Received: 17 December 2020 Accepted: 23 December 2020

DOI: 10.1002/cpp.2550

RESEARCH ARTICLE

A theory-based examination of self-care behaviours among

psychologists

Hou Jun Wong | Katherine M. White

School of Psychology and Counselling and

Institute for Health and Biomedical Innovation,
Queensland University of Technology, Kelvin
Grove, Queensland, Australia
Correspondence
Katherine White, School of Psychology and
Counselling and Institute for Health and
Biomedical Innovation, Queensland University
of Technology, Victoria Park Road, Kelvin
Grove, QLD 4059, Australia.
Email: km.white@qut.edu.au
Abstract
The present study examined psychological, spiritual, physical/leisure and social self-
care behaviours among psychologists using a major model of predicting human
behaviour, the theory of planned behaviour (TPB). The study used a mixed method
approach with two stages of data collection. Psychologists (N = 200) completed an
online questionnaire assessing TPB constructs (attitude, subjective norm, perceived
behavioural control and intention) and additional constructs of action planning, cop-
ing planning, peer and supervisor norms and organizational climate. Two weeks later,
participants (n = 110) completed a follow-up questionnaire assessing their self-care
behaviour. Results indicated general support for the standard TPB constructs in
predicting self-care intentions for psychologists and the additional construct of action
planning mediated the intention-behaviour relationship across most self-care dimen-
sions. Findings from the current research provide further understanding of the factors
influencing self-care engagement among psychologists and can be used to inform
development of strategies to foster greater engagement in self-care behaviour.

KEYWORDS
action planning, psychologist, self-care, stress, theory of planned behaviour

1 | I N T RO DU CT I O N El-Ghoroury, Galper, Sawaqdeh, and Bufka (2012), 70% of psychology

Self-care is a process whereby an individual engages in behaviours
that foster and maintain their health and mental well-being
(Norcross & Guy, 2007). Given the professional demands of psycholo-
gists where they are often working with people in distress, empirical
research has shown that psychologists are susceptible to occupational
hazards such as stress, vicarious trauma, burnout and compassion
fatigue (Baker, 2003; Di Benedetto & Swadling, 2014). Empirical stud-
ies conducted in various countries and among varied psychologist
populations ranging from trainees (Kaeding et al., 2017; Pakenham &
Stafford-Brown, 2012), early career psychologists to well-established
psychologists (Di Benedetto & Swadling, 2014; Lee, Lim, Yang, &
Lee, 2011) have found elevated stress and burnout levels in psycholo-
gists (Dattilio, 2015). Elevated stress levels are especially prominent in
psychology trainees, where 75% of trainees reported moderate to
high levels of stress (Cushway, 1992). Similarly, in a study by
trainees reported impaired functioning due to stress. Consequently, it
is imperative for psychologists to maintain their well-being through
processess such as self-care to reduce stress (Rupert, Stevanovic, &
Hunley, 2009) and foster resilience (Kramen-Kahn & Hansen, 1998) to
be in the optimal professional functioning state to help clients
(Dattilio, 2015). Given that psychologists are promoting self-care
engagement to their clients and may not be modelling the behaviour
themselves, there is a need to investigate the underlying processes
for psychologists to engage in self-care practices in all stages of their
training and careers.
2 | DE F I N I N G S E LF - C A R E
Despite the growing literature on self-care for psychologists where
researchers have used different approaches to conceptualize self-care

950 © 2021 John Wiley & Sons, Ltd. wileyonlinelibrary.com/journal/cpp Clin Psychol Psychother. 2021;28:950–968.
WONG AND WHITE
for psychologists, there appears to be no standard definition
for self-care (Dorociak, Rupert, Bryant, & Zahniser, 2017;
Malinowski, 2014; Norcross, 2000). Dorociak et al. (2017) describe
self-care as a multidimensional, multifaceted process of undertaking
intentional strategies with the goal of enhancing well-being that has
been conceptualized in different ways. Norcross and Guy (2007)
proposed 12 principles on how to practise self-care for psychother-
apists such as minding the body, setting boundaries, cultivating spiri-
tuality and mission and undergoing personal therapy with a focus
on both personal and professional areas. Baker (2003) also focused
on areas including personal and professional well-being of therapists
and conceptualized self-care as consisting of three parts: a clinician's
self-awareness of one's experiences, ability to regulate self to one's
reaction and maintaining balance between self, personal networks
and the wider community with a focus on physical, psychological,
personal and professional areas. Similarly, a common definition
comprising four dimensions of self-care (psychological, spiritual,
physical and social) has been discussed by a number of researchers
(Malinowski, 2014; Weiss, 2004). Psychological self-care refers to
the care of one's own psychological well-being to reduce distress in
one's work environment through strategies such as awareness, per-
sonal therapy and having a positive outlook (Ivey & Waldeck, 2014;
Pakenham, 2015a). Spiritual self-care refers to engagement in activi-
ties such as meditation or religious and cultural activities that can
foster tranquillity, meaning and purpose to one's life (Helmeke &
Sori, 2006). Physical self-care is associated with physical and leisure
activities such as exercising and reading which can foster work-life
balance and improve cognitive functioning, as well as physical, men-
tal and emotional well-being (Hansen, Stevens, & Coast, 2001;
Norcross & Guy, 2007). Social self-care refers to the care of one's
well-being through having social supports. Common social supports
for psychologists include professional and personal supports such as
family, peers and supervisors (Rupert & Kent, 2007; Stevanovic &
Rupert, 2004).
3 | M E N T A L W E L L- B E I N G A N D SE L F- C A R E
Many studies have identified a positive relationship between self-care
and mental health (Kramen-Kahn & Hansen, 1998; Shapiro, Astin,
Bishop, & Cordova, 2005; Slonim, Kienhuis, Di Benedetto, &
Reece, 2015; Stafford-Brown & Pakenham, 2012). A study examining
Australian psychologists undertaken by Di Benedetto and
Swadling (2014) revealed a negative correlation between mindfulness
self-care and burnout. Similarly, research examining Australian psy-
chology trainees found that an acceptance and commitment therapy
(ACT) intervention was positively correlated with well-being, such as
life satisfaction, and was negatively correlated with stress and distress
(Pakenham, 2015a, 2015b). Given the positive effects of self-care for
psychologists and the tendency for psychologists to ignore their self-
care (Dattilio, 2015), it may be beneficial to draw upon well-validated
theoretical framework to understand the underlying factors impacting
psychologists' self-care behaviour.
951
Key Practitioner Message
• Approval from others, perceived control and detailed
planning influence psychologists' self-care intentions.
• Detailed planning strongly influences psychologists' per-
formance of self-care behaviours.
• Findings can inform strategies to foster greater engage-
ment in self-care behaviour, especially forming specific
plans.
4 | BEHAVIOUR PREDICTION
FR A M E W O RK S : TH E O R Y OF P L A N N E D
BEHAVIOUR
One well-validated model of behaviour prediction used to understand
the motivations underlying people's actions is the theory of planned
behaviour (TPB; Ajzen, 1991). The TPB states that human behaviour
is a function of intention to perform that behaviour, and intention is
directly influenced by three constructs: attitude (positive or negative
evaluation of the behaviour), subjective norm (perceived social pres-
sure for engagement in the behaviour) and perceived behavioural con-
trol (PBC; perceived ability to perform the behaviour; also posited to
directly predict behaviour), all of which have an underlying belief
basis.
Meta-analytic results across a range of behaviours support
the predictive utility of the TPB variables, accounting for an
average of 39% and 27% of the variance in intention and
behaviour, respectively (Armitage & Conner, 2001), with slightly
lower values among health behaviours (McEachan, Conner, Taylor, &
Lawton, 2011). The TPB also successfully predicted self-care
intentions and behaviours of people with diabetes (Costa, Pereira, &
Pedras, 2012; Gatt & Sammut, 2008) and high blood pressure
(Peters & Templin, 2010).
Despite the meta-analytic support for the TPB and for predicting
self-care intentions and behaviours specifically, the model has faced
criticism suggesting that it is not useful to inform behaviour change
interventions, the validity of the model's propositions is in question,
and it is only partially complete in its representation of belief initiation
through to behavioural enactment and, thus, unable to explain all
of the processes of people's behavioural decisions adequately
(e.g., Sniehotta, Presseau, & Araújo-Soares, 2014). Comprehensive
rebuttal (e.g., Ajzen, 2014) outlined the sufficiency of the TPB, with
researchers arguing one of the strengths of TPB is that it has helped
identify other variables not included in the model that need further
research (e.g., Armitage, 2014). Ajzen asserts that the TPB is able to
accommodate additional variables if the inclusion makes theoretical
sense and improves its predictive validity. In the present study, action
planning and coping planning from the health action process approach
(HAPA), peer and group norms and organizational climate are
952
proposed as potential additional influences on psychologists' self-care
intentions and behaviour.
5 | HAPA: ACTION PLANNING AND
COPING PLANNING
The HAPA posits that the process of engaging in health behaviour is a
two-stage process that includes a motivation (intention forming)
and volition (self-regulative) phase that leads to intention
(Schwarzer, 2008). The volition phase of the HAPA process includes
post intentional factors involved in the intention to behaviour
translation process: self-efficacy, action planning and coping planning.
Empirical research on health behaviour change indicates that a compo-
nent of the HAPA, action planning of the when, where and how process
of achieving goals, can facilitate the gap between behaviour intentions
and behaviour engagement when used as a prospective self-regulatory
strategy (Gollwitzer & Sheeran, 2006; Sniehotta, Schwarzer, Scholz, &
Schüz, 2005). In addition, coping planning (a latter part of the planning
process) is used as a self-regulation strategy where coping responses
are planned to manage anticipated risks. The role of a psychologist is
complex, where intentions of self-care may be impacted by factors such
as conflicting demands of coursework, clinical work and personal
demands of trainees (Pakenham & Stafford-Brown, 2012), bureaucratic
demands of psychologists in private practice and the needs of high risk
clients which may require over-booking to accommodate those in crisis
(Barnett, Baker, Elman, & Schoener, 2007). It may be useful, then, to
consider the role of the action planning and coping planning
constructs proposed in the HAPA to assist the translation of intention
into behaviour given the constraints and the complexities of the
psychologist role. Empirically, planning has been shown to be a
mediator in the intention–behaviour relationship (Carraro
Gaudreau, 2013; Sniehotta, Araújo Soares, & Dombrowski, 2007).
6 | G RO U P N O R M S
Another construct potentially relevant to self-care engagement is
group norms. The conceptualization of group norms is based on the
perspectives of two theories: social identity (Tajfel & Turner, 1986)
and self-categorization (Turner, Hogg, Oakes, Reicher,
Wetherell, 1987) which posit that specific salient reference groups
norms can influence behaviour due to the behavioural relevance of
the group. Group norms consists of behavioural norms (behaviour
engagement by important group members) and group attitudes (group
evaluation of the behaviour; Johnston & White, 2003; Terry, Hogg, &
White, 1999; White, Terry, & Hogg, 1994). Given supervision for psy-
chologists is either compulsory (for trainees) or beneficial for manag-
ing difficult cases or unfamiliar presentations (often provided by peers
for practising psychologists; Norcross & Guy, 2007; Stevanovic &
Rupert, 2004), the perceived self-care attitudes and behaviours of
peers and supervisors on psychologists' own self-care intentions and
behaviour may be influential.
WONG AND WHITE
7 | ORGANIZATIONAL CLIMATE
Research in organizational psychology has found that healthy
organizational climate is associated with better well-being, including
psychological health (Wilson, DeJoy, Vandenberg, Richardson, &
McGrath, 2004). Kolar, von Treuer, and Koh (2016) explored resilience
in early career psychologists and found workplace culture is
associated with resilience in early-career psychologists. The authors
recommended strategies such as self-care education, exercise and
socializing to promote resilience. Given the importance of organiza-
tional climate, Stafford-Brown and Pakenham (2012), Bamonti
et al. (2014) and Zahniser, Rupert, and Dorociak (2017) recommended
that training institutions support psychology trainees who are
susceptible to stress by cultivating a culture of self-care in their
training programme.
8 | T H E P R E S EN T S T U D Y
There is a significant gap in understanding the underpinnings of psy-
chologists' self-care including among trainee psychologists. There is a
paucity of research using established behaviour prediction models to
examine psychologists' self-care practices.
Given the potential negative effects associated with the
neglect of self-care among psychologists, the aim of the present
study is to test the TPB to predict psychologists' self-care inten-
tions and behaviour regarding four self-care dimensions (psycholog-
ical, spiritual, physical/leisure and social). The predictors in the
standard TPB are attitude, subjective norm and PBC for the out-
come of intention and, subsequently, the predictors of PBC and
intention for the outcome of behaviour. The additional variables of
& action planning, coping planning, peer and supervisor norms and
organizational climate will be examined also as predictors of the
outcome variables of both intention and behaviour. Finally, the
relationship between engaging in self-care behaviours and mental
well-being will be explored.
For the TPB, it is hypothesized that psychologists would be
more likely to intend to engage in self-care behaviours if they have
a positive attitude towards the behaviour, perceive social pressure
to engage in the behaviour (subjective norm) and perceive control
& over the behaviour (perceived behavioural control). It is also hypoth-
esized that psychologists with a stronger intention to engage in
self-care behaviours, and who perceive the behaviour to be within
their control will be more likely to engage in self-care performance.
For the additional variables, it is hypothesized that psychologists will
have stronger self-care intentions and behaviours when they have
implemented action and coping planning, they perceive self-care to
be normative among their peers and supervisors, and they perceive
a supportive health climate at their work or placement. Given evi-
dence of planning as a mediator in the intention-behaviour relation-
ship (Carraro & Gaudreau, 2013; Sniehotta et al., 2007), a
mediational path is predicted from intention through action and
coping planning to the self-care behaviours. Finally, the relationship
WONG AND WHITE 953

between self-care behaviour and mental well-being was explored; it
was predicted that depression, anxiety and stress would be lower
when psychologists engage in more self-care behaviours.
9 | METHOD
Ethical clearance was provided by the University's Human Research
Ethics Committee. The present study used a mixed method approach,
initially exploring the factors influencing self-care practices for psy-
chologists qualitatively and then validating these factors quantitatively
in a larger sample.
psychologists [51.8%]; Meanage = 34.36 years, SDage = 10.93) reported
their self-care engagement during the past fortnight.2 The Time 1 sur-
vey was available in electronic format, and participants were asked for
consent to be contacted again in 2 weeks to complete a follow-up
survey which was available in electronic form or by a phone interview.
Surveys completed at both time points were matched via a unique
self-generated code identifier. Participants who completed the survey
at Time 2 were offered the opportunity to enter a prize draw to win
1 of 3 AUD$50 store vouchers as a thank you.
9.2.2 | Measures

