WHAT IS PAST IS PROLOGUE

Looking Back – A View of the Future?  Nearly a decade and a half ago, the President's Committee on Advisors on Science and Technology submitted the report of their Panel on Educational Technology "On the Use of Technology to Strengthen K-12 Education in the United States."  "In an era of increasing international economic competition, the quality of America's elementary and secondary schools could determine whether our children hold highly compensated, high-skill jobs that add significant value within the integrated global economy of the twenty-first century or compete with workers in developing countries for the provision of commodity products and low-value-added services at wage rates comparable to those received by third world laborers.  Moreover, it is widely believed that workers in the next century will require not just a larger set of facts or a larger repertoire of specific skills, but the capacity to readily acquire new knowledge, to solve new problems, and to employ creativity and critical thinking in the design of new approaches to existing problems….  During a period in which technology has fundamentally transformed America's offices, factories, and retail establishments, however, its impact within our nation's classrooms has generally been quite modest."

Psychologist John Bransford served on that Panel which made several high-level strategic recommendations that are clearly relevant today, both for education and for health care reform.  1. Focus on learning withtechnology, not about technology.  Although both are worthy of attention, it is important to distinguish between technology as a subject area and the use of technology to facilitate learning about any subject area.  2. Emphasize content and pedagogy, and not just hardware.  Particular attention should be given to the potential role of technology in achieving the goals of educational reform efforts through the use of new pedagogic methods focusing on the development of higher-order reasoning and problem-solving skills.  3. Give special attention to professional development.  The substantial investment in infrastructure that is necessary will be largely wasted if teachers (and today's clinicians) are not provided with the preparation and support they will need to effectively integrate information technologies into their teaching (and clinical practice).  At that time, only about 15 percent of the typical educational technology budget was devoted to professional development, a figure which the Panel felt should at least be doubled.  Ongoing mentoring, consultative support, and the allocation of time are absolutely necessary.  4.  Engage in realistic budgeting.  While voluntarism and corporate equipment donations may be of both direct and indirect benefit under certain circumstances, White House policy should be based on a realistic assessment of the relatively limited direct economic contribution such efforts can be expected to make overall.  Educational technology is an unusually high-return investment (in both economic and social terms) in America's future.  5. Ensure equitable, universal access.  Access to knowledge-building and communication tools based on computing and networking technologies should be made available to all of our nation's students, regardless of socioeconomic status, race, ethnicity, gender, or geographical factors, and special attention should be given to the use of technology by students with special needs.  The rate of home computer ownership diverges widely for students of different racial and ethnic groups and socioeconomic status.  6.  Initiate a major program of experimental research.  A large-scale program of rigorous, systematic research on education in general and educational technology in particular will ultimately prove necessary to ensure both the efficacy and cost-effectiveness of technology use within our nation's schools.  Funding levels for educational research have been alarmingly low.

Health policy observers of the systematic implementation of President Obama's landmark Patient Protection and Affordable Care Act (ACA) are acutely aware of its investment in, and emphasis upon, the inherent potentially revolutionary contributions of the advances occurring in communications and computer technology; i.e., electronic health records, evidence-based protocols, tele-health, comparative clinical effectiveness research, as well as virtual realities.  And, we would suggest, similar evolutionary obstacles, such as getting too far ahead of practitioners must be expected.  Change is always unsettling.

The Panel urged that in order to ensure high standards of scientific excellence, intellectual integrity, and independence from political influence, a critical education-oriented research program should be planned and overseen by a distinguished independent board of outside experts appointed by the President, and should encompass (a) basic research in various learning-related disciplines and on various educationally relevant technologies; (b) early-stage research aimed at developing new forms of educational software, content, and technology-enabled pedagogy;  and (c) rigorous, well-controlled, peer-reviewed, large-scale empirical studies designed to determine which educational approaches are in fact most effective in practice.  Such a program could well prove critical to the economic security of future generations of Americans and should thus be assigned a high priority in spite of current (1997/2013) budgetary pressures.  Within the ACA, the newly authorized Patient-Centered Outcomes Research Institute (PCORI) might well serve a similar function.

