Public Education Committee Reports/Updates

August 2022

A JOURNEY OF DISCOVERY:  GETTING PSYCHOLOGY BACK! 

After decades of “Giving Psychology Away” as part of the Public Education Committee, this year I came to a wonderful and unexpected realization – I have also been “Getting Psychology Back!” This spring my husband and I set out on a cross-country road trip along with our dog Earl. Our plans included stopping along the way to visit family and friends, mostly to see folks we haven't seen for the past couple of years and to meet the newer and younger ones that have been born since COVID. We've traveled a lot, both of us, beginning as Army brats and then just as adults with families to raise and jobs to pursue. This time, although we didn't know it at first, we were on a mission of discovery. We needed to see for ourselves how everyone was really doing after living with the pandemic, and we needed to find out how we were doing psychologically and emotionally. There were no special life cycle events to attend like weddings, birthdays, or graduations. Instead we spent a lot of time sharing meals, hanging out, visiting dog parks and, mostly, just talking and listening. We heard about health issues, job situations, and relationship ups and downs. We heard about retirement dilemmas and exciting new volunteer efforts. People talked about their families – elderly parents, children leaving the nest, adult children with struggles – and also successes and school situations impacted by the pandemic. Everyone was glad to see us and talk, as all of us have been doing for the past couple of years about the ways our lives have changed and adapted to living with COVID. For the most part, everyone was managing, and often thriving, despite all the challenges. As we were traveling and immersed in all these rich and complex lives, I didn't really have the time to think about it and process what was happening to me. It wasn't until we returned home, exhausted and overwhelmed by the experience, that I started to understand what really happened.
For so many years, I have been a psychologist, a helper, a listener, a person focused on caring for others. Many years ago, Dr. Tony Farrenkopf of the PEC shared the phrase, “Giving Psychology Away,” borrowing from George Miller (Banyard & Hulme, 2015). We psychologists have spent years speaking and writing and offering our skills and expertise to the public, both in our professional jobs and as volunteers committed to sharing with the larger community. What I discovered this year during my 10,400 mile trip across America is that communicating and giving have been a reciprocal process all along. I have been enriched and enlightened by all those interactions. I have taken in the strengths and insights of all those other people. I have been privy to so many stories and examples of great heart and caring, amazing resilience in the face of challenges and adversity. Even as folks have looked to me for wisdom and guidance, I've been learning all the ways they are already coping and figuring out what to do to fix things and care for themselves and others. As many of you probably already know, we are not the experts, despite our years of education, training, and experience. What you may not always realize is that we still have many things we can learn from others, both about the human experience and also about ourselves. What is really important to us? How do we want to spend our time? With whom do we want to be and why? What are things we still need in life, such as opportunities and adventures to have? In order to get to the place where we can ask these questions and explore possible answers, we have to take the time and really listen to the stories others are telling us. We have to appreciate the gift of psychology being given back to us. I discovered that being a psychologist and being lucky enough to engage with other people on a regular basis has been a truly valued journey.

References

Banyard, P., & Hulme, J. A. (2015). Giving psychology away: How George Miller's vision is being realised by psychological literacy. Psychology Teaching Review, 21(2), 93–101. PTR 21_2 (ed.gov)


May 2022

Health Equity and Reproductive Justice – APA Calls for Action – Oregon is on it!
Written by Nancy Felipe Russo, PhD and Stephanie Van Orden, PsyD of the OPA Public Education Committee 

At the national level, the American Psychological Association (APA) has made a commitment to ensuring that psychologists are at the forefront of critical and complex social issues, including health equity and reproductive justice (APA, 2021a). The need for action is great and the recent call for action at APA’s 2021 council meeting is urgent. In October 2021, the APA published the APA Resolution on Advancing Health Equity in Psychology (APA, 2021b) and it highlighted strong takeaways for our psychological community:

Advancing health equity is central to APA’s strategic goal to utilize psychology to make a positive impact on critical societal issues, including the objective of employing psychology to improve population health, increase access to services, and reduce disparities, and the objective of fostering the advancement of human rights, fairness, diversity, and inclusion through the application of psychological science. (para. 22)

Aspirational goals for health equity are no longer sufficient. Health inequity is driving dire need and substantial physical and psychological suffering. Inequities are so great they warrant immediate transformative action. (para. 1)

This resolution adopted by the APA Council of Representatives is but one of several related actions, including a resolution that affirms APA’s long-standing commitment to reproductive rights (APA, 2021c).

