New Master's Degree in Psychology

The management here at Universidad San Francisco de Quito have given the go-ahead for us to develop a new master’s degree for training clinical psychologists. It will, without a doubt, be the best clinical psychology training course in Ecuador. The core trainers all have doctoral degrees in clinical psychology from highly respected institutes in the USA. In addition to this we have several full-time psychology professors with research PhDs from top universities in the USA and UK. None of the other universities can muster such academic weight, with most of their professors having only masters’, or lower, degrees. And often those master’s degrees were earned online.

The program will be directed by Dr Richard West. It will follow an evidence-based model with the psychotherapy component focused on Cognitive Behavioral Therapy (CBT). This makes perfect sense, CBT has much more evidence to support its clinical efficacy than any other psychotherapy.  

Such a course is sorely needed in Ecuador. Due to a lack of appropriate regulation, people with only undergraduate level training can call themselves ‘psychologist’ or even ‘clinical psychologist’. Consequently, there is much quackery passed off as professional practice. The situation is changing though and soon a postgraduate qualification will be needed to use the title ‘psychologist’- hence the new master’s program.

It won’t be ready to go for a while, it still needs to be approved by the national authorities, but it will likely have its first intake in 2016. In addition, a second master’s degree is being planned that will take a more eclectic approach and focus more on sub-clinical clients and counselling skills. That will be directed by Dr Teresa Borja. 

The State of Psychology in Ecuador

Psychology here in Ecuador is a strange thing. Firstly, there is currently very little legal protection over the professional title, anybody with a degree in psychology is a ‘psychologist’. I could legally set up private practice here as a Clinical Neuropsychologist if I wanted to, despite having no clinical training. Indeed there are lots of ‘Clinical Psychologists’ here who have no clinical training. Their titles being based on postgraduate academic qualifications from abroad. Ironically, those who do have clinical training usually only have an undergraduate degree in ‘Clinical Psychology’. So most trained clinical psychologists have no postgraduate qualifications.

There is also a tendency to faddishness. Sub-academic pseudo-psychology is peddled by numerous life coaches, brain trainers, aroma therapists and other cranks. When professional psychology is considered an undergraduate degree, then this is understandable. Many students are just not sufficiently trained to spot pseudoscience. Not surprisingly, what passes as mental health care sometimes borders on superstition and charlatanism. For example, I’ve heard of some ‘clinical psychologists’ using tarot cards as part of their therapy, others horoscopes. Many use hypnotic regressions to ‘past lives’.

How can a country have gotten to a state where graduates (aka Clinical Psychologists) think that tarot and horoscopes are real psychology? One reason is that supernatural beliefs are very common here anyway, so things like tarot are respected by the public and tend to go unchallenged. Another issue is the lack of expertise in Ecuador, there are simply not enough people in the country with doctorate qualifications to staff the universities. Thus, many professors have only masters degrees, and of varying quality at that. Worse, for many years there were few checks on the validity of qualifications, and so there are professors here with PhDs that were bought over the internet. These frauds are the likely source of much of the full-blown mumbo jumbo that passes as psychology. When ‘real’ psychology is taught, it’s frequently based on pop-science paperbacks and TED talks, with little distinction made between entertainment and academia.

Fortunately, the current government is taking steps to improve standards in higher education. For example they are recruiting more experts from abroad and sending Ecuadorian students to top universities in the USA and Europe for postgraduate training (there are very few postgraduate opportunities within Ecuador). The students get their fees paid and generous grants if they agree to return to Ecuador afterwards. The government is also checking all professors’ qualifications and adding the details to an open-access database, so the public can check who really has professional training. In addition, legal steps are being taken to require a postgraduate qualifications for professional psychological practice. With time these steps should improve the current dire situation nationally.

Independent of the government provision, at Universidad San Francisco de Quito we now have the best trained psychology faculty in the country, including several professors with (real) doctorates from respected universities in North America. Some of these are Ecuadorian, some foreigners. We have brought skills in research and clinical work that have generally not been available in Ecuadorian psychology departments before. The potential therefore exists to greatly improve psychology training, and over time, the quality of mental health care provided by the country's next generations of psychologists. 

