Psychotherapy
OFFICIAL PUBLICATION OF THE SOCIETY FOR THE ADVANCEMENT OF PSYCHOTHERAPY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION www.societyforpsychotherapy.org B In This Issue
SpecIal FocuS: SelF-care acroSS The lIFeSpan early career Self-care Together: Strategies That Benefit Early Career Psychology Faculty and Psychology Doctoral Trainees U Student Feature The Game of Strife: A Means of Coping for Psychology Doctoral Students Stifled: Art and the “Task” of Self-care L
psychotherapy research, Science, and Scholarship An MTurk Primer for Psychotherapy Researchers
psychotherapy practice Asking for Help in Building My Private Practice: How I Stopped Grasping in the Dark and Invested in My Business L
Retirement Myths, Continued
education and Training Positive Regard in Clinical Supervision: Trainee Perspectives public Interest and Social Justice E “Let’s Talk on the Fourth Floor”: Trials and Tribulations in Our Attempt to Increase Access to Psychotherapy Services T I 2019 VOLUME 54, NUMBER 2 N Society for the advancement of psychotherapy n 2019 Governance Structure ELECTED BOARD MEMBERS President Domain Representatives Domain Representatives, continued Nancy Murdock, PhD Public Interest and Social Justice Diversity University of Missouri-Kansas City Lavita Nadkarni, PhD, 2018-2020 Rosemary Phelps, PhD, 2017-2019 215 Education Building Director of Forensic Studies University of Georgia 5100 Rockhill Road University of Denver-GSPP 402 Aderhold Hall Kansas City, MO 64110 2450 South Vine Street Athens, GA [email protected] Denver, CO 80208 Ofc: (706) 542-1812 Ofc: 816-235-2495 fax: 816-235-6925 Ofc: 303-871-3877 E-mail: [email protected] E-mail: [email protected] E-mail: [email protected] Diversity President-elect Psychotherapy Practice Manijeh Badiee, PhD. 2019-2021 Jennifer Callahan, PhD Barbara Vivino, PhD, 2019-2021 Department of Psychology UNT Department of Psychology 921 The Alameda #109 California State University Terrill Hall, Room 376 Berkeley, CA 94707 5500 University Parkway 1155 Union Circle #311280 Ofc: 510-303-6650 San Bernardino, CA 92407 Denton, TX 76203-5017 E-mail: [email protected] Ofc: 909-537-7305 Ofc: 940-369-8229 E-mail: [email protected] Education and Training E-mail: [email protected] Marilyn Cornish, PhD, 2019-2021 International Affairs Secretary Auburn University Frederick Leong, Ph.D. 2018-2020 Rebecca M. Ametrano, Ph.D., 2018-2020 2084 Haley Center Michigan State University Office of Patient Centered Care Department of Special Education, Department of Psychology VA Boston Healthcare System Rehabilitation, and Counseling East Lansing, MI 48824 1400 VFW Parkway Auburn University, AL 36849 Ofc: 517-353-9925; Fax: 517-353-1652 West Roxbury, MA 02132 Ofc: 334-844-7601 E-mail: [email protected] Ofc: 857-203-5394 Email: [email protected] E-mail: [email protected] Membership APA Council Representatives Lillian Comas-Diaz, PhD, 2017-2019 Treasurer Jean Birbilis, PhD, 2019-2021 908 New Hampshire Ave NW Ste 700 Jesse J. Owen, PhD, 2019-2021 University of St. Thomas Washington, DC University of Denver 1000 LaSalle Ave., MOH 217 Ofc: (202) 775-1938 Morgridge College of Education Minneapolis, Minnesota 55403 E-mail: [email protected] Counseling Psychology Department Ofc: 651-962-4654 fax: 651-962-4651 1999 E Evans Ave E-mail: [email protected] Elizabeth Nutt Williams, PhD, 2017-2019 Denver CO 80208 Early Career St. Mary’s College of Maryland Ofc: 303-871-2482 Leigh Ann Carter, PsyD, 2017-2019 18952 E. Fisher Rd. E-mail: [email protected] University of Delaware - Center for Counse - St. Mary’s City, MD 20686 ling and Student Development Ofc: 240- 895-4467 Fax: 240-895-2234 Past President E-mail: [email protected]. Michael J. Constantino, PhD 261 Perkins Student Center Newark, DE 19716 Deptt of Psychological & Brain Sciences Student Representative Ofc: 516-641-2066 612 Tobin Hall - 135 Hicks Way Carly Schwartzman, 2019-2020 E-mail: [email protected] University of Massachusetts University at Albany, SUNY Amherst, MA 01003-9271 Science and Scholarship Social Sciences, Department of Psychology Ofc: 413-545-1388 Susan S. Woodhouse, PhD, 2017-2019 1400 Washington Ave. E-mail: [email protected] Department of Education and Human Serv - Albany, NY 12222 ices Lehigh University Ofc: (551) 265-6750 111 Research Drive E-mail: [email protected] Bethlehem, PA 18015 Ofc: 610-758-3269 Fax: 610-758-3227 E-mail: [email protected]
STANDING COMMITTEES Continuing Education Finance Program Chair: Ken Critchfield, PhD Chair: Jeff Reese, PhD Chair: James Boswell, PhD Email: [email protected] E-mail: [email protected] E-mail : [email protected]
Diversity International Affairs Psychotherapy Practice Chair: Sheeva Mostoufi, PhD Changming Duan, PhD Daniel Gaztambide, PhD E-mail: E-mail: [email protected] E-mail: [email protected] [email protected] Membership Psychotherapy Research Early Career Psychologists Rosemary Adam-Terem, PhD Chair: Joshua Swift, PhD Chair: Sara Danitz, PhD E-mail: [email protected] E-mail : [email protected] E-mail: [email protected] Nominations and Elections Social Justice Education & Training Chair: Jennifer Callahan, PhD Linda Campbell, PhD Chair: Eric Sauer E-mail: [email protected] E-mail: [email protected] E-Mail: [email protected] Professional Awards Fellows Chair: Michael Constantino, PhD Chair: Robert L. Hatcher, PhD E-mail: [email protected] E-mail: [email protected] n
pSYchoTherapY BulleTIn pSYchoTherapY BulleTIn Published by the Official Publication of the Society for the Advancement of SocIeTY For Psychotherapy of the American Psychological Association The adVancemenT oF pSYchoTherapY American Psychological Association 2019 Volume 54, number 2 6557 E. Riverdale conTenTS Mesa, AZ 85215 602-363-9211 e-mail: [email protected] President’s Column ...... 2 edITor Lynett Henderson Metzger, PsyD Editors’ Column ...... 4 [email protected] Special Focus: Self-care across the lifespan aSSocIaTe edITor Early Career ...... 5 Cara Jacobson, PsyD Self-care Together: Strategies That Benefit Early [email protected] Career Psychology Faculty and Psychology conTrIBuTInG edITorS Doctoral Trainees diversity Student Feature Manijeh Badiee, PhD and The Game of Strife: A Means of Coping for Rosemary Phelps, PhD Psychology Doctoral Students ...... 13 education and Training Stifled: Art and the “Task” of Self-care ...... 19 Marilyn Cornish, PhD and Eric Sauer, PhD Psychotherapy Research, Science, and Scholarship ..22 ethics in psychotherapy An MTurk Primer for Psychotherapy Researchers Apryl Alexander, PsyD Psychotherapy Practice psychotherapy practice Asking for Help in Building My Private Practice: Barbara Vivino, PhD and Daniel Gaztambide, PsyD How I Stopped Grasping in the Dark and Invested in My Business ...... 29 psychotherapy research, Science and Scholarship Retirement Myths, Continued ...... 33 Susan Woodhouse, PhD, and Joshua Swift, PhD Education and Training ...... 35 Positive Regard in Clinical Supervision: public Interest and Social Justice Lavita Nadkarni, PhD, and Trainee Perspectives Linda Campbell, PhD Public Interest and Social Justice ...... 41 Washington Scene “Let’s Talk on the Fourth Floor”: Patrick DeLeon, PhD Trials and Tribulations in Our Attempt to early career Increase Access to Psychotherapy Services Leigh Ann Carter, PsyD and Sara Danitz, PhD International Scene ...... 44 Student Feature On Cheap Psychotherapy Carly Schwartzman Washington Scene ...... 47 editorial assistants “This Land Is Your Land” Salwa Chowdhury [email protected] Society for the Advancement of Psychotherapy Cory Marchi Grant Winners ...... 51 [email protected] STaFF central office administrator Tracey Martin Website www.societyforpsychotherapy.org
1 preSIdenT’S column Nancy L. Murdock, PhD University of Missouri-Kansas City
editor’s note : This issue’s from 4-4:50, followed by our wonderful Column was originally sent Awards Reception. This year we will be to the membership listserv again reviewing student poster award in email form; we hope finalists at the SfAP poster session (Fri - many readers were able to day at 11AM) in anticipation of present - attend APA and all of the ing the winner at our Lunch with the Society activities there. Luminaries for students and early career Make sure and check out professionals. You also might want to President Murdock’s Column in the next pop in on my presidential symposium at issue of Psychotherapy Bulletin for a fol - 9AM on Friday— Out of the Office and low-up on all of these exciting events. into the Streets: Interventions for Diverse Clients and Settings , which I promise, is made up of some very interesting Hello Everyone! As you read this, over presentations. half of my presidential year will have This year is also the inaugural year for passed and I would again like to thank the bestowal of the two Jeremy Safran you for allowing me the opportunity to Awards for Outstanding Poster Submis - serve the Society for the Advancement sions by the Society for the Advance - of Psychotherapy (SfAP) in this role. ment of Psychotherapy and the Society I am very much looking forward to for the Exploration of Psychotherapy In - the APA convention and all of our won - tegration (SEPI). These awards, created derful events there! Be sure to review by now SfAP past president Mike Con - the Division’s programming, currently stantino and SEPI president Catherine posted on our website, and mark your Eubanks, are given at the primary con - calendars for the Business Meeting and Awards Ceremony to be held on Friday continued on page 3
American Psychological Associa - tion—Society for the Advancement of Psychotherapy (Div. 29)—Inau - gural Jeremy Safran Memorial Outstanding Poster Award, to Brin Grenyer, Kate Lewis, Mahnaz Fanaian, Beth Kotze, and Project Air Team for “Integrative Psy - chotherapy for Personality Disor - der: A Stepped Care Randomised Controlled Trial” presented by Nancy Murdock, SAP President, at the 35th Society for the Exploration of Psychotherapy Integration meeting, Lisbon, Portugal, June 2019
2 ferences of the two organizations. By the to the Board of Directors at our fall meet - time you are reading this note, I will ing, which will be held September 20-21 have had the honor to present the win - in Kansas City, MO, my home base. It is ner at SEPI’s conference in Lisbon, Por - my hope that we can, using the survey tugal, and we anticipate that Dr. results, better understand and perhaps Eubanks will present the SEPI awardee, find ways to improve the experience of chosen from among our poster session our colleagues in SfAP. submissions, at the SfAP business meet - ing/awards ceremony at the APA con - I hope you love the new SfAP logo as vention in Chicago. much as I do! It was quite a while in the making but I personally and thrilled I hope that you have also helped your with the result! Huge thanks to the logo division leadership out by completing task force, led by Susan Woodhouse, for the Member Survey developed by the their hard work on this project. The Presidential Task Force on Communica - other members of the task force were tion and Member Relations. The task Rebecca Ametrano and Amy Ellis. force, which includes members from across the division leadership, is eager That’s all for now. I look forward to to analyze our results and present them seeing you in Chicago in August!
Find the Society for the Advancement of Psychotherapy at www.societyforpsychotherapy.org
3 edITorS’ column
Lynett Henderson Metzger, JD, PsyD University of Denver-Graduate School of Professional Psychology Cara Jacobson, PsyD Loyola University Maryland Welcome to another issue pand access to psychotherapy services of Psychotherapy Bulletin ! on a college campus.
Inside, you will find ar - We would love to have you write for the ticles from a range of Bulletin! You can find guidelines and the perspectives, including submission portal on our website: those of students, early- http://societyforpsychotherapy.org/ and mid-career profes - bulletin-about/ (and, as always, feel free sionals, and a follow-up to reach out to Lynett or Cara with ideas, article regarding retire - feedback, or suggestions). ment myths from Dr. Tom Barrett. We are We look forward to hearing from you! pleased to offer three ar - Lynett Henderson Metzger, JD, PsyD ticles on this year’s Special Focus, “Self- Psychotherapy Bulletin Editor care Across the Lifespan” (and please email: note that the final deadline for the this [email protected] topic—and the year—is November 1, so office: (303) 871-4684 send in those submissions!). You will also find pieces on a variety of other top - Cara Jacobson, PsyD ics, ranging from a primer on MTurk to Psychotherapy Bulletin Associate Editor tips for investing in your practice as a email: [email protected] business, to a reflection on efforts to ex - phone: (443) 520-2036
Find the Society for the Advancement of Psychotherapy at www.societyforpsychotherapy.org
4 SpecIal FocuS: SelF-care acroSS The lIFeSpan earlY career Self-care Together: Strategies That Benefit early career psychology Faculty and psychology doctoral Trainees Dhara T. Meghani, PhD School of Nursing and Health Professions University of San Francisco In the hectic pace of academia, who must develop and teach being an early career new courses, establish and fund a pro - psychologist (ECP) and gram of research, and manage multiple junior faculty member, service and administrative commit - it is often more possible ments (Good, Keeley, Leder, Afful, & to extol the virtues of Stiegler-Balfour, 2013). There is evidence self-care rather than to that academic psychologists are more authentically engage in it. In many stressed earlier in their careers, and on cases, this challenge may partially stem the whole, experience greater stress and from limited education and insufficient less personal fulfillment from their work opportunity to develop effective self- compared to licensed practitioners care habits during doctoral training. (Boice & Myers, 1987; Radeke & Ma - Perhaps it is reasonable to consider that honey, 2000; Watkins, 1992), although generating and maintaining self-care these phenomena have been understud - practices as a doctoral student and ECP ied among ECPs. faculty member are two sides of the same coin. In this article, I briefly review In a health services psychology doctoral literature concerning stressors and program, an ECP faculty member may potential benefits of self-care for ECP simultaneously be in the process of in - faculty and doctoral students in psy - tegrating newly acquired roles such as chology and highlight barriers that may licensed psychologist, clinical supervi - decrease the likelihood of self-care prac - sor, and/or clinical training director. tice among these groups. I offer concrete ECP faculty are also likely to be juggling strategies to incorporate in academic additional responsibilities and life tran - programs that have potential to increase sitions, such as repaying student loans, productivity and well-being of ECP fac - entering a committed relationship, start - ulty and trainees simultaneously. ing a family, relocating, settling into a home, and assuming responsibility for early career psychology Faculty elderly or ill family members. Indeed, Across the professional developmental research indicates that among the great - trajectory, ECPs report more emotional est challenges encountered by ECP fac - exhaustion, less satisfaction with their ulty is achieving a “balance” between career, and less engagement with self- academic and home demands (Good et care than mid- or late-career psycholo - al., 2013). To borrow loosely from Daniel gists (Dorociak, Rupert, & Zahniser, Stern’s concept of “motherhood constel - 2017). Although these data are reflective lation” (Stern, 1995), the transition from of professional psychologists, similar ex - doctoral trainee to an ECP faculty mem - periences are encountered by ECPs in continued on page 6
5 ber thus involves a vulnerable and psychology doctoral Students heightened state of negotiation and re- Not surprisingly, there are parallels be - organization of identities, during which tween the challenges that an ECP faculty self-care is unlikely to be a priority. member and a doctoral student in psychology encounter in their roles. Although there is a sizeable literature— Doctoral students in health services psy - and even a division within the American chology are a particularly vulnerable Psychological Association—devoted to group given the challenge of managing pedagogical practices within psychol - coursework, clinical training, and per - ogy, which are essential to supporting sonal demands while providing super - instructional skills and professional de - vised therapeutic services in the velopment, there is less emphasis on community. Further, the sheer length of self-care and its potential utility in ad - a doctoral program in psychology (five dressing academic burnout and stress to seven years) exposes students to en - (Weimer, 2010). Exploratory research during several episodic and chronic with faculty in a social work program re - stressful life events during the course of vealed that whereas faculty members their training (i.e., health and relation - across academic rank did engage in ship problems, illness/death of close multiple forms of self-care, assistant pro - family members, financial distress), fessors tended to engage in fewer self- which can interfere with or delay timely care practices than associate and full progression. Underrepresented students professors (Miller, Grise-Owens, & Sha - in psychology doctoral programs may lash, 2018), citing tenure-related stress additionally encounter unique barriers and financial reasons as potential barri - such as being disproportionately bur - ers. Of the various forms of self-care dened in culturally or linguistically spe - measured (i.e., professional support; cific clinical settings (Verdinelli & Biever, professional development; life support; 2009) and are less likely to seek counsel - cognitive awareness, and daily balance), ing services (Cheng, Kwan, & Sevig, “daily balance” (Dorociak, Rupert, 2013), further justifying the need for pro - Bryant, & Zahniser, 2017) was least en - grammatic support. dorsed by participants (Miller et al., 2018). This finding underscores the idea Compared to the literature on ECP fac - that integrating small—but potentially ulty and self-care, there is more research influential - self-care practices within the available on this topic among psychol - workday is perceived as challenging ogy doctoral students. Whereas self-care and reinforces the notion that self-care is is thought to aid in doctoral student something to be done outside of the pro - stress reduction (Myers et al., 2012), a fessional setting. This is problematic meta-analysis of 17 studies examining considering that junior faculty report self-care among graduate students in working nearly 10 hours/day (Good et psychology suggests that self-care is es - al., 2013), leaving little room for self-care pecially valuable in enhancing one’s afterwards. The combination of adjust - sense of satisfaction and self-compas - ing to institutional expectations and sion (Colman et al., 2016). These prac - barriers of consistently integrating self- tices are considered to support trainees’ care can contribute to poor mental productivity and well-being and to po - health and burnout among ECP faculty tentially reduce likelihood of profes - (Fowler, 2015; Lackritz, 2004) and po - sional burnout and dropout from the tentially compromise their road to career advancement. continued on page 7