Meanwhile, back in our home state, the Oregon Public Health Association (OPHA) has led the effort to declare racism as a public health crisis (OPHA, 2022). After 2 years of hard work, with the passage of HB40 (Oregon Legislature, 2022), we have come another step closer to a vision of equity where the lives of all Oregonians are rooted in the conditions that foster health, stability, and dignity (HB4052, 2022).

These developments underscore the fact that Oregon psychologists have roles to play in joining with other health professionals to develop and communicate advancements in achieving health equity and reproductive justice in our state and nationally. Whether you consider or decide to share supportive research on the topic, engage in research yourself, or advocate at the national and state level, we all can support health equity for our communities across Oregon.

This month APA will have a meeting to discuss possible actions at the state and national level to follow up on the Reproductive Rights resolution… watch for updates!

References

American Psychological Association. (2021a, June). Health equityhttps://www.apa.org/pi/health-equity

American Psychological Association. (2021b, October). APA resolution on advancing health equity in psychology. https://www.apa.org/about/policy/advancing-health-equity-psychology#:~:text=Aspirational%20goals%20for%20health%20equity,key%20driver%20of%20health%20inequities

 American Psychological Association. (2021c, October). APA resolution affirming and building on APA’s history of support for reproductive rights. https://www.apa.org/about/policy/resolution-reproductive-rights.pdf

Oregon Legislature. (2022). Legislative summary report - HB 4052https://www.oregonlegislature.gov/lpro/summleg/2022%20Legislative%20Summary%20Reports.pdf

Oregon Public Health Association. (2022).  Legislative updates: HB 4052 (2022b). Racism is a public health crisis. https://www.oregonpublichealth.org/legislative-updates#HB2337 


 February 2022

Outreach in Psychology: A How-To In Giving Psychology Away
Paige Reohr, MS, Ann Clarkson, PhD, and Stephanie Van Orden, PsyD

“Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists…” (from Principle D, Justice of the American Psychological Association’s [APA] Ethical Principles and Code of Conduct, 2017).

As professionals in psychology, we are ethically obligated to seek out ways to serve our communities and promote equity in mental health, which may be promoted through community outreach efforts (Ramirez, 2018). Community outreach describes diverse means of extending clinical service beyond the traditional view of clinical psychology offerings within a community setting. It’s moving out of the office and into our communities’ environments, whether virtually or physically. Outreach efforts contribute to health promotion and prevention of mental illness by increasing health literacy, teaching communities about resources available to them, and working against barriers to accessing mental health care. Clients navigate numerous systemic and social barriers in order to receive clinical care; community outreach extends service to those who otherwise may not make it to our offices.

Broadly, goals of community outreach include the following:

    ●          Promoting and increasing health literacy on specific topics

    ●          Responding to community-level events (e.g., pandemic stress, wildfires)

    ●          Empower communities by giving them tools to better manage their health

    ●          Creating awareness of health inequities you have observed as a health professional

    ●          Reducing stigma related to mental health and informing communities of resources available

    ●          Disseminating research findings and implications or making recommendations

    ●          Building and/or strengthening community and organization partnerships

    ●          Meeting people where they are (Ramirez, 2018).

Furthermore, community outreach and engagement balance the unequal power that exists in clinical care in the sense that professionals move into a community-based environment, outside of their traditional healthcare setting. The importance of this is related to not only logistical access but also reducing stigma and countering the perspective that psychological professionals exclusively sit in stuffy offices and practice psychoanalysis.

Outside of clinical practice, psychological science is largely disseminated through peer-review publications. Kools et al. (2018) pointed out a system of gatekeeping, in which researchers’ career growth is largely dependent on publishing in academic journals, which are accessible only to fellow researchers and read to support future research. In addition to affordability barriers, scientific language is not easily digestible to those who have not received training in reading scientific materials. Though a shift in valuing other models of dissemination is not easily attainable, it is clear that giving psychological knowledge away to the very communities affected by the research is a powerful way to balance social power.

I encourage you to assess the ways in which you have learned to value the dissemination of scientific knowledge, perhaps valuing professional over community-based methods. Consider the potential impact of disseminating your research and knowledge from the field broadly with community members, stakeholders, and decision-makers.

Make it Happen

The Public Education Committee focuses on giving psychology away by educating the public via several methods (Ramirez, 2021). We outline below action steps to give psychology away through community outreach and engagement.  We invite you to explore options that appeal to your interests.

