Category Archives: Advocacy

My Journey through Outrage

Jennifer M. Doran, M.A.

Like so many of you, my reactions to the Hoffman Report ranged from shock, to disgust, to outrage. I couldn’t wrap my head around the report and its findings – that some senior leaders at APA colluded with the Department of Defense in order to allow psychologists’ involvement in settings where detainees were being tortured. As someone who has spent the past 5 years involved in the leadership of APA, I questioned my own judgment, sense of respect for the organization, and passion for engaging in its work. My outrage gave way to embarrassment and sadness. What I previously viewed as a professional achievement now felt like something to hide and run away from.

To make matters worse, the formal responses by APA felt hollow and woefully insufficient. I didn’t see my outrage reflected by the organization, and felt anger in response to what appeared to be “managed” communications. Such was my mindset as I traveled to the 2015 Annual Convention – with a heavy heart, and a suitcase full of disappointment.

But then I arrived. I sat in APA’s Council meeting among many colleagues and friends. And what I saw surprised me. Despite the stress and horror of everything that had transpired, I witnessed the most civil and respectful Council meeting that I had seen over the past three years. I heard passionate pleas for action, personal stories and perspectives on the underlying thread of racism in what had transpired, a range of emotions, and a general will to do good and correct the course of APA. When resolution NBI 23B passed (instituting a policy that clarifies the definition of torture and preventing psychologists from participating in interrogations where detainees are not afforded Constitutional protections), via a verbal roll call, I watched the room erupt in excitement. In a flurry of emotion hugs, cheers, and tears followed. This moved me.

Throughout the convention I witnessed a similar constructive and emotional tone. I heard graduate students share and process their reactions in the APAGS town hall, and the views of the larger membership in the general APA town hall. I watched leaders reflect, listen, feel, and (most importantly) truly show remorse and apologize. Through these events, I felt inspired by the genuine desire to take strong action, correct the problems in APA, and address the horrific transgressions that were perpetrated.

I am still outraged. But that outrage is now blended with small glimmers of hope. I believe that there is much work to be done. “Fixing” what transpired goes far beyond the torture issue alone; rather, such a task necessitates addressing larger cultural problems deeply embedded in the organization. Issues of transparency, collaboration, power and privilege, checks and balances, and the disconnect from the voices of the membership must be addressed. This is no small feat.

But I can see a better APA. An APA that is truly a members-first organization; an APA that prioritizes its values and human rights above other interests, such as prestige and profit; an APA that strives to be a force of good in the world above all else.

And building that APA will take time. It will take strong, dedicated, impassioned leaders to help steer the ship back on course, to rebuild the foundation that has fallen. When I first read the report, I (like many) considered leaving APA. Did I really want to be part of an organization where such things occurred? No, I could not stay.

But then I realized that I had to. Change can only be made by those who are outraged, by those who wish for change to occur. If you choose to leave the table (via your membership or your activity in leadership), you give something up – your voice, which is worth holding on to. For if the most outraged among us – if those who truly value social justice and human rights – choose to leave, change will not occur. We need to stay, and stay loudly.

APA needs the perspectives of graduate students and ECPs to help shape what it will become. It is our future at stake, and our voices must be part of the dialogue. Our outrage can be productive, particularly when combined with passion, hope, and a vision that we can heal. This is why I am choosing to remain a part of the organization. For only with our collective voices can we advocate for a better future – for APA – and, more importantly, for psychology.

To keep up to date on the Independent Review and the actions of APA and APAGS, see: http://www.gradpsychblog.org/ir/#.VdPlFrGFNZQ.

 

The Gift of They!

As a second-year practicum student in clinical psychology in San Francisco, California, I was honored to encounter people from diverse backgrounds. The location greatly enriched my experiences in multicultural counseling—but it only went so far. I very quickly became aware of the lack of onsite training and the failure of the English language in providing appropriate services to the transgender population in our clinic.

One particular incident with a client opened my eyes to the bias that not only exists in popular culture but also in the therapeutic world. During my last two months at the practicum, I received a referral for psychological assessment from a therapist who was working with a person who identified as genderqueer.

In our first session, the client told me that they prefer the neutral gender pronoun. The client told me that they don’t like to be referred to as “he” or ”she.” After our initial interview, I went to see my supervisor to ask her for guidance regarding creating a proper battery of assessments and writing a report with gender-neutral pronouns. My supervisor looked at me with surprise and told me she needed to consult with her mentor.

I was surprised that this lack of clear guidelines related to language had not come up before in her experience with clients. I consulted further by talking with an assessment professor who informed me that she, too, had never experienced a client who preferred gender neutral pronouns. This made me feel lost and in a very ambiguous, uncomfortable situation.

I deeply believe that clients are the masters of their experience. I realized that the field of psychology has largely ignored the needs of gender-variant and gender-nonconforming clients, and that, like homosexuality, the biases that exist in pop culture dominate our clinical work.

“The biases that exist in pop culture dominate our clinical work.”

With the help of my clinical supervisor and with my client’s generous offer to connect me with available resources on gender nonconformity, I was able to write my first psychological assessment, fully using the they, them, their pronouns as a singular neutral pronoun.

