Understanding mental health difficulties and disclosure within psychology professions

Section A: Supervision is critical in the psychological professions for the development of knowledge and therapeutic skills, as well as for monitoring the safety and effectiveness of interventions. However, supervisee nondisclosure is common and may impact negatively upon the supervisory process and client outcomes. This literature review systematically examined the relationship between supervisee nondisclosure and the supervisory working alliance within the professions of clinical and counselling psychology. Findings relate to content of nondisclosure, psychology culture and expectations, compatibility and supervisory competence, power dynamics, weighing risk, aiding disclosure, alternative strategies, supervisory reactions and the cycle of nondisclosure and the changing supervisory relationship. Practice implications and future research are discussed.

Section B: The prevalence of mental health difficulties among trainee clinical psychologists is reported to be high, with low disclosure rates. Clinical psychology training can be stressful, and it has been suggested that trainees are more likely to experience distress and self-doubt because of their inexperience. Despite this, little is known about how mental health issues are navigated within training. This study explored how trainees, clinical supervisors and training facilitators understand and navigate mental health difficulties, support, and time off. Seven main categories were created, using grounded theory methodology: trainee and staff histories and stressful life events, personal attitudes towards mental health difficulties, power and autonomy, questioning workplace competence, complex systemic issues, navigating access to support and time out, mental health in the psychological trenches and learning and hindsight. The culture within clinical psychology and unclear processes and communication may be implicated and are discussed in relation to practical implications.