A qualitative study exploring the challenges experienced by trainee psychologists when conducting a formal mental status examination during the clinical interview.

Abstract

Trainee Psychologists in South Africa undergo comprehensive theoretical and practical postgraduate training within their respective disciplines (Clinical, Counselling, Educational, Industrial and Research Psychology). An aspect of training involves developing competencies in implementing and interpreting the Mental Status Examination. Research in the area of postgraduate professional training has been restricted to disciplines such as medicine and social work. Very little research has been done to understand mental health trainees‘ experiences regarding their professional development. Specifically, training as a mental health professional involves an evolution of the self as a working apparatus in the assessment and management of a client/patient. The aim of the current study was to explore the challenges faced by trainee psychologists when conducting a mental status examination with an adult client. Data was collected through interviewing trainee psychologists who, at the time of the study, were currently enrolled at the University of KwaZulu-Natal for their Clinical or Counselling Psychology Master‘s Degree. Eight Participants were interviewed, and the data was analysed using Thematic Analysis. Results indicated that the trainees experienced a number of different challenges when it came to administering the MSE such as difficulty transitioning from theory into practice. This included, but was not limited to, difficulties such as personal challenges and managing the various elements of the MSE. A number of process issues also arose whilst administering the MSE, including difficulties managing the structured and unstructured elements of the MSE and dealing with discomfort surrounding specific MSE questions. In addition to this, trainees described how the characteristics of the clients either aided them in their ability to conduct the MSE (through shared understandings or experiences) or resulted in increased difficulty (differences in age, gender or race were found to negatively impact MSE administration). Similarly, culture and language was found to play both a positive and negative role when it came to administering the MSE. Some trainees found that cultural similarities enhanced their ability to conduct the MSE, whilst others found that it hindered them in conducting the MSE. Enhanced understanding of these challenges allows for training institutions to reflect on their Psychology Master‘s training programmes, which in turn allows for Professional programme co-ordinators to take cognisance of these challenges when engaging in skills development training.