APA Rebuilding Morale

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I have spent the last five nights in Toronto and now it is time to go home. It is bittersweet.

This year’s convention was steeped in history. The APA Council of Representatives passed a measure banning psychologists from participating in national security interrogations. The complete resolution can be found here.

I strongly encourage you to take the time to read this report. Do not simply read news articles responding to the resolution. Go to the source material. It is the only way to be fully informed.

This marks a significant milestone and will make this convention one that history will not forget. This feels like one of the first steps toward rebuilding. It feels like hope for those of us who wore our “Do No Harm” t-shirts and buttons over the past few days. I believe the APA governance should be commended for cutting through the red tape and passing this measure.

In addition to being official APA policy, this measure is significant from a social justice perspective. It represents compassion in ideology as well as standing up for fundamental principles. As the largest psychological association in the world, APA is essentially saying that science cannot be used to harm people.  As I drove back across the border and looked to the American flags just past Niagara Falls, I could not help but feel that the APA made the U.S. a little better. I feel proud to be a psychologist today and that was something wonderful to take with me on a long drive home.

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How To Go from OCPD to Disheveled Over the Course of a Weekend

When I come to APA’s convention, I am a very organized psychologist. I have a set agenda. I know where I am going to be and what time I am going to get there. I have my laptop and cell phone fully charged and I am completely prepared to learn, network, discuss and do everything else you are suppose to do at a professional conference.

By the end of the day, I feel like a tornado has swept me up and spit me out back into my hotel room. I am sitting in the Fairmont Hotel and my hair is a mess, my feet hurt from walking, my agenda of symposiums/meetings to attend has grown significantly, and my laptop is currently hanging on at 18 percent battery life.

So what happened?

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One of my favorite parts of convention is the pace. For me, convention feels like a mad scramble to get as much out of the day as I can with limited time as well as physical and emotional energy. Between going to events, running into colleagues and mentors, managing my own presentations, and just trying to figure out where I am going in the convention center/city, its easy to feel a blend of stimulus overload and exhaustion. Whenever I run in to someone, they ask me, “Are you going to this meeting or that symposium or their presentation?” Today alone, I have been invited to five to six additional events that somehow slipped passed me when I originally perused the agenda book. The pressure to support colleagues and friends takes a toll, especially when balancing it against taking time to breathe.

Yet, somehow even though it is strenuous … I still love it. Seeing old friends and learning about new psychological breakthroughs is reinvigorating. I endure, because there are certain moments that really make convention worthwhile. This blog is about some of these moments.

Today, I heard an APA board member discuss her feelings about the Hoffman report with a small group. She described the macro reaction she has observed from the larger membership as well as her own personal feelings. This resulted in a powerful blend of institutional knowledge and interpersonal connectedness. This allowed me to deinstutionalize my view of the APA and realize these are real people who are doing their best to manage this difficult time. It was very humanizing and humbling to observe.

I also got to take a walk with my former adviser, whom I have not seen since my dissertation defense. We reflected on our time working together and our new goals while furiously walking between meetings. Only at convention does a meaningful relationship get discussed while frantically trying to figure out which building your next presentation is in.11145117_10102756963400265_6556092373046282420_n

Finally, I was able to attend the Div. 17 governance meeting, where something truly special happened. I was able to watch one of the doctoral interns from my home site of Ohio State University – Counseling and Consultation Service win an award. Basak Kacar-Khamush won the Donald E. Super Fellowship Award for Outstanding Research in Vocational Psychology. Basak’s office has been two doors down for mine for the entire year. Seeing her receive this award filled me with a sense of pride as I reflected on her growth during internship.

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When I look at convention as a whole, it is a mixed bag of exhaustion and happiness. Most important, despite my messed up hair and sore feet, it’s worth the time, money and energy to attend. The celebratory moments are memories I will cherish.

Not Goodbye, Just ‘See You Next Year’

It is hard to believe that it is already the final day of convention. This week has been filled with opportunities to learn new information, to grow personally and professionally, and to connect with friends old and new. Yes, the Girl Scout in me wants to break out into song. “Make new friends, but keep the old. One is silver and the other’s gold.”

One of the reasons I come to the conference is for the opportunity to connect with others in the profession — this year did not disappoint. I enjoyed the chance to catch up with other early career professionals during a number of events. The Committee on Early Career Professionals hosted a social hour on Friday night and a coffee hour Saturday morning. ECP coffee hourI also attended an ECP social hour that was a collaboration of Divs. 17, 35 and 51.  All of these events provided fun opportunities to chat with other ECPs and share stories about getting licensed, starting new jobs, applying for tenure, and striving to find some work/life balance.

