A new role for psychologists--hospital ethics committees

Over the past decade psychology has begun to appreciate that it represents more than "merely mental health care" and has become increasingly involved in the generic health care arena. The participation of psychologists in Hospital Ethics Committees (HECs) is presented as a professional activity for which psychologists are particularly well suited. The clinical mission of HECs, the historical importance of ethical considerations to psychology, and the field's specific training and psycho-social expertise suggest valuable contributions that psychologists can make in this particular area. Further, as psychology actively increases its participation in HECs, other professional disciplines outside of the mental health field will systematically have the opportunity to become more familiar with psychology and its clinical and research expertise.     

Personal Therapy and Self-Care in the Making of Psychologists

Abstract

Psychologists are skilled in assessing, researching, and treating patients’ distress, but frequently experience difficulty in applying these talents to themselves. The authors offer 13 research-supported and theoretically neutral self-care strategies catered to psychologists and those in training: valuing the person of the psychologist, refocusing on the rewards, recognizing the hazards, minding the body, nurturing relationships, setting boundaries, restructuring cognitions, sustaining healthy escapes, maintaining mindfulness, creating a flourishing environment, cultivating spirituality and mission, fostering creativity and growth, and profiting from personal therapy. The latter deserves special emphasis in the making of health care psychologists. These strategies are recommended both during training and throughout the career span. Recommendations are offered for enhancing and publicizing systems of self-care throughout the profession.     

“Part of me feels like there must be something missing”: a phenomenological exploration of practising psychotherapy as a clinical psychologist

The experience of practising psychotherapy as a clinical psychologist was explored through a small number of in-depth interviews. Using Interpretative Phenomenological Analysis, three main themes were identified: “Feeling there’s something missing”, “Being able to get in there emotionally” and “Needing somewhere to go for support”. This study suggests that training for psychotherapy work can be experienced as piecemeal and fragmented, contributing to professional self-doubt, with clinical psychologists seeking more structured, cohesive training in this area. It also suggests that engagement in personal therapy can contribute to greater emotional capacity as a psychotherapy practitioner, although clinical psychologists can fear engaging in something that is unfamiliar. In addition, the psychologists highlighted the felt necessity of safe and satisfying supervision for resilient practice.     

Issues in training clinical health psychologists

The author describes general issues in the training of clinical health psychologists and provides an overview of specific content needed in core health psychology and clinical health psychology assessment and intervention. Special attention is given to training in professional, personal, ethical and legal issues of practice.     

Training and Consultation in Psychological Assessment With Professional Psychologists: Suggestions for Enhancing the Profession and Individual Practices

Once central to the identity and practice of clinical psychology, psychological assessment (PA) is currently more limited in professional practice and generally less emphasized in graduate training programs than in the past. Performance-based personality tests especially are taught and used less, even though scientific evidence of their utility and validity has never been stronger. We review research on training in PA and discuss challenges that contributed to its decreased popularity. We then review continuing education requirements for ethical practice in PA and recommend that PA should be reconceptualized as a specialty best practiced by psychologists who have the resources and time to maintain competency. We offer recommendations about how professional organizations concerned with PA can promote its practice and how individual expert clinicians can assist. We conclude by describing a collaborative model for providing group consultation in PA to practicing psychologists. If implemented widely, this model could help promote PA and raise its standard of practice.     

Better Preparing Sports Psychologists for the Demands of Applied Practice: The Emotional Labor Training Gap

The aim of this article was to investigate the emotional educational–training–practice gap in the professional formation of sport and exercise psychologists in the United Kingdom through the theoretical lens of emotional labor. Twenty semistructured interviews were conducted with 4 participant groups: master’s students (n?=?5), trainees (n?=?5), neophytes (n?=?5), and experienced sport and exercise psychologists (n?=?5). Adopting an interpretive epistemology, an abductive thematic analysis was conducted in relation to the participant groups recruited. Several overarching themes were identified in each participant group: (a) master’s students (emotional labor as theory, practice), (b) trainees (emotional labor to survive, a professional development tool), (c) neophytes (emotional labor as a new professional, self-care), and (d) experienced sport and exercise psychologists (emotional labor as a professional resource, lifelong learning). A synthesized list of applied recommendations to improve the professional formation of sport and exercise psychologists was developed based on the analysis. The themes extend sport and exercise psychology professional development literature, and we make recommendations for educators, professional associations, and regulatory bodies with regard to (a) bridging the emotional labor and experiential gap when transitioning between development phases via collaborative and innovative educational provision, (b) supporting the development of skills relating to the enactment of emotional labor, and (c) considering support mechanisms for student/trainee/neophyte safeguarding and welfare issues as a result of the emotion-laden transactions in professional practice. The implications for future pedagogy, andragogy, and research are discussed.

