Rehabilitation psychology practice, ethics, and a changing health care environment.

Rapid changes in the health care environment have brought about ethical and professional challenges for rehabilitation and rehabilitation psychology. The response of rehabilitation psychologists to the threats and opportunities of these challenges will have an impact on the welfare of persons with disabilities and the future of the profession. Managed care organizations have focused their efforts on the management of acute illness. Ethical concerns are being raised about patient access to care, self-determination, confidentiality, provider accountability, and marketing in managed care systems. Rehabilitation psychologists' skills in program development and outcome evaluation place them in a key position to influence the changes in the health care environment. To be effectual, however, fundamental changes must be made in research psychology practice, education and training, research focus, and professional activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discussion 1.

Discusses the three articles by Meyers (see record 1989-17318-001), Phillips (see record 1989-17118-001), and Genshaft and Wiesniewski (see record 1989-17107-001) that comprise the symposium on the challenges and opportunities inherent in the future of social psychology, which centers on the linkages between psychological theories and research and school practice; the implications for the current state of knowledge and practice for professional education and training, especially the evaluation of professional preparation components; and finally, the ultimate effect that these new directions will have on credentialing and licensing standards, statues, and regulations. This is an important session for school psychology because we now enter a phase in our professional history where there are more than 10,000 practitioners identified with the field, more than 40 APA-accredited school psychology programs, a recently adopted set of policy statements for the joint accreditation of doctoral-level school psychology programs by the American Psychological Association (APA) and the National Association of School Psychologists (NASP), and standards for professional practice promulgated by these two organizations that share common elements and emphases. Moreover, national attention to the state of education at the elementary and secondary levels as well as precollege preparation, in combination with longstanding concerns for exceptional individuals, the handicapped, and the gifted, place psychology and school psychology in an advantageous position to contribute significantly to the education of all children as well as to the promotion of mental health and social role functioning of children, youths, and adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intended Consequences.

Comments on Peterson's article (see record 2003-08988-002). The present author maintains that the National Council of Schools and Programs of Professional Psychology (NCSPP) has intentionally and systematically pursued quality and relevance in professional psychology training for nearly 30 years, and asserts that Peterson's article (2003) is a continuation of the old and unsupported claim for the superiority of professional programs based in research universities, and is particularly ill timed. It is further maintained that Schools of Education (professional schools housed primarily in research universities) are actively discussing the crisis of their growing lack of relevance to primary education in the United States, while Schools of Psychology are defining new and essential contributions to primary health care, legal and prison systems, and employment settings. It is also asserted that professional psychology programs housed in a great diversity of settings provide the best array of forums to conduct the necessary dialogues with the world regarding the relevance of psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Practicing psychology in the era of managed care: Implications for practice and training.

Beginning with the HMO Act of 1973, managed care, a system for controlling health care costs, rapidly expanded and gained influence as the main vehicle for health care delivery in the United States. Implementation of managed care principles in the mental health arena has generated much debate, particularly with respect to issues of quality of care. The authors briefly trace the development of managed care and evaluate its impact on the practice of psychology. The extant literature is reviewed with specific attention to issues of quality of care, confidentiality of patient information, and shifting practice patterns of clinicians. Finally, the future of professional psychology within the context of managed care is examined, and the implications of newly created mental health roles for practitioners, training programs, and organized psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of managed care on employment and training: A primer for survival.

Managed care has become the dominant economic force in health care delivery and has challenged many of professional psychology's training concepts and cherished attitudes. Organized psychology has not kept pace with the rapid industrialization of health care during the past decade and has been overlooked as a participant in health economic decisions. A number of changes need to be made in professional education and training if psychology is to be a major player in the new health systems. Additionally, professional psychologists must reexamine some of their most generally accepted attitudes and beliefs if they are to survive. These are described with a number of recommendations for the survival of an embattled profession. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training psychologists for evidence-based practice.

Evidence-base practice (EBP) is now commonplace in many health care services and, in recent years, there has been a healthy debate about the role of EBP in psychology. In this article, I provide information on the nature of EBP and how it is consistent with professional training models and standards in psychology. In discussing some of the concerns that have been raised about the value of EBP in psychology, I present research findings on the relevance and potential impact of evidence-based assessment and treatment practices. Finally, after highlighting the promise of EBP, I offer some recommendations for how training efforts in professional psychology should be refocused in order to optimally prepare current and future psychologists to practice in an evidence-based manner. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distance education in professional training in psychology.