I was happy to see so many events for ECPs. When I first graduated, I had never heard of the term “early career professional.” Thanks to Katharine Hahn Oh’s hard work restarting the Div. 17 ECP committee, I soon learned what it meant. I had the honor of serving on the committee for four years and helped to bring more awareness to this career stage during convention. Seeing the great attendance at all of these events makes me confident that there will continue to be supports for ECPs for years to come.

I was especially delighted to connect with one my mentees who recently graduated. It was wonderful to spend time with her at her first convention as “Dr.” I am so proud and happy to welcome her as a colleague. I got some much needed Vitamin F from my dear friends at the Div. 35 award ceremony and was inspired,as always, by the authentic interactions I had during Div. 51’s social hour.

So, it is somewhat bittersweet to part ways on Saturday night and Sunday morning. Sometimes a few days just doesn’t seem long enough to say everything we want to say. I reassured friends that we would stay in touch over Facebook and keep each other posted about important life updates. I try to avoid thinking too much about how long a year can be.

So as I get ready to begin the re-immersion process into my day-to-day life, I don’t say goodbye. Just, see you next year in Denver.

Money Talks: Social Class at Convention

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Some of you may know that I serve on CSES. Just in case you have been inundated with acronyms over the last week, CSES stands for the Committee on Socioeconomic Status and resides under the Board for the Advancement of Psychology in the Public Interest (BAPPI). Over the last few years, social class issues have gained some significant momentum. The Recession of 2008, the Occupy Wall Street movement, rising inequality and the work of several national political representatives have brought social class concerns to the forefront of the nation’s collective consciousness.

As a result, several very important presentations and activities occurred at the APA convention concerning SES. Here are a few highlights.

The hashtag #StopSkippingClass is a CSES initiative to continue the discussion around social class issues on social media. This campaign was launched in memory of the 50th anniversary of the War on Poverty introduced by President Lyndon B. Johnson. CSES members asked psychologists from around the convention to tweet, post on Facebook, or hold a sign completing the sentence ” Poverty is …

Here is an example of Ramani Durvasala, Ph.D. holding her sign at the CSES Business Meeting.

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In addition, Paul Piff, PhD, led a plenary session Saturday called “What’s Social about Social Class.” Piff has appeared on NPR, television, in The Wall Street Journal, and even did a TED Talk: Does Money Make You Mean. His TED talk, which has had some  2 million downloads, focuses on how people’s social class impacts their moral reasoning. In the session, Piff described several of his studies that appear to indicate that in American culture, those who are identified or made to feel like they have a higher social class are more likely to engage in “utilitarian” style thinking and be self focused. A few of the interesting studies he conducted have fascinating research designs, such as looking at how much candy people were willing to steal from children, how willing people were to cheat on a game, and whether owning a luxury car makes people more likely to cut off pedestrians. The consensus is that those with a lower social class (or those that are made to feel like they have a lower social class) tend to act more moral, caring and empathetic toward others. This contrasts with the stereotype that low-income people are more likely to steal or try to take advantage of others.

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Although there were many other presentations and activities, the last one I want to focus on was student driven. At the APAGS booth, they had a great study/art activity going on. They had a board set up with different dollar amounts across a spectrum. Students were asked to take stickers and indicate what their total student debt would be at the completion of their degree. They were also asked what strategy they would be using to pay of this debt. This allowed for a visual representation of how inflation and rising tuition have affected students. On Saturday, the numbers varied, but many stickers hovered around the $100,000 mark, which should be of serious concern for all APA members. APAGS has completed a report on student debt, which they will be discussing over the next year. When it’s released, I implore psychologists to move toward  action on loan forgiveness legislation.

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Got Purpose? Your Health Might Depend on It

In a symposium that felt much like a philosophy lecture, attendees were treated to a spirited discussion of the gap (or perceived gap) between humanistic and positive psychology. The room was filled beyond capacity- the strongest turnout of any of the symposiums I attended throughout the convention. Why? Psychology can ask some pretty big questions. Big questions like “what does it mean to be human?” and “what is the purpose in life?” are some of the questions that draw people to psychology in the first place.

While many psychologists relegate such big questions to philosophical debates, others are trying to get at them scientifically. One such researcher is Dr. Carol Ryff, a professor at the University of Wisconsin, Madison. Ryff has made a career out of developing and testing core constructs that define well-being. One of these constructs she calls “purpose in life.” How does one define purpose in life? Ryff defined it as “finding meaning and direction in your life.” In a several studies, she has documented that purpose in life, as a measure, has impressive predictive utility for health. First, purpose in life is not static (i.e., it changes over time). In a recent study, she and her colleagues found the purpose in life plummets, on average, as we get older. In addition, low levels of purpose in life are associated with several biomarkers indicative of early disease risk and premature mortality. For example, she has linked low purpose in life to markers of systemic inflammation, which has been linked to heart disease, among other chronic conditions.

