Professionalism in Psychology

Charles DeLeeuw, PhDPsychology Resident, 2011-2012Allison Aosved, PhD Director, Psychology TrainingVA Pacific Islands Health Care System

Objectives

•Develop a working definition of professionalism in psychology

•Identify at least five key areas in professionalism in psychology

•Increase personal awareness of strengths and weaknesses related to professionalism in psychology

Defining ProfessionalismObjective 1

Why is professionalism important?

Why is professionalism important? •Credibility

▫Public▫Professional communities▫Psychology

•Halo Effect•Reliable•Effective•Enhance quality of service

Why do we struggle?

•What gets in the way of professionalism?

Why do we struggle?

•Lack of awareness▫Attitude▫Ego▫Fear▫Seniority▫Confusion▫Poor impulse control

•Transition points •Lack of effort/commitment

Definition of professionalism

•How do you define it?

Definition of professionalism

•“Professional values and ethics as evidenced in behavior and comportment that reflects the values and ethics of psychology, integrity, and responsibility.” (Fouad et al., 2009).

Notice your reactions…

•Even if you do not say your initial reactions… notice where your mind goes and pay attention to your internal dialogue

•Understand how you can improve your sense of professionalism and training this year

Rules or Context?

•You may have learned about professionalism as a set of rules

•You may have learned that professionalism is contingent on contextual factors

•Appropriate professional behavior is ▫Attuned to client needs▫Context contingent▫Flexible

Key DomainsObjective 2

Integrity• Honesty, personal responsibility and adherence to

professional values

• Practicum Behavioral Anchors: ▫Understands professional values; honest,

responsible▫Demonstrates honesty, even in difficult situations▫Takes responsibility for own actions ▫Displays basic understanding of core professional

values ▫Demonstrates ethical behavior & basic knowledge

of APA Ethical Principles & Code of Conduct

Integrity • Honesty, personal responsibility and adherence to

professional values

• Internship Behavioral Anchors:▫Adherence to professional values & infuses values

into work as psychologist-in-training▫Demonstrates knowledge of professional values▫Demonstrates adherence to professional values ▫ Identifies situations that challenge professional values,

and seeks faculty/supervisor guidance as needed.▫Demonstrates ability to share, discuss and address

failures and lapses in adherence to professional values with supervisors/faculty as appropriate

Integrity

•Honesty, personal responsibility and adherence to professional values

•Professional Practice Behavioral Anchors:

▫Monitors and independently resolves situations that challenge professional values and integrity

▫Articulates professional values▫Takes independent action to correct situations

that are in conflict with professional values

Vignettes • You are asked to provide feedback to a

supervisor who has not shown for supervision 3 times in the past quarter. Historically, the supervisor has become defensive and angry when given minor feedback. What do you do? Why?

• You are supervising a practicum student who repeatedly makes the same mistakes in his/her documentation, after constructive feedback. His/her evaluation is due to the grad program’s practicum coordinator. What do you do? Why?

Objective 3Where are you with regard to integrity?

Deportment

•Personal Conduct

•Practicum Behavioral Anchor: ▫Understands how to conduct oneself in a professional manner

▫Demonstrates appropriate personal hygiene and attire

▫Distinguishes between appropriate and inappropriate language and demeanor in professional contexts

Deportment • Personal Conduct

• Internship Behavioral Anchors:▫Communication and physical conduct

(including attire) is professionally appropriate, across different settings

▫Demonstrates awareness of the impact behavior has on client, public and profession

▫Utilizes appropriate language and demeanor in professional communications

▫Demonstrates appropriate physical conduct, including attire, consistent with context

Deportment

•Personal Conduct •Professional Practice Behavioral Anchors:

▫Conducts self in a professional manner across settings and situations

▫Verbal and nonverbal communications are appropriate to the professional context including in challenging interactions

▫Consistently conducts self in a professional manner across and settings and situations

Vignettes

•Your male peer comes in on Friday morning. He looks tired, unkempt (has not trimmed his beard or cut his hair), and looks possibly hung over. What do you do? Why?

•You overheard some veterans discussing the new female intern and her cleavage. What do you do? Why?

Objective 3

Where are you with regard to deportment? Reactions to directed readings?

Accountability •Accountable and Reliable

•Practicum Behavioral Anchors: ▫Accountable and reliable ▫Turns in assignments in accordance with

established deadlines ▫Demonstrates personal organization skills ▫Plans and organizes own workload ▫Aware of and follows policies and

procedures of institution

Accountability • Accountable and Reliable

• Internship Behavioral Anchor:▫Consistently reliable; consistently accepts

responsibility for own actions ▫Completes required case documentation promptly

and accurately▫Accepts responsibility for meeting deadlines▫Available when “on-call”▫Acknowledges errors▫Utilizes supervision to strengthen effectiveness of

practice

Accountability

•Accountable and Reliable •Professional Practice Behavioral Anchor:

▫Independently accepts personal responsibility across settings and contexts

▫Works to fulfill client-provider contract▫Enhances productivity▫Holds self accountable for and submits to

external review of quality service provision

Vignette • You are tired and your day has been packed. You

were recently sick and still recovering. You have several hours of notes to complete and you feel pressured to get them done. What do you do? Why?

• You are supervising a practicum student who you have assigned a project to (i.e., prepare materials for a psychoeducation group session) and as the two of you sit down to lead group it is apparent that the practicum student did not prepare the materials for the session. What do you do in the moment in group? Why? What do you do after group? Why?

Objective 3Where are you related to accountability? Give examples of where you think you are in this process?

