Next Article in Journal
Father Involvement and Children’s Social Behavior: A Three-Level Meta-Analysis
Previous Article in Journal
Navigating the Unknown: A Sensemaking Inquiry into the Mental Health Experiences of First-Year University Students at a Regional University in Fiji
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Behavioral Sciences
Volume 16
Issue 8
10.3390/bs16081425
behavsci-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Therapists’ Personal Identity Factors and Professional Self-Efficacy: A Path Analysis Model

by
Alessio Gori
1,2,* and
Eleonora Topino
3
1
Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Florence, Italy
2
Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
3
Department of Theoretical and Applied Sciences, e-Campus University, Via Isimbardi 10, 22060 Novedrate, Italy
*
Author to whom correspondence should be addressed.
Behav. Sci. 2026, 16(8), 1425; https://doi.org/10.3390/bs16081425
Submission received: 25 May 2026 / Revised: 21 July 2026 / Accepted: 9 August 2026 / Published: 19 August 2026
Browse Figure
Versions Notes

Abstract

The integration of the Internet into clinical practice has facilitated the implementation of digital mental health interventions, including eTherapy. In this context, the present study examined factors associated with Therapist Self-Efficacy during synchronous video-based eTherapy, specifically focusing on Self-Esteem, General Self-Efficacy, and Insight Orientation while controlling for Years of Clinical Practice. A sample of 290 mental health professionals (39% psychologists; 61% psychotherapists) completed a survey including the Therapist Self-Efficacy Scale, General Self-Efficacy Scale, Rosenberg Self-Esteem Scale, and Insight Orientation Scale. A path analysis was performed to analyse the collected data. Results showed a significant total mediation model. Specifically, significant and positive total effects in the relationships of Self-Esteem and General Self-Efficacy with Professional Self-Efficacy emerged. Furthermore, Insight Orientation fully mediated these associations. Years of Clinical Practice was not significantly associated with Therapist Self-Efficacy. These findings may inform the development of tailored eTherapy training for mental health professionals.

1. Introduction

Over recent decades, technological developments have enabled the implementation of eTherapy in mental health care. eTherapy has been defined as a “professional therapeutic interaction that makes use of the Internet to connect qualified mental health professionals and their clients” (Rochlen et al., 2004, p. 270). This modality has broadened access to specialized mental health services by reducing physical barriers (e.g., distance, difficulty in moving; Leykin et al., 2012; Stoll et al., 2020), and psychosocial barriers (e.g., perceived stigma; Marques et al., 2010). At the same time, the implementation of this modality requires the professional to adopt some safeguards so that the therapeutic process is not hindered both by technical (e.g., there must be a good connection and an adequate camera resolution; Waller et al., 2020) and/or ethical (e.g., Internet communications must be secure; Scharff, 2012; Stoll et al., 2020) issues. Indeed, synchronous video-based psychotherapy requires therapists to adapt established clinical skills to a setting characterized by physical distance, reduced access to bodily and contextual cues, possible technical disruptions, and different challenges in maintaining emotional connection and therapeutic presence. Research has shown that therapists may experience lower therapeutic presence during teletherapy and that concerns about connecting with clients online are associated with less favorable perceptions of this modality. Conversely, mastery of teletherapy-specific interventions has been associated with stronger working alliance, real relationship, and therapeutic presence (Békés et al., 2021; Békés et al., 2023; Aafjes-Van Doorn et al., 2024). In this framework, the dimension of professional self-efficacy appears to be of great relevance (Gori et al., 2022a): indeed, it is essential that clinicians who decide to practice eTherapy feel capable of adapting to this web-based modality while maintaining confidence in their professional skills. Professional self-efficacy refers to an individual’s confidence in their ability to achieve quality results in the professional tasks of their specific occupation (Fraser et al., 2018; Yoo & Cho, 2020). In the mental health field, it was associated with higher compassion satisfaction (Saleem & Hawamdeh, 2022), job and role satisfaction (Lent et al., 2009), lower levels of emotional exhaustion, depersonalization (Gunduz, 2012), and anxiety (Daniels & Larson, 2001), as well as more realistic definitions of clinical goals and more effective performance (Reese et al., 2009). Considering these meaningful outcomes, the study of the personal factors associated with mental health therapists’ professional self-efficacy is of great interest both in the clinical and research fields. Previous evidence has defined Professional Self-Efficacy as a component of professional identity (Heled & Davidovitch, 2021; Tan et al., 2017), which refers to the meanings, values, roles, knowledge, and competencies through which individuals define themselves as members of a profession (Tan et al., 2017; Wiles, 2013). Experienced counsellors have described their personal characteristics and life experiences as informing who they are professionally (Alves & Gazzola, 2011), while research on counsellor and therapist development has conceptualized professional growth as a lifelong process of integration between the personal and professional selves, supported by continuous reflection (Rønnestad & Skovholt, 2003). Following this research line, the present study examined the association between some personal identity factors and Professional Self-Efficacy during eTherapy in a synchronous video-based setting, by specifically investigating the relationships with Self-Esteem, General Self-Efficacy, and Insight Orientation.
Self-esteem refers to individuals’ global evaluation of themselves as persons (Rosenberg, 1965b). It is a constitutive and supportive element of one’s personal identity (Luyckx et al., 2013): individuals with higher levels of self-esteem are more inclined to consider themselves worthy and capable, whereas individuals with lower self-esteem are more likely to doubt their self-worth (see Pyszczynski et al., 2004 for a review). Consistently, self-esteem has shown negative relationships with depression and anxiety (see Sowislo & Orth, 2013, for a meta-analysis), and positive associations with well-being (Pandey et al., 2021), happiness (Dogan et al., 2013), and greater openness towards self-insight (Kwan et al., 2004). Furthermore, in the organizational field, it was related to high skill confidence (Betz & Klein, 1996), career decision self-efficacy (Choi et al., 2012), and occupational self-efficacy (Peng et al., 2021). Within psychotherapy, the relevance of Self-Esteem is also supported by evidence that therapists’ personal self-concept, in interaction with professional self-doubt, is associated with patient change and may be expressed through therapists’ in-session behavior (Nissen-Lie et al., 2017).
General Self-Efficacy refers to an element of one’s personal identity that concerns people’s beliefs about their ability to activate and use their motivations and personal resources to meet situational demands (Bandura, 1986, 1997; Berzonsky, 1992; Zhou, 2016). Individuals with high levels of self-efficacy perceive themselves as effective in overcoming difficulties to achieve their goals, and tend to persist in facing obstacles, increasing the chances of success; on the other hand, those with lower self-efficacy usually have lower aspirations and greater difficulty pursuing their goals (Feltz et al., 2008). General self-efficacy has been associated with optimism (Salanova et al., 2011) and subjective well-being (Céspedes et al., 2021), as well as with a greater aptitude for reflexivity (van Seggelen-Damen & van Dam, 2016; Gori et al., 2021a). In the professional field, individuals with higher general self-efficacy showed better performance (Lee & Ko, 2010), as well as higher commitment (Bowling et al., 2010), job satisfaction (Kondratowicz et al., 2022), and occupational self-efficacy (Betz & Klein, 1996). Among psychotherapy trainees, General Self-Efficacy has shown an association with Counseling Self-Efficacy, suggesting that broad beliefs about one’s ability to cope with demands may provide a general basis for confidence in performing therapy-specific tasks (Hahn et al., 2021).
Finally, previous evidence showed that the perception of the self is significantly associated with self-reflection and self-insight (Cowden & Meyer-Weitz, 2016). Insight is a complex construct (Castonguay & Hill, 2007) definable as a “dynamic variable that ranges from superficial consciousness to complex comprehension of elaborated emotional material” (Gori et al., 2015, p. 298). It is associated with adaptive behaviors (Gabbard, 2014) and a better quality of life (Gibbons et al., 2009). Furthermore, people with higher insight orientation also showed higher job satisfaction (Gori & Topino, 2020), job crafting (Gori et al., 2021b), and professional self-efficacy (Gori et al., 2022a). Insight Orientation may be particularly relevant to psychotherapy because self-reflection and self-awareness help clinicians distinguish their own needs and reactions from those of clients, recognize transference and countertransference processes, and make more considered clinical and ethical decisions (Gori et al., 2015; Prasko et al., 2023).
Taken together, previous research has highlighted both the relevance of these personal dimensions to therapists’ professional functioning and the close interplay between personal and professional aspects of therapist development (Alves & Gazzola, 2011; Rønnestad & Skovholt, 2003; Nissen-Lie et al., 2017; Hahn et al., 2021; Prasko et al., 2023). However, studies examining how Self-Esteem, General Self-Efficacy, and Insight Orientation are jointly associated with Professional Self-Efficacy in synchronous video-based eTherapy remain limited.
Given this theoretical and empirical framework, the present study examined the associations of Self-Esteem, General Self-Efficacy, and Insight Orientation with Therapist Self-Efficacy during synchronous video-based eTherapy in a sample of mental health professionals. To this end, a path analysis mediation model was tested, with the following hypotheses:
H1: 
Self-esteem and General Self-Efficacy would be significantly and positively associated with Professional Self-Efficacy;
H2: 
Self-esteem and General Self-Efficacy would be significantly and positively associated with Insight Orientation;
H3: 
Insight Orientation would be significantly and positively associated with Professional Self-Efficacy;
H4: 
Insight Orientation would significantly mediate, either partially or fully, the associations of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy.
Finally, previous evidence has suggested that clinical experience may be associated with therapists’ perceived professional efficacy (Wampold et al., 2017). Although evidence concerning this association in eTherapy remains limited (e.g., Gori et al., 2022a), Years of Clinical Practice was included as a covariate to examine whether the hypothesized associations remained significant after accounting for general clinical seniority.

