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|An Emerging Model for Providing Psychological Services for Postdoctoral Research Fellows|
The struggle for a postdoc, as for any person on a competitive career path in life, is to find balance between personal and professional life. The stressors of graduate students and postdoctoral researchers are likely common in virtually all research institutions and across disciplines. While the concerns faced by graduate students and postdocs are often quite similar in many areas, this article is directed primarily towards the issues affecting postdocs.
The life of the postdoc is particularly complicated, since the services to support them are less targeted than for any other group in a university environment. Administration, faculty, staff, and students [both undergraduate and graduate] typically have well defined support services available for them, including mental health. However, the postdocs, and especially research fellows with stipends only, are less fortunate. Research fellows with stipend-only status could be described as a professional group without full support services.
Identification of Problems Faced by Postdoctoral Researchers and Fellows
The postdocs affiliated with the Biomedical Research Education and Training [BRET] in the School of Medicine at Vanderbilt University face the same array of problems as their colleagues at other universities. Interviews were conducted with selected administration, faculty, and postdocs as the new psychological services were being initiated for the BRET graduate students and postdocs. In addition to the universal interest in matters such as salary and benefits, the following compilation of issues have been identified as major stressors faced by postdocs in the BRET community at Vanderbilt.
Some of these problems, e.g. pressure to succeed and language barriers, are amplified for international postdocs. Added to these stressors for international research fellows are the issues of cultural sensitivity/adjustment and coping with anxiety regarding visa status.
Vanderbilt University Responds to the Challenge
Realizing the pressures with which postdocs must contend, the Office of Biomedical Research Education and Training [BRET] in the School of Medicine at Vanderbilt University seized an opportunity in the fall 2005 to create a unique service for postdocs. With financial support and endorsement by the Dean of the School of Medicine, along with collaborative efforts of other key persons, a psychologist was hired and the Biomedical Trainee Wellness Program [BTWP] was launched to serve the postdoctoral research fellows and graduate students in the BRET environment. The Biomedical Trainee Wellness Program became the third service in a trio of targeted programs for professionals in Work/Life Connections-EAP, the internal employee assistance program at Vanderbilt. The other two specialty predecessors are the Faculty and Physician Wellness Program [FPWP] and the Nurses Wellness Program [NWP].
While the BTWP was framed similarly as the wellness programs for faculty, physicians and nurses, which have been in operation for a number of years, a unique aspect was having an office located directly within the academic and research environment. This additional office encourages and facilitates easy access to the services to accommodate the busy schedules of both graduate students and postdocs. The office is located so it can be accessed without the postdoc being easily seen by others when entering and leaving the office.
One of the important features of these Work/Life Connections programs is the designation of a "champion" who understands the unique needs and stressors of the target population. The psychologist who coordinates the BTWP has experience as both a clinician and previous university graduate faculty status and is familiar with academic structure and concerns. Another key issue is the importance of knowing the organization and maintaining a neutral and confidential stance in the role as psychologist. As in any client-therapist relationship, information shared with the other parties, including the fact of the postdoc's participation in the BTWP, requires the client's written permission. Even though the chief administrator of BRET, who was a key player in establishing the new services, and the psychologist work closely concerning the general programmatic needs, consultations and referrals are addressed in a manner that upholds confidentiality and privacy.
Although the salaried postdocs and graduate students have access to professional services for health and wellness the rationale for locating the psychological services within BRET was four-fold: (1) to provide supportive psychological services at no cost to the post docs who are supported by training grant stipends; (2) to provide assessment and referral services which are easily and quickly accessible for both graduate students and all postdocs; (3) to have a professional who is easily accessible for consultation and/or intervention in the event of a crisis or emergency; and (4) to be visible to faculty, graduate students, and postdocs to enhance referrals and use of the psychological services. In sum, the psychological services provided for BRET are marked by affordability, accessibility, proximity, immediacy and visibility.
Marketing and Accessing the Services
It is important that professional services be visible in multiple formats and venues so that the postdocs and graduate students are reminded of the resources at the time they need to make use of them. Availability of the psychological services is communicated through a Web page, brochures, participation of the psychologist in orientation activities, regular meetings of the leaders of the postdoc association [PDA], conducting workshops and seminars, and interaction with potential referral resources such as administrators and faculty.
In order to make the services user friendly, postdocs and graduate students may schedule appointments by e-mail, phone, or simply walk-in the psychologist's office if the door is open. The psychologist can be reached when out of office by cell phone.
Profile of Services Provided
Goals. The following generic goals have been established for the promotion and delivery of the special psychological services provided in-house for the postdocs and graduate students in Vanderbilt's Biomedical Research Education and Training: (1) To communicate the nature, availability, location, and scope of services for the BRET population as thoroughly and widely as possible to the intended users of the services; (2) To intervene with graduate students and research fellows to improve relationships with their classmates, lab mates, mentors and supervisors; (3) To reduce the levels of anxiety and depression experienced by BRET community by assisting them in the development of skills in stress, task, and time management; assertiveness training; empowerment; relationship skills; anger management; and strategies for coping with emotions; and (4) To assist graduate students and research fellows in their efforts to seek balance in study, work, and personal lives outside the university.