  • Offering trainings or workshops on specific mental health topics. Reach out to community-serving organizations (e.g., community or cultural centers, libraries, universities) and pitch specific topics or offer to create trainings based on specific organization needs.
  • Presenting your research to populations represented in your sample, special interest groups, policymakers, or advocacy groups.
  • Creating or distributing existing psychoeducational materials, such as handouts from the APA Help Center.
  • Being present at a health fair or other health/wellness event distributing psychoeducational materials and information about community resources.
  • Advocating for community spaces to share available psychoeducational materials.
  • Being available to speak to news media outlets on areas you hold expertise related to significant events and social concerns.
  • Writing an op-ed on a topic of interest, passion, or advocacy (see APA’s feature on how to write an op-ed; Lee, 2018). For example, see what our colleagues from Pacific University and the Michigan Psychological Association wrote for The Washington Post.

References

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). http://www.apa.org/ethics/code/index.html

Kools, F. R. W., Mirali, S., Holst-Bernal, S., Nijhof, S. L., Cavalli, G., & Grandner, M. A. (2018). Publications are not the finish line: Focusing on societal rather than publication impact.  Frontiers in Medicine. https://doi.org/10.3389/fmed.2018.00314

Lee, K. (2018, February). How to write an op-ed. Monitor on Psychology, 49(2). http://www.apa.org/monitor/2018/02/write-op-ed

Ramirez, S. (2018, July). Giving psychology away. Public Education Committee Reports/Updates. https://opa.memberclicks.net/public-education-committee-reports#GivingPsychologyAway

Zaman, A., Fiore, E., & Comrie, C. (2022, January 28). Daniel Snyder might be about to rename his team, but he still has to acknowledge the harm the old name caused [Editorial]. The Washington Post. https://www.washingtonpost.com/opinions/2022/01/28/daniel-snyder-might-be-about-rename-his-team-he-still-has-acknowledge-harm-old-name-caused/


 

November/December 2021

A window of opportunity: Psychologists’ role in COVID-19 vaccine uptake
Samantha Domingo, PsyD, DBSM, OPA Public Education Committee

With the COVID-19 vaccine becoming widely available in the United States to adults and children over the age of 16 in April 2021 (Anthes et al., 2021), along came a new hope for the eventual suppression of this pandemic. However, due to the compounding political divide amongst Americans in recent years, in addition to other sociocultural and psychological factors, vaccine uptake has been hindered. This is rather unsurprising given that some of these factors have also heavily influenced the public’s adherence to preventative measures against the spread of the virus, specifically the use of face masks and social distancing. 

As of October 2021, 56.5% of the United States population (Centers for Disease Control and Prevention [CDC], 2021, para. 3) and 61.6% of Oregonians have been fully vaccinated (USA Facts, 2021, line 3). Full immunization can be defined as 2 weeks after an individual’s second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or 2 weeks after a single-dose vaccine, such as Johnson & Johnson's Janssen vaccine (CDC, 2021, para. 3). The COVID-19 vaccine is effective at offering protection against the virus and reducing the risk of severe illness, hospitalization, and death (CDC, 2021, para. 5). Why then, do so many eligible people remain vaccine hesitant? 

Vaccine hesitancy can be defined as “the delay in acceptance or refusal of vaccination despite the availability of vaccination services” (MacDonald, 2015, p. 4163). Some of the factors impacting vaccine hesitancy in our current context include social (e.g., lack of access to childcare, transportation, or protected time off work), cultural (e.g., individualistic vs. collectivistic communities, religious beliefs), access to misinformation (e.g., self-selected exposure to media), health literacy (e.g., lack of accessible information appropriate for reading comprehension level, access to reputable sources of information), historical factors (e.g., history of abuse and exploitation of BIPOC populations by medical and scientific communities), and psychological factors (e.g., heuristics, confirmation bias, groupthink, affective states). This is, of course, an expanding area of research. 

Psychologists, particularly those practicing within the subspecialty of health psychology, are in a unique position as social scientists and practitioners to steer efforts and help inform strategies to address vaccine hesitancy and improve public health communications (Freedland et al., 2020). Though psychologists and other mental healthcare providers have been integral to addressing the emotional consequences of the pandemic, there is certainly room for increased involvement in research exploring COVID-related health behaviors and health communications (Freedland et al., 2020). Furthermore, psychologists possess multiple competencies that could expand the understanding of the variety of factors that impact decision making, and help mediate and connect with organizations and communities to facilitate this information. 