6 field (Myers et al., 2012; Zahniser, Ru - the importance of self-care practices for pert, & Dorociak, 2017). Of note, the as - doctoral students in health service psy - pects of self-care related to professional chology (e.g., Zahniser et al., 2017; support (e.g., cultivating collegial rela - Burkhart, 2014). Examples of self-care tionships) and cognitive awareness (e.g., focused programs offered in health serv - monitoring one’s own reactions) have ice psychology training include topical been especially important in students’ workshops on self-care, a peer mentor - well-being and training outcomes (Zah - ing program for new students (Dittman, niser et al., 2017). However, psychology 2005), mindfulness training (Chlebak, doctoral students, like ECP faculty, also James, Westwood, Gockel, Zumbo, & struggle with implementing regular self- Shapiro, 2013) and Integral Life Practice care practices, due to time limitations, interventions (Burkhart, 2014). Integrat - stigma, and lack of encouragement to ing such practices within the program engage in self-care (El-Ghoroury, Galper, can relay a powerful message to stu - Sawaqdeh, & Bufka, 2012). dents about the value of self-care; at the same time, these measures require a rel - In sum, there is evidence that ECP fac - atively substantial commitment from ulty and doctoral students in psychol - graduate students and faculty. Because ogy experience concerning levels of a majority of the aforementioned self- stress and possess limited practical care programmatic efforts are optional, training and knowledge about how to they could be viewed as an additional successfully integrate self-care practices burden and may unintentionally ex - in their personal and professional lives. clude students who are in most need of Understandably, traditional conceptions self-care and support. Programs lacking of self-care may be incongruent with the the infrastructure to implement these varied schedules of doctoral students programs may aspire to these practices and ECP faculty. Additionally, the finan - and begin with simpler, intermediate cial burden that many graduate students steps that address the idea of “daily bal - (as well as ECPs) carry may prohibit or ance” (Dorociak, Rupert, & Zahniser, reduce the likelihood and frequency of 2017). There are positive implications for engaging in favored self-care activities ECP faculty (and likely, all program fac - (e.g., massage; vacations; going to a ulty and staff) if there is a concerted ef - gym; dining out; attending music, art, fort to normalize the ethical necessity of and other cultural events; and self-im - self-care in health services psychology. provement activities). An interpretation of the existing literature on self-care ef - Self-care Strategies ficacy among ECP faculty and doctoral I am currently an ECP faculty member trainees in psychology suggests that im - in a tenure-track position within the plementing self-care “daily balance” ac - Clinical Psychology PsyD Program at tivities within the workday may help the University of San Francisco. I joined target specific stressors in the academic the program one year after its concep - and clinical environment, be less costly tion, and thus, in addition to the usual than “traditional” self-care, and enhance demands of junior faculty, my col - overall satisfaction and productivity in leagues and I have been significantly in - one’s role. volved with program development and the APA accreditation process. Needless Multiple studies recommend imple - to say, self-care has traditionally been menting a culture of self-care at the pro - less publicly emphasized within our grammatic level to socialize and model continued on page 8
7 program, although we are striving to - gested for the teaching domain are per - ward more systematic practices as we haps most easily embedded on a regu - progress in our development. In the lar basis, whereas the strategies for meantime, it has been helpful—both for research and mentoring may take more myself and for students in our pro - planning or initial investment. gram—when we can make self-care more attainable in the classroom, within As the landscape of mental health serv - our respective research efforts, and in ices and training continues to diversify, mentoring relationships. professional and academic psycholo - gists must find ways to keep pace and I provide suggestions for self-care based sustain themselves through increasing on strategies that I have consistently in - demands and limited resources. Self- corporated across teaching (Table 1), re - care is an essential component of teach - search (Table 2), and mentoring (Table 3) ing, research, administrative service, domains. While not comprehensive, and clinical work, and should not be these strategies are intentionally simple, considered an elusive afterthought, but meant to be mutually beneficial for fac - rather acknowledged for its restorative ulty and students in supporting both potential to promote and elevate the ef - parties’ self-care, and can be adapted ficacy of trainees, faculty, and practi - based on individual program curricula tioners alike. and requirements. The strategies sug -
Table 1: Self Care Strategies in the Teaching Domain Self-care Strategy Description and Rationale In-class These moments should be brief and can be self, faculty- and/or mindfulness student-led at the beginning or end of class. Gives explicit moments “permission” to breathe, re-center, and focus inward. Opportunity to ground oneself and increase engagement with material. Stretching and Beyond class breaks, incorporate opportunities to stretch, stand, moving and move around the classroom. Music can also be incorporated during this time to aid in movement. Some of these exercises can be built into transitions between activities, and are especially helpful for graduate courses which tend to be 2-3 hours in length Class pulse This is a time-limited opportunity (~5-10 minutes) that faculty can offer to students to “check in” about how their day or week is going, which can include personal and professional concerns. This activity can be particularly useful during stressful times in the academic year cycle and provide students and faculty opportunity to transparently share contextual factors that may interfere with course engagement. In-class written Aligned somewhat with the idea of a “flipped classroom,” reflections students can be given time to reflect on course readings and topics in-class to help bring a more present focus to the discussion. This activity can occasionally or routinely replace “homework,” reducing demands on faculty and students outside of the classroom.
continued on page 9
8 In-class snacks A brief discussion at the beginning of a course can help determine whether students and faculty want to involve food as part of the class setting (this is particularly helpful when classes occur during standard mealtimes); a rotating schedule can be set up to distribute the task, and students and faculty should be able to opt out. Nutritious snacks nourish the body and provide fuel for engagement Outdoor class When possible, take the class outside (could be done for more sessions discussion-oriented courses); give advance notice to students and/or take a vote at the beginning of class so that students can be prepared and participate in the decision. In addition to providing fresh air and exposure to nature, this offers a different way for faculty and students to engage with one another.
Table 2: Self-Care Strategies in the Research Domain Self-care Strategy Description and Rationale Writing challenges Many forums support ECPs to progress in their writing by joining an online “writing challenge,” which involves committing a specified amount of time to writing daily and participating in a forum to report one’s productivity. Faculty can encourage students to participate and create their own internal “writing challenges” to progress on their independent and shared research projects. This helps to alleviate stress for faculty and students by creating structure and accountability for the often amorphous task of writing. Synchronous On an agreed upon date/time block, faculty and students sit writing days/ together (or participate virtually) for a writing retreat to work on retreats their respective writing projects. If possible, procure funding from program for food and beverages. Within each hour of writing, build in a 10-15 required break to enhance productivity. This models the importance of setting aside dedicated time for writing, and also enables faculty and students to make steady progress on their writing. Allowing for “on Faculty can determine, based on other commitments, a days” and “off reasonable and realistic period of time each week that can be days” devoted to research. Similar strategies can be offered to students during their dissertation process, with permission to designate certain days or weeks during which other tasks are prioritized (“off days”). This intentional effort reduces guilt and self-blame related to research progress, and may enhance productivity and motivation for students and faculty. Research lab Within the limitations of resources, these mini-celebrations help mini-celebrations to acknowledge the efforts of faculty and students and recognize important milestones or moments in student and faculty lives. Can be built into already existing meeting time (i.e., at the end of a scheduled lab meeting) and additionally provides opportunity to socialize as a group.
continued on page 10
9 Table 3: Self-Care Strategies in the Mentoring/Advising Domain Self-care Strategy Description and Rationale Offering recurring, For students who may want more frequent contact, faculty can shorter meetings offer to have recurring meetings scheduled. Meetings do not need to be scheduled weekly or for 1-hour, which is often the default on calendar settings. Instead, they can be bi-weekly or monthly, and 30-40 minutes to reduce faculty time and improve efficiency. This provides predictability for students and faculty, may relieve anxiety for students, and reduces last minute scheduling for faculty. Flexibility can be offered to cancel meetings or to conduct them virtually/by phone if either the faculty member or student has other pressing issues on a given week. Walking/outdoor As weather and physical ability permit, walking meetings meetings provides exercise, reduce screen time, and stimulate creative thought. This is a “daily balance” strategy that could be incorporated with other one-on-one meetings as well. If weather is not conducive to an outdoor walking meeting, identify an indoor area on campus that may work alternatively. Advertising office Faculty are required to hold office hours, which are often hours underutilized by students. Encouraging students to come to office hours to discuss issues other than coursework can be beneficial in multiple ways, including supporting student and faculty professional development, enhancing student-faculty relationships, and making use of this already scheduled time instead of scheduling a separate meeting. Encouraging use ECP faculty can sometimes feel overwhelmed with the amount of of other faculty support their student advisees need; additionally, students can and peer mentors benefit from cultivating relationships with other faculty and peer mentors. When the primary mentor suggests consulting others’ guidance, it may help alleviate some of the pressure felt by faculty, and support students in their professional networking and growth.
references 00231-004&site=ehost- Boice, R., & Myers, P. E. (1987). Which live&scope=site setting is healthier and happier, Cheng, H. L., Kwan, K. L. K., & Sevig, academe or private practice? Profes - T. (2013). Racial and ethnic minority sional Psychology: Research and college students’ stigma associated Practice , 18 (5), 526-529. with seeking psychological help: Ex - https://doi.org/10.1037/0735- amining psychocultural correlates. 7028.18.5.526 Journal of Counseling Psychology , Burkhart, J. (2014). An integral model 60 (1), 98. of self-care for clinical psychology Chlebak, C. M., James, S., Westwood, graduate students. Journal of Integral M. J., Gockel, A., Zumbo, B. D., & Theory and Practice , 9(1), 55-73. Re - Shapiro, S. L. (2013). Mindfulness trieved from http://search.ebsco - meditation & gratitude journalling: host.com/login.aspx?direct=true&A The experiences of graduate coun - uthType=sso&db=psyh&AN=20 15- continued on page 11
10 selling psychology students. Coun - psychologists. Teaching of Psychol - selling and Spirituality / Counseling et ogy , 40 (4), 340-345. https://doi.org/ Spiritualité , 32 (2), 79-103. Retrieved 10.1177/0098628313501048 from http://search.ebscohost.com/ Lackritz, J. R. (2004). Exploring login.aspx?direct=true&AuthType=s burnout among university faculty: so&db=psyh&AN=20 14-21468- Incidence, performance, and demo - 003&site=ehost-live&scope=site graphic issues. Teaching and Teacher Colman, D. E., Echon, R., Lemay, M. S., Education , 20 (7), 713-729. McDonald, J., Smith, K. R., Spencer, https://doi.org/10.1016/j.tate.2004.0 J., & Swift, J. K. (2016). The efficacy 7.002 of self-care for graduate students in Myers, S. B., Sweeney, A. C., Popick, V., professional psychology: A meta- Wesley, K., Bordfeld, A., & Fingerhut, analysis. Training and Education in R. (2012). Self-care practices and per - Professional Psychology , 10 (4), 188-197. ceived stress levels among psychol - https://doi.org/10.1037/tep0000130 ogy graduate students. Training and Dittman, M. (2005). Arizona State stu - Education in Professional Psychol - dents create self-care program. ogy , 6(1), 55-66. https://doi.org/ GradPsych: The Magazine of the Ameri - 10.1037/a0026534 can Psychological Association of Gradu - Miller, J. J., Grise-Owens, E., & Shalash, ate Students , 3, 35. N. (2018). Investigating the self-care Dorociak, K. E., Rupert, P. A., Bryant, F. practices ofsocial work faculty: An B., & Zahniser, E. (2017). Develop - exploratory study. Social Work Educa - ment of a Self-Care Assessment for tion , 37 (8), 1044- Psychologists. Journal of Counseling 1059.https://doi.org/10.1080/02615 Psychology , 64 (3), 325-334. https:// 479.2018.1470618 doi.org/10.1037/cou0000206 Radeke, J. T., & Mahoney, M. J. (2000). Dorociak, K. E., Rupert, P. A., & Zah - Comparing the personal lives of psy - niser, E. (2017). Work life, well-being, chotherapists and research psycholo - and self-care across the professional gists. Professional Psychology: Research lifespan of psychologists. Professional and Practice, 31 (1), 82-84. Psychology: Research and Practice http://dx.doi.org/10.1037/0735- 48 (6), 429-437. https://doi.org/ 7028.31.1.82 10.1037/pro0000160 Stern, D. N. (1995). The motherhood con - El-Ghoroury, N. H., Galper, D. I., stellation: A unified view of parent–in - Sawaqdeh, A., & Bufka, L. F. (2012). fant psychotherapy . New York, NY: Stress, coping, and barriers to well - Basic Books. Retrieved from ness among psychology graduate http://search.ebscohost.com/login.a students. Training and Education in spx?direct=true&AuthType=sso&db Professional Psychology , 6(2), 122. =psyh&AN=19 55-97481- Fowler, S. (2015). Burnout and depres - 000&site=ehost-live&scope=site sion in academia: A look at the dis - Verdinelli, S., & Biever, J. L. (2009). course of the university. Empedocles: Spanish-English bilingual psy - European Journal for the Philosophy of chotherapists: Personal and Communication , 6(2), 55-167. professional language development Good, J. J., Keeley, J. W., Leder, S., and use. Cultural Diversity and Ethnic Afful, S. E., & Stiegler-Balfour, J. J. Minority Psychology , 15 , 230-242 (2013). Supporting our junior fac - http://dx.doi.org/10.1037/a0015111 ulty: Assessing the concerns and Watkins, C. E. (1992). Early profession - needs of early career continued on page 12
11 als in counseling psychology: The Jossey-Bass. academic setting. The Counseling Zahniser, E., Rupert, P. A., & Dorociak, Psychologist , 20 (1), 47-52. K. E. (2017). Self-care in clinical psy - https://doi.org/10.1177/0011000092 chology graduate training. Training 201007 and Education in Professional Psychol - Weimer, M. (2010). Inspired college teach - ogy , 11 (4), 283-289. ing: A career-long resource for profes - https://doi.org/10.1037/tep0000172 sional growth. San Francisco, CA:
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12 SpecIal FocuS: SelF-care acroSS The lIFeSpan STudenT FeaTure The Game of Strife: a means of coping for psychology doctoral Students
Salwa Chowdhury, MA Isabelle Dousarkissian, MA Tommy Fritze, MA Andrew Grego, MS Alison Gothro, MS Kelsey Hyde, MA Nikki Pond, MA Molly Shmerling, MA Colter Snethen, MA Dani Speelman, MA Madison Taylor, MA
University of Denver Graduate School of Professional Psychology Internship Consortium
Psychology graduate students face is a valuable investment in student many challenges, balancing academic health. This paper will outline how to demands, field placement requirements, create a board game specifically often financial limitations, and the designed for psychology doctoral responsibilities of personal life. These students to attract them to play more competing obligations can often lead board games. to burnout, defined by the Mayo Clinic as “a state of physical or emotional literature review exhaustion that also involves a sense of Playing games with peers can come so reduced accomplishment and loss of naturally that it is easy to overlook the personal identity” (2018, para. 1). A numerous social and psychological study from RealNetworks, Inc. (2006) benefits of engaging in imaginative play. showed that games help combat stress Board games have been played since by lowering blood pressure, increasing 5000 BC, the first using dice made out of speed of response time, boosting painted or carved rock, and some of the immune system, improving memory oldest games known to have been formation and cognitive skills, and played by humans are still played today, protecting against cognitive decline such as Senet, thought to be developed (Health Fitness Revolution, 2015). around 3100 BC in pre-dynastic Egypt (Brunscheen-Cartagena, 2019; Considering the wealth of benefits Johnstone, 2012). Despite games having provided by playing board games, a long history in human culture, it is encouraging students in psychology only recently that the social benefits of doctoral programs to play board games continued on page 14
13 playing games have begun to be studied balance both their professional and systematically. personal lives while performing well academically and clinically. One of the For example, Salur, Ala-Ruona, U çar, most common stressors that negatively and Eren (2017) have offered that games impacts a graduate student’s training is involving metaphors may be an the experience of a loss or debilitating effective avenue for improving illness. Stratton, Kellaway, and Rottini emotional processing, particularly if the (2007) suggest that while a loss or de- emotions are related to content or bilitating illness can be a source growth, experience that individuals would it can also interfere with a graduate stu - rather not or cannot discuss verbally. dent’s training. Other stressors include The results of such research has even financial hardship, interpersonal lead to new forms of therapy such as relationships, and navigating constant Nature Therapy (Berger & Lahad, 2010), transition. which involves key mechanisms of engaging in play and creativity and has The pre-doctoral internship year for been shown to facilitate coping with future psychologists is marked by a new academic environments. According number of transitions, with the intern - to a review by Granic, Lobel, and ship being one of the most stressful Engels (2013), early developmental transitions professionally. For many psychologists including Vygotsky and years, research has explored the impact Piaget proposed that imaginary play of this developmental stage and the provides children with the opportunities unique challenges pre-doctoral interns to formulate and test hypotheses about face. Kaslow and Rice (1985) described the world as they reproduce real-world pre-doctoral internship year as “pro- problems and attempt to problem solve fessional adolescence” where interns are for their own enjoyment or to abate required to balance their training with negative feelings. Recent neuroscience new professional responsibilities and studies have found that among rats, autonomy. It is therefore important for play fighting is associated with increases training staff to consider the distinct in chemical growth factors in the orbital type of stress that interns face and ways frontal cortex which is highly involved in which they can be supported. Because in the coordination of social activities psychological practice can lead to (for review, see Pellis & Pellis, 2007). compassion fatigue and burnout, self- care is highly important in managing Importantly, playing a game can be a these symptoms; Bettney (2017) ex - valuable means of relieving stress. As it plored the idea that frequently shared is the professional role of the mental characteristics of people in helping health therapist to help patients reduce professions are likely to lead to burnout, stress, and as therapists are repeatedly as well as the many roles (personal and exposed to stress in their line of work, professional) that students, interns, and therapists and student-therapists should professionals often play. Therefore, it is consider using games as a powerful critical to implement self-care well in therapeutic tool, with their clients, and order to practice effectively. in their own lives. Turner and colleagues (2005) reference Norcross (2000), who compiled a list Graduate school is an integral part of a of “consensual self-care strategies,” psychologist’s professional develop- ment. Graduate students are asked to continued on page 15
