Planning for your psychology career:

Transcription

1 Planning for your psychology career: What tomorrow s psychology health service providers need to know today Daniel Michalski, MPA Tanya Mulvey, MAPP American Psychological Association Center for Workforce Studies August 13, 2010 American Psychological Association 2010 APA Center for Workforce Studies

2 For Further Information A PDF version of this presentation is available for download. American Psychological Association

3 CWS Mission Statement The APA Center for Workforce Studies collects, analyzes, and disseminates information relevant to psychology's workforce and education system. American Psychological Association

4 Definitions Health Service Provider (HSP): Doctorallevel degree in a psychology subfield focused on providing health/mental health services; typically a clinical, counseling, or school subfield. Note: This differs from the official APA definition. (See below). Recent Doctorate: Psychologist within 2 years of doctorate degree. Pursuant to the revised Recognition of Health Service Providers as passed by the APA Council of Representatives, Psychologists are recognized as Health Service Providers if they are duly trained and experienced in the delivery of preventive, assessment, diagnostic and therapeutic intervention services relative to the psychological and physical health of consumers based on: 1) having completed scientific and professional training resulting in a doctoral degree in psychology; 2) having completed an internship and supervised experience in health care settings; and 3) having been licensed as psychologists at the independent practice level (APA, 1996). American Psychological Association

5 Caveat In order to identify psychologists providing direct services in the United States, the 2008 APA Survey of Psychology Health Service Providers sampled doctoral-level APA members identified as trained in a Clinical, Counseling, or School subfield and eligible for licensure; and non-apa members holding a professional license in psychology from at least one state licensing board or agency. The study also included non-member psychologists. At this time, state licensing boards provide the most complete (comprehensive) option for identifying psychologists who are not members of APA. Yet, state licensing boards do not report information on the specific training settings (degrees or internships) for licensees nor does APA collect data on internship settings of its membership. While not all participants in this survey meet the formal APA definition of HSP, the sampling criteria provide a reasonable approximation and do capture a representative sample of all psychologists licensed to provide direct services. American Psychological Association

6 Overview Demographics and Education Employment Practice/Client Demographics Practice Demand: Client Needs/Issues Salaries Emerging Practice Issue: Telepsychology Trend: Collaboration American Psychological Association

7 Demographics and Education What does the current Health Service Provider (HSP) workforce look like? What will the future HSP workforce look like? American Psychological Association

8 Demographic Characteristics of Psychology Health Service Providers: 2008 % Female: 58 % Spanish/Hispanic/Latino: 4 % African American/Black: 3 % with a disability: 5 % Self Identified as LGBT: 7* Median Age: 55 % Licensed: 94 Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April *Only online survey participants were asked the sexual orientation item.

9 Demographic Characteristics of New Doctorate Psychology Health Service Providers: 2009 % Female: 75 % Spanish/Hispanic/Latino: 14 % African American/Black: 7 % Asian American: 8 % Self Identified as LGBT: 7 Median Age: 32 Source: 2009 APA Doctorate Employment Survey. Preliminary Data. Compiled by APA CWS, July 2010.

10 Highest Earned Degree for HSP Psychologists: 2008 PhD 79% EdD 3% PsyD 18% Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April 2010.

11 Highest Earned Degree: New Psychology Doctorates in HSP Subfields: 2009 PhD 71% PsyD 29% Source: 2009 APA Doctorate Employment Survey. Preliminary data. Compiled by APA CWS, July Notes. No EdDs were reported by 2009 survey participants; JD, MD, RhD, and Other degrees totaled less than 1% of responses. Selected HSP subfields included: Clinical, Child Clinical, Counseling, Family, School, and Sport.

12 Number of Clinical PhDs and PsyDs Awarded in Psychology: Number of Degrees PhD PsyD Source: Data on PsyDs are from Graduate Study in Psychology (APA). Data on PhDs are drawn from NSF/NIH/USED/NEH/USDA/NASA; 2007 Survey of Earned Doctorates. Compiled by APA Center for Workforce Studies, April Notes. Data on PsyDs represent an undercount as several departments did not report number of PsyDs awarded. Clinical refers specifically to those receiving doctorates in the Clinical subfield and does not include other HSP subfields.

13 Employment Characteristics The landscape for new doctorates--perceptions Attributes of the HSP employment landscape Where are they working (settings)? What are HSPs doing (activities)? Geographic distribution of licensed psychologists Is the present a prelude to emerging employment trends of the future? American Psychological Association

14 Recent Doctorates Perception of the Psychology Job Market: Percent Bleak Poor Fair Good Excellent Not Specified Rating Source: APA Doctorate Employment Survey, selected years. American Psychological Association, Center for Workforce Studies, June Note data are preliminary and from online survey participants only.

