The Practice Leadership Conference is always the highlight of my APA year. Once again, Dan Abrahamson and Susie Lazaroff did an outstanding job this spring, with nearly 400 of our colleagues actively participating in Advocacy and Leadership. Jared Skillings' visionary Welcoming Remarks nicely set the stage for the exciting conference. "These are exciting times. We're at the start of a new era for APA and professional psychology. It is an era that offers each and every one of us tremendous opportunities." One of aspects of these conferences which I most appreciate is the wide range of important topics to which the attendees become exposed. From my perspective the Department of Defense (DOD) has two major complementary missions: enhancing national security and fostering humanitarian efforts worldwide. DOD's humanitarian efforts can be considered preventive in nature; and, as such, although extraordinarily important and highly cost-effective in the long-run, they are constantly subject to cost-containment concerns, especially by those emphasizing budgetary priorities. Accordingly, this must become a critical focus for military psychology's leadership. One of our policy seminar speakers at the Uniformed Services University, a former Vietnam War POW, recently commented that the military has many fine managers; however, leadership is different.
To become a successful leader one must understand and honor the past. At this year's conference Gary Howell chaired a workshop addressing psychology's potential for ameliorating today's humanitarian crisis on our Southwest border. Shirley Higuchi and Giselle Hass provide an important global perspective: "Psychologists have long understood how separating family members can exact a long-term toll on children, creating traumas spanning multiple generations. During a February forum on Capitol Hill, Arthur Evans compared the World War II Japanese American incarceration with the plight of immigrants to the United States who have been placed in detention camps while they await their claim for asylum. The incarceration broke up families, which had serious effects on the children as they grew older. That impact is similar to the separation of families at the border, which particularly damages children. 'The bond established with a parent is important, particularly early in life. When that attachment is disrupted, children experience anxiety and depression.'"
Recently Arthur and his wife, and separately my wife and I, visited the site of the former Japanese American camp at Heart Mountain, Wyoming – an experience which affected each of us profoundly. Many things struck us. How can our government do this? How we can make other people 'the others' is how we can do that. Representative Mark Takano, Chairman of the House Veterans Affairs Committee: "I never thought that my being in Congress and my parents being in internment camps would be so relevant now. The difference between now and 1942 was that no one was speaking out on behalf of the Japanese Americans at that time."
Sam Mihara, a Heart Mountain Foundation board member and incarceree as a child, said the incarceration devastated his family, including how the incorrect treatment of his grandfather's colon cancer caused him to die prematurely. "In two weeks, I saw him wither away to skin and bones. He was like a Holocaust survivor." Visiting multiple detention camps for immigrants it is clear the children are given a poor diet, lots of bread and pasta and few fresh vegetables and protein. Just as the Japanese American children did, these immigrant children receive the message that they are unwanted, socially rejected, that their human rights are not important, and that they do not deserve any care by the government who should protect them.
Giselle is an immigrant from Central America who has focused her psychological research and clinical work on immigrants and the unjust situations they endure in the United States. She and Shirley have spoken in several forums, including teaching the judges, lawyers and other members of the National Consortium for Racial and Ethnic Fairness in the Courts on the similarities between what happened during World War II and today. One lesson learned is how the incarceration experience has shaped the Japanese Americans in ways that so many are just discovering now, more than 75 years after they and their ancestors were first incarcerated. Silence is the first coping trait; many Japanese Americans felt too much shame to speak about what happened to them. For years, they wanted to be anything than what they were. Some strove so hard to assimilate into white-dominated "American" culture that they lost their sense of identity and community. Others compensated by working so hard that no one could question their place in society. That workaholism often cost them healthy relationships with their families. For some, perfectionism became their path to acceptance. Everything they did had to be better than anyone else lest they lose their place in society. Former Cabinet member Norman Mineta talked about the shame he felt being labeled an "enemy alien" as a child and his determination to show that he was an American as anyone else. The Latino families and children targeted by our current border and immigration policies face the same fate. Only our memory of the Japanese American incarceration and commitment to social justice can prevent a new round of multigenerational trauma.
The Heart Mountain Wyoming Foundation, chaired by Shirley, runs a very impressive and definitely emotionally moving museum on the site of the Heart Mountain camp, where her parents met as children. The foundation is dedicated to preserving the memory of the incarceration in the hopes that knowledge will prevent it from happening again.
