The objectives of the study are to determine whether these stressors influence practitioners' experience of stress when consulting with a non-fatal suicidal client. Most trainees stated that preparing for supervision was not stressful. Practitioners reported generally feeling overwhelmed by the number of non-fatal suicidal clients they were seeing.
Personal relationships were identified as one of the main sources of stress for some of the trainees. Some of the interns reported that they felt that their personality style contributed to their experience of stress. Three of the trainees reported that they generally feel tired and fatigued most of the time.
Family and friends have been a source of stress for some of the interns as mentioned earlier. Most trainees felt that with experience they would become more comfortable dealing with nonfatal suicidal clients.
Primary Appraisal
The majority of trainees also reported that academic stress associated with the master's program as well as the academic and competency-based requirements also resulted in stress. Performance expectations were expressed by the supervisors at the beginning of the internship, and the trainees were told about the negative behavior of the previous trainees. Although the majority of interns reported having a good relationship with their supervisors, a few of the interns felt that they were not always sure what was expected of them and were concerned that they were being evaluated negatively.
Workload included the number of clients the interns saw on a daily basis, administrative work, and academic and competency-based requirements. Folkman (1984), constraints that may exist in the environment and be beyond the individual's control may hinder his/her best efforts to cope with stressful situations and events. Most interns reported that the number of clients they were seeing during the internship was much greater than in MI and this was reported as a source of stress for the interns.
Interns reported that administration and workload resulted in stress as well as access facilities and certain work and intercultural problems. Some of the trainees believed that the translators did not always convey everything that the client had said. Three of the trainees felt that they were anxious by nature and worried that they were not performing.
Some of the interns reported feeling depressed and tired at times, and one intern reported feeling physically ill in the morning. Two of the interns reported that they were unable to forget their clients and were unable to relax when they went home. According to Oubifia, Calvo, and Rios (1997), psychologists may experience burnout more quickly than most other health professionals because of the nature of the problems they encounter.
They may feel that they have limited capacity to change the course of certain disorders and behaviors of clients and as mentioned in the data collected, interns reported that they feel responsible for the clients.
Secondary Appraisal
As identified in chapter four, the interns used various coping mechanisms when dealing with stress. The interns tried to change the environment or their thoughts and feelings about the situation. The interns used both positive and negative coping strategies that were either constructive or harmful.
Stress from the internship was identified by the interns as the reason for social withdrawal, which in turn reduced social support. Most of the interns felt that they could exercise more, but could not find the time or energy to do so. In summary, the stress experienced by the interns was due to an imbalance between environmental demands and available resources.
Although trainees' perceived stressors were consistent and elicited the same experience, the most prominent resource reported to be lacking was Jack's perceived knowledge and skills in treating suicidal clients. The sources and consequences of stress are related and influence each other, and this in turn can be detrimental to the personal and professional lives of practitioners. Lazarus' Transactional model of stress and coping was used in the above study to conceptualize the stress experienced by practicing clinical/counseling psychologists when dealing with non-fatal suicidal clients.
Stress in dealing with a non-fatally suicidal client can have serious consequences for the internal psychologist if not handled properly. Several factors influence the level of stress the trainee experiences when dealing with a non-fatally suicidal client and these have been highlighted in the previous chapter. Dexter-Mazza and Freeman (2003) found that ninety-nine percent of trainee psychologists in their study had worked with suicidal clients and that trainees had not received adequate training in dealing with suicidal clients.
As such, every effort should be made to help educate and train students in dealing with suicidal clients, and any training provided by institutions must effectively offer programs that emphasize how to work affectively with this population in their formal training.
Recommendations
This is concerning when considering that suicidal clients are one of the populations at highest risk for death that psychologists will treat (Oubifia, Calvo, and Rios (1997). Practitioners can be taught skills such as time management as and providing orientation about the institution's procedures and policies before beginning practice. Increasing support from various sources such as supervisors was also suggested by research in terms of reducing stress experienced by practicing psychologists.
Debriefing and crisis intervention should be provided to trainees to alleviate the stress of dealing with high-risk clients. According to Aronson, Wilson and Brewer (in Gilbert, Fiske and Lindzey, (998), psychological debriefing is a one-time, semi-structured conversation with a person who has just experienced a stressful or traumatic event. In most cases, the purpose of debriefing is to reduce any possibility of psychological harm by informing people about their experience or giving them the opportunity to talk about it.
Crisis intervention refers to methods used to provide immediate, short-term assistance to individuals who experience an event that causes emotional, mental, physical, and behavioral distress or problems. A crisis can refer to any situation in which an individual perceives a sudden loss of their ability to effectively solve problems and cope. The main focus of crisis intervention is exploring coping strategies and developing new coping skills.
Support from colleagues and supervisors can be achieved by providing control to interns through intern meetings which can be scheduled once a month. Supervisors and other members in the institution can also be a source of support for the trainee and this can be achieved through mentoring programmes. It is important to note that all interns described their internship as stressful and most described their experiences as negative.
Individual factors may be difficult to change, but organizational and professional factors are not and should therefore provide the most support for the intern.
Limitations
Concluding Remarks
Interviewer: Can you tell me about some of the experiences you had during your internship that were or are stressful. Some patients will agree with what you have told them, and they may still attempt suicide. SI: The thing is that you want to do your own thing, but the thing is how to put what you learned in M I into practice.
Then your supervisor asks you about this, and they look at you like you've completely missed the point. I find it very hard to deal with..some people are more controlled even with suicidal cases you can still talk to the person, while you have someone in front of you who is just sobbing..and you don't know what to do. do. We were basically told to ask the question have you had any suicidal thoughts, in general you have to be very careful when you ask if they have had any thoughts, sometimes you don't want to miss it if it's there.
Interviewer: Please tell me about some of the experiences you have encountered during your internship that have been or are stressful. S3: I feel quite tired sometimes, I don't really notice it during the week because you have a lot to do, but [ you know on the weekend [ I'm often not very motivated to have to get up early and do things , so I tend to be very careful about saving time for myself and planning things so that I don't have to rush anywhere or fulfill obligations when it's my free time. Once you've had a few cases, you'll get a better perspective on your ability to do that.
Interviewer: Can you tell me about some of the experiences you had during your internship that you found stressful. One of the psychologists did a quick session on what to do so by then I kind of knew, but it's still stressful dealing with clients, you've never been exposed to it either and you're expected to just to deal with. In the beginning that's all you heard, you can't do it, you don't have the strength to do it.
