This research presents the findings of a qualitative study using IPA methodology to facilitate the exploration of experiences of Trainee Clinical Psychologists who have undertaken PBL as part of their doctoral-level training in the UK. While it is important to recognise that participants in this study do not necessarily speak for all Trainee Clinical Psychologists who have undertaken PBL as part of their training, this research endeavours to provide a rich and meaningful insight into participants’ dynamic, complex and emotional experiences.
There was a pervasive sense of intangibility, intensity and a reverberating emotional impact which necessitated arduous and complex emotional work on individual and group levels.
The difficulty in articulating PBL and its impact appeared to relate to an intense desire to put meaning into words; a process which was eased through effective group facilitation, writing reflective essays, and additional reflective contexts such as talking with peers and even, engaging in these research interviews. These seemed to scaffold individuals’ abilities to process intense emotional experiences often stemming from the complex dynamics occurring within the PBL experience, for example, between group members.
‘Intensity’ appeared to emanate from issues such as perceived time pressures, interpersonal dynamics within and between groups, clinical vignettes which resonate with individuals’ personal histories or difficulties and changes in group membership or facilitation. Different responses and strategies individuals adopted to manage these issues included experiential avoidance (for example, disconnection and efforts to generally create distance between themselves and these intense emotions), and conflict. However, through effective facilitation, the support of fellow group members, and personal risk-taking individuals were able to acknowledge and connect with this emotional intensity from a place of safety. These aspects seem to be the underlying ‘therapeutic factors’ within PBL groups and have invariably led individuals’ to experience a reverberating emotional impact – within the group, the wider cohort, in professional contexts, individuals’ personal lives, and beyond.
This application of the learned lessons and experiences of PBL to the outside world is of high importance given the multiple contexts and pressures trainees relate to. These differences make it difficult for trainees to be congruent within themselves across contexts, and with
others. Within these circumstances, it is easy to only connect with what is ‘acceptable’ within that context. In addition, intellectual development seems to be favoured over emotional development, which reinforces experiential avoidance of emotion on a societal level. Within the specific context of Clinical Psychology training, competition and uncertainty are rife and may represent a threat to the exploration of emotions and vulnerability. PBL embraces these differences, bridging the intellectual and the emotional, alongside the professional and the personal.
Participants within the study valued my peer status as my sameness enabled them to feel like I could connect and understand their experiences whilst my difference provided a degree of therapeutic space to allow deeper meanings and understandings to emerge. They also spoke of the therapeutic benefit of the interviews and of being able to reflect upon their experiences with another; the same, but different. I also valued occupying the same reflective space as my participants – I was truly privileged to be able to share in my participants stories and support them in making sense of their experiences. In doing so, I feel that my reflections on my own experiences of PBL, in hindsight, have become richer. However, this left me struggling to balance my roles within the research interviews: when emotive material arose, was I a researcher, a peer or a clinician?
It was through engaging in a self-reflexive process, both individually as well as with my research supervisors that I was able to negotiate the challenges that lay within balancing such competing roles. Supervision allowed me to acknowledge what I was bringing to the interviews and the analyses and allowed my participants’ voices to be heard within the write-up of my research, and so self-reflexivity thus became a key aspect of my thesis.
In concluding my research and in coming to the end of my own doctoral studies and thus my direct involvement with PBL, I found that an extract from Yalom (2005) struck a particular chord;
“Groups hate to die, and members generally try to avoid the ending. They may, for example, pretend that the group will continue in some other setting – for example, reunions or regularly scheduled social meetings. But the therapist is well advised to confront the group with reality: the end of a group is a real loss. It never really can
be reconvened, and even if relationships are continued in pairs or small fragments of the group as the members then know it – in this room, in its present form, with the group leaders – will be gone forever.” (Yalom, 2005, p.389)
Therefore, perhaps my undertaking of this thesis can be construed as a sign of my unwillingness to let go of PBL; of my experiences within it; of my connections with other members within my PBL group and with other PBL groups within my cohort; of the relationship with my PBL group facilitator; of the meaning and significance of all of these.
The participants within this research reveal to us that the journey is far more important than the destination. Like travellers and pioneers of a bygone age, it is the very act of navigating one’s way through unchartered territory and finding ways to overcome roadblocks that has the potential to be so transformative. Regardless of what Yalom says, I intend to ensure that I carry my travelling companions with me on my future professional and personal journeys throughout life, no matter where the road ahead takes me.