07 Nov 2017

Special Report: 10 Trends to Watch in Psychology

Monitor on Psychology, November 2017
Monitor on Psychology, November 2017

More than ever before, there is a growing appreciation for psychologists’ expertise, including the research they do to illuminate human behavior and the treatment and insights they provide to improve health and well-being.

But of course the field’s capabilities go far beyond research and practice—psychology’s ever-multiplying subfields touch on every facet of life. Today’s psychologists are the innovators improving American products and services, from self-driving cars to the health-monitoring apps on our cellphones. They are the trailblazers steering efforts that improve health outcomes and enrich the performance of teams in workplaces nationwide. They are the thought leaders advocating for critical causes, from women’s rights to science-based public policy.

In this special APA Monitor report, “10 Trends to Watch in Psychology,” we explore how several far-reaching developments in psychology are transforming the field and society at large.

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26 Oct 2017

Grad Student Laura P. Minero on Advocating for Undocumented Immigrants

Grad Student Laura P. Minero on Advocating for Undocumented Immigrants

At age 5, Laura P. Minero left her home in Guadalajara, Jalisco, Mexico, with her mother, to join her father, who'd traveled to California two months before. In Tijuana, she posed as another family's daughter for the trip over the border, separated from her mother, who stowed under the passenger seat of a different car. "I still remember the sights, and the sounds and the smells, and just how scared I felt," Minero says.

Today, Minero is a graduate student in counseling psychology at the University of Wisconsin–Madison, where she has received a Ford Foundation fellowship to study the mental health of undocumented transgender individuals held in U.S. detention centers. Hard work—and a rare scholarship available to undocumented students—gave her access to education. Meanwhile, the Deferred Action for Childhood Arrivals program, enacted in 2012 to offer protections to undocumented immigrants brought to the United States as children, provided her a work permit and a measure of security she'd never had before.

But since November, that sense of security has eroded, and Minero has become a vocal advocate for herself and other undocumented students on the UW–Madison campus. She spoke to the Monitor about her life and work, and how both have changed in recent months.

How has being undocumented affected you?

Growing up, I knew that there were a lot of things that we didn't have access to because we were undocumented. My mom started working in the fields right away, and my dad has worked in dairies pretty much since he arrived in the United States. We haven't been back [to Mexico], there are family members we haven't seen in 21 years. My parents have experienced a lot of exploitation, particularly my mom. She's had lots of laborious, back-breaking jobs, and we didn't have access to health insurance. Thankfully my family was pretty healthy, but I also know that there were times that there was something most people would go to the doctor for, and we just tried to get better on our own.

As for me, I was tracked into honors classes since I was in sixth grade, but when I started applying to colleges, I got stopped on the very first page where they ask for your Social Security number. My high school counselors helped me call the colleges and universities to navigate that. But then, even though I got accepted into four universities, my family didn't have $25,000 per year for my education, and I didn't have access to state or federal financial aid. Thankfully, I was offered a full ride to a local community college, West Hills College Lemoore, and that provided me access to higher education. Then I was able to transfer to California State University Fullerton to finish my undergraduate degree and then master's degree.

How did you become involved in advocacy for other undocumented students?

Last spring, I found out that 15 undocumented undergraduates at Madison were at risk of losing their scholarships. A few of us went to talk to the vice provost directly to ask him or her to reconsider. I felt like I had to use my privilege — I'd gotten to a place where I felt safer, and I felt like I had to speak up.

The students were able to retain their scholarships, and that success prompted me to co-found the first group for undocumented students on campus.

What does this group do?

We've been fundraising for the first scholarship for undocumented students and organizing an event with the Latino Health Coalition in Madison to help families develop safety plans for the possibility of deportation. We're going to have lawyers there to help people who are at risk of deportation, and who have U.S. citizen children, sign power of attorney over to a family member who wouldn't be affected by deportation, so that their children could stay with them instead of being put into foster care.

How has your life changed in the past few months?

With the anti-immigrant and xenophobic executive orders, I've definitely changed the way I behave at home. I don't play music as loud, I don't play it at all some nights. I look out the little keyhole if I hear noise. If someone knocks on the door, it startles me — could that be ICE [Immigration and Customs Enforcement]?

It's been an incredibly emotional process, but it has also pushed me to advocate for others. When Trump was elected, I was contacted by professor [Cindy I-fen] Cheng and one of my colleagues, Sergio González. And within an hour we developed a letter and sent out a petition imploring the university to protect undocumented and international students. In just a couple of days, we had more than 2,000 local signatures.

The university staff initially responded with "we can't offer those protections." But then we asked to have a meeting with them. And we brought a resolution that we thought would be helpful, and they were actually open to it, and ran it by their legal team, and pretty much put it into policy.

How has this changed how you think about your research?

I have a passion for intersectionality and linking experiences, particularly of undocumented and LGBTQ individuals. So, one area where I see a gap in the research is in looking at the experiences of undocumented trans individuals, especially those in detention or facing deportation.

We know that these individuals are put in cells that don't align with their gender identity, so they are at high risk for physical and sexual abuse. Or they are often held in solitary confinement, supposedly to keep them safe. My hope is that if we have data to suggest that this is incredibly traumatic and dehumanizing, we can change that.

