Showing papers in "Professional Psychology: Research and Practice in 2012"

Mobile, Social, and Wearable Computing and the Evolution of Psychological Practice.

Abstract: Psychological assessment and intervention are extending from the clinic into daily life. Multiple forces are at play: Advances in mobile technology, constrained clinical care, and consumer demand for contextualized, nonstigmatizing, and low-cost alternatives are beginning to change the face of psychological assessment and interventions. Mobile, social, and wearable technologies are now enabling individuals to measure themselves and to integrate myriad forms of help and entertainment. The massive data sets generated by self-tracking of mood and passive sensing of voice, activity, and physiology may eventually reorganize taxonomies of mental health concerns. Compelling mobile therapies will also emerge, involving contextually appropriate, entertaining, and dynamic feedback to provide help in the context of daily life. The efficacy of such applications will be tested through citizen science as well as clinical trials. This article reviews technical advances that can be applied to enhance assessment and intervention and dramatically increase access to psychotherapy. It is recommended that, in addition to exploring clinically oriented products, practitioners should support patients’ use of direct-to-consumer applications in ways that align with therapeutic objectives.

Dissemination and Implementation of Evidence Based Treatments for Youth: Challenges and Recommendations

Abstract: How can we best facilitate the application of child/adolescent evidence-based treatments (EBTs) in community clinic settings? Many factors have been cited as potential barriers to successful implementation. For example, children treated in community settings tend to have higher comorbidity and greater ecological risks than children treated in university settings. At the provider level, attitudes about EBTs may influence whether or how a therapist chooses to implement the treatment. At the system level, financing constraints on dissemination tools, like training or availability of materials, may be obstacles. We review these factors using the Mental Health System Ecological (MHSE) model and offer recommendations for professional psychologists interested in overcoming these barriers. Our focus for this article is on the child, therapist, and system levels of the MHSE model.

A Qualitative Investigation of Practicing Psychologists' Attitudes Toward Research-Informed Practice: Implications for Dissemination Strategies.

Abstract: This article presents the results of a qualitative analysis of interviews with 25 psychologists in independent practice, investigating everyday treatment decisions and attitudes about treatment outcome research and empirically supported treatments (ESTs). Clinicians noted positive aspects about treatment outcome research, such as being interested in what works. However, they had misgivings about the application of controlled research findings to their practices, were skeptical about using manualized protocols, and expressed concern that nonpsychologists would use EST lists to dictate practice. Clinicians reported practicing in an eclectic framework, and many reported including cognitive-behavioral elements in their practice. To improve their practice, they reported valuing clinical experience, peer networks, practitioner-oriented books, and continuing education when it was not too basic. Time and financial barriers concerned nearly all participants. Clinicians suggested they might be interested in ESTs if they could integrate them into their current frameworks, and if resources for learning ESTs were improved.

Co-Occurring Presenting Problems in African American College Clients Reporting Racial Discrimination Distress

Abstract: Ethnic minority students’ perceptions of racism may be associated with a host of secondary emotional, interpersonal, and academic difficulties that can nevertheless be the chief reason these students seek treatment at a counseling center. This study examined archival data from the Presenting Problems Checklist completed by 1555 African American clients seen at the counseling centers of 7 predominantly White Midwestern universities. Findings of ordinal correlations (Kendall’s tau-b) suggested that, for both men and women, perceived racial discrimination was associated with a broad range of co-occurring presenting problems, including academic (e.g., performance anxiety, adjustment to university), interpersonal (dating concerns), psychological/emotional (perfectionism, depression, suicide risk), and existential concerns (confusion in beliefs/values, spiritual/religious concerns). Separate analyses conducted for men and women suggested some sex differences; for example, irritability/anger had the strongest correlation with perceived discrimination for men, whereas for women the strongest correlation was for procrastination. Awareness of the full range of likely sequelae of racial discrimination could improve psychologists’ assessment and intervention efforts and lead to a better understanding of how perceived racism affects students’ functioning in multiple areas.

