Results from a National Survey of Psychologists in Medical School Settings—2003

Preliminary results are presented from a 2003 collaborative survey of psychologists employed in medical schools and academic health centers. The findings are reported along with comparable data from a similar survey conducted in 1997. There were several noteworthy changes in results from 1997 to 2003. Salaries increased substantially at all ranks, though women’s earnings remain lower than men’s. There were increases in the percentage of respondents who completed their doctorates 20 or more years ago, and in the percentages holding higher academic ranks and having tenure. However, there was a decrease in the absolute number and percentage of psychologists at lower ranks who received their doctorates recently. Overall, the findings indicate that psychologists have established a secure home in medical school settings. Future reports will present more detailed analyses of the 2003 dataset as well as additional comparisons with the 1997 survey data.     

National Survey of Psychologists' Test Feedback Training,Supervision, and Practice: A Mixed Methods Study

In this empirical, mixed methods study, we explored test feedback training, supervision, and practice among psychologists, focusing specifically on how feedback is provided to clients and whether feedback skills are taught in graduate programs. Based on a 48.5% return rate, this national survey of clinical, counseling, and school psychologists' suggests psychologists provide test feedback to clients but inconsistently. Most respondents, 91.7%, indicated they give verbal feedback at least some of the time, whereas 35% do so every time. However, 2.8% indicated they never give feedback. A negative correlation exists for clinical psychologists between years since graduation and providing verbal feedback. Of particular interest, approximately one third of respondents indicated predoctoral coursework, practica, and internship were of little-to-no help in preparing them to provide feedback. Also, feedback training in predoctoral coursework, practica, and internship was not correlated to actually providing feedback. There was, however, a significant correlation between postdoctoral training and providing feedback. Consistent with existing ethical exceptions, the most frequent reason for not providing feedback was using assessments in forensic settings. Individuals who indicated their training was not helpful cited “trial and error” and self-instruction as ways in which they learned feedback skills. We discuss implications and suggestions for feedback training, research, and practice.     

Sentence completion tests: a review of the literature and results of a survey of members of the Society for Personality Assessment

Test usage surveys consistently find that sentence completion tests (SCTs) are among the most popular personality assessment instruments used by practitioners. What is not noted is which SCTs practitioners are using, why these tests are so popular, and whether practitioners are using formal scoring. We surveyed a random selection of 100 members of the Society for Personality Assessment. With a 60% return rate on a single mailing, we found that most psychologists who use incomplete sentence tests use the Rotter (1951) Incomplete Sentences Blank with children (18%), adolescents (32%), and adults (47%). Most practitioners said they do not read stems aloud and record answers themselves, and even fewer said they use formal scoring. The most common reasons for using an SCT are (a) to use it as part of an assessment battery (41 endorsements), (b) to determine personality structure (18 endorsements), and (c) to elicit quotable quotes (17 endorsements). Implications for practitioners and training suggestions for academicians who prepare future psychologists are noted.     

The languages we use

Members of the Society for Computers in Psychology responded to a survey concerning their programming practices and language use. The results reveal current hardware and software use; relationships among computer science training, task, and language choice and usage; and areas in which attention to some structured programming principles might improve the code that psychologists write.     

Adolescents,Risk Behaviour and Confidentiality: When Would Australian Psychologists Breach Confidentiality to Disclose Information to Parents?

