Public Education Committee Reports/Updates

November/December 2021

A window of opportunity: Psychologists’ role in COVID-19 vaccine uptake
Samantha Domingo, PsyD, DBSM, OPA Public Education Committee

With the COVID-19 vaccine becoming widely available in the United States to adults and children over the age of 16 in April 2021 (Anthes et al., 2021), along came a new hope for the eventual suppression of this pandemic. However, due to the compounding political divide amongst Americans in recent years, in addition to other sociocultural and psychological factors, vaccine uptake has been hindered. This is rather unsurprising given that some of these factors have also heavily influenced the public’s adherence to preventative measures against the spread of the virus, specifically the use of face masks and social distancing. 

As of October 2021, 56.5% of the United States population (Centers for Disease Control and Prevention [CDC], 2021, para. 3) and 61.6% of Oregonians have been fully vaccinated (USA Facts, 2021, line 3). Full immunization can be defined as 2 weeks after an individual’s second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or 2 weeks after a single-dose vaccine, such as Johnson & Johnson's Janssen vaccine (CDC, 2021, para. 3). The COVID-19 vaccine is effective at offering protection against the virus and reducing the risk of severe illness, hospitalization, and death (CDC, 2021, para. 5). Why then, do so many eligible people remain vaccine hesitant? 

Vaccine hesitancy can be defined as “the delay in acceptance or refusal of vaccination despite the availability of vaccination services” (MacDonald, 2015, p. 4163). Some of the factors impacting vaccine hesitancy in our current context include social (e.g., lack of access to childcare, transportation, or protected time off work), cultural (e.g., individualistic vs. collectivistic communities, religious beliefs), access to misinformation (e.g., self-selected exposure to media), health literacy (e.g., lack of accessible information appropriate for reading comprehension level, access to reputable sources of information), historical factors (e.g., history of abuse and exploitation of BIPOC populations by medical and scientific communities), and psychological factors (e.g., heuristics, confirmation bias, groupthink, affective states). This is, of course, an expanding area of research. 

Psychologists, particularly those practicing within the subspecialty of health psychology, are in a unique position as social scientists and practitioners to steer efforts and help inform strategies to address vaccine hesitancy and improve public health communications (Freedland et al., 2020). Though psychologists and other mental healthcare providers have been integral to addressing the emotional consequences of the pandemic, there is certainly room for increased involvement in research exploring COVID-related health behaviors and health communications (Freedland et al., 2020). Furthermore, psychologists possess multiple competencies that could expand the understanding of the variety of factors that impact decision making, and help mediate and connect with organizations and communities to facilitate this information. 

More direct applications of these ideas on a smaller scale translate into having direct conversations with clients/patients/consumers about making informed decisions regarding their health, exploring how to communicate with vaccine hesitant family and friends, and utilizing psychological principles to facilitate the informed decision-making process, by identifying barriers, addressing ambivalence, exploring values, and supporting critical thinking. On an organizational scale, psychologists integrated in hospitals, clinics, group practices, and community health settings can work as essential parts of interdisciplinary teams to develop interventions specific to the organization. On a larger, community-based scale, there are opportunities to enhance public education efforts by participating in media interviews, community outreach, and engagement. 

If you would like to become more involved in our community’s public education efforts, OPA’s Public Education Committee welcomes your participation.

References

Anthes, E., Ngo , M., & Sullivan, E. (2021, April 19). Adults in all U.S. states are now eligible for vaccination, hitting Biden's target. Half have had at least one dose. The New York Times. https://www.nytimes.com/2021/04/19/world/adults-eligible-covid-vaccine.html

Centers for Disease Control and Prevention. (2021). CDC Covid data trackerhttps://covid.cdc.gov/covid-data-tracker/#datatracker-home

Freedland, K. E., Dew, M. A., Sarwer, D. B., Burg, M. M., Hart, T. A., Ewing, S. W., Fang, C. Y., Blozis, S. A., Puterman, E., Marquez, B., & Kaufmann, P. G. (2020). Health psychology in the time of Covid-19. Health Psychology, 39(12), 1021–1025. https://doi.org/10.1037/hea0001049

MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine33(34), 4161–4164. https://doi.org/10.1016/j.vaccine.2015.04.036

USA Facts. (2021). Oregon coronavirus vaccination progress. https://usafacts.org/visualizations/covid-vaccine-tracker-states/state/oregon


July 2021

Giving Psychology Away
Sandy Ramirez, PsyD, and the Public Education Committee

During the recent OPA Annual Conference, our Public Education Committee offered a presentation to share about our work and how things have changed in recent years. Here we offer a continuation of that discussion. Why is it that we as a profession and we as individuals have the need to reach out? 