Quito Brain and Behavior Laboratory

Yesterday I gave a presentation at the inaugural Brain Meeting of the Quito Brain and Behavior lab. The presentation was on neurocognitive function and socioeconomic status. Not everybody’s cup of tea, but it attracted about 20 academics from various fields. That was what we wanted, there are lots of people here who want to do some brain based research, and the monthly Brain Meetings are a way to get them together. Hopefully, this will encourage research and collaborations. The meetings will be held at 4pm every first Tuesday of the month during the teaching semesters.

The advertising poster for the inaugural Brain Meeting of the new lab. 

The Brain Meetings are organized by the Quito Brain and Behavior lab, which is being set up at Universidad San Francisco de Quito by me and Dr. Ana F. Trueba, a psychophysiologist. With her interest and expertise, and my background in neuropsychology and psychopathology, we are forming an international class research group on brain sciences. We both have a lot of experience in running projects, and publishing data in international journals, so forming the lab is helping us to extend this. In addition we have a paid research assistant and several graduate and undergraduate volunteers who are gaining research experience in the lab. Recently an expert in genetics and cognitive neuroscience also joined the group. 

We currently have two projects running, one on predication of academic performance with neuropsychological tests, and the other a validation study on various tests of premorbid function. We are also developing a new battery of cognitive tests that could be used in various clinical studies, for example to measure cognitive decline in dementia. The development of these tests is important because there are currently few assessment tools that are validated for use in Ecuador. By producing our own, we can facilitate future research. We also have studies planned on the role of cortisol and inflammation markers in sub-clinical psychopathology, and some experimental studies of the effects of the hormone and neuromodulator oxytocin. As more collaborators join us, the number and range of projects will increase.

The lab houses a reasonable neuropsychological test library, in fact possibly the biggest in Ecuador. This includes several commercial tests (such as Wechsler tests, Delis Kaplan Executive Function System) as well as many more experimental tests. In addition, we already have some physiological recording equipment, and the university is in the process of buying eye-tracking systems, which will be used in neuromarketing research. So there is plenty of potential. The next Brain Meeting will be held on March 3rd at 4pm at Universidad San Francisco de Quito. 

“Street Children” Research

The concept of ‘street child’ is a difficult one. It includes both homeless children and those who have homes to go to, but spend a lot of time working in urban environments. In fact, it also includes many, many other life contexts. However, it has been a convenient label to describe the poor children often seen unaccompanied in many of the cities of Latin America, Africa and Asia. It’s a term easily understood by the public and hence favored by charities that appeal to the public. However, possibly a more accurate term would simply be urban poor children.

Whether we refer to them as ‘street children’ or simply ‘urban poor children’ is to a large extent a gentile discussion for armchair sociologists. It makes precious little difference to the tens of millions of children worldwide trying to get through their days. Nevertheless, research is needed to inform professionals involved with street children and to combat the abundant stereotypes of street children (generally negative) and present the true situation, regarding the extreme poverty, mental illness, resilience etc. of this significant global demographic.

We have recently published two journal articles on the lives of street children. Most recently a review article in the Psychologist. This examined some of the strengths as well as weaknesses of development associated with street connectedness.

Our recent article in the Psychologist made the front cover. The photo shows a boy who works selling gum to motorists in Quito, Ecuador.  

The other article, published in the InternationalJournal of Mental Health and Addiction describes a study of former street children in Quito. This was research involving three students as research assistants in which we estimated levels of post-traumatic stress disorder (PTSD). We found it to be shockingly high at around 60%. PTSD is not just a mental health concern, it also has significant effects on brain development of children. Thus potentially affecting the course of their whole lives and the success or failure of their struggles with poverty. In fact, we are working on a third journal article looking at the effects of street-connectedness and poverty on neuropsychological development. It appears that, at least in the context of Quito street children, there are particular delays in the development of social cognition skills as measured by Theory of Mind tasks. Such tasks measure the ability to understand the contents of other people's minds. The data seem to suggest therefore that rather than driving specific development, street connectedness in children may delay development of some of the highest cognitive processes.

Many 'street children' are simply working because their families are very poor. Here we see a shoe shine boy working in La Paz, Bolivia

However, on the other hand, studies in Brazil and Bolivia have found the opposite, that street children do indeed develop some skills better than conventionally educated children. This is an interesting and important topic and we intend to continue the line of investigation here in Ecuador.