The Panel further noted that if computers are destined to play an increasingly important role in education over the next 20 years, it is natural to ask what roles will be played by human beings (i.e., the Human Element).  Although it seems clear that the expanded use of technology in education will have significant implications for teachers, students, parents, and community members, there is reason to believe that interpersonal interactions among all these groups will be at least as important to the educational process of 2017 as they are in 1997.  Indeed, the changing nature of these interactions is probably as central to the promise of new educational technologies as the hardware, software, and curricular elements.  The Panel also appreciated that there was a growing consensus that technology should be applied in such a way as to foster broader community-wide involvement in the educational process.  It was further thought that the linking of schools with research universities, public libraries, and private companies could make valuable educational resources available to both students and teachers while simultaneously building awareness within each community of the needs of its local schools.  "Real-world" projects initiated by outside organizations often generate considerable enthusiasm among students and frequently prove unusually effective from an educational perspective.  Some educators at that time were even discussing the possibility of instituting "tele-apprenticeship" or "tele-mentoring" programs involving brief, but relatively frequent interactions between students and other community members that would be impractical in the absence of networking technologies due to travel time considerations.

Not surprisingly the Panel found, and we would seriously wonder if the comparable data is any different today, that the most significant disparities in socioeconomic status access to technology is not found in the schools, but in the homes of the students.  As of June 1995, computers were present in only 14% of all households headed by adults who had completed no more than a high-school education, and in which annual household income was less than $30,000; the comparable figure for households headed by college-educated adults having a combined income of more than $50,000 per year was more than five times greater, at 73%.  Similarly, on average girls and boys differed only slightly in their use of computers at school and at home.  On a personal note, at the Uniformed Services University of the Health Sciences (USUHS) graduate school of nursing, it is impressive how graduate students today are able to effectively utilize technology to integrate relevant You Tube (which was created in February, 2005) videos routinely into their classroom presentations.

Integrated Healthcare – New Training Models?  Fundamental to the President's ACA vision is providing patient-centered, integrated primary health care for all Americans in which the various disciplines will work collaboratively, rather than competitively.  Over the past several decades, visionary health psychologist Cynthia Belar, now Executive Director of the APA Education Directorate, has been urging psychology to appreciate the magnitude of change that is approaching.  "There is nothing new about interprofessional education (IPE), team based care, or integrated care.  What is new is the national recognition of its importance for 'Crossing the Quality Chasm' (Institute of Medicine (IOM)) and the increasing calls for such by leaders in medical education.  Indeed the " Interprofessional Competencies for Collaborative Care" have now been endorsed by a number of health professions, and will go to the Council in February for APA's endorsement.  The APA governance groups and the Board of Directors have been uniformly supportive to date.

"Psychologists in health settings have often provided team based care, but training for such has usually begun at the internship or postdoctoral levels.  With the focus on interprofessional competencies there are increased demands for interprofessional education in the earliest stages of training, where students can learn with and from each other and before stereotypes get rigidified.  The IOM Global Forum on Innovations in Health Professions Education, of which APA is a sponsor, has made this the primary topic for its first two forums.  It is being clearly acknowledged that those not trained to work together will not know how to work together after they graduate.

"Early involvement in IPE provides a challenge for doctoral programs housed in colleges of arts and sciences or universities without other health professions students, but not one impossible to meet.  In fact the Graduate Psychology Education program of HRSA, of which APA was the architect, has since its inception required the training of psychologists with at least two other health professions for receipt of grand funds.  To my knowledge, other than the Burdick Rural Interdisciplinary training program which unfortunately has not been funded for a number of years, such requirements are not part of other Title VII, Title VIII, or Medicare GME programs, but one wonders why not.

"We have said before how federally qualified health centers (FQHCs) and departments of internal medicine, pediatrics, and family practice can provide invaluable experiences in training for team-based primary care, which is seen as the foundation for the reformed health care system.  In my opinion, programs that want to prepare health service providers should run, not walk, to these settings and work to establish collaborative opportunities for training.  Psychology has articulated the competencies needed in the healthcare environment, including the special needs of primary care.  Even the Patient-Centered Primary Care Collaborative (an advocacy group of employers, providers, payors, and consumers) recognizes the need for new models of training that require not only team-based skills but a population-based perspective.  (I am currently the co-chair with a family practitioner of the Education and Training Task Force.)  Psychology has some superb programs that provide relevant training, but we need more."