2. Materials and Methods

2.1. Study Design, Participants, and Procedure

This study adopted a quantitative, non-experimental, cross-sectional, and correlational design. The study was conducted in Italy, and data were collected during a single recruitment wave lasting approximately 6 months through an online self-report survey administered via Google Forms. No pilot study was conducted prior to the main data collection. A sample of 290 mental health professionals was involved in this research (see Table 1). Most participants were female (n = 257, 88.6%). Participants ranged in age from 25 to 71 years (M_age = 38.25, SD = 8.40). Concerning professional qualification, 39% were psychologists and 61% were psychotherapists. Participants were recruited through a non-probability snowball sampling procedure. Eligibility criteria were being a licensed psychologist, with or without a specialization in psychotherapy, having sufficient proficiency in Italian, and providing electronic informed consent. No additional exclusion criteria were applied. The survey link was initially disseminated through the researchers’ professional contacts and through social media groups whose membership was restricted to mental health professionals. The recruitment message invited licensed psychologists to participate in a study on professional self-efficacy and encouraged them to share the survey with other colleagues who met the eligibility criteria. More detailed information about the specific aims and procedures of the research was provided on the first page of the survey.
The survey consisted of four sections. The first section provided detailed information about the study aims and procedures. The second section presented the informed consent form, and only participants who provided their consent were allowed to continue. The third section collected demographic and professional information, including age, sex, professional qualification, Years of Clinical Practice, and, for psychotherapists, Theoretical Orientation. The fourth section included the self-report measures. The survey required approximately 15 min to complete. All survey questions were mandatory; consequently, participants could not submit the questionnaire with unanswered items, and no item-level missing data were present in the final dataset. Participation was voluntary, and no financial or other incentives were offered. All procedures of this research were approved by the first author’s institutional Ethicas Committee.

2.2. Measures

2.2.1. Therapist Self-Efficacy Scale (T-SES)

The Therapist Self-Efficacy Scale (T-SES; Gori et al., 2022a) is a self-report measure designed to assess mental health therapists’ professional self-efficacy. The T-SES consists of 21 items rated on a 5-point Likert scale, from 1 (not at all) to 5 (a great deal). The scale was originally validated to assess clinicians’ self-confidence during eTherapy (Gori et al., 2022a). The original Italian validation supported a one-factor structure explaining 70% of the variance and showed excellent internal consistency (α = 0.93; ω = 0.94). Although the items cover six clinically relevant content areas (communicative effectiveness, clinical competence, intrapsychic competence, relational competence, affect regulation, and diagnostic skills), these areas do not constitute separate subscales; therefore, only the total score, ranging from 21 to 105, was used (Gori et al., 2022a). In the present research, the total score of the original (Italian) version was used, and it showed excellent internal consistency (Cronbach’s α value of 0.97).

2.2.2. General Self-Efficacy Scale (GSE)

The General Self-Efficacy Scale (GSE; Schwarzer & Jerusalem, 1995) is a self-report measure designed to assess general self-efficacy. The GSE consists of 10 items rated on a 4-point Likert scale, from 1 (not at all true for me) to 4 (very true for me). Cross-national psychometric analyses supported the unidimensional structure of the scale, with internal consistency values of α = 0.81 for the German version and α = 0.79 for the Italian adaptation (Scholz et al., 2002). The total score ranges from 10 to 40, and no subscale scores were calculated. In the present research, the total score of the Italian version (Sibilia et al., 1995) was used, and it showed excellent internal consistency (Cronbach’s α value of 0.90).

