Category Archives: Advocacy

Mental Health and Immigration Detention

berks-countyThis summer, I joined psychologists and lawyers from across the Midatlantic and New York to visit the Berks County Detention Center, in Pennsylvania.  Berks is one of 108 immigration detention centers around the country run by U.S. Immigrations and Customs Enforcement (ICE), and it is home to 36 families, including children of as young as two years old, who are awaiting deportation from the U.S.  The purpose of our visit, which was arranged by Human Rights First, was to review conditions in the detention center; as a doctoral student in clinical psychology, my particular interest was in understanding the mental health needs of the detainees, and the availability of qualified mental health care in the Center.

Many studies and reports have demonstrated the impact of detention on mental health, and some of these impacts were clearly visible in talking to the families at Berks.

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Ian Gutierrez, APAGS Chair

An introduction from the new APAGS Chair

IanAs the new APAGS Chair, I will have the privilege of representing graduate students within the American Psychological Association beginning August 8th. By way of introduction to those of you who may not know me, I wanted to share a few thoughts and reflections in advance of the beginning of my term.

I am a very political person. I believe wholeheartedly in the power of community organizing, the necessity of labor rights, stronger protections for working people, and the critical importance of creating a more just society that offers opportunity for all, regardless of race, class, ethnicity, sexual orientation, or gender identity.

For me, becoming a psychologist necessitates being politically minded. Just look at the world we live in: The post-war order that secured peace and stability in Europe is under siege; Iraq and Syria are engulfed in intractable civil wars; and terrorism continues to claim the lives of innocent civilians around the world. At home, women still earn only three-quarters of what equally-qualified men earn; African-Americans disproportionately suffer the injustices of mass incarceration, and others find that a routine traffic stop by a police officer may have life-threatening consequences; rural and impoverished communities have been torn apart by the opioid and methamphetamine crises; many Americans remain unemployed or underemployed in the wake of the 2008 economic crisis; student debt has ensnared millions of Americans in a financial trap from which they find it impossible to escape; Americans continue to lead the Western world in gun deaths, most of them the result of suicide; and, as a result of these and other developments, racism, sexism, and xenophobia have found new political purchase in our social and cultural landscape.

Professional psychology likewise faces enormous challenges. The findings of the APA’s Independent Review (i.e., the Hoffman Report) have undermined the public’s faith in our profession’s most prominent institution. The “replication crisis” has prompted serious challenges to longstanding claims made by many research psychologists. Psychologists remain excluded from the Medicare definition of a physician, barring psychologists access to resources critical for supplying the public with quality mental health care. Despite the proven effectiveness of psychotherapy, too many Americans still lack access to the care they so desperately need.

Psychologists must be involved in finding solutions to all of these problems. Yet, for students, this can be overwhelming. “The world has its problems, but I just need to finish my dissertation.” “I am concerned about the challenges facing our profession, but right now I just need to match for internship.”  I have heard these and other similar statements many times.

Graduate school can be difficult, and many obstacles must be overcome to complete a doctorate in psychology. Believe me, I know just as well as you do. However, I strongly believe that we are living in a significant period in both our nation’s history and that of our profession. Maybe you’ve asked a parent what they did during the Summer of Love or what it felt like to see the Berlin Wall come tumbling down. I believe that great changes are taking place in our lifetimes, right now, that demand our presence and action. More importantly, they demand our skills, knowledge, passion, and talents as psychologists in training. Ask yourself: Years from now, when your family asks you what you did when the world changed in 2017, what do you imagine yourself saying? Where were you standing?

Where are you standing?

Even though there are enormous challenges facing our society and our world, I remain confident that the world of tomorrow will be better than the world of today. I have that hope because I have seen the future. The future is us. The maturity, vision, energy, and character of our generation is unparalleled, and I know that because I have had the privilege of hearing so many of you share your dreams and ideas. Already we have accomplished so much, and we’re just getting started.

As APAGS Chair, I promise to do my very best to show APA and the field of psychology the energy and promise that you bring to the table. I believe that the student voice is critical to the future of our profession and our society, and I will give everything I can to ensure that the student voice is heard. In turn, I ask that you keep bringing your energy, creativity, passion, and vision to your research, your practice, your education, your advocacy, and your activism. The future is counting on us.

I am an open book. You can follow me on Twitter at @IanAGutierrez.

Author Bio:

Ian A. Gutierrez, MA, is a graduate student at the University of Connecticut pursuing his doctorate in Clinical Psychology and the 2016-2017 Chair of the American Psychological Association of Graduate Students (APAGS). His research focuses on the development of belief systems over the life span.

