2015 APA Survey of Psychology Health Service Providers

Auntré Hamp, Karen Stamm, Luona Lin, and Peggy Christidis
APA Center for Workforce Studies
Report Text

Executive Summary

The purpose of the 2015 American Psychological Association Survey of Psychology Health Service Providers (HSP) was to gain valuable information about licensed psychologists in the United States, including educational background, employment characteristics, and provision of health services. Major findings include:

Health service provider psychologists primarily worked in private practice. Although psychologists worked across many different employment settings, nearly half (44.8 percent) worked in private practice, and most (85.8 percent) were actively working in license-required positions. Respondents spent a mean of 36.0 hours per week in primary positions and spent the most time (18.4 hours per week) providing direct patient/client care. Clinical psychology was the most commonly reported primary specialty (45.1 percent of respondents); anxiety, depressive, and trauma and stressor-related disorders were the most common treatment areas.

Psychologists provided services to diverse groups of people. Respondents frequently or very frequently provided services to White/Caucasian (96 percent), heterosexual (96 percent), and adult (83 percent) populations, while lower percentages of respondents frequently or very frequently provided services to transgender, American Indian/Alaska Native, Asian, children, older adult, active duty military, homeless, and rural populations.

Psychologists who frequently provided services to older adults spent the most time providing direct individual psychotherapy. Respondents who frequently provided services to older adults reported spending a mean of 8.7 hours a week providing services to older patients/clients. They also reported similar amounts of time conducting individual psychotherapy (7.7 hours). These respondents were most interested in further educational opportunities in assisting patients/clients adjust to medical illness or disability (57.1 percent), depression (54.2 percent), and bereavement and grief (51.5 percent).

Most psychologists collaborated with other types of health professionals. Psychologists reported engaging in a mean of 2.3 collaborative clinical care activities, such as sharing waiting room space with other health care professionals (50.4 percent of respondents) and using the same electronic medical record (39.2 percent). Respondents reported frequently collaborating with psychiatrists, social workers, non-psychiatrist physicians, and counselors. Overall, respondents reported high levels of confidence in working with a variety of health care professionals.

Psychologists felt well prepared to provide services to diverse populations. Over half of respondents (52.7 percent) reported being well-prepared to deal with diverse populations. Additionally, they reported being knowledgeable about working with many diverse populations. Books and peer-reviewed journals and colleagues were the most common resources that they used to gain information about diverse populations. Psychologists reported that they utilized their graduate training program the least in regards to increasing competency.

Introduction and Methodology

This report summarizes the findings of the 2015 American Psychological Association (APA) Survey of Psychology Health Service Providers (HSP). It provides an overview of the demographic and educational characteristics, employment settings, direct patient/client care provision, and other provider-related information for licensed health service psychologists in the United States.

Sample

The target population for the survey was U.S. licensed, doctoral-level psychologists. State licensing board lists from 50 states and the District of Columbia were collected, standardized, merged, and de-duplicated by staff in APA’s Information Technology Services. Records were matched by first and last name, email address (where available), and mailing address. APA Center for Workforce Studies staff identified doctoral-level psychologists by the license type and license status records reported by each state.

A total of 100,305 unique licensed psychologists with doctoral degrees were identified. Of these, 45,595 individuals had email addresses: 29,902 (65.6 percent) were APA members, and 15,693 (34.4 percent) were non-members. The majority of email addresses were obtained from APA member records and the state licensing board records. Other sources of email addresses, such as American Board of Professional Psychology rosters,1 were also used.

A total of 8,914 email messages were undeliverable, bringing the number of delivered emails to 36,681. A total of 5,325 individuals completed the survey, yielding a response rate of 14.5 percent. 3,986 APA members and 1,339 non-members completed the survey, yielding a 16.4 percent response rate for APA members and 10.8 percent response rate for non-members.

Measures

The survey contained sections on demographic and educational characteristics, licensure, practice and employment characteristics, and populations served. In order to reduce survey burden, half of the respondents were randomly directed to a survey section on team-based care. The other half were randomly directed to a section on cultural competency. Those who reported working with older adults occasionally, frequently, or very frequently were directed to a section on geropsychology.

Procedures

Potential respondents received a pre-notification email message and were informed of the forthcoming survey and its purposes. One week later, potential respondents received an email message with a unique survey link. Up to three reminder emails were sent approximately one to two weeks apart to those who had not completed the survey. As an incentive for participation, respondents who completed the survey were entered into a random drawing for one of 10 iPad tablets.

Caveats

Results should be compared cautiously to the results of the 2008 Survey of Psychology Health Service Providers. There was a shift from a mixed mode survey format in 2008 (online and mailed versions) to an entirely online survey format in 2015. The survey questions may not be identical for the 2008 and 2015 surveys. Even minor changes in question wording can influence response patterns.

Sample Differences between APA Members and Non-Members

The 2015 APA Survey of Psychology Health Service Providers included both APA members and non-members. APA members represented the majority (74.9 percent) of the sample, while non-members accounted for 25.1 percent. Analyses were conducted to assess any differences between APA members and non-members on a number of factors.

Statistically significant differences or relationships between APA membership status were found in various characteristics such as age, race/ethnicity, employment arrangement and status of currently providing direct patient/client care.2 Racial/ethnic diversity was greater in non-members than APA members. Approximately 14.0 percent of non-members and 11.5 percent of APA members identified as racial/ethnic minorities. APA members also tended to be older, with a mean age of 56.8 years (median = 59 years) compared to non-members at 52.6 years (median = 53 years). Over half (61.3 percent) of APA members were 55 years or older, where only 47.8 percent of non-members were within the age range. APA members were also more likely to be self-employed (53.2 percent) than non-members (35.8 percent). Lastly, 89.9 percent of APA members reported currently providing direct patient/client care, which was slightly higher than non-members (87.7 percent). A complete comparison of demographic characteristics and employment arrangement is provided in Table 1 in Appendix A.

Despite these differences between the two groups, the aim of this report is to provide a snapshot of all psychologists. In addition, chi-square tests, which were used to test relationships among groups of respondents, are more sensitive to larger sample sizes. As such, data from APA members and non-members were analyzed together. The remainder of this report will present results from all respondents, collapsed across APA membership status.