15 Perceived Underemployment of Recent Doctorate Recipients in Psychology by Subfield % Underemployed Year of Doctorate HSP Subfields Other Subfields * Source: APA Doctorate Employment Survey (selected years). Compiled by APA Center for Workforce Studies, April Note. *2009 data are preliminary and from online respondents only.

16 Time to Current Job: Recent Doctorates in Psychology Percent In job when began program Before completing program Within 3 months 4 6 months More than 6 months Not specified HSP (N=402) Not HSP (N=455) Source: 2007 Doctorate Employment Survey. Compiled by APA Center for Workforce Studies, February 2009.

17 Employment Characteristics of Psychology PhDs: 2006 Psychology PhDs 102,280 Employed 89.4% Not Employed 10.6% Retired 7.8% Full-time 68.8% Part-time 20.6% Unemployed, seeking employment 0.8% Unemployed, not seeking employment 2.0% Source: NSF/NIH 2006 Survey of Doctorate Recipients. Compiled by APA Center for Workforce Studies, April Notes. Postdoctorate information is not included in this chart, but is reported separately. This graphic represents HSP and non-hsp psychology PhDs. 17

18 Employment Characteristics of Psychology PsyDs: 2008 Psychology PsyDs Employed 97.2% Not Employed 2.8% Full-time 71.4% Postdoctoral Study 3.3% Part-time 18.7% Retired 1.2% Unemployed, seeking employment 0.7% Unemployed, not seeking employment 0.9% Source: 2008 APA Directory. Compiled by the APA Center for Workforce Studies, July Notes. *Approximately 4% of employed PsyDs have an unknown status; 1% of PsyDs employment characteristics are uncategorized above.

19 Employment Status of HSP Psychologists: 2008 Full Time 67% Other 3% Retired and Not Working 2% Not Working; Not Seeking 1% Not Working; Seeking Work 1% Postdoctoral Study 1% Part Time 25% Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April 2010.

20 Primary Employment Setting for HSP Psychologists: 2008 Educational Setting 19% Other 1% Independent Practice 45% Business and Governement 7% Other Organized Human Service Setting 11% Managed Care (HMO,PPO,IPA) 5% Hospital Settings 12% Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April Note. Educational setting category includes: University settings; Four-year colleges; Medical schools; Primary/Secondary schools/systems; and other academic settings (2-year colleges and Professional schools).

21 Primary Employment Setting for HSP Psychologists: 1998 Private Practice 54% Hospital Settings 11% Not Specified 1% Other 3% Educational Setting 13% Business and Governement 4% Other Organized Human Service Setting 8% Managed Care (HMO,PPO,IPA) 5% Source: 1998 APA Directory, APA Practice Organization (APAPO) Assessment payers. Compiled by APA CWS, July Note. Educational setting category includes: University settings; Four-year colleges; Medical schools; Primary/Secondary schools/systems; and other academic settings (2-year colleges and Professional schools).

22 Primary and Secondary Positions for Psychology Health Service Providers: 2008 Source: 2008 APA Survey of Psychology Health Service Providers. APA CWS, July 2010

23 Primary and Secondary Employment Settings for HSPs in Direct Human Service Positions Primary Position Secondary Position Private Practice Organized Human Service Business & Government Educational Institutions and School Systems Private Practice Organized Human Service Business & Government Educational Institutions and School Systems Source: 2008 APA Survey of Psychology Health Service Providers. APA CWS, July 2010

24 Proportional Distribution of Licensed Psychologists in the United States Top 10 States (as a proportion of all licensed psychologists): 1.) CA 17% 2.) NY 9% 3.) PA 5% 4.) TX 5% 5.) FL 5% 6.) MA 5% 7.) IL 4% 8.) OH 4% 9.) MN 3% 10.) MI 3% These 10 states account for 60% of the licenses for the professional practice of psychology in the United States; and 2 states, (CA and NY) account for more than one fourth of licenses. These 10 states represent 52% of the overall United States population. Source: 2008 APA Survey of Psychology Health Service Providers, Sampling Frame provided by Psychlist, Inc. (2008), and US Census Bureau (2000). Compiled by APA CWS, July Notes. Percentages calculated based on number of state licenses divided by total number of psychology licenses nationwide. Duplicate records for individuals holding multiple licenses were excluded from the analysis.

