Symposium:
Div. 17 Special Section Health Psychology
“Preparing Students for New Roles in
Integrated Health: The Evolving
Interface of Counseling and Health
Psychology”
Participants
1.
Chair: Brian L. Lewis, Ph.D.
–
2.
Donald R. Nicolas, Ph.D.
-
3.
Auburn University
Sarah Hastings, Ph.D. & Tracy Jay Cohn, Ph.D.
-
5.
Ball State University
Annette Kluck, Ph.D. & Daniel Stabin, M.A.
-
4.
Salem VA Medical Center
Radford University
Mary Ann Hoffman, Ph.D.
-
University of Maryland
Recent Health Care Developments and
their Implications for Training in
Counseling Psychology
Donald R. Nicholas, PhD
Dept. of Counseling Psychology
Ball State University
Change
is under way and on the way. . . . .
health care reform (ACA)  accountability for effective
(evidence-based) & cost efficient care  change in health
care delivery systems (PCMHs, ACOs) 
credentialing/privileging to identify highest quality
providers  change in education/training  health service
psychology, competency movement, accreditation
(program, internship, postdoc) and board certification
(ABPP)  specialty recognition  taxonomy of terms
the confusing terminology
of change
Health Service Psychology
Health Service Psychology
Education Collaborative (HSPEC)
Given that professional psychology includes diverse areas of practice
and the mounting concerns about psychology’s role in a
reformed health care system, HSPEC chose to focus on
preparation of psychologists for the delivery of health care
services and made seven recommendations that constitute
the core of a blueprint for the future.
(HSPEC, 2013)
Why the change? --- Health Care Reform
Affordable Care Act (ACA)
• Economist Jonathan Gruber - brief explanation
– http://www.youtube.com/watch?v=IF8SiN8Bbh0
Some Implications for
Counseling Psychology
Affordable Care = Accountable Care
• Accountability in health care
– effective (evidence-based) and cost efficient care
• To do so will effect psychologists
– settings & forms of practice
– processes of credentialing & privileging
– education and training
ACA & implications for
practice settings
Patient Protection and Affordable Care Act
(ACA; Public Law No: 111-148, Mar 23, 2010:),
… will continue to focus on the growing expectation
that interprofessional healthcare organizations (that is,
patient center healthcare homes & accountable care
organizations) will become the nexus of the delivery of
efficient, cost effective, and quality healthcare services.
(Rozensky, 2014, APA Convention, Hawaii)
Interprofessional health
care delivery organizations
•
Patient Centered Healthcare (Medical) Home
– proposed since 1967 by American Academy of Pediatrics
Accepted 1990s
– A model of care in which “patients have a direct relationship
with a provider who coordinates a cooperative team of
healthcare professionals, takes collective responsibility for the
care provided and arranges opportunities for other qualified
professionals as needed…
• Interprofessional Collaboration
Interprofessional Collaboration
• “Interprofessionalism involves the
development of competencies across
disciplines and the application of those shared
competencies in an integrated, team based
health care system….
• Rozensky & Janicke, 2011
IPEC
Interprofessional
Collaborative Practice
• “When multiple health workers from different
professional backgrounds work together with
patients, families, carers [sic], and
communities to deliver the highest quality of
care” (WHO, 2010)
Interprofessional team
based care
•
Care delivered by intentionally created,
usually relatively small work groups in health care,
who are recognized by others as well as by
themselves as having a collective identity and shared
responsibility for a patient or group of patients, e.g.,
rapid response team, palliative care team, primary
care team, operating room team (IPEC, 2011).
ACA and Diversity
• IOM identified INSURANCE as key factor for quality of health /
health disparities
–
–
–
–
Uninsured…..
1 out of 3 Hispanics/ Latinos and American Indians
1 out of 5 African Americans
1 out of 8 White Americans
Dr. Garden Grant/ Minority Health 2012
Practice of Health
Service Psychology
• In this era of health care reform (ACA), with its focus
on accountability, evidence-based and cost-efficient
practice, health service psychologists (counseling,
clinical, school) will practice in settings where
interprofessional collaboration is essential/expected.
• How does one become a member of an
