Friday, July 31, 2020

Clinical psychology applications and ethnicity (Review of thesis by Ragavan, 2018)



There's a major bottleneck in clinical psychology training in Ireland and the UK, with many people with a psychology degree hoping to pursue clinical psychology as a career, and much demand for the services clinical psychologists provide, but a limited number of places on training courses. Not only are applicants trying to build up clinical experience, but also research/publication experience and continuous professional development. Psychology graduates often work for years after finishing their primary degree (often taking on voluntary/unpaid work part-time or even full time) in order to pad their CV's enough to compete. Needless to say, this creates a lot of scope for those from less advantaged backgrounds to face an uphill struggle if they want to get into this area of training.  

With regard to ethnicity and clinical psychology, much previous research has focused on people who are already on training courses, but there's a whole cohort of those who may or not make it onto such courses. An interesting thesis by Dr Romila Naiken Ragaven interviewed people from a BAME (Black and minority ethnic) background who were applying for clinical psychology training courses.

The participants were eight females working in typical roles for those applying for clinical psychology roles (e.g.assistant psychologist). No males took part in the study- it would have been interesting to have male interviewees as well, but there does tend to be a higher proportion of female applicants for clinical psychology roles.

The participants reported wanting to be agents of change within their own communities, but also wanting to contribute to change the conversation around Western conceptualisations of mental health (e.g. they mentioned cultural difference as being a brief addendum to educational materials they'd seen). One quote from a Black British participant was used to illustrate how they negotiate multiple identities and narratives. This quote speaks to the value of being a BAME applicant, but also struck me as containing a false dichotomy that worryingly hints at the persistence of stereotypes around ethnicity and competence: 

On the one hand you wanna be seen for like your skill set and the fact that you are an intelligent person that's capable of doing the doctorate, and on the other hand, you wanna show how your own background can benefit the field, and I think it's hard to marry the two without having some sort of, like, controversy (pages 69-70)

Participants referred to having to work harder to achieve the same results as their White counterparts. One person reported feeling that they might not articulate themselves in a manner that comes off as professional as some of her White peers (while pointing out this is a class issue as well), and furthermore that she might not have as much research experience. All this will be filtered through the lens of the intensity of competition for places on training courses. As one person put it:

I’m not going to lie, it freaking annoyed me. This girl had one year’s experience post masters and then she got an interview for two courses and I’m thinking “but I’ve got more years’ experience than you”, but one thing we were talking about was that she has the privilege of not working because she’s middle class, so she was able to go an volunteer and stuff like that. But for me, I needed to work. I don’t come from money like that. (page 87)

The participants referred to experiences of overt racism from clients/service users, but perhaps more concerning was a sense that such experiences were being minimised by some of their supervisors. 

...She was like “oh I don't think he meant it like that”, and I said, "Regardless of how he meant it as a joke, he offended my skin tone." And then she was like, "Well, I've never had anybody say that to me". And I said, "Yeah because you're White like you don't understand." (page 78)

They described a pervasive baseline anxiety about being treated in a negative manner because of their ethnicity, and not mentioning their ethnicity on application forms out of fears that it might negatively affect their chances. This might surprise some readers, as (and the interviewees acknowledge this) there have been increased efforts to make cohorts of clinical psychology trainees more representative. Nonetheless, the participants expressed a certain ambivalence about this, wondering if they might be selected to fill a quota rather than on merit (while simultaneously experiencing hostile discrimination from other quarters). The reported lack of role models alluded to by the participants here may suggest that mentoring could help to overcome concerns about tokenism; external validation from a senior peer with whom candidates can identify with may offer reassurance they can stand over the quality of their application in its own right, rather than seeing themselves as filling a quota.

For a deep dive, do check out the thesis itself:

Ragavan, R. N. (2018). Experiences of Black, Asian and minority ethnic clinical psychology doctorate applicants within the UK. [Doctoral dissertation, University of Hertfordshire]

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