Early career psychologists and ‘the revolving door’

As I walk in a little late to a session for early career psychologists, Barry Chung, PhD, is speaking about a common topic at this type of convention — “the revolving door.”

The revolving door is a metaphor for “recycled leadership” in association governance. Basically, the same people hold the power year after year. Some people have served in various leadership positions for many years without ever rotating out of APA governance. The result is that there is a huge barrier that prevents new leaders from breaking in to APA governance. It also does not allow for new ideas and promotes group think/the formation of cliques. In the wake of the Hoffman report, this has become a hot topic around convention.

Chung adds that APA has a problem — it’s getting old. With an average membership age in the mid-50s, APA is struggling to recruit new people. This is why it is an APA imperative to get early career psychologists (ECPs) involved in leadership within the association.

Also at the session is Angela Kuemmel, PhD, who serves on APA’s ECP Committee and shares some facts about ECPs. First, she defines ECPS as within 10 years of receiving their terminal degree. Also, ECPs represent only 20% of APA membership, they tend to be more diverse in terms of identity and work in more diverse settings. They also tend to have a better scope of the career prospects in psychology and are more in touch with the contemporary issues facing the field.

A slight smirk then comes to Angela’s face as she describes another phenomenon  — “unempirical supported stereotypes about ECPs.” She describes microagressions that  damage the credibility of ECPs. She says that while ECPs are seen as having “lots of energy and being technology/social media experts,” they are not seen for their expertise within psychology. She goes on to describe the importance of not equating ECPs with students, which more seasoned folks too often do. These  beliefs discredit ECPs’ expertise in psychology.

I think of my own experience within APA governance and how often I have felt these microagressions. At this point, I feel a sense of irony blogging this event and fulfilling the stereotype. I am also aware of how often I am asked if I am a student.

Then Katharine Oh, PhD, a former ECP Committee member steps discusses the importance of modeling and leadership. When an ECP considers getting involved in an organization, it is crucial that they see other ECPs as models. She also discusses the importance of mentoring and helping ECPs get oriented within their leadership positions. She describes several leaderships programs she has been part of including a few “leadership development academies” designed to help early career leaders develop and gain experience for future leadership positions.

I think to my own mentors and how they helped me gain experience and leadership positions. If it weren’t for these people, I would have felt lost upon entering governance.

When I leave the session, there is a general sense of hope and optimism. It feels like the revolving door is starting to close. Only time will tell if significant changes happen, but it is truly encouraging to see this programming at convention.

Women’s Life Problems Aren’t Always Medical Problems

Medicine and the media are helping to medicalize everyday life experiences like anxiety, sadness, weight loss, menopause, and reproductive health, and women are the primary targets, according to psychologists and co-authors of a new book, “The Wrong Prescription for Women,” who spoke at a symposium on the topic.

While it’s important to acknowledge and treat real illness, women are too often prescribed medicines and medical procedures, more so than men, even when their experiences are normal.  “Many of these treatments aren’t problematic,  but the problem is they make normal parts of our lifes and bodies and experiences [seem abnormal]. The pharmaceutical industry created [these issues] to sell drugs to everyone, and sadly they’ve been very effective at this,” said Maureen McHugh, PhD, of Indiana University of Pennsylvania.

For example, modern society has a tendency to look at the prolonged grief that may naturally accompany a loss as depression that needs medication. Women are more likely to express their grief more explicitly and intensely, said Leeat Granek, PhD, Ben-Gurion University of the Negev.

“Women [have long been] expected to carry grief for their families and communities and states. Today, women are being pathologized for doing this job too well,” Granek said. Society — and clinicians — see grieving as a much briefer process with a deadline for moving on, which can be as little as two weeks, she said.

Woman taking medicines

Women are far more likely than men to be diagnosed with depression and to be prescribed medications for it, which can be a broad form of social control, said Alisha Ali, PhD, of New York University. “If you’re a deviant outside the norm, we are believed to have the responsibility of ‘fixing you’ so we can bring you inside of the norm,” she said.

However, women most prone to depression are also the most marginalized, including those who are abused, poor or victimized. When they take medication for depression, women report reduction in self-destructive thoughts, but also report apathy and disengagement, Ali said.

“Therefore, treatment for depression chemically neutralizes the very feelings most needed to fight for social change. We need approaches to depression that can support women in changing the material conditions of their lives. We need empirical research documenting the effectiveness of feminist-informed approaches to treating depression and other mental health problems,” she said.

Even menstruation is becoming taboo, said Jessica Barnack-Tavlaris, PhD, of The College of New Jersey. Perhaps influenced by advertisements that promote convenience, women are increasingly using contraceptives to suppress menstruation, and doctors giving them to young women to counter the effects of early puberty.

“Viewing menstruation as negative, not normal, or unnecessary has implications for women’s physical and emotional well-being. Some women will then experience shame with menstruation and those who do that are more likely to self-objectify,” she said.

Mindy Erchull, PhD, associate professor at the University of Mary Washington, spoke of how media promote an unnaturally thin body, with the result that it has become the norm for women to be dissatisfied with their bodies.

The thin ideal now often encompasses a fit ideal, especially in advertisements, Urchell said – a dual standard that may be even harder to achieve, as “Most people assume that to be fit you have to be thin. But muscles take up room,” she said. At the same time, breasts are seen as desirable, yet they mainly consist of body fat.

Even public health officials may cause undue worrying with the so-called war on obesity that primarily targets women, said Christine Smith, PhD, of the University of Wisconsin-Green Bay. Women are more likely to be labeled obese and more likely to turn to bariatric surgery – now offered to women who are as little as 20 pounds overweight — which can have serious side effects, such as digestive problems and nutritional deficiencies. Yet the link between weight and health isn’t definitive, she said: “The war on obesity is common trope … that we need to have people lose weight, otherwise our health system is going to collapse.”

Worrying about your body can limit women’ lives on multiple levels, including “how we think of our bodies, of ourselves and how we think of other women,” McHugh said. “When you feel your or your body isn’t good enough, it makes it hard to become socially engaged. And worrying about our thighs takes attention away from other activities.”

What’s Next for the Multicultural Competence Movement?

“Psychologists should do more than address the downstream consequences of racism, but also work to tackle racism itself,” said Brian Smedley, PhD, during a session examining the past, present, and future of the multicultural competence movement. Smedley spoke about his work addressing health inequities in communities of color by examining structural causes, especially segregated communities.

In addition to providing an in-depth review of the important achievements of the multicultural competence movement, Lillian Comas-Diaz, PhD, offered her suggestions for future areas of focus. She called upon psychologists to consider ways to integrate folk healing into our work, to explore psychospirituality, to examine intersectionality, and to develop transnational and international competence.

The role of psychologists in doing advocacy work to dismantle systems of oppression was identified as one of the key areas for the future of the multicultural competence movement. Rebecca Toporek, PhD, described how the multicultural competence movement and social justice movement have worked together (and indeed need each other). She invited audience members to reflect on their own experience of the interaction of the two, asking participants to consider the reason they decided to study multicultural competence and what keeps them going in the face of obstacles. She surmised that for many in the room, the drive to work for social justice sustained individuals when they met roadblocks in their work in multicultural education.

However, very few psychologists receive direct training about how to blend social justice work into their roles, often feeling constrained to focus solely on work with individuals (and families/couples). Toporek suggested that many feel hesitant to take the next step toward action, believing there should be separation among science, practice and activism. Training programs can address this reluctance and find ways to educate graduate students about social justice advocacy and activism, provide training about policy and acknowledge the structural causes of inequity.

I teach the diversity/ multicultural counseling course in our master’s program and have begun to integrate advocacy training into the curriculum. Students learn about the many ways counselors and psychologists engage in advocacy and activism and develop proposals for advocacy projects. Some of the students have actually gone on to implement the projects at the university and within the community. Although students are often surprised that the course includes discussions of advocacy, many embrace this aspect of the course and ask for additional resources. Their enthusiasm makes me hopeful about the future of the multicultural competence movement and the profession.

Help for Toronto’s Firefighters

Four out of five firefighters will suffer a stress-related illness or absence sometime in their career, Toronto Fire Chief Jim Sales told attendees at APA’s Annual Convention in Toronto. “As of yesterday, I had 87 staff on long-term disability, and 60 percent of those are stress or anxiety related.”

In 2015, 29 first responders in the city have died by suicide and the Toronto Fire Service, which lost a firefighter to suicide in February, averages one to three suicides per year. A lack of mental health support from the department is partly responsible, said Sales. “Historically, fire services haven’t looked at the mental health side, at the ability to cope with the stress [firefighters] find on the job each and every day.”