interprofessional team?
Credentialing and Privileging
• Health care providers do not just walk into an
organized healthcare facility and just see
their patients. They must have permission to
see patients as members of the professional
staff (Stromberg et al., 1988, p 329)
Credentialing
•
Defined as the process of obtaining,
verifying and assessing the qualifications of a health
care practitioner to provide patient care services in or
for a health care organization.
• Credentialing of professional staff assures that
systems of care only include the highest qualified
providers as part of their system of care
Credentialing and Training
• That is, credentialing will require graduation from accredited
education and training programs which suggests that
providers have met (at least minimal) defined standards of
training (Rozensky, 2011).
• increasing expectation of specialty board certification —
already routine expectations of hospital-based healthcare
providers on the “professional staff” (Rozensky, 2012).
– American Board of Professional Psychology (ABPP)
Privileging
• Defined as the process whereby a specific scope and content
of patient care services (i.e., clinical privileges) are
authorized for a health care practitioner by a health care
organization, based on evaluation of the credentials and
performance
• practice organizations regularly and routinely require
evidence of competence to maintain clinical privileges – recredentialed every xxx years
Education & Training
• (HSPEC) Blueprint
– 7 recommendations
• Multiple competencies
–
–
–
–
Counseling Psychology
Psychology Practice in Primary Care
Patient Centered Medical Home
Interprofessional/integrative/collaborative care
• APAs Specialties Taxonomy
HSPEC 7 issues addressed:
1: The competencies . . . should be clearly articulated and understood by all . .
2: There should be guidelines for minimal qualifications to enter doctoral programs . . .
3: Psychology needs to articulate and evaluate the competencies for each level in the
sequence of education and training . . .
4: There needs to be increased focus on competency assessment in health service
psychology education and training . . .
5: The future of health service psychology rests on the integration of science and practice.
6: Psychology needs to establish the standard of self-regulation for education and training
in the profession.
7: Psychology needs more research relevant to the preparation and roles of health service
psychologists and must have . . . workforce analysis.
Multiple Competencies: Resources
– http://www.apa.org/ed/graduate/competency.asp
x
• A Practical Guidebook for the Competency Benchmarks (July 2012) New
guidebook that provides practical information on implementing a
competency-based approach to education and training
• Final Report of the APA Task Force on the Assessment of Competence in
Professional Psychology, October 2006
• Revised Competency Benchmarks for Professional Psychology (June
2011) (DOC, 239KB)
Competencies Resources
• Counseling psychology competencies rationale statement. CCPTP website.
• Overview of counseling psychology competencies and essential
components. CCPTP website.
• Counseling psychology core competencies, essential components,
behavioral anchors and examples. CCPTP website
• Competencies for Psychology Practice in Primary Care Report of the
Interorganizational Work Group on Competencies for Primary Care
Psychology Practice, APA, March 2013.
What is a specialty?
truth in advertising &
the need for a taxonomy
• If specialties are becoming essential and
PCMHs and ACOs are going to be credentialing
and privileging providers, consistency in
terminology is needed.
• The CRSPPP Taxonomy
Commission for the Recognition
of Specialties in Professional
psychology (CRSPPP) Taxonomy
13 APA Recognized Specialties in Health
Service Psychology
•
•
•
•
•
•
•
Behavioral and Cognitive
Clinical Child
Counseling
Clinical Neuropsychology
Clinical Health
Clinical
Forensic
•
•
•
•
•
•
Family
Psychoanalysis
School
Prof. Geropsychology
Police and Public Safety
Sleep
so what am I getting in
my doctoral program?
• Specialty in Counseling Psychology with a _________________ in
_________________
–
–
–
–
major area of study ----- 2-3 yrs didactics and a dissertation or research project
emphasis
----- at least 4 courses and 2 practica
experience
----- at least 1-2 courses and 1 practicum
exposure
----- at least 1-2 courses
