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Psychology - American Psychological
A PUBLICATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION • JUNE 2020

psychology
monitor on

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COVID-19
SPECIAL
EDITION
How psychology
is mobilizing and
responding to the crisis

CE Corner: Ethics
Advice for a New Era
PAGE 34

Research on
COVID-19’s Impact
PAGE 30

Telepsychology
Expands to
Meet Demand
PAGE 18

How Students and
Trainees Are Faring
PAGE 52
Psychology - American Psychological
monitor on
                                                                                               psychology
                                                                              A PUBLICATION OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION
                                                                                                                                                                                                                                                                                      Contents                                                                                                                    JUNE 2020

                                                                                                          PRESIDENT           Sandra L. Shullman, PhD

                                                                                                PRESIDENT-ELECT               Jennifer F. Kelly, PhD, ABPP                                                                                                                                                       COVID-19 SPECIAL EDITION
                                                                                  CHIEF EXECUTIVE OFFICER                     Arthur C. Evans Jr., PhD
                                                                                                                                                                                                                                                                                           As the coronavirus pandemic upends life as we knew it, psychologists are responding on several critical
                                                                                                                                                                                                                                                                                          fronts. Practitioners are helping health-care providers with stress, researchers are studying the pandemic’s
                                                                                                                              Alicia Aebersold
                                                                       CHIEF COMMUNICATIONS OFFICER
                                                                                                                                                                                                                                                                                                   mental and behavioral health effects, educators are moving their classes online and more.
                                                                                           APA EDITOR IN CHIEF                Sara Martin

                                                                                                                   EDITORIAL

                                                                                                  EDITOR IN CHIEF             Lea Winerman

                                                                                                  SENIOR EDITORS              Lindsey Allen, Jamie Chamberlin, Tori DeAngelis

 CONTRIBUTING WRITERS Ashley Abramson, Rebecca A. Clay, Bryan Goodman,
		                    Zara Greenbaum, Nicole Owings-Fonner, Chris Palmer,
		                    Stephanie Pappas, Kirk Waldroff, Kirsten Weir

                                                                                                             ART AND DESIGN

                                                                                                     ART DIRECTOR             Michele Chu

                                                                                           DESIGN CONSULTANT                  Jerry Sealy

                                                                                       PRODUCTION MANAGER                     Peter S. Kovacs

                                                                                                  A PA M E D I A A N D E V E N T S A L E S

                                                                                 DIRECTOR OF ADVERTISING                      Jodi Ashcraft

                                                                            ADVERTISING SALES MANAGER                         James Boston

                                                          APA PSYCCAREERS OPERATIONS MANAGER                                  Amelia Dodson

                                                      RECRUITMENT ADVERTISING SALES MANAGER                                   Nancy Onyewu

                                           RECRUITMENT ADVERTISING SALES REPRESENTATIVE                                       Shawn Deadwiler II

                                                                             SENIOR MARKETING MANAGER                         Robin Tiberio

                                                                                  BUSINESS ADMINISTRATOR                      Eric Fuller
                                                                                                                                                                                                                                                                                      1 4 AS THE U.S. STAYS HOME,             40 PSYCHOLOGISTS RUSH TO HELP             DEPARTMENTS
                                              GRAPHIC DESIGN AND PRODUCTION, ADVERTISING                                      Rebecca Halloran                                                                                                                                            PSYCHOLOGISTS MOVE ONLINE              HEALTH-CARE PROFESSIONALS
                                                                                                                                                                                                                                                                                                                                                                         3    FROM THE PRESIDENT
                                                             MEDIA AND EVENT SALES COORDINATOR                                Age Robinson
                                                                                                                                                                                                                                                                                      1 8 TELEPSYCHOLOGY EXPANDS              44 FIGHTING INEQUITY IN THE                     AND THE CEO
                                                                                                                                                                                                                                                                                          TO MEET DEMAND                         FACE OF COVID-19                        4    THE HOT LIST
                                                                                                                                                                                                                                                                                      22 REACHING THE PUBLIC                  48 SUICIDE AND COVID-19                    7    IN BRIEF
                                                                                                                                                                                                                                                                                         AT A CRITICAL TIME
                                                                                                                                                                                                                                                                                                                              52 GRAD STUDENTS NAVIGATE                 11    CONVERSATION: 4 QUESTIONS
                                                                                                                                                                                                                                                                                      24 SEVEN FINDINGS THAT CAN                 THE UNKNOWN                                  FOR STEVEN TAYLOR
● Got a story idea? We want to hear from you. Send your ideas to Monitor on Psychology Editor Lea Winerman at lwinerman@apa.org.
                                                                                                                                                                                                                                                                                         HELP PEOPLE DEAL WITH                                                          13    JUDICIAL NOTEBOOK
● Need to contact APA? Answers to many of your questions may be found on APA’s website: www.apa.org                                                                 For phone service call (800) 374-2721                                                                                COVID-19                             56 ENHANCING ONLINE LEARNING
                                                                                                                                                                                                                                                                                                                                                                        64    BY THE NUMBERS
The Monitor on Psychology (ISSN-1529-4978) is the magazine of the American Psychological Association (APA) and is published 8 times per year—January/February combined, March, April/May combined, June, July/August combined,                                                        28 HOW WILL PEOPLE REACT TO             58 GRIEVING LIFE AND LOSS
September, October, and November/December combined. Publications office, headquarters and editorial offices are at 750 First St., N.E., Washington, DC 20002-4242. APA purchases only “first publication rights” for photos and
illustrations. Therefore, it cannot grant permission to reuse any illustrative material. APA holds the copyright for text material in Monitor on Psychology articles. Permission requests to reproduce text material should be addressed to APA,                                         THE NEW FINANCIAL CRISIS?                                                      65    APA ELECTION GUIDELINES
                                                                                                                                                                                                                                                            JUANMONINO/GETTY IMAGES

Permissions Office, at the APA address. Telephone numbers: Headquarters (202) 336-5500; TDD (202) 336-6123; Display advertising (202) 336-5714; Classified advertising (202) 336-5564; and Subscriptions (202) 336-5600. The views
                                                                                                                                                                                                                                                                                                                              62 LIFE AFTER COVID-19:
expressed in the Monitor on Psychology are those of the authors and may not reflect the official policies or positions of the American Psychological Association or the Monitor on Psychology. No endorsement of those views should be                                                30 RESEARCHERS PIVOT TO                    MAKING SPACE FOR GROWTH
inferred unless specifically identified as the official policy or position of the American Psychological Association. The publication of any advertisement by APA is an endorsement neither of the advertiser nor of the product. APA endorses
equal employment opportunity practices, and we reserve the right to edit all copy and to refuse ads that are not in consonance with the principles of Title VII of the Civil Rights Act of 1964. Subscription to the Monitor on Psychology ($6) is                                       STUDY IMPACT OF COVID-19
included in the annual dues and fees for all APA members and student affiliates. Individual subscription rate is $50; individual surface rate is $107; and individual airmail rate is $139. Institutional subscription rate is $93; institutional surface
rate is $203; and institutional airmail rate is $235. Single copies are $20 each. For $16 extra, the Monitor on Psychology will be mailed first-class to subscribers in the United States, Canada and Mexico. For $75 extra, airmail is available
to foreign subscribers (other than Canada and Mexico). Periodical postage is paid at Washington, DC, and at additional mailing offices. POSTMASTER: Send address changes to Monitor on Psychology Subscriptions Department, 750 First
                                                                                                                                                                                                                                                                                      34 CE: ETHICAL GUIDANCE FOR
St., N.E., Washington, DC 20002–4242. CANADA SUBSCRIPTIONS: Canada Post Agreement Number 40036331. Send change of address information and blocks of undeliverable copies to PO Box 1051, Fort Erie, ON L2A 6C7. Printed in                                                               THE COVID-19 ERA                                                               COVER: COLDSNOWSTORM/GETTY IMAGES
the United States of America. ©2020 by APA. Address editorial inquiries to the Monitor on Psychology editor, and advertising and subscription inquiries to Monitor on Psychology/advertising or Monitor on Psychology/subscriptions.