This report is composed of 6 major sections:

  • Section 1 provides an overall demographic and educational breakdown of survey respondents. The demographic characteristics include age, gender, race/ethnicity, sexual orientation, disability status, marital status, and number of dependents. Section 1 also examines education and training characteristics, including doctoral internship, post-doctoral training, doctoral re-specialization, and other professional degrees.
  • Section 2 assesses the employment characteristics of doctoral-level psychologists. It provides information on work settings, professional licensure and service characteristics. It also describes the hours worked, psychological specialties, and types of disorders commonly treated by psychologists.
  • Section 3 examines the various populations served by health service psychologists. These populations were analyzed by age, gender, race/ethnicity, sexual orientation and other characteristics.
  • Section 4 discusses a subset of health service psychologists that serve older adults. Data include types of psychological services provided, participation in Medicare, and interest in types of educational opportunities.
  • Section 5 describes participation in team-based care, including types of shared clinical care activities, perceived professional influence on team-based care, understanding of the roles of other professionals, and the importance of educational and training experiences in team-based care provision.
  • Section 6 looks at self-reported cultural competency measures, such as preparation to serve diverse populations, knowledge about working with various demographic groups, and the utilization of various sources to build competence in providing clinical services to diverse populations.

Limitations of the data presented in this report, as well as issues for future research, are discussed in the Conclusion. Data tables can be found in Appendix A (PDF, 1MB). Appendix B (PDF, 544KB) contains the survey instrument.

Section 1. Demographic and Educational Characteristics

Demographic Characteristics of Survey Respondents

In terms of gender identity, the majority of respondents were female (59.2 percent) with around 40 percent of the respondents being male. Less than 0.1 percent of respondents reported being transgender.

The median age of survey respondents was 58 years, while the mean age was 55.7 years. Over half of respondents (58.0 percent) were over the age of 55. Approximately 5.4 percent of the respondents were under 35 years of age.

In terms of race/ethnicity3, most respondents identified as White/Caucasian (87.8 percent). Racial/ethnic minorities accounted for 12.2 percent of the respondents, with Asians at 2.5 percent, Black/African Americans at 2.6 percent, and Hispanics at 4.4 percent. Less than 1 percent identified as American Indian/Alaska Natives or Native Hawaiian/Pacific Islanders. 1.7 percent identified as multiracial/multiethnic.

Of those reporting Hispanic ethnicity, Mexican was the most common response, along with other Hispanic/Latino/Spanish origin at 1.7 percent, and 0.5 percent each for Cuban or Puerto Rican.

Regarding sexual orientation, 90.2 percent of respondents identified as heterosexual/straight. Approximately 7 percent of respondents identified as gay, lesbian, bisexual, or other, with 2.4 percent identifying as gay, 2.4 percent identifying as lesbian, 2.1 percent identifying as bisexual, and 0.4 percent identifying as other. Approximately 3 percent of respondents preferred not to answer.

When assessing disability status, 5.8 percent of respondents indicated that they had at least one disability. About 2.0 percent reported having a physical/systemic disability, 0.9 percent reported being deaf or hard of hearing, 0.7 percent reported having a psychiatric disability, 0.6 percent reported a learning disability, 0.5 percent reported being blind or visually impaired, and less than 0.2 percent reported having a cognitive disability.

Table 1a (PDF, 342KB) summarizes the demographic characteristics of survey respondents.

Table 1a. Demographic and Educational Characteristics of Survey Respondents

Table 1a. Demographic and Educational Characteristics of Survey Respondents

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding or multiple selections.
s = suppressed due to small cell size or to prevent disclosure.
a Racial/ethnic groups are mutually exclusive. Racial/ethnic groups other than Hispanic do not include individuals who reported Hispanic ethnicity.
Source: 2015 APA Survey of Psychology Health Service Providers.

Table 1b (PDF, 423KB) summarizes the marital status and number of dependents of survey respondents. The majority (77.4 percent) of respondents were married or partnered, with 10.5 percent divorced, 8.6 percent single, 2.8 percent widowed, and 0.7 percent separated. Over half (53.4 percent) of respondents reported having dependents. For those with dependents, the mean and median number of dependents was 2, and nearly 40 percent reported having dependents ages 7-18 years.

Table 1b. Marital Status and Dependents of Survey Respondents

Table 1b. Marital Status and Dependents of Survey Respondents

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to individual having dependents in multiple age categories.
s = suppressed due to small cell size or to prevent disclosure.
Source: 2015 APA Survey of Psychology Health Service Providers.

Education and Training Characteristics of Survey Respondents

Figure 1a (PDF, 515KB) examines the highest psychology degree awarded, internship type and length, doctoral re-specialization, and other non-psychology professional degrees awarded.

The majority of respondents (78.2 percent) reported holding Ph.D. degrees as the highest degree in psychology. Psy.D. (Doctor of Psychology) degrees were the second most held highest degree at 19.3 percent, while 2.7 percent reported Ed.D. (Doctor of Education) degrees as the highest degree in psychology. Approximately 12.9 percent of all respondents reported holding other professional degrees. Types of other professional degrees included theological (16.5 percent), social work (8.3 percent), business (6.4 percent), nursing (5.9 percent), public health (4.9 percent), law (3.5 percent), medical (0.7 percent), and other (53.9) degrees (e.g., counseling, education, public administration, sociology, etc.).

Figure 1a. Types of Degrees, Re-specialization, and Internship of Survey Respondents

Figure 1a. Types of Degrees, Re-specialization, and Internship of Survey Respondents

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 2 and Table 3 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

The vast majority (94.3 percent) of respondents reported completing a psychology internship as part of the doctoral program. Most (81.8 percent) completed a one year full-time internship, 12.5 percent completed a two year part-time internship, and 5.7 percent did not complete an internship. Most (71.9 percent) of respondents completed an APA (American Psychological Association)-accredited internship, while 3.0 percent completed a CPA (Canadian Psychological Association)-accredited internship.

