Shari Miles-Cohen & Caroline Signore: On Women With Disabilities

This is the latest in a series of interviews with APA Books authors. In this interview, Tyler Aune, Editorial Supervisor at APA Books, spoke with Shari Miles-Cohen PhD, Senior Director of the Women’s Programs Office at the American Psychological Association, and Caroline Signore, MD, MPH, a board-certified obstetrician-gynecologist and a fellow of the American College of Obstetricians and Gynecologists (ACOG).  Their book, Eliminating Inequities for Women with Disabilities: An Agenda for Health and Wellness was recently released by APA Books.   

Note: The opinions expressed in this interview are those of the authors and should not be taken to represent the official views or policies of the American Psychological Association.

 

 

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Shari E. Miles-Cohen, PhD, is Senior Director, Women’s Programs Office (WPO) at the American Psychological Association (APA).  Dr. Miles-Cohen has received funding from the National Science Foundation and the US Department of Health and Human Services, Office of Women Health to explore the educational needs and health care needs of women with disabilities. Prior to joining APA, she served in leadership positions with university-based and independent non-profit organizations working to improve the lives of women and girls, including the African American Women’s Institute, the Society for the Psychological Study of Social Issues, and the Women’s Research and Education Institute. Dr. Miles-Cohen holds a Bachelor of Arts from the University of Colorado at Boulder, and a Master of Science and a Doctor of Philosophy in Personality Psychology from Howard University.

 

Caroline Signore

Caroline Signore, MD, MPH, is a board-certified obstetrician-gynecologist, and a Fellow of the American College of Obstetricians and Gynecologists (ACOG).  Her interest in the reproductive health care needs of women with disabilities arose in 1996, when, shortly after completing her residency training, she sustained a traumatic cervical spinal cord injury. Since then, she has delivered a number of presentations on reproductive health and wellness in women with disabilities, served as a guest reviewer for a handbook on health for women with disabilities in developing countries, and authored chapters for women’s health textbooks. From 2004 to 2009, Dr. Signore served as an Advisory Board member to an American College of Obstetricians and Gynecologists committee to produce resources to assist ACOG members with providing quality reproductive health care to women with disabilities.

What’s great about your book is that you don’t just describe the problem: You also lay out a very detailed agenda for reform, with specific information about what needs to change, and where. And I was really struck by how hopeful the language in that chapter is.  Did you feel hopeful all the way through this project?

Shari: I think we’re both hopeful people by nature, so that helps.  But I also think, if I can name the problem, I can solve the problem.  We may need a lot of people, we may need a lot of money, but there is a solution out there for almost everything.  And for me, the solution is trying to meld the behavioral and physical health structures to better serve women with disabilities.

Caroline: Well, sometimes I didn’t think this book would ever get finished!  But that aside, I agree with Shari, we are hopeful people, and I also believe that if you name the problem you can start to fix it.  We realistically know nothing’s going to change overnight, but there are incremental steps, and this book will serve a guide for people who may be drawn into the field, or who are already here, doing the work that needs to be done.

Shari: I feel like I learned a lot, coming to these issues from a psychologist’s background.  I have a better understanding now of physicians and what they need, and how they think, and what challenges they may have with integrated care.  Because you lose a little bit of autonomy when you start to share, and that can be challenging for people from different disciplines.  And so that was really helpful, because it’s much easier to communicate that path forward when you have a better sense of what the other people who will be part of the team are thinking.

Caroline: I have to say I came into the project not understanding what integrated care is, and Shari has been a patient teacher.  But the more I understood it, the more I thought: This makes so much sense! Why are we so siloed?  Integrated care is especially important for underserved populations, who could really use extra care and guidance.  Particularly in areas like biopsychosocial models of care that aren’t taught in medical school, that physicians may feel poorly equipped to handle on their own.  I’m hopeful that this book can educate physicians about how to provide better care to women with disabilities.

 

Shirley Chisolm, the first black female member of the U.S. congress, said that she faced more obstacles in her life because of her gender than her race. At the risk of oversimplifying a very complex issue, do you think women with disabilities face more discrimination because of their gender, or because of their disability?

Caroline: Without question, in the health care setting, especially in the reproductive health care setting, women with disabilities feel a-gendered. They feel that their caregivers don’t think of them as women.  And that’s very troubling, for them and for me.  Not only are there physical barriers to actually getting to a doctor’s office.  But to not get information, or careful, complete care [in reproductive and sexual health] because of an assumption on the part of the caregiver that’s wrong, is really galling.

