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PubMed1991

Psychologists' role in family-centered approach to practice, training, and research with young children.

Family-centered, community-based, coordinated care for children with special needs is presented as the best practice model for providing services to children and families. Psychologists must learn to play an active role in this frame-work that both integrates psychology with other health and education disciplines and uses the broad spectrum of psychological knowledge about families, development, community organization, and intervention strategies. Key principles of family-centered child psychology affect practice research and training. The psychologist becomes part of a team created to support families as the primary care-givers of their children. Training programs must reorganize the types of experiences both in the classroom and the field to train new psychologists within this model. As mandates for family-centered care affect policies at the state and federal levels, research will remain a critical factor in understanding the effects of these policy shifts on child and family functioning and the delivery of services.

Child↗
PubMed2001

Physician-assisted dying: review of issues and roles for health psychologists.

The authors review the recent empirical and theoretical literature on physician-assisted dying (PAD) since implementation of the Oregon Death With Dignity Act (ODDA) in 1997. The authors provide a brief overview of end-of-life practices; consider ethical and practical issues regarding PAD; outline governments' acts and health care organizations' current codified principles regarding PAD, including the American Psychological Association's goal to increase the visibility of psychology in end-of-life issues; examine recent data pertinent to ODDA implementation and psychologists' attitudes regarding PAD; and outline potential roles for health psychologists responding to requests for PAD and implementing PAD (where it is legal). Health psychologists can assume at least 4 roles regarding PAD: (a) policy advocates, (b) educators, (c) practitioners, and (d) researchers.

Ethics, Medical↗
PubMed2003

Where is psychology going? Structural fault lines revealed by psychologists' use of Kuhn.

Psychologists' appropriation of language and ideas from Thomas Kuhn's (1962, 1970b) The Structure of Scientific Revolutions reveals deep and contradictory concerns about truth, science, and the progress of the field. The author argues that psychologists, uncomfortably straddling natural and social science traditions, reference Structure for 2 reasons largely overlooked: first, because it presents an intermediate, naturalistic position in the war between relativist and rationalist views of scientific truth, and second, because it presents a psychologized model of scientific change. The author suggests that the history of this mutual influence--psychologists being influenced by Kuhn and vice versa--may usefully inform current practices of psychological science.

Forecasting↗
PubMed1991

Collaboration for child adjustment: issues for school- and clinic-based child psychologists.

Therapeutic gains for children may be maximized if the important systems serving their mental health needs develop sophisticated collaborative relationships. School- and clinic-based psychologists may overlook important ways in which they can cooperate. School-based psychologists may not be aware of how to extend or support the therapeutic interventions suggested by other psychologists. Clinic-based child therapists may lack a full understanding of both the promise of school-based programs and the constraints under which schools operate. Collaborative efforts between clinic- and school-based practitioners may increase ecologically valid treatment options. This article explores both the gains and the potential pitfalls that may arise when school- and clinic-based practitioners work together.

Affective Symptoms↗
PubMed1992

A new role for psychologists--hospital ethics committees.

Over the past decade psychology has begun to appreciate that it represents more than "merely mental health care" and has become increasingly involved in the generic health care arena. The participation of psychologists in Hospital Ethics Committees (HECs) is presented as a professional activity for which psychologists are particularly well suited. The clinical mission of HECs, the historical importance of ethical considerations to psychology, and the field's specific training and psycho-social expertise suggest valuable contributions that psychologists can make in this particular area. Further, as psychology actively increases its participation in HECs, other professional disciplines outside of the mental health field will systematically have the opportunity to become more familiar with psychology and its clinical and research expertise.

Committee Membership↗
PubMed1999

When psychologists work with religious clients: applications of the general principles of ethical conduct.

Psychologists become more effective and relevant when they appreciate that many clients hold religious values and commitments. Greater awareness of religion and religious values in the lives of clients may aid clinicians' efforts to provide more accurate assessments and effective treatment plans. The authors use the American Psychological Association's (1992) "Ethical Principles of Psychologists and Code of Conduct" as a framework to examine many of the ethical issues relevant when psychologists work with religious clients. This article also provides suggestions for ways in which clinicians may obtain the skills needed to offer competent assessments and interventions with religiously committed clients.

Ethics, Professional↗
PubMed2000

Psychologists' ethical responsibilities in Internet-based groups: issues, strategies, and a call for dialogue.

