Careers in Psychology
is a person with an advanced degree (master's or higher) in
clinical psychology, counseling, industrial psychology,
educational psychology, or one of many other subfields of
psychology. Depending on his or her education and
background, a psychologist works in such roles as
therapist, counselor, researcher, teacher or consultant.
The workplaces of psychologists include private practices, clinics, health maintenance organizations, schools, universities, governmental agencies, private agencies, and industry. Some psychologists work alone. Others work on teams with physicians, nurses, social workers, public health workers and people in non-health related fields.
Health-Related Subfields of Psychology
Scores of career paths are open to psychologists. Here we focus only on health-related areas.
Clinical Psychologists work in such settings as counseling centers, individual and group practices, clinics, hospitals, and rehabilitation centers. They assess and help clients deal with mental, emotional, and behavioral challenges and disorders, including anxiety, depression, post traumatic stress disorder, and phobias. They also help people deal with injury, illness, divorce, abuse, the death of a loved one, and other stressful life events. Some psychologists work mostly with individuals. Others involve family members and others. Some clinical psychologists focus on specific populations such as children, youth or the elderly. Traditional psychotherapy (talk therapy) is central to the practices of many clinical psychologists, but psychologists use a wide range of strategies, depending on the unique needs of the client.
Some clinical psychologists work as members of healthcare teams or as administrators of community and behavioral health programs. Others serve as educators of students and clinicians in psychology and the other health professions. Their work places include healthcare settings as well as universities, medical schools, and other schools in the health professions. A smaller number of psychologists do research.
Counseling psychologists, like clinical psychologists, engage in direct patient care, and some serve as educators, administrators and researchers. In general, the clients of counseling psychologists are healthier than the clients of clinical psychologists. Counseling psychologists are more involved in career and vocational counseling than are clinical psychologists
Health psychologists specialize in biopsychosocial aspects of health and illness. Many have advanced education in psychopharmacology, physiology, and rehabilitation. Typically, health psychologists work with medical professionals in clinical setting. Their work can include the direct care of patients, for example, people with chronic pain or brain injury. Health psychologists also develop patient programs that encourage healthy life styles and discourage smoking and other harmful behaviors. Researchers in health psychology tend to focus on problems, such as substance abuse, risky sexual behavior, and pain reduction. Some health psychologists serve as consultants to healthcare organizations and organizations involved in health policy.
Rehabilitation psychologists work with stroke and accident victims, people with mental retardation, and people with developmental disabilities caused by such conditions as cerebral palsy, epilepsy, and autism. They help clients adapt to their situation, dealing with such issues as pain management and functioning in the work world. Rehabilitation psychologists are also involved in public health programs designed to prevent disabilities. And they testify in court as expert witnesses about the causes and effects of a disability and a person's rehabilitation needs.
Neuropsychologists (and behavioral neuropsychologists) study the relationships between brain systems and behavior, and they explore the clinical application of that knowledge to human problems. For example, they may study the way the brain creates and stores memories or how various diseases and injuries of the brain affect emotion, perception, and behavior. With the dramatic increase in the number of survivors of traumatic brain injury, clinical neuropsychologists work with health teams to help brain-injured people resume productive lives.
For more information on these health-related subfields, as well as other subfields, such as social psychology, industrial/organizational psychology, forensic psychology, and engineering psychology, see the American Psychological Association website.
Spero Manson, Pembina Chippewa, PhD, describes the highly stressful environment in which many American Indian and Alaska Native people live. Manson says that given all these factors it’s not surprising, particularly in rural reservation communities, to find a high prevalence of alcohol, drug, and, mental health problems. Manson, however, stresses, “This is not a statement about moral weakness or characterlogical weakness of Indian and Native people….In fact, it’s incredible that Indian and Native people are as resilient and vibrant and optimistic as they are. This really speaks to the strength of our people.”
The challenges facing Indian and Native people are further exacerbated by the great need for psychologists and other mental health practitioners, particularly in rural reservation communities. The American Psychological Association (APA) recognizes the great mental health disparities, noting that the lack of mental and health and substance abuse services contribute to the high rate of suicide and post traumatic stress disorder. In 2006 the APA called on Congress to provide an additional $30 million to the Indian Health Service for mental health and alcohol and substance abuse programs.
Need for Culturally-Sensitive Services
Hiring just any psychologist, however, doesn’t guarantee that the needs of Indian people will be met. Even when services are available, it is not unusual for American Indian and Alaska Native people to be uneasy about using them or to prematurely discontinue treatment. This is especially true when Native people feel that the mental health professionals are trying to shape their behavior in ways that conflict with traditional values and lifestyle preferences. "Particularly for more traditional people, mental health services are regarded as white man's medicine," says Carolyn Barcus, Blackfeet, EdD. “It isn't their way. Another barrier can be confidentiality. On reservations people know each other. The Indian Health Service is the only game in town on many reservations."
Barcus says that Native people are typically better able than non-Native people to address Native health issues: “If you don’t understand the culture, there’s no way you can give Native people the kinds of treatment that is culturally appropriate. No one understands a culture as well as someone who grew up in it. Even though other peoples’ hearts can be in the right place, there are just certain things about the culture that they aren’t going to comprehend."
Barcus continues, “With their respect for traditional ways, Native psychologists can help make services more responsive to the needs and values of the community and help ensure that both Traditional and Western wisdom are called upon. They can also help people and communities figure out how to prevent behavioral and mental problems in the first place. In addition, Native psychologists can help people and communities enhance their capacities to learn, teach, and work.”
Need for Indian and Native Psychologists in Academe
John Chaney, Mvskoke Creek, PhD, argues that there is a great need for more Native American psychologist-educators who can help shape graduate programs that are relevant to the values, perspectives and needs of Indian people. The competitive atmosphere in many programs is counter to more collaborative Indian ways. Also psychology itself tends to focus on the individual rather than the community. Further, Chaney points out that research is showing that some of the well-established psychological constructs and measurement instruments do not appear to fit the experiences of Indian communities.
These challenges, which are linked to the differences between the dominant western ways and Indian ways, has led Barcus to argue that the “science of American Indian psychology” needs to be created. Native psychologists, she says, “have the opportunity to be in on the ground floor of creating this science, which is currently in the infant stages.”
At the very least, Indian psychologists are in an excellent position to stretch and enrich the whole field of psychology by challenging assumptions and offering alternative perspectives and models.
The U.S. Department of Labor, Bureau of Labor Statistics predicts that employment opportunities for psychologists will grow 12 precent from 2008 to 2018. Employment will grow because of the increased demand for psychological services in schools, hospitals, social service agencies, mental health centers, substance abuse treatment clinics, consulting firms and private companies.
Psychologists are likely to be needed in Indian communities for many years. The Indian Health Service Division of Behavior Health needs psychologists to help with its mission that includes supporting tribal and urban Native communities in reducing the prevalence and incidence of alcoholism, drug dependencies, and behavioral health conditions.
Parts of this article were originally published in the Fall 2000 issue of Winds of Change. (The cover artist is Roy Henry Vickers, Tsimshian and English.)