Certainly as we build our careers and practices we know the importance of networking and getting our name out there, letting people know what we have to offer. As a profession, we are bound by ethical guidelines and responsibilities to protect the public, implying a mandate to seek out ways we can be of service and promote equity. Public education is a wonderful and comprehensive way to address the process from “individual career success and publication impact to a collaborative multidirectional ecosystem for societal impact,” as suggested by Kools et al. (2018, p. 3). We advocate and educate to support mental health awareness and destigmatization, social justice, improved health outcomes, and ethical dissemination of psychological research. How do we reach out? Historically, beginning with published research, articles and books, teaching and lectures, we evolved and added public media formats like television and radio. Key factors for success required networking with public media sources, building relationships to enhance communication, and gaining opportunities for presentations offered in a timely fashion. 

As we are well into 2021, an important way to reach the public has been through social media. Keeping in mind that we are bound by our ethics and psychological science, Kools et al. (2018) explained that scientific journals and research are both the gatekeepers for what we may disseminate and a great source of material worth sharing. Why social media? Social media platforms are widely used and reach more people, including those who are harder to reach in person. Social media disseminates knowledge faster than traditional methods and has been shown to boost research citations. Social media also facilitates networking among researchers, clinicians, and consumers. According to Dijkstra et al. (2018), an added value to our use of social media is the opportunity to counter ‘Fake News.’ 

Another way of connecting the public with psychological science is through direct community outreach. Consider what communities you already have rapport with or communities you hope to advocate for through shared learning and collaboration. For example, the Public Education Committee has partnered with community organizations such as the YMCA, NAMI, and Rotary to offer psychoeducational events, and covered topics such as “Tips for managing pandemic stress” and “Brain health and wellness.” We have also partnered with community organizations (e.g., “Dial a Smile” and “Conversaciones con los Abuelos”) to support social connection among older adults through senior-student check-in calls. Our modalities have adapted during COVID-19 to include virtual presentations, outdoor events, and digital sharing of materials and resources. 

An important factor to recall is that we are bound by the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association [APA], 2017) and must remain within our scope of education, training, and practice when sharing mental health information. As we aspire to withhold the principles and practice in congruence with the ethical guidelines, and to actively support the Black, Indigenous, and People of Color (BIPOC) community, we are reminded to reach out, connect and learn, and be both accessible and transparent in our communication. 

Connect with us!
[email protected]
[email protected]
www.opa.org/public-education-committee

References

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code/ 

Dijkstra, S., Kok, G., Ledford, J. G., Sandalova, E., & Stevelink, R. (2018). Possibilities and pitfalls of social media for translational medicine. Frontiers in Medicine. https://doi.org/10.3389/fmed.2018.00345 

Kools, F. R. W., Mirali, S., Holst-Bernal, S., Nijhof, S. L., Cavalli, G., & Grandner, M. A. (2018). Publications are not the finish line: Focusing on societal rather than publication impact.  Frontiers in Medicine. https://doi.org/10.3389/fmed.2018.00314


March 2021

Community Courts: A Role for Mental Health in the U.S. Justice System
Paige Reohr, M.S. and Kevin McGovern, PhD - Public Education Committee

Criminal justice system involvement is closely entwined with mental illness. As such, the consequences of criminal or unlawful behavior (e.g., heavy fines, jail time, prison sentences) do not always serve the individual, who in many cases may need mental health or substance abuse treatment to support more adaptive behaviors when facing stressors in both custody and the community. Many find general sentencing to be counterproductive for those suffering from mental illnesses and believe access to community services would create better responses compared to criminal justice supervision (Almquist & Dodd, 2009). Responding to individuals who are underserved and part of marginalized communities in a community-oriented manner could influence long-term change and reduce the cyclical nature of both competency restoration programs and incarceration for these communities.

