2019 Ten Trends

A PUBLICATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION • 2018
psychology
monitor on
2019
TRENDS
REPORT
OUR ANNUAL GUIDE TO CHANGES
AHEAD FOR PSYCHOLOGISTS
IN PATIENT CARE, RESEARCH,
TECHNOLOGY, SOCIAL
JUSTICE AND MORE
2019 ANNUAL TRENDS REPORT
10 TRENDS TO WATCH IN 2019

This year’s report on the trends emerging in the psychology field features areas
where psychologists’ research and interventions are transforming patient care,
as well as emerging areas that have the potential to change psychology itself.
Not surprisingly, several of this year’s trends focus on technology.
1 CLIMATE CHANGE IS OUR CALL TO ACTION | 2

2 THE RISE OF NON-DRUG PAIN TREATMENT | 5
AMANDA DALBJORN/UNSPLASH; COVER: BENJAMIN DAVIES/UNSPLASH
3 A GROWING DEMAND FOR SPORT PSYCHOLOGISTS | 8

4 A GREATER ROLE IN NUTRITIONAL HEALTH | 1 1
5 RE-ENVISIONING LONG-TERM CARE | 14
6 SHINING A SPOTLIGHT ON EQUITY | 17
7 BIG DATA GETS BIGGER | 20
8 DESIGNING SMARTER TECH TOOLS | 23
9 TREATING THE MISUSE OF DIGITAL DEVICES | 26
1 0 THE ASCENT OF DIGITAL THERAPIES | 29
M O N I TO R O N P S YC H O LO G Y ● 2 0 1 8 1
Even if we could halt

greenhouse gas emissions
tomorrow, the carbon dioxide
already in the atmosphere will
fuel warming for decades to
come. We have no choice but
to deal with the fallout.
1
CLIMATE CHANGE IS
OUR CALL TO ACTION
Organizations and policymakers are tapping into psychologists’
expertise to find ways to mitigate climate change and help
VEETERZY/UNSPLASH
people adapt to a warming world B Y K I R ST E N W E I R
W
WHEN IT COMES TO THE SCIENCE of climate change,
psychology has long taken a backseat to the geophysical
sciences. Now, more organizations and policymakers are
recognizing the vital role that psychology can play in finding
solutions to mitigate global warming—and helping people
adapt to the inevitable changes to come. ¶ “Psychology is
about contributing to human well-being—climate change is
a significant present and emerging threat to that well-being,”
says Patricia Winter, PhD, a research social scientist at the
FURTHER
READING
“[But] we also need to start
thinking as a professional com-
munity about adaptation. The
idea of psychological impacts is
really beginning to gain interest
and attention.”
Psychologists have recently
begun to study climate-related
factors as sources of psycholog-
ical stress, and early findings
U.S. Forest Service’s Pacific Southwest Research Station, in Psychology and are alarming. Researchers have
Climate Change
Albany, California. “There’s a place here for every subspe- Clayton, S., &
long been aware that the suicide
cialty within psychology, if we work together to find it.” ¶ Manning, C. (Eds.) rate increases in the warmer
Traditionally, much of psychologists’ work on climate change Academic Press, months—and an increase in
has been in areas of behavior change, environmental decision-
2018 warming could drive those
rates higher. A 2018 analysis by
Climate Change:
making and how to effectively as societies, organizations and What Psychology Marshall Burke, PhD, an assis-
communicate pro-environmental governments. Psychologists are Can Offer in Terms tant professor of earth system
messages: How do you get peo- behind such efforts as rewarding of Insights and science at Stanford University,
ple to reduce energy use? What employees’ sustainable behaviors, Solutions and colleagues projected that
incentives encourage people to working with cities to reduce Van Lange, unmitigated climate change
P.A.M., et al.
buy electric cars? their carbon footprint and con- Current Directions
could result in 9,000 to 40,000
Such research continues ducting research to understand in Psychological additional deaths by suicide in
to be essential, says Robert why and when people engage Science, 2018 the United States and Mexico
Gifford, PhD, a psychologist in green behaviors. (Read more by 2050 (Nature Climate Change,
at the University of Victoria, about these approaches in the Mental Health Vol. 8, No. 8, 2018).
and Our Changing
British Columbia, who studies May Monitor article “Building a Climate: Impacts, Researchers also predict that
the interface of environmental, Sustainable Future.”) Implications, and climate-related effects such as
social and personality Guidance more frequent natural disasters,
psychology. HELPING PEOPLE ADAPT Clayton, S., et al. increased migration as well
“Climate change is a human APA and as loss of a sense of place will
Yet even if we could halt green-
ecoAmerica, 2017
problem. It’s the result of 7.6 house gas emissions tomorrow, result in mental health impacts
billion people making decisions the carbon dioxide already in the Beyond the including feelings of loss and
every single day. That right atmosphere will fuel warming Roots of Human hopelessness, more mental
there makes it a psychological for decades to come. We have Inaction: Fostering health emergencies, and higher
problem,” he says. And psychol- no choice but to deal with the Collective Effort rates of aggression and violence,
Toward Ecosystem
ogy has the tools to address that fallout. Conservation according to a 2017 report by
problem, he adds. “We’re the “We certainly need to keep Amel, E., et al. APA and ecoAmerica titled
experts on individual behavior, doing the work we’ve been Science, 2017 Mental Health and Our Changing
we know about messaging and doing, trying to change behav- Climate.
how to create interventions.” ior,” says Susan Clayton, PhD, Such findings highlight a
Those interventions can a professor of psychology and reality that many working in
promote sustainable behav- environmental studies at the the climate change space have
iors among individuals, as well College of Wooster in Ohio. already realized: Climate change
isn’t just a problem for envi-

ronmental psychologists; it’s a
“CLIMATE CHANGE IS … THE RESULT OF
matter that clinical psycholo- 7.6 BILLION PEOPLE MAKING DECISIONS
gists, too, cannot ignore.
EVERY SINGLE DAY. THAT RIGHT THERE
MOVING FORWARD
For 30 years, the United Nations’ MAKES IT A PSYCHOLOGICAL PROBLEM.”
Intergovernmental Panel on
Climate Change (IPCC) has
—ROBERT GIFFORD, PHD, UNIVERSITY OF VICTORIA, BRITISH COLUMBIA
been the world’s authority on

the science of climate change.
In the past, their reports have Conservation Psychology). “That says Linda Silka, PhD, a social
focused primarily on the is a radical departure from what and community psycholo-
geophysical aspects of global we witnessed in the past.” gist and a senior fellow at the
warming. For the next install- Beyond the IPCC, climate University of Maine’s Sen.
ment of its assessment report, change experts and activists George J. Mitchell Center for
due out in 2021, the IPCC has in other disciplines are finally Sustainability Solutions.
made an effort to include psy- appreciating what psychology “This is a challenge that is
chologists in the outlining and has to offer, says Clayton. “I’m Thousands of so complex, just having more
writing process. seeing a lot of interdisciplinary protesters came data isn’t going to lead directly
to Ocean Beach
“The IPCC, for the first time organizations and projects where in San Francisco to solutions that everyone will
in its history, has acknowledged people are asking psychologists on Feb. 11, agree on,” she says, adding that
the relevance and importance of to be part of the team. There has 2017, to send a psychologists can help bridge
message regarding
psychological theory to helping definitely been an increase in the administration cross-disciplinary gaps to work
build a more resilient future,” recognition by nonpsychologists policies: “Resist!!” toward solutions. For instance,
says psychologist John Fraser, that psychology has an import- she’s working on a National
PhD, president and CEO of ant role to play in addressing Science Foundation–funded
the social science think tank climate change.” project with engineering faculty
NewKnowledge and president And the climate problem and climate scientists at the
of APA Div. 34 (Society for needs all the help it can get, University of New Hampshire.
Environmental, Population and from experts across disciplines, The project aims to use climate
models to inform infrastructure
development—understanding
how higher temperatures will
affect asphalt, for instance, or
how to build bridges that will
withstand rising seas. But the
engineers and climate scientists
weren’t used to speaking the
same professional language, so
they called on social scientists
including Silka to help them
work together more effectively.
“More people are seeing
that they need someone who
can help them find common
TIM GOUW/UNSPLASH
ground—and that’s one of the

tools psychologists have in their
toolkit,” Silka says. n
Two factors are leading
2019 ANNUAL TRENDS REPORT physicians to increasingly
seek psychologists’
expertise in pain care:
the opioid crisis and a
greater awareness of the
psychological factors
involved in pain.
2
THE RISE OF NON-DRUG
PAIN TRE ATMENT
As the United States fights an opioid crisis, psychologists
MILADA VIGEROVA/UNSPLASH
are in demand for nonpharmacological treatment options for

