ON THE SHOULDERS OF GIANTS
Honoring Visionary Colleagues: During our APA conventions, I enjoy attending the APF/APA Awards ceremonies, reflecting upon the outstanding accomplishments of our colleagues over the years. In Toronto, Division 18 Fellow Walter Penk received the APF Gold Medal Award for Life Achievement in the Practice of Psychology, recognizing his distinguished career and enduring contributions for advancing professional practice. His dedication and leadership at various federal and state agencies, as well as in academic settings, has significantly improved the lives of numerous veterans and Wounded Warriors, inspiring resiliency and post-traumatic growth. Walter was among the first to publish clinical work identifying PTSD, as well as addressing the need to consider issues of diversity among ethnic groups when looking at PTSD. We were proud that under the Presidency of Femina Varghese, Division 18 honored two members of the Psychological Services editorial team, Lisa Kearney and Phil Magaletta, for their tireless inspirational leadership. With these visionary mentors, the future for public service psychology looks very bright.
At the American Psychological Foundation (APF) Toronto reception, former East-West Center Fellow and Visionary Grant recipient Kate Corlew provided an overview of her research addressing risk perception regarding natural disasters and climate change in Hawaii and American Samoa. “Many communities in the Pacific Islands Region are vulnerable now to the impacts of climate change. The extent of the impacts varies from place to place, but what remains true is that the impacts do not occur in a vacuum – they accumulate and exacerbate each other and other disaster events and environmental hazards. My project was based on Maui and American Samoa. Both sites experience the accumulated effects of disasters and hazards. Maui has experienced increased rates of extreme drought punctuated by heavy storms (as opposed to the regular rainy and dry seasons). Secondary impacts from fluctuating between extremes include wildfire and dusty air during drought, and floods and mudslides during storms. American Samoa has been hit by a number of disasters in the last six years – a devastating tsunami that destroyed villages and killed many people, followed by multiple hurricanes. American Samoa is experiencing and projected to continue to experience compounding disasters.
“My research compared the psychological experiences of disaster recovery in the two sites (minor emergency events in Maui and large-scale disasters in American Samoa). Through a series of surveys, interviews, and community workshops, I explored psychological recovery, risk perception for future disasters and for climate change, and preparedness (emergency kits, plans, etc.) for future disasters. I found that having experienced a large scale disaster was the best predictor for taking preparedness actions against future disasters. Surviving a disaster was a better predictor than profession (i.e., disaster and climate change professionals were no more likely than other participants to have an emergency kit and plan in place than anyone else, unless they had personally experienced disasters) and was a better predictor than experiencing small-scale hazards that were inconveniently damaging but not devastating (e.g., a mudslide that blocked roads but did not kill anyone.)
“During the interviews and community workshops, I gathered stories and advice from community members, disaster and climate change professionals, and community leaders about disaster preparedness education in the focal communities. Using disaster preparedness guidelines from the American Red Cross and Ready.Gov, I developed community preparedness handbooks for the focal communities. The handbooks included simple step-by-step guides for preparedness planning, as well as stories from their community about disaster events, hazards, risk, and preparedness. Over 1,000 handbooks were disseminated for free back into communities (funded by the APF Visionary Grant), including handbooks in English and Samoan to American Samoa. I have received requests from both sites to hold more workshops. I am also beginning to develop a similar program of research and community education in Maine, where I am now located.” APF is in the middle of the Campaign to Transform the Future to increase its grant-making capacity. Although APF grants approximately $800,000 annually, only 10% of those who apply can be supported. It is the Foundation’s hope that with this Campaign no worthy graduate student or early career psychologist will go without needed support. Psychology’s visionaries can make a real difference in the lives of our nation’s citizens.
Change Can Be Unsettling: The Senate Appropriations Committee estimates the Department of Veterans Affairs (VA) is responsible for providing care to approximately 48.3 million Americans, or 15% of the nation’s population. The VA has the nation’s largest integrated healthcare system, consisting of 167 medical centers, 1,018 community-based outpatient clinics, 300 Vet centers, and 135 community-based living centers. This year the Committee noted: “Congress authorized the employment of licensed professional mental health counselors [LPMHC] and marriage and family therapists [MFT] by VA. However, the two professions comprise less than 1 percent of the VA behavioral health workforce despite representing 40 percent of the overall [nation’s] independent practice behavioral health workforce…. The Department is directed to report… on the status of hiring additional LPMHC and MFT professionals and detailing how many are currently enrolled and planned to be enrolled in VA’s mental health professional trainee program.” Further, “The Committee encourages the Department to consider the expanded use of physician assistants [PAs] specializing in psychiatric care to address the mental health provider gap. PAs provide high quality, cost-effective medical care and are held to the same standard of healthcare delivery as their physician colleagues.”
I recently had the opportunity to read the thought-provoking book Building School-Based Collaborative Mental Health Teams: A Systems Approach to Student Achievement by Kathleen Laundy. She is a psychologist who is also a MFT. It is important for practitioners who are concerned about the future of their profession to understand the experiences of the other behavioral health professions, rather than remaining within isolated professional silos. Our colleague describes the impressive contributions that MFTs have made within the Connecticut school system and their increasingly successful efforts to develop a national grass-roots support network. Her case examples are vivid illustrations of how MFTs are making a real difference in individual student lives – which, of course, is the key to political success.
This is at a time when the Obama Administration is raising fundamental issues regarding the consequences of restrictive licensure for health care professionals, including limitations on licensure mobility and variations in professional scopes of practice within the states. “Current scope of practice laws for advanced practice registered nurses – nurses such as nurse practitioners (NPs) with master’s degrees or more – vary dramatically by State, both in terms of their substantive content and the level of specificity that they provide. But State-level evidence suggests that easing scope of practice laws for APRNs represents a viable means of increasing access to certain primary care services. Research finds that APRNs can provide a broad range of primary care services to patients as effectively as physicians.” The Administration notes that this trend has expanded to the legal profession with the Supreme Court of Washington State in 2012 adopting a rule creating a new category of legal practitioners – limited license legal technicians (LLLTs). And, “According to the Pew Health Professions Committee report in 1995, policymakers should endeavor to allow practitioners to offer services to the full extent of their competency and knowledge, even if this means that multiple professions are licensed to offer overlapping services (Occupational Licensing: A Framework for Policymakers).” Aloha,
Pat DeLeon, former APA President – Division 18 – September, 2015