2.2.3. Rosenberg Self-Esteem Scale (RSES)

The Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965a) is a self-report measure designed to assess global self-esteem. The RSES consists of 10 items rated on a 4-point Likert scale, from 0 (strongly disagree) to 3 (strongly agree). The original version showed a coefficient of reproducibility of 0.92 (Rosenberg, 1965a, 1965b), whereas the Italian validation showed good internal consistency (α = 0.84) and test–retest reliability (r = 0.76; Prezza et al., 1997). The RSES provides a global Self-Esteem score ranging from 0 to 30; therefore, no subscale scores were calculated. In the present research, the total score of the Italian version (Prezza et al., 1997) was used, and it showed good internal consistency (Cronbach’s α value of 0.81).

2.2.4. Insight Orientation Scale (IOS)

The Insight Orientation Scale (IOS; Gori et al., 2015, 2022b) is a self-report measure designed to assess the levels of insight. The IOS consists of 7 items scored on a 5-point Likert scale, from 1 (not at all) to 5 (a great deal). The original validation showed satisfactory internal consistency (α = 0.77) and evidence of concurrent and discriminant validity, while a subsequent Item Response Theory analysis further supported its psychometric stability and measurement precision (Gori et al., 2015, 2022b). The total score ranges from 7 to 35, and the seven components assessed by the items do not constitute separate subscales. In the present research, the total score of the original (Italian) version was used, and it showed good internal consistency (Cronbach’s α value of 0.86).

2.3. Data Analysis

All statistical analyses were performed using SPSS 21.0 (v. 21.0; IBM, New York, NY, USA) and AMOS 24.0 (v. 24.0; IBM, New York, NY, USA). Descriptive statistics were calculated. Partial correlations controlling for Years of Clinical Practice were calculated to examine associations among the study variables. Then, the hypothesized model was tested by implementing a path analysis (Bollen & Long, 1993), to investigate the mediation of Insight Orientation in the relationship of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy during eTherapy, also controlling for Years of Clinical Practice. The following goodness-of-fit indicators were used to assess the statistical fit of the model: the model Chi-square (χ2), indicating a good model fit when p > 0.05 (Hooper et al., 2008); the normed-fit index (NFI), Tucker–Lewis index (TLI), and Comparative Fit Index (CFI) indicating a reasonable fit for values above 0.90 (Byrne, 1994; Kline, 2015; Hu & Bentler, 1999); the root mean square error of approximation (RMSEA) and the standardized root mean square residual (SRMR), indicating a reasonable fit for values below 0.08 (Hooper et al., 2008; Marsh & Hocevar, 1985). The R2 index was also explored, considering values < 0.02 as indicative of very weak effect, values between 0.02 and 0.12 as indicative of a weak effect, values between 0.13 and 0.26 as indicative of a moderate effect, values > 0.26 as indicative of a substantial effect (Cohen, 1988). The bootstrapping technique (5000 bootstrapped samples with 95% bias-corrected bootstrap confidence intervals) was performed to support the statistical stability of the model (Preacher & Hayes, 2008). Finally, a post hoc power analysis was conducted using G*Power version 3.1.9.7 (Faul et al., 2009), based on a fixed-effects linear multiple regression model testing the deviation of R2 from zero. In accordance with Cohen’s (1988) conventional criterion, statistical power values of 0.80 or higher were considered adequate.

3. Results

The largest proportion of participants (32%) declared more than 10 years of clinical practice (see Table 1). Concerning the Psychotherapists’ Theoretical Orientation, 13% of the sample were integrated, 11% systemic, 10% cognitive behavioral, 10% psychodynamic, 6% cognitive, 6% humanistic, and 5% psychoanalytic (see Table 1).
Correlation analysis showed significant and positive relationships between the observed variables (see Table 2). Therapist Self-Efficacy during eTherapy was significantly and positively associated with General Self-Efficacy (r = 0.33, p < 0.01), Self-Esteem (r = 0.29, p < 0.01), and Insight Orientation (r = 0.51, p < 0.01).
Concerning the path analysis, the hypothesized path model showed a satisfactory overall fit: χ2 (2) = 5.721 (p = 0.057), NFI = 0.979; TLI = 0.927, CFI = 0.985, RMSEA = 0.080, SRMR = 0.042 (see Figure 1).
Specifically, Self-Esteem and General Self-Efficacy showed a significant total effect in their relationship with Therapist Self-Efficacy during eTherapy (H1; β = 0.18, p < 0.01 and β = 0.25, p < 0.001, respectively). Furthermore, both Self-Esteem and General Self-Efficacy were significantly and positively associated with Insight orientation (H2; β = 0.17, p < 0.01 and β = 0.45, p < 0.001, respectively), which in turn showed a significant relationship with Therapist Self-Efficacy during eTherapy (H3; β = 0.45, p < 0.001). Concerning the covariate, no significant effects have been highlighted between Years of Clinical Practice and Insight Orientation (p = 0.220) and Therapist Self-Efficacy during eTherapy (p = 0.115). Finally, when included in the model, Insight orientation fully mediated the effect of Self-Esteem and General Self-Efficacy on Therapist Self-Efficacy during eTherapy, determining non-significant direct effects (H4; see Figure 1 and Table 3).
The model explained 28% of the total variance, indicating a substantial effect (R2 > 0.26).
The post hoc power analysis yielded a value exceeding the conventional adequacy criterion of 0.80, indicating adequate statistical sensitivity to detect the observed overall model effect.
The bootstrapping technique supported the statistical stability of the model (see Table 3).

