Could Psychologists Unionize?

[Therapist4Chnge]

In response to the Hoffman report et al., one suggestion I recently read talked about the option to unionize (as a way to gather support and advocate for the profession). I'm not sure if this is even possible, but it was definitely an outside of the box thought.

Thoughts?

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[LAPsyGuy]

This is an interesting, but ultimately unhelpful idea. It would essentially strip us of our professional standing. A well run association would serve our purposes better. We just have to find one that won't endorse torture. What might be more helpful would be to split out some of the roles of the association. For instance, clinical psychologists might be better off with their own association instead of a group within the APA.

 

[WisNeuro]

Possibly, but I imagine different psychologists have different needs. E.g., clinical vs. academic. So, their priorities would be in fairly different directions in terms of bargaining.

 

[LAPsyGuy]

Possibly, but I imagine different psychologists have different needs. E.g., clinical vs. academic. So, their priorities would be in fairly different directions in terms of bargaining.

Right, but it would be a smaller set of priorities to deal with than all of psychology. Perhaps professional clinical psychologists might need their own association. The AMA views research as secondary to the professional role of physicians, but then again, there are many more practicing physicians than academic physicians. My guess is that clinical psychology would do well with its own association.

 

[WisNeuro]

Perhaps, but there is enough interplay. Many clinical psychologists (those involved primarily in clinical work) are still involved in research, just to a much lesser extent. So, those issues are still relevant, but we are much more concerned with things like reimbursement structure and being able to practice without a physician referral or oversight in certain matters.

 

[PsyDr]

Here's what would happen:

MFTs/MSWs/LMHCs/LPCs/etc: "we'll take all the psychotherapy cases. There's a lot of "trauma" going round."

MDs:/DOs/NPs/SLPs: "with Q-Local and Neurotrax, our nurses can do testing and we can sign the printed report!"

Some PhDs/PsyDs: "we're going to fight the power/some random amorphous authority figure! Also someone should do somethings! But not me. I can't be bothered to donate/pay more dues/do anything/whatever!. Also any psychologist who joins the union is "the man" and needs to fought against. Did I mention I was trained in 1972 by the academic equivalent of Jesus?"

 

[LAPsyGuy]

Here's what would happen:

MFTs/MSWs/LMHCs/LPCs/etc: "we'll take all the psychotherapy cases. There's a lot of "trauma" going round."

MDs:/DOs/NPs/SLPs: "with Q-Local and Neurotrax, our nurses can do testing and we can sign the printed report!"

Some PhDs/PsyDs: "we're going to fight the power/some random amorphous authority figure! Also someone should do somethings! But not me. I can't be bothered to donate/pay more dues/do anything/whatever!. Also any psychologist who joins the union is "the man" and needs to fought against. Did I mention I was trained in 1972 by the academic equivalent of Jesus?"

This only happens if the demands are well beyond what psychologists are making now, and some of it is happening anyway. Unions are great unskilled and some skilled labor positions. Nurses should never have unionized. They made the decision to become hourly labor many years back, and it's been haunting them every since. Professions simply don't unionize, instead they control the content and context of their work, as well as acting as the gatekeepers of entry into the profession. They do this through associations and quasi-governmental organizations, and through participation directly with government entities. Going union would destroy all of that. We should be moving more and more towards a model similar to what medicine and law use. Unions tend to constrict roles and responsibilities instead of expand them.

 

[Fan_of_Meehl]

Here's what would happen:

MFTs/MSWs/LMHCs/LPCs/etc: "we'll take all the psychotherapy cases. There's a lot of "trauma" going round."

MDs:/DOs/NPs/SLPs: "with Q-Local and Neurotrax, our nurses can do testing and we can sign the printed report!"

Some PhDs/PsyDs: "we're going to fight the power/some random amorphous authority figure! Also someone should do somethings! But not me. I can't be bothered to donate/pay more dues/do anything/whatever!. Also any psychologist who joins the union is "the man" and needs to fought against. Did I mention I was trained in 1972 by the academic equivalent of Jesus?"

