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News and Views Viewpoints and Opinions |
Public View of Psychology |
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The following description of the field of Psychology is copied from the Bureau of Labor Statistics Occupational Outlook Handbook (OOH) which appears online as a public service. Many traditional occupations are listed in the OOH and it is a useful tool in career counseling with young people. The section on psychology is presented here with annotations to alert the profession as to how we are seen by others. Some of it you will agree with and parts you will question. My concern is that we are listed as a Social Science rather than a Health profession. Over 70% of the members of APA are dependent upon some part of their income from "health and health care." Therefore, psychology should be listed as a diagnosing health care profession or at least a health care profession in addition to a social science. According to the National Science Foundation report (April 2000), Psychology had the highest percentage (19%) of Science and Engineering doctoral recipients with loan indebtedness of over $30,000. Medical/health sciences and other sciences including Social sciences were less than half to 1/3 of the percentage of psychologists with $30,000 of indebtedness. Only 27% of psychology doctorate recipients graduated debt free compared to 37% for Social sciences and 45% for Medical health sciences and 50% or more for Engineering and Computer sciences. Doctorates in clinical and Counseling Psychology had the greatest percentage of indebtedness and fewest percent of debt-free graduates largely attributable to graduates from professional schools. (http://www.nsf.gov/sbe/srs/issuebrf/sib00321.htm) Being listed as a social science confuses our professional identity as a health profession and makes it difficult to reconcile with the prevailing biopsychosocial model of health care. This also creates difficulties when we try to become a full partner profession in health initiatives such as Medicare and obtain funding for postdoctoral training for students from Graduate Medical Education monies available through the Medicare pool of funds. This identity crisis also exists when we try to get included in legislation authorizing services. The APA Council of Representatives made an important stride forward at the August 2000 convention meeting by adding "health" into the APA Mission statement. We must now revisit the Bureau of Labor with this new self image and request the necessary changes. Our Psychologist/Congressmen can perhaps help us with this task. In the OOH, the health field is subdivided into three categories, health diagnosing, health assessment and treating, and finally health technicians. The diagnosing health professions include allopathic and osteopathic physicians as well as limited health practitioners who specialize in a specific scope of practice, e.g. chiropractic physicians, dentists, optometrists, podiatric physicians and surgeons, and veterinarians. The health assessment and treating professions include nursing, occupational therapy, physical therapy, speech pathology and hearing, etc. Health technicians include laboratory technicians, audiologists, opticians and others. Nursing and pharmacy are difficult to categorize for some are diagnosticians and some are therapists or technicians. Psychology should be in the health diagnosing category but is listed as social science as previously mentioned. To gain a view of how other health professions are presented and see how we are seen by the federal government, it is necessary to review these several categories of health professions in the OOH. There are several notes of caution. While these data are revised regularly, the data come from household surveys. As a result psychologists are numbered as 166,000 not counting students. ( APA membership is 87,000 plus 44,000 graduate students). Since anyone can claim to be a psychologist in a household survey, the title of psychology is probably over represented. When this title of psychologist is compared to reported income, it skews the median income downward. This may or may not be true in other professions as well. Another point is that the information on nursing lists Advanced Nurse Practitioners (AHPs) but there are no data parcelled out on their incomes which sometimes is over $100,000 . Thus, the data on nursing may somewhat overestimate the incomes of nurses in general. The number of certified counselors has also more than doubled in the last 20 years. It has become increasingly difficult for licensed psychologists to distinguish themselves from Marriage and Family Therapists, Mental Health Counselors, Alcohol and Substance Abuse Counselors and other state certified counselors. Swindle et al in the July, 2000 American Psychologist report on "Responses to Nervous Breakdowns" over the last 40 years points out the use of medications by those coping with mental breakdowns has increased 70% from 35% to 60%. However, the use of medical doctors as formal advisors to those with breakdowns has shrunk from 44% to 18%. These people are relying more on Counselors as formal advisors than the combination of psychologists, psychiatrists, nurses and mental hospitals. The role of Counselors has grown from .6% in 1957 to over 15% in 1996. These people use Counselors because they do not consider themselves as mentally ill and the term counselor is less stigmatizing than the labels of psychiatrist or psychologist. In the same period there are reports of an oversupply of licensed psychologists. Even if psychology training programs reduce their number of training slots counselor training programs will continue to flood the health care market with master level counselors. My second concern about the OOH data is that the incomes of psychologists are too low in comparison to other professions. Let us see how psychologists have fared in comparison to the other professions listed in the 1993 survey during this same period. Let us now look at how psychology salaried incomes of $48,050 compares with non-MD (or DO) prescribing professions. The two most closely overlap with psychology are Psychiatry at $124,000 and Advanced Nurse Practitioners, who can prescribe in all 50 states, can be in the $90,000 to $100,000 range. Podiatry is listed at $79,530 for salaried and $146,000 for private practice. Optometry, which used to run neck and neck with psychology in terms of income until optometrists started prescribing, now have median salaried incomes