Understanding Stress and Burnout Experiences Among Trainee Clinical Psychologists: Mediating Role of Self-Efficacy

The aim of the present study was to determine the role of self-efficacy as a mediator between academic stress and burnout in trainee clinical psychologists. Correlational research design was employed in this present study. The sample was taken from various mental health institutes of Karachi, Pakistan. Purposive sampling technique was used to select the research participants that was comprised of 110 trainee clinical psychologists with the age ranged between 20 to 40 years (X̄= 24.5, SD= 2.71). The Student Life Stress Inventory (Gadzella, 1991), Oldenburg Burnout Inventory (Demerouti et al., 2003), and General Self-efficacy Scale (Schwarzer & Jerusalem, 2014) were administered to measure the study variables. The data was scrutinized and analyzed by using Statistical Package for Social Sciences (SPSS, V-25.0). Self-efficacy has been found as a significant mediator in the relationship between academic stress and burnout in trainee clinical psychologists. The current study provided the insight of how self-efficacy can play a role as a mediator in the association of academic stress and burnout in trainee clinical psychologists.

Mental health fields have different groups of professionals like qualified and licensed mental health professionals and student mental health professionals such as trainee clinical psychologists. The trainee clinical psychologists are those professionals who are under training to complete professional degrees with extensive training related to assessment and treatment of psychiatric disorders (Robiner, 2006 ). Clinical psychology is a significant field in education and health, it demands skills and consistency, and courage to take complex tasks like assessment and treatment of a variety of psychiatric disorders. It is such a difficult task for trainee clinical psychologists to accomplish multiple tasks i.e., academic courses, clinical internship, and research within time limit of their degree. Therefore, trainee clinical psychologists are more likely vulnerable to face academic stress, anxiety, and burnout due to multiple factors like professional self-doubt, ambiguity, and their first interaction with their client. It produces a lot of stress and anxiety, whether they can complete it or not, or whether client may be satisfied with him/her or not. Another stressor of performing multiple roles in a short time affects trainee clinical psychologists in multiple ways including time constraints, long hour’s lectures, lengthy syllabus, evaluation of theory, and clinical performance, doing research and assignments (Rehman et al., 2015 ).

Moreover, the biggest stressor of trainee clinical psychologists is lack of clinical practice and supervision facilities. Many universities in Pakistan offering graduate and post-graduate programs in clinical psychology but most of them don’t have their own clinical settings for the internship and practice. To complete their internship and practice credentials they have to go to other government and/or private mental health institutes which are insufficient for the huge number of trainee clinical psychologists. Further they have to pay extra fees and give extra time which affects their time management that directly impacts their performance. All these academic challenges create stress that can lead to self-doubts and lower efficacy beliefs, in post graduate students of clinical psychology (Rehman et al., 2015 ).

It is proposed that not every student of clinical psychology suffers from academic stress. It depends on the individual differences like their interest, mental well-being, and efficacy beliefs about their potentials and how accurately and strongly they manage their academic stressors. Some trainees perform better and stand against their educational stressors, while some of the trainees are unable to resolve their academic stressors and find themselves out of their potentials that’s why stress prolonged in them due to low efficacy beliefs (Bakar, 2011 ).  In result their prolonged academic stress appears in the form of different mental disorders like anxiety, depression, and burnout (Rehman et al., 2015 ). Nowadays self-efficacy is one of the major areas of researchers and psychologists who pay more attention to the importance and impact of self-efficacy in real life. Bandura (1977 ) defines self-efficacy as an individual’s belief that he or she can successfully execute the behaviors required by a particular situation. Self-efficacy affects the individual’s activities, desires and efforts they make (Khoshnevisan & Afrouz, 2011 ).

Self-efficacy in context of academics referred to individuals’ beliefs that they can successfully accomplish the given academic tasks at the time (Schunk, 1991 ). Personality traits, level of motivation of a student, and nature of the academic task are the factors which affect directly or indirectly academic efficacy beliefs of individuals. Academic self-efficacy is nearly related to general efficacy beliefs which are explained as an accurate performance in the educational field and successful accomplishing of the educational tasks by the students. Efficacy beliefs are the utmost significant thing in trainee clinical psychologists. Self-efficacy beliefs in reference to the trainee clinical psychologists defined as how they think they are capable of controlling and exercising the academic trials and clinical training. Moreover, efficacy beliefs are the faith of trainee mental health care professionals in their abilities that they will remain successful in academic tasks i.e., theory, clinical training, and research (Khoshnevisan & Afrouz, 2011 ).

