Applying Task Force Recommendations on Integrating Science and Practice in Health Service Psychology Education

The proper role of research skills and training to conduct research in professional psychology education has been controversial throughout the history of the field. An extensive effort was undertaken recently to address that issue and identify ways the field might move forward in a more unified manner. In 2015, the American Psychological Association (APA) Board of Educational Affairs convened a task force to address one of the recommendations made by the Health Service Psychology Education Collaborative in 2013. That recommendation stated that the education and training of health service psychologists (HSPs) include an integrative approach to science and practice that incorporates scientific-mindedness, training in research skills, and goes well beyond merely “consuming” research findings. The task force subsequently developed recommendations related to the centrality of science competencies for HSPs and how these competencies extend beyond training in evidence-based practice. This article discusses the findings of the task force and the implications of its recommendations for education and training in HSP. The challenges and opportunities associated with implementing these recommendations in HSP graduate programs are examined

Ophthalmology

PURPOSE: To investigate systemic and ocular determinants of peripapillary retinal nerve fiber layer thickness (pRNFLT) in the European population. DESIGN: Cross-sectional meta-analysis. PARTICIPANTS: A total of 16 084 European adults from 8 cohort studies (mean age range, 56.9+/-12.3-82.1+/-4.2 years) of the European Eye Epidemiology (E3) consortium. METHODS: We examined associations with pRNFLT measured by spectral-domain OCT in each study using multivariable linear regression and pooled results using random effects meta-analysis. MAIN OUTCOME MEASURES: Determinants of pRNFLT. RESULTS: Mean pRNFLT ranged from 86.8+/-21.4 mum in the Rotterdam Study I to 104.7+/-12.5 mum in the Rotterdam Study III. We found the following factors to be associated with reduced pRNFLT: Older age (beta = -0.38 mum/year; 95% confidence interval [CI], -0.57 to -0.18), higher intraocular pressure (IOP) (beta = -0.36 mum/mmHg; 95% CI, -0.56 to -0.15), visual impairment (beta = -5.50 mum; 95% CI, -9.37 to -1.64), and history of systemic hypertension (beta = -0.54 mum; 95% CI, -1.01 to -0.07) and stroke (beta = -1.94 mum; 95% CI, -3.17 to -0.72). A suggestive, albeit nonsignificant, association was observed for dementia (beta = -3.11 mum; 95% CI, -6.22 to 0.01). Higher pRNFLT was associated with more hyperopic spherical equivalent (beta = 1.39 mum/diopter; 95% CI, 1.19-1.59) and smoking (beta = 1.53 mum; 95% CI, 1.00-2.06 for current smokers compared with never-smokers). CONCLUSIONS: In addition to previously described determinants such as age and refraction, we found that systemic vascular and neurovascular diseases were associated with reduced pRNFLT. These may be of clinical relevance, especially in glaucoma monitoring of patients with newly occurring vascular comorbidities

Prevalence of Age-Related Macular Degeneration in Europe: The Past and the Future

Purpose Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. Design Meta-analysis of prevalence data. Participants A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohorts from 10 countries in Europe. Methods AMD was diagnosed based on fundus photographs using the Rotterdam Classification. Prevalence of early and late AMD was calculated using random-effects meta-analysis stratified for age, birth cohort, gender, geographic region, and time period of the study. Best-corrected visual acuity (BCVA) was compared between late AMD subtypes; geographic atrophy (GA) and choroidal neovascularization (CNV). Main Outcome Measures Prevalence of early and late AMD, BCVA, and number of AMD cases. Results Prevalence of early AMD increased from 3.5% (95% confidence interval [CI] 2.1%–5.0%) in those aged 55–59 years to 17.6% (95%

Parental Self-Efficacy and Morbidity in Pediatric Asthma

This study investigated the relationship between parental self-efficacy and asthma-related morbidity. Participants included 139 parents of children (ages 5-8) who were diagnosed with asthma and were primarily from lower-income and minority backgrounds. Parents completed a 22-item measure of self-efficacy; factor analysis was conducted on this measure, yielding two factors: learned helplessness and self-efficacy. Correlational analyses indicated that higher scores on the learned helplessness factor were significantly related to increased asthma-related morbidity for the majority of morbidity variables. The self-efficacy factor was significantly related to days of school missed. Regression analyses conducted with the factor scores and the morbidity variables provide further support that the learned helplessness factor accounts for a significant amount of the variance in asthma morbidity for many of the variables studied, while the self-efficacy factor was related to only a few. Although improving health outcomes of children with asthma is a multifaceted process, the results of this study suggest that targeting parental self-efficacy, particularly with parents who are experiencing high levels of perceived learned helplessness, may be a helpful component of an intervention program with this population

Guidelines for Clinical Supervision in Health Service Psychology: Evidence and Implementation Strategies

With counseling psychology as perhaps a notable exception, health service psychology has been generally slow to recognize clinical supervision as a specific competence that requires formal preparation. Despite compelling evidence for substantial variability in the quality of supervision being provided our trainees and best practices, U.S. psychologists had no guidelines for offering competent supervision until 2014 when the American Psychological Association (APA) adopted “Guidelines for Clinical Supervision in Health Service Psychology” as policy. The guidelines are organized around seven domains with specific, evidence-supported competencies. But guidelines are useful to the extent that they are implemented. This article speaks to implementation of the guidelines and offers supervisors a guideline-based tool to self-assess their supervisory competence. The article’s intent is to enable supervisors to advance from self-assessment to reflection on their current level of competence in supervision to implementation of practices enhancing skills, knowledge, and attitudes

Professional psychology in health care services: A blueprint for education and training

In 2010, an interorganizational effort among the American Psychological Association, the Council of Graduate Departments of Psychology, and the Council of Chairs of Training Councils, known as the Health Service Psychology Education Collaborative (HSPEC), was initiated to address mounting concerns related to education and training for the professional practice of psychology. Given that professional psychology includes diverse areas of practice and the mounting concerns about psychology\u27s 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. These recommendations require significant changes in graduate education- changes critical to the future of psychology as a health profession. As part of its work, HSPEC developed a statement of core competencies for the preparation of health service psychologists, integrating feedback solicited through public comment and review by the psychology community, including education and training councils and APA governance groups. The articulation of these competencies serves to inform not only the preparation of health service psychologists but students, employers, regulators, and policymakers as well. It also reflects the discipline\u27s commitment to quality and accountability in the preparation of its workforce. HSPEC recognizes that its recommendations to strengthen the core preparation and identity of health service psychologists will result in some limitations on degrees of freedom at the program level but believes such limitation to be in the service of coherent and uniform standards for education and training. This blueprint supports the evolution and development of the profession within a scientific context. It supports standards as meaningful, versus minimum, indicators as part of the profession\u27s obligation to the public. The blueprint also calls for the profession to develop a mechanism for systematic monitoring of progress, challenges, and opportunities to ensure that psychology as a health profession meets societal needs. © 2013 American Psychological Association