What is the role of psychologists in reducing injustice and increasing social justice?

[beginner2011]

I saw a TED talk recently where the speaker shared some useful allegories for the effects of racism on the provision of health care services, and the downstream consequences. Given that we as psychologists often view our role in the health care system not simply as providers but also as leaders/administrators of the system, what do people see as the role of psychologists and how it relates to social justice/injustice?

The TED Talk
Dr. Camara Jones is a family physician and epidemiologist whose work focuses on the impacts of racism on the health and well-being of the nation. She seeks to broaden the national health debate to include not only universal access to high quality health care, but also attention to the social determinants of health (including poverty) and the social determinants of equity (including racism).

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[deleted480308]

Health care providers should stay in their lane and stop pretending that they have to fix everything about the world as part of their career. Just give what patients you have the best care you are trained to do

Try to fix the world in your off hours and don’t confuse the two roles

 

[beginner2011]

Health care providers should stay in their lane and stop pretending that they have to fix everything about the world as part of their career. Just give what patients you have the best care you are trained to do

Try to fix the world in your off hours and don’t confuse the two roles

I'd be especially curious to hear your thoughts about the topic after having viewed any portion of the talk.

 

[deleted480308]

I'd be especially curious to hear your thoughts about the topic after having viewed any portion of the talk.

I’m a doctor, I’ve seen a hundred talks of people (doctors and otherwise) pushing the notion that doctors should be responsible for pushing the govt to do literally everything for everyone.

That’s not an appropriate role for the healthcare professional. My job is to be good at what I do. I’m not God and the govt shouldn’t be pretending to be either. All the details of my patient’s lives are not my jurisdiction. And I shouldn’t be using the white coat to push my personally felt political agendas.

 

[PsyDr]

1) It’s a tedX talk. Wholly different thing than a ted talk.

2) Life isn’t fair. The only thing we can change is ourselves. We are responsible for our own actions, despite the background.

 

[Skye18]

This climate is already incredibly politically volatile, and I would be hesitant at best to politicize yet another component of our social fabric. If anything, I can see this just creating political lines through what should be a neutral institution.

 

[Fan_of_Meehl]

I saw a TED talk recently where the speaker shared some useful allegories for the effects of racism on the provision of health care services, and the downstream consequences. Given that we as psychologists often view our role in the health care system not simply as providers but also as leaders/administrators of the system, what do people see as the role of psychologists and how it relates to social justice/injustice?

The TED Talk
Dr. Camara Jones is a family physician and epidemiologist whose work focuses on the impacts of racism on the health and well-being of the nation. She seeks to broaden the national health debate to include not only universal access to high quality health care, but also attention to the social determinants of health (including poverty) and the social determinants of equity (including racism).

I listened. Whenever anyone talks about 'social DETERMINANTS' (i.e., those things that CAUSE other things), we have to be mindful of the lesson we all learned in intro to psychology courses, namely, that correlation does not equal causation. Usually, research in this area tends to focus on correlating one variable with another variable and going on to wax poetically about how one 'causes' the other (consistent with particular philosophical/ideological theories popular at the time) without causation having actually been established and without examining a multivariate landscape or utilizing methodology that would actually more directly address causation (rather than association). Those who propose alternative explanations and/or suggestions to critically (if methodologically possible) test/refute the author's hypotheses are generally subjected to ad hominem accusations of being 'uninformed,' 'lacking competence,' 'insensitive,' etc. if not outright being accused of being racist/sexist/bigoted/homophobic/etc. It gets really tiresome. I'm open to listening to any arguments that apply to the field of psychology but I also expect those putting forward those arguments to be open to critical debate/discussion. It's been my observation, over many years, that any research (and its proponents) in the areas of 'multicultural diversity,' 'racism,' 'diversity,' etc. within the field does a very poor job at truly adhering to a scientific approach that involves critically examining and questioning (by attempts at falsification) their own theories/hypotheses and they tend to react poorly to those who would offer substantive methodological critique. Heretical rant over.

 

[Sanman]

The role on social justice? None. The practice of psychology has its roots historically in upper middle class society and particularly among Viennese Jewish people.

Social justice is a traditional social work ideal. We can see how well a focus on social justice has treated them. Can't walk down the street without running into a rich social worker in a Porsche 911.

