Exploring Barriers to Accessing Mental Health Services Among Therapists-in-Training: A Thematic Analysis

Abstract

Therapist well-being is widely regarded as a crucial aspect of effective therapy. Decades of research highlight the negative impacts of unmanaged distress on therapists' treatment outcomes, which has led to a focus on the ethical importance of managing challenges through self-care. However, a gap remains between the recognized importance of accessing mental health care and the actual use of these services, particularly among therapists-in-training. This presents a critical concern for both trainee well-being and client care. The purpose of this qualitative study was to explore the barriers that prevent therapists-in-training in Canada from accessing mental health services. Guided by a constructivist framework, six master's-level counselling and psychotherapy students participated in semi-structured interviews, which were analyzed using thematic analysis (Braun & Clarke, 2021). Seven overarching themes and twenty-three subthemes emerged: (1) Internal Resistance to Help-Seeking, (2) Structural and Systemic Barriers, (3) Dual Relationships and Being Caught Between Roles, (4) The Demands of Training as a Barrier, (5) Internalized Stigma and Incongruence with the Idealized Therapist Identity, (6) Fear of Professional Consequences, and (7) Broken Trust in Therapeutic Systems. Together, these themes reveal that barriers to help-seeking reflect individual, relational, and systemic factors. This study addresses a gap in the literature by providing insights into the unique obstacles faced by therapists-in-training. The findings contribute to the development of interventions aimed at improving access to mental health services for professionals, enhancing their long-term well-being. This, in turn, benefits clients, as well-supported therapists are better equipped to provide ethical and effective care - the profession's primary goal.