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PubMed2001

Potential clients' beliefs about the relative competency and caring of psychologists: implications for the profession.

To assess the extent to which the results reported by Warner and Bradley (1991) can be generalized beyond the population of undergraduate psychology students, 132 adults in the metropolitan Harrisburg area were asked to evaluate the competency and traits of clinical psychologists, licensed professional counselors, and psychiatrists. Results indicated that the general public believed counselors to be more caring than psychologists and psychiatrists. All three professional groups were perceived to be comparable in their ability to treat the least severe disorders. Licensed counselors were perceived to be most competent to treat disorders rated by the subjects as moderately severe, comparable in competence to clinical psychologists for adjustment disorders, and comparable to psychiatrists for marital problems. Psychiatrists and psychologists were considered the most competent to treat the most severe disorder, major depression. The results indicate that while clinical psychologists often were viewed as competent, they were not viewed as the single practitioner of choice for any diagnostic classification, nor were they noted to have positive character traits.

Adolescent↗
PubMed2006

Clinician to frontline soldier: a look at the roles and challenges of army clinical psychologists in Iraq.

Psychologists have a long and respected history of service during wartime that dates back to World War I. From the early days of scientific personnel selection, clinical psychologists have made a number of wartime contributions. Today, Army clinical psychologists serving in Iraq are providing behavioral health services as both clinicians and prevention specialists in order to meet the psychological and emotional needs of service members abroad. They are also performing as Army officers and soldiers contributing to the success of military operations as a whole. The authors, two clinical psychologists and Army officers currently deployed to Iraq, provide a small glimpse into the clinical and personal opportunities and challenges faced by wartime Army clinical psychologists.

Autobiographies as Topic↗
PubMed2006

Tobacco intervention practices of licensed psychologists.

Tobacco dependence is a serious public health concern. The U.S. Department of Health and Human Services has issued a practice guideline of best practices to encourage all health care providers to intervene with tobacco-dependent individuals they encounter. Psychologists may be ideally suited to implement brief tobacco interventions due to their expertise in behavior change strategies and interpersonal counseling skills. This study sought to investigate current tobacco assessment and intervention practices and perceptions of responsibility for tobacco intervention among a regional sample of licensed, practicing psychologists. Results suggest that a majority of psychologists fall far short of the ideal best practices recommended in the practice guideline, and many are unaware of the availability of the guidelines. Further, psychologists in this study perceived tobacco intervention to be a greater responsibility of physicians and other health care providers than of psychologists and other mental health professionals.

Adult↗
PubMed2001

Collaborating for social change: the black psychologist and the black community.

Several prominent Black scholars have argued that the predicament of Black intellectuals is inseparable from that of Black communities (C. West, 1994), and that Black psychologists should be at the forefront in developing culturally relevant psychological interventions (J. A. Baldwin, 1989). Yet, for Black psychologists there are a number of challenges to conducting successful interventions in Black communities, including historical abuses of Black communities by the "helping" professions and divergences in values, goals, and behaviors of professionals as compared to community members. In order for community psychologists to design interventions that are respectful of the cultural traditions and norms of Black communities, these obstacles to collaboration need to be addressed. This paper outlines some of the challenges faced by Black community psychologists, as well as the unique strengths they can mobilize when collaborating on research and interventions in Black communities. The paper also addresses methods of empowering Black communities and improving the training of community psychologists.

Adolescent↗
PubMed2005

Exploring unique roles for psychologists.

Presents a comment on "Psychological Treatments" by D. H. Barlow. Barlow highlighted unique roles that psychologists can play in mental health service delivery by providing psychological treatments--treatments that psychologists would be uniquely qualified to design and deliver. In support of Barlow's position, the authors draw from their own clinical practice with special psychiatric populations, such as adults with severe and persistent mental illness and behaviorally disordered youths, to illustrate some potential unique roles for psychologists. The authors believe psychologists are uniquely trained to design such individualized functional behavioral analysis protocols because of their training in research design, behavior analysis, learning theory, and behavior change. Psychologists may also be uniquely qualified to design, implement, and evaluate many specialized therapy techniques, as Barlow has outlined and suggested.

Humans↗
PubMed2001

Experimental practices in economics: a methodological challenge for psychologists?

