Thesis (Ph. D.)--Auburn University, 2008. / Abstract. Includes bibliographical references (p. 53-61).

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Clinical psychologists’ experiences of training are under-represented in the research area, particularly in the field of transformational and experiential learning and its influence on trainees during their training. Yet, it is a growing topic of interest for training providers and commissioners. Understanding whether the current method of training, using problem-based learning at the University of Hertfordshire (UH), is effective in preparing trainees to work in the NHS as clinical psychologists may have wider implications for clinical psychology training and practice. This thesis aimed at exploring clinical psychologists’ narratives of identity changes through problem-based learning (PBL). For this purpose, I chose to explore their reflective PBL written accounts using a narrative analysis to identify plots and sub-plots of identity changes within their PBL stories. I knowingly took a social constructionist stance to frame this project as it reflects my constructions of clinical psychology and the epistemological choice of the UH course. This means that this research situates itself within a particular context and does not claim any truth, but proposes a constructed view on identity changes during training and their implications for clinical practice. The analysis enabled me to identity three main plots: ‘identity changes through the PBL group’, ‘experimenting with alternative roles and identities’ and ‘Identity changes through PBL & training’. The first plot was characterised by anxiety, vulnerability, tensions between individualism and collectivism and the impact of differences. The second plot was characterised by trainee psychologists finding the balance between process, task and reflections, sharing and connecting with others, changing their relationship with theories; and working to empower themselves. The third plot highlighted the demands of PBL and training and PBL’s place in training. These factors seemed to have influenced and contributed to identity changes in clinical psychologists engaged in PBL during their training at UH. The discussion highlighted which aspects of PBL relate to identity changes and their implications for training and clinical practice. To conclude, I shared my growing interest for further exploration. I also highlighted the ever-evolving nature of PBL and the importance of exploring its use in training and its implications for the professional development of trainee clinical psychologists. Finally, the project ends with reflections about the research process and epistemological considerations.

The purpose of this thesis is to examine how the professional and social roles of clinical psychologists are described in Turkey, how clinical psychologists evaluate these roles, and which factors are affecting the role definitions. It was hypothesized that there would be differences between the role definitions of the public, the role definitions of the other professions working with psychologists and the role definitions of psychologists themselves. Also, it was expected that the public would not differentiate the professions &lsquo / psychologist&rsquo / , &lsquo / clinical psychologist&rsquo / , and &lsquo / psychiatrist&rsquo / . Participants were 27 professions working with psychologists, 27 psychologists, and 105 citizens from Ankara, istanbul, Mugla, and Aydin. The data were gathered by administering 3 versions of Perceptions about Psychologists Questionnaires developed by the writer. Content Analyses were done to examine the data. The results indicated that although public had a general idea about the role definitions of clinical psychologists, it was also unable to differentiate the three relate professions. The results also summarized how clinical psychologists were understood in Turkey, and showed the factors related to the comprehension process. The findings, and their implications with suggestions for future research and practice, were discussed in the light of relevant literature.

The purpose of personal therapy for psychologists can be understood as a method of personal and professional development (PPD) and/or in terms of help-seeking. This study aims to consider differences in the use of personal therapy among trainee clinical psychologists. It used a cross-sectional, survey design and invited all British trainees to participate. 437 trainees (25% response rate) completed measures on intrapersonal and interpersonal variables, and answered several factual questions pertaining to demographics and clinically relevant experiences. Several trainees reported experiencing childhood abuse. A large proportion had experienced therapy prior to training. These issues were explored. Discriminant analyses demonstrated that attitude to therapy for PPD and psychological flexibility were important predictors of use of personal therapy, as was emotional neglect in childhood. The potential link between difficult early experience and ability to manage internal experience was considered. Therapeutic orientation of trainee, year of training and course support were also important factors in differentiating between groups. Implications for training and PPD were discussed in terms of suggestions for courses and trainees.

Notre thèse porte sur les troubles des comportements alimentaires (TCA). Ces derniers ont certaines spécificités représentatives des nouvelles formes de symptômes. La dimension de jouissance y est prédominante et a tendance à étouffer la dimension d’appel propre à toute formation symptomatique. Au regard de ces particularités, les traitements dits « habituels » sont fréquemment inopérants, ce qui peut amener certains patients à entrer dans un protocole de soin hospitalier. Lieu, offrant de multiples scènes de soins qui œuvrent de façon convergente pour vider le symptôme d’une partie de sa jouissance.La thèse montre que la démarche clinique auprès de ceux qui souffrent de TCA, doit amener le psychologue clinicien, à faire preuve de créativité et prendre une posture active, s’il veut permettre au sujet de s’ouvrir à sa division subjective / Our research dealt with eating disorders. They have specific characteristics that represent new forms of symptoms. The ‘Jouissance’ dimension is predominant and tends to overwhelm the ‘address dimension’ corresponding to any symptomatic formation. In view of these particularities, treatments called ‘usual’ are frequently ineffective, leading some of the patients to medical care. The clinical environment allows a multidisciplinary team to meet and work together under certain conditions in order to remove part of the ‘jouissance’ in the symptoms. This work aims to show that the clinical procedure addressed to those who suffer from eating disorders must provide a clinical psychologist who will have to prove creativity and an active behaviour in order to give the subject the possibility to access his unconcious