The protection of confidentiality in psychological practice is vital. However, confidentiality is not absolute and psychologists are permitted to breach confidentiality under particular circumstances. Ethical challenges surrounding confidentiality are complex with adolescent clients, as assessments often consider the risk that adolescents pose to themselves in addition to the risk posed to others. The current study documented situations in which Australian psychologists would breach adolescents' confidentiality to disclose information about risk behaviour to parents, with a focus on situations where adolescents posed a risk to themselves as opposed to other people putting adolescents at risk. A total of 264 Australian psychologists were surveyed online. They were each presented with 68 variations of a vignette about a 15‐year‐old boy who was engaged in risk behaviour and were asked whether they would breach confidentiality in each case. The vignettes covered six behavioural domains (smoking, sexual behaviour, drinking, drug use, suicide, stealing) and varied in behaviour intensity, frequency and duration. Consensus was reached about breaching confidentiality in 16% of cases (related to sexual behaviour, drug use, and suicide). Consensus was reached about not breaching confidentiality in 41% of cases (relating to smoking, sexual behaviour, drug use, suicide, and stealing). In the remaining 43% of cases, significant disagreement occurred (relating to all six behavioural domains). The findings suggest a high degree of variation in opinion about confidentiality with adolescents, emphasising the importance of transparent communication and informed consent. The findings also raise questions about how important consistency of psychological practice is across Australia.     

Psychologists in medical schools in 1997. Research brief

The activities, income, and medical staff membership and limitations on that membership for psychologists working in U.S. medical school settings in 1997 were examined. A total of 1,938 psychologists responded to a survey conducted by the Research Office of the American Psychological Association, in conjunction with the Association of Medical School Psychologists. Some of the most salient findings were that (a) the largest number of psychologists was involved in research activities, (b) just over half of medical school psychologists were required to generate all or part of their own income through clinical work and research, and (c) the majority of these psychologists were members of a medical staff but were not extended full medical staff privileges. These and other results are discussed in the context of academic rank, tenure status, and other relevant factors.     

Family therapy and clinical psychology

The results of a survey of 111 clinical psychologists in the Republic of Ireland along with some comparable data from US and UK surveys were used to address a series of questions about the link between family therapy and clinical psychology. Family therapy was not a clearly identifiable sub-specialty within clinical psychology in Ireland. Family therapy theoretical models were used by more than a quarter of the Irish sample to conceptualize their work but by less than a tenth of US and UK respondents. In all three countries about a tenth of treatment time was devoted to the practice of family therapy. In Ireland, the use of family systems models, family assessment interviews and family therapy was more common within the child and family specialty than within the mental handicap or adult mental health clinical psychology specialties. The experience of live supervision and participation in family or couples therapy were important formative factors in the development of some clinical psychologists. Further training in systemic consultation, particularly in situations where an abuse of power has occurred, was identified in the survey as a priority area for continuing professional development. The evolving relationship between family therapy and clinical psychology is discussed in the light of these findings.     

A survey of psychological test use patterns among forensic psychologists

Clinical psychologists are frequently called on to testify in court regarding mental health issues in civil or criminal cases. One of the legal criteria by which admissibility of testimony is determined includes whether the testimony is based on methods that have gained "general acceptance" in their field. In this study, we sought to evaluate the psychological tests used in forensic assessments by members of the American Psychology-Law Society Division of the American Psychological Association, and by diplomates in the American Board of Forensic Psychology. We present test results from this survey, based on 152 respondents, for forensic evaluations conducted with adults using multiscale inventories, single-scale tests, unstructured personality tests, cognitive and/or intellectual tests, neuropsychological tests, risk assessment and psychopathy instruments, sex offender risk assessment instruments, competency or sanity-related instruments, and instruments used to evaluate malingering. In addition, we provide findings for psychological testing involving child-related forensic issues.     

Ethical Dilemmas of Confidentiality With Adolescent Clients: Case Studies From Psychologists

Navigating limits to confidentiality with adolescent clients can be ethically and professionally challenging. This study follows on from a previous quantitative survey of psychologists about confidentiality dilemmas with adolescents. The current study used qualitative methods to explore such dilemmas in greater depth. Twenty Australian psychologists were interviewed and asked to describe an ethically challenging past case. Cases were then used to facilitate discussion about the decision-making process and outcomes. Interviews were transcribed and analyzed using interpretive content and thematic analysis. Three key findings are discussed. First, it is of little use to perceive confidentiality dilemmas as binary choices (breach/don’t breach) because psychologists described 5 distinct options. These can be conceptualized on a spectrum of varying degrees of client autonomy, ranging from “no disclosure” (highest client autonomy) to “disclosure without the client’s knowledge or consent” (lowest client autonomy). Second, confidentiality dilemmas often involve balancing multiple and conflicting risks regarding both immediate and future harm. Third, a range of strategies are employed by psychologists to minimize potential harms when disclosing information. These are primarily aimed at maintaining the therapeutic relationship and empowering clients. These findings and the case studies described provide a valuable resource for teaching and professional development.     