Challenges and Opportunities in Internet-Mediated Telemental Health

Abstract: The use of technology to provide remote psychological assessment and intervention services is growing rapidly. Remote assessment, treatment, training, and consultation options, particularly those provided via the Internet (e.g., videoconferencing, self-help Web sites, handheld devices), have the potential to increase access to high-quality psychological services. Despite the promise of these technologies, a variety of clinical, ethical, and logistical challenges accompany the remote delivery of such services. Among these challenges are issues involving security, competence, the therapeutic alliance, usability, and technical difficulties. We elucidate some of the challenges posed by these technologies and suggest preliminary recommendations for psychologists considering their use.

Reflections and directions: The profession of sport psychology past, present, and future.

Abstract: The authors review the historical context of sport psychology to explore the present state of sportpsychology and make suggestions for the future of the field. The origins of sport psychology are rootedin efforts to improve athletic performance. However, the label “sport psychology” has been used todescribe two different service delivery models: performance enhancement and therapy with athletes.Presently, advancements have been made in terms of organizational structure, but there has been littleimpact on the applied profession. In order to advance the profession, protect the public, and resolveconfusion, sport psychology is examined. The authors identify performance excellence as the uniqueaspect of sport psychology and propose the field be identified as “performance psychology.” In order topractice performance psychology competently, four areas of training are identified: (a) performanceexcellence, (b) mental health counseling, (c) consulting psychology, and (d) performance specialtydomain(s). Finally, the authors recommend that a licensure specific to performance psychology bedeveloped.Keywords: sport psychology, performance psychology, profession, practice

Social media in the future of professional psychology.

Abstract: In the past several years, the practice and profession of psychology have been greatly influenced by digital culture and social media. The prevalence of psychologists using websites and technology to engage, socialize, market, and interact has created new opportunities and challenges for the practitioner, particularly in regard to potential therapeutic and extratherapeutic interactions with clients on the web. Given the speed with which these media are permeating our world, we can expect to see a proliferation of new issues, challenges, and opportunities for clinical practice and the delivery of services. This article provides an overview of the relevant issues, ongoing trends, and what the future holds for psychology, psychologists, and the populations we serve. How current technological and policy shifts may influence clinical practice, clinical training, and our responsibilities as providers of clinical care will be addressed. Social networking sites are becoming a standard means of living and interacting. Two thirds (66%) of American adults use social media sites such as Facebook, Twitter, LinkedIn, and MySpace (Smith, 2011). Many of these sites are being accessed by mental health professionals who are using them to connect socially with peers, network with other professionals, and provide education to consumers of psychological services. This article provides an overview of the pertinent issues, continuing trends, and the future outlook for psychology, psychologists, and the people we serve. It will address how shifts in current and future technology and policy may affect clinical care, clinical training, and our responsibilities as clinicians. Applicable ethical issues as well as potential dilem- mas for practitioners will be defined. The primary activities that occur on social networking sites include the exchange of messages, news items, events, photos, videos, and the quick sharing of additional information through "liking," "sharing," "retweeting," and "1," actions. However, the development of new technologies is increasing at a pace that makes it difficult for clinicians to fully understand the ethical implications of their activities on these sites. As a consequence, this creates challenges for clinical training programs to provide adequate supervision and training on how to manage the develop- ment of trainees' professional identities with their online presence. This can prove even more onerous when one's online presence began primarily as a social one, early in life, as is the case for many "digital natives," (Prensky, 2001) who were born during or after the introduction of digital technology and are entering psy- chology programs today. At the same time, digital natives are being taught and supervised by "digital immigrants," (individuals born before the existence of digital technology who have adopted it later in life) who do not always fully perceive the nuances of digital culture. This wave of plugged in consumers and clinicians who are fluent in online culture and social networks will influence our cultural understandings of digital interactions and the delivery of services in ways that we are only beginning to comprehend and in some other ways that are difficult to predict. At the same time, technological advances are creating exciting

Predicting Work-Family Conflict and Life Satisfaction Among Professional Psychologists

Abstract: Balancing work and family lives is a challenge faced by many psychologists. The present study examined an integrated model of resources, work–family conflict, family, work, and life satisfaction among professional psychologists. To test this model, a sample of 368 doctoral psychologists who worked at least 20 hours a week and who were married and/or had children were selected from respondents to a national survey on professional and family life. Support was found for three-stage mediational models through which the resources of control and family support exerted cross domain effects and influenced overall life satisfaction. Control at work reduced work to family conflict which increased family satisfaction while family support reduced family to work conflict and increased work satisfaction. Both work and family satisfaction then increased life satisfaction. These models were significant for both men and women. There was, however, evidence that family support was more important in reducing family to work conflict for women.