 

[Ollie123]

Very tough question to answer. I in part agree with others - social justice has kind of become a catch-all term so it depends exactly what is meant by it. Similarly, its important to differentiate the role of "psychology" versus the role of "individual psychologists". Evaluating developmental delays in toddlers absolutely falls under the purview of psychology, but isn't something I am likely to ever be involved in myself. Nothing wrong with it (obviously), just has zilch to do with where my efforts are focused.

- I think all psychologists have a responsibility to help ensure the public and politics are informed of the latest research on mental health when prompted. This includes things like environmental causes, health disparities, etc. so includes elements of social justice as I define it.
- I think it is admirable when people want to dedicate themselves to advancing certain causes that research suggests will lead to better mental health at a societal level. This can come in many forms that vary in the degree to which they fall under a professional role. Doing cutting-edge health disparities research would clearly fall under a professional role. I'd certainly consider that to fall under the social justice umbrella and I imagine exceedingly few people would take issue with anyone doing that (and those who do are likely not people I'd consider worth listening to). Voting for Bernie would fall at the opposite end of the spectrum and is clearly a personal matter.

I clearly have a somewhat broader view of what psychology entails than some on this board, but I think public/population health can certainly fall within our wheelhouse. There is a whole lot of grey in between the things I describe above. That is the issue here. Can psychologists advocate for criminal justice reform? Of course! Should they? Probably? But it kinda depends exactly what reforms? Are they ethically obligated to close their clinic to attend the latest BLM rally? No. Could they? If they want.

So in short - I think psychologists have a boatload they can contribute to social justice and as a profession (but not necessarily all individuals) we should be Beyond that, I think the question is too broad to answer.

Despite being heavily neuroscience and pharmacology-based these days, the broader conceptual framework guiding my research certainly dovetails with elements from social justice movements (e.g. opportunities for access to reinforcers). This is not by accident. I mention this just because I do also need to say that I agree with the above that a disappointing large amount of the social justice research is pure indisputable trash science. Unfortunately, a not insignificant amount of advocacy has spawned from that. So caution is needed. Even as someone who supports the broader missions they are often setting out to achieve, implementation needs to be better.

 

[DynamicDidactic]

I do not support codifying social justice advocacy within the field of psychology. I am in support of other psychologists being social justice advocates but without the expectations that all psychologists should be social justice advocates. I advocate on behalf of the people I work with, which I think should be part of psychology. However, this does not mean the broad social justice advocacy one finds in other fields.

More importantly, I prioritize scientific advocacy. I am particularly concerned when scientific findings clash with social justice beliefs. Unfortunately, I see (my anecdotal experiences) the APA move toward social justice much faster than science.

 

[DynamicDidactic]

particularly among Viennese Jewish people.

I separate psychoanalysis from psychology. Psychoanalysis was not started by psychologists, it has its own schools, and its own history. Of course, psychoanalysis permeated all of mental health. But as time marches forward, psychoanalysis (and its successors) are slowly being pushed out of psychiatry and psychology. Nowadays, social work and other masters-level fields are the most common trainees in schools of psychoanalysis (I've been told anyway).

I think the history is relatively clear that the roots of psychology are within measurement and science, which lead to treatment.

 

[DynamicDidactic]

a disappointing large amount of the social justice research is pure indisputable trash science.

 

[Sanman]

I separate psychoanalysis from psychology. Psychoanalysis was not started by psychologists, it has its own schools, and its own history. Of course, psychoanalysis permeated all of mental health. But as time marches forward, psychoanalysis (and its successors) are slowly being pushed out of psychiatry and psychology. Nowadays, social work and other masters-level fields are the most common trainees in schools of psychoanalysis (I've been told anyway).

I think the history is relatively clear that the roots of psychology are within measurement and science, which lead to treatment.

I'm not so sure it is easy to separate the roots of clinical psychology practice. Alfred Adler mentored Maslow and formed the roots of humanistic psychology. Albert Ellis was a trained psychoanalyst and Jungian Analyst trained in NY before he defected and started Rational Emotive Therapy. Sullivan and Erikson were analysts who laid the groundwork Klerman to develop interpersonal therapy. More than psychoanalysis came out of Vienna, Poland, and a later generation in NY.