This target article is concerned with the implications of the surprisingly different experimental practices in economics and in areas of psychology relevant to both economists and psychologists, such as behavioral decision making. We consider four features of experimentation in economics, namely, script enactment, repeated trials, performance-based monetary payments, and the proscription against deception, and compare them to experimental practices in psychology, primarily in the area of behavioral decision making. Whereas economists bring a precisely defined "script" to experiments for participants to enact, psychologists often do not provide such a script, leaving participants to infer what choices the situation affords. By often using repeated experimental trials, economists allow participants to learn about the task and the environment; psychologists typically do not. Economists generally pay participants on the basis of clearly defined performance criteria; psychologists usually pay a flat fee or grant a fixed amount of course credit. Economists virtually never deceive participants; psychologists, especially in some areas of inquiry, often do. We argue that experimental standards in economics are regulatory in that they allow for little variation between the experimental practices of individual researchers. The experimental standards in psychology, by contrast, are comparatively laissez-faire. We believe that the wider range of experimental practices in psychology reflects a lack of procedural regularity that may contribute to the variability of empirical findings in the research fields under consideration. We conclude with a call for more research on the consequences of methodological preferences, such as the use on monetary payments, and propose a "do-it-both-ways" rule regarding the enactment of scripts, repetition of trials, and performance-based monetary payments. We also argue, on pragmatic grounds, that the default practice should be not to deceive participants.

Deception↗
PubMed1995

Expectations and preferences regarding confidentiality in the psychologist-client relationship.

Two hundred and fifty-six members of the Australian public were surveyed regarding situations in which a psychologist might breach confidentiality and third parties to whom information might be disclosed. There was strong agreement between respondents' expectations about the way in which psychologists would act, and their preferences regarding how psychologists should act. While respondents supported confidentiality within the psychotherapeutic relationship, they clearly distinguished situations in which, and third parties to whom, disclosure could appropriately occur. Disclosure was expected and preferred when a client revealed a murder (planned or confessed), suicide plans, child abuse, or treason, and where the recipients of the information were colleagues of the psychologist or parents of a client younger than 13 years. Compared to nonparents, parents more strongly supported disclosure regarding illegal drug use and child abuse, and believed that parents should have access to a child's records. In general, respondents' view of the way in which psychologists should treat confidentiality issues were consistent with the guidelines prescribed by the Australian Psychological Society in the Code of Professional Conduct (1986).

Australia↗
PubMed1987

School psychologist: an integral member of the school health team.

The primary responsibility of school psychologists is the application of psychological assessment, consultation, and intervention within public school settings. This article examines the role of the school psychologist as an individual and as a member of a school's child study team. The changing role of the school psychologist is noted as are the various organizations school psychologists may join, their educational requirements, and other facets of the school psychologist field.

Affective Symptoms↗
PubMed1983

Communication between doctors and psychologists.

Changing roles of the psychologist over the past 30 years or so have been rapid and fundamental. This has led to difficulties when psychologist and doctor do not see the former's role in the same way. Psychologists achieve clinical independence for their work rather sooner than doctors do, and if this is not understood there can be difficulties in communication. If the doctor and psychologist employ different theoretical models of illness, this may affect the ease with which agreed therapeutic strategies are reached. The respective roles played by the doctor and the psychologist may be consonant, in that both are research, or both are clinically, oriented. When this is not the case, difficulties may occur. It is suggested that job descriptions should be agreed before appointments are made. Unresolved tensions concerning clinical responsibility may cause communication difficulties. It is suggested that the claims of functional leadership over status leadership be examined.

Communication↗
PubMed1996

Stress in clinical psychologists.

This paper summarises the findings of a series of studies of British clinical psychologists and discusses them in relation to the (mainly US) literature. Four main questions are addressed: (1) How stressed are clinical psychologists? (2) Which psychologists are most stressed? (3) What are the main sources of stress for clinical psychologists? and (4) What coping strategies are used by clinical psychologists? A figure summarises the main risk factors emerging from the literature which appear to be important mediators between the stressor and the psychological outcome variables. These are: (1) low job satisfaction; (2) low range of active coping strategies; (3) high use of avoidance coping strategies involving denial; (4) stressor not externalised and objectified; (5) stressor threatens other roles/relationships; (6) low experience in job; (7) no quality relationship with confidant(e)/poor quality relationship with partner; and (8) female.

Adaptation, Psychological↗
PubMed2006

Working with parentification: implications for clients and counselling psychologists.