More direct applications of these ideas on a smaller scale translate into having direct conversations with clients/patients/consumers about making informed decisions regarding their health, exploring how to communicate with vaccine hesitant family and friends, and utilizing psychological principles to facilitate the informed decision-making process, by identifying barriers, addressing ambivalence, exploring values, and supporting critical thinking. On an organizational scale, psychologists integrated in hospitals, clinics, group practices, and community health settings can work as essential parts of interdisciplinary teams to develop interventions specific to the organization. On a larger, community-based scale, there are opportunities to enhance public education efforts by participating in media interviews, community outreach, and engagement. 

If you would like to become more involved in our community’s public education efforts, OPA’s Public Education Committee welcomes your participation.

References

Anthes, E., Ngo , M., & Sullivan, E. (2021, April 19). Adults in all U.S. states are now eligible for vaccination, hitting Biden's target. Half have had at least one dose. The New York Times. https://www.nytimes.com/2021/04/19/world/adults-eligible-covid-vaccine.html

Centers for Disease Control and Prevention. (2021). CDC Covid data trackerhttps://covid.cdc.gov/covid-data-tracker/#datatracker-home

Freedland, K. E., Dew, M. A., Sarwer, D. B., Burg, M. M., Hart, T. A., Ewing, S. W., Fang, C. Y., Blozis, S. A., Puterman, E., Marquez, B., & Kaufmann, P. G. (2020). Health psychology in the time of Covid-19. Health Psychology, 39(12), 1021–1025. https://doi.org/10.1037/hea0001049

MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine33(34), 4161–4164. https://doi.org/10.1016/j.vaccine.2015.04.036

USA Facts. (2021). Oregon coronavirus vaccination progress. https://usafacts.org/visualizations/covid-vaccine-tracker-states/state/oregon


July 2021

Giving Psychology Away
Sandy Ramirez, PsyD, and the Public Education Committee

During the recent OPA Annual Conference, our Public Education Committee offered a presentation to share about our work and how things have changed in recent years. Here we offer a continuation of that discussion. Why is it that we as a profession and we as individuals have the need to reach out? 

Certainly as we build our careers and practices we know the importance of networking and getting our name out there, letting people know what we have to offer. As a profession, we are bound by ethical guidelines and responsibilities to protect the public, implying a mandate to seek out ways we can be of service and promote equity. Public education is a wonderful and comprehensive way to address the process from “individual career success and publication impact to a collaborative multidirectional ecosystem for societal impact,” as suggested by Kools et al. (2018, p. 3). We advocate and educate to support mental health awareness and destigmatization, social justice, improved health outcomes, and ethical dissemination of psychological research. How do we reach out? Historically, beginning with published research, articles and books, teaching and lectures, we evolved and added public media formats like television and radio. Key factors for success required networking with public media sources, building relationships to enhance communication, and gaining opportunities for presentations offered in a timely fashion. 

As we are well into 2021, an important way to reach the public has been through social media. Keeping in mind that we are bound by our ethics and psychological science, Kools et al. (2018) explained that scientific journals and research are both the gatekeepers for what we may disseminate and a great source of material worth sharing. Why social media? Social media platforms are widely used and reach more people, including those who are harder to reach in person. Social media disseminates knowledge faster than traditional methods and has been shown to boost research citations. Social media also facilitates networking among researchers, clinicians, and consumers. According to Dijkstra et al. (2018), an added value to our use of social media is the opportunity to counter ‘Fake News.’ 

Another way of connecting the public with psychological science is through direct community outreach. Consider what communities you already have rapport with or communities you hope to advocate for through shared learning and collaboration. For example, the Public Education Committee has partnered with community organizations such as the YMCA, NAMI, and Rotary to offer psychoeducational events, and covered topics such as “Tips for managing pandemic stress” and “Brain health and wellness.” We have also partnered with community organizations (e.g., “Dial a Smile” and “Conversaciones con los Abuelos”) to support social connection among older adults through senior-student check-in calls. Our modalities have adapted during COVID-19 to include virtual presentations, outdoor events, and digital sharing of materials and resources. 

An important factor to recall is that we are bound by the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2017) and must remain within our scope of education, training, and practice when sharing mental health information. As we aspire to withhold the principles and practice in congruence with the ethical guidelines, and to actively support the Black, Indigenous, and People of Color (BIPOC) community, we are reminded to reach out, connect and learn, and be both accessible and transparent in our communication. 