TPB constructs
9.1 | Pilot study The target behaviour, self-care, was categorized into four dimensions
in accordance with one of the most frequently employed definitions
A pilot study was conducted to confirm the definitions and provide of the construct in the self-care literature: psychological, spiritual,
examples of self-care for the four dimensions. The sample comprised physical and social (Malinowski, 2014; Norcross & Guy, 2007;
10 female and two male (N = 12) participants (Mage = 39.25 years,
SD = 15.09 years). Six individuals were provisional psychologists TABLE 1 Self-care dimensions for psychologists: Definitions and
(trainee psychologists working under supervision) and six were fully examples
registered psychologists (psychologists who have completed training).
Self-care
Four focus groups and three individual interviews were conducted. dimension Definition Examples
Informed consent was obtained, and participants received a movie
Psychological The care of one's own Awareness,
voucher as a thank you. Open-ended questions obtained feedback on dimension psychological well- mindfulness-based
definitions and examples of self-care across the four dimensions and being to reduce stress reduction
identified other factors influencing psychologists' self-care behaviours, distress in one's work activities, monitoring,
environment through psychotherapy,
revealing time management (relevant to planning) and the role of
strategies such as having a humorous
peers, supervisors and workplaces as salient influences. Of note, pilot awareness, personal outlook
participants nominated examples across social, psychological, physical therapy and having a
and spiritual domains as reflecting self-care. positive outlook
Spiritual Engagement in activities Worshipping in a
dimension such as meditation or congregation and
religious and cultural improving one's
9.2 | Main and follow-up study activities that can mental health
foster tranquillity, through meditation
9.2.1 | Participants and procedure meaning and purpose
to one's life

Participants comprised practising and trainee psychologists currently Physical/ Physical and leisure Walking, yoga,
leisure activities such as gardening, watching
providing therapeutic psychological services in the mental health
dimension exercising and movies and craft
sector in Australia. The main study sample comprised 183 female reading which can
and 17 male (N = 200) participants1 (Mage = 34.13 years, foster work-life
SD = 10.48 years; 102 fully registered psychologists and 98 provisional balance and improve
cognitive functioning,
psychologists (of whom about half were current students of
physical, mental and
psychology-related courses). Most participants identified as Caucasian emotional well-being
(85.4%), followed by Asian (9.5%) and ‘other’ (5.1%). Most partici-
Social The care of one's well- Attending supervision,
pants stated that religion was less than somewhat important in their dimension being through having peer collaboration,
life (73%). Participants in the pilot and main study were recruited social supports. talking with family
through word of mouth, emailing, snowballing, social media and face- Common social and friends and doing
supports for a fun activity with
to-face request. Two weeks later, 110 of the participants from the
psychologists can family and friends
first survey (53 practising psychologists [48.2%], 57 trainee include professional
and personal supports
1
The sample comprised mainly female participants reflecting the ratio of the psychology such as family, peers
profession in Australia
2
and supervisors.
2 weeks
954 WONG AND WHITE

TABLE 2 Self-care for psychologists: Scale items for the model constructs

Scale detail and

Variable Item Scoring or rating reliability
Intention I plan to engage in psychological self-care activities [1] strongly disagree to [7] strongly Pearson's r = .89 (Psy)
I intend to engage in psychological self-care agree Pearson's r = .96 (Spi)
activities [1] strongly disagree to [7] strongly Pearson's r = .94 (Phy)
agree Pearson's r = .96 (Soc)
Attitude For me to engage in psychological self-care [1] good to [7] bad Cronbach's α = .84 (Psy)
activities in the next 2 weeks would be … [1] positive [7] negative Cronbach's α = .99 (Spi)
[1] favourable [7] unfavourable Cronbach's α = .99
(Phy)
Cronbach's α = .96
(Soc)
Subjective norm Those people who are important to me would [1] strongly disagree to [7] strongly Pearson's r = .98 (Psy)
want me to engage in psychological self-care agree Pearson's r = .86 (Spi)
activities [1] strongly disagree to [7] strongly Pearson's r = .86 (Phy)
Most people who are important to me would agree Pearson's r = .74 (Soc)
approve of me to engage in psychological self-
care activities
Perceived behavioural I have complete control over whether I engage in [1] strongly disagree to [7] strongly Pearson's r = .74(Psy)
control psychological self-care activities agree Pearson's r = .42(Spi)
It would be easy for me to engage in psychological [1] strongly disagree to [7] strongly Pearson's r = .77(Phy)
self-care activities agree Pearson's r = .68(Soc)
Action planning I have made a plan regarding: [1] not at all true to [4] exactly true Cronbach's α = .92 (Psy)
When to engage in psychological (Psy) self-care [1] not at all true to [4] exactly true Cronbach's α = .96 (Spi)
activities in the next 2 weeks [1] not at all true to [4] exactly true Cronbach's α = .95
Where to engage in (Psy) self-care activities in the [1] not at all true to [4] exactly true (Phy)
next 2 weeks Cronbach's α = .95
How to engage in (Psy) self-care activities in the (Soc)
next 2 weeks
How often to engage in (Psy) self-care activities in
the next 2 weeks
Coping planning What to do if something interferes with my plans [1] not at all true to [4] exactly true Cronbach's α = .89 (Psy)
in the next 2 weeks [1] not at all true to [4] exactly true Cronbach's α = .98 (Spi)
How to cope with possible setbacks in the next [1] not at all true to [4] exactly true Cronbach's α = .97
2 weeks [1] not at all true to [4] exactly true (Phy)
What to do in difficult situations in order to act Cronbach's α = .97
according to my intentions in the next 2 weeks (Soc)
What I have to pay extra attention to prevent
relapses in the next 2 weeks
Peer norm How many of your peers/other psychologists/ [1] strongly disagree to [7] strongly Pearson's r = .40 (Psy)
colleagues would think that engaging in agree Pearson's r = .64 (Spi)
psychological self-care is a good thing to do? [1] strongly disagree to [7] strongly Pearson's r = .43 (Phy)
How many of your peers/other psychologists/ agree Pearson's r = .52 (Soc)
colleagues would practice psychological self-
care?
Supervisor norm How many of your work/placement supervisors [1] strongly disagree to [7] strongly Pearson's r = .49 (Psy)
would think that engaging in psychological self- agree Pearson's r = .68 (Spi)
care is a good thing to do? [1] strongly disagree to [7] strongly Pearson's r = .33 (Phy)
How many of your work/placement supervisors agree Pearson's r = .49 (Soc)
would practice psychological self-care?
Organizational climate My organization is committed to employee health [1] strongly disagree to [7] strongly Cronbach's α = .90
and well-being agree
My organization provides me with opportunities [1] strongly disagree to [7] strongly
and resources to be healthy agree
When management learns that something about [1] strongly disagree to [7] strongly
our work or the workplace is having a bad effect agree
on employee health or well-being, then [1] strongly disagree to [7] strongly
something is done about it. agree
My organization encourages me to speak up about
issues and priorities regarding employee health
and well-being
WONG AND WHITE 955

TABLE 2 (Continued)

Scale detail and

Variable Item Scoring or rating reliability
Follow-up behaviour In the last 2 weeks, to what extent did you engage [1] not at all to [7] a great extent Pearson's r = .92 (Psy)
in psychological self-care activities? Pearson's r = .99 (Spi)
In the last 2 weeks, how often did you engage in Pearson's r = .95 (Phy)
psychological self-care activities? Pearson's r = .86 (Soc)

Note: Items shown above are for psychological self-care dimension only; all scores were summed and averaged. Scale reliability is shown for four
dimensions: Psy = psychological; Spi = spiritual; Phy = physical/leisure; Soc = social.

