Our destructive culture
I WELCOME PRESIDENT DeLeon's call for us "to provide visionary leadership in addressing society's pressing needs" (March Monitor).
Recently, Div. 9 (Society for the Psychological Study of Social Issues) set up a task force on destructive aspects of our culture. As chair of that task force, I would urge us to look more broadly at our pressing needs. There are many disturbing trends in our society which we need to understand better and deal with more effectively. Some examples are: Our high and growing murder rate, the great and growing disparity between rich and poor with destructive social consequences and continuing devastation of our natural environment.
I believe there are basic aspects of our culture which lead to these and other destructive trends. This is a hypothesis which psychologists and other social scientists should have a lot to say about. We can do a lot more in our research and writing to promote understanding of these trends, their cultural sources, and what to do about them. (I'm not suggesting policy
statements, just more professional attention, with people obviously
free to draw their own conclusions.)
ARTHUR I. GLADSTONE, PHD
Somerville, Mass.
Let the dialogue begin!
AS A CLINICAL PSYCHOLOGIST, director of a master's program and board member of the Northamerican Association for Masters in Psychology, it was encouraging to read Dr. DeLeon's president's column in the January 2000 APA Monitor. His view of psychology "as one family--science, practice, education and public interest" is certainly a positive and inclusive one. And his willingness to "re-examine" the issue of "master's-level personnel" is exciting.
DeLeon suggests that a "clear split, with master's-level practitioners seeking their own licensure and title, would be best for both groups." He indicates that "ending the confusion and conflict that has characterized the master's issue...might make it possible for two separate professions, one doctoral and the other master's, to coexist in friendship and perhaps ultimately result in some type of affiliation that would serve the unique needs of both groups."
Would an exodus of master's practitioners best serve psychology? In my opinion, no! Exclusion will not work! Instead of seeking a master's in psychology degree, these practitioners will seek other avenues for practice, such as social work and counseling. And psychology will lose a presence in rural areas and the public sector--areas with few doctoral psychologists!
DeLeon's willingness to begin a dialogue regarding the "master's issue" is exciting! A shared undergraduate curriculum coupled with similar coursework and practica in the first two years of training suggests that master's and doctorate's in psychology are "part of the same family." Let the dialogue continue!
MARY E. STEIR, PHD
West Hartford, Conn.
THOSE WHO ADVOCATE
master's-level licensure for psychologists seem to imply that level of training doesn't really matter. If this is the case, why require a master's degree? Perhaps we should designate a bachelor's degree--or two-year associate's degree--as the standard for psychology licensure.
MARK B. WEISBERG, PHD, ABPP
Minneapolis
What about PsyDs?
JAMIE CHAMBERLIN'S ARTICLE in the February Monitor claims to address "job market realities." Yet it appears that a very large proportion of psychologists and psychologists in training are being excluded from that view of reality. The article focuses exclusively on PhD students and graduates. At a time when outstanding PsyD training programs such as Rutgers University, Graduate School of Applied and Professional Psychology are celebrating their 25th anniversaries, it is disconcerting that the big picture of trends in the field should be considered complete without any reference to the experiences of PsyDs.
Unfortunately, this sends a rather bleak message--intended or not--to those who are investing their time and energy preparing for applied and professional careers. What is known about employment amongst PsyDs and EdDs? And if we don't know the answer, perhaps we aren't asking the right questions.
DEANA N. STEVENS
Piscataway, N.J.
Prescription privileges
THE MOVEMENT TOWARD prescription privileges seems to be inevitable in some jurisdictions. I certainly see it as a mixed blessing: I only hope that my clinical colleagues who elect to take this route are adequately trained, not only in the psychopharmacology of the relevant drugs but in how to order the appropriate lab tests and interpret them, how to take or order full medical histories including previous drug reactions, illnesses, other medications of all kinds, etc.
I also hope that they can finance the insurance and legal burdens that are coming. Certainly, when psychologists prescribe medications, they are recognizing the role of brain disorder in mental illness, and showing some flexibility in their own models, which is all to the good.
However, I was dismayed to read the column by Russ Newman (March Monitor) about a psychological model for prescribing. What dismayed me was not the model, but that he sadly felt the need to stereotype psychiatrists and the so-called medical model. When we consider that our medical colleagues must assume the legal responsibility for the patient and that there is a drastic shortage of psychiatrists just about everywhere, certainly medications provide a useful shortcut for some. However, many, many psychiatrists are much more thoughtful and sophisticated than is suggested in his article.
They read our journals, they too are using the new therapies such cognitive behavior modification and as EMDR and they are certainly aware that symptom severity may not indicate increased pathology. In fact, they are increasingly careful and co
nservative in the use of medications. Indeed, much of what may be called "overprescribing" is done by general practitioners. Psychiatrists also have and use the "power not to prescribe."
The coming reality is clear: a
convergence in how psychiatrists and psychologists understand psychopathology and treat patients. Simplistic
characterizations of another allied
profession is no way to enhance our own.
STAN SADAVA, PHD
St. Catharines, Ontario
Caring for ourselves
IT WAS A PLEASURE TO FIND IN the March Monitor the brief article by Joe Volz, "Clinician, heal thyself." The issues of managing stress and self-care are of obvious importance to psychologists personally, but they are also important for those to whom we provide services. The line between distress and impairment can be unfortunately thin.
The available literature shows that psychologists not only do work well-crafted for burnout and other problems, but also often come from backgrounds that fostered the kind of selflessness your article warns about. As with so many things in life, a balance must be struck, and in some cases, psychologists who do not take care of themselves will endanger their clients in the process of getting their needs met inappropriately in the therapy room. Male psychologists also have the highest suicide rate of any profession, according to the Occupational Safety and Health Administration. We would all be wise to ponder our own state of well-being and make necessary amends, as your article reminds us.
If there were one additional recommendation I would make, it would be to beware of isolation. I have found local, state and national committee work to be an enjoyable way to counter the isolation of psychotherapy practice, and it does other good as well. In any case, thank you for your timely attention to this important topic.
MICHAEL F. O'CONNOR, PHD
Palo Alto, Calif.
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