Perceived effects of the COVID-19 pandemic on clinical psychology internships in Sweden

Abstract

Background The COVID-19 pandemic has had an unprecedented impact on societies and health care services worldwide, including the clinical training of psychology interns. Some of the pandemic-related restrictions were in breach of the internship requirements, increasing the risk of failed internships and a shortage of new health care professionals. This situation needed to be assessed. Methods Web-based surveys were administered to clinical psychology interns in Sweden 2020 (n = 267) and 2021 (n = 340), as well as to supervisors in 2020 (n = 240). The supervisors also provided information about their interns (n = 297). Results Risk factors for a prolonged internship, such as pandemic-related absence from work (12.4% in 2020 and 7.9% in 2021), unqualified work (0% in 2020, 3% in 2021), and change in internship content were low. However, remote interactions using digital services increased. Face-to-face patient contacts decreased significantly from 2020 to 2021 (Χ2 = 5.17, p = .023), while remote work and remote supervision increased significantly (Χ2 = 53.86, p < .001 and Χ2 = 8.88, p = .003, respectively). Still, the content in patient contacts and supervision was maintained. Most interns reported no difficulties with remote supervision or supervision in personal protective equipment. However, of the interns who reported difficulties, role-play and skills training in remote supervision were perceived as significantly harder (Χ2 = 28.67, p < .001) than in supervision using personal protective equipment. Conclusions The present study indicates that clinical training of psychology interns in Sweden could proceed despite a societal crisis. Results suggest that the psychology internship was flexible in the sense that it could be realized in combined face-to-face and remote formats without losing much of its value. However, the results also suggest that some skills may be harder to train in remote supervision.

‘They couldn’t really gauge where we were and what we were struggling with’: intern psychologists’ experiences of support within their placement during COVID-19

“…In South Africa, intern psychologists play a crucial role in providing accessible mental health care in academic institutions, schools, non-governmental organisations (NGOs), government military services, government hospitals, and clinics. The COVID-19 pandemic of 2020 significantly influenced professional training (Bergvall et al, 2023; Sheerin et al, 2021). For example, due to gaps in training and time away from the internship sites due to lockdown restrictions, the professional career development, competency, and professional identity of intern nurses, physicians, and psychologists were compromised during the outbreak of the COVID-19 pandemic (Kinnear et al, 2021; Lourens & Uren, 2023).…”

“…Due to the initial closure of educational facilities during the COVID-19 pandemic, interns placed at university counselling centres generally had to provide telehealth and online therapy for clients (Lourens & Uren, 2023; Ortiz & Levine, 2022). While intern psychologists in high-income countries had access to technology to aid in online psychotherapy (Bergvall et al, 2023; Stein et al, 2023), in South Africa, they often had to provide distanced psychotherapy without efficient technological equipment nor sufficient internet data connectivity (Goldschmidt et al, 2021; Lourens & Uren, 2023). The latter, therefore, often incurred extra financial costs to mitigate the aforementioned challenges – despite the fact that they often struggled financially (Lourens & Uren, 2023).…”

“…Not only did intern psychologists provide remote online support to clients, but they also received supervision in these virtual spaces (Bergvall et al, 2023; Sheerin et al, 2021). Since online psychotherapy and supervision require a certain skill set that was mostly unfamiliar to many practitioners (Bergvall et al, 2023; Frye et al, 2022), some interns found online supervision problematic – particularly in terms of role-playing, skills training (Bergvall et al, 2023), and training in assessments (Frye et al, 2022).…”