Interviewing a Clinical Psychologist.

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Executive Summary

In Ontario, clinical psychologists are recognized as health professionals. Registered and regulated by the College of Psychologists of Ontario. Individuals in this profession are governed by specific training, educational, and professional obligations. Therefore, only members of the College may call themselves a psychologist. A local psychologist in private practice, henceforth known as Dr. Melissa Jones (*Name was changed to maintain privacy) was called to conduct an interview in an effort to address how psychologists go about working with student based populations versus adults and whether or not there are any differences or similarities in bringing about therapeutic change. The basis of this research stems from my own experience with a mental health illness, thus it was a fitting choice to gain a better understanding of how mental health issues impact a student’s ability to thrive in an academic setting. Prior to the interview, a Letter of Information and consent form was drafted for the participant to review and sign and a 30-minute interview consisting of 10 questions was carried out. The questions and their accompanying answers were then analyzed and coded, leading to the distinction of three main themes that arose throughout the interview. These codes involved: scope of practice, consisting of both micro and macro influences, and a caring approach made up of micro factors. Thus, answers for a select number of questions were then further analyzed in the results section using the coded data categories. Overall, the assignment has contributed to my greater understanding of how psychologists are able to work with various groups of individuals and some of the unique challenges and similarities that arise in designing treatment plans. This assignment has further motivated to take an active role in promoting the importance of mental health initiatives on campus, and reiterates the idea of why I would like to work in a health care profession related to treating individuals with mental health issues.
                                         Interviewing a Health Care Profession
Introduction and Background:

A common thread that unites most post-secondary students together involves the transitional period many of us find ourselves in. Many of these students experience living independently for the first time, and are often faced with unique physical and mental health challenges.  Having experienced my own mental health challenges within the last year, I chose to interview someone in a health profession that has been relevant to my situation, a clinical psychologist. Through the medium of an interview and I sought to gain a better understanding of their impact, particularly in relation to post-secondary students.  With a growing number of post-secondary students facing mental health challenges, my own experience acting as a foundation for my research question it was odd for me to realize how over-crowded mental health services were on campus and how lack of access could impede the necessary measures to get healthy. Therefore, I wanted to understand in a more detailed analysis how psychological treatment plans vary between students and adults, and whether there are any similarities or difference in how psychologists approach working with these groups of individuals.

To become a clinical psychologist in Ontario, an individual must be a member of The College of Psychologists of Ontario. The college is the governing body for all psychologists in Ontario, and as such only member of the College may call themselves a Psychologist. To qualify for professional registration to become a practicing psychologist, an individual is required complete a doctoral level education degree in psychology and training in professional psychology, one year of supervised professional experience, and successfully complete three examinations (College of Psychologists of Ontario, 2007).  Similar to other health care providers, psychologists see people of all ages, working with individuals or within group settings. Currently, fees for psychologists in Ontario are generally covered solely by private payment, employee assistance programs, and extended medical plans. Unlike psychiatrists who are able to prescribe medication and focus on more biological aspects of mental health, psychologists tend to focus on cognitive, emotional, and behavioural aspects. Oftentimes, both psychologists and psychiatrists work closely together when treating an individual. Psychologists are also able to join the Ontario Psychological Association, with the aim of serving the public through education and advocacy in regards to issues that affect the profession or the public (Ontario Psychological Association, n.d.).

Under the National Occupational Classification 2011 database, psychologists “assess and diagnose behavioural, emotional, and cognitive disorders” (Human Resources and Skills Development Canada, 2011). Oftentimes, this involves the psychologist counseling patients, providing various therapies, conducting research and being able to apply theories to related behaviours and mental processes (Human Resources and Skills Development Canada, 2011). Although it is generally thought that psychologist focus mainly on treating patients, they also work towards the maintence and enhancement of psychological and interpersonal functioning.  Psychologists are able to work in various settings including private practice, hospitals and clinics, rehabilitation centers, schools, and in government agencies.

Methods:

            An appointment was booked by telephone with my chosen health professional, Dr. Melissa Jones, (referred to by Student Health Services) to arrange an interview. In the initial phone call I was able to introduce myself briefly and discuss the purpose of the interview, which was to understand the role of a psychologist. I also indicated that the interview would take approximately 30-40 minutes and left my phone number for her to contact me with any further questions prior to setting an interview date. The interview was to take place two weeks after the initial phone call in Dr. Jones’ private practice. Before the interview was conducted, a letter of information (LOI) was drafted inviting the potential participant to participate in the interview. The LOI contained detailed information regarding the use of information, project procedures, possible risks and benefits, as well as a section on confidentiality. While sitting down with the potential participant, the LOI was given for the participant to review prior to the start of the interview. Before a signature was obtained I quickly summarized the LOI and explained how the interview would contribute to the final product. The participant was also given time to ask any questions or raise any concerns they may have had prior to signing the consent form.