4. Discussion

Technology and the Internet have become increasingly integrated into mental health practice. Evidence indicates that eTherapy can be effective across different therapeutic approaches, diagnostic and assessment contexts, and populations, with treatment outcomes comparable to those of in-person interventions (Barnett et al., 2021; Bashshur et al., 2016; Hilty et al., 2013; Lin et al., 2022). Because therapeutic outcomes are also associated with clinicians’ characteristics and perceptions (the so-called therapist effect; Barkham et al., 2017), therapists’ confidence in their ability to facilitate therapeutic processes through synchronous video-based care warrants specific attention. Accordingly, the present research aimed at exploring the interaction of different personal characteristics in influencing Therapist Self-Efficacy during eTherapy in a synchronous video-based setting by focusing on Self-Esteem, General Self-Efficacy, and Insight Orientation.
Overall, the findings suggest that general evaluations of personal worth and capability and the tendency to reflect on and understand one’s internal experiences represent distinct but interrelated dimensions associated with clinicians’ confidence in providing online psychological interventions. Self-Esteem and General Self-Efficacy showed significant and positive total effects in their relationships with Professional Self-Efficacy, supporting the first hypothesis (H1). This was in line with previous research. Indeed, higher levels of self-esteem have been associated with higher job satisfaction (Reilly et al., 2014), lower risk of burnout (Molero Jurado et al., 2018), and better self-conception as a professional (Glotova & Wilhelm, 2014). In parallel, individuals with greater self-efficacy presented a greater perception of professional competence (Yao et al., 2021), higher resilience scores (Orkaizagirre-Gómara et al., 2020) and professional commitment (Cheng et al., 2021), as well as lower perceived stress (Orkaizagirre-Gómara et al., 2020). Taken together, the present findings and previous evidence suggest that general evaluations of personal worth and capability may also be reflected in the way clinicians evaluate their ability to manage the specific demands of online therapeutic practice. These broad personal resources may be particularly relevant when therapists must sustain confidence while managing technology-mediated communication, possible technical disruptions, and reduced access to some non-verbal and contextual cues (Simpson & Reid, 2014; Stoll et al., 2020).
Self-Esteem and General Self-Efficacy were also significantly and positively related to Insight Orientation, confirming the second hypothesis (H2). Consistently, previous evidence showed a significant and positive relationship between self-esteem and self-insight (Kwan et al., 2004), as well as the significant predictive role of general self-efficacy on reflection (van Seggelen-Damen & van Dam, 2016), one of the core constitutive elements of insight orientation (Castonguay & Hill, 2007; Gori et al., 2015). In turn, Insight Orientation was significantly and positively associated with Professional Self-Efficacy, in line with the third hypothesis (H3). Reflective thinking and self-awareness have been identified as fundamental competencies for mental health professionals by the British Psychological Society (2006). The American Psychological Association (2012) also included these components in its definition of “Professionalism”, which encompasses reflective practice, self-evaluation, and self-care. In the specific context of eTherapy, Insight Orientation may be relevant because professional confidence does not depend solely on technical knowledge. Online clinical practice may also require therapists to monitor their own reactions, recognize personal strengths and limitations, and adapt established therapeutic skills to a technologically mediated relational setting.
Consistently, results also showed that Insight Orientation fully mediated the associations of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy, confirming the final hypothesis (H4). This pattern can be interpreted in light of the literature highlighting the relevance of personal factors to professional confidence (Holland et al., 2012; Gori et al., 2023). In this regard, Nuttman-Schwartz (2017) argued that individuals simultaneously inhabit multiple identities that, although distinguishable, are deeply intertwined (Wijeyesinghe & Jones, 2014). Accordingly, the present findings are consistent with the view that personal identity-related dimensions are associated with professional identity, understood as the meanings individuals attribute to themselves within their professional context (Wiles, 2013). Conceptually, Self-Esteem and General Self-Efficacy reflect broad evaluations of personal worth and capability, whereas Insight Orientation involves reflective understanding of internal experiences (Gori et al., 2015). It may therefore represent the process through which these general personal resources are associated with a more differentiated appraisal of therapists’ professional strengths and limitations, consistently with models emphasizing reflection in therapist development (Rønnestad & Skovholt, 2003; van Seggelen-Damen & van Dam, 2016; Gori et al., 2022a). In synchronous video-based eTherapy, this reflective dimension may be especially relevant because therapists must evaluate their ability to adapt communication, relational attunement, and established clinical skills to the online medium (Simpson & Reid, 2014; Stoll et al., 2020).
Finally, Years of Clinical Practice was included as a covariate and was not significantly associated with either Insight Orientation or Therapist Self-Efficacy during eTherapy. This result is consistent with previous evidence (Gori et al., 2022a) and suggests that confidence in online clinical practice may not be directly related to the duration of face-to-face clinical experience. One possible interpretation is that eTherapy presents specific technological, communicative, and relational demands that differ from those encountered in traditional in-person practice. The technologically mediated setting may also reduce some of the advantages ordinarily associated with clinical seniority, as established therapeutic skills and routines must be adapted to different channels of communication and interaction. These findings therefore suggest the potential value of training specifically focused on online clinical practice, in line with previous evidence linking education and training to therapist self-efficacy (Meyer, 2015; Poletti et al., 2020; Reese et al., 2009). Familiarity with video-based platforms, previous eTherapy practice, specific telepsychology training, and perceived digital competence may be more relevant than the overall number of years spent in face-to-face clinical work. Adaptation to eTherapy may also be associated more closely with flexibility and attitudes toward technology than with professional seniority alone. Although younger clinicians may be more familiar with digital communication, greater age or clinical experience does not necessarily imply lower adaptability; therefore, these possibilities require direct empirical examination. Research on psychologists’ digital competence has highlighted considerable variability across digital tasks and identified clinicians’ skills, technical conditions, workplace support, and training as relevant dimensions of digital practice (Dobson et al., 2022). Future studies should therefore distinguish general clinical seniority from eTherapy-specific experience and directly assess digital competence, previous training, frequency of online sessions, attitudes toward technology, flexibility in adapting clinical practices, and familiarity with digital platforms.
The model explained 28% of the variance in Therapist Self-Efficacy, suggesting that the personal dimensions examined account for a meaningful, although necessarily partial, proportion of clinicians’ confidence in providing eTherapy. At the same time, alternative explanations and potential contextual confounders should be considered. Professional self-efficacy may also be associated with factors more specific to digital practice, including prior exposure to online therapy, attitudes toward technology, eTherapy-related preparation, digital competence, targeted training, and workplace or technical support (Chen et al., 2023; Dobson et al., 2022). These variables may further shape clinicians’ familiarity with digital platforms and their confidence in managing the technical and relational demands of online practice, and may therefore have contributed to the observed pattern of associations. Thus, the present model highlights a relevant set of personal correlates within the broader, multifactorial nature of Therapist Self-Efficacy.
The present study has some limitations that should be addressed. First, the cross-sectional design does not allow the temporal ordering or causal direction of the observed associations to be established. Alternative temporal sequences and reciprocal relationships are also plausible. Future longitudinal studies, particularly those including repeated assessments and cross-lagged analyses, could clarify the direction, temporal development, and possible reciprocal nature of these associations.
Furthermore, the sample was predominantly female, which may limit the generalizability of the findings to male professionals. This marked gender imbalance also prevented an in-depth examination of potential gender-related differences. Information concerning participants’ ethnicity, cultural background, and geographic distribution was also not collected, limiting the assessment of the sample’s sociocultural and geographic representativeness. Future studies could strengthen the generalizability of the present findings by including more gender-balanced and socioculturally and geographically diverse samples.
In addition, the online snowball sampling procedure may have preferentially reached professionals who were more familiar with digital technologies or more interested in eTherapy. Although this recruitment strategy enabled access to a relevant professional population, it may have resulted in a greater representation of clinicians who felt more comfortable with online practice. Future research could complement online recruitment with broader professional channels to include clinicians with different levels of digital experience and confidence in eTherapy.
Finally, all key variables were assessed through validated self-report measures. Although these instruments provided reliable information on participants’ perceptions, the use of a single assessment method may be associated with common method variance and response biases. Future studies could integrate self-report measures with interviews, supervisor evaluations, behavioral indicators, or client-reported outcomes to provide a more comprehensive assessment.