– anything else is a focus
– only applicable to the 13 recognized specialties
References
•
•
•
•
Rozensky, Ronald H. (2011). The institution of the institutional practice of psychology: Health
care reform and psychology's future workforce. American Psychologist, 66(8), 797-808. doi:
10.1037/a0025074
Rozensky, Ronald H., Celano, Marianne, & Kaslow, Nadine. (2013). Implications of the
Affordable Care Act for the practice of family psychology. Couple and Family Psychology:
Research and Practice, 2(3), 163-178. doi: 10.1037/cfp0000009
Rozensky, Ronald H., Grus, Catherine L., Belar, Cynthia D., Nelson, Paul D., & Kohout, Jessica L.
(2007). Using workforce analysis to answer questions related to the internship imbalance and
career pipeline in professional psychology. Training and Education in Professional Psychology,
1(4), 238-248. doi: 10.1037/1931-3918.1.4.238
Rozensky, Ronald H., & Janicke, David M. (2012). Commentary: Healthcare reform and
psychology's workforce: Preparing for the future of pediatric psychology. Journal of Pediatric
Psychology, 37(4), 359-368. doi: 10.1093/jpepsy/jsr111
References
•
•
•
•
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for
interprofessional collaborative practice: Report of an expert panel. Washington, D.C.:
Interprofessional Education Collaborative.
American Psychological Association. (2012). Education and training guidelines: A
taxonomy for education and training in professional psychology health service
specialties. Retrieved from http://www.apa.org/ed/graduate/specialize/taxonomy.pdf
Rodolfa, Emil, Bent, Russ, Eisman, Elena, Nelson, Paul, Rehm, Lynn, & Ritchie, Pierre.
(2005). A Cube Model for Competency Development: Implications for Psychology
Educators and Regulators. Professional Psychology: Research and Practice, 36(4), 347354.
Rozensky, Ronald H. (2012). Health care reform: Preparing the psychology workforce.
Journal of Clinical Psychology in Medical Settings, 19(1), 5-11. doi: 10.1007/s10880-0119287-7
References
•
•
•
•
•
Beacham, Abbie O., Kinman, Carissa, Harris, Josette G., & Masters, Kevin S. (2012). The patient-centered
medical home: Unprecedented workforce growth potential for professional psychology. Professional
Psychology: Research and Practice, 43(1), 17-23. doi: 10.1037/a0025320
Hatcher, Robert L., Fouad, Nadya A., Campbell, Linda F., McCutcheon, Stephen R., Grus, Catherine L., &
Leahy, Kerry L. (2013). Competency-based education for professional psychology: Moving from concept to
practice. Training and Education in Professional Psychology, 7(4), 225-234. doi: 10.1037/a0033765
Nash, Justin M., Khatri, Parinda, Cubic, Barbara A., & Baird, Macaran A. (2013). Essential competencies for
psychologists in patient centered medical homes. Professional Psychology: Research and Practice, 44(5),
331-342. doi: 10.1037/a0033106
Nicholas, Donald R., & Stern, Marilyn. (2011). Counseling psychology in clinical health psychology: The
impact of specialty perspective. Professional Psychology: Research and Practice, 42(4), 331-337. doi:
10.1037/a0024197
Schaffer, Jack B., Rodolfa, Emil R., Hatcher, Robert L., & Fouad, Nadya A. (2013). Professional psychology
competency initiatives: Reflections, contrasts, and recommendations for the next steps. Training and
Education in Professional Psychology, 7(2), 92-98. doi: 10.1037/a0032038
Health Psychology in
Counseling Psychology
Academic Training
Programs:
Annette S. Kluck, Ph.D.
Daniel Stabin, M.A.
Auburn University
What Are Faculty and
Trainees Doing?
Counseling Health
Psychology
Recent push in APA focuses on Health Service
Psychologists
– APA recognizes that Counseling Psychologists can contribute
to health services beyond mental health (APA, 1996, 2011)
– APA’s public definition of counseling psychologists lists
among the problems we treat: helping people adapt to
physical disabilities, diseases, or injury (APA, 2013)
– Division 17 definition includes attention paid to healthrelated concerns (SCP, 2014)
What Happens in Our
Programs?
This should translate to the practice of health psychology activities among
counseling psychology students and the faculty that train them
Existing research documents general trends of an interest in counseling
psychology among students and faculty
There appear to be a subset of counseling psychology division members who also
hold membership in the health psychology division (Nicholas & Stern, 2011)
Core areas of competence for counseling health psychologists can be identified
