Informal Collaborative Engagement Supports Professional Preparedness in Clinical Child Psychologists: A Qualitative Study

Measures and Procedures

This qualitative study was conducted using the Database of Individual Patient Experiences (DIPEx) method developed by the Health Experiences Research Group at Oxford University. This research design has been applied in studies examining the experiences of individuals with various illnesses and disabilities. ²³ In the present study, the interviews with clinical child psychologists focused on mental health issues of children were conducted. This study followed the guidelines of the Standard for Reporting Qualitative Research (SRQR) to present the methodology and findings. This approach ensures the transparency, rigour, and clarity of qualitative research. ²⁴ The method involves the rigorous analysis of narrative interviews from individuals with specific conditions, selected to represent a broad range of experiences. ²⁵ The methodology was adapted to the context Czech Republic. ²⁶

Ethics

The research adhered to ethical guidelines following the Oxford University’s DIPEx methodology and was approved by the Ethics Commission of the Sts Cyril and Methodius Faculty of Theology in Olomouc (2022/8). The team received ethical training and supervision. Participants provided informed consent, were aware of their right to withdraw, and approved anonymised transcripts. All data were stored in compliance with GDPR and personal data regulations. All the participants signed the written consent.

Design

Between November 2022 and April 2023, interviews with ten clinical child psychologists were conducted. The study analysed their preparedness and expertise in carrying out interventions with children and youth experiencing mental health problems.

Participants

The study involved ten clinical child psychologists working with children aged up to eighteen years old from various regions of the Czech Republic; see Table 1. Participants were selected through purposive sampling, ensuring a diverse range of clinical child psychologists.

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Table 1.

Sociodemographic Factors.

Pseudonym	Gender	Age	Length of practice (in years)	Specialisation
Michael	m	59	20	CAN, relationship violence, bullying, domestic violence, crisis
Anna	f	34	3	depression, eating disorders, borderline disorder
David	m	37	10	the full spectrum of mental health diagnoses
Samuel	m	30	5	the full spectrum of mental health diagnoses
Peter	m	43	5	trauma, ADHD, anxiety, conflict, parenting difficulties
Sofie	f	23	1	the full spectrum of mental health diagnoses
Lea	f	N/A	1	the full spectrum of mental health diagnoses
Thomas	m	29	2	the full spectrum of mental health diagnoses
Vanessa	f	30	1	anxiety, self-harm, depression
Tobias	m	36	1	the full spectrum of mental health diagnoses

Inclusion Criteria

Inclusion criteria included: to be clinical child psychologists who provide care for children under eighteen years old with mental health issues, work as a clinical child psychologists for at least one year.

Exclusion Criteria

Participants were excluded: if they worked in a profession other than clinical child psychologist, had less than one year of practice, or primarily worked with individuals older than eighteen years or declined to provide informed consent.

Data Collection Procedures

Nine interviews were conducted online, and one interview took place by telephone. The interviews lasted from 26 min to 52 min (average 40 min) and followed a set scenario, which included two parts – a narrative part and a semi-structured part. The researcher began the interviews by asking the same open question: “Please tell me about your experiences working with children (or families of children) facing mental health challenges,” which focused on listening to the story that participants shared in their own words. The second part consisted of semi-structured questions, which gathered information about these topics:

Data Analysis

Reflexive thematic analysis was used for the data analysis process. Transcripts were tagged with thematic codes and subcodes (names of main topics and subtopics), such as “professional preparedness,” “professional competence,” and “mental health disorder of children,” among others. NVivo software was used to facilitate the analysis process by organising and managing the data, and the follow-up analysis was performed manually by the researchers. In this phase, the researchers systematically sorted the text from the transcripts, assigning codes and subcodes. They also explored new partial subcodes, enriching the existing subcode tree. Following this, the “One Sheet of Paper” (OSOP) ²⁵ technique was employed. Researchers read and coded the transcripts, labelled participant interviews for identification, identified thematic clusters and connections, and organised the statements into a mind map to illustrate their interrelationships.

Findings

Through analysis and careful examination of the data, the following key themes emerged where viewpoints were identified: school preparedness, lifelong learning, professional competences and forming professional identity, and supervision and collaboration.

Professional Competences and Forming a Professional Identity

Participants emphasised the importance of personal development, whether achieved through experiential training, professional experiences, or personal life events.

Thomas stated:

I definitely don’t have enough experience to say, ‘I'm done, I don’t need anything else.’ And I think no one can really say that, you know, in the world because, yeah, I believe I could develop anything; it’s just that the work is never completely routine. . .

This participant’s statement highlights that professional development is a continuous process, with individuals recognising that constant growth is essential. The idea that work is never entirely predictable or monotonous reinforces the belief that continuous learning and improvement are necessary components of professional development.

Moreover, some participants mentioned specific turning points that propelled their professional growth, while others described a gradual increase in their competencies:

Sometimes, there are cases that occur directly in our work that open up new horizons for us. We discover interesting facts gradually, you know; it’s not like some groundbreaking discovery or anything, but there are definitely small shifts and improvements. – Anna.

This participant’s observation underscores the incremental nature of professional development, where small shifts and improvements contribute to overall advancement. The acknowledgment of gradual discovery and improvement further emphasises the dynamic and evolving nature of professional competencies.

In summary, participants expressed the importance of ongoing personal development in their professional journeys. They recognised the necessity of continuous learning, irrespective of one’s level of experience.

School Preparedness and Lifelong Learning

While some participants appreciated the practical training provided during their university studies, many professionals felt that their education fell short of adequately preparing them for the demands of child psychology work.

Certain participants positively highlighted their university education, pointing out that they had gained applied knowledge and skills through practical training during their later years of study. These experiences allowed them to engage in diagnostic work, couples counselling, and therapy sessions, helping them to discover their interests and preferred target groups.