I haven't collected any data myself yet; I've been doing a lot of literature review to try to connect pieces and I have been looking at secondary data. Now, I question whether it's safe for me to walk into detention centers to collect data. Would I be putting myself at risk of detention and deportation under the new executive orders?

Still, the study is really important, so it's forcing me to be more imaginative and think about whether I train people or send other people who can do this safely to collect the data. It's still work that needs to be done.

By Lea Winerman


This article was originally published in the June 2017 Monitor on Psychology

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18 Oct 2017

Navigating from Graduate School to Early Career Booklet

Navigating from Graduate School to Early Career Booklet

Traversing the landscape from graduate student to early career psychologist can be challenging. This two-volume series offers useful tools and advice for those on the journey. The first volume includes articles on how to succeed in the early years of graduate school, including how to find a mentor, how to pay for graduate education, and how to improve your writing and presentation skills. The second volume focuses on the later years of graduate school, with advice on how to ask for more responsibility, how to earn research funding and how to make the transition into the workforce.

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16 Oct 2017

Access to Care for All Veterans

Access to Care for All Veterans

The Department of Veterans Affairs and APA are working to improve treatment for veterans in new ways

Hiring 1,000 more mental health professionals and increasing the number of private-sector mental health providers who are culturally competent in military issues are among the new priorities at the Department of Veterans Affairs (VA), according to VA Secretary David J. Shulkin, MD, who testified in March to the House Veterans Affairs Committee.

Shulkin also emphasized the need to strengthen suicide-prevention programs and announced his intention to open up access to treatment to veterans with other-than-honorable discharges.

APA is helping to ensure that the secretary's goals become a reality by pushing Congress to expand resources for VA mental health care and research. "We are thrilled that Dr. Shulkin was named VA secretary," says Heather O'Beirne Kelly, PhD, who in March was named APA's first-ever director of veterans and military health policy. "And we applaud all his newly announced priorities."

Saving lives

The number of veterans committing suicide has dropped to roughly 20 a day, the secretary told Congress. But when it comes to suicide prevention, he said, "What we are doing now—and we are doing a lot—is not enough." The VA is seeking new approaches, he said. "We are reaching out to the very best and brightest from the academic world and the community to come in and tell us what else we can do."

As part of Shulkin's suicide-prevention effort, he plans to make emergency mental health care accessible to the 500,000-plus veterans who have other-than-honorable discharges, which render them ineligible for VA care. "Our goal is simple: to save lives," said Shulkin, explaining that the suicide rate among veterans who don't use VA facilities is increasing at a greater rate than that of veterans receiving care within the VA.

Shulkin's proposal would give veterans with other-than-honorable discharges access to VA emergency departments, vet centers and the Veterans Crisis Line at (800) 273-8255. The secretary plans to meet with members of Congress, Department of Defense officials and representatives of veterans service organizations before finalizing his proposal this summer.

Veteran Thomas Burke, who received an other-than-honorable discharge after being booted from the Marines for smoking hashish to manage post-traumatic stress disorder (PTSD) in Afghanistan, supports the proposal. "When people think of ‘less-than-honorable' discharge, they think of dishonorable; to get a dishonorable discharge, you have to rape or murder someone," says Burke, now treasurer of High Ground Veterans Advocacy and a master's degree candidate at Yale Divinity School. But, he says, other-than-honorable discharges are often the result of behavior related to PTSD, traumatic brain injury, military sexual assault and other mental health problems. Of course, says Burke, the secretary's proposal is just a proposal. That's why he and other veterans in High Ground support the Honor Our Commitment Act, which seeks to transform the proposal into legislation requiring the VA to provide mental and behavioral health services to veterans with other-than-honorable discharges.

APA outreach

APA supports the secretary's proposals, says Kelly. APA generally supports the proposed legislation, too, although Kelly wants to keep a close eye on implementation details. There have been calls to retroactively assess veterans' discharge statuses, for example, and it would be critical to understand how and by whom those assessments would be performed and interpreted and how they would be used by the VA for health-care decision-making, Kelly says.

Of course, the secretary will also need resources to fulfill his vision for the VA. APA called for that increased funding along with other requests in testimony to the House Appropriations Committee's Subcommittee on Military Construction, Veterans Affairs and Related Agencies in March:

  • Suicide prevention. APA supports Shulkin's commitment to enhanced suicide prevention efforts. In terms of other clinical priorities, Kelly urged Congress to support the hiring of more psychologists, increase support for integrated care and hold community providers to the VA's high standards.
  • Prescriptive authority. Kelly also urged Congress to grant prescriptive authority to appropriately trained psychologists in the VA.
  • Research funding. As part of the Friends of VA Medical Care and Health Research, APA asked for $713 million in fiscal year 2018 for VA research. "A strong VA psychological research program provides the scientific foundation for high-quality care within the VA system," Kelly told Congress.

One concern is the VA's push toward privatization, with more care being provided outside of VA facilities, adds Kelly. While many veterans groups were happy to hear the secretary talk of eliminating the rule requiring veterans who live close to VA facilities to get their care there, she says, APA is concerned that community providers may lack the preparation and capacity to handle the increased demand. Plus, says Kelly, having psychologists embedded into primary-care settings is vital to ensuring high-quality care for veterans.

