FUTURE TRAILS -- FROM TWO UNIQUE PERSPECTIVES

      * Exciting Opportunities for the Profession:  As our nation steadily implements President Obama's landmark Affordable Care Act (ACA), visionary early career psychologists will appreciate the importance of positioning themselves within expanding and challenging niches.  The FY'2013 HRSA budget highlights the Institute of Medicine report that there are three shortfalls in our current health care system: 1.) Health care needs of older adults will be difficult to meet by the current health care workforce.  2.) There will be severe shortages of geriatric specialists and other providers with geriatric skills. And, 3.) There will be increased demand for chronic care management skills.  Thanks to the continuing efforts of APA's Cynthia Belar,Diane Elmore, and Nina Levitt psychology is eligible for support under the HRSA Geriatric Education Centers Program in order to provide high quality interdisciplinary geriatric education and training and the Graduate Psychology Education (GPE) initiative.  HRSA points out that mental disorders rank in the top 5 chronic illnesses in the nation, accounting for significant economic and productivity costs, as well as an overall poorer quality of life for those affected.  During the academic year 2010-2011, 20 GPE grantees taught 620 trainees and graduated 90 psychologists.  These trainees provided psychology services to over 46,000 individuals, including special minority populations and children living with diabetes, trauma, and ADD.  These two initiatives are providing our next generation with unique and highly valued clinical skills, addressing a truly national priority.  Mahalo.

 

It is affirming that support for psychology's programs has been expressly included in the HHS budget.  HRSA also requested $10 million for the National Centerfor Health Workforce Analysis to obtain information to inform public policies and programs related to the health workforce, including projections of future health workforce needs in order to assure access to high quality, efficient care for the nation.  ACA provides the States with considerable flexibility to develop the health care system which best fits their unique needs and expertise.  Similarly, the Center intends to actively develop a Federal-State infrastructure in order to coordinate and collaborate with its State partners in building the foundation for more effective and useful health workforce analysis to address their individual needs.  Our training programs must become active participants in this far reaching discussion at the local level and craft programs addressing state and national needs; for example, through federally qualified community health centers (FQCHCs) which remain a high Administration priority.

 

            ** A Personal View:  Having retired from the U.S. Senate staff after 38+ years, I have become particularly interested in the experiences and stories of senior colleagues who have embarked upon similar journeys or transitions.  Many of us have never really thought about this next phase of our lives until the time, seemingly suddenly, arrives.  Ellen Cole and Mary Gergen have recently editedRetiring But Not Shy: Feminist Psychologists Create Their Post-Careers, a moving compilation of the stories of pioneering feminist psychologists who, during their illustrative careers, have revolutionized the field, if not society.  The timely thoughts of a long time friend and colleague, Linda Garcia-Shelton, former Executive Director of the California Psychology Internship Council, who recently returned to rural Michigan:

 

            Reflections On a (so far) Short Retirement:  "I have found retirement to be a state with many experiences and challenges, some consciously expected, others vaguely familiar from different times in my life.  So far I have experienced nothing that flatly surprised me, but I am not so sure that is necessarily a good thing.  Like many other females of my age (a war baby), I helped care for my younger brothers earlier than I can remember and began paid work for neighbors as mother's helper when I was 10.  Each year I expanded my scope of work and increased my hourly pay, finally running a baton lesson business the last three years of high school.  By the time I entered college I had saved enough for spending money to accompany my scholarship and NDEA loan funds.  When my savings were exhausted I secured several part time on-campus jobs using federal work-study allocations.  Coming from a blue collar immigrant family background, and a girl besides, there was no possibility of financial support for college from my family.  I did not consider this a problem, although I recognize that current high school graduates coming from families like mine are seldom able to attend or complete a baccalaureate degree because of financial constraints.  Times were different then.