 

[jdawg2017]

One major role I think we have is disseminating evidence-based assessments and treatments. It’s not entirely the case, but much of social work is not situated is an evidence-based framework, but as a field social work and master’s level clinicians are broadly providing a lot more therapeutic care than psychologists as a group. Evidence based treatments may have even less utilization by social works in underserved communities and organizations in which case loads are high and complex. We still have a lot of research to do about how to apply these EBTs with diverse groups, but we need to partner with community organizations to do this research and disseminate what we can demonstrably use to assess and treat psychological disorders.

Aside from that, I largely agree with what’s been posted that our job should consist in doing what we know best, as not everyone can do everything. Of course, we can and should do what we do attuned to the backdrop of social inequality and work toward figuring out ways to not minimize legitimate inequality experiences with patients while still figuring out ways to most adaptively live in their current context.

 

[DynamicDidactic]

I'm not so sure it is easy to separate the roots of clinical psychology practice.

There is definitely cross contamination. At one time psychoanalysis was the most commonly found approach in clinical psychology and psychiatry. However, both fields existed prior to Freud and in a few generation will hopefully be rid of much of the pseudoscience that came from Freud.

My goal was to disagree with the following:

the roots of clinical psychology in upper middle class society and particularly among Viennese Jewish people

My take on the history: I think the "roots" of clinical psychology (in the US) are first and foremost rooted in psychology either from the Wundt or James trees. Slight run ins with clinical work afterward (mostly learning disorders and intellectual functioning). Then, after WWII, clinical psychology all of sudden gets thrust onto the VAs and clinical psychology adopts the only thing available, Freudian ideas. Since then it has been a slow move away from those ideas. It would make sense many of the big names started with Freudian ideas but used their psychology training to move toward something else. I think the roots of clinical psychology are rooted in measurement and science with an entanglement of Freud when there was no science of psychotherapy.

More than psychoanalysis came out of Vienna, Poland, and a later generation in NY.

In your original statement, did you mean something different than psychoanalysis when you said among Viennese Jewish people? Were there other important clinical approaches that came out of Vienna?

 

[Sanman]

There is definitely cross contamination. At one time psychoanalysis was the most commonly found approach in clinical psychology and psychiatry. However, both fields existed prior to Freud and in a few generation will hopefully be rid of much of the pseudoscience that came from Freud.

My goal was to disagree with the following:


My take on the history: I think the "roots" of clinical psychology (in the US) are first and foremost rooted in psychology either from the Wundt or James trees. Slight run ins with clinical work afterward (mostly learning disorders and intellectual functioning). Then, after WWII, clinical psychology all of sudden gets thrust onto the VAs and clinical psychology adopts the only thing available, Freudian ideas. Since then it has been a slow move away from those ideas. It would make sense many of the big names started with Freudian ideas but used their psychology training to move toward something else. I think the roots of clinical psychology are rooted in measurement and science with an entanglement of Freud when there was no science of psychotherapy.


In your original statement, did you mean something different than psychoanalysis when you said among Viennese Jewish people? Were there other important clinical approaches that came out of Vienna?

I don't disagree with this, though I would consider Wundt and James the founders of the science of Psychology. I would say that psychoanalysis, humanism, as well as the general practice of psychotherapy can trace its roots in European Jewish tradition in the upper middle classes that came over to the U.S. in the early half of the 20th century. Germany and Austria more generally was the seat of the most of the roots of psychology and and immigrants to the U.S. were those that were the early pioneers. Modern psychotherapy, as you mentioned began through the VA following WWII and really intertwined the science and the practice.

The larger point being that the roots of this practice were never particularly focused on social justice or helping those of lesser means. Social work, on the other hand, was founded in England to deal with economic upheaval, poverty, and social justice.

 

[cara susanna]

This is pretty funny because I've seen Freudians criticize CBT for being "capitalist" (emphasis on functioning, time-limited approach fits with insurance model, etc)

As for the general question, I think that psychology can and probably should have a role in social justice. That being said, I think that sometimes APA needs to step back from its announcements because it can hurt our field's credibility. Also, I'd rather that they focus on protecting our scope than saying things like "discrimination is bad."

 

[WisNeuro]

This is pretty funny because I've seen Freudians criticize CBT for being "capitalist" (emphasis on functioning, time-limited approach fits with insurance model, etc)

As for the general question, I think that psychology can and probably should have a role in social justice. That being said, I think that sometimes APA needs to step back from its announcements because it can hurt our field's credibility. Also, I'd rather that they focus on protecting our scope than saying things like "discrimination is bad."

