‘Isn't it mad that we're all psychologists and we can't talk about our feelings?’: A mixed-methods study exploring trainee clinical psychologists' experience of (non)disclosure of psychological distress during training

Abstract

Objective: Literature on trainee clinical psychologists' mental health has highlighted elevated levels of mental health difficulties and/or psychological distress and low levels of disclosure within the workplace. The current study aimed to explore (1) trainee experiences of disclosure and/or concealment of psychological distress during their training, (2) beliefs, assumptions or predictions related to disclosure and (3) responses to disclosure. Methods: A mixed-methods strategy was employed; 165 trainee or recently qualified clinical psychologists took part in an online survey. Thirteen of these were interviewed. Descriptive statistics and a reflexive thematic analysis were conducted to analyse the quantitative and qualitative data, respectively. Results: The sample largely consisted of those who had disclosed distress. Beliefs related to negative judgement from others and feelings of anxiety and embarrassment were commonly endorsed responses within quantitative findings. Six main themes were constructed: (1) Diagnostic or psychological conceptualisations, (2) Worries about judgement complicate disclosure decisions, (3) Disclosure likelihood is determined by relationships, (4) Emotional support versus practical responses, (5) Desired changes that could increase disclosure and (6) Legacies of disclosure experiences. Conclusion: There is a need for training programme staff to prioritise emotional support, increase permission giving and enhance disclosure guidance. Further research including disclosure recipients is required.