A qualitative interview was designed to give a more complete and meaningful picture, and allow myself to develop and make connection in understanding the profession from the perspective of a practicing psychologist.  It was thought a semi-structured interview would best meet my needs, with questions prepared for the participant ahead of time and probes used to help clarify or exploit certain issues that could potentially arise in the context of an interview. The semi-structured approach also allowed for the inclusion of questions that were not thought of prior to the interview but were added in while going through the process.  Overall, the design of the interview guide (refer to Appendix A) planned for a 30-minute audio-recorded interview with approximately 10 questions to being asked to the participant.  The interviewee also had a chance to add any further comments or ask questions once the interview was completed.

Results:

When it came to analyzing the audio recording, there were several main themes that arose.  The analysis and coding of the interview led to me devising four coded categories, three of which I chose to more specifically analyze: scope of practice (both micro and macro factors), occupational structure (micro factors), and a caring approach (micro factors). For the complete coding list, refer to Appendix B. Another issue that could be classified within a caring approach, was in regards to how mental health counseling benefits students who seek the services, in comparison to their fellow peers that don’t receive such services. As well as how the distinction of being a student seeking psychological services and treatment may differ from an older patient seeking the same services.

As pointed out by Dr. Jones, public perception plays a significant role in influencing the profession. One misconception pointed out by Dr. Jones is the confusion between psychologists and psychiatrists. With the latter profession being able to prescribe medications. With being asked where psychologists stood on the issue and whether they could be expected to be able to prescribe medication, Dr. Jones replied that it may be best to allow psychologists to focus on therapeutic treatment. Speaking on behalf of fellow colleagues and psychiatrists that she interacted with over time, both professions noted, “if [they were] seeing a patient psychotherapeutically, they preferred to not also prescribe medication” (M. Jones, personal communication, March 4, 2014). Her own personal opinion on the matter and the future of her profession pointed out it may be better “if psychologists have their own way to treat people, [while allowing] another profession to have the right to prescribe medication” (M. Jones, personal communication, March 4, 2014).

Dr. Jones was also asked about physical demands that her occupation involved. Major demands included sitting for long periods of time, often times her work week consisted of 55-60 hours a week, particularly during the school year when many students seek her help. Other demands include being able to hear and see, as attention to detail is important. Lastly, as pointed out by Dr. Jones, being able to write is key in her occupation as psychologists are required to keep ongoing notes, and may be required to write reports for some individuals. Since Dr. Jones operates her own private practice, it was discussed what she thought were some challenges her profession faced. One issue that was raised was accessibility and the fact that there are more people who need the services than can be helped. As she points out, it can often be difficult to find alternative resources for these individuals. Many people also cannot afford the services, and there is a portion of psychologists who wish that their services were covered by government funding. Running her own private practice has proven to be beneficial. Benefits include being able to avoid the beurocracy and paperwork that often comes with being government funded and being able to remain autonomous in her treatment plans.

Lastly, there were three questions that summed up the caring category, which consisted of micro factors that influenced her practice. One question focused on the difference in treatment plans between student’s in post-secondary education and a typical adult patient. Dr. Jones pointed out that her treatment plans for students generally “focus on seeing results in the short run”, while many of her adult patients have an ongoing relationship often being seen for years  (personal communication, March 4, 2014). Thus, designing a treatment plan often entails “deal[ing] with issues in a different depth”, particularly since many student patients are typically facing many significant changes for the first time with little external structure to help them maneuver all those changes  (personal communication, March 4, 2014).  In the eyes of Dr. Jones when asked how do psychological services benefit those who receive it, she pointed out those who seek help often have better outcomes. Mental health issues can be debilitating for individuals, particularly students who need adequate concentration to focus on their studies. Thus, those who seek treatment are often able to overcome the illness and develop coping strategies to avoid relapse, while those who sought no treatment may be susceptible to future episodes of mental health issues that impact daily living of the individual.
Reflection and Conclusion:
Overall, I feel that the most important lesson that I learned from my interviewee, was how important having access to mental health services is. Reflecting on the growing number of students being diagnosed with mental health issues, there will definitely be a continuous demand for clinical psychologists to help these individuals. As society continues to grow and acknowledge current and new mental health diagnoses’, I would think this would contribute to the growth and need for individuals in this particular profession. Post-secondary students face unique challenges, often experiencing the high pressures that come with being a student. As Dr. Jones points out, she believes that there is more pressure now in life, then during any other period. This is particularly related to the tendency to be the best in all that they do, thus coming to university if often a huge wake up call to many students. There needs to be a greater priority for academic institutions to prioritize academics and mental health together, because if students are both happy and health, it can help them achieve success both academically and socially.

