24 May 2017

New APA Data Show Where Practitioners Work

New APA Data Show Where Practitioners Work

Most are in private practice and work with the white, heterosexual and adult population, finds the APA Center for Workforce Studies

Almost three-quarters of respondents to APA's 2015 Survey of Psychology Health Service Providers reported that they collaborated in clinical care with other professionals, most commonly psychiatrists, social workers, physicians and surgeons.

According to the new report from APA's Center for Workforce Studies, the most common form of collaboration was sharing a waiting room with other health professionals, reported by half of respondents. Thirty-nine percent of respondents shared electronic medical records with other professionals. And while only 19 percent saw patients alongside other professionals, 36 percent participated in multidisciplinary team meetings and 33 percent reported integrated treatment plans.

"There's a path toward integration, and a lot of psychologists are taking the first steps down that road," says W. Douglas Tynan, PhD, director of integrated health care at APA.

The increase in team-based care is just one of the findings from the survey, which offers a snapshot of who licensed psychologists in the United States are, how they work and their experience with older clients, cultural competence and team-based care, says report co-author Karen Stamm, PhD, a senior research officer in the center. More than 5,000 licensed psychologists across the country—75 percent of them APA members—responded to the survey. Other major findings include:

Most licensed psychologists are private practitioners. Consistent with past findings, most licensed psychologists are working in private practice: 45 percent of respondents cited private practices as their primary work setting (see chart). Clinical psychology was by far the primary specialty most often cited.

Respondents spent a mean of 36 hours weekly working at their primary positions, with half of that time devoted to providing direct care to clients. Respondents spent seven hours on administrative tasks each week, four hours on teaching and research, two hours on clinical supervision and an hour on other services.

Licensed psychologists are mostly treating white, heterosexual, adult populations. About 96 percent of respondents reported that they provide services frequently or very frequently to white clients. Just 38 percent served African-American clients frequently or very frequently and 34 percent Hispanic clients. The vast majority of respondents—83 percent—reported seeing adult clients ages 19 to 64 frequently or very frequently. In contrast, just 23 percent served children and 34 percent served adolescents frequently or very frequently.

Respondents' own demographic characteristics tended to mirror those of their clients, although the median age of survey respondents was almost 58. Almost 88 percent of respond

ents identified as white, for example, and 90 percent identified as heterosexual.

Few practitioners are serving patients age 80 and older. While 37 percent of survey respondents reported serving older adults frequently or very frequently, just 9 percent served the "oldest old"—those 80 and older.

Respondents spent an average of almost nine hours a week providing services to older adults. They spent more time providing psychotherapy than conducting assessments or offering consultations. They also spent much less time—fewer than two hours weekly—providing services to clients' family members.

About two-thirds of those working with older adults are Medicare providers. Thirteen percent reported that they were previously Medicare providers but no longer participated in the program. Almost 18 percent had never participated. Low reimbursement rates were the most commonly cited reason for not participating. Others said they didn't participate in any insurance programs or had caseloads composed mainly of non-Medicare patients.

Respondents were eager to learn more about geropsychology, calling for education on depression, adjustment to medical illness and disability, and grief and bereavement.

Practitioners believe they are prepared to serve an increasingly diverse nation. Almost 53 percent of respondents felt that their doctoral programs had prepared them well or extremely well to work with culturally diverse groups. Another 44 percent felt they were fairly well prepared or slightly prepared to do so. Just 3 percent felt they weren't at all ready.

Respondents' level of knowledge varied, however. More than half said they were not at all or only slightly knowledgeable about working with transgender clients, for example, compared with the 51 percent who rated themselves quite or extremely knowledgeable about working with lesbian, gay and bisexual clients.

The most helpful resources for learning about diverse populations were books and peer-reviewed journals, respondents said. The least helpful? Graduate training. That's not a slam against graduate training, Stamm explains. Instead, she says, the finding may simply reflect the demographics of respondents.

"The majority of the sample was in their mid-50s, so they're fairly far removed from their graduate training," she says. "They may have changed their practice patterns or emphases over time, so their graduate training is less relevant."

The survey findings point to the need for further research, adds Stamm. One priority area is to determine whether there are enough psychologists to meet Americans' needs. "This report has a lot of information about the supply side," says Stamm. "Now we'd like to focus on the demand."

To read the full report, visit www.apa.org/workforce/publications/15-health-service-providers/index.aspx.

Little diversity

  • 87.8%
  • 4.4%
  • 2.6%
    Black/African American
  • 2.5%
  • 1.7%
  • 0.3%
    American Indian/Alaska Native
  • 0.1%
    Native Hawaiian/Pacific Islander

By Rebecca A. Clay

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