Genetic Counselors’ Perspectives and Practices Regarding Expanded Carrier Screening after Initial Clinical Availability

Expanded carrier screening (ECS), introduced in 2009, identifies carriers for dozens or hundreds of recessive diseases. At the time of its introduction into clinical use, perspectives of the genetic counseling community regarding ECS were unknown. We conducted a survey in early 2012 of GCs and report the results here. They represent a snapshot of opinions and usage at that time, providing a baseline for comparison as the technology continues to evolve and as usage increases. The survey assessed personal perspectives, opinions on clinical implementation and clinical utilization of ECS. The sample included 337 GCs of varying clinical fields, of whom 150 reported practicing in reproductive settings. Our findings demonstrate that, at the time, GCs indicated general agreement with ECS as a concept – for example, most GCs agreed that carrier screening should address diseases outside of current guidelines and also indicated personal interest in electing ECS. There were also disagreements or concerns expressed regarding appropriate pre- and post-test counseling (e.g., the content and delivery mode of adequate informed consent) and practical implementation (e.g., the amount of time available for follow-up care). This was the first quantitative study of a large number of GCs and it revealed initial overall support for ECS among the GC profession. The authors plan to re-administer a similar survey, which may reveal changes in opinions and/or utilization over time. A follow up survey would also allow further exploration of questions uncovered by these data.     

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.     

Variables Associated With Adolescent Alcohol Use: A Multiethnic Comparison

Abstract

The authors examined the influence of sociodemographic variables on the frequency and intensity of alcohol use among a nationally representative sample of Black, Hispanic, and White adolescents who had participated in the 1991 National Household Survey on Drug Abuse (U.S. Department of Health and Human Services, 1993). The sample consisted of 8,756 U.S. adolescents aged 12 to 18 years. The authors found that (a) approximately 19% of the respondents had used alcohol in the last 30 days; (b) among the respondents who had used alcohol, 21% had consumed 1 or more drinks per drinking episode; and (c) there were important similarities as well as important differences in variables that promoted alcohol use among Black, Hispanic, and White adolescents.     

Ethical Concerns of Nonclinical Forensic Witnesses and Consultants

Current research suggests that nonclinical forensic psychologists[sup1] are appearing increasingly more often in the legal arena. We argue that many of the ethical dilemmas that face these psychologists differ from those encountered by clinical forensic psychologists. To test the accuracy of this assertion, 37 nonclinical forensic psychologists were surveyed to identify some of the ethical issues and dilemmas they have encountered while engaging in expert testimony or pretrial consulting. Respondents were asked also about how they have resolved these ethical issues and whether they were aware of the "Specialty Guidelines for Forensic Psychologists" (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Results of the survey are discussed in terms of the need for additional regulatory guidelines or professional standards that speak directly to the ethical issues confronting nonclinical, forensic expert witnesses and consultants.     

A Study of the Ethical Dilemmas Experienced by School Psychologists in Portugal

This study examines the ethical dilemmas and difficulties encountered by Portuguese school psychologists. As part of a larger survey, participants were asked about ethical issues faced in daily practice and asked to describe ethical incidents. Of the 477 respondents, 274 reported 441 ethically troubling or challenging situations. Responses were coded into a six-category system based on the code of ethics of Portuguese psychologists. Most of the reported dilemmas concerned privacy and confidentiality principles (53%). Results are discussed in light of relevant literature and international findings. Implications for the development of the profession and future research are provided.     