Health Insurance Exchanges:  In 2014 the ACA will ensure that health insurance exchanges will be available in every state with all plans providing the same package of essential health benefits, although they will vary by four different levels of "actuarial value" (percentage of costs that a plan pays on average).  The individual States can decide whether they will set up their own exchanges, or rely upon the federal government.  At the last APA State Leadership conference, Practice Directorate Executive Director Katherine Nordal strongly urged the attendees to get personally involved at the state level.  "We're facing uncharted territory with proposed new models of care.  Change is inevitable….  We're going to have to address health insurance exchanges.  These are exchanges that provide health plans for individuals and small businesses that will be set up at the state level."  The State of Hawaii was the first in the nation to declare its intent to establish a state-certified exchange.  Governor Neil Abercrombie: "The successful establishment of the Hawai'i Health Connector is part of our New Day Plan in transforming healthcare in Hawai'i."

Coral Andrews is executive director of the Hawai'i Health Connector whose aim is to provide an online marketplace that is of Hawai'i-for-Hawai'i, effectively taking into account the state's unique culture and its Prepaid Health Care Act, an employer health mandate in effect since 1974 and incorporated into the ACA.  "We are socializing our vision to the Board and stakeholders-at-large, focused on a community investment model.  Our brand/logo will be built on the host culture's teachings and values.  We are working on it.  If we remain grounded in what we value and the Native Hawaiian cultural ideals, then it will act as a guidepost as we seek to navigate these new blended public-private models.

"Our proposed sustainability plan would draw like-minded community leaders together around the opportunity to improve the overall health and well-being of the population.  We don't just want to teach consumers how to come to an exchange to buy.  We want to focus on the longer term opportunity of social change.  If we can, in that consumer encounter, provide the education and critical thinking tools to them, then we have a greater opportunity of effecting change overall.  If we truly believe in the core values of our host culture, then that should be the basis by which we develop our plan.  Internationally, these ideas of social transformation have been applied to impoverished societies.  The true intent of the ACA is what we're focused on; not just building an IT system.

"We have recruited a development officer from the Hawaii Community Foundation to assist us with strategy and sustainability.  We believe that there are philanthropists and like-minded organizations in Hawai'i who will join us in gaining momentum around the idea of a community investment model.  There are also very cool theories and analyses that have emerged from the Stanford Social Innovation Center and a non-profit called Code for America.  Applying some of these ideas in this market could be interesting.  When all is said and done, we want to be able to look back and know that we have invested time in something that improves the health and well-being of our population and supports a more prosperous Hawai'i.  The end opportunity is a stimulated economy via indirect efforts."

The NMSU/SIAP Interdisciplinary RxP Program:  "The New Mexico State University/Southwest Institute for the Advancement of Psychotherapy Interdisciplinary Master's Degree Program in Clinical Psychopharmacology stands out from other APA "designated training programs" (i.e., meets the APA model curriculum) in many important ways.  We are the only program located in a state with prescriptive authority so we frequently have program alumni and working prescribing psychologists attend our classes for continuing education, enriching class discussion with perspectives from the prescriptive practice world.  We are the only program that offers live in-person instruction throughout the course, fostering more student interaction with our instructors as well as strong collegial relationships among students during breaks, lunches, and before and after class.

"The centerpiece of our program is the nine class integrated Advanced Pathophysiology and Physical Health Assessment module where students are instructed by family practice physicians using a systems-problem based learning approach.  The first day of the weekend is a lecture followed by a day of hands-on assessment skills practice in a real world family practice clinic setting.  The curriculum for this module, though challenging, uses the same texts and instruction methods as the New Mexico State University Nurse Practitioner graduate program, giving our program added clinical rigor.  New this iteration, we have added a section on clinical primary care psychology to each class, helping equip psychologists for work in primary care or other medical settings, with and without a prescription pad.  Another unique experience is our neuroanatomy/brain dissection lab taught by a prescribing neuropsychologist.  If you have never had the opportunity to see exactly what a choroid plexus looks like in person, you should consider our program.  We are also the only program directed by a practicing prescribing/medical psychologist (myself), who became the first prescribing psychologist working at the New Mexico Behavioral Health Institute (the State Psychiatric Hospital) in 2008.

"In 2012, our program established an ongoing part-time residency program for psychologists to do the required physician supervised practicum hours in a primary care clinic setting serving families in southern New Mexico in a partnership with La Clinica de Familia, a Federally Qualified Health Center (FQHC).  Two psychologists are presently doing their practicum hours there and several more are currently being credentialed and plan to begin in 2013.  Another exciting new option is shadowing a prescribing psychologist the day before or the day after the class weekend.  Students sign up to accompany a working prescriber at his/her practice setting on the Friday or Monday around the class weekend, combining the practical and academic in one trip to New Mexico.  Our website for further information ishttp://education.nmsu.edu/cep/siap [Christina Vento]."

The Commonwealth Fund's 2012 Annual Report:  This year was a dramatic one for health care reform and, for several months around the Supreme Court's decision on the constitutionality of the Affordable Care Act (ACA), a time in which an unusually large number of Americans were closely following federal health policy.  As we learned last summer, the Supreme Court ultimately upheld the law, enabling vital health care delivery and health insurance reforms to continue and an estimated 30 million Americans to gain health insurance coverage by the end of the decade.  The United States is finally on the path to join all other major industrialized countries in ensuring near-universal health insurance coverage.  This accomplishment in one that U.S. presidents have struggled to achieve over the past hundred years.  Thanks to the health reform law, we as a nation will no longer have a health care system that allows so many Americans to suffer from treatable diseases because they cannot afford health care – or to lose their savings to pay for treatment.

In many ways, the ACA has been the fruition of work that The Commonwealth Fund and others have conducted over the past 20 years.  The law's principles were articulated a decade ago.  Today, a number of these principles and recommendations are beginning to realize their promise.  There has already been substantial progress in the first two years of ACA's implementation.  After 12 years of increases in the uninsured, the number of people without coverage dropped by 1.3 million in 2011.  Nearly all states have taken legislative or regulatory steps to implement the law's early insurance market reforms and coverage of preventive care services without cost-sharing.  We may be witnessing new models of health care delivery, improved quality and safety, health information technology, and preventive care.  Aloha,

Pat DeLeon, former APA President – Division 29 – February, 2013

 

THE DAWN OF AN EXCITING NEW ERA FOR PSYCHOLOGY

    Creative Educational Initiatives:  Now that I have the opportunity of serving within the academic arena, one of the most personally fulfilling experiences has been being constantly exposed to creative educational endeavors.  "At the Uniformed Services University of the Health Sciences (USUHS) DoD students and faculty can participate in Operation Bushmaster which is a two week field exercise for the School of Medicine fourth year students and the Graduate School of Nursing family practitioner and psychiatric mental health students.  During this period, the students are put into medical platoons as they learn combat casualty care, care of refugees, and the challenges of providing medical aid to detainees.  The students rotate through leadership and medical provider roles where they are evaluated by expert faculty in the areas of leadership, clinical decision making, and the transport of casualties under fire.  For over 350 students this year, the exercise culminated with a simulated MASCAL exercise; a simulated attack during a nighttime operation, resulting in mass casualties.  The students then drew on their education, training, and experience as they tried to make order out of chaos while triaging, treating, and evacuating patients.  The goal of the exercise is for the students to be prepared for being deployed to austere environments to perform any medical support operation.  Thus, the students have fulfilled USU's motto, 'Learning to care for those in harm's way.'

            "Faculty must be invited to serve as evaluators and/or observer controllers.  Most of the faculty selected has been deployed several times to many areas of the world.  The trick for faculty during the exercise is to allow the students the latitude to make decisions while being a 'measuring stick' and guide to steer the students in possibly another direction.  Each exercise performed by the students has an after action report period where the students perform a self-assessment on how they performed while the faculty provides additional feedback.  The faculty has a vested interest in participating in this exercise because they know these students may be serving under or alongside them in medical support operations in the future [Tom Rawlings, GSN]."

