Therapist Self‐Regulation in Clinical Practice: A Grounded Theory of Adaptive Emotion Regulation Under Systemic Constraints in Iran

ABSTRACT Objective While self‐care is crucial for preventing compassion fatigue in psychotherapists, existing literature frequently reduces it to a prescriptive checklist of extracurricular activities, largely neglecting its embeddedness in the therapeutic process. This study aimed to develop a grounded theory explaining how therapists negotiate clinical self‐regulation and emotional distress under specific systemic and cultural constraints in Iran. Method Using a Systematic Grounded Theory approach, semi‐structured interviews were conducted with 19 practicing psychotherapists (10 female, 9 male). Data were analysed using open, axial and selective coding until theoretical saturation was reached. Results Analysis revealed ‘Contextualised Adaptive Self‐Regulation’ as the core category. Instead of viewing self‐care as a set of static external activities, the data showed it to be an ongoing, in‐session metacognitive negotiation. Therapists continuously balance clinical demands against internal emotional strain. This process is heavily shaped by Iranian contextual pressures, including an absence of formal supervision and the cultural expectation to act as a ‘self‐sacrificing healer’. As a result, therapists rely on moment‐to‐moment emotional monitoring and covert, micro‐restorative behaviours to sustain their therapeutic presence. Conclusions Self‐care in psychotherapy extends beyond lifestyle choices; it is a core clinical competency dictated by contextual boundaries. The Iranian setting illustrates how systemic scarcity forces clinicians to internalise regulatory mechanisms. These findings expand counselling psychology literature by framing therapist resilience as an active clinical negotiation integrated directly into practice, rather than an isolated after‐hours activity.