chronic pain—though hurdles remain B Y L E A W I N E R M A N
A
ABOUT 100 MILLION AMERICANS live with some form
of chronic pain—more people than are affected by diabetes,
heart disease and cancer combined. For nearly two decades
beginning in the late 1990s, the first-line treatment for many
of these patients was opioid drugs. But over the past several
years, as physicians and health officials realized that opioid
overprescription had spiraled into an addiction crisis, the tide
has turned. The Centers for Disease Control and Prevention
altered its guidelines for prescribing the drugs in 2016; several RESOURCES
to steer their thoughts away
from “catastrophizing” pain and
toward thinking of pain as a
manageable problem that they
can address through treatment
and self-care. CBT-based pro-
grams provide education about
pain, self-management skills
and psychological tools to help
patients manage symptoms,
states have passed laws limiting their use; and opioid pre- become more active and live
scriptions decreased 22 percent between 2013 and 2017 as Core better within the context of pain.
Competencies
physicians’ awareness of their risks increased. ¶ These changes for the Emerging In a new comprehensive
have wrought a powerful new incentive for doctors to look Specialty of Pain literature review, the Agency
for non-drug treatments for pain, including psychological Psychology for Healthcare Research and
Wandner, L., et al. Quality (AHRQ, 2018) found
treatments, says psychologist American that CBT can lead to long-term
Defense (DOD)—to study non-
Psychologist, 2018
Beth Darnall, PhD, a clinical pharmacological pain treatments improvements in patients with
psychology professor in the for veterans. Psychological lower back pain and fibromyal-
department of anesthesiology, “There’s a growing apprecia- Treatments for gia. (The review also looked at
perioperative and pain medi- tion for the psychosocial aspects Patients With neck pain, osteoarthritis and hip
cine at Stanford University and of pain,” says Sean Mackey, Chronic Pain pain, but found either no long-
Darnall, B.
author of the new APA book MD, PhD, an anesthesiologist APA, 2018
term improvement due to CBT
“Psychological Treatments for and director of the division of or insufficient evidence to make
Patients With Chronic Pain.” pain medicine at Stanford. “It’s Pain Psychology: a determination.)
“We’ve always known that growing for two reasons: One is A Global Needs Other psychological and
pain is best treated biopsycho just a greater awareness of the Assessment and behavioral treatments include
National Call to
socially, with an integrated psychological factors that play Action acceptance and commitment
approach,” Darnall says. “When a role in pain. The second is the Darnall, B., et al. therapy, hypnosis and mind-
we talk about treating pain in a opioid crisis. It’s going to be a Pain Medicine, 2016 fulness-based stress reduction
way that has the lowest risks, it tragic benefit of the opioid crisis (MBSR), among others. In one
necessarily involves behavioral that it will bring attention to recent randomized clinical trial,
and psychological treatment.” pain psychology.” for instance, researchers found
Now, the opioid crisis that two months of either mind-
has spurred new interest in EVIDENCE-BASED fulness training or CBT could
these long-standing treat- TREATMENTS improve symptoms and function-
ment options—as well as some Research into psychological ing in 342 patients with chronic
new funding. That includes an and behavioral treatment for lower back pain, relative to usual
$81 million investment by a pain dates back decades. The care (Journal of the American
collaboration of three govern- most common psychological Medical Association, 2016).
ment agencies—the National treatment for pain is cognitive- And importantly, no studies
Institutes of Health (NIH), the behavioral therapy (CBT). have found documented harms
Department of Veterans Affairs Through CBT-based programs, from these psychological treat-
(VA) and the Department of Darnall says, patients can learn ments, as opposed to the definite
risks of opioids and other phar- ford pain clinic loses money on
macological treatments. the services that its five psychol-
Armed with these results, ogists provide. “I could force
physicians are eager to prescribe them to cover their expenses
behavioral pain treatments, says by giving them less time to see
Darnall, who offers continuing- patients, but then they can’t
education lectures to national provide the services the patients
physician groups. “Physicians deserve,” he says. “So I’ve made a
are intensely interested in how decision to lose money on it for
to connect their patients to the greater good. We would like
behavioral pain management,” to see reimbursements increase.”
she says. “Their questions are: Those structural issues will
How do I implement this? And take time to address, but in the
who do I refer them to in my meantime, research continues on
community?” expanding access to behavioral
treatment for pain. For example,
CHALLENGES the $81 million NIH-VA-DOD
Those questions often have no collaboratory will fund 11 large-
easy answers. “The barriers are scale “pragmatic clinical trials” to
implementation, access and look at how military and veteran
insurance,” says Darnall. health-care providers can add
First, there are simply not management at the VA. nonpharmacological treat-
enough psychologists trained In an article in Pain Medicine, ments, including psychological
in pain psychology, a problem Kerns, Darnall, Mackey and treatments like mindfulness and
Tennessee pain psychologist their co-authors cited the need CBT, to the care they provide.
Ted Jones, PhD, sees daily at a for more pre- and postdoctoral Psychological Meanwhile, Darnall is work-
medical pain clinic in Knoxville. training programs in pain psy- and behavioral ing to bring behavioral pain
treatments
While the clinic has an active chology, with the goal of making include cognitive- treatment to more patients by
patient load of 1,600 people, it it an APA specialization (Pain behavioral therapy, developing shorter treatments
has only two psychologists to Medicine, 2016). acceptance and and treatments that can be deliv-
commitment
provide services to them. In addition to training, therapy, hypnosis ered online. She has developed a
“We’re seeing more and more another challenge is reimburse- and mindfulness- single-session, two-hour CBT-
patients here, and we’d like to ment. Some insurance companies based stress based pain psychology class and
reduction.
offer more services,” says Jones, and public insurance programs is conducting a randomized
who evaluates potential candi- don’t cover behavioral treatment clinical trial to compare its effec-
dates for drug treatments and for pain, or they reimburse for tiveness with that of a standard
provides psychological treat- it at a lower rate than physical eight-week course of CBT.
ments like CBT in group and treatments such as medications In another clinical trial, she’s
individual sessions. He would or injections, which makes it investigating whether an online
like to hire another psycholo- more difficult for some patients CBT-based class can help reduce
gist—but he can’t find a good to access these treatments. recovery pain in surgical patients.
candidate. The issue is not universal and Overall, the aim is to bring
“We haven’t yet built the varies by location—Jones, for the benefits of pain psychology
incentives that would encour- example, says that he generally treatment to as many patients as
age enough psychologists to has not had problems with possible. “Psychology is already
SAM BURRISS/UNSPLASH
go into this field,” says Robert reimbursement, including from integrated into the definition of
Kerns, PhD, a professor at Yale TennCare, Tennessee’s Medicaid pain,” Darnall says. “It is not an
University and former national program. ‘alternative’ treatment, it is a pri-
program director for pain But Mackey says the Stan- mary treatment for pain.” n
While improving
2019 ANNUAL TRENDS REPORT performance remains
a cornerstone of
sport psychology, it’s
only a slice of what
sport psychologists
are now doing to
support athletes.
3
A GROWING
DEMAND FOR SPORT
PSYCHOLOGISTS
With the issues of mental health, violence and activism in sports on the rise,
more athletes and teams are seeking the expertise of sport psychologists
AMR/GETTY IMAGES
B Y K I R ST E N W E I R
S
SPORTS ARE A MICROCOSM of society, as the old maxim
goes—and that’s never been more apparent. When elite ath-
letes such as swimmer Michael Phelps and basketball player
Kevin Love speak out about their mental health struggles, it
reflects a growing awareness of mental health among society
at large. When football players like Colin Kaepernick kneel
during the national anthem, it sparks a national conversation
about social justice. When Olympic champions speak out
about the sexual abuse they endured from USA Gymnastics
FURTHER
RESOURCES
better performance. Pro sports
teams—especially in Major
League Baseball (MLB)—have
expanded access to performance
psychology resources in recent
years, says Courtney Albinson,
PhD, a sport psychologist
at Northwestern University
and president of APA Div. 47
(Society for Sport, Exercise &
national team doctor Larry Nassar, it adds gold-medal weight Mental Health Performance Psychology). In
Best Practices:
to the #MeToo movement. ¶ As athletes navigate these diffi- Inter-Association 2018, for instance, a record 27 of
cult topics, sport psychologists are playing an expanded, and Consensus 30 MLB teams employed “men-
increasingly important, role. ¶ Sport psychologists are best Document: Best tal skills coaches” to help players
Practices for deal with the mental challenges
known for helping athletes overcome mental roadblocks and Understanding of the game.
and Supporting
improve their performance: has become more widely rec- Student-Athlete Stigma once kept athletes
for example, helping a baseball ognized as being beneficial to Mental Wellness from seeking help for mental
player snap out of a hitting slump address a variety of needs,” says NCAA Sport Science health issues. As athletes are
or supporting a runner as she Sari Fine Shepphird, PhD, a Institute, 2016 exposed to sport psychologists
regains confidence postinjury. Los Angeles–area sport and to improve performance, it
Attitudes Toward
While that performance empha- performance psychologist. And Sport Psychology helps chip away at that stigma,
sis remains a cornerstone of sport demand is growing, she adds, Consulting making it easier for them to seek
psychology, it’s only a slice of even among youth athletes in Athletes: help for mental health prob-
what sport psychologists are now and serious amateurs. “There’s Understanding lems. Prominent athletes like
doing to support athletes. Their increased demand for sport the Role of Culture Phelps, Love and others who
and Personality
expanding roles include helping psychologists to address sports Ong, N.C.H., &
disclose their own mental health
athletes navigate interpersonal performance as well as mental Harwood, C. challenges are also bringing
issues and addressing mental health concerns, which is fantas- Sport, Exercise, attention to the issue of mental
health problems such as anxiety, tic not just for the field of sport and Performance health in sports. “By discussing
depression and eating disorders. psychology but for athletes and Psychology, 2018 their mental health concerns,
The practice of sport psychol- for the general population.” APA Div. 47 they have opened the door for
ogy is also finding fans beyond (Society for athletes of every age and back-
athletics. Sport psychologists’ PERFECTING Sport, Exercise ground to seek help for theirs,”
skills are increasingly sought out PERFORMANCE & Performance says Shepphird.
by professionals in high-stress Technically, only licensed clini- Psychology) Even superstar athletes are
Resources
jobs, such as surgeons, firefight- cal and counseling psychologists www.apadivisions.
susceptible to the same mental
ers and performing artists. In can describe themselves as “sport org/division-47/ health issues as nonathletes. And
fact, the U.S. Army is now the psychologists.” (APA approved a about/resources/ sometimes athletes face unique
country’s largest employer of proficiency in sport psychology index.aspx struggles, including the psycho-
sport psychology professionals, in 2003.) This field is growing as logical pressure to perform at
who help soldiers learn to focus today’s athletes realize that psy- an elite level, or dealing with a
in combat and deal with stress- chologists can help them gain culture in which eating disorders
ful situations. “Sport psychology a mental edge that translates to are common.
Fortunately, athletic organi- equation, sport psychologists also consult with sport psychol-
zations are getting the message may serve as important resources ogists to help them perform at
that mental health and mindset for the victims of assault and their peak in the boardroom.
are as important as an ath- violence, such as the members Even The Juilliard School has a
lete’s physical condition. In of USA Gymnastics and USA sport psychologist on faculty to
May, the National Basketball Swimming who have spoken out help students overcome perfor-
Players Association launched recently about sexual abuse and mance anxiety.
a new Mental Health and misconduct in their sports. That growth is good news
Wellness Program, headed by Psychologists can also help for those interested in a career
a psychologist, to assist players athletes manage the emotions in sport psychology. Not every
with mental health challenges. and decisions involved in speak- sport psychologist will find
And the National Collegiate ing out or becoming activists, work with Olympic athletes, but
Athletic Association (NCAA) Abrams says. Athlete activists interesting opportunities are out
has made mental health for like Kaepernick draw both praise there, says Jamie Shapiro, PhD,
college athletes a strategic pri- and criticism for voicing issues Athletes can associate professor of sport and
ority, Albinson notes. In 2016, of social importance. When struggle with the performance psychology at the
pressure to perform
the NCAA issued its Mental aligning themselves with a con- at an elite level. University of Denver. “To work
Health Best Practices document, troversial cause, athlete activists in sport psychology, you often
outlining steps colleges and can experience public backlash, have to be a bit entrepreneurial,”
universities should take to better professional repercussions and says Shapiro. “But the skill set
promote and support student all kinds of emotional upheaval. you develop during graduate and
athletes’ mental health. “We’re at a time where athletes postgraduate training is applica-
Sport psychologists are also are given a platform to have a ble to almost any performance
poised to help with other pres- real voice with regard to social area.” n
sures and challenges familiar to justice. Sport psychologists have
athletes, including violence and to be standing side by side with
anger issues, says Mitch Abrams, athletes on this,” Abrams says.
PsyD, a New Jersey–based sport
psychologist who specializes in BEYOND THE
anger management, violence PLAYING FIELD
and trauma in athletes. While Meanwhile, professionals in
it’s a myth that athletes are fields outside athletics are
more prone to violence than realizing the benefits of sport
nonathletes, he says, there are psychology. Like athletes, those
factors that increase the risk of in tactical positions, such as
violent behavior and sexual mis- paramedics, police officers and
conduct among male athletes. military personnel, have to act
Among them: adoption of tra- fast and function in high-stress
ditional concepts of male roles, environments. The U.S. Army
groupthink in teams and the now provides soldiers with
proverbial locker room talk that mental skills training—drawn
teaches young men that women heavily from sport psychol-
are objects for conquest. But ogy—to improve cognitive and
those problems can be overcome, physical abilities.
Abrams says. “Most aggressors Many business executives
can be rehabilitated, but we need
OSTILL/GETTY IMAGES
more prevention, risk assessment