JUNE 2020 | VOLUME 51 | NUMBER 4

                                                                                                                                                                                                                                                                                                                                                                         M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   1
Psychology - American Psychological
From the President and the CEO

Dr. Ashley Batastini                                                                                    Dr. Jonathan Stange
University of Southern Mississippi                                                                      University of Illinois at Chicago
Reaching the Restricted: Examining the                                                                  Regulation in the Real World:
Feasibility and Effectiveness of a Novel                                                                Real-Time Assessment of

                                                                                                                                                                                                                       PSYCHOLOGY’S MOMENT
Psychosocial Intervention for Female                                                                    Suicide Risk in Context
Inmates in Administrative Segregation

                              Erika Esposito                                                                         Dr. Luz Garcini
                                                                                                                                                                                                                          FOR LEADERSHIP
                              Graduate Student, University of Rochester                                              UT Health San Antonio                                                                   Across the field, APA and psychology are addressing the initial crisis of
                              Suicide Risk Among Transgender                                                         How Does Contextual Stress                                                              the COVID-19 pandemic—and strategically preparing for a new normal
                              Youth: A Multimethod, Multi-informant                                                  Get Under the Skin of Young
                                                                                                                      Undocumented Immigrants?:                                                                                     BY APA PRESIDENT SANDRA L. SHULLMAN, PhD, AND
                              Examination of Gender Identity
                                                                                                                        Identifying Mechanisms of                                                                                          APA CEO ARTHUR C. EVANS JR., PhD
                                                                                                                           Risk and Resilience

Alejandro Vazquez                                                                                           Ha (Milkie) Vu
Graduate Student,
Utah State University                                            APF’S                                      Graduate Student,
                                                                                                            Emory University

                                                                                                                                                                                                       T
Mental Health Service                                                                                       An Examination of Multi-
                                                                                                            level Factors Influencing

                                                                 2019                                                                                                                                              he COVID-19 pandemic has illustrated in stark terms the intricate com-
Preferences Among
Latinx Caregivers:                                                                                          Vietnamese-American
A Step Towards                                                                                              Parents’ HPV Vaccine                                                                                   plexity of human behavior. Worldwide, people are reacting to highly
Culturally Congruent                                                                                        Uptake for Their
                                                                                                                                                                                                                   stressful life and death events, fueled by unknown risks and uncertainty.
Intervention Formats
for Children and
Adolescents
                                                              VISIONARY                                     Adolescent Children

                                                                                                                              Dr. Kerrie Wilkins-Yel
                                                                                                                                                                                                                   People are hungry for leadership and social connectedness and too many
                                                                                                                                                                                                       are coping with deeply rooted inequities that determine the quality of their health
                                                               GRANTS
                                                                                                                              Indiana University
                                                                                                                              Centering Those at The                                                   and their livelihoods. ¶ As the discipline that best understands human behavior, psy-
Susan Murray and Naoise Mac Giollabhui
                                                                                                                              Margins: Understanding                                                   chology can have a significant impact on improving life in this age of COVID-19. This
                                                                                                                              Counterspaces as an
Graduate Students, Temple University                                                                                                                                                                   work is well underway. ¶ Across the breadth of our field, APA members, governance
                                                                                                                                Avenue to Advance
Examining the Roles of
                                                                                                                                   STEM Persistence
Socioeconomic Status and                                                                                                                                                                               and staff are speaking out on key issues in the media   such questions as: What will work, education and
                                                                                                                                    Among Women
Relevant Health Correlates                                                                                                                                                                             and with policymakers. We have tapped into the          health care look like? How will we address the
                                                                                                                                      of Color
(Body Mass Index, Diet
                                                                                                                                                                                                       expertise of our members and international col-         increasing wave of mental health needs and loss of
Quality, and Inflammation)
                                                                                                                                                                                                       leagues to develop, curate and widely share a wealth    wellness among the public and our first responders?
for Neuropsychological                                                                 Melek Yildiz Spinel                                                                                             of COVID-19-related resources, tools and informa-       How can we help policymakers collect and use data
Function in Young Adults                                                               Graduate Student, University
                                                                                                                                                                                                       tion for psychologists, policymakers and the public.    in ways that reduce social inequities and disparate
                                                                                       of South Carolina
                                                                                       Gender Role Discrepancy,
                                                                                                                                                                                                       We are applying psychological science to                         impact?
                                                                                       Relationship Satisfaction, and                                                                                  policies, practices and interventions. Our                           In short, how do we ensure APA and its
                                                                                       Intimate Partner Violence                                                                                       practitioners are using different technol-                       members are a resource for our field, our
                                                                                       Risk for Latina Women                                                                                           ogies to reach those who most need our                           nation and the world?
                                                                                                                                                                                                       help. And we are supporting efforts to bring                         Over the last several months, the world
                                                                                                                                                                                                       psychological knowledge and tools to our                         has experienced great trauma and pain.
                                                                                                                                                                                                       communities as we all work for a better                          But we’ve also seen great resilience and
                                                                                                                                                       TOP: KIRK IRWIN; BOTTOM: SCOTT SUCHMAN
                                                                                                                                                                                                       future.                                                          hope. Armed with the power of psychol-
                                                 The Visionary Grants are APF’s flagship program, providing funding to psychology graduate
                                                 students and early career psychologists to seed innovation through supporting research, education,                                                       APA is focused on the here and now—                           ogy’s collective expertise, we are confident
                                                 and intervention projects and programs that use psychology to solve social problems. In 2020, in                                                      helping our communities to adjust and heal.                      and determined to bring our knowledge
                                                 response to the urgent need, APF added two COVID-19 Rapid Response grants to its portfolio.                                                           But we are also concentrating on what’s                          to a world that needs our help. APA is
                                                                                                                                                                                                       coming next, working to identify the future                      dedicated to providing the leadership and
                                                 Your support is critical to fund these programs. To find out more, go to                                                                              needs of individuals, families, community                        support needed to help create a safe and
                                                 www.apa.org/apf/funding/visionary or make your gift at www.apa.org/apf/giving                                                                         members and psychologists. We’re exploring                       healthy future for us all. ■
                                                 If you have additional questions, contact APF’s Interim COO, Miriam Isserow
                                                 at misserow@apa.org or 202-336-5622.

    2   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                                                                                              M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   3
Psychology - American Psychological
News From APA

The Hot List
MENTAL HEALTH RESOURCES                                                                                                                                                  APA SECURES KEY                                                                                           PRACTICE
                                                                                                                                                                         PROVISIONS FOR                                                                                            RESOURCES
FOR AN UNPRECEDENTED CRISIS

