PracticeNet 911 Survey


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  • Using PracticeNet TM , a unique internet-based data collection infrastructure, the APA Practice Directorate conducted a survey of practicing psychologists regarding the effects of the terrorist attacks of September 11. The survey was conducted October 8 - 11, one month after the attacks. This presentation describes the results of that survey. When viewing these data, it is important to remember that this is a volunteer sample, so participating psychologists were not randomly selected. While we believe that the experiences of participating practitioners are extremely important and informative, these findings cannot be generalized to all APA members or to all psychologists.
  • PracticeNet 911 Survey

    1. 1. <ul><ul><li>The Impact of the September 11 Terrorist Attacks on Psychologists and Their Clients </li></ul></ul>
    2. 2. Suggested Citation American Psychological Association Practice Directorate (2002). The Impact of the September 11 Terrorist Attacks on Practitioners and Their Clients. Unpublished results of the PracticeNet  9/11 survey, October 8-15, 2001, Washington, DC.
    3. 3. Acknowledgements PracticeNet's initial development has been underwritten by the federal Center for Substance Abuse Treatment (CSAT) as part of the agency’s effort to learn more about the ways in which psychologists are encountering and treating problems related to substance use.
    4. 4. What is PracticeNet? <ul><li>PracticeNet is a “Practitioner Research Network” of professional psychologists within the APA membership </li></ul><ul><ul><li>All APA members who provide direct health services to clients at least 5 hours per week are encouraged to enroll </li></ul></ul><ul><ul><li>Practice Directorate hopes to enroll several thousand psychologists from diverse areas of practice serving a wide range of populations </li></ul></ul><ul><li>Uses a proprietary Internet-based data collection system </li></ul>
    5. 5. What is PracticeNet? <ul><li>Captures specific moment, or snapshots, of practitioner activity </li></ul><ul><li>Over time, snapshots combine to provide a detailed and accurate picture of practice </li></ul><ul><li>Brief & “Real-Time” Data Collection Episodes </li></ul><ul><ul><li>Data collection tied to recent, specific episodes of care </li></ul></ul><ul><ul><li>Data collected at regular, randomly determined times </li></ul></ul><ul><ul><li>Objective reporting about a recent event </li></ul></ul><ul><ul><li>No &quot;mental averaging” </li></ul></ul><ul><ul><li>Observation of many points in time </li></ul></ul><ul><ul><li>Significant data analysis opportunities </li></ul></ul>
    6. 6. Goals <ul><li>To give members up-to-the-minute information about psychological practice </li></ul><ul><li>To serve as a useful practice improvement tool </li></ul><ul><li>To inform Practice Directorate initiatives by reversing APA-member flow of information </li></ul><ul><li>To influence and provide data base for advocacy efforts on behalf of psychology </li></ul><ul><li>Change how government agencies and health care decision makers think about Practice data </li></ul>
    7. 7. Early Questions <ul><li>How are psychologists using their time? </li></ul><ul><li>How are health plans’ utilization management practices affecting the provision of care? </li></ul><ul><li>What kinds of problems are psychologists seeing more and less often? </li></ul><ul><li>What services are psychologists providing? </li></ul><ul><li>How have recent events such as natural disasters or a school shooting affected psychology practices? </li></ul>
    8. 8. How Do I Sign Up? <ul><li>Complete enrollment on-line: </li></ul><ul><ul><li> </li></ul></ul><ul><ul><li>Click “Enroll Now” </li></ul></ul>
    9. 9. PracticeNet 9/11 Survey <ul><li>Administered October 8-12, 2001 </li></ul><ul><li>643 email invitations sent to PracticeNet members </li></ul><ul><li>Total responses N = 407 </li></ul><ul><ul><li>Providing direct clinical services within 72 hours of selected date n = 341 (84%) </li></ul></ul><ul><ul><li>NY/DC/SW PA n = 126 (31%) </li></ul></ul><ul><ul><li>Non NY/DC/ SW PA n = 281 (69%) </li></ul></ul>