To mitigate the problematic approach of blanket sentencing, community courts take an individualized, community health approach. Community courts are a type of problem-solving or specialized court, housing mental health courts, drug courts, and domestic violence courts. The overarching foci of these courts are on: (1) promoting information about specific issues for participants, (2) facilitating community engagement, (3) ensuring collaborative work among the justice system and community social services, (4) taking an individualized approach to justice, (5) providing accountability, and (6) evaluating program outcomes (Almquist & Dodd, 2009).

Forming community courts in Oregon

Judge Larry J. Blake, a graduate of the University of Washington and Lewis and Clark Law School, teaches part-time at Mt. Hood Community College, runs his private practice, and serves as a Municipal Court Judge for several Oregon cities. In a dedicated effort to improve the management of misdemeanors in small community legal systems, Judge Blake initiated a community court system. He set up his first community court in the city of Sweet Home, Oregon, and it was up and running for 2 months before the pandemic hit. He is actively working to reinstate the program in not only Sweet Home, but also in Newberg and Corvallis, with hopes for continued growth.

Judge Blake’s community court initiative utilizes a shared effort by the legal system and community social services to support individuals charged with misdemeanors and, importantly, their families. Community courts take place inside municipal courthouses but have a starkly different setup from traditional hearings. Individuals presenting for their community court date are welcomed by representatives from community mental health, substance use and addiction support, transportation services, and housing assistance. After completing a needs assessment with the support of a peer, the presenting individual meets with each service representative. Then, if the individual is in agreement, an alternative to traditional sentencing can be offered. The individual must adhere to mental health and/or substance abuse treatment in lieu of jail time and fines. After 6 months, the individual returns to the court to assess progress in treatment.

Although community courts in Oregon are in their early stages and do not serve everyone going through the legal system, there has been enthusiasm from community services and community members alike. Running community courts is relatively low cost. Community services save the cost of meeting individuals around the community and there are no legal fees to cover. Further, regardless of political affiliation, American ideals tend to favor rehabilitation as a goal of the criminal justice system, which includes the work of these specialty courts (Thielo et al., 2019). These community-supportive efforts may play an important role in reducing the harmful impact of racism and classism in the U.S. justice system.

Program outcomes

Limited research demonstrates some promising outcomes of these efforts, with graduates of such programs showing significantly reduced recidivism (Hiday et al., 2013). McNiel and Binder (2007) found that successful completion of mental health court programming was related to a reduction in both recidivism and violence among adults with mental illnesses compared to peers who were instead booked into the county jail. Honegger (2015) reviewed several studies and observed a similarly successful reduction in recidivism among many, but not all, participants of problem-solving courts. Higher lifetime arrests and jail time, being on disability, substance use, low education, some racial group memberships, and being younger predict poorer outcomes (Honegger, 2015; Landess & Holoyda, 2017).

For years, researchers have highlighted a need for consistency in the implementation of such courts in order to assess evidence-based efficacy and other outcomes (Honegger, 2015; Pratt & Turanovic, 2019; Slinger & Roesch, 2010). Further research is certainly needed.

Getting involved

Judge Blake shared an interest in assistance from mental health professionals in his efforts to establish additional community courts. Since the Oregon Department of Corrections provides limited therapeutic services for the mentally ill, alternative community court programs of this nature should be established throughout the state. Psychologists and psychology students alike can contribute to community court efforts by providing valuable knowledge about mental health, substance abuse, and effective interpersonal interaction. Students and professionals are encouraged to reach out to their local courts to see how they can be of service, which may include conducting research to support the need for evidence-based programming or providing trauma-informed training to various parties involved in the community court systems.

