Psychology graduate students experience significant stress as they try to balance the demands of their academic work, practicum training and personal lives--and many of their training programs don't seem to be helping them with self-care issues, according to the results of an APA Advisory Committee on Colleague Assistance (ACCA) survey presented at APA's 2006 Annual Convention.
The survey--conducted earlier this year with the aim of finding out what's stressing students, and how their programs are helping them with it--queried a convenient sample of almost 500 graduate students recruited from postings on American Psychological Association of Graduate Students (APAGS) listservs.
Of the students who responded, about 77 percent reported being in a health services provider doctoral program.
The survey found that:
82.8 percent of respondents said their training program does not offer written material on the issue of self-care and stress.
63.4 percent said their training program does not sponsor activities promoting self-care.
59.3 percent said their training program does not informally promote an atmosphere of self-care.
"Those three things really scare me. All of you [graduate students] in the audience need to go back to your programs and say 'Hey, let's see what we can do about this,'" said Janine Delardo, a psychology doctoral student who serves as APAGS liaison to ACCA.
Delardo spoke about the survey's results along with James Oraker, PhD, chair of ACCA, and Lynn Bufka, PhD, assistant executive director for practice research and policy at APA.
SURVEYS OF STRESS
Delardo's presentation started with a look at existing studies of stress among psychology graduate students.
In a 1992 study in the British Journal of Clinical Psychology (Vol. 31, No. 2, pages 169-179), 75 percent of students reported being "moderately" or "very" stressed as a result of their clinical training. A 2001 study of clinical psychology doctoral students in Psychological Reports (Vol. 88, No. 3, pages 759-767) listed the top three sources of stress as coursework, the dissertation and financial concerns.
Although a study in Professional Psychology: Research and Practice (Vol. 36, No. 3, pages 323-329) found that cost, time constraints and confidentiality concerns can hamper students seeking therapy, research has shown that many do enter therapy, with one study in Professional Psychology: Research and Practice (Vol. 27, No. 1, pages 98-101) finding that 74 percent of its participants reported receiving therapy during graduate school. A majority of these students cited personal growth as the reason they sought therapy.
The 2006 ACCA survey found that slightly more than half of respondents said there is no policy regarding psychotherapy for students at their programs, while just over 31 percent said psychotherapy is encouraged but not required. About 9 percent of respondents said psychotherapy is required of all trainees in their program.
CHANGING TO MEET STUDENTS' NEEDS
What can training programs do to help stressed-out students? Oraker described an initiative under way at the Colorado School of Professional Psychology in Colorado Springs, where he's an ethics professor.
Oraker chairs the school's Academic Standing Committee, a body that helps students with significant academic problems stay in the program. The initiative was prompted by the feedback the committee received from students after it distributed a 44-item pilot survey earlier this year on such issues as faculty competence, advising and school policies and procedures.
To the committee's surprise, students reported a lack of clear communication regarding school policies, minimal supervision and guidance from advisers, inconsistent faculty grading and workload expectations, and a dearth of mentoring-all of which added to the students' stress level.
"Some of the things we thought were sailing along just fine were not sailing along just fine," Oraker said.
The school responded to the survey results by redesigning the Academic Standing Committee, making it more of a collaborative partnership between students and faculty. The school also wrote a new orientation guide for students, and faculty will complete additional training on how to refer students to the committee. In August, all incoming students were paired with an older student tasked with helping them transition into the program.
The program's intent, he said, is to make the committee, which will be renamed to reflect its expanded mission, more like a student assistance program--just like state associations offer colleague assistance programs for psychologists--with the twin goals of teaching self-care skills and offering remediation to get students back on track academically, Oraker said.
HELP YOURSELF, SO YOU CAN HELP OTHERS
Students need to take care of themselves, Bufka noted, because stress can negatively affect professional performance, which may hurt client care.
She outlined a number of strategies for students, including:
Self-care. Get enough sleep, eat healthy foods and exercise regularly. Take up a hobby, and develop relationships with people outside of your training program. Set limits and boundaries on the number of projects you agree to participate in.
Foster self-awareness. Periodically, evaluate your sense of happiness and balance, and find ways to involve friends and family in your life by searching for some give in your schedule.
Foster change. Talk to your peers about stress and self-care before problems arise and strive to be a catalyst for a healthy attitude within your program by speaking up about the need for change. Look for wellness resources, and seek out allies on campus.
Know when to intervene. Know APA's Ethics Code, and be ready to assist an impaired colleague-helping him or her recognize a problem before it leads to harm. If you need to intervene, role play a conversation to make sure you know what you want to say. (For more tips on intervening, see www.gradpsych.apags.org/mar06/peers.html.)
Develop concrete strategies, and think big. Identify the specific sources of stress and the self-care needs in your training program, and help propose ways to meet those needs. Consider working with graduate students in other departments to form support groups for dealing with common stumbling blocks, such as the dissertation.
Bufka urged students to learn to deal effectively with stress during graduate school, given the challenges that await them in the profession.
"If you don't figure out how to deal with stress now," she said, "you're going to continue to struggle with it."