The Aspiring Psychologist Podcast - Power imbalances in fiduciary relationships and how to address them as an aspiring psychologist

Episode Date: May 23, 2022

Show Notes for The Aspiring Psychologist Podcast Episode: 24: Power imbalances in fiduciary relationships and how to address them as an aspiring psychologist Thank you for listening to the Aspiring Psychologist Podcast. When working as in psychology, or in a caring profession, it is important we consider power imbalances. This podcast is a special request, it highlights some of the ways I consider power imbalances in my practice. It will look at how I consider individual differences, culture, language, and social factors. I hope it helps you to reflect on power imbalances in your own work!The Highlights: 00:28: A special request on power imbalances01:49: Fiduciary relationships03:01: Polite and respectful 03:54: You can call me Marianne04:57: Confidentiality and Netflix! 05:59: Overidentifying with clients 06:52: Testimonial from incoming Trainee!07:48: What is it like for our service users?09:32:  Trusty Maslow’s Hierarchy of Needs!10:43: Different experiences of the same problem11:48: Social factors12:48: Take me through your day-to-day13:46: Ask the difficult questions! 14:45: Language and coping strategies15:49: Don’t be afraid and don’t assume! 16:41: Thank you, review, and the aspiring psychologist membership17:17: Jingles Check out ways to work with her including the upcoming aspiring psychologist book and the aspiring psychologist membership head to her linktree: https://linktr.ee/drmariannetrentTo check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0 Like, Comment, Subscribe & get involved:If you enjoy the podcast, please do subscribe and rate and review episodes. If you'd like to learn how to record and submit your own audio testimonial to be included in future shows head to:https://www.goodthinkingpsychology.co.uk/podcast and click the blue request info button at the top of the page.

Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field,

the principles can work for you. There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode. If you're looking to become a psychologist, then let this be your guide. episode. With Dr. Marianne Trent Hi, welcome along to the Aspiring Psychologist podcast.

I am Dr. Marianne Trent and I hope that you will find this really useful. Thank you for being part of my world. Today is a special request from Henein who got in contact. And she says, I'm thinking about what might be beneficial for aspiring psychologists, could be power imbalances during our sessions and how to address these. And also maybe how we take into account social factors and inequalities when working with clients and families. So thank you so much for your request, Henaen. I will do my very best to answer that for you because it is a great question. So thank you. So when I was applying for doctorate places myself, I had a tendency to reflect on fiduciary relationships, which might not be a relationship that you have heard of before. But a fiduciary relationship is one where someone else has, you know, a duty of care for the other person.

So one person is coming along because they need something, or maybe not always because they need something, they might not think that they need anything, but one of you has a duty of care or some kind of responsibility for the other person so we would get fiduciary relationships if we were a psychologist and we had a client we'd get them if you were a GP you get them if you were a dentist you know or an occupational therapist you know speech and language therapist all of these professions would be, whether they knew it or not, because it's not a very common term, would be subject to fiduciary relationships. And there are obviously, you know, there's caveats to that, that can make relationships

a bit more complicated. And, you know, so along the lines of the boundary setting episode, which I believe from the top of my head is episode eight, there are limits to our relationship. And of course, our relationships should be friendly with our service users. They should be, you know personable i believe um although i have you know previously worked in a service where an hour is dynamic and so um that is a slightly different type of relationship but you're still polite you know you're not rude to people um so yeah it's it's worth thinking about um those power imbalances you know I know that many clients I've worked with

have wanted to call me Dr Trent and I say to them you know you don't have to call me Dr Trent you can just call me Marianne but for them perhaps culturally or because it's just the way they've been brought up they want to continue to call me Dr. Trent. And I respect that about them, you know. I'm not going to correct them every time. I will explain that with them, you know, once. But many of them do still want to call me Dr. Trent. And clients that I might have been working with, you know, for over a year,

still message me in emails formally as Dr. Trent. But obviously to my face might call me Marianne. But, you know, we're not we're not correcting or dismissing what a client brings to them. But, you know, we do have to be very careful with how we are handling our power and our responsibility. And, you know, just to go over some of the boundaries stuff again, we have to make sure that we are being clear about the caveats to our role. We need to make sure that people have insight and can make an informed consent, knowing what, you know, what therapy and dealing with us as a service entails for them. So yeah, you can't ever really talk too long about consent and about the limits of confidentiality.