Trainee clinical psychologists who are studying and under training often experience high level of anxiety and stress. Stressful academic conditions affect their performance and grades which may deteriorate their beliefs about their potential and create self-doubt that they do not have enough potential and abilities to complete their academic tasks successfully. This uncertainty made them drained about their work, and they started avoidance and gradually detached themselves from their profession (Carson & Fagin, 1996 , Sharififared et al., 2015 ). Multiple studies suggested that most of trainee clinical psychologists experience high level of academic stress. It is noted that high self-efficacy beliefs help trainee clinical psychologists to use their cognitive, behavioral, and social skills by integrating with their roles as a professional. Much research has revealed that trainee clinical psychologists with strong efficacy beliefs can address their challenges and difficulties as compared to those who have low efficacy beliefs (Hill et al., 1987 ; Lent et al., 198 7 ; Nease et al., 1999 ). Gunduz (2012) conducted a study on trainee school counselors and investigated that the trainee school counselors who have good academic performance and high skills and knowledge got high score on self-efficacy scale. Further he reported that trainee school counselors with high self-efficacy beliefs perceive lower degree of stress and burnout. Another study results revealed that those trainee clinical psychologists who have high self-efficacy beliefs are more likely to learn and perform better than those who rated them low on self-efficacy. Further it is also suggested that post graduate trainee clinical psychologists are more efficacious than undergraduate students of clinical psychology (Bakar, 2011 ).

Hypothesis 

1. Self-efficacy would mediate the relationship between academic stress and burnout in trainee clinical psychologists.

Method

Research Design 

The present study is of quantitative in nature and is based on correlational research design. The basic purpose of study was to explore the mediating role of self-efficacy on academic achievement and burnout in trainee clinical psychologists. The study employed the use of structured questionnaires to collect data.

Sample

Purposive sampling technique was used in this study. The sample consisted of 110 female trainee psychologists with the age ranges between 20 to 40 years (M = 24.5, SD = 2.71) taken from various public and private mental health institutions of Karachi, Pakistan. In the current sample of trainee psychologists, 81.8% (n = 90) had nuclear family structure and 18.2% (n = 20) had joint family structure. Out of 110 trainee psychologists, 86.4% (n = 95) were single, while 13.6% (n = 15) were married.

Table 1: Demographic Characteristics of Sample (N = 110)

Measures

Demographic Information Sheet

Demographic sheet comprised of information regarding participants’ age, gender, birth order, and marital status. Further, the form collected information regarding education level, no. of years of training in the field of psychology, socio-economic status and family structure.

General Self-Efficacy Scale (GSES)

The General Self-Efficacy Scale (Schwarzer & Jerusalem, 1995) is a self-administered assessment tool for measuring the general level of self-efficacy. The GSES is comprised of 10 items with a 4-point Likert scale with responses ranging from “Not at all True” to “Exactly True”. Participant scores on the scale can be calculated by summing the scores on all items which yield a total score ranging from 10 – 40; low score shows low level of self-efficacy while the higher score is indicative of high level of self-efficacy.

Student-Life Stress Inventory (SLSI)

Student-Life Stress Inventory (Gadzella, 1991) is self-report measure contains 51 items with a 5 point Likert scale from “1= Never” to “5 = Most of the Time”. The SLSI has two major domains, and each domain has variety of subscales. The SLSI first domain is designed to assess academic stressors, and it is comprised of subscales: Frustration, Conflicts, Pressures, Changes and Self-Imposes; While the second domain of the scale measures participants’ reactions to stressors which comprised to four subscales (Physiological, Emotional, Cognitive and Behavioral). The overall reliability of SLSI is estimated to be .92 and test-retest reliability is calculated to be .78 (Gadzella, 1994). In this present study, only first domain “stressors” of SLSI was used while the second domain “reaction to stressors” was excluded as per the objectives of the study.

Oldenburg Burnout Inventory (OBI)

Oldenburg Burnout Inventory (Demerouti et al., 2003) is intended to assess burnout. The scale consisted of 16 items with 4-point Likert scale with responses ranging from “Strongly Agree” to “Strongly Disagree”. The OBI has two subscales which are Exhaustion and Disengagement. 8 items in this scale are reversed scored. The internal consistency (α) of OBI is .83 (Khan & Yusoff, 2016).