            Similarly, former HRSA senior staff Dan Kavanaugh: "I am enjoying my second career pursuing my acting interests, continuing to do standardized patient work at USUHS.  Since the fall, I have had a 'steady gig' with George Washington University School of Medicine (GWU) that uses theatre to work with physicians and other health care professionals around issues of professionalism and 'burnout.'  We have received very high marks from our audience (various specialties at GWU, VA hospital leadership, Society of Anesthesiologists, among others).  We are presenting to the American Association of Medical Colleges in the near future.  Essentially, we perform a short 25 minute one-act play to look at these issues and then an audience interactive piece which is facilitated by a physician from the GWU School of Behavioral Health Sciences [http://charlessamenowmd.com/medicaltheater/]."

            Expanding the RxP Agenda:  Bob McGrath (2006 Division President) estimates that there are 1,700 colleagues who have now completed their advanced RxP training.  APA's Jan Ciuccio reports that the data on achieving the Recommended Passing Score on the national Psychopharmacology Examination for Psychologists (PEP) includes both first-time takers and repeat-test takers combined.  As of November 2012, 289 individuals had taken the PEP and 230 had met the Recommended Passing Score.  Thus, approximately 80% of those taking the exam have eventually passed.  Bob: "The M.S. Program in Clinical Psychopharmacology at Fairleigh Dickinson University has enrolled a new class every year since its inception in 2000.  We have purposely kept our classes small, and will split them if they become too large.  Even so, I'm pleased to say that enrollments have actually been growing in recent years.  Since the program became one of the first designated by APA as meeting its model curriculum for training in psychopharmacology (designed for state licensing board consideration), recent incoming classes have been almost twice the size of those of 4-5 years ago.  It's clear that more and more psychologists recognize the benefits of prescriptive authority in the long term, and enhanced knowledge of psychotropic medications in the immediate future, to their patients and the profession.  Though distance based and completely online, we use a traditional academic course model in which activities, readings, and video lectures are completed weekly under the guidance of a course instructor.  We have been lucky to retain some faculty members who have been with the program since its very early days, including several exceptional pharmacists and prescribing psychologists.  The university has recently established its own School of Pharmacy, so we anticipate even greater collaboration between our program and pharmacists in the future."

During my APA Presidency in 2000, we met several times with pharmacy's national leadership and held our last Board of Directors' dinner meeting at the American Pharmacists Association (APhA) historical building on the National Mall.  The newest RxP training program is at the University of Hawaii at Hilo College of Pharmacy which graduated its first two students this past December, one of whom will soon be sitting for the PEP.  Those who have been involved with this critical legislative agenda from the beginning will recall Linda Campbell's trailblazing efforts with her colleagues at the University of Georgia School of Pharmacy.  With the enactment of President Obama's landmark Patient Protection and Affordable Care Act (ACA) [P.L. 111-148], pharmacy has been increasingly expanding its primary care role.  Back in 2008, 44 states had already recognized pharmacists' collaborative practice authority which allows for the initiation, monitoring, and modification of medication therapy for patients, typically under protocol.  What better profession to collaborate with to learn about the fundamentals and intricacies of prescribing?

            International Progress:  "The Postdoctoral Master of Science program in Clinical Psychopharmacology at the California School of Professional Psychology (CSPP) at Alliant International University will start its 15^th cohort in 2013.  The program which has also been designated by APA as meeting its model curriculum now includes a course in Molecular Nutrition and RxP.  Three psychologists from South Africa will be included in the new group, as well as at least two additional psychologists from Guam (one having already graduated).  This group will bring the number of Alliant RxP graduates to close to 500.  The program is now delivered through interactive distance education, so students can participate live from their own computers, with no travel necessary.  Classes are also recorded and archived so students can watch at a later time.  For further information contact me at stulkin@alliant.edu.  Additional news is that Dean Morgan Sammons (2009 Division President) and I will be traveling to New Zealand next spring to consult with the New Zealand College of Clinical Psychology and the New Zealand Psychology Board on the development of training programs for prescriptive authority [Steve Tulkin]."