This paper concerns the concept of parentification, whereby children take on inappropriate parental roles. A brief theoretical overview is presented, showing that parentification has important implications for understanding both clients' and counselling psychologists' experiences. Specific ways of assessing adult clients who were parentified as children are described, focusing on parentification criteria and typical profiles. This is followed by a description of a deparentifying process, including exploring shame-based experiences, resisting splitting and working with projective identification. These discussions are illustrated by examples from an anonymized case study of a client who was parentified as a child. Finally, the paper includes a discussion of possible dilemmas and difficulties that may arise when parentified clients and parentified counselling psychologists work together. Although previous literature has discussed parentification separately for counselling psychologists and clients, this paper is unique in its discussion of the interaction between the client's and counselling psychologist's experiences of parentification and the corresponding impact on the therapeutic alliance. The paper concludes by emphasising the importance of personal therapy and supportive working environments for the well-being of counselling psychologists and consequently that of their clients.

Adolescent↗
PubMed2002

Singaporean graduate majors in education perceptions of workplaces and roles of psychologists.

This paper examined perceptions of workplaces and roles of psychologists of 315 Singaporean undergraduate students in education. The participants rated the appropriateness of 21 workplaces and 32 roles of psychologists using a 7-point scale. The group showed restricted views of psychology and psychologists as they related psychologists' work mainly to social and organizational services and referred roles of psychologists to giving social services related to delinquency and disorders.

Adult↗
PubMed2006

Role function and job satisfaction of school psychologists practicing in an expanded role model.

School psychologists are typically itinerant among multiple schools and often spend up to two-thirds of their time on assessment activities related to students with disabilities and special education programs. School psychologists in delivery of an expanded role service model are assigned to a single school and provide more consultation and intervention services. 97 school psychologists assigned to an expanded role in a single southeastern urban school district were surveyed on their job roles and job satisfaction. The majority were satisfied or very satisfied with their jobs, particularly with engaging in activities that were of service to others and staying involved in a variety of job activities. School psychologists wanted to spend less time in assessment, multidisciplinary team meetings, and administrative duties. The discrepancy between the desired and actual amount of time spent in multidisciplinary meetings was negatively related to job satisfaction. Psychologists wanted to spend more time in direct and indirect intervention, professional development, and networking.

Adult↗
PubMed1997

Beliefs about the helpfulness of interventions for mental disorders: a comparison of general practitioners, psychiatrists and clinical psychologists.

OBJECTIVE: The aim of this study was to assess health professionals' beliefs about the helpfulness of a broad range of possible interventions for mental disorders. METHOD: The study involved a postal survey of 872 general practitioners (GPs), 1128 psychiatrists and 454 clinical psychologists. These health practitioners were presented with a vignette describing either a person with schizophrenia or one with depression. The vignettes were taken from an earlier survey of the general public. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: Two-thirds or more of each profession agreed that the person with schizophrenia would be helped by GPs, psychiatrists, clinical psychologists, antipsychotic agents and admission to a psychiatric ward. Similarly, two-thirds agreed that the person with depression would be helped by GPs, psychiatrists, clinical psychologists, antidepressants, counselling and cognitive-behavioural therapy. However, there were also areas of disagreement. Psychiatrists were less likely than GPs and clinical psychologists to rate psychological and lifestyle interventions as helpful, while clinical psychologists were less likely to rate specifically medical interventions as helpful. Younger members of the professional groups and female members (who also tended to be younger) tended to rate a wider range of interventions for each disorder as likely to be helpful. CONCLUSIONS: Despite areas of broad agreement about treatment, health practitioners were more likely to endorse the interventions associated with their own profession. However, younger members of each profession tended take a broader view. If these age differences represent a cohort effect, health professionals may in the future show greater acceptance of the helpfulness of interventions offered outside their profession. These conclusions are limited by the methodology of the survey, which involved a questionnaire designed for the public rather than professionals.

Adult↗
PubMed1998

[Cognitive impairment and cardiovascular disease risk factors. Project CASCADE Kraków. II. Agreement of Mini-Mental State Examination (MMSE) obtained by nurses and by psychologists from the same persons at age 67-78 years of age].