Background: Stress and burnout is often reported within the ‘human service’ professions. A systematic review aimed to ascertain the prevalence of stress and burnout within clinical psychologists, and the coping strategies utilised by members of this profession. Specifically, the role of clinical psychologists that work with people with intellectual disabilities and behaviour that challenges may, arguably, be particularly challenging, given the risks inherent in behaviour that challenges. Previous work has found that paid and family carers for this population experience substantial levels of stress. However, little is known about the experiences of clinical psychologists who may play a pivotal role in the multi-disciplinary team supporting individuals and their carers. Methods: The systematic review explores the prevalence of stress, burnout and coping in clinical psychologists. An electronic review and hand search of the literature was completed. The quality of all eligible articles was assessed, and themes within the findings were discussed using a narrative synthesis approach. The subsequent empirical article explores the perspectives of 14 female clinical psychologists. Thematic analysis was utilised to derive themes from their interview transcripts. Results: Eight studies met inclusion criteria for the review; findings suggest that a large proportion of clinical psychologists experience symptoms of stress and burnout. Nevertheless, most psychologists also experience high levels of personal achievement in their role. Within the empirical study, two overarching themes were apparent across participants. These included difficult and positive experiences. Participants reported barriers to influencing change and feelings of stress, worry, anxiety, self-doubt and frustration within the role. However, supervision and support from colleagues appeared to moderate difficult emotions. All conveyed a sense of reward within their role. Conclusions: Comparable to other ‘human service’ professionals, clinical psychologists experience symptoms of stress and burnout. With regard to clinical psychologists working with people with intellectual disabilities and behaviour that challenges, it appears that supervision and support from colleagues is key in managing difficult emotions. Based on the findings, provisions that are believed to improve clinical psychologists’ experiences are considered.

Aim: Knowledge of the experience of qualified BME clinical psychologists in clinical practice is currently lacking in the research literature. The aim of the current study was to explore the lived experience of qualified BME clinical psychologists currently employed in the National Health Service (NHS). By investigating this under-researched topic, the study hopes to shed light on the impact on clinicians' personal and professional identity of practicing within a profession that lacks cultural diversity. It is hoped that the results of this study will contribute to ongoing efforts to diversify the profession, improve our knowledge of the experience of BME groups in the helping profession and also challenge current misconceptions concerning the BME experience. Method: A mixed method qualitative approach was employed for this study. Repertory grids and semi-structured interviews were conducted with six female qualified BME clinical psychologists who are currently working in the NHS. They had been qualified between three and sixteen years. Their repertory grids were analysed using Idiogrid and their accounts were analysed using Interpretative Phenomenological Analysis (IPA). Results: Four master themes emerged from the analysis and were supported by the findings from the repertory grids showing that BME clinical psychologists feel that they stand out as different on account of their ethnic difference. The analytic procedure also highlighted how participants have to find a way to negotiate their cultural and professional values whilst also sitting with the uncertainty of their experiences in the profession. The final theme relates to the privilege that participants held in making it as a clinical psychologist. Implications: Initiatives to increase cultural competency and sensitivity need to be addressed by the profession. Efforts to increase ethnic diversity should be followed through to ensure practitioners are not left on the fringes of the profession on account of their minority ethnicity.

Although it is not a professional requirement, research shows that some Trainee Clinical Psychologists (CPs) access PT (PT) whilst training (Nel, Pezzolesi & Stott, 2012). CPs' practice is moving towards the Reflective-Scientist-Practitioner Model, therefore identifying ways that CPs may develop reflective skills is required. Most other therapeutic trainings have PT as a requirement (Malikiosi-Loizos 2013), which is suggested as a method of developing reflective skills (Lavender, 2003; Wigg Cushway & Neal, 2011). Little research has investigated the use of PT by Trainee CPs. The current study explored processes by which 12 Trainee CPs experienced their own (PT), and how these processes related to their development whilst training. Participants were interviewed using single, semi-structured interviews. Data was analysed using Constructivist Grounded Theory (Charmaz, 2014). Two models were constructed, these described participants' decision to access PT mediated by anticipating or experiencing distress and learning about the self through PT. Participants seemed to develop and learn about themselves in three domains; 1) Learning about me: Personally; 2) Learning about me: Professionally; and 3) Learning about me: Being a client. I understand this development occurred through the continuous process of participants taking a dilemma to PT, reflecting upon the dilemma, and thereby acquiring a different understanding of themselves. These experiences apparently permit participants to integrate personal attributes into their professional identities and to model positive experiences from their own therapy in their practice. The results support PT as a method of developing competencies required within the Reflective Practitioner Model, implying that the use of PT for Trainee CPs should be considered within professional training. Furthermore, participants described emotional struggles during training which they perceived, according to professional discourses, to be unacceptable. This implies that evaluating formal and informal support systems for Trainee CPs is essential.