To be fair, the lion's share of lobbying and money is actually spent on practice issues, reimbursement, and fighting against scope creep into our profession, the social issues just seem bigger than they are because they are hot button topics and get magnified in social media and by news sources. Unfortunately, people choose to only see the social justice stuff and stop financially supporting our lobbying arms, leaving less money and resources to actually fight for practice-related issues.

 

[PsyDr]

Psychology has this weird “fight the power” 1960s bs, without any vague self awareness that not only do psychologists have insufficient social capital to make any meaningful change, but also that they are an agent of social reinforcement.

Of course, this is usually just a way to discharge some anxiety without actually having to you know, do anything. It’s just the same as psychologists saying “someone should do something about reimbursements”, and then say they don’t have enough money to donate to lobbyists or time to call politicians. Simple nonsense.

Some people have low IQs, some people are ugly, some people are born into poverty, etc. there’s no psychotherapy or pill in the world that will force the world to act like those factors are just as widely desired as the converse.

 

[WisNeuro]

Of course, this is usually just a way to discharge some anxiety without actually having to you know, do anything. It’s just the same as psychologists saying “someone should do something about reimbursements”, and then say they don’t have enough money to donate to lobbyists or time to call politicians. Simple nonsense.

We are constantly getting calls from psychologists, about half of which are non-members of our state org, because of problems they are having with reimbursements from regional insurers. We actually ask them why they are not members most of the time "well, I'm just not sure what good it'll do..." Apathy and willful ignorance is the downfall of psychology.

 

[PsyDr]

We are constantly getting calls from psychologists, about half of which are non-members of our state org, because of problems they are having with reimbursements from regional insurers. We actually ask them why they are not members most of the time "well, I'm just not sure what good it'll do..." Apathy and willful ignorance is the downfall of psychology.

I personally believe it is something much more primal and immature. Might be related to the simultaneous needs to benefit from structures (e.g., professional associations) and the need to feel like one's capabilities are being held back by said structures (e.g., "If they would just get that right, I could make more money, and then I could give it to them"). Might help avoid a realistic self appraisal and resulting narcissistic injury.

There’s a reason some 60+year old psychologists tell you who they trained under, at every chance they get.

 

[WisNeuro]

There’s a reason some 60+year old psychologists tell you who they trained under, at every chance they get.

Well, I did attend the 90th birthday party of Albert Ellis...

 

[Sanman]

I personally believe it is something much more primal and immature. Might be related to the simultaneous needs to benefit from structures (e.g., professional associations) and the need to feel like one's capabilities are being held back by said structures (e.g., "If they would just get that right, I could make more money, and then I could give it to them"). Might help avoid a realistic self appraisal and resulting narcissistic injury.

There’s a reason some 60+year old psychologists tell you who they trained under, at every chance they get.

Honestly, I think it harkens back to the age old problem I'm our profession that continues to plague would be students. Many people work in the insurance based model, but the dream is the $300/hr self-pay practice with the swanky office sitting your nice leather chair. Some make it a reality and others suffer from the apathy of those that attempt to follow that dream. So, we end up like those poor people against an estate tax because they might win the lotto or be rich some day.

 

[Sanman]

Well, I did attend the 90th birthday party of Albert Ellis...

Did you get him a gift?

 

[WisNeuro]

Did you get him a gift?

My presence.

 

[deleted480308]

Honestly, I think it harkens back to the age old problem I'm our profession that continues to plague would be students. Many people work in the insurance based model, but the dream is the $300/hr self-pay practice with the swanky office sitting your nice leather chair. Some make it a reality and others suffer from the apathy of those that attempt to follow that dream. So, we end up like those poor people against an estate tax because they might win the lotto or be rich some day.

Or because they think pillaging someone’s estate is morally wrong

 

[Justanothergrad]

Very tough question to answer. I in part agree with others - social justice has kind of become a catch-all term so it depends exactly what is meant by it. Similarly, its important to differentiate the role of "psychology" versus the role of "individual psychologists". Evaluating developmental delays in toddlers absolutely falls under the purview of psychology, but isn't something I am likely to ever be involved in myself. Nothing wrong with it (obviously), just has zilch to do with where my efforts are focused.