Weiss, 2004). For the four self-care behaviour definitions and exam-
ples used in the present study, see Table 1. These self-care behaviour
definitions and examples were provided to participants in the survey.
Table 2 provides item examples and reliability information for all the
study's constructs. Pearson's correlations were reported to assess the
reliability of 2-item scales whereas Cronbach's alpha coefficients were
used to assess the reliability for scales with three or more items. Reli-
abilities for all scales were moderate to strong except for supervisor
norm for physical self-care (r = .33) which was retained for consis-
tency across the four self-care behaviours (see Table 2). In accordance

T A B L E 3 Hierarchical multiple
Variable B β 95% CI R2 ΔR2
regression analysis involving standard
and extended TPB constructs predicting Prediction of intention (N = 180)
psychological self-care intention and Step 1
behaviour Attitude .94 .40*** [.66, 1.22] .39***
Subjective norm .22 .15* [.04, .40]
Perceived behavioural control .26 .32*** [.16, .36]
Step 2
Attitude .78 .34*** [.54, 1.0] .57*** .19***
Subjective norm .29 .20** [.13, .44]
Perceived behavioural control .13 .16** [.03, .23]
Action planning .67 .50*** [.49, .84]
Coping planning −010 −.06 [−.28, .10]
Peer norm −.02 −.02 [−.19, −.15]
Supervisor norm .06 .05 [−.10, .21]
Organizational climate −.03 −.04 [−.12, .06]
Variable B β 95% CI R2 ΔR2
Prediction of behaviour (N = 99)
Step 1
Intention .42 .35** [.17, .68] .16***
Perceived behavioural control .08 .08 [−.13, .29]
Step 2
Intention .15 .12 [−.15, .44] .41*** 33***
Perceived behavioural control −.05 −.06 [−.26, .15]
Attitude .05 .02 [−.48, .58]
Action planning .73 .43** [.30, 1.16]
Coping planning .26 .14 [−.16, .68]
Subjective norm −.26 −.15 [−.60, .07]
Peer norm .82 .05 [−.25, .41]
Supervisor norm −.04 −.03 [−.36, .28]
Organizational climate .23 .22* [.31, .42]

Note. For intention, Step 1: F(3,176) = 36.79, p < .001; Step 2: F(5,171) = 15.06, p < .001; and the overall
model: F(8,171) = 28.71, p < .001. For behaviour, Step 1: F(2,96) = 9.30, p < .001; Step 2: F(7,89) = 5.42,
p < .001; and the overall model: F(9,89) = 6.95, p < .001.
*p < .05. **p < .01. ***p < .001.
956 WONG AND WHITE

T A B L E 4 Hierarchical multiple
Variable B β 95% CI R2 ΔR2 regression analysis involving standard
Prediction of intention (N = 179) and extended TPB constructs predicting
Step 1 spiritual self-care intention and behaviour
Attitude .42 .37*** [.29, .56] .69***
Subjective norm .42 .32*** [.25, .60]
Perceived behavioural control .51 .34*** [.37, .66]
Step 2
Attitude .29 .25*** [.17, .41] .79*** .10***
Subjective norm .29 .21** [.13, .45]
Perceived behavioural control .31 .21*** [318, .44]
Action planning .80 .40*** [.56, 1.04]
Coping planning .07 .3 [−.18, .31]
Peer norm −.01 −.00 [−.20, .19]
Supervisor norm .05 .04 [−.13, .23]
Organizational climate −.05 −.03 [−.15, .06]
Variable B β 95% CI R2 ΔR2
Prediction of behaviour (N = 100)
Step 1
Intention .50 .55*** [.31, .69] .31***
Perceived behavioural control .00 .00 [−.27, .28]
Step 2
Intention .25 .27 [−.82, .57] .48*** .18***
Perceived behavioural control −.06 −.05 [−.34, .21]
Attitude −.05 −.04 [−.33, .24]
Action planning 1.07 .61*** [.55, 1.60]
Coping planning −.10 −.05 [−.58, .37]
Subjective norm −.21 −.17 [−.59, .17]
Peer norm −.16 −.11 [−.54, .22]
Supervisor norm .08 .06 [−.29, .45]
Organizational climate .20 −15 [−0.2, .41]

Note. For intention, Step 1: F(2,175) = 126.75, p < .001; Step 2: F(5,170) = 16.04, p < .001; and the
overall model: F(8,170) = 16.04, p < .001. For behaviour, Step 1: F(2,97) = 21.56, p < .001; Step 2:
F(7,90) = 4.39, p < .001; and the overall model: F(9,90) = 9.38, p < .001.
*p < .05. **p < .01. ***p < .001.

with recommendations by Ajzen (2020), multi-item psychometric
measures of intention (two items; rs range from .89 to .96), attitude
(three items; αs range from .84 to .99), subjective norm (two items; rs
range from .74 to .98) and PBC (two items; rs ranges from .42 to .77)
for the next 2 weeks were developed for each self-care behaviour.
Planning
Based on Sniehotta et al., (2005), the planning scales assessed both
action planning (planning of when, where, how and frequency of
self-care engagement) and coping planning (planning of how to cope
with barriers to self-care engagement). Action planning was mea-
sured for each behaviour with 4-item scales (αs ranging from .92 to
.96). Coping planning was measured across the four behaviours with
4-item scales (αs ranging from .89 to .98).
Peer and supervisor norms
Peer (the extent self-care is perceived to be normative among peers/
other psychologists/colleagues) and supervisor (the extent self-care is
perceived to be normative among supervisors at work or placement)
group norms were measured using 2-item scales based on previous
research (Terry et al., 1999; White et al., 1994). The peer norm scales
(rs range from .40 to .64) and supervisor norm scales (rs range from .33
to .68) possessed adequate reliability across the self-care behaviours
except for supervisor norm for physical self-care (r = .33) which was
retained for consistency across the four behaviours.
Organizational climate
Participants' perceptions of active support for their well-being from
their organization were measured using the 4-item organization
WONG AND WHITE 957

T A B L E 5 Hierarchical multiple
regression analysis involving standard Variable B β 95% CI R2 ΔR2
and extended TPB constructs predicting Prediction of intention (N = 181)
physical/leisure self-care intention and Step 1
behaviour Attitude .11 .65 [−.08, .30] .44***
Subjective norm .41 .31*** [.25, .57]
Perceived behavioural control .34 .48*** [.26, .43]
Step 2
Attitude .09 .06 [−.07, .26] .60*** .16***
Subjective norm .34 .25*** [.19, .48]
Perceived behavioural control .23 .32*** [.14, .31]
Action planning .63 .47*** [.46, .80]
Coping planning −.06 −.05 [−.21, .10]
Peer norm −.06 −.05 [−.22, .11]
Supervisor norm .06 .04 [−.11, .22]
Organizational climate −.00 −.01 [−.08, .07]
Variable B β 95% CI R2 ΔR2
Prediction of behaviour (N = 99)
Step 1
Intention .45 .34** [.13, .76] .17***
Perceived behavioural control .09 .09 [−.15, .33]
Step 2
Intention .20 .15 [−.18, .58] .32* .15***
Perceived behavioural control .07 .07 [−.17, .30]
Attitude .20 .10 [−.17, .57]
Action planning .60 .34* [.13, 1.06]
Coping planning .22 .15 [−.14, .58]
Subjective norm −.34 −.16 [−.80, .12]
Peer norm −.14 −.08 [−.56, .28]
Supervisor norm .06 .04 [−.34, .46]
Organizational climate −.10 −.10 [−.30, .10]

