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Ableism in clinical psychology training

Tris Smith writes.

25 November 2021

Disability, lived experience, and the barriers into Clinical Psychology are starting to be discussed. However, instead of leaving a recent DCP minorities group event feeling inspired, I was struck by the institutional inflexibility and inherent ableism around training. None of the speakers disclosed physical disabilities, but a program director highlighted the impossibility of extended or part-time training as an adjustment. The intensity of training was emphasised, being beyond a fulltime job. Being 'ready for training' requires 'strength' and 'resilience'.

Why does Clinical Psychology require physical strength and stamina? Physical capability does not affect competence; but it can affect intensity and speed. Disabled people achieve excellence working or studying part-time, while also managing serious conditions. Why should they not do this in Clinical Psychology? An unwillingness to consider adjustments is not a good enough reason if Clinical Psychology seriously wishes to represent the people it treats.

A great emphasis was placed on emotional strength and emotional resilience. It was suggested that individuals work on themselves until they were tough enough to cope with demanding training. Where is the line between emotional strength and episodes of mental illness? When does an expectation of wellness become discrimination against individuals with mental health problems that are disabilities under the Equality Act?

I have treated individuals who have been diagnosed with bipolar disorder or schizophrenia, and have regular episodes of disabling impairment, but are otherwise highly capable, resilient, and emotionally tough. With the right adjustments, why shouldn't they be able to be clinical psychologists?

Inflexible training, and the implied assumption throughout that only the healthy can heal, means that by definition the people most commonly treated by clinical psychologists cannot enter the profession. There are many examples of people with severe mental health problems achieving excellence in other fields – why not Clinical Psychology?

Disabled people can be brilliant. It is a pity they are stopped from being brilliant Clinical Psychologists.

- Tris Smith, Oxford.