¶ Overcoming Test Anxiety in Therapists
Hello and welcome to our Licensure Exams podcast In today's episode . This is why passing your licensure exam might be hard for you . I'm your co-host , stacey Frost , and I'm joined , as always , by my other co-host , dr Linton Hutchinson . How are you doing today , linton ?
I'm M-OK today . Stacey , Thanks for asking . I'm looking forward to diving into today's topic and maybe providing some insights and advice for therapists who have been struggling with their licensure exams .
Absolutely . Obtaining your therapy license is a major milestone and a gateway to beginning your professional career , but for many people , the licensure exam represents a daunting , anxiety-provoking hurdle , and today we want to explore some of the reasons why individuals might have a hard time passing these high-stakes tests .
Okay , Stacey . As you know , there's a number of factors that make licensure exams really challenging , from gaps of your basic knowledge to poor test-taking strategies . But one of the most pervasive issues that hold people back is test anxiety .
Even though most students are prepared to take the exam and they're knowledgeable , they can be derailed by nerves and stress when that exam day happens .
And test anxiety is super common and I think some test takers underestimate how much it might be impacting their performance . So I think it's important that we talk about what test anxiety is , the different ways that it can manifest , and then we'll provide some concrete coping techniques . What do you say , Linton ?
Okay , let's do it . Test anxiety is a form of . You might think about it as performance anxiety . Stacey , do you get performance anxiety ?
Well , I did . But then there was wine Wednesday and just after practice and practice and practice . I'm a little less impacted by performance .
Basically , when you're in a situation where performance really counts , such as an exam , your body and minds can react with intense fear and worry . The anxieties cause the symptoms like a racing heart , sweating , shaking , nausea and , most important , difficulty concentrating and bringing back information .
Exactly , and these symptoms are , as you can imagine , part of the body's fight or flight or freeze response , which is triggered by the perception of a threat . And the problem is that , while this response can be useful in actual dangerous situations like you know , running from a mountain lion it's not helpful during an exam .
And the heightened arousal can interfere with your ability to think clearly and , as Linton said , recall information .
Those physical stress responses can really throw you off your game when you're trying to focus on a complex exam and it really becomes a vicious cycle the more anxious you feel , the more your mind goes blank , which then amplifies the anxiety , and on and on it continues precisely test .
anxiety has cognitive , behavioral and emotional components that interact as that negative feedback loop . Worries and negative self-talk interfere with your ability to think clearly .
The desire to escape the uncomfortable situation really makes it tempting to rush through the test , or even the freeze up , and the guilt , embarrassment and frustration over struggling with anxiety compounds all your emotional distress .
So we have this multifaceted problem of test anxiety that's very likely plaguing a significant portion of therapists who are seeking licensure . So , linton , why do some people experience this more intensely than others ?
There's a couple of factors . Genetic predisposition is one . If you had a family history of anxiety , you may be more prone to experiencing it yourself , so past experiences also play a role . If you had a negative experience with tests in the past , you might develop a conditioned response to them . You might develop a conditioned response to them .
I think that most therapists can be particularly vulnerable to test anxiety , for a few key reasons . First , the mental health professional tends to be highly self-aware and reflective in nature .
While this is an asset in your clinical work , it can mean that you are more prone to rumination and getting stuck in cognitive distortions related to your performance and your abilities .
That makes a lot of sense . As exam day approaches , I've heard several test takers say that they find themselves constantly questioning whether they're really cut out for this field and whether they know enough to be an effective therapist . It's like their inner critic is in hyperdrive .
You know , I think most of us can relate to that experience . It's sort of like the imposter syndrome is rampant among high achieving professionals such as therapists . But for therapists there is an additional pressure at play . We work in a field where licensure and documentation of qualifications carry really heavy weight .
There's an understandable fear that if you can't pass the exam , all of those years of education and training are down the drain .
Right , and all that pressure and the fear of failure can really be paralyzing , especially since , as much as we might intellectually know that a test score is not the ultimate measure of clinical competence , there's still so much riding on it in terms of your career and livelihood , and failing can mean delaying job prospects , additional financial burdens you know those
exam fees can really start to add up .
Absolutely . The high stakes nature of licensure exams is a major contributor to test anxiety , as is the often grueling study process leading up to taking the test . Aspiring therapists are usually juggling work responsibility , family obligation and an intensive study schedule .
And an intensive study schedule , Sleep deprivation , inadequate self-care and lack of social support can exacerbate all the stress levels that you might be feeling , and let's not forget the one that some people I know have .
Some people Linton .
Perfectionism . Many therapists are driven individuals with high standards for themselves and others . While this can be a strength , it can also contribute to anxiety right .
Yes , that is very true , very true . Now all of these factors converge to create this perfect storm of anxiety come exam day . Even the most competent , well-prepared individuals can find themselves overwhelmed by panic . So the question becomes how do we help people overcome test anxiety and show up as their best selves when it matters the most ?