References

Almquist, L. & Dodd, E. (2009). Mental health courts: A guide to research-informed policy and practice.
          Council of State Governments Justice Center.
          https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/CSG_MHC_Research.pdf

Hiday, V. A., Wales, H. W., & Ray, B. (2013). Effectiveness of a short-term mental health court:
          Criminal recidivism one-year post-exit. Law and Human Behavior, 37, 401–411.
          https://doi.org/10.1037/lhb0000030

Honegger, L. (2015). Does the evidence support the case for mental health courts?
          A review of the literature. Law and Human Behavior, 39(5), 478–488.
          https://doi.org/10.1037/lhb0000141

Landess, J., & Holoyda, B. (2017). Mental health courts and forensic assertive community
          treatment teams as correctional diversion programs.
          Behavioral Sciences & the Law, 35(5-6), 501-511. https://doi.org/10.1002/bsl.2307

McNiel, D. E., & Binder, R. L. (2007).
          Effectiveness of a mental health court in reducing criminal recidivism and violence.
          American Journal of Psychiatry, 164, 1395-1403. https://doi.org/10.1176/appi.ajp.2007.06101664

Pratt, T. C., & Turanovic, J. J. (2019). A criminological fly in the ointment:
          Specialty courts and the generality of deviance. Victims & Offenders, 14(3), 375-386.
          https://doi.org/10.1080/15564886.2019.1595247

Slinger, E., & Roesch, R. (2010). Problem-solving courts in Canada:
          A review and a call for empirically-based evaluation methods.
          International Journal of Law and Psychiatry, 33(4), 258-264. 
          https://doi.org/10.1016/j.ijlp.2010.06.008

Thielo, A. J., Cullen, F. T., Burton, A. L., Moon, M. M., & Burton, V. S. (2019).
          Prisons or problem-solving: Does the public support specialty courts?
          Victims & Offenders, 14(3), 267-282. https://doi.org/10.1080/15564886.2019.1595243


January 2021

Fighting Compassion Fatigue
Paige Reohr, MS & Stephanie Van Orden, PsyD

If you have been on the front lines providing public services, juggling the complexities of maintaining work and family obligations during COVID-19, caring for ill or high-risk loved ones, coping with your own mental and physical needs in times of notable social isolation, and/or struggling to see the light at the end of the tunnel, this message is for you. You are not alone. Despite these very likely human struggles, others may be depending on us for mental health services and our expertise. Despite our own best intentions, we can be pushed to limits that can impact our ability to effectively and ethically serve others.

Compassion fatigue is defined as decreased ability or interest in empathically caring for clients (Rossi et al., 2012). Similar to burnout, which is defined by cumulated emotional exhaustion, compassion fatigue is characterized by holding the stressful experiences of others. It differs depending on the intensity of the stressor and its onset becomes a secondary trauma in a helping professional (Duarte & Pinto-Gouveia, 2017), characterized by increased tension, emotional numbing or avoiding, hypervigilance, and irritability (Rossi et al., 2012). Harmful to clinical work, compassion fatigue impairs clinical judgement and treatment and increases instances of errors (Rossi et al., 2012).

Mental health professionals across the board have the potential to be affected by compassion fatigue and burnout, including trainees and professionals who have been in the field for years. Unsurprisingly, students and trainees are at risk of compassion fatigue as they encounter their first clients (Beaumont et al., 2016; Can & Watson, 2019; Knight, 2011). For each year spent working in a community-based mental health setting, the risk of burnout and compassion fatigue increases (Rossi et al., 2012). This has also been observed in other helping professions (Fahy, 2007; Fontin et al., 2020) and may be, in part, credited to evidence-based buffers against compassion fatigue being only relatively recent studied (Fahy, 2007).

One identified risk factor for greater levels of compassion fatigue includes having experienced at least one negative event in the prior year (Rossi et al., 2012), putting all mental health professionals working during the pandemic at a greater risk. The COVID-19 pandemic is both conceptualized as a single and a series of negative events, subject to individual experience and perception. Yet, previous research suggests the risk of compassion fatigue is more strongly related to minimal negative events in the past 12 months, versus the risk of burnout, which is more strongly related to multiple negative experiences (Rossi et al., 2012). Present applications may suggest that, while we may see high rates of compassion fatigue now, we may see an increasing rate of burnout among mental health providers as the pandemic surges.

We are in this together, and the following ways may help us all to reduce the risk of both compassion fatigue and burnout.

Find value in your work

Compassion satisfaction, which means finding value and satisfaction in  helping others, appears to protect against compassion fatigue (Duarte & Pinto-Gouveia, 2017; Rossi et al., 2012). Psychological distress among mental health care workers is associated with lower levels of compassion satisfaction and higher levels of compassion fatigue (Rossi et al., 2012). To antidote such fatigue, consider enhancing gratitude practice, focusing on the things that bring you more joy in your work, and/or reducing the things that result in less satisfaction.

Foster self-compassion

A greater sense of self-compassion is related to greater resiliency against others’ distress (Beaumont et al., 2016), demonstrated by neural activity observed in those who complete compassion training (Klimecki et al., 2012). Seemingly counterintuitive by name, increased self-compassion, such as practicing mindfulness and meeting your own needs, will build resiliency needed to care for others.

Set boundaries (especially from home)

Working from home in the era of COVID-19 brings on another challenge when work is helping in nature. Work-life imbalance contributes to burnout (Yester, 2019); however, mental health professionals working from home no longer have the walls of an office or other external workplace to set natural boundaries. Rather, the spaces associated with self-care, such as home, family, relaxation, etc., are now blurred with clinical work. Change your environment in ways you may have not considered before with sensory tools and exercise, or even consulting with an occupational therapist. Above all else, practice self-compassion.

Build and model practices for trainees

While a strong supervisory alliance is an important aspect of clinical training, the alliance alone does not appear to buffer against compassion fatigue (Can & Watson, 2019). Rather, clinical supervisors might encourage wellness and self-care practices for trainees as part of their training, integrating protective factors early in trainees’ clinical careers. Open discussions around risk factors and symptoms of compassion fatigue might foster preventative practices and awareness for trainees to incorporate into their professional careers.

References

Beaumont, E., Durkin, M., Martin, C. J. H., & Carson, J. (2016).
          Measuring relationships between self-compassion, compassion fatigue, burnout,
          and well-being in student counsellors and student cognitive behavioural psychotherapists:
          A quantitative survey.
          Counselling and Psychotherapy Research, 16(1), 15-23. 
          https://self-compassion.org/wp-content/uploads/2016/06/Beaumont_2015.pdf

Can, N., & Watson, J. C. (2019).
          Individual and relationship predictors of compassion fatigue among counselors-in-training.
          The Professional Counselor, 9(4), 285-297. https://tpcjournal.nbcc.org/wp-content/uploads/2019/11/Pages_285-297-Can-Individual_and_Relational_Predictors_of_Compassion_Fatigue_in_CITs.pdf

Duarte, J., & Pinto-Gouveia, J. (2017).
          The role of psychological factors in oncology nurses’ burnout and compassion fatigue symptoms.
          European Journal of Oncology Nursing, 28, 114-121. 
          https://doi.org/10.1016/j.ejon.2017.04.002

Fahy, A. (2007). The unbearable fatigue of compassion:
          Notes from a substance abuse counselor who dream of working at Starbucks.
          Clinical Social Work Journal, 35, 199-205.
          https://psycnet.apa.org/doi/10.1007/s10615-007-0094-4

Fontin, F. M. B., Pino, E. C., Hang, J., & Dugan, E. (2020)
          Compassion satisfaction and compassion fatigue among violence intervention caseworkers.
          Journal of Social Service Research.
          https://doi.org/10.1080/01488376.2020.1839628

Klimecki, O., Leiberg, S., Lamm, C., & Singer, T. (2012).
          Functional neural plasticity and associated changes in positive affect after compassion training.
          Cerebral Cortex, 23(7), 1552-1561.
          https://doi.org/10.1093/cercor/bhs142

Knight, C. (2011). Indirect trauma in the field practicum:
          Secondary traumatic stress, vicarious trauma, and compassion fatigue among social work
          students and their field instructors.
          Journal of Baccalaureate Social Work, 15(1), 31-52.
          https://doi.org/10.5555/basw.15.1.l568283x21397357

Rossi, A., Cetrano, G., Pertile, R., Rabbi, L., Donisi, V., Grigoletti, L., Curtelo, C., Tansella, M., Thornicraft, G., & Amaddeo, F.(2012).
          Burnout, compassion fatigue, and compassion satisfaction among staff in community-based
          mental health services.
          Psychiatry Research, 200(2-3), 933-938.
          https://doi.org/10.1016/j.psychres.2012.07.029