Connect with us!
Instagram@opapubliceducationcommittee
Facebook@opapec
www.opa.org/public-education-committee

References

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code/ 

Dijkstra, S., Kok, G., Ledford, J. G., Sandalova, E., & Stevelink, R. (2018). Possibilities and pitfalls of social media for translational medicine. Frontiers in Medicine. https://doi.org/10.3389/fmed.2018.00345 

Kools, F. R. W., Mirali, S., Holst-Bernal, S., Nijhof, S. L., Cavalli, G., & Grandner, M. A. (2018). Publications are not the finish line: Focusing on societal rather than publication impact.  Frontiers in Medicine. https://doi.org/10.3389/fmed.2018.00314


March 2021

Community Courts: A Role for Mental Health in the U.S. Justice System
Paige Reohr, M.S. and Kevin McGovern, PhD - Public Education Committee

Criminal justice system involvement is closely entwined with mental illness. As such, the consequences of criminal or unlawful behavior (e.g., heavy fines, jail time, prison sentences) do not always serve the individual, who in many cases may need mental health or substance abuse treatment to support more adaptive behaviors when facing stressors in both custody and the community. Many find general sentencing to be counterproductive for those suffering from mental illnesses and believe access to community services would create better responses compared to criminal justice supervision (Almquist & Dodd, 2009). Responding to individuals who are underserved and part of marginalized communities in a community-oriented manner could influence long-term change and reduce the cyclical nature of both competency restoration programs and incarceration for these communities.

To mitigate the problematic approach of blanket sentencing, community courts take an individualized, community health approach. Community courts are a type of problem-solving or specialized court, housing mental health courts, drug courts, and domestic violence courts. The overarching foci of these courts are on: (1) promoting information about specific issues for participants, (2) facilitating community engagement, (3) ensuring collaborative work among the justice system and community social services, (4) taking an individualized approach to justice, (5) providing accountability, and (6) evaluating program outcomes (Almquist & Dodd, 2009).

Forming community courts in Oregon

Judge Larry J. Blake, a graduate of the University of Washington and Lewis and Clark Law School, teaches part-time at Mt. Hood Community College, runs his private practice, and serves as a Municipal Court Judge for several Oregon cities. In a dedicated effort to improve the management of misdemeanors in small community legal systems, Judge Blake initiated a community court system. He set up his first community court in the city of Sweet Home, Oregon, and it was up and running for 2 months before the pandemic hit. He is actively working to reinstate the program in not only Sweet Home, but also in Newberg and Corvallis, with hopes for continued growth.

Judge Blake’s community court initiative utilizes a shared effort by the legal system and community social services to support individuals charged with misdemeanors and, importantly, their families. Community courts take place inside municipal courthouses but have a starkly different setup from traditional hearings. Individuals presenting for their community court date are welcomed by representatives from community mental health, substance use and addiction support, transportation services, and housing assistance. After completing a needs assessment with the support of a peer, the presenting individual meets with each service representative. Then, if the individual is in agreement, an alternative to traditional sentencing can be offered. The individual must adhere to mental health and/or substance abuse treatment in lieu of jail time and fines. After 6 months, the individual returns to the court to assess progress in treatment.

Although community courts in Oregon are in their early stages and do not serve everyone going through the legal system, there has been enthusiasm from community services and community members alike. Running community courts is relatively low cost. Community services save the cost of meeting individuals around the community and there are no legal fees to cover. Further, regardless of political affiliation, American ideals tend to favor rehabilitation as a goal of the criminal justice system, which includes the work of these specialty courts (Thielo et al., 2019). These community-supportive efforts may play an important role in reducing the harmful impact of racism and classism in the U.S. justice system.

Program outcomes

Limited research demonstrates some promising outcomes of these efforts, with graduates of such programs showing significantly reduced recidivism (Hiday et al., 2013). McNiel and Binder (2007) found that successful completion of mental health court programming was related to a reduction in both recidivism and violence among adults with mental illnesses compared to peers who were instead booked into the county jail. Honegger (2015) reviewed several studies and observed a similarly successful reduction in recidivism among many, but not all, participants of problem-solving courts. Higher lifetime arrests and jail time, being on disability, substance use, low education, some racial group memberships, and being younger predict poorer outcomes (Honegger, 2015; Landess & Holoyda, 2017).

For years, researchers have highlighted a need for consistency in the implementation of such courts in order to assess evidence-based efficacy and other outcomes (Honegger, 2015; Pratt & Turanovic, 2019; Slinger & Roesch, 2010). Further research is certainly needed.