of $68,500 and another $30,000 or more for those in private practice. Chiropractors, who are prescribing herbals, vitamins and trace minerals, report incomes of $63,930. Dentists median salaried incomes are $110,160. Physician assistants, with MA training, who prescribe under specified conditions in 48 states have median salaried incomes of $47,080. Veterinarians are the lowest paid at $50,950 of the health diagnosticians. Although Pharmacists' (not listed in this categorization) median salaried income was $66,220. Pharmacists have some degree of prescriptive authority in seven states even with a BA degree and RPH certification. The foregoing data suggests that prescribing controlled substances does not guarantee an increase in income for psychology, prescribing does create opportunities for greater incomes. Training in prescriptive authority in psychology is currently a postdoctoral proficiency. Until state laws authorize psychologists to prescribe psychologists with this training find their services are more sought after and their opinions more respected by other professionals. Some senior psychologists are now enrolling medical schools because they are unwilling to wait for these changes to take place. Twenty of our best and brightest students are enrolling this fall in a 5 year joint MD/PSYD program to become physician/psychologists. A five year program resulting in both the MD and PsyD degrees suggests there can be a significant overlap in training for these two degrees. It is now time to reexamine our graduate curricula in psychology to see if a core biopsychosocial model could be included in the health psychology programs. The OOH data does not list incomes for private practice of psychology and even fails to list anything beyond salaries working in someone else's office. In my June, 1993 American Psychologist article I listed the Median Incomes of various health professions from an April 1993 survey by Money magazine. (The OOH data for 1993 were not available at that time and the Money data was current and roughly comparable but updated to the OOH findings of the past. I am not able to secure the OOH data for 1993 at this time, therefore have used the Money data to reflect changes in salary structures during the 5 year period. Obviously there are sampling errors in these unrefined comparisons).
The reader is encouraged to make his/her own comparisons by searching the various health occupational categories using a search engine such as Google at Bureau of Labor Statistics or stats.bls.gov or oohinfo@bls.gov. Of interest are the median 50% range of salaries and the earnings of the top 10% of the occupational categories. The description of the Psychology Category of the OOH follows. Search by occupation: Psychologists
Nature of the Work Psychologists study the human mind and human behavior. Research psychologists investigate the physical, cognitive, emotional, or social aspects of human behavior. Psychologists in applied fields provide mental health care in hospitals, clinics, schools, or private settings. Like other social scientists, psychologists formulate hypotheses and collect data to test their validity. Research methods may vary depending on the topic under study. Psychologists sometimes gather information through controlled laboratory experiments or by administering personality, performance, aptitude, and intelligence tests. Other methods include observation, interviews, questionnaires, clinical studies, and surveys. Psychologists apply their knowledge to a wide range of endeavors, including health and human services, management, education, law, and sports. In addition to a variety of work settings, psychologists usually specialize in one of a number of different areas. Clinical psychologists' who constitute the largest specialty usually work in counseling centers, independent or group practices, hospitals, or clinics. They help mentally and emotionally disturbed clients adjust to life and may help medical and surgical patients deal with illnesses or injuries. Some work in physical rehabilitation settings, treating patients with spinal cord injuries, chronic pain or illness, stroke, arthritis, and neurologic conditions. Others help people deal with times of personal crisis, such as divorce or the death of a loved one. Clinical psychologists often interview patients and give diagnostic tests. They may provide individual, family, or group psychotherapy, and design and implement behavior modification programs. Some clinical psychologists collaborate with physicians and other specialists to develop and implement treatment and intervention programs that patients can understand and comply with. Other clinical psychologists work in universities and medical schools, where they train graduate students in the delivery of mental health and behavioral medicine services. Some administer community mental health programs. Areas of specialization within clinical psychology include health psychology, neuropsychology, and geropsychology. Health psychologists promote good health through health maintenance counseling programs designed to help people achieve goals such as to stop smoking or lose weight. Neuropsychologists study the relation between the brain and behavior. They often work in stroke and head injury programs. Geropsychologists deal with the special problems faced by the elderly. The emergence and growth of these specialties reflects the increasing participation of psychologists in providing direct services to special patient populations. Counseling psychologists use various techniques, including interviewing and testing, to advise people on how to deal with problems of everyday living. They work in settings such as university counseling centers, hospitals, and individual or group practices. School psychologists work in elementary and secondary schools or school district offices to resolve students' learning and behavior problems. They collaborate with teachers, parents, and school personnel to improve classroom management strategies or parenting skills, counter substance abuse, work with students with disabilities or gifted and talented students, and improve teaching and learning strategies. They may evaluate the effectiveness of academic programs, behavior management procedures, and other services provided in the school setting. Industrial-organizational (I/O) psychologists apply psychological principles and research methods to the workplace in the interest of improving productivity and the quality of work life. They also are involved in research on management and