Stopping Sex Trafficking: How Psychology Can Help

Psychology can be a big part of ending global sex trafficking, said psychologist Mary Crawford, PhD, of the University of Connecticut in a plenary talk about her work in Nepal to stop sex trafficking. While it’s hard to grasp the number of girls and women who are trafficked globally each year, the United Nations estimates that number to be somewhere between 700,000 and 2 million women and children, she said.

And yet there is far too little research on how sex trafficking actually happens, what interventions are most effective and what the long-term psychological impact is for victims, said Crawford. What research there is has shown that these women experience high rates of anxiety, depression and post-traumatic stress disorder and that survivors are often stigmatized by their families and loved ones, she said.

In Nepal, sex trafficking is a huge problem as is violence against women in general, said Crawford. Around 49 percent of Nepalese women report having experienced marital rape. “Sex trafficking is part of a larger social acceptance of violence against women there,” she said. Psychologists can help by lending their expertise to such areas as better monitoring of interventions by nongovernmental organizations that rescue and rehabilitate women who have been trafficked and also in figuring out how, and how frequently, trafficking is happening.

“We need evidence-based intervention design, but first we need evidence,” she said.

More research is also needed on what sort of public education messages are most effective in curbing trafficking. Psychologists with expertise in gender inequality, violence against women, and the psychology of men and masculinity also need to be part of the conversation and the solution, she said. “It is not a hopeless cause,” added Crawford, who shared several stories in her talk of Nepalese survivors she has met who are on the road to recovery. “The courage and resilience of trafficking survivors can inspire us to act.”

Helping Military Kids Succeed in School

Military children are highly likely to attend civilian public schools -— 1.3 million go to public schools, compared with 84,000 who attend schools connected to the military.

But civilian schools are woefully unequipped to deal with these children’s unique issues, which include growing up in the military culture, multiple deployment of parents, and numerous geographic and school relocations. This transience represents a big part of the problem: Military parents don’t always know how to connect with teachers on their children’s behalf, said Hazel Atuel, PhD, of the University of Southern California, at a session entitled “Treating Children and Spouses of Military Personnel.”

Atuel described research being conducted by a USC team headed by Ruth Ela Berkovitz that aims to address this gap. The researchers are gathering baseline information on military parents’ perceptions of school climate, their own engagement with the school, the quality of school programs and activities for their children, and school problems like bullying. They compared the responses of 3,914 civilian parents and 448 military parents whose children attended schools in eight districts in Southern California.

Military families viewed school climate less favorably than non-military parents, and schools encouraged less involvement with military than non-military families, the team found. In addition, many military parents wanted support for their kids around deployment and transitions, the researchers found.

Based on this and related data, schools can do several things to start making the school experience a better one for these youngsters, said Atuel. Suggested remedies include:

•    Creating more positive and welcoming environments for these children

•    Developing explicit strategies for communicating and collaborating with military families

•   Creating high-quality programs and activities that take into account these children’s various cultural identities, including their military identity and their ethnic backgrounds.

It’s an important population to serve, Atuel added.

“The sacred trust we have with our military families includes their children,” she said.

Status-seeking and Dominance: It’s Not Just Testosterone Talking

In the popular imagination, there’s one hormone associated with status-seeking and dominant behavior: testosterone, the bad boy of the hormone world.

But the research literature on the subject is inconsistent, the University of Oregon’s Pranjal Mehta, PhD, told attendees at a session on cutting-edge research in social behavioral endocrinology. Although many studies back up the connection between testosterone and dominance, many others don’t find it — the literature is rife with null effects.

Why the inconsistency? Mehta has found that it’s because testosterone alone does not cause people to act in status-seeking, dominant ways. Instead, he said, it’s the interaction between testosterone and another hormone, cortisol, traditionally associated with stress. In a series of studies, he and his colleagues have found that people are more likely to behave in dominant ways when they have both high levels of testosterone and low levels of cortisol. In other words, if your stress level is high, you’re less likely to try to be the boss – even if you have high levels of testosterone.

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In one study, for example, Mehta and his colleagues measured the levels of cortisol and testosterone in the saliva of 100 participants. They then videotaped same-sex pairs of these participants doing a task in which one, the “leader,” had to tell the “follower” how to arrange a set of blocks. Raters coded the videos on how comfortable, confident or nervous the leaders seemed. They found that the most comfortable, dominant leaders had high levels of testosterone and low levels of cortisol. People with high testosterone but also high cortisol did not rate high on the dominance scale.

