Geographic distribution of U.S. psychologists: A human ecological analysis.

Characteristics of cities and states were correlated with measures of the geographic distribution of US psychologists. Correlations for psychologists providing mental health services were compared with correlations for psychiatrists, clinical social workers, and school guidance personnel. Population size was the strongest correlate of the absolute number of psychologists in various states and cities. When number relative to population was considered, psychologists were concentrated in affluent urban states and in university towns. The same pattern was obtained for all the groups providing mental health services. No evidence was obtained that any of these groups are distributed in a way offering special advantages for serving groups such as poor, Black, or rural people, who appear to need better access to mental health services. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of law and regulation on professional practice and use of mental health services: An empirical analysis.

This is a case study under natural conditions of the effects that laws and regulations have had on professional practice and mental health service use in Hawaii from 1981 to 1989. Three major plans (Civilian Health and Medical Program of the Uniformed Services [CHAMPUS], Hawaii Medical Services Association [HMSA], and Medicaid) had the same fiscal intermediary and were served by the same pool of providers. Under conditions of direct access, psychologists provided more outpatient services than did psychiatrists. Under physician referral, the opposite was true. Trends over time are noted. To overturn certain restrictive Medicaid regulations, corrective legislation was introduced and enacted. Follow-up demonstrated that, when both psychologists and psychiatrists could certify mental impairment but the certifier could no longer be the therapist, service volume dropped—and so did public expenditure by $4.8 million (on removal of this conflict of interest, despite more than doubling the number of practitioners who could certify). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research with the deaf: Implications for language and cognition.

Deaf people who are deprived of linguistic experience during the formative years seem to provide a unique opportunity to psychologists concerned with the language-cognition relationship. Empirical studies of deaf people's performance on nonverbal cognitive tasks were reviewed. Deaf were found to perform similarly to hearing persons on tasks where verbal knowledge could have been assumed a priori to benefit the hearing. Such evidence appears to weaken a theoretical position which attributes to language a direct, general, or decisive influence on intellective development. The poorer performance of the deaf on some tasks is parsimoniously attributed to either lack of general experience which is no longer manifest by adulthood or to specific task conditions which favor linguistic habits. (2 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Access to justice for deaf Inuit in Nunavut: The role of "Inuit sign language."

Presents a personal perspective on the issue of access to justice (in the context of the Canadian Charter of Rights and Freedoms) for the deaf Inuit population of Canada's newest Territory—Nunavut. The author's experience in assessing a deaf Inuit in Baker Lake R v. Suwarak (1999) who apparently had no known language, followed an earlier Nova Scotia case R v. Roy (1994) which involved a deaf man who could not hear, speak or use sign language. In the case of Suwarak, the possibility was raised that an indigenous form of sign language, tentatively termed "Inuit Sign Language" was being used. The results of a preliminary study of the status of signed languages in Nunavut based on field visits and interactions with deaf people and their families in 3 communities is described. The possibility that "Inuit Sign Language" exists is discussed within the framework of various theories of language development and also within the context of earlier literature which indicates that many Aboriginal communities had (and possibly still have) flourishing signed languages. Finally, the need for increased research by psychologists on the complex linguistic environment of deaf persons in Nunavut is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mobility for industrial-organizational and consulting psychologists.

This article addresses an important aspect of professional mobility: the need for industrial-organizational (I/O) and other psychologists who provide consultation to businesses and who are licensed in one jurisdiction to be able to practice for a short term in another. A growing number of these psychologists have national practices. Current laws and regulations, typically designed for clinicians providing direct mental health services, make such practice difficult. The article provides an analysis of state laws and regulations dealing with short-term cross-state practice and describes the challenges confronted by I/O and consulting psychologists in working across jurisdictional lines. Recommendations for rectifying this issue are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The homeless assessment program: A service-training model for providing disability evaluations for homeless, mentally ill individuals.

Many of the nation's homeless people suffer from unrecognized mental illnesses and do not have access to the kind of disability benefits they would be entitled to when properly assessed. The current system of disability evaluations for Social Security income claims is frequently inadequate and leaves these individuals without any source of income, health insurance, and mental health treatment. This article introduces a model of providing psychological assessments for homeless, mentally ill individuals by supervised student examiners, a model that could be replicated by other psychologists and training institutions. The authors argue that there may be a large number of homeless adults who suffer from disabling mental conditions but who are not properly diagnosed and, therefore, do not qualify for benefits. The authors propose that the model presented can help to fill a gap in services and may serve as a model of socially relevant clinical training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues and Implications of Deaf Culture in Therapy.

In the United States, it is estimated that between 200,000 and 500,000 individuals are culturally Deaf. Deaf culture provides unique challenges that can impact standard therapeutic techniques. Issues regarding the ability of hearing therapists to effectively work with Deaf clients are addressed, and a number of guidelines are offered to assist hearing therapists in bridging language barriers and cultural gaps with Deaf clients. Additionally, concerns about the selection and inclusion of sign language interpreters are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis in training pediatric psychologists.