Editor’s Note: Interested in becoming a part of APAGS Leadership? There are many ways to get involved!

 

An Account of Invisible Disability in Graduate Psychology Training

“But you look so healthy, I’m sure you’ll be fine.”

You would never know that I have a disability from just looking at me. To most people, I appear to be healthy and well-adjusted for my age. Enrolled in a doctoral clinical program, doing well in my coursework, taking on extra curricular activities – from an objective viewpoint, it is easy to assume that I lead a similar life to most people my age in my situation. Yet the very fact that things seem normal is one of the most challenging aspects to an invisible disability. Unless I go out of my way to explain it, you would likely never know that I suffer from severe tinnitus and hyperacusis, or constant ringing in the ears and extreme sensitivity to sound.

“Oh I get tinnitus sometimes, too. You should just ignore it like I do.”

Although increasingly common, issues of tinnitus and hyperacusis are not widely understood, nor is there a clear way of measuring what makes someone’s condition severe (Blasing, Goebel, Flotzinger, Berthold, & Kroner-Herwig, 2010). Unlike hearing impairment, in which the limitations of hearing are objectively measured by a hearing test, the methods for measuring tinnitus are far more subjective. Therefore, people tend to measure tinnitus severity by the amount of stress that people who encounter it experience – tinnitus generally falls into the basic categories of bothersome and non-bothersome. For the bothersome type, there are several remedies with an evidence basis, including various audiological interventions that incorporate psychoeducational counseling (Chan, 2009).

Additionally, Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Stress Reduction (MBSR) protocols have all been shown to alleviate tinnitus-related distress to varying degrees (Gans, Cole, & Greenberg, 2015; Hesser, Westin, Hayes, & Andersson, 2009). Yet once all of these have been attempted, and the person experiencing the tinnitus and hyperacusis is still not well, current available interventions have little else to offer. Having founded a support group in Palo Alto that is part of a national network and witnessing the pain and despair tinnitus can cause firsthand, I can personally attest to the widespread need for more effective treatments and interventions.

 “Sorry, but I can’t lower the music volume because the other customers want it turned up loud.”

The challenges I face with tinnitus and hyperacusis have impacted every area of my life. While providing me with a sense of mission to contribute to research and advocacy for individuals with my condition and other invisible disabilities, the path to get there has been thoroughly demanding and challenging. Simple things like riding on public transportation, food shopping, and being in noisy restaurants are all potentially painful situations for me. Urban environments are also dangerous, considering the regularity of emergency vehicle sirens, construction, car horns, loud motorcycles, and other frequent noise. At a more personal level, I have even had to tell people that their voice or laugh is too loud, and ask if they can speak more quietly when I am nearby. Frequently, my conditions become exacerbated if I do not have an opportunity to advocate for myself and explain to people the unusual nature of my sound sensitivity so that it may be accommodated.

“If the class gets too loud for you, you can just leave.”

While I am grateful to be engaged in a course of study that I am passionate about, it is a constant challenge to maintain an effective balance between self-care and productivity. Graduate level training in psychology is thoroughly demanding of a person’s physical and emotional resources, particularly considering clinical placements that may require long commutes on top of endless hours of coursework and research requirements. My condition results in frequent exhaustion and difficulty sleeping, with the symptoms often intensified resulting from stress and demands of graduate school. Excessive fatigue is common when someone experiences a disability (Olkin, 1999); by sheer requirement of rest alone, it takes more time to get the same amount of things done. In my case, many aspects of my training are limited and guided by my condition, starting from choosing a school that has parking access and adequate disability resources. Other aspects of the process are restrictive for me too, as clinical training placements involving families with small children and milieu settings with youth are frequently quite loud and therefore not compatible with my illness. Even socializing can be a challenge, as my condition is worsened from time spent in large groups of people in which many conversations are happening. I must rely on my professors, supervisors, and peers to understand and help when I need accommodations for my disability, and even when I must leave a potentially harmful situation for me.

“Oh come on, this can’t be too loud, we’re just having fun.”

Explaining this is frequently difficult. When it’s people’s lifetime experience that being in social situations is a good thing, and they display the best of intentions by wanting me to be there. It can be very hard to articulate how challenged I am by being in the places where people gather such as restaurants, parties, and bars. As such, I am left out of much social activity that I used to partake in and that used to be a resource for me – having a disability requires constant re-adaptation to life, and often in isolation from others.