and treatment.”
On the other side of the
M O N I TO R O N P S YC H O LO G Y ● 2018 10
Research shows that
2019 ANNUAL TRENDS REPORT nutrition, biology and
family factors—such as
mealtime rituals and
child involvement in food
preparation—interact to
predict dietary habits.
4
A GRE ATER ROLE IN
NUTRITIONAL HE ALTH
Both what we eat—and how we eat it—directly influence
our mental health, according to growing research in the
CAJU GOMES/UNSPLASH
integrative field of culinary medicine B Y Z A R A G RE E N B A U M
A
A GROWING BODY OF NEW RESEARCH is supporting
the adage that we are what we eat—not only physically but
psychologically. For example, studies have linked diets high in
processed meat, fast food and sugar to depression (Psychiatry
Research, Vol. 253, 2017) and attention-deficit hyperactivity
disorder (Pediatrics, Vol. 139, No. 2, 2017). And the physical
health problems associated with poor diet, such as diabetes,
can come with accompanying mental health concerns. ¶ “All
food is not created equal, and the dietary choices we make
FURTHER
READING
hospitals and 3,600 providers in
western Michigan. The health
system’s culinary medicine
program, launched in 2017,
offers a curriculum for medical
residents as well as continuing
education for licensed clinicians,
including nurses, psychologists
and dietitians. Classes com-
bine nutritional education with
affect our bodies and minds over the weeks, months and What Is Culinary hands-on cooking instruction to
Medicine and
years,” says Lauren Broch, PhD, a clinical health psychologist What Does It Do? give participants the knowledge,
based in New York City who specializes in dietary and sleep La Puma, J. skills and confidence to cook
issues. ¶ And it’s not just what we eat. How we eat can also Population Health healthy and affordable meals at
influence our physical and mental health. Psychologist
Management, home. Spectrum Health also
2016 began offering classes to its
Barbara Fiese, PhD, a profes- physical and mental health,” says Time Allocation patients in October.
sor of human development and Leanne Mauriello, PhD, director and Dietary Habits Psychologists are central to
family studies and director of of behavioral science and life- in the United the effort, both in educating
the Family Resiliency Center style management at Spectrum States: Time for medical residents and clinicians
at the University of Illinois at Health, an integrated health Re-evaluation? about the behavioral principles
Fiese, B.H.
Urbana-Champaign (UIUC), system based in Grand Rapids, Physiology &
associated with nutrition and
for example, has shown that Michigan. “Their expertise in Behavior, dietary change and in working
nutrition, biology and fam- human behavior allows them to 2018 directly with patients who need
ily factors—such as mealtime help patients make successful support maintaining healthier
rituals and child involvement in and sustained changes to their Towards diets and implementing the
Microbiome-
food preparation—interact to dietary behaviors.” Informed Dietary skills learned during culinary
predict dietary habits later in life The training psychologists Recommendations medicine classes.
(Appetite, Vol. 126, 2018). pursue to work on nutrition for Promoting “Psychologists know that
Now, practitioners and issues is varied. While some Metabolic and when patients leave, there’s
health-systems administra- earn doctorates in clinical health Mental Health: still a whole set of barriers and
Opinion Papers
tors are using these insights psychology then earn a mas- of the MyNewGut routines that can either help or
to improve patient care in a ter’s in nutrition, others get less Project hinder them translating what
variety of ways: through culinary formal training. Here are some Sanz, Y., et al. they’ve learned into their home
medicine programs for clini- of the efforts psychologists are Clinical Nutrition, kitchen,” says Mauriello, whose
cians, which combine cooking spearheading to apply culinary in press expertise in behavior change
skills with nutritional science; health insights to boost popula- stems from her training in
hands-on learning initiatives for tion health. experimental health psychology.
children; and integrated-care “The power of the clinical health
programs for patients. CULINARY MEDICINE psychologist is in coaching
“Psychologists are a crucial One of the leaders in supporting the patient to overcome those
part of the interdisciplinary nutritional health is Spectrum barriers and in providing con-
effort to improve diet quality, Health, which serves nearly tinued support throughout the
which in turn improves overall 1 million members with 12 behavior-change journey.”
Spectrum Health’s team- cook. Typically administered