There are a number of proven strategies that can make a real difference , and a good place to start is by first normalizing test anxiety and reframing it as a common , surmountable challenge . So often people feel really alone in their struggle , like there's something wrong with them if they can't simply push through the nerves .
If you stop and think and reframe the test like this , you've already started taking the test right now . You are in the exam at this particular moment . You're here listening to the podcast and that's part of the exam process , so you are already taking that exam
¶ Managing Test Anxiety Through Techniques
. So another effective strategy is to practice relaxation techniques . Deep breathing , progressive muscle relaxation and grounding exercises can help calm your body and mind .
At the same time , the techniques can be practiced regularly and actually during the exam to help manage anxiety in the moment and one of my favorite grounding techniques is the five , four , three , two , one exercise what's that ?
it's it's where you look around the room and you name five things that you can see . You close your eyes and identify four things that you can hear . Name three things you can feel , like the ground beneath your feet , your clothes , et cetera . Two things you can smell that one's a little tricky . And one thing you can taste .
So like maybe if you're really anxious , there's probably some weird like for me , like sometimes it gets like a metallic taste . Yeah , so yeah anyway , I really like that one . I think it's it helps me focus when I'm I'm thinking about things in a really structured way like that Five things , you can see , four things you can hear , three things .
You can feel , two things you can smell , one that you can taste . So , Linton , do you have any favorite relaxation techniques ?
breath awareness meditation in the weeks leading up to the test , starting with just a few minutes a day and building up your tolerance . You can use the anxious energy as a reminder to check in with your breath . Am I breathing ? Almost like an alarm bell , like cuing you to come back to your center .
Ah , that's a good one . So you're basically conditioning a relaxation response to the anxiety triggers ? So it really becomes an adaptive coping mechanism . Oh Linton , you behaviorist , you . Next thing you know you'll be training people to fetch your BOGO sushi from Publix as a reward for every deep breath they take .
That's good . Let's see if it works . Stacey Okay , just imagine the aisles of Publix filled with relaxful , mindful shoppers , all taking deep breaths and loading up their carts with sushi . Maybe we should start a new trend Zen shopping .
There you go , folks . A trademark is born . Another key strategy is to plan and prepare for your exam . Another key strategy is to plan and prepare for your exam . Now , this sounds pretty obvious , but when you know what to expect and you've made a solid plan to prepare for what lies ahead , that can take the edge off of your anxiety .
This means not just knowing the material , but also familiarizing yourself with the test format and practicing under timed conditions .
Simulating the exam environment can really help to reduce anxiety on actual testing . Okay , and one thing that therapists forget is to apply the techniques that they use with their client . Cognitive restructuring can be really helpful . As you know , it involves challenging and changing negative thoughts throughout and about the exam .
For example , instead of thinking I have to pass the exam or my career is over , you can reframe it as passing this exam is important , but it doesn't define my worth as a person or as a professional . It's all about catching those sneaky little thoughts like gosh , I'm going to fail or I'm not good enough , and reframing them to a more balanced , realistic way .
So instead it becomes something like I prepared to the best of my ability and I trust myself to do my best .
Exactly . It's a simple tool , but it does take practice , and I encourage students to jot down their worry thoughts in the lead up to the exam and actively practice countering them with affirmations , mantras like I am capable , I can handle discomfort . My worth is not defined by this test . Over time , it starts to reprogram the anxious inner monologue .
You know , the one that I use and the one that I really like and I've used it over the years is I am , I am able , I will , I am , I am able , I will . And you visualize yourself holding that piece of paper in front of you that indicates you've passed the exam . So another key strategy I emphasize is self-care in the lead up to the exam .
Prioritizing sleep , nutrition , exercise and social connection creates a strong foundation of resilience . Some people actually , the day before they'll go have a massage .
People actually the day before they'll go have a massage .
Well , if we had a bathtub , I would take a bath .
Yeah , that's mine . I'm also really a big believer in the power of a good night's sleep . When you are sleep deprived , it leads to all kinds of difficulty thinking , making decisions . So good night's sleep and a nourishing meal before a stressful event .
Sort of sushi .
Yes , sushi , lots of sushi . It's really tempting to pull all-nighters cramming and you're fueled by caffeine and comfort food . I do love those Michigan cherry barbecue potato chips .
And don't forget the pig's feet .
Oh man , no , that'd give me a stomachache , which is not what I want to have happen right before the exam . But you know , when you're tempted and you start doing the all-nighter routine , it's really a recipe for burnout and brain fog . Trust me , I've been there and I'd venture to say that you have too .
Definitely 100% . So the research is clear that sleep deprivation impairs cognitive functions , especially memory retention and quick thinking under pressure . Same goes for dehydration and nutritional deficits . If you don't already follow a healthy self-care routine , I advise you to start shifting to doing it now .