And, you know, sometimes it can be useful to say, you know, this applies for all of our sessions together. But sometimes people start the beginning of every session by saying, you know, a little something about confidentiality again. But yeah, we do need to be mindful of the impact that we have over others, you know, and it's my clients seem to have a great deal of impact over what I watch on on Netflix, because they will often tell me what they're watching. And then I think, oh, well, I feel like I don't want to miss out on the party. I feel like I need to get involved with that. And, you know, I might have had a similar impact on you

when I spoke about This Is Us. You know, maybe recently you listened to that and you're like, well, I've never watched This Is Us, but she says that's all right. You know, because you become a bit of an influencer, don't you, when you're chatting about things. So, yeah, we can have shared experiences with our clients, but we also have to know that there are differences. And this is really useful fodder for supervision as well. And, you know, whilst you might have shared characteristics with your client, we have to be careful that we're not over identifying or diminishing our clients experiences because we have some understanding of what they've been through.

But, you know, sometimes our clients will purposefully seek us out, especially in private practice, because they believe that we will know with um with what they're talking about let's take a short break here and i will be back with you on the other side of this um this break hi my name is mark i'm an assistant psychologist in a specialist autism team in liverpool and i've just gotten onto the doctorate in exeter starting this september the aspiring psychologist podcast has been great for me the content and the guests guests are brilliant and I think Marianne does a really good job as a host of being really positive, normalising negative experiences and reminding people to be compassionate towards themselves. For me the podcast is especially useful because I feel like I'm always busy and on the run-up to interviews I could listen to it whilst I was at the gym and it

allowed me to feel as though I was still getting that important time for myself and do things that are important for me whilst still engaging with stuff that is going to help me on my psychology journey without needing to carve out any separate and dedicated time for it. I definitely recommend that anyone wanting to know more about working in psychology give this podcast a listen, as it gives a really clear and honest insight into the things you can expect. Okay, welcome back. So I was talking to a journalist yesterday about eating alone and cooking alone for ourselves, and how that can be an ultimate act of self-care but I also asked her

to make reference to the fact that for many people currently it would feel like a bit of a a decadent thing to do to be perhaps switching an oven on just for ourselves or you know using all the resources of using a gas hob and then having to wash up all of the stuff just for one person and I think unless you've got some awareness of the social context of that unless you've yeah just taken that on board then we need to be make, we need to make sure that some of the suggestions and some of the things we might be discussing with clients, you know, for activity scheduling, for example, or for building structure and routine into life to make it more functional and enjoyable. We do need to make sure that we're not, you know,

socially unaware of what it is like for our service users to be trying to navigate the world at the moment, when they might well be, you know, scared of, you know, factors associated with the pandemic. They might, you know, be struggling financially to heat homes or put food on the table. And so it's really useful to have conversations with people, even when it might look like they couldn't possibly be struggling for money. It's useful to check in with people about, you know, some of the factors from the Maslow's hierarchy, just to check how things are for them financially, how things, you know, you're not asking for bank statements here, but if someone is really struggling to pay their water bill or you know they're worried that they can't you know can't cover the cost of the next food shop that really does impact

on people in in a big and important way and I had a recent conversation with a client where it came came to light that they they weren't really sure how they were going to fill their cupboards next time. And so we used a bit of our time in the session to look at options for, you know, emergency food provision. And that then freed the client up to feel validated to feel seen and it wasn't done in a way at all to be shaming but to just feel like they had other options available to them because if you feel like you can't feed yourself or your children then it's you don't know where your next meal is coming from it's very difficult to think about anything else you know because it can really dominate things so it's important for us to have conversations even though it might be very different to your own experiences currently so I know everybody