            State Level Advances:  During the past year, we have been particularly pleased to see an increasing number of state psychological associations pursuing legislative RxP agendas.  Rebecca Gordon, one of the RxP lobbyists for the Illinois Psychological Association (IPA): "Illinois has robust discussion on RxP, moves toward passage of bill."  On March 6^th, IPA's bill for prescriptive authority passed out of the Senate Public Health Committee with a 7-5 vote.  This was the first time in Illinois history that the IPA's RxP bill had passed out of a legislative committee.  On May 1^st, the IPA, together with its lobbying and public relations teams, initiated an extensive statewide grassroots campaign to garner broad-based support for RxP.  Under the leadership of IPA President-elect Beth Rom-Rymer (2004 Division President & IPA 2011-2012 President), over 250 IPA psychologists, around the state of Illinois, have been meeting with legislators and the broader mental health care community to educate them on the legislation that would give prescriptive authority for psychotropic medications to psychologists with advanced, specialized training in clinical psychopharmacology.  Interest, accompanied by much intense discussion, has been strong with legislators and others in Illinois who are concerned about mental health treatment options.  By late November, 38 meetings with legislators and RxP supporters in their districts had been completed with an additional 48 meetings in the works.  Whereas five third party statewide organizations have officially endorsed the RxP bill, there have been ongoing discussions with numerous other third party organizations that will yield significant formal endorsements over the next several months.  Jana Martin CEO of the APA Insurance Trust and Elaine LeVine (2007 Division President and the first prescribing psychologist in New Mexico) have been actively engaged in many of these discussions.  The IPA is looking forward to re-introducing the RxP legislation early in 2013 with the hope that the bill will pass out of both Houses of the State Legislature by May 31^st, the date on which the 2013 legislative session ends.  Beth and the IPA membership are well aware of the many challenges that face their RxP bill.  That Illinois is the home of the American Medical Association is only one of those challenges.  We also understand that, as anticipated, the leadership of the Hawaii Psychological Association will again be pursuing RxP legislation at their legislature, following up on their previously vetoed bill.  There have recently been changes in the Administration and State House leadership; as well as renewed interest by rural legislators, which we would expect is a direct result of the University of Hawaii at Hilo's graduation of its first psychopharmacology graduates.

            Enacting RxP legislation at the state level is extremely important not only for psychology's clients but also for the very future of the profession.  In many ways, the President's visionary proposal (ACA) for providing quality health care to all Americans places the primary responsibility for implementation of his overarching schema at the state and local level.  Integrated care, interdisciplinary collaboration, wellness and prevention, and effectively utilizing the extraordinary potential inherent in the advances occurring almost daily within the communications and technology fields are critical to the Administration's patient-centered mission.  Clinical services are to be data-based and represent gold standard care.  Mental health care (i.e., behavioral health) is envisioned as being an important component of primary health care.  There will be an unprecedented opportunity to objectively demonstrate the clinical "cost off-set" which former APA President Nick Cummings has discussed for decades.  However to thrive as a primary care health provider in such an evolving and unsettled environment, psychology must learn and adapt to the culture of primary care and medicine.  This will be a challenge for our traditional training institutions.  Change is always unsettling, especially fundamental change.  And we have come to appreciate over the years that only a small subset of our profession is comfortable being in uncharted waters.  Those colleagues who are on the forefront of the prescriptive authority quest and thereby investing in the future are unique.  The majority of practitioners and our training institutions are unfortunately sitting back and waiting for more concrete personal and institutional benefits to evolve.

Lenore Walker: "I have thought about whether or not to write a paragraph about Nova Southeastern University's psychopharmacology program.  However, there is not much to say.  We are on what we call 'a hiatus' while we re-evaluate the program.  Under consideration is the possibility we will re-design it as an on-line program together with some of the other health science practitioners from our health science programs and include students from our doctoral program, particularly the health concentration students but possibly others also.  Nothing has been finalized yet but if we really do get one or two more states with prescribing privileges that would make a big difference amongst our administrators.  We are also mindful of the national movement towards interprofessional practice so including training psychologists together with other health care practitioners would move us closer to that goal."

Reflecting upon how members of our profession do not appreciate the magnitude of change coming, at the request of the former Dean of the School of Public Health at the University of Hawaii, HPA is attempting to ascertain to what extent Hawaii psychologists are utilizing electronic health records, which is another cornerstone of the ACA.  Alex Santiago: "I have been trying to get the information you requested about psychologists using electronic filings.  We sent a request over our list serve and I have been in touch with the Department of Health.  Very little information is available on this.  Many members report using electronic filing for billing, but only a few reported actually using them in their practice for patient records.  However, Kate Brown over at Tripler Army Medical Center did indicate that the DoD has used electronic medical records for at least the last 10 years.  In Hawaii, this would include Tripler and all outlying military clinics using the AHLTA system and the VA using the JANUS system.  At this time the two systems do not communicate with each other although she believes there are plans for the two to ultimately be integrated, including for psychology.  I am not sure if anyone has any more information on this, however, I will continue to ask."

            Intriguing Developments in Accreditation:  Alan Kraut, executive director of the Association for Psychological Science (APS), addressed our USUHS psychology public policy class this fall and described the new Psychological Clinical Science Accreditation System (PCSAS).   Over the years Alan has had a very positive impact upon professional practice.  For example, APA's first Black Tie event for national politicians was hosted by Alan, honoring U.S. Senator Daniel K. Inouye, in Los Angeles.  Increasingly, professional schools have suggested that the current APA accreditation system makes it very difficult for them to offer public policy courses or psychopharmacology.  The APS Observer reports that PCSAS was recently recognized after a three year review process (including application, several cycles of accrediting programs, and then review) by the Council for Higher Education Accreditation (CHEA), which is the national nongovernmental gatekeeper of accrediting organizations.  This should open the way for graduates of PCSAS-accredited clinical science training programs to work in settings in which graduation from an accredited program is a prerequisite for further training and employment.  CHEA is one of two organizations in the nation with the power to recognize national accrediting bodies, the other being the U.S. Department of Education.

            Under consideration is adoption by the Department of Veterans Affairs (VA) of the PCSAS standards as the federal statute provides considerable flexibility.  Currently the VA only accepts students and hires graduates from APA accredited programs.  Antonette Zeiss, who is the first psychologists and first woman to be appointed as chief consultant for mental health services in the VA, has indicated to Alan that's likely to change.  She has been leading an internal group that is in the process of revising VA qualification standards, potentially including PCSAS as an acceptable accrediting body for clinical programs.  "I think it certainly should happen.  I think the only question is just the time it will take."  The leadership of PCSAS has indicated that a next step will be to gain acceptance from state licensing boards.

            PCSAS was created in late 2007 to promote science-based training and, by extension, to introduce a new culture of scientific clinical psychology.  Their underlying objectives, which are highly consistent with the ACA, is to promote superior science-centered education and training in clinical psychology, and to increase the quality and quantity of clinical scientists, thereby contributing to the advancement of public health, and to enhance the scientific knowledge base for mental and behavioral health care.  The Director of the National Institute of Mental Health called this recognition "an important step towards allowing this brand of clinical psychology to thrive, and to ultimately benefit the public."  Over the years we have come to appreciate that in the long run competition is extraordinarily beneficial to consumers.  With the substantial professional school market for accreditation, perhaps this development will result in sufficient flexibility for an expansion of the underlying mission of psychology's training institutions to include societal-oriented courses, such as public policy and psychopharmacology.

An Interesting Proposal:  "I am very interested in virtual treatment opportunities.  I would start with licensed providers over the age of 65 who want to offer services via a virtual network.  This would allow all of us in the 'retirement' community to keep on working in our areas of expertise and not necessarily be confined to geographical borders.  If a person is licensed in State A on a doctoral level this should hold for States B, C, etc., if the National Register is the clearing house.  We certainly could refine and define the best networking possibilities (Helen Ackerman)."  Aloha,

Pat DeLeon, former APA President – Division 55 – January, 2013