Copyright is owned by the Author of the thesis. Permission is given for a copy to be downloaded by an individual for the purpose of research and private study only. The thesis may not be reproduced elsewhere without the permission of the Author. THE PREVALENCE AND PERCEIVED EFFECTS ON PSYCHOLOGICAL PRACTICE OF PRIOR EXPOSURE TO MENTAL ILLNESS AND/OR PSYCHOLOGICAL TRAUMA IN PSYCHOLOGISTS A thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Albany, New Zealand. SHEILA LARAINE BOYLAND 2002 ' . .. if we can look at ourselves in a forthright fashion , then most assuredly the anguish and despair of our present colleagues and our future generations of young therapists ... will be significantly diminished.' Herbert J. Freudenberger ( 1987) ABSTRACT One hundred and fifty-six participants comprising registered psychologists and postgraduate psychology students responded to a mail survey requesting information on their experiences prior to undertaking their postgraduate study in psychology. Clinical and counselling psychologists/students were compared with psychologists and students specialising in other areas of psychology. The clinical/counselling group differed significantly from the comparison group in a number of ways. Clinical/counselling participants were more likely to report prior exposure to mental illness and some types of psychological trauma, as well as a greater number of these experiences. The influence of prior exposure to mental illness and/or traumatic events on the decision to study psychology, and the perceived effects of these experiences on future psychological practice, were investigated with mixed results. Motivators to enter the field of psychology were also investigated and clinical/counselling participants were more likely to have been motivated by dysfunctional reasons than the comparison participants. Additionally, the findings of this study suggest that psychology students with psychological problems may be fearful of disclosing these for fear of negative consequences. It is also suggested that, in general, psychologists and postgraduate psychology students in New Zealand may not be entirely satisfied with their education with regard self-care and self­ reflection issues. Ill The results are discussed in terms of effects on psychological practice, and specific issues regarding the education of postgraduate psychology students are raised. Recommendations for further research are suggested. IV ACKNOWLEDGMENTS Thanks to Paul Merrick, my supervisor, for his encouragement and enthusiasm for this project. Thanks also to Linda Kemp for her help with administration matters during the course of the year. v I would also like to thank in general the staff in the psychology department at Massey University, some of who received the odd e-mail query from myself out of nowhere but took the time to reply with helpful advice. The various courses on aspects of thesis preparation and completion run throughout the year were extremely helpful and provided a boost to motivation when it was needed. Finally I would like to acknowledge the participants of this study, without whose contributions this project would not have been possible. If we do not take the time to look at and try to ' know' ourselves, how are we able to expect to come to ' know' others? TABLE OF CONTENTS ABSTRACT .. . ACKNOWLEDGEMENTS .. . LIST OF TABLES .. . LIST OF FIGURES .. . CHAPTER 1 INTRODUCTION CHAPTER2 1. 1 Professional Impainnent Due to Mental Health Problems in Psychotherapists ... 1. 2 1.3 Rationale Hypotheses and Additional Aims 1.31 Hypotheses 1.32 Additional Aims THE LITERATURE 2.1 Prevalence Rates VI Page Ill v x Xlll 1 5 6 6 8 9 2.11 Prior History of Psychological Trauma in Therapists .. . 9 2.12 Prior History of Mental Illness in Therapists . . . 11 2.13 Prior History of Exposure to Family Members with Mental Illness or Psychological Trauma 13 CHAPTER3 2.2 Possible Effects for Therapists with a History of Exposure to Mental Illness and/or Psychological Trauma ... 2.21 Possible Positive Effects 2.22 Possible Negative Effects 2.23 Additional Possible Effects on Clinical Practice 2.3 Motivations 2.31 Functional Motivators ... 2.32 Dysfunctional Motivators 2.33 Psychoanalytic Theory of Career Choice 2.34 Motivators pertaining to the Family of Origin 2.35 Research in the Area of Motivation .. . 