New roles for psychologists?
Should psychologists worry that they’re being replaced by
computer programs or individuals without doctoral training?
Absolutely not, says Kazdin.
In fact, he says, psychology risks being left behind in an
evolving health-care system if the discipline fails to embrace
new ways of getting care to those who need it. The physical
health-care realm is already moving in this direction, he points
Take the developing world’s fight against HIV/AIDS, for
example. “They have enormous needs that cannot be met by
doctors and nurses, but they can be met,” says Kazdin, citing
the World Health Organization’s 2008 report Task Shifting:
Rational Redistribution of Tasks Among Health Workforce Teams.
If psychology digs in and insists that psychotherapy is the only
way to get help, says Kazdin, the health system will simply
And traditional one-on-one psychotherapy isn’t going to fade
away, whatever psychologists may fear, say Kazdin and others.
Some psychologists think that “we’re going to outsource
psychotherapy to Bangalore,” says Mohr. “But people want
psychotherapy; it’s been demonstrated to be effective, and it’s
going to continue to have an important — and probably central
— place in the mental health care system.”
By offering other avenues for receiving care, says Mohr, the
field could treat greater numbers of patients, allocating more
expensive and less abundant one-on-one services to those who
are in greater need and who do not respond to less intensive
Of course, determining who would benefit from less
intensive approaches is key, a point that University of Arizona
psychology professor Varda Shoham, PhD, and National
Institute of Mental Health Director Thomas R. Insel, MD,
make in another 2011 commentary on Kazdin and Blase’s piece
in Perspectives in Psychological Science. While applauding the
goal of reaching more people, they worry that increased use of
technology and similar approaches may not make much of an
impact on alleviating mental illness.
What’s needed, they argue, is better knowledge about who
needs more intensive interventions and who could benefit from
simplified interventions, plus a national research agenda that
puts these questions on center stage. “In the absence of such
knowledge,” they write, “we risk treatment decisions guided by
accessibility to resources rather than patient needs — the very
problem Kazdin and Blase aim to solve.”
Practitioners will also have new roles. In addition to
providing traditional psychotherapy to the subset of patients
who need it, psychologists will need to promote self-help, peer
support, Internet-based interventions and other less intensive
options, says Steven D. Hollon, PhD, a psychology professor at
“Someone is going to have to train.
Someone is going to have to supervise.
Someone is going to have to develop
systems. Who better than psychologists?”
For Hollon, the prospect of an
expanded array of service delivery options
is exciting. And it would help American
psychology catch up to its counterparts
in the United Kingdom and other places
where such approaches are already in
“Psychology defines itself as a discipline
that pays attention to the data and the
evidence,” says Hollon. “We’ve changed
many times over the course of our history.
We’re a hardy weed species that always
does well.” n
A brain teaser? Or a psychological test
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Learn how understanding behaviour in psychological testing can be one way
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Rebecca A. Clay is a writer in Washington, D.C.
Slide Show: To see a
demonstration of Dr. David
Mohr’s Internet intervention
for depression, visit our digital
edition at www.apa.org/monitor/digital/
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