Learning from Compassion-Fatigue and Moral Injury within the Clinical Psychology Profession during the COVID-19 Era

Abstract

Rationale and Aims: Recognition that the physical and mental wellbeing of healthcare workers is crucial to safe and effective healthcare is well established. There is emerging research into the impact of the pandemic on physical healthcare professionals, however knowledge related to the impact on mental health professionals, especially Clinical Psychologists, is limited. It is important we hear from Clinical Psychologists themselves as experts in their lived experiences. The current research aimed to explore the experiences of National Health Service (NHS) Clinical Psychologists who worked during the COVID-19 pandemic and their experience of moral injury and compassion-fatigue. Methods: This study took a qualitative approach to explore the experience of NHS Clinical Psychologists who worked during the COVID-19 pandemic. Twelve Clinical Psychologists took part in semi-structured interviews to share their experiences and identify lessons learnt from the pandemic. Analysis: Data were analysed using inductive reflexive thematic analysis, and six main themes and nine subthemes were identified from the data. Qualitative data highlighted the complex and multifaceted experiences of compassion-fatigue and moral injury reported by participants. They faced significant challenges including the loss of privacy and containment from completing therapy online at home, supporting the emotional distress of colleagues, deciding who could access psychological therapy and who needed to have therapy paused, and feeling pressurised into having the COVID-19 vaccine. These experiences highlight the need to offer more support for Clinical Psychologists within the NHS and to create a less stigmatising environment to allow Clinical Psychologists to feel comfortable discussing their own mental health needs. This needs to occur at an individual and contextual level. Discussion: Findings of this study were discussed in relation to the wider literature. This research produced new knowledge about how Clinical Psychologists made sense of their experiences during the pandemic, including the impact on both their personal and professional lives. This novel research will be of importance in shaping policy developments and procedures at both an organisational (NHS and professional bodies) and government level. Clinical implications for this population were also considered.