14 commonly used self-care strategies as 1963. Games are a great way to relieve well as recommendations for interns stress and cope with the pressures of on internship. Some of these include life, and can be a good way to practice “recogniz[ing] the hazards in con - life lessons and make choices about ducting psychotherapy,” cultivating a life milestones in a low-risk, imaginary lifestyle of self-care, and finding joy and environment. The Game of Strife high - peace in one’s practice. Turner et al. lights the trials and tribulations of the (2005) also noted that from a systemic graduate school experience. In partic- viewpoint, it would be beneficial for ular, this game focuses on doctoral internship sites to examine self-care psychology programs. Doctoral psy - from various theoretical orientations, chology programs are particularly and each site should attempt to challenging, as they require a high level implement forms of self-care that play of intellectual and emotional engage- on the strengths of the sites themselves. ment and exploration. During graduate school, students face a number of life The idea of using a board game to milestones and challenges, which are educate, reflect the experience of a incorporated in the Game of Strife. chosen profession, and genuinely be entertaining is not a new one: Andrew The original game pieces are adapted in and Andrew (1979) created a patent the Game of Strife to reflect doctoral for a board game with these particular psychology program students’ ex- goals in mind. The goal was to create a periences. Graduate students commute complex system relating to medical in a number of ways. In the Game of practice, while also creating a game that Strife, players can choose from a number “simulates the life of an intern in a large of transportation methods including a teching [sic] hospital.” As it is widely car, walking shoes, bike, bus, train, known that board games can be used skateboard, motorbike, or electric for educational purposes, creating a scooters. Each playing piece will have game that would reflect the working holes to place human and animal figures experience of a psychology intern would that become part of the player’s family likely be highly beneficial for teaching, during the game. All human figures will offering a source of entertainment, and be the color purple. In addition to reflecting the experience in a way that human figures, there will be cats and could be easily identifiable for trainees dog figures to add to students’ families who may want the sense of a shared during the game, similar to children experience. If play and creativity could being added to families in the original. be fostered in graduate students or At certain points in the game, players groups of graduate students together, will be cued to choose a housing card, their adjustment to and functioning in a loan disbursement card, and a the various roles and hurdles of practicum or internship placement card. graduate school and internship could be These cards will indicate type of enhanced housing and the rent or mortgage amount, loan amounts, practicum or description of the Game internship site. The Game of Strife is based on the popular children’s game, The Game The game board is comprised of a path of Life™ (GOL), co-developed in its that leads to the ultimate goal of modern form by Reuben Klamer and graduating from the player’s doctoral Bill Markham for Milton Bradley in continued on page 16
15 program. At the beginning of the game, stress, practice self-care, and to foster players can choose to complete a positive social interactions with their master’s program route and borrow fellow students. However, it is money, or begin working and earn important to note the limitations of this money before both paths converge back game. The game includes content that to the “Start Doctoral Program” point. some may find distressing, such as The path then continues on to the end “working with a suicidal client” or point of graduation. Players will spin a “family emergency,” as steps in the dial that tells them how many spaces to game. This may have the opposite effect move forward on each turn, and each than what was intended; students may spot on the game board will have find the experience of playing the game different graduate school and life events to be negative, stressful, and potentially that occur during play. Examples emotionally painful. When playing this include the following: Be a teaching game, it would be most beneficial for assistant for a class, free food from players to be aware of how such content school event, adopt a dog, go on a good may affect others in the room and be date, pass competency exam, apply for understanding if a player wishes to take practicum, propose doctoral paper or a break or leave the game. dissertation, start a remediation plan, get in a car accident, get divorced, bad Another limitation is that this game is Tinder date, health emergency, forget to specifically designed for doctoral file FAFSA. psychology students. In the future, a game that is more generalizable and Players will accrue loans and earn applicable could be created so that income throughout the game when they master’s-level psychology students and land on “Strife” places on the board. perhaps other types of mental health When players land on a “Strife” place on graduate students (e.g., social work the board, they grab a “Strife” tile, students, forensic psychology students) which they will not flip over until the could also play. This game could be used end of the game. On the back of the as a model to create similar games in “Strife” tiles are either income the player other areas of graduate study, such as earns or debt they accrue. Players can law or business, and provide a positive also get income when they pass “Loan and validating experience for students Disbursement” landmarks on the boar, in those fields. It should also be noted and they have to pay rent or pay back this game was created using the loans when places on the board indicate experiences of students from a small to do so. At the end of the path, players group of graduate programs. The will apply for internship and choose an experiences included in this game may internship card. When they reach the not reflect and may exclude experiences end and graduate from their psychology students in other programs have had. doctoral program, the game is over. At Future games could be created by this point, players will total up their individuals from a wider variety of loans and income, and whoever has the graduate programs, and it would most money and least amount of loans be important to include students from wins. a wider range of multicultural backgrounds. discussion and recommendations The Game of Strife concept was created to help doctoral psychology students de- continued on page 17
16 Finally, like the original version, built Annual Lesson Series , 1-4 . into The Game of Strife is the assumption Granic, I., Lobel, A., & Engels, R.C.M.E that “winning” means accumulating the (2013) The benefits of playing video most money. This is a convenient way to games. American Psychologist, 3 (66), tally points at the end of play; however, 1-13. it is ironic that a game designed to Health Fitness Revolution. (2015). Top promote self-care ultimately focuses on 10 Health Benefits of Board Games. finances as the sole measure of success. Retrieved from It is likely that many students attracted https://www.healthfitnessrevolutio to the field of psychology in the first n.com/top-10-health-benefits-board- place would find this counterintuitive. games/ Perhaps future versions of the game could include emotional well being, life Johnstone, I. (2012). How to play satisfaction, or similar concepts as Senet. Ancient Egypt Magazine , 13 (3), objectives at least equal to having the 23-25. most accumulated wealth at the end of Klamer, R., & Markham, B. (1963). The the game. game of life [board game]. Springfield, MA: Milton Bradley. conclusion Kaslow, N. J., & Rice, D. G. (1985). This has been a playful consideration of Developmental stresses of the benefits of developing a board game psychology internship training. to reflect the experiences of doctoral Professional Psychology: Research and graduate students, and to help them Practice, 16 (2), 253-261. navigate the twists, challenges, and doi:10.1037/0735-7028.16.2.253 rewards of their training. It is important Mayo Clinic. (2018). Job burnout: How to to also recognize, that, although the spot it and take action . Retrieved from game ends at graduation, for most https://www.mayoclinic.org/health doctoral-level graduates, their careers y-lifestyle/adult-health/in- are just beginning. depth/burnout/art-20046642 Pellis, S. M., & Pellis, V. C. (2007). references Rough-and-tumble play and the Andrew, C. G., & Andrew, L. B. (1979). development of the social brain. U.S. Patent No. 4,136,879 . Current Directions in Psychological Washington, DC: U.S. Patent and Science , 16 , 95-98. doi:10.1111/j.1467- Trademark Office. 8721.2007.00483.x Berger, R., & Lahad, M. (2010). A safe Rowe, A., & Regehr, C. (2010). place: Ways in which nature, play and Whatever gets you through today: creativity can help children cope with An examination of cynical humor stress and crisis—establishing kinde r - among emergency service garten as a safe haven where children professionals. Journal of Loss and can develop resiliency. Early Child Trauma , 15 (5), 448-464. Development and Care, 18 , 889-900. Salur, Ö., Ala-Ruona, E., Uçar, S., & Bettney, L. (2017). Reflecting on self- Eren, N. (2017). Enjoying expression: care practices during clinical Exploring the benefits of music psychology training and beyond. therapy on patients diagnosed with Reflective Practice , 18 (3), 369-380. schizophrenia and using metaphor Brunscheen-Cartagena, E. (2019). games/improvisations for increasing Bonding thru board games, fact sheet. Family and Consumer Sciences: continued on page 18
17 emotional awareness level. European Psychology: Research and Practice, Psychiatry, 41 , S835. 38 (6), 589-595. doi:10.1037/0735- Solway, K. S. (1985). Transition from 7028.38.6.589 graduate school to internship: A Turner, J. A., Eicken, I. M., Castro, J. R., potential crisis. Professional Edwards, L. M., Yokoyama, K., Psychology: Research and Practice, Ngoc-Thuy Tran, A., & Haggins, K. 16 (1), 50-54. L. (2005). Intern self-care: An Stratton, J. S., Kellaway, J. A., & Rottini, exploratory study into strategy use A. M. (2007). Retrospectives from and effectiveness. Professional three counseling psychology Psychology: Research and Practice, predoctoral interns. Professional 36 (6), 674-680.
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18 SpecIal FocuS: SelF-care acroSS The lIFeSpan STudenT FeaTure Stifled: art and the “Task” of Self-care
Meli Sarkissian, MA Denver, Colorado
The creation of art is around me: “I never have time anymore known to offer a to read,” or “I wish I could paint again.” variety of benefits for I was confused. I observed my dad physical and mental come home after a long day of working well-being, but in our and unleash his colorful thoughts onto rush to categorize the canvas. I observed my mom settling production of art as down to relax with a romantic novel. I “self-care,” we may be observed my brother sacrificing hang - overlooking the most essential piece. ing out with friends to go into the vi - This article explores the idea that dis - brant wilderness and take beautiful missing the work of passion as one more photographs, displaying a unique per - task to check off a list may be missing spective I had never known anyone to the essential self for which one is caring. have. I then would close my door and transform my room into another world I was born into a rather unique scenario. found only inside my writing. It seemed Among the prevalent narratives of ei - natural to me. But the narrative around ther choosing a creative but impractical me was changing. The words “passion” pathway or choosing a dull but practi - and “creativity” disappeared almost cal pathway, my father chose to be both overnight under a new umbrella term a dentist and an artist. I grew up, not that arose hesitantly out of the wood - just around his buzzing dental equip - work of academia: self-care. ment, but also found myself wrapped within the swirling and turbulent array Suddenly, I was being told that my writ - of creativity that marked his artwork ing was such a good method of “self- with such distinctive flair. Both chosen care.” My dad’s painting became a avenues were intertwined—his dental means of “coping.” My mom’s reading practice became known for its striking became a means of “destressing.” My creativity, and his artwork possessed brother’s photography became a means immense attention to detail. I was never of “escaping.” Higher education ar - made to choose between practical and rived, and students were instructed to impractical or passionate and realistic. I take an hour of their days and engage in was allowed both. self-care, which included art, exercise, and many other avenues that used to be As a developing child, I read both fic - part of a person’s character but now tion and nonfiction, filled out my as - seemed as though they were tasks. Cre - signments with crayons, and drew out ativity was stifled, because it became an material we were taught in class. I com - assignment—just another deadline to bined my passion for artwork with my meet. Classes needed to be taken specif - passion for learning. Over time, I began hearing interminable arrays of thoughts continued on page 20
19 ically to make way for creativity, but entific discovery, stifling spirituality and rules and guidance morphed artwork beauty. I will reference some ideas from into society’s products. writer Linda Johnson (2006), who wrote a book called Lost Masters —exploring What we have now is a generation of the underlying spiritual teachings of an - young adults and adolescents who seem cient philosophers, which have been to have no choice but to adapt rapidly to manipulated into science and rational - the current world of dispiritedness, ity. She laments the dismissal of Plato in where temporary healing and joy are current teachings, stating that, “For found in material attainments or med - Plato, the spiritual world we can see ication. Science was once an exploration only with the mind was the real world; but has transformed into a concrete for scientists and academicians today, way of thinking. After all, “research that world doesn’t even exist” (p.82). shows…” is the popular saying now and The realm of creativity is stifled and one that is classically conditioned to be funneled into a system that ensures the indefatigable phrase repeated over academic success at the expense of emo - and over again by students. tional and spiritual freedom.
The field of psychology has displayed One salient example she provides is the this transformation most apparently. story of Pythagoras: He was not the in - Psychology has become very scientific, ventor of the popular mathematical the - attempting to describe the vast wonder ory we hear ceaselessly throughout of the brain by its mechanisms. “Re - early education—he was the teacher search shows…” has become the foun - who created the first ever documented dation of a good student and a yogi camp and who taught that num - successful psychologist. Wonder has dis - bers brought order to the spiritual and appeared, and in its place is a type of ac - metaphysical universe—which is now ademia so afraid of not having the called numerology, a concept popularly answers and getting last place in the dismissed as pseudoscience. His camp race that it throws wonder to the wind. was known for its pure joy and mani - fested friendships that were strong and My hope for the future is to bring it back lasted for a long time. However, just as to the field of psychology—that unbri - modern science has stifled his true dled color that exists in the bridge be - teachings, so did his enemies of the time tween the brain and the heart, that (politicians) destroy him by burning internal music that guides the spirit to - down his entire camp and murdering ward fulfillment, that wide-eyed won - everyone there. This is quite symbolic derment that fosters genuine curiosity. and representative of the current move - Once this can be found again and en - ment. Politics surrounding psychology couraged within our children, then can have manipulated its teachings, trans - true “self-care” be achieved. The indi - forming it over time to become an ex - vidual will find ways to bring physical tremely monitored and directed field of and mental health back to a natural study and dismissing the spiritual ques - maintenance, by allowing passion to tions as “useless inquiries of a supersti - enter into the workplace as an aspect of tious mind” (Johnson, 2006, p.31). the self instead of as an assignment. There seems to be this push and pull This is not a new belief. This goes back working to the world, with one camp centuries to those ancient philosophers that have faded into the backdrop of sci - continued on page 21
20 struggling to express itself and the other point (Johnson, 2006, p.ix). Only through working to counter it, almost mimicking that state would someone be able to find the idea of a work-life balance, which wisdom. And this I believe is the root of splits the two in a dysfunctional manner real “self-care.” instead of joining them together. In the current world, the group with the most When artistic expression is funneled into political power are the ones who are a separate avenue of “self-care,” then working to counter it. Children are less one’s creativity is stifled. This is why the likely to display spirituality, developing common narrative around me has been into adults who need an hour of “self- this frustration with how an artist is care” in order to tap into the parts of unable to find their imagination. But them that are required to make them imagine the emotional and mental de - human. Where they would be encour - velopment that would occur if imagina - aged to take moments to immerse them - tion/wonder/creativity were fostered selves into nature or artwork, the into studying. If, instead of knocking current Western generation is rooted in down various items as being “pseudo - technology that feeds opinions and science,” or “not scientific enough,” they thoughts to them. That childlike wonder were utilized to see if they work for in - is vanishing. dividuals. If work-life balance actually went hand-in-hand and allowed an ex - Johnson recounts when Socrates fa - pression of the self with various outlets. mously said, “Wisdom begins in won - If my dad can tie in two fields that are der.” When the Oracle at Delphi asked completely opposite to each other and him why he was the wisest man, he re - use them both to increase his effective - sponded, “I am the wisest man alive, be - ness in both fields, then why should cause I know one thing, and that is that I psychologists be any different? know nothing.” Suddenly, through inter - pretation, his first quote was forgotten, The artistic and creative potential of hu - and scholars translated his meaning to be mans can really be fostered to psychol - one of modesty: He is wise because he ogy’s advantage. The wonder and recognizes where he is ignorant. How - fascination that lies within the mind can ever, in order to understand Socrates, his produce creativity and wisdom that can first quote is just as important. He found take our field forward in great strides that wisdom came out of wonder, which and introduce a way for genuine self-ex - he defined as being that fascination with pression and natural healing without something so much greater than one’s the requirement of a separate hour of self, which could be viewed really only self-care. through inner awareness. So, to “know nothing” to Socrates means to be in a references state of awareness that removes concrete Johnson, L. (2006). Lost masters . thought. Socrates was not being modest; Novato, CA: Himalayan Institute he was being wise, precisely proving his Press. Book.