Getting involved

Judge Blake shared an interest in assistance from mental health professionals in his efforts to establish additional community courts. Since the Oregon Department of Corrections provides limited therapeutic services for the mentally ill, alternative community court programs of this nature should be established throughout the state. Psychologists and psychology students alike can contribute to community court efforts by providing valuable knowledge about mental health, substance abuse, and effective interpersonal interaction. Students and professionals are encouraged to reach out to their local courts to see how they can be of service, which may include conducting research to support the need for evidence-based programming or providing trauma-informed training to various parties involved in the community court systems.

References

Almquist, L. & Dodd, E. (2009). Mental health courts: A guide to research-informed policy and practice.
          Council of State Governments Justice Center.
          https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_MHC_Research.pdf

Hiday, V. A., Wales, H. W., & Ray, B. (2013). Effectiveness of a short-term mental health court:
          Criminal recidivism one-year post-exit. Law and Human Behavior, 37, 401–411.
          https://doi.org/10.1037/lhb0000030

Honegger, L. (2015). Does the evidence support the case for mental health courts?
          A review of the literature. Law and Human Behavior, 39(5), 478–488.
          https://doi.org/10.1037/lhb0000141

Landess, J., & Holoyda, B. (2017). Mental health courts and forensic assertive community
          treatment teams as correctional diversion programs.
          Behavioral Sciences & the Law, 35(5-6), 501-511. https://doi.org/10.1002/bsl.2307

McNiel, D. E., & Binder, R. L. (2007).
          Effectiveness of a mental health court in reducing criminal recidivism and violence.
          American Journal of Psychiatry, 164, 1395-1403. https://doi.org/10.1176/appi.ajp.2007.06101664

Pratt, T. C., & Turanovic, J. J. (2019). A criminological fly in the ointment:
          Specialty courts and the generality of deviance. Victims & Offenders, 14(3), 375-386.
          https://doi.org/10.1080/15564886.2019.1595247

Slinger, E., & Roesch, R. (2010). Problem-solving courts in Canada:
          A review and a call for empirically-based evaluation methods.
          International Journal of Law and Psychiatry, 33(4), 258-264. 
          https://doi.org/10.1016/j.ijlp.2010.06.008

Thielo, A. J., Cullen, F. T., Burton, A. L., Moon, M. M., & Burton, V. S. (2019).
          Prisons or problem-solving: Does the public support specialty courts?
          Victims & Offenders, 14(3), 267-282. https://doi.org/10.1080/15564886.2019.1595243


January 2021

Fighting Compassion Fatigue
Paige Reohr, MS & Stephanie Van Orden, PsyD

If you have been on the front lines providing public services, juggling the complexities of maintaining work and family obligations during COVID-19, caring for ill or high-risk loved ones, coping with your own mental and physical needs in times of notable social isolation, and/or struggling to see the light at the end of the tunnel, this message is for you. You are not alone. Despite these very likely human struggles, others may be depending on us for mental health services and our expertise. Despite our own best intentions, we can be pushed to limits that can impact our ability to effectively and ethically serve others.

Compassion fatigue is defined as decreased ability or interest in empathically caring for clients (Rossi et al., 2012). Similar to burnout, which is defined by cumulated emotional exhaustion, compassion fatigue is characterized by holding the stressful experiences of others. It differs depending on the intensity of the stressor and its onset becomes a secondary trauma in a helping professional (Duarte & Pinto-Gouveia, 2017), characterized by increased tension, emotional numbing or avoiding, hypervigilance, and irritability (Rossi et al., 2012). Harmful to clinical work, compassion fatigue impairs clinical judgement and treatment and increases instances of errors (Rossi et al., 2012).

Mental health professionals across the board have the potential to be affected by compassion fatigue and burnout, including trainees and professionals who have been in the field for years. Unsurprisingly, students and trainees are at risk of compassion fatigue as they encounter their first clients (Beaumont et al., 2016; Can & Watson, 2019; Knight, 2011). For each year spent working in a community-based mental health setting, the risk of burnout and compassion fatigue increases (Rossi et al., 2012). This has also been observed in other helping professions (Fahy, 2007; Fontin et al., 2020) and may be, in part, credited to evidence-based buffers against compassion fatigue being only relatively recent studied (Fahy, 2007).

