یک مطالعه ی کیفی استرس و مقابله با آن در شرایط قبلی روانشناسی بالینی It’s like being in a little psychological pressure cooker sometimes! A qualitative study of stress and coping in pre-qualification clinical psychology

Introduction Stress in mental health professionals As pressure on mental health services increases, so too does the likelihood of excessive stress impacting on those working and training in the mental health field (Paris and Hoge, 2010; Rossler, 2012). Stress not only has consequences for the individual, but also the organisation in which they work and the clients they seek to help. For example, 30% of sickness absence in the National Health Service is due to stress, with a bill to the service of around £300m-£400m per year (NHS, 2015). Stress has been defined as a “particular relationship between a person and their environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her wellbeing” (Lazarus and Folkman, 1984, p. 19). This definition suggests that stress occurs when an individual perceives an event or situation as threatening, and lacks the appropriate coping strategies to deal with it. Stress has been shown to affect concentration, cause deficits in problem-solving abilities, and impact on learning and memory (Kaplan and Saddock, 2000; Kuoppala et al., 2008). Therefore, stress is an important topic in need of further investigation. This is particularly true in healthcare education settings, where stress has the potential to interfere with trainee learning, functioning and performance. High stress is related to low self-esteem (Mimura et al., 2008), suicidal thoughts (Hawton et al., 2011), substance abuse (Melaku et al., 2015), psychological ill health (Galvin and Smith, 2015) and burnout (Lizano and Mor Barak, 2012). Burnout is defined as a syndrome consisting of emotional exhaustion, feelings of ineffectiveness, and diminished interest at work (Maslach and Leiter, 1997), and research shows it is most likely to occur in individuals exposed to stressful working conditions (Rosenberg and Pace, 2006). Evidence suggests that working in the field of clinical psychology might be particularly stressful (Cushway and Tyler, 1994; Hannigan et al., 2004), with many clinical psychologists reporting feeling “stuck”, “overwhelmed”, and “incompetent” in their work (Crowley and Advi, 1999).