25 Trend Licensure at Receipt of the Doctoral Degree 2006 APA policy recommended eligibility to sit for licensure upon receipt of doctoral degree Since then 5 states have changed licensing laws (UT, WA, OH, MD, ND) Other states considering BUT Mobility Greater focus or scrutiny on what types of supervised experience can count

26 The Provision of Service Fields of current practice focus and theoretical orientations of HSPs Clients and populations served by HSPs Underserved populations: Opportunities American Psychological Association

27 Selected Fields of Current Practice Focus and Work for HSP Psychologists: Percent Behavioral Child Clinical Clinical Clinical Neuro Counseling Educational Family School Other Field Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April Notes. Totals sum to more than 100% as respondents could select multiple fields.

28 Current Primary Theoretical Orientation by Degree for Psychology Health Service Providers: 2008 Source: 2008 APA Survey of Psychology Health Service Providers. APA CWS, July 2010

29 Average Proportions of Time Spent Providing Psychological Health Services to Clients by Age Groups: 2008 Source: 2008 APA Survey of Psychology Health Service Providers, APA CWS, July, 2010.

30 Average Proportions of Time Spent Providing Psychological Health Services to Clients by Practice Populations: 2008 Source: 2008 APA Survey of Psychology Health Service Providers, APA CWS, July, 2010.

31 Average Proportions of Client Caseload Receiving Psychological Health Services by Race/Ethnicity: 2008 Source: 2008 APA Survey of Psychology Health Service Providers, APA CWS, July, 2010.

32 Median Number of Clients from Underserved Populations Treated in a Typical Month by Psychology Health Service Providers: 2008 Source: 2008 APA Survey of Psychology Health Service Providers, APA CWS, July, 2010.

33 Average Proportions of Caseload by Clinical Issue for Psychology Health Service Providers: 2008 Source: 2008 APA Survey of Psychology Health Service Providers, APA CWS, July, 2010.

34 Areas of Need/Opportunities for those in the Field Underserved populations Individuals in corrections Chronically mentally Ill (Axis I diagnosis) Veterans/military Youth/children Elderly/geriatric population Retiring/Aging baby boomer generations psychology Opportunities for prevention vs. intervention Health Care Reform medical teams Holistic care teams

35 Debt & Salaries Debt for doctoral recipients How much do recent doctorates make? How much do experienced HSP s make? Preparing for your financial future American Psychological Association

36 Median Debt Owed by New Doctorate Recipients in Health Service Provider Subfields by Degree: $120,000 $100,000 $80,000 $60,000 $40,000 $20, PhD PsyD Source: APA Doctorate Employment Survey, selected years. Compiled by APA Center for Workforce Studies, April Note. Bureau of Labor Statistics inflation calculations used to adjust debt amounts.

37 Loan Repayment/Forgiveness Programs National Health Service Corps U.S. Department of Veterans Affairs National Center on Minority Health and Health Disparities American Recovery and Reinvestment Act of 2009 National Institutes of Health Federal Student Loan Forgiveness Program Army Reserve Medical Corps

38 Starting Salaries for Full-time Employment Positions of Recent Doctorates in HSP Subfields of Psychology: 2007 Asst professor* (N=52) Research positions (N=15) Admin of research (N=5) Direct human svcs, clin (N=261) Admin of human svcs (N=18) Applied Psychology (N=39) Admin of Applied Psychology (N=5) $0 $10 $20 $30 $40 $50 $60 $70 $80 $90 Thousands of Dollars Source: 2007 Doctorate Employment Survey. Compiled by the APA Center for Workforce Studies, June Notes. Graph includes first quartile, median, and third quartile values. PsyDs included. *Faculty salaries are for all higher education, including undergraduate and community college. Salaries are reported for a 9-10-month academic year. To calculate month equivalent, multiply by 11/9.

39 Full-time Salaries of Doctoral-level HSP Psychologists by Employment Position: 2009 Full professor* (N=593) Associate professor* (N=438) Assistant professor* (N=304) Lecturer/Instructor* (N=27) Research Admin (N=45) Education Admin (N=137) Admin of Applied Psych (N=150) Research position (N=117) Applied psych./i-o (N=81) Admin of human svcs (N=621) Direct Human Services (N=3803) $0 $20 $40 $60 $80 $100 $120 $140 $160 $180 $200 $220 Thousands of Dollars Source: 2009 Salaries in Psychology Survey. Compiled by the APA Center for Workforce Studies, June Note. Graph includes first quartile, median, and third quartile values. Includes PsyDs. *Faculty salaries are reported for a 9-10-month academic year. To calculate month equivalent, multiply by 11/9.