based approach involves a in five two-hour lessons during
collaborative effort among psy- summer break, the experiential
chologists, dietitians, chefs and program, which began in 2016,
physicians. To follow patients’ will go nationwide next year.
progress, the health-care team “We know that culinary skills
relies on ongoing electronic have gone by the wayside in the
communication with patients, last decade—adults cook much
reviewing photos of meals, less than they used to,” says
sending healthy recipes and pre- Fiese, whose doctoral student is
scribing mobile applications such evaluating the program’s effec-
as MyFitnessPal to help patients tiveness. “This is beginning to
monitor their own progress. have an impact on kids because
they don’t have opportunities to
A PRACTICE TOOL model these skills early on.”
Clinical health psychologists are “Regardless of their back-
also incorporating new culinary ground, it’s important for kids
health findings into their work of all ages to develop inde-
with patients. After 20 years She helps patients reduce pendent cooking skills so that
in clinical psychology practice, unhealthy eating habits by mak- they can make healthy choices
Broch earned a master’s in nutri- ing small, manageable changes. when they’re on their own,”
tion after observing a pattern in For example, one patient’s dieti- Psychologists are says Jessica Metcalfe, MPH, a
her patients and personal life: tian instructed her to monitor now designing and doctoral candidate in human
testing programs
Digestive issues appeared closely water intake, exercise, steps, that teach children development and family studies
linked to feelings of poor mood calories consumed and more than about nutrition—as at UIUC and research coordina-
and low energy. 12 different macro- and micro- well as how to tor for the program.
cook.
“I often suggest an elimina- nutrients to lose weight. “She was According to research by
tion diet that challenges patients going to get tired of that in about Fiese and Metcalfe, children
to cut out foods they may be three days,” Bereolos says. “My who participate in the one-week
sensitive to,” such as dairy, job was to take those instruc- class show significant improve-
gluten and red meat, she says. tions and psychologically set ments in cooking skill, attitudes
Broch monitors how patients her up for success.” They picked toward cooking, healthy cooking
respond and instructs them to two items to track: protein behaviors and preferences for
reincorporate foods slowly over and exercise. Bereolos says the fruits and vegetables (Journal
a period of several weeks. patient achieved a minor success of Nutrition Education and
Nicole Bereolos, PhD, MPH, early on, increased her confi- Behavior, Vol. 49, No. 7, 2017).
a clinical health psychologist dence and ultimately met her Moving forward, Bereolos
and certified diabetes educator weight-loss goal. suggests that dietitians, phy-
based in Dallas, helps patients sicians and psychologists
make dietary changes to address TEACHING KIDS collaborate more in their work
both chronic illness and the HEALTHY BEHAVIORS on dietary behavior change.
associated psychological issues. Psychologists are also key “Integrating our continuing
Diabetes, for instance, can pres- to the Illinois Junior Chefs education and practice is the
ent with obsessive-compulsive program, which is run by the best way to identify gaps in our
SHIRONOSOV/GETTY IMAGES
disorder or disordered eating University of Illinois Office of training. This will allow us to
because of the numerous metrics Extension and Outreach and continue opening our eyes about
patients must monitor, such as teaches low-resource children the relationship between food
blood sugar levels and insu- ages 8 to 13 the importance of and mental and physical health,”
lin-to-carbohydrate ratios. a healthy diet as well as how to she says. n
New federal regulations
2019 ANNUAL TRENDS REPORT call for greater attention
to the mental health and
behavioral needs of long-
term care residents.
5
RE-ENVISIONING
LONG-TERM CARE
By fostering more person-centered care in these settings,
CRISTIAN NEWMAN/UNSPLASH
psychologists are improving life for residents and caregivers

B Y T O RI D E A N G E L I S
T
THE NURSING HOME REFORM ACT of 1987 led to major
improvements in the quality of long-term care in the United
States by emphasizing patient rights and beefing up federal
standards, inspections and enforcement. Now, new regulations
issued by the Centers for Medicare and Medicaid Services in
2017 go a step further in boosting care by emphasizing the
need for facility staff to learn more about who residents are as
people, provide greater support for resident preferences and
give residents increased control and choice. ¶ The new regu-
FURTHER
READING
FINDING MORE JOY
A similar program aimed at
promoting the ideals of person-
centered, homelike care is the
Montessori-Based Dementia
Programming method,
developed by applied gero-
psychologist Cameron Camp,
PhD. It applies principles of the
Montessori education method
lations also require increased attention to the mental health Transforming and behavioral psychology to
Long-Term Care:
and behavioral needs of residents, among other changes. ¶ Expanded Roles help people with Alzheimer’s
Psychologists are playing an important role in realizing these for Mental Health disease develop more agency in
reforms, both in creating new care models that better serve Professionals their daily lives, connect with
both residents and staff and in implementing these ideas on
Carney, K.O., & others and find joy in living.
Norris, M.P. At the Veterans Health
APA, 2017
the ground, says geropsycholo- example, staff might discover that Administration’s Community
gist Kelly O’Shea Carney, PhD, a resident enjoys eating ice cream Effectiveness Living Centers, or nursing
co-author with Margaret P. before dinner, and they’ll make of Expanded homes, staff psychologists are
Norris, PhD, of “Transforming sure to supply that. Or, they may Implementation among those implementing
Long-Term Care: Expanded find out a resident grew up on of STAR-VA the STAR-VA program, which
for Managing
Roles for Mental Health a horse farm and bring in a pic- Dementia-Related uses interdisciplinary behavioral
Professionals” (APA, 2017). ture book with horses. “It all has Behaviors Among approaches to manage dementia-
“Mental health professionals to do with changing the external Veterans related behaviors. These include
are uniquely equipped to assist, triggers to a challenging behavior Karel, M.J., et al. identifying and resolving behav-
support and perhaps even lead and increasing the chances of The Gerontologist, ioral problems using “ABC”
2016
the evolution in care that is more desirable behavior with (antecedents, behaviors and
taking place across the long- the ultimate goal of enhancing Identifying consequences) methodology;
term-care continuum,” says quality of life and well-being for Barriers to building in events that residents
Carney, of Acts Retirement- each resident,” Carney says. Cultural Change: find pleasurable—such as
Life Communities, a nonprofit Studies show that the model A Qualitative going for a car ride, listening to
Analysis of
serving 10,000 older adults at 23 improves outcomes for both the Obstacles music or discussing past events,
locations in nine states. residents and caregivers. Among to Delivering depending on the individual;
Carney has developed one of residents, it reduces falls, the use Resident-Centered promoting effective communi-
the approaches that is leading of psychotropic medications and Care cation between staff and older
to better care: the Eldercare challenging behaviors. For staff, Engle, R.L., et al. adults; and fostering realistic
Psychological
Method, which fosters well- it decreases injuries and turnover. Services, 2017
expectations of what residents are
being among long-term-care Increasingly, psychologists capable of. In a study examining
residents by teaching interdisci- are essential to such person- the uptake and effectiveness of
plinary professional staff centered programs—as well as this program in 17 centers, VA
—administrators, aides, nurses, to the evaluation of their effec- psychologist Michele J. Karel,
social workers and others—to tiveness and the development PhD, and colleagues found that
incorporate knowledge of res- of interprofessional teams to veterans in these nursing homes
idents into their services. For implement and assess them. were significantly less depressed,
anxious and agitated after a What’s more, a greater num-

