psyc lecture #4

What is a Psychologist?

Psychologists engage in a variety of activities, often specializing in one or more areas:

• Teaching: Approximately $30-40\%$ of psychologists are involved in teaching, particularly at smaller colleges where professors may teach $\text{4-5}$ courses per semester and do little to no research (e.g., Guilford College).

• Research: Researchers investigate various phenomena. For instance, a colleague at the National Institute of Aging researched nutrition and lean body weight for cognitive preservation and life prolongation in nonhuman animals.

• Patient Care (Therapy & Diagnostic Work): This involves helping individuals through therapy or conducting diagnostic assessments to identify conditions like ADHD, learning disabilities, or brain damage. The American Psychological Association (APA) refers to this as "the practice of psychology." Applied Behavior Analysis (ABA) is a common therapy-focused area, often working with autism.

• Community Involvement: Psychologists can work on public health initiatives, such as smoking cessation programs or understanding vaccine adoption. Historically, psychologists worked at the CDC on behavioral aspects of public health, though the current administration's stance on disease and vaccines has impacted these roles.

• Diverse Roles: Many psychologists, like the speaker, combine multiple roles, including forensic work, teaching, research, and involvement with professional organizations like the APA. Some specialize in a single area.

What Psychologists are NOT

It is crucial to distinguish psychologists from other related professions:

• Psychiatrists: These are medical doctors (MD degree) who complete a residency. They almost exclusively prescribe medicine (e.g., Zoloft, Klonopin, Adderall) for mental health conditions. Interestingly, primary care doctors and pediatricians often write the most common prescriptions for mental health issues like Adderall and antidepressants, not psychiatrists.

• Counselors: Most counselors hold a master's degree (e.g., MSW - Master's in Social Work) which is typically a terminal degree for their profession. They generally handle lighter, less complicated cases, such as marriage and family therapy.

Doctoral Degrees in Psychology

To be called a "psychologist," an individual must possess a doctoral degree. There are two primary types:

• PhD (Doctor of Philosophy):

  • Meaning: Colloquially, "Piled Higher and Deeper"; formally, Doctor of Philosophy.

  • Focus: Emphasizes research and teaching. Most full-time, tenure-track professors at universities, regardless of discipline (e.g., chemistry, philosophy, English, psychology), hold PhDs.

  • Example: The speaker's son, Nick, has a PhD from the University of Georgia, works at George Washington University School of Medicine in neuropsychology, teaches medical students, and conducts research in cultural neuropsychology.

• PsyD (Doctor of Psychology):

  • Focus: Primarily geared towards professional practice and clinical work.

  • Training: PsyD programs often immerse students in clinical settings very early in their education. For example, the speaker's daughter saw her first patient on the first day of graduate school.

  • Example: The speaker's daughter, Krista, has a PsyD from the Florida Institute of Technology. She works in private practice, seeing children, adults, and veterans, often dealing with trauma and depression, typically without significant involvement in research or teaching.

Application of Psychology: Service-Oriented Roles

This sector involves providing psychological services for a fee, making it the "hottest part of psychology" currently in terms of job opportunities. However, it faces financial challenges.

• Forensic Psychology: The intersection of psychology and the legal system (e.g., death penalty work, understanding criminal behavior). This area is in high demand, though insanity pleas are not a primary focus.

• School Psychology: Psychologists working within educational systems, primarily as diagnosticians assessing for ADHD, learning disabilities, or other issues. Some counseling may be involved.

• Health Psychology: Merges psychology with medicine, addressing issues like pain management, diabetes, surgical preparation, and even transplant psychology. This is a very active field, handling approximately $95\%$ of healthcare-related psychological concerns.

• Clinical Psychology: The oldest and most common applied field, focusing on providing services to individuals with mental health problems, usually through therapy, but also diagnostic work.

• Applied Behavior Analysis (ABA): Often involves intensive work with individuals with autism spectrum disorder. It's a rapidly growing but potentially "too hot" area regarding reimbursement models.

