Welcome. My name is Garth A. Fowler, and I’m the Associate Executive Director of the APA’s office of Graduate and Postgraduate Education and Training. I will be your moderator today for our latest installment in our PsycIQ series on emerging careers.
I’m excited today to be joined by my colleague Vaile Wright, who is a licensed psychologist in the District of Columbia and she’s also the APA’s Director of Research and Special Projects. So today Vaile and I are going to talk about career opportunities for psychologists, plus areas - both new and old – where practitioners can really make a huge impact.
So for a little history, let’s think about this when I was a graduate student many of my classmates have their sights on a Health Service psychology, being a clinician or counselor. And they went to work with patients every day. That is - and continues to be - a really common track for budding psychologists. But much has changed, and today there’s a need for a professional psychological help, greater than there ever was before. So it’s important that we look beyond these traditional client settings - things that happen outside the therapy room - where we can actually have the greatest impact from our profession and help as many people as possible. So we hope this conversation today is going to help you on your way to kind of filling that need and building your career.
I’m going to turn it over to Vaile l in a second here, but I want to remind you that you can submit questions throughout the talk using the question section, and at the end will be able to vet some of those and ask them.
And so now to get us started, I’m going to hand it over to Vaile who is going to givea presentation. So Vaile,take it away!
(Vaile): Thanks so much for having me Garth, I’mexcited to be here. You know as apsychologist and as a researcher I lovenumbers, and so I thought we could startby framing our discussion with a little bit talk about kind of what thescene is right now.
Our nation’shealth care system is going through agreat deal of change in recent years.Thanks in part to the Affordable CareAct, nearly 81 percent ofAmericans with serious psychologicaldistress, such as hopelessness anddepression, had access to healthcarecoverage in 2015. And yet, despite thatincrease, in access only 34.2 percent ofpeople actually sought help from amental health professional in 2015. Youknow a lot more research is needed tounderstand you know what this gap is allabout there’s clearly I need to get tothe people that aren’t getting the carethat they need.
Further, the importance ofmental health is not lost on usemployers. In fact, 75-percent of USemployers say stress is their number oneconcern for their employees. So I think aspsychologist there’s a real opportunityto serve the needs of the public and toreach out those who need help, but justaren’t being reached.
I think a lot of us were trained withina traditional therapy model which Garth alreadyalluded to. As you know, the primaryway that we think about treatingpatients, but you know we really need torecognize that there are many wayspsychologists can benefit patientsoutside of a traditional 50-minutesession.
And a lot of the things we’regoing to talk about today our ways thatpsychologists can be more proactive inreaching patients and clients as opposedto just sort of sitting back and waitingfor people to contact us. So within thatvein, I want to talk about howpsychologists that we can utilize thefull scope of our doctorate, close thismental health care gap that we’re seeing,and also help those who might otherwiseget overlooked. And trying to advance myslide....there we go. So I’m going to highlight four areas today.
The first area for growth is going to bethe healthcare sector. Let me startwith just a really quick caveat. And whenI was thinking about this webinar - what Iwant to talk about, what are emergingareas for practice - It really donned on me thatpsychology is already kind of everywhere,right. We have psychologist working withCirce-de-Solei, helping them with their performance, we have psychologist workingwith astronauts going you know intoouter space. So it’s not that the areasI’m going to talk about todaypsychologists aren’t already working in,there are people that have come beforeus.
But the four areas I want tohighlight today I think are places wherethere’s still room for growth.
And so for example, in healthcare I thinkwe’veseen a bit of a shift where thehealthcare system is increasinglyrecognizing the benefits ofpsychologists, and what we can bring thepatients, and that they want to find waysto incorporate us into the overall carecontinuum. And you know where we hearthis happening the most right now is inthe area of primary care integration. AndAPA has been providing members resources onhow to take advantage of these primarycare integration opportunities. But reallyprimary care is just one area of health
care and it’s not just the only option.
For example, there are number especiallyhealth clinics around the country thatmay be looking for psychologists to jointheir organizations. I don’t think It’llsurprise anyone to think about the waysin which the psychologist can be a realbenefit for those who are treatingcancer and in cancer clinics. Yet, even atthe Cleveland Clinic - you knowworld-renowned premier hospital – theyonly just added a psychologist withinthe last two months to the clinic. So youcan still see where there are lots ofopportunities for psychologists tocontinue to grow and embed themselvesin these different areas. I thinksome other examples here, fertility andyou know OBGYN type services. For example,we know that one in seven women who getpregnant will have postpartum depression.
