Psychology around the world

[psych844]

I was reading about in-demand jobs around the world, and which countries need a supply of certain professionals, and it showed that Canada, the Nordic nations (Sweden, Denmark, Norway) and Australia/New Zealand need Psychologists.

Got me to look a bit around about how Psychology as a profession is doing in those nations, and it seems the Nordic nations have done especially well in selling the profession. It appears they have sold the idea that a Psychologist is an important and key member of a medical team, and that they are crucial in trying to prevent mental health problems (as most nations are facing a situation where health costs are high, and prevention is seen as a potential saver). It also seems that a Masters is the standard there.

Australia..I have no idea how their education system works, but seemed 4yrs of Uni was necessary to be a Psychologist..and then rather 2 yrs of supervised practice, or you could get a Masters.

What have you guys heard..about the professions future in the USA, and how are the standards in other parts of the world?

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[deleted343839]

This article might help: http://www.apa.org/gradpsych/2009/03/cover-abroad.aspx.

If you really want to delve into the fine details, this might help: http://www.pce-europe.org/file/Infos/Publ-EEA-Regulations.pdf

Go to usajobs.gov and you'll see that in the US there is also a need for psychologists. If you want to work in the VA or the Federal Bureau of Prisons, you have some options.

 

[psych844]

Really useful!

I'm surprised about the qualifications being so low, especially in Western European nations (for most part anyways). I guess in a large part of the world it still isn't that respected of a field.

 

[deleted343839]

I think it has less to do with respect and more to do with differences in the history of professionalization of psychology (you can thank the military for ours in the US) and the quirks of postsecondary education from one country to the next.

Look closely, too, at the distinction between "psychologists" and "psychotherapists" as distinct professions in some countries. The training and qualifications don't necessarily map on so well to ours.

 

[psych844]

I'm just saying that in much of the world getting psychological services is seen as a luxury and hardly a necessity, so it is quite expanded in nations that have the money..sort of how the veterinary profession has made gains. Since it isn't seen as necessary, that is where i'm getting the sense that it isn't all that prestigious or well respected profession in many parts.

 

[PsyDr]

I have gone so far as to consult a few international attorneys to get licensed in three different countries. Long story short: it's either not worth it financially (I.e., low pay), or immigration is a severe problem (I.e. You can't get into the country), or the profession is unregulated except prescribing is illegal.

 

[deleted343839]

I have gone so far as to consult a few international attorneys to get licensed in three different countries. Long story short: it's either not worth it financially (I.e., low pay), or immigration is a severe problem (I.e. You can't get into the country), or the profession is unregulated except prescribing is illegal.

Even Canada?

 

[psych844]

Even Canada?

We might have a need for Psychologists, but our system is essentially the same as yours. (so not sure where the need for consults would be)

 

[deleted343839]

We might have a need for Psychologists, but our system is essentially the same as yours. (so not sure where the need for consults would be)

That was my understanding too, that there are not too many barriers to Canadian licensure for US psychologists with APA-accredited training. Most other countries, though, certainly...

 

[Fan_of_Meehl]

One important reason that we don't make more $$$ for what we do is that we don't (in general and as a profession) do a very good job at quality control with respect to differentiating (in the workplace, e.g., the VA) high quality therapeutic services (based on the best available scientific understanding of the processes governing recovery from a certain condition/diagnosis) vs. 'just come to my office physically and sit and talk/listen with me for 50 min.' I have colleagues who are absolutely content with getting paid six figures to, essentially, visit with people all day long and drop a few points regarding sleep hygiene, for example, or I dunno, maybe pass along some generic (and sound) wisdom regarding the fact that we can't change others, only ourselves and they 'call it a day.' Hell, I dunno, maybe I'll be there some day soon and just end up doing the same in five years or so. In the VA the rabid focus now is on 'harvesting wRVU's' which basically translates into how many people come through your office, not necessarily how many people you actually help recover from their condition or improve their quality of life. My 'productivity' as a professional psychotherapist is measured by how many asses plop in and out of the chair in my office, not the quality of my work. Every moment I spend actually reviewing a chart, actually checking on the latest research of what works for what condition, photocopying manuals/worksheets to structure therapy in a way that will maximize effectiveness, actually putting together a decent case formulation, etc., is a moment of 'sunk' cost in terms of time/effort as compared to just 'free-ballin' it and having a casual conversation (or, my favorite, simply documenting the symptoms of major depressive disorder that the person is presenting with and articulating my 'plan' of treatment is for them to go to their next psychiatrist appointment so their antidepressant medication regimen can be reviewed by that provider...yeah...state-of-the-art psychotherapeutic intervention there).