marketing problems. They conduct applicant screening, training and development, counseling, and organizational development and analysis. An industrial psychologist might work with management to reorganize the work setting to improve productivity or quality of life in the workplace. They frequently act as consultants, brought in by management in order to solve a particular problem. Developmental psychologists study the physiological, cognitive, and social development that takes place throughout life. Some specialize in behavior during infancy, childhood, and adolescence, or changes that occur during maturity or old age. They may also study developmental disabilities and their effects. Increasingly, research is developing ways to help elderly people stay as independent as possible. Social psychologists examine people's interactions with others and with the social environment. They work in organizational consultation, marketing research, systems design, or other applied psychology fields. Prominent areas of study include group behavior, leadership, attitudes, and perception. Experimental or research psychologists work in university and private research centers and in business, nonprofit, and governmental organizations. They study behavior processes with human beings and animals such as rats, monkeys, and pigeons. Prominent areas of study in experimental research include motivation, thinking, attention, learning and memory, sensory and perceptual processes, effects of substance abuse, and genetic and neurological factors affecting behavior. Working Conditions A psychologist's specialty and place of employment determine working conditions. Clinical, school, and counseling psychologists in private practice have their own offices and set their own hours. However, they often offer evening and weekend hours to accommodate their clients. Those employed in hospitals, nursing homes, and other health facilities may work shifts including evenings and weekends, while those who work in schools and clinics generally work regular hours. Psychologists employed as faculty by colleges and universities divide their time between teaching and research and may also have administrative responsibilities. Many have part-time consulting practices. Most psychologists in government and industry have structured schedules. Increasingly, many work as part of a team and consult with other psychologists and professionals. Many psychologists experience pressures due to deadlines, tight schedules, and overtime work. Their routine may be interrupted frequently. Travel is required to attend conferences or conduct research. 'Employment Psychologists held about 166,000 jobs in 1998. Educational institutions employed about 4 out of 10 salaried psychologists in positions other than teaching, such as counseling, testing, research, and administration. Three out of 10 were employed in health services, primarily in hospitals, mental health clinics, rehabilitation centers, nursing homes, and other health facilities. Government agencies at the Federal, State, and local levels employed about 17 percent. Governments employ psychologists in hospitals, clinics, correctional facilities, and other settings. The Department of Veterans Affairs and the Department of Defense employ a majority of the psychologists working for Federal agencies. Some psychologists work in social service organizations, research organizations, management consulting firms, marketing research firms, and other businesses. After several years of experience, some psychologists' usually those with doctoral degrees enter private practice or set up private research or consulting firms. About one half of psychologists are self-employed. In addition to the jobs described above, many held positions as psychology faculty at colleges and universities, and as high school psychology teachers. Training, Other Qualifications, and Advancement A doctoral degree is usually required for employment as a licensed clinical or counseling psychologist. Psychologists with a Ph.D. qualify for a wide range of teaching, research, clinical, and counseling positions in universities, elementary and secondary schools, private industry, and government. Psychologists with a Doctor of Psychology (Psy.D.) degree usually work in clinical positions. An Educational Specialist (Ed.S.) degree will qualify an individual to work as a school psychologist. Persons with a master's degree in psychology may work as industrial-organizational psychologists. Others work as psychological assistants, under the supervision of doctoral-level psychologists, and conduct research or psychological evaluations. A bachelor's degree in psychology qualifies a person to assist psychologists and other professionals in community mental health centers, vocational rehabilitation offices, and correctional programs. They may work as research or administrative assistants or become sales or management trainees in business. Some work as technicians in related fields such as marketing research. However, without additional academic training, their opportunities in psychology are severely limited. In the Federal Government, candidates having at least 24 semester hours in psychology and one course in statistics qualify for entry-level positions. Because this is one of the few areas in which one can work as a psychologist without an advanced degree, competition for these jobs is keen. Clinical psychologists usually must have completed the Ph.D. or Psy.D. requirements and served an internship. Vocational and guidance counselors usually need 2 years of graduate study in counseling and 1 year of counseling experience. School psychology requires a master's degree followed by a 1-year internship. Most students need at least 2 years of full-time graduate study to earn a master's degree in psychology. Requirements usually include practical experience in an applied setting and a master's thesis based on an original research project. A doctoral degree usually requires 5 to 7 years of graduate study. The Ph.D. degree culminates in a dissertation based on original research. Courses in quantitative research methods, which include the use of computer-based analysis, are an integral part of graduate study and are necessary to complete the dissertation. The Psy.D. may be based on practical work and examinations rather than a dissertation. In clinical or counseling psychology, the requirements for the doctoral degree usually include at least a 1-year internship. Competition for admission into graduate programs is keen. Some universities require an