Concern for the welfare of others •Acts to Protect Others

•Practicum Behavioral Anchors:▫Demonstrates awareness of the need to

uphold and protect the welfare of others

▫Displays initiative to help others▫Articulates importance of concepts of

confidentiality, privacy, informed consent▫Demonstrates compassion

Concern for the welfare of others •Acts to Protect Others

• Internship Behavioral Anchors:▫Consistently acts to understand and

safeguard the welfare of others ▫Regularly demonstrates compassion▫Displays respect in interpersonal interactions

with others including those from divergent perspectives or backgrounds

▫Determines when response to client needs takes precedence over personal needs

Concern for the welfare of others • Independently acts to safeguard the welfare of

others

• Professional Practice Behavioral Anchor:▫Independently acts to safeguard the welfare of

others ▫Communications and actions convey sensitivity to

individual experience and needs while retaining professional demeanor and deportment

▫Respectful of the beliefs and values of colleagues even when inconsistent with personal beliefs and values

▫Acts to benefit the welfare of others, especially those in need

Vignette • A supervisor has repeatedly said demeaning

comments regarding a patient. What do you do? Why?

• An early career psychology colleague who is closer in age to the psychology trainees appears to be socializing with current trainees, but you have no evidence. Then, one of your trainees speaks to you during supervising about his/her concerns that the intern being supervised by the early career colleague has an unfair advantage in training due to the social relationship between the intern and the supervisor. How do you handle this? Why?

Objective 3Where are you with regard to your concern for the welfare of others? Give examples of where you think you are in this process?

Professional Identity • Identity as a Professional Psychologist

• Practicum Behavioral Anchor: ▫Beginning understanding of self as

professional, “thinking like a psychologist” ▫Has membership in professional organizations▫Demonstrates knowledge of the program and

profession (training model, core competencies)▫Demonstrates knowledge about practicing within

one’s competence ▫Understands that knowledge goes beyond formal

training

Professional Identity

•Identity as a Professional Psychologist

•Internship Behavioral Anchor:▫Emerging professional identity as

psychologist; uses resources (e.g., supervision, literature) for professional development

▫Attends colloquia, workshops, conferences▫Consults literature relevant to client care

Professional Identity • Identity as a Professional Psychologist

• Professional Practice Behavioral Anchors:▫Consolidation of professional identity as a

psychologist; knowledgeable about issues central to the field; evidence of integration of science and practice

▫Keeps up with advances in profession▫Contributes to the development & advancement of

the profession and colleagues▫Demonstrates integration of science in professional

practice

Vignette • You were trained in WAIS-III and never trained in WAIS-

IV. You are not required to administer WAIS-IV during your training year but realize that this is a “puka” in your training. What do you do? Why?

• You are asked to represent the discipline of psychology at an interprofessional (e.g., medicine, nursing, SW, etc.) case conference on a patient who is a high utilizer of mental health and primary care services. At the meeting, you find it difficult to speak up and wonder if you have anything valuable to add to the discussion. However, you suspect the veteran in question has BPD and you are familiar with DBT as an intervention that could help. What do you do in the moment? Why? What do you do afterward? Why?

Objective 3Where are you with your professional identity development? Reactions to directed readings?

Self-Care

•Attention to personal health and well-being to assure effective professional functioning

•Practicum Behavioral Anchors:▫Understanding of the importance of self-

care in effective practice; knowledge of self-care methods; attention to self-care

▫Demonstrates basic awareness and attention to self-care

Self-Care•Attention to personal health and well-being to

assure effective professional functioning

• Internship Behavioral Anchor:▫Monitoring of issues related to self-care

with supervisor; understanding of the central role of self-care to effective practice

▫Works with supervisor to monitor issues related to self-care

▫Takes action recommended by supervisor for self-care to ensure effective training

Self-Care•Attention to personal health and well-being to

assure effective professional functioning •Professional Practice Behavioral Anchor:

▫Self-monitoring of issues related to self-care and prompt interventions when disruptions occur

▫Anticipates and self-identifies disruptions in functioning and intervenes at an early stage/with minimal support from supervisors

▫Models self-care

Vignette

•You develop a terrible flu that takes several weeks to recover. What do you do? Why?

•Your colleague stops by to ask you a question and says “I hate to bother you, it always seems to irritate you when I have a question, but…” this is a person that you like and respect. What do you do? Why?

Objective 3Where are you with your self-care right now? Give examples of where you think you are in this process? Quick self-assessment?

References • APA (2011). Revised competency benchmarks. Retrieved from: http://

www.apa.org/ed/graduate/competency.aspx• Elman, N. S., Illfelder-Kaye, J., Robiner, W. N. (2005). Professional development:

Training for professionalism as a foundation for competent practice in psychology. Professional Psychology: Research and Practice, 36(4), 367-375.

• Fouad, N.A., Grus, C.L., Hatcher, R.L., Kaslow, N.J. Hutchings, P.S., Madson, M., Collins, F.L., Jr. & Crossman, R.E. (2009). Competency benchmarks: A developmental model for understanding and measuring competence in professional psychology. Training and Education in Professional Psychology. 3(4), S5-S26.

• Kaslow, N., McCarthy, S., Roger, J., & Summerville, M. (1992). Psychology postdoctoral training: A developmental perspective. Professional Psychology: Research and Practice, 23, 369-375.

• Kaslow, N., & Rice, D. (1985). The developmental stresses of psychology internship training: What training staff can do to help. Professional Psychology: Research and Practice, 16, 253-261.

• Sachs Hills, L. (2008). Polishing your professional image: Eight rules for medical practice employees. Journal of Medical Practice Management, May/June 2008, 358-362.