'I think it does just opens it up and … you're not hiding it anymore': Trainee clinical psychologists' experiences of self-disclosing mental health difficulties

Contributory Factors to Self-Disclosure in Clinical Supervision: A Meta-ethnography

Research on supervisee disclosure in clinical supervision has predominantly focused on supervisees' tendency to withhold important information (e.g., negative feelings, perceived power differentials, clinical mistakes, personal issues and countertransference), highlighting a significant gap in understanding the factors that influence supervisees' self-disclosure. Self-disclosure, which is considered essential for supervisors to provide personalised feedback and tailored guidance, plays a critical role in effective supervision but remains underexplored in terms of its facilitators and barriers. This study addresses this gap by systematically exploring the contributory factors affecting supervisee self-disclosure within the context of clinical supervision. Using the principles of meta-ethnography, this systematic review synthesised findings from eight qualitative studies involving 180 participants (the sample ranging from 3 to 110). Through a thorough process of data extraction, translation, and synthesis, a conceptual framework was developed, positioning self-disclosure as a dynamic process shaped by the interplay between supervisory dynamics, contextual factors, and supervisees' internal experiences. Key factors influencing self-disclosure included the quality of the supervisory relationship, supervisees' perception of supervisors' personal characteristics, the emotional impact of self-disclosure on supervisees and power differentials. These findings highlight the relational and systemic factors shaping supervisee self-disclosure. Implications include strategies to improve supervisory relationships, reduce power imbalances and foster supportive environments. The study informs future research, enhances supervisory practice and guides training programmes to improve clinical supervision effectiveness.

'Isn't it mad that we're all psychologists and we can't talk about our feelings?': A mixed-methods study exploring trainee clinical psychologists' experience of (non)disclosure of psychological distress during training

OBJECTIVE

Literature on trainee clinical psychologists' mental health has highlighted elevated levels of mental health difficulties and/or psychological distress and low levels of disclosure within the workplace. The current study aimed to explore (1) trainee experiences of disclosure and/or concealment of psychological distress during their training, (2) beliefs, assumptions or predictions related to disclosure and (3) responses to disclosure.

METHODS

A mixed-methods strategy was employed; 165 trainee or recently qualified clinical psychologists took part in an online survey. Thirteen of these were interviewed. Descriptive statistics and a reflexive thematic analysis were conducted to analyse the quantitative and qualitative data, respectively.

RESULTS

The sample largely consisted of those who had disclosed distress. Beliefs related to negative judgement from others and feelings of anxiety and embarrassment were commonly endorsed responses within quantitative findings. Six main themes were constructed: (1) Diagnostic or psychological conceptualisations, (2) Worries about judgement complicate disclosure decisions, (3) Disclosure likelihood is determined by relationships, (4) Emotional support versus practical responses, (5) Desired changes that could increase disclosure and (6) Legacies of disclosure experiences.

CONCLUSION

There is a need for training programme staff to prioritise emotional support, increase permission giving and enhance disclosure guidance. Further research including disclosure recipients is required.