The majority (81.8 percent) of respondents completed at least one year of post-doctoral supervised training (full-time or equivalent). Only 5.7 percent reported completing a program of doctoral re-specialization.

Figure 1b (PDF, 418KB) illustrates the type of degree awarded by gender and race/ethnicity. Statistically significant relationships4 were found between the type of doctoral degree earned and a crosstabulation of gender and race/ethnicity. There was a higher proportion of racial/ethnic minority members among respondents who held Psy.D. degrees than other degrees, whereas the proportions of White respondents who held Ph.D. or Ed.D. degrees were comparably higher. Male representation of respondents who held Ed.D. degrees was the highest among all degrees.

Figure 1b. Type of Doctoral Degree by Gender and Race/Ethnicity

Figure 1b. Type of Doctoral Degree by Gender and Race/Ethnicity

Note: Missing values were excluded prior to analysis. White group does not include Hispanics; racial/ethnic minority group includes any racial/ethnic groups other than non-Hispanic White. For data underlying this figure, please refer to Table 4 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Section 2. Employment Characteristics

Employment characteristics, such as work setting, employment status and employment arrangement, all influence the delivery of behavioral health care services. These characteristics provide critical information regarding the supply of doctoral-level psychologists. As the health care delivery system continues to change, it is important for psychologists to be aware of the clinical areas and employment settings that are in the greatest demand.

Work Settings

Figure 2a (PDF, 419KB) shows employment characteristics. Nearly half of all respondents (44.8 percent) reported their primary work setting as private practice, while 23.6 percent reported working in hospitals or organized human service settings. Approximately 19.4 percent reported working in education settings, such as universities (12.0 percent), four-year colleges (1.1 percent) or other educational settings (6.3 percent). About 12 percent reported working in other work settings, such as government, business, or other settings. Secondary work settings followed similar patterns.

Most respondents reported self-employment (48.9 percent) or salaried employment (43.6 percent). Approximately 85.8 percent of respondents were actively working in positions that required a license. About 11.4 percent reported working in a position where a license was not required, with the remaining respondents reporting working in other fields (1.4 percent), not currently working (1.3 percent), or retired (4.9 percent).

Figure 2a. Employment Characteristics: Setting, Arrangement, and Status

Figure 2a. Employment Characteristics: Setting, Arrangement, and Status

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Tables 5-7in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2b (PDF, 510KB) displays employment arrangements by gender and race/ethnicity. Analysis found a statistically significant relationship5 between employment arrangement and a crosstabulation of gender and race/ethnicity. White females reported the highest proportion of self-employment (54.3 percent), followed by White males (35.8 percent). Ethnic minority females (7.1 percent) and ethnic minority males (2.8) were less likely to report self-employment.

Figure 2b. Employment Arrangement by Gender and Race/Ethnicity

Figure 2b. Employment Arrangement by Gender and Race/Ethnicity

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. White group does not include Hispanics; racial/ethnic minority group includes any racial/ethnic groups other than non-Hispanic White. For data underlying this figure, please refer to Table 9 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2c (PDF, 511KB)  illustrates primary and secondary employment settings. Private practice was the most common primary (44.8 percent) and secondary (47.2 percent) setting among respondents. In general, the distribution of secondary employment settings was similar to that of primary employment settings.

Figure 2c. Primary and Secondary Broad Employment Settings

Figure 2c. Primary and Secondary Broad Employment Settings

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 5 and Table 6 in Appendix A (PDF, 1MB). Totals may not sum to 100 percent due to rounding.
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2d (PDF, 420KB) shows primary employment setting by gender and race/ethnicity. There was a significant relationship6 between primary employment setting and a crosstabulation of gender and race/ethnicity. White females accounted for the largest proportion across all settings, with the smallest proportion in business settings (38.5 percent) and largest proportions in other settings (55.2 percent) and private practice settings (54.3 percent). White males were more prominent within business settings (43.6 percent), with the lowest proportion in four-year college settings (26.5 percent).

A lower proportion of racial/ethnic minority females (6.8 percent) and males (3.1 percent) reported private practice than in other primary work settings. The highest proportion of racial/ethnic minority females was found in four-year college settings (18.4 percent), followed by university settings (non-medical or professional school) (8.3 percent). Similar to racial/ethnic minority females, the highest proportion of racial/ethnic minority males was found in four-year college settings (8.2 percent percent), followed by government settings (8.0 percent).

Figure 2d. Primary Employment Settings by Gender and Race/Ethnicity

Figure 2d. Primary Employment Settings by Gender and Race/Ethnicity

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. White group does not include Hispanics; racial/ethnic minority group includes any racial/ethnic groups other than non-Hispanic White. For data underlying this figure, please refer to Table 8 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Work Hours

Figure 2e (PDF, 646KB) displays the number of hours worked (in intervals) per week for primary and secondary positions. The median number of hours worked per week in the primary position was 40 hours and 10 hours in the secondary position (mean hours per week were 36.0 and 10.4, respectively). When looking at the categorical breakdown of hours worked, 41.7 percent of respondents reported working between 40 and 49 hours week in their primary positions, followed by 30 to 39 hours per week (17.6 percent) and 20 to 29 hours (13.9 percent). For secondary positions, the majority of psychologists (85.4 percent) reported working 19 hours or less per week.

Figure 2e. Hours Worked per Week

Figure 2e. Hours Worked per Week

Note: Missing values and outliers (more than 100 hours per week for primary positions and more than 70 hours per week for secondary positions) were excluded prior to analysis. For data underlying this figure, please refer to Table 10 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2f (PDF, 512KB) presents mean number of hours worked per week by work activity. For primary position, providing direct patient/client care/healthcare services was the work activity in which psychologists spent the most hours (18.4) per week, followed by administrative management (7.4 hours), teaching/ education/research (4.0 hours), clinical supervision (1.7 hours), and other human services (1.3 hours). There was a similar pattern for secondary position.

