Service user and carer representatives’ experiences of the personal effects of involvement in clinical psychology training

Abstract

This study explores the experiences and personal effects of service user (SU) involvement in clinical psychology training. A critical realist stance was adopted throughout the research process. Extant literature has predominantly focused on evaluating and optimising SU involvement for the benefit of clinical psychology trainees. Only recently has research started to consider the effects involvement may have on SUs. The research exploring SUs’ experiences in clinical psychology training has derived samples from singular training programmes. Exploring SUs’ experiences from multiple programmes seemed the logical next step. The deductive application of psychological theory allowed further exploration into power, recovery, identity and group development (concepts highlighted as important in the SU involvement literature). Purposive sampling was utilised, with advertisements disseminated via course staff who oversee SU involvement. Fourteen SU representatives, from eight different courses were recruited (with two also identifying as carers). Each participant took part in either a face-to-face or telephone semi-structured interview which was audio recorded and transcribed by the researcher. A deductive thematic analysis was used to analyse the data. Five themes were identified, some with subthemes: Environment determines sense of safety (subthemes: Supportive relationships, Group dynamics); Meeting challenges; Sense of purpose, worth and value (subthemes: Feeling listened to and valued, A positive way to feed back into the system); The person you see now is not the person I was (subthemes: A game changer for personal growth and development, Relating to difficulties in a different way, Reengaging with skills that I thought had gone); and Wanting to break the glass ceiling. Findings are considered and discussed in relation to theories of social identity, power, group development and mental health recovery. Identified benefits for SUs included a positive change in self-perception, including re-engaging with lost skills. Findings suggest involvement can offer an opportunity to further develop recovery. However, there were reported difficulties in joining a new SU group including group dynamics and power imbalances. Findings also suggest that there is a glass ceiling to involvement which SUs have a desire to break. The findings suggest it is important that the environment in clinical psychology training fosters psychological safety for SUs, via positive and supportive relationships with trainees and staff, in which SUs are treated as equal colleagues and financially reimbursed as such. Additionally, the intricacies and nuances of managing and sharing power need to be explored to enable SUs to feel valued and reap benefits from involvement, including developing a positive sense of identity. There are also implications for professionals in mental health services who should look to share theoretical knowledge with SUs who reportedly found that having access to psychological theory via their involvement was enlightening in better understanding their difficulties. A limitation is only two participants identified as carers (and they also identified as SUs) therefore carers experiences are under-represented. The research also failed in attempts to recruit SUs who were no longer involved, and thus whose experiences might differ. Future research should focus on these areas.