- I think all psychologists have a responsibility to help ensure the public and politics are informed of the latest research on mental health when prompted. This includes things like environmental causes, health disparities, etc. so includes elements of social justice as I define it.
- I think it is admirable when people want to dedicate themselves to advancing certain causes that research suggests will lead to better mental health at a societal level. This can come in many forms that vary in the degree to which they fall under a professional role. Doing cutting-edge health disparities research would clearly fall under a professional role. I'd certainly consider that to fall under the social justice umbrella and I imagine exceedingly few people would take issue with anyone doing that (and those who do are likely not people I'd consider worth listening to). Voting for Bernie would fall at the opposite end of the spectrum and is clearly a personal matter.

I clearly have a somewhat broader view of what psychology entails than some on this board, but I think public/population health can certainly fall within our wheelhouse. There is a whole lot of grey in between the things I describe above. That is the issue here. Can psychologists advocate for criminal justice reform? Of course! Should they? Probably? But it kinda depends exactly what reforms? Are they ethically obligated to close their clinic to attend the latest BLM rally? No. Could they? If they want.

So in short - I think psychologists have a boatload they can contribute to social justice and as a profession (but not necessarily all individuals) we should be Beyond that, I think the question is too broad to answer.

Despite being heavily neuroscience and pharmacology-based these days, the broader conceptual framework guiding my research certainly dovetails with elements from social justice movements (e.g. opportunities for access to reinforcers). This is not by accident. I mention this just because I do also need to say that I agree with the above that a disappointing large amount of the social justice research is pure indisputable trash science. Unfortunately, a not insignificant amount of advocacy has spawned from that. So caution is needed. Even as someone who supports the broader missions they are often setting out to achieve, implementation needs to be better.

This. 100% This.

It is impossible to remove 'social justice' from the role of psychologist practitioner, or from the field in large. This doesn't mean leading marches with your clients, but when they come back with X perception of racism or Y perception of opportunity, you challenge and align changing those views / supporting your client in understanding the barreiers (real and imagined) and how to address them. Likewise, it doesn't mean that every social issue needs psychology leading it, but at an advocacy level issues related to reimbursement and service availability are CRITICAL issues to who and what we do. Ignoring social justice/public health issues that stem from those issues is impossible. It's just a matter of how we frame 'social justice' and what our level of involvement is. Either way, we are involved and we can't avoid that (and shouldn't).

 

[WisNeuro]

Seriously dude, every thread does not need an ideological tagline from Ayn Rand.

 

[Spydra]

This. 100% This.

It is impossible to remove 'social justice' from the role of psychologist practitioner, or from the field in large. This doesn't mean leading marches with your clients, but when they come back with X perception of racism or Y perception of opportunity, you challenge and align changing those views / supporting your client in understanding the barreiers (real and imagined) and how to address them. Likewise, it doesn't mean that every social issue needs psychology leading it, but at an advocacy level issues related to reimbursement and service availability are CRITICAL issues to who and what we do. Ignoring social justice/public health issues that stem from those issues is impossible. It's just a matter of how we frame 'social justice' and what our level of involvement is. Either way, we are involved and we can't avoid that (and shouldn't).

This is precisely my thought. I didn't decide to pursue a degree in this field to lead marches or anything like that, yet it seems like there's a bigger push for everything social justice to be my problem. I'm also still not understanding how anyone gets paid for social justice work. If someone else wants to make such work their mission so be it, but I want to focus on mental health research and assessment. I'd say the closest to social justice I want to get when I'm done with my program is conducting research to establish assessment norms for diverse groups.

 

[mkberry85]

This is precisely my thought. I didn't decide to pursue a degree in this field to lead marches or anything like that, yet it seems like there's a bigger push for everything social justice to be my problem. I'm also still not understanding how anyone gets paid for social justice work. If someone else wants to make such work their mission so be it, but I want to focus on mental health research and assessment. I'd say the closest to social justice I want to get when I'm done with my program is conducting research to establish assessment norms for diverse groups.

Social justice is much more than leading marches; it's the view that individuals deserve equal political, social, legal, and economic opportunities. This plays in mental health, often.

 

[Fan_of_Meehl]

Just out of curiosity...are there ANY people arguing that 'individuals DON'T deserve equal political, social, legal, and economic *opportunities?*'

 

[Sanman]

Just out of curiosity...are there ANY people arguing that 'individuals DON'T deserve equal political, social, legal, and economic *opportunities?*'

Sure there are. A lot of people actually.

 

[WisNeuro]

Just out of curiosity...are there ANY people arguing that 'individuals DON'T deserve equal political, social, legal, and economic *opportunities?*'

In addition to the above, people may say that they believe all people deserve equality across those settings, but their favored policies would indicate otherwise.

