Developing healthy mental health professionals: what can we learn from trainees?

Abstract

There is considerable interest in the recruitment, training and retention of workers in the field of mental health, as evidence shows significant problems in the retention of highly qualified professionals in this field. Large numbers leave, some leaving the professions for other careers as a result of burnout, caused in part by the emotional burden of work in stressful and emotionally charged environments. We propose a training approach in which students are encouraged to reflect on their own emotional responses to such stressful and upsetting situations. We argue that this approach, in allowing them to be more at ease with themselves, would make them both more available to the emotional experiences of their patients, and in turn enhance their own resilience and capacity to survive stressful situations.We took for our study a cohort of trainees from The Tavistock Clinic in London, a major training institution providing post-graduate mental health courses based in psychoanalytic and systemic theory. We aimed to investigate what the students reported to be the key components in these trainings to enhance their capacity to manage in their demanding and highly stressful work environments, alongside ordinary human experience. The trainees were from a range of backgrounds and included doctors, psychologists, social workers and teachers. The courses had in common the following elements: small work discussion groups providing an opportunity to reflect on their work in practice, lectures on background theory, tutorials, and small seminar groups to which they brought ongoing observations of young children in ordinary settings. Some also had the opportunity to undertake supervised clinical work in the Clinic.We used a detailed qualitative questionnaire to elicit the trainees' expectations and experience of the trainings. In addition, all participants completed the 30-item General Health Questionnaire (GHQ), and some took part in the Adult Attachment Interview, later rated for Reflective Function.

Coping with work‐related stressors and building resilience in mental health workers: A comparative focus group study using interpretative phenomenological analysis

“…The second theme, ways of building resilience, demonstrated that there are many different ways people cope with excessive stress. Participants in both groups appeared to share several of the characteristics found by previous research to indicate resilience, for example the ability to use humour (Simeon et al ., ; Stevanovic & Rupert, ), being female (Rutter, ; Werner & Smith, ), good communication (Cushway & Tyler, ; Werner & Smith, ), supportive relationships (Joseph & Linley, ; Luthar & Cicchetti, ), self‐reflection (Joseph & Linley, ; Trowell, Davids, Miles, Shmueli, & Paton, ), and the personal use of clinical and therapeutic skills (Shapiro et al ., ). This last point is of most relevance to NPs, who have the clinical skills mentioned.…”

“…The researcher attempted to minimize any such effect by not demonstrating overfamiliarity with any individual participants. In this study, it seems that several of the themes that emerged were consistent with the kinds of issues raised in previous research (Cushway & Tyler, ; Joseph & Linley, ; Luthar & Cicchetti, ; Shapiro et al ., ; Trowell et al ., ; Werner & Smith, ), which may have been due to the researcher's familiarity with this work‐limiting analysis. However, the analysis highlighted additional themes that warrant further exploration, and so it is not felt that previous research overly influenced the outcomes of the study.…”

Clinical Psychologists' Experiences of Reflective Staff Groups in Inpatient Psychiatric Settings: A Mixed Methods Study

“…It is argued that reflection is important to understanding relationships, group dynamics and the impact of the context on individual thoughts and feelings (Davenport 2002;Holmes 2002;Kurtz 2005). It is also argued that reflection can assist staff in dealing with difficult feelings aroused by the inpatient context (Holmes 2002;Kurtz 2005), and reflective ability has been linked to increased resilience in stressful and upsetting situations (Trowell, Davids, Miles, Shmueli, & Paton 2008). Therefore, regular space for reflective processes such as groups is important for both staff satisfaction and the functioning of the unit (Kurtz 2005;Terenyi, Kis, & Eszik 2004;Thorndycraft & McCabe 2008).…”

Mentalizing capacities of mental health nurses: A systematic PRISMA review

“…This study used a matched case-control, cross-sectional study design. In a study of Trowell et al (2008) that used a pretest-post-test design, mental health clinicians, social workers and teachers undergoing psychotherapy (whether currently or previously) at the start of post-graduate mental health courses also displayed higher levels of mentalizing capacity (measured with the RFS) than therapists who…”