of early adverse experiences in adulthood (Nurius et al., 2015). Indeed, an obvious further resource which may offer these social and emotional benefits are supervisory support and personal therapy, an often though not always required feature of training programs. Given the remarkable prevalence of early adversities and trauma in therapists (Pope and Feldman-Summers, 1992; Feldman-Summers and Pope, 1994; Orlinsky, 2022), this part of training may well be valuable and is also frequently rated by therapists as being so (Orlinsky and Rønnestad, 2005).

Lastly, in terms of social, cultural, and national origins of life quality, we also found that trainees who recognize they would be viewed in their society as a minority person are less often Fortunate/Happy and more often experiencing great stress (although also life satisfaction), tending to have a more Intense/Impassioned life. This finding was also in line with prior literature, which has found both ethnic and sexual minorities to experience greater stress (Cochran et al., 2003; Ramirez and Paz Galupo, 2019). Apart from its general policy making implications on a societal level, therapist training programs would also do well to attend to their trainees’ minority experience, and thus promote inclusiveness in both training and conduct of therapy (Davis et al., 2018).

In the same domain, we saw life quality to be notably associated with nationality itself. The most striking observation was the exceptionally frequent distress of Italian trainees. Although the direction of the findings fits with prior findings in comparison to some of other Western European countries, such as Austria, Germany, and Finland (Abdallah et al., 2008; Park et al., 2009), the size of the effect was nevertheless surprisingly large. As within-nation changes in happiness are typically also relatively small (Veenhoven and Hagerty, 2006), this finding may be partly attributable to confounding factors, e.g., greater financial distress among Italian trainees, which need further clarification.

The study involved a few major strengths. First, a comprehensive self-report instrument enabled covering a multitude of plausible determinants of life quality. Second, the large, multinational sample allowed identifying relatively subtle associations which, even if small, shed light on the nuances of trainees’ quality of life. Third, assessing both life satisfaction and stress allowed for a more balanced picture of life quality than assessing either one alone.

The study also involved some limitations common to life satisfaction research. First, the generalizability of the findings is unknown, since the sample was mostly based on convenience samples, representing ongoing training programs during the study years only in a few mostly European countries (e.g., Austria, Finland, and Italy), and even in these countries, percentages and data of non-responders are not available. However, the associations between life satisfactions and its correlates reflected largely findings of prior literature, supporting the validity and reliability of the present findings. Second, both life satisfaction and life stress were assessed as unidimensional measures, which might result in different answers in different contexts. However, studies have shown that even single-item measures in this area have moderately high reliability and validity, in addition to being most feasible for use in large-scale studies (Diener et al., 2018). Third, the cross-sectional design cannot establish temporal precedence on whether life satisfaction is preceded by some factors (e.g., marriage status), or vice versa, or if a third underlying variable is responsible for both of them. On the other hand, many of the variables in the present study reflect “objective” trainee characteristics (e.g., nationality, minority status, age) that would not be influenced by subjective life quality or reflect past situations (e.g., childhood economic background) that would not be influenced by current life quality, even if the mechanisms that link them to life satisfaction call for closer study. Fourth, relatedly, measurement issues have been raised regarding the common practice of assessing life satisfaction and its determinants retrospectively and by the same person (Nivison et al., 2021). While daily experience-sampling and day-reconstruction procedures have been suggested for achieving a more refined picture of experienced life satisfaction, these solutions remain labor-intensive and not feasible to implement in all research contexts (Diener et al., 2018).

There is sometimes a popular if implicit assumption that as the professionals of mental health, therapists must have the secret to the “good life” and thus also possess it. Equally, there may sometimes be a moralistic assumption that therapists should have it—for if one is not capable of living well oneself, how can one help others to do so? Yet the present study on therapist trainees indicates that even if they are a highly self-selected group of people by virtue of their preferred profession—and this self-selection may also be evidenced in some of their personality-related or relational qualities (Peter et al., 2017; Peter and Wolf, 2021)—therapist trainees appear subject to the same sources of life satisfaction and stress as people in general, just as good physicians can themselves be well or fall ill.

Given the findings that life satisfaction can substantially affect learning outcomes (Bücker et al., 2018), and more specifically in the case of therapists can affect their therapeutic relationships (Nissen-Lie et al., 2013), our results call for serious thinking about how to protect trainees’ life quality when it is good and how to raise it when it is deficient. As suggested in this study, some interventions may be targeted on a societal level (e.g., availability of low-cost student loans); some on a training program level (e.g., promoting supportive supervision and positive between-trainee relationships); and some on an individual level (e.g., providing personal therapy and learning positive self-care). Clearly further research is warranted to investigate how such interventions or even training curricula may promote a favorable balance trainees’ levels of life satisfaction and stress, and how both directly influence their learning and treatment outcomes.