Diversity factors among graduate students include all the varied forms in which disability manifests. While mobility issues obviously must be accounted for, greater awareness of other types of disabilities, including less visible, chronic disabilities such as endometriosis, Crohn’s disease, irritable bowel syndrome, brain injury, fibromyalgia, and other common conditions such as tinnitus and hyperacusis still require greater awareness among the general public. In this time when diversity is becoming an ever more present dimension of clinical proficiency, it is essential that training programs incorporate greater awareness of the potential impact of disability on people’s lives.

“Well, at least you don’t have a real disability.”

Despite the challenges my disability has put me through, it has been my experience that people truly want to help – even when they aren’t sure how. Yet sadly, often it is the case that when things become too challenging to attend to, it is a culturally consistent reaction to tend to look away. Many of the needs of people who experience limitations due to their disability may be solved by a very simple method – don’t be afraid to ask what it’s like for them, and how you may be able to help. Even just being recognized for dealing with the challenge of an invisible disability can be a huge relief.

About the Author:

Ben Greenberg is a fourth-year doctoral clinical psychology student at the American School of Professional Psychology at Argosy University, San Francisco. A former professional symphony French horn player, he played in the Colorado Symphony Orchestra, Jerusalem Symphony, Hong Kong Philharmonic, and Cairo Opera Orchestra before leaving his career due to debilitating tinnitus and hyperacusis. He is currently a grant recipient of the American Tinnitus Association for his research in the impact of sound sensitivity in tinnitus, and lives in Oakland, CA.

 

References:

Blasing, L., Goebel, G., Flotzinger, U., Berthold, A., & Kroner-Herwig, B. (2010). Hypersensitivity to sound in tinnitus patients: An analysis of a construct based on questionnaire and audiological data. International Journal of Audiology, 49(7), 518-526. doi: 10.3109/14992021003724996

Chan, Y. (2009). Tinnitus: Etiology, classification, characteristics, and treatment. Discovery Medicine, 8(42), 133-136. Retrieved from: http://www.discoverymedicine.com/Yvonne-Chan

Gans, J., Cole, M., & Greenberg, B. (2015). Sustained Benefit of Mindfulness-Based Tinnitus Stress Reduction (MBTSR) in Adults with Chronic Tinnitus: a Pilot Study. Mindfulness. doi: 10.1007/s12671-015-0403-x

Hesser, H., Westin, V., Hayes, S. C., & Andersson, G. (2009). Clients’ in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress. Behavior Research and Therapy, 47(6), 523-528. doi: 10.1016/j.brat.2009.02.002

Olkin, R. (1999). What psychotherapists should know about disability. New York: Guilford Press.

Why Policy?

US Capitol Rotunda

U.S. Capitol Rotunda, Source: Flickr, user sidkid

“Why policy?”

I have been asked this simple, two-word question more times than any other question in the past year. Back in September, I began working as a graduate-level policy scholar for the Public Interest Government Relations office at the American Psychological Association. As this opportunity coincided with my fifth year of doctoral studies at Virginia Commonwealth University, I have often had to explain my hectic schedule upon meeting new individuals. Research and academia, most will understand, as those things fit seamlessly into the doctoral studies mold. But then comes the follow-up question: Why policy?

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How Much Do Black Lives Matter to the APA?

protestAs a student member of the APA and a psychologist in training, I’ve been disappointed in the American Psychological Association’s (APA) public response to the deaths of African American’s at the hands of police officers as well as mass shooters. While I’ve appreciated APA’s vigorous response to the Orlando tragedy, I couldn’t help but compare it to the APA’s response to the Charleston shootings. When I looked back to see if the APA offered services to the families of the victims of the Charleston shootings, or any other resources, I couldn’t find anything, not even a public statement condemning the shootings. Granted, the Charleston shooting occurred only a few weeks before the release of the Hoffman Report.  Yet preoccupation with the Hoffman Report does not explain APA’s silence, as it issued four press releases between the day of the Charleston shooting and the release of the Hoffman Report.

Moreover, the APA’s virtual silence in response to the numerous police shootings of unarmed African American men, women, and children is dumbfounding.  In an op-ed in response to Ferguson, written by former APA President Nadine Kaslow and former APA CEO Norman Anderson, the authors fall short of condemning the shooting of an unarmed black teenager and state, “[t]he judicial system will determine exactly what transpired between Michael Brown and the police officer.” Considering the historical treatment of African Americans by the judicial system, and the continued shocking disparities, their faith in the ability of the system to determine what transpired and provide a just outcome was questionable at best.  Perhaps Kaslow and Anderson’s questionable faith is representative of the APA’s position overall, and explains the silence.

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