Guidelines for the promotion of the well-being of South African psychologists

In hierdie artikel word riglyne aangebied om ’n program wat gemik is op die beskerming en bevordering van Suid-Afrikaanse sielkundiges se welstand te ontwikkel. Die sosio-ekonomiese situasie in Suid-Afrika lei daartoe dat sielkundiges leef en werk in gemeenskappe wat gekenmerk word deur misdaad, armoede, siekte en maatskaplike euwels, wat hierdie riglyne vir die verryking van sielkundiges se welstand ’n noodsaaklikheid maak. Hierdie studie benadruk dat welstand nie outomaties plaasvind nie, maar dat dit strategies ontwikkel moet word. Die navorsers het die welstandskonsepte betekenis, veerkragtigheid en positiewe affek van Suid-Afrikaanse sielkundiges ondersoek en waardevolle temas geïdentifiseer wat aanduidend is daarvan dat spesifieke bevoegdhede, soos selfsorg, bewustheid, liefdevolle goedheid en selfdeernis, noodsaaklik is vir die bevordering van welstand. Deur die bevordering van welstand tot op ’n vlak van florering, kan sielkundiges net blote bestaan verbysteek en ’n rykdom van lewenservaring ondervindThe question in well-being research has changed from why people become ill to how people can experience a good and full life despite life problems, and this article addresses that specific question in relation to South African psychologists. Investment in the well-being of health professionals is crucial, as their professional contribution is vital to the effective provision of health services. Psychologists have been referred to as happiness facilitators and their work involves assisting with clients’ well-being and mental health. It is therefore important to provide guidelines for South African psychologists to sustain and enhance their own well-being, and this makes the present research necessary and important. Social, economic and political problems are endemic to South Africa, while there exists a severe shortage of qualified health-care professionals, with a mere 0,32 psychologists per 100 000 people of the population. In addition, mental health-care budgets are disproportionately low in comparison with the high prevalence of mental disorders in South Africa. While the availability of psychologists as a resource in the South African health care sector is rather low, mental illness is very prevalent, with an estimated 16,5% of the population requiring mental health services, of whom a mere 25% actually receive mental health-care. This information clearly needs to be taken into account considering the impact that it may have on psychologists in terms of workload and functioning. Many researchers have investigated the spill-over effect between people’s work and personal lives. Although psychologists implement strategies such as professional boundaries to prevent spill-over, certain types of spill-over still occur. Spill-over is an especial reality for psychologists, as they bring the tools of their trade, namely themselves, to each of their life roles. Psychotherapy works in two directions: while psychologists affect their clients they are also affected by their clients, which may impact psychologists’ well-being. The American Psychological Association (APA) indicated that psychologists need measures to protect them against occupational stress. However, despite the clear need for such measures, this need is often ignored. The recommendations of the APA for psychologists towards self-care include awareness in order to avoid becoming overwhelmed by the challenges posed by their profession. Psychologists are also encouraged to identify mechanisms to reduce stress and foster proper self-care. In South Africa the word self-care does not even appear in the Health Professions Act (1974) that regulates psychologists’ professional behaviour. Although many psychologists dedicate themselves to caring for others, it is questionable whether they are able to create a sustainable balance between client care and self-care with a view to experiencing well-being. Psychologists work long and inconvenient hours, have an unstable income when working in private practice, work with difficult cases such as homicide and suicide and are frequently faced with clients’ exhausted medical aids. The limitations and problems experienced by psychologists as a result of scope of practice in psychology has led to legal action on the part of practitioners to attempt to have their experience and knowledge acknowledged and to be reimbursed for their services by medical aids. Complete mental health protects people against physical disease. The maintenance and promotion of mental health is therefore as important as the prevention and treatment of mental illness. Well-being can be promoted and protected via the strengthening of psychological capacity and by paying attention to possible threats to health. When such efforts are undertaken, it may ensure the experience of psychologists’ well-being, as well as impact the level of service delivery to clients. Enhancing the well-being of psychologists will therefore contribute positively to the mental health sector in South Africa. The big question in positive psychology is how well-being can be advanced and how life problems can be survived. The central question of this article corresponds to the stated question of positive psychology: How can the well-being of South African psychologists be promoted while practical solutions are found for the career-specific problems experienced by them? This focus on well-being and intentional activities makes positive psychology an ideal paradigm for the development of guidelines for enhancing South African psychologists’ well-being. This article is based on a thesis titled “The well-being of South African psychologists: a mixed method study” by the first author, Erika Hitge. The thesis consisted of a literature study and a qualitative and quantitative study pertaining to the well-being of South African psychologists (henceforth “psychologists”, unless stated otherwise) and conclusions and recommendations. The researcher investigated well-being constructs namely meaning, resilience and positive affect of psychologists and valuable themes were identified indicating that specific skills and competencies are crucial aspects relative to the enhancement of well-being. The study emphasised that well-being does not occur automatically, but has to be strategically cultivated. It is suggested that enhancing well-being and experiencing flourishing can assist people in moving beyond mere existence to experiencing a well-lived life. The guidelines for the promotion of the well-being of psychologists are based on data forthcoming from the results of the mixed-method study, along with existing literature. Psychologists’ well-being and character strengths need to be compared through pre- and post-testing to establish whether the guidelines and the resulting programme do indeed promote the well-being of local psychologists. Participants in the programme should be interviewed to establish the strengths and limitations of the programme. Once a pilot study has been conducted and the above steps have been executed to refine the programme, it will be possible to make recommendations to the Health Professions Council of South Africa (HPCSA) and the Psychological Society of South Africa (PSYSSA) with a view to national application of this well-being programme. Aspects that should be incorporated into a well-being programme for psychologists are flourishing, character strengths, self-care, self-compassion, mindfulness, lovingkindness, work content and context, relationships and personal resources. The suggested programme consists of 13 sessions. These guidelines constitute an attempt to avoid focusing on what is negative and problematic regarding the work of psychologists, such as exhaustion, burnout, isolation and compassion fatigue. Instead, these guidelines focus on well-being as a motivation to accept the positive and negative dimensions of life and still to experience well-being through enhanced self-care. Practising these guidelines may result in a more meaningful life in which people use their best strengths in the service of both their own and others’ well-being. Deciding to use these guidelines may require a willingness to be flexible and to grow increasingly towards acting on life, as opposed to merely consuming wellness. Designing a well-being programme for South African psychologists can also assist in promoting and protecting the well-being of these healthcare professionals through enabling psychologists to apply specific skills, such as practising of character strengths, career-sustaining behaviours and self-care, mindfulness, lovingkindness and self-compassion, with due consideration of the relevant contex