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The Profession Status of Clinical Psychologists In India (1998)
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Title: The Profession Status of Clinical Psychologists In India (1998)
1
Clinical Psychologists in India A time for
Reflection and Action
- A survey conducted by kiran rao Seema mehrotra
-
2
Introduction
- Rao Mehrotra (1998) studied about the job
characteristics, professional stress, role
satisfaction, coping strategies and overall
well-being among a group of clinical
psychologists. - The area which received considerable attention in
the past two decades is work-related stress. - Two sets of factors are responsible for work
related stress- - 1. Job environment (building structure,
lighting, etc.) - 2. Job characteristics (nature of the work,
overload, role conflict, etc.). - Basically, there were two groups of health
professionals in which more occupational stress
had found in health care domain- - General physician
- Nurses
- Mental health professionals are said to be
vulnerable as they work in emotionally demanding
environments. - Burnout as used by Maslach (1982), refers to
the syndrome of emotional
3
Introduction
- exhaustion, depression and reduced personal
accomplishment seen in response to the strain
dealing with other human beings. - 21 mental health professionals had been studied
by Thara (1997) dealing with chronic mental
health illness. He reported that over 60 had
experienced some kind of stress reflected in
physical symptoms and emotional problems due to
stress burden and satisfaction. - Moderate level of job-stress with work load and
lack of resources being major sources of stress
was found in 60 psychiatrists. (Chaudhary
Rao,1997). - Many different studies of clinical psychologists
have described clinical psychology as profession
in India but no descriptions were available about
clinical psychologists job-stress. - Verma (1997) reported almost 600 clinical
psychologists trained from Ahmedabad, Bengalore
and Rachi, but less than half of them may be
active in field. - Prabhu (1983) reported factors behind this three
Ms matrimony , migration and misplacement.
4
Method
- The sample comprised of 273 clinical
psychologists from the IACP -1995 directory
and/or from state level directories. Finally,
116 clinical psychologists were included in the
sample and rests were dropped out because of
abroad residing, changed addresses,
non-responding and incomplete profarmas. - Tools
- 1. A socio-demographic and work related data
sheet was used. - 2. Subjective perception measures to assess
functional compensation, perception of work as
routine or mechanical or scope for growth in
career. - 3. Job satisfaction scale ( Quinn and Shephard,
1974) was used to measure Professional role
satisfaction. - 4. To identify specific sources of stress for
mental health professionals, Mental Health
Professional Stress Scale (MHPSS) developed by
Cushway et al. (1996) was used. - 5. An open-end statement was used to assess
coping strategies. These strategies
5
- include problem-focused, emotion-focused and
support-seeking strategies. - 6. The subjective well-being inventory (Nagpal
Sell,1992) was used to measure well-being and
distress as experienced in day-to day life
concerns.
6
Results
- Socio- Demographic Characteristics
- Almost two thirds of the clinical psychologists
who responded are male (64) and the average age
was found to be approximately 42 years. Majority
are married (88) and beloged to nuclear families
(75). Half of the clinical psychologists in
India had M.Phil (49) and half had Ph.D.
degree(51). - The clinical work group is seemed to be well
settled as, having experience of 15 years, with
approximately 10 years in current work setting. - Work-related characteristics
- About 60 of the clinical psychologists are
worked in more than one setting, 40 worked
independently and 23 work exclusively in private
practice. - More than two-third (80) see individuals across
all age group and of different diagnostic
categories (77). Both acute and chronic cases
are seen(78).
7
Results
- Time Spent in Different Professional Activities
- Clinical psychologists spent time in clinical
work significantly more and time spent in
research activity is significantly less than that
considered ideal. - Most would prefer to spent about two-third of
their time in intervention related work and the
remaining one third for psychological assessment,
but there is great deal of individual variation. - In practice, almost half the group (48) did not
have any exposure to administrative work and
about 30 spent their 5-10 time in
administration. - 75 individuals would like to spend 20-30 of
their time in carrying out research. 29 were
currently not involved in any research activity,
while 26 reported spending 20-30 of time in
research. - 40 individuals would like to engage in therapy
for 40-60 of the time and 11 ,for more than 75
of the time. - They rated a fair degree of autonomy in
functioning, growth in career as fairly low and
choice of clinical psychology as a profession,
high.
8
Results
- On the whole, clinical psychologists feel low
level of professional stress. They feel work load
of too much work to do (78) and too many
different things to do (84) and lack of
resources of shortages of equipment (71),
inadequate clerical backup (68), and lack of
financial resuorces for attending training
courses/ workshops (68). - They were not fully satisfied with the
organizational structure in which they were
working and felt stress with regard to the way
policies are framed (64) and the manner in which
conflicts are resolved within the
organization(62). - Clinical psychologists feels professional stress
who have worked in an out-patient setting and
those seeing only one diagnostic group for more
than 50 of the time. - Professional stress was negatively correlated
with professional role satisfaction(r-.28).
9
Results
- Coping Strategies
- 35 individuals reported the use of a single
coping strategy, while others used more than
one. Emotion-focused coping is the most
frequently used(67), followed by social support
utilization (66) and problem solving strategies
(44). - Among the emotion-focused strategy, distraction(
listening music, spending time with family, etc.)
was mostly used (56). - Subjective well-being and distress
- Well-being and distress were significantly
related to professional role satisfaction and
professional stress. It is found that while age
and professional role satisfaction significantly
influence levels of well-being, home/work
conflict and professional self doubt contribute
to distress.