21 pSYchoTherapY reSearch an mTurk primer for psychotherapy researchers
Kelley Tompkins, PhD University of Alaska Anchorage
Joshua K. Swift, PhD Idaho State University Pocatello, Idaho
In recent years, psychol - 1 for summary of citations by year). ogy researchers have While Google Scholar identified on 23 begun to use online scholarly articles with MTurk in 2005, methods for participant 10,500 citations were identified for 2017. recruitment and data Specific to the field of psychology, some collection. One of the have estimated that approximately half most popular online of all researchers have utilized MTurk methods is Amazon’s for data collection (Goodman, Cryder, & Mechanical Turk Cheema, 2012). Despite the increasingly (MTurk), an online high use of MTurk in the field of psy - crowdsourcing website. chology in general, many psychother - To get a glance of its apy researchers are unfamiliar with this popularity, we recently data collection tool. Thus, in this article did a Google Scholar search using the we present a primer on MTurk for psy - keyword “Mechanical Turk” (see Figure chotherapy researchers.
continued on page 23
22 mTurk history can be done by “workers” using a com - MTurk is a crowdsourcing marketplace puting device. Examples of these tasks tool that was originally created in 2005 include writing, evaluating product ad - by Amazon.com’s founder, Jeff Bezos. vertisements and websites, using simple Crowdsourcing means it utilizes an un - templates, transcribing, and completing organized collection of individuals to do online research (Buhrmester, Kwang, & work. It can be contrasted to outsourc - Gosling, 2011). For online research, re - ing, in which work is allocated to a de - searchers can create a survey within fined organization. In creating MTurk, MTurk or can utilize other online survey Bezos aimed to create a decentralized tools like SurveyMonkey or Qualtrics. If marketplace of workers to perform tasks using a different survey tool, researchers that computers could not perform, or simply create a HIT that gives the could not perform efficiently, such as worker a unique identifier and a link to recognizing patterns, audio transcrip - the survey, thus allowing the researcher tion, filtering adult content, writing to approve only HITs that were submit - short product descriptions, and discern - ted by “workers” with the specific iden - ing meaning from images or text (Mason tifier (Mason & Suri, 2012). & Suri, 2012; Pontin, 2007). Seeing the value that MTurk brought to his own Once created, tasks are displayed on the company, Bezos believed that it might site in a standardized format, with be useful to others that had similar “workers” being able to browse or needs (Pontin, 2007). search for specific jobs. All HITs include information about the title of the HIT, Interestingly, the name MTurk was in - the name of the “requester” who created spired by “The Turk,” an automated the HIT, the compensation associated chess-playing invention developed by with completing the HIT, the number of Wolfgang von Kempelen (Paolacci, HITs of this type available to be worked Chandler, & Ipeirotis, 2010). The Turk on, how much time the “requester” has was eventually revealed to not be an au - allotted for completing the HIT, and the tomation, but a human chess master date/time when the HIT expires (Mason who was disguised under the chess & Suri, 2012). Other information that is board and controlling the chess move - commonly presented includes a more ments of a humanoid dummy. In a sim - detailed description of the HIT and the ilar way, MTurk is a platform that allows “worker” qualifications to be able to humans to help perform tasks for which work on a HIT. “ Requesters” can also computers are not yet suited. provide keywords that workers can search, with the keywords with the most mTurk Basics HITs being “data,” “collection,” “easy,” To utilize this platform, researchers must “writing,” and “transcribe” (Ipeirotis, first register for an account at the MTurk 2010a). After reviewing posted studies, website ( https://www.mturk.com/ “workers” can decide which HITs they mturk/welcome ). In this system, indi - would like to complete. Upon comple - viduals or businesses from around the tion, “requesters” get to review the qual - world can register as “requesters” who ity of the work completed by the advertise tasks that require completing, “workers” and make a decision about or as “workers” who work to fulfill the compensation based on the quality of specific tasks the requesters post. “Re - the work. “Workers” who repeatedly re - questers” post Human Intelligence ceive poor ratings on their work quality Tasks (HITs), which are online tasks that continued on page 24
23 may be disqualified from future HITs, rent mean pay for an MTurk worker is depending on the specifications set up between $1.38 and $1.71 per hour (Hor - by the “requesters.” ton & Chilton, 2010; Paolacci et al., 2010). When analyzing data collected from As of 2007, there were more than 100,000 over 165,000 HIT groups, Ipeirotis MTurk workers in more than 100 coun - (2010a) found that 10% of HITS had an tries across the globe (Pontin, 2007), with incentive of $0.02 or less, 50% had a that number expanding to over 500,000 price above $0.10 and 15% had a price workers in more than 190 countries in above $1. Researcher have to pay a 40% 2014 (Paolacci & Chandler, 2014). A commission fee to Amazon for using number of studies have sought to exam - MTurk, which is a recent increase from ine the characteristics of the MTurk its 10% commission fee (Buhrmester et worker population (Berinsky, Huber, & al., 2011; Miller et al., 2017). Based on Lenz, 2012; Paolacci et al., 2010; Shapiro, this, a researcher who pays $100 dollars Chandler, & Mueller, 2013). In fact, there for participant payments would owe is a website called MTurk Tracker MTurk an additional $40 in fees, bring - (Ipeirotis, 2010a) that shows a daily up - ing the total cost of participant reim - date of the demographics of MTurk bursement up to $140. users based on a brief survey (gender, year of birth, marital status, household potential advantages of using size, household income, and country) mTurk for psychological research . that is posted to MTurk every 15 min - The increased popularity of MTurk is utes; workers are restricted to answering likely related to the numerous potential the survey once per month (Ipeirotis, benefits of conducting research through 2015). Overall, MTurk samples are the crowdsourcing platform. One of the found to be more representative than main advantages of using MTurk for college samples (Berinsky et al., 2012) study recruitment is increased access to and samples obtained through many a large subject pool. With hundreds of other online sources (Casler, Bickel, & thousands of “workers,” researchers Hackett, 2013). have access to a substantially larger sub - ject pool through MTurk than they Research does indicate that money is not might have using traditional recruiting the sole motivation for participation in methods (i.e., undergraduate research MTurk. For example, approximately pools or flyer advertisements) (Pontin, 70% of U.S. MTurk workers indicate that 2007). A large subject pool can allow re - they use it as a fruitful way to spend free searchers to more easily recruit enough time while making cash, while approxi - participants based on a priori power mately 40% report doing it because the analyses for more complex statistical de - tasks are fun. Most workers spend a day signs. This may be particularly valuable or less per week working on MTurk, and for researchers who would not other - generally complete between 20 and 100 wise have easy access to participants, HITS in this amount of time (Ipeirotis, such as researchers from smaller col - 2010b). There is no set reimbursement leges or universities, researchers in more fee that is required by MTurk, although isolated geographical locations, and new there have been discussions to try to re - researchers who may not yet have a net - quire reimbursement that is comparable work of collaborators to aid in study re - to minimum wages (Miller, Crowe, cruitment at multiple sites (Mason & Weiss, Maples-Keller, & Lynam, 2017). Suri, 2012; Smith & Leigh, 1997). Some studies have found that the cur - continued on page 25
24 A second advantage of using MTurk is the research can be conducted at a rela - the ability to recruit a more diverse sam - tively low cost. Through advertising on - ple of participants than might be avail - line, researchers can save costs on able through traditional recruitment recruitment methods (e.g., making fly - methods (Pontin, 2007). By not having ers, postage, research assistant time, etc.) barriers on the location where data is and travel costs that might be needed to collected, researchers can have access to bring participants to the researcher or more demographically diverse subset of the researcher to the participants. There the population and, depending on the can also be saved costs associated with online recruitment criteria, can have ac - not having to have a dedicated place to cess to international populations to conduct in-person studies. Additionally, study. MTurk workers have been found as mentioned earlier, the incentives to be more diverse than traditional un - given to participants tend to be less than dergraduate samples and standard In - traditional incentive rates given to in- ternet samples, especially in regard to person participants (Berinsky et al., age, ethnicity, and educational level 2012; Ipeirotis, 2010a). (Behrend, Sharek, Meade, & Wiebe, 2011; Casler et al., 2013). This diversity drawbacks of using mTurk for in research samples can aid in the gen - psychological research eralizability of the data and can also While there are numerous benefits to allow cross-cultural research questions MTurk, there are also several disadvan - to be more easily examined. Besides di - tages. One disadvantage is a self-selec - versity in common demographics, the tion bias, workers who volunteer for the anonymous format also allows access to specific study may differ in important unique populations, like people from ways from workers who do not. While stigmatized groups or people who there could be personality or clinical dif - might hold unsocially desirable views ferences between those groups, this bias (Wright, 2005). might also include more socioeconomic factors, with individuals who do not A third advantage of using MTurk for have financial means to access the Inter - psychology research is the speed at net regularly not being involved in re - which studies can be conducted (Mason search as often (Hartz et al., 2017). These & Suri, 2012; Wright, 2005). While there sampling issues can impact the general - are some daily and weekly seasonal izability of the study results. trends in workload HITs through MTurk (such as posting of HITs being slightly Attrition is another disadvantage of on - more likely during the weekdays and line studies conducted through MTurk. completion of HITs dropping on Mon - Research indicates that attrition is more days, often a function of limited HITs likely to occur in online experiments being posted over the weekend), over - than laboratory experiments, possibly all, participation is fairly constant because of technology issues (i.e., Inter - (Ipeirotis, 2010a). Due to ease of quick net connectivity), distraction, or lack of data collection, researchers have been the social pressure that is present in in- able to get several hundred participants person data collection (Mason & Suri, a day using MTurk for recruitment 2012). When looking at MTurk dropout (Berinsky et al., 2012). rates, researchers have found that it can be as high as 51% of the sample (Zhou & A fourth benefit of conducting psycho - Fishbach, 2016). logical research through MTurk is that continued on page 26
25 The fact that MTurk workers have the op - through MTurk when compared to other portunity to participate in many studies recruitment methods (Buhrmester et al., also creates some unique challenges. 2011; Eriksson & Simpson, 2010; Horton, Since MTurk workers often complete Rand, & Zeckhauser, 2011; Lutz, 2016; many surveys, they are more likely to Paolacci et al., 2010; Rand, 2012). Still, to have filled out many of the common psy - check data quality, researchers can ex - chological instruments which could im - amine the data, just like in in-person pact study results (Miller et al., 2017). studies, and consider excluding data Therefore, researchers should be cautious that has very obvious random respond - about conducting research where practice ing. To examine the accuracy and truth - effects might influence study findings. fulness of data provided by MTurk workers, comparison studies can also be Another concern with MTurk is that par - done with samples collected through ticipants might not meet study criteria. more traditional methods. To address this concern, Chandler and Shapiro (2016) recommend unobtru - mTurk for psychotherapy research sively prescreening using an initial ques - Although there is a growing body of ev - tionnaire to screen for desired criteria idence supporting the validity of data and restrict access to the longer ques - obtained through MTurk for psychology tionnaire to workers who meet the in - research in general, less is known about clusion criteria. In an example of this whether it is an appropriate tool for psy - process at work, Wiens and Walker chotherapy research. It is possible that a (2015) had an initial questionnaire on sample of MTurk workers who engage beverage preference that was used to in psychotherapy might in some way be screen for inclusion criteria for a study different than individuals who present on alcoholism. To help insure that indi - to psychotherapy clinics where research viduals meet the screening criteria, re - is typically conducted. searchers have also either asked a To date, only a few studies have specifi - screening questionnaire again during the cally examined the clinical characteris - actual survey or used knowledge based tics of MTurk users (Arditte, Cek, Shaw, questions that correlate with the screen - & Timpano, 2016; Kim & Hodgins, 2017; ing criteria (i.e., having individuals Miller et al., 2017; Shapiro et al., 2013; claiming to be Veterans order insignia by Wymbs & Dawson, 2015). Overall, it has rank) to determine responses that should been noted that the rates of some clinical be excluded from the analysis (Chandler phenomena (such as depression, anxiety & Shapiro, 2016). Related, some will cre - disorder, trauma, and substance use) ate “bots” to complete the work instead met or exceeded the rates reported in the of actual human participants. Re - general population (Shapiro et al., 2013). searchers who use MTurk should in - Further, the psychometric properties of clude CAPTCHA questions, attention several clinical measures (e.g., BDI, BAI, checks, and type in response questions DASS-21, PID-5) have been established to ensure human participation. in MTurk samples (Arditte et al., 2016; Miller et al., 2017; Shapiro et al., 2013). There is worry that participants in on - line forums like MTurk do not provide Future directions for psychotherapy high quality valid data (Buhrmester et research in mTurk al., 2011). However, many studies have While these studies have added to the indicated that similar quality data or even higher quality data can be obtained continued on page 27
26 knowledge base regarding clinical phe - Casler, K., Bickel, L., & Hackett, E. nomenon in a general population of (2013). Separate but equal? A com - MTurk users, there is more research that parison of participants and data is needed for psychotherapy process and gathered via Amazon’s MTurk, social outcome researchers to be able to confi - media, and face-to-face behavioral dently use this research platform. Stud - testing. Computers in Human Behavior, ies need to examine the prevalence of 29 (6), 2156-2160. http://dx.doi.org/ clinical symptoms and the psychometric 10.1016/j.chb.2013.05.009 properties of common instruments with a Chandler, J., & Shapiro, D. (2016). Con - population of MTurk users who report ducting clinical research using crowd - currently engaging in psychotherapy. sourced convenience samples. Annual More specifically, research is needed that Review of Clinical Psychology, 12 , 53- directly compares results obtained from 81. https://dx.doi.org/ 10.1146/an - MTurk workers who report engaging in nurev-clinpsy-021815-093623 psychotherapy to clients that might be Eriksson, K., & Simpson, B. (2010). presenting for psychotherapy in tradi - Emotional reactions to losing explain tional clinics. In addition, further research gender differences in entering a risky is needed to establish the best practice lottery. Judgment and Decision Making, standards (e.g., compensation rates, 5(3), 159-163. Goodman, J. K., Cryder, C. E., & screening questions, eligibility require - Cheema, A. (2013). Data collection in ments) for conducting psychotherapy re - a flat world: The strengths and weak - search in MTurk. nesses of Mechanical Turk samples. references Journal of Behavioral Decision Making, Arditte, K. A., Çek, D., Shaw, A. M., & 26 (3), 213-224. http://dx.doi.org/ Timpano, K. R. (2016). The impor - 10.1002/bdm.1753 tance of assessing clinical phenom - Hartz, S. M., Quan, T., Ibiebele, A., ena in Mechanical Turk research. Fisher, S. L., Olfson, E., Salyer, P., & Psychological Assessment, 28 (6), 684- Bierut, L. J. (2017). The significant im - 691. https://doi.org/10.1037/ pact of education, poverty, and race pas0000217 on Internet-based research partici - Behrend, T. S., Sharek, D. J., Meade, A. pant engagement. Genetics in Medi - W., & Wiebe, E. N. (2011). The viabil - cine, 19 (2), 240-243, https:// ity of crowdsourcing for survey re - doi.org/10.1038/gim.2016.91 search. Behavior Research Methods, 43 , Horton, J. J., & Chilton, L. B. (2010). The 800-813, https://doi.org/10.3758/ labor economics of paid crowdsourc - th s13428-011-0081-0 ing. Proceedings of the 11 Association for Berinsky, A. J., Huber, G. A., & Lenz, G. Computing Machinery conference on S. (2012). Evaluating online labor Electronic Commerce. New York, NY: ACM. markets for experimental research: Horton, J. J., Rand, D. G., & Amazon.com’s Mechanical Turk. Zeckhauser, R. J. (2011). The online Political Analysis, 20 (3), 351-368. laboratory: Conducting experiments https://doi.org/10.1093/pan/mpr057 in a real labor market. Experimental Buhrmester, M., Kwang, T., & Gosling, Economics, 14 (3), 399-425. https:// S. D. (2011). Amazon’s Mechanical doi.org/10.1007/s10683-011-9273-9 Turk: A new source of inexpensive, Ipeirotis, P. G. (2010a). Analyzing the yet high-quality, data? Perspectives on Amazon Mechanical Turk market - Psychological Science, 6 (1), 3-5. place. ACM XRDS: Crossroads, 17 (2), http://dx.doi.org/10.1177/17456916 16-21. https://doi.org/10.1145/ 10393980 continued on page 28