Exploring Cultural Competence in Acceptance and Commitment Therapy Outcomes

Abstract: Professional psychologists have an ethical obligation to engage in culturally competent service delivery within their research and practice. Although the American Psychological Association has published guidelines for multicultural competence within these areas, researchers continue to rely on conve

Implementing Clinically Feasible Psychophysiological Measures in Evidence-Based Assessments of Adolescent Social Anxiety

Abstract: How clinicians should assess adolescent patients distressed by physiological experiences of social anxiety is often unclear. Clinicians might hypothesize that this component of social anxiety will resolve with treatment of other components (e.g., negative thoughts or behavioral avoidance) and thus focus assessments on these other components. However, research has indicated that expressions of the different components of social anxiety often do not operate in synchrony. Evidence-based assessment and treatment of social anxiety in adolescence is critical because of its potential impact on psychosocial functioning; if left untreated, social anxiety places an adolescent at greater risk for developing substance use problems in adulthood. Practitioners rarely assess adolescents’ physiological experiences, but when they do, they tend to rely on subjective measures (e.g., paper and pencil) rather than on a multimethod approach including objective psychophysiological measures. It is possible that practitioners infrequently utilize objective psychophysiological assessments because they assume that subjective measures comprehensively assess this physiological component of social anxiety. Additionally, practitioners may believe that the use of objective psychophysiological methods is cost-prohibitive. Yet, recent technological innovations have resulted in low-cost, portable instruments to objectively assess psychophysiology in research and practice. In this review, we discuss objective psychophysiological measures of social anxiety in adolescents and provide recommendations for their use in research and practice. We argue that neither subjective nor objective measures alone yield a comprehensive understanding of psychophysiology. Rather, joint use of these measures may greatly improve both the assessment and treatment of adolescent social anxiety.

The integration of Complementary and Alternative Medicine (CAM) into the practice of psychology: A vision for the future.

Abstract: Complementary and Alternative Medicine (CAM) has a long history of use with some modalities being in existence for thousands of years. In recent years there has been a greater awareness of the many benefits of CAM for promoting health and wellness as well as for ameliorating a wide range of conditions and ailments treated by psychologists and other health professionals. One vision of the future of the practice of psychology includes each psychologist developing and maintaining competence in CAM and integrating it into each client’s care as is relevant and appropriate. Support is provided for the belief that CAM will play an important role in the practice of psychology for years to come. Relevant issues emphasized include an emphasis on Evidence Based Practice in Psychology, the needs and preferences of a rapidly diversifying society, and the increasing focus on health promotion, wellness, spirituality, and many non-Western traditions that are consistent with this approach. This article provides an overview of each of the 14 most widely used forms of CAM, discusses limitations in the current body of scientific evidence in support of CAM and makes recommendations for how psychologists should be integral in addressing them, highlights ethical issues that each psychologist will want to be cognizant of and address when integrating CAM into their practices, and makes recommendations for education, training, and practice.

A Resilience-Based Lens of Sex Work: Implications for Professional Psychologists

Abstract: An analysis of recent empirical and theoretical literature in psychology investigating sex work highlights the field’s focus of pathology and stigma. We offer an alternative understanding of sex work by using a resilience-based lens and apply it to three areas of research with sex work. Specifically, we critique research investigating sex work-related phenomena in psychology and related fields that focus on pathology, stigma, and psychological sequelae using a resilience-based perspective about sex work language, location and practice environment, involvement with drugs and alcohol, and trauma. Implications for future practice and scholarship in professional psychology are also discussed, to help psychologists consider strength-based and empowerment-focused approaches for work with this population.

Application of a Competency Model to Clinical Neuropsychology

Abstract: Professional competencies in psychology have received significant attention as education and training standards have been increasingly framed in the context of behavioral, knowledge-based, and attitudinal learning outcomes. We first review the development of the specialty of clinical neuropsychology and describe the establishment of educational and training guidelines in the specialty, including their most recent update (Hannay et al., 1998). Competency initiatives in professional psychology over the last decade are then summarized. Specialties in professional psychology have delineated education and training guidelines and are beginning to incorporate competency-based approaches to describe advanced and specialized abilities that build on generic, core, foundational and functional psychology knowledge, skills, and attitudes. Following the model of France et al., (2008), we apply the Assessment of Competency Benchmarks framework to describe specific competencies required for specialty practice in clinical neuropsychology.