 

            "The pace and nature of work continued throughout my life in the same way that it began in my youth – there were always jobs, I loved what I did, I enjoyed going to work, and I was one of those people who generally say 'yes' to requests.  Typically, I juggled many projects, worked on time-lines of from 4 months to 6-8 years, and seldom was limited by borders, at least not consciously.  One of the most difficult aspects of retirement is that I am seldom asked to do something for others, and I must create structure for myself.  Since, for the most part, I defined my own work roles and tasks throughout my work life I have been surprised to find it quite challenging to define my retirement roles and tasks.  Even writing 'roles and tasks' makes me wonder if I am missing something – do some people have pleasurable days and weeks without defined 'roles and tasks'?

 

            "During weeks that I am working on professional tasks (research and writing projects mostly) I am happily busy and oblivious to feelings of 'drift' – that is, What to do next?  Who cares about this?  What did I do today?  However, I really don't want to continue AS IF I am still at work.  I do believe I need to develop more ways to live in the non-professional world.  I have started this self-development project by doing some of the activities I have always loved, but which fell by the wayside over the years or simply timed-out (e.g., raising children).

 

            "I am doing a lot more non-psychology reading.  I finished a history of World War II, focusing most heavily on areas my father and uncles were involved in, and am now readingCarthage Must be Destroyed.  I read some fiction (Saramago, Russo, Rushdie, and others), and am reading magazines and books about heritage plants that we might include in our garden this coming Spring and Summer.  My mother died a year ago, and I have been slowly going through her possessions, hastily boxed up last Winter and Spring to empty her house for sale.  This has been both difficult and, in some cases, quite surprising.  I can only do it for a few days at a time before I must drift off to another project for awhile.

 

            "It has occurred to me that my retirement has taken on a similar structure to my professional activity of many long years – blocks of time focused on a project, followed by another block of time on another project – but without the external impetuous of multiple ongoing projects each with their own deadlines.  The difference is that now there are no natural deadlines to prompt me to shift from one project to another, hence a sense of drifting when I become aware of myself.  I am now thinking I should enlist the help of others (my husband, my friends, my family) to create some regular place-keepers in my day and week (a group exercise class, a theatre night, etc.) to both improve my health (I am a natural couch potato) and inject some expected/planned social activities in what are becoming fairly solitary days.  I am hoping that committing to participate with others in an activity will make it more likely that I will do it.  When I was working my colleagues were always around, offering regular interaction with others and issuing many invitations to get involved; now I must find ways to do this myself.

 

            "This last Fall I traveled to Italy andSpain to spend time with friends (Italy) and family (Spain) as a way of announcing a transition in my life, and inviting participation from them in it.  My Italian friends have been professional collaborators for nearly 2 decades, and while our professional collaborations will continue, they also are dedicating more time to retirement activities.  From a distance, they seem to be doing better than me at the retirement portion of their life.

 

            "My family is large and very spread out, so connecting with them in my new mode will hopefully increase the attention we give to each other.  I am now (January-March, 2012) in the midst of a 2 ½ month auto caravan with my husband to spend concentrated time with our 3 sons and their families (2 in Californiaand 1 in North Carolina), and shorter visits with a bunch of cousins spread across the Southern States (California, Arizona, Texas, and Florida).  An ongoing cousin project that I am belatedly joining is to collect more family information than our parents provided to us about our ancestors, their immigration and non-immigration decisions, and tracking down varying versions of 'the distant past' (3-5 generations) and comparing this with whatever contemporaneous information we can dig up.  Now that I have announced openly that I will join this project, I know that my cousins will give me many invitations to take on pieces of the project – indeed I am depending upon them.  Besides increasing interaction with my cousin group, I think this project will reconnect me with my larger family (both historical and current) that I somewhat withdrew from during my busy years in the working world.  This reconnection feels like a fitting activity for this time in my life.

