Practicing What We Preach

Abstract

I congratulate Forrest, Elman, Gizara, and Vacha-Haase (1999 [this issue]) on a fine piece of research and writing that covers the topic of trainee impairment in more depth than anything in print. I generally agree with their observations and conclusions but would like to extend the discussion further in several areas. NOT AS A STRANGER-TRAINING PSYCHOTHERAPISTS AND COUNSELORSBetween the third and second centuries B.C., someone authored an oath that became part of a body of medical writings termed the Corpus Hippocratum by historians, stored in the Library of Alexandria, one of the great libraries of the ancient world. Now called the Oath of Hippocrates, in taking this oath early, medical practitioners promised that "in purity and holiness," they would "guard their life and their art." Often cited today for its proscriptions concerning sex with clients, it is rarely noted for an even longer passage in which the physician promises to hold he who taught the art of medicine as "equal to my parents." It goes on to promise that the student will help the teacher financially, teach the children of the teacher the art of medicine, and hold them equal to his brothers.The field of psychology, in part a descendent of early medicine, is also a field dependent on an apprenticeship model of training. Demonstration, case examples, videotapes, practica, and internships all involve apprenticeshiptype training. As a result, some of those who teach form close relationships with students as well as directly instructing them. Furthermore, the public relies on the effectiveness of our training and presumes that those who graduate are fully able to provide service that is effective and safe. It is within this context that we ponder the issue of trainee impairment and what can be done about it.Not only are trainer and trainee often closely involved, but the field we are in requires that the practitioner not only use tools but also be the tool. Part of counseling, psychotherapy, and teaching in our field depends on who we are as people. This includes our personal adjustment, both long-term and short-693

Challenges in Addressing Graduate Student Impairment in Academic Professional Psychology Programs

“…Graduate students also should be encouraged and held responsible for monitoring themselves and their peers with respect to the issue of impairment. In fact, the APA Advisory Committee on the Impaired Psychologist stressed the importance of identifying problems in trainees still in graduate school (Schoener, 1999). Students who are impaired should first be noticed and attended to by their respective graduate programs so as to prevent further impairment as they continue their careers (Lamb et al, 1987).…”

A Systems Perspective on Trainee Impairment

“…We agree with Schoener (1999) that the scholarly and practical work with practicing psychologists who are impaired is not well linked with educators' efforts and responsibilities for evaluating impairment in trainees. Although ours was a review of the literature on trainee impairment, we did venture, in a limited fashion, into the literature on impairment among practicing psychologists.…”

“…In thinking systemically about evaluation throughout training, Schoener's (1999) work suggests that an outside assessment must not focus just on the trainee but must include all of the parties involved with the trainee. Such an evaluation process might include assessments of the structure and timing of training activities to lessen or remove competing stressors, as well as to address the individual trainee's situation.…”

“…Even given these cautions, we believe that the scholarly and practical work on colleague assistance as described by Schoener (1999) needs to be compared and contrasted with the efforts by educators and trainers to address impairment among trainees. Much could be learned from a systematic analysis that compares and contrasts these two literatures.…”

Psychologist suicide: Incidence, impact, and suggestions for prevention, intervention, and postvention.

“…As Schoener (1999) has pointed out, however, psychology, as a field, has not emphasized this aspect of professional education. By way of example, Schwebel and Coster (1998) surveyed the heads of 107 APA-approved programs in professional psychology to learn their views on well-functioning in psychologists.…”