Distance learning methods have had a dramatic effect on undergraduate education and are being incorporated by graduate and professional programs in a variety of areas, including psychology. To address the implications of these developments, an APA task force was organized in 2001 and presented its findings in 2002. This article summarizes key findings of the task force regarding (a) developments in distance education applications to training in professional psychology, (b) significant issues regarding best practices and quality assurance, (c) implications of accreditation standards for programs based on distance methods, (d) licensure and recognition of graduates from online programs, and (e) implications of distance education methods for campus-based programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School psychology and health care: Moving service delivery into the twenty-first century.

Contends that school psychology must articulate its legitimate relationship with health care. Failing to do so, the field risks becoming marginalized in American professional psychology. In light of the central educational elements of psychotherapy and major health crises such as smoking, the indirect contributions of education to health, and the need to focus more aggressively on prevention, the field of school psychology has the potential to make important contributions to health care. Given that some form of health care reform is imminent, school psychology now has a unique opportunity to realize long-standing agendas for role expansion and enhance the quality of services provided to children, youth and adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training psychologists to assess, manage, and treat posttraumatic stress disorder: An examination of the National Center for PTSD Behavioral Science Division training program.

Most traumatized people do not get the care they need, making the demand for well-trained clinicians, researchers, and supervisors in the trauma field particularly acute. We describe the psychology training program at the Behavioral Science Division of the National Center for PTSD, provide a rationale for the training procedures we employ, and summarize the challenges we face. We suggest that the trauma field needs to establish training guidelines and criterion-based outcomes, and to conduct systematic evaluation of training program efficacy. As a first step toward these goals, we present information about our program and our unique clinical and professional context to assist those who intend to develop training programs and to allow existing training programs to compare and contrast practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation and the Cultures of Professional Psychology Education Programs.

Evaluation is an important aspect of professional psychology education programs, particularly as the field moves increasingly toward competency-based models and concerns arise about the qualifications of students in some doctoral programs. Attitudes about evaluation are shaped by the cultures of professional training programs, which are illuminated by K. J. Gergen's (1991/2000) distinction among the romantic, modernist, and postmodernist views. Issues considered include the effects of competition, the implications of competency-based evaluation, evaluation-free environments versus evaluation-rich environments and safety, the wish for the "riskless risk," faculty roles, faculty modeling, evaluation of faculty by students, and the distinction between client and student roles. The cultures of evaluation and associated attitudes influence the nature of collegiality and how one responds to diverse theoretical positions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental health and managed care: Training for the 21st century.

Discusses some of the difficulties future clinicians may encounter as they make the transition from graduate training to clinical work, and suggests that many traditional pre-doctoral psychology internships inadequately prepare trainees for the prospective practice of psychology in the era of managed mental health care. Graduate training programs need to integrate clinical work in a managed care setting during internship training utilizing the scientist-practitioner model to (1) more effectively prepare trainees for future work in managed care, (2) expand professional psychology's unique contributions to mental health treatment, and (3) apply the research methodology of psychology to evaluate clinical efficacy and treatment outcomes within the managed care environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bilevel training in school psychology: Interlocking degrees for program accreditation.

Multiple standards exist for the accreditation of training programs in school psychology: American Psychological Association's standards apply to doctoral programs and National Association of School Psychologists/National Council for Accreditation of Teacher Education's standards apply to doctoral and specialist programs for professional school personnel. Program accreditation by these associations is designed to assure the quality of professional preparation. However, the multiple standards for accreditation seriously challenge programs to accommodate requirements for content, breadth, and depth of professional preparation. The problem is compounded for training programs offering bilevel training. An interlocking relationship between training levels is proposed as one approach compatible with both the generic and specific criteria of the several associations accrediting school psychology programs. The design of a training program that integrates specialist and doctoral-level preparation is analyzed, using multiple criteria of the major accrediting associations to determine advantages and disadvantages of this approach. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Special issue editorial: The art and science of trauma-focused training and education.

In spite of the importance of trauma education, efforts on the part of the Division 56 Education and Training Committee to identify higher education programs that emphasize trauma reveal surprisingly few programs (e.g., see http://www.apatraumadivision.org/ resources/apa_doctoral_sites.pdf). Lack of trauma education at undergraduate and graduate levels increases the urgency to develop effective training for postgraduate professionals. Compounding the problem of integrating effective trauma education and training at all stages of professional development, relatively little information about pedagogy is shared in our professional journals. This special issue addresses that gap by presenting articles focused on practices, theory, and data from a wide range of training/education settings (e.g., community clinics, VA settings, classrooms) focused on diverse forms of trauma exposure (e.g., disaster, military, child abuse/neglect, violence against women). The breadth of the topics and ideas conveyed in these articles reveals that we have many stakeholders whose interests lie in the development of high quality education and training practices, from higher education programs involving undergraduate and graduate students to practitioners seeking continuing education and managers/supervisors transforming health care delivery systems. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

La psychologie et la santé.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health.