Figure 2f. Mean Hours Worked per Week by Work Activity

Figure 2f. Mean Hours Worked per Week by Work Activity

Note: Missing values and outliers (total work hours of more than 70 hours per week) were excluded prior to analysis. “Other” category includes clinical/community consultation & prevention, non-clinical consultation, and other work activities. For data underlying this figure, please refer to Table 11 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Psychologists reported working a mean of 48.3 weeks (median = 52 weeks) per year, which resulted in a mean of 1742.4 (median = 2000) hours worked in primary positions, and a mean of 465.7 (median = 416) hours worked in secondary positions per year. See Table 12 of Appendix A for a full summary of weeks worked per year.

Licensure

Professional licensure is an important and often necessary component of practicing as a psychology health service provider. Licensure requirements differ from state to state, though there are some general requirements for obtaining professional licensure. Some of the requirements for licensure as a psychologist include a doctoral degree in psychology (some states, e.g., Vermont and West Virginia, license psychologists at the master’s degree level), supervised experience and successful completion of the Examination for the Professional Practice of Psychology (EPPP). Given the extensive training and overlap with behavioral health-related degrees, it is also possible for some psychologists to gain other types of licensure.

Figure 2g (PDF, 326KB) displays the type of licenses that psychologists reported holding. A vast majority of respondents reported being actively licensed as a psychologist (94.0 percent). Among the 6.0 percent of respondents with other types of licenses, the most common licensure type was licensed school psychologist (55.8 percent), followed by licensed marriage and family therapist (27.4 percent).

Figure 2g. Types of Licenses

Figure 2g. Types of Licenses

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 13 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

In regards to the geographic distribution of respondents actively licensed as psychologists, the Pacific region (21.0 percent) had the highest representation, followed by the South Atlantic region (16.8 percent). The East South Central region (2.7 percent) had the lowest representation among respondents. See Table 14 of Appendix A for a full summary of licensure by geographic distribution.

More than (54.8 percent) of psychologists with a license have held the license for more than 20 years. See Table 15 of Appendix A for a full summary of years since licensure.

Approximately 83.9 percent of respondents reported having a National Provider Identifier (NPI) number.

Characteristics of Psychologists Providing Direct Services

Approximately 89.3 percent (4,235) of respondents reported providing direct patient/client care. Only respondents who reported providing direct patient/client care were included in the remainder of this report.

Figure 2h (PDF, 419KB) illustrates the distribution of the number of psychologists in their practice locations. Most respondents reported having 1 to 5 psychologists (including themselves) working at the practice location of their primary (72.0 percent) and secondary (81.7 percent) positions. Approximately 17.6 percent reported having more than 10 psychologists working at the practice location of their primary position, while 9.6 percent reported the same at the practice location of their secondary position.

Figure 2h. Number of Psychologists at Practice Locations of Primary and Secondary Positions

Figure 2h. Number of Psychologists at Practice Locations of Primary and Secondary Positions

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 16 in Appendix A.
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2i (PDF, 419KB) shows the distribution of primary and secondary area of specialty. Almost half (45.1 percent) of respondents reported their primary specialty as clinical psychology, followed by clinical child and adolescent psychology (15.5 percent), counseling psychology (9.4 percent), and clinical health psychology (7.0 percent). The least common primary specialties were group psychology, organizational and business consulting psychology, and police and public safety psychology. Similar to primary specialty, clinical psychology was the most common secondary specialty.

Figure 2i. Primary and Secondary Specialty

Figure 2i. Primary and Secondary Specialty

Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2j (PDF, 513KB) displays the percentages of patient/client coverage by types of payment. Payment coverage was classified into four categories, in which 25 percent or less of patient/client coverage was considered low coverage, 26 to 50 percent was considered moderately low coverage, 51 to 75 percent was considered moderately high coverage, and over 75 percent was considered high coverage. Except for private insurance, over 60 percent of respondents reported low coverage for all types of payment coverage. Ninety percent of respondents reported low coverage for Tricare. Veteran’s Affairs coverage had the highest percentage (29.7 percent) of high payment coverage, followed by private insurance (27.1 percent), and other government insurance (21.6 percent).

Figure 2j. Payment Coverage for Patients/Clients

Figure 2j. Payment Coverage for Patients/Clients

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 19 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 2k (PDF, 324KB) displays future plans to provide direct clinical services in the next 12 months. About 74.4 percent reported they had no plans to change their current arrangement. Approximately an even number of respondents reported they would decrease hours (11.8 percent) or increase hours (10.7 percent). One percent of respondents reported that they planned to seek a non-clinical job, and 2.4 percent reported having other future plans.

Figure 2k. Future Plans for Direct Services in Next 12 Months

Figure 2k. Future Plans for Direct Services in Next 12 Months

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 20 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Approximately 10.8 percent of respondents reported being able to provide services in a language other than English, including Spanish (5.5 percent), French (1.1 percent), and other languages (3.7 percent).

Figure 2l (PDF, 516KB) shows the frequency of providing services to patients/clients by treatment areas. Anxiety, depressive, and trauma and stressor-related disorders were the most frequently treated disorders. About 85 percent of respondents reported providing services to patients/clients with anxiety disorders frequently or very frequently, followed by depressive disorders (84.2 percent) and trauma and stressor-related disorders (57.0 percent). The least treated disorders included paraphilic, elimination, and medication- induced movement disorders.

Figure 2l. Frequency of Providing Services to Patients/Clients by Treatment Areas

Figure 2l. Frequencyof Providing Services to Patients/Clients by Treatment Areas

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 22 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Due to the difference in the quality of email addresses obtained from various sources in different states, the sample of the HSP survey may not be nationally representative.

All comparisons are statistically significant at p < 0.05.

Racial/ethnic groups are mutually exclusive. Racial/ethnic groups other than Hispanic do not include individuals who reported Hispanic ethnicity. Racial/ethnic minorities include any racial/ethnic groups other than White.

Section 3. Populations Served by Psychologists

Psychologists provide clinical services to diverse populations. Healthcare services research data show that various populations utilize behavioral health services at different rates (Substance Abuse and Mental Health Services Administration, 2013). Figure 3a (PDF, 517KB) provides an overview of population groups and categories described in this report.