5. Conclusions

Among the factors associated with effective therapeutic practice, previous evidence has highlighted the relevance of mental health professionals’ confidence in their personal and professional resources and in their ability to apply them within clinical work (Hatcher et al., 2013; Knapp et al., 2017). In light of this, and given the growing integration of the Internet into mental health practice, the present study focused on factors associated with Professional Self-Efficacy during synchronous video-based eTherapy. Specifically, it examined its associations with Self-Esteem, General Self-Efficacy, and Insight Orientation, while controlling for Years of Clinical Practice as a covariate. Results showed significant positive total associations of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy, both of which were fully mediated by Insight Orientation. This interpretation is consistent with Gori et al.’s (2022a) conceptualization of Therapist Self-Efficacy as therapists’ awareness and appraisal of their ability to facilitate therapeutic processes and promote change across clinical settings. Finally, Years of Clinical Practice was not significantly associated with Therapist Self-Efficacy, suggesting that general clinical seniority may not be directly related to confidence in providing online therapy. These findings may have relevant practical implications, pointing to the potential value of specific eTherapy training for mental health professionals. Such programs could address the technical and ethical management of online practice, including the appropriate use of digital platforms, confidentiality, data protection, informed consent, and the management of technical disruptions and emergency situations. They could also focus on adapting therapeutic communication, assessment procedures, alliance-building, and the interpretation of verbal and non-verbal cues to synchronous video-based settings. Finally, reflective supervision could support clinicians in examining their emotional reactions, perceived strengths and limitations, and confidence in managing the specific relational and organizational demands of online therapy.