An Exciting Opportunity: On April 3rd, 2017 Idaho became the fifth state to allow prescriptive authority (RxP) for psychologists. Their legislation passed both houses of the legislature without any serious opposition and with only two "nay" votes. Susan Farber reports: "Idaho's Clinical Psychopharmacology Master's program is up and running at Idaho State University (ISU). New students now are being accepted for fall entrance. It is the only program in the country where students can obtain a master's degree after two years that includes pre-degree practicum work. Classes are held on Thursday and Friday. The majority of pre-master's patient-facing work is done over each summer. Consideration will be given to transferring appropriate work in other programs on a case-by-case basis. The program is being taught in a new facility next to Boise that is one of the most advanced healthcare training facilities in the country. Multidisciplinary contributions are the norm. For a full Idaho prescribing certificate, students do supervised clinical fellowship work for two years after their didactic training. For further information contact Page Haviland (US Navy Veteran), the ISU program consultant at pagehaviland@gmail.com,or Erik Silk, the program director, at silkeric@isu.edu.
"The rules for RxP were created by an advisory board consisting of nominees from the Boards of Psychology, Medicine and Pharmacy. They are in temporary effect until the legislature convenes next winter. A dispute within the legislature has affected all rules, not just ours, and put them in the hands of the Governor's office. Because of the intense vetting, our lobbyist is confident ours are in no danger. Many members of the Idaho Psychological Association plus our Executive Director, Deb Katz, and lobbyist have worked on the RxP initiative. We are very proud of this premier contribution to psychology and to the deeply underserved people of our state and of the nation." Personally, over the years, I have come to appreciate the uniqueness of the military culture and thus have been very pleased with the extent to which those involved in this particular training initiative clearly embrace this from their own experiences. "From where I stand, the future of our profession – the future of the this association – looks very promising, not in spite of the changes we face, but because of them" [Jared Skillings]. Aloha,
Pat DeLeon, former APA President – Division 19 – May, 2019
Sent from my iPhone
Thursday, June 13, 2019
Wednesday, June 12, 2019
ALOHA - D19
TRANSFORMATIONAL CHANGE
The Practice Leadership Conference is always the highlight of my APA year. Once again, Dan Abrahamson and Susie Lazaroff did an outstanding job this spring, with nearly 400 of our colleagues actively participating in Advocacy and Leadership. Jared Skillings’ visionary Welcoming Remarks nicely set the stage for the exciting conference. “These are exciting times. We’re at the start of a new era for APA and professional psychology. It is an era that offers each and every one of us tremendous opportunities.” One of aspects of these conferences which I most appreciate is the wide range of important topics to which the attendees become exposed. From my perspective the Department of Defense (DOD) has two major complementary missions: enhancing national security and fostering humanitarian efforts worldwide. DOD’s humanitarian efforts can be considered preventive in nature; and, as such, although extraordinarily important and highly cost-effective in the long-run, they are constantly subject to cost-containment concerns, especially by those emphasizing budgetary priorities. Accordingly, this must become a critical focus for military psychology’s leadership. One of our policy seminar speakers at the Uniformed Services University, a former Vietnam War POW, recently commented that the military has many fine managers; however, leadership is different.
To become a successful leader one must understand and honor the past. At this year’s conference Gary Howell chaired a workshop addressing psychology’s potential for ameliorating today’s humanitarian crisis on our Southwest border. Shirley Higuchi and Giselle Hass provide an important global perspective: “Psychologists have long understood how separating family members can exact a long-term toll on children, creating traumas spanning multiple generations. During a February forum on Capitol Hill, Arthur Evans compared the World War II Japanese American incarceration with the plight of immigrants to the United States who have been placed in detention camps while they await their claim for asylum. The incarceration broke up families, which had serious effects on the children as they grew older. That impact is similar to the separation of families at the border, which particularly damages children. ‘The bond established with a parent is important, particularly early in life. When that attachment is disrupted, children experience anxiety and depression.’”
Recently Arthur and his wife, and separately my wife and I, visited the site of the former Japanese American camp at Heart Mountain, Wyoming – an experience which affected each of us profoundly. Many things struck us. How can our government do this? How we can make other people ‘the others’ is how we can do that. Representative Mark Takano, Chairman of the House Veterans Affairs Committee: “I never thought that my being in Congress and my parents being in internment camps would be so relevant now. The difference between now and 1942 was that no one was speaking out on behalf of the Japanese Americans at that time.”
