Under Pressure: Navigating the Surge in Psychological Service Demand

While hiring more psychologists and additional compensation to treat extra patients could be possible solutions, these ideas may not have the feasibility or influence to resolve our psychologist shortage. Additionally, treating extra patients will likely contribute to burnout, which may result in lower quality patient care or increased turnover among psychologists. We instead offer strategies that may benefit psychologists in reaching more patients while working with limited resources. When examining these strategies, psychologists should consider potential benefits or barriers to determine what may best fit their setting and practice.

Treating multiple patients simultaneously. One potential solution is providing services that allow multiple patients to be seen simultaneously. The idea of seeing multiple patients at one time is not a new concept, but is something providers should consider when working to reduce waitlists. Group formats are a common way to concurrently treat several patients with similar needs. In addition to the traditional in-person format, the increased use of telepsychology can be leveraged to conduct groups via video-conferencing, which may address barriers to access, while also reducing waitlists. A similar strategy is the use of half- or full-day workshops or education days. This is particularly effective if wanting to provide specific skills or information to a large number of individuals, families, or providers.

Mobile Health. Another way to reach many individuals is through the use of mobile health (mHealth). Representing a more novel approach to telecommunication, mHealth can come in the form of phone applications that are skill- or therapy-based, text-based therapy, or even virtual reality services. These and other forms of mHealth have the potential to reach many individuals and require limited need for an assigned psychologist. Unfortunately, while the novelty of mHealth (e.g., self-help phone applications, wearable technologies, artificial intelligence) comes with a lack of regulation and supervision, our field and the public continue to trudge towards its use. As licensed psychologists and ABPP specialists, we must consider how we can utilize this field and become its leaders, rather than allow companies without knowledge of ethical or evidence-based practices to dominate the field.

Providing pertinent information online. Information regarding evidence-based mental health interventions can also reach large audiences when we utilize online communications. Individuals who need help with their mental health often seek information online. Unfortunately, online articles and forums are often littered with opinions from non-professionals or even misinformation. Licensed psychologists and ABPP specialists can help minimize this problem by updating and improving our websites and developing videos/articles that describe evidence-based treatments, conceptualizations, and recent research related to our areas of specialty. We can be the messengers who present this information to the public. By updating our websites, we add substantiated information to the collective pool of knowledge that can be accessed on the internet, allowing individuals to search and find accurate information related to our specialties in psychology.

Utilizing master’s-prepared clinicians. One additional solution to reducing long waitlists and difficulty accessing evidence-based mental health treatment, is to train and hire master’s prepared clinicians including licensed clinical social workers (LCSWs), master’s prepared psychologists, licensed marriage and family therapists (LMFTs), and licensed mental health counselors (LMHCs) in academic and clinical settings. Specifically, licensed psychologists may be able to train and supervise these master’s prepared clinicians, who are then able to provide psychological clinical services (e.g., individual, family, or group therapy) within the context of their job roles and licensure. Multiple options for this type of model may exist. First, departments may want to consider hiring master’s prepared clinicians for primarily clinical positions where they can see 20-30 patients per week, which would significantly reduce long waitlists. Additionally, in settings such as academic medical centers and hospitals, it may be feasible to have current employees, such as social workers, transition to a position that includes both traditional social work services and the provision of evidence-based interventions in the form of individual, family, or group therapy. Utilizing licensed psychologists as temporary supervisors for master’s prepared clinicians would allow for these clinicians to be sufficiently trained in specific gold-standard, evidence-based interventions, and then be able to independently provide these mental health interventions. This model can be implemented simultaneously with current psychology training programs used in academic medical centers, universities, and hospital settings. Given that master’s prepared clinicians are licensed providers, supervision and training to teach specific evidence-based interventions may be completed in a shorter time frame (3-6 months) than the comprehensive supervision given to a psychology graduate student, intern, or postdoctoral fellow.