Author Contributions

Conceptualization: A.G.; Data curation: A.G., and E.T.; Formal analysis: A.G., and E.T.; Investigation: A.G.; Methodology: A.G., and E.T.; Project administration: A.G.; Writing—original draft: A.G., E.T.; Writing—review and editing: A.G., E.T.; Supervision: A.G. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Integrated Psychodynamic Psychotherapy Institute (ethical approval number 014/2022, 22 April 2022).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data presented in this study are available on request from the corresponding author.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Aafjes-Van Doorn, K., Békés, V., Luo, X., & Hopwood, C. J. (2024). Therapists’ perception of the working alliance, real relationship and therapeutic presence in in-person therapy versus tele-therapy. Psychotherapy Research, 34(5), 574–588. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  2. Alves, S., & Gazzola, N. (2011). Professional identity: A qualitative inquiry of experienced counsellors. Canadian Journal of Counselling and Psychotherapy, 45(3), 189–207. Available online: https://files.eric.ed.gov/fulltext/EJ944808.pdf (accessed on 14 July 2026).
  3. American Psychological Association. (2012). Revised competency benchmarks in professional psychology. American Psychological Association. Available online: https://www.apa.org/ed/graduate/benchmarks-evaluation-system (accessed on 6 December 2020).
  4. Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of Social and Clinical Psychology, 4(3), 359–373. [Google Scholar] [CrossRef] [Scilit]
  5. Bandura, A. (1997). Self-efficacy: The exercise of self-control. Freeman. [Google Scholar]
  6. Barkham, M., Lutz, W., Lambert, M. J., & Saxon, D. (2017). Therapist effects, effective therapists, and the law of variability. In L. G. Castonguay, & C. E. Hill (Eds.), How and why are some therapists better than others? Understanding therapist effects (pp. 13–36). American Psychological Association. [Google Scholar]
  7. Barnett, P., Goulding, L., Casetta, C., Jordan, H., Sheridan-Rains, L., Steare, T., & Johnson, S. (2021). Tele-mental health services: A rapid umbrella review of pre-COVID-19 literature. Journal of Medical Internet Research, 23(7), e26492. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  8. Bashshur, R. L., Shannon, G. W., Bashshur, N., & Yellowlees, P. M. (2016). The empirical evidence for telemedicine interventions in mental disorders. Telemedicine and e-Health, 22(2), 87–113. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  9. Berzonsky, M. D. (1992). Identity style and coping strategies. Journal of Personality, 60(4), 771–788. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  10. Betz, N. E., & Klein, K. L. (1996). Relationships among measures of career self-efficacy, generalized self-efficacy, and global self-esteem. Journal of Career Assessment, 4(3), 285–298. [Google Scholar] [CrossRef] [Scilit]
  11. Békés, V., Aafjes-van Doorn, K., Luo, X., Balarajan, S., & Hopwood, C. J. (2023). Mastery of teletherapy is related to better therapeutic relationship and presence in teletherapy: The development of the teletherapy intervention scale. Frontiers in Psychology, 14, 1206960. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  12. Békés, V., Aafjes-van Doorn, K., Luo, X., Prout, T. A., & Hoffman, L. (2021). Psychotherapists’ challenges with online therapy during COVID-19: Concerns about connectedness predict therapists’ negative view of online therapy and its perceived efficacy over time. Frontiers in Psychology, 12, 705699. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  13. Bollen, K. A., & Long, J. S. (1993). Testing structural equation models (Vol. 154). Sage. [Google Scholar]
  14. Bowling, N. A., Eschleman, K. J., Wang, Q., Kirkendall, C., & Alarcon, G. (2010). A meta-analysis of the predictors and consequences of organization-based self-esteem. Journal of Occupational and Organizational Psychology, 83(3), 601–626. [Google Scholar] [CrossRef] [Scilit]
  15. British Psychological Society. (2006). Core competencies—Clinical psychology: A guide. Leicester. [Google Scholar]
  16. Byrne, B. M. (1994). Structural equation modeling with EQS and EQS/windows: Basic concepts, applications, and programming. Sage. [Google Scholar]
  17. Castonguay, L. G., & Hill, C. E. (2007). Insight in psychotherapy. American Psychological Association. [Google Scholar]
  18. Céspedes, C., Rubio, A., Viñas, F., Malo Cerrato, S., Lara-Órdenes, E., & Ríos, J. (2021). Relationship between self-concept, self-efficacy, and subjective well-being of native and migrant adolescents. Frontiers in Psychology, 11, 620782. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  19. Chen, W.-C., Chan, H.-Y., Sung, Y.-H., Chen, P.-L., Hung, Y.-F., Huang, K.-C., & Hsu, S.-S. (2023). Therapists’ practical implementation and preparation of online counseling in the post-pandemic era. Current Psychology, 42, 30548–30560. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  20. Cheng, L., Chen, Q., & Zhang, F. (2021). Mediating effects of meaning in life on the relationship between general self-efficacy and nursing professional commitment in nursing students: A structural equation modeling approach. Medicine, 100(29), e26754. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  21. Choi, B. Y., Park, H., Yang, E., Lee, S. K., Lee, Y., & Lee, S. M. (2012). Understanding career decision self-efficacy: A meta-analytic approach. Journal of Career Development, 39(5), 443–460. [Google Scholar] [CrossRef] [Scilit]
  22. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates. [Google Scholar]
  23. Cowden, R. G., & Meyer-Weitz, A. (2016). Self-reflection and self-insight predict resilience and stress in competitive tennis. Social Behavior and Personality: An International Journal, 44(7), 1133–1149. [Google Scholar] [CrossRef] [Scilit]
  24. Daniels, J. A., & Larson, L. M. (2001). The impact of performance feedback on counseling self-efficacy and counselor anxiety. Counselor Education and Supervision, 41(2), 120–130. [Google Scholar] [CrossRef] [Scilit]
  25. Dobson, R., Variava, R., Douglas, M., & Reynolds, L. M. (2022). Digital competency of psychologists in Aotearoa New Zealand: A cross-sectional survey. Frontiers in Digital Health, 4, 951366. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  26. Dogan, T., Totan, T., & Sapmaz, F. (2013). The role of self-esteem, psychological well-being, emotional self-efficacy, and affect balance on happiness: A path model. European Scientific Journal, 9(20), 31–42. [Google Scholar]
  27. Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  28. Feltz, D. L., Short, S. E., & Sullivan, P. J. (2008). Self-efficacy in sport. Human Kinetics. [Google Scholar]
  29. Fraser, J. A., Flemington, T., Doan, D. T. N., Le Doan, B. T., & Ha, T. M. (2018). Professional self-efficacy for responding to child abuse presentations. Journal of Children’s Services, 13(3/4), 81–92. [Google Scholar] [CrossRef] [Scilit]
  30. Gabbard, G. O. (2014). Psychodynamic psychiatry in clinical practice. American Psychiatric Pub. [Google Scholar]
  31. Gibbons, M. B. C., Crits-Christoph, P., Barber, J. P., Wiltsey Stirman, S., Gallop, R., Goldstein, L. A., Temes, C. M., & Ring-Kurtz, S. (2009). Unique and common mechanisms of change across cognitive and dynamic psychotherapies. Journal of Consulting and Clinical Psychology, 77(5), 801–813. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  32. Glotova, G., & Wilhelm, A. (2014). Teacher’s self-concept and self-esteem in pedagogical communication. Procedia-Social and Behavioral Sciences, 132, 509–514. [Google Scholar] [CrossRef] [Scilit]