Mehta and his colleagues have found the same pattern in studies of MBA students, and in studies that look at risk-taking behavior, another area traditionally associated with only testosterone.

The takeaway message, Mehta says, is that “we can’t just look at testosterone or cortisol, but rather the interaction between the two.”

A Jam-Packed Day Filled With Memories, Tributes

Saturday was a very busy day, I must say. Got to be a discussant on Patti Johnson’s panel addressing effective psychological interventions for military children and families. Recalled how it takes 25-plus years for what the science says works gets into practice. The late Sen. Daniel K. Inouye had made military children a priority and under President Reagan, had $100 million for these initiatives. Health care is slowly evolving for the best.

The late Sen. Daniel K. Inouye, D-Hawaii

The late Sen. Daniel K. Inouye, D-Hawaii

Then I heard Colleen Hacker and APA’s Rhea Farberman describe how the best always undergo adversity and push through it. Kate Hays was masterful in crafting this panel. Then Beth Rom-Rymers’ hourlong tribute to the late Sen. Inouye with moving photos, memories and audience reflections. Morgan Sammons and Debra Dunivin were so moving.

After the truly inspirational APF/APA award ceremony — which I attend every year — I “escaped” to the Bishop Museum annual event, this year honoring the late Sen. Inouye. I hope all visiting Hawaii take the time to visit this unsurpassed treasure before returning to the mainland.

Treating Cheating Men

92526140It’s said that infidelity is America’s favorite spectator sport. “But [for] a participant in the sport, it’s a train wreck for everyone involved,” said Steven Kadin, PhD, of Antioch University Santa Barbara. He was speaking at a session Saturday on engaging men in couples therapy along with David S. Shepard, PhD, and Matt Englar-Carlson, PhD, both of California State University-Fullerton; Gary Brooks, PhD, an independent practitioner in Temple, Texas; and John Thoburn, PhD, of Seattle Pacific University.

Kadin focused on heterosexual male infidelity because — even though women are “catching up” — “it’s primarily still men who are the instigators of infidelity,” he said. It’s also common: Up to 40 percent of all couples report infidelity and it’s a presenting concern for about 25 percent of couples who come into therapy, he said.

Treating them isn’t easy. For one, men and women typically have very different ideas of how best to address the problem. A woman who’s been cheated on, for example, commonly shows symptoms similar to those of post-traumatic stress disorder at first — rage, difficulty concentrating, hypervigilance and even flashbacks, Kadin said. In therapy, the hurt woman typically wants her partner to apologize, explain, show remorse, empathy and compassion, stop cheating — and prove it.

Men, on the other hand, just want to forget about it and move on.

“This puts the couples therapist in a tremendous bind,” Kadin said. “Even the most skilled therapist is going to have difficulty reconciling those two fields.”

But it’s possible. First, Kadin said it’s important to assess what kind of infidelity has occurred. Did the man cheat because there was a void in the relationship or was it a pursuant affair? “The latter is a repeated behavior that has little to do with relationship issues,” he said. Knowing this can inform treatment.

Kadin also recommended seeing unfaithful men first in individual therapy. In this setting, psychologists can help prepare them for couples therapy by speaking to their “strength and courage for coming in,” preparing them for hard questions and setting up a plan. “They feel more comfortable if they know there’s a plan and structure,” Kadin said.

He also suggested using metaphors and humor, and encouraging men to say what they mean rather than withdrawing to protect their partners. “Having them speak those hard truths is the way of preventing the distance that helped create the space for infidelity to begin with,” Kadin said.

We Want YOU!

145854755Psychologists, heed the call: You’re needed to help out after disasters, which are growing exponentially as weather-related and human-made catastrophes burgeon, said panelists at a Saturday symposium called, “Five Things Every Psychologist Needs to Know about Disasters.”

You need formal training (see the bottom of this post for suggestions), but some basic guidelines can help you navigate these situations. Panelists advised psychologists to:

• Anticipate and foster resilience. Take a resiliency approach when working with people after a disaster, advised Patricia Watson, PhD, of the National Center for PTSD in White River Junction, Vt. Most healthy adults cope quite well with disaster-related stress, and their psychological symptoms tend to be transitory. That said, be aware that certain populations may need extra attention and help, including the elderly, children and the homeless, she said.

• Be pragmatic and flexible. Disaster scenes are chaotic, and people have experienced many losses and traumas. Accordingly, keep your interventions brief, simple and clear:  “Any kind of intervention requires people’s energy, and that energy may already be parceled out to 50 different things,” Watson said.