Lay Summary

Sports psychologists need to manage their emotions when working with athletes and coaches, but this is not often taught during education or training. This study aimed to understand whether sports psychologists were aware of or prepared to manage their emotions and to identify activities that could develop education and training courses.     

Learning Experiences Contributing to Service-Delivery Competence in Applied Psychologists: Lessons for Sport Psychologists

The purpose of the present study was to compare learning experiences perceived to contribute to service-delivery competence in sport, clinical, and counseling psychologists. Twenty psychologists (11 female, 9 male; 28–70 years of age) participated in semistructured interviews. All participants emphasized the role of client interactions in learning service-delivery processes. In addition, clinical and counseling participants reported personal therapy and supervision as influential experiences. Applied implications for training include (a) regional supervision networks comprising peers and elders, (b) university-based sport psychology clinics, and (c) personal and professional development groups.     

The practice of psychology in rural communities: potential ethical dilemmas

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas.     

It's about time we had a professional oath in psychology

Symbols and ceremony are an important element in the formation and continuation of all societies. They enunciate the values of the citizenry or the membership of the society, and often provide the only tangible representation of those values. Furthermore, little has been written about the process of “formation” of identity of professional psychologists. One issue that has received little attention in terms of its symbolic importance as well as its capacity to aid formation concerns the development of an oath for professional psychologists. This paper considers the need for a professional oath for Australian psychologists. The concept of the professional oath is explored, and an examination of the merits of adopting a professional oath is considered. The practical issues of adopting a professional oath will then be briefly examined. The paper concludes by recommending that professional oath taking by psychologists be initiated as a matter of high priority.     

Ethical and Professional Issues for Psychologists and Counselors Employing Biofeedback in Counseling Settings

Biofeedback training is a relatively new procedure that is being incorporated into the counseling services of psychologists and counselors. If the highest professional standards and the appropriate safeguards for clients' welfare are to be maintained, careful attention should be given to the ethical and professional issues involved. The American Psychological Association's (1977) ethical standards for psychologists are the basis of the discussion. It is hoped that the discussion will stimulate further consideration of ethical and professional issues of the clinical application of biofeedback among practitioners.     

California psychologists' religiosity and psychotherapy

Forty-seven randomly selected California clinical psychologists were surveyed to examine the effect religious or spiritual orientation has on the practice of psychotherapy. This included an assessment of ideology, attitudes toward religiosity, affiliation with organized religion, dimensions of religiousness, and use of clinical interventions of a religious nature. The majority of these psychologists were found to address religious and spiritual issues in their personal lives, to respect the function religion serves in peoples' lives, and to address religious and spiritual issues in professional practice. The majority of these psychologists use interventions of a religious nature. Very limited training occurs respective of religious and spiritual concerns; 81% reported that religious or spiritual issues were rarely or never discussed in the course of their graduate education and training.This paper was presented at the annual meeting of the American Psychological Association in Los Angeles in August 1985.     

How special are the specialties? Workplace settings in counseling and clinical psychology in the United States

How special are the specialties? Although clinical and counseling psychology each have distinctive origins, past research suggests their potential convergence across time. In a survey of 5666 clinical and counseling psychologists, the similarities and differences between their workplace settings were examined during early-, mid-, and late-career phases to explore the distinctiveness of the two specialties. Overall, clinical and counseling psychologists reported markedly similar workplace settings. However, some significant differences remained; a greater proportion of counseling psychologists reported working in counseling centers, while a greater proportion of clinical psychologists reported working in medical settings. In addition, during late-career, substantially more counseling and clinical psychologists worked in independent practice contexts than in community mental health centers, medical settings, academia, or university counseling centers. Findings are discussed in relation to the ongoing distinctiveness of the two specialties and the implications of this for training and service in the field of professional psychology.     