"We will continue to work with Secretary Shulkin and the VA about what they mean by community care to ensure that the VA is strengthened as an integrated-care provider for veterans and not just as a funder of outside care," Kelly says.

To read Dr. Heather Kelly's full testimony to the House Subcommittee on Military Construction, Veterans Affairs and Related Agencies, go to www.apa.org/about/gr/issues/military/testimony_va_research.pdf.

By Rebecca A. Clay


This article was originally published in the June 2017 Monitor on Psychology

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11 Oct 2017

How Much Do Today’s Psychologists Earn?

How Much Do Today’s Psychologists Earn?

The latest salary report from APA finds that psychologists in the middle of the country outearn their peers

In May, APA's Center for Workforce Studies (CWS) released its most comprehensive salary report to date. The report finds that the median annual salary for U.S. psychologists in 2015 was $85,000, but that salaries varied widely by subfield and geographic region.

Most psychologists (57.4 percent) earned between $60,000 and $120,000, 20 percent earned less than $60,000, and 22.7 percent earned more than $120,000. Those in industrial/organizational psychology were at the top of that range—the median annual salary for I/O psychologists was $125,000. Those with a degree in educational psychology, at the other end of the spectrum, earned a median salary of $75,000.

Want to earn more? Move to the Middle Atlantic region, where psychologists earned, on average, $108,000 per year. Psychologists in the East South Central region, in contrast, earned $59,000 per year.Psychologist salaries

Meanwhile, women continued to earn less than men ($80,000 compared with $91,000), white psychologists earned more ($88,000) than racial/ethnic minority psychologists ($71,000), and those with a PhD earned more ($85,000) than those with a PsyD ($75,000). (To read more about the gender pay gap, see the article "Women Outnumber Men in Psychology, But Not in the Field's Top Echelons" in the July/August Monitor.)

The new salary report is APA's most representative look yet at psychologists' earning power, according to Luona Lin, a CWS research associate. In previous reports, the association's salary data came from member surveys, but APA members skew older and less racially and ethnically diverse than the profession as a whole.

The new report instead analyzes data from the 2015 National Survey of College Graduates, a nationally representative survey conducted every two years by the U.S. Census Bureau on behalf of the National Science Foundation's National Center for Science and Engineering Statistics. The CWS report pulls the survey's data on full-time working psychologists—those with a doctorate or professional degree in psychology who work at least 35 hours per week.

The NSF survey was revised with a new sample design in 2010, adding a fresh level of detail for CWS to examine.

"Because this is a new data set to look at salaries in psychology, we have a lot of variables that weren't available before," Lin says. For example, for professional service positions, she and her colleagues were able to analyze salaries by employment sector (public, private, nonprofit) and employer size. For psychologists in management, they could break out salaries by a person's number of direct reports. And for researchers, they could examine salaries by type of institution and research activity.

There were a few surprises in the data. For example, salaries were highest in the Middle ­Atlantic region, which includes cities with a high cost of living, such as New York and Philadelphia. But salaries were also relatively high in the Midwest—$92,000 in the West North Central area (which stretches from Kansas to Minnesota), and $91,000 in the West South Central area (which includes Texas, Arkansas, Oklahoma and Louisiana).

"That was kind of surprising at first glance," Lin says.

But, she adds, the explanation might lie in a 2014 CWS report on job ads, which found a high concentration of open positions in the center of the country.

"We haven't done a causal analysis for this, but we think it might be highly relevant—the salaries [in the Midwest] could be driven higher by demand."

Lin says that interest in the report has been high, and that CWS staff plan to produce new salary reports biannually when NSF releases new survey data.

To read the full report and access the underlying data, go to www.apa.org/workforce/publications/2015-salaries/index.aspx.

By Lea Winerman


This article was originally published in the September 2017 Monitor on Psychology

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04 Oct 2017

Boosting Productivity

Boosting Productivity

Research identifies small changes that lead to big improvements in performance

When Larry Rosen, PhD, talks to people who want to improve their productivity, he zeroes in on the importance of minimizing interruptions. Rosen, professor emeritus of psychology at California State University, Dominguez Hills, goes as far as to suggest that people put up a "do not disturb" sign when they need to focus on a task.

While this may not be plausible for everyone, Rosen's studies have shown how being distracted can become a bad habit that ultimately decreases our effectiveness at work or in school.

Fortunately, he and other psychology researchers have identified new ways to help people overcome the hurdles that stand in the way of their productivity, whether they are personal habits or environmental challenges. Here are some of those findings.

Grow your attention span

Even though technology can empower us to accomplish things faster, Rosen has found that those benefits can disappear when digital distractions are so readily available.

In one study, Rosen asked 260 middle school, high school and university students to study for 15 minutes in their homes. He found that participants averaged less than 6 minutes of studying before switching tasks, most often due to technology distractions—phones vibrating, new email alerts or instant message notifications, as well as students' "self-interruptions" to check electronic devices (Computers in Human Behavior, Vol. 29, No. 3, 2013).

While it can be tempting to think that dealing with these messages is productive, Rosen says this is a false sense of effectiveness. "We may think we are multitasking, but we are really task-switching," he says. "These interruptions take us away from the task at hand." The original task becomes less salient in our brains, and when we return, we waste time trying to remember what we were thinking when we left, Rosen explains.