Examines the shortage in the US of personnel who are trained in child mental health care that results in underservice to children, youth, and families. Doctoral programs offering specialty training are in short supply, as are pediatric psychology training programs. In addition, many clinical psychology programs are ill-equipped to offer curriculae for the development of skills and knowledge bases required by child psychologists. It is concluded that a training conference is needed to communicate the issues involved in this mental health provider crisis if children are to have access to psychological services. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists' roles and opportunities in rehabilitation and recovery for serious mental illness: A survey of Council of University Directors of Clinical Psychology (CUDCP) clinical psychology training and doctoral education.

The emergence of psychiatric rehabilitation and the recovery movement generate new and expanded roles for psychologists in services for people with serious mental illness (SMI). However, the proportion of psychologists working in SMI services today is substantially less than previous decades. This article reviews the roles of psychologists in various mental health systems and outlines the contributions that psychologists can make in implementing evidence based approaches for people with SMI. A survey of American Psychology Association (APA)-accredited Council of University Directors of Clinical Psychology (CUDCP) Clinical Psychology doctoral programs was conducted. The results of the survey indicate an increase, since the early 1990s, in clinical faculty with SMI interests, and suggest that many graduate programs provide opportunities for SMI-relevant research and practicum training. However, the survey also indicates a lack of coursework on topics relevant to SMI and a lack of coursework relevant to assuming administrative and leadership roles in the mental health system. Despite training opportunities in graduate school, production of new PhDs who choose the SMI field is unlikely to meet the demand. According to the present study, the limiting factor is not availability of training, but student career choice. The opportunities and challenges that psychologists face in SMI recovery-oriented service delivery are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public policy and the provision of psychological services to older adults.

Public policy shapes who delivers health care, how care is delivered, and how much providers are paid. The impact of public policy will become even more important to psychologists who serve older adults as 76 million members of the so called “baby boom” generation enter their later years. Armed with basic public policy facts, psychologists can better maneuver the systems created by public policy and even change policy. This article reviews how Medicare works since it is the primary payer of mental health services for older adults. The article then turns to the question of how many health care professionals (including psychologists) will be required to meet the needs of a rapidly growing older population and concurrent challenges of training and building that work force. Finally, different policy visions for a better mental health care system for older adults are summarized since they may be roadmaps to what the future of mental health care will look like. The article closes with practical recommendations on how psychologists can influence mental health and aging public policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The structure of English.

Reviews the book, The structure of English by C. C. Fries (1952). A grammar based on a consistent and meaningful analysis of language into significant component parts has long been a felt need both for linguists as well as for psychologists. The present work attempts to provide an empirical grammatical system free of the logical flaws that permeate contemporary grammar. The use of this book for a psychologist lies in investigations concerned with predicting the verbal behavior of the same people in different situations and of different people in the same situations. In this work lies at least the beginning of a solution to the problem of defining a unit in content analysis; it, furthermore, provides psychologists with a better means of comparing the functional relationships between different parts of speech in mental patients, since the parts of speech are more soundly defined than they have been in previous studies. Finally, in studies of learning, the knowledge of functional units of speech as defined by Fries can be used to study the laws of acquisition and extinction of verbal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental disorders and access to medical care in the United States

OBJECTIVE: The authors examined the barriers to receipt of medical services among people reporting mental disorders in a representative sample of U.S. adults. METHOD: The sample was drawn from adults who responded to the 1994 National Health Interview Survey (N=77,183). The authors studied the association between report of a mental disorder and 1) access to health insurance and a primary provider, and 2) actual receipt of medical care. Multivariate techniques were used to model problems with access as a function of mental disorders, controlling for demographic, insurance, and health variables. RESULTS: While people who reported mental disorders showed no difference from those without mental disorders in likelihood of being uninsured or of having a primary care provider, they were twice as likely to report having been denied insurance because of a preexisting condition or having stayed in their job for fear of losing their health benefits. Among respondents with insurance, those who reported mental illness were no less likely to have a primary care provider but were about two times more likely to report having delayed seeking needed medical care because of cost or having been unable to obtain needed medical care. CONCLUSIONS: People who reported mental disorders experienced significant barriers to receipt of medical care. Efforts to measure and improve access to health care for this population may need to go beyond simply providing insurance benefits or access to general medical providers.     

Mental Health Services for Native Americans in the 21st Century United States.

As the population of American Indians and Alaska Natives continues to expand in the 21st century United States, an increasing number of professional psychologists will be called upon to provide culturally appropriate mental health services for Native American people and their communities. This article provides a general overview of contemporary tribal America before describing the legal, political, and institutional contexts for mental health service delivery administered through the federally sponsored Indian Health Service. Recommendations for mental health professionals who desire to avoid a subtle but profound Western cultural proselytization in their therapeutic service to Native clients and their communities are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internship accessibility issues for deaf and hard-of-hearing applications: No cause for complacency.