Shari: It’s hard for me to separate the gender and the disability, or the gender and the race. A woman with a disability is intact, a gestalt; she is one person.  It’s all in there together, and you can’t really separate them out.  You have to work hard to separate them.  In some ways, physicians and psychologists and others are working against human nature when they a-gender a person coming into the office.

 

So it takes effort to discriminate. I never thought about it that way before.

 Shari: I think it does, yeah.  You have to work at it, right?  I think you have to work hard to see people in that way.

 

Research shows that women with disabilities who live in poverty and particularly in rural areas are at especially high risk for poor outcomes. And these are outcomes that may be difficult to change, given that many of the accommodations you describe in this book will be made to medical facilities that are far away from where they live.  What can we do for these people? 

Caroline: Telehealth is really promising.  Today you can FaceTime with most anybody, almost everybody has a smartphone now.  And even in rural areas, if you can’t physically go to the physician’s office—heck, I’d rather FaceTime with my doctor than actually have to go to his office, it’s just so much easier.  I have high hopes for the incorporation of telemedicine into care in general, and especially care for people who have

difficulty traveling—not just women with disabilities, all people with disabilities, geriatric populations; there’s a lot of care we can give without actually putting two people physically in front of each other.

Shari: Along with technology, infrastructure also has to change.  The smartphone and the monitor are important, but so are the wires and conduits running to rural communities.  So is educating doctors (and psychologists) that it’s a good thing to do, and educating patients that they can still get good care via telehealth.  But all of that’s doable, it just takes education.  We need to educate policymakers here [in Washington], and in the States, using the State Psychological Associations and State Medical Associations to get them engaged in the conversation.

 

Making people aware of the urgent challenges that this population faces, as you’ve done in this book, is obviously enormously beneficial. What are the next steps? 

Shari: We’re seeing women with disabilities across the country who are really engaged in making change.  The book can help give them have a better sense of what the entire map looks like, and how they can be most strategically engaged.  Because one of the things that Caroline and I talk a lot about is, how do you change the ways that physicians and psychologists are educated?  It’s all about teaching hours.  Well, how do you get a school to dedicate teaching hours to the issues women with disabilities face?  One way is that you change the standards: What’s gonna be on the board exam, right?  So how do you get that done?  There are all these steps.  In addition to public education efforts which bring  attention to the issue, raising visibility, there are other complementary activities, such as professional development, research, and policy efforts, which we discuss at some length in the book’s recommendations section, that together can help to bring about change.

Caroline: This is not a completely ignored issue.  But it is underrecognized.  And understudied.  It isn’t just a matter of psychological care or medical care.  It is also a matter of civil rights, and politics, and policy, and that makes it a little more complex.  We must have patience, as each person tries to get the word out.  My hope is that our work will be viewed as a standard textbook for disabilities studies.  I would love to see it in medical schools, nursing schools, psychology classes, graduate education.  The more people know about it, the more we can get done.

 

 

 

 

 

 

 

Meet Me in Illinois: A Behind-the-Scenes Look at Making APA Psychotherapy Videos

By Resarani Johnson, APA Video Supervisor

The APA Psychotherapy Video Series presents distinguished psychologists demonstrating specific approaches to a wide range of patient problems. Designed for clinical training and continuing education, these videos and DVDs were created to provide psychology students and practitioners with expert introductions to various therapeutic approaches and hands-on knowledge of how to treat particular patient issues. To learn more, including how to use these in classes or workshops, see About the APA Psychotherapy Video Series.

Making a psychotherapy training video is uniquely challenging. Imagine you are a psychologist, having spent most of your career either in the therapy room or writing scholarly articles and books. Now try to condense all of your knowledge and expertise into 90-minute therapy demonstration video. Now, imagine someone—let’s say a video producer, like me—puts a kibosh on your expectations and tells you to not try to be so comprehensive and not cover everything you know, but instead to just “be natural… as if you’re not being filmed.”

Simplifying a great body of scientific and scholarly knowledge down to its most concise points is indeed a hardy task that is easier said than done, and it certainly should not be mistaken for “dumbing down.” I understand their frustration, but will never know it firsthand. Although I am in the world of psychology, I am neither a therapist nor an academic, and so I try to put myself in their shoes as much as possible.

