Early Career Psychologists Media Opportunity Form

Early Career Psychologists Media Opportunity Form

Contact information

Institution:

First name:

M.I.

Last name:

Address line 1:

Address line 2:

City:

State/Province/Region:

Postal/Zip code:

Country:

Email:

Phone (include country code outside U.S.):

Education and professional information

Select your highest degree earned:

What was the degree type (e.g., Clinical Psychology, Counseling Psychology)?

Year your doctorate degree was awarded:

Are you a current, dues-paid APA memeber?

YesNo

Have you previously presented or been interviewed by any APA media outlets?

YesNo

Areas of expertise

Please select the following topics you have expertise in:

Adolescent/Children's mental health Burnout (e.g., health care providers, psychological impact of COVID on mental health, connection to life/job changes) Climate changeDis/MisinformationRacismRacial traumaSocial media: Impact on children's mental health and developmentAdapting to a changing work environmentChanging the workplace culture toward mental health (e.g., destigmatizing mental health)Other

If you selected “Other” please indicate topic:

Professional background

Two published research papers or a webpage listing your research or clinical work:

An example of a past media or public speaking engagement:

An online biography or LinkedIn page: