Workforce analysis of psychological practice with older adults: Growing crisis requires urgent action.

Abstract

As the proportion and sheer number of older adults in the United States continues to increase, we need to plan for their behavioral health care. Access to accurate data about current workforce characteristics in psychology can provide essential information to inform workforce planning. In this paper, we present results of the American Psychological Association's Center for Workforce Studies survey of psychologists, with a focus on older adults. Participants (N = 4,109) were doctoral psychologists identified through state licensing boards. Only 1.2% of those surveyed described geropsychology as their specialty area, although 37.2% reported seeing older adults frequently or very frequently, most often from the specialties of rehabilitation psychology, clinical neuropsychology, and clinical health psychology. Frequent providers of aging services were more likely to be older, nonethnic minority, working in independent practice as their primary work setting, and self-employed as compared to other respondents. In addition, frequent providers of services to older adults were more likely to be in practices colocated with medical professionals and to accept Medicare as payment. Low reimbursement rates were cited as a reason for not accepting Medicare by those who did not. There was strong interest in further education in aging from all psychologists in areas including adjustment to medical illness/disability, depression, bereavement, dementia, anxiety, psychotherapy, and caregiver stress. The results of this survey suggest a continued urgent need to train psychologists across subfields in foundational

Age differences in public stigma, self‐stigma, and attitudes toward seeking help: A moderated mediation model

“…Our findings do not suggest that stigma and attitudes are not barriers to older adults' mental health service use, because they are (Pepin et al, 2015;Wuthrich & Frei, 2015). Instead, research points to other factors as being greater barriers to treatment among older in comparison to younger adults, including perceived need for help (Meadows et al, 2002), poor mental health literacy (Farrer, Leach, Griffiths, Christensen, & Jorm, 2008), and structural barriers such as insufficient geriatric mental health care F I G U R E 3 Gender moderates the moderating influence of age on the association between public stigma and self-stigma of seeking help providers (Bartels & Naslund, 2013;Moye et al, 2019) and poor detection of mental health problems among older patients in primary care (Park & Unützer, 2011). These findings challenge dire warnings about stigma's role in explaining why older adults are especially unlikely to seek mental health services (e.g., Graham et al, 2003;Katona & Livingston, 2000).…”

“…These findings challenge dire warnings about stigma's role in explaining why older adults are especially unlikely to seek mental health services (e.g., Graham et al, 2003;Katona & Livingston, 2000). Instead, research points to other factors as being greater barriers to treatment among older in comparison to younger adults, including perceived need for help (Meadows et al, 2002), poor mental health literacy (Farrer, Leach, Griffiths, Christensen, & Jorm, 2008), and structural barriers such as insufficient geriatric mental health care F I G U R E 3 Gender moderates the moderating influence of age on the association between public stigma and self-stigma of seeking help providers (Bartels & Naslund, 2013;Moye et al, 2019) and poor detection of mental health problems among older patients in primary care (Park & Unützer, 2011).…”

Geropsychology career pipeline perceptions

“…The underrepresentation of racial/ethnic minorities within psychology (16%; APA, 2018) and the general higher education system may further exacerbate restrictions on resources (e.g., barriers to occupational opportunities, experiences of discrimination), support (e.g., limited within group mentorship and community), and subsequent confidence (Fouad & Byars-Winston, 2005;Schwarz & Hill, 2010). Geropsychology providers tend to be older and non-racial-ethnic minorities (Moye et al, 2019), where the older adult demographic is increasingly racially and ethnically diverse (Vespa, Medina, & Armstron, 2020).…”

“…Unfortunately, there is a notable shortage of clinical and academic psychologists trained to address the complex needs of this aging population. Within the American Psychological Association (APA), only 1% of members providing direct patient care have declared geropsychology as a specialty area (Moye et al, 2019). The American Board of Professional Psychology has recognized geropsychology as a specialty since 2012 (American Board of Geropsychology [ABGERO]) and recognizes professional geropsychologists as individuals who have “knowledge, skills, training and experiences in aging and late‐life, particularly related to how the processes of aging and the social and cultural context of being old affect older adults' experience, mental health, and wellbeing” (SCG, 2020).…”

“…Geropsychology is not considered an aspect of “broad and general” psychology training (APA Commission on Accreditation; http://www.apa.org/ed/accreditation/about/index.aspx), and therefore a majority of psychology programs in the United States (67%) do not offer any geropsychology coursework Pachana, Emery, Konnert, Woodhead, & Edelstein, 2010). Rather, training in geropsychology has suffered from benign neglect, possibly due to the assumption that training in areas such as health, rehabilitation, or neuropsychology cover the content and skills‐based competencies required for working with older adults (Moye et al, 2019). Ongoing workgroups disseminate information for psychologists across specialty areas regarding the foundational competencies needed for ethical practice with older adults (Hinrichsen, Emery‐Tiburcio, Gooblar, & Molinari, 2018).…”