Upon reflecting on the interview and my own personal experience, I would like to find a career where I have influence on treating or working with patients experiencing mental illness. While becoming a psychologist most likely won’t be in my future, a career such as a physician’s assistant or midwifery might be. However, both these career options may involve dealing with patients with mental health issues and referring patients to psychological services. Also these health care providers would most likely receive some form of limited training in mental health related issues. Psychological issues can have debilitating effects on student’s ability to be successful in their studies. I would therefore like to take a more active role in promoting mental health services and advocating for a greater amount of health care provides dealing with mental health issues on campus.

Appendix:
Appendix A.

Target Participant: Dr. Melissa Jones

Date: March 4, 2014

Interviewer: Megan Simpson
Interview Guide:
Outline to Open Interview:

  1. Greet participant, give name, and state purpose of project and interview
    1. Learn more about the participant and background of occupation
    2. Ask questions to get specific information to answer research question
  2. Give participant Letter of Information and consent form to review and sign
    1. Answer any questions participant may have about the interview and its purpose
    2. Indicate that I will be recording the session

 Background Information:

  • Please tell me your name, educational background, and number of years in practice

Interview Questions:

  1. In Ontario, how does an individual become a clinical psychologist?
    1. Probe: What degrees or training are required?
  2. What are some of the activities related to your occupation that a patient could expect to receive?
  3. What are some physical demands that your job requires?
  4. What are some of the rewarding aspects of your job?
  5. What are some of the challenges a psychologist may come across in practice?
    1. Probe: How does one overcome those challenges?
    2. Probe: Are there any misconceptions about psychologists?
      1. Probe: Can you elaborate on this?
    3. Do you feel mental illnesses are more prevalent now or in the past?
      1. Probe: Do you feel life is regarded as being more stressful now, as compared to in the past?
    4. How does it benefit students that do get psychological counseling, compared to those who do not seek out any psychological counseling?
    5. How do you approach working with post-secondary students as opposed to adults?
      1. Probe: What are some of the common issues they face?
      2. Probe: What are some issues that one group may be more likely to face compared to the other?
    6. Do you feel that there is a present demand for people in this particular occupation?
      1. Probe: Do you foresee the demand growing, shrinking, or staying the same over the next 5-10 years?
    7. Do you have any questions and or comments you would like to make prior to the completion of this interview?

Appendix B.

Coded Version

  1. In Ontario, how does an individual become a clinical psychologist? [occupational structure]
  2. What are some of the activities related to your occupation that a patient could expect to receive? [caring approach]
  3. What are some physical demands that your job requires? [occupational structure]
  4. What are some of the rewarding aspects of your job? [occupational structure]
  5. What are some of the challenges a psychologist may come across in practice? [occupational structure]/ [scope of practice]
  6. Do you feel mental illnesses are more prevalent now or in the past?
  7. How does it benefit students that do get psychological counseling, compared to those who do not seek out any psychological counseling? [caring approach]
  8. How do you approach working with post-secondary students as opposed to adults? [caring approach]
  9. What do you think the future of psychological counseling looks like? [scope of practice]
  10. Do you have any questions and or comments you would like to make prior to the completion of this interview? [not categorized] 

Hope my interview shed some light on such an important profession! I have posted the works cited list below in case anyone wants further information or a place to start.

Just to note, prior to the interview a privacy disclosure and risk form were signed by the interviewee and a letter of information was provided for the participant. Lastly, consent was obtained in allowing me to post the interview on my blog.

Cheers,

M

 

 Works Cited:

Human Resources and Skills Development Canada. (2011). National occupation classification.       Retrieved March 1, 2014, from            http://www5.hrsdc.gc.ca/NOC/English/NOC/2011/Welcome.aspx

Ontario Psychological Association (OPA). (n.d.). What do psychologists do?. Retrieved March 1,  2014, from http://opajoomla.knowledge4you.ca/index.php/getting-help-faq/what-do

The College of Psychologists of Ontario. (2007). Psychological service providers: psychologists    and psychological associates. Retrieved March 3, 2014, from      http://www.cpo.on.ca/members-of-the-public/complaints-about         members/index.aspx?id=122&ekmensel=10_submenu_24_link_3#