Trainee disclosure of mental health and psychological difficulties

Last Updated on 15/08/2024

Programme ethos

The Lancaster DClinPsy programme recognises that all trainee clinical psychologists are human beings, who have potential to experience mental health difficulties or psychological distress during training. People also may have experienced such difficulties prior to training, and may be accessing mental health services or have accessed services in the past. Experiences of mental health difficulty and psychological distress may include low mood and ‘depression’, ‘anxiety’, voice hearing, extreme stress, and others.

It is recognised that training to be a clinical psychologist can be challenging and trainees may experience adverse life events in their personal lives that impact their well-being during the course of training. On placement, the supervisory role involves exploration of how a trainee feels in relation to their work and support with managing this. Trainees’ ability to identify when their well-being is negatively impacted is an important skill, and trainees are encouraged to talk with their tutor pair and placement supervisor, and access support as needed (see section on Support in the programme handbook). When necessary, trainees can be referred to access support from Occupational Health within their employing Trust, Lancashire and South Cumbria NHS Foundation Trust (LSCFT). Trainees might also need to take leave for reasons relating to stress or mental health difficulty (see section on Absence from work in the programme handbook).

Although experiences of mental health difficulties can be difficult and distressing, the insights they provide can be valuable to clinical psychology trainees. Such experiences may help equip trainees to work with individuals experiencing mental health difficulties, to understand what it is like for others to access mental health services, and to understand how mental health difficulties are seen within a cultural context.

The programme welcomes trainees sharing current or previous experiences of mental health difficulty at relevant times during training, such as during selections, learning sessions, placement supervision, or in discussion with the tutor pair. It is recognised that disclosing such experiences can be difficult, particularly for those who have had experiences of being stigmatised or ‘othered’ because of their experiences. The programme aims to promote a culture whereby these disclosures and contributions are valued and normalised. Trainees’ disclosure of mental health difficulties or use of services will not be assessed negatively, and should not be conceptualised negatively by others who contribute to the programme, including other trainees, staff, external facilitators, and placement supervisors. In the event that a trainee feels their experiences of mental health difficulties are being seen negatively, it is encouraged for this to be fed back to the programme through the appropriate channels. For example, the trainee could feed this back to representatives on the Trainee Council.

Confidentiality

When a trainee discloses current or previous personal experience of mental health difficulty or access to mental health services during training, this would usually be kept confidential between the trainee and the person or people with whom they have shared this information. When the person who is being informed thinks there is a need for this to be shared, they should discuss with the trainee in the first instance. The trainee’s preference for what they do and do not give permission to be shared should be respected, and followed wherever possible. There are occasions when it might be necessary for the person who has been informed to encourage the trainee to share this information with an appropriate person, particularly if they are concerned about the trainee’s current well-being. For example, if a trainee’s ‘buddy’ is told that the trainee is struggling with difficulties such as stress and anxiety, the buddy might encourage the trainee to speak to their clinical tutor about this. If the trainee does not want to share the difficulties with anyone else, the person who has been informed should be sensitive to the possibility that their own perspective on the issues might be impacted by societal biases e.g. internalised racial biases. They should consider that the person themselves is often the best judge of what they need. However, there may be occasions in which the person informed has a professional responsibility to share some of this information. For example, a placement supervisor who is concerned about a trainee’s well-being and the impact of this on their placement work might need to share their concerns with the trainee’s clinical tutor. In such an event, the psychological contract set up between the trainee and supervisor should be referred to for how best to go about this in a collaborative and sensitive way. The trainee should be offered support from the clinical tutor and placement supervisor, and next steps should be considered collaboratively. The trainee’s clinical tutor may also share information with the clinical director as needed. This is because the clinical director is line manager to all trainees and clinical tutors.

Trainees should be aware that due to nature of the profession they are training in, it is possible that they will meet someone through their training who they have seen before in a personal capacity. For example, a clinical psychologist who has offered them psychological therapy might teach on the programme. In such an event, the clinical psychologist is bound to follow HCPC guidelines with regard to the confidentiality of service-users, and any contract/agreement surrounding confidentiality between the trainee and the other individual should apply.


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