six-month staff training (The ber of young psychologists are
Gerontologist, Vol. 56, No. 1, entering geropsychology thanks
2016). to expanding opportunities in
Psychologists are implement- health-care settings, says PLTC
ing these ideas in a range of President Craig H. Schweon,
other long-term-care settings, PhD. Training in the area is
adds Carney’s co-author Norris, improving, too: A survey of 100
an independent practitioner and graduates of geropsychology
past-president of Psychologists doctoral and postdoctoral train-
in Long-Term Care (PLTC), ing programs by the VA’s Karel
a national nonprofit organiza- and colleagues found that most
tion. Individual interventions graduates of these programs
with residents continue to be a reported receiving strong train-
powerful approach to improving ing for providing geropsychology
both resident and staff well- services, though they wanted
being, she says. “Residents get more training and practice in
better, their roommates get bet- as they do the services of social supervisory roles (Training
ter, the aides caring for them get workers, recreational therapists and Education in Professional
better, and their families become and rehabilitation therapists, Psychology, Vol. 10, No. 1, 2016).
more relaxed,” Norris says. says long-term-care consultant Those who do work in these
Systems-level interventions Eleanor Feldman Barbera, PhD, When psychologist- health and long-term-care set-
can also provide dramatic results. author of “The Savvy Resident’s designed programs tings say they’re an option more
are implemented
In that capacity, psychologists Guide” (Psychology Insights with residents, not psychologists should consider,
train staff in behavioral princi- Press, 2012), a guide for residents only do residents offering an up-close look at
ples and encourage them to treat starting out in nursing homes. get better, the residents’ relationships with staff,
aides caring for
residents as human beings rather And while Medicare reimburses them get better roommates and family members.
than as “the hip in room 303,” as physicians for conducting staff and the residents’ Cultural differences are also part
Carney puts it. They also foster training and care-plan meet- families become of the mix. “It’s unbelievably
more relaxed.
agency and communication ings, it doesn’t do the same for fascinating,” Barbera says.
among staff members. psychologists, meaning psychol- She recalls a woman who
This communication creates ogists often work as consultants initially resisted being in a nurs-
an atmosphere in which team in these capacities, Barbera says. ing home but adjusted thanks in
members feel free to discuss On a more positive note, part to Barbera’s help in making
what works and what doesn’t. nursing homes are now more the experience more like home.
“The interdisciplinary team willing to pay such consult- Barbera connected the woman
process becomes a forum for ing fees to psychologists, and with other residents who were
learning among staff members, Medicare reimbursement for sewing a quilt for Haitian refu-
as well as for care planning,” long-term-therapy services has gees, and she had the woman’s
Carney says. improved and stabilized in the family bring beloved objects
last several years, says Norris. from home, including her elec-
REMAINING BARRIERS That’s largely due to advocacy tronic piano.
Yet despite those and other by APA and other organiza- “She’d play it, and staff and
benefits, many psychologists tions, which helped to gradually residents would gather around
SQUARED PIXELS/GETTY IMAGES
continue to face reimbursement reduce all Medicare Part B her door to listen,” says Barbera.
challenges in these settings. mental health co-payments from “And she said to me, ‘I know
Medicare regulations, for exam- 50 percent in 2008 to 20 percent people say terrible things about
ple, still don’t require facilities to starting in 2014, including those these places—but I’m having a
provide psychological services involving long-term care. ball here.’” n
A boy and father from
2019 ANNUAL TRENDS REPORT Honduras are taken into
custody by U.S. Border
Patrol agents near the U.S.-
Mexico border in Mission,
Texas, on June 12, 2018.
6
SHINING A
SPOTLIGHT ON EQUIT Y
In an era of increased activism, psychologists
armed with research are raising their voices on behalf
JOHN MOORE/GETTY IMAGES
of vulnerable populations B Y RE B E C C A A . C L A Y
P
PSYCHOLOGY’S VOICE was in full force in 2018 when the
administration began separating immigrant children from
parents at the U.S.-Mexico border. Armed with decades of
their research, psychologists spoke out about the harms of the
policy, sought to assist children and families, and expressed
their shock in mainstream media and social media, among
other actions. ¶ “That’s our mission—taking care of the psy-
chological health of folks, not just on an individual client
basis but in our communities and society as well,” says Jeff
APA ACTION
ON FAMILY
Immigration Task Force. The
task force has developed recom-
mendations for psychologists
working with undocumented
immigrants and their families
and has created a database of
culturally competent psycholo-
gists willing to provide low- or
no-fee services to immigrants.
In a similar vein, psycholo-
R. Temple, PhD, a board member of the Texas Psychological SEPARATION gists are working with refugees
Association who has urged his colleagues to fight against POLICY through the Refugee Mental
family separation. ¶ Activism by psychologists has moved into Health Resource Network
As soon as (www.refugeementalhealthnet.
a higher gear, especially when it comes to the most vulnerable psychologists
populations, says Kevin L. Nadal, PhD, a psychology discovered
org). Initiated in 2016 by several
that the Trump APA divisions, the network’s
professor at John Jay College of Psychologist (Vol. 72, No. 9, administration interactive database of volun-
Criminal Justice in New York. 2017). was separating teer psychologists and mental
“Since the 2016 election, I’ve Today, top on psychologists’ immigrant children health professionals is aimed at
from their parents at
seen an increase in psychologists’ list of public interest advocacy the Mexican border,
filling the need for evaluations,
activism—from organizations priorities is advocating for the APA President psychosocial support services,
releasing policy statements to nation’s most vulnerable people, Jessica Henderson training and research concern-
social media engagement to such as immigrants and refugees. Daniel, PhD, issued ing this underserved population
participation in protests and “Family separation is not a lib- a statement of worldwide. “This growing pro
concern about the
rallies,” says Nadal. “The more eral or conservative issue,” says psychological harm
bono APA project exemplifies
that seasoned psychologists Temple, who helped push the the policy would innovative outreach to benefit
engage in activism, the more Texas Psychological Association cause, which was society,” says Elizabeth Carll,
that early career psychologists to issue a statement condemning cited in The New PhD, chair of the network. The
and students will know that family separation. “It’s a human- York Times and project was funded in part by a
beyond. Daniel and
activism is acceptable and even itarian issue.” The Arizona APA Chief Executive
grant from the Committee on
encouraged.” Psychological Association also Officer Arthur C. Division/APA Relations.
Of course, such activism is issued a statement strongly Evans Jr., PhD, Another priority for
not new to psychologists. Their opposing the “atrocity” of fam- followed up with a psychologists is keeping front-
research was key to buttressing ily separation and noting that letter to President line activists safe. St. Louis
Trump, urging him
the landmark Supreme Court the policy’s termination does to end the policy.
University associate professor
decision on school desegrega- nothing to alleviate the suffering of psychology Kira Hudson
tion in 1954, the removal of already caused. Banks, PhD, for example, offers
homosexuality as a psychiatric Others are ensuring that
disorder from the Diagnostic psychologists are prepared to
● To get involved in APA’s advocacy
and Statistical Manual of assist undocumented immi- efforts, visit www.apa.org/advocacy/
Mental Disorders in 1973 and grants. One leader in the area index.aspx.
the Supreme Court decision is Elizabeth Hernandez, PhD, ● To learn more about APA’s
Multicultural Guidelines, go to www.
on marriage equality in 2015, who co-chairs the California apa.org/about/policy/multicultural-
points out Nadal in American Psychological Association’s guidelines.aspx.
therapy to burned-out activists

and uses de-escalation strat-
egies to help defuse conflict,
calm tempers and prevent vio-
lence at Movement for Black
Lives protests. She has served
as a consultant to the Ferguson
Commission, a group brought
together by Missouri’s gover-
nor to study the issues brought
to light by the death of Michael
Brown and recommend ways
of making the St. Louis area a
better, fairer place. And she tes-
tified in a lawsuit that resulted
in police being required to give
protesters adequate warning
before using tear gas during
peaceful protest.
Psychologists are also mak-
ing sure their peers have the
cultural competence they need.
In 2017, for example, APA
released updated Multicultural
Guidelines, which urge psychol-
ogists in all settings to consider
individuals’ multiple intersecting
identities and to understand
the roles of power, privilege and
oppression in their relationships
with clients and in their clients’
lives.
To complement these
“umbrella” guidelines for overall
cultural competence, an APA
task force is now developing
a companion document with
guidelines focused on race and
ethnicity.
“Since the original Multi-
cultural Guidelines were ethnicity guidelines. A draft Same-sex marriage and society and how that bias
developed in 2002, there has for public review should be demonstrators may hinder well-being and
rally outside the
been an enormous amount out shortly and then will be U.S. Supreme access to treatment.
of scholarship on race and considered by APA’s Council Court before oral “You can’t just pay attention
ethnicity,” says University of of Representatives in February. arguments on to differences,” Suyemoto adds.
KEN CEDENO/GETTY IMAGES
same-sex marriage
Massachusetts Boston psy- Going beyond the one-on-one on April 28, 2015. “You have to pay attention to
chology professor Karen L. level of therapy, these guidelines the meaning of those differences
Suyemoto, PhD, who chairs urge psychologists to consider in relation to things like access
the task force for the race and the systemic bias of institutions and equity.” n
7
BIG DATA
GETS BIGGER
Large data sets—generated by social media, wearables and
other sources—are opening more avenues for researchers
OTTO STEININGER/IKON
to explore real-world human behavior B Y L E A W I N E R M A N
T
TWO DECADES AGO, a psychology experiment with millions
of participants was nearly impossible to imagine. Gathering
data was expensive and time-consuming, requiring dozens or
maybe hundreds of people (often college undergraduates) to
troop into a physical lab to take part. ¶ Today, researchers can
create an online survey and watch it gather hundreds of thou-
sands of responses from diverse participants around the world.
They can access millions of tweets with a few lines of computer
code. And they can use newly powerful computer-analysis
FURTHER
READING
emotionally stable than people
who grew up in colder areas
(Nature Human Behaviour, Vol.
1, 2017).
At the University of
Pennsylvania, meanwhile, a
consortium of psychologists and
computer scientists is working
on the World Well-Being
Project—founded by positive
techniques to glean insight into human behavior from these Special Issue: psychology pioneer Martin E.P.
Big Data in
and other large data sets. ¶ Propelled by these tools, big data Psychology Seligman, PhD—an attempt
research is taking off in fields as diverse as cognitive, personality, Harlow, L.L., & to measure worldwide well-
social and industrial/organizational psychology. ¶ “Five years Oswald, F.L. (Eds.) being by analyzing social media
ago, many people were talking about big data psychology, but I
Psychological postings. In one recent study,
Methods, they found that by analyzing the
2016
wondered whether they would in Psychology” (Psychological language in millions of tweets
actually do it,” says Samuel Methods, Vol. 21, No. 4, 2016). Using they could predict which U.S.
Gosling, PhD, a personality Psychologists, however, rarely Smartphones counties consume more alcohol
researcher at the University of work with data sets that large. to Collect than others (PLOS ONE, online
Texas, Austin, who has been “We often just use it to mean Behavioral Data publication, April 2018).
in Psychological
gathering data online since the ‘data that’s much bigger than Science: In a different field, cognitive
late 1990s. “But to my happy we’re used to,’” Wojcik says. Opportunities, psychologist Brendan Johns,
surprise, they did. At this point “There’s no threshold.” Practical PhD, is exploring texts, not
it’s well under way.” That’s because even large data Considerations, tweets. Johns, an assistant
sets that might not impress a and Challenges professor in the communi-
Harari, G.M., et al.
FERTILE RESEARCH computer scientist can provide Perspectives on
cative disorders and sciences
GROUND fertile ground for psychological Psychological and computational linguistics
Big data has become a buzz research. What those data sets Science, departments at the University
phrase, but what does it mean? consist of varies by subfield in 2017 at Buffalo, uses big data analysis
How big is big? There’s no psychology. methods to analyze Wikipedia,
Can Twitter
one answer to that question, Often, they involve online Be Used to publicly available ebooks and
researchers say. When com- surveys or social media postings. Predict County other digital troves of written
puter scientists talk about big For example, in their research Excessive Alcohol language. His goal is to under-
data, they are usually talking on personality, Gosling and his Consumption stand how people learn the
terabytes, petabytes or larger— colleagues combined meteo- Rates? meanings of words from
Curtis, B., et al.
amounts that require distributed rological data from every ZIP PLOS ONE,
the structure of language,
computing systems to analyze, code in the United States with 2018 and how that learning affects
says psychologist Sean Wojcik, data from more than 1.6 million memory and other forms of
PhD, a senior data scientist participants who took an online cognition.
at the digital media company personality test. They found that “We can train our models
Upworthy and co-author (with people who grew up in more on a corpus of 2 billion words,
Eric Chen, PhD) of “A Practical temperate climates were more and that’s been a big change,”
Guide to Big Data Research likely to be agreeable, open and he says.
PROMISE AND “The question of where to start