(Nicholas & Stern, 2011)
We sought to examine how this relates to the future of the field and current
program activity
Survey of Programs
Based on study by Raque-Bogdan, Torrey, Lewis, & Borges (2012), we can
generally assume the following about Counseling Psychology programs
Less than a fifth of programs were particularly known for subspecialty in
health psychology or primary care
Over half have no formal specialty track/concentration/minor
In most programs that lack formal training, it would be somewhat
difficult to impossible to offer formal coursework in health psychology
Training directors indicated that there is some interest in health
psychology among students
Majority of programs with students interested in health psychology have
one or no faculty members with expertise
Faculty Job Openings
Reviewed classified ads from the Monitor on
Psychology from May 2011 to March 2014
– Imperfect data source
• Not all programs advertise in the magazine
• Same job advertised across multiple issues
• Programs do not always list everything they are
considering or wanting
• Programs may not list the exact number of positions
• Program alignment is no always clear in ads
Faculty Job Openings
Who is in the data?
– We included new programs known to be seeking
accreditation and participation in CCPTP
– We did not include ads that suggested the
position was for another program in the
department
– We included ads for positions in departments
with counseling psychology programs
• Department head positions
• Open lines to contribute to any program
Faculty Job Openings
Who are we trying to hire in APA-accredited programs
– 39 advertised positions
– 8 explicitly mentioned interest in filling position with someone
with health psychology focus
– 10 of the 39 were for admin (head/dean) slots
– Translates to 20.5% of positions
– Relative to current proportion of faculty with health
psychology expertise, there is a trend to advertise for health
psychology expertise among non-administrative faculty lines
Counseling Psychology
Faculty Grants
Examined grants held by counseling psychology faculty
reported in the Insider’s guide to graduate programs in
clinical and counseling psychology: 2012/2013 edition
(Norcross & Sayette, 2013)
– A source that can be used for recruiting
– Applicants may review to find faculty research interests
and programs that match what they desire
– Training directors were given opportunity to update the
data to reflect current program activity
Counseling Psychology
Faculty Grants
–
–
–
–
51 total grants at 28 counseling psychology programs
26 grants listed as explicitly focused on health
8 others might have a health focus
16 of the 28 programs had a least 1 grant explicitly linked
to health psychology
– Based on proportion of faculty with health psych expertise
(Raque-Bogdan et al., 2012), significantly greater portion
of grants have health psych focus (p < .001)
Counseling Psychology
Student Interests
Based on existing research (Raque-Bogdan et al., 2012),
– Most programs have at least some students who are at
least somewhat interested in health psychology
– Over half of programs have at least some opportunity
for practicum training in a health psychology setting
– A minority of graduates go on to a health psychology
position after completion of their degree
Internship Activities
We know that there were 407 counseling psychology
doctoral students who matched during phases 1 and 2
to APPIC sites. Not all are from APA-accredited
programs
– Contacted only training directors of APA accredited
counseling psychology programs
– 377 from PhD
– 40 from PsyD
– 45 respondents (11% response rate)
Internship Activities
What settings are they training in for their primary
setting?
•
•
•
•
•
69.2% at college counseling centers
2.8% at jail/prison/correctional facilities
8.1% at medical hospital/centers
2.8% at medical schools
22.2% at VAs
Internship Activities
Activities while on internship For comparison purposes
•
•
•
•
•
•
•
•
•
•
•
100% have had experience thus far providing individual therapy
100% have or will have experience providing brief therapy
78% have or will have experience providing assessment
95.1% have or will have experience providing group therapy
78% have or will have experience providing long-term therapy
82.1% have or will have experience providing supervision
86.8% have or will have experience with serious mental illness