Note. For intention, Step 1: F(3,177) = 46.24, p < .001; Step 2: F(5,172) = 13.49, p < .001; and the overall
model: F(8,172) = 31.89, p < .001. For behaviour, Step 1: F(2,96) = 9.62, p < .001; Step 2: F(7,89) = 2.79,
p = .011; and the overall model: F(9,89) = 4.59, p < .001.
*p < .05. **p < .01. ***p < .001.

subscale of the multifaceted organizational health climate assessment
scale (Zweber, Henning, & Magley, 2016) which assessed the commit-
ment and provision of support from the organization for employees'
health and well-being (Eisenberger, Huntington, Hutchison, &
Sowa, 1986; Zweber et al., 2016). The scale was reliable (α = .90).
depression, anxiety and stress using a 21-item scale where partici-
pants rate on a scale ranging from 0 = never to 3 = almost always on
the extent to which the statements applied to them over the past
week. The scale had good reliability, with αs of .89 for depression, .74
for anxiety and .85 for stress.

Follow-up behaviour
Two weeks following the Time 1 survey, self-care engagement
across the four domains during the past fortnight was measured using
a two-item scale for each of the four dimensions of self-care (rs range
from .92 to .99).
Mental well-being
Negative emotional states were measured using the DASS-21
(Lovibond & Lovibond, 1995) which assesses symptom severity of
9.3 | Statistical analyses overview
For all analyses, a significance level of .05 was used. Results were
analysed with the Statistical Package for the Social Sciences (SPSS-
26) and SPSS PROCESS macro (Hayes, 2018). For the regression
analyses, TPB conventions (Ajzen, 1991) were followed to deter-
mine the order of entry of variables in the regression equations. For
the regressions predicting intention, the standard TPB constructs of
958 WONG AND WHITE

T A B L E 6 Hierarchical multiple
Variable B β 95% CI R2 ΔR2
regression analysis involving standard
Prediction of intention (N = 180) and extended TPB constructs predicting
Step 1 social self-care intention and behaviour
Attitude .12 .05 [−.16, .41] .46***
Subjective norm .55 .36*** [.36, .74]
Perceived behavioural control .36 .42*** [.26, .47]
Step 2
Attitude .03 .01 [−.24, .30] .55*** .09***
Subjective norm .48 .32*** [.29, .67]
Perceived behavioural control .25 .29*** [.14, .36]
Action planning .44 .30*** [.25, .64]
Coping planning .08 .06 [−.09, .25]
Peer norm .08 .05 [−.15, .31]
Supervisor norm −.04 −.03 [−.27, .19]
Organizational climate −.06 −.08 [−.16, .03]
Variable B β 95% CI R2 ΔR2
Prediction of behaviour (N = 99)
Step 1
Intention .25 .22 [−.01, .51] .12**
Perceived behavioural control .15 .16 [−.07, .37]
Step 2
Intention .14 .13 [−.17, .45] .18 .07*
Perceived behavioural control .15 .16 [−.08, .38]
Attitude .02 .01 [−.45, .50]
Action planning .27 .17 [−.13, .67]
Coping planning .21 .15 [−.13, .55]
Subjective norm −.06 −.04 [−.48, .35]
Peer norm −.12 −.07 [−.59, .35]
Supervisor norm .09 .05 [−.37, .55]
Organizational climate −.09 −.10 [−.28, .10]

Note. For intention, Step 1: F(3,176) = 49.00, p < .001; Step 2: F(5,171) = 6.86, p < .001; and the overall
model: F(8,171) = 25.72, p < .001. For behaviour, Step 1: F(2,97) = 6.39, p = .002; Step 2: F(7,90) = 1.03,
p = .418; and the overall model: F(9,90) = 2.22, p = .028.
*p < .05. **p < .01. ***p < .001.

