Barriers to Professional Self-Care Scale (BPS-CS)

Abstract

The Barriers to Professional Self-Care Scale (BPS-CS) is a psychometric instrument developed by Paulo Adrián Rodríguez-Ramos, Laura Aguilera-Ávila, and Rosaura Gonzalez-Mendez (2025) designed to identify, categorize, and quantify the specific structural, cultural, ideological, and cognitive obstacles that hinder helping professionals from engaging in essential self-care practices. Initially conceptualized and validated among social workers providing essential social services in Spain, the instrument addresses a critical gap in occupational health and human services literature: while the necessity of self-care for mitigating burnout, secondary traumatic stress, and compassion fatigue is widely acknowledged, practitioners frequently encounter systemic and individual impediments that prevent implementation. The BPS-CS consists of 17 items organized into four correlated dimensions: Lack of Information (4 items), Self-Care Is Unprofessional (4 items), Self-Care Is Not a Priority (5 items), and Noninvolvement of Organizations (4 items). Respondents rate the perceived significance of each barrier using a 5-point Likert-type response format ranging from 1 (“not very important”) to 5 (“very important”). Structural validation using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) demonstrated robust psychometric properties, yielding an excellent model fit ($\chi^2(106) = 185.09$, $ ext{RMSEA} = .048$,$ ext{SRMR} = .043$,$ ext{CFI} = .99$) and exceptional internal consistency reliability, with subscale Cronbach’s alpha coefficients ranging from .92 to .96. The BPS-CS provides human service organizations, clinical supervisors, and organizational psychologists with an empirically validated diagnostic tool to identify institutional bottlenecks and cognitive distortions, thereby informing structural interventions and workplace wellness initiatives.

Keywords

Barriers to Professional Self-Care Scale, BPS-CS, self-care barriers, social workers, occupational burnout, compassion fatigue, employee well-being, organizational support, professional ethics, psychometrics, workplace mental health.

Authors

The scale was developed and psychometrically validated by researchers from the Universidad de La Laguna, Santa Cruz de Tenerife, Spain:

• Paulo Adrián Rodríguez-Ramos — Department of Communication Sciences and Social Work (Ciencias de la Comunicación y Trabajo Social), Universidad de La Laguna.
• Laura Aguilera-Ávila — Department of Communication Sciences and Social Work (Ciencias de la Comunicación y Trabajo Social), Universidad de La Laguna.
• Rosaura Gonzalez-Mendez (Corresponding Author) — Department of Cognitive, Social and Organizational Psychology (Psicología Cognitiva, Social y Organizacional), Faculty of Psychology and Speech Therapy, Universidad de La Laguna, Campus de Guajara, 38205 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain. Email: [email protected].

Purpose

Human service professionals—including social workers, clinical psychologists, case managers, and healthcare providers—routinely confront emotionally demanding environments characterized by high caseloads, acute trauma exposure, and resource scarcity. Decades of empirical inquiry have underscored that regular professional self-care is a prerequisite for ethical competence, sustained empathy, and occupational longevity. Despite universal recommendations across professional codes of ethics advocating self-care, a profound implementation gap persists: practitioners consistently underutilize well-being strategies and report pervasive distress. The primary purpose of the Barriers to Professional Self-Care Scale (BPS-CS) is to move beyond the assumption that self-care is merely an individual choice or personal failing, systematically assessing the institutional, normative, and educational obstacles that actively inhibit self-care behaviors.

From an applied perspective, the BPS-CS serves several distinct clinical, administrative, and research functions:

• Organizational Diagnosis and Auditing: Human service agencies can administer the instrument to pinpoint whether low self-care compliance is driven by macro-level deficits (e.g., lack of institutional resources and policies) or micro-level cultural norms (e.g., viewing self-care as a sign of weakness or poor commitment).
• Targeted Workplace Interventions: Rather than relying on generic wellness seminars, administrators can tailor organizational changes. If an agency scores exceptionally high on Noninvolvement of Organizations, interventions must focus on supervisory reform, scheduling autonomy, and structural workload reallocation rather than individual mindfulness exercises.
• Supervisory and Clinical Training: Field instructors and clinical supervisors can utilize the scale to facilitate reflective discussions with trainees and frontline practitioners, identifying maladaptive cognitive schemas (such as the belief that prioritizing one’s well-being is unethical) before they crystallize into chronic emotional exhaustion.
• Empirical Research on Workplace Health: The BPS-CS enables researchers to model complex structural equations linking organizational climate, perceived self-care barriers, actual self-care adoption, and subsequent clinical outcomes such as vicarious traumatization, turnover intentions, and job satisfaction.