is feeling the pinch of increased cost of living. But where people, where clients have got limited resources because the benefits haven't been increased, then, you know, the pressures are going to be that much more, really, than if you're working with a client who is able to put up their wages or put up their rates or, you know, go out there and earn more money just by picking up some more clients, for example. So just having an awareness of the social factors that are around right now can be really useful. And similarly, you know, when I've worked with clients who are in social housing it's very difficult to imagine if you aren't in that context yourself about just what an impact it has upon you if you are living in close proximity to you know a crack den for example which is something that

one of my clients had experienced and the impact that has on you have been able to smell crack all the time and feeling like it's in your home and you know it's affecting your health and so you know sometimes even just having a conversation about your home what it's like how you feel to be there when you're there. Does it feel like a place of sanctuary or are there factors that make it very tricky? So they might not tell you about some of these factors just unless you ask, because there may be a great deal of shame or stigma.

And similarly, I work with someone else who's got, I would do work with them, don't work with them anymore, and their neighbor's dogs were incredibly noisy. And it was, you know, affecting all areas of their well being, really. And it was incredibly difficult, but it wasn't something that I never I necessarily would have thought to ask about had we not been doing a bit of a rundown of, you know, of what it's like to be them, you know, take me through your day from morning to night and, you know, give me a flavour of some of the things that crop up for you in that day. So that can be a really useful exercise, getting to know your

client and getting to know the unique struggles, which they might not necessarily be thinking are contributing to their difficulties, but as we know, they really can. If it's impacting on our sleep, or it's impacting on our ability to nourish or provide for ourselves or our children, then that can be very difficult indeed. And neighbour conflict is a big deal,

because it can really make people feel, you know, vulnerable in their home. So these are important conversations to have. Yeah, I think being brave enough to ask questions, but also just saying, well, how is that for you? What's that like? Or being honest, I don't have any experience of growing up in a situation where, you know, English wasn't my first language, for example. How has that been for you? And I was recently doing a session with someone who spoke three or four languages. And so I asked them, well, how is it when I ask you questions in English and that isn't your first language can you tell me what goes on for you at that time and they were then able to answer you know what that

is like for them and they said that under pressure it does get a bit trickier but generally speaking they are able mostly to think about situations now in English but under pressure we will often revert back to our earliest coping strategies that might be worth knowing that for many of our clients that we might be working with their earliest coping strategies might not almost be, you know, within the British, if you're listening to this in Britain, they might not be socially that common within our British culture. So it's worth thinking with our clients about what makes them unique and about their coping strategies and their way of thinking about the world and what things have been like growing up and how that might be different for them now so many of my

clients in the past have have have then been not with their family you know not in the same birth not in the same country as their birth families and that has its own unique challenges as well. So yeah, just be open and interested and compassionate and wise and don't be afraid to ask how things are for your clients. Don't always assume that you know. You know, we really want to be getting a bespoke feel for your clients as being unique and valuable people and not just being treated as a number. So that's my own personal take on it. But yeah, I hope you found this useful. Henaen, I hope this was what you imagined it might be. But if it hasn't been, let me know and I can give it another go. Okay, thank you so much for listening. Please do take a moment

to rate and review my podcast episodes on the Apple podcast app. Find me the aspiring psychologist podcast, scroll right to the bottom, right underneath the trailer. And that's where you'll find the rate and review section. So thank you so much for listening. If you would like to sign up to the waiting list for the Aspiring Psychologist membership, you can do that by checking out the details in the show notes or on my link tree. Thanks for listening and hope you have a lovely day. Take care. Psychologist. Then let this be your guide. With this podcast at your side, you'll be on your way to being qualified. It's the Aspiring Psychologist podcast.

With Dr. Marianne Trent. My name's Jana and I'm a trainee psychological well-being practitioner. I read the Clinical Psychologist Collective book. I found it really interesting about all the different stories and how people got to become a clinical psychologist. It just amazed me how many different routes there are to get there and there's no perfect way to become one and this kind of filled me with confidence that no I'm not doing it wrong and put less pressure on myself. So if you're feeling a bit uneasy about becoming a clinical psychologist, I'd definitely recommend this just to put yourself at ease and everything will be okay. But trust me, you will not put the book down once you start.