To increase attention span and productivity, one of Rosen's solutions is the "technology break." He encourages students and workers to give themselves a couple of minutes to check alerts, texts and other messages after 15 minutes of undistracted work. The best way to stay focused is silencing the phone, turning it face down to avoid seeing visual notifications, turning off email alerts and closing distracting websites, Rosen says.

"Once you learn how to work for 15 minutes, start increasing the time before taking a technology break," Rosen says.

Taking short breaks not only satisfies the technology fix, but it also allows us to maintain focus, according to a study conducted by Alejandro Lleras, PhD, a psychology professor at the University of Illinois at Urbana–Champaign. He found that participants who took a short break while focusing on a visual task maintained the same level of performance for 40 minutes, but performance declined for those who didn't take any breaks (Cognition, Vol. 118, No. 3, 2010).

"We know that after about 30 minutes, concentration starts to decrease, so it's important to take small breaks to stay focused on your main task."

The results also showed that the breaks can be surprisingly short—only a couple of seconds for some tasks—to achieve this effect.

Write out your goals

Many people who work are familiar with the idea of setting goals for themselves, but achieving those goals can be elusive. Research is showing that establishing a habit of writing about goals can boost performance.

Cheryl Travers, PhD, a professor at the School of Business and Economics at Loughborough University in Leicestershire, England, asked students to identify areas where they needed to improve, such as raising a grade in a class or increasing concentration while studying. The students were asked to visualize desired outcomes and outline how they could put their goals into practice.

Then the students kept diaries for three months to reflect on their goal progress. For example, students could write down what happened as they attempted to make a change in a particular situation, what worked well or not well, what could have been done better and actions they could take going forward. Travers found that the reflective goal-related writing had a significant impact on their ability to perform better academically (British Journal of Educational Psychology, Vol. 85, No. 2, 2015).

"The act of writing something down seems to make us accountable to a goal," Travers says. "It also helps people to write their way through a problem when they encounter barriers."

By writing about successes and failures and thinking about strategies to overcome difficulties, students gained confidence in themselves and developed academic self-efficacy, Travers says. What was particularly interesting was the evidence showing that academic performance improved even for students who set nonacademic, "softer" goals, such as "increase my assertiveness" or "decrease stress."

Travers is now collecting diaries for managers in organizations, and she will be studying whether this reflective goal setting improves their effectiveness as leaders. "This process allows people to essentially become self-coaches because they are continually evaluating goal outcomes and becoming more self-aware about leader behaviors."

Get together

The idea of fitting in another meeting may seem counter-productive for people working in group settings, but research suggests that taking time to debrief as a team can improve productivity in the long run.

Michaela Schippers, PhD, a professor of behavior and performance management at the Rotterdam School of Management at Erasmus University, studied teams working in a health-care environment. She found that the groups that met regularly to evaluate work processes were much more likely to come up with innovative solutions to problems than groups that did not meet regularly. Her work has shown how this team reflexivity (reflecting on team functioning) can significantly improve work performance levels (Journal of Management, Vol.41, No. 3, 2015; Journal of Organizational Behavior, Vol. 34, No. 1, 2013).

"Workers should have regular debriefings, like in the military, but the purpose is not to point out what people are doing wrong," Schippers says. "Instead, the group can brainstorm how to improve as a team, ideally with a facilitator who is leading the meeting."

In the study, the reflexive teams talked about issues such as decreasing waiting times for patients, improving patient record systems and developing a more effective appointment system.

"Our work showed that it was very important for teams that are particularly busy to meet regularly to debrief, because these teams benefited most from the innovative improvements," Schippers says. "The meetings gave them space to think collectively about what could be changed."

Get out of the chair

Researchers are finding that employees with stand-­capable workstations may be more productive than their seated counterparts. Mark Benden, PhD, a professor in the department of environmental and occupational health at Texas A&M School of Public Health, studied two groups of call center employees over six months. One group sat at traditional desks and the other group at stations that enabled workers to elevate their tables whenever they wanted to stand. Benden found that those with stand-capable workstations stood about 1.5 hours longer per day and were 42 percent more productive than those who worked at seated desks. Productivity was measured by how many successful calls the workers completed per hour (IIE Transaction on Occupational Ergonomics and Human Factors, Vol. 4, No. 2-3, 2016).

"By being up more of the time, we improve blood flow to the brain and circulation to the body, and these things combine to make the brain more active and engaged," Benden says.

Research also suggests that it is important for people to avoid "static standing" in one place, he says. The best stand-­capable workstations have foot rails that allow workers to take weight off of one side of the body. If it's not possible to get this type of workstation, workers should take breaks to walk around and get out of the chair, Benden says.