Figure 3a. Frequency of Providing Services to Groups of Populations

Figure 3a. Frequency of Providing Services to Groups of Populations

Note: Missing values were excluded prior to analysis. Racial/ethnic groups other than Hispanic do not include individuals with Hispanic ethnicity. For data underlying this figure, please refer to Table 23 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3b (PDF, 510KB) shows the distribution of the frequency of providing services to age populations. The vast majority of psychologists reported seeing adults at higher frequencies than any other age group. About 83 percent of respondents reported providing services frequently or very frequently to adults, compared to 37.1 percent to older adults, 34.2 percent to adolescents, 23.0 percent to children, and 9.2 percent to oldest old adults. Fifty percent of respondents reported never providing services to children and 46.8 percent reported never providing services to oldest old adults.

Figure 3b. Frequency of Providing Services to Age Populations

Figure 3b. Frequency of Providing Services to Age Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3c (PDF, 417KB) displays the frequency of providing services to gender identity populations. Psychologists reported seeing female and male patients/clients at similar frequencies. About 92 percent of respondents reported providing services frequently or very frequently to females, and 90.2 percent reported providing services to males. About 84 percent of respondents reported rarely or never providing services to transgender patients/clients.

Figure 3c. Frequency of Providing Services to Gender Identity Populations

Figure 3c. Frequency of Providing Services to Gender Identity Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3d (PDF, 606KB) shows the frequency of providing services to race/ethnicity populations. The vast majority of psychologists reported seeing White/Caucasian patients/clients at higher frequencies than any other race/ethnicity group. About 96 percent of respondents reported providing services frequently or very frequently to White/Caucasian patients/clients, compared to 38.0 percent to Black/African American patients/clients, and 33.6 percent to Hispanic patients/clients. Almost a third of psychologists reported seeing patients/clients from two or more racial/ethnic groups (32.7 percent). Nearly 80 percent of respondents reported rarely or never providing services to American Indian/Alaska Native patients/clients, and 48.0 percent rarely or never providing services to Asian patients/clients.

Figure 3d. Frequency of Providing Services to Race/Ethnicity Populations

Figure 3d. Frequency of Providing Services to Race/Ethnicity Populations

Note: Missing values were excluded prior to analysis. Racial/ethnic groups other than Hispanic do not include individuals with Hispanic ethnicity. For data underlying this figure, please refer to Table 23 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3e (PDF, 510KB) displays the frequency of providing services to sexual orientation populations. The vast majority of psychologists reported seeing heterosexual or straight patients/clients at higher frequencies than any other sexual orientation group. About 96 percent of respondents reported providing services frequently or very frequently to heterosexual patients/clients, compared to 26.1 percent to gay patients/clients, 22.8 percent to lesbian patients/ clients, and 11.3 percent to bisexual patients/clients. Only 4.3 percent of respondents reported never providing services to gay patients/clients, and 6.8 percent reported never providing services to lesbian patients/clients.

Figure 3e. Frequency of Providing Services to Sexual Orientation Populations

Figure 3e. Frequency of Providing Services to Sexual Orientation Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3f (PDF, 510KB) illustrates the frequency of providing services to socioeconomic status populations. About 40 percent of respondents reported providing services frequently or very frequently to unemployed patients/clients, with a similar proportion (38.6 percent) reporting providing services at the same frequency to working poor patients/clients. About 74 percent of psychologist reported rarely or never seeing homeless patients/clients.

Figure 3f. Frequency of Providing Services to Socioeconomic Status Populations

Figure 3f. Frequency of Providing Services to Socioeconomic Status Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3g (PDF, 510KB) displays the frequency of providing services to military status populations. Over 80 percent of respondents reported never or rarely providing services to active duty military, compared to 49.0 percent for retired military/veterans. Approximately 18.5 percent of respondents reported frequently or very frequently providing services to retired military/veterans. 

Figure 3g. Frequency of Providing Services to Military Status Populations

Figure 3g. Frequency of Providing Services to Military Status Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3h (PDF, 509KB) displays frequency of providing services to rural communities. Approximately 44.4 percent of respondents reported never or rarely providing services to rural communities, whereas only 29.8 percent reported frequently or very frequently serving this population.

Figure 3h. Frequency of Providing Services to Rural Communities

Figure 3h. Frequency of Providing Services to Rural Communities

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 23 in  Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Figure 3i (PDF, 419KB) shows the frequency of providing services to patients/clients with types of disability and health conditions. Psychologists reported providing services to patients/clients with physical disabilities more frequently than any other disability. About 46.2 percent of respondents reported providing services to patients/clients with physical disabilities, compared to 34.6 percent to patients/clients with developmental disabilities, and 30.6 percent to patients/clients with intellectual disabilities.

In regards to serving patients/clients with health conditions7, 62.3 percent reported working with patients/clients with at least one health condition. Among those serving patients/clients with health conditions, obesity (58.3 percent) was the most common health condition, followed by diabetes (56.1 percent), and cancer (52.7 percent). About 16 percent of respondents reported providing services to those living with HIV or STIs.

Figure 3i. Treatment of Patients/Clients Whose Primary Focus of Care Was Related to Disabilities and Health Conditions

Figure 3i. Treatment of Patients/Clients Whose Primary Focus of Care Was Related to Disabilities and Health Conditions

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 24 in Appendix A (PDF, 1MB).
Source: 2015 APA Survey of Psychology Health Service Providers.

Section 4. Geropsychology Service Provision

In the United States, the population of older adults (ages 65 and older), has been growing more rapidly than the general population. It is expected that the proportion of the entire U.S. population in this age group will increase from 13 percent in 2010 to 16 percent by 2020 (Karel, Gatz & Smyer, 2012). The need and demand for behavioral health services for this age group is also expected to grow.

Although the older population has many of the same behavioral health needs as other age groups, there are specific needs in older adults. Dementia is one of the most common behavioral health disorders experienced by the aging population. Karel et al., (2012) found that the estimated prevalence of dementia for individuals over the age of 65 was 10 percent, while 20.4 percent of individuals over 65 experienced some sort of mental disorder (including dementia).

Competency and training in this area are critical to meet the needs of this growing population. Evidence indicates that there is currently an inadequate number of behavioral health professionals trained to work with older adults (Institute of Medicine, 2008; Hoge, Karel, Zeiss, Alegria & Moye, 2015).

