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Tuesday, August 23, 2011

Professional Competence in the Face of Life-Threatening Illness

The new issue of *Professional Psychology* includes an article: "Preventing Problems of Professional Competence in the Face of Life-Threatening Illness."

The authors are W. Brad Johnson & Jeffrey E. Barnett.

Psychologists are human. Like our clients, we are nearly certain to encounter difficult life stressors such as relational break-downs, emotional low points, phase-of-life problems, serious medical challenges, or the onset of cognitive decline. Sadly, being a psychologist does little to insulate us from life's tribulations.

At some point during his or her career, nearly every mental health professional will confront a significant health problem. Medical issues may run the gamut from relatively minor (e.g., pneumonia, minor surgery, thyroid dysfunction) to life-threatening (e.g., cardiovascular disease requiring open heart surgery, neuromuscular disorders with a short life-expectancy, various forms of cancer).

Because many psychologists expect to work beyond the typical retirement age, with nearly a fifth reporting that they plan to work until death (Guy, Stark, Poelstra, & Souder, 1987), the probability of life-threatening medical diagnoses occurring during the course of one's career are significant.

But even early career psychologists are vulnerable to life-altering and potentially fatal medical problems (Philip, 1993).

Recent epidemiologic data for U. S. adults between the ages of 45 and 64 indicate that 13% suffer from some form of heart disease and 9.4% have been diagnosed with cancer; between the ages of 65 and 74, these numbers jump to 25.8% for heart disease and 22.5% for cancer (Centers for Disease Control & Prevention, 2010).

Although practitioner emotional health is considered essential and fundamental to the delivery of competent services (Vasquez, 1992), few things may threaten a psychologist's emotional stability more acutely than the diagnosis of a life-threatening illness.

Unfortunately, psychologists are not always effective when it comes to accepting their own vulnerabilities, taking time for self-care, and identifying decrements in their own competence due to either emotional or physical distress (Barnett & Johnson, 2008).

In this article, we direct our focus to the prospect of a life-threatening illness in the psychologist and the subsequent implications for professional competence.

By life-threatening we mean a terminal disease or a progressive medical condition leading to increasing disability and, in most cases, premature death.

Although psychologists are enjoined by the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association; APA, 2010) to ensure their own competence, psychologists struggling with life-altering medical problems may be especially vulnerable to problems in this area.

We highlight how seriously ill and subsequently distressed psychologists may be ineffective at self-assessing and monitoring their professional competence, as well as in making essential decisions about continued clinical practice.

We conclude with numerous recommendations for psychologists designed to both prevent and manage threats to professional competence caused by a life-threatening illness.

Thanks to Ken Pope for this information.