A meeting of bioethics and psychology
[REGARDING "The bioethics niche" (November Monitor)], I am a clinical bioethicist and research associate at the Center for Bioethics at the University of Pennsylvania. I have worked on dozens of ethics cases in my short career and am beginning to understand that, while my training in medical ethics is perfectly suited for diagnosing dilemmas and making recommendations for resolution, formal training in psychology is essential.
Understanding the complex psychosocial dynamics of ethical decision-making is an oft overlooked dimension of the bioethical process.
Coming from the field of bioethics, I recognized the "psychology niche" that needs to be filled, and I hope to begin doctoral training in psychology next fall.
University of Pennsylvania
IN THE ARTICLE, "REDUCING behavioral health disparities will take more psychologists, outreach programs" (October Monitor), Dr. Lonnie Snowden reported that blacks and Latinos with mental health or substance abuse problems are half as likely as whites to receive professional help. This same population is more likely than whites to become teenage parents (one in five black and one in six Hispanic teens become pregnant every year, reports the director of the National Institute of Child Health and Human Development at the National Institutes of Health, 2002), abuse drugs (1.4 percent of blacks abused cocaine, 0.8 percent of Hispanics, and 0.6 percent of whites), drop out of school (the Civil Rights Project of Harvard University reports that 8 percent of whites drop out compared with 14 percent of blacks and 30 percent of Hispanics), and live in poverty (the U.S. Census Bureau reports 8 percent of whites live in poverty as compared with 22 percent of Hispanics and 24 percent of blacks).
I strongly agree with Dr. Snowden that we need an increased number of psychologists in outreach programs with large ethnic-minority populations. For this reason, as well as others, I propose that psychologists be mandated, or required by the APA Ethics Code, to provide outreach services or volunteer psychological services, on a pro bono basis, in underrepresented communities.
In 1992, the Ethics Code endorsed the concept of pro bono work. Why then, 12 years later, with crime, poverty, and lack of education on the rise, have we forsaken the concept? Especially now that it is needed most?
ALYCIA A. ADAMS
IN THE ARTICLE "REVEALING racism" (October Monitor), I was encouraged by Henderson Daniel's view on multicultural education that compels students to examine their own beliefs and experiences with racism. Particularly, her suggestion to include a dedicated course addressing racial identity and racism excited me, as this is not a required course in most doctoral programs. In my research as a graduate assistant, I examined the course requirements and electives for 20 well-known, APA-accredited counseling psychology doctoral programs across the country. All programs required at least one multicultural education course, usually under generic titles such as "multicultural counseling" or "counseling diverse populations." Only two programs required an additional course, which was dedicated to a more specific minority group like African Americans or Native Americans. With even the most knowledgeable and skilled professor, the required one course addressing all minority groups and their experience with racism and oppression is obviously limited.
A broad and laudatory goal is to integrate cultural issues into the entire curriculum. The next step would be to at least offer an additional course (i.e., in addition to a generic course) dedicated to racism, racial identity development and implications for clinical work with minority populations. I hope our training programs will move in this direction.
THE PIECE "REVEALING RACISM"
The first component of the Multicultural Skills Training Model, introduced by the University of Hawaii at Manoa ("A model for honing your multicultural skills," October Monitor), stated that one should "become aware of your own worldview, such as by learning about your own culture and recognizing the limits of your competence." As professionals, and professionals-in-training, we mustn't forget the adage "Therapist, know thyself." Without a true understanding of who we are, within a multicultural context, we are doing our clients, and ourselves, a substantial disservice.
Strengths and virtues
WHAT A PROACTIVE IDEA-- a formal classification of positive traits put into the format of a handbook for easy use by practitioners. "Character Strengths and Virtues: A Handbook and Classification" (APA, 2004), by Christopher Peterson, PhD, and Martin E.P. Seligman, PhD, is featured in a July/August Monitor article ("Accentuating the positive"). As a doctoral student in counseling psychology, I thought, "Yes, yes, yes," when I read this article.
I chose to go into the field of counseling psychology precisely for its focus on wellness vs. pathology. While I do see a need for and respect the study of psychopathology, there seems to be more psychologists can be doing to help people lead mentally healthier lives. Psychologists typically engage in therapy or treatment with clients when something is going wrong, framing encounters with clients in a negative view from the start. Positive psychology puts a needed spotlight on one of the often preached premises of counseling psychology--wellness. Not only does positive psychology have applications (e.g., identifying positive traits and implementing them) for clients with severe pathology, but it could also be of help to people who may be functioning adequately but who seek to build positive traits that have been found to increase life satisfaction.
I was surprised to read in the article that research is still working on determining "how and if people can learn to add particular strengths to their personalities." Certainly, we are beyond speculating whether or not this is a fruitful area. The fact that this book is backed up by 20 years of research into positive traits makes it a valid and needed contribution to the field.
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