Further reading

The Distracted Mind: Ancient Brains in a High-Tech World 
Gazzaley, A., & Rosen, L., 2016

Managing Motivation: A Manager's Guide to Diagnosing and Improving Motivation 
Pritchard R.D., & Ashwood, E.L., 2008

Evidence-Based Productivity Improvement: A Practical Guide to the Productivity Measurement and Enhancement System 
Pritchard, R.D., Weaver, S.J., & Ashwood, E.L., 2012

Future Time Perspective and Promotion Focus as Determinants of Intraindividual Change in Work Motivation 
Kooij, D.T., Bal, P.M., & Kanfer, R., Psychology and Aging, 2014

By Heather Stringer


This article was originally published in the September 2017 Monitor on Psychology

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03 Oct 2017

How Did You Get That Job? A Q&A with Senior Analyst Dr. Jerome Pagani

The knowledge, skills and experience gained through your psychology training can transfer successfully to a variety of jobs. Dr. Jerome Pagani works as an analyst in the global health sector of professional services firm EY Knowledge. In his role, Pagani monitors and reports on trends in health around the globe. Learn how you can apply your psychology education in a similar career path.

Jerome PaganiSpeaker: Dr. Jerome Pagani is the senior analyst in the global health sector at EY Knowledge, a global professional services firm, in an area called “core business services.” He follows global health trends and how they might impact the company’s service offerings as well as the overall market. He spent his early career in the lab at NIH but decided to switch to consulting. Prior to joining EY Knowledge, he spent time at Booz Allen, working with federal agencies like NIH, DoD and the military. Pagani has a Ph.D. in behavioral neuroscience and a master's degree in cognitive psychology.

 

Garth Fowler, PhDHost: Garth A. Fowler, PhD, is an Associate Executive Director for Education, and the Director of the Office for Graduate and Postgraduate Education and Training at APA. He leads the Directorate’s efforts to develop resources, guidelines, and policies that promote and enhance disciplinary education and training in psychology at the graduate and postdoctoral level.

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02 Oct 2017

Using Objective Data to Improve Performance

Using Objective Data to Improve Performance

Psychologists are using biofeedback to help clients identify and change their physical responses to stress and more

When Denver sport and performance psychologist Steve Portenga, PhD, first started providing therapy to athletes, he taught them breathing and relaxation exercises to practice at home. But he often doubted whether the athletes were doing their homework correctly, if at all.

"I'd ask them how their relaxation went over the past week and was getting answers like, ‘Oh, yeah...right.'" he says. The replies left him thinking, "You didn't do it, did you?"

Then Portenga learned about biofeedback—a tool that provides empirical evidence of physiological activity, such as heart rate, breathing rate, muscle tension, skin temperature and brain wave patterns. Using sensors connected to displays, he and his clients could see how their bodies reacted to stress and to stress-reduction exercises. Athletes can also train with biofeedback apps at home and these sessions can be tracked, to see not only that they do their homework, but how well it works.

Portenga says he appreciates not just biofeedback's ability to provide accountability, but the way it has helped his athletes learn to handle competitive pressure. He has used the technique with athletes in every major professional sport, including at Super Bowls, world championships and the Olympics.

Biofeedback is an umbrella term covering several types of therapies. Common ones include heart-rate variability (HRV) biofeedback, which looks at the interval between heartbeats; electroencephalograph (EEG) biofeedback, also called neurofeedback, which focuses on brain wave activity; and electromyography biofeedback, which concentrates on muscle activity.

During biofeedback training, clients can see the response that's being measured while under simulated stress—such as by viewing a competition video or playing a challenging computer game. Biofeedback therapy holds that as people practice different responses to stress (slower breathing, for example), they can see how effective these are and adjust accordingly, which helps them learn how to better manage stress.

While large-scale research covering biofeedback's efficacy remains scant, studies have indicated biofeedback's potential in treating a variety of physical and psychological conditions. Research led by Poppy Schoenberg, PhD, now at the Vanderbilt University Osher Center for Integrative Medicine, examined 63 studies on various types of biofeedback used to treat psychiatric disorders. She found that about 81 percent of participants showed some level of improvement, with 65 percent demonstrating "statistically significant" symptom reduction (Applied Psychophysiology and Biofeedback, 2014). A meta-analysis by Richard Gevitz, PhD, a health psychology professor at Alliant International University, examined HRV biofeedback's effectiveness in treating both psychological and physical disorders. Gevitz's review of more than 55 studies found that it shows promise in treating many disorders, including asthma, cardiovascular conditions, hypertension, depression, anxiety and insomnia, and has potential for improving performance (Biofeedback, 2013).

Today, Portenga, a founding member of APA's Coalition for the Psychology of High Performance, focuses his practice on adolescent athletes and nonathletes who may be faced with stressful situations that involve being judged or evaluated, including sports competitions and school tests. A session typically includes a mix of biofeedback and psychotherapy. As such, he says, he doesn't bill separately for biofeedback, in the same way a therapist wouldn't bill separately for mindfulness training. Portenga provides detailed invoices to clients to use for insurance filing, and is paid out-of-pocket by clients.

Portenga recommends clients use biofeedback apps at home—such as Respiroguide Pro—to help them visualize their breathing, like with an image of a ball rising with each inhalation and dropping with each exhalation. This helps clients adopt slower, synchronized breathing and heart rates to evoke a calmer state of mind, which is part of HRV biofeedback training. Over time, clients become accustomed to breathing at the slower rate and have less need to use apps, Portenga says. "To be able to track this to see what's going on, to see when things are progressing and when they're not, has just been fantastic."

