Clinical psychologists’ experiences of negotiating dual identities as mental health service users and service providers

Rhinehart, Molly and Hodge, Suzanne and Wilson, Hannah (2023) Clinical psychologists’ experiences of negotiating dual identities as mental health service users and service providers. PhD thesis, Lancaster University.

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Abstract

This thesis consists of three papers: a literature review, research paper, and a critical appraisal. The systematic literature review explores how key individuals in a young person’s life respond to the young person’s self-harm. A thematic synthesis was undertaken on 12 papers. Five themes were identified: 1) initial responses fuelled by emotions, 2) the importance of a calm façade, 3) modifying my approach and our relationship, 4) offering support, and 5) we need more help! Recommendations highlight the importance of training for education and healthcare staff. The findings also illustrate the need for a greater focus on the experiences of peers caring for their friend who is self-harming, and the need for support programmes for parents of young people who self-harm. The research paper explores the experiences of clinical psychologists in negotiating dual identities as both mental health service user and service provider. Narrative analysis was utilised to explore the experiences of 12 participants. The analysis resulted in the development of five chapters: Prologue: Developing Dual Identities, Chapter One: Separation of Identities, Chapter Two: Negotiation of Identities, Chapter Three: Co-Existence of Identities, and an Epilogue: Looking Forward. The findings discuss the initial separation of service user and service provider identities, often due to stigma, and community expectations placed on the service provider role. Participants negotiated their identities often by prioritising one identity and reframing their service user identity as part of their ‘humanness’. Participants settled at different points of their negotiation, ranging from separate but alongside each other, to fully integrated identities. The critical appraisal provides a personal exploration of multiple identities during clinical training and writing the two papers. The appraisal also considers how the two papers are connected to provide two perspectives on stigmatised experiences, and the commonality between the clinical implications for both papers.