attitude, subjective norm and PBC were entered in the first step,
with additional variables entered in the second step. For the regres-
sions predicting behaviour, the proposed direct predictors of behav-
iour in the TPB of intention and PBC were entered in the first step,
whereas all other variables were entered in the second step. In
addition, a mediation hypothesis was explored with action planning
as the mediator which was regressed onto self-care intention,
whereas self-care behaviour was regressed onto self-care intention
and action planning. This hypothesis was explored for each self-care
behaviour (i.e., four mediational models were conducted), using con-
fidence intervals of 95%, which were generated by bootstrapping
with 5000 resamples. Finally, inspection of the correlation matrix
allowed for an analysis of the associations between self-care behav-
iour and mental well-being.
10 | RESULTS
Tables in Appendices A to D displays the means, standard deviations
and Pearson's r correlations across the four self-care dimensions. Mean
scores are based on 7-point scales (1 to 7), except for action planning
and coping planning (1 to 4). Based on average scores in comparison to
the mid-point of the scale, participants reported strong intentions for
psychological self-care (M = 5.98, SD = 1.64) and engaged in moderately
amounts of psychological self-care (M = 4.59, SD = 1.13). Similar trends
were found for physical self-care intentions (M = 6.08, SD = 1.07) and
behaviour (M = 4.87, SD = 1.54). In comparison, for social self-care,
stronger intentions (M = 5.95, SD = 1.14) and a higher engagement in
behaviour (M = 5.31, SD = 1.25) were reported. Participants indicated
lower levels of intention (M = 4.42, SD = 1.96) and behaviour (M = 3.07,
WONG AND WHITE
SD = 1.84) for spiritual self-care than the other three self-care behav-
iours. In the spiritual and physical/leisure dimension, intention corre-
lated with all other variables. In the psychological and social dimension,
intention correlated with all variables except for organizational climate.
In all dimensions of self-care, behaviour correlated with PBC, action
planning and coping planning. No significant multivariate effects (i.e., no
group differences) were identified on the TPB and additional variables
between the subsample of those who participated in the follow-up
study and the subsample of those from Time 1 who did not.
10.1 | Regression analyses predicting intentions
To identify the important predictors of self-care intentions for the four
dimensions, the standard TPB constructs (attitude, subjective norm and
PBC) were entered into the first step of the regression analysis while
the additional variables (action planning, coping planning, peer norm,
supervisor norm and organizational climate) were entered into the
second step. As shown in Tables 3 to 6, the standard TPB constructs
explained significant proportions of variance in the first step for all four
self-care dimensions: psychological (39%), spiritual (69%), physical/lei-
sure (44%) and social (46%). Overall, the TPB and additional predictors
accounted for 57%, 79%, 60% and 55% of the variance in self-care
intentions in the psychological, spiritual, physical/leisure and social
dimensions, respectively. Subjective norm and PBC emerged as signifi-
cant predictors for all four self-care intentions, although attitude did
not emerge as a significant predictor of intention in Step 2 for the
physical/leisure and social self-care dimensions. Among the additional
variables, action planning was the only variable to emerge as a
significant predictor of intentions for all self-care dimensions.
10.2 | Regression analyses predicting behaviour
To identify the important predictors of self-care behaviour for the
four dimensions, intention and PBC were entered into the first step of
the regression analysis whereas attitude, subjective norm, action plan-
ning, coping planning, peer norm, supervisor norm and organizational
climate variables were entered into the second step. As shown in
Tables 3 to 6, the standard TPB constructs (intention and PBC)
explained significant proportions of variance in the first step for all
four self-care dimensions: psychological (16%), spiritual (31%), physi-
cal/leisure (17%) and social (12%). Overall, the predictors accounted
for 41%, 48%, 32% and 18% of the variance in self-care behaviour for
the psychological, spiritual, physical/leisure and social dimension,
respectively. PBC did not emerge as a significant predictor of behav-
iour in both steps, and intention only emerged as a significant predic-
tor of behaviour in Step 2 for 3 of the three self-care behaviours:
psychological, spiritual and physical/leisure self-care. Action planning
was the only variable to emerge as a significant predictor of behaviour
in Step 2 for three self-care behaviours of psychological, spiritual and
physical/leisure self-care. Organizational climate emerged as a signifi-
cant predictor of psychological self-care behaviour only.
959
10.3 | Mediation regression analysis
Given that action planning consistently emerged as a strong predictor
of intention and behaviour, and intention became non-significant with
its inclusion for psychological, spiritual and physical/leisure self-care, a
regression analysis with action planning as the mediator, intention as
the independent variable and behaviour as the dependent variable
was conducted for self-care across the four dimensions. The
PROCESS macro (Hayes, 2018) was used to conduct the
bootstrapped Sobel test of the indirect effect to test for the presence
of mediation (using 5000 bootstrapped samples) across all four behav-
iours. Figures in Appendices E to H provide a visual representation of
the pathways for the four behaviours and their associated statistical
significance.
For psychological self-care, the indirect effect was significant,
providing statistical support for the argument that mediation is
present (B = 0.34, Boot 95% CI [0.17, 0.58]). Given the direct effect of
intention on behaviour is nonsignificant, the result indicates full
mediation.
For spiritual self-care, the indirect effect was significant, providing
statistical support for the argument that mediation is present
(B = 0.46, Boot 95% CI [0.27, 0.65]). Given the direct effect of inten-
tion on behaviour is nonsignificant, the result indicates full mediation.
For physical/leisure self-care, the indirect effect was significant,
providing statistical support for the argument that mediation is present
(B = 0.31, Boot 95% CI [0.10, 0.56]). Given the direct effect of intention
on behaviour is nonsignificant, the result indicates full mediation.
For social self-care, the indirect effect was significant, providing
statistical support for the argument that mediation is present
(B = 0.13, Boot 95% CI [0.03, 0.28]). Given the direct effect of inten-
tion on behaviour is significant, the result indicates partial rather than
full mediation.
Overall, a full mediation effect was found between intention and
behaviour via action planning for the three self-care dimensions of
psychological, spiritual and physical/leisure self-care, whereas partial
mediation was found between intention and behaviour via action
planning for the social self-care dimension.
10.4 | Psychological distress analysis
Analysis of the DASS-21 scores (see Table 7) indicated that partici-
pants' symptoms severity fell in the normal ranges for depression,
stress and anxiety. Depression was negatively correlated with psycho-
logical and social self-care. Stress was negatively correlated with psy-
chological and spiritual self-care, with no significant correlations for
anxiety and self-care.
11 | DISCUSSION
The aim of the present study was to test the utility of the TPB, incor-
porating the additional constructs of action planning, coping planning,
960 WONG AND WHITE

TABLE 7 Self-care in all dimensions: Means, standard deviations and bivariate correlations between behaviour and DASS-21 measures

Variable 1. 2. 3. 4. 5. 6. 7.
1. Psychological self-care .50*** .25** .48*** −.23* −.33** −.19
2. Spiritual self-care −.12 .14 −.20 −.30** −.16
3. Physical/leisure self-care .29** .04 −.07 −.04
4. Social self-care −.25* −.19 −.13
5. Depression .67*** .57***
6. Stress .56***
7. Anxiety
M 4.59 3.07 4.87 5.31 5.00 9.92 2.89
SD 1.45 1.81 1.54 1.25 7.36 8.13 4.46
N 110 110 109 110 184 182 190

Note. Mean scores are based on 7-point scales (1 to 7), except for depression, stress and anxiety (4-point scales of 0 to 3, possible range from 0 to 21).
Recommended cut-off scores applicable to current scores for conventional severity labels are as follows: normal range for depression (0–9), stress (0–14)
and anxiety (0–7).
*p < .05. **p < .01. ***p < .001.