CHALLENGES is a very big hurdle to people,”
So, what do these far-flung Wojcik says. “A lot of psy-
applications of big data have chologists’ training is in SPSS,
in common? Broadly speaking, and that’s not an ideal tool for
large data sets change the kinds analyzing very large data sets.”
of questions that psychology can Learning a new program-
seek to answer, researchers say. ming language that’s a better
For Lyle Ungar, PhD, a fit, like R or Python, can seem
professor of computer science daunting. But Wojcik suggests
and psychology at the University thinking of the time investment
of Pennsylvania who co-leads as similar to the data-gathering
the World Well-Being Project, stage of traditional psychology
that change is embodied in a research. Once you learn R or
shift from “hypothesis testing” Python, “data collection can be
to “hypothesis generation.” incredibly fast,” he says. “In a
Most of psychology research, he traditional lab, you might devote
points out, involves coming up several months to collecting
with an experiment to test one data. You can devote that time
hypothesis. “But that’s only half confirmatory methods, but also to learning R instead.”
of science,” he says. “And that’s [that we] test for other trends On a broader scale, big data
not big data—which is primar- that wouldn’t be found unless collection—particularly from
ily data driven, not hypothesis you explored.” social media postings—brings
driven.” In a typical study, for Another advantage of big A key advantage of up a host of ethical and privacy
example, Ungar might collect data, says Gosling, is that the big data is that it challenges for psychology and
allows researchers
millions of tweets from people high-powered studies allow to come closer other fields. “I do think about
with attention-deficit hyper- researchers to come closer to to understanding it a lot—what it means to con-
activity disorder (ADHD), understanding the complexity of the complexity of sent,” says Ungar. “For example,
real-world human
then explore those data to find real-world human behavior. behavior. when participants give me access
ways that the tweets of people “Most of human behavior to their [Facebook] posts, I don’t
with the disorder differ from is extremely complicated and take what their friends post on
the tweets of people without you simply cannot examine the their page because those people
it, all while having no particu- interactions of so many things haven’t consented.”
lar hypothesis in mind (Journal unless you have sufficient power Overall, says Gosling, psy-
of Attention Disorders, 2017). to do it,” he says. In traditional chologists can contribute to the
That kind of insight into the psychology research, researchers debate over data privacy by being
daily experiences of people with could examine only a few fac- good stewards of data themselves
ADHD could help lead to bet- tors or do studies in extremely and by using their expertise to
ter treatments. controlled environments that help understand the factors that
Kevin Grimm, PhD, a may not approximate the real play into people’s decisions about
research methods psychologist at world. “Until the advent of the privacy and data security.
Arizona State University, agrees big data age, we didn’t have tools “How do people decide when
that searching for the unex- that were well matched to the they feel safe and don’t feel safe
pected is an important aspect of complexity of the phenomena sharing data? That’s a question
METAMORWORKS/GETTY IMAGES
big data research, but adds that we wanted to study.” psychology can help answer.” n
the key is that big data analysis The potential rewards of
methods provide a systematic exploring large data sets are ● Interested in learning more? APA
conducts an annual Advanced Training
way to do that. “It’s important great, but for many psychologists Institute on big data. The next one will
that we test our hypotheses with the barriers to entry can be high. be held in 2019.
Psychologists have
2019 ANNUAL TRENDS REPORT become integral
to ensuring that
technological devices
are easy to use and
helpful to those
they serve.
8
DESIGNING
SMARTER TECH TOOLS
New technology in educational gaming, health-care
communication, robotics and more is benefiting from
FZANT/GETTY IMAGES
psychologists’ input B Y T O RI D E A N G E L I S
T
TECHNOLOGY OFFERS tremendous opportunities to help
people learn, manage their health and connect with others.
But technological devices, products and services are only as
good as their design—and psychologists have become inte-
gral to ensuring that these tools are easy to use and helpful
to those they serve. ¶ “Psychologists have an important role
to play both in developing these tools to accomplish positive
changes for people, and in understanding the outcomes of
technology on things like health and well-being, life satis-
says Lane. “On the surface,
kids might act like they aren’t
interested in the science,” he
adds, “but then they start asking
questions.”
■ Improving
health-care
communication. Psychologists
are also among those testing
different technology vehicles
faction, productivity, interpersonal relationships, education for delivering vital health-
and health care,” says industrial/organizational psychologist care information. In a study
Tara Behrend, PhD, director of the WAVE (Workplaces and RESOURCES reported online in June 2018,
Virtual Environments) lab at The George Washington psychologist Susan J. Persky,
APA Technology, PhD, an associate investiga-
Mind and Society
University. Some of the many if it didn’t have a moon (brief Conference tor at the National Human
arenas where psychologists are answer: extremely windy and www.apa.org/ Genome Research Institute
playing leading roles include: not very habitable). Their version members/your- (NHGRI), and colleagues at
of “Minecraft” allows players focus/science/ the NHGRI and the National
to move freely throughout a technology-mind- Cancer Institute compared the
■ Drawing kids into science.
and-society-
Psychologists are increasingly world that Lane and his team conference/index.
way patients reacted to genom-
tapping the power of tech- have configured as a moonless aspx ics-related information about
nology to enhance education Earth. Children are invited to their weight when they received
on every level. An example of post virtual signs in locations Cognitive it either from an internet-based
collaborative work in the area is that look odd to them—where, Development in virtual physician or from a vir-
Digital Contexts
a National Science Foundation– for example, tides are behaving Blumberg, F.C., &
tual physician in immersive 3-D
funded project headed by strangely or there is a lack of Brooks, P.J. (Eds.) technology (a form of virtual
computer scientist H. Chad plant life—and then they receive Elsevier, 2018 reality).
Lane, PhD, an associate profes- brief education on the topic. Those receiving the informa-
sor of educational psychology Lane’s research is framed tion in immersive 3-D reported
at the University of Illinois at by the work of Renninger greater self-efficacy in man-
Urbana-Champaign. Working and her collaborator Suzanne aging their weight and greater
with developmental psycholo- Hidi, PhD, of the University of intentions to engage in dietary
gist K. Ann Renninger, PhD, Toronto, which finds that when and physical activity than those
of Swarthmore College in people’s interest is effectively receiving it over the internet, the
Pennsylvania, and astrophys- triggered by compelling experi- team found.
icist Neil Comins, PhD, of ences, learners will return to the “It’s essential to figure out
the University of Maine, Lane subject again when given the how we can best use technology
is using the popular game opportunity. Lane’s challenge to fill the gaps in current models
“Minecraft” as a context for gen- was to parlay children’s interest of care,” says Persky, “while also
erating interest in science among in “Minecraft” into a focus on providing a better experience
children. The team is helping science. for patients and helping them to
children explore questions like “For the ones who get it, optimize their decision-making
what the Earth would be like you can see when it clicks,” and their health.”
■ Expanding the reach of ROBOTS THAT PEOPLE STEREOTYPED AS