A
                                                                                                                                                                         PSYCHOLOGY                                                                                                YOU NEED
              PA has joined the nation’s leading mental health advocacy                                                                                                  Thanks in part to APA advocacy, the $2.2                                                                  APA has created a hub for
                                                                                                                                                                         trillion pandemic relief package will                                                                     all its business-of-practice
              groups and health insurance companies to launch the
                                                                                                                                                                         expand access to telehealth services,                                                                     information related to
              COVID-19 Mental Health Resource Hub, offering free                                                                                                         including tele­psychology. The legislation                                                                the COVID-19 pandemic.
              digital resources to help the public and health-care                                                                                                       will also benefit psychologists who                                                                       Psychology practitioners can
providers address their mental health needs during the pandemic.                                SUPPORT FOR                                                              provide ­services in universities, state                                                                  find all the latest advocacy
Resources include online courses and videos on topics such as how to                            STUDENTS & ECPS                                                          and local governments, and community                                                                      updates; telepsychology and
improve your sleep, how to use guided meditation to manage stress,                              APA is hosting regular webinars for                                                            health centers, as                                                                  tele-assessment tips and
                                                                                                students, postdocs and early career                                                            well as students                                                                    tools; billing, reimbursement
how to help children manage their anxiety and how organizations can
                                                                                                ­psychologists on pandemic-related                                                             and early career                                                                    and licensing guidance; self-
best support remote workers. Visit https://psychhub.com/covid-19.                                career topics including navigating the                                                        ­psychologists.                                                                     care advice and much more
      Many of the resources come from APA’s COVID-19 public information                          new job m­ arket, getting licensed and                                                         Learn more at                                                                      at www.apaservices.org/
center at www.apa.org/topics/covid-19. It includes dozens of evidence-                           completing research from afar. Watch at                                                        https://on.apa.org/                                                                practice/clinic.
based articles for the public on ways to cope with the pandemic, on                              https://pages.apa.org/staying-on-track.                                                        CARESAct.
how to manage stress, how to do physical distancing while maintaining
social connections and tips for quarantined parents. For psychologists,
                                                                                                                                                                                                                                                                       HOW WE CAN MITIGATE
the APA page offers guidance on continuing research, supervising                                HELP KIDS AND TEENS                                                      FUNDING OPPORTUNITIES                                                                         COVID-19 INEQUITIES
students from afar, offering telepsychology, teaching online and                                MANAGE THEIR FEELINGS                                                    FOR COVID-19 RESEARCH                                                                         A new episode of APA’s “Speaking of
practicing self-care. APA will add resources as the crisis continues.                           Magination Press Family has new                                          APA is tracking the new federal funding                                                       Psychology” podcast features APA Chief
Tell us what else you need at SixThings@apa.org.                                                resources designed for children and                                      opportunities available for ­psychologists                                                    of Psychology in the Public ­Interest
                                                                                                teens to help them cope with the uncer-                                  to explore the immediate and long-                                                            Brian Smedley, PhD, talking about why
                                                                                                tainty of the COVID-19 pandemic and                                      term impacts the pandemic will have on                                                        COVID-19 is dispro-
                                                                                                new guidance for                                                         mental and behavioral health related                                                          portionately affecting
                                                                                                caregivers on how                                                        to COVID-19. Find a list of opportunities     TAKE A BREAK                                    African Americans
                                                                                                to foster a sense of                                                     at www.apa.org/topics/covid-19/               TO MEDIDATE                                     and ­Latinos and
                                                                                                security during this                                                     funding-­research-opportunities.              APA is hosting free wellness ­webinars          what can be done
                                                                                                challenging time. Go                                                                                                   to help people avoid burnout, stay              to mitigate these
                                                                                                to www.­magination                                                                                                     healthy and manage their stress                 ­disparities. ­Listen
                                                                                                pressfamily.org.                                                                                                       during the pandemic. This month’s                to this episode and others that are
                                                                                                                                                                         STORY TIME WITH                               offerings include a mix of meditation,           related to ­the COVID-19 p
                                                                                                                                                                                                                                                                                                 ­ andemic
                                                                                                                                                                         MAGINATION PRESS                              yoga and Pilates. Find them at https://          at www.apa.org/research/action/
                                                                                                                                                                         APA’s children’s book authors are taking      pages.apa.org/wellness-webinars.                 speaking-of-psychology.
                                                                                                FREE MATERIALS FOR                                                       turns reading timely Magination Press
                                                                                                YOUR SUMMER CLASSES                                                      titles such as “A Feel Better Book for
                                                                                                Educators can use APA’s PsycLearn                                        Little Worriers” online to help children
                                                                                                ­digital resources in research m
                                                                                                                               ­ ethods                                                         manage stress and      “Our country is facing a potentially historic
                                                                                                 and social psychology in summer
                                                                                                 semester courses. To gain access, email
                                                                                                                                                                                                anxiety brought on
                                                                                                                                                                                                by the pandemic.        mental health crisis. The psychological
                                                                                                 psyclearn@apa.org. Find a full list of
                                                                                                 free resources from APA Publishing at
                                                                                                                                                                                                Each reading is fol-
                                                                                                                                                                                                lowed by an online
                                                                                                                                                                                                                        impact of this pandemic is just as great as
                                                                                                 www.apa.org/pubs/covid-19-resources.                                                           activity. Tune in at    the epidemiological gravity to human lives.”
                                                                                                                                           GETTY IMAGES

                                                                                                                                                          GETTY IMAGES

                                                                                                                                                                                                www.magination-        Dr. Arthur C. Evans Jr., APA CEO, calling for all sectors
                                                                                                                                                                                                pressfamily.org.       of business, nonprofits and health care to work together
    DID YOU KNOW?               APA is offering free membership to new psychology doctorates at https://pages.apa.org/newdoctorates.

4    M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                                                                                 M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   5
Psychology - American Psychological
In Brief
                                                                                                                         Research                                                                                               COMPILED BY CHRIS PALMER

               Help Those We
               Serve Find You                                                                                                                 THE LATEST PEER-REVIEWED STUDIES WITHIN PSYCHOLOGY AND RELATED FIELDS

      COVID-19 has impacted everyone and the demand
     for licensed psychologists is greater than ever. APA’s
    Psychologist Locator is a trusted, practical tool for those
        searching for psychological telehealth services.

                                                         This dynamic online tool offers:
                                                         • New —Telehealth availability filter
                                                         • Robust search & filtering
                                                           capabilities
                                                         • Simple navigation
                                                         • And more…                                                     COVID-19’s Impact on Children

                                                                                                                         A
                                                                                                                                   bout one in five children in the Chinese        of the students reported depressive symptoms and
                                                                                                                                   cities of Wuhan and Huangshi showed signs       19% reported anxiety symptoms. Students in Wuhan,
                                                                                                                                   of depression and anxiety while their schools   the epicenter of the outbreak, were more likely to
                                                                                                                         were closed and they were restricted to home because      report depressive symptoms than those in Huangshi,
Expand your reach and better inform those looking for the                                                                of the COVID-19 pandemic, according to a study in         about 60 miles away. Further studies are needed to
                                                                                                 USCHOOLS/GETTY IMAGES

                                                                                                                         JAMA Pediatrics. Researchers surveyed 1,784 students      determine whether the pandemic’s mental health
               help that you can provide.                                                                                in grades two through six. Schools in both cities were    effects on children are temporary or will persist ­­
                                                                                                                         closed in late January, and the students were surveyed    long term, according to the researchers.
                                Create or update your profile                                                            about a month later. The researchers found that 23%       DOI: 10.1001/jamapediatrics.2020.1619

                                  on.apa.org/psychlocator
6   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                              M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   7
Psychology - American Psychological
In Brief

                                                                                                                 between cells—in mouse tissue                                                                                                                                             even fatal if not taken under a                                                                          risk: Among those younger than
                                                                                                                 exposed to the stress hormone                                                                                                                                             doctor’s supervision.                                                                                    65, they were almost twice as
                                                                                                                 corticosterone. After stress                                                                                                                                              DOI: 10.1001/jamainternmed.2020.1764                                                                     likely to have one or more risk
                                                                                                                 treatment, the vesicles showed                                                                                                                                                                                                                                                     factors compared with higher-­
                                                                                                                 changes in overall size, protein                                                                                                                                          WORK OUT                                                                                                 income respondents.
                                                                                                                 content and small noncoding                                                                                                                                               NEGATIVE FEELINGS                                                                                        DOI: 10.1016/j.amepre.2020.04.003
                                                                                                                 RNA content. When sperm were                                                                                                                                              Among healthy but sedentary
                                                                                                                 incubated with these “stressed”                                                                                                                                           adults in their 20s, 30s and                                                                             ISOLATION AND
                                                                                                                 vesicles prior to egg fertilization,                                                                                                                                      40s, exercise can lower ­levels                                                                          INFLAMMATION
                                                                                                                 the resulting mouse pups showed                                                                                                                                           of depression and hostility,                                                                             Social isolation and loneliness
                                                                                                                 significant changes in early                                                                                                                                              according to research in Health                                                                          may be associated with inflam-
                                                                                                                 brain development, and as adults                                                                                                                                          Psychology. Researchers asked          Factor Surveillance System study.     Adding exercise to          mation in the body, suggests
                                                                                                                 they responded differently to                                                                                                                                             119 sedentary men and women            They found that among people          their routines helps        research in Neuroscience &
                                                                                                                                                                                                                                                                                                                                                                        sedentary people
                                                                                                                 stress than control animals. The                                                                                                                                          in the United States, ages 20          under age 65, 33% of blacks and       feel less depression        ­Biobehavioral Reviews. Ana-
                                                                                                                 researchers also asked 15 men,                                                                                                                                            to 45, about their current levels      42% of Native Americans had           and hostility.               lyzing 30 previous studies, 16
                                                                                                                 ages 19 to 25, to donate sperm                                                                                                                                            of depression, anxiety, ­hostility     at least one risk factor, such as                                  centered on social isolation and
                                                                                                                 each month for six months and                                                                                                                                             and anger. The researchers then        heart disease, diabetes or chronic                                 14 on loneliness, researchers
                                                                                                                 complete questionnaires about                                                                                                                                             randomly assigned half of the          lung disease, compared with                                        found social isolation was asso-
                                                                                                                 their perceived stress. They found                                                                                                                                        volunteers to begin ­exercising        27% of white respondents under                                     ciated with higher levels of the
                                                                                                                 that men who had previously                                                                                                                                               four times a week for three            65. Among those age 65 and            Social isolation             inflammation markers ­C-­reactive
                                                                                                                 experienced elevated stress                                                                                                                                               months—35 minutes at 75%               older, 61% of blacks and 69% of       and loneliness               protein and fibrinogen. Some
                                                                                                                                                                                                                                                                                                                                                                        could lead to
                                                                                                                 showed changes in their sperm’s                                                                                                                                           maximum heart rate—and the             Native Americans had at least         inflammation and             analyses also indicated a link
FRACTURED FRONT LINE                                interventions to promote their           Women and front-    small RNA content, in patterns                                                                                                                                            other half to a control group.         one risk factor in addition to age,   its associated               between loneliness and levels of
Depression, anxiety and                             mental health, with ­particular          line health-care    similar to those observed in the                                                                                                                                          The group that exercised for           compared with 54% of white            health risks,                Interleukin-6. The ­researchers
                                                                                             workers in Wuhan                                                                                                                                                                                                                                                           research suggests.
insomnia are common in the                          attention to those groups at             reported more       mice.                                                                                                                                                                     three months saw scores on a           respondents. Lower-income                                          note that the studies v­ aried
high-stress environments faced                      greatest risk.                           severe mental       DOI: 10.1038/s41467-020-15305-w                                                                                                                                           depression scale fall by 35%,          respondents were also at higher                                    in design and quality and
by health-care workers amid the                     DOI: 10.1001/jamanetworkopen.2020.3976   health symptoms                                                                                                                                                                               while scores for the control group
                                                                                             compared with
COVID-19 pandemic, according                                                                 other groups.       FALSE HOPE                                                                                                                                                                remained unchanged. Hostility
to research in JAMA Network                         STRESSED SPERM                                               Internet searches for unproven                                                                                                                                            levels also decreased in the exer-
Open. Researchers surveyed                          Stress-inducing events may lead                              COVID-19 remedies spiked                                                                                                                                                  cise group, but no changes were
1,297 health-care workers from                      to changes in a male’s sperm that        Stressful events    after President Trump and                                                                                                                                                 observed in anxiety and anger.
34 hospitals in China about their                   could impact future offspring,           may impact a        other high-profile people touted                                                                                                                                          The researchers also found that
                                                                                             male’s sperm and
mental health in late ­January                      according to a study in Nature           future offspring,   them online and in the press,                                                                                                                                             the mood benefits of working out
2020. Distress was widely                           Communications. Researchers              finds research in   finds research in JAMA Internal                                                                                                                                           can linger for weeks after people
reported (72%), followed by                         examined extracellular vesicles—         mice and humans.    Medicine. Researchers analyzed                                                                                                                                            stop their exercise routines.
depression (50%), anxiety (45%)                     structures that deliver molecules                            Google Trends data on internet                                                                                                                                            DOI: 10.1037/hea0000836