Sam Mihara, a Heart Mountain Foundation board member and incarceree as a child, said the incarceration devastated his family, including how the incorrect treatment of his grandfather’s colon cancer caused him to die prematurely. “In two weeks, I saw him wither away to skin and bones. He was like a Holocaust survivor.” Visiting multiple detention camps for immigrants it is clear the children are given a poor diet, lots of bread and pasta and few fresh vegetables and protein. Just as the Japanese American children did, these immigrant children receive the message that they are unwanted, socially rejected, that their human rights are not important, and that they do not deserve any care by the government who should protect them.
Giselle is an immigrant from Central America who has focused her psychological research and clinical work on immigrants and the unjust situations they endure in the United States. She and Shirley have spoken in several forums, including teaching the judges, lawyers and other members of the National Consortium for Racial and Ethnic Fairness in the Courts on the similarities between what happened during World War II and today. One lesson learned is how the incarceration experience has shaped the Japanese Americans in ways that so many are just discovering now, more than 75 years after they and their ancestors were first incarcerated. Silence is the first coping trait; many Japanese Americans felt too much shame to speak about what happened to them. For years, they wanted to be anything than what they were. Some strove so hard to assimilate into white-dominated “American” culture that they lost their sense of identity and community. Others compensated by working so hard that no one could question their place in society. That workaholism often cost them healthy relationships with their families. For some, perfectionism became their path to acceptance. Everything they did had to be better than anyone else lest they lose their place in society. Former Cabinet member Norman Mineta talked about the shame he felt being labeled an “enemy alien” as a child and his determination to show that he was an American as anyone else. The Latino families and children targeted by our current border and immigration policies face the same fate. Only our memory of the Japanese American incarceration and commitment to social justice can prevent a new round of multigenerational trauma.
The Heart Mountain Wyoming Foundation, chaired by Shirley, runs a very impressive and definitely emotionally moving museum on the site of the Heart Mountain camp, where her parents met as children. The foundation is dedicated to preserving the memory of the incarceration in the hopes that knowledge will prevent it from happening again.
An Exciting Opportunity: On April 3rd, 2017 Idaho became the fifth state to allow prescriptive authority (RxP) for psychologists. Their legislation passed both houses of the legislature without any serious opposition and with only two “nay” votes. Susan Farber reports: “Idaho’s Clinical Psychopharmacology Master’s program is up and running at Idaho State University (ISU). New students now are being accepted for fall entrance. It is the only program in the country where students can obtain a master’s degree after two years that includes pre-degree practicum work. Classes are held on Thursday and Friday. The majority of pre-master’s patient-facing work is done over each summer. Consideration will be given to transferring appropriate work in other programs on a case-by-case basis. The program is being taught in a new facility next to Boise that is one of the most advanced healthcare training facilities in the country. Multidisciplinary contributions are the norm. For a full Idaho prescribing certificate, students do supervised clinical fellowship work for two years after their didactic training. For further information contact Page Haviland (US Navy Veteran), the ISU program consultant at pagehaviland@gmail.com,or Erik Silk, the program director, at silkeric@isu.edu.
“The rules for RxP were created by an advisory board consisting of nominees from the Boards of Psychology, Medicine and Pharmacy. They are in temporary effect until the legislature convenes next winter. A dispute within the legislature has affected all rules, not just ours, and put them in the hands of the Governor’s office. Because of the intense vetting, our lobbyist is confident ours are in no danger. Many members of the Idaho Psychological Association plus our Executive Director, Deb Katz, and lobbyist have worked on the RxP initiative. We are very proud of this premier contribution to psychology and to the deeply underserved people of our state and of the nation.” Personally, over the years, I have come to appreciate the uniqueness of the military culture and thus have been very pleased with the extent to which those involved in this particular training initiative clearly embrace this from their own experiences. “From where I stand, the future of our profession – the future of the this association – looks very promising, not in spite of the changes we face, but because of them” [Jared Skillings]. Aloha,
Pat DeLeon, former APA President – Division 19 – May, 2019
Wednesday, June 5, 2019
TINY BUBBLES IN THE WINE
The Modern Era of Technology: Back on April 27, 2004, President George W. Bush highlighted the importance for the nation of our health care system embracing the exciting potential of utilizing the advances in the communications and technology fields to provide the highest quality, cutting-edge care to our citizenry. "Today we're going to talk about (how) to make sure America is innovative and is a leader in the world, and that is how to make sure our health care system works better. And there are some fantastic ideas as to how to do that. The way I like to kind of try to describe health care is, on the research side, we're the best…. Except when you think about the provider's side, we're kind of still in the buggy era…. There's a lot of talk about productivity gains in our society, and that's because companies and industries have properly used information technology. If properly used, it is an industry-changer for the good. It enables there to be a better cost structure and better quality care delivered, in this case in the health field. And, yet the health care industry hasn't touched it, except for certain areas. And one area that has is the Veterans Administration…. And one of the reasons the Veterans Administration is doing so well in changing, kind of, behavior… is because of our Secretary, a Vietnam Vet, a really decent guy, and who is doing a fabulous job, Tony Principi." Senior VA psychologists will recall that Secretary Principi attended the VA Psychology Leadership Conference, sponsored now by APA, Division 18, and AVAPL, during my APA Presidency.