undergraduate major in psychology. Others prefer only course work in basic psychology with courses in the biological, physical, and social sciences, statistics, and mathematics. The American Psychological Association (APA) presently accredits doctoral training programs in clinical, counseling, and school psychology. The National Council for Accreditation of Teacher Education, with the assistance of the National Association of School Psychologists, also is involved in the accreditation of advanced degree programs in school psychology. The APA also accredits institutions that provide internships for doctoral students in school, clinical, and counseling psychology. Psychologists in independent practice or those who offer any type of patient care, including clinical, counseling, and school psychologists, must meet certification or licensing requirements in all States and the District of Columbia. Licensing laws vary by State and by type of position. Clinical and counseling psychologists usually require a doctorate in psychology, completion of an approved internship, and 1 to 2 years of professional experience. In addition, all States require that applicants pass an examination Most State boards administer a standardized test and many supplement that with additional oral or essay questions. Most States certify those with a master's degree as school psychologists after completion of an internship. Some States require continuing education for license renewal. Most States require that licensed or certified psychologists limit their practice to areas in which they have developed professional competence through training and experience. The American Board of Professional Psychology (ABPP) recognizes professional achievement by awarding certification, primarily in clinical psychology, clinical neuropsychology, counseling, forensic, industrial-organizational, and school psychology. Candidates for ABPP certification need a doctorate in psychology, 5 years of experience, professional endorsements, and a passing grade on an examination. Aspiring psychologists who are interested in direct patient care must be emotionally stable, mature, and able to deal effectively with people. Sensitivity, compassion, and the ability to lead and inspire others are particularly important qualities for clinical work and counseling. Research psychologists should be able to do detailed work independently and as part of a team. Excellent communications skills are necessary to succeed in research. Patience and perseverance are vital qualities because results from psychological treatment of patients or from research usually take a long time. Job Outlook Employment of psychologists is expected to grow for all occupations through 2008. Employment in health care will grow fastest in outpatient mental health and substance abuse treatment clinics. Numerous job opportunities will also arise in schools, public and private social service agencies, and management consulting services. Companies will use psychologists' expertise in survey design, analysis, and research to provide marketing evaluation and statistical analysis. The increase in employee assistance programs, which offer employees help with personal problems, should also spur job growth. Opportunities for people holding doctorates from leading universities in areas with an applied emphasis, such as clinical, counseling, health, and educational psychology, should have particularly good prospects. Psychologists with extensive training in quantitative research methods and computer science may have a competitive edge over applicants without this background. Graduates with a master's degree in psychology qualify for positions in school and industrial-organizational psychology. Graduates of master's degree programs in school psychology should have the best job prospects, as schools are expected to increase student counseling and mental health services. Masters' degree holders with several years of industrial experience can obtain jobs in consulting and marketing research. Other master's degree holders may find jobs as psychological assistants in the community mental health field, which often requires direct supervision by a licensed psychologist. Still others may find jobs involving research and data collection and analysis in universities, government, or private companies. Very few opportunities directly related to psychology will exist for bachelor's degree holders. Some may find jobs as assistants in rehabilitation centers, or in other jobs involving data collection and analysis. Those who meet State certification requirements may become high school psychology teachers. Earnings Median annual earnings of salaried psychologists were $48,050 in 1998. The middle 50 percent earned between $36,570 and $70,870 a year. The lowest 10 percent earned less than $27,960 and the highest 10 percent earned more than $88,280 a year. Median annual earnings in the industries employing the largest number of psychologists in 1997 were as follows: Offices of other health care practitioners $54,000 Hospitals 49,300 Elementary and secondary schools 47,400 State government, except education and hospitals 41,600 Health and allied services, not elsewhere classified 38,900 The Federal Government recognizes education and experience in certifying applicants for entry-level positions. In general, the starting salary for psychologists having a bachelor's degree was about $20,600 in 1999; those with superior academic records could begin at $25,500. Psychologists with a master's degree and 1 year of experience could start at $31,200. Psychologists having a Ph.D. or Psy.D. degree and 1 year of internship could start at $37,800, and some individuals with experience could start at $45,200. Beginning salaries were slightly higher in selected areas of the country where the prevailing local pay level was higher. The average annual salary for psychologists in the Federal Government was $66,800 in early 1999. Disclaimer: Links to non-BLS Internet sites are provided for your convenience and do not constitute an endorsement. For information on careers, educational requirements, financial assistance, and licensing in all fields of psychology, contact: · American Psychological Association, Research Office and Education in Psychology and Accreditation Offices, 750 1st St. NE., Washington, DC 20002. For information on careers, educational requirements, certification, and licensing of school psychologists, contact: National Association of School Psychologists, 4030 East West Hwy., Suite 402, Bethesda, MD 20814. |