                                                                                                                                                                                                                      TOP: ERAXION/GETTY IMAGES; BOTTOM: MARJAN_APOSTOLOVIC/GETTY IMAGES
and insomnia (34%). Women,                                                                                       searches for chloroquine and
                                                                                                                                                        TOP: NATHAPHAT/GETTY IMAGES; BOTTOM: FOTOTOCAM/GETTY IMAGES

front-line health-care workers                                                                                   hydroxychloroquine from Feb.                                                                                                                                              STRUCTURAL INEQUITIES
and health-care providers in                                                                                     1 to March 29, 2020, which                                                                                                                                                Black, Native American and
Wuhan reported more severe                                                                                       includes the period before and                                                                                                                                            lower-income Americans are
mental health symptoms across                                                                                    after Trump and entrepreneur                                                                                                                                              more likely to have risk ­factors
all measurements compared                                                                                        Elon Musk hailed the unproven                                                                                                                                             that increase the chances of
with men, health-care workers                                                                                    drugs as potential cures. Searches                                                                                                                                        severe illness or death due to
not directly treating C
                      ­ OVID-19                                                                                  for the drugs jumped 442% for                                                                                                                                             COVID-19, finds a paper in the
patients and those outside of                                                                                    chloroquine and 1,389% for                                                                                                                                                American Journal of Preventive
Wuhan, respectively. These                                                                                       hydroxychloroquine. Searches                                                                                                                                              Medicine. Researchers analyzed
findings suggest that health-care                                                                                remained elevated even after                                                                                                                                              2018 data on about 330,000
workers exposed to the corona-                                                                                   news reports came out that the                                                                                                                                            people from the nationally
virus should immediately receive                                                                                 drugs could be poisonous and                                                                                                                                              representative Behavioral Risk

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Psychology - American Psychological
In Brief                                                                                                                                                                                                               Conversation

                                                                                                               contacts were among members
                                                                                                               of the same household. Using                                                                            4 QUESTIONS FOR STEVEN TAYLOR
                                                                                                               a mathematical model, the                                                                               The author of the timely book “The Psychology of Pandemics” explains where
                                                                                                               researchers concluded that the                                                                          we have gone wrong with preparing for COVID-19—and what we can still get right
                                                                                                               physical distancing ­measures
                                                                                                               were enough to curb the spread                                                                          BY LINDSEY ALLEN
                                                                                                               of the virus in those cities.
                                                                                                               According to the model, school
                                                                                                               closures alone reduced the peak

                                                                                                                                                                                                                       A
                                                                                                               incidence of infections by 40%
                                                                                                               to 60%.                                                                                                                      lthough some aspects     lessons from COVID-19 as they unfold           People will lose their marriages, their
                                                                                                               DOI: 10.1126/science.abb8001                                                                                                 of the novel coro-       and start preparing without panicking.”        jobs, their houses and their finances. The
                                                                                                                                                                                                                                            navirus remain                                                          upheaval and stress of being in close
                                                                                                               HIGHER SUICIDE RISK                                                                                                          unknown, research        What can we expect to see in terms of          confines can have lasting impacts on
                                                                                                               FOR NURSES                                                                                                                   on past ­pandemics       long-term impacts on mental health?            people’s mental health and well-being. A
                                                                                                               Nurses in the United States are                                                                                              and other o­ utbreaks,   There will be a significant minority of        seemingly unrelated situation provides a
                                                                                                               at higher risk of suicide than                                                                          such as influenza, SARS and Ebola, pro-       people severely impacted by COVID-19           point of comparison: In the case of wild-
                                                                                                               the general population, accord-                                                                         vides valuable insights into how health       —particularly people who had pre­              fires, people are cramped up together in
                                                                                                               ing to a study in Worldviews                                                                            experts can help contain the spread of        existing psychological problems and who        temporary accommodation, experiencing
                                                                                                               on ­Evidence-Based Nursing.                                                                             COVID-19 and encourage people to              experience a disruption in access to their     stress and financial hardship, and it leads
                                                                                                               Researchers analyzed ­Centers                                                                           get vaccinations once they are available,     mental health-care providers. People with      to an increase in fights, marital discord and
                                                                                                               for Disease Control and Pre-                                                                            says Steven Taylor, PhD, a professor and      a high level of intolerance for uncertainty,   domestic violence. We should expect to see
                                                                                                               vention data from 1,824 nurses                                                                          clinical psychologist at the University of    for example as you see in generalized          some of the same issues in this pandemic.
point to the need for further                        that reflect the ability to achieve                       and 152,495 non-nurses in the                                                                           British Columbia in Canada and author         anxiety disorder, are at a higher risk for         However, people as a whole are highly
research to demonstrate these                        goals and maintain stability but                          United States who completed                                                                             of “The Psychology of Pandemics,”             experiencing long-term impacts.                resilient. As a species, we have survived
­associations and their underlying                   not traits that reflect plasticity                        suicide from 2005 to 2016. They                                                                         published in October 2019—just two               But long-term impacts will not be           countless pandemics—and while it can
 mechanisms.                                         and adaptiveness.                                         found that suicide rates from                                                                           months before the novel coronavirus was       limited to those with pre-existing issues.     be stressful during the unfolding of a
DOI: 10.1016/j.neubiorev.2020.02.002                 DOI: 10.1037/apl0000488               Experiencing job    2005 to 2016 were higher in                                                                             first reported in China.                                                                             disaster, people do go on to adapt
                                                                                           insecurity may      female nurses (10 per 100,000                                                                               Taylor’s 30 years of research                                                                    and recover.
                                                                                           make people more
JOB INSECURITY                                       DISTANCING WORKS                      neurotic and less   person-­years) than in the                                                                              on health anxiety pointed him to
CHANGES PERSONALITY                                  Physical distancing measures          agreeable and       ­general female population (7 per                                                                       the psychological phenomenon                                                                        Would the spread of the novel
Experiencing chronic job inse-                       were effective in stopping the        conscientious.       100,000 person-years). ­Similarly,                                                                     of pandemics, which are caused                                                                      coronavirus be different if people
curity can lead to changes in                        transmission of C­ OVID-19                                 suicide rates were higher in male                                                                      and contained by the way peo-                                                                       had been paying closer attention
personality, suggests a study in                     in Wuhan and Shanghai,                                     nurses (33 per 100,000 person-­                                                                        ple behave and react to the threat                                                                  to past research on pandemics?
the Journal of Applied ­Psychology.                  China, finds a study in S­ cience.                         years) than in the general male                                                                        of infection. He has found that                                                                     Unfortunately, probably not. We,
Researchers analyzed survey                          Researchers surveyed 636 ­people                           population (27 per 100,000                                                                             health experts can take critical                                                                    as humans, tend to be myopic and
responses from 1,046 ­workers                        in Wuhan and 557 people in                                 person-­years) for the same                                                                            steps in containment, including                                                                     forget the things of the past.
in Australia collected over nine                     Shanghai about their daily con-                            time period. The ­researchers                                                                          clearly communicating risk levels,                                                                      The World Health Organiza-
years. Using the Big Five per-                       tacts—in-person ­conversations                             also found that nurses who                                                                             encouraging vaccination adher-                                                                      tion (WHO) has learned lessons
sonality trait framework, they                       or physical contacts such as                               completed suicide were more                                                                            ence, providing stress management                                                                   from past pandemics, but those
found that job insecurity that                       handshakes—before and after                                likely to have had job problems                                                                        advice for the general public and                                                                   lessons can be hard to put into
lasted four or five years was asso-                  stringent physical ­distancing                             and a history of mental health                                                                         learning from our mistakes.                                                                         practice with the public. For exam-
ciated with a small increase in                      orders were put in place in                                problems than non-nurses who                                                                               He believes we should be                                                                        ple, they’ve learned the potential
                                                                                                                                                                                      COURTESY OF DR. STEPHEN TAYLOR

­neuroticism and small decreases                     late January 2020. The ­average                            completed suicide. ■                                                                                   treating COVID-19 as preparation                                                                    harm in naming pandemics or
                                                                                                                                                         DEAN MITCHELL/GETTY IMAGES

 in agreeableness and conscien­                      ­number of daily contacts                                 DOI: 10.1111/wvn.12419                                                                                  for the next pandemic or disaster.                                                                  diseases after people, places or
 tiousness, but they found no links                   dropped from 14.6 to 2.0 in                                                                                                                                      “With climate change increasingly                                                                   things. Imagine if this virus had
 with changes in extra­version or                     Wuhan and from 18.8 to 2.3 in                                                                                                                                    impacting people’s lives, we can                                                                    formally been called the Wuhan
                                                                                                               ● For direct links to the research
 openness. The researchers suggest                    Shanghai, and after distancing                           cited in this section, visit our online
                                                                                                                                                                                                                       expect further disasters down the                                                                   Bat Flu. These kinds of labels can
 that job insecurity affects traits                   measures, the vast majority of                           edition at www.apa.org/monitor.                                                                         road,” says Taylor. “We can take the                                                                cause rampant racism and needless

10   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                                                                                                                               M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   11
Psychology - American Psychological
Conversation                                                                                                               Judicial Notebook

              STUDENTS
      SHARE
                                                          calling of names—labels, words and
                                                          names count a lot.
                                                                                                          they should get vaccinated. Many people
                                                                                                          are unaware of the importance of herd                                      PRIVACY VERSUS PUBLIC HEALTH
      YOUR
                                                              The WHO has also learned the                immunity, which is the indirect protection                                 As governments and corporations use smartphone data and facial recognition
                                                          importance of risk communication. It            that a population experiences when a large                                 software to track and curtail the spread of COVID-19, psychologists can help

     PASSION
                                                          was important to sound the alarm early          enough proportion is immune to infec-
                                                          to get the public’s attention, but not at a     tion, and getting out this message has the
                                                                                                                                                                                     policymakers understand the public’s expectations around digital privacy
                                                          level that people are terrified because that    potential to increase vaccination. Interven-                               BY JENNIFER K. ROBBENNOLT, JD, PhD, UNIVERSITY OF ILLINOIS COLLEGE OF LAW
                                                          can be socially disruptive in itself. They’ve   tions based on motivational interviewing
     FOR PSYCHOLOGY                                       presented people with information early         can be successful in individual or small
                                                          and described uncertainties, which is           group settings, with providers addressing
     ‹ Connections                                        essential in earning the public’s trust.        people’s underlying worldviews. Cognitive-

                                                                                                                                                                                     T
           to Campus                                          But officials could have been much          behavioral therapy can be effective for
           Ambassadors                                    more proactive about addressing behav-          people with injection phobia.                                                            he COVID-19 global pandemic has raised many                       Illinois Biometric Information Privacy Act (BIPA),
                                                          iors seen in previous pandemics. For                One of the big failures in this pan-                                                 issues at the intersection of law and psychology.                 for example, restricts the ability of private entities
           throughout the                                 example, many countries did not prepare         demic is that most countries have not
                                                                                                                                                                                                   One that is becoming a focus of debate is the ten-                to collect biometric information without notice
           country on private                             as well as they could have for the pre-         been proactive in dealing with this. This
                                                                                                                                                                                                   sion between privacy and public health. Already,
                                                                                                                                                                                                                                                                     and consent. In January, Facebook agreed to a $550
                                                          dictable rise in racism, the surge of the       is one area where we still have the oppor-                                                                                                                 million class action settlement for using facial rec-
           Facebook page                                  worried well into hospitals and the panic       tunity to be proactive.                                                                  companies are using aggregate smartphone loca-                    ognition technology without users’ consent. In April,
                                                          buying. For example, with panic buying,                                                                                    tion data to assess whether residents are following stay-at-home                parents sued Google under BIPA and the federal
     ‹ Tools, resources                                   officials could have worked with major          What are the important research                                            orders. In some countries, like South Korea, smartphone apps                    Children’s Online Privacy Protection Act, alleging
           and tips to assist                             grocery stores and food distributors            questions for this pandemic?                                               alert authorities when quarantined residents leave their homes.                 that Google collected, stored and used children’s
                                                          ahead of any messaging to the public and        My team is collecting data online, looking                                                                                                                 biometrics without parental consent by providing
           you during these                                                                                                                                                          Other countries, including Australia and several European
                                                          asked them to put limits on purchasing.         at how people are coping with self-­                                                                                                                       access to laptop computers with preinstalled apps
                                                                                                                                                                                     nations, are developing apps that use location data to facilitate
           challenging times                              Then when messaging went out to the             isolation, among other topics related to
                                                                                                                                                                                     contact tracing. Singapore has already deployed such an app,
                                                                                                                                                                                                                                                                     that required voiceprints and faceprints.
                                                          public, it could have been framed appro-        this pandemic. We’re also investigating                                                                                                                        Claims like these are likely to proliferate in the
                                                                                                                                                                                     called TraceTogether. Commercial products that could enable
     ‹ APA swag to                                        priately to let people know that they           people’s varying coping strategies, both                                                                                                                   wake of the pandemic, and the decisions made are
                                                          should stock up with a two-week supply          adaptive behaviors such as finding creative                                employers to track workers’ health or locations are also available.             likely to outlast it. Psychologists have much to con-
           share with                                     of groceries but that purchases would be        ways to connect with friends and mal-                                      Employers and schools are considering using facial recognition                  tribute by helping policymakers understand whether
           your friends                                   limited to prevent panic buying.                adaptive strategies such as substance use.                                                                                                                 people appreciate how much digital and biometric
                                                                                                              Looking ahead, we will be ­studying                                    software to implement new timekeeping practices,                                information they are transmitting and how (and
                                                          How can we encourage people                     how this unfolds. As we’ve seen already,                                   security protocols and exam-proctoring methods.                                 by whom) it will be used. Psychologists can add to
     ‹ And more!
                                                          to get vaccinated once a vaccine                pandemics are not static—they’re                                              Issues related to digital privacy have been brew-                            discussions of what informed consent might look
                                                          becomes available?                              dynamic situations in which certain anx-                                   ing for some time, and these COVID-19-related                                   like in these contexts, the differences between opt-in
                                                          We should expect to see vaccine non-            ieties might spike early on, but as things                                 developments will only accelerate that trend. In                                and opt-out participation and the role of (often fine-
                                                          adherence, which has been a problem             change, different anxieties arise. We will                                 Carpenter v. United States (2018), the U.S. Supreme                             print) privacy policies. Research might explore how
                                                          in previous pandemics such as the               study the long-term impacts of the pan-                                    Court held that, given the privacy interest indi-                               the use of digital data might affect trust between
                                                          2009 H1N1 pandemic, and it will be a            demic, such as the adaptive behaviors and                                  viduals have in information about their physical             AT ISSUE           individuals and public health workers responsible
                                                          problem for COVID-19. Many people               effects of isolation. We also would like to                                location, authorities needed to obtain a warrant               What are         for contact tracing interviews, or how digital contact
                                                                                                                                                                                                                                                people’s rights
                                                          will not get vaccinated because of the          get a better handle on how people cope                                     before seeking a week’s worth of location data from                             tracing might interact with poverty and the technol-
                                                                                                                                                                                                                                               and expectations
                                                          uncertainty around COVID-19, which              with uncertainty—not just for COVID-                                       a cellular service provider as part of a criminal           around digital      ogy divide. Psychologists can contribute to solutions
                                                          will transfer to uncertainty concerning         19 but also for the upcoming impacts of                                    investigation. The court noted that cellphones have                             for helping people protect themselves against
      Discover more                                       the vaccine. People are going to wonder         climate change. How can we boost peo-                                      become “almost a ‘feature of human anatomy’” and
                                                                                                                                                                                                                                                 privacy when
                                                                                                                                                                                                                                               digital data could    counterfeit contact-tracing apps and other forms of
     and get started at                                   about how extensively it has been tested        ple’s resilience and reduce mob-mentality                                  that location data “provides an intimate window           help fight a global
                                                                                                                                                                                                                                                  pandemic?
                                                                                                                                                                                                                                                                     cybercrime. More broadly, psychologists can con-
                                                          and whether it’s safe. This vaccination         behaviors, like panic buying, and help                                     into a person’s life, revealing not only his particular                         tinue to study people’s expectations of privacy, an
      on.apa.org/cap
                                                                                                                                                         ROMZICON/THE NOUN PROJECT