Psychological Construct

The BPS-CS measures the overarching construct of perceived barriers to professional self-care, operationalized as the subjective appraisal of cognitive, ideological, practical, and environmental impediments that prevent a professional from enacting wellness-enhancing and restorative behaviors during or in relation to their occupational role. Rather than treating barriers as a monolithic constraint, the scale delineates four interrelated yet functionally autonomous dimensions:

1. Lack of Information

This cognitive and psychoeducational dimension captures the deficiency of clear, actionable knowledge regarding what constitutes evidence-based self-care and how to operationalize it within the constraints of daily practice. Rather than assuming that practitioners inherently possess the behavioral repertoire for stress mitigation, this factor reflects an educational deficit where professionals report an absence of clear formal training, institutional guidelines, or accessible resources. For instance, practitioners may recognize that they feel drained but lack concrete knowledge regarding cognitive reframing, boundary-setting strategies, or peer consultation techniques tailored to human service delivery.

2. Self-Care Is Unprofessional

This normative and deontological dimension measures internalized socio-cultural beliefs and professional role schemas that equate self-care with diminished dedication, moral failure, or weakness. Human service professions frequently inherit historical tropes of martyrdom, altruism, and self-sacrifice, wherein total devotion to the client is held as the paramount virtue. Consequently, practitioners scoring high on this dimension perceive that attending to personal emotional exhaustion or stepping back to rest signifies ethical neglect, poor professionalism, or personal incompetence. This cognitive distortion generates acute guilt and emotional dissonance whenever the professional considers prioritizing their own psychological integrity.

3. Self-Care Is Not a Priority

This behavioral and operational dimension evaluates the displacement of self-care under the pressure of unyielding operational demands, high crisis volume, and task saturation. In environments characterized by chronic understaffing and emergency triage, urgent tasks perpetually crowd out essential maintenance behaviors. Practitioners scoring high on this factor report that self-care is deferred until complete physical and psychological collapse occurs. Unlike the normative belief that self-care is morally wrong, this factor reflects practical, time-pressured prioritization dynamics wherein acute client crises systematically eclipse routine self-preservation.

4. Noninvolvement of Organizations

This systemic and ecological dimension assesses the perceived failure of administrative hierarchies, executive leadership, and institutional policies to facilitate, legitimize, or resource employee well-being. While individual self-care is often promoted rhetorically, human service organizations frequently fail to embed restorative spaces, mental health leave, realistic caseload formulas, or supportive supervisory mechanisms into their operational frameworks. High scores on this subscale reflect employee perceptions that their management prioritizes output, performance metrics, and rapid service throughput while displaying indifference or active neglect toward the physical and psychological toll borne by frontline staff.

Theoretical Framework

The conceptual architecture of the BPS-CS is anchored in the synthesis of several foundational psychological and organizational frameworks:

The Job Demands-Resources (JD-R) Model

According to the Job Demands-Resources (JD-R) model formulated by Arnold Bakker and Evangelia Demerouti, occupational well-being is dictated by the balance between job demands (physical, psychological, social, or organizational aspects of the job requiring sustained effort) and job resources (aspects that reduce demands, foster goal achievement, and stimulate personal growth). In this framework, perceived barriers to self-care function as severe institutional resource deficits and amplified secondary demands. When organizations fail to provide structural support (Noninvolvement of Organizations) or when workload volume prevents respite (Self-Care Is Not a Priority), the health impairment process is accelerated, depleting the professional’s adaptive energy reserves.

Conservation of Resources (COR) Theory

Stevan Hobfoll’s Conservation of Resources (COR) theory posits that individuals strive to acquire, retain, foster, and protect core resources (e.g., energy, social support, time, health). Psychological stress ensues when resources are threatened, lost, or when an investment of resources fails to yield expected returns. The BPS-CS operationalizes key blockages within resource investment cycles. When practitioners operate under the ideological belief that Self-Care Is Unprofessional, they are systematically constrained from investing current energy into restorative activities, entering a resource loss spiral that inevitably culminates in severe burnout and depersonalization.