Yester, M. (2019). Work-life balance, burnout, and physician wellness.
          The Health Care Manager, 38(3), 239-246.
          https://doi.org/10.1097/hcm.0000000000000277


September 2020

How Institutional Racism Affects BIPOC Students in Higher Education: Graduate Students’ Perspectives

Preeti Pental, MA, & Hannah Smith, MA, OPA Public Education Committee

Since the resurgence of the Black Lives Matter movement in May 2020, many groups of Black, Indigenous, and People of Color (BIPOC) students and student allies have banded together through various platforms to create safe spaces for BIPOC voices to share their own stories of racial injustice within higher education. For example, many students have come together to write letters to their educational leaders regarding discrimination and harassment on campus across universities nationwide. Another notable example includes the Instagram account @blackatusd, which is an account created by students at the University of San Diego to allow their peers to share their experiences with microaggressions and inequality. The response to such efforts has been mixed and has demonstrated the need for an informed approach in response to the limited awareness of higher education systems. Some administrators come forward as a united front to take ownership of their culpability in the racist culture of their programs and others fail to respond, or worse, react by diverting the problem away from themselves.

The OPA Public Education Committee strives to educate the public about how the application of psychology can benefit society and improve lives. As student members of the committee who have both experienced such injustices and work with other students to fight against them, a few things come to mind that align with our mission of educating the public. First, we feel the words of the late John B. Lewis to be particularly pertinent at this time: “Never ever be afraid to make some noise and get in good trouble, necessary trouble.” Reading the stories of other students’ experiences from our university and universities across the country sparks an urgency to get in reasonable and necessary trouble. Second, the underwhelming documented responses nationwide by educators and administrators are troubling. We call upon our OPA community to start a discussion for actionable steps that higher education can implement to ensure the well-being and education of BIPOC students.

Campbell and Khin (2020) noted the importance of culturally grounded and trauma-informed care to BIPOC students. These practices build upon Bronfenbrenner’s Ecological System Model (1979). It is suggested that this model is imperative for clinical psychologists and members of higher education to facilitate culturally grounded care for BIPOC students. According to Campbell and Khin, culturally grounded practices promote healing within systems and in BIPOC students’ personal lives. These authors further urge readers to recognize that minority stress is unique, persistent, and socially-based. This recognition then further supports the need for universities and institutions to implement actionable steps to support BIPOC students.

Knowing that minority stress is unique, persistent, and socially-based is crucial for psychologists and educators to understand, as these are attributed to BIPOC students’ experiences of discrimination, systemic oppression, and institutional racism (Campbell & Khin, 2020). Having this awareness further supports the need for universities and institutions to implement actionable steps to support BIPOC students.

Some university-based advisory committees have created and documented steps to promote change on an institutional level; however, these proposed action plans allegedly take years to implement. This alone illustrates how institutional racism is deeply embedded in higher education and, moreover, that the need to implement more immediate and strategic change remains dire. If not, we risk contributing to further racial trauma as BIPOC students continue awaiting justice. Fish and Syed (2018) provided more immediate, actionable steps to assist in dismantling racist systems including correcting historical inaccuracies (e.g., Columbus Day) and removing inappropriate stereotypes (e.g., culturally appropriating mascots). We must remember that the time directed towards implementing change does not take away from the continued injustices that BIPOC students face until real justice ensues.

Thank you,

OPA Public Education Committee
Oregon Psychological Bulletin
@OPAPEC (Facebook)
@opapubliceducationcommittee (Instagram)

References

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Black @ USD [@blackatusd]. (n.d.). Posts [Instagram profile]. Retrieved August 13, 2020, from https://www.instagram.com/blackatusd.

Campbell, C., & Khin, P. P. (2020). Building resilience through culturally grounded practices in clinical psychology and higher education. 


Fish, J., & Syed, M. (2018). Native Americans in higher education: An ecological systems perspective. Journal of College Student Development, 59(4), 387-403. https://doi.org/10.1353/csd.2018.0038

Lewis, J. [@repjohnlewis]. (2018, June 27). Do not get lost in a sea of despair. Be hopeful, be optimistic. Our struggle is not the struggle of  [Tweet]. Twitter. https://twitter.com/repjohnlewis/status/1011991303599607808?lang=en