    10. 10. Client Demographics <ul><li>46% Male; 54% Female </li></ul><ul><li>Average age 37 (range 5 - 98) </li></ul><ul><li>Ethnicity </li></ul><ul><ul><li>6% Hispanic or Latino </li></ul></ul><ul><ul><li>86% White </li></ul></ul><ul><ul><li>8% Black or African American </li></ul></ul><ul><li>Education </li></ul><ul><ul><li>20% some college </li></ul></ul><ul><ul><li>20% college degree </li></ul></ul><ul><ul><li>16% graduate degree </li></ul></ul><ul><ul><li>16% less than high school </li></ul></ul><ul><ul><li>13% high school graduate/GED </li></ul></ul>
    11. 11. Client Demographics <ul><li>Employment </li></ul><ul><ul><li>39% employed full-time </li></ul></ul><ul><ul><li>47% not working </li></ul></ul><ul><ul><ul><li>36% students </li></ul></ul></ul><ul><ul><ul><li>25% disabled </li></ul></ul></ul><ul><ul><ul><li>11% retired </li></ul></ul></ul><ul><li>Living arrangements (not mutually exclusive) </li></ul><ul><ul><li>33% with a legal spouse </li></ul></ul><ul><ul><li>24% with parent(s) </li></ul></ul><ul><ul><li>21% with children </li></ul></ul><ul><ul><li>20% alone </li></ul></ul>
    12. 12. Clinical Services and Settings <ul><li>Individual therapy or counseling 83% </li></ul><ul><li>Formal assessment or evaluation 19% </li></ul><ul><li>Providing educational information and/or materials 14% </li></ul><ul><li>Independent/private practice - solo 48% </li></ul><ul><li>Independent/private practice - group 28% </li></ul><ul><li>Organizational health care setting 18% </li></ul><ul><ul><li>44% Mental health services setting </li></ul></ul><ul><ul><li>13% Primary health care setting </li></ul></ul>
    13. 13. Results <ul><li>During the specified clinical encounter, did this client: </li></ul><ul><li> Yes </li></ul><ul><li>Bring up the terrorist attacks of September 11? 49.3% </li></ul><ul><li>NY/DC/PA 53.3% </li></ul><ul><li> Non-NY/DC/PA 47.5% </li></ul><ul><li>Bring up any subsequent related events, actual </li></ul><ul><li>or feared (e.g. preparations for war, military </li></ul><ul><li>build-up and mobilization)? 39.3% </li></ul><ul><li> NY/DC/PA 44.8% </li></ul><ul><li> Non-NY/DC/PA 36.9% </li></ul>
    14. 14. Results <ul><li>During the specified clinical encounter, did this client: </li></ul><ul><li> Yes </li></ul><ul><li>Bring up specific traumatic or anxiety reactions to </li></ul><ul><li>environmental stimuli associated with the event? 21.7% </li></ul><ul><li>NY/DC/PA 30.5% </li></ul><ul><li> Non-NY/DC/PA 17.8% </li></ul><ul><li>Discuss a prior traumatic event, memories of which </li></ul><ul><li>were triggered or intensified by the events of 9/11 </li></ul><ul><li>or related subsequent events? 22.6% </li></ul><ul><li> NY/DC/PA 24.8% </li></ul><ul><li> Non-NY/DC/PA 21.6% </li></ul>
    15. 15. Results During the specified clinical encounter, proportion of time spent discussing the terrorist attacks of 9/11, subsequent related events (actual or feared), traumatic or anxiety reactions to associated stimuli, and/or memories of prior traumatic events triggered by the attacks and their aftermath:
    16. 16. Results Implications of the Events of 9/11 Discussed in Terms of Client’s Identity, Priority, World View and Spiritual Outlook
    17. 17. Results <ul><li>Client Proximity to Attacks According to Practitioner Location </li></ul>
    18. 18. Results Client Symptoms that First Appeared or Worsened since September 11
    19. 19. Results <ul><li> </li></ul>
    20. 20. Results <ul><li>Cumulative Effect of Client’s Discussion of Events on Practitioner </li></ul><ul><li> </li></ul>
    21. 21. Results <ul><li>Practitioners’ Strategies for Dealing with Their Own Reactions </li></ul><ul><li> </li></ul>
    22. 22. Summary <ul><li>Randomly selected sample of clients engaged in sessions with practitioners exhibited an increase in the following symptoms: generalized fear, hypervigilance and fear or uncertainty about the future </li></ul><ul><li>Regardless of geographical location, clients’ world view was challenged by 9/11 events </li></ul><ul><li>Those in the metro NY/DC area were more likely to discuss the events in personal terms, such as in terms of their priorities, spiritual outlook, or identity </li></ul>
    23. 23. Summary <ul><li>Impact of these events on practitioners, as assessed by immediacy of exposure, was greater than that of their clients, regardless of the geographical area in which they were practicing </li></ul><ul><li>Psychologists reported being significantly affected by their own personal responses, as well as cumulatively affected by the responses of their clients/patients </li></ul>
    24. 24.