How can psychologists participate ethically as facilitators, advisers, and peer members in Internet-based groups? The astonishing growth of Internet technology and on-line groups has outpaced the development of formal ethical guidelines for psychologists involved in on-line groups. This article provides an initial appraisal of psychologists' ethical responsibilities in discussion, support, and self-help groups that operate on the Internet and offers practical strategies for avoiding ethical problems. By presenting initial strategies and guidelines for ethical behavior in Internet-based groups, the authors hope to stimulate the field to further discuss and analyze these issues.

Confidentiality↗
PubMed1998

Chen Li: China's elder psychologist.

Chen Li is one of a small group of psychologists in China who trained abroad early in their careers, returned to teach and do research, and continued doing so into later life beyond normal retirement age. His contacts with a number of prominent psychologists in England and Germany in the 1930s, and his inadvertent position at the center of a political row in China in the 1960s, leading to the shutting down of psychology for 10 years, made him historically important. Known for his work in organizational psychology and education, he is a distinguished psychologist and educational leader. Although trained as an experimentalist, he now embraces a broader view of psychology but remains emphatic it should be applied to real-life problems.

China↗
PubMed2000

The role of the psychologist in determining competence for assisted suicide/euthanasia in the terminally ill.

This paper discusses the history of assisted suicide/euthanasia and public attitudes in Canada; discusses depression in the terminally ill and the potential role of the psychologist in the assisted suicide/euthanasia process; and specifically addresses the importance of determining competence in terminally ill patients. One area in which the services of psychologists have not been used to their fullest potential is in the care of the terminally ill, particularly in helping them make end-of-life decisions. It is very important that individuals making end-of-life decisions be used to assessed for mental disorders in order to ensure that they are able to make competent decisions. If assisted suicide and euthanasia were to become legalized, psychologists should be involved in the assessment process in order to determine competency.

Attitude of Health Personnel↗
PubMed1999

Reliability of childhood mental disorder: diagnoses by Japanese psychologists.

The recent entry of psychologists into psychiatric practices and schools in Japan calls for diagnostic skills, because psychiatrists are less available in such settings. We examined the reliability of the diagnoses of 10 DSM-IV childhood mental disorders by 11 Japanese psychologists, using 20 case vignettes. Most categories had good reliability (kappa), except for attention deficit hyperactivity disorder. Japanese clinical psychologists may be able to use DSM-IV reliably as a tool for diagnosis of childhood psychiatric disorders, if sufficient training is provided.

Adolescent↗
PubMed1986

Can psychologists recognize neurological disorders in their patients?

A variety of insidious neurological disorders may present initially as psychological difficulties. In an effort to determine whether psychologists could recognize these disorders in their patients and refer them to a neurologist or nonneurological physician, a questionnaire containing four clinical vignettes was sent to a total of 566 members of the Los Angeles Psychological Association. Each vignette contained a salient description of an underlying neurological disorder with a psychological presentation. No explicit indication was made that the psychological problem represented an underlying neurological disorder. Each psychologist was instructed to read each vignette carefully and to decide what to recommend for each patient. Analysis of the data revealed that nearly one-third of the psychologists failed to recognize the underlying neurological disorder.

Adolescent↗
PubMed1993

Pediatric psychologists' perceptions of their work settings.

Describes the results of a survey of pediatric psychologists' perceptions of their work settings. Respondents (n = 261) described heterogeneous work settings, professional activities, expectations for workload and administrative arrangements. Clinical activities were prominent, accounting for nearly half the respondents' time. Respondents generally reported high levels of overall satisfaction with their work environments. Highest ranked sources of satisfaction included professional autonomy, patient care, and relationships with colleagues. Highest ranked sources of dissatisfaction included lack of time for research, salary, and patient care workload. Pediatric psychologists in private practice reported higher work satisfaction than those in other settings. Findings have implications for the work-related functioning of pediatric psychologists that should be addressed in research and professional activity.

Adult↗
PubMed2001

Managed mental health care: attitudes and ethical beliefs of child and pediatric psychologists.

OBJECTIVE: To examine child and pediatric psychologists' ethical beliefs and attitudes toward managed mental health care. METHODS: In a survey mailed in spring 1997, 252 child and pediatric psychologists responded to three vignettes depicting ethical dilemmas related to working with managed mental health care (confidentiality, restriction of services, misdiagnosis). Data were collected about psychologists' ethical choices and reasons given for choices, attitudes toward managed care, the extent to which managed care affected ethical decision making, and level of managed care involvement. RESULTS: Differences were found in choices made for the ethical dilemmas in regard to what participants thought they should do, would do, and actually did do. Overall, participants endorsed negative attitudes toward managed care. Participants reported that managed care somewhat affected their ethical decision making for the vignettes. Level of managed care involvement was not related to ethical decision making or attitudes toward managed care. CONCLUSIONS: The findings suggest areas for examination as new ethical standards are created for work in managed care environments.