• Neuropsychology: Highly specialized field focused on the relationship between brain function and behavior. It includes diagnosing and tracking neurodegenerative diseases like dementia and Alzheimer's (which typically progresses over $7-9$ years).

• Sports Psychology: Integrates psychological principles into sports performance and well-being. Though not historically as "fruitful" financially as other fields, it is growing (e.g., psychologists at UNC Chapel Hill, Duke, and UNCW, working with athletes on issues like concussions).

• Family Psychology: While existing, this area is not as popular as it once was.

Challenges in Applied Psychology

• Funding Cuts: Medicaid is facing cutbacks of $30-40\%$, impacting healthcare access. The CDC has also seen reductions in funding for behavioral health initiatives.

• Federal Disinterest: The federal government shows less support for mental health and science than in the past.

• Insurance Reimbursement: Insurance companies are increasingly reducing reimbursement rates for psychological services, making it harder for practitioners to earn a living in the "health side" of psychology.

• Societal Shift: This leads to a projected bifurcated healthcare system where those with significant financial resources can pay cash for comprehensive care, while others may receive minimal services. This is influenced by a government stance that views healthcare as a privilege rather than a right.

The Academic Side of Psychology: Teaching and Research

A significant portion of psychologists (e.g., $30-32$ out of $35$ faculty in the speaker's department) are primarily interested in teaching and research, not selling direct services.

• Research Focus: In larger universities, research often takes precedence over teaching for professors.

• Funding Crisis for Research: Federal government funding for scientific research is decreasing. Universities traditionally retained $50-60\%$ of research grant money, with researchers receiving about $45\%$ (if lucky). New regulations may limit university overhead to $15\%$, severely impacting revenue. For example, UNC Chapel Hill is projected to lose approximately $100,000,000$ in funding this year due to research cuts and declining sports revenue.

• Examples of Academic Psychology Fields (with departmental examples):

  • Social Psychology: Studies social interactions, group behavior, and societal issues (e.g., racism).

  • Psychopharmacology: Investigates the effects of drugs on the mind and behavior (e.g., addiction).

  • Geriatric Psychology: Focuses on the minds and well-being of older adults.

  • Child Cognition/Development: Researches how children's thinking and cognitive abilities develop (e.g., Simone Ni Yang's work).

  • Basic Learning and Forgetting: Explores fundamental processes of how organisms acquire and lose information.

The American Psychological Association (APA)

The APA is the largest psychological society in the world, with approximately $170,000$ members, reflecting a vast diversity within the field.

• Organizational Structure:

  • Headquarters: Two buildings and roughly $500$ employees in Washington D.C.

  • Leadership: Led by a CEO (e.g., Arthur Evans, earning around $1,200,000$ annually), with directors for key areas: Science, Clinical/Applied, Teaching, and Social Justice.

  • Bifurcated Model (Post-2017):

    • C3 (APA): Focused on advancing the science of psychology.

    • C6 (APA Services Inc.): Focused on the profession of psychology, highly political, and dedicated to advocacy.

• Advocacy: A significant function of the C6 entity. APA advocacy is based on scientific evidence, not personal opinions. For instance, the speaker, representing the APA, publicly condemned the separation of children from parents at the border, citing established science (e.g., Harry Harlow's work on the detrimental effects of maternal deprivation on children). They avoid taking stances where no scientific basis exists (e.g., building walls).

  • Political Engagement: Psychologists typically lean left-of-center, but APA's advocacy efforts distribute approximately $50\%$ of political donations to Democrats and $50\%$ to Republicans to work with whoever is in power. This pragmatic approach supports mental health legislation, even if championed by a Republican senator.

  • Example Advocacy: The speaker's lobbying against the repeal of Obamacare by appealing to a conservative senator's moral values and highlighting the impact of Medicaid (connected to Obamacare) on healthcare in his state, stressing its role in addressing drug abuse, suicide, and covering a third of the state's counties.

• Volunteer Leadership:

  • President: Currently Deborah, an academic, Asian American, social justice psychologist.

  • Board of Directors: Provides support to the president.