psychological research. Other
psychologists are jumping into HIGHLY WARM AND COMPETENT LOOKED
the world of big data—using
techniques for collecting and LIKE HUMANS RATHER THAN MACHINES.
analyzing large data sets to
uncover patterns, trends and
associations that might not oth- arenas, says Anneke Buffone, for use by citizens, policymakers
erwise be apparent. PhD, lead research psycholo- and others.)
Psychologists at the gist for the World Well-Being
University of Pennsylvania’s Project, who conducted the study ■ Designing better robots. Still
World Well-Being Project, for with project colleagues Sharath other psychologists are work-
example, are using the method- Chandra Guntuku, PhD, ing with robotics designers to
ology to examine stress at the Johannes Eichstaedt, PhD, and make these electronic helpers
county level. (For more on psy- Lyle Ungar, PhD. (These data more relatable for humans. Key
chologists’ use of big data and and more can be seen on a map to that work is understanding
the work of the World Well- what people think of social
Being Project, see the article on robots. In a study under review,
page 20.) Stanford University psychol-
First, they built and tested ogist Jeff Hancock, PhD, and
a model for predicting individ- Stanford University colleagues
ual-level stress by examining Byron Reeves, PhD, and Xun
the language patterns of 2,700 “Sunny” Liu, PhD, asked 4,035
consenting Facebook users who participants to rate social robots’
took Cohen’s Perceived Stress personal attributes on a variety
Scale. Those with high stress of dimensions.
levels talked more about feeling Intriguingly, participants rated
depressed and ignored and robots in the same way that social
having regrets, they found, while psychologist Susan Fiske, PhD,
PSYCHOLOGISTS AT THE TABLE
those with low stress levels were of Princeton University, and
more likely to share pleasant APA’S TECHNOLOGY, MIND others have shown that people
or positive activities like taking AND SOCIETY CONFERENCE rate people: They instantly judge
trips with family. Applying this them on dimensions of warmth,
model to more than 6.5 million
Twitter users and some 40 bil-
R ecognizing the interdisciplinary nature of today’s
technology, in April APA gathered psychologists,
computer scientists, roboticists, neuroscientists, clini-
competence or both. What’s
more, robots that people stereo-
lion tweets, the team then found cians, education scientists and others in Washington, typed as highly warm and highly
that stress levels were higher in D.C., to share their findings and discuss the future of competent looked like humans
some U.S. counties than others, technology at the association’s Technology, Mind and rather than machines—and they
and that those counties tended Society (TMS) Conference. tended to be white. Such findings
to have higher rates of smoking Along with new products and ideas, ethical issues imply that stereotypes play a part
were on the table, such as the need to protect user
and diabetes and fewer opportu- in people’s perceptions of robots,
privacy, to keep technology from creating undue
nities to exercise than others, for stress and distraction, and to esure that technology is
and that designers should build
example. multiculturally sensitive. “Like any tool, technology can accordingly, says Hancock.
“These large data sets allow us be used or misused, so you have to be smart about it,” “If you’re designing robots
to see that stress can be a feature says Tara Behrend, PhD, director of the WAVE (Work- to enhance children’s sense of
of communities and not just of places and Virtual Environments) lab at The George belongingness,” for example,
individuals,” with myriad poten- Washington University. APA is planning to host TMS in “you want the appearance of the
fall 2019 in Washington, D.C. —Tori DeAngelis
tial applications in public health, robots to be similarly inclusive,”
precision medicine and other he says. n
Problematic
2019 ANNUAL TRENDS REPORT smartphone use
has been linked
with depression and
anxiety in a recent
literature review.
9
TRE ATING THE
MISUSE OF
DIGITAL DEVICES
Psychologists are spearheading efforts to help
wean people off technology B Y RE B E C C A A . C L A Y
RAWPIXEL/UNSPLASH
P
PEOPLE’S LOVE OF SOCIAL MEDIA, emails and texts has
created a new category of tech users: “constant checkers,” who
relentlessly scan their smartphones, computers and tablets
for the next wave of messages. And it is fueling some peo-
ple’s anxiety. According to APA’s 2017 Stress in America
survey, 43 percent of Americans qualify as constant checkers
and almost a fifth of Americans report that technology use
is a very or somewhat significant source of stress for them. ¶
Increased stress is just one of the negative side effects that can
good online citizenship and
discuss digital decision-making.
Now, a new Device
Management and Intelligence
Committee of Div. 46 is devel-
oping guidance for the public
and psychologists on device and
social media use. The document
will address such topics as
good online citizenship on
come with too much technology use. Problematic smartphone RESOURCES social media and recovery from
use—addiction-like behavior in which excessive smartphone online embarrassment. One key
APA Digital concern is “absent presence”—the
use results in negative outcomes in daily life—has been linked Guidelines:
with depression and anxiety in a review of the literature by Promoting Healthy phenomenon of being physically
University of Toledo psychology professor Jon D. Elhai, PhD, Technology Use present with other people but
for Children paying more attention to a phone
and colleagues (Journal of Div. 50 (Society of Addiction www.apa.org/ or other device than to them, says
Affective Disorders, Vol. 207, Psychology) created a task force helpcenter/digital- Joanne Broder-Sumerson, PhD,
guidelines.aspx
2017). “We can’t determine to come up with a response. a committee co-chair.
cause and effect, because most of In the meantime, a growing Media and Child “One of our taglines is
the studies were correlational,” number of psychologist-led Health Clinician ‘Unplug and hug,’” she says.
says Elhai. efforts aim at helping people Toolkit “Technology helps facilitate our
And while problematic develop healthier relationships http://cmch.tv/ relationships with people far
clinicians
device use in general does not with technology. away, but not the people sitting
yet qualify as an addiction, there Children’s media use is of APA Div. 46 next to us.”
is enough evidence about inter- special concern. A 2017 United (Society for Media Of course, screen time isn’t
net gaming in particular that Nations Children’s Fund Psychology and always a negative. In one study,
the World Health Organization (UNICEF) report found that Technology) Facebook use was associated
www.apa.org/about/
(WHO) added gaming disor- children under 18 represent division/div46.aspx
with increased face-to-face
der to the latest update of its a third of all internet users communication, especially for
International Classification of globally. And adolescents and introverts (Psychology of Popular
Diseases, and the American young adults ages 15 to 24 are Media Culture, online first pub-
Psychiatric Association lists it as the most connected cohort, with lication, 2017). Facebook may
a condition that warrants further 71 percent online versus just 48 help introverts develop trust
study in the latest version of percent of the overall population. and rapport in a less threatening
the Diagnostic and Statistical APA has issued guidance for environment before they ven-
Manual of Mental Disorders. In promoting healthy technology ture into real-life relationships,
response to these controversial use for children, which empha- speculates lead author Alexander
moves, APA’s Div. 46 (Society sizes the need for parents to Spradlin, PhD, an instructor in
for Media Psychology and discuss the benefits as well as the the department of psychology at
Technology) issued a statement risks of technology with their Washington State University.
expressing concern over WHO’s children. The guidelines urge Other psychologists are
decision, noting that the research parents to monitor the websites developing measures that clini-
base is still insufficient; APA’s their children are visiting, teach cians can use to assess whether
patients have a problematic rela- violent porn. There are infor-

tionship with digital technology. mation seekers who get drawn
Sarah E. Domoff, PhD, an down rabbit holes of Wikipedia
assistant professor of psychology and YouTube, which leads to
at Central Michigan University, huge amounts of use.”
has developed and validated the Adults often have different
Problematic Media Use Measure, media use problems than their
which clinicians can use to assess children, says Paula Durlofsky,
whether screen-based media PhD, a private practitioner in
use is causing difficulties for Bryn Mawr, Pennsylvania, who
children ages 4 to 11 (Psychology has seen the number of adults
of Popular Media Culture, online with social media concerns soar
first publication, 2017). in recent years. Durlofsky urges
“If a child becomes upset or these adult patients to reflect
has a meltdown when a parent for problematic digital media on what they hope to get out
tries to take away a tablet or usage during well-child visits is of social media, whether it is
screen, that could indicate a the goal of the Media and Child new friends, deeper connections
problem,” says Domoff. Health Clinician Toolkit, devel- or networking. She counsels
Other red flags include dis- oped by research scientist David APA recommends patients to use social media to
ruption of family events by video Bickham, PhD, and colleagues that parents enhance offline friendships, not
discuss the benefits
games or other media, missing at Boston Children’s Hospital’s as well as the risks replace them. She also advises
out on opportunities because of Center on Media and Child of technology with patients to find alternative
screen time and screen time as Health. The toolkit helps pedi- their children. responses to feelings of boredom
the only activity a child looks atricians, parents and children or whatever emotion is driving
forward to. assess whether media use is overuse of social media and to
For kids whose results contributing to such problems as schedule social media breaks.
indicate a problem, Domoff aggression, obesity and attention Specialized treatment clinics
encourages a gradual weaning deficit. are also springing up. In Santa
from devices coupled with “Rather than saying, ‘Are you Monica, California, Don Grant,
alternative activities that help fill having trouble with media use?’ PhD, who co-chairs the Div.
gaps in a child’s development. If it is ‘Do you have these behaviors 46 Device Management and
a child is excessively gaming, for or experience these things, and Intelligence Committee, runs an
instance, Domoff recommends how might media use be related intensive outpatient program for
that parents provide opportuni- to that?’” explains Bickham, also adolescents called Resolutions
ties to engage with peers offline. an instructor in pediatrics at Teen Center, which combines
A family approach to reducing Harvard Medical School. device-management help with
screen time is key, she adds. The toolkit tries to get at mental health and substance use
“A lot of times parents are also the complexity of children’s treatment. In addition to therapy,
struggling with putting down media use and its impact, says he encourages patients to connect
their phones,” she says, adding Bickham, explaining that the with the present—to look at the
that her clinic at the Center problem may be either the ocean instead of taking a selfie
for Children, Families and content a child is exposed to via with it, for instance. Meanwhile,
Communities treats children media or the amount of time a a parents’ group he runs helps
with problematic screen media child spends on a device. “There families create healthier house-
ELIJAH O. DONELL/UNSPLASH
use and serves as a practicum are kids who are playing video hold media environments.
site for training future psychol- games all night and missing “You can write ‘LOL’ all you
ogists on how to assess and treat school,” says Bickham. “There want,” says Grant. “It’s not going
the problem. are kids who are viewing a lot to have the same effect as laugh-
Helping pediatricians screen of porn and being exposed to ing with people.” n
Unlike most wellness

apps marketed directly
to consumers, digital
therapeutics follow
an R&D path that
looks more like drug
development.
10
THE ASCENT OF
DIGITAL THER APIES
Evidence-based apps could enhance—and in
MARCO PIUNTI/GETTY IMAGES
some cases, replace—medications for treating a range