Sales aims to turn that around by boosting mental health support throughout the department. Consulting with the Canadian Mental Health Commission and police, he is working to improve firefighters’ access to mental health services, enhance peer support programs, educate supervisors on how to provide support and create sick-leave policies that support mental health needs.
The fire service will also be committed to eliminating the shame often associated with seeking mental health services among firefighters, he said. “There’s a stigma attached to telling your boss or coworkers that you’re having an issue with a call — it’s considered weak,” he said. “We need to change that philosophy and make it understood that these things impact us all.”

Shift work can also add to the stress of an already-stressful profession. Toronto firefighters work eight 24-hour shifts per month, which can be hard on their families and make it difficult for supervisors to spot signs of mental distress. The department will build a health and wellness center that families can access and implement 24-hour follow-ups and check-ins with firefighters who have gone out on particularly difficult emergency calls.

“We want to be a leader in this area,” Sales said. “The old saying, an ounce of prevention is worth a pound of cure? We need to be investing in that ounce.”

Ask My Mom: Can Video Games Help Brain Power?

Growing up in the ’70s and ’80s, I was part of the first generation of video game players. I spent many an afternoon playing Space Invaders or waiting in line at the local electronics store for the latest offering from Atari. That obsession continued into college with all-night sessions of Super Mario Brothers. But after graduation, my interest in video games faded for the better part of a decade, only to be refueled by a defining influence in my life: My mom.

400536409_3b18c7d9b2_oTo say my mother is an avid gamer is an understatement. She owns multiple gaming consoles, including several iterations of Sony’s Playstation and an X-box. She is on a first-name basis with the salespeople at the local video game store, where at any given time she is probably on a presale list for another title. Her preference is fantasy-based role playing games, the type with titles like Final Fantasy or Dragon Age. When I go to visit I her, I often spend hours watching her diving in dungeons for more treasure or going up against a monster boss. Did I mention she’s 74?

My family tolerates and even encourages my mother’s gaming obsession because we kid that it’s helping her to stave off dementia. Turns out we may be right.

Research presented in a symposium today at the APA convention by Chandramallika Basak, PhD, and her colleagues at the University of Texas, Dallas, suggests that regular playing of strategy role-playing video games can increase cognition and memory compared to people who simply train their brains with written word games and crossword puzzles. The psychologists focused their research on one game: Rise of Nations. In this real-time strategy computer game, players acquire territory upon which they build, defend and expand their nation.

After playing the game for approximately 20 hours over six to eight weeks, participants scored significantly better on a number of cognitive tests than a control group whose members simply trained on word games. They also continued to have better visual memory updating 45 days after they stopped playing.

There are two paths to success in this game. Combat mode relies on the player to conduct military campaigns. Wonder mode rewards players for developing resources and building important structures, known as wonders, such as a Colossus, a pyramid or (in future ages) even a supercollider. The researchers had expected that given a choice, older adults would  choose to play in Wonder mode, but participants preferred to play in combat mode. This may not have been the best choice because the researchers found better results in those who played Wonder mode.

Which leaves me wondering — perhaps I should introduce Mom to Rise of Nations.

#itdoesnthavetohurt

Studies have shown that it takes 17 years on average for research findings to translate into improvements in clinical care. That’s a long time for a child in pain to wait, Christine Chambers, PhD, told attendees at a symposium on children’s health on Thursday.

In an effort to move child health research off the shelf and into practice sooner, Chambers, a clinical psychologist and professor of pediatrics, psychology and neuroscience at Dalhousie University in Halifax, Nova Scotia, has partnered with several other health researchers and the Yummy Mummy Club (YMC), a group of Canadian “mommy bloggers.” They created a social media campaign dedicated to increasing parent’s use of evidence-based knowledge on children’s pain.

shotsThe “It Doesn’t Have to Hurt” social media campaign (#itdoesnthavetohurt), led by the Centre for Pediatric Pain Research, where Chambers also holds an appointment, launches on Sept. 15. It will include a year of targeted sharing and discussion of content about children’s pain, using blogs, videos, Twitter parties, Facebook polls and social media images, all posted and promoted on the Yummy Mummy Club website and through social media.

Chambers already has had success using social media to improve parental behavior around pediatric pain. Last year, she developed a YouTube video providing parents with evidence-based strategies to help children better handle shots. She also posted the video on Facebook and delivered a TEDx talk on the topic, moves that led to almost 150,000 YouTube views in 120 countries. Chambers also conducted a parental survey on the video and found that after watching the video, parents felt more confident in how to help their children deal with shots and were likely to use the video’s tips, including distracting the child with videos and games and having them blow bubbles before a shot to promote deep breathing.