100% have had experience with anxiety, PTSD/trauma, and mood disorders
65.8% have or will have vocational/career experience
94.9% have or will have multicultural therapy experience
30.8% have had experience with the modality of health psychology
Internship Activities
Activities while on internship Within areas of health psychology
• 22% have or will have primary care experience
• 28.9% have or will have integrative health care experience
• 27.0% have or will have experience with integrative health care within a
specialty
• 5.1% have had oncology experience
• 15.4% have or will have HIV/AIDS experience
• 33.3% have or will have pain management experience
• 34.2% have or will have chronic/terminal illness experience
• 51.5% have or will have eating disorder/weight management experience
• 23.7% have or will have neuropsychology experience with adults
Internship Activities
Identity evidenced by membership of pre-doctoral interns
– Comparing to the Nicholas & Stern (2011) data for professionals
– Members by division
•
•
•
•
•
•
63.2% are 17
2.9% are 12
5.7% are 22
11.1% are 38
2.9% are 40
All respondents who indicated membership in 38 also indicated
membership in 17
So where are we?
Appears to be an interest in faculty with health psychology
expertise when new lines are advertised in the Monitor on
Psychology
When counseling psychology faculty get grants, they tend to get
grants in an area of health psychology
About 1/3rd of counseling psychology students obtain experience in
the modality of health psychology while on internship
Supports need to provide students with training even if they are
unlikely to go onto health psychology careers because internships
involve work in health psychology specialties
References
•
•
•
•
•
•
American Psychological Association [APA]. (2011). Model act for state licensure of psychologists.
American Psychologist, 66, 214-226.
American Psychological Association [APA]. (2013). Public description of counseling psychology.
Retrieved September 20, 2013 from http://www.apa.org/ed/graduate/specialize/counseling.aspx
American Psychological Association [APA]. (1996). Recognition of health service providers.Approved
Council Resolution. C.(17). Retrieved February 6, 2014 from
http://www.apa.org/about/policy/chapter-10.aspx#recognition-service
Nicholas, D. R., & Stern, M. (2011). Counseling psychology in clinical health psychology: The impact
of specialty perspective. Professional Psychology: Research & Practice, 42, 331-337.
Raque-Bogdan, T., L., Torrey, C. L., Lewis, B. L., & Borges, N. J. (2012).
Counseling health
psychology: Assessing health psychology training within counseling psychology doctoral programs.
The Counseling Psychologist, 41, 428-452.
Society for Counseling Psychology [SCP}. (2014). What is counseling psychology? Retrieved March
10, 2014 from http://www.div17.org/about/what-is-counseling-psychology/
Integrated Care Training
New River Valley Free Clinic
A Collaboration Between Radford
University and the NRV Free Clinics
Christiansburg and Giles, VA
Sarah Hastings, Ph.D. & Tracy Jay Cohn, Ph.D.
RU Doctoral Program
History
•
•
•
•
First admissions in 2008
Accredited in 2012
Graduated 2 cohorts
Emphases
Clinic History
•
•
33 year old clinic
Established as Free Clinic
– Consists of two clinics in medically underserved areas
•
HPSA Scores are developed for use by the National Health Service Corps in determining priorities for
assignment of clinicians. Scores range from 1 to 25 for primary care and mental health, 1 to 26 for
dental.
–
–
Montgomery Co, VA: Medical = 18/10
Mental Health = 19/15
– The mission of the Free Clinic of the New River Valley/Community Health Center: is to provide
affordable and high quality medical, dental, behavioral and preventive health services to
people of all ages and circumstances, regardless of ability to pay or insurance status.
– In Fall of 2013, the Free Clinic received funding to become a Federally Qualified Health Center
Models of Care
Models of Care
Models of Care
Practicum Positions
• Two positions in rural Giles County clinic
• Two positions in Christiansburg clinic
• One behavioral health position, Christiansburg
Involved Staff and Faculty
Clinic Staff: Brittany Hall, M.S., Integrated
Treatment Care Coordinator
RU Faculty:
Valerie Leake, Ph.D., Associate Professor, RU,
Practicum Coordinator
Tracy J. Cohn, Ph.D., Associate Professor, RU, Clinic
Board Member
Referral Procedure


