APA delegation visits Cuba
By Carol D. Goodheart, EdD, APA Past President
The American Psychological Association, in partnership with Professionals Abroad, sponsored its first international delegation of members to Cuba for a professional exchange with Cuban psychologists this past March. The meetings and activities were described by both Cuban and U.S. psychologists as historic, intellectually stimulating and emotionally powerful. It was a wonderful opportunity for members to study psychology practices, services, education and research in Cuba, as well as to meet with our Cuban colleagues who have had limited contact with U.S. counterparts for more than half a century.
Our mission was to represent APA in welcoming collaboration and communication and to lay the groundwork for further collaboration between APA and the Cuban Psychological Society. We brought examples of the work of APA, and in return we received examples of Cuban psychologists' work, which included their diagnostic classification system (Tercer Glosario Cubano de Psiquiatria: Diagnostico y Classificacion de los Trastornos Mentales) and research institute monographs.
We met with representatives from the Ministry of Public Health (MINSAP), the National Health Psychology Group of MINSAP, and the Cuban Society of Psychologists; with the dean and faculty at University of Havana's Department of Psychology; with psychologists, students and professors who teach psychology to medical students at a leading "Policlinico" — a community-based primary and secondary health care facility; with researchers at the Center for Psychological and Sociological Research (Centro de Investigaciones Psicologicas y Sociologicas/CIPS), which is organized under the Ministry of Sciences; with physician and neuropsychology specialists from the Cuban Neuroscience Center (Centro de Neurosciencias de Cuba/CNEURO); and with senior faculty and students at The National School of Public Health (Escuela Nacional de Salud Publica/ENSAP). With the able assistance of our translator — who is also a professor of phonetics ― we were able to have lively conversations with each of these groups.
Overview of psychology in Cuba
There are 1,700 psychologists and 800 psychology technicians in Cuba's health care system. All psychological services are delivered in health and community settings, and psychology is integrated in the Ministry of Public Health. Their system is based on a biopsychosocial concept of care, with a health and prevention focus. The policlinico staffs work to modify risk factors in communities. Health teams are multidisciplinary. Psychology training for practice is now focused on increasing competencies throughout all levels. All research at CIPS is done at the request of the government and is multidisciplinary; psychologists study family, religion, learning, I/O processes, social health, work, youth, and creativity and education. A variety of institutions within the National Health System collectively support the development of neuropsychology research and applications. For example, the Institute of Science and Technology Ministry's Cuban Neuroscience Center (CNEURO) is dedicated to conducting research that improves the quality of life. This research includes developing image processing toolboxes for medical applications, such as the development of neuroformatics, neuroimaging, neurostatistics and, most recently, neurofeedback as a form of treatment for epilepsy.
Dr. Alexis Lorenzo Ruiz, President of the Cuban Society of Psychology, described the goals of the Society as similar to APA: the advancement of science, the quality of the profession, organizational activities for applications of psychology, and research related to social conditions. Dr. Lorenzo trained in the USSR, as did many Cuban psychologists after major links with Soviet psychology were established in the 1970s. He is a disaster specialist whose first experiences in disaster response followed the Chernobyl nuclear reactor accident in 1986. More recently, the national curriculum for psychology has incorporated European, Latin American and U.S. approaches, although much remains based on the Soviet training model.
The evolution of health psychology in Cuba includes three levels of training: technicians trained for community‐level services, master's level health psychologists and doctoral-level psychologists specializing in health psychology. This evolution was explained to us by Dr. Jorge Grau Abalo, president of the National Psychology Group (who was instrumental in arranging the psychology meetings for the entire visit); Dr. Alberto E. Cobián Mena, President of the Cuban Society of Health Psychology; and Dra. Isobel Lauro Bernal, Professor at ENSAP. ENSAP's purpose is resource training in health care. Its lines of research are the promotion of healthy behavior, evaluation of health organizations, quality of life and well-being, human resource management, and family and health. Part of the Latin American network, ENSAP is based upon an integrated public health model that includes psychological science with other sciences.
The APA delegation members described their visit to Cuba as "transformative," "one of the two or three most profound experiences of my life," "a powerful experience" and "a fabulous adventure."
There was limited free time outside of the psychology meetings, but the delegation made good use of it. Group members managed to squeeze in a visit to the oldest continuously producing pottery maker in the country, a walking tour of Old Havana, walks or runs along the Malecón (the sea wall), dancing at Ernest Hemingway's favorite nightclub, and many photo opportunities. The live music was beautiful and played in every restaurant we dined in – from breakfast musicians to the Buena Vista Social Club professionals to the Jazz Café Show.
Two delegation members have family backgrounds in Cuba. One was able to locate his grandfather's home, where his father was raised, and take photographs of the site to take back to the United States. Another delegate, who emigrated with his family at the age of 7 years old, was gratified to be welcomed back so warmly by the Cubans.
Our Cuban colleagues shared their strengths with us: integrated medical and behavioral science and service, strongpublic health prevention and promotion efforts, excellent disaster response systems, and a pervasive sense of the collaborative multidisciplinary approach to health in families, communities, and workplaces. They have achieved these advances in the face of significant resource shortages of goods/ supplies/equipment taken for granted by U.S. professionals. Staff in the APA Office of International Affairs and the Office of Continuing Education are assembling a package of professional materials on topics requested by the Cubans, such as bibliographies, books and journals. The package will be sent as a token of the delegation's appreciation. The full report of the delegation meetings is accessible online.
Comments from the delegation
"Cubans are reputed to be the friendliest people on the planet. My experiences interacting with our Cuban colleagues comported with this reputation. Cubans from all walks of life whom I had the privilege of meeting were remarkably polite, engaging, and genuine. Nobody was staring at the screen of a handheld mobile device. Everybody was interacting and connecting with the people around them. Experiencing the culture in Cuba was as refreshing as a drink of water from a mountain stream after a long day of hiking." ~Paul Craig, PhD
"APA's trip to Cuba was a fantastic experience because I met interesting colleagues from both the USA and Cuba. Conversations among the group were stimulating and rewarding. It was a once-in-a-lifetime experience!" ~Susan Lipkins, PhD
"I've nurtured a curiosity about Cuban people and culture since I was a teenager, which is also when I learned my first Spanish word. My warm, welcoming experiences with the Cuban-American community in New Jersey, where I grew up, catapulted me into intense study of the Spanish language, and within a few years I had become fluent on my own. My passion for everything Cuban made its way into my professional work and led to the relocation of my practice to Miami, where a majority of my clinical focus now is providing bilingual services to the Latino community. The APA delegation to Cuba was, for me, the perfect "finishing touch" to years of dedication and service to this special and dear community." ~Gregg A. Pizzi, PsyD
"A highlight for me included a spontaneous role-play conversation to demonstrate Motivational Interviewing with a Cuban provider whose patient had expressed fear about getting a routine Pap test. Another highlight was the enthusiasm about our research from psychology graduate students at the University of Havana. Since I've returned to New Mexico, I have received several email messages from Cuban colleagues thanking us for the visit and for sharing our work." ~Carolina Yahne, PhD