This section provides analysis based on results from the geropsychology section of the HSP survey. Only respondents who reported providing services to older adults occasionally, frequently, or very frequently (2,542, or 47.7 percent of all respondents) were directed to this section.

Hours Providing Care to Older Adults

Figure 4a (PDF, 419KB) illustrates the mean number of hours respondents spent conducting various clinical activities with the older population. Overall, respondents providing services to this population spent an average of 8.7 hours per week providing services to older adults (with or without family present.) There was significantly less time spent providing direct services to family (1.6 hours) and conducting consultations and staff training (0.8 hours).

In regards to the provision of psychotherapy services, respondents spent most of their time conducting individual psychotherapy (7.7 hours per week), followed by couples/family psychotherapy (1.5 hours). Respondents spent the least amount of time conducting other psychotherapy services (0.5 hours).

Overall, respondents spent more time conducting psychotherapy services than assessment services or consultation services. In the area of assessment, respondents spent the most time conducting cognitive assessment (3.0 hours), followed by psychodiagnostic services (2.5 hours). Respondents spent the least amount of time conducting capacity (1.0 hours) and other assessment services (0.5 hours). Respondents spent little time providing consultation services. An average of 1.3 hours a week was spent on consultation to health teams and 1.0 hour to families, while less than 1 hour per week was devoted to consultation with agencies and families or other types of consultation.

Figure 4a. Mean Hours per Week Spent on Types of Services Provided to Older Adults

Figure 4a. Mean Hours per Week Spent on Types of Services Provided to Older Adults

Note: Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 25 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Interest in Further Geropsychology Specialized Educational Opportunities

Figure 4b (PDF, 512KB) shows the areas in which psychologists reported interest in further geropsychology specialized educational opportunities. Respondents were most interested in adjusting to medical illness or disability (57.1 percent), followed by depression (54.2 percent) and bereavement and grief (51.5 percent). They were least interested in staff training (10.5 percent), personality disorders (12.3 percent), and chronic mental illness (12.6 percent).

Figure 4b. Interest in Further Geropsychology Specialized Educational Opportunities

Figure 4b. Interest in Further Geropsychology Specialized Educational Opportunities

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 26 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Medicare Participation and Changes

Figure 4c (PDF, 418KB) displays Medicare participation for respondents or their organizations. About 66 percent of respondents serving older adults reported that they were Medicare providers, while 13.1 percent were previous Medicare providers who no longer participated and 17.7 percent had never participated in Medicare. Among those who reported not currently participating in Medicare, the most common reason for not participating was that reimbursement rates were too low, followed by not participating in any insurance plans, and having a primarily non-Medicare case-mix.

Figure 4c. Medicare Participation

Figure 4c. Medicare Participation

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 27 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 4d (PDF, 512KB) shows changes in the number of Medicare patients/clients over the past three years (only respondents who identified as Medicare providers were asked to answer this question). Almost half of respondents (46.8 percent) reported there was no change in their Medicare patient/client caseload, while 39.6 percent reported they saw more Medicare patients/clients. Only 7.3 percent reported seeing fewer Medicare patients/clients over the past three years.

Figure 4d. Medicare Changes

Figure 4d. Medicare Changes

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 27 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Section 5. Team-Based Care Provision

Over the last several decades, healthcare has moved toward a more integrated model of service delivery that involves collaboration and communication among a variety of health professionals. Psychologists are more likely to work in “teams” of various sorts with professionals in other fields. These team relationships may be either formal or informal and do not necessarily involve working at the same site.

This section presents analysis based on results from the team-based care section of the survey. About half of the respondents who reached this part of the survey (N= 1947) were randomly directed to answer questions in this section.

Table 5a (PDF, 419KB) displays the percentage of respondents collaborating with other professionals by clinical care activity. Sharing a waiting room space (50.4 percent) was the most common way of collaborating with other health professionals, followed by using the same electronic medical record (39.2 percent). The least common collaborative activities were participating in joint clinical research (13.2 percent) and having joint sessions with providers from different disciplines (19.0 percent).

Table 5a. Collaborative Clinical Care Activities

Table 5a. Collaborative Clinical Care Activities

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding.
Source: 2015 Survey of Psychology Health Service Providers.

Table 5b (PDF, 419KB) shows the percentage of psychologists who conducted clinical care activities with other professionals. Almost three-fourths of respondents (72.3 percent) conducted at least one type of clinical care activity with other professionals. The median number of clinical care activities conducted with other professionals was two. About 40 percent reported engaging in 3 or more activities with others. Slightly over a quarter of respondents reported engaging in no clinical activities with other professionals.

Table 5b. Number of Collaborative Clinical Care Activities

Table 5b. Number of Collaborative Clinical Care Activities

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding.
Source: 2015 Survey of Psychology Health Service Providers.

Figure 5a (PDF, 600KB) illustrates the frequency of providing collaborative care with other professionals. Psychologists reported collaborating with psychiatrists, social workers and physicians and surgeons at higher frequencies than other health professionals. About 50.6 percent of respondents reported collaborating with psychiatrists always or often, followed by social workers (37.3 percent) and physicians and surgeons (31.5 percent). Counselors were the behavioral health professionals with whom psychologists were least likely to provide collaborative care, with 45.4 percent rarely or never collaborating with this type of professional. Respondents reported the least collaboration with dentists, pharmacists, and community health workers.

Figure 5a. Frequency of Collaboration by Type of Professional

Figure 5a. Frequency of Collaboration by Type of Professional

Note: Missing values were excluded prior to analysis. Totals may not sum to 100 percent due to rounding. For data underlying this figure, please refer to Table 28 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 5b (PDF, 608KB) illustrates ratings (on a 1-7 scale) of the degree of influence of various professionals in clinical decision-making. A majority of psychologists reported that psychologists had the greatest degree of influence among healthcare professionals. About 77 percent of respondents reported the degree of influence of psychologists as 5 or greater on the scale. Other professionals with high degrees of perceived influence were psychiatrists, physicians and surgeons, nurse practitioners, and social workers. Respondents reported the least degree of influence for dentists, community health workers, pharmacists, and nutritionists.