Procedure

The study employed purposive sampling to recruit the participants. At first permission was taken from different mental health care institutes of Karachi, Pakistan. Afterwards, informed consent was taken from the participants. They were assured to maintain their confidentiality and their participation is voluntarily and they can withdraw from study any time. After receiving consent from participants, they were presented with study scales i.e., Demographic Form, Student Life Stress Inventory, Oldenburg Burnout Inventory, and General Self-efficacy Scale.

Results

The data was scrutinized and analyzed through SPSS-25. To calculate the frequencies and percentages, descriptive statistics were used. Further mediation analysis was used to study the indirect effect of academic stress on burnout through self-efficacy. Demographic information has been shown by using descriptive statistics (see Table 1). The relationship between academic stress, burnout and self-efficacy in trainee clinical psychologists were investigated using correlational analysis. In conjunction, mediational analysis was also used in the study.

Table 2: Correlation Matrix for All Variables (N = 110)

*p<.01.

Table 2 indicates that academic stress is positively associated with burnout and negatively associated with self-efficacy in trainee clinical psychologists. Further results indicate that self-efficacy is negatively associated with burnout in trainee clinical psychologists.

Table 3: Mediating Role of Self-Efficacy in Predicting Burnout from Academic Stress (N = 110)

Note. AS = Academic Stress; SE = Self-efficacy; BO = Burnout; Bootstrap sample size = 5000.

The findings indicate that academic stress is indirectly linked with burnout via self-efficacy in trainee clinical psychologists, and the total effect on burnout is significant (p< .01; 95% CI [.068, .222]).

Figure 1: Mediation Model of Self-efficacy on the Relationship Between Academic Stress and Burnout

Discussion

In this present study the mediating role of self-efficacy between academic stress and burnout among trainee clinical psychologists has been investigated. Results of the present study indicate that self-efficacy significantly mediates the relationship between academic stress and burnout in trainee clinical psychologists. Findings of the current study are also supported by the study (Sharififared et al., 2015) which revealed that academic stress is indirectly associated with burnout in trainee clinical psychologists; if self-efficacy increases it reduces the academic stress which decreases the burnout in trainee clinical psychologists.

Learning and training at post-graduate educational level in clinical psychology is different from the early stages of education of psychology. It demands excellence, skills, patience, motivation, determination, and strong self-belief. Trainee clinical psychologists need to have these qualities for good academic performance (Schunk, 1991). A trainee’s feelings of growing need of knowledge in their field and at the same time trainee’s perception of not having enough time and ability to achieve the knowledge can lead him/her toward academic stress. Academic stress is considered as the key reason of different behaviors in professional students like trainee clinical psychologists such as academic performance, achievement, and interpersonal relationships. These all features directly linked with a trainee’s mental health and academic life (Hudd et al., 2000).

It is suggested that strong efficacy beliefs are important for trained clinical psychologists. It helps them not to give up and try to face the hurdles and find the solutions of their academic problems. Moreover, it is proposed that trainee clinical psychologist’s with strong efficacy beliefs are good at problem solving and planning ability that is why they face less academic stress during academic life as compared to those who are low at self-efficacy beliefs. Further, it is explained that academic stress is the key dynamic in clinical psychology that can lead to burnout in TCPs. When the academic duties increased and the trainee clinical psychologist’s do not have enough resources, i.e., mental, physical, social, and economical, it gradually creates pressure in them and they will feel excessive pressure, and their ability and motivation for doing the academic tasks declines, and if it prolongs it can change into burnout syndrome (Halbesleben & Buckley, 2004).

Limitations and Recommendations

The present study was conducted only on trainee clinical psychologists. In future studies can also be carried out on other mental health care professionals, i.e., psychiatrists, counselors, nurses, addiction therapists, and behavior therapists etc. Further the sample of the study was small. In the future, studies can carry out on large samples of trainee clinical psychologists and other mental health care professionals. 

Conclusion

The results of the study supported the assumption that self-efficacy is indirectly linked with academic stress and burnout in female trainee clinical psychologists. Based on current findings and other related evidence, it can be concluded that self-efficacy has significant impact on academic stress and burnout in trainee clinical psychologists. It is suggested that self-efficacy beliefs are important for a trainee clinical psychologist because they affect their cognition and behavior and help them to deal with stressful academic situations.

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Received 03 June 2024
Revision received 26 February 2025