So there’s a lot of room I thinkthere for the role of psychology tobecome more embedded. In fact, there was justan article in New York Times today aboutfertility and IVF, and how the
percentage for IVF after 40 is actuallymuch lower than people think. I justI see so many opportunities there forpsychologist to help work with women whoare trying to become pregnant, or areunable to become pregnant ,and then howyou adjust to those differences – thosechanges in your life.
Another area is obviously painmanagement, with the move towards andaway from pain medications and theconcerns about opiate addiction,psychologist for behavioral healthexperts there’s a real role for them inthis area. And then also with geriatricand aging populations. Again we’re seeingthe baby boomers get older, it’s ourlargest growing population there are notnearly enough psychologist or otherhealth professionals that specialize in this population, and so itthat’s another really huge growth areafor psychologists to get into. So you cansee there’s some real clearopportunities for psychologists to assumeleadership roles in these areas whichcould help them expand their servicessort of outside - so what you think interms of - your private practice setting.
The second area I want to talk about istechnology and telehealth. This isactually an area where we’ve received a lot ofadvanced questions about, so clearlythere’s a lot of interest. More and morepatients are seeking ways to receivecare. In recent years, there have been a numberof new apps and new technologies thatallow practitioners to provide careremotely. In fact, todays patients I think are really looking forpractitioners that provide them withoptions - whether it’s by phone, online, orteleconference - and can best fit theirindividual needs and schedules. Forexample, I was at a meeting forNCQA last year where speakers are comingand talking about advances in healthcare. They were really focusing a lot ontelehealth, particularly with millennialgeneration. The younger generation is morecomfortable using these types of technologies but they’re becoming toexpect that this is going to be a wayfor them to receive care.
And in fact, onthe NBC world news last night therewas an entire segment about telemedicine.And that there were these kiosks beingput into work places so that people canaccess, again, healthcare remotely. So eventhough this might be a little differentfrom how we conducted our practices inthe past, or how we thought of ourselves,and how we provide psych therapy byfinding new ways to reach clients youcan increase access for patientswho need help. And I think we alreadyknow a lot of the ways that telehealthcan address these barriers to accessingcare.Perhaps your client is looking to speakwith you, but their work schedule won’t all ow them meet with youin person.Maybe they couldn’t find childcare oneday and they don’t want to cancel theirappointment, but they can’t leave theirhouse so telehealth can offer somesolutions to these different barriers.
And I’ll give you another example,there’s an excellent piece and theSeptember issue of the APA Monitor, whichtalks about Dr. Sherry Benton, who usedto direct the University of Florida’sCounseling and Wellness Center. And shewas really frustratedthat the Wellness Center couldn’t get toall the students needed help -they had these hugewait lists -so she started searchingfor programs that could help addressthis access issue. And she found sometechnologies online that allow patientsto have a brief phone conversation withthe therapist, and then also use anonline program teaching kind of morecognitive behavioral type strategies andskills. She was able to use this at theuniversity and it really took off,students really enjoyed it they wereable to get a lot more care that theyneeded, and also allow the university’stherapist the ability to monitor studentprogress by collecting outcome data. Andthen eventually, Dr. Benton - you know -tailored this program to create her ownbusiness in 2015.
Now I’m not expecting everyone to go outthere and become entrepreneurialpsychologist who develop their onlinetreatment programs, but I think thatthere is a lot of room here forpsychology to take advantage of some ofthese opportunities as they relate totechnology and telehealth. For those interested in learning more, my lastslide which is going to focus on
resources will also have a link for,Guidelines for the Practice of Telepsychology that APA developed. Whichagain would come in handy for those whoare really particularly new orinterested in this topic.
Third area, I want to focus on is wellness and prevention. As we talked about earlier 75-percent of US employers to stresses their number one concern with their employees. So given that reality, young companies are really beginning to develop wellness and prevention programs to help employees cope with stress, encourage work-life balance, and promote overall health and
well-being. In fact, APA has a lot of these programs it really practices what it preaches and I you know as an APA employee, and as an APA member appreciate that. You know while the jury is still out, on the effectiveness of some of these programs certain companies like Dow Chemical, Honest Tea, and Johnson & Johnson have actually found great success with their wellness programs. So that I think there’s a real need an opportunity for clinical psychologist to work closely with companies to bolster their wellness programs. Psychologists are the experts in behavior change this is what we do. And so our participation could go a long way in ensuring these programs are successful.