Webinars: Ray Folen, Executive Director of the Hawaii Psychological Association (HPA): "In the mid-90's psychologists at Tripler Army Medical Center were providing counseling and psychotherapy using inexpensive videophones that – by today's standards – offered unimaginably low bandwidth. The video was often slow and pixelated, but it was sufficient – if barely so – to deliver needed services to those located in distant parts of the world. These early pioneering efforts demonstrated the utility and efficacy of this communications medium. Since then, of course, access to high bandwidth connectivity has increased tremendously, resulting in broad coverage and improved quality. The DOD and VA now embrace telehealth and, in particular, the use of behavioral telehealth.
"Videoconferencing for training and educational purposes has followed an evolutionary path similar to behavioral telehealth services. Compared to behavioral telehealth, though, the videoconference centers of the 90's had greater bandwidth (still pathetically low in today's terms). These centers were rare to find and required significant amounts of money, time and effort to operate. Videoconference sessions were highly complex events, typically requiring a dedicated videoconference room with $50K of equipment, full-time technical staff and extensive pre-session preparation. Despite all this effort, conference calls failed more often than not due to a myriad of technical problems: frozen screens, lost audio, lost connections, etc. As a result, these rooms were dark and unoccupied 95% of the time – it was simply too much trouble.
"The extraordinary changes in technology and bandwidth since that time have made videoconferencing available to just about anyone with a computer or smart device. Recently, HPA completed what may be our 100th videoconference session – an all-day in-person workshop that was simultaneously broadcast via the web to HPA members who attended the event from the comfort of their office or home. To date, 98% of our videoconference webinar workshops, presentations and meetings have been problem-free. They require a computer, a separate microphone and camera, and decent Wi-Fi connectivity. If Wi-Fi is not available, a cell phone with a 'hot spot' has provided an adequate Wi-Fi connection, as webinar platforms like 'Zoom' are very forgiving of variations in bandwidth and connectivity; audio and video quality has consistently been good.
"HPA now has highly-regarded researchers and authors giving presentations to us from all over the world. Costs are very low, given that a presentation via webinar requires no travel time or travel expenses. Almost without exception, invitations to present have received a positive response. The webinar format has become extremely popular with our members, who are now receiving excellent training in a very convenient format at very low cost."
The National Academy of Medicine (NAM) of the National Academies of Sciences, Engineering and Medicine has developed an impressive series of webinars addressing a wide range of critical global topics. This June the Culture of Health (on which Hortensia de los Angeles Amaro, Velma McBride Murry, and I have the honor of serving) will be hosting Messaging to Advance Health Equity in Public Policy. Co-Director Ivory Clarke effectively keeps stressing to the committee the importance of the community voice – ensuring that communities are continuously brought to the table and their unique expertise elevated if policy makers want to succeed. "Health equity is crucial and health inequity is costly. Communities across the country are deploying action strategies to reduce health inequities." Value-based messaging has proven effective in creating common ground to advance necessary change [https://nam.edu/event/messaging-to-advance-health-equity-in-public-policy/].
Under the visionary leadership of Morgan Sammons, the National Register has initiated a series of cutting-edge Clinical Webinars for health service psychologists, including this May Psychopharmacology Training and Legislation Update. "Webinars have become a quite effective vehicle for educating and disseminating valuable information to far-flung communities of psychologists. Gery Rodriguez-Menendez, Chair of the Clinical Psychopharmacology Department at the Chicago School of Professional Psychology, and I are conducting a webinar during which we will discuss the Illinois path to RxP legislative success and name the critical factors that any state could use to achieve RxP success. We will also be discussing the Illinois model of training for the prescribing psychologist that reflects our statutory requirements.