• Hew to basic principles such as fostering people’s safety, their connection with supportive others, their self-efficacy and hope, and have both public health and individual interventions ready for each domain. Public health interventions related to hope might include helping people think about ways to rebuild their local economy, for instance, while individual interventions could mean helping people control self-defeating statements and encouraging positive coping behaviors.

• Provide a spectrum of services. Assess who in your team is good at what, and assign tasks accordingly. Needs will include basic First aid, psychological first aid, outreach and information dissemination, and treatment for those with ongoing distress, to name a few.

• Provide evidence-informed treatments, which again, you will learn through proper training.

Keep in mind there are scads of great resources to help you, added psychologist Cynthia K. Hansen, PhD, of the Department of Health and Human Services.

“You don’t have to reinvent this,” she said. “There’s a whole cadre of people who grew up learning how to do this, and our knowledge is expanding all the time.”

Training resources are available at the federal At-Risk, Behavioral Health & Community Resilience program (www.phe.gov/abc), the APA Disaster Response Network (www.apa.org/practice/programs/drn), and your state psychological association, to name a few. 

What’s Your Duty to Warn?

104383981Why are laws intended to protect victims of therapy clients from bodily harm or death less than optimal?

Because they tend to abort the possibility of helping potentially violent patients get better, and in some cases, may make matters worse, said 2013 APA President Donald N. Bersoff, PhD, JD, in his presidential address, “Protecting Victims of Violent Patients While Protecting Confidentiality.”

Bersoff, who is former APA counsel and an expert on mental health law and ethics, described both the original 1976 case mandating the protection of potential victims of therapy clients, Tarasoff v. Regents of the University of California, and subsequent state laws that have created even stricter standards.

In Tarasoff, University of California graduate student Prosenjit Poddar dated Tatiana Tarasoff, who subsequently brushed him off. Poddar went first to a psychiatrist, then to a psychologist, telling both he intended to kill the young woman. The psychologist told him if he continued talking this way he’d have him hospitalized. The threat kept Poddar from returning to therapy, and he eventually killed Tarasoff with a kitchen knife.

The drama of the case led to some rather knee-jerk conclusions on the part of judges and justices, said Bersoff, such that 33 states now require psychologists to warn potential victims of a violent client if the risk is sufficiently high. Eleven states have made that duty discretionary, and seven haven’t yet ruled on the issue, meaning psychologists in 18 states can consider doing things differently if they do so carefully, Bersoff said.

For those psychologists, Bersoff advised trying approaches that are more in line with psychologists’ identity, values and training, urging them to:

•  Seek consultation from respected peers or supervisors, with the goal of developing realistic options for preventing violence.

•  Recommend hospitalization, which unlike involuntary commitment, won’t necessarily breach the person’s confidentiality.

• If the client is threatening imminent harm to someone, consider clearing your schedule and working with the client until the crisis is over.

• If you perceive there is time, refer the patient for appropriate medication.

While psychologists can’t change the way laws are moving, they can still have a say, Bersoff concluded.

“It’s not too late to contemplate the consequences of making mental health professionals agents of the state, torn between their duty and ethical obligations to clients and their responsibilities of the larger society in which they live.”

Why Can’t We Talk About Race?

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Dr. Derald Wing Sue

The Trayvon Martin case is just one of the recent incidents that remind us of how difficult it is for Americans to talk about race and racism, said Derald Wing Sue, PhD, of Teachers College, Columbia University. Sue’s comments came during his Board for the Advancement of Psychology in the Public Interest award address on Saturday.

“The acquittal of George Zimmerman, in which the judge, the prosecution, the defense and even the juror who spoke out said that race was not an issue … [ignored] the invisible elephant in the room,” he said. “Race was always present.”

Sue has just completed four studies examining why race is so challenging for people to discuss. When it comes to whites, for example, Sue has found that they don’t want to talk about it because they don’t want to be seen as racist. They may also have a fear of realizing their own unacknowledged racism or of confronting the privileges that they have just because they are white.

There are, however, ways to have successful talks about race, he said. That can happen when people:

  • Truly listen to each other and engage in dialogue, rather than the monologues so popular with the talking heads on TV.
  • Understand the worldview of others.
  • Become less defensive.
  • Become increasingly comfortable with differences between themselves and others and see those differences not as impediments but as sources of strength.
  • Achieve new insights about themselves, about others and about how society treats people of different social and sexual orientations.