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Does one’s purpose in life effect one’s biology directly? People who report more purpose in their lives appear to take better care of themselves. For example, Ryff and colleagues used data from the Health and Retirement Study, a longitudinal study of older adults, and found that those reporting greater purpose in life were more likely engage in preventive care (e.g., get their cholesterol checked, get cancer screenings).

Is it possible to increase someone’s purpose in life? On the face of it, sure. I can certainly think of friends and loved ones who have found greater purpose in response to life experiences, such as surviving a health scare or having a baby. What about an intervention that could be deployed to lots of people? That’s something Ryff and her colleagues are thinking about. While she didn’t get into details, she did note a recent study, known as the Lighten Up study, that seeks to improve well-being among older adults. Just another example of how psychologists are tackling questions at the core of human experience.

Gaming, Wearables and Big Data: Psychology’s Hi-Tech Future

Simulated therapy training. Apps that monitor behavior and stand-in therapy. Vast streams of data shaped into undeniable patterns. According to a report by psychologists on the cutting edge of technology development, these could be familiar practice adds in the not-distant future.

Jason Satterfield, PhD, director of behavioral medicine UCSF Medical Center spoke of how hi-tech training could help equip clinicians to help meet the demands of truly integrated behavioral health care, otherwise known as the patient-centered medical home.

“The average primary care physician has a panel of 2,500 patients … [and] would need to work 21.7 hours per day just to do [treatments], and 7.4 hours per day for prevention, to deliver best standards of care,” he said. Meanwhile, 70 percent of of health care expenditures are due to chronic illness, and one in four of those patients will have diagnosable mental illness.

Newer tools may help clinicians to treat more people more efficiently and effectively. These include social networking using podcasts and online discussion panels, MOOCs (massive open online courses), and e-mentoring and supervision. “Smart care” tools might remind clinicians when it’s time to do a test or when a patient’s record indicates an intervention. Actors could play patients in simulated online scenarios.

To further help access, “extender and augmenter” apps can that help boost the lessons of cognitive behavioral therapy between sessions. For example, one mobile phone app called Addiction CHESS, currently in development, helps people in recovery for substance abuse, buzzing if they’re approaching a behavioral trigger and delivering appropriate messages. There’s also a “panic button” to call for help and therapists after hours.

That said, “There are lots of studies on digital health and ehealth tools, but if you build it, it doesn’t mean people will use it. Folks are too overwhelmed; there are too many choices and too many things to do. As psychologists we need to think about motivation,” Satterfield said.

One way may be through gamification of virtual therapy. People get drawn into games because they’re tapping into the psychology of motivation and rewards, like badges and scores, limiting play time and setting challenges just above your level of ability to add just enough fun.

“What if we had our training programs set up that way? Not to make light of them, but if they were fun and easy to use, and  where people were bored and could take out a pad and do their CBT exercises — how awesome would that be?” he said.

Assessment is critical to helping clinicians and supervisors of care managers make decisions, but can take up much of the time they have with patients, said Patricia Areán, PhD, of the University of Washington.

“We don’t know how our patient is doing until they walk into our office, and [sometimes] don’t even see patients once a week. We also have to rely on self report, which is guided by how person feels that day,” she said. “What if we could capture all of this information before you see your patient? Data collected in real time and presented in a really efficient way gives us the time to do treatments we need to do to make our patients feel better.”

Mobile phones and wearables may be the vehicles. Smartphone apps can give clinicians clues as to how patients are faring by collecting activity and social data, listening for voice data and changes, looking for typing errors and giving quick mood surveys or memory tests, and being on the lookout for texts and emails that get no response. Plus, they could help reach groups that currently lack access; minorities use mobile health apps more than Caucasians, according to Pew surveys, she said. Wearable sensors have grown 110 percent since 2011, and older adults are more likely to use these devices than any other demographic.

“It’s a combination of data points that will really come up with a signal for people on whether they are really doing better or worse,” Areán said.

All of this personal and public health data and electronic health records are generating enormous amounts of useful information, said Kari Stephens, PhD, who teaches biomedical informatics at the University of Washington, but the challenge lies in ” getting this data wrangled and unburying ourselves,” she said.

Government and other groups are spending millions of dollars to create information-sharing networks that have great value for behavioral scientists, she said, including the National Institutes of Health BD2K (big-data-to-knowledge) project,  the Patient-Centered Outcomes Research Institute’s clinical data repository network, the research-focused NIH Collaboratory, and the FDA’s Mini-Sentinel, which monitors the safety of medical products.