"The Chicago School of Professional Psychology is the only School, nationally, whose faculty are training psychology students, who have chosen to become prescribing psychologists, at the predoctoral level. Pursuant to the February, 2019 decision by the APA Council of Representatives to support the predoctoral training in Clinical Psychopharmacology, we expect that schools, nationwide, will begin to train predoctoral psychology students in Clinical Psychopharmacology, following our lead and that of NOVA Southeastern University, whose faculty trained predoctoral psychology students in the early 2000's.
"Every day, I receive calls from practicing psychologists. They have decided to begin their training to become prescribing psychologists because of the dire shortages of psychiatrists and of other healthcare professionals who have competence in diagnosing mental illness and prescribing psychotropic medications. A 2015 study by Princeton University researchers found that when advanced practice nurses were granted independent prescriptive authority in their states, the suicide rate, in those states, plummeted by 12%. I believe that we will see similar statistics in the states in which we have independently prescribing psychologists" (Beth Rom-Rymer, APA Board of Directors).
Licensure Mobility: One of the most significant consequences of the growing impact of technology on the health care field is the critical importance of licensure mobility for practitioners. "PSYPACT is operational! The Psychology Interjurisdictional Compact (PSYPACT) is an interstate compact designed to facilitate the practice of tele-psychology and the temporary in-person, face-to-face practice of psychology across state boundaries. PSYPACT allows psychologists to provide electronic psychological services from their home compact state to a patient in a distant compact state without having to be licensed in the distant state. It also allows psychologists to temporarily physically go into another compact state to provide face-to-face psychological services without having to be also licensed in that distant state. Legislative action by states is needed to adopt PSYPACT into law in their state. PSYPACT became operational once seven states adopted it. Now the PSYPACT Commission will be set up to develop the bylaws and oversee PSYPACT. This commission will be made up of one delegate from each compact state.
"As of May 1st 2019, PSYPACT is alive! The following states have adopted the necessary legislation: Arizona, Utah, Nevada, Colorado, Missouri, Nebraska, Georgia, Oklahoma, and Illinois (effective January 1st 2020). There is also active legislation in Rhode Island, New Hampshire, North Carolina, Texas, the District of Columbia, and Pennsylvania. Psychologists in these states are urged to contact their own legislators to support PSYPACT. For psychologists in compact states who want to provide interjurisdictional tele-psychology services to patients in other compact states, they will have to apply for an E.Passport and for those who want to temporarily provide in person, face-to-face services in other compact states, they will have to apply for an Interjurisdictional Practice Certificate (IPC)" (Alex Siegel, asiegel@asppb.org)." Our personal congratulations to Steve DeMers, former ASPPB Executive Director; Gerald O'Brien, President); and Mariann Burnetti-Atwell, CEO for their vision and persistence in successfully implementing this very important and timely APA Council Policy. "Make me warm all over" (Don Ho). Aloha,
Pat DeLeon, former APA President – Division 42 – May, 2019
Sent from my iPhone
Webinars: Ray Folen, Executive Director of the Hawaii Psychological Association (HPA): "In the mid-90's psychologists at Tripler Army Medical Center were providing counseling and psychotherapy using inexpensive videophones that – by today's standards – offered unimaginably low bandwidth. The video was often slow and pixelated, but it was sufficient – if barely so – to deliver needed services to those located in distant parts of the world. These early pioneering efforts demonstrated the utility and efficacy of this communications medium. Since then, of course, access to high bandwidth connectivity has increased tremendously, resulting in broad coverage and improved quality. The DOD and VA now embrace telehealth and, in particular, the use of behavioral telehealth.
"Videoconferencing for training and educational purposes has followed an evolutionary path similar to behavioral telehealth services. Compared to behavioral telehealth, though, the videoconference centers of the 90's had greater bandwidth (still pathetically low in today's terms). These centers were rare to find and required significant amounts of money, time and effort to operate. Videoconference sessions were highly complex events, typically requiring a dedicated videoconference room with $50K of equipment, full-time technical staff and extensive pre-session preparation. Despite all this effort, conference calls failed more often than not due to a myriad of technical problems: frozen screens, lost audio, lost connections, etc. As a result, these rooms were dark and unoccupied 95% of the time – it was simply too much trouble.
"The extraordinary changes in technology and bandwidth since that time have made videoconferencing available to just about anyone with a computer or smart device. Recently, HPA completed what may be our 100th videoconference session – an all-day in-person workshop that was simultaneously broadcast via the web to HPA members who attended the event from the comfort of their office or home. To date, 98% of our videoconference webinar workshops, presentations and meetings have been problem-free. They require a computer, a separate microphone and camera, and decent Wi-Fi connectivity. If Wi-Fi is not available, a cell phone with a 'hot spot' has provided an adequate Wi-Fi connection, as webinar platforms like 'Zoom' are very forgiving of variations in bandwidth and connectivity; audio and video quality has consistently been good.