 

[deleted480308]

Just out of curiosity...are there ANY people arguing that 'individuals DON'T deserve equal political, social, legal, and economic *opportunities?*'

It depends on the differing use of the word. If opportunities means, “legal freedom to pursue something using their personal time/talent/possessions”? Almost everyone is on board

if opportunities means “the govt takes taxes away from others and gives it to me because I don’t have as much as they do” the number of folks on board drops dramatically

 

[psychstudent5]

I"m a psychologist who is not white and not male. Yes, I think psychology has a role in social justice (a term that encompasses many things). I think it's important for psychology to advocate for policies (not just at the national level) that strive to reduce inequality. Given all the psychology research in health disparities and how racism and sexism lead to increased emotional distress, it's short-sighted to say otherwise. Then again, I'm neither white nor male...so social justice is important to me.

 

[PsyDWannabe]

I"m a psychologist who is not white and not male. Yes, I think psychology has a role in social justice (a term that encompasses many things). I think it's important for psychology to advocate for policies (not just at the national level) that strive to reduce inequality. Given all the psychology research in health disparities and how racism and sexism lead to increased emotional distress, it's short-sighted to say otherwise. Then again, I'm neither white nor male...so social justice is important to me.

#BLOOP!

 

[PsyDr]

I"m a psychologist who is not white and not male. Yes, I think psychology has a role in social justice (a term that encompasses many things). I think it's important for psychology to advocate for policies (not just at the national level) that strive to reduce inequality. Given all the psychology research in health disparities and how racism and sexism lead to increased emotional distress, it's short-sighted to say otherwise. Then again, I'm neither white nor male...so social justice is important to me.

The approach using health stuff is really bad news for our profession. Day one move is to ask if psychologists are legally permitted to diagnose these health conditions. No? Okay, then are you an epidemiologist? No? So you’re just someone taking outside your scope.

 

[beginner2011]

The approach using health stuff is really bad news for our profession. Day one move is to ask if psychologists are legally permitted to diagnose these health conditions. No? Okay, then are you an epidemiologist? No? So you’re just someone taking outside your scope.

Is that true, though? A quick google shows there's a lot of evidence for disparities in mental health care, for example:

https://www.jaacap.org/article/S0890-8567(12)00287-0/fulltext

Integrated Health COE - National Council

The Center of Excellence (CoE) for Integrated Health Solutions advances treatment for co-occurring physical and mental health conditions.

www.integration.samhsa.gov

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.27.2.393

 

[Fan_of_Meehl]

Is that true, though? A quick google shows there's a lot of evidence for disparities in mental health care, for example:

https://www.jaacap.org/article/S0890-8567(12)00287-0/fulltext

Integrated Health COE - National Council

The Center of Excellence (CoE) for Integrated Health Solutions advances treatment for co-occurring physical and mental health conditions.

www.integration.samhsa.gov

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.27.2.393

I think the issue for a lot of people involves the questions regarding the causes (the why?) of said disparities/differences. In every other area of clinical psychology we adhere to a scientific approach which generally means examining multiple different theories of causation, complex (multi-factorial) causation, and, very importantly, a skeptical/critical attitude towards ALL theories that are employed to make causal claims as well as vigorous debate among various scholars. This is an area where anyone even daring to question the claims of the univariate ('racism explains everything') approach is immediately attacked with ad hominems (they're 'racist,' or 'ignorant'). It's bizarre to witness.

 

[futureapppsy2]

I think the issue for a lot of people are the questions regarding the causes (the why?) of said disparities/differences. In every other area of clinical psychology we adhere to a scientific approach which generally means examining multiple different theories of causation, complex (multi-factorial) causation, and, very importantly, a skeptical/critical attitude towards ALL theories that are employed to make causal claims as well as vigorous debate among various scholars. This is an area where anyone even daring to question the claims of the univariate ('racism explains everything') approach is immediately attacked with ad hominems (they're 'racist,' or 'ignorant'). It's bizarre to witness.

I do a lot of social justice-y work, including on health disparities, and no one is coming up with a single variable they label as "racism" and saying that is explains everything (or at least no one getting published in a halfway decent journal). People are examining different experiences and stressors to see if and how they connect to health outcomes and healthcare use, however.