“Big data is correlational, not causal. … and messy and that’s OK, as long it’s mediated by human interpretation,” she said. “Lots of reporting pieces can help us figure out how behavioral health specialists are supporting evidence-based care. Imaging mapping a patient to providers to see how well each provider consults across a team. We also need to be thinking out of the box when we pioneer new ways to do research” with data.

Other big data boons on the horizon: cloud services, actigraphy, consumer data clouds, genomic profiling, and discovering new neurocognitive measures. Psychologists are integral to designing and implementing these tools, and supervising real world change in practice and policy, she said.

 

‘But How Do I do It?’ Application of Theory to be Focus of Revised Mulitucultural Guidelines

Only 20 percent of doctoral degrees in psychology go to students of color, despite the fact that 40 percent of Americans are people of color, according to Nayeli Chavez-Duenas, PhD. Even with the shifting demographics in the United States, studies have demonstrated low levels of cultural competency among psychologists. The proposed revisions to APA’s multicultural guidelines are designed to address this problem by offering concrete suggestions for preparing psychologists to become multiculturally competent.

 The current guidelines were approved in 2002 and have been studied in most psychology training programs, providing important direction about preparation of psychologists for working in a diverse world,

“Addressing culture within psychology requires complex thinking,” said Patricia Arredondo, EdD, one of the lead scholars working on the proposed revisions. This comment reflects the spirit of the revisions, which will seek to build on the current guidelines by maintaining the core principles, while emphasizing ways to operationalize and apply the values. revised multicultural guidelines

I regularly teach our required diversity/ multicultural competence course to master’s students and one of the questions they often as me is, “But how do I do it?” Getting buy-in for the importance of multicultural competence is a needed first step for some students but even those who fully embrace the idea in theory struggle to learn how to put it into practice. The proposed revisions offer strategies for just that.

The new guidelines would offer ways to deconstruct and increase self-awareness about one’s own ethnic identity, said Hector Adames, PsyD. They provide specific recommendations about developing awareness about various aspects of identity (such as one’s identity as a white person), while encouraging psychologists to “use multiple lenses to understand complex processes, especially complex human experiences and identities, ” according to Adames.

I am especially enthusiastic about the proposed recommendations for skill development, including how to engage in dialogue and behavioral change.

Although the revisions are not yet available (they are undergoing the approval process within APA), I am excited to take what I have learned back home with me. I will certainly be integrating some new ideas as I prepare my fall syllabi in the coming weeks.

Health service psychologists wanted! How do we get there?

Thanks to the Affordable Care Act (ACA), there is a greater need than ever for psychologists in integrated health care. But what is integrated health care? A comprehensive definition from APA is here, but basically it reflects the growing interdisciplinary nature of the health-care system and recognizes the need to develop  comprehensive treatment — and prevention — plans to meet patients’ psychological, social and medical needs.

Many psychologists are interested in working collaboratively in a medical setting, but how do we ensure that psychologists are ready upon graduation?

A symposium panel, chaired by Dr. Emil Rodolfa, answered that question by discussing several important areas. The first was competencies. Dr. Stephanie Wood of Alliant International University outlined the competencies health service psychologists need. These include:

  • Interprofessionalism: The ability to work collaboratively with others in a medical team, including speaking the same language (e.g., what is a electronic medical record?)
  • Leadership: Positioning psychologists to be in an ideal situation to lead effectively in medical settings. This includes not being afraid to ask physicians questions and working to ensure psychology remains an integral part of integrated care teams.
  • Cultural competence: Raising the level of knowledge around who seeks care and why.
  • Use of evidence-based interventions: Teaching psychologists to effectively review the literature and implement only interventions that have a robust evidence base.

The good news is that there are already programs in place for this sort of health services training, particularly at the clinical internship level.

Dr. Jeffrey Baker, the executive director of APPIC, reported there are 226 internship programs that provide experiences in integrated primary health care. Others provide more specialized training. Also, there are as many as 63 APPIC postdoctoral programs that offer ample experience. Check out the APPIC website for more details.

The medical system is changing and there is a true need for trained psychologists that can navigate health care and deliver psychological treatments to those in need.

“The Stanford Prison Experiment” movie: What happened in the film that didn’t happen in real life?

The new feature film “The Stanford Prison Experiment” is “about 90 percent accurate,” said Stanford University psychologist Philip G. Zimbardo, PhD, at a showing of the film today as part of APA’s Film Festival.