Until our field truly has its 'Abraham Flexner moment' and we begin (post-graduate school/internship training) holding ourselves and our colleagues accountable for consistently providing an actual effortful and evidence-based professional service (rather than just visiting or talking with a few pebbles of advice thrown in) in exchange for payment, our services won't be respected or highly compensated.

 

[psych844]

Fan_of_Meehl

You have really expressed all my concerns with the field, and said it a lot better than I could!

 

[Fan_of_Meehl]

What if, in the world of medicine:

We have a hypothetical patient, 'Bernie', who is concerned about a persistent headache over the past month that hasn't gone away and decides to go to a physician to get himself checked out. Depending on the particular licensed 'physician' he chooses to see (chosen at random because there is no way, from his perspective, to tell them apart going in) he may have one of the following experiences:

(1) 'Physician A', After reviewing a written statement of Bernie's complaint Dr. Umlaut greets Bernie in his consulting room by emerging from a cloud of incense smoke humming to himself wearing a purple silk robe and the top half of a crocodile skull on his head and proclaiming that Bernie must spend the next five days running naked in and out of heavy traffic screaming at the top of his lungs, "Glory and approbation to the Great High Lord and Crocodile Deity Schnap-Schnap Um-Nomm-Nomm-Nomm!!!" If he survives the trial, the Crocodile Deity will have found him worthy and reward him by removing the offending headache.

Charge = $200; Dr. Umlaut's annual salary = $300,000; License to practice medicine intact

(2) 'Physician B', (Colonel) Dr. Sanders greets Bernie in his consulting space (the porch of a nicely kept, if aging, southern style home) sitting in rocking chair wearing a white suit with black bow-tie. Dr. Sanders listens patiently and kindly to Bernie's complaint for 30 some odd minutes (letting Bernie ramble on and feel 'listened to' but never interjecting interview questions to clarify specifics of the complaint, gather information on pertinent medical history, etc.) and, finally, offers Bernie a delicious glass of sweet iced tea and a prescription to 'drink plenty of fluids, try to avoid worrying about life stresses, and take two aspirin in the evening before bed-time for one week.'

Charge = $200; Colonel Dr. Sanders' annual salary = $300,000; License to practice medicine intact

(3) Physician C, Dr. Schultz greets Bernie warmly (but professionally) in his standard-looking office and spends a good 30 mins taking a precise and detailed medical history, asking Bernie pertinent questions to clarify specifics of past medical diagnoses/treatments, family history, details regarding the specific parameters of his main presenting complaint of persistent headache (timing of onset, course of progression, association with changes in diet/stressors or medication changes). He then orders some blood tests to examine a few hypotheses regarding ruling in/out high base-rate (common) medical conditions that could be causing the headaches but, if these come back negative and he can't pin down a likely (benign) cause of the headaches will responsibly refer Bernie to a specialist to rule out more serious conditions that would require more intensive treatment. He will not prescribe medication or any other treatment before testing out his clinical hypotheses.

Charge = $200; Dr. Schultz' annual salary = $300,00; License to practice medicine intact

The analogy isn't perfect, but it does capture the essence of the wild variations (in terms of quality and value) in clinical practice of psychotherapy at the present time.