27 1869086.1869094 and Decision Making, 5 (5), 411-419. Ipeirotis, P. (2010b, March 9). The new Pontin, J. (2007, March 25). Artificial in - demographics of Mechanical Turk. telligence: With help from the hu - [blog post]. Retrieved from: mans. The New York Times . Retrieved http://www.behind-the-enemy- from: http://www.nytimes.com/ lines.com/2010/03/new-demo - Rand, D. G. (2012). The promise of graphics-of-mechanical-turk.html Mechanical Turk: How online labor Ipeirotis, P. (2015, April 6). Demo - markets can help theorists run graphics of Mechanical Turk: Now behavioral experiments. Journal of Live! [blog post]. Retrieved from: Theoretical Biology, 299 , 172-179. https:// http://www.behind-the-enemy- doi.org/ 10.1016/j.jtbi.2011.03.004 lines.com/2015/04/demographics- Shapiro, D. N., Chandler, J., & Mueller, of-mechanical-turk-now.html P. A. (2013). Using Mechanical Turk Kim, H. S., & Hodgins, D. C. (2017). to study clinical populations. Clinical Reliability and validity of data ob - Psychological Science, 1 (2), 213–220. tained from alcohol, cannabis, and https://doi.org/10.1177/2167702612 gambling populations on Amazon’s 469015 Mechanical Turk. Psychology of Addic - Smith, M. A., & Leigh, B. (1997). Virtual tive Behaviors, 31 (1), 85-94. subjects: Using the Internet as an al - https://doi.org/10.1037/adb0000219 ternative source of subjects and re - Lutz, J. (2016). The validity of crowd - search environment. Behavior Research sourcing data in studying anger and Methods, 29 (4), 496-505. http://dx.doi. aggressive behavior: A comparison org/10.3758/BF03210601 of online and laboratory data. Social Wiens, T. K., & Walker, L. J. (2015). The Psychology, 47 (1), 38-51. https:// chronic disease concept of addition: doi.org/10.1027/1864-9335/a000256 Helpful or harmful? Addiction Mason, W., & Suri, S. (2012). Research & Theory, 23 (4), 309-321. Conducting behavioral research on https://doi.org/10.3109/16066359.2 Amazon’s Mechanical Turk Behavior 014.987760 Research Methods, 44 (1), 1-23. Wright, K. B. (2005). Researching Inter - https://doi.org/10.3758/s13428- net-based populations: Advantages 011-0124-6 and disadvantages of online survey Miller, J. D., Crowe, M., Weiss, B., research, online questionnaire au - Maples-Keller, J. L., & Lynam, D. R. thoring software packages, and web (2017). Using online, crowdsourcing survey services. Journal of Computer- platforms for data collection in per - Mediated Communication , 10 (3). sonality disorder research: The ex - https://doi.org/10.1111/j.1083- ample of Amazon’s Mechanical Turk. 6101.2005.tb00259.x Personality Disorders: Theory, Research, Wymbs, B. T., & Dawson, A. E. (2015). and Treatment, 8 (1), 26-34. Screening Amazon’s Mechanical Turk https://doi.org/10.1037/per0000191 for adults with ADHD. Journal of At - Paolacci, G., & Chandler, J. (2014). In - tention Disorders. https://doi.org/ side the Turk: Understanding Me - 10.1177/1087054715597471 chanical Turk as a participant pool. Zhou, H., & Fishbach, A. (2016). The Current Directions in Psychological Sci - pitfall of experimenting on the web: ence, 23 (3), 184-188. http://dx.doi. How unattended selective attrition org/10.1177/0963721414531598 leads to surprising (yet false) research Paolacci, G., Chandler, J., & Ipeirotis, P. conclusions. Journal of Personality and G. (2010). Running experiments on Social Psychology, 111 (4), 493-504. Amazon Mechanical Turk. Judgment https://doi.org/10.1037/pspa0000056
28 pSYchoTherapY pracTIce asking for help in Building my private practice: how I Stopped Grasping in the dark and Invested in my Business
Daniel Jose Gaztambide, PsyD New York, NY
let’s Start by Keeping a selling point of the position for me at It a hundred the time. I wouldn’t have to pay rent for I know it. You know an office, the practice had their own it. Everybody who is a billing department so they could submit therapist knows it— out-of-network insurance claims for my we barely if at all get clients, and there was the possibility of any training in how to cross-referrals with other faculty. All I build, run, and grow a private practice. had to do then was set up my website For most of us we definitely did not and Psychology Today profile, and I’d be have any courses in graduate school. good to go and let the referrals flow. Maybe when we were on internship or Easy-peasy. fellowship. my First run at private practice Maybe . Dear reader—whether you are a sea - soned clinician, graduate student, or We might have had a graduate or faculty early career professional—it may sur - member come in and talk to us about prise you to know that things do not their practice, getting on insurance, get - work this way. I know . I was just as ting a website, getting on Psychology shocked to find out as you are right now. Today, maybe even something about While I did over time build up a private SEO. But what is SEO you ask? I could practice caseload at the hospital, there not even begin to tell you back then, as I were some major growing pains. Per - probably forgot whatever the presenter haps the first issue I had to contend with said. It was a bit over my head at the was setting my fee. time. Still, it didn’t seem that difficult— finish psychotherapy training (oh, the Oh, the fee . youth!), get your license, get a job, open As someone from an ethnic minority my practice. Piece of cake. background who specialized in working So I did the thing—I got my doctorate, with low-income and culturally diverse passed my licensing exam, and got a job. populations, I agonized over what my My first job was as a psychologist and fee should be. If I set it too high, would faculty member at a teaching hospital, I be marginalizing and excluding the pa - which offered an in-house private prac - tients I want to work with, both at the tice for faculty. The hospital was in a di - hospital and at my practice? Initially, verse community with substantial there was no such thing in my mind as clinical need, which was part of my in - “setting your fees too low.” It felt like it terest as somebody committed to cul - had to be very low. Eventually, I rea - tural competence and social justice. At soned to myself that since I was already the same time, the faculty practice was continued on page 30
29 serving patients from communities in sensed some shame, as if questions need during the day as part of my “day about private practice risked exposing job,” I needed to justify the extra something about them as therapists, evening hours I was spending in my pri - business owners, and people. Maybe vate practice. I set my fee higher, at a everybody struggled with private practice level commensurate with the “market in some way. Whichever the case, after a rates” in New York City, and later fig - while I just stopped asking. ured out a flexible system for having conversations with potential patients I continued my small practice after about the fee, and when to lower the fee work, slowly trying to build without re - to make treatment more accessible. ally knowing what I was doing. Or more precisely, whether what I was doing was While this was a learning process in actually helping my practice grow or which I became aware of the beliefs I not. Without some mentorship or people had around money and how they I could talk about private practice emerged from my family history and openly with, I decided it was time to re - cultural context, what struck me at the ally reach out, this time to an expert— time was what would happen when I enter Dr. Google, MD, MBA, PhD, PsyD, broached the topic of private practice EdD, Esq. with my mentor, supervisors, and ther - apist friends. Of course, when I started The good doctor had an unending list of out it made sense to reach out to them. prescriptions for me to follow for a suc - They had been in private practice much cessful practice—start a blog; get on In - longer than I had; surely they have stagram; get on insurance; get off knowledge, experience, and wisdom to insurance; don’t blog, vlog instead; iden - impart. So, I started asking how they ran tify a niche; get a logo; work on your their private practices. How did they set SEO; don’t ever get on insurance; clarify their fees? What was it like starting out? your message; why the fuck are you on How do I grow my practice? Instagram?; and so on and so on. Not re - ally knowing how these different com - The same pattern would emerge. We’d ponents worked and in what sequence, I be discussing the latest article in Psy - tried all of them. It turned out to be pretty chotherapy , a recent training in this or overwhelming trying to write a weekly that treatment approach, or the latest blog, come up with content, edit, re-edit, Game of Thrones episode, maybe even and re-re-edit a website, or playing gossip about the latest intrigue in this around with Google Ads. After a while, I program or that organization (Oh you realized that the usually effective behav - know we’ve all done it). Then I would ioral technique of throwing spaghetti at just bring up a question about private the wall to see what sticks had failed me. practice. I was too burned out to keep trying to fig - ure things out. With my day job and daily The awkwardness was palpable. life already being busy I stopped focus - It was like some taboo had been crossed. ing on my practice. At least, until it was People stumbled over their words trying time to leave the hospital. to answer my question. At times it al - most felt like they had some “trade se - how I learned to Stop Worrying and cret” they dared not share, lest it lead to really Really reached out for help some kind of competition in the psy - A combination of professional goals and chotherapy market. At other times, I continued on page 31
30 life changes made me decide to leave was winding down at the hospital, and my position at the hospital. I took a part- included a cohort, meaning I would be time faculty job where I would teach taking each sequence with a group of and supervise, leaving me with plenty therapists sailing in the same unknown of time for a private practice. In getting waters. The consultant running the ready to leave, I knew I’d be taking a course was very fun, dynamic, and plunge into the unknown. I would be down to earth. I enjoyed my time in this running my own practice, initially sub - course and got to learn from other ther - leasing an office, and would need to apists struggling with the same ques - grow it in order for things to be sustain - tions and conundrums. Through it I was able. In my search for resources and in - also introduced to other consultants in formation, I had come across not only this industry, some of whom also pro - blogs and downloadable pdfs about pri - vided one on one consulting. vate practice but stumbled into an entire cottage industry of private practice con - Having a good experience with this sultants. These were typically psy - course, and learning actionable steps chotherapists who had learned the ins and skills for practice building, really and outs of building a successful prac - impressed on me the value of not just tice and ran a side business helping asking your friends or mentors, not just other therapists build and grow their looking up free and available informa - own. In some cases, consulting for other tion on the internet, but of investing in therapists had become their primary your practice. By the time I finished the source of income, while continuing with course and was wrapping up at the hos - a smaller therapy caseload. pital I was set and ready to transition my practice from the faculty practice into I wasn’t sure what to make of these peo - my own setting and my own terms. ple at first, to be honest. Were they run - Based on some of the initial changes I ning some sort of racket, seducing implemented, I started having a more unsuspecting therapists into giving steady flow of good fit, full fee patients, them their hard-earned money with the and patients with whom I collabora - promise of clinical and business success? tively set fees that worked for them to Could I really trust these therapists make our work accessible, especially turned entrepreneurs? This was not an where there was a good fit on both sides. easy decision to make. On the one hand, I literally saw the money I had invested working with any one of them would paying off, for me and for my clients. cost money. It was one thing to rent out office space or pay a Psychology Today Based on my initial experience, I con - subscription. But to truly invest in my tacted one of the consultants I had been practice? Into learning the skills, tools, introduced to and applied to work one and knowhow for running my practice? on one with them. This would have cost It seemed foreign to me, as strange and more money than the course, but it felt alien as the idea of having a return on worth the investment to have some real my investment. guidance and mentorship. This consult - ant was also very down to earth, prag - I started out small, enrolling in an online matic, and with a great sense of humor. course offered by one of the consultants But they also had access to a wealth of in - I found online. The course felt within formation on how to market one’s prac - my budget, it followed a weekly se - tice in this day and age and build a brand quence that would run during the time I continued on page 32
31 that reflects one’s personality and style. Things I learned along the Way Ultimately, what leads potential patients This essay reflects my experience becom - to have that initial experience of “This ing comfortable with reaching out for person gets me ” even before they pick up help and investing in how to build, run, the phone or send you that e-mail. grow, and nourish a private practice. In that spirit I want to share a couple of tips We worked on identifying my “mes - that could be useful to other therapists: sage” to the clients I want to work with, and then using that message to redesign • Buy a copy of Building a Story Brand my website copy (e.g. the material you (Miller, 2017). If someone ever wrote write for your website) and Psychology a book on marketing for therapists, it Today profile. We came up with a plan would be this book. And it’s not even for blogging at a pace that worked for written by a therapist! It describes my schedule and got connected with a how to harness the power of story to separate company that has experts in clarify one’s message. Every story designing Google Ads for therapists. All has a hero, a villain, and journey. We of these orbited around my message, often write our website copy as if which emerged organically from the we—the therapist—are the hero of populations I was passionate about— the story. But it is the patient who is young adults and professionals of color. the hero, the issues that bring them I learned that tailoring my message to to therapy the villain. We are the the people I wanted to reach first did not guide that helps them on their jour - exclude or prevent others outside that ney. Clarifying this message sets the focus from reaching out for therapy, but tone for everything else in building it did give a needed vision for who I one’s practice. wanted to serve. More importantly, after • Research private practice consult - all was said and done, I had way less ants: There is a plethora of them writing on my website. available online. If you find one whose style and message you click It turns out we therapists can get wordy. with, check out their free content. And people don’t care about what we have to say or where we earned our de - • When you are ready, invest! Build - grees. Potential clients care about our ing a private practice can be a message getting across to them loud and lonely and stressful experience. It clear, and about how that message doesn’t have to be that way. A good makes them feel. investment in a resource, a training, or a tool for growing your practice Once things clicked into place, my calls is likely to yield a good return. increased dramatically. I feel more se - cure in my practice and had access to a references community of therapists that spoke Miller, D. (2017). Building a story brand . openly not just about our clinical work, HarperCollins. Available from https: but about the nuts and bolts of creating //www.amazon.com/Building-Story - a humane, conscious, and successful Brand-Clarify-Message-Customers practice. And just as importantly, a /dp/0718033329/ref=sr_1_1?ie=UTF8 lifestyle that nourishes and supports our &qid=1498750284&sr=8-1&key - clinical work in turn. words=building+a+story+brand
32 pSYchoTherapY pracTIce retirement myths, continued
Thomas Barrett, PhD Clinical Professor Emeritus Graduate School of Professional Psychology University of Denver
editors’ note : This a additional myths about retirement follow-up piece to Dr. Myth number five . If you are capable of Barrett’s 2018 article working, you should be working . describing four myths commonly held about At times I have made the mistake of retirement. To access the thinking that if I am able to work I original article, please visit should be continuing to work. I am sure the SAP website : https://societyforpsy - that the values instilled by my Catholic chotherapy.org/retirement-myths/ upbringing have contributed to this thinking. Realistically, working after re - In my last article I listed four retirement tirement is contingent on at least three myths: factors. It is not sufficient to be able to work, you must also be willing to work 1. It is easy to retire from an active and there needs to be on opportunity to professional life to a less active work. I know that are many profession - lifestyle; als who have made the mistake of think - 2. Retired people do not want to ing that they should be working and feel work; guilty about not working. 3. Retired people do not want to be Let’s talk about opportunity. Some peo - paid; and ple continue working at their same job 4. Retired people have unlimited free in a reduced capacity. In my case, I re - time (Barrett, 2018). tired from core faculty at the University of Denver, but I continue to teach two courses as professor emeritus. I am In that article I admitted to having re - grateful for this opportunity. I know tired three times. I am now 13 years past many other professionals who continue my first retirement and I find myself to work in their preretirement positions moving into a different stage of retire - in a reduced capacity. For example, ment characterized by a significant re - many psychologists in private practice duction in professional activity. I am reduce the number of clients but con - spending less than 20% of my free time tinue to practice. However, not everyone professionally. This change has in - has this opportunity. Even in my situa - creased my free time and has led to in - tion, my two previous retirements (from creasing questions about how much the state of Colorado and from the time I want to devote to professional World Health Organization) did not work. In this piece, I will be addressing allow any paid continued employment. two additional myths about retirement I have come to understand over the past several months. continued on page 34
