practicenet 911 survey
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The Impact of the September 11 Terrorist Attacks on Psychologists
and Their Clients
The Impact of the September 11 Terrorist Attacks on Psychologists
and Their Clients
Suggested CitationSuggested Citation
American Psychological Association Practice Directorate (2002). The Impact of the September 11 Terrorist Attacks on Practitioners and Their Clients. Unpublished results of the PracticeNet 9/11 survey, October 8-15, 2001, Washington, DC.
AcknowledgementsAcknowledgements
PracticeNet's initial development has been underwritten by the federal Center for Substance Abuse Treatment (CSAT) as part of the agency’s effort to learn more about the ways in which psychologists are encountering and treating problems related to substance use.
What is PracticeNet?What is PracticeNet?
PracticeNet is a “Practitioner Research Network” of professional psychologists within the APA membership All APA members who provide direct health services to clients
at least 5 hours per week are encouraged to enroll
Practice Directorate hopes to enroll several thousand psychologists from diverse areas of practice serving a wide range of populations
Uses a proprietary Internet-based data collection system
What is PracticeNet?What is PracticeNet?
Captures specific moment, or snapshots, of practitioner activity
Over time, snapshots combine to provide a detailed and accurate picture of practice
Brief & “Real-Time” Data Collection Episodes
Data collection tied to recent, specific episodes of care
Data collected at regular, randomly determined times
Objective reporting about a recent event
No "mental averaging”
Observation of many points in time
Significant data analysis opportunities
GoalsGoals
To give members up-to-the-minute information about psychological practice
To serve as a useful practice improvement tool
To inform Practice Directorate initiatives by reversing APA-member flow of information
To influence and provide data base for advocacy efforts on behalf of psychology
Change how government agencies and health care decision makers think about Practice data
Early QuestionsEarly Questions
How are psychologists using their time?
How are health plans’ utilization management practices affecting the provision of care?
What kinds of problems are psychologists seeing more and less often?
What services are psychologists providing?
How have recent events such as natural disasters or a school shooting affected psychology practices?
How Do I Sign Up?How Do I Sign Up?
Complete enrollment on-line:
www.apapracticenet.net
Click “Enroll Now”
PracticeNet 9/11 SurveyPracticeNet 9/11 Survey
Administered October 8-12, 2001
643 email invitations sent to PracticeNet members
Total responses N = 407
Providing direct clinical services within 72 hours of selected date n = 341 (84%)
NY/DC/SW PA n = 126 (31%) Non NY/DC/ SW PA n = 281 (69%)
Client DemographicsClient Demographics
46% Male; 54% Female
Average age 37 (range 5 - 98)
Ethnicity 6% Hispanic or Latino
86% White
8% Black or African American
Education 20% some college
20% college degree
16% graduate degree
16% less than high school
13% high school graduate/GED
Client DemographicsClient Demographics
Employment 39% employed full-time 47% not working
36% students 25% disabled 11% retired
Living arrangements (not mutually exclusive) 33% with a legal spouse 24% with parent(s) 21% with children 20% alone
Clinical Services and SettingsClinical Services and Settings
Individual therapy or counseling 83% Formal assessment or evaluation 19% Providing educational information and/or materials 14%
Independent/private practice - solo 48% Independent/private practice - group 28% Organizational health care setting 18%
44% Mental health services setting 13% Primary health care setting
ResultsResults
During the specified clinical encounter, did this client:
Yes
Bring up the terrorist attacks of September 11? 49.3%
NY/DC/PA 53.3%
Non-NY/DC/PA 47.5%
Bring up any subsequent related events, actual
or feared (e.g. preparations for war, military
build-up and mobilization)? 39.3%
NY/DC/PA 44.8%
Non-NY/DC/PA 36.9%
ResultsResults
During the specified clinical encounter, did this client:
Yes Bring up specific traumatic or anxiety reactions to
environmental stimuli associated with the event? 21.7%
NY/DC/PA 30.5%
Non-NY/DC/PA 17.8%
Discuss a prior traumatic event, memories of which
were triggered or intensified by the events of 9/11
or related subsequent events? 22.6%
NY/DC/PA 24.8%
Non-NY/DC/PA 21.6%
ResultsResults
During the specified clinical encounter, proportion of time spent discussing the terrorist attacks of 9/11, subsequent related events (actual or feared), traumatic or anxiety reactions to associated stimuli, and/or memories of prior traumatic events triggered by the attacks and their aftermath:
0
10
20
30
40
50
None of thetime
Small amount(< 25%)
Moderateamount (26 -
50%)
Large amount(51-75%)
>75% of thetime
Total
NY/DC/PA
NonNY/DC/PA
ResultsResults
Implications of the Events of 9/11 Discussed in Terms of Client’s Identity, Priority, World View and Spiritual Outlook
0
10
20
30
40
% Yes
Identity Priorities Worldview
Spiritualoutlook
Total
NY/DC/PA
Non N/DC/PA
ResultsResults
21.9
23.8
28.6 13.1
30.9
0 10 20 30 40 50 60
Attacks w itnessed f irsthand
Attacks experienced fisthand by loved one(s)
Loved one(s) killed in attack
Loved one(s) injured in attack
Attack sequealae w itnessed firsthand
Witnessed LIVE coverage of attacks
Period of Uncertainty about saftey of love one(s)
Air Travel on 9/11
% NY/DC/PA
Non-NY/DC/PA
Client Proximity to Attacks According to Practitioner Location
ResultsResults
11
11
13.8
29
10.6
15.8
2
0 5 10 15 20 25 30 35
Tearfulness
Irritability
Sleep disturbance
Fear, anxiety or uncertainty about the future
Hypervigilance
Generalized fear
Use of Alcohol or Drugs
%
Client Symptoms that First Appeared or Worsened since September 11
ResultsResults
Practitioner Proximity to Attacks
39.7
52.4
54
62.7
16
53
54.8
0 20 40 60 80 100 120
Attacks w itnessed f irsthand
Attacks experienced f isthand by loved one(s)
Loved one(s) killed in attack
Loved one(s) injured in attack
Attack sequealae w itnessed f irsthand
Witnessed LIVE coverage of attacks
Period of Uncertainty about saftey of love one(s)
Air Travel on 9/11
% NY/DC/PA
Non-NY/DC/PA
ResultsResults
Cumulative Effect of Client’s Discussion of Events on Practitioner
0
5
10
15
20
25
30
35
%
Not at all A little bit Somewhat Quite a bit A great deal
NY/DC/PA
Non NY/DC/PA
ResultsResults
Practitioners’ Strategies for Dealing with Their Own Reactions
11.8
48.2
48.6
65.4
68.6
71.3
92.9
0 10 20 30 40 50 60 70 80 90 100
Personal therapy
Spiritual and/or religious involvement
Volunteering professional services
Taking time for yourself
Balancing activities, e.g., hobbies, exercise
Consultation with colleagues or supervisors
Contact or communication with friends and/or family
%
SummarySummary
Randomly selected sample of clients engaged in sessions with practitioners exhibited an increase in the following symptoms: generalized fear, hypervigilance and fear or uncertainty about the future
Regardless of geographical location, clients’ world view was challenged by 9/11 events
Those in the metro NY/DC area were more likely to discuss the events in personal terms, such as in terms of their priorities, spiritual outlook, or identity
SummarySummary
Impact of these events on practitioners, as assessed by immediacy of exposure, was greater than that of their clients, regardless of the geographical area in which they were practicing
Psychologists reported being significantly affected by their own personal responses, as well as cumulatively affected by the responses of their clients/patients
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