There are different ways to do this. One would be maybe working directly with an organization that you contacted - create a relationship with - but I also have a friend who recently took a job with them a private company and they develop these health wellness programs, and then sell these out to a variety employers. So I think there are different ways to get involved. Another option is mentioned here is working in the area prevention. Which under the Affordable Care Act, these programs have been expanded in order to maximize positive health outcomes. So you know as we know early and focused interventions can limit the length and severity of mental and physical health symptoms and advanced functions particularly in children. And I think psychologist can play a major role in developing and enhancing programs that focus on wellness prevention on the front end, instead of just getting individuals back end when they are already sick, or are dealing with a mental health issue.
Of course this is going to involve creating community partnerships. It might mean going out to the churches, into the schools, into other community organizations, and really again being proactive in how can you bring your services to work collaboratively with them in order to reach the people that need help the most. And the last area is the area of program evaluation, in particular developing outcome measurement programs. As psychologists, you know we’re trained in the area ofresearch and methodology, this enables us to measure the effectiveness of programs to show whether patients are improving. This is huge, right. And it’s a skill set for which psychologists are uniquely trained compared to other mental and behavioral health professionals. It’s really our value add as psychologists.
Under the Affordable Care Act, I’m sure many people are aware of this, but the healthcare system is transitioning away from fee-for-service model, and instead to one where providers will begin to be paid based off the quality of their services. And in this system, hospitals will be incentivized to focus on patient outcomes, provide the highest quality of care, and lower readmission rates and costs overall. And so as the healthcare system begins to make the shift, psychologists have a huge opportunity to play really a leading role.
Not only as I mentioned are we researchers and methodologists, but many cases - particularly when it comes to mental behavior health - we created the measures that they want to use to measure outcomes. We know about reliable, we know about validity, we know how to create programs, and then evaluate them. So I think we could play a future role in measuring and helping to measure whether healthcare organization services are effective and ensuring positive patient outcomes. And again this is going to be area that psychologists we also believe are going to have to themselves be providing outcomes.
But again I think there’s a lot of opportunities for psychologists to assume leadership roles in healthcare organizations and make a considerable contribution outside the conventional therapy space. So there’s a lot of information in a really quick period of time, and I was kind of rushing through because I want to make sure we have time for questions, but also want to draw you attention to some resources. In particular, Practice Central which is the website for the APA Practice Organization which provides resources specifically tailored towards practicing psychologist.
So on the website are variety of resources including information on innovative practice models, including colocation, IPAs and ACOs, and then how to go about creating these relationships with other providers, other organizations for advocacy and outreach. In addition, as I mentioned earlier the link for the APA Professional Practice Guidelines, which are developed by experts intended to be aspirational in nature, but can provide some real important guidance for those interested in learning more about the topics we discussed today. In particular highlighted four telepsychology which we talked about, prevention, working in healthcare delivery systems, and then also older adults. And so with that I thank you for letting me speak and I’ll hand it back over to Garth for questions.
(Garth): Alright. Thank you Vaile. We’re going to turn now to the Q&A portion of our webinar. Again, I want to encourage our attendees to please submit your questions using the Go-To Meeting chat function. We’ve had some submitted already, we’ve had someone come in earlier through the registration process so we’ll have a number to get us started. And we’re going to try and get to as many of those as we possibly can.
But to get us to get started on this part of the presentation Vaile, you talked a lot about how psychologists should get more involved in the healthcare sector - particularly like the idea of leveraging technology in their prime this - and areas we talk about bolstering wellness and prevention programs.
And I think there’s a lot of amazing opportunities there in the area program evaluation, but what do you think are some of the biggest barriers for entry into these particular sectors? And I’m thinking more particular, how could, we had one question from an attendee who said they’re currently a student, so I was trying to think of how do you think our attendees could leverage themselves? And maybe for those who are now in their early careers versus maybe who are in their more established careers to try and make headways into these particular areas.
(Vaile): Yes, I think that’s a great question and to be quite frank the biggest barrier right now is payment and reimbursement. We just don’t necessarily have the systems in place yet to catch up to where we see psychology going when it comes to these emerging career areas. For example, you know if you’re looking to embed within a healthcare clinic the only way to really make that feasible is likely to be salaried. And so that might require you presenting a business