The first three years were more focused on theory, and then the next two years were really hands-on with a lot of practical experience. I got to try out diagnostics, like working with couples or being present in marriage counselling. Of course, I also had opportunities in therapy settings, maybe to figure out what suits me better, which target group resonates with me more. – Anna.

However, the majority of professionals expressed reservations about the sufficiency of their higher education. They felt that their studies lacked practical subjects relevant to their professional practice and included unnecessary topics. Some participants mentioned the need for more practical experiences and emphasised the importance of meaningful interactions and real-world scenarios during their studies.

One participant shared his perception that university education alone was insufficient to fully prepare them for their future practice. He stressed the importance of gaining practical experience and real-life exposure, as he believed that true professional preparedness comes from first-hand encounters and learning on the job.

Tobias emphasised the urgency of strengthening education in psychiatry, mental health, psychology, and related fields, particularly concerning children. He expressed that his university education did not adequately prepare him for the challenges he encountered in his work and highlighted the value of real-life experiences in building practical skills and knowledge.

Sure, university didn’t prepare me for that. Even though we had psychiatry, we visited a children’s psychiatric clinic only once during the entire six years, so it was very marginal. . . I feel like everyday life prepared me more, you know. – Tobias.

The participants reported the importance of recognising the dynamic nature of their roles and the necessity for ongoing self-improvement. All research participants actively pursued diverse forms of continuing education, such as courses, internships, seminars, and psychotherapeutic training courses, to enhance their professional skills. These educational opportunities were widely acknowledged as being highly beneficial for their overall professional growth.

In summary, the participants recognised the limitations of their university studies in preparing them for working with clients with mental disorder. The need for further professional education to enhance their competence and meeting the demands of their profession. Overall, the research findings highlighted the importance of diverse continuing education opportunities for practitioners’ professional growth.

Supervision and Collaboration

The development of professional expertise in child psychology extends beyond formal education and training, being profoundly influenced by collaboration with peers and multidisciplinary teams. This highlights the transformative impact of peer support, the contributions of multidisciplinary teamwork, and the integration of formal and informal methods in advancing professional growth.

Participants reported that their university education was insufficient for their future work with children. According to the findings, graduates from various universities did not feel adequately prepared to work with children experiencing mental disorders. They emphasised the need for more practical training in their curriculum, including hands-on experience through internships or placements, courses focusing on child development and mental health disorders, and opportunities to engage in real-world diagnostic and therapeutic practices. Additionally, participants highlighted the value of incorporating interdisciplinary collaboration exercises and more exposure to case studies to better prepare for the complexities of professional practice.

Participants reported that the process of enhancing professional competencies and preparedness was effectively facilitated through communication channels and the support of fellow professionals. Formal mechanisms, including specialised supervision, methodological consultations, and case-study seminars, played a pivotal role in this regard. These structured platforms provided individuals with opportunities to seek guidance, exchange insights, and delve into complex scenarios.

Participants reported that informal practices, such as peer intervision, collegial consultations, and knowledge sharing, were equally valued as complements to formal avenues. These informal interactions fostered an environment of mutual support and engagement. In situations where uncertainties arose or intricate cases were encountered, professionals united their efforts to provide assistance and collectively sought solutions. In the workplace, a sense of cohesion was cultivated through collaborative sessions, where professionals gathered to exchange ideas and explore alternative approaches.

In the moment when one of us, let’s say, is unsure or encounters a more difficult or challenging case, or let’s say, diagnostically something that is not entirely clear or simple, we always try to support each other, help each other, put our heads together to find some kind of answer that we are seeking at that moment. So, in our workplace, we actually try to do that; so we have these sorts of consultations, or supportive, like mutual sitting-together sessions, you could say. – Samuel.

The benefits of working within a multidisciplinary team of a child psychiatrist, physicians, social workers, and teachers were particularly emphasised:

The multidisciplinary team works really well here, because when we, from different professions, are not entirely familiar with a certain topic, we can study it on our own to some extent, but it will never be as comprehensive as the knowledge possessed by the experts. . . – Anna.

Such teams provided a rich platform for cross-pollination of expertise and knowledge. Child psychologists highlighted the importance of consulting with experts from other disciplines. Transformative supervision allowed professionals from diverse fields to recognise the limitations of individual study when facing unfamiliar topics and appreciate the unique insights of experts in each domain. This multidisciplinary approach enabled the team to achieve a comprehensive understanding, receive valuable guidance, and effectively address complex situations. Through embracing supervision and collaboration, participants recognised the collective wisdom present within their professional networks. Through these collaborative endeavours, professionals fortified their skills, refined their approaches, and remained adaptable in the face of evolving challenges.

In summary, the experiences shared by professionals underscored the transformative impact of supervision and collaboration in professional development. The fusion of formal supervision structures and informal discussions with colleagues supported the growth, mutual assistance, and knowledge exchange. By harnessing these synergistic elements, professionals fortified their capabilities, navigated intricate scenarios, and delivered enhanced outcomes within their respective domains.

Strengths and Limitations

This study provides valuable insights into the professional preparedness of clinical child psychologists working with children and adolescents with mental health challenges. Qualitative methods enabled a rich understanding of their experiences and identity development.

However, limitations include a small sample size, which may cause limited data saturation, partly due to the potential high workload of other participant. Recruitment bias is also possible, as those with particularly strong experiences may have been more likely to participate.

The considerable time elapsed since graduation may have contributed to recall bias among some participants. Moreover, the wide range of participants’ professional experience – from one to over twenty years – may reflect significant differences in their training and practice. Future studies would benefit from broader sampling, increased data saturation, and prospective designs.