peer and supervisor norms and organizational climate, for the predic-
tion of psychological, spiritual, physical/leisure and social self-care
intentions and behaviours among psychologists. In general, support
was found for the efficacy of the standard TPB constructs in
predicting self-care intentions (39% to 69%) when compared to the
proportion of variance typically accounted for by the TPB as indicated
in meta-analytic results of around 39% (Armitage & Conner, 2001).
However, the proportion of variance for behaviour prediction (12% to
31%) was generally lower than the typical amount expected based on
Armitage and Conner's meta-analysis of 27%, suggesting that inten-
tion and PBC are not reliably translating to behaviour for self-care
enactment. All three standard TPB variables (attitude, subjective norm
and PBC) emerged as significant predictors of psychological and spiri-
tual self-care intentions but only subjective norm and PBC signifi-
cantly predicted physical/leisure and social self-care intentions.
Action planning was the only additional variable that emerged as a sig-
nificant predictor of intention for all self-care behaviours. For the
three self-care dimensions of psychological, spiritual and physical/
leisure, neither intentions nor PBC directly predicted behaviour after
including other predictors in the model although intention was signifi-
cant in the first step of the model for these three behaviours. How-
ever, mediational analyses showed an indirect effect between
intention and behaviour through action planning for psychological,
spiritual and physical/leisure self-care.
11.1 | Predicting self-care engagement for
psychologists
Based on the average scores compared to the midpoint of the scale,
engagement in psychological, physical/leisure and social self-care was
moderate, whereas engagement in spiritual self-care was lower among
psychologists, potentially reflective of the study demographics where
most participants stated that religion was less than somewhat
important in their life. Nevertheless, given previous research
suggesting that psychologists have a tendency to neglect their own
self-care (Wise, Hersh, & Gibson, 2012), it is encouraging that partici-
pants in the present study indicated at least moderate engagement in
psychological, physical/leisure and social self-care. In addition, the
average scores for depression, anxiety and stress were within the nor-
mal ranges. Based on Cohen's (1988) effect size classification (large
correlation: around .50 or above; moderate correlation: around .30;
small correlation: around .10), engagement in psychological and spiri-
tual self-care correlated moderately with lower reported stress.
Although the association was not overly strong, engagement in psy-
chological self-care was also correlated with lower scores on
depression.
Two of the TPB constructs (subjective norm and PBC) were con-
sistent significant predictors across the four self-care intentions,
suggesting it is important to consider the importance of perceived
social pressure from important others to engage in self-care and per-
ceived ability to engage in self-care for developing strong self-care
intentions. Personal attitudes were only relevant for the psychological
and spiritual self-care intentions, domains where personal beliefs are
likely more dominant.
Social influences related to peer and supervisor norms and organi-
zational climate did not significantly predict intention, although sub-
jective norm (related to important others) did. These findings suggest
that social influence from professional contacts may have less of an
impact on self-care intentions than the influence of more personal sig-
nificant contacts and that it might be useful to further break down
social self-care into professional and personal aspects (Dorociak
et al., 2017).
When entered on their own in the first step of the regression ana-
lyses predicting behaviour, intention and PBC together explained sig-
nificant amounts of variance; however, intention was the only
significant predictor of behaviour across three of the four self-care
behaviours. These results indicate some support for the role of
WONG AND WHITE
intention as a direct predictor of behavioural performance in relation
to this hypothesized path of the TPB. There was no evidence for the
role of PBC, suggesting the behaviours may be considered to be under
a person's volitional control. When other variables were entered in
the equation predicting behaviour; however, it was action planning,
and not intention, that emerged as the significant predictor of behav-
iour for three of the four self-care behaviours and action planning was
found to have a full mediational effect for the pathway between
intention to behaviour. These findings highlight the importance of
planning when, where and how to engage in self-care and how it can
facilitate the gap between behaviour intentions and engagement as
predicted by the HAPA (Schwarzer, 2008) and is consistent with find-
ings of the mediational role for planning in previous research on
health behaviours, such as physical activity (Cowie, White, &
Hamilton, 2018; Hamilton, Cox, & White, 2012). Planning may be par-
ticularly important for psychologists who have complex roles and are
balancing multiple demands such as coursework (for trainees), clinical
work and personal demands. In addition, psychologists may over-book
themselves when working with high risk clients who may be in crisis.
The process of making a specific plan of when, where and how to
engage in self-care may help psychologists to better manage their
multiple demands and increase their self-care engagement, given con-
straints of their role. The only significant additional variable with a
direct influence on behaviour was organizational climate for psycho-
logical self-care, suggesting an important role for explicit support from
an organization for employee psychological well-being as opposed to
physical, spiritual or social aspects.
Overall, there was substantial support for the TPB in predicting
psychologists' self-care intentions but less support in the prediction of
behaviour with constructs from the HAPA model (i.e., planning) prov-
ing more useful in understanding behaviour execution. In relation to
critiques of the TPB more broadly (e.g., Sniehotta et al., 2014), the
findings of the present study suggest general support for the utility of
the TPB at least for predicting intention but raise questions about the
prediction of behaviour, with the substantial role for action planning
confirming the benefit of adding other relevant constructs, especially
to address the identified intention-behaviour gap.
11.2 | Practical implications
Given that the pattern identified suggesting that personal individuals
or groups important to psychologists are more influential than profes-
sional groups for self-care engagement, it may be useful to consider
the influential roles of partners, friends and family when fostering
self-care behaviour in psychologists. Training institutions and regula-
tory bodies could organize ‘family and friends’ events and provide
information on self-care and its benefits. Social support could be used
to leverage self-care by arranging self-care activities within personal
social circles which may increase motivation to engage in self-care,
such as arranging to go for nature walks with family and friends.
Based on the role of PBC across all four behaviours, efforts to
strengthen control perceptions could be achieved by having realistic
961
self-care intentions, such as going for a short walk instead of having
unattainable activity goals and intending to partake in familiar activi-
ties. Training institutions and regulatory bodies could send out
monthly bulletins containing tips on how to develop realistic goals for
self-care intention to increase psychologists' perceived control of their
self-care.
Given the strong role for action planning on both intention and
behaviour, as part of the planning process, psychologists could set
self-care goals with significant others such as family, friends, col-
leagues and supervisors. Psychologists could incorporate self-care
engagement into their supervision contract with supervisors. Psychol-
ogists could also be encouraged to develop self-care goals with family,
friends and colleagues such as to partake in self-care activities
together at a set time at home or in the work place. Goal setting strat-
egies can also be implemented in the planning process whereby a
good goal is characterized as being specific, stated as a positive,
meaningful, measurable and achievable. Value-based self-care could
also be considered in the planning process as psychologists are more
likely to engage in self-care activities that are in line with their values
such as, if family is an important value, eating dinner with the family
every day may be a value-based self-care activity. It may also be use-
ful to use a graded approach such as focusing on one dimension of
self-care in each planning process to increase the likelihood of adher-
ence to plans (Beck & Beck, 2011). Technology can also be used to
facilitate self-care engagement such as setting reminders for self-care
on the phone as part of the planning process, using step counters on
smart devices for physical self-care and using apps such as mindful-
ness apps on smart phones which can be easily accessible given psy-
chologists may be limited for time. Given that greater self-care
engagement was associated with lower levels of stress and depres-
sion, it is important to plan and continue to engage in self-care to
facilitate self-care as a proactive measure, rather than a reactive mea-
sure, which is in line with findings from research by Rupert and
Dorociak (2019) who found that proactive self-care is more effective
that reactive self-care for stress reduction.
11.3 | Strengths, limitations and future research
The strengths of the present research include using a pilot study to
inform definitions and examples of self-care and identify key
factors that may be related to self-care engagement. However, it is
acknowledged there is a number of ways to conceptualize
and operationalize self-care. Future research could incorporate an
established measure such as the self-care assessment for psycholo-
gists (Dorociak et al., 2017). Dorociak et al., (2017) measure features
the five factors of professional support, professional development,
life balance, cognitive awareness and daily balance; however, as
their research did not provide empirical support for the inclusion of
a physical dimension in their measure, it was not deemed relevant
for the current study given pilot participants in the present study
nominated examples related to the physical dimension as reflecting
self-care.
962
A further strength of the study was its theory-based approach to
understand the underlying factors impacting on psychologists' inten-
tions and behaviour to engage in self-care by utilizing a well-validated
behaviour prediction framework. The study also extended the TPB by
including additional variables to predict self-care intentions and
behaviours in psychologists. It is also a novel approach to investigate
the underlying processes for psychologists to engage in self-care
behaviour across the four different dimensions, enabling the highlight-
ing of differences between the four self-care behaviours.
The present study also has limitations such as the sample com-
prising mainly female participants, although this ratio reflects that of
the psychology profession in Australia. Although it is difficult to know
precisely the difference in findings expected with a greater represen-
tation of male participants, published statistics about engagement in
some self-care activities across the broader population show similar
levels of engagement. For instance, population levels of engagement
in physical activities show similar proportions of males and females
engaged in 150 or more minutes of exercise in the last week in
2017–2018 (Australian Bureau of Statistics, 2019, National Health
Survey). However, engagement in spiritual self-care may exhibit a bias
towards females given the bias in church attendance favouring
women (Pew Research Center, 2016). Differences in the pattern of
significant predictors of self-care may also emerge between gender
groups; more male participants would be needed to undertake mean-
ingful analyses of differences. Another limitation is the inclusion of
both professional and personal groups in the social self-care dimen-
sion as there may be differences in their relative influence on individ-
uals; thus, it may be useful to further break down social self-care into
professional and personal aspects in future research. There may also
be other variables related to the intention–behaviour relationship,
such as the demands of balancing carer responsibilities given that par-
ticipants were mostly female. In future research, it may also be benefi-
cial to examine the full range of constructs in the HAPA model such
as motivation and self-efficacy. The present study was guided by the
responses in the pilot study to inform the selection of variables to
include in the main study.
It is also possible that there may be a self-selection bias in partici-
pants which may limit the generalisability of the current findings to
psychologists who currently engage in self-care behaviour or have
lower levels of stress and depression compared to findings in previous
studies (Cushway, 1992; Dattilio, 2015). Psychologists may also have
familiarity with the mental-health related measures, influencing their
responses. Another limitation of the study is the attrition rate at the
follow-up study, a common occurrence in prospective studies.
12 | CO NC LUSIO N
The present study adopted a theory-based approach to understand
the self-care of psychologists. Overall, support was found for the role
of subjective norm and PBC on self-care intentions and action plan-
ning on behaviour. The average amount of engagement in most forms
of self-care behaviour among psychologists was moderate at best,
WONG AND WHITE
with intentions to do so at higher levels. Encouragingly, greater self-
care engagement was associated, albeit modestly, with lower levels of
stress and depression.
Suggested targets of interventions include strengthening psychol-
ogists' perceived control perceptions, using positive social influence
from important personal others such as friends and family in self-care
support and encouraging the implementation of action planning as
part of their self-care process, with strategies such as the use of con-
tracting and goal setting to facilitate the behavioural enactment of
one's intentions. It is hoped that, by increasing self-care intentions
and behaviour, a culture of self-care in psychologists will be fostered
with increased well-being and a reduction of stress and impact of
other occupational hazards inherent in the psychology profession.
CONFLIC T OF INT ER E ST
On behalf of all authors, the corresponding author states that there
are no conflicts of interest.
DATA AVAILABILITY STAT EMEN T
The data that support the findings of this study are available on
request from the corresponding author. The data are not publicly
available due to ethical restrictions.
OR CID
Katherine M. White https://orcid.org/0000-0002-0345-4724
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1002/cpp.2550