 

            "A major thought project I am in the midst of is making sense of the drastic changes in the U.S. social system over my lifetime, and doing this in a way that allows me to stay engaged with that system.  I grew up in a family that strongly believed in facing challenges directly by working to make changes so that the world around you becomes a better one, a more fair one, and a happier one.  My grandparents were political activists in the country they were born and in the country of their chosen citizenship, the U.S.  My father and his brothers were very active in unionizing activities in the Detroit auto plants in the 1930s, and my father was a low level elected union officer during much of my childhood.  I was involved in the mid-1960s in civil rights work in Mississippi that was initiated and supported by the SCLC, and my work in primary care health psychology was heavily oriented toward public health and access to care.

 

            "Now I see a nation that seems to be forsaking the majority of its citizens.  I see an ever widening income gap between the extremely wealthy and the middle and working classes.  I see massive de-investment in public education that still is responsible for the overwhelming majority of children and youth.  I see basic health outcomes in communities I have worked in getting worse, while as a nation we spend more and more money to no good effect.  I see basic freedoms that drew my grandparents to this nation – predominately our then secular civil state – being eroded to the point where religious beliefs of some are being forced upon all through the power of the law.  All this makes me feel old, tired, and very sad.  A lifetime of work that has apparently resulted in a nation with reduced opportunity and freedom for the majority of its citizens.

 

            "On some days I am greatly depressed (with the accompanying sense of helplessness and hopelessness) that I am leaving a dysfunctional country to my grandchildren.  This is my definition of failure, since family is at the center of my world.  On better days I talk with like-minded folks in my small rural home town about how we can affect the coming state and national elections; how we can maintain and advance a health system that provides universal access; how we can support our local school as it struggles with an ever shrinking state-allocated budget and increasing student numbers; and how we can influence our tiny village council and county supervisors to seriously consider the environmental dangers of 'fracking' for gas that they approved several years ago without making clear to any of us the dangers of the method for our formerly pristine northern Lake Michigan shore side community.  So, I am trying to use my energy to preserve a secular political system, good health care, schools for the future leaders of this nation, and a home that is not the twenty-first century equivalent of a garbage dump.  I don't know if I have enough energy."  Aloha,

 

Pat DeLeon, former APA President – Division 42 – March, 2012

FUTURE TRAILS -- FROM TWO UNIQUE PERSPECTIVES:

     * Exciting Opportunities for the Profession:  As our nation steadily implements President Obama's landmark Affordable Care Act (ACA), visionary early career psychologists will appreciate the importance of positioning themselves within expanding and challenging niches.  The FY'2013 HRSA budget highlights the Institute of Medicine report that there are three shortfalls in our current health care system: 1.) Health care needs of older adults will be difficult to meet by the current health care workforce.  2.) There will be severe shortages of geriatric specialists and other providers with geriatric skills. And, 3.) There will be increased demand for chronic care management skills.  Thanks to the continuing efforts of APA's Cynthia Belar,Diane Elmore, and Nina Levitt psychology is eligible for support under the HRSA Geriatric Education Centers Program in order to provide high quality interdisciplinary geriatric education and training and the Graduate Psychology Education (GPE) initiative.  HRSA points out that mental disorders rank in the top 5 chronic illnesses in the nation, accounting for significant economic and productivity costs, as well as an overall poorer quality of life for those affected.  During the academic year 2010-2011, 20 GPE grantees taught 620 trainees and graduated 90 psychologists.  These trainees provided psychology services to over 46,000 individuals, including special minority populations and children living with diabetes, trauma, and ADD.  These two initiatives are providing our next generation with unique and highly valued clinical skills, addressing a truly national priority.  Mahalo.

It is affirming that support for psychology's programs has been expressly included in the HHS budget.  HRSA also requested $10 million for the National Centerfor Health Workforce Analysis to obtain information to inform public policies and programs related to the health workforce, including projections of future health workforce needs in order to assure access to high quality, efficient care for the nation.  ACA provides the States with considerable flexibility to develop the health care system which best fits their unique needs and expertise.  Similarly, the Center intends to actively develop a Federal-State infrastructure in order to coordinate and collaborate with its State partners in building the foundation for more effective and useful health workforce analysis to address their individual needs.  Our training programs must become active participants in this far reaching discussion at the local level and craft programs addressing state and national needs; for example, through federally qualified community health centers (FQCHCs) which remain a high Administration priority.