At least a week out before you take the exam , stay well rested , well fed and well watered .
Oh yes , Just like my plants . So it really is the basics that make such a difference . I also think there's something to be said for building in time for fun and relaxation amidst the intense study . So engaging in hobbies , connecting with loved ones , getting out in nature these things replenish the reserves and improve stress tolerance .
So when I'm feeling overwhelmed and stressed to the max , I grab a glass of fizzy lemonade and I join my chickens out in the backyard . Or , if you're Lenten , you put on some sunscreen and take a stroll along the beach and keep an eye out for sand sculptures and sea turtles .
Oh yeah , and that's exactly what I did this morning , and we found all kinds of sand dollars . I couldn't believe it . They were just all strewn all over the place .
I love sand dollars . Oh , and on the Gulf Coast too , you have a better chance of finding them . Yeah , there are .
They were all over the place . I'll send you some . It's all about striking the balance between diligent preparation and restorative downtime . The exam study process is a marathon , not a sprint , and you're already taking the exam . The fact that you're listening to this podcast indicates that you are ready and you're part of the exam process .
You still need to pace yourself and attend to your whole self along the way .
Very well said . Another strategy I want to touch on is the power of the mock exam . So I'm a big proponent of simulating test conditions as closely as possible in the weeks leading up to the real thing . Same location , same timing , same format , the whole nine yards .
Mock exams are tremendously valuable for reducing test anxiety . They give you a chance to confront your fears in a low-stake environment and build up gradual exposure . Plus , you get real-time feedback on your knowledge gaps , pacing and timing , so that you don't run out of time towards the end of the examination .
Exactly . I find students almost always do better than they expect on the mock exams , which is such a confidence booster and those that don't . It's really an opportunity to double down on content areas and test-taking strategies , with plenty of runway to course correct .
It's also a great way to fine-tune your self-regulation techniques in a realistic context . You can note when your anxiety starts to spike and experiment with different grounding exercises , finding the right way of hydrating and ways of sustaining your energy , and then , by exam day , you're already road tested and your coping toolkit is with you .
So the mock exam is really like a dress rehearsal or a big performance . You want to arrive on test day feeling like you've done this a hundred times before . Familiarity breeds confidence and calm under pressure .
I couldn't agree more Stacey . So to recap , therapists can overcome test anxiety by normalizing it , reframing negative thoughts , practicing mindfulness , prioritizing self-care and simulating exam and exam conditions . But I want to add one more strategy to the mix leveraging social support .
Oh yes , Social support is crucial . I think there's a tendency , especially among high achievers , to isolate when we're feeling stressed or we're feeling ashamed of our struggles .
Absolutely . I encourage test takers to form study groups whenever they can to talk about test anxiety , share coping skills , celebrate each other's progress and work through the problems that you're having about anxiety and about the test itself .
So having a sense of there are people around you and someone that will help with accountability can be incredibly motivating and help you get through this particular exam .
And I think it's important to communicate with people who you care about . You know about what you need during the exam preparation process . That is , if you choose to tell others that you're taking the exam . So some people choose to keep that more private , and that's fine too .
But if you do want to involve other people , let your friends and family know how they can best support you , whether it's by quizzing you with flashcards , cooking you nourishing meals or just lending an empathetic ear when you need to vent .
Right and don't hesitate to seek out professional support as well . If test anxiety is severely impacting your functioning . You need Test anxiety is severely impacting your functioning , you need to work with a therapist who specializes in techniques of performance anxiety .
It can be transformative , and there is no shame in getting help from a mental health professional . In fact , I think it sets a really great example for you as a therapist to prioritize your own well-being and practice what you preach about seeking support .
Agreed and , at the end of the day , conquering your test anxiety is about developing a toolkit of strategies and supports that works specifically for you . It's , like I said , a very highly individualized process and there's no one-size-fits all kind of solutions .
But with persistence , self-compassion and a willingness to ask for help , it's absolutely possible to overcome the common barrier of anxiety to licensure .
Well said , Lyd . So I want to leave our test takers with a final word of encouragement If you're struggling with test anxiety , know that you're not alone . The final word of encouragement If you're struggling with chest anxiety , know that you're not alone . Your worth as a therapist and as a human being is not defined by your exam performance .
Trust in your resilience and lean on your supports . You've made it this far and you are on the home stretch . You've got this .
And don't forget the exam is just one checkpoint of a lifelong journey of learning and growth . The real test is how you show up for your clients with empathy , wisdom and humility , day in and day out . Really , that's what truly matters .
Well , amen to that . Thank you all for listening . If you found this episode helpful , please share it with a friend or a colleague who might be struggling with chest anxiety .
And remember you are capable of extraordinary things , believing in yourself and trust the process Until next time celebrate the small victories and keep pushing toward your dreams .
Remember it's in there .