Developing healthy mental health professionals: What can we learn from trainees?

There is considerable interest in the recruitment, training and retention of workers in the field of mental health, as evidence shows significant problems in the retention of highly qualified professionals in this field. Large numbers leave, some leaving the professions for other careers as a result of burnout, caused in part by the emotional burden of work in stressful and emotionally charged environments. We propose a training approach in which students are encouraged to reflect on their own emotional responses to such stressful and upsetting situations. We argue that this approach, in allowing them to be more at ease with themselves, would make them both more available to the emotional experiences of their patients, and in turn enhance their own resilience and capacity to survive stressful situations. We took for our study a cohort of trainees from The Tavistock Clinic in London, a major training institution providing post-graduate mental health courses based in psychoanalytic and systemic theory. We aimed to investigate what the students reported to be the key components in these trainings to enhance their capacity to manage in their demanding and highly stressful work environments, alongside ordinary human experience. The trainees were from a range of backgrounds and included doctors, psychologists, social workers and teachers. The courses had in common the following elements: small work discussion groups providing an opportunity to reflect on their work in practice, lectures on background theory, tutorials, and small seminar groups to which they brought ongoing observations of young children in ordinary settings. Some also had the opportunity to undertake supervised clinical work in the Clinic. We used a detailed qualitative questionnaire to elicit the trainees' expectations and experience of the trainings. In addition, all participants completed the 30-item General Health Questionnaire (GHQ), and some took part in the Adult Attachment Interview, later rated for Reflective Function