Psychology Trainees May Not Be Allowed to Practice What They Preach

This post was written by Rita M. Rivera, M.S., CTP and David Benitez, M.S. representatives of the Higher Education working group of the COVID-19 Psychological Task Force (established by 14 divisions of the American Psychological Association).

Ironically, minimal information is available on the mental health of psychology students, trainees, clinicians, and researchers. What’s more, very few studies have explored the prevalence of mental illness among psychology graduate students, and almost none exist that focus on other contributing factors, such as the COVID-19 pandemic, social justice movements, financial barriers, and disability status.

A 2012 report by the American Psychological Association noted that psychology graduate students usually work up to 60 hours per week, leaving little time for self-care but ample room for a constrictive work-life balance. The report also highlighted another inconsistency of these graduate programs: keeping mental illness a secret is puzzlingly expected by many psychology departments (Willyard, 2012).

Back in 2009, the APA conducted a survey that revealed that 87 percent of psychology graduate students experienced anxiety, 68 percent reported symptoms of depression, and 19 percent reported suicidal thoughts (Willyard, 2012). Naturally, that data is somewhat outdated, but with the pandemic’s disruption of higher education, the rates can only be presumed to have increased, perhaps exponentially.

The Self-Care Panacea

Although these statistics usually lead to a “self-care”-themed conversation, most seem to ignore the challenges and barriers faced by psychology students throughout their graduate journey. Equally, trainees require more than simply being told to engage in this social-media-popularized, somewhat mystical, and mentally elusive concept of “self-care”; they ought to be allowed to do so.

Consider the aforementioned data regarding psychology graduate students’ weekly work hours. This time is usually broken down into segments dedicated to coursework with significant portions spent on clinical work. However, the “student” role is just one among the many assumed by these clinicians in training. These individuals are more than just trainees; not surprisingly, psychology students are also caregivers, employees, financial providers, and all-around regular human beings, susceptible to succumbing to the very same problems they focus on healing during their clinical rotations. Additionally, while psychology graduate students are inculcated to be empathetic and supportive of others, this is not the reality they face at their institutions, practicum sites, and sometimes even at their homes.

In addition to their academic responsibilities, students are highly incentivized to participate in extracurricular activities, such as state associations and professional practice organizations, as well as research projects, to become proficient and competitive candidates for practicum and internship placement, employment, and overall career development. Learning and leadership experiences outside of the classroom contain a myriad of benefits for prospective candidates; nonetheless, these initiatives require time, energy, and effort on behalf of the trainees to implement most adaptively. Thus, allocating time for self-care is easier said than done, and as argued by psychologist Justin Henderson, self-care is not the solution for burnout.

Challenges Associated with Mental-Health Distress

Many clinicians in training are overworked at their practicum sites and sometimes even asked to complete activities, such as burdensome administrative tasks, that are not part of their contractual responsibilities. For most trainees, work-life balance becomes a poorly coordinated balancing act as academic success, clinical training, and research endeavors take precedence over personal, family, and social life.

Moreover, individuals from marginalized communities face additional challenges and inequities based on their identities, such as race, gender, sexual orientation, socioeconomic status, religion, disability status, and immigration status. For instance, first-generation graduate students are generally considered at high-risk for attrition as they are more likely to experience financial challenges, language barriers, and identify as racial minorities (King, 2017). Yet there continues to be a lack of ethnic/racial representation among faculty members and within graduate psychology programs, which further hinders the recruitment and retention of ethnic/racial minority students (Anderson, 2014).

The APA recognizes that the institutional environment impacts graduate psychology students’ mental health and academic success (APAGS, 2015). Nonetheless, when examining statistics and data on how the APA ensures underrepresented student populations are treated with fairness, respect, and acceptance, one discovers the dearth of empirical data or mandated regulations. Most articles are comprised of suggestions and recommendations based on limited data from a few training programs or outdated, pre-pandemic studies.

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Normalizing a Toxic Culture of Overwork and Burnout?

Overwork and subsequent burnout impact mental health professionals, including psychology students, clinicians, and trainees. The challenges brought by COVID-19, and inequities based on their intersectional identities, jeopardize the well-being of psychology students, many of whom have and continue to serve as frontline workers during this unprecedented crisis.

It is not just unethical for academic institutions and practicum sites to fail to understand how mental health students monitor themselves; it is irresponsible toward their trainees and the public they serve. To understand an issue, it first needs to be assessed thoroughly. To obtain a comprehensive understanding of the current mental health distress of psychology trainees, we need to prioritize and conduct inclusive and intentional research.

More importantly, psychology students and trainees need immediate access to comprehensive, inclusive, and equitable mental health services across all programs, concentrations, and years of study. Clinicians in training deserve to receive the compassion and empathy they are taught to provide to the general public. As a field that promotes mental health and overall well-being, we can no longer keep buying into (and selling students) the cult of “overwork.” The future of psychology is burning out.