As 2002 comes to a close, I would like to share some reflections on current issues for clinical psychologists regarding the topic of behavioral emergencies. By behavioral emergencies I am referring to clinical situations in which there is an imminent risk of violent or suicidal behavior, or of interpersonal victimization.
Behavioral emergencies represent high stakes crises for which clinical psychologists need to be prepared. Most clinical psychologists will encounter behavioral emergencies at some point in their careers, whether as doctoral students, interns, postdoctoral fellows, or independent psychologists. In addition, clinical psychologists have specialized research skills that permit them to make substantive advances in the understanding and management of behavioral emergencies. However, in the past, psychologists interested in the clinical, scientific, and professional aspects of behavioral emergencies have not had a forum within organized psychology that focuses specifically on these issues.
The APA Society of Clinical Psychology (Division 12) has shown foresight in supporting creation of a Section specifically focused on Clinical Emergencies and Crises (Section VII). Although only in existence for a few years, Section VII has shown consistent growth in membership, perhaps reflecting the level of interest in the topic among clinical psychologists. At the August 2002 APA convention in Chicago, the Section VII program was very well attended, with some sessions standing room only.
I believe that we need to nurture this momentum through further efforts to grow the membership of Section VII. I encourage each member to continue to work to expand the Section, through discussions with colleagues, handing out the membership applications when we give presentations at professional conferences, and informing our students of the activities of the Section.
As the American Psychological Association has given increased attention to issues of responding to disasters and terrorism, the membership of Section VII may also be in a position to share their skills and energy in responding to these broader issues. While the mission of the Section has been on individual clinical situations, many of our members have talents that can extend to these broader concerns. To this end, Section VII cosponsored a recent workshop on Response to Disasters and Terrorism that was held in Menlo Park, California. The workshop, spearheaded by Bruce Bongar, Ph.D. (President-Elect of Section VII), Philip Zimbardo, Ph.D. (President of APA), and Larry Beutler, Ph.D. (President of Division 12) brought together a group of experts in the area of anxiety, trauma, and terrorism to address issues including determining whether there is a sufficient body of knowledge to support specialized training in disaster psychology, identifying consultants to help develop a response network, and developing a model curriculum to guide training in this topic.
Education and Training
Although most clinical psychologists will have to respond to behavioral emergencies during their careers, many psychologists have received little formal training in the area. Section VII is in a position to make important contributions to the profession through education and training in behavioral emergencies.
A valuable step in this process is the recent work of Phillip Kleespies, Ph.D., Jason Spiegelman, M.A., and Daniel DeBrule, M.A., who have compiled a list of APPIC (Association of Psychology Postdoctoral and Internship Centers) predoctoral internship programs that offer training in behavioral emergencies. This list can be viewed on the Section VII website at
My expectation is that the availability of this list will help clinical psychologists who recognize the importance of training in behavioral emergencies to make more informed decisions when selecting internship experiences.
Dialogue has been established with organized training groups to formally increase the education of psychologists-in-training in behavioral emergencies at the predoctoral level. A practical consideration is that, because clinical psychologists need training in so many specific areas, how can doctoral training programs best integrate behavioral emergencies into their already full curricula? One idea that has been proposed is that members of Section VII who develop training materials could make them available to doctoral programs in clinical psychology, so that course instructors and practicum supervisors could incorporate them within existing courses.
Many Section VII members have made extensive contributions to the profession through offering continuing education this represents a viable way of helping practicing psychologists stay current on this topic. With this in mind, members of Section VII are planning for an increase in continuing education efforts on evaluation and management of clinical emergencies and crises.
Linking Research and Practice
The assessment and management of risk of suicide, violence, and victimization are very active areas of research, to which members of Section VII have been major contributors. A challenge for Section VII is how to optimally translate these research advances into enhancements in the clinical practice of psychologists responding to behavioral emergencies. For example, many new tools and concepts have been developed in the area of violence risk assessment over the last decade, but their widespread adoption in clinical practice is only beginning. In a manner similar to the empirically supported treatment movement in the psychotherapy area, the membership of Section VII has the potential to facilitate evidence-based practice in the area of behavioral emergencies.