New patient or patient returning for PC appointment (who has not been screened using QPD
[Quick Psycho Diagnostics panel] in past 6 months) enters building.
Patient checks in at front desk. Patient waits until called to exam room by nurse.
Patient called to exam room:

Nurse records vitals, blood pressure, current medications, and reason for visit.

Nurse administers QPD panel (assisting as necessary).

QPD is scored by nursing staff and report is added to medical record under mental health tab.
QPD Positive Result:

Care Coordinator is notified. Care Coordinator, on-site
behavioral health volunteer or advanced student
enters the exam room before or after PCP/NP,
depending on patient and practitioner flow, to see
patient.

Brief, psychoeducational-based intervention is
conducted; follow-up appointment is made for a
thorough BH intake.
QPD Negative Result:

Patient resumes traditional medical
appointment.

Re-Screen for behavioral health concerns
at next PC appointment within 6 months.

If patient presents with BH concern,
follow procedure for positive result.
Referral Procedure
BH Condition Severity is Assessed:

Patient returns for 50-minute appointment with Psych NP or Care
Coordinator.

Psych NP or Care Coordinator conducts BH assessment; determines if
patient has sufficient BH and PC issues to refer to Collaborative Care
Team.
If patient IS appropriate for Collaborative Care Team:

PCP or BH provider or Psych NP informs Care Coordinator, who arranges for case
to be reviewed by Team, and sets date.

Team reviews case as a group, and Integrated Treatment Plan is
developed/approved.

Patient is assigned a BH counselor (if patient does not already have one) and
referred to other specialists as necessary.

Patient or patient case is seen/reviewed by Consulting Psychiatrist, as
appropriate.

Care Coordinator reviews plan at least monthly, or as health and/or circumstances
change.

Care Coordinator communicates with patient and facilitates patient attending all
BH and PC appointments, which are coordinated to the extent possible.

Patient may “graduate” from Team care as determined by Team or patient.

Patient may re-enter Team care if BH conditions worsens.
If patient is NOT
appropriate for
Collaborative Care
Team:

BH provider
sees patient
as necessary
or PsyNP sees
patient only
during
medical
appointments
for brief,
psychoeducational
interventions.

