“Being human”: A grounded theory approach to exploring how trainers on clinical psychology doctorate programmes decide whether or not to disclose personal experiences of psychological distress to clinical psychology doctorate trainees

Objective

Recent research and guidelines recommend that trainers on clinical psychology doctorate training programmes consider disclosing personal experiences of psychological distress to trainees. Disclosure is thought to promote cultures of openness, validate and normalise trainee distress, encourage trainee disclosure and help-seeking and challenge stigmatising narratives. However, little is known about how trainers decide whether, what or how to disclose. This study aims to address that gap by exploring the processes and factors involved in trainers deciding whether or not to disclose personal experiences of psychological distress to trainees, generating findings of relevance across counselling, psychotherapy and psychology training courses.

Methods

In-depth interviews were conducted with nine trainers on UK clinical psychology doctorate programmes from around the country and analysed in accordance with constructivist grounded theory methods.

Results

Findings indicated that participants valued disclosure personally and professionally but were wary of the dangers of disclosure. Disclosure decisions were made by judging the context against internally held criteria. If criteria were not met, then disclosures were not made. Outcomes, whether positive or negative, served to reinforce the value of disclosure and the importance of managing risks, creating a positive feedback loop.

Conclusions

The findings of this study suggest factors that are important for trainers to consider when deciding whether or not to disclose. The six-factor framework developed may be useful for trainers to consider within reflective practice, supervision or during guided self-reflection in order to make safe, helpful and ethical decisions.     

Conflict of interest: the importance of potential

The UK Medical Research Council (MRC) takes the issue of conflict of interest very seriously. The overall aim is to preserve a climate in which personal and organisational innovation can flourish while ensuring that potential conflicts are disclosed and identified and conflicts are either avoided or managed with integrity. The approach needs to encompass the MRC’s various responsibilities and the levels at which conflicts might arise: MRC staff (scientists and administrators); the governing Council; research Boards and committees; external peer-reviewers; and applicants for funding. To achieve its goals, the MRC has issued practical guidance on various aspects of conflict of interest. For the future, the MRC has identified the continuing commercialisation of science and the increasing involvement of lay people in scientific decision-making as special challenges in this area. An earlier version of this paper was presented at an International Conference on “Conflict of Interest and its Significance in Science and Medicine” held in Warsaw, Poland on 5–6 April, 2002.     

Clients’ experiences of dynamic interpersonal therapy (DIT): opportunities and challenges for brief,manualised psychodynamic therapy in the NHS

Dynamic interpersonal therapy (DIT) is a brief manualised psychodynamic intervention for depression. This is a first study exploring clients’ experiences of DIT specifically and brief, manualised psychodynamic psychotherapy (PP) in general. Interpretative phenomenological analysis was the methodology employed. Five participants completed a semi-structured interview, three weeks to ten months after completing DIT. The scores of pre- and post-therapy outcome measures of depression and anxiety were also available. Two emerging superordinate themes are presented here: (1) ‘The Distinct Features of DIT’, referring to how its therapeutic style and time limitations were experienced and (2) the ‘Impact of Therapy’, referring to perceived outcomes. While previous findings showed that therapist’s perceived limited activity in long-term PP was experienced as hindering/unhelpful, the perceived sense of direction in DIT appeared adequate to most participants. Secondly, the time limitations provoked complex responses. Reactions to the distinct elements of DIT are to be treated both as therapeutic opportunities and as challenges. Further, in line with psychoanalytic theory, most participants described relational changes that went beyond symptom relief and remained in progress after therapy ended. Intriguingly, there was no consistency between participants’ qualitative accounts of change and the scores of the outcome measures.     

Employment issues of women in jail

This study examines the recent employment history and needs of 110 women held in 2 urban county jails in Ohio. Those who had worked recently were more likely to have a high school education, to have a skill, to have a driver's license with access to a car, and to have dependents. Women who had worked recently were less likely to have a drug or alcohol problem, a chronic medical condition, or a mental disorder. Results indicate that women in jail are more motivated to engage in employment counseling provided that housing and social service needs are addressed.     

Unspoken Ethics: A Multi-Religion Group and Building a Public Identity

Dealing with the differences among its participants has been one of the most difficult aspects which the Council for Religious Studies (CONER/SC) has faced. Formed by different religions, the Council was founded in 1998 to assist the State of Santa Catarina, Brazil, in the implementation of Religous Studies in state run schools. As a public identity was necessary to legitimize its purpose to the state and to religious studies teachers, the group had to deal with tensions provoked by the differences among Christians of various denominations and representatives from Catholic and Protestant (among them only one Pentecostal), Hindu, Muslim and Afro-Brazilian religions. The strategies used to avoid conflict and produce an agreed discourse include resort to silence when hot topics were broached and discussion of issues which were considered to be possible to discuss. The article focuses on the ethical values expressed, but not spoken of in this process, and on some challenges to the group's unity.     

A comparison of alcohol drinkers at a state and private university

The purpose of this study was to compare the drinking behaviors of college students at a large state university to the drinking behaviors of their counterparts at a smaller church university.Questionnaires were administered to a total sample of 764—434 students represented the state university, while 330 students represented the church university. Statistical analysis of the data revealed significant differences at the .05 alpha level between the two groups of drinkers. However, many similarities between the two groups did exist. Two of the three null hypotheses were supported by the data. Only in one category did the drinkers at the church school respond notably higher than the state school drinkers. Considerably more church school drinkers admitted to drinking primarily when in a lonely or sad mood than the state school drinkers. Drinkers at the church school felt a need to hide or be alone when drinking and did not use alcohol to socialize as often as their state school counterparts.     

Integrating Web-Based Applications into Aged Care: Two Case Studies and Discussion

In anticipation of the growing need for adequate mental health care for older adults in residential aged care facilities, psychologists are challenged to overcome several barriers that impede the uptake and delivery of their services in such settings. Information and communication technologies (ICT) have strong potential to overcome some of these barriers by supporting the delivery of evidence-based psychosocial treatments for common psychogeriatric issues. This paper presents two case studies that illustrate when and how psychologists can use various ICT applications (e.g., tablet devices, web-based applications) integrated with cognitive behavioural and reminiscence-based therapies. Both case studies demonstrate that ICT can effectively support the therapeutic alliance, enhance therapeutic engagement, and individualize treatment delivery to accommodate the needs of elderly patients. It is hoped that these case studies will encourage clinicians to consider using ICT to augment therapy with their elderly patients.