Figure 5b. Degree of Influence in Clinical Decision-Making by Type of Professional

Figure 5b. Degree of Influence in Clinical Decision-Making by Type of Professional

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 29 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 5c (PDF, 520KB) shows ratings of level of understanding of the roles of various professions and confidence in working with other professionals. A majority of psychologists reported the highest understanding and confidence in working with psychologists, followed by psychiatrists, social workers, counselors, and physicians and surgeons. Respondents reported the lowest understanding and confidence in working with community health workers, dentists, pharmacists, and nutritionists.

Figure 5c. Understanding and Confidence in Working with Types of Professionals

Figure 5c. Understanding and Confidence in Working with Types of Professionals

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 30 in  Appendix A (PDF, 1MB). Level of knowledge and confidence ranges from minimal to complete mastery as follows:

  • Complete Mastery: I fully understand this profession’s role, and so feel completely confident about how to work with members of this profession.
  • Proficient: In general, I understand this profession’s role, and so feel reasonably confident about how to work with members of this profession.
  • Intermediate: I have some understanding of this profession’s role, but I have things to learn about them, and so don’t feel entirely confident about how to work with members of this profession.
  • Beginning: My understanding of this profession’s role is limited. There’s a lot I have to learn about them, and so am not confident about how to work with members of this profession.
  • Minimal: My understanding of this profession’s role is minimal. I know very little about them and so am not at all confident about how to work with members of this profession.

Source: 2015 Survey of Psychology Health Service Providers.

Figure 5d (PDF, 419KB) displays ratings of the importance of various educational and training activities for the provision of team-based care. On-the-job training and internship were the most important educational and training activities, while graduate coursework was the least important of the activities.

Figure 5d. Importance of Educational and Training Experiences in Team-Based Care Provision

Figure 5d. Importance of Educational and Training Experiences in Team-Based Care Provision

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 31 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Section 6. Cultural Competency Characteristics

Cultural competency has been defined as the ability to provide services to diverse groups through clinical interventions and interactions that account for the patient/client’s own personal and cultural background (Sue, Ivey & Pedersen, 2006; Sue, 2006). Many psychology graduate training programs have adopted development of cultural competency as an explicit goal. Moreover, the Affordable Care Act requires that health teams that receive federal grant dollars “provide quality-driven, cost-effective, culturally appropriate, and patient- and family-centered healthcare” (Patient Protection and Affordable Care Act of 2010).

This section presents analysis from the cultural competency section of the survey. Approximately half of the respondents who reached this part of the survey (N=1909) were randomly directed to answer questions in this section.

Level of Preparedness and Knowledge

Figure 6a (PDF, 511KB) illustrates ratings of level of preparedness to work with culturally diverse groups. Over half (52.7 percent) reported being well prepared or extremely well prepared by their doctoral training programs. Only 3.0 percent felt not at all prepared, while 44.4 percent felt that they were slightly or fairly prepared to work with culturally diverse groups.

Figure 6a. Level of Preparedness for Providing Services to Culturally Diverse Groups

Figure 6a. Level of Preparedness for Providing Services to Culturally Diverse Groups

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 32 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6b (PDF, 423KB) displays respondents’ ratings of how knowledgeable they felt about working with particular populations.

Figure 6b. Level of Knowledge by Type of Patient/Client Populations

Figure 6b. Level of Knowledge by Type of Patient/Client Populations

Note: Missing values were excluded prior to analysis. Racial/ethnic groups other than Hispanic do not include individuals with Hispanic ethnicity. For data underlying this figure, please refer to Table 33 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6c (PDF, 510KB) illustrates level of knowledge about working with age groups. Level of knowledge differed slightly by age group. About 58 percent of respondents reported being quite or extremely knowledgeable about working with adolescents (14-17 years of age). Similar percentages of being quite or extremely knowledgeable were reported for level of knowledge about providing service to children under 13 years of age (45.0 percent) and older adults age 65 years or older (48.2 percent). There were, however, differences in being extremely knowledgeable about various age groups, with 13.2 percent reporting being extremely knowledgeable about working with older adults, 24.5 percent with children, and 28.8 percent with adolescents.

Figure 6c. Level of Knowledge by Age Groups

Figure 6c. Level of Knowledge by Age Groups

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 33 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6d (PDF, 510KB) displays level of knowledge about working with racial/ethnic minority groups. Levels of knowledge differed for some racial/ethnic minority groups. About 46 percent of respondents reported being quite or extremely knowledgeable about working with Black/African American patients/clients. Similar percentages were found for level of knowledge about working with Hispanic patients/clients (44.9 percent). Respondents reported lower levels of knowledge for working with Asian, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander patients/clients with 29.8, 17.3 and 11.6 percent, respectively, reporting being quite or extremely knowledgeable. About 26.8 percent of respondents reported being not at all knowledgeable about working with Native Hawaiian/Pacific Islanders. Only 1.0 percent reported being not at all knowledgeable about working with Black/African American patients/clients, and 2.0 percent reported being not at all knowledgeable about working with Hispanic patients/clients.

Figure 6d. Level of Knowledge by Racial/Ethnic Groups

Figure 6d. Level of Knowledge by Racial/Ethnic Groups

Note: Missing values were excluded prior to analysis. Racial/ethnic groups other than Hispanic do not include individuals with Hispanic ethnicity. For data underlying this figure, please refer to Table 33 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6e (PDF, 417KB) displays level of knowledge about working with gay, lesbian, bisexual and transgender patients/clients. Level of knowledge was higher for working with gay, lesbian and bisexual patients/clients than transgender patients/clients. About 51 percent reported being quite or extremely knowledgeable about working with gay, lesbian and bisexual patients/clients, while only 19.7 percent reported the same about working with transgender patients/clients. Over half (52.3 percent) of respondents reported being not at all or slightly knowledgeable about working with transgender patients/clients.