Beyond stress management

Leah Lagos, PsyD, a performance psychologist in private practice in New York City, has been using biofeedback in her practice for about 10 years. She has used HRV biofeedback to help post-concussion syndrome patients alleviate headache, problems concentrating and other symptoms. She is working with New York University on a study exploring the use of HRV biofeedback with this syndrome, which she explains is linked to an injury to the autonomic nervous system. "I've treated over 100 athletes [with post-concussion syndrome] and they have very similar trajectories of experience: At week four their headaches dissipate, by week seven they can focus again," says Lagos.

She's also used biofeedback to help a patient end persistent vomiting after other medical interventions didn't work, and reduced incidence of migraines in other patients.

In addition, Lagos provides biofeedback to PGA tour golfers, dancers, Olympic rowers, soccer players, track athletes, basketball players and others. She typically meets patients once a week for about 10 weeks, with sessions lasting 45 minutes to an hour, during which time she uses biofeedback as well as cognitive-behavioral skills such as mindfulness training. She also insists clients do homework: two 20-minute sessions where they practice heart-rate variability using apps, such as Heartmath and Breath Pacer.

Biofeedback can also foster other benefits, says Lagos, including improved mood, reduced anxiety, lower muscle tension and improved attention.

While she doesn't accept insurance, she has had patients tell her that sometimes they are able to get insurance coverage for their biofeedback, particularly if they are being treated for headaches, she says. One of the aspects of this training that she most treasures, she says, "is seeing how it develops the patient's confidence."

Helping Olympians master their nerves

Lindsay Thornton, EdD, is a sport psychologist and a senior sport psychophysiologist at the U.S. Olympic Committee in Colorado Springs, Colorado, working with Olympic-bound athletes in sports such as track and field and swimming. "What I'm mainly working on is managing pressure, anxiety and stress around performance," Thornton says.

Thornton counsels athletes when needed, but the bulk of her work is helping athletes prepare to compete, which often entails using biofeedback. She claims that biofeedback can provide a "faster learning curve" for athletes to learn pressure-management skills.

"Sometimes in talk therapy, we can talk, talk, talk" without being able to change behaviors, she says. "But for me, using psychophysiology as a tool has been really powerful to teach athletes skills" in ways that would be difficult to do using words alone—with a sensor on the muscle, the client can visualize what's happening and see the impact of various exercises.

Thornton primarily uses HRV biofeedback and EEG biofeedback, also called neurofeedback, which focuses on brain waves. When Thornton first sees athletes, she does a "full-cap" assessment with 19 sensors on an athlete's head to allow her to see brain-wave patterns under different conditions. For example, she'll have athletes work on virtual tasks, which enables her to see their physiological responses to stress.

With neurofeedback, clients are able to see their brainwaves displayed and to differentiate between those that occur when they are stressed or losing concentration and those that happen when they are calm and focused. Through neurofeedback training, athletes learn to modify their brainwaves and states of mind, which helps improve performance, says Thornton.

"The goal of neurofeedback training is to create an awareness over what certain mental states feel like and then to develop strategies to recreate that state under pressure or in the face of distraction," she says.

Thornton creates routines for each athlete that are rehearsed repeatedly under simulated stress conditions. Athletes may practice pre-performance rituals, for instance, that can include visualizations of their performance, breathing exercises and use of code words associated with what they expect to do (an archer may say, "smooth, shoulder, through" to reinforce upcoming actions to take).

Thornton became attracted to biofeedback during her training in sport psychology. "I wasn't sure I was always doing the right things with athletes," she says. "We were talking about muscle relaxation and visualization. The athlete might believe they were doing it correctly and I might think they were doing it correctly, but I wanted some type of assurance that we were achieving our goal." Biofeedback helps provide that objective evidence, she says.

Olympic-level athletes are fascinated by peering inside their bodies—by seeing the responses her sensors display. "They enjoy that type of feedback," she says.

Thornton has her athletes practice outside her lab with apps such as Stress Doctor, which reinforces their heart-rate variability training. But she doesn't want her clients to rely on technology, pointing out that "they can't pull out their phone on the field." So, she gradually weans them from visual and auditory feedback to just audio to no feedback at all, using only their own now-heightened body awareness.

The payoff, she says, is seeing athletes master these strategies and witnessing "the pride and comfort and confidence they have." And when the hard work she and her athletes have put in results in Olympic medals, as happened in the 2016 Rio Olympics? "It's really exciting," says Thornton.

"No Insurance Required" is a Monitor series that explores practice niches that require no reimbursement from insurance companies. To read previous installments, go to www.apa.org/monitor/digital and search for "No Insurance Required."

For a more extensive look at the research on biofeedback, visit our digital edition at www.apa.org/monitor/digital and search for "Positive Feedback" in the March 2016 issue.

Resources

Biofeedback Certification International Alliance 
BCIA.org

The Association for Applied Psychophysiology and Biofeedback Inc. 
AAPB.org

By Lorna Collier


This article was originally published in the June 2017 Monitor on Psychology

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29 Sep 2017

How Did You Get That Job? A Q&A with Sports Psychologist Dr. Nyaka NiiLampti

The knowledge, skills and experience gained through your psychology training can transfer successfully to a variety of jobs. Dr. Nyaka NiiLampti is the director of player wellness for the NFL Players Association (NFLPA), the union for professional football players. In her role, NiiLampti ensures that players are educated about the NFL’s policies for substance abuse, and provides education, resources and guidance to players in multiple areas of wellness, including mental health support.

