Incongruous identities: Mental distress and burnout disparities in LGBTQ+ health care professional populations

Wolfe, Atticus

doi:10.1016/j.heliyon.2023.e14835

Cited by 2 publications

(3 citation statements)

References 79 publications

(120 reference statements)

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“…For example, a population-based study of accredited psychology doctoral programs between 2005 and 2015 found that only 11% of trainees identified as Black or Hispanic/Latinx (Callahan et al, 2018). The current findings suggest these groups warrant attention in future research to better understand and address identity-based psychosocial challenges that may be experienced within doctoral training programs (e.g., code-switching, personal and professional identity incongruence; Crumb et al, 2023; Wolfe, 2023).…”

Section: Discussionmentioning

confidence: 88%

“…The current findings provide preliminary empirical evidence for the importance of authenticity and belonging in the associations between identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities. Coupled with prior research showing that burnout is associated with lower levels of authenticity and belonging (Grandey et al, 2012;Öztürk et al, 2022;Puranitee et al, 2022;van den Bosch & Taris, 2018) and poorer psychotherapy outcomes (e.g., higher levels of depression and anxiety in clients; Delgadillo et al, 2018), these findings can support the development of nondiscrimination policies, trainings, and other environmental changes (e.g., displaying a rainbow symbol) aimed at creating safer, more welcoming work and education environments for psychology trainees with concealable stigmatized identities (e.g., LGBT+ identity; Burke, 2021;Wolfe, 2023). In clinical training sites and other mental health care facilities, these changes would also facilitate affirmative therapy practices and benefit clients with concealable stigmatized identities (Alessi et al, 2019;Kelley, 2015).…”

Section: Implications For Clinical Practice and Policymentioning

confidence: 96%

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Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Shepherd,

Brochu

2024

Psychotherapy

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Identity concealment thwarts psychological needs of authenticity and belonging, both of which are important for mental health and relationship building. Through the lens of minority stress theory and relational-cultural theory, the present study examined whether identity concealment in the workplace by psychology trainees is indirectly associated with greater burnout and poorer therapeutic relationship quality. To test this hypothesis, a parallel mediation analysis was conducted on data from 335 clinical and counseling psychology doctoral trainees with concealable stigmatized identities using Hayes's (2018) PROCESS macro. As expected, identity concealment at a practicum or internship site was negatively associated with authenticity and belonging, both of which were negatively associated with burnout and positively associated with therapeutic relationship quality. Furthermore, identity concealment was associated with lower therapeutic relationship quality and greater burnout indirectly through lower authenticity and lower belonging. Findings suggest trainees who engage in more identity concealment at their clinical training sites may be at increased risk for burnout and poorer relationships with clients due to limited opportunities for authenticity and belonging. Future research is encouraged to longitudinally examine the impact of identity concealment on professional burnout and relationships, as well as potential protective factors. Such knowledge can support the development of interventions and policies that foster safer, more welcoming work environments for trainees with concealable stigmatized identities. Clinical Impact StatementQuestion: Does identity concealment present a possible barrier to the psychotherapy process among clinical and counseling psychology doctoral students with concealable stigmatized identities, and why? Findings: Psychology trainees with concealable stigmatized identities who engaged in more identity concealment within their practicum or internship reported higher rates of burnout and poorer therapeutic relationship quality, possibly as a function of lower levels of authenticity and belonging. Meaning: Psychology trainees need to be aware of the potential risks of concealing a stigmatized identity within their clinical training sites-as well as their own human need for authenticity and belonging-for the sake of their well-being and the well-being of their clients. Next Steps: These findings underscore the need for the development of structural changes (e.g., the implementation of culturally responsive policies, discussions, and trainings) that reduce identity-based stigma and the likelihood of identity concealment within graduate training programs in clinical and counseling psychology.

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Section: Discussionmentioning

confidence: 88%

Section: Implications For Clinical Practice and Policymentioning

confidence: 96%

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Shepherd,

Brochu

2024

Psychotherapy

View full text Add to dashboard Cite

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“…impact of sociodemographic factors. [40][41][42][43] The purpose of this analysis, therefore, was to assess variations in the SDOH across HCW job categories, as a rst step in understanding differences in social needs and identifying targeted employee wellness strategies.…”

mentioning

confidence: 99%

Social Determinants of Health-Informed Healthcare Worker Well-being: Findings from a Cross-Sectional Study

Kim,

Hollingsworth,

Coleman

et al. 2023

Preprint

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Background: There is limited research on the prevalence across sociodemographic groups of environmental and social factors associated with healthcare worker (HCW) burnout, and findings are often inconclusive or inconsistent. Evidence suggests individuals from historically underrepresented minority groups may experience burnout differently, yet those data that do exist rarely explore variations among the HCW job categories and sub-groups, including the impact of sociodemographic factors. The purpose of this analysis, was to assess variations in the social determinants of health (SDOH) across HCW job categories, as a first step in understanding differences in social needs and identifying targeted employee wellness strategies. Methods: This study included 12,715 HCWs (e.g., Physicians; RNs and LVNs; Scientists/Research/Information Systems; Administrative Support; Allied Health Professionals; Management; Trades/Crafts/Engineering/Facilities; Unlicensed Assistive Personnel [UAP], Security; Food Services; and Environment [EVS]/Transportation Services), across 586 California zip codes. The California Healthy Places Index (HPI) data file was used to examine the impact of SDOH on HCWs based on their reported zip codes. Analysis of variance with Bonferroni Correction to adjust for multiple comparisons was used to assess differences across job categories, and Two-step Cluster Analysis was used to evaluate how job categories might form distinct clusters on SDOH. Results: While physicians had the highest HPI percentiles across all HPI sub-categories, the lower-wage workers including EVS/ Transport Services, Food Services, and Security consistently ranked lower, below the state average (50th percentile). Overall, the HPI percentile was lowest for environmental living conditions and pollution for all HCWs and considerably lower than the statewide standardized average. The education and economic components of the HPI were higher on average than the state average. Ranking by job category put Physicians at, or near, the top for most HPI components; while Security, Food Service, and Environmental Services and Transportation employees at, or near, the bottom rank for most components. Conclusions: The findings from this highlight the importance of SDOH-informed employee wellness programs and research studies. Findings also underscore the importance of a call to action for policymakers to act upon health disparities in the HCW population.

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Incongruous identities: Mental distress and burnout disparities in LGBTQ+ health care professional populations

Cited by 2 publications

References 79 publications

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Let’s get real: Identity concealment, burnout, and therapeutic relationship quality among psychology trainees with concealable stigmatized identities.

Social Determinants of Health-Informed Healthcare Worker Well-being: Findings from a Cross-Sectional Study

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