This article traces the historical development of Canadian medicare and its significant influence on shaping not only the clinical services provided within Canada's public health care system but also its major impact on the nation's overall health research agenda. Particular emphasis is placed on how this has influenced the development and role of psychology in the public health care system. It is argued that all psychologists, whether their work is focused on the applied or experimental areas of the discipline, have much to offer Canadians across the entire health care spectrum. Nevertheless, psychological services in the public health care system, and particularly in hospitals, have mainly developed within and continue to be primarily focused around mental health. Services in nonmental health areas of health have been more limited, although their importance is well recognized. The current situation partly reflects the limited training in general health issues that clinical psychologists-in-training generally receive in many graduate school programs in Canada. However, it also reflects the overall influence of medicare on the development of Canada's health care system. Medicare has tended to focus the activities of Canada's health care system primarily on treating illness rather than on preventing it and/or maintaining health. Also, medicare has oriented Canada's health care system mainly toward delivering medical services rather than providing more comprehensive health services (e.g., the "medically necessary" criterion for funding). However, times are changing. The growing emphasis among health policymakers in Canada on illness prevention and health promotion (e.g., the creation of the federal government Public Health Agency of Canada in 2004) will significantly expand psychology's role across all areas of health. Psychology education and training programs are urged to seriously examine whether psychology practitioners and researchers are being adequately prepared at present for the much broader array of future interdisciplinary professional, research, and educational activities and responsibilities that will emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Economics and psychology practice: What we need to know and why.

Economic contexts and trends relevant to the practice of psychology in mental health and health settings are presented to help practitioners plan better for the future. Professional skills alone are no longer sufficient to thrive and deliver quality services in the current economic climate. A greater focus on understanding the economic indicators for psychology is necessary too. This includes the cost-driven policies, health and behavioral health financing, demands for accountability, losses, and opportunities inherent in the major systemic health care changes occurring in the United States. Practical questions with economic implications about the direction of psychology practices are raised, and the role of psychology initiatives designed to advance practice, which take both professional and economic factors into account, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinguished career contribution to education and training in psychology: Donald R. Peterson.

Presents an overview of the career and contributions that Donald R. Peterson has made to psychology. For more than thirty-five years Donald R. Peterson has shown exemplary dedication to the education and training of psychologists. He is recognized, and valued, among his colleagues for his dauntless advocacy in behalf of the highest standards for professional psychology programs. He was dean of the first university-based school to award a professional doctorate in psychology. He may well be the only living person who has directed a research-oriented scientist-practitioner program, directed a professional program in an academic department, and also directed a professional school in a major research university. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward an empirically derivable definition of entry level.

Discusses the "entry level" issue in relation to the example of school psychology, the structure of graduate programs, and the professional characteristics of psychology. A causal modeling approach to evaluating the effects of education and training on practice is presented. Two major perspectives on entry level are individuated on the basis of their emphases on education and practice, and empirical strategies for relating entry level to practice are proposed. An approach that encompasses the relative contributions of a range of individual difference, education and training, professional competence, and practice factors is suggested as an alternative to the narrow, degree-based approach to entry level. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investing in our future: Unrealized opportunities for funding graduate psychology training.

Purpose: Changes in the health care environment have brought challenges and opportunities to the field of psychology. Practitioners have been successful in modifying service models to absorb losses of financial support for behavioral health care, due to managed care and public policy changes, while simultaneously managing the growing need for these services. However, in this reactive mode of responding to evolutions in the health care system, the field of psychology has at times lost sight of the long-term vision required to promote psychology's inclusion in the health care system of the future. In particular, a focus on training psychologists and ensuring the availability of funding to support these activities must be a priority in planning for the future. This article provides an overview of federal programs that currently offer funding for psychology training, as well as other opportunities for federal funding that have been unrealized. Details regarding advocacy efforts that were required to secure available sources of funding are given, followed by consideration of strategies for taking advantage of existing resources and prioritizing advocacy for additional funding. Conclusion: Funding for psychology training provides an avenue for increasing the number of well-trained psychologists who can serve patients' mental and behavioral health needs and thereby improve health outcomes. Moreover, capitalizing on available funding opportunities for psychology training and promoting efforts to expand these opportunities will help ensure that the field of psychology is positioned to remain an important contributor to the health care system of the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)