Learn how you can apply your psychology education in a similar career path.

Nyaka NiiLamptiSpeaker:
Dr. Nyaka NiiLampti is a sports psychologist with over 15 years of experience in the field. A collegiate athlete, her senior thesis explored the psychological impacts of sports on women. She holds an M.A. in exercise and sport science (sport psychology) and a Ph.D. in counseling psychology. Before joining the NFLPA, NiiLampti worked in college counseling centers and a large group private practice, and was an assistant professor of psychology at Queens University of Charlotte in North Carolina.


Garth Fowler, PhDHost:
Garth A. Fowler, PhD, is an Associate Executive Director for Education, and the Director of the Office for Graduate and Postgraduate Education and Training at APA. He leads the Directorate’s efforts to develop resources, guidelines, and policies that promote and enhance disciplinary education and training in psychology at the graduate and postdoctoral level.

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27 Sep 2017

How to Tackle Tough Topics in the Classroom

How to Tackle Tough Topics in the Classroom

In an age of polarized opinions, psychology educators are amplifying their efforts to promote more understanding

The day after the 2016 presidential election, assistant psychology professor Evelyn Hunter, PhD, knew she had to be prepared for different types of discussion in the three classes she was teaching that day at Presbyterian College, a small, mostly white liberal arts college in Clinton, South Carolina.

"I realized it was going to be hard for me to concentrate on just lecturing, and that students would be activated by the results, too," says Hunter, who is African-American and says that she was concerned about how the election results might affect people of color.

Fortunately, Hunter was armed with techniques that allowed her to safely introduce the topic of difficult dialogues for discussion, which she had gleaned from co-writing a paper on the topic as a graduate student, and later watching others conduct difficult dialogues and then conducting them herself. She grouped the students in circles, first emphasizing the importance of respecting and valuing everyone's opinions, then inviting them to air their thoughts and concerns. A biracial student said she felt hated by other students and that no one seemed bothered by that. White students revealed they felt that others unfairly viewed them as racists for voting for Donald J. Trump.

The conversation appeared to enlighten some, while leaving others uncomfortable—and that is part of the process, says Hunter, now an assistant professor at Auburn University. "Earlier in my career, I thought that a good dialogue meant everyone left happy and feeling great about it, but that's not always realistic," says Hunter. "If the dialogue is truly difficult and it's really a necessary conversation, maybe it's not the best thing if we all stay in our comfort zones."

Leaving things unsaid does not mean they do not exist, she adds. "I believe we give things more power to do harm when we allow them to remain unexposed."

Hunter's approach to such discussions is just one of many ways that psychology educators are helping students address tough social issues. Known by terms like "difficult dialogues" and "challenging conversations," the work can take myriad forms, including brief discussions about current events, classes dedicated to key themes, and planned events that focus on hot-button topics within local communities. The work isn't easy, but it's highly rewarding, says Sue C. Jacobs, PhD, a professor at Oklahoma State University and fellow of APA Div. 17 (Society of Counseling Psychology), who has been training others in difficult dialogues since 2009.

"We live in a world of bullet points," Jacobs says, "but to have truly difficult dialogues, you have to go underneath the bullet points and listen to other people."

Preparing students

For two main reasons, colleges and universities are key places to hold such exchanges, adds psychologist Beverly Daniel Tatum, PhD, president emerita of Spelman College and author of "Why Are All the Black Kids Sitting Together in the Cafeteria? And Other Conversations about Race," slated for a 20th-anniversary edition this year. For one, universities are one of the few places that young adults from diverse backgrounds come together and share the same spaces. For another, they're settings where these dialogues can take place in a safe and structured way, with positive, educational outcomes as the goal.

"From an educator's viewpoint, it seems a shame not to take full advantage of this unique opportunity to prepare the next generation for effective leadership"—in this case, by fostering the ability to successfully engage with a wide range of people, Tatum says.

Not surprisingly, this work can meet with opposition. Administrators and fellow faculty may consider such discussions too political or too removed from what they see as the central aim of education, namely, imparting objective information to students. And for their own reasons, faculty may be leery of getting involved—fearing the disapproval of colleagues, a diminished shot at tenure or even ignorance about the subject matter. But in an increasingly complex world where personal aspects of identity are ever more salient at school, work and in other contexts, facilitators believe these difficult dialogues are essential.

"Most of our students have never thought about why they think the things they think," says Oklahoma State University professor and APA Div. 2 (Society for the Teaching of Psychology) fellow Shelia Kennison, PhD, who infuses difficult dialogue strategies into her undergraduate courses. The conversations allow the students to learn about themselves and other people "in a way that is more uniting than dividing," she says.

A starting point

The term "difficult dialogues" was first used in 2005 by the Ford Foundation to support work that would address a national concern: growing racial and religious tensions on U.S. campuses in the wake of 9/11. Through a competitive process, the foundation awarded 27 colleges and universities up to $100,000 to launch relevant projects in the area, for a total of $2.5 million.