            ** A Personal View:  Having retired from the U.S. Senate staff after 38+ years, I have become particularly interested in the experiences and stories of senior colleagues who have embarked upon similar journeys or transitions.  Many of us have never really thought about this next phase of our lives until the time, seemingly suddenly, arrives.  Ellen Cole and Mary Gergen have recently editedRetiring But Not Shy: Feminist Psychologists Create Their Post-Careers, a moving compilation of the stories of pioneering feminist psychologists who, during their illustrative careers, have revolutionized the field, if not society.  The timely thoughts of a long time friend and colleague, Linda Garcia-Shelton, former Executive Director of the California Psychology Internship Council, who recently returned to rural Michigan:

            Reflections On a (so far) Short Retirement:  "I have found retirement to be a state with many experiences and challenges, some consciously expected, others vaguely familiar from different times in my life.  So far I have experienced nothing that flatly surprised me, but I am not so sure that is necessarily a good thing.  Like many other females of my age (a war baby), I helped care for my younger brothers earlier than I can remember and began paid work for neighbors as mother's helper when I was 10.  Each year I expanded my scope of work and increased my hourly pay, finally running a baton lesson business the last three years of high school.  By the time I entered college I had saved enough for spending money to accompany my scholarship and NDEA loan funds.  When my savings were exhausted I secured several part time on-campus jobs using federal work-study allocations.  Coming from a blue collar immigrant family background, and a girl besides, there was no possibility of financial support for college from my family.  I did not consider this a problem, although I recognize that current high school graduates coming from families like mine are seldom able to attend or complete a baccalaureate degree because of financial constraints.  Times were different then.

            "The pace and nature of work continued throughout my life in the same way that it began in my youth – there were always jobs, I loved what I did, I enjoyed going to work, and I was one of those people who generally say 'yes' to requests.  Typically, I juggled many projects, worked on time-lines of from 4 months to 6-8 years, and seldom was limited by borders, at least not consciously.  One of the most difficult aspects of retirement is that I am seldom asked to do something for others, and I must create structure for myself.  Since, for the most part, I defined my own work roles and tasks throughout my work life I have been surprised to find it quite challenging to define my retirement roles and tasks.  Even writing 'roles and tasks' makes me wonder if I am missing something – do some people have pleasurable days and weeks without defined 'roles and tasks'?

            "During weeks that I am working on professional tasks (research and writing projects mostly) I am happily busy and oblivious to feelings of 'drift' – that is, What to do next?  Who cares about this?  What did I do today?  However, I really don't want to continue AS IF I am still at work.  I do believe I need to develop more ways to live in the non-professional world.  I have started this self-development project by doing some of the activities I have always loved, but which fell by the wayside over the years or simply timed-out (e.g., raising children).

            "I am doing a lot more non-psychology reading.  I finished a history of World War II, focusing most heavily on areas my father and uncles were involved in, and am now readingCarthage Must be Destroyed.  I read some fiction (Saramago, Russo, Rushdie, and others), and am reading magazines and books about heritage plants that we might include in our garden this coming Spring and Summer.  My mother died a year ago, and I have been slowly going through her possessions, hastily boxed up last Winter and Spring to empty her house for sale.  This has been both difficult and, in some cases, quite surprising.  I can only do it for a few days at a time before I must drift off to another project for awhile.

            "It has occurred to me that my retirement has taken on a similar structure to my professional activity of many long years – blocks of time focused on a project, followed by another block of time on another project – but without the external impetuous of multiple ongoing projects each with their own deadlines.  The difference is that now there are no natural deadlines to prompt me to shift from one project to another, hence a sense of drifting when I become aware of myself.  I am now thinking I should enlist the help of others (my husband, my friends, my family) to create some regular place-keepers in my day and week (a group exercise class, a theatre night, etc.) to both improve my health (I am a natural couch potato) and inject some expected/planned social activities in what are becoming fairly solitary days.  I am hoping that committing to participate with others in an activity will make it more likely that I will do it.  When I was working my colleagues were always around, offering regular interaction with others and issuing many invitations to get involved; now I must find ways to do this myself.

            "This last Fall I traveled to Italy andSpain to spend time with friends (Italy) and family (Spain) as a way of announcing a transition in my life, and inviting participation from them in it.  My Italian friends have been professional collaborators for nearly 2 decades, and while our professional collaborations will continue, they also are dedicating more time to retirement activities.  From a distance, they seem to be doing better than me at the retirement portion of their life.

            "My family is large and very spread out, so connecting with them in my new mode will hopefully increase the attention we give to each other.  I am now (January-March, 2012) in the midst of a 2 ½ month auto caravan with my husband to spend concentrated time with our 3 sons and their families (2 in Californiaand 1 in North Carolina), and shorter visits with a bunch of cousins spread across the Southern States (California, Arizona, Texas, and Florida).  An ongoing cousin project that I am belatedly joining is to collect more family information than our parents provided to us about our ancestors, their immigration and non-immigration decisions, and tracking down varying versions of 'the distant past' (3-5 generations) and comparing this with whatever contemporaneous information we can dig up.  Now that I have announced openly that I will join this project, I know that my cousins will give me many invitations to take on pieces of the project – indeed I am depending upon them.  Besides increasing interaction with my cousin group, I think this project will reconnect me with my larger family (both historical and current) that I somewhat withdrew from during my busy years in the working world.  This reconnection feels like a fitting activity for this time in my life.

            "A major thought project I am in the midst of is making sense of the drastic changes in the U.S. social system over my lifetime, and doing this in a way that allows me to stay engaged with that system.  I grew up in a family that strongly believed in facing challenges directly by working to make changes so that the world around you becomes a better one, a more fair one, and a happier one.  My grandparents were political activists in the country they were born and in the country of their chosen citizenship, the U.S.  My father and his brothers were very active in unionizing activities in the Detroit auto plants in the 1930s, and my father was a low level elected union officer during much of my childhood.  I was involved in the mid-1960s in civil rights work in Mississippi that was initiated and supported by the SCLC, and my work in primary care health psychology was heavily oriented toward public health and access to care.

            "Now I see a nation that seems to be forsaking the majority of its citizens.  I see an ever widening income gap between the extremely wealthy and the middle and working classes.  I see massive de-investment in public education that still is responsible for the overwhelming majority of children and youth.  I see basic health outcomes in communities I have worked in getting worse, while as a nation we spend more and more money to no good effect.  I see basic freedoms that drew my grandparents to this nation – predominately our then secular civil state – being eroded to the point where religious beliefs of some are being forced upon all through the power of the law.  All this makes me feel old, tired, and very sad.  A lifetime of work that has apparently resulted in a nation with reduced opportunity and freedom for the majority of its citizens.

            "On some days I am greatly depressed (with the accompanying sense of helplessness and hopelessness) that I am leaving a dysfunctional country to my grandchildren.  This is my definition of failure, since family is at the center of my world.  On better days I talk with like-minded folks in my small rural home town about how we can affect the coming state and national elections; how we can maintain and advance a health system that provides universal access; how we can support our local school as it struggles with an ever shrinking state-allocated budget and increasing student numbers; and how we can influence our tiny village council and county supervisors to seriously consider the environmental dangers of 'fracking' for gas that they approved several years ago without making clear to any of us the dangers of the method for our formerly pristine northern Lake Michigan shore side community.  So, I am trying to use my energy to preserve a secular political system, good health care, schools for the future leaders of this nation, and a home that is not the twenty-first century equivalent of a garbage dump.  I don't know if I have enough energy."  Aloha,

Pat DeLeon, former APA President – Division 42 – March, 2012

NEW CHALLENGES -- NEW FRONTIERS

Having retired from U.S. Senator Daniel K. Inouye's staff after 38+ years, I am beginning my new career as a faculty member at the University of Hawaii Schools of Nursing, Law, and Pharmacy.  The 21^stcentury will be an era of interdisciplinary collaboration, with educators and clinicians being actively encouraged to leave their historically isolated "silos" and engage in cross-disciplinary activities.  What better place to spend the next decade?  This will also be a time for capitalizing upon the exciting opportunities provided by the advances occurring almost daily in the communications and technology fields.  Electronic medical records, telehealth (telepsychology), and data-driven effectiveness comparisons across patients and populations will become the norm.  President Obama's landmark Affordable Care Act (ACA) places a high priority on patient-centered primary care, prevention and wellness activities; as well as providing the various States, such as Hawaii, with considerable flexibility to craft the health care environment which best fits their unique needs and strengths.  HPA has a major responsibility to be "at the table" during these crucial deliberations, as APA Practice Directorate Katherine Nordal has so elegantly proclaimed at the annual State Leadership conferences.  Being personally involved in crafting the future of the profession is yourresponsibility.

            The Administration (HHS) recently announced that the number of hospitals utilizing health information technology (HIT) and electronic health records (EHRs) has more than doubled in the last two years from 16% to 35%, with 85% of hospitals expecting to accept HHS's incentive payments by 2015.  This past January, CMS provided $519 million to eligible providers.  At the time that the President signed his Economic Stimulus legislation, providing $19+ billion in incentives for utilizing HIT, only 5% of physicians had fully functional EHR systems – the goal is 90% by 2019.  This evolution is expected to ultimately result in afundamentally different health care environment.  One which will no longer take on average 17 years for new scientific knowledge to be incorporated into practice.  It will have a dramatic impact upon the practice of psychology and highlights the importance of licensure mobility, as 24/7 consultations (for example with schools of pharmacy) become readily available, and today's geographically imposed barriers are no longer considered relevant.

            The Joint Task Force for the Development of Telepsychology Guidelines:  This effort is a joint venture between APA, the Association of State and Provincial Psychology Boards (ASPPB), and the APA Insurance Trust, and is co-chaired by Linda Campbell (APA) and Fred Millan (ASPPB).  The Task Force (TF) members have backgrounds, knowledge, and experience reflecting expertise in the broad issues that practitioners must address each day in the use of technology -- ethical considerations, mobility, and scope of practice.  A two-day meeting was held in Atlanta in November; the second face-to-face meeting of the TF.  Prior to this meeting the members were grouped into four teams to summarize and outline the various issues identified during its July, 2011 meeting.  Team members reviewed at least 14 content areas that will provide a foundation for telepsychology guidelines (i.e., informed consent, access to care, inter-jurisdictional practice, competence, education, etc.) and produced documents and draft statements which were reviewed electronically.  Conference calls and e-mail discussions facilitated their work between July and November.

            In November, the TF members discussed the work done by the various teams, as well as reviewed the current research and policy literature related to international, national, and state statutes and regulations; as well as guidelines on the use of technology in the delivery of psychological services.  In addition they reviewed the current guidelines related to the delivery of psychological services.  Considerable time was also spent gaining an understanding of the APA process for developing practice guidelines.  Various models for inter-jurisdictional practice were discussed, noting the importance of the issue to many stakeholders.

            Taking into account comments gathered prior to the meeting, the TF worked on the development of an outline for guidelines to be drafted by the four working teams formed by TF members.  The outline reflects the knowledge gained from the review of the literature and research, current and draft documents outlining the use of technology in the delivery of services; and input and feedback from experts, organizations, and individuals.  As a next step, the TF members outlined the key areas and assigned guideline writing teams to begin the preparation of draft guidelines.  Efforts to reach out to identified individuals and groups with expertise in the various content areas will be made.  A time-line was established with the four writing teams sharing their first drafts with the entire TF early this year.  The next step will be to share the evolving draft during a public comment period in the Spring.  APA will host a special session at the APA convention inOrlando.  The convention presentation will focus upon presenting details of the newest draft, discussing feedback received during the public comment period, and providing a face-to-face interaction with the TF members.  Additional input and comments from the field and public will be broadly sought throughout the year [Deborah Baker].

            HHS Fiscal Year 2012 Budget Request:  The Administration's request notes that there are nearly 50 million people living in rural America who face ongoing challenges in accessing health care.  Rural residents have higher rates of age-adjusted mortality, disability, and chronic disease than their urban counterparts.  Rural areas also continue to suffer from a shortage of diverse providers for their health care needs.  The goal for the President's "Improving Rural Health Care Initiative" is to build healthier rural populations and communities through evidence-based practices, with the HRSA Office of Rural Health Policy improving the coordination of rural health activities.  These programs are among the only non-categorical grants within HHS which allows grantees to determine the best way to meet local needs.  The $11.5 million telehealth grant initiative will link rural health providers with specialists in urban areas and strengthening rural health care infrastructure.  Has HPA worked with the Lanai FQCHC or HRSA?

            Retirement Really?  These are indeed exciting times.  Upon learning of my "retirement," John Sexton, former U.S. Navy psychologist and one of the first two graduates of the Department of Defense psychopharmacology training program: "Aloha, Thank you for your continued strong efforts on RxP.  I might stick my toe back into the pool, but I have been enjoying my retirement too much.  After retiring on July 1, my wife, son, and I went to Oahu for a month to join our daughter, as she lived there briefly. Hawaii is paradise.  We returned to San Diego, brought a motor home, and have been travelingNorth America ever since.  Knowing your large amount of energy, retirement may be something not in the cards for you.  I thought I would have some trouble with it, but have found it to be wonderful.  Take care."  We shall see….  Aloha,

 

Pat DeLeon, former APA President – HPA – March, 2012

MAKING A DIFFERENCE

As I begin my new career on a university faculty after 38+ years on the U.S. Senate staff, I am impressed by the opportunities the behavioral sciences (including psychology) have to "make a difference."  David Krantz, Chair of the Department of Psychology at the UniformedServices University of the Health Sciences (Department of Defense) and I visited their Center for Deployment Psychology (CDP).  Courtnee Pelton serves as the Military Programs Training Course Coordinator.  Commissioned into the Army in 2006 through the Health Professions Scholarship Program, she completed her Army psychology internship at Tripler Army Medical Center, Honolulu and her residency at Madigan Army MedicalCenter, Joint Base Lewis-McCord, Tacoma.  She was then assigned to the 162^nd Infantry Brigade, Ft. Polk, serving as Brigade Psychologist for two years.  At the CDP she directs the 8-day "Topics in Deployment Psychology" conference, in addition to presenting on issues related to the deployment cycle.  This conference provides in-depth training on a variety of deployment related issues; specifically, Warrior trauma and resilience, behavioral health care of the wounded, and military families.  While geared towards all uniformed behavioral health care providers, the training focuses on preparing behavioral health interns and residents with the skill set and confidence needed to successfully treat service members on deployment and in the garrison environment.  David Riggs serves as Director and William Brim, a health psychologist with over 10 years of USAF experience, as Deputy Director.  The Congress approved the mission of training military and civilian health care providers to work with service members, veterans, and their families around psychological health and traumatic brain injury related to deployment, emphasizing evidence-based training.  Since 2007, CDP has trained over 20,000 mental health providers.  It is estimated that there are 700,000+ service members or veterans experiencing psychological health or traumatic brain injury concerns (www.DeploymentPsych.org).

            Health Care Reform:  With the enactment of President Obama's landmarkPatient Protection and Affordable Care Act, our nation's health care environment is undergoing unprecedented change.  Health care will become patient-centered, based upon gold standard protocols, and utilize the most up-to-date advances in the communications and technology world.  No longer will practitioners (or educators) live in isolated professional silos.  Instead, interdisciplinary, integrated care will be the norm with transdisciplinary scientific expertise readily available.  Virtual 24/7 consultations with, for example, colleges of pharmacy will be possible.

The new law provides the States withconsiderable flexibility to craft the health care environment that works best for them.  It is extremely important that our next generation be actively involved in the Georgia Psychological Association – to be at the table when decisions impacting their careers are made, as Katherine Nordal of the Practice Directorate elegantly describes.  They will be practicing collaboratively with Doctors of Nursing Practice, Clinical Pharmacists, and Physical Therapists.  Wellness, prevention, and primary care will become priorities – including for reimbursement.  With care available for an additional 32+ million Americans for the first time in their lives, there will be renewed necessity for allowing each discipline to practice in expanded roles.  Already there are 48 Nursing State Action Collations working to implement the Institute of Medicinerecommendations that nursing be allowed to practice to the full extent of their training and education and further, to achieve higher levels of training through an improved education system that promotes seamless academic progression.  Historical anti-competitive restrictions must be overcome.  With 251,000 advanced practice nurses (APNs), the health care world is definitely evolving.  Change is always unsettling and yet provides exciting opportunities for those involved.

Prior to becoming the first non-physician and first female U.S. Army Surgeon General, Patty Horoho commented: "Maureen's [USAF Nurse Congressional Fellow] comments on the behavior health effort of the services to care for and build resiliency in our soldiers and their family members are right on target.  Preserving the mental and physical well being of our service members is absolutely critical to improving resilience.  The services have collectively initiated a number of programs that support behavior health issues in military and civilian personnel.  Behavioral health care is one of my top priorities, and in my dual hatted role as Deputy Surgeon General and Chief of the Army Nurse Corps, I'm responsible for the health and well being of all soldiers, to include Army Nurses.  Therefore in addition to Army initiatives, we've implemented a number of Corps initiatives and research studies focused on the care of the caregiver.  I'm very pleased to share that the programs have had a very positive effect on improving and maintaining resiliency among Army Nurses.  The Nurse Corps evaluates the health and resiliency of our caregivers in many ways.  The Army Nursing Research Team is conducting research on compassion fatigue, nurse burnout, stress, hardiness, resilience and PTSD in military health care personnel (nurses, physicians, technicians, ancillary, and behavioral health) in Landstuhl Germany, San Antonio, and Bagram Afghanistan.  The team is also collecting data examining post deployment reintegration of nurses.  From the results of these studies, we anticipate the development of tools and training to ensure that Army Nurses remain mentally healthy and fit."  These are, indeed, exciting times for our next generation.

            Ode To Retirement:  "As a LTJG in the U.S. Navy, I was being encouraged to stay in and probably reach the Admiral level, but even then I thought that life would get to be boring with shipboard drills and so forth.  Hence, with a wife who did not want the Navy and enjoyed teaching and helping children to grow as much as I, I decided to return to a plan which she and I made for me to become a child psychologist.  It seemed far more sensible to be able to practice in that capacity as long as I wanted.  Even then, retirement was not an attractive option.

            "Now, after 51 years as a practicing psychologist, I have again confronted the 'retirement' issue.  I even announced to friends that I was 'about' to retire.  Many were already retired, some for 25 years.  I began to stop taking new patients and just planned to finish with those lingering cases that were also not ready to retire.  Many were sailing, traveling, golfing, and/or writing books.  Most of those things I had already done and they were blocked now by an aging body, and my ongoing enjoyment of working with patients.  I found that giving up what I liked to do and felt proficient at was not as attractive as others had found it.  So now, here I am, accepting a couple of new clients and enjoying it for now.  You would think that I would give up the battle with hearing aids and 3^rd party payors, but no.  The challenge and good feeling is still there, so I am only semi-retired.  Thus, I can keep doing what I like and still play golf and travel" [Jay Benedict].  Yes, psychology can be a very fulfilling life IF one is actively involved.  Aloha,

 

Pat DeLeon, former APA President – Georgia Psychological Association – February, 2012