I'm afraid this prediction is spot-on accurate.

We already have these folks attempting to undercut us and do the 'same thing' (therapy) for less $$$.

The real root of the problem is that:

1) as others have said, we need serious quality control in the profession both leading up to and, in some form or other, after licensure to ensure that we are actually providing, on average, a high quality evidence-based professional service worthy of higher compensation than just 'supportive listening'

and

2) those potential customers (patients and organizations) who have the $$$ to spend on 'psychotherapy' unfortunately have no clue what high quality evidence-based professional psychotherapy is (in terms of how it is distinguished from what they see on TV or imagine it to be by reading about Freud and Janet in their Intro to Psychology textbooks)

Also, I see what unions have done in the public sector (government run hospitals) and they are, unfortunately, organizations that end up defending the worst of the worst employees

 

[Therapist4Chnge]

Also, I see what unions have done in the public sector (government run hospitals) and they are, unfortunately, organizations that end up defending the worst of the worst employees

I'm in agreement, though I still thought it an interesting idea.

 

[Fan_of_Meehl]

I'm in agreement, though I still thought it an interesting idea.

I agree, it is a very interesting idea...I really wish there were solutions.

The field really seems to be in a transitional state right now...thinking of different possible solutions (including unionizing) certainly makes sense.

 

[OneNeuroDoctor]

Some are suggesting some sort of federal government takeover similar to when major corporations have engaged in fraud of using money, grants, or other types of fraud for a specific time period to change the corporation to establish safeguards to prevent such incompetence from reoccurring.

I am hearing that a number of lawsuits will be filed against APA and the leadership and some could be criminal charges.

State Association member may be demanding swift action or remove any connection to APA.

 

[deleted343839]

In response to the Hoffman report et al., one suggestion I recently read talked about the option to unionize (as a way to gather support and advocate for the profession). I'm not sure if this is even possible, but it was definitely an outside of the box thought.

Thoughts?

Tighter control on access to the "guild" and a beefed up lobbying arm would probably be more effective, and though this would affect the organization's tax status there is an argument to be made in favor of a restructuring. For comparison, about 50% of American Medical Association dues go toward lobbying efforts.

 

[LAPsyGuy]

Some are suggesting some sort of federal government takeover similar to when major corporations have engaged in fraud of using money, grants, or other types of fraud for a specific time period to change the corporation to establish safeguards to prevent such incompetence from reoccurring.

I am hearing that a number of lawsuits will be filed against APA and the leadership and some could be criminal charges.

State Association member may be demanding swift action or remove any connection to APA.

Who is suggesting a government takeover. Can you cite a source because I'm very curious. This is really nothing like the takeover of the car companies. It is not to big to fail, and this would be more like the government taking over a union. Please cite.

 

[OneNeuroDoctor]

Many heated discussions on some APA list Servs and State Association list servs from psychologist posting on the list servs. One option stated was that either the government or a professional management firm needs to take over for a period to protect APA members from being liable concerning the lawsuits. Many are stating APA needs to fire all the leaders and file ethic charges or complaints to the State Psychologist Board. One listserv discussion became so heated the Board Director had to step in and specify rules for posting about the Hoffman Report. If I were to cut and paste this information you would know who posted the information and I believe the APA list serves has rules on cutting and pasting and revealing members names. Some are just hearing about the Hoffman report and going through panic mode.

 

[WisNeuro]

I have heard 0 chatter on a "government takeover" on several listservs I am part of. Sounds like another wild exaggeration.

 

[OneNeuroDoctor]

Well some of the comments are made by State Psychology Board Chairs and Board Members and having some of the most harsh comments about APA and how they are letting people resign and then thanking them for their service, as if they have done nothing wrong.