One identified risk factor for greater levels of compassion fatigue includes having experienced at least one negative event in the prior year (Rossi et al., 2012), putting all mental health professionals working during the pandemic at a greater risk. The COVID-19 pandemic is both conceptualized as a single and a series of negative events, subject to individual experience and perception. Yet, previous research suggests the risk of compassion fatigue is more strongly related to minimal negative events in the past 12 months, versus the risk of burnout, which is more strongly related to multiple negative experiences (Rossi et al., 2012). Present applications may suggest that, while we may see high rates of compassion fatigue now, we may see an increasing rate of burnout among mental health providers as the pandemic surges.

We are in this together, and the following ways may help us all to reduce the risk of both compassion fatigue and burnout.

Find value in your work

Compassion satisfaction, which means finding value and satisfaction in  helping others, appears to protect against compassion fatigue (Duarte & Pinto-Gouveia, 2017; Rossi et al., 2012). Psychological distress among mental health care workers is associated with lower levels of compassion satisfaction and higher levels of compassion fatigue (Rossi et al., 2012). To antidote such fatigue, consider enhancing gratitude practice, focusing on the things that bring you more joy in your work, and/or reducing the things that result in less satisfaction.

Foster self-compassion

A greater sense of self-compassion is related to greater resiliency against others’ distress (Beaumont et al., 2016), demonstrated by neural activity observed in those who complete compassion training (Klimecki et al., 2012). Seemingly counterintuitive by name, increased self-compassion, such as practicing mindfulness and meeting your own needs, will build resiliency needed to care for others.

Set boundaries (especially from home)

Working from home in the era of COVID-19 brings on another challenge when work is helping in nature. Work-life imbalance contributes to burnout (Yester, 2019); however, mental health professionals working from home no longer have the walls of an office or other external workplace to set natural boundaries. Rather, the spaces associated with self-care, such as home, family, relaxation, etc., are now blurred with clinical work. Change your environment in ways you may have not considered before with sensory tools and exercise, or even consulting with an occupational therapist. Above all else, practice self-compassion.

Build and model practices for trainees

While a strong supervisory alliance is an important aspect of clinical training, the alliance alone does not appear to buffer against compassion fatigue (Can & Watson, 2019). Rather, clinical supervisors might encourage wellness and self-care practices for trainees as part of their training, integrating protective factors early in trainees’ clinical careers. Open discussions around risk factors and symptoms of compassion fatigue might foster preventative practices and awareness for trainees to incorporate into their professional careers.

References

Beaumont, E., Durkin, M., Martin, C. J. H., & Carson, J. (2016).
          Measuring relationships between self-compassion, compassion fatigue, burnout,
          and well-being in student counsellors and student cognitive behavioural psychotherapists:
          A quantitative survey.
          Counselling and Psychotherapy Research, 16(1), 15-23. 
          https://self-compassion.org/wp-content/uploads/2016/06/Beaumont_2015.pdf

Can, N., & Watson, J. C. (2019).
          Individual and relationship predictors of compassion fatigue among counselors-in-training.
          The Professional Counselor, 9(4), 285-297. https://tpcjournal.nbcc.org/wp-content/uploads/2019/11/Pages_285-297-Can-Individual_and_Relational_Predictors_of_Compassion_Fatigue_in_CITs.pdf

Duarte, J., & Pinto-Gouveia, J. (2017).
          The role of psychological factors in oncology nurses’ burnout and compassion fatigue symptoms.
          European Journal of Oncology Nursing, 28, 114-121. 
          https://doi.org/10.1016/j.ejon.2017.04.002

Fahy, A. (2007). The unbearable fatigue of compassion:
          Notes from a substance abuse counselor who dream of working at Starbucks.
          Clinical Social Work Journal, 35, 199-205.
          https://psycnet.apa.org/doi/10.1007/s10615-007-0094-4

Fontin, F. M. B., Pino, E. C., Hang, J., & Dugan, E. (2020)
          Compassion satisfaction and compassion fatigue among violence intervention caseworkers.
          Journal of Social Service Research.
          https://doi.org/10.1080/01488376.2020.1839628

Klimecki, O., Leiberg, S., Lamm, C., & Singer, T. (2012).
          Functional neural plasticity and associated changes in positive affect after compassion training.
          Cerebral Cortex, 23(7), 1552-1561.
          https://doi.org/10.1093/cercor/bhs142

Knight, C. (2011). Indirect trauma in the field practicum:
          Secondary traumatic stress, vicarious trauma, and compassion fatigue among social work
          students and their field instructors.
          Journal of Baccalaureate Social Work, 15(1), 31-52.
          https://doi.org/10.5555/basw.15.1.l568283x21397357