To find out how educators can facilitate successful race talks in the classroom, watch for  in an article by Sue slated for the October issue of American Psychologist.

Can Feedback Convince Consumers To Cut their Energy Use?

Imagine if every time you went to the grocery store, you left without a receipt in hand. Instead, at the end of every month, Safeway would send you an un-itemized bill – “This month you spent $527 on food.”

That’s essentially the situation for most energy consumers, who get un-itemized electric, water and other utility bills each month, Beth Karlin, PhD, of the University of California-Irvine, told attendees at a session on energy feedback and conservation.

But the situation is changing. As more utility companies install “smart meters” and companies like Opower offer software that can track energy use in minute detail, consumers can find out how much energy their washing machine, dishwasher and computer router use, and when.meter

Such feedback could help consumers cut back their energy use — and there’s a lot of room to cut. Previous research has shown that energy use in homes of equal size with the same appliances can vary more than 260 percent, Karlin said.

But giving people such detailed feedback doesn’t necessarily guarantee that they’ll change their behavior, and that’s where psychology comes in. In the session, entitled “Technology to the Rescue? The Potential and Pitfalls of Feedback in Energy Conservation,” Karlin and three other researchers discussed their work on how to design feedback programs to encourage people to use the information for good.

Stephanie Vezich, of the University of California-Los Angeles’s ENGAGE project, studied how graduate students living apartment housing at UCLA responded to feedback about how their energy use compared to their neighbors’ use. She found that when people received negative feedback – letting them know that they were doing worse than their neighbors – they actually increased their energy use compared with people who received positive feedback. Vezich and her colleagues think that perhaps the reason is that their negative feedback message, which included information about how energy use hurts the environment and health, might have scared the participants and turned them off from paying attention to the feedback. The researchers plan to study feedback messages more in future research.

Also in the session, University of Hawai’i at Manoa computer scientist Robert Brewer, PhD, described his work developing the Kukui Cup, an energy-use-reduction competition for undergrads. And Oberlin College psychologist Cynthia Frantz, PhD, talked about her “bioregional dashboard,” a website that helps people visualize moment-by-moment utility use in their city.

Below, Karlin offers her thoughts on why it’s so important to integrate psychological research into energy feedback programs.

Hypnotic Credit Where Credit is Due

In Goa, There is a Statue of Abbe Faria Performing Hypnosis

In Goa, there is a Statue of Abbe Faria Performing Hypnosis

Although Scottish surgeon James Braid (1795-1860) is widely credited as the “father of hypnosis,” an earlier figure known as Abbe Faria was actually first to draw hypnosis out of the realm of parlor trick and into the practitioner’s office, according to a presenter at the session “History of Hypnosis – From Mesmerism to the Great Debates.”

Faria, who was born Jose Custodio de Faria in 1746 on the Indian island of Goa, pioneered many of the hypnosis techniques and applications still in use today, said Ian E. Wickramasekera, PsyD, of the University of the Rockies. Faria came up with the practice of focusing subjects’ eyes on something and suggesting that they are feeling sleepy, Wickamasekera said. He also came up with the practice of using hypnosis (a term that didn’t yet exist; he called it “lucid sleep”) to block pain during medical procedures, “one of the most respected uses of hypnosis today,” Wickamasekera noted. “He also pioneered the use of post-hypnotic suggestion.”

Faria, who was a Catholic priest, became interested in methods to control the mind when he developed stage fright while delivering a sermon to the Portuguese royal family in Lisbon, Wickamasekera said. His father was in the audience and, seeing his son’s terror, called out in the Goan language, “They are all vegetables; cut the vegetables.”

“It snapped him right out of his stage fright,” Wickamasekera said. “He learned there were words that could actually dispel an anxiety attack at a critical moment.”

Faria began studying the work of Franz Mesmer and his followers, but he did not believe in “mesmeric fluid” or that electromagnetism had anything to do with hypnosis, Wickamasekera said. “He developed a theory that the effects were due to the mental and psychophysiological properties of the subject.”

Braid wrote about Faria’s work to downplay it, “while repeating his ideas and methods,” Wickamasekera said. Part of the reason much of Faria’s work has not gotten more renown was his book, “On the Cause of Lucid Sleep,” (1819), was written in a mashup of Portuguese, French and the Goan language, Wickamasekera said. It was translated into English in 2004 by Laurent Carr, PhD, he added.

“I think we should be listing Abbe Faria more regularly” as a discoverer of hypnosis, he said.