33 For those not able to continue in prere - glad to accept opportunities based on tirement jobs, there is, of course, the op - my previous experience and previous portunity to work in other settings. contacts. However, as I get farther and However, there are often problems for farther from my active years, many of retirees to find new work. Some em - my contacts have already retired from ployers are hesitant to hire retirees be - active professional work. cause they think a younger person “needs” the money more than a retiree. Myth number six : If I can do the work better Also, there is outright discrimination in than the person who replaced me, I should be some settings. While there is ample evi - doing the work myself . dence that most people prefer a multi - generational employment situation I admit that I am susceptible to this (Anderson, 2019), many organizations myth. I am sure that there is often some will choose a younger person when bias in my perception of my ability. there is an opportunity. While this action However, I am sure that I can do a better is discriminatory, it is difficult to prove. job in some instances, but that does not In one of my consulting positions, I was mean that I should necessarily be doing part of an application for a state grant. the work. There should be opportunities However, after the grant was awarded, for a person to grow into the position. there was pressure to reduce my in - Otherwise, there would be few oppor - volvement in the grant activities in favor tunities for younger people. Also, there of younger people. While my age was may be a need for someone to come in never mentioned, I am quite certain that with a different perspective. it was a factor. At least for me, retirement is a process AARP Research (Anderson, 2019) sug - that continues through my retirement gests that many value the mentorship of years. I am constantly examining how older workers. However, my experience much I can still contribute through work in state and international work suggests and how much I want and need to work. that there is a bias against older people. It is sometimes frustrating when I can - When I went to work for the World not achieve that perfect balance between Health Organization in 2004 at the age of what I want and what I can get, but that 58, I was warned that most people in the is part of the challenge of retirement—a main office of WHO are younger people. challenge that I gladly accept. I was told that I might be uncomfortable in this situation. As it turned out, I references worked a lot with younger people and I Anderson, G. O. (2019, January). Men - believe they respected my experience. torship and the value of a multigen - Also, I socialized with interns through erational workforce. AARP Research. sports and other activities. Again, they Retrieved from https://www.aarp. seemed to appreciate my perspective. org/research/topics/economics/inf o-2019/multigenerational-work- One of the decisions I have been forced mentorship.html to make as a retiree is how much time Barrett, T. (2018). Retirement myths. and energy I am willing to expend to ob - Psychotherapy Bulletin , 53 (4), 29-31. tain new consulting activities. I am no Retrieved from https://society - longer willing to spend a huge amount forpsychotherapy.org/psychother - of time pursuing these activities. I am apy-bulletin-archives/
34 educaTIon and TraInInG positive regard in clinical Supervision: Trainee perspectives
Emily Carl, MA The University of Texas at Austin Natasha H. Bailen, MA Washington University in St. Louis The supervision relation - regard, he feels warmly toward the ship is multifaceted. client’s weaknesses and problems as well Watkins (2011) wrote, “Is as the client’s potential (Rogers, 1957a). supervision teaching? Rogers also believed that clinical Is supervision therapy? Is supervisors should model unconditional supervision con sul- positive regard toward trainees during tation? Is it some blend supervision (1957b). of the three?” Although the primary objectives of Evidence supports this assertion. The supervision are to foster trainee-reported strength of the super - professional growth, mon - visory alliance has been found to be it or the quality of pro- associated with client-reported strength fessional services, and of the therapy relationship, as well as serve as a gatekeeper for the profession trainee adherence to the intended (Bernard & Goodyear, 2014), the treatment model (Patton & Kivlighan, similarities to a therapeutic relationship 1997). There is evidence that com- cannot be overlooked. Both relationships ponents of positive regard, including rely on a strong working alliance, are warmth, empathy, and genuineness, are intended to promote personal essential to the effectiveness of didactic development through guided discovery training (e.g., Carifio & Hess, 1987; and problem-solving, and ideally adhere Lambert, 1980). Trainees report that to the major principles of the therapeutic positive experiences in supervision orientation (Newman & Kaplan, 2016; frequently involve support, empathy, Milne, 2006). Furthermore, the super - respect, and an attitude of non- vision relationship can be used as a judgment on the part of the supervisor platform for modeling therapeutic skills. (Kennard, Stewart, & Gluck, 1987; In an interview with the APA (Tracey, Watkins, 1995; Worthen & McNeill, 2006), Dr. Judith Beck said that during 1996). Lastly, therapists trained by supervision she will “directly model what supervisors who scored highly on [she] would like to see [trainees] do in a dimensions including empathy, respect, therapy session” in order to demonstrate and genuineness tended to exhibit the a collaborative relationship. greatest gains in these dimensions from before to after training (Carkhuff & One well-established element of effective Berenson, 1967; Pierce, Carkhuff, & psychotherapy is unconditional positive Berenson, 1967; Truax & Carkhuff, 1967). regard (Rogers, 1957a; Farber & Doolin, 2011; Keijsers, Schaap, & Hoogduin, Conversely, a survey of doctoral stu- 2000). Rogers wrote that when a therapist dents or recent graduates found that is experiencing unconditional positive continued on page 36
35 clinical supervision that emphasized tionship (Magnuson, Norem, & Wil - negative or critical styles (e.g., “cri ticized coxon, 2002). In this case, the tone was my performance in a demeaning and set for a supportive relationship. In an personal way”) was associated with a interview with APA, Dr. Stoltenberg, a weaker experience of the bond in the Professor in Educational Psychology alliance (Ladany, Mori, & Mehr, 2017). and Director of Training at the Uni - Supervisory alliances perceived by versity of Oklahoma, endorsed the use trainees as unsatisfactory or weak have of “supportive and facilitative inter - been associated with trainee stress, ventions, in which supervisors provide exhaustion, and burnout (Watkins, 2014). support and encourage the development of the trainee through praise and It is apparent that positive regard is attentive listening” (Tracey, 2006). crucial in the clinical supervision relationship, but how does this practically Furthermore, the reflection of strengths play out? A trainee might approach within a counseling relationship has supervision sessions wondering what to been suggested as a way to develop expect from a supervisor: Will the them. In their chapter “Toward a supervisor observe my negative or positive positive psychotherapy: Focus on qualities that will affect my clinical work? human strength,” Gelso and Woodhouse Will the supervisor see me and my work the (2003) suggest that therapists can way I see myself, or will I be blindsided by comment on strengths that are not yet feedback? Will the supervisor assume the fully developed in order to encourage best of me and my intentions when there is them: “Therapists can react to the incomplete information? We present three nascent strengths in a way that exchanges between supervisors and appropriately reflects and magnifies trainees from our pre-doctoral, pre- them” (p. 182). Thus, this action by this practicum and practicum training in supervisor may have served two very which positive regard or the lack of it valuable purposes early in the was a turning point in the relationship supervisees’ training: to bolster the and training experience. supervision alliance, and to support the development of strengths. case Illustrations Setting the tone: Early in one of these Validating and reinforcing difficult authors’ experiences with a new supervisor, disclosures : One of these authors suspected the supervisor ended a group supervision that a client had negatively interpreted and session by reflecting a unique strength she possibly taken offense to a suggestion. I was saw in each of the beginning counselors. nervous to tell my supervisor, fearing that What she said to me seemed accurate and posing the suggestion to the client had been felt meaningful. Having her notice and a mistake. My supervisor first thanked appreciate a strength in me helped me to feel me for raising this issue, and provided that even in the event of a mistake or validation that therapists’ words can often be negative feedback in our future work, she misinterpreted. She then asked what made would likely still perceive some positive me feel badly about the interaction, and qualities. Moving forward, I felt less anxious we role-played addressing the mis - in our meetings and I was more willing to be communication with the client. Finally, she candid with her. asked me to consider how I might react differently if a similar situation arose next The initial meeting with the supervisor time. I felt grateful for the room to explore sets the tone for the supervisory rela- continued on page 37
36 what had occurred, and subsequently, I felt never mentioned how it had impacted me, but better able to disclose situations and I found myself feeling more guarded and decisions that made me feel vulnerable as a defensive in our supervision sessions afterward. clinician. This case illustrates an instance when a It is widely acknowledged that super- trainee felt a breach in perceived positive vision can be anxiety-provoking for regard from her supervisor. While trainees, as supervision entails per- assessing for the level of preparation was formance evaluation and there is a power appropriate in this professional rela - dynamic inherent in the relationship. tionship, the manner and tone in which However, Milne (2006) pointed out that it was asked led the trainee to feel the supervision process mirrors the defensive about her work. The result was therapy process in that both involve a a weakening of the supervision alliance “shared emphasis on a problem-solving and a degree of withdrawal from the approach, founded on a working alliance” process by the trainee. (p. 215). Trainee anxieties can be alle- viated by supervisors’ conveyance of There is evidence that it is common for trust and positive regard (Newman & a trainee’s perception of a negative Kaplan, 2016; Talen & Schindler, 1994); exchange to go unnoticed while having this then serves to strengthen the work - far-reaching consequences. In inter views ing alliance. In the above illustration, with psychotherapy trainees about positive regard was expressed and the counter productive events in supervision, alliance was strengthened by the Gray, Ladany, Walker, and Ancis (2001) normalization of trainee difficulties and found that most trainees did not believe reinforcement of a difficult disclosure that their supervisors were aware of the (Newman & Kaplan, 2016). impact of the event, and most did not disclose the event to their supervisors. The establishment of a safe, nonjudg- Meanwhile, all trainees stated that the mental environment allowed for the event weakened the relationship, led to focus of supervision to shift to problem- a change in their approach to their solving. The supervisor’s positive regard supervisors, and most even believed this relieved the trainee’s anxiety about how negatively affected their work with their what occurred might reflect on her, and clients. Thus, exchanges that might be allowed for a productive exploration of subtle enough to go unnoticed by the how ruptures in the therapeutic supervisor can still be very damaging to relationship could be repaired and how the work. In the illustrated case, a subtle to do differently next time. conveyance of negative assumptions about the trainee weakened the super - A breach in positive regard: While reviewing vision alliance. a videotaped session, one of these authors was told by a supervisor that they seemed discussion “unprepared” during a meeting with a client. Several important lessons can be drawn She then asked me if I had done anything to from these exchanges. First, supervisors prepare for the session. Because she had asked should work to establish a supportive if I had prepared at all, it seemed to me she tone early in the relationship. Having thought I must not invested. In fact, I had this in place early will create an spent a great deal of time preparing. I thought environment in which trainees are my good intentions and level of hard work comfortable disclosing disagreement, were unnoticed, and I felt misunderstood. I continued on page 38
37 confusion, or difficult situations with supervision operates within the tension clients. Similarly, whenever possible, of a working alliance in which supervisors should take care to convey supervisors must juggle multiple positive regard during instances of responsibilities, including imparting evaluation or ambiguity. Given that the new skills and techniques to trainees, supervisory relationship is inherently ensuring client welfare, and setting the evaluative and critical feedback is bar for competence in the profession. necessary (Newman & Kaplan, 2006), However, despite the professional positive regard will not look the same in nature to this relationship, we have supervision relationships as it does in demonstrated in the preceding therapeutic ones. However, positive examples that this is also a relationship regard or the lack of it still has an effect in which positive regard is appropriate on this relationship; the second case and critical. The presence or absence of illustrates that in the presence of positive regard has the potential to alter ambiguous information, assuming the the trajectory of a supervision alliance, best of the trainee’s work and intentions the trainees’ professional development, while delivering feedback might avoid and ultimately, the quality of the a rupture and facilitate problem-solving. services delivered to the client. Illustrations from our clinical training Next, trainees can be mindful of their demonstrate the practical, day-to-day reactions when they feel the absence of ways that this crucial component of positive regard. Mehr, Ladany and effective supervision plays out. Caskie (2010) found that trainees who rated their working alliance with their references supervisor more highly reported more Bernard, J. M., & Goodyear, R. K. willingness to disclose, and that higher (2014). Fundamentals of clinical trainee anxiety was related to less supervision (5th ed.). Upper Saddle willingness to disclose. Likewise, River, NJ: Merrill. Yourman (2003) reviewed four cases that Carifio, M. S., & Hess, A. K. (1987). illustrated that ruptures in the Who is the ideal supervisor?. Profes - supervisory relationship led to feelings sional Psychology: Research and Prac - of shame for trainees and inhibited tice , 18 (3), 244 disclosure. Therefore, it is important for Carkhuff, R., & Berenson, B. (1967). trainees to note how they might be Beyond counseling and theory . New influenced by their perception of their York, NY: Holt, Rinehart & Winston. supervisor’s regard toward them, Farber, B. A., & Doolin, E. M. (2011). especially in terms of withholding Positive regard. Psychotherapy, 48 (1), information. Of note, positive regard 58. does not, and should not, preclude Gray, L. A., Ladany, N., Walker, J. A., & constructive feedback and problem- Ancis, J. R. (2001). Psychotherapy solving. In fact, positive regard at its best trainees’ experience of facilitates difficult conversations: if counterproductive events in supervisees are assured that their supervision. Journal of Counseling supervisors hold them in positive Psychology, 48 (4), 371. regard, they can disclose more easily, Gelso, C. J., & Woodhouse, S. (2003). because they can trust that advice and Toward a positive psychotherapy: feedback are well-intentioned. Focus on human strength. In W. B. Walsh, Counseling psychology and As Kottler and Hazler (1997) remarked, continued on page 39
38 optimal human functioning (pp. 171- Patton, M. J., & Kivlighan, D. M. J. 197). New York, NY: Routledge. (1997). Relevance of the supervisory Keijsers, G. P. J., Schaap, C. P. D. R., & alliance to the counseling alliance Hoogduin, C. A. L. (2000). The and to treatment adherence in impact of interpersonal patient and counselor training. Journal of therapist behavior on outcome in Counseling Psychology, 44, 108-111. cognitive-behavior therapy: A review Pierce, R., Carkhuff, R. R., & Berenson, of empirical studies. Behavior B. G. (1967). The differential effects Modification, 24 (2), 264-297. of high and low functioning coun - Kennard, B. D., Stewart, S. M., & selors upon counselors-in-training. Gluck, M. R. (1987). The supervision Journal of Clinical Psychology , 23 (2), relationship: Variables contributing 212-215. to positive versus negative Rogers, C. R. (1957a). The necessary experiences. Professional Psychology: and sufficient conditions of thera - Research and Practice , 18 (2), 172. peutic personality change. Journal of Kottler, J. A., & Hazler, R. J. (1997). Consulting Psychology, 21 (2), 95. What you never learned in graduate Rogers, C. R. (1957b). Training indi- school: A survival guide for therapists . viduals to engage in the therapeutic New York, NY: Norton. process. In C. R.Strother (Ed.), Ladany, N., Mori, Y., & Mehr, K. E. Psychology and mental health (pp. 76- (2013). Effective and ineffective 92). Washington, DC: American supervision. The Counseling Psychological Association. Psychologist , 41 (1), 28-47. Talen, M. R., & Schindler, N. J. (1994). Lambert, M. J. (1980). Research and the Goal-directed supervision plans: A supervisory process. In A. K. Hess model for trainee supervision and (Ed.), Psychotherapy supervision: evaluation. The Clinical Supervisor, Theory, research, and practice (pp. 423- 11 (2), 77-88. 452). New York, NY: Wiley. Tracey, M. D. (2006, March). More Magnuson, S., Norem, K., & Wilcoxon, effective supervision: Clinical super - S. A. (2002). Clinical supervision for vision informed by research and licensure: A consumer’s guide. The theory can help trainees excel. Journal of Humanistic Counseling, Monitor on Psychology , 37 (3), 48. Education and Development, 41 (1), Retrieved from: http://www.apa.org/ 52-60. monitor/mar06/supervision.aspx Mehr, K. E., Ladany, N., & Caskie, G. I. Truax, C., & Carkhuff, R. (1967). Toward (2010). Trainee nondisclosure in effective counseling and psychotherapy: supervision: What are they not Training and practice . Chicago: Aldine. telling you?. Counselling and Watkins, C. E., Jr. (1995). Psychotherapy Research , 10 (2), 103-113. Psychotherapy supervisor and Milne, D. (2006). Developing clinical supervisee: Developmental models supervision research through and research nine years later. Clinical reasoned analogies with therapy. Psychology Review , 15 (7), 647-680. Clinical Psychology & Psychotherapy: Watkins, C. E., Jr. (2010). Psycho - An International Journal of Theory & analytic constructs in psychotherapy Practice, 13 (3), 215-222. supervision. American Journal of Newman, C. F., & Kaplan, D. A. (2016). Psychotherapy, 64 (4), 393-416. Supervision essentials for cognitive- Watkins, C. E. (2011). Psychotherapy behavioral therapy. Washington, DC: supervision since 1909: Some American Psychological Association. continued on page 40
39 friendly observations about its first phenomenological investigation of century. Journal of Contemporary “good” supervision events. Journal of Psychotherapy, 41 (2), 57-67. Counseling Psychology , 43 (1), 25. Watkins, C. E. (2014). The supervisory Yourman, D. B. (2003). Trainee alliance as quintessential integrative disclosure in psychotherapy variable. Journal of Contemporary supervision: The impact of shame. Psychotherapy, 44 (3), 151-161. Journal of Clinical Psychology, 59 (5), Worthen, V., & McNeill, B. W. (1996). A 601-609.
Find the Society for the Advancement of Psychotherapy at www.societyforpsychotherapy.org
40 puBlIc InTereST and SocIal JuSTIce
“let’s Talk on the Fourth Floor”: Trials and Tribulations in our attempt to Increase access to psychotherapy Services
Paul Kwon, PhD Washington State University
Our idea, which three dents, and a key collaborator, Marcela of us came up with Pattinson, a student services staff mem - nearly simultaneously, ber who leads undocumented initiatives was born out of good at our university, we devised a resilience intentions. We noticed workbook and led support groups to in - that our most vulnera - crease academic persistence among un - ble students were often documented students. reluctant to go to our university’s counseling center. Our idea In the course of conducting that study, I was to bring psychotherapy services to met one research participant in the stu - the place where they felt most comfort - dent union building who recognized me able, the floor of the student union build - and revealed to me that she was strug - ing that housed multicultural student gling in school. I recommended the centers and the center for LGBT students. counseling center, but as she turned to get into the elevator to go up to the mul - There were several initiatives that fos - ticultural student centers, I could feel tered our thinking. First, four clinical the palpable reluctance that she had to psychology doctoral students and I had take that step. started a grass-roots diversity committee in the fall of 2016 that flourished beyond During a diversity committee event for all expectations, leading to a president’s which Marcela was the invited speaker, award for leadership award from our our idea to bring psychotherapy services university in 2018 and a current mem - to the fourth floor of the student union bership of 19 graduate students and five building emerged and gained immedi - faculty members. As an aside, working ate enthusiasm. After Marcela and I had with this wonderful group of graduate talked about this idea before her talk students has been the single most re - began, one of the graduate students in warding component of my 23 years as a the audience, Catherine Sumida, raised psychology professor at Washington her hand during the question and an - State University. As a group, we have swer period and suggested this idea as been active in advancing equity when - well. The confluence in our thinking ever possible in our work. suggested that this was meant to be! We would start a practicum within our Second, since the summer of 2016, I had graduate program with two graduate led a team effort on a research project student therapists from our program. I aimed at increasing resilience among volunteered to supervise the practicum undocumented students at our univer - at no cost to the department. Marcela sity (Kwon et al., in press). Along with and I split our responsibilities for turn - graduate students, undergraduate stu - continued on page 42
41 ing this plan into reality: I would get the counseling center staff, who would need psychology department on board with to be involved despite the satellite loca - the idea, and Marcela would deal with tion. In fact, the satellite location would our university administrators and han - make their work more burdensome, not dle the politics. less. We also considered the fact that having a designated therapy office in the I eventually learned my first lesson: student union building would poten - Never delegate politics. Politics require tially make confidentiality more of a all hands on deck. challenge, something that had not oc - curred to me before. And the liability is - After a few months, Marcela and I were sues involved in offering therapy invited to a meeting with the director of services outside of the counseling center the counseling center, the director of were thoroughly discussed. We also dis - health services, and two associate vice cussed the possibility that this satellite presidents from student affairs. Some - location would be viewed as a segrega - how, I was under the impression that we tion of psychotherapy services, again were there just to finalize our terrific something that had not occurred to me. idea. I arrived in a jovial mood, joking around with everyone. Once the meet - The ultimate plan that we all agreed to ing started, I suddenly realized that I was to implement the Let’s Talk model had walked into a room that was sim - (Boone et al., 2011), which is utilized by mering with tension. We had not in - nearly 100 universities. This model pro - volved the counseling center enough in poses the use of an outreach program in our proposal. In addition, there were which consultants, not therapists, en - multiple concerns about logistics and gage students in the locations where potential liability issues. they are most comfortable. Our gradu - ate students would hold office hours in Honestly, these problems occurred to me the student union building, and offer too, at times waking me up from a sound consultation to anyone who has per - sleep. I supervise doctoral students at the sonal concerns. These consultations may counseling center, but there is a tremen - consist of simply directing the student dous amount of paperwork that the staff to specific university services outside of handle with new clients. How would we the counseling center. Other students handle all of that in a satellite practicum may benefit from hearing what psy - location? What would we do if a client chotherapy is like, particularly if they do was suicidal? However, I would always not have any experience with the find a way to push these concerns out of process or hold stigma about what it my mind. Surely it must be a good idea represents. Finally, other students may given that our entire program appeared benefit from going to the counseling to be enthusiastic about it. In hindsight, center. The consultants would be avail - we were perhaps victims of groupthink able to answer questions about the (Janis, 1982). process and would also offer to walk Despite the initial tension in the room, a over to the counseling center with the wonderfully collaborative and open dis - student during walk-in hours. cussion emerged in our meeting. We reached consensus on the major issues. The revised idea was received enthusi - The idea, as Marcela and I had pre - astically by our students and faculty. It sented it, was unworkable due to the de - turns out that we didn’t need to invent mands that it would place on the continued on page 43
42 anything new. We simply needed to be out of the counseling center to serve educated about what already works at hard-to-reach students. Journal of other universities. Our new practicum Multicultural Counseling and Develop - was one of the most popular options se - ment, 39 (4), 194-205. doi: lected by students. Out of many who ex - http://dx.doi.org/10.1002/j.2161- pressed an interest, two advanced 1912.2011.tb00634.x students will be the inaugural consult - Janis, I. L. (1982). Groupthink (2nd ed.). ants in our Let’s Talk on the 4 th Floor Boston, MA: Houghton Mifflin. practicum. Here’s to wishing that the Kwon, P., Pattinson, M. C., Faust, E., growing pains are behind us, and Hobaica, S., Tse, J., Sainz, R., … greater access to services among our Keiser, G. H. (in press). A resilience most vulnerable students is ahead of us. intervention to increase academic persistence among undocumented references students in higher education. Journal Boone, M. S., Edwards, G. R., Haltom, of Hispanic Higher Education . M., Hill, J. S., Liang, Y., Mier, S. R.,... doi.org/10.1177/1538192718823185. Yau, T. Y. (2011). Let’s talk: Getting
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43 InTernaTIonal Scene on cheap psychotherapy Roger P. Greenberg, PhD Distinguished Professor, SUNY Upstate Medical University Syracuse, New York
On March 16, 2019, the since psychotherapy is only talking esteemed international …no possible harm can result from it. It magazine The Econo - may be advisable to be cautious, how - mist published an arti - ever, before applying the label of “psy - cle titled “Talk is chotherapy” too broadly to the types of Cheap: What Disasters interventions such non-specialists can Reveal About Mental- be quickly trained to administer effec - Health Care.” The arti - tively. cle extolled the virtues of using lightly trained “psychotherapists” to deal with The psychotherapy research literature is emotional problems in countries that at odds with the idea that talking ther - have a shortage of mental health profes - apy is consistently benign and incapable sionals. After highlighting the role of of producing negative effects. More than stressors such as natural disasters and 50 years ago, Bergin (1966) introduced civil wars, the piece went on to suggest the term “deterioration effect” to de - the potential usefulness of “psychologi - scribe the possibility that psychotherapy cal first aid” that can be provided with could lead people to becoming either minimal training by recruiting pastors, better or worse adjusted. Others have teachers, barbers and taxi drivers. The highlighted a number of studies show - article went on to suggest that “non-spe - ing the potential negative side-effects cialists” could be trained in a few hours that psychotherapy might produce (e.g., to treat mild-to-moderate depression Berk & Parker, 2009). Similarly, large and anxiety as well as posttraumatic numbers of studies have documented stress disorders. In general, the piece that some therapists are clearly better brought to mind the quote often attrib - than others (Castonguay & Hill, 2017). uted to Renaissance scholar Erasmus: In Factors such as therapist adjustment the land of the blind, the one eyed man (e.g., Fisher & Greenberg, 1985) and can be king. ability to establish a therapeutic alliance and demonstrate facilitative interper - Particularly in the context of post-disas - sonal skills are empirically linked to ter settings where people are in distress better outcomes (Boswell, Kraus, Con - but well-trained mental health profes - stantino, Bugatti, & Castonguay, 2017; sionals are not available, the idea that Greenberg, 2016; Wampold, Baldwin, “doing something is better than doing Holtforth, & Imel, 2017). It is also true nothing” has understandable appeal. that novice; less experienced therapists Though it is common to observe that are more likely to have clients who drop medications may produce harmful side- out of treatment before maximum bene - effects, verbal treatments, by contrast, fits can be attained (Swift & Greenberg, are often presumed to be either helpful 2015). or innocuous. As Nutt and Sharpe (2008) observed, many assume that continued on page 45
44 In addition, some therapist qualities that thing when he said in a 1923 speech to directly produce harmful outcomes the Royal College of Surgeons in Lon - have been observed. For instance, Karon don, “Words are, of course, the most and VandenBos (1972) and VandenBos powerful drug used by mankind.” and Karon (1971) describe a variable they called “therapist pathogenesis.” references This dimension measures the degree to Bergin, A. E. (1966). Some implications which therapists use others who are de - of psychotherapy research for thera - pendent on them to meet their own peutic practice. Journal of Abnormal needs. In a series of studies they were Psychology, 71 (4). 235-246. able to show that schizophrenic patient http://dx.doi.org/10.1037/h0023577 outcome deteriorated in direct propor - Berk, M., & Parker, G. (2009). The ele - tion to the level of pathogenesis dis - phant on the couch: Side-effects of played by their therapist; the greater the psychotherapy. The Royal Australian level of pathogenesis, the worse the out - and New Zealand College of Psychia - come for the patient. trists, 43 (9) , 787-794. https://doi. org/10.1080/00048670903107559 Responding to disasters worldwide Boswell,J. F.., Kraus, D. R., Constantino, may, as the article in The Economist M. J., Bugatti, M., & Castonguay, L. points out, require rethinking how to G. (2017). The implications of thera - use available personnel and resources in pist effects for routine practice, policy, ways that are creative and, ultimately, and training. In L. G. Castonguay & most helpful to those effected. Regard - C. E. Hill (Eds.), How and why are some less of setting, however, the art and sci - therapists better than others?: Under - ence of psychotherapy requires standing therapist effects (pp.309-324) . clinicians who are able to use empiri - Washington, DC: American Psycho - cally supported treatments in a way that logical Association. is empathetic and attuned to the charac - Castonguay, L. G., & Hill. C. E. (Eds.). teristics of the person with whom they (2017). How and why are some thera - are working (Greenberg, 2018). Thera - pists better than others?: Understand - pist style and ability to keep personal ing therapist effects. Washington, DC: needs under control appears to be American Psychological Association. highly significant. Some people are Fisher, S., & Greenberg, R. P. (1985). The clearly more adept at it than others who scientific credibility of Freud’s theories may turn out to be “psycho-noxious.” and therapy. New York, NY: Colum - The literature suggests some caution bia University Press. should be employed in deciding on who Greenberg, R. P. (2016). The rebirth of will be chosen to provide emotional sup - psychosocial importance in a drug- port for others and what level of in - filled world. American Psychologist. struction/training is needed to ensure 71 (8), 781-791. http://dx.doi.org/ reasonable outcomes. 10.1037/amp0000054 Greenberg, R. P. (2018). Essential ingre - Whether it is being practiced in the dients in successful psychotherapy: United States or internationally, it is too Effect of common factors. In M. J. simplistic to view psychotherapy as a Dewan, B. J. Steenbarger, & R. P. benign enterprise that can do no harm Greenberg (Eds.) , The art and science since it is only based on words! Perhaps of brief psychotherapies: An illustrated Rudyard Kipling, who won the Nobel guide (3rd ed., pp. 17-28). Washing - Prize for Literature, was on to some - continued on page 46
45 ton, DC: American Psychiatric Press. about mental-health care. (2019, Karon, B. P., & VandenBos, G. R. (1972). March 16). The Economist . Retrieved The consequences of psychotherapy from https://www.economist.com/ for schizophrenic patients. Psycho - VandenBos, G. R., & Karon, B. P. (1971). therapy: Theory, Research, and Practice. Pathogenesis: A new therapist 9(2), 111-119. http://dx.doi.org/ personality dimension related to 10.1037/h0086728 therapist effectiveness. Journal of Nutt, D. J., & Sharpe, M. (2008). Uncrit - Personality Assessment. 35 (3), 252-260. ical positive regard? Issues in the ef - http://dx.doi.org/10.1080/00223891 ficacy and safety of psychotherapy. .1971.10119661 Journal of Psychopharmacology, 22 (1), Wampold, B. E., Baldwin, S. A., Holt - 3-6. https://doi.org/10.1177/ forth, M. G., & Imel, Z. E. (2017). 0269881107086283 What characterizes effective thera - Swift, J. K., & Greenberg, R. P. (2015). pists? In L. G. Castonguay & C. E. Premature termination in psychother - Hill (Eds.) , How and why are some apy: Strategies for engaging clients and therapists better than others? (pp. 37- improving outcomes. Washington, DC: 53) . Washington, DC: American Psy - American Psychological Association. chological Association. Talk is cheap: What disasters reveal
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46 WaShInGTon Scene “This land Is Your land”
Pat DeLeon, PhD Former APA President
This spring I had the port equitable good health for all Amer - wonderful opportu - icans. Its four aims: Lead—identify a set nity, along with our of consensus study topics that build colleagues Hortensia upon one another, leading to a solid de los Angeles Amaro knowledge base that can inform a set of and Brian Smedley, to actions and partnerships to advance attend the National health equity. Translate—bridge science Academy of Medicine to action for impact on health equity (NAM) Culture of Health stakeholder and optimal health for all. Engage— meeting Engaging Allies in the Culture of strengthen capacity in communities to Health Movement . The expressed objec - continue to advance progress in achiev - tives of this particular meeting were to ing optimal health for all and inform discuss why Anchor Institution (such as legal, policy, and system reform. And, academic health centers, hospitals, Sustain—transform culture in the United health systems, and universities) Strate - States to sustain progress made and to gies are a key component to advancing accelerate progress in areas that still health equity and a culture of health in have significant health disparities. neighboring underserved communities; explore how to shape and use an Anchor “All too often in healthcare, we ask the Institution mission to advance health eq - wrong questions, deploy the wrong re - uity and a culture of health in commu - sources, and are focused on the wrong nities highlighting promising models; solutions—and then wonder why health - explore how to effectively shape and use care is broken. We ask patients if they an Anchor Institution mission for busi - have medications, but we don’t ask if nesses, non-profit foundations, and mu - they have food, heat, or a job. We pro - nicipalities; and share information and vide education to patients, but we don’t “lessons learned” to determine a way ask if they can read. We encourage peo - forward in taking purposeful action ple to lose weight, but we don’t ask if through an Anchor Institution approach. they have the ability to secure healthy Several key participants included high food…. We need to step outside our level representatives from Healthcare, comfort zones…. We need to focus on Microsoft; Kaiser Permanente; Associa - how we can have truly significant im - tions of American Universities and Aca - pact on health outcomes and in our demic Health Centers; Nashville communities by addressing the root Chamber of Commerce; and naturally causes of health and well-being.” One the all-important student voice. might reasonably ask why are organiza - tions such as Kaiser Permante investing The Culture of Health Program is a high significant funding in communities personal priority of NAM President Vic - where not all of the residents are their tor Dzau. It represents a multiyear col - members? Perhaps because: “Creating laborative effort to identify strategies to a culture of health across all of its oper - create and sustain conditions that sup - continued on page 48
47 ations is not just the right thing to do, importance of seeking to serve those it’s a smart way to get ahead of the cost that simply do not have access to any curve of providing effective care, by health care: “e.g., children, older indi - helping create and sustain healthier viduals, single parents, individuals of communities.” ethnicity, victims of violence, and it goes on.” I vividly recall my discussions with Interestingly, during the discussion pe - Seymour Sarason during his final years riod several participants, including my - in an extended care facility where many self, “pushed back a bit” on the almost of his Yale colleagues would eventually exclusive focus during the meeting of retire. He wished that he had been aware Anchoring Institutions. Federally Qual - of the way that our nation’s elderly were ified Health Centers (FQHCs), for ex - “treated” so that he could have ad - ample, have long been stressing the dressed this during his nearly half a cen - importance of communities and holistic tury on the Yale psychology faculty. On care, including the cultural-psychoso - the island of Lana’i visionary colleagues cial-economic component of quality are making a lasting difference. health care. Notwithstanding, “Anchor Institutions have tremendous potential “Lana’i Community Health Center’s to invest in communities in ways that (LCHC) Behavioral Health Program improve social, economic, and environ - started with our involvement in a Fed - mental conditions that shape health. eral Training grant in 2012. Being a small Our NAM panel highlighted innovative remote, rural federally qualified health approaches that offer strong returns on center (FQCHC) we were thrilled to be institutional investment. I’m grateful a part of this grant—but mostly we were that psychologists, such as Hortensia thrilled to offer Behavioral Health (BH) Amaro, are leading thinking and action psychology services to our community. in this space, for psychology offers criti - The island of Lana’i is one of the small - cal insights that public health and health est of the inhabited Hawaiian islands – systems are increasingly embracing” its population is 3,100, with mostly Fil - (Brian Smedley). My personal sincerest ipino residents who originally relocated appreciation to Co-Directors Ivory to work in the pineapple fields. Health Clarke and Charlee Alexander for or - care of any sort is limited: there is a chestrating a truly outstanding meeting. small critical care access hospital with the ability to treat and release or send an Increasingly Important Focus out to the other larger islands, our As the years pass, I have become increas - FQCHC, one small private practice ingly sensitive to the importance of each medical provider, and a small private of the health professions learning from practice dental office. Our organization the wisdom of those they elected to be is the only location where BH services their national Presidents. That experience are provided to all in need and the only gives one a unique perspective—on the place on island to offer such services on potential unique contributions of their a sliding fee scale. From the first LCHC own profession and equally important, training grant fellows, to Cori Takesue, the nation’s ever-evolving global envi - the first FTE Post-doc fellow hired with ronment. Former APA President Susan non-grant funds, we now have 2.5 FTEs. McDaniel stressed the importance of in - All post-docs are in the process of secur - terprofessional collaboration, especially ing their license, and at least 2 FTE will during the formative graduate school ex - hopefully remain with us. LCHC and its periences. Alan Kazdin emphasized the continued on page 49
48 providers have worked hard to remove being utilized. But now what? Sadly, we the stigma of seeking BH services, to be have the funds to support additional accepted and trusted by our community hires but no candidates to hire. Isn’t one members. Our success can be seen by of the roles of government to step in and the growth in our patient numbers… provide workable solutions and over - and the growth in our wait list. sight to protect harm to the individual? Clearly, in my opinion, government has “What is also clear is that in our com - failed—at least to this point. munity it is not the opioid crisis that is affecting many areas of nation; it is de - “But all is not lost. Some programs and pression, anxiety, stress, alcohol, and efforts show signs of recognition of needs smoking that are bringing people to our and response. Under the leadership of doorstep. It is the stress of trying to former USPHS chief nurse, Dean Carol make ends meet on an island where cost Romano, the Daniel K. Inouye Graduate of living clearly outpaces salary. It is the School of Nursing at the Uniformed Serv - depression and stress associated with ices University (USU) has placed DNP feeling as if you are failing your family. graduate students with us. U.S. Navy So we continue to see the need grow. LCDR Kayla R. Horton and U.S. Army LCHC has been recruiting for a third MAJ Margaret Martin interned last year, FTE… for over two years. We will accept sharpening their skills as a future APRN post-docs or licensed providers – how - in rural, remote, and diverse settings. ever, due to the severe shortage of can - This partnership with USU brings a didates, combined with the rural, shared opportunity for learning and new remote nature of our community, we experiences. Their experiences provided have continually fallen short of our re - them with access to a full range of family cruitment goal. Our most likely candi - practice issues, home visits, participation dates – those who are willing to work in LCHC’s school-based education pro - and live on our island – are those who gram, and the use of telemedicine – es - have ties in Hawaii. Even better, if they pecially for services that are uncommon intern with us for a year. Our main in the military—including surviving a feeder has been Argosy with its connec - hurricane on a small austere island. They tions to I Ola Lahui (a Native Hawaiian were exposed to the cultural diversity of initiative, established by psychology) Lana’i’s community, which will add en - and their training program. hanced cultural sensitivity to their arse - nal of health care tools. Overall, by “We have successfully integrated all our allowing faculty and students to partici - services (medical, dental, and vision) pate in LCHC’s activities and live within with behavioral health—knowing that our community, this joint effort and our the key to wellness is a holistic ap - combined resources works to develop, proach. We utilize telemedicine for psy - improve, and sustain the delivery of out - chiatry, as well as a number of our standing medical, dental, nursing, and specialty medical programs; however, clinical care and preventive medicine. for the basic day-to-day support we find that it is best if we have individuals liv - “The relationship that LCHC has forged ing and working on our island. It is bet - with USU and other teaching programs ter for our patients who create a sound has proven to be critical both to future base of trust, and it is better for our health care providers as well as to providers who interact with all disci - LCHC’s workforce development. One of plines to ensure the holistic approach is continued on page 50
49 our main goals is role model develop - Courage is needed on the part of the ment. With the current nurse and health government to take this next step… not care provider shortage in the United just leaving health care organizations States, and more notably in rural areas like LCHC without the ability to address such as Lana’i, these select students are these pressing behavioral needs” (Diana able to go into the community and edu - Shaw, LCHC Executive Director). cate school age children on a career in nursing and/or as a nurse practitioner. rxp —The maturing agenda These intimate interactions may also at - Under Morgan Sammons’ stewardship tract young people into the military the National Register has done an out - nursing and medicine fields. We saw the standing job representing the interests potential to inspire the next generation of psychology’s practitioners and par - of Lanai’s citizens in seeking nursing as ticularly in educating them regarding a career and coming back to serve in our the unprecedented changes occurring community. within the nation’s health care environ - ment. For example, the Register will be “Additionally, these rotations benefits sponsoring an RxP Webinar providing students in numerous ways, such as an update on Training and Legislation, teaching critical thinking skills needed featuring APA Board Member Beth to practice in remote austere settings, Rom-Rymer and her colleague Gerardo gaining a greater appreciation for cul - Rodriguez-Menendez from the Chicago tural diversity, and exposure to systems School of Professional Psychology. thinking outside of the Military Treat - ment Facility. A similar nursing program “This land was made for you and me” for Behavioral Health is needed—one (Woody Guthrie). that will be beneficial to both partici - pants and will result in a larger appli - Aloha. cant pool with rural health experience.