2.4 Psychotherapists Who Undergo Their Own Personal Psychotherapy ... THE METHOD 3.1 Participants 3. 11 Sample Characteristics 3.12 Coding of Demographics 3.13 Missing Data 3.2 Measure 3.21 Survey Development 3.3 Procedure Vll 15 15 17 27 28 29 30 31 33 34 36 41 41 43 45 46 47 51 CHAPTER4 RESULTS 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Hypothesis One Hypothesis Two Hypothesis Three Hypothesis Four Hypothesis Five Hypothesis Six Additional Aims Additional Findings 4.81 Effect Size and Power Calculations 4.82 Gender Effects 4.83 Age Effects 4.84 Effects due to Status 4.85 Effects due to Time Elapsed since Commencement of Postgraduate Study Qualitative Findings ... CHAPTERS DISCUSSION 5.1 5.2 5.3 5.4 5.5 Discussion of the Findings Strengths of the Present Study Limitations of the Present Study Implications for Practice Recommendations for Further Research Vlll 53 54 59 61 64 66 67 70 70 74 75 76 76 78 79 88 90 94 96 REFERENCES APPENDIX A APPENDIXB APPENDIXC APPENDIX D IX 98 Questionnaire used in the Study l 08 Information Sheet used for Registered Psychologists 1 13 Information Sheet used for Postgraduate Psychology Students - e-mail ... Qualitative Findings 115 117 Table 1. Table 2. Table 3. Table 4. Table 5. Table 6. Table 7. Table 8. Table 9. LIST OF TABLES Functional Motivators for Entering the Profession of Psychotherapy ­ as Identified by Guy (1987) ... Possible or Potentially Dysfunctional Motivators for Entering the Profession of Psychotherapy - as Identified by Guy ( 1987) Comparison of Groups on Demographic Variables Table of Specifications for Research Questionnaire Prevalence Rates for Exposure to Different Types of Psychological Trauma Prior to Undertaking Postgraduate Study in Psychology Trauma Specified by Participants Under the 'Other Psychological Trauma Category' Prevalence Rates for Exposure to Psychological Trauma in a Family Member or Close Friend Prior to Undertaking Postgraduate Study x Page 29 30 42 48 55 56 in Psychology . . . 57 Descriptive Statistics relating to the Total Number of Different Types of Traumatic Experiences Reported by the Total Sample and the Two Comparison Groups ... Percentage of Participants Indicating Extent oflnfluence of Personal Exposure to Mental Illness or Traumatic Psychological Experience, Prior to Undertaking Postgraduate Study in Psychology, in their Decision to Study Psychology 59 61 Xl Table 10. Percentage of Participants Indicating Extent of Influence of Personal Exposure to Mental Illness or Traumatic Psychological Experience Via a Family Member or Close Friend, Prior to Undertaking Postgraduate Study in Psychology, in Their Decision to Study Psychology 61 Table 11. Perceived Effects on Future Practice of Psychology in Clinical/ Counselling Participants Who Experienced Personal Exposure to Mental lllness or Psychological Trauma, Prior to Undertaking Postgraduate Study in Psychology, and Did or Did Not Receive Psychotherapy or Counselling Prior to or During their Training 63 Table 12. Perceived Effects on Future Practice of Psychology in Clinical/ Counselling Participants Who Experienced Personal Exposure to Mental lllness or Psychological Trauma Via a Famil y Member or Close Friend, Prior to Undertaking Postgraduate Study in Psychology, and Did or Did Not Receive Psychotherapy or Counselling Prior to or During their Training ... 64 Table 13. Participants ' Responses to the Statement ' In general , psychology students do not disclose psychological problems for fear of negative consequences, eg. not being selected into a training program of their choice, or being thought incompetent' 68 Table 14. Participants' Responses regarding their Satisfaction with the Degree of Emphasis Placed on Self-Care During their Postgraduate Study in Psychology 69 Table 15. Participants' Responses regarding their Satisfaction with the Degree of Emphasis Placed on Self-Reflection During their Postgraduate Study in Psychology ... 70 Table 16. Table 17. Effect Size and Power Calculations for Hypotheses One to Six and Additional Aims Emergent Themes Derived from Voluntary Comments Made by Participants Xll 71 118 Xlll LIST OF FIGURES Page Figure 1 Model Underlying Present Author' s Research 4