During my last session with the client, I gave the client their report. As part of my training in therapeutic assessment, I wrote the report using a format that non-clinicians and clinicians could understand. I saw tears on the face of the client as they read the report. They told me that it was the first time they had felt understood and respected regarding their gender identity by a clinician.

To this date, I remain very grateful for the client’s kind words, and for the wonderful insight I was given into the power of language, through the gift of they.

Editor’s Note: Khashayar Farhadi-Langroudi is a student at the American School of Professional Psychology at Argosy University – San Francisco Bay Area. Khashayar is also a member of the APAGS Committee on Sexual Orientation and Gender Diversity.         

Hoffman Report: Two More Resources and a Request

Since our latest posts on APA’s Independent Review (better known as the Hoffman Report), here is where we’ve been focusing our energies:

1. APAGS created a dedicated page (gradpsychblog.org/ir) where we’ve attempted to compile requests from students who came forward with specific concerns and questions. The list will be frequently updated, and we hope you find it useful.

2. APAGS members have assembled a student-focused town hall at APA’s Convention this coming week in Toronto. On Friday 8/7 from 2 to 2:50pm, come to room 707 in the Convention Centre to share your concerns, discuss potential solutions, and hear from your peers. The dialogue will intentionally be structured in a safe and constructive way.

Click to access Student-Town-Hall-One-Pager.pdf

3. Finally, we are asking all students to fill out a feedback survey from APAGS Chair Emily Voelkel. The survey will be open for a week following Convention. YOUR feedback will help guide the ways that APAGS leaders advocate to APA’s Board of Directors and membership council, and it will inform how APAGS sets its own course as a committee and constituency. A summary of results will be posted on this blog. The following word cloud shows common reactions to the findings of the Hoffman Report, as reported by the first three hundred responders.

wordle 3

Thank you for being a part of APAGS during this difficult time. Please keep bringing your opinions to the forefront.

Meet Your APAGS Leaders!

Getting involved in APAGS governance is a great way to hone your leadership skills, network with other leaders in the field, and learn about and advocate for important issues affecting the field of psychology. Staff here at gradPSYCH Blog want all members to meet their appointed and elected leaders in our new series—Meet Your APAGS Leaders!

Our first introduction is Emily Voelkel, the current Chair of APAGS.

Tell us about yourself. committee-bio-voelkel_tcm7-158532

I grew up in a small town near Cincinnati, Ohio. I’m the oldest of three girls, and family has always been very important to me. Growing up, I always felt a strong desire to see the world. So, when I graduated high school I went to Chicago to attend Loyola University. Chicago is a wonderful, vibrant place, and I just loved my time there. I was especially appreciative of the opportunity to study abroad in Rome and travel some of Europe! I can’t wait to go back again. After college I actually joined Teach For America and spent two years teaching 6th grade in Houston before deciding to go to graduate school. It was a life-changing experience that changed my view of our education system and my role in social justice in our country. Currently, I am near the end (finally!) of my training and completing a clinical PTSD fellowship at the Boston VA. I’m married to theHadley Texan I met in Houston, Kolby, and we have an adorable 3 year old pup named Hadley. In my free time (yes, you do get some free time later in training) I love to walk with Hadley, cook, garden, and binge watch TV shows. I love food and traveling and am greatly looking forward to the days Kolby and I can experience more of the world together.

How did you get involved with APAGS?

I first got involved with APAGS very early in my doctoral career. I was at the 2011 National Multicultural Conference and Summit in Seattle when I saw the APAGS booth. I stopped by and talked to the person working there. I realized my program did not have a Campus Representative (CR) for advocacy, and I really wanted to bring that role to the University of Houston (UH). So, I sent in the materials and became the first UH Counseling Psychology department CR! I really loved being a part of the APAGS Advocacy Coordinating Team (ACT) and was thrilled to be discussing key psychology advocacy issues with my peers. During my year as CR, I was promoted to Texas State Advocacy Coordinator (SAC). I was honored to be asked to attend the APA State Leadership Conference in D.C. during that time and attend the APAGS-ACT business meeting. From that point on I was definitely hooked on APAGS! I wanted to be involved with this inspiring group of leaders and work toward solving important student issues as much as possible. Eventually, I ran for Chair-Elect, won, and here I am today!

What has been the most memorable pop culture moment of your lifetime?

Awesome question! I’m sure many people will have poignant or funny responses to this. I can’t wait to read them. But, honestly, I am not that into pop culture, fame, or celebrities. The things that stand out to me the most over even the last few years are how many talented people have lost their lives…Michael Jackson, Whitney Houston, Robin Williams, Heath Ledger, only to name a few. Mental health concerns have, in my opinion, influenced the loss of many of these lives that were iconic in pop culture and the arts.

What was your last Facebook post or Tweet?

