Emotional stresses and coping among first year trainee clinical and counselling psychologists : a qualitative study of students' experiences and perceptions.

Abstract

South African clinical and counselling training experiences occur in a context in which dealing with cultural diversity and a range of complex traumatic presenting problems is unavoidable, due to the legacy of the past and ongoing social transformation. Trainee psychologists are exposed to unfamiliar contexts and clients throughout their training process and are thus are confronted with clients whose cultural backgrounds are potentially very different from their own. There are also ethical and pragmatic requirements for trainees to offer services beyond a middle-class and culturally familiar client base. Thus the emotional impact of having to step out of their range of contextually experiential backgrounds as well the experience of intense professional development pertaining to formal supervision, skills development and skills evaluation can result in heightened trainee anxiety and vulnerability towards career specific occupational stress. Such anxiety may potentially disrupt learning and trainees may feel inadequate and this may inhibit their development as clinical or counselling psychologists (Eagle, Haynes & Long, 2007). A review of literature shows that the plight of the South African trainee psychologists is relatively unexplored. South African students are exposed to numerous stressors (Morgan & De Bruin, 2010) and there is a need for further research with regards to the intrinsic stressors that training in psychology present to trainees. Aim: The aim of this study is to explore the emotional challenges that confront students in their first year of Masters Level training as either Clinical or Counselling psychologists, the particular aspects that prompted personal difficulty for the trainee, why these aspects are particularly difficult for trainees and the mechanisms employed to overcome these difficulties. This research investigated the meaning of these experiences for trainee psychologists in order to determine whether these experiences contributed in any way to their emotional stress and level of coping. Modes of coping strategies employed by trainees as well as the effectiveness of selected coping strategies for the trainee were examined. Methodology: A qualitative methodological framework was selected in this research as it allowed for the uncovering of underlying and subjective experiences of the emotional stresses experienced by the trainees and the coping strategies that were employed to overcome these stresses. This study uses an interpretive approach guided by an interpretive paradigm which focuses on a detailed examination of the subjective meanings that individuals place on their social and personal world based on their personal perception or accounts of the phenomena. In this regard an interpretive approach has a particular potency and effectiveness in bringing out the subjects lived experiences and perceptions within a particular context, and can be applied to the study of the shared experiences of trainees. A total of nine clinical/counselling participants comprised the sample for this study. Semi-structured in-depth interviews were conducted with the participants. The interview schedule, based on the literature review and content areas relevant to this study, was compiled to facilitate an open discussion around understanding of trainee experiences. The data from this study were analyzed using thematic analysis to identify recurrent themes and patterns. Findings: The findings of this study is based on the relevant empirical cognitive-transactional model of stress and coping proposed by Lazarus and Folkman (1984). What has clearly emerged in this study is that the vast majority of the participants interpreted and evaluated the psychology academic training environment as stressful or threatening. Participants identified similar professional, academic and personal sources of stress as a result of the training conditions and experience. The multiple clinical, client-related and academic demands inherent in the professional training process were associated with the sources of stress that were experienced by the trainees. The majority of trainees in this study adopted emotion-focused coping strategies in order to mitigate the demands and realities of the emotional stress they are experiencing in the Masters programme and gain some degree of control over the environment. This research further demonstrated the different meanings (external or internal) attributed to the source of stress experienced by the trainee will evoke different reactions to the same stressor and these results thus suggests support for an interactional perspective of understanding the emotional stresses that are experienced by the trainees. It is thus critical that this process of stress and coping be understood to better understand the obstacles that the trainees face which may impede their professional development process. Recommendations: A range of pragmatic recommendations are suggested to assist trainees to function adequately and be given the best chance for professional development and growth. These include sensitivity to the needs of trainees and to the stressful challenges faced by the trainees and the implementation of early intervention strategies to target these challenges. The need for on-going informal feedback from trainees as well as providing timeous and thoughtful evaluation and performance feedback, is emphasized as a requirement for the establishment of a climate of mutual respect and tolerance and to promote less vulnerability in trainees. Other recommendations include introducing additional training programmes addressing issues such as resilience, career options and burnout are important considerations as well as the importance of promoting journaling for critical reflection. The possibility of offering support and therapy groups for trainees is recommended as an important factor for training institutions to consider. Finally, the importance of the need for training providers to actively encourage trainees to take care of themselves both physically and emotionally is included as a recommendation.