10
Discussion
- In India, Clinical Psychology have become a
female dominated profession (Prabhu,1983).
Females were largerly non-responders since there
was a risk of losing status and momentum, not due
to a lack of involvement. - The individuals who had engaged in clinical
psychology, have, by and large, settled down to
family life and have gained considerable
professional experience in the work domain. - In clinical psychologists, the level of
professional role satisfaction and subjective
well-being reported is high and the level of
professional stress and subjective distress
experienced is low. - Several factors may be responsible for the above
pattern - Gender Women , in general, tend to report
higher levels of distress than men. - Marital status Married males have been found to
report lower levels of job-related stress
(Cushway et al.,1994,96), because being married
provides the
11
Discussion
- presence of a confidant and acts as a stress
buffer. For women, marriage brings on multiple
roles which increases the strain( Agarwal,1992). - Also the quality of the marital relationship,
presence of young children and type of work need
to be kept in mind. - Generally, marriage has been found to increase
job satisfaction( Crosby, 1982), but as Cooper et
al.(1988) found that single individuals were high
on job satisfaction and less stressed
occupationally. - Work Experience Professional stress decreases
with increase in experience, because people with
more experience are likely to have less direct
client contact and more control over their
activities. - While trainees and relatively new entrants to the
profession are more likely to be affected by
client distress and self-doubt. - Age and professional role satisfaction
contributing to personal well-being and home/work
conflict and professional self-doubt to distress.
12
Discussion
- Work related characteristics are important
determinants of stress and burnout. - Thornton(1992) reported increased burnout in
mental health workers employed in an in-patient
setting, as compared to those working in an
out-patient setting. - In-patient settings usually cater to the more
severly and/or chronically ill, and, therefore,
perceived as stressful. Out-patient settings in
India, unlike in the west, are characterized by
large case loads. The pressure of having to see
many patients in a limited period of time may be
more emotionally demanding. - In India, the clinical work group enjoys a
relatively high degree of independence in its day
to day work functioning. - While a large number have reported functioning
independently (41), an almost equal number
function as part of a multidisciplinary team. - There is a general level of satisfaction with the
current job profile with time spent in role
related activities. Reports in the seventies had
debated whether the assessment or the therepeutic
role was more important for clinical
13
Discussion
- psychologists( Verma, 1996). Most clinical
psychologists felt happy with both these roles,
they also prefer to intervention works. - Findings indicated that most Indian clinical
psychologists would not like to be engaged in
administrative duties. Proccer et al. (1997)
explained that while working with people was a
source of satisfaction, too much administrative
work or paper work was a source of stress for
mental health staff members. - Prabhu (1974) commented on the glaring absence of
clinical psychologists from major policy making
bodies. - Clinical psychologists spent significantly less
time in research. The clinical psychologist is
trained for this role and is referred to as the
scientist-practitioner, but rarely is able to do
justice to both these roles (Stricker,1992).
However, an increase in research output is
identify areas to be studied on a priority basis
and making provisions for funding such research. - In addition, workshops could be conducted on
how to skills such as record
14
Discussion
- keeping for research, writing project
proposals for grants and publishing papers. - Work load, lack of resources and organisational
structure emerged as the main sources of stress
for clinical psychologists. - The number of trained clinical psychologists is
small which puts considerable pressure on the
ones in the field large case loads and essential
if we are to make an impact as a professional
body at the national level. - At the level of the professional body, it may
involve forming a research cell to - working in multiple settings/roles become
necessary. - Also a number of existing positions remain vacant
due to lack of trained personnel. - As Prabhu (1974,83) observed that lack of job
opportunities resulting in two phenomena - (1) Within the country, involvement in
fields other than clinical psychology, - (2) Migration to western countries in search
for better prospects. - Despite the high level of role satisfaction, the
general perception was inadequate
15
Discussion
- financial compensation and there was not
much scope for advancing growth in - career.
- In this study, the variety and complexity of
coping behaviour in relation to work stress was
not reflected. Emotion focused and social support
strategies were used more than problem focused
ones. - Emotion focused strategies are usually used when
the stressor is perceived as being beyond ones
control or having to be accepted. - The emotion focused coping may be effective in
dissipating or reducing distress at the
individual level, but also indicates a certain
degree of helplessness and inability to bring
about change in the work situation. Therefore ,
such strategies may not be very adaptive for both
the individual and the profession. -
16
Conclusion
- It is concluded that the strength of a
professional body would lie in the strength of
its individual members. It was found that the
overall picture for the clinical psychologists
group as a whole is a positive one. - Clinical psychologists would prefer to spent time
in clinical work, research and teaching, found
high subjective well-being and low distress work
load, lack of resources and organizational
structure as main source of professional stress. - Limitations
- The sample was selected from the IACP membership
list which may not reflect the views and needs of
a large number of new entrants, as yet, not
members of the professional body. - While the quantitative methods used, provide
summery information, it would be more useful to
identify subgroups of individuals with specific
concerns.
17
Conclusion
- The use of single item measures was also a
limitation. The manner in which coping behaviour
were measured, was not adequate to understand the
variety of things actually used in the time of
distress. - Finally, stress, coping and well-being are
complex ongoing processes which can be best
examined with longitudinal studies. - Presented by
ANUPAM PANDEY -
18
- Thank you
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