  33. Gori, A., Arcioni, A., Topino, E., Craparo, G., & Lauro Grotto, R. (2021a). Development of a new measure for assessing mentalizing: The multidimensional mentalizing questionnaire (MMQ). Journal of Personalized Medicine, 11(4), 305. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  34. Gori, A., Arcioni, A., Topino, E., Palazzeschi, L., & Di Fabio, A. (2021b). Constructing well-being in organizations: First empirical results on job crafting, personality traits, and insight. International Journal of Environmental Research and Public Health, 18(12), 6661. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  35. Gori, A., Craparo, G., Giannini, M., Loscalzo, Y., Caretti, V., La Barbera, D., & Schuldberg, D. (2015). Development of a new measure for assessing insight: Psychometric properties of the insight orientation scale (IOS). Schizophrenia Research, 169(1–3), 298–302. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  36. Gori, A., & Topino, E. (2020). Predisposition to change is linked to job satisfaction: Assessing the mediation roles of workplace relation civility and insight. International Journal of Environmental Research and Public Health, 17(6), 2141. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  37. Gori, A., Topino, E., Brugnera, A., & Compare, A. (2022a). Assessment of professional self-efficacy in psychological interventions and psychotherapy sessions: Development of the Therapist Self-Efficacy Scale (T-SES) and its application for eTherapy. Journal of Clinical Psychology, 78(11), 2122–2144. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  38. Gori, A., Topino, E., Cacioppo, M., Schimmenti, A., & Caretti, V. (2023). Definition and criteria for the assessment of expertise in psychotherapy: Development of the psychotherapy expertise questionnaire (PEQ). European Journal of Investigation in Health, Psychology and Education, 13(11), 2478–2497. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  39. Gori, A., Topino, E., Svicher, A., Schuldberg, D., & Di Fabio, A. (2022b). Insight orientation scale: A promising tool for organizational outcomes—A psychometric analysis using item response theory. Frontiers in Psychology, 13, 987931. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  40. Gunduz, B. (2012). Self-efficacy and burnout in professional school counselors. Educational Sciences: Theory and Practice, 12(3), 1761–1767. [Google Scholar]
  41. Hahn, D., Weck, F., Witthöft, M., & Kühne, F. (2021). Assessment of counseling self-efficacy: Validation of the German counselor activity self-efficacy scales-revised. Frontiers in Psychology, 12, 780088. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  42. Hatcher, R. L., Fouad, N. A., Grus, C. L., Campbell, L. C., McCutcheon, S. R., & Leahy, K. L. (2013). Competence benchmarks: Practical steps toward a culture of competence. Training and Education in Professional Psychology, 7, 84–91. [Google Scholar] [CrossRef] [Scilit]
  43. Heled, E., & Davidovitch, N. (2021). Personal and group professional identity in the 21st century: Case study: The school counseling profession. Journal of Education and Learning, 10(3), 64–82. [Google Scholar] [CrossRef] [Scilit]
  44. Hilty, D. M., Ferrer, D. C., Parish, M. B., Johnston, B., Callahan, E. J., & Yellowlees, P. M. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine Journal and e-Health, 19(6), 444–454. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  45. Holland, K., Middleton, L., & Uys, L. (2012). Professional confidence: A concept analysis. Scandinavian Journal of Occupational Therapy, 19(2), 214–224. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  46. Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6(1), 53–60. [Google Scholar] [CrossRef]
  47. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. [Google Scholar] [CrossRef] [Scilit]
  48. Kline, R. B. (2015). Principles and practice of structural equation modeling (4th ed.). The Guilford Press. [Google Scholar]
  49. Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Self-awareness questions for effective psychotherapists: Helping good psychotherapists become even better. Practice Innovations, 2(4), 163–172. [Google Scholar] [CrossRef] [Scilit]
  50. Kondratowicz, B., Godlewska-Werner, D., Połomski, P., & Khosla, M. (2022). Satisfaction with job and life and remote work in the COVID-19 pandemic: The role of perceived stress, self-efficacy and self-esteem. Current Issues in Personality Psychology, 9(1), 49–60. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  51. Kwan, V. S. Y., John, O. P., Kenny, D. A., Bond, M. H., & Robins, R. W. (2004). Reconceptualizing individual differences in self-enhancement bias: An interpersonal approach. Psychological Review, 111(1), 94–110. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  52. Lee, T. W., & Ko, Y. K. (2010). Effects of self-efficacy, affectivity and collective efficacy on nursing performance of hospital nurses. Journal of Advanced Nursing, 66(4), 839–848. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  53. Lent, R. W., do Céu Taveira, M., Sheu, H. B., & Singley, D. (2009). Social cognitive predictors of academic adjustment and life satisfaction in Portuguese college students: A longitudinal analysis. Journal of Vocational Behavior, 74(2), 190–198. [Google Scholar] [CrossRef] [Scilit]
  54. Leykin, Y., Thekdi, S. M., Shumay, D. M., Munoz, R. F., Riba, M., & Dunn, L. B. (2012). Internet interventions for improving psychological well-being in psycho-oncology: Review and recommendations. Psycho-Oncology, 21(9), 1016–1025. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  55. Lin, T., Heckman, T. G., & Anderson, T. (2022). The efficacy of synchronous teletherapy versus in-person therapy: A meta-analysis of randomized clinical trials. Clinical Psychology: Science and Practice, 29(2), 167–178. [Google Scholar] [CrossRef] [Scilit]
  56. Luyckx, K., Klimstra, T. A., Duriez, B., Van Petegem, S., Beyers, W., Teppers, E., & Goossens, L. (2013). Personal identity processes and self-esteem: Temporal sequences in high school and college students. Journal of Research in Personality, 47(2), 159–170. [Google Scholar] [CrossRef] [Scilit]
  57. Marques, L., LeBlanc, N. J., Weingarden, H. M., Timpano, K. R., Jenike, M., & Wilhelm, S. (2010). Barriers to treatment and service utilization in an internet sample of individuals with obsessive–compulsive symptoms. Depression and Anxiety, 27(5), 470–475. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  58. Marsh, H. W., & Hocevar, D. (1985). Application of confirmatory factor analysis to the study of self-concept: First- and higher-order factor models and their invariance across groups. Psychological Bulletin, 97(3), 562–582. [Google Scholar] [CrossRef]
  59. Meyer, J. M. (2015). Counseling self-efficacy: On-campus and distance education students. Rehabilitation Counseling Bulletin, 58(3), 165–172. [Google Scholar] [CrossRef] [Scilit]
  60. Molero Jurado, M. D. M., Pérez-Fuentes, M. D. C., Gázquez Linares, J. J., & Barragán Martín, A. B. (2018). Burnout in health professionals according to their self-esteem, social support and empathy profile. Frontiers in Psychology, 9, 424. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  61. Nissen-Lie, H. A., Rønnestad, M. H., Høglend, P. A., Havik, O. E., Solbakken, O. A., Stiles, T. C., & Monsen, J. T. (2017). Love yourself as a person, doubt yourself as a therapist? Clinical Psychology & Psychotherapy, 24(1), 48–60. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  62. Nuttman-Schwartz, O. (2017). Rethinking professional identity in a globalized world. Clinical Social Work Journal, 45, 1–9. [Google Scholar] [CrossRef] [Scilit]
  63. Orkaizagirre-Gómara, A., Sánchez De Miguel, M., Ortiz de Elguea, J., & Ortiz de Elguea, A. (2020). Testing general self-efficacy, perceived competence, resilience, and stress among nursing students: An integrator evaluation. Nursing & Health Sciences, 22(3), 529–538. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  64. Pandey, R., Tiwari, G. K., Parihar, P., & Rai, P. K. (2021). Positive, not negative, self-compassion mediates the relationship between self-esteem and well-being. Psychology and Psychotherapy: Theory, Research and Practice, 94(1), 1–15. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  65. Peng, J., Zhang, J., Zhou, X., Wan, Z., Yuan, W., Gui, J., & Zhu, X. (2021). Validation of the occupational self-efficacy scale in a sample of Chinese employees. Frontiers in Psychology, 12, 755134. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  66. Poletti, B., Tagini, S., Brugnera, A., Parolin, L., Pievani, L., Ferrucci, R., & Silani, V. (2020). Telepsychotherapy: A leaflet for psychotherapists in the age of COVID-19. A review of the evidence. Counselling Psychology Quarterly, 34, 352–367. [Google Scholar] [CrossRef] [Scilit]
  67. Prasko, J., Ociskova, M., Abeltina, M., Krone, I., Kantor, K., Vanek, J., Slepecky, M., Minarikova, K., Mozny, P., Piliarova, M., & Bite, I. (2023). The importance of self-experience and self-reflection in training of cognitive behavioral therapy. Neuroendocrinology Letters, 44(3), 152–163. [Google Scholar] [PubMed]
  68. Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  69. Prezza, M., Trombaccia, F. R., & Armento, L. (1997). La scala dell’autostima di Rosenberg: Traduzione e validazione italiana [The Rosenberg Self-Esteem Scale: Italian translation and validation]. Giunti Organizzazioni Speciali, 223, 35–44. [Google Scholar]