Adding the Voices of Jewish Girls to Developmental Theory

Abstract

Feminist psychologists do not often include Jewish representation when they discuss issues of difference and diversity. Jewish female adolescents have not been included in the current research on teen-age girls and voice. The author finds that Jewish female adolescents do experience themselves as different from the majority culture. This difference is associated with respondents emerging from early adolescence while maintaining relational competence.     

Is the Role of the School Psychologist in Early Childhood Truly Expanding? A National Survey Examining School Psychologists' Practices and Training Experiences

Historically, the role of school psychologists in early childhood settings has been limited to the identification and evaluation of children who may be in need of special education services under Part B of the Individuals with Disabilities Education Act. It has been suggested that the role should reflect a more proactive model; specifically, it should continue to expand to include involvement in school readiness and early intervention for all students. The purpose of this study was to examine the present role of school psychologists in early childhood settings and investigate the graduate-level training provided to school psychology graduate students. Results of the survey found that a significant percentage of school psychologist practitioners continue to spend a substantial portion of their professional time completing special education evaluations. Furthermore, respondents reported minimal to moderate graduate training in the area of early childhood populations. Implications for school psychology practitioners and school psychology graduate training programs are discussed.     

Psychological assessment on internship: a survey of training directors and their expectations for students

We used a survey of internship training directors to examine the nature of assessment use and assessment skills training at 382 internship settings in professional psychology across the United States and Canada. For the purposes of this study, we created a questionnaire that inquired about the types of assessment instruments used at each internship setting, the amount and type of training offered at internship sites, and the type of assessment experience desired of interns before beginning their rotations. The results revealed several differences across type of internship facility surveyed as well as several trends in the current use of assessment in applied settings. The findings further demonstrate the important role of projective assessment in the training of graduate students and lead to the conclusion that major discrepancies may exist between what is being taught in graduate school and what students are expected to know on entering their internship positions.     

Test use and assessment practices of school psychologists in the United States: Findings from the 2017 National Survey

Although several studies have examined the specific instruments and procedures used by school psychologists when conducting comprehensive psychoeducational evaluations, the last one was published over 20 years ago (viz., Wilson & Reschly, 1996). Given the substantial theoretical and practical advances in assessment since then, the purpose of the current study was to examine the test use and assessment practices of contemporary school psychologists in the United States. Data from the 2017 National Survey of Assessment Practices in School Psychology revealed that test use and assessment practices have evolved significantly. Much of this change consists of the substitution of tests and practices with limited reliability and validity with those with greater psychometric support. Results of this study also indicate that school psychologists regularly conduct multi-method assessments to prevent, identify, monitor, and remediate child and adolescent learning difficulties and other presenting problems in the schools.     

Survey on present and potential instructional use of computers in psychology

A survey of academic psychologists was taken to determine present use of computers in instruction, willingness to use good education software, and kinds of potential uses of computers in psychology courses. A majority of the respondents reported using computers in instruction. Respondents indicated substantial willingness to adopt computer-based courseware. Respondents believed that a variety of uses, including classroom demonstrations and student experiments, would facilitate student learning. The results of the survey are compared with the instructional modules the task force is developing.     

Exercise Stage of Change and Self-Efficacy in Primary Care: Implications for Intervention

Multiple chronic diseases are caused or complicated by a sedentary lifestyle. Thus, an important and challenging application of psychology in clinical settings is changing the behavior of sedentary primary care patients. This study focused on exercise stage of change and self-efficacy in a sample of adult family practice patients recruited while waiting for their scheduled physician appointment. Regarding exercise stage of change, 15% of respondents were in the Precontemplation stage, 26% in the Contemplation stage, 50% in the Preparation stage, 7% in the Action stage, and 13% in the Maintenance stage. Mean self-efficacy scores for exercise were significantly higher among respondents in the Action and Maintenance stages of change. These cross-sectional data are consistent with the hypothesis that movement through the exercise stages of change could be encouraged by clinical interventions that increase exercise self-efficacy. The identification of multiple personal opportunities for increasing exercise self-efficacy may be clinically useful in this context. Recommendations for psychologists in primary care settings in their work with physicians are offered.