Setting Expectations

It’s a thin tightrope to walk. Our target audience consists in part of practicing therapists, researchers, and professors, but the main audience is graduate students. So, my first goal is getting guest experts to understand that they are talking not to their peers, but to the students that will one day be their colleagues. My second goal is convincing the guest experts not to second guess their on-camera performances. I’ve found that lending them a final video of a related topic or approach well before the shoot commences helps them to ease into the idea of being on-camera, and visualize what the end result may look like. That doesn’t mean, of course, that we don’t come across little snags, such as when the guest therapist forgets to look at the roundtable participants and not the cameras when they’re answering a question. But these are small things, and we can usually stop and reshoot whenever they crop up.

Often there are moments toward the end of the day where the guest therapist has a moment to reflect on their performance. This usually includes self-criticism and lamentations, “I wish I would’ve…,” or “Do you think we could redo…,” or the more infamous request: “Can we edit the beginning of the [said] therapy session and mix that in with the latter part of the other session?” The answer is always no. I advise them, as the oil canvas in my office says: “Don’t overthink it.”

Filming

On the first day, three therapy sessions are shot. The guest therapist selects the best one, which goes into the final video product. The next day, university counseling and psychology students and instructors at Governors State University, in University Park, Illinois—where our sessions are filmed—screen the chosen therapy session and participate in a question-and-answer session. They also get to meet and have lunch with the guest therapist, and make fruitful networking connections.

Many key players help make our productions successful: the guest therapists, client volunteers, roundtable participants, as well as our studio crew, and coordinators. Sometimes, we’ll hire actors to perform roles based on actual case material with identifying characteristics removed, or we’ll have actors play roles that are completely fictional and conceived to help illustrate the guest therapists’ approach. We do this whenever we may be demonstrating a sensitive presenting issue or difficult topic.

Group Therapy Sessions

The most challenging demonstrations often are those featuring group therapy. Getting one person to commit to recording a therapy session is hard enough. Asking a group of strangers to divulge their intimate thoughts and feelings in front of other people, on-camera, is even harder. Which is why I’m always on pins and needles the day that these shoots occur. We always have backup client participants on speed dial, in the event anyone decides to renege at the last minute (and yes, this has happened on several occasions). By contrast, the easiest sessions usually depict couples’ therapy. These client participants are less likely to cancel their session and usually are the most eager to get their issues resolved.

Shortly after a shoot has wrapped, most guest therapists say that the process wasn’t as bad as they originally anticipated—in fact, most enjoy it. From viewer feedback, we know that students, therapists, and instructors alike enjoy these videos and find them to be a valuable teaching aid. Overall, what makes this work rewarding is seeing the client volunteers leave the sessions feeling so much better than they were when they arrived.

What Is the Seat of Mind?

Timothy McAdooby Timothy McAdoo

Is your mind inside your skull? When you’re thinking, do you “feel” or “hear” the thoughts inside your head? These questions may seem to have obvious answers, but the seat of mind, as defined by the APA Dictionary of Psychology, has been, and still is, a matter of debate:

girl-thinking-1200seat of mind: the proposed place or organ in the body that serves as the physical location of the mind (or, in cartesian dualism, the location in the body where mind and body interact; see conarium). In current thinking, the brain is the seat of the mind; historically, other organs have been proposed, such as the heart. Some theories suggest that the mind (or the spirit) is diffused throughout the body.

In fact, in their new book, Transcendent Mind: Rethinking the Science of Consciousness, Drs. Imants Barušs and Julia Mossbridge argue that consciousness may not be from one’s brain.

What do you think? Or, perhaps I should ask, where do you think you think?

References

Barušs, I., & Mossbridge, J. (2016). Transcendent mind: Rethinking the science of consciousness. Washington, DC: American Psychological Association.

VandenBos, G. R. (Ed.). (2015). APA dictionary of psychology (2nd ed.). Washington, DC: American Psychological Association.

August Releases from APA Books!

 

affirmative counselingAffirmative Counseling and Psychological Practice With Transgender and Gender Nonconforming Clients

Edited by Anneliese A. Singh and lore m. dickey

Fewer than 30% of psychologists report familiarity with transgender and gender nonconforming (TGNC) clients’ needs, which indicates a large gap in knowledge, skill, and competence in this area of practice. This timely volume provides mental health practitioners with theory-driven strategies for affirmative practice with TGNC clients of different ages, ethnicities, sexual orientations, and religious backgrounds. Affirmative care entails a collaborative, client-guided partnership in which clinicians advocate for the client’s needs. Chapters cover an array of complex issues, including ethical and legal concerns, working with trauma survivors, and interdisciplinary care.