If BH
condition
worsens (as
indicated on
subsequent
QPD or via
patient
report),
severity is reassessed.
Outcome Measures
•
QPD
– Overview of QPD
– Psychometrics
– Alternatives
•
•
•
Administration protocol
Time A “Intake”
As close to the marked time but not before:
–
–
–
–
–
•
Time B: After 1 month but not before
Time C: After 3 months but not before
Time D: After 6 months but not before
Time E: After 12 months but not before
Time FinalX: the exit assessment.
Existing clients who were already receiving IC (BH and PC) were administered the
QPD and this became their Time A.
Challenges/Future
Directions
•
•
•
•
•
•
•
Supervision
Funding
Space
Distance
Benefits to clinic
Benefits to students
Looking ahead
Developing a Health Psychology Research
Focus in Counseling Psychology Programs
Mary Ann Hoffman, Ph.D.
University of Maryland
hoffmanm@umd.edu
What is Clinical/Counseling
Health Psychology?
• Interdisciplinary field including clinical, counseling, social
and developmental psychologists.
• A significant minority of these psychologists trained as
counseling psychologists (Nicholas & Stern, 2011)
• Yet my review of key journals in Counseling Psychology
show little scholarship on health-related topics (20032013, about 20 articles in TCP and a handful in JCP)
• Case needs to be made that mind-body interface is an
important and timely research topic.
Why Should We Care about
Clinical Health Psychology?
• Research interests of applicants often foreshadow timely
topics.
• An increasing number of students are interested in the
mind-body interface; and,
• In utilizing positive psychology variables to intervene in
health-related concerns (1/4 of applicants at UMD)
• Attention to health and wellness fits well with our field’s
focus on hygieology versus pathology
Developing a Research Emphasis
in Health Counseling Psychology
• facilitating scholarship by identifying health
topics that fit counseling psychology core values;
• mentoring our students in health psychology
research by bridging our interests; and,
• increasing visibility of clinical health research in
key counseling psychology journals.
Identifying Health Topics Aligned
with Counseling Psychology
Facilitate more research by identifying way Counseling
Psychology can uniquely contribute. Examples:
• Strengths-based approaches to healthy adaptation and coping.
• Understudied variables that intersect with health and wellbeing: self-compassion, forgiveness, positive coping, gratitude,
meaning-making and benefit-finding
• Interface between health and work, work identity, and income
• Role of cultural variables in health outcomes (e.g., disparities,
gender, race, ethnicity, and housing insecurity)
Examples of Health-Related Projects
at the University of Maryland
• Prostate cancer study- social support and social
networks; quality of life
• Expressive writing for chronic pain: role of selfcompassion and self-efficacy in pain perception
• Breast cancer in young women: effect on career
and career identity and meaning
A Qualitative Analysis of Psychosocial
Support in Online Prostate Cancer Forum
(Furhmann, Ross & Hoffman)
• Prostate cancer affects 1 in 6 men; most survive but with QOL issues
• What role do online support forums play in survivorship?
• We categorized content and intent of the 100 “most viewed” and “most
responded to” posts on prostate cancer forum Healing Well
• Most observed content categories: ED Treatments, Urinary Incontinence,
Quality of Sexual Life, Cancer Treatment Options.
• Most observed intent categories: Seeking Info. Based on Experience,
• Offering Support/Reassurance, Seeking support/reassurance.
• Online support forums fill medical void by offering reassurance and
normalization from others going through similar experience
Effectiveness of a Positive Writing
Intervention for Chronic Pain
(Ziemer & Hoffman)
• Chronic pain is widespread, affects QOL, and is often not treated
effectively with biomedical approaches
• Would a brief expressive writing intervention using either a selfcompassion or self-efficacy prompt be effective?
• 93 randomly assigned participants - met criteria for chronic pain
• Ss in both conditions reported sig. less pain and less depression
• Ss in self-compassion condition reported less intrusive pain
• Ss in both conditions reported greater self-compassion
• Those who wrote using more positive adjectives reported less pain, less
intrusive pain, less pain catastrophizing
The Work Life and Career Development of Young
Working Women who are Breast Cancer Survivors
(Raque-Bogdan & Hoffman)
• Cancer at a younger age has more significant and enduring psychosocial
effects than cancer at older ages
• Does breast cancer during early adulthood impede career development and
commitment?
• Women’s career trajectories have traditionally been understudied in the
career literature as have careers of persons with chronic disease
• Results: Early cancer diagnosis intensified most women’s need for purpose
in life and led them to re-appraise meaning in their work
• Need for financial security and medical insurance prevented re-appraised
sense of life meaning the focus of their career
• Or, from redirecting their career paths to one that better expressed their reappraised life meaning.
Mentoring Student Research:
• Finding a “bridge” between interests of advisor/advisee
• Examples: You may know about career development but not about
effect of health challenges on career
• You may know about expressive writing but not that it’s a great way to
study health issues such as chronic pain, caregiver experiences, and
cancer survivorship
• You may know about social networks but not their role in seeking
health support and receiving health services
• Advisee/Advisor projects
• Student initiated research teams
Your Research Helps in Seeking a Career
In Health Counseling Psychology
• Research, extern, and intern experiences create a foundation for a
career in clinical health psychology
• These experiences are becoming more important than designation of
program as clinical or counseling psychology
• Your research demonstrates your passion, commitment and skills
• Student who studied chronic pain interned at VA and is interviewing
at research centers, NIMH, etc.
• Student who studied QOL in persons w/ autoimmune disorders works
in behavioral medicine setting and teaches health psychology
• Student who studied and did externship re/ disordered eating offered
post doc opportunities at both ED clinics and Counseling Centers
So Many Interesting Topics! So
Little Time!