Rossi, A., Cetrano, G., Pertile, R., Rabbi, L., Donisi, V., Grigoletti, L., Curtelo, C., Tansella, M., Thornicraft, G., & Amaddeo, F.(2012).
          Burnout, compassion fatigue, and compassion satisfaction among staff in community-based
          mental health services.
          Psychiatry Research, 200(2-3), 933-938.
          https://doi.org/10.1016/j.psychres.2012.07.029

Yester, M. (2019). Work-life balance, burnout, and physician wellness.
          The Health Care Manager, 38(3), 239-246.
          https://doi.org/10.1097/hcm.0000000000000277


September 2020

How Institutional Racism Affects BIPOC Students in Higher Education: Graduate Students’ Perspectives

Preeti Pental, MA, & Hannah Smith, MA, OPA Public Education Committee

Since the resurgence of the Black Lives Matter movement in May 2020, many groups of Black, Indigenous, and People of Color (BIPOC) students and student allies have banded together through various platforms to create safe spaces for BIPOC voices to share their own stories of racial injustice within higher education. For example, many students have come together to write letters to their educational leaders regarding discrimination and harassment on campus across universities nationwide. Another notable example includes the Instagram account @blackatusd, which is an account created by students at the University of San Diego to allow their peers to share their experiences with microaggressions and inequality. The response to such efforts has been mixed and has demonstrated the need for an informed approach in response to the limited awareness of higher education systems. Some administrators come forward as a united front to take ownership of their culpability in the racist culture of their programs and others fail to respond, or worse, react by diverting the problem away from themselves.

The OPA Public Education Committee strives to educate the public about how the application of psychology can benefit society and improve lives. As student members of the committee who have both experienced such injustices and work with other students to fight against them, a few things come to mind that align with our mission of educating the public. First, we feel the words of the late John B. Lewis to be particularly pertinent at this time: “Never ever be afraid to make some noise and get in good trouble, necessary trouble.” Reading the stories of other students’ experiences from our university and universities across the country sparks an urgency to get in reasonable and necessary trouble. Second, the underwhelming documented responses nationwide by educators and administrators are troubling. We call upon our OPA community to start a discussion for actionable steps that higher education can implement to ensure the well-being and education of BIPOC students.

Campbell and Khin (2020) noted the importance of culturally grounded and trauma-informed care to BIPOC students. These practices build upon Bronfenbrenner’s Ecological System Model (1979). It is suggested that this model is imperative for clinical psychologists and members of higher education to facilitate culturally grounded care for BIPOC students. According to Campbell and Khin, culturally grounded practices promote healing within systems and in BIPOC students’ personal lives. These authors further urge readers to recognize that minority stress is unique, persistent, and socially-based. This recognition then further supports the need for universities and institutions to implement actionable steps to support BIPOC students.

Knowing that minority stress is unique, persistent, and socially-based is crucial for psychologists and educators to understand, as these are attributed to BIPOC students’ experiences of discrimination, systemic oppression, and institutional racism (Campbell & Khin, 2020). Having this awareness further supports the need for universities and institutions to implement actionable steps to support BIPOC students.

Some university-based advisory committees have created and documented steps to promote change on an institutional level; however, these proposed action plans allegedly take years to implement. This alone illustrates how institutional racism is deeply embedded in higher education and, moreover, that the need to implement more immediate and strategic change remains dire. If not, we risk contributing to further racial trauma as BIPOC students continue awaiting justice. Fish and Syed (2018) provided more immediate, actionable steps to assist in dismantling racist systems including correcting historical inaccuracies (e.g., Columbus Day) and removing inappropriate stereotypes (e.g., culturally appropriating mascots). We must remember that the time directed towards implementing change does not take away from the continued injustices that BIPOC students face until real justice ensues.

Thank you,

OPA Public Education Committee
Oregon Psychological Bulletin
@OPAPEC (Facebook)
@opapubliceducationcommittee (Instagram)

References

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Black @ USD [@blackatusd]. (n.d.). Posts [Instagram profile]. Retrieved August 13, 2020, from https://www.instagram.com/blackatusd.

Campbell, C., & Khin, P. P. (2020). Building resilience through culturally grounded practices in clinical psychology and higher education. 


Fish, J., & Syed, M. (2018). Native Americans in higher education: An ecological systems perspective. Journal of College Student Development, 59(4), 387-403. https://doi.org/10.1353/csd.2018.0038

Lewis, J. [@repjohnlewis]. (2018, June 27). Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of  [Tweet]. Twitter. https://twitter.com/repjohnlewis/status/1011991303599607808?lang=en