Witnessed and Internalized Stigma among Prosumers in Clinical Psychology

Abstract

Research has demonstrated that stigma is widespread within the field of clinical psychology. However, no research has examined prosumers’ (providers and consumers of mental health services) experiences of witnessing discrimination within the field of clinical psychology. Furthermore, no research has evaluated how experiences of witnessing discrimination may influence prosumers’ experiences with internalized stigma, anticipated stigma and stigma resistance. The purpose of this study was to establish associations and interactions between having witnessed discrimination towards others with lived experiences of mental illness and internalized stigma, anticipated stigma and stigma resistance from the perspective of prosumers within the clinical psychology field. Further, we wanted to elucidate on the impact these different dimensions of stigma have on prosumers, as well as on how it manifests for them. We recruited a total of N= 175 prosumers, of which n= 39 had graduated from doctoral programs in clinical psychology and n= 136 were still in-training. A mixed-methods approach was employed in order to understand these dynamics through the use of descriptive, correlational, and multivariate regressions and grounded theory qualitative analysis. Our overall findings suggest that prosumers endorsed high levels of stigmatizing experiences and these experiences were often associated with their identities as prosumers, as well as to other dimensions of stigma. Emergent qualitative themes related to our variables included: witnessed discrimination (invalidation, overpathologizing, clinical psychologists as experts and training as a breeding ground for stigma, psychological distress, negative feelings related to field, sense of connection), anticipated stigma (agency and identity rejected, degree of acceptance) internalized stigma (perceived competence and social desirability) and stigma resistance (academia in action, engaging communities, comes with a risk, worthwhile). Our findings have implications for the role of clinical psychology in perpetuating stigmatizing views and attitudes towards individuals with lived experiences of mental illness, specifically in training and academic settings. Further directions should strive to gain a better understanding of how clinical psychologists, including prosumers, engage in stigma and the associations between different types of discrimination and other stigma dimensions, as well as investigating the role of mental illness in a prosumer’s role as a provider.