In a seminal 1973 paper, Robert Clark described the very different “cultures” of the first and second year students in a four year clinical psychology PhD programme. The author applies Clark’s template to his own experiences as trainee or trainer in five different counsellor education programmes, one in the US and four in Australia. Each of the programmes, to varying degrees, demonstrates key features of the pattern identified by Clark, where the first year is “therapeutic” and other-oriented, the second is “professional” and self-focused. The author concludes that all the surveyed programmes exhibited some level of “second year crisis”, in which a significant number of students felt abandoned, dissatisfied, or rebellious. The author extends and refines Clark’s developmental analogy (first year = childhood; second year = adolescence) to reflect recent neurological research, in particular, the shift from a right hemisphere-dominant first year of life, prioritising affiliative needs, to a left hemisphere-dominant second year, prioritising autonomy and control. This shift is paralleled later by a more gradual move from a protective, supportive childhood to necessary, but sometimes conflictual, individuation in adolescence. The first two years of a counsellor training programme broadly echo this process, a process exacerbated by the second year internship/placement, in which students must “leave home” and adjust to unfamiliar, potentially less nurturing, authority figures. Finally, the author suggests introducing more rigorous “academic holding” into the first year, and greater attention to “therapeutic holding” of dissident students in the second, hopefully decreasing student dropout, and achieving a better balanced training experience.
Still want to be a doctor? Medical student dropout in the era of COVID-19