Identifying perceived personal barriers to public policy advocacy within psychology.

Abstract: Public policy advocacy within the profession of psychology appears to be limited and in its infancy. Various hypothesized barriers to advocacy within the field are analyzed in this study. Findings indicate that those who advocate do so regardless of whether the issue is specific to the profession of psychology or specific to another field. Furthermore, several components, including disinterest, uncertainty, and unawareness, were identified as barriers to advocacy. However, all barriers were subsumed by a lack of awareness of public policy issues. By identifying barriers to advocacy in psychology, programs promoting advocacy could be fine-tuned to address the lack of knowledge, which inhibits students, professionals, and clinicians from engaging in the essential role of public policy advocacy.

Nonpharmacological Interventions for Preschool ADHD: State of the Evidence and Implications for Practice

Abstract: What exactly is the psychologist to do to increase the probability that intervention can alter the multiple impairments and often poor long-term outcomes associated with preschool-onset attention-deficit/ hyperactivity disorder (ADHD)? Intervening to support a preschool child with ADHD is complex given the child’s developmental stage and the need to coordinate services across multiple people and settings. Identifying what interventions have been empirically evaluated and the extent to which these interventions affect ADHD-related behaviors and impairments is a critical first-step to providing quality care for these children. Recent guidelines set forth by the American Academy of Pediatrics (2011, ADHD: Clinical practice guidelines for the diagnosis, evaluation and treatment of attention/deficit-hyperactivity disorder in children and adolescents. Pediatrics, 128, 1007–1022. doi:10.1542/peds.2011-2654) recommend that medication only be used when behavioral interventions are not available or when significant room for improvement exists following effective implementation of behavioral interventions. As such, we review herein nonpharmacological interventions for preschool ADHD, identifying approaches in the published literature focused on training parents, teachers, and children, as well as dietary restrictions, nutritional supplements, and acupuncture interventions. This review suggests that behaviorally based approaches focused on parent and teacher training are the most well-studied and effective interventions. Child-training approaches, dietary interventions, nutritional supplements, and acupuncture require substantially more evaluation before clinical implications can be fully appreciated. We conclude by discussing key principles gleaned from this literature for psychological practice for the treatment of preschool children with ADHD.

The Patient-Centered Medical Home: Unprecedented Workforce Growth Potential for Professional Psychology

Abstract: Changes in the health care system and a renewed focus on patient-centered medical homes, which integrate behavioral health services into primary care, present professional psychologists with unprecedented workforce and growth opportunities. However, the profession must act immediately to take full advantage of these emerging opportunities. Although many conceptualize integrated primary care as including mental health services in primary care, in practice, the role of the primary care behavioral professional extends far beyond mental health concerns. The authors suggest two key domains of action: First, in order to serve optimally as behavioral health professionals and leaders in primary care, psychologists must receive training in clinical health psychology. Second, psychologists need to increase knowledge and skills in the conduct of translational research in “real-world” clinical settings. The discussion centers on delineating the imperatives the profession must address and offers general suggestions for possible approaches, which ideally will form the basis for specific models of professional preparation. What is abundantly clear is that, as the face of health care changes, professional psychology must respond swiftly and appropriately not only to remain viable, but to thrive.

Integrated Health Care and Professional Psychology: Is the Setting Right for You?

Abstract: Over the last decade, integrated care models have increased in both public and private sectors. This trend is especially apparent in primary care settings. Integrated care is designed to offer comprehensive and coordinated health services while addressing the economic realities and failures of the current health care system. Proposed integrated care models such as Accountable Care Organizations and Patient Centered Medical Homes include marked changes in health care delivery, financing, and reimbursement, which are designed to create a more cost-effective health system. This article provides an overview of integrated care to help practicing psychologists develop a better understanding of interprofessional health care and evaluate their interest in and readiness to provide professional services in health care. The advantages and challenges associated with integrated care will be provided.