At the screening, Zimbardo — who conducted the now-famous experiment in 1971 to simulate the conditions of prison and examine the power of social situations over individual personality — shared some of the differences between what really happened in the basement of the Stanford psychology building and what’s depicted in the film.

Among the greatest differences is that the movie shows one student being “arrested” by Palo Alto police at his home to begin the study, omitting the fact that all nine students assigned as prisoners were first taken to the Palo Alto police department after their arrests. There, they were booked, fingerprinted and held in a cell for several hours before they were taken to the university.

Other differences include:

• The Stanford professor who encounters Zimbardo as he is sitting outside the prisoners’ cells one night and asks, “What is the independent variable in your study? This is an experiment, right, not just a simulation?” is played by an older actor in the movie. In reality, the person who posed that question was Zimbardo’s same-age Stanford colleague and his Yale graduate school roommate – well-known experimental psychologist Gordon Bower, PhD.

• Zimbardo was never involved in the “parole hearings” held for prisoners as he is in the movie. Instead, some secretaries ran those meetings along with Carlo Prescott (who is featured in the film) — a man Zimbardo brought in to help with the experiment because he had recently been released from prison after serving 17 years.

• In the real study, there was less frequent physical abuse by the guards, Zimbardo noted. “The only physical abuse was during the rebellion when the guards broke in and the prisoners started attacking them,” he said.

Zimbardo told attendees that the experiment eventually led him to shift his area of research to shyness, which he studied for the next 20 years. “One of the messages of the study is the extent to which all prisons are prisons of the mind,” he said. “Shyness is a self-imposed psychological prison.”

He also said that he moved away from “creating evil” to “inspiring heroism” by launching the Heroic Imagination Project, a nonprofit organization that teaches children about heroism and promotes the use of social science research to teach people ways to resist bullying and oppression.

Zimbardo is now organizing a screening of “The Stanford Prison Experiment” for President Obama at the While House since the president recently made the first visit by a sitting president to a federal prison and is calling for prison reform.

“The Stanford Prison Experiment” is showing in theatres in limited release. Zimbardo will be answering attendees’ questions about the film online over the next few days. Email questions to .

Cyberbullying: R U 4 real ????

When kids communicate online, their relationships in real life may help them determine whether someone is cyberbullying.

Emoticons, writing in all caps and using acronyms can influence adolescents’ perceptions of what their peers write, helping replace other cues like tone of voice and facial expressions that might help them interpret meaning in real life. Still, an offline relationship guides how kids might interpret ambiguous sentences such as, “I’ll find you after school. :-)

Michal Bak, a graduate student at the University of Victoria, British Columbia, presented a pilot study on how young people process information online during a symposium entitled “Cyber Aggression – Perceptions, Behaviors and Influential Factors.” While knowing a writer helps, research in the field so far suggests that other things come into play, such as social status, when kids react to what’s put online, he said.

“Social status cues may be more prominent in online settings, because adolescents can obtain additional info like followers, positive comments, likes and up-votes,” Bak said. The 30 youngsters he and his team interviewed often couldn’t recall receiving ambiguous messages, but “sometimes emoticons tend to obscure the message, and we find that students tend to hide their real intentions using them,” he said.

More people may be liable to come to a victim’s defense in real life, too, according to work from Nicole Summers, a graduate student at Carleton University. She and her research colleagues are studying moral disengagement in cyber aggression.

Looking at almost 500 emerging adults in Canada ages 16 to 20, she and her colleagues found that over 88 percent of them reported having read insults or mean comments in social media forums at least once in the past year, and over 35 percent of participants witnessed these behaviors weekly. Those who had higher levels of moral disengagement – such as believing one couldn’t help, blaming or dehumanizing the bullying victim, or disregarding help – were more likely to have pro-bullying behaviors such as enjoying reading mean online posts.

“In [real life] social situations you can be an insider, meaning somebody who goes along with bullying, but being online you’re always an outsider. You don’t have to disengage online, because you’re already disengaged to begin with,” she said.

When it comes to online versus social aggression, gender may make a difference, said Megan Lamb, a graduate student at Carleton University. In her study of 429 students ages 11 to 18 in rural eastern Canada, 86 percent reported using social aggression against a friend, and 92 percent reported being socially victimized by a friend in the past school year. The bullying happened online, too, and there was a strong relationship to bullying or being victimized in both arenas. About half of all students reported using cyber aggression against a friend in the past school year, and 67 percent reported being victimized.

Girls reported using and being victims of face-to-face social aggression more than boys. However, boys and girls did not differ much in how often they engaged in cyber aggression.

“Boys are often less comfortable using social aggression, but because cyber aggression is more anonymous, maybe [they] feel more comfortable using that,” she said.