 

Conducting a Culturally Informed Neuropsychological Evaluationneuropsych assessment

by Daryl Fujii

When conducting a neuropsychological evaluation, the clinician must develop a contextual knowledge base to fully understand a client’s current functioning. Doing so can be especially challenging when the client’s cultural background differs from that of the evaluator. This book helps neuropsychologists enhance their cultural competency, avoid biased assessments, and optimize outcomes for culturally different clients. The author describes strategies for improving communication, selecting valid tests, interpreting results, estimating premorbid functioning, working with translators, and making effective treatment recommendations.

 

 

Mindfulness-Based Therapy for Insomniainsomnia

by Jason C. Ong

Insomnia is a pervasive issue for many adults that is difficult to remedy with existing treatments. This clinical guide presents mindfulness based therapy for insomnia (MBTI)—an innovative group intervention that can reduce insomnia symptoms. Combining principles from mindfulness meditation and cognitive behavioral therapy, MBTI helps participants create meaningful, long-term changes in their thoughts and behaviors about sleep. This book reviews new research on MBTI and teaches mental health professionals how to integrate it into their own practices.

 

 

 

psych 101 half Psychology 101½

The Unspoken Rules for Success in Academia, SECOND EDITION

by Robert J. Sternberg

In this second edition of his popular Psychology 101½, eminent psychologist Robert J. Sternberg updates and extends a trove of wisdom gleaned from decades of experience in various academic settings and leadership positions. In his signature straightforward, intellectually honest, and pragmatic style, he imparts life lessons for building a successful and gratifying career. This revision features lessons in five basic categories: identity and integrity, interpersonal relationships, institutions and academia, problems and tasks, and job and career. Recent developments in the field are covered, and new questions at the end of each lesson prompt reader self-reflection. Valuable to academic psychologists at any level, this book will be especially prized by graduate students, post-doctorates, and early-career professors.

 

young eyewitnessThe Young Eyewitness

How Well Do Children and Adolescents Describe and Identify Perpetrators?

by Joanna Pozzulo

This book summarizes the research on how well children can describe an event and perpetrator (which is a recall task) and how well they can identify the perpetrator in person or in photographs (which is a recognition task). Joanna Pozzulo shows that although children may be less advanced in these skills than adults, they nonetheless can provide invaluable evidence. She interprets the research in light of developmental theories and notes practical implications for forensic investigations. In particular, the chapters highlight interviewing techniques to facilitate accurate recall and lineup techniques to facilitate accurate recognition. This book is an essential resource for all forensic investigators.

 

transcendent mindTranscendent Mind

Rethinking the Science of Consciousness                         

by Imants Barušs and Julia Mossbridge

Everyone knows that consciousness resides in the brain. Or does it? In this book, Imants Barušs and Julia Mossbridge utilize findings from quantum mechanics, special relativity, philosophy, and paranormal psychology to build a rigorous, scientific investigation into the origins and nature of human consciousness. Along the way, they examine the scientific literature on concepts such as mediumship, out-of-body and near-death experiences, telekinesis, “apparent” vs. “deep time,” and mind-to-mind communication, and introduce eye-opening ideas about our shared reality. The result is a revelatory tour of the “post-materialist” world—and a roadmap for consciousness research in the twenty-first century.

 

Becoming Brilliant

Reading and Math
Becoming Brilliant

For the full interview, see this episode of The
Brookings Cafeteria podcast
, from the Brookings Institution website. Note: The opinions expressed in this interview are those of the authors and should not be taken to represent the official views or policies of the American Psychological Association.


Everyone’s talking about Becoming Brilliant, by Roberta Golinkoff and Kathy Hirsh-Pasek! When we published it in May of this year, it was an Amazon.com best seller, and it remains in the Top 20 of the Child Psychology books.

In July, we published an interview with the authors, where we explored what inspired the authors and how the Six Cs are measured, and NPR also posted an interview with the authors.

They were also interviewed for “The Brookings Cafeteria” podcast, “a podcast about ideas and the experts who have them.”

Here are two highlights from that podcast, courtesy of Brookings Institution. In the first short clip, you can hear the authors discuss “the Six Cs”: collaboration, communication, content, critical thinking, creative innovation, and confidence. In the second clip, the authors discuss how children should be invited “to think critically and to learn in a more open-ended and playful and joyful way.”