                                                          hesitancy is going to make it even more         people tolerate uncertainty?                                               movements, but through them his ‘familial, political,                           important concept under the Fourth Amendment to
                                                          difficult to manage this sort of infection.         It’s very difficult to predict how this                                professional, religious, and sexual associations.’” But                         the U.S. Constitution. ■
                                                              Repetition of messaging is going to be      pandemic will unfold, but cross-cutting                                    how these concerns will play out in the public health
                                                          critical. We need to get people used to the     issues in coping and stress tolerance will                                 and surveillance context remains to be seen.                                    ● “Judicial Notebook” is a project of APA Div. 9 (Society for
                                                          idea now that a vaccine is coming and that      apply to disasters beyond COVID-19. ■                                         State privacy laws will play a role as well. The                             the Psychological Study of Social Issues).

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Psychology - American Psychological
COVID-19 | SPECIAL REPORT
                                                                                                                                              Practitioners have dealt
                                                                                                                                                with technical hurdles
                                                                                                                                             and logistical challenges
                                                                                                                                               as they’ve moved their
                                                                                                                                                   caseloads online—
                                                                                                                                                  but have also found
                                                                                                                                                 unexpected rewards.
     REMOTE WORK

AS THE U.S. STAYS HOME,
PSYCHOLOGY MOVES ONLINE
The rapid switch to telehealth, online data-gathering and
distance teaching requires flexibility and creativity, experts say
BY KIRK WALDROFF

P
            rior to 2020, Nina Shiffrin, PhD, a psychologist in                              built-in camera, have proven
            Rockville, Maryland, conducted about 10% of her                                  challenging. And since patients
            therapy sessions with patients online. Teletherapy                               may be dealing with the same
                                                                                             issues, practitioners have, at
            was a flexible solution she used to accommodate
                                                                                             times, had to play the dual role
the occasional adult patient unable to leave work at midday
                                                                                             of health-care and IT service
or children who couldn’t get to Shiffrin’s office on their own.                              provider. There are also case-­
But in March, when a state of emergency was announced in                                     specific challenges that have
the United States because of the coronavirus and state govern-                               forced psychologists to get cre-
ments began issuing stay-at-home orders, she quickly pivoted                                 ative. For example, practitioners
to move 100% of her patients to telehealth services. ¶ Thou-                                 have reported advising patients
sands of psychologists have made the same pivot. Many, like                                  who live in close quarters with
Shiffrin, are practitioners who are rapidly getting themselves                               others to get in a car and drive to
                                                                                             a parking lot for their telehealth
—and their patients—up to speed                       some psychologists have been           sessions. “While not ideal, join-
on telehealth. Others are scien-                      experiencing and lessons they’ve       ing a session from the privacy of
tists who are rushing to adopt                        learned.                               a car is preferable to potential
new data-gathering methodolo-                                                                eavesdropping by a roommate or
gies or to protect animal subjects,                   TELEHEALTH HASSLES                     partner,” says Kristi K. Phillips,
and educators who are becoming                        AND REWARDS                            PsyD, chair of APA’s Committee
more versed in distance learning                      While many practitioners had           on Rural Health and a psycholo-
software and building online                          some experience using telehealth       gist in Litchfield, Minnesota.
connections with students.                            platforms prior to the onset of            Meanwhile, providing online
    The common thread for all                         the pandemic, few were using           care to children comes with its
psychologists dealing with the                        them as their exclusive means for      own set of challenges. According
new reality ushered in by the                         conducting therapy sessions. In        to an APA fact sheet, ­without
pandemic has been the need for                        just a few weeks, that changed         the control of the clinical setting,
flexibility and creativity. “We’re                    dramatically. Like Shiffrin, many      practitioners must pay close
finding new ways to help, mostly                      practitioners moved their entire       attention to the space on the other
small, but we’re doing what we                        caseloads online as federal and        side of the screen as children may
can. Across my university faculty,                    state regulations changed to           become more easily distracted
staff and students have really                        encourage expanded access to           or may require more room for

                                                                                                                                                                                              MOYO STUDIO/GETTY IMAGES
pulled together,” says Jeff Zacks,                    telehealth (see article on page 18).   hands-on activities. And psychol-
PhD, head of the Dynamic                                  For some psychologists, issues     ogists working with vulnerable
­Cognition Laboratory at Wash-                        with logistics, such as having         children must also be more vig-
 ington University in St. Louis.                      a spotty internet connection           ilant about looking for warning
    Here’s a sample of what                           or not having a laptop with a          signs of abuse and neglect during

14    M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                            M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   15
Psychology - American Psychological
COVID-19 | SPECIAL REPORT