  70. Pyszczynski, T., Greenberg, J., Solomon, S., Arndt, J., & Schimel, J. (2004). Why do people need self-esteem? A theoretical and empirical review. Psychological Bulletin, 130(3), 435–468. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  71. Reese, R. J., Aldarondo, F., Anderson, C. R., Lee, S. J., Miller, T. W., & Burton, D. (2009). Telehealth in clinical supervision: A comparison of supervision formats. Journal of Telemedicine and Telecare, 15(7), 356–361. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  72. Reilly, E., Dhingra, K., & Boduszek, D. (2014). Teachers’ self-efficacy beliefs, self-esteem, and job stress as determinants of job satisfaction. International Journal of Educational Management, 28(4), 365–378. [Google Scholar] [CrossRef] [Scilit]
  73. Rochlen, A. B., Zack, J. S., & Speyer, C. (2004). Online therapy: Review of relevant definitions, debates, and current empirical support. Journal of Clinical Psychology, 60(3), 269–283. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  74. Rosenberg, M. (1965a). Rosenberg self-esteem scale (RSE). Acceptance and Commitment Therapy: Measures Package, 61(52), 18. [Google Scholar]
  75. Rosenberg, M. (1965b). Society and the adolescent self-image. Princeton University Press. [Google Scholar]
  76. Rønnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist: Research findings and perspectives on professional development. Journal of Career Development, 30(1), 5–44. [Google Scholar] [CrossRef] [Scilit]
  77. Salanova, M., Llorens, S., & Schaufeli, W. B. (2011). “Yes, I can, I feel good, and I just do it!” On gain cycles and spirals of efficacy beliefs, affect, and engagement. Applied Psychology: An International Review, 60, 255–285. [Google Scholar] [CrossRef] [Scilit]
  78. Saleem, T., & Hawamdeh, E. S. (2022). Counselor self-efficacy, spiritual well-being and compassion satisfaction/fatigue among mental health professionals in Pakistan. Current Psychology. Advance online publication. [Google Scholar] [CrossRef] [Scilit]
  79. Scharff, J. S. (2012). Clinical issues in analyses over the telephone and the Internet. The International Journal of Psychoanalysis, 93(1), 81–95. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  80. Scholz, U., Gutiérrez Doña, B., Sud, S., & Schwarzer, R. (2002). Is general self-efficacy a universal construct? Psychometric findings from 25 countries. European Journal of Psychological Assessment, 18(3), 242–251. [Google Scholar] [CrossRef] [Scilit]
  81. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). NFER-NELSON. [Google Scholar]
  82. Sibilia, L., Schwarzer, R., & Jerusalem, M. (1995). Italian adaptation of the general self-efficacy scale. Available online: http://userpage.fu-berlin.de/~health/italian.htm (accessed on 6 December 2020).
  83. Simpson, S. G., & Reid, C. L. (2014). Therapeutic alliance in videoconferencing psychotherapy: A review. Australian Journal of Rural Health, 22(6), 280–299. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  84. Sowislo, J. F., & Orth, U. (2013). Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychological Bulletin, 139(1), 213–240. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  85. Stoll, J., Müller, J. A., & Trachsel, M. (2020). Ethical issues in online psychotherapy: A narrative review. Frontiers in Psychiatry, 10, 993. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  86. Tan, C. P., Van der Molen, H. T., & Schmidt, H. G. (2017). A measure of professional identity development for professional education. Studies in Higher Education, 42(8), 1504–1519. [Google Scholar] [CrossRef] [Scilit]
  87. van Seggelen-Damen, I., & van Dam, K. (2016). Self-reflection as a mediator between self-efficacy and well-being. Journal of Managerial Psychology, 31(1), 18–33. [Google Scholar] [CrossRef] [Scilit]
  88. Waller, G., Pugh, M., Mulkens, S., Moore, E., Mountford, V. A., Carter, J., & Smit, V. (2020). Cognitive-behavioral therapy in the time of coronavirus: Clinician tips for working with eating disorders via telehealth when face-to-face meetings are not possible. International Journal of Eating Disorders, 53(7), 1132–1141. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  89. Wampold, B. E., Baldwin, S. A., Holtforth, M. G., & Imel, Z. E. (2017). What characterizes effective therapists? In L. G. Castonguay, & C. E. Hill (Eds.), How and why are some therapists better than others? Understanding therapist effects (pp. 37–53). American Psychological Association. [Google Scholar]
  90. Wijeyesinghe, C. L., & Jones, S. R. (2014). Intersectionality, identity, and systems of power and inequality. In D. Mitchell, C. Y. Simmons, & L. A. Greyerbiehl (Eds.), Intersectionality and higher education: Theory, research, and praxis (pp. 9–19). Peter Lang. [Google Scholar]
  91. Wiles, F. (2013). “Not easily put into a box”: Constructing professional identity. Social Work Education, 32(7), 854–866. [Google Scholar] [CrossRef] [Scilit]
  92. Yao, X., Yu, L., Shen, Y., Kang, Z., & Wang, X. (2021). The role of self-efficacy in mediating between professional identity and self-reported competence among nursing students in the internship period: A quantitative study. Nurse Education in Practice, 57, 103252. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  93. Yoo, S. Y., & Cho, H. (2020). Exploring the influences of nurses’ partnership with parents, attitude to families’ importance in nursing care, and professional self-efficacy on quality of pediatric nursing care: A path model. International Journal of Environmental Research and Public Health, 17(15), 5452. [Google Scholar] [CrossRef] [Scilit] [PubMed]
  94. Zhou, M. (2016). A revisit of General Self-Efficacy Scale: Uni- or multi-dimensional? Current Psychology, 35, 427–436. [Google Scholar] [CrossRef] [Scilit]
Behavsci 16 01425 g001
Figure 1. Path analysis model examining the mediation of Insight Orientation in the associations of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy, controlling for Years of Clinical Practice.
Figure 1. Path analysis model examining the mediation of Insight Orientation in the associations of Self-Esteem and General Self-Efficacy with Therapist Self-Efficacy, controlling for Years of Clinical Practice.
Behavsci 16 01425 g001
Table 1. Demographic and professional characteristics of the sample (N = 290).
Table 1. Demographic and professional characteristics of the sample (N = 290).
Characteristics M ± SDn%
Age 38.25 ± 8.40
SexFemales 25788.6
Males 3311.4
Professional QualificationPsychologists 11238.6
Psychotherapists 17861.4
Years of Clinical PracticeLess than a year 227.6
1–2 years 3411.7
2–5 years 6321.7
5–10 years 7826.9
More than 10 years 9332.1
Theoretical Orientation
(Psychotherapists only)		Psychoanalytic 155.2
Psychodynamic 289.7
Cognitive 186.2
Cognitive behavioral 3010.3
Humanistic 175.9
Integrated 3813.1
Systemic 3211.0
Table 2. Partial correlations among the study variables, controlling for Years of Clinical Practice.
Table 2. Partial correlations among the study variables, controlling for Years of Clinical Practice.
General
Self-Efficacy		Self-EsteemInsight OrientationTherapist
Self-Efficacy
General Self-Efficacy1
Self-Esteem0.441
Insight Orientation0.520.371
Therapist Self-Efficacy0.330.290.511
Note: All correlations were significant at p < 0.01.
Table 3. Coefficients of the path analysis mediation model.
Table 3. Coefficients of the path analysis mediation model.
EstimateSEpBootLLCIBootULCI
Total effects
Self-Esteem → Therapist Self-Efficacy0.1830.062<0.010.0610.365
General Self-Efficacy → Therapist Self-Efficacy0.2470.060<0.0010.1270.364
Direct effects
Self-Esteem → Therapist Self-Efficacy0.1070.0590.083−0.0150.216
General Self-Efficacy → Therapist Self-Efficacy0.0470.0580.389−0.0630.165
Indirect effects
Self-Esteem → Insight Orientation → Therapist Self-Efficacy0.0770.032<0.0010.0340.133
General Self-Efficacy → Insight Orientation → Therapist Self-Efficacy0.2000.033<0.0010.1330.282
Note: Bold values indicate significant p values.
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Gori, A.; Topino, E. Therapists’ Personal Identity Factors and Professional Self-Efficacy: A Path Analysis Model. Behav. Sci. 2026, 16, 1425. https://doi.org/10.3390/bs16081425

AMA Style

Gori A, Topino E. Therapists’ Personal Identity Factors and Professional Self-Efficacy: A Path Analysis Model. Behavioral Sciences. 2026; 16(8):1425. https://doi.org/10.3390/bs16081425

Chicago/Turabian Style

Gori, Alessio, and Eleonora Topino. 2026. "Therapists’ Personal Identity Factors and Professional Self-Efficacy: A Path Analysis Model" Behavioral Sciences 16, no. 8: 1425. https://doi.org/10.3390/bs16081425

APA Style

Gori, A., & Topino, E. (2026). Therapists’ Personal Identity Factors and Professional Self-Efficacy: A Path Analysis Model. Behavioral Sciences, 16(8), 1425. https://doi.org/10.3390/bs16081425

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop