August 2009
THE NEWSLETTER OF THE WASHINGTON STATE PSYCHOLOGICAL ASSOCIATION • VOLUME 64 • ISSUE 4
The Future of Psychology at Tri-State Bob Grubbs, PhD, WSPA Vice-President
A
s a relative newcomer to both the and practice styles to the lack of common protocols.
The keynote address for the second day of
Pacific Northwest and the language and patient treatment preferences.
In order to establish a good working the meeting, “Looking Forward: Future
WSPA, a road trip to Idaho for
the
Tri-State
Psychological collaboration with a PCP, Dr. Bray Directions in Psychology & Ethics” was
Convention at the Coeur d’Alene Resort counseled paying attention to “the 3 R’s”: delivered by Dr. Steven Behnke, APA Ethics
Regular
Contact,
and Director. Dr. Behnke tried to dispel the idea
seemed like a good idea and it was in every Respect,
respect:
The
weather
and
the Reciprocation. Regarding respect, he that the APA Ethical Principles Code
accommodations in Coeur d’Alene were emphasized the value of adopting a medical approved in 2002 is an immutable stone
wonderful, and the presentations were first- anthropological perspective in developing a tablet; it should be viewed instead as a
rate. The opening session by Dr. James Bray, relationship with what in many ways is working document subject to modification as
APA President, on the Future of Psychology another culture for many of us – the primary experience dictates. For instance, there is a
Practice set the tone for the meeting. Dr. health care system as it currently exists! He growing appreciation that the standard
Bray gave an overview of the challenges also emphasized the importance of sending a prohibiting multiple relationships with a
client, is very difficult to follow in small
facing the APA today and the agenda that
has been developed to try to meet them. “...The Ethical Principles Code should rural towns, where it is difficult and
potentially awkward to avoid all social
The major theme of his talk was that
be viewed...as a working document”
contact with clients. Therefore, we are
psychology and psychologists need to be
likely to see this document evolve.
open to change with respect to the
The Saturday breakout sessions were
anticipated reforms in health care that are concise written report with specific
between
ethics
and
being discussed in Washington. He outlined recommendations to a referring PCP as a divided
his plan to transform the APA so that it will critical follow-up to establish a working psychopharmacology. In the morning, Dr.
Behnke presented on the ethical aspects of
respond quickly to issues as they arise in this relationship.
The other breakout sessions on Friday treating and evaluating children and families,
process. Perhaps one of his most important
on
informed
consent,
messages was that
treatment outcome included Dr. John Sommers-Flanagan, U. focusing
assessment will be a part of any reform Mont., who presented on how to work confidentiality, and providing services at the
package and that if we as psychologists don’t effectively with parents through use of a request of third parties. Later, he described
take the lead in defining these measures, brief consultation model. He also touched the legal and ethical aspects of supervision,
on contemporary approaches to assessing specifically, the role of supervisor versus
they will be defined for us by others.
In the breakout session that followed, Dr. and intervening in adolescent suicide that of consultant and therapist. Dr. John
Bray gave an overview of recent ideation. Following, Dr. Nicole Prause, Courtney, a practicing medical psychologist
developments in primary health care with Idaho St. Univ., presented her work on the at Children’s Hospital in New Orleans, gave
regard to changes in the delivery of care and treatment of women’s sexual difficulties the psychopharmacology presentations; the
how psychologists can integrate better into using new empirically supported treatment first was an introductory overview of the
topic while the second focused
this system. He noted that while
on drugs approved within the
primary care physicians (PCPs)
past three years (covered in a
currently
provide
initial
separate article).
treatment for 70% of mental
In summary, this was a wellhealth patients, they often fail to
organized
and
well-run
diagnose
mental
disorders,
conference which provided the
particularly if the disorder
opportunity not only to interact
presents with undifferentiated
with and hear from colleagues
somatic symptoms, like fatigue.
from all-over Washington and
He identified a number of
neighboring states, but also
barriers that need to be
with leaders from our flagship
addressed
in
developing
1st row: Steve Behnke, PhD, JD, John Moritsugu, PhD, R.J. Smith, PhD,
organization itself. And, the
effective collaborations, ranging
Darrelle Volwiler, PhD, Carol Moore, PhD, Wendi Biondi, MA,
weather was pretty nice for that
from differences in training/
Pamela Ridgeway, PhD, Stephanie Kuffel, PhD.
2nd row: Debra Brown, PhD, Jane Harmon Jacobs, PhD, Tim Popanz, PhD,
five-and-a-half-hour drive back
theoretical
orientations
James Bray, PhD, Laura Asbell, PhD, Andrew Forsythe, PhD,
across the state to Seattle.
(biomedical vs. psychosocial)
Dave Scott, PhD, Kayleen Islam-Zwart, PhD
Insurance CE Dinner—Page 8
2009 Fall Convention– Page 9
Meet WSPA Member
Name: Catherine A. MacLennan
Title: Licensed Psychologist, clinical and
forensic
711 N 35th Street, Suite 206
Seattle, WA 98103
Current Hometown: Omak
Telephone: (206) 547-4220
FAX: (206) 547-6366
Email: [email protected]
Web Address: www.wapsych.org
The Mission of WSPA is to support psychologists and
psychologists-in-training and to promote the practice of
psychology in order to maintain the vitality of the profession
in the public interest.
2008 WSPA EXECUTIVE BOARD
Timothy J. Popanz, PhD
Shannon Ledesma Jones, PhD
Alejandra Suarez, PhD
Robert Dale Grubbs, PhD
Leslie Anne Savage, PhD
Jevon Powell, PhD
John Moritsugu, PhD
Douglas Haldeman
President
President-Elect
Past President
Vice President
Secretary
Treasurer
APA Council Rep
Diversity Officer
2009 CHAPTER REPRESENTATIVES
Carol Moore, PhD
Mary Lynne Courtney, PhD
Elsa O’Connor, PhD
Denise McGuiness, PhD
Kathleen Bruhn, PhD
Chapter I
Chapter III
Chapter IV
Chapter VI
Chapter VI
CONSULTANTS & STAFF
Douglas M Wear, PhD
Lucy Homans, EdD
Executive Director
Director of Professional
Affairs/Legislative Consultant
Washington Psychologist
Editor: Dug Y. Lee, MA
[email protected]
Staff:
Workplaces: Private practice
Educational Background: PhD from
Fielding Graduate University
How long a member of WSPA? Student
member since 1997, and full member since
2005.
Why a member of WSPA? I joined as
soon as I started my doctoral program.
Membership is important because WSPA
is the only organization that attends to the
interests of psychologists in private
practice, and membership provides an
avenue to know and communicate with
psychologists.
What do you do for fun? Read fiction, sit in
or outside of my house in remote sagebrush
country.
Guilty pleasures: Watching mystery and cop
shows on TV.
If you were not in the field of psychology,
what would you do? Write fiction.
Who are you besides a psychologist? A
mom of healthy adults, a partner, and a
human being.
PsychoBabble by Joe Mills, PhD
Cynthia Mason, PhD
Joe Mills, PhD
Meredith Mason, PhD
The Washington Psychologist (WP) is a bimonthly
publication. Article and advertising submission deadlines
are January 1, March 1, May 1, July1, September 1 and
November 1. WP invites news, feature stories, academic/
clinical reports and creative works of interest to psychologists.
WP welcomes articles expressing the wide variety of
views held by WSPA members. Authors' opinions do not
necessarily represent the official position of WSPA. Readers
with opposing points of view, or further information, on
topics presented in the WP are invited to submit for possible
publication or post on our website member forums.
WSPA reserves the right to refuse to print or to allow to
appear on its website any advertisement, article, or other
material which is deemed by WSPA to be contrary to the
laws, regulations, and ethical guidelines applicable to the
practice of psychology, or which is deemed to be contrary to
the organization's goals and objectives. If WSPA determines
that it cannot continue printing or carrying on its website a
paid advertisement because of this policy, the balance of any
prepaid advertising fee will be returned to the advertiser.
Unless otherwise specified, WSPA does not endorse any
advertiser.
Submissions are subject to editing for length and clarity.
Article length must be a maximum of 800 words. Please submit
articles of interest to the WP editors by email to
[email protected].
2
Original Hometown: Windsor, Ontario,
Canada
“Well, we call it ‘kleptomania,’ and of course the farmers are mad at you.”
Washington Psychologist — August 2009
The Future of Psychology Practice
E
xcuse me, can I ask you a
question?
The gentleman standing next to
me in the elevator had been eyeing
my name tag, with the heading Summit on
the Future of Psychology Practice. It was the
last morning of the three-day Summit and I
was headed down to hear summaries and
final presentations from the Summit’s
primary organizers: Drs. James Bray, Carol
Goodheart, and Margaret Heldring. My head
was full of information and questions that
morning—what had we accomplished? How
would the leadership be able to capture the
excitement
and
broad,
sometimes
revolutionary
statements
from
the
participants? Had I personally said enough
about the topics important to me—spoken on
behalf of the “stakeholders” in my
mind (e.g., health care reform,
environmental public health, social
justice,
and
minority
communities)?
So, it was with a pensive mind and serious
heart—we came to the summit with the
incredible expectation that we would figure
out “what’s the future of psychology
practice?”—that I heard this stranger-in-theelevator’s question: “my daughter is thinking
Timothy Popanz, PhD
President
invited leaders included those from broad
areas of psychology practice and other
practice associations, including government,
training organizations, consumers, insurers,
economics and businesses. I was invited as a
representative of the WSPA, one of six
State,
Provincial,
and
Territorial
Associations at the summit. All were asked
to identify:
 Opportunities for future practice to
meet the needs of a diverse public.
 Priorities for psychologist practitioners
in private and public settings.
 Resources needed to address the
priorities effectively.
 Partnerships and roles to implement the
priorities.
“...the need for a cultural value of
“transparency” was identified…”
I want to summarize my major
impressions from the summit and how I
believe these themes will influence the
future practice of psychology and WSPA,
which is currently advancing its own threefive year strategic plan. Here are the five
primary themes that stood out to
me:
Changing demographics and
diversity issues
Our country’s ethnic diversity
will
continue
to
change
dramatically in the next several
decades.
All
health
care
professions
will
need
to
demonstrate
multicultural
competence; in fact there was
discussion during the summit to
make this part of psychologists’
CE law requirements. Our
current, non-integrated health
care system is designed to
Lucy Homans, EdD, Margy Heldring, PhD, Tim Popanz, PhD
“fail”—to
maintain
health
disparities, which are largely
about becoming a psychologist. What should based on socio-economic and racial/ ethnic
I tell her to do? Is the future of psychology status. Having psychologists participate
good?”
more within integrated health/ mental health
APA’s Presidential Summit on the Future delivery systems (e.g., public and
of Psychology Practice was held May 14 – community health, military, VA systems,
17th in San Antonio, Texas. The summit’s and prisons) was discussed as a way to
goal was to engage the broader practice address these health disparities.
psychology community in an agenda- and Creating health, not just health care
priority-setting meeting to inform the work
A systemic value shift toward defining
of the APA Practice Directorate and the health more broadly, including preventative
APA Practice Organization. A total of 150 care based on the determinants of health
Washington Psychologist — August 2009
rather than disease was
discussed at length. The
worsening health and health
habits of Americans was
explored as an example of the
inter-connectedness
of
“health” (e.g., moving to the
U.S. will negatively affect your
health within a generation).
Also, our mental health delivery
systems are extremely out of
balance, with almost all the
growth in mental health
spending
focused
on
psychopharmacology. In order
for gains in health to continue,
psychologists need to diversify
incentives---what is our “valueadded” to health outcomes? We
also have farmed-away most
mental health interventions to
general medicine and primary care
physicians.
Training for the marketplace
The “gaps” in the training of students and
early career psychologists were identified:
business of practice, technology, integrative/
community health/ preventative rather than
medical/ disease-model. In addition, the
management of chronic disease, which will
require more psychological practice in
primary care, hospital-based practice, and
Medicare was discussed. Changing the
psychology degree to a general degree, with
later specialization and the need for more
internship/ residency sites were specifics
addressed.
Changing scope of psychological practice
This was a large topic during the summit
with many themes emerging: advocacy and
public policy; creating working partnerships
with other sciences, associations, and
consumers and “branding” psychology as a
behavioral science focused on health,
nutrition, children’s health, productivity,
prevention, environmental public health, and
public safety. Although the flexibility of
being a psychologist as a profession was
stressed, the need for a cultural value of
“transparency” was identified. Psychology
has a perceived lack of value outside
traditional counseling. To improve our
implicit promise of quality-based results,
psychology practice needs to move away
from solo one-on-one interventions and
move toward collaboration, integration, and
social policy work. The need for national
Continued on page 10
3
Medicare Report Update &
APA Practice Summit Impressions
I
n the June, 2009 WP, I
printed an article about
Medicare. As a result (and
not surprisingly, given the
arcane nature of Medicare), there
have been a couple of areas of
confusion. The confusion centers
on the Medicare “opt out”
requirements and on non-covered
services. Here is the question
asked of me by one of our
WSPA members: “My reading of
Medicare regulations indicates
that we can bill the client for
excluded services if the client
agrees and signs an Advanced
Beneficiary Notice of
Noncoverage (ABN). This
disagrees with your (June WP)
article and the (APAIT) Trust’s recent notice
that we cannot bill for these services. Am I
misreading the regulation?”
According to Diane Pedulla, JD, the “goto” expert on Medicare at the APA Practice
Organization, the confusion exists because
of differences between Medicare’s general
rules, and Medicare’s exceptions. In the vast
majority of cases, psychologists who are
Medicare providers and who provide
Medicare covered services to Medicare
beneficiaries, must bill Medicare for those
services. However, some services that
psychologists might provide to Medicare
beneficiaries may be categorically excluded
from coverage by Medicare. That these
services are not covered at all by Medicare
does not prohibit a provider from providing
the service. The example given me by Ms.
Pedulla is cosmetic surgery. Medicare does
not pay for facelifts.
However, this does not
prevent a Medicare
beneficiary from arranging
to have one and to pay the
provider privately.
Please refer to Rule 40.19
in the Medicare Benefits
Policy Manual. Medicare’s
rules on claims filing and
on limits on charges do not
apply to categorically
excluded items or services.
Another exception is if
the service is not categorically excluded
from Medicare coverage, but which may be
noncovered in a specific case. One example
might be a situation where a service is
covered only when certain clinical criteria
4
are met and there is a question in the case as
to whether those criteria have been met. In
this case a Medicare provider is not relieved
of his/her requirement to file a claim with
Medicare. But, if the provider has given an
“Advance Beneficiary Notice (ABN)” to
Medicare, then the provider may collect the
full charge from the beneficiary if Medicare
denies the claim.
An ABN is defined in Rule 40.24 of the
Medicare Benefits Policy Manual. ABNs
allow beneficiaries to make appropriate
consumer decisions when they know in
advance that they may have to pay for a
service out of pocket. Again, ABNs are not
needed when a service is categorically
excluded from Medicare coverage. They
may be used when providers and/or
beneficiaries believe that Medicare
will not cover payment.
Finally, Ms. Pedulla describes
one more exception that does not
often occur. This is the situation
where a beneficiary refuses to
authorize a provider to submit claims to
Medicare. Ms. Pedulla has recommended
that in cases like this, psychologists should
contact Mr. Frederick Grabau at the Centers
for Medicare & Medicaid Services (CMS) in
Baltimore, MD for additional information.
His telephone number is 410-786-0206 and
his
email
address
is
[email protected].
Please
contact me by email if you have additional
questions about the information offered in
this article.
In May, WSPA President Tim Popanz,
PhD, WSPA member Doug Haldeman, PhD
and I had the opportunity to attend the APA
Summit on the Future of
Psychology in San
Antonio. Additionally,
one of the Summit cochairs was WSPA
member
Margy
Heldring, PhD. No
doubt the others will
provide their own
impressions of the
summit. Here are mine.
The two and one-half
day
summit was
structured with major
presentations followed by small group
discussions. The major presentations
provided a global focus, and the small
groups’ tasks were to take that global
information and apply it to psychology
specific issues. For example, Mr. Ian
Lucy A. Homans, EdD
Director of Professional Affairs
and Lobbyist Report
Morrison, a futurist, provided the global
perspective that we have quickly become a
global population that is predominately
young, and significantly split between rich
and poor. Additionally, (as you all know) as
a nation, Americans, for all we spend on
health care, are not healthy. We suffer from
the chronic diseases of obesity, diabetes,
hypertension, heart disease and cancer.
William Emmert, from the Campaign for
Mental Health Reform, argued that on
average, Americans suffering from mental
illnesses die 25 years younger than the
general population, in large part from the
chronic diseases listed above. Two statistics
of note: 25% of tobacco consumed by
Americans is consumed by the mentally ill;
one-third of the Native American population
“...some services...may be
categorically excluded ..”
dies before their 35th birthday. This suggests
(and was discussed at length in the small
groups) a significantly increased focus by
psychology on fuller integration of mental
health services with primary care services,
with publicly funded health clinics and on
access to treatment by diverse populations.
Other speakers argued that psychology
graduate programs must reconfigure to
address future requirements of practice. To
deliver appropriate and effective mental
health services, we must be a workforce of
practitioners who develop and use evidence
based treatment protocols who can work in a
variety of practice settings other than solo
practice, including primary care clinics, and
who will be able to prescribe. Ironically,
mental health services have never enjoyed
more visibility and less stigma than they do
now, and yet psychology may be unprepared
to take advantage of the opportunities
offered us now.
Please know that it is impossible to distill
all the information provided to us at the APA
summit into one short article. Summit
information was discussed at the WSPA
Council strategic planning retreat recently.
WSPA intends to incorporate what we have
learned into that plan, where appropriate,
and into our other regulatory and advocacy
efforts. Thank you.
Washington Psychologist — August 2009
Notes From the Social Issues Human
Rights Committee
Judy Weber, PhD &
Li Ravicz, PhD
Co-Chair, Social Issues &
Human Rights Committee
How can we promote our profession, gain greater visibility and
provide a vital public service at the same time?
Watch this space for details of plan that will focus on just those goals by
1) encouraging a culture of service while 2) recognizing and supporting
2) psychologists who give back to their community.
Judy Weber, PhD and Li Ravicz, PhD are the co-chairs of the SIHR committee. Other active members are Arthur Lewy, PhD
and Shelley Mackaman, PhD We are looking for additional members to join our committee. Please contact either
Li ([email protected]) or Judy ([email protected]) if you are interested in joining the committee.
Editor’s Note: In the June WP article, Developing A Culture of Service, this editor mistakenly excluded certain key players. The article was the result of the joint efforts of committee members Arthur Lewy, Tim Popanz, Li Ravicz, Shelley Mackaman, and Judy Weber.
I Have a Voice Samantha Slaughter, PsyD
T
he psychologist licensing laws are
changing on September 1, 2009.
Here is a brief summary of the
changes.
Currently, an applicant must have at least
300 hours of practicum experience with 100
hours of supervision. This must be followed
by a predoctoral internship of at least 1500
hours to be completed in 24 months (WAC
246-924-040) and then an additional 1500
hours in internship. Under these rules, some
students completed multiple practica or
extended their interships in order to meet the
minimum 3300 hours of supervised
experience for licensure.
Under the new requirements to be in effect
this upcoming September, an applicant must
still have 300 hours of practicum experience
and 1500 hours of intership. Yet, the new
laws dictate how the remaining 1500 hours
needed for licensure are to be achieved.
They must be obtained in one of the
following two ways, or a combination of the
two:
1. Complete a preinternship of up to 1500
hours between practicum and internship
(WAC 246-924-053)
2. Complete a postdoc of up to 1500 hours
after internship (WAC 246-924-059)
The changes in the laws mean that there
are many students currently in school who
are caught in the middle. They have
practicum hours that will no longer count
Washington Psychologist — August 2009
toward licensure, requiring them to either do
a postdoc, something they were not planning
on doing when they started school under the
current laws, or they have to stay in school
longer in order to be placed at a
preinternship site. Either way creates a huge
financial burden on students, many of whom
are already graduating with $150,000 to
$250,000 of debt.
As I was beginning my licensure process,
I was not sure if I would be caught by these
new laws. I met all the current state
requirements, but there was no guarantee
that I would be licensed by September 1. At
the same time I was applying for licensure, I
was approached by the trainees at the
Fremont Community Therapy Project
(FCTP), where I am the Assistant Director,
about the new licensure laws. Trainees at
Cancer Lifeline, where I am a Clinical
Program Manager, also expressed their
concerns to me about the new laws. Melanie
Mitchell, PsyD (a recent doctoral program
and FCTP graduate) and I decided to
approach Washington’s Examining Board of
Psychology and see what could be done to
help students caught in the transition from
old to new laws.
We met with the Examining Board twice.
At the meeting in March, Mark Calkins,
Assistant Attorney General, presented a
drafted statement to the Board stating that as
long as an application was pending, it would
fall under the current laws. As it turns out,
the Board had received several inquiries
about this portion of the law. While this
statement took care of people like me, it did
not address current students. Melanie and I
presented our case regarding current students
and discussed possible recommendations for
the Board. The Board members asked us to
come to the next meeting with specific
examples of students who were caught in the
gap and how the new laws would negatively
impact them.
These examples were not hard to find.
After compiling the stories from many
students, I sent the examples to the Board.
Melanie and I then attended the meeting in
May. We were allowed to sit in on the subcommittee work related to licensure laws.
We debated, asked and answered questions,
and discussed possible ways to remedy the
situation. In the end, Mr. Calkins helped the
Board draft two policy interpretations. The
first states that students who have practicum
hours that also meet the supervision and
education requirements for preinternship
may count these hours as preinternship
hours. The second states that students who
began doctoral programs prior to the 2007
academic year will be able to argue their
case before the Board to be excused from
preinternship or postdoctoral requirements
that did not exist at the time they
Continued on page 13
5
True Confessions of Your New ECP Co-Chair
A
Erik R. Jackson, PhD
Co-Chair, Early Career
Psychologist Committee
s an early career
Fortunately, the benefits of WSPA in- including the well-supported goal of having
psychologist transi- volvement for early career psychologists the unique views of an ECP voiced on every
tioning into a leader- was a germ first planted in my head by my committee. In turn, I was thrilled to have
ship position within internship training director at the Seattle VA seasoned members such as Andy Benjamin
WSPA (cannily, the co-chair of (I hope that many of you reading were also and Carla Bradshaw join the ECP committhe ECP committee), I wanted to informed to these benefits during your train- tee. In addition to addressing seminal issues
introduce myself by way of pro- ing, and, for supervisors reading, you know related our field’s identity, viability, and
viding some arguably navel- what to do!). Adding to this germ, I transi- integration into the 21st Century (and what
gazing background, but with the tioned from part-time employment as a reha- roles we wish to play in these transformalarger aim of illuminating some bilitation clinical psychologist into full-time tions), it was encouraging to find that my
themes (e.g., Values, Debt, Loss, employment as a private practitioner. I ECP-related concerns were not only respectRenewal!) that I’ve heard ech- joined a vibrant, community-oriented group fully heard, but also enthusiastically disoed from ECPs known to me practice that provided even more exposure cussed
For example, the goal of providing ECPs
both personally and profession- to the ways that I could re-engage with those
ally. Throughout my education – issues that actually have personal and pro- more affordable WSPA membership and
an eventual westward expansion fessional meanings. This exposure came attendance at conferences continues to be a
from my youth in the Deep from my co-workers who were members of commitment realized by the organization,
South to graduate school in St. WSPA, including both current and former echoing the obstacles outlined by previous
Louis and eventually to intern- leadership (i.e. our current President, Tim ECP sampling and what I’m hearing from
both member and non-member ECPs. I
ship at the Seattle VA and
am encouraged by the incorporation of
postdoctoral fellowship at the Univeradditional means to reduce the financial
sity of Washington – I fondly recall
“the otherwise appealing goal to “give
burden on ECPs by offering free Conthe process of discovering what I
back,” had somehow diminished”
tinuing Education credits via a number
found satisfying and meaningful to me
of programs (e.g., CEs in the WP, Chapas a trainee and nascent psychologist.
For me, my goals included broadening the Popanz). Witnessing the issues these com- ter events with topics relevant to ECPs), as
positive impact of our field into medical mitted individuals devote their energies to well as further consideration of reducing fees
populations and the often stigmatized and has helped renew my professional identity for students.
I hope that such exposure to the benefits
disenfranchised individuals with whom I and my optimism about our potential as
worked clinically. I envisioned future roles agents for change. While initially an inter- and community provided by WSPA may
in which I could act within a multi-faceted ested, but otherwise fairly, shall we say, inspire other ECPs to become more involved
professional identity, that of a clinician and “observational” member of WSPA, my in- and join us in the process of moving psyan a socially-conscious, legislatively- creased involvement as co-chair is proving chology toward directions that are meaninginformed advocate. Yet, somewhere along instrumental to how I think of myself as a ful to each of us. To facilitate mentorship for
ECPs with experienced psychologists, to
the line, these values admittedly ebbed away. psychologist and as a private practitioner.
Nowhere was this more evident for me provide opportunities for ECPs to easily
To be honest, it seemed as if my professional
identity was in danger of being bound by the than at the Council Retreat this Spring, after develop professional presentation skills by
job description of whatever position was accepting the warm invitation to co-chair the pairing with engaging members of the Public
paying the rent. How did this happen? While ECP committee. Despite the encouragement Education committee, to provide internet
I could go on to disclose the likely precipi- and support provided by several WSPA access to useful practice materials – these are
tating role of my own neuroses in this pre- Council members, including my co-chair among the several goals that our committee
dicament, I’ll preserve some privacy and Dawnn McWatters and car-pool mate/ hopes to offer early career psychologists, and
proceed to what I think is a more common cheerleader Stacey Prince, I must admit that I am pleased to be a part of it. I welcome you
dilemma, particularly for ECPs.
upon arriving at the retreat, my inner dia- to share your thoughts and needs with the
Now I’m sure this will be scandalously logue closely resembled the following: Are ECP committee and myself (or even conshocking for some, but, for me, somewhere my perspectives new, or even relevant? sider joining the committee) to address your
between navigating graduate school, practica How can I possibly represent the needs of needs and, possibly, like me, even re(i.e., low-paying employment), and the, um, such a diverse group? Does the future of this invigorate your own professional identities.
“invigorating” APPIC match process, incur- organization rest on my shoulders (which,
ring moving expenses and student loan debt, strangely enough, were not bequeathed with
completing the pre-doctoral internship, tran- inter-ECP telepathy upon my acceptance of
sitioning to post-doctoral work (not to men- the co-chair position)? Will coffee be
tion the time and cost of the licensure proc- served?
Fortunately, these mental imps were
ess) and securing a steady income, the notion
of voluntarily exerting energy to the other- quickly cast-out as it became evident that
wise appealing goal to “give back,” had the needs and interests of Early Career Psysomehow diminished, despite my ideals. chologists did not actually end at my comDoes this dilemma resonate with any ECPs mittee’s door; they have, in fact, grown even
out there?
more central in the organization’s focus,
6
Washington Psychologist — August 2009
Chapter 1 Honored With Presidential Citation—May 2, 2009
Presidential Citation
Washington State Psychological Association
tion of our Early Career
Psychologist Project; and
Whereas Chapter 1 consistently participates in association governance statewide and develops strong
leaders in positions such
as President and Chairs of
Whereas Chapter 1 models excellence by Ethics & Leadership Deeducating its members on clinical skills, velopment;
practice management, ethics, and diversity;
Chapter 1 is hereby
and
awarded this Presidential
Whereas Chapter 1 serves as a role model Citation of Excellence.
for the entire association through its chapter
practices which were a model for the creaWhereas Chapter 1 of the Washington State
Psychological Association demonstrates
innovation through community-building,
creative programming, and collaboration;
and
Beth Fitterer, PhD, Chapter 1 President-Elect, Carol Moore, PhD,
Chapter 1 President, Tim Popanz, PhD
Psychopharmacology Update Bob Grubbs, PhD
At the recent Tri-State Psychological Convention, Dr. John Courtney, PsyD, MP, gave
a presentation on psychopharmacological
drugs that have been approved over the past
2-3 years by the FDA. With one or two exceptions, these “new” drugs represent reformulations of existing drugs designed to address a problem or shortcoming of the “old”
drug. For example, abuse of psychostimulants prescribed for treating ADHD is a welldocumented issue. Vyvanse, which is dextroamphetamine combined chemically with the
amino acid lysine was designed to address
this problem. It is a pro-drug – inactive as
taken – that requires the action of an enzyme
in the GI tract to cleave the lysine from the
amphetamine to activate it. Any attempt to
abuse this drug – by smoking or injecting it –
will produce no effect since the activating
enzyme is not present in the blood. On the
other hand, ProCentra, which was approved
for use just this year, offers only one advantage over other forms of dextroamphetamine
on the market: it tastes like bubble-gum.
One of the more controversial new drugs
now in wide-spread use to aid with smoking
cessation is Chantix (varenicline). This drug
is a partial agonist for nicotine receptors,
which means that it produces a weak activation of the receptor (not enough to produce
the nicotine “high”) and so avoids triggering
the craving mechanism that commonly accompanies abstinence. Unfortunately, there
are now many reports of mood instability
and depression associated with the use of
this drug in some individuals. Because of the
severity of these adverse responses, there is
now talk of pulling this drug from the marWashington Psychologist — August 2009
ket.
The
introduction
of
Pristiq
(desvenlafaxine) provides an interesting
example of the contribution of genetics/
ethnic heritage in determining the response
to a drug. Pristiq is a metabolite of Effexor
(venlafaxine), meaning that in most people,
an enzyme converts venlafaxine into desvenlafaxine. The activity of this enzyme is
inhibited by a variety of other drugs and is
also defective in many people as the result
of inherited genetic mutations. People of
Asian and African heritage carry the highest
risk of having mutations that cause this enzyme to be ineffective. The bottom line is
that, together, these factors have contributed
to difficulties in dosing and achieving predictable results with Effexor. While Effexor
and Pristiq are both equally effective at inhibiting serotonin reuptake, Pristiq is better
than Effexor at inhibiting norepinephrine
reuptake. Whether this difference will translate into better efficacy in treating depression remains to be seen.
Another new drug that is the metabolite of
a well-known antipsychotic agent is Invega
(paliperidone). There is little pharmacological difference between Invega and its parent
drug, risperidone (Risperdal). Both are
classed as atypical antipsychotics and share
the same benefits and risks of other drugs in
this class: They should not be used to treat
dementia-related psychosis and they have a
propensity to induce weight-gain and hyperglycemia in addition to the usual spectrum
extrapyramidal side effects common to most
antipsychotics.
Stavzor (valproic acid delayed release)
and Aplenzin (bupropion hydrobromide) are
both essentially “old wine in new bottles.”
Valproic acid (Depakote, Divalproex sodium, Depakene) often produces nausea and
vomiting; Stavzor is a delayed-release formulation that makes use of an acid-resistant,
soft-gelatin capsule that reduces the occurrence of these GI effects. With Aplenzin,
Bupropion (Wellbutrin, Zyban) is formulated
as the hydrobromide salt instead of hydrochloride to take advantage of the known antiepileptic activity of bromide salts to address
the tendency of bupropion to produce seizures.
Finally, we come to Nuvigil (armodafanil),
a refined version of Provigil (modafanil),
which is classed as a CNS stimulant, although its mechanism of action is unclear
and differs somewhat from that of amphetamine. Many drugs, including amphetamine,
citalopram, and modafanil, possess a structural feature that makes it possible to form
mirror-image molecules during their synthesis. Usually, the pharmacological activity of
one form is much stronger/better than for the
mixture. This seems to be the case with Celexa (citalopram – the mixture) versus
Lexapro (escitalopram). For Nuvigil, however, the only relevant pharmacological difference between it and Provigil is that it lasts
longer so that dosing will be less frequent. It
is FDA approved for the treatment of narcolepsy, shift work sleep disorder, and obstructive sleep apnea/hypopnea syndrome, but as
with Provigil, there are likely to be many
off-label uses.
Continued on page 13
7
Insurance Companies, Regulators, Compliance…
There is Something You Can Do!
Sunday, August 23, 2009, 6:00-9:00 PM
Four Seas Restaurant, 714 S King St, Seattle, WA 98104
This is a specially developed WSPA program/dinner event scheduled as a result of yet further recent reductions in reimbursement rates for psychologists. Its purpose is to provide some expert knowledge and advice on how you can deal more effectively, legally, and ethically with insurers and
regulators. Please join us for this special Sunday evening dinner event. Group practices are especially encouraged to be well represented.
Program Description ( includes dinner and 2– hour program- up to 2 CE applied for. Note: subject mater may preclude CE being offered)
Have more time for patients. Improve patient outcomes. Lower your risks. Make your practice even more successful. In this fast-paced seminar led
by industry experts, you get the tools and training you need to deal more effectively with insurance companies and regulators. You will learn how
to negotiate with insurance companies and improve your contracts, benefit your practice and stay in compliance.
Jeff Coopersmith is president of Coopersmith Health Law Group and
the former Chief Counsel and Director of Enforcement at the Washington
State Office of the Insurance Commissioner. As Chief Counsel, Jeff created the first systematic prosecution of the insurance industry in state
history. He won record fines and refunds, and forced insurers to change
their business practices to benefit physicians and patients. In Congress,
Jeff was in charge of health-care issues for a Member of Congress during
a major overhaul of the Medicare system.
Jeff speaks widely about how medical practices and hospitals can improve
profitability, reduce the many risks associated with non-compliance, and
develop positive working relationships with insurance companies and
regulators. He is a board member of the Washington Health Foundation
and was recently profiled in the 2009 annual health law edition of the
King County Bar News. Jeff was named as a SuperLawyer by Washington Law & Politics in 2008 and 2009.
Dwight Johnson is the Director of Provider Contracting at Coopersmith Health Law Group. Dwight has an extensive background in
provider contracting. His experience includes six years as the Assistant Director of Provider Contracting at Regence BlueShield, where
he was responsible for all provider contracting, and five years with
Premera BlueCross where he was responsible for all hospital and
ancillary contracting in Washington and Alaska. In addition to his
extensive experience on the payer side, Mr. Johnson also worked for
many years on the provider side.
Dwight applies his broad knowledge of healthcare contracting in his
work, which includes provider-payer negotiations, contract review,
fee schedule analysis and development, claims process examination,
discussions with brokers and work with regulatory agencies. The
goal of his efforts is to create resolution out of conflict, allowing
providers and payers to come together in delivering care to the mutual clients they serve
Free Parking Available!
For registration or more information including learning objectives, please visit our website at http://www.wapsych.org
Insurance Companies, Regulators, Compliance…There is Something You Can Do!
(up to 2 CE applied for. Note: Subject mater may preclude CE being offered)
Please register online at www.wapsych.org if possible. Registration form and payment must be received in the office one week before
the program date to qualify for early rate. Cancellations may be made two weeks prior to the event.
Vegetarian Meal
Yes
No
Name:
Address:
Registration Fees
(Payment must be received in the WSPA office by August 19th, 2009)
Members
Non-Members
Student Members
$75
$125
$50
TOTAL ENCLOSED: Check#:
Please make checks payable to WSPA
City/State/Zip:
Credit Card Type:
Telephone/Fax:
Email:
Please mail registration and payment to:
WSPA Business Office
711 N 35th St, Suite 206
Seattle, WA 98103
Or Fax: (206) 547-6366
(Required)
Card Number:
Expiration:
Signature:
Name on Card:
Billing Address:
Note Re: Continuing Education Credits- The Washington State Psychological Association (WSPA) is approved by the American Psychological Association to sponsor Continuing Education for psychologists. Workshops offered by WSPA are recognized continuing educational activities under the rules adopted by the Washington State Examining Board of Psychology and the Licensed Counselors
Advisory Committee. WSPA maintains responsibility for the programs. Any comments, concerns, or complaints should be directed to Doug Wear, PhD, Executive Director, at the WSPA Office. Important
Notice: Only those who attend the workshops and complete the evaluation forms will receive continuing education credits. Please note that APA CE rules require that we only give credit to those who
attend entire workshops.
8
Washington Psychologist — March 2009
Jessica Henderson Daniels, PhD, ABPP
Jessica Henderson
Daniels, PhD, ABPP
is Director of Training in Psychology in
the Department of
Psychiatry and Associate Director for
LEAH (Leadership
Education in Adolescent Health) Training
Program in the Division of Adolescent Medicine, both at Children's
Hospital Boston. An Associate Professor of
Psychology in the Department of Psychiatry at
Harvard Medical School, she is also Adjunct
Associate Professor in the Clinical Psychology
Program at Boston University. Her 32 years in
the Department of Psychiatry and 17 years in
the Division of Adolescent Medicine will provide the background for her presentations.
Christopher Martel, PhD, ABPP
Christopher R.
Martell, Ph.D.,
ABPP is an
independent
practitioner and
Clinical Associate Professor in
the Department
of Psychiatry
and Behavioral
Sciences and in
the Department of Psychology at the
University of Washington. He has coauthored several books and numerous
peer reviewed articles and chapters on
behavioral treatment for depression and is
an international workshop leader and
speaker.
WATCH YOUR MAIL FOR THE FALL CONVENTION BROCHURE
For more information or to register, go to www.wapsych.org after Aug 15.
Jeffrey N. Younggren, Ph.D., ABPP
A Fellow of the American
Psychological Association
and a Distinguished Member of the National Academy of Practice, Dr.
Younggren is a clinical
and forensic psychologist
who practices in Rolling
Hills Estates, California.
He is also an associate
clinical professor at the
University of California,
Los Angeles, School of Medicine. Dr. Younggren
served as a member and chair of the Ethics Committees of the California Psychological Association and
the American Psychological Association. He consults to various licensing boards on ethics and standards of care, and he qualifies as an expert in criminal, civil and administrative proceedings. Dr.
Younggren testified regarding the fallibility of memory secondary to trauma and post traumatic stress
disorder before the United Nations Bosnian War
Crimes Tribunal in the Hague.
WORKSHOPS
All CE’s are applied for.
FRIDAY
Keynote: The Psychologist in Primary Health
-The Wellness Workbook: CBT for Chronic
Settings: Partners in Pediatric and Adolescent Low Back Pain Kelly Carpenter, PhD & Tamara
Medicine, Jessica Henderson Daniels, PhD,
Altman, PhD - 3.0 hours.
ABPP – 3.0 hours
Sports Concussion in Youth: Current Issues,
Keynote: Adolescent Cultures and Psychologi- Management, Return to Play Decisions, and
Prevention, Mark Mariani, M.D – 1.5 hours
cal Practice: Vernacular and Classical Cultures in Perspective, Jessica Henderson Daniel,
PhD, ABPP – 3.0 hours
Pediatric Psychopharmacology - John Holttum,
MD – 1.5 hours
Working with Dying: Practical, Clinical &
Medical Considerations in End-of-Life Care.
SATURDAY
Renee Katz, PhD, G. Andrew Benjamin, JD,
PhD, Judith Gordon, PhD - 3.0 hours
Morning Keynote:
Behavioral Activation for Depression: A
Treatment Who’s Time Has Come, Again,
The Technology of Psychology:
Christopher Martel, PhD, ABPP – 1.5 hours
-Using web-based CBT to supplement
face-to-face therapy for PTSD, Tamara
Altman, PhD & Kelly Carpenter, PhD
Psycho-education 101 for Parents of
-Coping with Breast Cancer: Delivering an Teens: Adolescent brain research, problemsolving with classic developmental issues and
empirically supported group intervention on
the web Brenda Stoelb, PhD & Kelly Carpenter, emotional regulation, Laura Kastner, PhD - 3.0
hour
PhD
BA Principles, Techniques and Competence,
Christopher Martel, PhD, ABPP – 3.0 hours Multiple perspectives of PTSD treatment with
ethnic minority populations and how our
practices may be enhanced by knowing how
healing is done in war torn communities
around the world, Carla Bradshaw, PhD & John
Van Eenwyk, PhD—1.5 hours
Heather Carmichael Olson, PhD – 3.0 hours
Losing Our Minds: Americans Failed Medical
Model of Psychotherapy , Peter Hunsberger,
PhD – 1.5 hours
SUNDAY
APAIT Risk Management Workshop – 6.0
hours
*This event is pending approval by the Washington State Psychological Association (WSPA). WSPA is approved by the American Psychological Association to sponsor Continuing Education for psychologists. Workshops offered
by WSPA are recognized continuing educational activities under the rules adopted by the Washington State Examining Board of Psychology and the Licensed Counselors Advisory Committee. WSPA maintains responsibility for this
program and its content. Any comments, concerns, or complaints should be directed to Doug Wear, PhD, Executive Director, at the WSPA Office, (206) 547-4220. Important Notice: Please note that APA CE rules require that we
only give credit to those who attend entire workshops. Those arriving more than 15 minutes after the scheduled start time or leaving before the workshop is completed will not receive CE credit. For more information,
please call the WSPA Office at (206) 547-4220.
Washington Psychologist — March 2009
9
WSPA Spring Retreat Lynnette Lewis
The setting was beautiful. The Alta Vista and distributed and answers collected from a
Resort can be found in the national forest at variety of sources. What is important to
Mt. Rainier and is nestled among beautiful Washington psychologists? Where should
trees next to a lively creek. It began as a the WSPA concentrate its energy and rerecreation lodge in the 1920s and now boasts sources?
cabin-like suites with fireplaces and kitchDuring this weekend the council took
ens. The weather was perfect. The morning those answers and turned them into topics
air was crisp and the
with
key
afternoon sun warm.
points
and
It’s the perfect place to
action items
get away from it all
that will be
and play in nature. But
used to create
the hardworking mema 3-5 year
bers of the WSPA
strategic plan.
council were not there
While
it
to relax. There was a
seemed to me
lot of work awaiting
a
daunting
Small-groups work: Shannon Ledesma Jones, PhD,
them. And they were
task,
we were
Carla Bradshaw, PhD, John Moritsugu, PhD,
more than up to the
very fortunate
Sally Wing, PhD, Jane Harmon Jacobs, PhD
challenge.
to have a
This was my first council retreat and I was- process called Open Space. Open Space
n’t sure what to expect. What does one do on provided enough structure to keep everyone
a council retreat? People were arriving from on task while at the same time providing the
all over the state. Some had started driving flexibility to allow the individual members
before dawn. There was an air of anticipa- to work in the areas they were most passiontion and excitement. Old friends greeted one ate about. Working in small groups, everyanother. Some people have been attending one had the opportunity to really express
these retreats for years. New attendees were what was important to them. The result was
eagerly welcomed. There was a real sense of seen not only in the body of work they creexcitement about the beautiful setting, the ated but also on the faces of the members at
work to be done, and the chance to get to- the end of the retreat. Everyone had a
gether.
chance to share their experience of the procOne of the first tasks the council was given ess and the comments were universally posiwas to create a vision statement for the tive.
It was inspiring to be with a group of
people who clearly care so deeply about
both their professions and the work of the
organization. More than once, when given
the option to leave something for another
day or another committee, the group chose
to stay and finish what they had started. I
felt a real sense of energy and purpose in
the room. And when there was down time,
the council members made good use of it
to enjoy the beautiful setting, catching up
with old friends and making new ones.
I remember at one point in the process
Full council strategic planning
just looking around at all of the passionate
WSPA. There were so many ideas about dedicated people and thinking that it felt like
what should be included. This is one of the having a family in my profession. I am a
times when the group showed how well it relative newcomer to psychology, just finworks together to compromise and find the ishing up my 3rd year of grad school. I am
common elements. The result was a state- also new to Washington, having moved here
ment that seemed to satisfy and inspire eve- 3 weeks before my first classes started. I
ryone in the room. So far so good!
attended my first WSPA convention during
The main objective of this particular retreat my first year of school and became a comwas to work on a strategic plan. The strategic mittee member in my 2nd. I’ve always felt
planning work group (which I am proud to that being involved in my professional orbe a part of) had been working hard to pre- ganization was an important part of being a
pare for this retreat. Surveys were designed professional. So finding that my profes10
sional organization feels like a family is
quite special to
me. I am both
excited and humbled to be a part
of a group that
cares so deeply
and works so
well together.
A
special
thanks to the
retreat’s strategic
planning
facilitator, Ryan
Kellogg
([email protected]), a Seattle-based
consultant who works with nonprofits and
government agencies on organizational development, strategic planning and process
facilitation.
“Future” continued from page 3
licensure was one specific change discussed
to address these needs.
Economic and health reform issues
Our economic and health reform issues are
explicitly interwoven, since U.S. health care
costs are such a large part of our overall
expenditures. “Out of balance” economics
was one major theme during the summit—
that costs and savings for health care are
accrued in different places and that nonintegration is rewarded. This coupled with
the fact that most “mental health” will be
paid for by the government through
Medicare/ Medicaid, creates the need for
psychologists to focus on pay for
performance or creating effectiveness and
measurement data—how do we make
people’s lives measurable better? This
“value added” thinking in health care will
determine how and where psychologists
practice and reimbursement rates. We may
also need to create a new set of practice
guidelines not based on the medical DSM. In
general, psychologists need to define the
work that needs to be done legislatively,
partner and join coalitions and work
collectively on health care reform.
Now, to get back to the father standing
next to me in the elevator, “should my
daughter become a psychologist?”
“Yes,” I answered after a thoughtful pause.
“The future of psychology is a good one.
Tell your daughter, yes.”
Washington Psychologist — August 2009
Youth Suicide: Statistics and Strategies
Sue Eastgard, MSW, Executive Director, Youth Suicide Prevention Program
The latest data indicates that far too many
are dying. Between 2003 and 2007, 539
Washington State children, teens and young
adults between the ages of 10 and 24 ended
their lives by suicide. This translates to an
average of two youth suicides each week in
our state. And this only reflects those deaths
that the county medical examiner or coroner
could substantiate as a suicide. What about
the child who was playing the “choking
game” alone with a belt in his closet or the
adolescent whose car slammed into a tree,
without any evidence of attempting to stop??
The latest data also tells us that too many
teens are unhappy and don’t feel as though
they have adults who they can turn to. From
the Healthy Youth Survey that is conducted
every two years in voluntary public schools
across the state, we learned that 1/3 of Washington State 10th graders reported feeling so
sad or hopeless almost every day for two
weeks or more that it effected their “usual”
activities. Nearly 30% of 10th graders reported that they did not have (or they weren’t sure) that they have adults to turn to for
help when feeling sad or hopeless.
We understand that these factors contribute
to suicidal behavior:
 Loneliness, social isolation, emptiness,
invisibility, and/or a lack of connection
 Negative feelings, including despair,
depression, hopelessness and desperation
 The desire to escape an unbearable
situation or state of mind
 Either a lack of control or an attempt to
gain control over one aspect of their life
 Interpersonal conflicts or problems with
significant others or caregivers
 Dislike or a disgust with oneself; low
self-esteem; not believing that one is
worthy of being loved, valued or cared
for
And we understand that there are protective factors that can increase support for
young people and reduce their risk for suicide, such as:
 Safe and welcoming school environments
 Family love and acceptance
 Individual coping and social skills, like
emotion regulation and distress tolerance
 Positive peer relationships
 A sense of purpose
 Being affirmed as a worthwhile person
 Ability to connect with others
The Youth Suicide Prevention Program of
Washington State (www.yspp.org) began in
1995 in response to a suicide of a young
man who was living in south Snohomish
County. He was bright, popular, and athletic, and according to his parents, had no
obvious reason to be depressed. Trevor hung
himself with the jumper cables from the
trunk of his car and we will honestly never
know exactly why he ended his life. When
we look back and dissect the last days of his
life, we can see some warning signs. Trevor
reportedly gave a friend his favorite baseball
cap and indicated that he didn’t need it. He
asked another friend, “If you were going to
kill yourself, how would you do it?” He sat
sullenly in the family kitchen – partially
hidden under a hooded sweatshirt – annoying his mother with his lack of communication. But there were no calls from the school
counselor or any of Trevor’s teachers or his
football coach suggesting that there were
problems or reason for concern.
His parents, Scot and Leah, did not attend
a bereavement support group or talk with a
counselor; instead they engaged in
“involvement therapy” trying to convince
the Legislature to require public schools to
include content in their health curricula on
mental illness, depression and suicide prevention. While this specific effort was not
successful, they were able to secure funds
for the development of a youth suicide prevention plan. The University of Washington’s School of Nursing took the lead on
writing the plan and it has been the “map”
for the state’s suicide prevention efforts ever
since.
Our objectives are to build public awareness about the issue, to offer professional
training and to support communities taking
action. We believe that we need to train
“gatekeepers” – adults working on the front
lines with youth – to recognize depression
and suicidal behaviors and intervene. We
believe that we need to recruit young people
into our prevention efforts because youth
will more likely reach out to their peers before talking with an adult. We believe that
schools and communities need to get involved in prevention BEFORE a young person takes his/her life.
But the sad statistics tell us that we still
have plenty of work to do. We need more
champions for this cause – more people
speaking out and advocating for resources,
curricula, and training. Trevor may never
have asked for help directly, but what if his
parents and friends had known the warning
signs and known what to do – maybe he
would be alive today.
Member Happenings
Please send relevant “Member Happenings” info to [email protected]
Executive Board and Council Nominations 2009
Executive Board and Council Nominations 2009
WSPA Leadership Nominations Due September 15, 2009
Nominations may be submitted for the following open positions on the Executive Board and Council of Representatives for WSPA.
Any full member in good standing may be nominated. The deadline is September 15, 2009.
Vice-President (ascension to Presidency 2012)
Member-at-Large (two year term)
Consulting Psychologists (two year term)
Private Agency Work Setting (two year term)
Secretary (two year term)
Student Representative (two year term)
Public Agency Work Setting (two year term)
School Psychologists (two year term)
Please send nominations or requests for additional information to Past President Alex Suarez, Ph.D. at
[email protected] or via regular mail to: Alex Suarez, 2326 6th Ave, Seattle Wa 98121
Washington Psychologist — August 2009
11
12
Washington Psychologist — August 2009
TRAINING
TRAINING &
& CE
CE
POSITIONS
OFFICE
OFFICESPACE
SPACE
University of Washington Professional and
Continuing Education
Consultant Position, 1 Day Per Week,
Flexible. We have openings in Skilled
Nursing & Rehabilitation Centers in Shelton,
Stanwood, Poulsbo, Everett, Marysville and
other locations. Assessment, brief therapy
and behavior management with older
population.
Consultation
with
multidisciplinary team for psychological
issues impacting care. Training, materials,
and clinical support provided. Insurance
billing provided. Our ARNPs provide
medication management. Please call The
Lantern Group at (206) 526-8376 for more
information.
Seattle Office Space. 2
Peaceful spaces in Seattle for
psychotherapy
or
bodywork:144 sq ft or 350 sq
ft, furnished, waiting room,
access to kitchen, phone,
access to bathroom, utilities
included, easy street
parking.$130mo or $190mo for
1 day per wk. Open to neg. 2-6
days per wk. 206-527-0908.
Earn a certificate in Psychological Trauma,
Geriatric Mental Health, and more. Learn
from leading clinicians and researchers and
earn CEUs. Psych. Trauma courses are
conveniently offered in an online + classroom combined format. For more information, visit www.extension.washington.edu.
MEMBER HAPPENING
Laura Kastner
For thirty
y e a r s ,
Laura Kastner
has
been treating families
with teenagers and
teaching,
training,
and writing
about them.
Her most
r e c e n t
book, coauthored
with writer
J e n n y
Wyatt, was published in June by ParentMap
and is entitled, Getting to Calm: Coolheaded strategies for parenting tweens and
teens. Since hormonal changes and the remodeling of the prefrontal cortex render
most teens moody, emotionally reactive and
impulsive, it has become more explicitly
clear that parents need to be the ones to take
the lead on keeping interactions calm enough
for useful problem-solving. Laura’s mission
is to help parents understand their teens from
a developmental and brain science perspective so that they can become “cool-headed”
and choose more effective approaches for
handling typical challenges like defiance,
rule-breaking, school problems and substance use.
Kastner has given hundreds of presentations on adolescence in public lectures in the
community and in her teaching capacity at
University of Washington, where she is a
clinical associate professor in both psychology and psychiatry and behavioral sciences.
She sees a direct link between her theoretical
orientation, which emphasizes family systems, developmental psychology, attachment
theory and community psychology, and her
training at University of Virginia. Wanting to
get evidence-based and relevant information
into the hands of parents, her other two
books were also focused on family interactions, practical ways to solve typical problems and the importance of a securely attached parent-child relationship (The Seven
Year Stretch: How families work together to
grow through adolescence; The Launching
Years: Parenting strategies from senior year
to college life).
“Update” continued from page 7
For more detailed information about these
and other medications, I recommend several
websites:
www.rxlist.com,
www.epocrates.com, www.drugs.com, are
relatively user friendly and provide comprehensive information, including drug interaction and adverse effects data. For anecdotal
accounts of client experience with specific
medications, there are online forums, such as
Washington Psychologist — August 2009
www.depressionforums.org, that provide
potentially useful information on the spectrum of effects produced by psychopharmacological drugs. Finally, as Dr. Courtney
reminded us, no matter what the pharmaceutical industry comes up with next, it will
never replace the need for psychotherapy.
“Voice” continued from page 5
commenced their training. Their applications
will initially be denied because they will not
meet the new requirements, but they can
request a Brief Adjudicative Proceeding
during which they would present evidence to
the Board as to why they should fall under
the current laws instead of the new ones.
There is no guarantee the Board will approve
the application, but the opportunity is there.
Details on these policy interpretations can be
found
at
http://www.doh.wa.gov/hsqa/
Professions/psychology/default.htm.
It
should be noted that these policy
interpretations are drafts only; they must be
signed by the Secretary of State. However,
the Board does not foresee any reason why
they would not be signed.
That is the nuts and bolts of the new laws
and how they affect current doctoral
psychology students. This process was an
amazing and enriching experience. It is really
easy to vilify those in charge and assume that
they do not care about what happens, that
maybe they are writing laws and making
changes without thinking about the
outcomes. I have to say that this is NOT the
case with the Washington Examining Board
of Psychology. Melanie and I found all the
members willing to hear our side of the story.
They were open and welcomed our input.
This experience has taught me that I do
indeed have a voice in what happens in my
chosen profession. I could have fretted and
complained about the changes, but instead I
chose to talk to those involved and see if I
could help make some changes. This
experience has empowered me. I intend to
continue being involved in WSPA and APA
in whatever ways I can. I know I can make a
difference. Any questions? I can be reached
at [email protected].
13
ETHICS CONSULTATION LINE
Diane DeWitt, PhD
206-920-6006
Paul Daley, PhD
360-452-4345
Pamela Ridgway, PhD 509-353-9885
Jan Tackett, PhD
206-764-2823
Aaron Turner, PhD
206-277-6134
When leaving a voicemail message, please
give several times and dates when you can
be reached directly for a return call.
Psychologists’ Support
Program
New in Washington?
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Trying to balance career and family?
Call us for a mentor.
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(253) 752-2795
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(425) 646-2444
Andy Benjamin, JD, PhD Anne Purcell, PhD
(206) 328-8409
(425) 917-1542
LOW-COST REFERRALS FOR THE PUBLIC
Antioch Community Counseling
and Psychology Clinic
2326 Sixth Avenue, Seattle
206-268-4840
Therapy: Yes
Evaluations: Yes
Sliding scale, master’s and doctoral
student therapists
City University Counseling Center
11900 N.E. First Street, Bellevue
425-709-5333
Therapy: Yes
Evaluations: No
Sliding scale, master’s student
therapists
The Psychotherapy Cooperative
2711 E. Madison, Seattle
206-320-7988
Therapy: Yes
Evaluations: No
Sliding scale, volunteer therapists,
no crisis/CD/history of hospitalizations
Pat Cole, PhD
(509) 963-1391
Sally Wing, PhD
(425) 747-5924
Argosy Psychology Center
2601-A Elliott Avenue, Seattle
206-393-3605
Therapy: Yes
Evaluations: Yes
Sliding scale, master’s and doctoral
student therapists
Fremont Community Therapy
Project
3417 Fremont Avenue N, Seattle
206-633-2405
Therapy: Yes
Evaluations: Yes
Sliding scale, doctoral practicum/
intern therapists, no crisis
Please contribute to this important
referral resource list for psychologists by informing us of additional
non-profit (non-agency) sites offering low-cost therapy and/or evaluations. We are looking for sites
throughout WA state. You can send
site information to
[email protected].
“Anxiety Thursdays”
Disorder-Specific Support Groups. On-going monthly
groups for patients in cognitive behavior therapy for OCD,
Social Phobia, Panic Disorder, and
Trichotillomania.
$50/session or $200/six sessions.
David J. Kosins, PhD, Certified Cognitive Therapist and
UW Depts. of Psychology and Psychiatry Clinical Instructor, with 19 years experience conducting CBT groups for
anxiety disorders. Contact David J. Kosins at (206) 2850900 or [email protected].
14
Washington Psychologist — August 2009
Help us celebrate
A Primer for Parents: Teen Brain Changes,
your accomplishNormative Developmental Challenges and
Laura Kastner, Ph.D. ments too…send
Emotional Regulation
Most of us who see adolescents and their hormones and the teen’s super-sensitivity to
families in our practices want parents to have dopamine, a lot of extra fuel can be added to
skills and knowledge about adolescent the fire of teen emotions. The dominance of
development for handling the normal neuronal activity in the emotional region of
challenges of the teen years. Sure, we can the brain during high arousal situations has
provide parent counseling as part of our been called an “amygdala hijack.”
Neuroscience research helps explain why
treatment. But there is virtually always a
time crunch for addressing all of our agenda really good teens can still seem rather
(and
theirs),
isn’t
t h e r e ? brainless on a random Saturday night. When
My co-author, Jennifer Wyatt, and I wrote a teen forgets to call home, jumps into a
this book for parents to help them friend’s car with a six pack, gets a tattoo
w i t h o u t
understand:
permission, or
developmental
“...a teen forgets to call home, jumps runs out the door
issues
of
into a friend’s car with a six pack...”
when the parent
adolescence;
says “no” to
new
brain
something,
it
s c i e n c e
research which relates to teen moodiness, helps to know about the “amygdala” hijack.
emotional reactivity and risk-taking; It doesn’t excuse, but it does help to explain.
management approaches for 14 of the It also helps parents understand why they
biggest hot-button issues; and the critical need to “get to calm” and cool down their
importance of the parent-teen relationship. own emotions, so that they can access their
We titled our book Getting to Calm thinking brains and choose productive ways
because we wanted to underscore the role of to approach and manage their teen.
Melt downs happen in perfectly ordinary
emotions in relationships. Neurobiological
research helps us understand teen behavior, families who lack mental disorders or
and it also helps us understand why loving significant psychosocial stressors. Add a
family members can have their buttons few risk factors, and the probability
pushed and interact in harmful ways. increases that there will be emotional
Around the age of 13 and the beginning of dysregulation, communication problems,
puberty, the structural remodeling of the and more complicated teen difficulties.
prefrontal cortex in the teen brain begins. Parents will need even more support for
The prefrontal cortex helps make possible their own emotional self control and shrewd
the executive functioning skills of planning, choice of parenting strategies. But even in
reasoning, impulse control and weighing normal circumstances, most parents need
risks and rewards. In a process called more skills for coping with teen challenges
pruning, up to 40% of the neural branches than they had ever imagined.
In Getting to Calm, we cite the great
are sloughed off in this region. Despite the
elegant brain growth that occurs during the psychologists’ shoulders we stand on when
next decade (thanks to environmental we emphasize the importance of emotional
experience and the wiring of neurons over regulation—Gottman, Goleman, Seligman,
time), the brutal truth is that until maturation and many others. Psychologist readers will
is complete in the early twenties, cognition recognize principles of cognitive,
and decision making are compromised by behavioral, and family systems therapy
this construction project. Furthermore, the wending their way through our practical
role of emotions becomes critical in the recommendations for handling the tough
understanding of teen behavior, since situations that parents face like sexuality,
emotions often trump cognition in any of substance use, rudeness, and disappointing
us—and even more so for teens. grades. One of the most unique ways we
In all humans, the limbic area, and make our points is by providing parent-child
specifically the amygdala, is activated by scripts, with “process” notes in the side
highly arousing emotional events that trigger margin. Readers can see how the thoughts
fear and anxiety. Emotional flooding and and emotions of parents drive what they say
“fight and flight” reactions can happen even and do, thereby influencing the outcome of
more readily for teens, because they lack the an interaction. This teaching method was
established inhibitory mechanisms which used in our two other parenting books (The
help reign in impulses. Along with sexual Seven Year Stretch: How families work
Washington Psychologist — March 2009
us an article about
what you are doing!
Doug Wear, PhD
Executive Director
Laura Kastner has recently written a book and shares the adjacent article in hopes that it and/or
her book can be of help to member psychologists seeing parents
or teens in their practices. She
also will be presenting on this
topic at the Fall Convention on
October 17 so do not miss that.
I am sure many other members are doing
something just as exciting. We want to
share that in the WP. If you would like to be
featured, please do write something up and
send it to us. We wish to prominently present our members’ accomplishments in this
publication whenever we can!
together to grow through adolescence; The
Launching Years: Parenting strategies from
senior year to college life), and the positive
parent feedback we received seemed to
indicate that parents benefitted from learning
about meta-cognition and interpersonal
“process” as much as we psychologists did
i n
g r a d u a t e
s c h o o l !
Although Getting to Calm was written for
parent readers, I hope that health providers—
especially psychologists—can use it as an
educational manual to buttress their own role
in supporting families during this wild and
wonderful developmental period. Read more
and/or order your own copy at
www.parentmap.com/gettingtocalm .
Contact information:
Laura Kastner, Ph.D.
[email protected]
[email protected]
NEED TO ADVERTISE?
Contact
Amanda Collins at [email protected]
to place your ad in the next edition!
15
PRSRT.STD.
US Postage
PAID
SEATTLE, WA
Permit No. 1502
CHANGE SERVICE REQUESTED
Calendar of Events
Future of Psychology
3
Medicare Update
4
New Graduates Licensing
5
New ECP Co-Chair
Psychopharmacology Update
6
7
Council Retreat
10
Youth Suicide
11
A Primer for Parents
15
For more information, other meetings and updates,
check the Calendar of Events at www.wapsych.org.
Aug 23
Insurance CE Dinner—Seattle
Sep 16
Executive Board Meeting—Seattle
Oct 16
Council Meeting—Seattle
Oct 16-18
Fall Convention—Seattle
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Pg. 9