That same work continues today, with more relevance than ever, many say. Although the foundation's funding ended in 2008, many campuses have continued to make creative and sustained efforts to address the plethora of challenging social issues that seem to arise on a daily basis. The pros and cons of gun control, environmental versus economic concerns, racial profiling, gender identity and sexual orientation issues, religious versus scientific belief systems, issues related to climate change—almost any charged social topic provides fodder for deeper discussion, says Libby Roderick, who directs the Difficult Dialogues Initiative at the University of Alaska Anchorage (UAA), which received some of the original Ford Foundation funding.

Given psychologists' expertise in human behavior and motivation, they are particularly strong players in this arena, as are sociologists and social workers, Tatum adds. That said, she'd like to see more faculty involved.

"I think every instructor can benefit from developing their capacity to facilitate what might feel like an uncomfortable conversation," Tatum says.

Only by imagination

Educators are incorporating difficult dialogues in a variety of creative ways. They can be a small but integral part of classroom activity, as with Hunter's election-related forum. They may be mandated adjuncts to traditional classes, per an Indiana University initiative called "Community Conversations," developed by psychologist and assistant professor Kerrie G. Wilkins-Yel, PhD. The effort requires students who are taking sections of the same class to meet in small groups once during the semester, and engage for two hours in a difficult dialogues process.

The format has the unique benefit of engaging a large number of students while maintaining the fundamental tenets of effective group dialogue, says Wilkins-Yel. At least two students in each group are of "marginalized identities," ensuring that the discussion is truly diverse, as opposed to simply including one "token" member of a minority group who might feel put on the spot, she says.

In other cases, entire classes are devoted to difficult dialogues. Last year, for instance, the counseling psychology department at the University of Missouri—another institution originally funded by the Ford Foundation—launched a graduate-level program focused entirely on helping students practice difficult dialogue skills and gain the tools to facilitate such discussions.

Other universities, like UAA, have centered on faculty development: Trainers there have taught difficult dialogue techniques to some 150 faculty members who are using the skills in a variety of ways.

These conversations are happening outside the classroom, as well. In Anchorage, UAA's Center for Advancing ­Faculty Excellence hosts a popular annual debate and faculty forum that's open to the public. There, students who are part of an internationally acclaimed debate team introduce a contentious topic—a recent example is whether the state's limited budget should go toward investing in the university or an oil and gas pipeline—and debate it for 40 minutes. They're followed by four faculty members who add their disciplines' perspectives to the conversation. After that, community members are invited to participate. 

"People come out of these things lit up," Roderick says. A common response: "‘This is what we're supposed to be doing; this is what higher ed is for,'" she says.

Stepping stones

Whatever form the work takes, there are several basic guidelines to keep in mind, educators involved in this work say. In general, preparation is key—it can include gaining specific training in the area; learning from manuals and other materials designed to walk educators through the process and its challenges; and attending conference and workshop presentations. At this year's APA Annual Convention in Washington, D.C., for example, Webster University psychology professor Linda Woolf, PhD, chaired a symposium on methods for addressing intolerance and hate on campuses, including difficult dialogues. Also, the biennial National Multicultural Conference & Summit regularly includes material on difficult dialogues. The Difficult Dialogues National Resource Center—created by facilitators to continue the work started by the Ford Foundation—hosts a biennial conference specifically on difficult dialogues; the next is slated for sometime in 2018 (see Resources below for more).

Once educators have received the training to start such conversations, it's important to lay a strong foundation for the discussion at the beginning of the conversation—one that emphasizes students' rights to express their thoughts and opinions and to respectfully disagree, no matter how intense a session becomes, says Wilkins-Yel. She also highlights expectations of how students should behave: They should actively listen to fellow students, talk in the first person and enter dialogues with a spirit of curiosity, for example.

Tiffany G. Townsend, PhD, senior director of APA's Office of Ethnic Minority Affairs, urges educators to underscore that everyone has biases—­educators included—a tack that ­lowers defenses and gets students into a more receptive frame of mind for dialogue. To this end, it's also important that educators examine their own beliefs: Doing so "ensures that their biases don't color the conversation or inadvertently instill the very divisions that they are trying to address with the conversation," Townsend notes.

It helps to infuse relevant research into these conversations as often as possible, says Woolf. For instance, if a topic involves sexual orientation and gender identity, a discussion host can showcase research demonstrating the misinformation about and the effects of discrimination and violence against LGBTQIA people, which can help expand students' viewpoint on the topic.

To meet fellow educators who want to foster more of these discussions, psychologists may want to contact Div. 17's Subcommittee on Social Action, Jacobs recommends. Educators can also form groups with other interested faculty on their campuses.

Those who teach difficult dialogues say the work is like planting seeds—it may not ­produce immediate results, but it eventually bears fruit. "Students tend to come back long after the fact and say these dialogues were a formative experience for them," Kennison says. 

Resources

Difficult Dialogues National Resource Center 
Holds a biennial conference on difficult dialogues. www.difficultdialogues.org

University of Alaska's Difficult Dialogues Initiative 
Free handbooks and other information. www.difficultdialoguesuaa.org/handbook/landing

Promoting Student Engagement: Vol. 2, APA's Div. 2 (Teaching of Psychology) 
Chapters on infusing diversity, peace-related and other relevant material into difficult dialogues. Free download. http://teachpsych.org/ebooks/pse2011/vol2/index.php

By Tori DeAngelis


This article was originally published in the September 2017 Monitor on Psychology

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