Social Cognitive Theory and Professional Socialization

Albert Bandura’s Social Cognitive Theory emphasizes the triadic reciprocal determinism between cognitive factors, behavioral patterns, and environmental influences. The BPS-CS captures how environmental modeling (or lack thereof from leadership) and cognitive schemas (internalized cultural myths regarding self-sacrifice in social work) inhibit self-efficacy regarding self-care execution. Professional socialization in human services has historically reinforced the myth of the invulnerable, completely selfless provider. The BPS-CS quantifies how these socio-cultural narratives act as cognitive barriers that actively prevent practitioners from implementing self-protective behaviors.

Validity

The psychometric validation of the BPS-CS followed rigorous instrument design guidelines, moving from initial qualitative inquiry and item generation to rigorous statistical verification within representative samples of human service providers:

Content and Face Validity

The initial pool of 40 items was constructed through a comprehensive review of extant psychological literature and qualitative semi-structured interviews with practicing social workers acting as providers of essential public and social services in Spain (Rodríguez-Ramos et al., 2025). The qualitative grounding ensured that the instrument reflected the authentic lived experiences, institutional vernacular, and nuanced ethical tensions faced by frontline professionals.

Construct and Structural Validity

Structural validity was established through sequential exploratory and confirmatory factor analyses. The exploratory factor analysis reduced the item pool from 40 to 26 items while revealing a coherent four-factor multidimensional structure. Subsequent confirmatory factor analysis (CFA) further refined the instrument to 17 items, demonstrating that all indicators loaded substantially and significantly onto their designated latent factors (standardized factor loadings $> .30$, $p < .001$). The four latent dimensions exhibited moderate inter-factor correlations, affirming that while they contribute to an overarching barriers construct, they represent distinct, non-redundant facets.

Criterion-Related and Convergent Validity

Construct and criterion validity were corroborated by examining associations between the BPS-CS subscales and validated measures of professional self-care practice and psychological distress. As theoretically predicted, a significant negative association was identified between actual self-care practices and the belief that self-care is unprofessional. Practitioners who held higher internalized beliefs that self-care equates to weakness or lack of dedication engaged in significantly fewer self-care routines. Moreover, differential correlations between the subscales and specific well-being indices revealed that barriers are not uniform in their impacts; organizational neglect and extreme workload prioritization exhibited unique predictive paths toward emotional exhaustion and organizational cynicism, whereas information deficits were more strongly linked to low professional self-efficacy.

Reliability

The BPS-CS exhibits exceptional internal consistency across all four constituent dimensions. Psychometric evaluation reported in the original validation study yielded the following Cronbach’s alpha ($lpha$) coefficients:

• Lack of Information (Items 1–4): $lpha = .92$
• Self-Care Is Unprofessional (Items 5–8): $lpha = .96$
• Self-Care Is Not a Priority (Items 9–13): $lpha = .93$ to $.95$ across comparative subsamples
• Noninvolvement of Organizations (Items 14–17): $lpha = .92$ to $.94$ across model tests

These coefficients significantly exceed the accepted psychometric benchmark of $.70$ for research purposes and $.80$ for applied diagnostic assessment, demonstrating minimal measurement error and high item-total correlation across all subscales. The high alpha for Self-Care Is Unprofessional ($lpha = .96$) highlights an exceptionally cohesive underlying ideological construct among social work professionals.

Factor Analysis

The latent structure of the BPS-CS was derived through a two-stage analytic process consisting of an Exploratory Factor Analysis (EFA) followed by a Confirmatory Factor Analysis (CFA) conducted on independent or split-half samples of social workers.

Exploratory Factor Analysis (EFA)

Initial EFA was conducted on the original 40-item candidate pool. Items exhibiting inadequate communalities, high cross-loadings, or ambiguous semantic framing were sequentially removed, producing an intermediate 26-item four-factor model. The four factors accounted for a substantial portion of the total variance and mapped cleanly onto distinct conceptual arenas: informational deficits, professional role myths, task-driven reprioritization, and organizational disengagement.