                                                                                                                                                                                                                                                                                         APA STYLE

this time. Staying at home means                                                                                                                                               says Siara Rouzer, a behav-      Hall University, has gone
these children aren’t regularly in                                                                                                                                             ioral neuroscience graduate      from zero online teaching to
contact with teachers or coun-                                                                                                                                                 student at Binghamton            100% online teaching. She’s
selors, who are typically relied                                                                                                                                               University in New York who       found that her students are
upon to spot such signs and are                                                                                                                                                uses rat models to study fetal   adapting to the switch.
mandated to report them.                                                                                                                                                       alcohol disorders.                    “Some have become
    Despite such challenges,                                                                                                                                                                                    anxious about making the
some practitioners are also expe-                                                                                                                                              EMPTY CLASSROOMS                 technology work, but many
riencing pleasant surprises while                                                                                                                                              Psychology teachers and          of them seem to be adjust-
shifting to telehealth. Several of                                                                                                                                             students have experienced        ing well—using the chat            Free Access to
Phillips’s patients, for example,                                                                                                                                              massive changes as well.         function to comment on the
have told her that learning to use                                                                                                                                             Fortunately, most academic       course content, downloading        APA Style Resources
Zoom during their telehealth                                                                                                                                                   institutions had e-learning      the recorded lectures after
sessions empowered them to use                                                                                                                                                 capabilities in place prior      the fact, even introducing         for Distance Learning
the platform to better connect                                                                                                                                                 to the COVID-19 pan-             their pets on video,” she says.
with friends and family as well—                                                                                                                                               demic. In these institutions,         Teachers have been quick
for Phillips, an unexpected and                                                                                                                                                teachers have been able to       to assist fellow teachers, as
rewarding side effect.                                                                                                                                                         draw heavily on support from     well, including by sharing
     Others note that having a                                                                                                                                                 their institutional technology   resources such as online           •   Always available are APA Style
glimpse into where their patients                                                                                                                                              office or instructional design   lesson plans and lectures to           Instructional Aids offering an
live offers them insights that                                                                                                                                                 team (see article on page 56).   use during the pandemic.
they previously wouldn’t have                        pandemic. But Zacks has had                            designed to include an in-person                                       Regan Gurung, PhD,           On March 13, for example,
                                                                                                                                                                                                                                                       extensive collection of free
had access to. They’re getting                       to place fMRI and eye-tracking                         group-based treatment begin-                                       director of the general psy-     the day the United States              resources, including handouts
to meet pets and siblings and                        studies on hold because they rely                      ning later this year.                                              chology program at Oregon        declared a state of emer-              and quick guides, webinars, and
are better able to see how a                         on face-to-face interaction.                                “I am worrying about my                                       State University and exec-       gency, David Kenny, PhD, of            sample papers.
patient may behave in a less                             Besides the research studies                       options and the consequences for                                   utive director of the Center     ­Wesleyan University, immedi-
clinical setting. “It’s fun to get                   that are taking a hit, Zacks and     Psychology        adjusting the in-person aspects                                    for Teaching and Learning         ately took to Twitter: “During    •   Available through July 1, 2020, are
to see patients in their n ­ atural                  his colleagues are concerned         teachers have     of the study, if needed,” she says.                                (CTL), says his university’s      this health crisis, I am
                                                                                          been quick to                                                                                                                                                13 tutorials and quick guides
settings—I get to meet pets                          about students who were assigned     share resources       Meanwhile, other researchers                                   eCampus unit and CTL have         waiving all charges for the 40
… children can show off their                        to participate in experiments as     and online        simply have no online options.                                     been working long hours to        webinars and 70 PowerPoints
                                                                                                                                                                                                                                                       adapted from Academic Writer®,
artwork or favorite toys,” says                      part of their learning coursework.   lesson plans.     Researchers working with ani-                                      help faculty get up and run-      that I have posted. Feel free         APA’s tool for teaching and
Shiffrin.                                            “At my university, instructors                         mals, for instance, are not able                                   ning with remote teaching.        to use as needed. Most are on         learning effective writing.
                                                     have altered the assignments,                          to interact with their subjects                                        Yet even with tools and       Dyadic Analyses & SEM.”
STUDIES ON HOLD                                      and we’re making more exper-                           online. The setbacks go well                                       tech support in place, there          Overall, the rapid shift to   •   Learn more about APA electronic
Psychological scientists are also                    iments available online; these                         beyond forfeiting data collec-                                     are formidable challenges for     working online has touched            resources available for distance
confronting major challenges as                      seem to be helping,” he says.                          tion. Animal lineages that were                                    teachers. Helping students        every corner of society, and          learning.
the COVID-19 crisis unfolds                              Many researchers and stu-                          created over months and even                                       who have never used online        psychology. While some
(see article on page 30). Even                       dents question whether they’ll be                      years—while being kept physi-                                      learning resources and figur-     psychologists were already
labs that were already con-                          able to continue to use funding                        cally safe by essential staff—are                                  ing out effective ways to keep    familiar with working online      Connect with APA Style on Twitter,
ducting a significant amount                         for studies that now require                           now missing the meticulous level                                   track of students who are not     before the pandemic, most         Facebook, and Instagram to ask
of online research are feeling                       altered (from in-person to                             of attention provided by research                                  participating are particular      are now fully embracing           questions and receive the latest
the effects. Zacks’s Dynamic                         online) data-gathering method-                         staff and, as a result, may fall                                   challenges, Gurung says.          online platforms in a more        updates on seventh edition APA Style.
Cognition Laboratory, for exam-                      ologies. Natalie Hong, a doctoral                      outside the parameters of exper-                                   Other concerns include help-      comprehensive way out of
ple, has been conducting both                        student in the clinical science                        iments and be rendered unusable.                                   ing remote students learn         necessity. “We’re all being
                                                                                                                                                  G-STOCKSTUDIO/GETTY IMAGES

small- and large-scale online                        program at Florida International                           “This loss means much more                                     from one another and pro-         creative to make sure every-
studies for ­several
              ­­     years now,                      University, had already secured                        to me than deficits of time and                                    moting a sense of community       thing we do is in the best
and it launched two new online                       funding from the National Insti-                       resources and is something ani-                                    among remote students.            interest of our patients, sub-
studies in April, which likely                       tute of Mental Health for her                          mal researchers in particular will                                     Susan Nolan, PhD, a psy-      jects and students,” Phillips
won’t be severely affected by the                    dissertation project, which was                        have to bear moving forward,”                                      chology professor at Seton        says. ■                                      apastyle.apa.org

16   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                                                                          M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   17
COVID-19 | SPECIAL REPORT

 TELEHEALTH CHANGES                                                                                                                                                                                                                                                 crisis (90839, -40)
                                                                                                                                                                                                                                                                  ●  Psychological and neuro­
TELEPSYCHOLOGY                                                                                                                                                                                                                                                      psychological testing
                                                                                                                                                                                                                                                                    (96130–96133 and
EXPANDS TO MEET DEMAND                                                                                                                                                                                                                                              96136–96139)
                                                                                                                                                                                                                                                                  ● Health behavior assessment
APA advocacy convinced regulators to change telehealth rules                                                                                                                                                                                                        and intervention services,
to increase access to care during the pandemic                                                                                                                                                                                                                      individual and group (96156,
                                                                                                                                                                                                                                                                    -58, -59, -64, -65, -67, -68,
BY NICOLE OWINGS-FONNER, MA
                                                                                                                                                                                                                                                                    -70, -71)
                                                                                                                                                                                                                                                                  ● Psychoanalysis (90845)

T
                                                                                                                                                                                                                                                                  ● Neurobehavioral status
             he COVID-19 public health emergency has                                       priations Act, 2020, CMS issued                                                                                                                                          ­examination (96116, -21)
             increased demand for mental and behavioral health                             ­further guidance based on APA                                                                                                                                         ● Interactive complexity (90785)

             services at the very time it has driven most of those                          recommendations to waive key                                                                                                                                          ● Behavioral Screening (96127)
                                                                                            telehealth requirements and allow                                                                                                                                     ● Screening, Brief Intervention,
             services to telehealth platforms. In response, APA
                                                                                            psychologists to provide most of                                                                                                                                         and Referral to Treatment
has led a successful advocacy and education campaign to max-
                                                                                            their typical services via audio-                                                                                                                                        (G0396, G0397)
imize the availability of telepsychology services for vulnerable                            only telephones. Both new and
populations and to ensure that psychologists are prepared to                                existing Medicare beneficiaries                                                                                                                                       Services Allowed via ­
provide these services and are properly reimbursed for them.                                can receive expanded telehealth                                                                                                                                       Traditional Telehealth Only
¶ APA’s campaign began in full force on March 10, as part                                   services from their homes.                                                                                                                                            ● Developmental Screening and
of its annual Practice Leadership Conference. APA ­members                                                                                                                                                                                                          Testing (96110, -12, -13)
and staff conducted 250 congressional visits by phone and                                  ■   The ability to work from home.                                                                                                                                     ● Adaptive Behavior Assessment

