Psychology’s Gordian Knot: Problems of identity and relevance.

Abstract

Psychology's image has been of concern since the first organisational meeting of the American Psychological Association (APA) in 1892 (Benjamin, 1986). Almost 80 years later, George Albee (1970) stated in his presidential address to APA that... psychology has entered a paradoxical phase in its development where its problems of identity and relevance threaten it with extinction at the same time that its opportunities seem boundless (p. 1071). Concerns about psychology's image continue to be noted today (e.g., Bray, 2010; Eby, Chin, Rollock, Schwartz, & Worrell, 2011).Mental illness is the leading cause of disability in Canada (Mental Health Commission of Canada [MHCH], 2014) and costs the economy an estimated $51 billion annually (Lim, Jacobs, Ohinmaa, Schopflocher, & Dewa, 2008); yet access to mental health care in general, and psychological services in particular, is severely lacking (Peachey, Hicks, & Adams, 2013).While Canadians self-reported preferred method of mental health treatment is psychotherapy and counselling (not pharmacotherapy), it is the least likely treatment to be received (Sunderland & Findlay, 2013). In a national survey, respondents (N ^ 2,832) indicated that paying out-of-pocket (54%) and lack of provincial health care (50%) and employer's (40%) coverage were very significant obstacles to psychological care, whereas long wait times and stigma were identified as very significant barriers by only 38% and 17% of respondents respectively (EKOS, 2011). These findings indicate that lack of public and private funding are prominent barriers preventing Canadians from receiving needed psychological care.Some psychology scholars have attributed the lack of accessible and affordable psychological services in Canada to health care managers, policymakers, and insurers not recognising or valuing the differences among the disciplines providing mental health services (Cohen & Peachey, 2014; Murdoch, Gregory, & Eggleton, 2015). This inability to differentiate psychologists and their contributions from other mental health providers, however, may largely be the result of psychology's failure to articulate a clear and distinct image for itself. As such, we critically review discussions and evidence for how psychology has contributed to its own identity issues, and in particular, how psychology is often perceived as a nonspecific, nonscientific discipline, and one that is nonessential to Canada's health care mandate. Thus, by and large, psychology has come to be implicitly defined by what it is not.While psychology's problems of identity have each individually been discussed in the literature, here we highlight how these issues are interrelated and mutually perpetuate a diminished image of psychology. With the aim of upholding the high standards of care established and promoted by the Canadian Psychological Association (CPA; see Dozois et al., 2014), we propose a multipronged approach to redressing psychology's image problems. Remediation entails identifying promising opportunities for the discipline to strengthen its image so that it may come to be valued for what it is. Succinctly put, advancing the discipline's image is not only about communicating what we already do more effectively, but also about reexamining our current practices in order to improve and evolve as a discipline. The more psychology's reputation in research, training, and service provision is understood and valued, the greater the likelihood of becoming a priority for research funding and health care dollars-thereby granting the public greater access to the psychological services that they desire and need (Sunderland & Findlay, 2013). While our commentary may be critical, our critiques are offered with a sense of optimism and with the intention of engaging in self-reflection in order to enhance the relevance and application of psychology within Canada.Image Problem No. 1: Psychology Seen as NonspecificIn 2013, the CPA hosted a summit on the need, demand, and supply of psychologists in Canada (Votta-Bleeker & Cohen, 2014). …