Mini-Mental State Examination (MMSE) can be used for screening procedures by personnel with no university training in psychology. However, little is known on the reliability of the results of MMSE obtained by medical personnel with little experience in cognitive function assessment. The goal of the paper was to assess the agreement between the results of MMSE obtained by trained community nurses and by psychologists, and to study whether the agreement depends on age, sex and education of examined persons. Studied group were 92 women and 90 men at age 65-78 years. Most of them (81.3%) had only elementary education. There was no significant difference between the distribution of the results obtained by nurses and obtained by psychologists. Individual difference < or = 2 points was found in 63.1% participants and difference < or = 3 points in 78.4% participants. There was a significant correlation between the results obtained by nurses and by psychologists (r = 0.64, p < 0.001). The correlation was also significant within the age, sex and education strata. Variation of the results obtained by nurses was explained in 42% by variation of the results obtained by psychologists. The best agreement in classification in cognitive function was found for the MMSE cut-off point < or = 19 (kappa = 0.75 in women and kappa = 0.58 in men). The worst agreement was found for the cut-off point < or = 25. Also weak agreement was found for the cut-off point < or = 23. There was a significant agreement between the results of MMSE obtained by nurses and results obtained by psychologists on the population level. However at the level of individuals the agreement in classification of cognitive function depended of cut-off point used. The agreement was only fair if cut-off point < or = 23 and < or = 25 were used.

Aged↗
PubMed2001

Rated casemix of general practitioner referrals to practice counsellors and clinical psychologists: a retrospective survey of a year's caseload.

Although evidence-based guidelines are beginning to be produced as to which psychological therapies might be appropriate for which patients, little is known about how general medical practitioners (GPs) in practice distribute referrals between different psychological therapy services. In a retrospective survey, 19 practice counsellors and 10 clinical psychologists from the same geographical area rated a year's caseload of GP referrals using identical data collection methods. Rated casemix was found to be broadly similar, although practice counsellors rated relationship and bereavement problems as more common in their caseloads (totalling 986 patients), and clinical psychologists rated panic disorder, phobias, and obsessive-compulsive problems as more common in their caseloads (totalling 320 patients). Depression and anxiety reactions were the most common problems rated in both groups, but the clinical psychologist cases of depression were rated as more severe and complex. Where differences were found, they may have reflected the different ways that counsellors and clinical psychologists conceptualize cases rather than actual differences in casemix. The results are discussed in relation to evidence-based guideline recommendations about cases appropriate to be seen by practice counsellors and by clinical psychologists in primary and secondary care, and the need to adapt such guidance to local services and skills of practitioners.

Acute Disease↗
PubMed2001

Rated casemix of general practitioner referrals to practice counsellors and clinical psychologists: A retrospective survey of a year's caseload.

Although evidence-based guidelines are beginning to be produced as to which psychological therapies might be appropriate for which patients, little is known about how general medical practitioners (GPs) in practice distribute referrals between different psychological therapy services. In a retrospective survey, 19 practice counsellors and 10 clinical psychologists from the same geographical area rated a year's caseload of GP referrals using identical data collection methods. Rated casemix was found to be broadly similar, although practice counsellors rated relationship and bereavement problems as more common in their caseloads (totalling 986 patients), and clinical psychologists rated panic disorder, phobias, and obsessive-compulsive problems as more common in their caseloads (totalling 320 patients). Depression and anxiety reactions were the most common problems rated in both groups, but the clinical psychologist cases of depression were rated as more severe and complex. Where differences were found, they may have reflected the different ways that counsellors and clinical psychologists conceptualize cases rather than actual differences in casemix. The results are discussed in relation to evidence-based guideline recommendations about cases appropriate to be seen by practice counsellors and by clinical psychologists in primary and secondary care, and the need to adapt such guidance to local services and skills of practitioners.

Journal Article↗
PubMed1988

A re-evaluation of the clinical psychologist in general practice.

Recent evaluations have questioned the early claims that psychologists make a valuable clinical contribution in general practice. In particular, it has been suggested that the promising outcomes have been the result of a 'worst year' phenomenon and that psychologists only slightly accelerate clinical improvement. This paper describes a small but relatively comprehensive evaluation of the work of a clinical psychologist. Analyses of economic and clinical data on 22 patients referred by the general practitioner indicated that the psychologist made a distinctive clinical contribution by improving personal coping strategies and reducing distress among patients with more chronic problems who did not show any such changes during a waiting list period. It is concluded that the recent negative evaluations of the clinical psychologist in general practice may have been misleading and premature.

England↗