40 Plan for Your Financial Future Research financial support options Debt includes tuition and living expenses Pay off interest on debt during school Debt repayment options Starting salaries vs Experienced Salaries Cost of living index Beware of credit card debt

41 Emerging Practice Issue: Telepsychology What is telepsychology? How common is telepsychology? What types of media are used and what services are provided? What are the benefits and concerns? American Psychological Association

42 Telepsychology Telepsychology refers to health services that are provided to patients/clients by a health professional in which parties are physically separated when the service is rendered. Various media are used to enable communication between the parties.

43 Use Telepsychology to Deliver Health Services: 2008 No 13% Yes 87% Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce Studies, October (N=1,216) Note: Telepsychology refers to health services provided to patients/clients by a health professional in which parties are physically separated when the service is rendered.

44 Telepsychology Use in Providing Direct Health Services, 2000 & % 80% 60% 40% 20% 0% Never < Monthly 1 3x Month Weekly or more **does not include cell phones. ***includes cell phones Sources: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce Studies, October APA Telehealth Survey, American Psychological Association, Center for Workforce Studies, February 2001.

45 Types of Services Provided Using Telepsychology: 2008 Scheduling appointments Communication between sessions Providing resources Referrals Consulting Psychotherapy Counseling Supervision Other Percent Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce Studies, October (N=1,053) 45

46 Benefits & Concerns Accessibility of health services Efficacy Laws and reimbursement Client confidentiality/privacy issues

47 Trend: Collaboration How often do HSP s collaborate? With whom do they collaborate? What types of activities are involved in collaboration? Why is it important to collaborate? American Psychological Association

48 Collaboration How regularly do you collaborate with other health care providers or other professionals? Percent Daily Once a week or more Two/three times a month Once a month Several times a year or less Source: 2008 APA Survey of Psychology Health Service Providers, Preliminary Results. Compiled by APA CWS, May 2010.

49 Collaboration with Other Professionals: 2008 Other psychologists Psychiatrists Primary care physicians Social workers Nurse practitioners Specialty care physicians Attorneys Clinical nurses Court system personnel Physicians assistants Percent Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce 49 Studies, October (N=1,237)

50 Collaboration with Other Professionals: 2008 Probation officers Registered dieticians Physical therapists EAP personnel Law enforcement personnel Alternative medicine practitioners Human resources Personal trainers Other Percent Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce 50 Studies, October (N=1,237)

51 Activities Involved in Collaboration with Other Professionals: 2008 Provision of psychological services Making referrals for psych services Health conditions Consulting on treatment approaches Treatment adherence Medication suggestions Screening for MH, pediatric issues, etc. Life style changes Provision of training Forensic assessment Other Percent Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce 51 Studies, July (N=1,230)

52 Need to Collaborate Integration with health care Medication Holistic care Comorbidity

53 Challenges & Opportunities Doctoral Internship Client Complexity Psychotropic Medication American Psychological Association

54 APPIC Match : Participants, Positions, & Matched Number 4,000 3,500 3,000 2,500 2,000 1,500 1, Source: Association of Psychology Postdoctoral and Internship Centers (APPIC), Match Statistics, various years. Compiled by the APA Center for Workforce Studies, February Participants Positions Matched

55 Client Complexity Since you began providing health care services, has your average client become more complex, less complex, or stayed the same? More Complex 53% Less Complex 6% Stayed Same 40% Source: 2008 APA Survey of Psychology Health Service Providers. Compiled by APA CWS, April 2010.

56 Client Caseload Currently on Psychotropic Medication: Percent % 1-20% 21-40% 41-60% 61-80% 81-99% 100% Caseload on Medication Source: 2008 APA Psychology Health Service Provider Survey, American Psychological Association, Center for Workforce Studies, October (N=1,155) 56

57 Conclusion Continual and ongoing increase in representation of women and ethnic minorities amongst health service providers and their clients. Changes in work settings: Growth in areas outside of independent practice. Technology Cross-and inter-disciplinary collaboration The workforce is dynamic! New challenges and new opportunities around every corner! American Psychological Association

58 Thank You! Daniel Michalski, MPA Tanya Mulvey, MAPP American Psychological Association Science Directorate Center for Workforce Studies American Psychological Association 2010 APA Center for Workforce Studies