Here is one comment That has no identifying information from a leader of a State Psychology Board:

"So, let the haranguing begin! Bring on the bombastic assaults on the APA leadership. They deserve it for betraying our trust. I personally find it disgusting that Anderson, et al was allowed to take a golden parachute. However, I suspect the APA town meeting in August at Toronto will be historic. Too bad we can't get it webcast for those who are not able to attend."

 

[G Costanza]

Some are suggesting some sort of federal government takeover similar to when major corporations have engaged in fraud of using money, grants, or other types of fraud for a specific time period to change the corporation to establish safeguards to prevent such incompetence from reoccurring.

I am hearing that a number of lawsuits will be filed against APA and the leadership and some could be criminal charges.

State Association member may be demanding swift action or remove any connection to APA.

I highly doubt legislators or their constituents care that much about our field. I give it another week before all the news stories dry up and the only folks discussing this topic are on listservs.

 

[WisNeuro]

"So, let the haranguing begin! Bring on the bombastic assaults on the APA leadership. They deserve it for betraying our trust. I personally find it disgusting that Anderson, et al was allowed to take a golden parachute. However, I suspect the APA town meeting in August at Toronto will be historic. Too bad we can't get it webcast for those who are not able to attend."

And, where in this statement does anyone talk about a government takeover?

 

[bmedclinic]

A well run association would serve our purposes better. We just have to find one that won't endorse torture.

It's not just about having a well run org that wont support torture, but sadly, I guess that's a prerequisite. How about a well run org that is united in what they advocate for, and effectively does so? How much money has been spent on advocating for RxP even though that's not our forte (and there's other professions that are medically trained exactly for that!). Yes, I know- supply and demand with RxP- but that's not the issue- the issue is that what APA has chosen to push hard for (and some state level orgs, too) isnt what psychologists really want or are trained for.

To add to that, while advocating for more, we're also allowing encroachment. I know I've said it on here a few times over the years, but my wife is an SLP and I fundamentally disagree with a lot of cognitive measures that SLPs and other rehab therapists are administering. I dont argue with my wife over this, but I know none of those people has a decent understanding of statistics, none have had courses in psychometrics, yet they're administering tests that if they read carefully enough, state that they are not qualified to administer. Yet they do so, bill for it (as something related, not sure what), and get reimbursed. As you all know, it's not just SLPs in rehab settings. NPs, MSW's (as much as I love them, wtf sometimes), etc. All erase psychologists jobs in different ways.

And we, in psychology sit in the mud and say "oh shucks".

 

[WisNeuro]

On the flip side, there are many psychologists in APA who do support RxP, so you can't really say that it's something nobody wants to support. It is one of a dozen issues that is being lobbied for at the state and national level. That being said, I would be interested in seeing the breakdown of expenses when it comes to the topic being lobbied. I would hope the majority would be on reimbursement and independent practice priorities.

 

[Therapist4Chnge]

The direct lobbying is the realm of the APAPO, not APA. However there are "education" and non-direct lobbying that the APA does related to advocacy. An interesting wrinkle of the APA (compared to most other associations), the largest $$ actually come from publishing/royalties and not membership. Membership is still a large consideration, but it isn't purely a financial one with the APA.

 

[bmedclinic]

On the flip side, there are many psychologists in APA who do support RxP, so you can't really say that it's something nobody wants to support. It is one of a dozen issues that is being lobbied for at the state and national level. That being said, I would be interested in seeing the breakdown of expenses when it comes to the topic being lobbied. I would hope the majority would be on reimbursement and independent practice priorities.

You are right. I didnt mean to make it sound (and perhaps it did as I was in a hurry) that no one supports RxP. More that it's one of many issues, but that selectively it seems that it has been pushed the hardest instead of focusing on other areas that are more likely to succeed (e.g. encroachment). Part of this admittedly is my bias.

 

[WisNeuro]

Fair enough, granted we don't know exactly how the pie is divvied up between the 8ish advocacy topics of the APAPO, just seems that people have this assumption that like 90% of the money goes to RxP, which I highly doubt. My understanding is that Medicare reimbursement and independent practice issues are priorities at the moment.