My most recent Facebook post was in response to the heartbreaking events in Baltimore recently. I recommended a good piece on White Fragility by goodmenproject.com:

“One of the experiences I am most grateful for from my doctoral education was having courses that allowed me to explore my Whiteness. Discuss what it means to be White in our society and the ways in which I have benefitted from a societal system that continues to perpetuate and thrive on racism in many ways. What is happening in Baltimore is only one of many examples of the consequences of continuing to be unwilling to discuss and take responsibility for this system and make efforts toward change. My heart goes out to everyone involved. For those interested in a great article that explains why it is so difficult for many White people to talk about racism, I recommend this piece.”

If your life was a book, what would the title be?

Finding Peace Amidst the Chaos

What advice do you have for future leaders in the field of psychology?

I think the best advice I can give to psychology’s future leaders is to be innovative and forward-thinking. Psychology as our advisors knew it and as we know it is changing. If we are going to be true leaders in psychology, we need to start to look forward to what psychology could be and how it will fit into the changing healthcare, research, university, and other systems. If we continue to define psychology by current parameters, I worry we will spend much more time defending “our turf” and less time defining what a new psychology can and should be.

 

Talking to Clients about Their Sexual Histories and HIV Testing

Talking to Clients about Their Sexual Histories and HIV Testing

By David Martin, PhD, ABPP (Senior Director, APA Office on AIDS)

Talking to Clients about Their Sexual Histories and HIV Testing

It is important to talk with your clients about their sexual histories and about the importance of HIV testing. (Source: The Stigma Project on Flickr. Some rights reserved.)

June 27 is National HIV Testing Day.  Of the estimated 1.2 million people living with HIV in the United States, approximately 20% don’t even know they have HIV. The U.S. Preventive Services Task Force (USPSTF) recommends that everyone ages 15-65 be tested for HIV at least once as part of routine medical care.

Who else should get tested?

  • People who have vaginal or anal sex without using a condom or taking Truvada® (a medication that can prevent HIV infection if taken as prescribed) every day.
  • People who inject drugs and who share injection drug equipment.
  • Even people taking precautions while engaging in these behaviors should be tested periodically.

Aside from considering getting tested yourself, if you are a clinical, counseling, or school psychology student, you should seek ways of integrating information about HIV testing while assessing your clients.

Here’s why:

  • Many psychology practicum and internship sites are located in health facilities where the clients are poor and underserved.
  • Among people diagnosed with HIV, incidence is highest in regions where unemployment and poverty are most prevalent and educational levels are lowest.
  • Lack of socioeconomic resources and unstable housing are linked to riskier health behaviors (e.g., earlier initiation of sexual activity, less frequent condom use), which can lead to contracting HIV.
  • Ethnic minorities, notably African Americans and Latinos, are at disproportionate risk for HIV.

Here are 5 things you can do to address HIV testing with your clients:

1. Talk to your clients about HIV/AIDS.

When seeing a patient for the first time, or during initial assessment, a portion of the evaluation should always entail a health screening anyway. Integration of HIV-risk questions is not hard:  “Do you have a regular doctor? … Have you ever been tested to see if you have diabetes? … high blood pressure?  … problems with your thyroid?  … problems with your liver?  … been tested for HIV?”  Treating HIV as just another health issue to which the client should attend should help reduce any feelings of HIV-related stigma.  There are a number of medical history outlines available; here’s one (PDF).

2. Ask about their sexual history. 

I learned to take sexual histories on all my patients when I was in training.  Asking about different specific sexual activities (anal, oral, vaginal sex, insertive or receptive) as a routine part of the interview is critical in assessing risk for HIV and other sexually-transmitted diseases. You probably don’t want to start with these questions. The CDC’s Taking Routine Histories of Sexual Health:  A System-Wide Approach for Health Centers (PDF) outlines how to lead up to questions this specific. If you’re uncomfortable (and most people are at first), practice with fellow students or friends—and learn to use language that is familiar to and comfortable for your clients. This would not be the time to stutter in the interview—it would signal your discomfort to your client and make him/her more anxious.

3. Don’t leave out substance use.

It’s important to assess your client’s history of substance use because injection drug use is linked directly to HIV transmission and because alcohol and drug use are associated with increased sexual risk.  Use non-judgmental approaches when asking questions about drug/alcohol use.  One of my former patients admitted to injecting heroin after six months of being clean.  Instead of lecturing him on the dangers of injecting drugs (which he already understood) I put on my empathy hat and asked what had happened.  It was a great opening to talk about the various stressors in his life (which were numerous and profound)—we treated his heroin relapse like difficulty quitting smoking.  The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a useful list of substance-abuse screening instruments.

4. Talk to your supervisor.

Different supervisors may have different approaches to discussing these issues.  Psychodynamically-oriented supervisors may want to emphasize feelings about being tested, whereas supervisors from CBT backgrounds may focus on skills and specific behaviors leading to testing.  Both approaches are important, and in approaching this topic with clients, the therapeutic relationship is always crucial.

5. Use the tools you have available.

There are several resources to help your clients determine their risk for HIV, including:

If your client tests positive, there are resources available, including informational websites and magazines specifically for people with HIV/AIDS like HIV Plus, Positively Aware, and POZ.

If you would like to know more about HIV and how APA is responding, I invite you to visit our webpage.