APPENDIX A.

TABLE A1 Psychological self-care: Means, standard deviations and bivariate correlations, between all study variables

Variable 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
1. Intention .42*** .45*** .33*** .44** .57*** .33*** .26*** .21** .08
2. Behaviour .14 .03 .29** .55*** .52*** .29** .16 .25*
3. Attitude .14* .17* .14 .12 .18** .25*** .03
4. Subjective norm .35*** .061 .07 .15* .25*** .22**
5. Perceived behavioural control .35*** .32*** .26*** .15* .29***
6. Action planning .59*** .26*** .09 .06
7. Coping planning .24** .14* .25**
8. Peer norm .56*** .18*
9. Supervisor norm .15
10. Organizational climate
M 5.98 4.59 6.82 6.41 5.13 2.69 2.18 5.80 6.01 4.62
SD 1.13 1.13 .50 .78 1.39 .84 .77 .84 .94 1.41
N 200 110 200 199 200 200 200 200 193 183

Note. Mean scores are based on 7-point scales (1 to 7), except for action planning and coping planning (1 to 4).
*p < .05. **p < .01. ***p < .001.
WONG AND WHITE 965

APPENDIX B .

TABLE B1 Physical/leisure self-care: means, standard deviations and bivariate correlations, between all study variables

Variable 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
1. Intention .37*** .20** .50*** .60*** .65*** .47*** .16* .16* .16*
2. Behaviour .12 .07 .27** .44*** .36*** −.15 −.02 .02
3. Attitude .26*** .08 .12 .07 .11 .06 .04
4. Subjective .36*** .30*** .26*** .39*** .24** .11
norm
5. Perceived .44*** .50*** .17* .20** .30***
behavioural
control
6. Action .62*** .06 .07 .11
planning
7. Coping .06 .16* .18*
planning
8. Peer norm .68*** .17*
9. Supervisor .19**
norm
10. Organizational climate
M 6.08 4.87 6.84 6.43 5.25 3.06 2.39 5.92 6.03 4.62
SD 1.07 1.54 .64 .81 1.51 .80 .82 .90 .86 1.41
N 200 109 200 200 200 200 200 199 194 183

Note. Mean scores are based on 7-point scales (1 to 7), except for action planning and coping planning (1 to 4).
*p < .05. **p < .01. ***p < .001.

APPENDIX C .

TABLE C1 Social self-care: Means, standard deviations and bivariate correlations, between all study variables

Variable 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
1. Intention .32** .15* .57*** .60*** .54*** .38*** .37*** .30*** .08
2. Behaviour .05 .14 .29** .34** .31** .10 .08 .01
3. Attitude .23** .03 .07 .07 .17* .13 −.12
4. Subjective norm .45*** .28*** .17* .42*** .38*** .08
5. Perceived .44*** .37*** .32*** .35*** .20**
Behavioural
control
6. Action planning .57*** .29*** .20** .19*
7. Coping planning .20** .21** .23**
8. Peer norm .71*** .21**
9. Supervisor norm .26***
10. Organizational climate
M 5.95 5.31 6.84 6.31 5.24 2.95 2.34 6.23 6.32 4.62
SD 1.14 1.25 .49 .77 1.34 .77 .88 .77 .78 1.41
N 200 110 200 200 200 199 199 200 193 183

Note. Mean scores are based on 7-point scales (1 to 7), except for action planning and coping planning (1 to 4).
*p < .05. **p < .01. ***p < .001.
966 WONG AND WHITE

APPENDIX D .

TABLE D1 Spiritual self-care: Means, standard deviations and bivariate correlations, between all study variables

Variable 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
1. Intention .57*** .67*** .73*** .57*** .79*** .62*** .39*** .44*** .23**
2. Behaviour .33*** .39*** .39*** .69*** .55*** .21* .23* .35***
3. Attitude .70*** .27*** .51*** .33*** .38*** .43*** .13
4. Subjective .49*** .57*** .50*** .50*** .54*** .30***
norm
5. Perceived .51*** .49*** .29*** .30*** .32***
behavioural
control
6. Action .75*** .32*** .36*** .23**
planning
7. Coping .33*** 31*** .27***
planning
8. Peer norm .82*** .17*
9. Supervisor .22**
norm
10. Organizational climate
M 4.42 3.07 5.78 5.23 5.20 2.14 1.78 4.57 4.75 4.62
SD 1.96 1.84 1.69 1.46 1.29 .98 .88 1.27 1.39 .98
N 200 110 199 200 200 200 200 200 192 183

Note. Mean scores are based on 7-point scales (1 to 7), except for action planning and coping planning (1 to 4).
*p < .05. **p < .01. ***p < .001.

APP E NDIX E : UNSTANDARDIZED REGRESSION COEFFICIENTS FOR THE RELATIONSHIP BETWEEN PSYCHOLOGICAL SELF-CARE
INTENTION AND BEHAVIOUR AS MEDIATED BY ACTION PLANNING
WONG AND WHITE 967

APP E NDIX F : UNSTANDARDIZED REGRESSION COEFFICIENTS FOR THE RELATIONSHIP BETWEEN SPIRITUAL SELF-CARE INTENTION
AND BEHAVIOUR AS MEDIATED BY ACTION PLANNING

APP E NDIX G : UNSTANDARDIZED REGRESSION COEFFICIENTS FOR THE RELATIONSHIP BETWEEN PHYSICAL/LEISURE SELF-CARE
INTENTION AND BEHAVIOUR AS MEDIATED BY ACTION PLANNING
968 WONG AND WHITE

APP E NDIX H : UNSTANDARDIZED REGRESSION COEFFICIENTS FOR THE RELATIONSHIP BETWEEN SOCIAL SELF-CARE INTENTION
AND BEHAVIOUR AS MEDIATED BY ACTION PLANNING
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