1. Deakin University CRICOS Provider Code: 00113B BARRIERS TO AND FACILITATORS OF CLINICAL PSYCHOLOGY TRAINEES’ DISCLOSURE OF MENTAL HEALTH DIFFICULTIES Talya Rabinovitz & Lucy Zinkiewicz School of Psychology, Deakin University, Australia lucyz@deakin.edu.au

2. Deakin University CRICOS Provider Code: 00113B THE BENEFITS OF SELF-DISCLOSURE IN RELATION TO MENTAL HEALTH ‘Mental health difficulty’ = not just clinically diagnosed mental illnesses, but also subclinical levels of stress, anxiety, & depression Self-disclosure (SD) of mental health difficulties fosters more positive attitudes towards mental illness, & has emotional & instrumental benefits For health professionals, increases empathy & insight in treatment of clients In graduate training, SD to peers is a learning tool, & fosters trust & cohesiveness among future colleagues 2

3. Deakin University CRICOS Provider Code: 00113B IMPORTANCE FOR PSYCHOLOGY GRADUATE TRAINING Clinical psychology graduate training is intrinsically challenging & stressful, tends to attract high achieving & perfectionist trainees, & may trigger mental health difficulties in susceptible trainees However, many trainees are hesitant to disclose these difficulties to staff, though disclosure is vital if staff are to help trainees manage their difficulties & engage in self-care Considering its benefits, SD should be encouraged, in order to reduce trainee withdrawal & burnout later in their career As a first step to foster this, this study examines barriers & facilitators to trainees’ SD 3

4. Deakin University CRICOS Provider Code: 00113B BARRIERS & FACILITATORS OF SELF- DISCLOSURE Barriers Fear of stigmatisation Self-stigma Personality-related variables (sensitivity to rejection) Facilitators Liking and trust between discloser & recipient Disclosure reciprocity SD out of necessity Perceived benefits of SD Personality-related variables (high disclosure flexibility & high self-monitoring) 4

5. Deakin University CRICOS Provider Code: 00113B RESEARCH QUESTIONS Do the same barriers and facilitators of mental health SD in the workplace & among health professionals & university students also exist for clinical psych trainees? Are there any barriers & facilitators that are unique to this population? 5

6. Deakin University CRICOS Provider Code: 00113B PARTICIPANTS 20 clinical psychology trainees completing their masters or doctorate courses, from Deakin University and other Melbourne & Sydney Universities Gender balance: 18 females, 2 males Age range: 24-38 6

7. Deakin University CRICOS Provider Code: 00113B METHODOLOGY Ethics approval granted from Deakin Uni HREC Qualitative: in-depth semi-structured interviews - face-to-face, phone or online, to allow for anonymity Interview schedule – Asked if had ever disclosed a mental health difficulty to anyone in their course, to whom & in what situation, & if so what happened? – If have had difficulties & not disclosed, why not? Might they do so later? – Why do they think trainees are hesitant to disclose, & why some do disclose? – Do they think training providers should do more to encourage SD? 7

8. Deakin University CRICOS Provider Code: 00113B DATA ANALYSIS Thematic analysis Focuses on identifying patterned meaning across a dataset Patterns identified through process of data familiarisation, data coding & theme development & revision Data analyses are still taking place, but some preliminary results follow Only presenting barriers, facilitators & moderators of disclosure 8

9. Deakin University CRICOS Provider Code: 00113B FACILITATORS OF DISCLOSURE Shared experience of stressful course – Disclosure to receive emotional support, debrief, share coping strategies – Disclosure to obtain instrumental support Closeness (& disclosure facilitated closeness) Proven competency Trust that recipient will not be judgmental or use info against them When their condition discussed in class Disclosure as part of recovery process Disclosure by staff Disclosure by fellow classmates 9

10. Deakin University CRICOS Provider Code: 00113B BARRIERS TO DISCLOSURE Fear of negative consequences, especially when unsure how recipient would react Pressure to conform to “ideal psychologist” idea Pressure to conform to “ideal psychology student” Previously bad experience of disclosure Stigma of mental health difficulties 10

11. Deakin University CRICOS Provider Code: 00113B MODERATORS OF DISCLOSURE Characteristics of the recipient, which varied by status & kind of support sought – Classmates - genuine, warm, caring, trustworthy, understanding – Staff may just need to be trustworthy Characteristics of discloser - personality, self-concept, self-stigma, upbringing/culture Stage of recovery – esp when currently experiencing, completely recovered Content of disclosure – external stressor vs internal stressor Level of stigma attached to their condition Culture of their university 11

12. Deakin University CRICOS Provider Code: 00113B DISCUSSION Facilitators, barriers & moderators consistent with general SD literature, but also reflects particular context of clinical psychology training – highly selective, high demands, high stress, nature of course content Trainees are generally unclear about consequences of disclosure, especially re professional regulation & AHPRA (registration board) Culture of university/school/program very important – If students unsure of what the uni/program/staff responses to SD will be, they will assume the worst – Staff SD & trustworthiness vital 12

13. Deakin University CRICOS Provider Code: 00113B IMPLICATIONS FOR TRAINING PROGRAMS Staff need to explicitly discuss the consequences of disclosure, especially re professional regulation & AHPRA (registration board), as early as possible in the course (e.g., orientation) Need for greater openness in training about issue of MHD & course-related stress Need for program staff to better support students with course- related stress & pre-existing or course-precipitated MHD Need for explicit training in self-care, development of resilience, as part of courses Need to select students with more resilience? 13

14. Deakin University CRICOS Provider Code: 00113B WHERE TO FROM HERE? Completion of analysis & thesis submission Additional papers based on same dataset on what happened if disclosed, & thoughts about what program staff should do Research into staff attitudes & experiences in relation to trainee SD Research into what programs do to support trainees in relation to MHD, stress, SD & self-care LT: to develop a series of modules on SD of MHD, for use at different stages of courses (e.g., orientation, pre-placements, during placements, pre-employment) Research collaborators welcome! Email lucyz@deakin.edu.au 14