 

[Fan_of_Meehl]

I do a lot of social justice-y work, including on health disparities, and no one is coming up with a single variable they label as "racism" and saying that is explains everything (or at least no one getting published in a halfway decent journal). People are examining different experiences and stressors to see if and how they connect to health outcomes and healthcare use, however.

Is there a representative book, book chapter, or manuscript that lays out an important area of vigorous debate within the field among the experts on some controversial issue. I'm thinking along the lines of the book 'Current Controversies in the Anxiety Disorders' where various experts had vigorous debates and were critical of one another's research and the conclusions they drew from it. Without controversy, there is no meaningful scientific process.

Edit: Of course they don't openly label it (literally) 'racism.'

But, regardless of the language, the predominant explanatory framework appears to be attributing all/most of the causal influence to sociocultural factors that point to 'racism,' 'discrimination,' 'bias,' etc.

 

[WisNeuro]

Is there a representative book, book chapter, or manuscript that lays out an important area of vigorous debate within the field among the experts on some controversial issue. I'm thinking along the lines of the book 'Current Controversies in the Anxiety Disorders' where various experts had vigorous debates and were critical of one another's research and the conclusions they drew from it. Without controversy, there is no meaningful scientific process.

Edit: Of course they don't openly label it (literally) 'racism.'

But, regardless of the language, the predominant explanatory framework appears to be attributing all/most of the causal influence to sociocultural factors that point to 'racism,' 'discrimination,' 'bias,' etc.

You have to be a little careful, as you are proceeding in the same manner that you are decrying. You started your argument very adversarial and accused everyone of doing this research as essentially putting the cart before the horse in engaging in research to "prove" an a priori line of thought rather than exploring it via the scientific method. @futureapppsy2 has always engaged in these discussions from a good faith position. I think we can have this discussion by giving them the same respect and openness that they bring to the table.

 

[PsyDr]

Is that true, though? A quick google shows there's a lot of evidence for disparities in mental health care, for example:

https://www.jaacap.org/article/S0890-8567(12)00287-0/fulltext

Integrated Health COE - National Council

The Center of Excellence (CoE) for Integrated Health Solutions advances treatment for co-occurring physical and mental health conditions.

www.integration.samhsa.gov

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.27.2.393

Yeah, that's not what APA is advocating for or about. They are advocating for such conditions as: "diabetes", HIV, "cancer", etc. There are no states in the union that allow psychologists to diagnose those conditions. "Dr. how many patients a month do you diagnose with "cancer"? Isn't it true that you are not licensed to diagnose cancer? And you're not an oncologist? epidemiologist? etc.

I have no issue with discussing disparities in mental healthcare. That is easily within our purview. By extending the issue outside of our scope, it makes us look ridiculous.

 

[Fan_of_Meehl]

You have to be a little careful, as you are proceeding in the same manner that you are decrying. You started your argument very adversarial and accused everyone of doing this research as essentially putting the cart before the horse in engaging in research to "prove" an a priori line of thought rather than exploring it via the scientific method. @futureapppsy2 has always engaged in these discussions from a good faith position. I think we can have this discussion by giving them the same respect and openness that they bring to the table.

I'm genuinely interested in areas of actual, vigorous, scientific controversy in this subarea of psychology. I am (and have) asked this in good faith. I don't appreciate you taking a tack of criticizing me for asking the question.

 

[WisNeuro]

We're actually having discussions about some of this within our own state association governance. Some SJ issues clearly intersect with practice of psychology, some more tangentially so. Additionally, how much time and resources do we put into this stuff, vs more resources in legislative advocacy regarding things such as reimbursement rates, telehealth, etc.

I'm genuinely interested in areas of actual, vigorous, scientific controversy in this subarea of psychology. I am (and have) asked this in good faith. I don't appreciate you taking a tack of criticizing me for asking the question.

Sure, but the way you phrase your questions certainly doe snot sound like you're entering this in good faith. I think for many things here, you do indeed. But, for this certain set of issues, I think you put some blinders on.

 

[Fan_of_Meehl]

We're actually having discussions about some of this within our own state association governance. Some SJ issues clearly intersect with practice of psychology, some more tangentially so. Additionally, how much time and resources do we put into this stuff, vs more resources in legislative advocacy regarding things such as reimbursement rates, telehealth, etc.



Sure, but the way you phrase your questions certainly doe snot sound like you're entering this in good faith. I think for many things here, you do indeed. But, for this certain set of issues, I think you put some blinders on.

