Tuesday, March 20, 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 (CaliforniaArizonaTexas, 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