  • Council of Representatives: Composed of about $180$ voting members who make key policy decisions (e.g., prioritizing diversity, equity, and inclusion).

  • Divisions ($51+$): Specialized sections covering diverse areas of psychology, such as children, adults, geriatrics, LGBTQ+ issues, military psychology (often conservative), peace psychology (often far-left), neuroscience, health psychology, and clinical psychology. Examples include Division $40$ (practice-heavy, ~$5,000$ members), Division $6$ (neuroscience/animals, ~$500$ members), and Division $52$ (global/international psychology, ~$1,000$ members). Divisions reflect the vast intellectual diversity within psychology.

• Challenges of Diversity: While variety allows for extensive knowledge, it can lead to fragmentation, making it difficult for diverse perspectives (e.g., clinicians vs. academics, political right vs. left) to cohere, as illustrated by the speaker's challenging experience in leading the APA.

• Historical Crisis (2015-2016): Discovery that some APA members supported controversial interrogation techniques (e.g., waterboarding) led to $75\%$ of the leadership being fired, retired, or resigning. The speaker, as president-elect, stepped into a leadership vacuum, resulting in a complex period of restructuring and crisis management. This included a period where the speaker and a colleague effectively co-led the APA due to the successor's developing dementia, shielding her and managing operations in her stead.

The Future of Psychology: Individual Empowerment and Science-Informed Decisions

Drawing from current societal shifts, the speaker advocates for a new role for psychology.

• Failure of Traditional Institutions: Traditional institutions (government, medicine, banks, religion) have faltered in adequately caring for individuals (e.g., government's inconsistent COVID-19 response, medicine's over-reliance on pills for behavioral issues, economic inequality, and religious leaders' susceptibility to disease).

• Empowering the Individual: Instead of external entities, the speaker suggests empowering individuals to take responsibility for their own well-being by providing them with skills and a sense of agency.

• Psychology's "Seat at the Table": Psychology should leverage its scientific foundation to foster a "better world by giving people a better mind." This aligns with the thinking of Roger Sperry, who believed in using science to make moral priorities.

• Science-Informed Debates: The speaker argues for shifting societal debates from purely political or religious frameworks to psychological and scientific ones. For example, instead of debating pro-life vs. pro-choice from a religious standpoint, a psychological discussion should focus on the scientific understanding of "when life begins" (e.g., at conception, at $3$ months when organs are formed, at $6$ months when viable outside the womb). This critical discussion, currently lacking, could provide valuable information to inform complex decisions.

• Depth of Care: Psychologists, unlike some medical practitioners who may offer brief consultations (e.g., $50$ minutes), can provide the in-depth understanding of a patient necessary for comprehensive care, which is crucial for tackling complex issues like addiction and depression beyond just medication.

Numerical and Statistical References

• Teaching: $\text{30-40\%}$ of psychologists teach.

• Teaching load: $\text{4-5}$ courses a semester for professors at small colleges.

• APA members: $\text{170,000}$.

• APA employees: Approximately $\text{500}$.

• CEO salary: About $\text{1,200,000}$.

• University research funding retention: Traditionally $\text{50-60\%}$ for the university, $\text{45\%}$ for the researcher. New rule: $\text{15\%}$ for the university.

• UNC Chapel Hill projected loss: $\text{100,000,000}$.

• Medicaid cuts: $\text{30-40\%}$.

• Political donations by APA: Roughly $\text{50\%}$ to Democrats, $\text{50\%}$ to Republicans.

• Cost of advocacy lunch: $\text{2,000}$ to $\text{5,000}\text{ dollars}$.

• Counties on Medicaid: A third of counties.

• APA Council of Representatives: About $\text{180}$ people.

• APA divisions: $\text{51}$ or more.

• Division 40 members: $\text{5,000}$ people.

• Division 6 members: $\text{500}$ people.

• Division 52 members: $\text{1,000}$ people.

• APA crisis leadership turnover: $\text{75\%}$ of leaders fired/retired/quit.

• Speaker's travel for APA: $\text{40-50}$ times a year.

• Alzheimer's progression: Usually a $\text{7-9}$ year event.