The 2003 Survey of Academic Medical Center Psychologists: Implications and Outlook

This paper offers commentaries on Pate and Kohout’s (2005) report of data from the 1997 and 2003 surveys of psychologists in medical school settings. The commentaries reflect upon the significance of the survey findings and implications for psychology’s role in medical school and academic health science settings. Though the response rate to the survey was disappointing, the data indicate that psychologists are moving up in academic rank, and have made substantial gains in salary. The data also indicate that among psychologists who are medical staff members, who constitute half the 2003 sample, an increasing proportion are functioning autonomously as reflected in gains in the percentage having admitting privileges, staff voting privileges, and authority to write orders. Research continues to be a major focus for psychologists in academic medical centers. Overall, the findings indicate that psychologists can have productive, satisfying careers in medical school/academic health center settings—though there is one troubling sign, a sizeable drop in the number of positions being created for younger, more recently trained psychologists. Methodological enhancements are described that could improve the quality, scope, and usefulness of data from future studies, both for understanding long-term trends and for conducting salary negotiations. High quality data provide a solid foundation for advocating for psychologists’ full participation in the life of medical schools and academic health centers.     

Fulfilling the Promise of School-Based Mental Health: Moving Toward a <Emphasis Type="Italic">Public Mental Health Promotion</Emphasis> Approach

School-based mental health (SBMH) programs and services are growing progressively in the United States for many reasons. However, the SBMH field is young and tenuously supported, and challenges are being confronted on many levels. There are major needs to continue to bring research-supported interventions into schools, and to better equip educators and mental health programs and staff in schools to function effectively. Articles in this special issue present the many challenges well and point to important directions for advancing SBMH. To truly advance the field a Public Mental Health Promotion approach is needed. Elements of this approach, in advancing training, quality assessment and improvement (including empirically supported practice), and advocacy and policy influence are discussed, as are strategic connections to the Community Science perspective and to the development of a growing Community of Practice in SBMH.     

Assessing adolescents who threaten homicide in schools

Psychoanalytic and psychiatric perspectives on children who threaten to kill others are reviewed in the context of the need for an interdisciplinary approach to the problem. Converging technologies derived from a psychoanalytically informed social systems model are compared to law enforcement approaches, psychoanalytic understanding of the individual dynamics of the child, and empirical research on conduct disordered adolescents. The interdisciplinary orientation of a broadly trained community psychoanalyst allows a unique contribution when trying to distinguish adolescents who make a threat from those who pose a threat. Case vignettes are used to illustrate the hypotheses.     

Relational-oriented character analysis

Referring to the diversity of psychoanalysis of today, a position called relational-oriented character analysis is discussed. It is stated that relation and character as concepts refer to different and partly contradictory points of view in psychoanalysis, the first one emphasising mobile, dynamic aspects of personality, the second underlining stable, structural aspects. The principle aim of the article is to argue how the two perspectives can be theoretically combined in an overriding object-relational (two-person) conception and to discuss some implications for analytic technique. Finally, convergences and differences with other positions or schools in contemporary psychoanalysis are suggested.     

Genetics,Faith, and Responsibility

The Battle of Dover is now concluded; and Charles Darwin's theory of evolution has won the legal day. The Theory of Evolution in the Darwainian and neo-Darwinian form is a very fertile theory; it generates hypotheses and research programs that lead to new knowledge. Even as a secular pursuit of knowledge, Christians appreciate science.

What the Christian community cannot tolerate is second-rate science; and it especially eschews pseudo-science. We ask for a general commitment; support the best science in our schools and laboratories as an expression of our Christian faith. In light of the public controversy regarding alternatives to teaching Darwinian science in our public schools, we offer six recommendations.     

Pediatric Do-Not-Attempt-Resuscitation Orders and Public Schools: A National Assessment of Policies and Laws

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored.     

Survey of School Psychologists' Attitudes,Feelings, and Exposure to Gay and Lesbian Parents and Their Children

Abstract

School psychologists' attitudes and feelings toward gay and lesbian parents were surveyed in relation to their training and exposure, and professional services offered to gay and lesbian parents and their children. The relationship between attitudes, feelings, training, exposure, and demographic characteristics was explored as well. A stratified random sample of 500 school psychologists who were members of NASP was surveyed using a 30-item questionnaire. Out of the 500 surveys sent, 267 school psychologists (53.4%) returned them. Overall, school psychologists have positive attitudes and feelings toward gay and/or lesbian parents. More specifically, school psychologists who were female, homosexual/bisexual, or living in the Western region of the United States had significantly more positive attitudes and feelings toward gay and/or lesbian parents. Although few school psychologists (30%) received any formalized training, those who had some training indicated more positive attitudes. The majority of school psychologists (89.4%) reported having personal associations with homosexual individuals. More exposure to homosexual individuals by a school psychologist indicated more positive attitudes as well as feelings. Implications of the findings and future research directions are discussed.     

How Schools Respond to Traumatic Events

Abstract

School systems face crises of a variety of types and forms, including the suicide death of a student, the death of a teacher, mass shootings, and the aftermath of terrorist attacks. This article examines ways for school systems to deal with the aftermath of those crises, both immediately and in the long term. Suggestions for classroom interventions, group experiences, and homework assignments are included. The impact of terrorism on school personnel is also discussed.     

A Trauma-Informed Call to Action: Culturally Informed,Multi-Disciplinary Theoretical,and Applied Approaches to Prevention and Healing,Part II

The prevalence of trauma and its negative impact on humankind have created a burgeoning awareness of the need for systems that are trauma-informed across the lifespan. A collaborative project with the National Partnership to End Interpersonal Violence (NPEIV) sought out research as a call-to-action to mitigate the impact of trauma. The following is Part II of an introduction to a special double-issue focused on theoretical and applied approaches to using trauma-informed care in multi-disciplinary, mental and physical health, criminal justice, school-based, and community settings. Consideration is given to essential issues such as resilience, self-care, and intersectional cultural awareness. Introspective exploration of biases was encouraged to address barriers to implementing trauma-informed care.