Deakin University CRICOS Provider Code: 00113B BARRIERS TO AND FACILITATORS OF CLINICAL PSYCHOLOGY TRAINEES’ DISCLOSURE OF MENTAL HEALTH DIFFICULTIES Talya

Deakin University CRICOS Provider Code: 00113B

BARRIERS TO AND FACILITATORS OF CLINICAL PSYCHOLOGY TRAINEES’ DISCLOSURE OF MENTAL HEALTH DIFFICULTIES

Talya Rabinovitz & Lucy ZinkiewiczSchool of Psychology, Deakin University, [email protected]


THE BENEFITS OF SELF-DISCLOSURE IN RELATION TO MENTAL HEALTH

•‘Mental health difficulty’ = not just clinically diagnosed mental illnesses, but also subclinical levels of stress, anxiety, & depression•Self-disclosure (SD) of mental health difficulties fosters more

positive attitudes towards mental illness, & has emotional & instrumental benefits•For health professionals, increases empathy & insight in

treatment of clients•In graduate training, SD to peers is a learning tool, & fosters

trust & cohesiveness among future colleagues

2


IMPORTANCE FOR PSYCHOLOGY GRADUATE TRAINING

•Clinical psychology graduate training is intrinsically challenging & stressful, tends to attract high achieving & perfectionist trainees, & may trigger mental health difficulties in susceptible trainees •However, many trainees are hesitant to disclose these

difficulties to staff, though disclosure is vital if staff are to help trainees manage their difficulties & engage in self-care•Considering its benefits, SD should be encouraged, in order to

reduce trainee withdrawal & burnout later in their career•As a first step to foster this, this study examines barriers &

facilitators to trainees’ SD

3


BARRIERS & FACILITATORS OF SELF-DISCLOSURE

Barriers•Fear of stigmatisation•Self-stigma•Personality-related variables (sensitivity to rejection) Facilitators •Liking and trust between discloser & recipient •Disclosure reciprocity •SD out of necessity •Perceived benefits of SD •Personality-related variables (high disclosure flexibility & high

self-monitoring)

4


RESEARCH QUESTIONS

•Do the same barriers and facilitators of mental health SD in the workplace & among health professionals & university students also exist for clinical psych trainees?

•Are there any barriers & facilitators that are unique to this population?

5


PARTICIPANTS

•20 clinical psychology trainees completing their masters or doctorate courses, from Deakin University and other Melbourne & Sydney Universities•Gender balance: 18 females, 2 males •Age range: 24-38

6


METHODOLOGY

•Ethics approval granted from Deakin Uni HREC•Qualitative: in-depth semi-structured interviews - face-to-face,

phone or online, to allow for anonymity •Interview schedule –Asked if had ever disclosed a mental health difficulty to anyone in

their course, to whom & in what situation, & if so what happened?– If have had difficulties & not disclosed, why not? Might they do so

later?–Why do they think trainees are hesitant to disclose, & why some

do disclose?–Do they think training providers should do more to encourage SD?

7


DATA ANALYSIS

•Thematic analysis•Focuses on identifying patterned meaning across a dataset•Patterns identified through process of data familiarisation,

data coding & theme development & revision•Data analyses are still taking place, but some preliminary

results follow•Only presenting barriers, facilitators & moderators of

disclosure

8


FACILITATORS OF DISCLOSURE

•Shared experience of stressful course –Disclosure to receive emotional support, debrief, share coping strategies–Disclosure to obtain instrumental support•Closeness (& disclosure facilitated closeness)•Proven competency •Trust that recipient will not be judgmental or use info against

them•When their condition discussed in class •Disclosure as part of recovery process•Disclosure by staff •Disclosure by fellow classmates

9


BARRIERS TO DISCLOSURE

•Fear of negative consequences, especially when unsure how recipient would react•Pressure to conform to “ideal psychologist” idea•Pressure to conform to “ideal psychology student”•Previously bad experience of disclosure •Stigma of mental health difficulties

10


MODERATORS OF DISCLOSURE

•Characteristics of the recipient, which varied by status & kind of support sought–Classmates - genuine, warm, caring, trustworthy, understanding– Staff may just need to be trustworthy

•Characteristics of discloser - personality, self-concept, self-stigma, upbringing/culture•Stage of recovery – esp when currently experiencing, completely

recovered•Content of disclosure – external stressor vs internal stressor •Level of stigma attached to their condition•Culture of their university

11


DISCUSSION

•Facilitators, barriers & moderators consistent with general SD literature, but also reflects particular context of clinical psychology training – highly selective, high demands, high stress, nature of course content •Trainees are generally unclear about consequences of

disclosure, especially re professional regulation & AHPRA (registration board)•Culture of university/school/program very important – If students unsure of what the uni/program/staff responses to SD will be,

they will assume the worst– Staff SD & trustworthiness vital

12


IMPLICATIONS FOR TRAINING PROGRAMS

•Staff need to explicitly discuss the consequences of disclosure, especially re professional regulation & AHPRA (registration board), as early as possible in the course (e.g., orientation)•Need for greater openness in training about issue of MHD &

course-related stress•Need for program staff to better support students with course-

related stress & pre-existing or course-precipitated MHD•Need for explicit training in self-care, development of

resilience, as part of courses•Need to select students with more resilience?

13


WHERE TO FROM HERE?

•Completion of analysis & thesis submission•Additional papers based on same dataset on what happened if

disclosed, & thoughts about what program staff should do•Research into staff attitudes & experiences in relation to

trainee SD•Research into what programs do to support trainees in relation

to MHD, stress, SD & self-care•LT: to develop a series of modules on SD of MHD, for use at

different stages of courses (e.g., orientation, pre-placements, during placements, pre-employment)•Research collaborators welcome! Email [email protected]

14

Documents

Deakin University CRICOS Provider Code: 00113B BARRIERS TO AND FACILITATORS OF CLINICAL PSYCHOLOGY TRAINEES’ DISCLOSURE OF MENTAL HEALTH DIFFICULTIES Talya