The state of the art of training in systemic family therapy in Switzerland

This article presents a training program in systemic therapy with families and couples. Our training institute was founded by an interdisciplinary group of psychologists, psychiatrists, sociologists, and social workers in 1987 in Meilen (Zürich), Switzerland, and has from the beginning been connected to the field of family therapy in Europe and the United States. The specific organization of our institute, our training program, and the theoretical base of the training concept are highlighted. Our multidimensional treatment and training model is grounded in a variety of conceptual frameworks and inspired by the tradition of Enlightenment in European philosophy. We pay special attention to the personal and professional development of the emerging family therapist.     

A survey of psychologists' attitudes towards and utilization of exposure therapy for PTSD

Although research supports the efficacy of exposure therapy for PTSD, some evidence suggests that exposure is under-utilized in general clinical practice. The purpose of this study was to assess licensed psychologists' use of imaginal exposure for PTSD and to investigate perceived barriers to its implementation. A total of 852 psychologists from three states were randomly selected and surveyed. An additional 50 members of a trauma special interest group of a national behavior therapy organization were also surveyed. The main survey results indicate that a large majority of licensed doctoral level psychologists do not report use of exposure therapy to treat patients with PTSD. Although approximately half of the main study sample reported that they were at least somewhat familiar with exposure for PTSD, only a small minority used it to treat PTSD in their clinical practice. Even among psychologists with strong interest and training in behavioral treatment for PTSD, exposure therapy is not completely accepted or widely used. Clinicians also appear to perceive a significant number of barriers to implementing exposure.     

The ethical issue of competence in working with the suicidal patient

In this article, I discuss the ethical need for competence in the assessment and management of the suicidal patient, and further suggest that this specific competence be considered a routine element in professional psychological practice. I also argue that this particular competence necessitates adequate training in working with this high-risk population, as well as the need for every clinician to personally evaluate her or his own technical and personal competencies to work with suicidal patients before beginning independent practice activities in clinical situations wherein he or she may be called on to evaluate or treat a suicidal patient. This article concludes with a discussion of specific ethical dilemmas (e.g., the issue of confidentiality), and a list of suggestions for specific competencies in working with the suicidal patient is provided.     

Thriving,burnout, and coping strategies of early and later career counseling center psychologists in the United States

We interviewed seven early career psychologists (ECPs) and seven later career psychologists (LCPs) employed at university counseling centers in the United States about their experiences with thriving, burnout, and coping. We analyzed the data using Consensual Qualitative Research. Typical factors that contributed to thriving included recognition for achievement and the climate of counseling center and campus, although the latter was more important for ECPs than LCPs. Typical factors that contributed to burnout included challenges with tasks and responsibilities and challenges related to professional relationships. Finally, interpersonal support (general), self-care, cognitive strategies, and behavioral strategies (typical) were coping strategies used by both ECPs and LCPs, but only ECPs identified using personal therapy. Implications for counseling centers and for research are presented.     

Ethical Considerations for Psychologists Taking a Public Stance on Controversial Issues: The Balance Between Personal and Professional Life

Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present article analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present article examines ethical issues that (a) should be taken into account before psychologists take a public position on a controversial issue and (b) are in conflict with APA’s Ethics Code or current research.     

The Ethical issue of Competence in Working With the Suicidal Patient

In this article, I discuss the ethical need for competence in the assessment and management of the suicidal patient, and further suggest that this specific competence be considered a routine element in professional psychological practice. I also argue that this particular competence necessitates adequate training in working with this high-risk population, as well as the need for every clinician to personally evaluate her or his own technical and personal competencies to work with suicidal patients before beginning independent practice activities in clinical situations wherein he or she may be called on to evaluate or treat a suicidal patient. This article concludes with a discussion of specific ethical dilemmas (e.g., the issue of confidentiality), and a list of suggestions for specific competencies in working with the suicidal patient is provided.