A Note to Students about Personal Difficulties
A Note to Students about Personal Difficulties
Personal difficulties are an expected part of life and can be anticipated to occur among clinicians and students (e.g., relationship conflict or loss, bereavement, anxiety, depression, stress, the need to contribute to care of a family member or child, etc.). They also have the potential to interfere with one's ability to function as a clinical psychologist or trainee, or to make timely progress in the program. For example, personal stress can interfere with learning during graduate school (Bischoff, Barton, Thober, & Hawley, 2002), lead to burnout and compassion fatigue, and might lead to impairment and improper behaviour (Wise & Gibson, http://www.apa.org/education/ce/ccw0012.aspx). Unfortunately, such stress is not uncommon. For example, there is an up to 60% prevalence rate of burnout in helping professions such as ours (Brodie & Robinson, 1991) and survey research indicates that 75% of psychotherapists experience major distress in any 3-year period (Epstein, 1997). In one survey, up to 85% of graduate students surveyed reported having been aware of at least one peer experiencing substantial problems during their training (Boxley et al., 1986; Hupruch & Rudd, 2004). Stress as a clinical psychology trainee, and clinical psychologist, is unfortunately very common.
An important first step is to monitor your stress and look after yourself. As stated in Ethical Standards II.11-12* of the Canadian Code of Ethics for Psychologists, it is students' responsibility to be alert for and to recognize when personal problems are interfering with their effectiveness, and to take appropriate action. The Saskatchewan College of Psychologists Professional Practice Guidelines note that “members must recognize that personal problems and conflicts may interfere with their effectiveness in work-related activities” and “they must take appropriate measures, and determine whether they should limit or terminate their work-related duties.” In summary, personal difficulties are likely to arise and it is important to notice and address them, both for your own well-being, client care, and to help you continue to make progress toward your goal of obtaining a Ph.D. in Clinical Psychology.
It is also the program's responsibility to facilitate and encourage such self-reflection and self-care, and to provide support for this process. Such support may be received in practicum supervision, research supervision, seminars, and in positive relationships among students and faculty. A necessary step for trainees who are facing personal problems might be to discuss the possible impact of these problems with the Director of Clinical Psychology Training, and/or with the student's clinical supervisor and/or research supervisor. There are a variety of avenues to explore, such as obtaining counselling, modifying or suspending the program of training, or arranging a probationary period with specified actions to correct the problem, or taking medical leave from the program temporarily (which stops the “clock” allotted for program completion). Mentors and peers can be an important buffer against distress and burnout (Skovholt & Trotter-Mathison, 2011).
Faculty and students also collectively share an ethical responsibility to take action if we believe that another person's personal problems may be harmful to current or future clients. Specific procedures (see below) are in place for faculty-recognized signs of distress and impairment (see below)
If you believe one of your peers is impaired to the point of negatively impacting client care or their progress in the program, it is important to discuss this with your peer and potentially bring it to the attention of faculty. We recognize this might be difficult – in one survey less than 60% of graduate students who identified peers as distressed took action about that distress. You might also be worried about negatively impacting a peer’s training and program progress. However, we all have a responsibility to ensure that we are providing competent client care. We hope acknowledging this openly, both in this policy and our program, will make this potentially difficult task easier. Further, by identifying concerns early we can provide support to one another and prevent stress from becoming distress, burnout, or impairment. We also encourage students to be open to feedback regarding distress and burnout. Unfortunately, although psychologists are very skilled at recognizing distress in others, they are often poor observers of their own distress.
*Standards cited from the Canadian Code of Ethics for Psychologists:
II.11 Seek appropriate help and/or discontinue scientific or professional activity for an appropriate period of time, if a physical or psychological condition reduces their ability to benefit and not harm others.
II.12 Engage in self-care activities that help to avoid conditions (e.g., burnout, addictions) that could result in impaired judgment and interfere with their ability to benefit and not harm others.