­in-­person, lobbying for support of telehealth services.                                  Psychologists can provide an                                                                                                                                             (97151, 97152, 0362T)
                                                                                           expanded portfolio of services                                                                                                                                         ● Adaptive Behavior Treatment
    “Three weeks later, in the thick                 COVID-19. As such, the Cen-           from their own homes using                                        providers who use telehealth to        be reimbursed for the same dol-                                 (97153-97158, 0373T)
of a public health emergency, a                      ters for Medicare & Medicaid          either audio-only telephones or                                   treat patients during the crisis.      lar amounts. During the crisis,
group of APA staff and leaders                       Services (CMS) improved access        through traditional telehealth                                    HHS specifically referenced            psychological and neuropsycho-                                ■   New ways of communicating.
in the field delivered a method                      to care for Medicare beneficia-       with audio and video functions                                    Skype, FaceTime and other non-         logical testing, health behavior    The federal               CMS has expanded the types
and payment policy that allows                       ries by:                              that provide two-way, real-time                                   compliant telehealth platforms         assessment and intervention,        Coronavirus               of communication available to
                                                                                                                                                                                                                                        Preparedness
for the provision of telepsy-                        ● Setting up advanced and             interactive communication.                                        as reasonable options to provide       and group psychotherapy can         and Response              Medicare beneficiaries during
chology services,” says Antonio                        ­accelerated payments to help       “To curb the spread of the                                        care. “While penalties are being       now be billed through telehealth.   Supplemental              this time period by activating
E. Puente, PhD, co-chair of                             with cash flow challenges.         coronavirus and help our                                          waived at the federal level for        Additional restrictions have        Appropriations            reimbursement for two sets of
                                                                                                                                                                                                                                        (CARES) Act
APA’s Advocacy Coordinating                          ● Easing the enrollment               communities heal, we ­cannot                                      non-HIPAA compliant telehealth         been waived regarding visits to     paved the way to          additional Current Procedural
Committee and a former APA                              ­procedures for new providers      leave any of our neighbors                                        platforms, it is still best practice   inpatient units, skilled nursing    expand access             Terminology (CPT) codes:
president. “From an idea to a real-                      by waiving certain require-       without access to videoconfer-                                    to choose one that is compliant,”      facilities and nursing homes. The   to mental health          (1) telephone assessment and
                                                                                                                                                                                                                                        care by making
ity in three weeks is a miracle, and                     ments and expediting new          encing technologies behind,”                                      notes Deborah C. Baker, JD,            telehealth services covered by      telehealth services       management services and (2)
it is a bright light that interfaced                     applications.                     says Arthur C. Evans Jr., PhD,                                    APA’s director of legal and regu-      Medicare during COVID-19 fall       more accessible           e-visits.
practice, policy and advocacy.”                      ● Granting exceptions and             APA’s CEO. “Psychologists can                                     latory policy. “Preferably one that    into two categories:                to Medicare               ●   Telephone assessment and
                                                                                                                                                                                                                                        beneficiaries.
    Several key changes resulted                         giving providers extra time       now use their specialty skills to                                 offers a business associate agree-                                                                       management services are pro-
from APA’s advocacy. They                                to meet Medicare’s quality        improve the health of all the                                     ment and that you can use beyond       Services Allowed via Phone                                        vided by a psychologist when a
include changes to:                                      reporting requirements, such as   communities we serve.”                                            the public health emergency.”          and Traditional Telehealth                                        patient calls and the psychol-
                                                         the Merit-based Incentive Pay-       The U.S. Department of                                                                                ●   Psychiatric diagnostic                                        ogist assesses the patient, then
                                                                                                                                ALEJO VAZQUEZ/GETTY IMAGES

MEDICARE                                                 ment System (MIPS), during        Health and Human Services                                         ■   Billing. Psychologists should        i­nterview (90791, -92)                                         provides an intervention ser-
On March 19, the federal                                 the public health emergency.      (HHS) is also waiving potential                                   bill Medicare for telehealth ser-      ● Psychotherapy, including                                        vice on the spot. These services,
government designated psy-                                In addition, under the           penalties for violations of the                                   vices in the same way that they           ­individual (90832, -34, -37),                                 and their accompanying codes,
chologists as critical, essential                    Corona­virus Preparedness and         Health Insurance Portability and                                  would have for face-to-face ser-           group (90853), family (90846,                                 do not replace traditional psy-
workers in the U.S. response to                      Response Supplemental Appro-          Accountability Act (HIPAA) for                                    vices—and they should expect to            -47) and psychotherapy for                                    chotherapy and reimburse at

18   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                                                                                                   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   19
COVID-19 | SPECIAL REPORT

  a lower rate because they were                    for existing telehealth coverage.                              for many this may be the first
  built for brief and directed                            Many state governors quickly                             time they are attempting to serve
  services.                                         responded to the APA/state                                     their patients in this way,” says
● E-visits are patient-­initiated                   psychological association letters                              Jared L. Skillings, PhD, ABPP,
  digital communications con-                       by issuing emergency orders                                    APA’s chief of professional prac-
  ducted through electronic                         to increase access to telehealth                               tice. “By partnering with leaders
  health record portal messages                     ­services and to increase the                                  in the field and other organiza-
  or other HIPAA-compliant,                          pool of available health-care                                 tions, we have worked to quickly
  secure platforms that require                      ­providers. Within weeks:                                     provide resources to educate
  professional patient assessment                     ● 12 states issued executive                                 psychologists on how to best
  and decision-making to direct                         orders calling for expansion                               provide a wide variety of psycho-
  subsequent management of the                          of telehealth service rates to                             logical services via telehealth.”
  patient.                                              be comparable to in-person          ADDITIONAL                  Psychologists who are new
    For additional specifics on                         service rates.                      RESOURCES              to telehealth can build their
how to bill telehealth services,                      ● 14 states issued executive                                 competence by studying APA’s
telephone assessment and man-                           orders allowing patients to              www.              Guidelines for the Practice of Tele-
                                                                                            apaservices.org/
agement services and the new                            receive telehealth services in       practice/clinic       psychology or taking a relevant
e-visit coverage for Medicare, see                      their own homes.                          The latest       course. APA has also developed
the expanded coverage on the                          ● 16 states temporarily lifted         advocacy updates,     an office and technology check-
APA Services website.                                   licensing requirements.             reimbursement and      list for telepsychological services
                                                                                            licensing/regulatory
                                                      ● 22 states either expanded their                            to help psychologists and their
                                                                                            guidance and other
STATE REGULATIONS                                       policies for out-of-state pro-       information to help   patients prepare for telehealth
Unfortunately, the new federal                          viders to temporarily practice       navigate the public   sessions, including by using an
legislation applies only to Medi-                       in their states or instituted         health emergency     informed consent document.
care beneficiaries and cannot                           emergency expedited registra-                                   APA has also developed
supersede state licensing laws.                         tion for out-of-state providers.      www.apa.org/         guidance for psychologists who
                                                                                             topics/covid-19
For example, licensed psychol-                            “We continue to urge each             Information        work remotely in specific settings
ogists are typically prohibited                       jurisdiction to reimburse the full      and resources        or with patient populations
from using telehealth to provide                      range of psychological services via   organized by topic     including:
services across state lines. To                       telehealth and are following up       for psychologists,     ● In nursing homes
                                                                                                health-care
encourage states to adopt more                        with additional efforts in those                             ● With children and adolescents,
                                                                                             workers and the
telehealth-friendly legislation,                      states where expanded coverage is            public             for testing
APA drafted letters to private                        still needed,” says Baker.                                   ● With those experiencing pain,
insurers, state regulators and                            Find out where your state                                   preparing for surgery or with
governors in all 50 states to be                      stands on telehealth by reading                                 obsessive-compulsive disorder
delivered in partnership with                         APA’s resource summarizing the                               ● When conducting psycho­
state psychological associations.                     current state emergency orders.                                 logical assessment or
The letters urge state officials                                                                                      neuropsychological assessment
to temporarily suspend state                        RESOURCES FOR                                                  ● In group therapy
licensing laws and regulations                      PSYCHOLOGISTS                                                       With all these changes, it is

                                                                                                                                                          We’re Here for You
regarding telepsychological                         In tandem with its advocacy                                    expected that psychologists might
services to ensure continuity of                    work, APA has ramped up educa-                                 have questions like what to do if
care and to avoid spreading the                     tion and communications efforts                                they might be infected or under
virus. This would include approv-                   to ensure that the telehealth ser-                             what circumstances should one
ing videoconferencing for all                       vices psychologists are providing                              provide in-person services.
providers without limitation, as                    are of the highest possible quality.                                Finally, here are concrete         The APA psycCareers team is committed to providing you with the
well as telephone-only services,                       “While some psychologists                                   strategies for psychologists to
interprofessional consultation                      have experience providing psy-                                 use to manage their stress during
                                                                                                                                                          information and support you need most during this time. Check out
and the elimination of barriers                     chotherapy services via telehealth,                            this challenging time. ■               our COVID-19 resources as they relate to your career in psychology.

20   M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020                                                                                                                      www.apa.org/careers            M O N I TO R O N P S YC H O LO G Y   ●   JUNE 2020   21
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