Psychologist

Description of Specialty

Practicing psychologists are broadly trained mental health professionals who provide a variety of services including psychological and cognitive assessment, psychotherapy, consultation, education and program evaluation. Services are provided to individuals, couples, families, groups, and organizations. Other work activities include practice management, clinical supervision, education and training, and management/administration.

Psychologists help people learn to cope with stressful situations, overcome addictions, manage their chronic illnesses and break past the barriers that keep them from reaching their goals. Practicing psychologists are also trained to administer and interpret a number of tests and assessments that can help diagnose a condition or tell more about the way a person thinks, feels, and behaves. These tests may evaluate intellectual skills, cognitive strengths and weaknesses, vocational aptitude and preference, personality characteristics and neuropsychological functioning.

Educational Requirements

A doctoral degree is considered the entry-level degree for the independent, licensed practice of psychology. On average, it takes 5-6 years to earn a doctoral degree. Typically, this involves at least four years of study at the academic program including the completion of a dissertation or scholarly research paper and the completion of a year-long (or equivalent) supervised clinical internship. Additional supervised experience, obtained after completion of the doctoral degree, is required for licensure in a majority of states. Psychologists generally receive one of the highest levels of education of all health care professionals, spending at least seven years in education and training after they receive their undergraduate degrees in order to be licensed.

Licensing Requirements

Requirements for licensure vary by State. Most states require a doctoral degree in psychology, one year of supervised postdoctoral clinical practice and passing scores on a test of State regulations related to the specialty.

Specialty Credentials Related to Geriatrics

Professional Geropsychology is a specialty in professional psychology that applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems and achieve maximum potential during later life. Professional geropsychology appreciates the wide diversity among older adults, the complex ethical issues that can arise in geriatric practice and the importance of interdisciplinary models of care. Professional geropsychology is recognized by the American Psychological Association as a specialty area of practice and, as such, has defined criteria for areas of expertise, levels of training and supervised experience, available at http://www.apa.org/ed/graduate/specialize/gero.aspx. Geropsychologists may also be board certified by the American Board of Professional Psychology (ABPP).

Scope of Services in Long Term Care Settings

  1. System Integration: Psychologists are well equipped to engage in the complex work of consultation directed at systems change. Psychologists bring expertise in research methods, program development and evaluation, outcome measurement and group facilitation that can promote the integration of new, non-pharmacological interventions into the day to day care of residents. The combined skill sets of advanced communication skills, group facilitation expertise and data management directed at measuring outcomes equips psychologists to serve as effective system change leaders to support ‘culture change’ and quality improvement initiatives.

  2. Education/Leadership: Psychologists can help nursing home staff to develop the knowledge and skills to implement evidence-based non-pharmacological approaches to care for the unique needs of each resident. Their advanced training in communication, interpersonal interactions, and environmental and systemic influences on behavior prepare psychologists to (1) provide evidence-based staff training tailored to the skills, abilities and interests of the audience and (2) consult with facility leadership to develop new models of practice, team building, and staff training.

  3. Assessment: Psychologists are experts in assessment. Trained in the assessment of personality, psychopathology, cognition and behavior, psychologists bring a variety of tools and expertise to the process of assessing the behavioral and psychological symptoms of dementia. They can help facilities to choose reliable and valid measures to guide treatment planning and outcomes. Likewise, psychologists can provide training and technical assistance to nursing home staff to utilize systematic processes for documenting behavioral observations and activators of behavioral expressions.

  4. Clinical Decision Making: By virtue of their familiarity with theory and evidence based practices in the management of behavioral and psychological symptoms of dementia (BPSD), psychologists are positioned to provide leadership in clinical decision making and interdisciplinary care planning related to dementia and BPSD. Psychologists can play a critical role in helping staff to learn and utilize a systematic approach for evaluating and responding to BPSD, and helping the team to communicate effectively in sharing perspectives on patient-centered care strategies. In particular, psychologists are equipped to provide leadership within care planning teams, serving as facilitators, fostering team development and enhanced communication and providing clinical insight and guidance on strategies for addressing psychological needs and implementing behavioral supports for residents.

  5. Non-pharmacological approaches: Evidence based non-pharmacological practices for addressing BPSD are grounded in psychological theory and research. Indeed most of the well-known approaches for reducing BPSD have been developed by psychologists. Person-centered care and engagement in meaningful activities are the foundation for reducing anti-psychotic medications. Psychologists are well-versed in behavioral principles that underlie non-pharmacological approaches for understanding and responding effectively to residents with dementia. Moreover, due to extensive training in research method and design, psychologists can support the facility in reviewing and developing evidence based programs to manage BPSD and can assist in developing processes for evaluating the effectiveness of these programs. In sum, psychologists are able to provide leadership, consultation and training to other professionals in this area.

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