I appreciate the direct feedback. However, I think (especially when interpreting written expressions), assuming 'bad faith' from someone and accusing them of asking questions out of 'bad faith' is pretty offensive and impossible to defend against because you are just stating your perception. That's cool that it's your perception but I would say that we are a scientific discipline and asking questions is not operating 'in bad faith.' And, at it's heart, it's simply a subtle ad hominem.

 

[futureapppsy2]

Is there a representative book, book chapter, or manuscript that lays out an important area of vigorous debate within the field among the experts on some controversial issue. I'm thinking along the lines of the book 'Current Controversies in the Anxiety Disorders' where various experts had vigorous debates and were critical of one another's research and the conclusions they drew from it. Without controversy, there is no meaningful scientific process.

Edit: Of course they don't openly label it (literally) 'racism.'

But, regardless of the language, the predominant explanatory framework appears to be attributing all/most of the causal influence to sociocultural factors that point to 'racism,' 'discrimination,' 'bias,' etc.

Things like "racism", "discrimination", and "bias" are broad, multifactorial concepts, and any research on health disparities/issues in marginalized groups is going to break them down and examine individual pieces of those concepts. I'm a violence researcher by trade, so often the dimension of oppression I'm looking at is being raped/beaten/etc. We know a lot of marginalized groups experience these things much more often, and it's reasonable to hypothesize that that likely contributes to the poorer health outcomes that we see in these groups. We can and have empirically studied this as well. We know chronic stress tends to lead to poorer outcomes and discrimination--in many forms, objective and subjective alike--is a source of chronic stress, so we study that. I'm not really sure how you're conceptualizing this really, really broad area of research, because it's not new, small, or homogenous.

Are there ideas and norms that are established in these areas, and is pushing back against those norms often hard? Yes, of course, but that's the same in literally any area of psychology or medicine.

 

[WisNeuro]

I appreciate the direct feedback. However, I think (especially when interpreting written expressions), assuming 'bad faith' from someone and accusing them of asking questions out of 'bad faith' is pretty offensive and impossible to defend against because you are just stating your perception. That's cool that it's your perception but I would say that we are a scientific discipline and asking questions is not operating 'in bad faith.' And, at it's heart, it's simply a subtle ad hominem.

Ok, bad faith may not be the best term, as it may imply malicious intent. So, we can drop that. And it's fine to ask the questions about the science, but, they answered one of your questions, and your response was fairly dismissive, rather than opening a more constructive dialog.

 

[Fan_of_Meehl]

Ok, bad faith may not be the best term, as it may imply malicious intent. So, we can drop that. And it's fine to ask the questions about the science, but, they answered one of your questions, and your response was fairly dismissive, rather than opening a more constructive dialog.

Things like "racism", "discrimination", and "bias" are broad, multifactorial concepts, and any research on health disparities/issues in marginalized groups is going to break them down and examine individual pieces of those concepts. I'm a violence researcher by trade, so often the dimension of oppression I'm looking at is being raped/beaten/etc. We know a lot of marginalized groups experience these things much more often, and it's reasonable to hypothesize that that likely contributes to the poorer health outcomes that we see in these groups. We can and have empirically studied this as well. We know chronic stress tends to lead to poorer outcomes and discrimination--in many forms, objective and subjective alike--is a source of chronic stress, so we study that. I'm not really sure how you're conceptualizing this really, really broad area of research, because it's not new, small, or homogenous.

Are there ideas and norms that are established in these areas, and is pushing back against those norms often hard? Yes, of course, but that's the same in literally any area of psychology or medicine.

I guess that what I'm trying to say is that whenever I try to educate myself in this area and read the literature from this area there appears to be a LOT LESS of this (pushing back against the prevailing model/theory or 'controversial' articles or journal issues devoted to people vigorously debating core principles). That's what I was noting and asking about. It's hard to get interested in an area of scientific inquiry where people appear (at least to me) to be more in 'lockstep' in their approach to interpreting the data. There's also the eternal conundrum of how to leverage (in a clinical situation) knowledge that has more to do with what is wrong with society vs. what is dysfunctional within the individual.

 

[deleted480308]

I think there is also an issue in some venues (anecdotal here) where someone wants to question the proposed reason for a disparity or the proposed solution for a disparity and the conversation is crushed by accusations that those with questions either don’t acknowledge or care about the disparity