of mental health disorders B Y K I R ST E N W E I R
W
WHEN IT COMES TO TREATING mental health and
behavioral disorders, there have traditionally been two choices:
medication and psychotherapy/behavioral interventions. Get
ready for a third option: digital health devices, software and
applications collectively known as “digital therapeutics.” ¶
These therapies aim to treat a variety of diseases and disorders,
from asthma and diabetes to depression and attention-deficit
hyperactivity disorder. Some digital therapeutics are designed to
be used in conjunction with medication or behavioral interven-
improving sleep also improves
mental health (The Lancet
Psychiatry, Vol. 4, No. 10, 2017).
Big Health is working with
more than two dozen self-
insured corporations in the
United States to offer Sleepio to
their employees. The aim, Espie
says, is to close a treatment gap.
Guidelines from groups such
tions. Others aim to replace traditional treatments altogether. FURTHER as the American College of
Examples include web-based cognitive-behavioral therapy READING Physicians indicate that CBT-I
(CBT) programs, digital dashboards that allow patients and should be first-line treatment
FDA’s for people with chronic insom-
providers to closely track indicators of health, and even game- Digital Health
based interventions. ¶ What the therapies have in common is Innovation nia, but there aren’t enough
Action Plan providers to meet the demand.
a commitment to evidence- an evidence-based intervention www.fda.gov/ “Anyone in America with
based medicine. Unlike most that uses CBT for insomnia, downloads/ chronic insomnia can go to the
wellness apps marketed directly or CBT-I. Instead of being MedicalDevices/ doctor and get a sleeping pill,
DigitalHealth/
to consumers, digital therapeu- delivered in an office by a psy- UCM568735.pdf
but they very seldom have access
tics follow an R&D path that chologist, Sleepio’s six-week to CBT,” says Espie. “Our goal is
looks more like drug develop- intervention is led by an ani- to create a new digital medicine
ment. The tools are evaluated in mated virtual sleep expert named that can replace sleeping pills.”
clinical studies and prescribed by The Prof and his narcoleptic Other companies are
a medical provider. And many of dog Pavlov. “It’s designed to feel designing tools that patients
the companies producing digital entertaining, but it’s actually and their health-care provid-
therapies are seeking regulatory full-octane CBT,” Espie says. ers will use collaboratively. For
approval. He and his colleagues tested example, Pear Therapeutics, a
Mental and behavioral disor- the intervention in a randomized, company based in Boston and
ders lend themselves particularly placebo-controlled trial of people San Francisco, is developing
well to digital interventions, with chronic insomnia. More prescription-based digital treat-
suggests psychologist Colin than 70 percent of participants ments for substance use disorder,
Espie, PhD, a professor of sleep who completed the online CBT post-traumatic stress disorder,
medicine at the University of intervention had healthy sleep generalized anxiety disorder and
Oxford and co-founder and eight weeks after the program schizophrenia.
chief medical officer of the ended, compared with less than In 2017, Pear’s reSET
digital therapeutics company 30 percent of participants who therapy for the treatment of
Big Health. “Digital medicine received a placebo in the form substance use disorders became
is really personalized behavioral of visualization exercises (Sleep, the first prescription digital
medicine,” he says. Vol. 35, No. 6, 2012). Further therapeutic for disease treatment
randomized controlled trials cleared by the Food and Drug
MOBILE CBT have been published since then, Administration (FDA). A simi-
Big Health centers on a web- including a study of more than lar product for the treatment of
based program called Sleepio, 3,700 participants that showed patients with opioid use disorder,
reSET-O, to be used in com- health companies, including

bination with the medication manufacturers of digital thera-
buprenorphine, is now under peutics, and certify companies to
review by the FDA. In April, go through a more streamlined
Pear announced a deal with review. Precertified companies
Sandoz, a division of the health- could potentially send low-risk
care company Novartis, to products to market without a
commercialize the two products. specific product review. “This
reSET centers around a pilot program is the first step
mobile app that leads patients in redesigning how the FDA
with alcohol, cocaine, marijuana regulates digital health prod-
and stimulant use disorders ucts,” says Bakul Patel, associate
through CBT-based tools and director for digital health in the
allows them to track substance FDA’s Center for Devices and
use, cravings and triggers such psychoeducation or self-help,” Radiological Health.
as social pressure and loneliness. Maricich says. “It’s an actual Requiring a prescription and
The system requires a physician’s treatment intended to improve seeking FDA approval involve
prescription, but it’s designed outcomes and enhance the One digital extra effort for developers of dig-
for patients who are undergoing therapeutic alliance between the therapeutic app ital therapeutics, but those efforts
leads patients with
outpatient therapy for treatment patient and the clinician.” alcohol, cocaine, are worth it to ensure patient
of their substance use disorder. marijuana and safety, Maricich says. When
Clinicians such as psycholo- STAMP OF APPROVAL stimulant use treating high-risk conditions
disorders through
gists or psychiatrists who are As digital therapeutics and other CBT-based tools such as substance use disorder,
working with those patients can new technologies gain in pop- and allows them to patients can face significant
log on to a dashboard to access ularity, the FDA is tasked with track use, cravings harm from treatments that don’t
and triggers.
a patient’s data and monitor his determining how best to evalu- do what they claim, he adds. An
or her progress. The application ate them. Software that aims to official stamp of approval indi-
also comes with a label, akin to a diagnose or treat medical con- cates that the digital therapeutic
prescription drug label, that conditions falls under the category has been rigorously evaluated.
tains instructions for clinicians of medical devices. But because “All medications and devices
about how to integrate the tool such software is so different need to be evaluated to make
into their therapeutic practice, from existing devices, the route sure they’re safe and effective.
says Yuri Maricich, MD, MBA, to approval isn’t straightforward. There’s no reason to presume
Pear’s chief medical officer. The reSET system was evaluated that software is any different,”
High-quality CBT for through a “de novo” premarket Maricich says. Regulatory
substance use treatment is review pathway, a regulatory approval is also an important
time-intensive and intention- pathway for some low- to mod- step toward getting insurance
ally repetitive so that patients erate-risk devices that are so companies to cover the costs of
can strengthen the neural cir- novel they have no equivalents digital therapeutics, he adds.
cuits involved in resisting the on the market. While regulatory and insur-
substance of misuse, Maricich Recognizing the need for ance wrinkles still need to be
says. With reSET, patients can a better approach, in 2017 ironed out, digital medicine
undertake the straightforward the FDA published a Digital pioneers say it’s only a matter
SHARON MCCUTCHEON/UNSPLASH
components of the treat- Health Innovation Action Plan of time before physicians are
ment on their own and focus and launched a new Software regularly prescribing digital
in-person therapy on more Precertification Pilot Program to therapeutics. “I don’t think we’re
complicated issues, such as develop a regulatory model for far from an environment where
exploring why particular settings software technologies. The pilot digital medicine is a first-line
cause cravings. “reSET isn’t program will evaluate digital option,” Espie says. n
monitor on
psychology
A PUBLICATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION
Jessica Henderson Daniel, PhD

PRESIDENT
Rosie Phillips Davis, PhD

PRESIDENT-ELECT
CHIEF EXECUTIVE OFFICER Arthur C. Evans Jr., PhD
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MEMBERSHIP RECRUITMENT AND RETENTION
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A PUBLICATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION • 2018

10 TRENDS TO WATCH IN 2019

1 CLIMATE CHANGE IS OUR CALL TO ACTION | 2

3 A GROWING DEMAND FOR SPORT PSYCHOLOGISTS | 8

Even if we could halt

people adapt to a warming world B Y K I R ST E N W E I R

isn’t just a problem for envi-

been the world’s authority on

ground—and that’s one of the

are in demand for nonpharmacological treatment options for

more prevention, risk assessment

integrative field of culinary medicine B Y Z A R A G RE E N B A U M

Spectrum Health’s team- cook. Typically administered

psychologists are improving life for residents and caregivers

anxious and agitated after a What’s more, a greater num-

therapy to burned-out activists

to explore real-world human behavior B Y L E A W I N E R M A N

PROMISE AND “The question of where to start

■ Expanding the reach of ROBOTS THAT PEOPLE STEREOTYPED AS

patients have a problematic rela- violent porn. There are infor-

Unlike most wellness

some cases, replace—medications for treating a range

reSET-O, to be used in com- health companies, including

Jessica Henderson Daniel, PhD

Rosie Phillips Davis, PhD

CHIEF EXECUTIVE OFFICER Arthur C. Evans Jr., PhD

EXECUTIVE DIRECTOR OF MEMBERSHIP Ian King, MBA

EDITOR IN CHIEF Sara Martin

SENIOR EDITORS Jamie Chamberlin, Tori DeAngelis, Lea Winerman

CONTRIBUTING WRITERS Rebecca A. Clay, Zara Greenbaum, Kirsten Weir

COPY EDITOR Mike O’Connor

ART AND DESIGN

ART DIRECTOR Michele Chu

DESIGN CONSULTANT Jerry Sealy

PRODUCTION MANAGER Peter S. Kovacs

DIRECTOR OF ADVERTISING Jodi Ashcraft

ADVERTISING SALES MANAGER James Boston

RECRUITMENT ADVERTISING PRODUCT MANAGER Amelia Dodson

RECRUITMENT ADVERTISING SALES MANAGER Nancy Onyewu

MARKETING MANAGER Robin Tiberio

BUSINESS ADMINISTRATOR Eric Fuller

ADVERTISING SALES CONSULTANT Shelby Watson

GRAPHIC DESIGN AND PRODUCTION, ADVERTISING Rebecca Halloran

ADVERTISING AND EXHIBIT SALES COORDINATOR Age Robinson

MEMBERSHIP RECRUITMENT AND RETENTION

DIRECTOR OF MEMBERSHIP MARKETING Tabitha Brown

ASSOCIATE DIRECTOR OF MEMBER CONTENT Peggy Mihelich

MEMBER CONTENT MANAGER Shannon Doty

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