Figure 6e. Level of Knowledge by Sexual Orientation/Gender Identity

Figure 6e. Level of Knowledge by Sexual Orientation/Gender Identity

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 33 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6f (PDF, 418KB) displays level of knowledge about providing services to various other groups of populations. Respondents reported higher levels of knowledge for religious clients, with 46.2 percent reported quite knowledgeable or extremely knowledgeable about working with them. Similar frequency (43.4 percent) was found for working with clients living in poverty. Respondents were less knowledgeable about working with immigrant populations, with over half (51.2 percent) reporting slightly knowledgeable or not knowledgeable at all working with this population. Respondents reported moderate level of knowledge working with military populations and rural populations.

Figure 6f. Level of Knowledge by other Groups of Populations

Figure 6f. Level of Knowledge by other Groups of Populations

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 33 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Figure 6g (PDF, 418KB) displays level of knowledge about providing services to patients/clients with various health conditions. Level of knowledge differed depending on the health condition. Respondents were most knowledgeable about working with patients/clients living with chronic illnesses and other health conditions, with 60.3 percent reporting being quite knowledgeable or extremely knowledgeable about working with this population. About 49 percent reported a similar level of knowledge when working with patients/clients with physical disabilities, followed by 42.3 percent with cognitive disabilities and 37.0 percent with intellectual disabilities. Less than 10 percent of respondents reported being not at all knowledgeable about working with each of these populations.

Figure 6g. Level of Knowledge by Health Conditions/Disabilities

Figure 6g. Level of Knowledge by Health Conditions/Disabilities

Note: Missing values were excluded prior to analysis. For data underlying this figure, please refer to Table 33 in  Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Resources for Building Cultural Competency

Table 6a (PDF, 259KB) illustrates the various resources that psychologists reported utilizing to build competency to work with diverse populations. Books and peer reviewed journals were the most utilized resource across population groups. Continuing education training and colleagues served as other important resources for competency building. Respondents utilized APA practice guidelines the least when building competency to work with diverse groups

Table 6a. Utilization of Resources by Groups of Patient/Client Populations

Table 6a. Utilization of Resources by Groups of Patient/Client Populations

Notes: Missing values were excluded prior to analysis. Racial/ethnic groups other than Hispanic do not include individuals with Hispanic ethnicity. For data underlying this figure, please refer to Table 34 in Appendix A (PDF, 1MB).
Source: 2015 Survey of Psychology Health Service Providers.

Conclusion

The 2015 American Psychological Association Survey of Psychology Health Service Providers provides a glimpse into the demographic characteristics, educational backgrounds, employment settings, and practice patterns of licensed psychologists in the United States, as well as examines their experiences with population groups, older adults, team-based care, and cultural competency.

Findings in this report detail the current state of direct service provision but also point to additional areas for further research. For example, although this report describes the utilization of direct services from psychologists, this report does not address unmet need for these services. It will be important to explore whether the supply of psychologists is adequate to meet the need (including unmet need) for services. In light of changing population demographics, research is also needed to understand the types of services provided to diverse populations.

A limitation of the HSP survey is that the results only reflect the portion of psychologists who participated in the survey. Despite a relatively large sample, the respondents of the survey may not be representative of all practicing health service psychologists. Because sampling procedures included email addresses from some (but not all) state licensing boards, proportionately more psychologists from those states may have responded. As such, the sample may not be geographically representative of the population of health service psychologists.

Additional analyses by the APA Center for Workforce Studies will examine in further detail the areas of geropsychology, team-based care, and populations served.

Footnotes

1 Due to the difference in the quality of email addresses obtained from various sources in different states, the sample of the HSP survey may not be nationally representative.

2 All comparisons are statistically significant at p < 0.05.

3 Racial/ethnic groups are mutually exclusive. Racial/ethnic groups other than Hispanic do not include individuals who reported Hispanic ethnicity. Racial/ethnic minorities include any racial/ethnic groups other than White.

4 X2 (6, N = 4566) = 60.5, p < 0.001.

5 X² (9, N = 3704) = 35.2, p < 0.001.

6 X² (9, N = 3704) = 35.2, p < 0.001.

7 Respondents were not asked if patients/clients were being seen because of their health condition.

References

American Psychological Association. (2015). 2014: APA Member Profiles. Retrieved from http://www.apa.org/workforce/publications/14-member/index.aspx

Hoge, M., Karel, M., Zeiss, A., Alegria, M., & Moye, J. (2015). Strengthening psychology’s workforce for older adults: Implications of the Institute of Medicine’s report to Congress. American Psychologist, 70(3), 265-278.

Institute of Medicine. (2008). Retooling for an aging America: Building the healthcare workforce. Washington, DC. National Academies Press.

Karel, M. J., Gatz, M., & Smyer, M. A. (2012). Aging and mental health in the decade ahead. American Psychologist, 67(3), 184-198.

Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 (2010).

Substance Abuse and Mental Health Services Administration. (2013). Behavioral Health, United States, 2012. HHS Publication No. (SMA) 13-4797. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Sue, D. W., Ivey, A. E., & Pedersen, P. B. (1996). A theory of multicultural counseling and therapy. San Francisco, CA: Brooks Cole.

Sue, S. (2006). Cultural competency: From philosophy to research and practice. Journal of Community Psychology, 34(2), 237-245.

Appendices
Tables
Figures
Acknowledgements

Recommended citation: American Psychological Association. (2016). 2015 survey of psychology health service providers. Washington, DC: Author.

This report describes research and analysis conducted by staff members of the American Psychological Association’s Center for Workforce Studies. It does not constitute official policy of the American Psychological Association.

Auntré Hamp is a former staff member of the Center for Workforce Studies and is currently at Healthy Solutions Institute.

We thank the following groups and individuals for their contributions to the 2015 Survey of Psychology Health Service Providers:

  • APA Committee on Aging (CONA)

  • Research Committee of the Association of Psychologists in Academic Health Centers (APAHC)

  • APA staff, particularly Gautam Balani, Lynn Bufka, Jaime Diaz-Granados, Deborah DiGilio, Catherine Grus, Howard Kurtzman, Kirk Waldroff, and C. Vaile Wright

  • APA’s Information Technology Services

  • Individuals who provided valuable feedback in the survey pilot

  • Survey respondents