Interventions. The interventions made into the BRET community can be appropriately fitted into four basic categories: (1) Direct clinical services that include assessment and counseling; (2) referral for medication and/or long-term treatment if needed; (3) consultation; (4) Brown Bag Seminars which focus on skills building; and (5) follow-up.
Desired outcomes. The psychological services are promoted in and provided for the BRET students and postdocs with the intention of accomplishing the following results: (1) Entire BRET population will have awareness of services available for them, where services are located, and how to access them; (2) Decrease in the levels of anxiety, stress, depression, guilt, and anger experienced by postdocs and students; (3) Improved relationships with mentors, supervisors, and other "authority figures"; and (4) Increased performance and productivity in academic endeavors and scientific inquiry.
Measuring success. A number of instruments are being developed to assess the outcomes of the psychological services provided for the BRET population. During the initial start up year, the following evaluation tools are being utilized: (1) Consumer satisfaction with professional relationship at intake; (2) Satisfaction with services at termination of services; and (3) Consumer indication at time of termination what specific interventions were effective.
A longitudinal study is in the planning stage to examine the impact of the academic pressure on the mental health of graduate students in Biomedical Research Education and Training. A comparative analysis will be made of the same students based on data obtained at the time of matriculation and in subsequent years of graduate study. This information will be used to provide additional preventive services as well as improve the delivery of existing services.
A Typical Scenario of an Intervention with a Postdoc
Each postdoc's issues are unique. In addition to the more traditional problems encountered such as stress, depression, relationship issues, and career concerns, conflict with the Principal Investigator (PI), mentor, or preceptor is among the most frequently presented problems. A typical complaint is that the PI, allegedly, is condescending, excessively demanding, rude, hard to please, critical, etc. Often there is transference of negative memories or experiences from former authority figures [parent, employer, teacher, etc.] to the PI. Such transference leads the postdoc to perceive and relate to the PI as if he/she were an authority figure in the postdoc's developmental past. However, the postdoc is unaware of this projection and how it is impacting the working relationship with the PI or supervisor.
In these cases, the BTWP psychologist has formulated an intervention approach that has been effective with this population. After carefully exploring and clarifying the dynamics of the postdoc-PI relationship, the postdoc is exposed to the four major ways of living and relating: aggressively, passively, passive-aggressively, and assertively. The characteristics of each way of relating are examined with the conclusion that only the assertive option is effective. Alberti and Emmons (2001)  define assertiveness thus: "Assertive behavior promotes equality in human relationships, enabling us to act in our own best interests, to stand up for ourselves without undue anxiety, to express feelings honestly and comfortably, to exercise personal rights without denying the rights of others."
The next step is to guide the postdoc in developing an adequate set of assertiveness skills. Personal empowerment is the logical consequence of relating assertively. Personal empowerment is followed by developing a script to be used by the postdoc with the PI in a meeting arranged by the postdoc and PI. The script is simply a message that the postdoc wants to express boldly and respectfully to his/her PI. The idea is to help the postdoc negotiate a win-win collaborative relationship with the PI.
During the first year of the BTWP, this intervention format has resulted in mutually satisfying working relationships between the postdoc and the PI in every situation. Those who are seeking the psychological services indicate in their post-treatment evaluation that they are having a similar level of success in resolving other presenting problems.
The success of the new services is very promising based on the number of graduate students and postdocs who have used the psychological services to date and given evaluative feedback when they terminate their counseling process. We have tracking data for 40 persons who used the psychological services during the initial year. The breakdown of those who sought help is as follows:
We estimate that 10 to 15 persons came to the psychologist's office for an informal one-time visit and left no "paper trail" of any kind.
The Biomedical Trainee Wellness Program will transition from a component of Work/Life Connections-EAP to BRET Psychological Services effective June 1, 2007. The "new" BRET Psychological Services will be a stand alone service housed uniquely within the Biomedical Research Education and Training study/work environment. Evaluative feedback and survey information indicated that the BRET population preferred the new identity and location. Following the June 1, 2007 transition date, Work/Life Connections-EAP will remain a major referral source for postdoctoral research fellows who are bona fide employees of Vanderbilt University.
Smith, D., & Chalkley, R. G. (2006). Biomedical Trainee Wellness Program, School of Medicine, Vanderbilt University, Nashville, TN 37232.
We acknowledge the role that James Kendall, Manager for Work/Life Connections-EAP, assumed in the development of the original Biomedical Trainee Wellness Program and his continued support of the psychological services.
 Alberti, R., & Emmons, M. (2001). Your perfect right: Assertiveness and equality in your life and relationships (8th edition). Atascadero, CA: Impact. p.36.