What are the experiences of Deaf and hard-of-hearing students in applying for predoctoral internships in professional psychology? Are internship programs aware of accessibility issues in regard to these applicants? Federal laws, accreditation guidelines of the American Psychological Association, and rules of the Association of Psychology Postdoctoral and Internship Centers require that internship training programs provide access for interns with disabilities. Compliance with these requirements is still evolving, however. Several recent examples of violations are outlined, and specific laws and ethical issues involved are discussed. Internship training centers must have information on their obligations regarding the provision of accessible services to Deaf and hard-of-hearing trainees, the adverse impact on applicants of certain interview questions and comments, and ways to provide equal access to training for qualified Deaf and hard-of-hearing students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responses of deaf adolescents to differences in counselor method of communication and disability status.

This study tested the effects of disability status (deaf or hearing) and communication method (sign language, interpreter, or written) on deaf subjects' ratings of counselor social influence, counselor empathy, and willingness to see the counselor. Deaf adolescent subjects (53 female and 53 male) rated one of six videotapes portraying a deaf or hearing counselor using sign language, an intepreter, or written communication in counseling a deaf client on a topic of high relevance. The results indicated that counselors were rated higher on social influence, counselor effectiveness, and empathy if they used sign language rather than written communication. No significant differences were found for counselor or disability status. The subjects indicated a greater willingness to see a hearing counselor who used a sign language or an interpreter rather than written communication, although these results were not replicated for a deaf counselor. We discuss the implications for the use of sign language with deaf adolescent clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of alcohol misuse and work behavior among professionals: Identification and intervention.

Examined the prevalence and effects of alcohol misuse and mental health problems on work behavior among 507 members (mean age 44.3 yrs) of the American Psychological Association (APA) who completed the Needs Assessment Survey (P. E. Nathan et al [1983]). Results indicate that at least one-third of the Ss knew of colleagues who misused alcohol on the basis of fairly overt signs of impairment. Only a select few of the Ss (n?=?61) confronted colleagues about their alcohol misuse; those confronters tended to be older men who saw clients with alcohol problems. In contrast, more Ss confronted colleagues about their mental health problems (n?=?182) and had better treatment outcomes. Considering the ambivalence of psychologists to confront colleague alcohol misuse in the presence of job-related detriment, use of the employee assistance program model of confrontation on demonstrable evidence of job decline seems appropriate. The roles of professional self-help organizations such as Psychologists Helping Psychologists in facilitating recovery of alcohol misusing psychologists and of APA in assisting psychologists in distress are discussed. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When hearing clients work with a deaf therapist.

Not being able to hear can present significant challenges for the therapist and for the deaf therapist/hearing client dyad. It can also create opportunities. Although the literature indicates that most culturally Deaf therapists work with Deaf clients due to their mutual use of American Sign Language, I describe (a) the background of an audiologically deaf therapist who relies on speech reading rather than sign language, and (b) this therapist's clinical work with hearing clients. Some of the relational dynamics of these treatments are identified, and I conclude by noting how attention to communication can benefit the work of all psychotherapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public attitudes about psychologists and mental health care: Research to guide the American Psychological Association public education campaign.

Focus groups and a random telephone survey were conducted to examine the public's attitudes toward mental health providers. The research showed that the public has very little understanding of the qualifications and credentials of psychologists and cannot tell one mental health provider from another. Respondents believed that their emotional health affects their physical health but were typically not willing to pay more for mental health insurance coverage. An information gap was also evident: A majority of respondents agreed that psychological health is important, but almost half said they wish they had more information about how and when to access psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mixed Professional Corporations.

In this article, the author argues that it is past time for psychology to regard itself simply as a mental health profession and to recognize itself as the health profession it is. It is as broad as the state acts that license, certify, or register its practice. It is as broad as direct recognition/freedom of choice state laws delineate. It is noted that many psychologists in practice have established cordial referral and other working relationships with family practitioners, pediatricians, internists, psychiatrists, and other medical specialists. Generally, these interdisciplinary relations are informal and based on mutual regard. Occasionally, the basis is joint membership in a business, as distinct from a professional corporation. Over 20 states have laws that proscribe organized group practice. However, if private sector health care delivery is to be comprehensive, effective, and viable, a medium must be found to enable health practitioners of different disciplines to engage in professional corporate practice as colleagues. A new California law helps set the stage and may prove to be a useful model. With this law, California becomes the third state in which psychologists can engage in multidisciplinary corporate practice with physicians. By enabling the formation of multidisciplinary professional corporations wherein psychologists and physicians may practice as colleagues, these laws open a new avenue for the delivery of this broadened range of professional services to the public and further establish, in statute, a collaborative basis for practice among psychologists and physicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)