Adult↗
PubMed2003

Pediatric psychology training and genetics: what will twenty-first-century pediatric psychologists need to know?

OBJECTIVE: To demonstrate the importance of genetic knowledge in coming decades and to outline necessary areas of genetic education. METHOD: This article reviews research involving genetic testing of children for cancer syndromes, development disabilities, psychiatric problems, and other conditions. RESULTS: The developmental, clinical, research, and consultation skills of well-trained pediatric psychologists will make them valuable collaborators with genetics professionals. Pediatric psychologists study the genetic etiology of psychiatric conditions and outcomes of genetic testing for physical disease. CONCLUSIONS: Pediatric psychologists will need training in the concepts and methods of the New Genetics. They should understand the implications of risk notification and genetic test disclosure and should be aware of related ethical concerns.

Child↗
PubMed2001

Electroconvulsive therapy for minors: experiences and attitudes of child psychiatrists and psychologists.

OBJECTIVE: To estimate knowledge, experience, and attitudes towards the use of electroconvulsive treatment in minors (patients < 18 years of age), among child and adolescent psychiatrists and psychologists. METHOD: 1,600 questionnaires were mailed to a group of child and adolescent psychiatrists and psychologists. RESULT: There were 625 (39%) respondents. 329 (53.8%) of the respondents stated that they possessed minimal knowledge about the use of ECT in children and adolescents. Lack of confidence in providing a second opinion was common and reported by 75%. Compared with those with minimal knowledge, respondents with advanced knowledge reported a higher perception of safety and efficacy. The majority (70%) of the respondents regarded ECT as a treatment of last resort. CONCLUSION: Many child and adolescent psychiatrists and psychologists have very little knowledge, training, or experience in this treatment. They seem to be ill equipped to appropriately consider or advise patients and families about ECT. Clinical and research implications of these findings are discussed.

Adolescent↗
PubMed1988

Psychologists and self-help books: attitudes and prescriptive practices of clinicians.

Data are presented from a survey of 123 practicing psychologists in 36 states concerning attitudes and prescriptive practices with regard to self-help books. Tables are provided indicating those self-help works most frequently read and prescribed by responding psychologists, along with ratings of quality and helpfulness. Results indicate widespread readership and prescription of popularized self-help books among psychologists and a positive evaluation of their utility. Questions as to how and why these works are being used are explored.

Attitude of Health Personnel↗
PubMed1994

Psychologists' beliefs concerning confidentiality with suicide, homicide, and child abuse.

A large number of psychologists from the Division of Psychotherapy and the Division of Psychologists in Practice were surveyed to determine their attitudes about confidentiality. It was found that psychologists reference their personal code to a considerable extent when making decisions about breaching confidentiality and when providing information to their clients about confidentiality. Approximately one-fourth of the respondents believed in absolute confidentiality. These respondents were found to differ from those respondents who did not believe in confidentiality with respect to their actions as therapists, their beliefs about the effects of informing clients concerning limits of confidentiality, and their actually breaching of confidentiality. The two groups differed much less with reference to items that assessed knowledge of matters pertaining to confidentiality, as well as information afforded their clients. Possible stress and conflict experienced by those believing in absolute confidentiality, in light of legal and APA mandates, is discussed along with the need for future research.

Adolescent↗
PubMed1981

A study of the causes of conflict between psychiatrists and psychologists.

Although there has been much discussion of the current professional conflicts between psychiatrists and psychologist, few studies have attempted to empirically evaluate how the professions view their roles and responsibilities within the mental health system. In this study a questionnaire was sent to psychiatrists, psychologist, social workers, and nurses in various mental health settings. They were asked to evaluate how large a role psychiatrists and psychologists played in 11 everyday activities, how competent the two professions were to perform the activity, and how much responsibility each should ideally have in carrying out the activity. The results showed that the two professions differ in their perceptions of their competence to perform several activities central to the mental health system. Based on the findings, the author suggest some ways to resolve the conflicts between the two professions.

Attitude of Health Personnel↗