Find the Society for the Advancement of Psychotherapy at www.societyforpsychotherapy.org
50 Congratulations to the soCiety for the advanCement of PsyChotheraPy grant Winners!
Each year, the Society for the Advancement of Psychotherapy offers an array of psychotherapy research grants to psychologists and students to further the field of psychotherapy. The Charles J. Gelso, Ph.D., Psychotherapy Research Grants, offered to graduate students, predoctoral interns, postdoctoral fellows, and psychologists (including early career psychologists), provide three $5,000 grants toward the advancement of research on psychotherapy process and/or psychotherapy outcome. The Norine Johnson, Ph.D., Psychotherapy Research Grant, offered to early career psychologists (within 10 years post earning the doctoral degree), provides $10,000 toward the advancement of research on psychotherapist factors that may impact treatment effectiveness and outcomes, including type of training, amount of train - ing, professional degree or discipline of the psychotherapist, and the role or im - pact of psychotherapists’ personal characteristics on psychotherapy treatment outcomes. The Diversity Grant program awards up to two $2,000 Diversity Research Grants to pre-doctoral candidates (enrolled in a clinical or counseling psychology doctoral program) and one $1000 Diversity Research Grant to an early career psychologist (within 10 years of graduation) who are currently conducting dissertation research that promotes diversity or an applied project that promotes diversity as outlined by the American Psychological Association (APA). The International Research Grant was established in order to promote more inter - national and cross-cultural research within SAP and within the profession of psy - chotherapy and provides $1000 to a graduate student or early career professional (within 10 years of receiving the doctoral degree) to support the completion of a re - search project. Charles Gelso Grant Awardees
Abby Blankenship, PhD is an Assistant Professor and a Licensed Clinical Psychologist. Dr. Blankenship is the Chief of Psychology for the STRONG STAR Consortium and the Consortium to Alle - viate PTSD at the Fort Hood site. She oversees the day to day clinical operations for clinical intervention research for combat related posttraumatic stress disorder (PTSD) and deployment re - lated problems in active duty service members, veterans, and their families. Dr. Blankenship has expertise in the areas of train - ing, supervision, and consultation in evidence-based assess - ments and treatments for PTSD and families experiencing military related transitions.
R continued on page 52
51 Dr. Amy Weisman de Mamani is a Professor and the Associate Director of the Adult Division of the Department of Psychology at the University of Miami. Her primary research areas focus on family and cultural factors that influence the course of serious mental illness (e.g, schizophrenia, bipolar disorder, and Alzheimer’s disease). She has published over 75 peer reviewed manuscripts on these topics. A major focus of her research has been aimed at developing and testing a 15-session culturally in - formed treatment for schizophrenia (CIT-S), which expands ear - lier interventions in an attempt to better serve minority families and patients coping with the illness. In particular, several spiri - tual and existential components were developed and combined with previously established cognitive behavioral techniques to make treatment more relevant for Hispanics and other minorities prevalent in Miami. Her recent research indicates that this inter - vention is effective (relative to a psycho-education only control condition) in reducing the severity of patient’s psychiatric symp - toms (in both single family and group format) and in decreasing shame, guilt, and psychological burden in schizophrenia care - givers. Surprisingly, her research also shows that religious indi - viduals are more likely to drop out of CIT-S prematurely. Based on this finding, Dr. Weisman de Mamani is currently extending this line of research through a pilot grant funded by the John Templeton Foundation. Through this project, she has combined forces with Reverend Laurie Hafner, Senior Pastor at Coral Gables United Congressional Church of Christ (UCC). This grant will allow her to examine whether systematically integrating religious components early on in treatment alongside already established cognitive-behavioral approaches, and offering some of the groups in a religious intuition, will make treatment more relevant and ap - pealing to religious individuals. She expects that this will improve efficacy and satisfaction with treatment and increase therapy re - tention. The current grant (Gelso) will allow Dr. Weisman de Ma - mani and her research team to extend this study to Spanish speaking individuals.
Margaret Boyer is a doctoral candidate in Counseling Psychol - ogy at the URniversity of California, Santa Barbara. Prior to her graduate studies, she received her B.A. in Psychology with a minor in Economics from Haverford College and managed the Emotion and Self-Control lab at the University of Michigan. Her current research pursuits explore the integration of positive psy - chology in psychotherapy, interpersonal processes in emotion regulation, and therapeutic processes in psychological assess - ment. She currently serves as student supervisor of the Psycho - logical Assessment Center at UCSB and provides individual and continued on page 53
52 Margaret Boyer, contineud from page 52 group therapy in local university and college counseling settings. The goal of the current project is to establish a strategy for effi - ciently and effectively measuring clients’ vagal tone as a mean - ingful predictor and indicator of psychotherapeutic change. It is hoped that this research can bridge disciplines of positive psy - chology and affective neuroscience by utilizing a novel method - ology to study vagal tone as both outcome and facilitator of psychological growth.
Norine Johnson Grant Awardee
Joanna M. Drinane is entering her second year as an Assistant Professor of Counseling Psychology at the University of Utah. She earned her Ph.D. from the University of Denver in 2018. Her scholarship has consistently focused on psychotherapy process and outcome with an area of emphasis on the relational and cul - tural dynamics that unfold between clients and therapists. In this vein, Joanna has contributed to the development of the frame - work of multicultural orientation, has written about microag - gressions, within therapist identity-based disparities, and cultural concealment, and has worked to explore how social identity conversations influence the trajectories of change clients undergo while in therapy.
Joanna’s 2019 Norine Johnson Psychotherapy Research Grant proposal is well aligned with her growing body of research. Her study aims to use novel methodology to obtain objective ratings of therapist cultural comfort/discomfort (operationalized as emotional arousal) in response to client statements about vari - ous social identities. Specifically, Joanna plans to use software to analyze basic linguistic processes to provide quantitative ratings of emotional arousal in response to cultural stimuli, and to ex - amine the associations between these ratings and internal mech - anisms of self-regulation and therapist response patterns to clients (direct, indirect, and avoidant). The primary goal of this work is to understand the relationships between these variables in order to yield information about potential profiles of providers who might engage more or less effectively in clinical and pro - fessional contexts which require culturally sensitive dialogues. The use of these methods will foster more in depth awareness of provider/patient interactions and can contribute to the en - hancement of educational methods and the reduction of dispar - ities that occur at the individual provider level.
continued on page 54
53 Diversity Grant Awardees
Sarah Bloch-Elkouby, Ph.D., is a post-doctoral fellow at the Zirin - sky Center for Bipolar Disorders and the Brief Psychotherapy Re - search Program at Mount Sinai Beth Israel Hospital. Originally from France, she moved to Israel after high school where she at - tended Law School and passed the Bar Exam. However, her life- long passion about psychology, coupled with her strong commitment to social justice and helping professions, then led her to pursue a Ph.D. in Clinical Psychology that she completed at Adelphi University, in New York, under the mentorship of J. Christopher Muran. Her doctoral research focused on psy - chotherapy outcome assessment and treatment failure and was awarded the Sylvia Sanger Foundation Award for Psychotherapy Research. She was also awarded the Career Development Lead - ership Award by the Anxiety and Depression Association of America for her clinical work. Her post-doctoral work focuses on alliance ruptures and microaggressions among racially diverse dyads, as well as on the short and long term risk factors which put individuals at high risk for imminent suicidal behaviors. The Early Career Diversity Research Grant provides her with the op - portunity to investigate the interpersonal dynamics reflected in and resulting from therapist-initiated racial microaggressions in the initial phase of cognitive-behavioral therapy.
My name isR Brian TaeHyuk Keum and I am a doctoral candidate in counseling psychology at the University of Maryland-College Park. I am currently completing my pre-doctoral internship at the University of Maryland’s Counseling Center. I am a scien - tist-practitioner-advocate with one overarching goal: make men - tal health services more accessible, relevant, and effective for diverse individuals in today’s society, particularly for historically marginalized groups who have been understudied and under - served in psychotherapy. To contribute to this goal, I have been developing research in the following interrelated areas: (a) de - velopment of awareness and advocacy on contemporary vio - lence and marginalization, such as online racism, and gendered racism, (b) therapist training in multicultural competence and advocacy work, and (c) multicultural measure evaluation/de - velopment. Upon completing my Ph.D., I hope to continue work - ing towards this goal through a career in academia.
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54 International Research Grant Awardee
Fangsong Liu is now a PhD candidate in the Department of Ed - ucational Psychology at The Chinese University of Hong Kong. Before he went to pursue doctoral degree, he has worked as a school counselor for six years in Shenzhen, China. He has great interest in psychodynamic psychotherapy and has completed two years Basic Training Program in The China American Psy - choanalytic Alliance (CAPA).
His research interest is multicultural counseling and sexual mi - nority stigma. He expects that his research could contribute to Chinese psychotherapists’ multicultural counseling competence for minority clients, especially the LGBT group.
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55 SOCIETY FOR THE ADVANCEMENT OF PSYCHOTHERAPY THE ONLY APA DIVISION SOLELY DEDICATED TO ADVANCING PSYCHOTHERAPY MEMBERSHIP APPLICATION The Society meets the unique needs of psychologists interested in psychotherapy. By joining the Society for the Advancement of Psychotherapy, you become part of a family of practitioners, scholars, and students who exchange ideas in order to advance psychotherapy. The Society is comprised of psychologists and students who are interested in psychotherapy. Although the Society is a division of the American Psychological Association (APA), APA membership is not required for membership in the Society. JOIN THE SOCIETY AND GET THESE BENEFITS! FREE SUBSCRIPTIONS TO: SOCIETY INITIATIVES Psychotherapy Profit from the Society initiatives such as This quarterly journal features up-to-date the APA Psychotherapy Videotape Series, articles on psychotherapy. Contributors History of Psychotherapy book, and include researchers, practitioners, and Psychotherapy Relationships that Work. educators with diverse approaches. NETWORKING & REFERRAL SOURCES Psychotherapy Bulletin Quarterly newsletter contains the latest news Connect with other psychotherapists so about Society activities, helpful articles on that you may network, make or receive training, research, and practice. Available to referrals, and hear the latest important members only. information that affects the profession.
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Name ______Degree ______Address ______City ______State ______ZIP ______Phone ______FAX ______Email ______If APA member, please Member Type: q Regular q Fellow q Associate provide membership # q Non-APA Psychologist Affiliate q Student ($29) q Check q Visa q MasterCard Card # ______Exp Date _____/_____ Signature ______Please return the completed application along with payment of $40 by credit card or check to: The Society for the Advancement of Psychotherapy’s Central Office, 6557 E. Riverdale St., Mesa, AZ 85215 You can also join the Division online at: www.societyforpsychotherapy.org Paul Kwon, PhD, 2019-2024 Department of Psychology PUBLICATIONS BOARD Johnson Tower 214 Chair: Laurie Heatherington, PhD, 2018 Washington State University Dept of Psychology / Williams College P.O. Box 644820 Williamstown, MA 01267 Pullman, WA 99164 Ofc: 413-597-2442 | Fax: 413-597-2085 Ofc: 509-335-4633 E-mail: [email protected] E-mail: [email protected]
Terrence Tracey, PhD 2018-2023 Brien Goodwin, 2019-2020 – Student Representative College of Integrative Science & Arts / Arizona State University 446 Payne Hall, mc-870811 Tempe, AZ 85287-0811 Office: 480-965-6159 \ Email: [email protected] EDITORS Psychotherapy Journal Editor Robert Hatcher, PhD, 2015-2020 Mark J. Hilsenroth, PhD, 2011-2020 Wellness Center / Graduate Center Derner Institute of Advanced Psych Studies City University of New York 220 Weinberg Bldg. 365 Fifth Avenue 158 Cambridge Ave. New York, NY 10016 Adelphi University Ofc: 212-817-7029 Garden City, NY 11530 E-mail: [email protected] Ofc: (516) 877-4748 Fax (516) 877-4805 E-mail: [email protected] Heather Lyons, PhD, 2014-2019 Department of Psychology – Loyola University Maryland Psychotherapy Bulletin Editor, 2014-2019 4501 N. Charles St. Lynett Henderson Metzger, JD, PsyD Baltimore, MD 21210 University of Denver-GSPP Ofc: 410-617-2309 2460 South Vine Street E-mail: [email protected] Denver, CO 80208 Ofc: 303-871-4684 Sarah Knox, PhD, 2019-2024 E-mail: [email protected] Department of Counselor Education and Counseling Psychology College of Education, Schroeder Complex 168 H Internet Editor Marquette University Amy Ellis, PhD Milwaukee, WI 53201-1881 Albizu University Ofc: 414288-5942 2173 NW 99 Avenue E-mail: [email protected] Miami, Florida 33172-2209 Ofc: 305-593-1223 x3233 E-mail: [email protected]
pSYchoTherapY BulleTIn Psychotherapy Bulletin is the official newsletter of the Society for the Advancement of Psychotherapy of the American Psychological Association. Published online four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designed to: 1) inform the membership of Division 29 about relevant events, awards, and professional opportunities; 2) provide articles and commentary regarding the range of issues that are of interest to psychotherapy theorists, researchers, practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions; and, 4) facilitate opportunities for dialogue and collaboration among the diverse members of our association. Psychotherapy Bulletin welcomes articles, interviews, commentaries, letters to the editor, book re - views, and SAP-related announcements. Please ensure that articles conform to APA style; graphics, tables, or photos submitted with articles must be of print quality and in high resolution. Complete Submission Guidelines and the online submission portal can be found at http://society forpsy - chotherapy.org/bulletin-about/ (for questions or additional information, please email Lynett.Hen - [email protected] with the subject header line Psychotherapy Bulletin ). Deadlines for submission are as follows: February 1 (#1); May 1 (#2); August 1 (#3); November 1 (#4). Past is - sues of Psychotherapy Bulletin may be viewed at our website: www.societyforpsycho -therapy.org. Other inquiries regarding Psychotherapy Bulletin (e.g., advertising) or the Society should be di - rected to Tracey Martin at the the Society’s Central Office ([email protected] or 602-363- 9211). Society for the advancement of psychotherapy (29) Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215 Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: [email protected]
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