“There’s a Pew Research Center survey that came out just last month showing that parents are really heavily using social media for parenting advice,” Chamber said. “It’s so important for us to work together to use these powerful tools to make sure our good research evidence reaches families sooner.”

We Need to Teach the Teachers: Training for the Future of Psychology – An Integrated Primary Care Curriculum.

IMG_0454It’s almost impossible these days to discuss psychological clinical work in the United States without also discussing how it fits into an integrated health care model. Luckily, the Div. 38 (Health Psychology) Clinical Services Counsel (CSC) is on the job. In the dark corridors of the Toronto Convention Centre, a few psychologists presented their proposed primary care curriculum to a clutch of students, faculty and clinicians.

They described a critical problem in psychological training programs: Students need to learn how to work in integrated health care, but we don’t have anyone to teach them — at least not on the mass scale necessary to train a generation of clinicians for a rapidly changing health care model. Most faculty in psychological training programs do not have experience or training in this type of treatment.

Essentially, we need to teach the teachers to teach the future of psychology.

How do we do this? Shanda Wells PsyD, described a curriculum the CSC is developing. It includes a plethora of materials that have been produced to help graduate faculty to teach integrated health care psychology — “beautiful Powerpoints, like you have never seen before,” plus handouts, pictures/models, videos, and even pre/post tests that have been produced by the committee to help develop teachers in graduate schools. She emphasized and repeated one point: “The materials are free and flexible”

IMG_0456

She and her colleagues showed a few of the videos, which featured high-quality cinematography and great use of diverse actors in real world settings. One video shows a psychologist in a “doctor’s office” talking to a man about behavior interventions for sleep. The video feels real and the acting is solid. It doesn’t feel like a generic psychology training video made in the 1980s. It feels current and relevant.

It feels like something students will respond to.

Nancy Ruddy, PhD, spoke of  the importance of setting expectations for the future of psychology for both students and faculty. The days are gone of “solo practice where you sit alone in a room with a box of Kleenex and a lamp,” she said. She described the importance of seeing ourselves as a component of treatment in holistic health care as opposed to islands off by ourselves.

In addition, committee members plan to make themselves available for consultation about the curriculum. They described the importance of allowing an “ongoing discussion” around this type of training experience. And they said they are excited to see how these materials get used in training settings and want to hear feedback on how they can improve them.

IMG_0457

The materials will be available for mass consumption soon. For more information, contact the Div. 38 (Health Psychology) Clinical Services Counsel (CSC).

Weight Stigma, Stress and Obesity

We have all heard about the perils of the obesity epidemic and its cost ho society. But something you may not know is that it’s not all about willpower and the make-up of the food environment. In this regard, Dr. Janet Tomiyama, an assistant professor at UC Los Angeles, gave a spirited, and impressively convincing, invited talk as part of Div. 38’s programming on the insidious role of weight stigma.

IMG_2225

So how does feeling stigmatized hurt your waistline? In a recent paper, she outlines a model in which weight stigma increases one’s psychological stress, leading to increases in one’s stress physiology- in particular, levels of cortisol (that pesky stress hormone). Cortisol has many known effects, including contributing to visceral fat deposition and a drive to eat, both of which certainly undermine the goal of losing weight. Not only does weight stigma fail to motivate individuals to lose weight, it may, as Tomiyama hypothesizes, lead to additional weight gain.

Is weight stigma that prevalent? Maybe in the general population, but not among experts or clinicians who treat obese individuals, right? WRONG. In another recent study, Tomiyama examined the explicit and implicit biases against obesity among attendees of a national obesity conference. Participants (around 200 of them) completed several measures of bias, and consistent with Tomiyama’s hypothesis and prior research, even the experts showed a high level of negative bias toward obesity. In fact, compared to a similar study carried out 10 years earlier, explicit bias is actually on the rise. To follow up on this work, she turned to the laboratory and subjected participants to pictures of thin and heavier people. The participants were under the impression that they were there to judge the pleasantness of different lotions (all the lotions were actually odorless). It turns out that individuals exposed to pictures of obese people rated the odors as less pleasant than when exposed to leaner stimuli. This is disturbing, of course, but also a fine example of great social psychology.  Tomiyama described a number of other studies supporting her model, as well as several forthcoming studies.