Confirmatory Factor Analysis (CFA)

In the confirmatory stage, an initial CFA of the 26-item version showed suboptimal initial fit indices ($ ext{RMSEA} > .06$ and $ ext{CFI} < .95$). Inspection of modification indices, standardized residuals, and item redundancies led to the targeted trimming of items, resulting in a parsimonious 17-item four-factor model. The final measurement model demonstrated exceptional global fit to the empirical data:

• Satorra-Bentler / Chi-Square: $\chi^2(106) = 185.09$ ($p < .001$,$chi^2/ ext{df} = 1.74$)
• Root Mean Square Error of Approximation (RMSEA): $.048$ ($90%\text{ CI } [.037, .059]$)
• Standardized Root Mean Square Residual (SRMR): $.043$
• Comparative Fit Index (CFI): $.99$

All 17 standardized factor loadings exceeded $.30$ ($p < .001$), with the vast majority loading between$.75$ and $.92$, verifying that the indicators are robust reflections of their respective latent constructs.

Instrument / Measurement Tool

• Tool Name: Barriers to Professional Self-Care Scale (BPS-CS)
• Original Authors: Paulo Adrián Rodríguez-Ramos, Laura Aguilera-Ávila, and Rosaura Gonzalez-Mendez (2025)
• Test Type: Psychometric self-report inventory / diagnostic questionnaire
• Target Population: Social workers, healthcare providers, mental health professionals, case managers, and other human service personnel (validated among adults aged 22 to 55 years)
• Administration Method: Electronic (online survey platforms) or paper-and-pencil self-administration
• Item Count: 17 items
• Factor Structure:
  • Factor 1: Lack of Information (Items 1 to 4)
  • Factor 2: Self-Care Is Unprofessional (Items 5 to 8)
  • Factor 3: Self-Care Is Not a Priority (Items 9 to 13)
  • Factor 4: Noninvolvement of Organizations (Items 14 to 17)
• Response Scale: 5-point Likert-type scale ranged from 1 = not very important to 5 = very important
• Scoring Guidelines:
  • No items are reverse-scored; all items are positively phrased toward representing barriers.
  • Subscale scores are obtained by calculating the arithmetic mean or the sum of items within each respective subscale.
  • A global BPS-CS composite score can be derived by averaging or summing all 17 items.
  • Higher numerical scores represent greater perceived severity or importance of barriers impeding professional self-care.
• Completion Time: Approximately 3 to 5 minutes

Permissions & Fee and Test Year

• Year of Publication: 2025
• Access Fee: Free for non-commercial academic research, pedagogical purposes, and institutional quality improvement initiatives.
• Permissions and Licensing: The scale was published in the journal Social Work (Oxford University Press / National Association of Social Workers). Researchers seeking formal permission or access to non-English translated adaptations should contact the corresponding author: Rosaura Gonzalez-Mendez ([email protected]), Facultad de Psicología y Logopedia, Universidad de La Laguna, Campus de Guajara, 38205 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.

References

• Bakker, A. B., & Demerouti, E. (2007). The Job Demands-Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/02683940710733115
• Hobfoll, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. American Psychologist, 44(3), 513–524. https://doi.org/10.1037/0003-066X.44.3.513
• Newell, J. M., & MacNeil, G. A. (2010). Professional burnout, vicarious trauma, secondary traumatic stress, and compassion fatigue: A review of theoretical terms, risk factors, and preventive methods for clinicians and researchers. Best Practices in Mental Health, 6(2), 57–68.
• Rodríguez-Ramos, P. A., Aguilera-Ávila, L., & Gonzalez-Mendez, R. (2025). Development and validation of the Barriers to Professional Self-Care Scale (BPS-CS). Social Work, 70(1), 69–79. https://doi.org/10.1093/sw/swae052
• Sánchez-Moreno, E., de La Fuente Roldán, I. N., Gallardo-Peralta, L. P., & de Roda, A. B. L. (2020). Burnout, compassion fatigue, and compassion satisfaction among social workers: A systematic review and meta-analysis. British Journal of Social Work, 50(2), 402–424. https://doi.org/10.1093/bjsw/bcz164

Items of the Scale