 

[deleted343839]

One option stated was that either the government or a professional management firm needs to take over for a period to protect APA members from being liable concerning the lawsuits.

That strikes me as profoundly ignorant. (1) On what basis could a rank-and-file APA member outside of the DC office be held liable? (2) Even if there was a cause for liability, how would a "takeover" like this change those circumstances? (3) What possible interest could the federal government have in taking ownership of this sh*tstorm? That's what got the APA into this mess to begin with.

There are a lot of good reasons to restructure/refocus the APA, but shielding members from legal action isn't one of them.

 

[3DLabelPrinter]

Here are my thoughts..maybe a little late, but I think the topic's a giant issue, that actually I'd like to think of in a different way. Call it "unionizing", "skirting lawsuits", or whatever. The apa needs reform across the board, by any means necessary. I think your looking at things all backwards here, because I'm not concerned about the profession itself I'm concerned about patient outcomes. For example when your handing out Dx's like candy for insurance purposes that's not doing your job("WTF am I talking about") because an example would be a young person whose parents send them to talk because they smoke pot and miss curfew..how many of those cases are billed as social anxiety disorder or polysubstance abuse disorder, then go further into the same kid, they dont want to be there, they don't want to talk to a stranger, and add on the confusion or negative rumination associated with the label, other examples? Misdiagnosis of any dx! Think about that. Domestic issues that are ineffectively treated sometimes by "clinical pathos". Not to mention the hype machine right now in the form of BIOLOGY BASED INFINITY! Effective change to that's fought on higher grounds by effective means(hence *unionizing*) PUBLIC AWARENESS(write a book Docs!). And. Putting on a brave face!

One idea I have is this:
With all the different roles and compartments within the APA, and the community surrounding the field: Post Dx LIFE COACHING. I am telling you right now that something in the.slightest capacity of that would change *client outcome* ..also SAVE people the money on months or years of therapy, ultimately just that(even just talking to your patients and EMPHASIZING THIS "DISORDER ISNT YOU SO DONT TRIP AS MUCH AS POSSIBLE). That could help to not only change what type of patients you would get in the typical office. I mean everybody's preaching mindfullness, and holistics...this could be a trendy move.

If you read this, yeah I preached, it's just a thought. I hope you continue the reform and union talks. The people you treat deserve better, that's all. Peace!

 

[Pragma]

3D said a bad word...

 

[Fan_of_Meehl]

As a practicing psychologist, I feel like I'm already serving too many 'masters,' as it were.

Just take a look at the last few issues of a professional journal like Professional Psychology: Research and Practice and compare the thoughtful analysis regarding professional psychological standards of care/practice as well as the actual empirical research database to some of the arbitrary pressures in applied settings to bow to Joint Commission standards, local bureaucratic policies/procedures, and even the demands of large groups of laypeople on the internet concerning such things as letters (essentially, forensic opinions) for emotional support animals (to name just one area). Paul Meehl once bemoaned the absurd and arbitrary feedback psychologists once received from gatherings of their professional peers ('Why I Do Not Attend Case Conferences') but--bloody hell--at least those attending case conferences in Meehl's day were actual professional psychologists in practice and/or academia. Nowadays it seems that every retired RN, social worker, or ladder-climbing bureaucratic functionary (mental health 'experts' in name only) is issuing the marching orders (at the actual point of care delivery) for the practice of professional psychology. The reality is the the professional practice of psychotherapy is an extremely complex endeavor and the more super-ordinate levels of supervision/oversight we slather on, the farther removed any particular accrediting/oversight body gets from the actual phenomenon of interest. As individual providers--scientist-practitioners, practitioner-scholars, or whatever we label ourselves these days--we've ceded a lot of territory over the years. And, it's such a complex and systemically-embedded problem, I'm not sure what the solution(s) may be. And I realize that it's not unique to psychology.