Weight stigma reflects a novel, and often unacknowledged, contributor to the obesity epidemic. It will take further scientific creativity from Tomiyama and others to move weight stigma onto the national stage. Until then, as I told Tomiyama after her talk, “if I was still an undergraduate and had heard you talk, I would have wanted to become a social psychologist.”

Mom’s Attitude Can Affect Dad’s Parenting

To get fathers to be more involved with their children, mothers should encourage dads to play a bigger role in their children’s upbringing — and then remember to step back and let them do just that, according to presenters Thursday at a symposium on fathers’ parenting patterns during the 2015 APA Annual Convention in Toronto.

Instead, some 21 percent of mothers engage in what’s known as “maternal gatekeeping,” where they might consciously or unconsciously dissuade fathers from helping with child-related chores or activities, or just do the tasks themselves, said Alex Rowell, a doctoral student at Ohio University, who presented at the symposium, “A Quantitative Evaluation of New Fatherhood: Implications for Policy and Practice.” That’s partly because of society’s expectations, standards and social validation of child-rearing duties, he said. And it can lead to dads taking a lesser role in parenting.

parenting“[Maternal gatekeeping] affects paternal abilities, as in how confident fathers are in being able to do tasks like changing diapers or arranging playdates,” Rowell said. “There’s not that reinforcement of confidence, so [he might] start withdrawing a little bit.” Other barriers may include gender role conflict, professional biases and work-life balance, anxiety and feelings of low self-efficacy when it comes to parenting.

Still,  dads have a greater role in parenting than is often thought, and their interaction with their children can have a big influence on how those children develop. According to what’s called the activation relationship theory, fathers interact with children differently than do mothers. They can help their children learn how to safely explore the world, and they bring a playful attitude to parenting that helps kids learn about appropriate social behavior.

“The central nervous system is spiked a little more through rough-and-tumble play, and the child has to learn to self-regulate,” Rowell said. Other studies suggest that a father’s involvement at various ages can protect against negative psychological conditions and influence a child’s motor development, school readiness and IQ.

Psychologists still are trying to tease out how family, mental health and social factors come into play for new fathers and to develop measures for their involvement, said Brian Cole, PhD, an assistant professor at Seton Hall University.

“Parenting doesn’t occur in a vacuum, and there’s no manual,” Cole said. “When you pair that with gender norms that discourage men from taking an active role in parenting, it’s important to understand what processes encourage men to actively engage in it.” Research so far suggests that social support is a significant factor.

Researchers in the field also are studying how these relationships play out with single- or same-sex parents.

What Does a Concussion Look Like? And How Is It Different in Kids?

FullSizeRenderNeuroimaging technology aimed at better diagnosing and understanding concussion is developing rapidly but there is still much that  neuropsychologists don’t know about mild traumatic brain injuries, especially among younger children.

In a session entitled “New Ways of ‘Seeing’ Concussion in the Adolescent Brain,” presenters described some cutting-edge neuroimaging tools, including one new technique — near infrared spectroscopy — that can actually be used when a subject is performing a task. “It’s based on light refraction and properties of blood,” said Anthony Kontos, PhD, of the University of Pittsburgh Medical Center. Clinicians can actually see where blood is going in the brain, he said.

However, Kontos said there is still no clinical imaging protocol to assess and manage these injuries. “We can see stuff but we just don’t know what it means,” he said. “A lot of times, the findings say two different things. … We don’t have a clinically acceptable way to neuroimage concussion.” Indeed, he said, research has shown that more than 95 percent of concussion patients have “normal” imaging when subjected to CT scans or MRIs, for example.

Luke Henry, PhD, of the UPMC Sports Medicine Concussion Program at the University of Pittsburgh, described the differences in the development of gray matter and white matter in children’s and adults’ brains. However, he noted that most of the research on post-concussion brain change has been on adults, especially boxers and football players, not young children. That being said, one thing that researchers and clinicians know for sure about mTBI is that the effects are cumulative. “History matters,” he said. “If you’ve had a bunch of injuries in the past, that’s probably a bad thing for you.”

Two or more mild brain injuries in the past can result in long-term effects, he said, but “the exact nature of cumulative effects is up for debate.” And, he said, some groups are more vulnerable to these effects than others, and certain deficits are more apparent.