"HPA now has highly-regarded researchers and authors giving presentations to us from all over the world. Costs are very low, given that a presentation via webinar requires no travel time or travel expenses. Almost without exception, invitations to present have received a positive response. The webinar format has become extremely popular with our members, who are now receiving excellent training in a very convenient format at very low cost."
The National Academy of Medicine (NAM) of the National Academies of Sciences, Engineering and Medicine has developed an impressive series of webinars addressing a wide range of critical global topics. This June the Culture of Health (on which Hortensia de los Angeles Amaro, Velma McBride Murry, and I have the honor of serving) will be hosting Messaging to Advance Health Equity in Public Policy. Co-Director Ivory Clarke effectively keeps stressing to the committee the importance of the community voice – ensuring that communities are continuously brought to the table and their unique expertise elevated if policy makers want to succeed. "Health equity is crucial and health inequity is costly. Communities across the country are deploying action strategies to reduce health inequities." Value-based messaging has proven effective in creating common ground to advance necessary change [https://nam.edu/event/messaging-to-advance-health-equity-in-public-policy/].
Under the visionary leadership of Morgan Sammons, the National Register has initiated a series of cutting-edge Clinical Webinars for health service psychologists, including this May Psychopharmacology Training and Legislation Update. "Webinars have become a quite effective vehicle for educating and disseminating valuable information to far-flung communities of psychologists. Gery Rodriguez-Menendez, Chair of the Clinical Psychopharmacology Department at the Chicago School of Professional Psychology, and I are conducting a webinar during which we will discuss the Illinois path to RxP legislative success and name the critical factors that any state could use to achieve RxP success. We will also be discussing the Illinois model of training for the prescribing psychologist that reflects our statutory requirements.
"The Chicago School of Professional Psychology is the only School, nationally, whose faculty are training psychology students, who have chosen to become prescribing psychologists, at the predoctoral level. Pursuant to the February, 2019 decision by the APA Council of Representatives to support the predoctoral training in Clinical Psychopharmacology, we expect that schools, nationwide, will begin to train predoctoral psychology students in Clinical Psychopharmacology, following our lead and that of NOVA Southeastern University, whose faculty trained predoctoral psychology students in the early 2000's.
"Every day, I receive calls from practicing psychologists. They have decided to begin their training to become prescribing psychologists because of the dire shortages of psychiatrists and of other healthcare professionals who have competence in diagnosing mental illness and prescribing psychotropic medications. A 2015 study by Princeton University researchers found that when advanced practice nurses were granted independent prescriptive authority in their states, the suicide rate, in those states, plummeted by 12%. I believe that we will see similar statistics in the states in which we have independently prescribing psychologists" (Beth Rom-Rymer, APA Board of Directors).
Licensure Mobility: One of the most significant consequences of the growing impact of technology on the health care field is the critical importance of licensure mobility for practitioners. "PSYPACT is operational! The Psychology Interjurisdictional Compact (PSYPACT) is an interstate compact designed to facilitate the practice of tele-psychology and the temporary in-person, face-to-face practice of psychology across state boundaries. PSYPACT allows psychologists to provide electronic psychological services from their home compact state to a patient in a distant compact state without having to be licensed in the distant state. It also allows psychologists to temporarily physically go into another compact state to provide face-to-face psychological services without having to be also licensed in that distant state. Legislative action by states is needed to adopt PSYPACT into law in their state. PSYPACT became operational once seven states adopted it. Now the PSYPACT Commission will be set up to develop the bylaws and oversee PSYPACT. This commission will be made up of one delegate from each compact state.
"As of May 1st 2019, PSYPACT is alive! The following states have adopted the necessary legislation: Arizona, Utah, Nevada, Colorado, Missouri, Nebraska, Georgia, Oklahoma, and Illinois (effective January 1st 2020). There is also active legislation in Rhode Island, New Hampshire, North Carolina, Texas, the District of Columbia, and Pennsylvania. Psychologists in these states are urged to contact their own legislators to support PSYPACT. For psychologists in compact states who want to provide interjurisdictional tele-psychology services to patients in other compact states, they will have to apply for an E.Passport and for those who want to temporarily provide in person, face-to-face services in other compact states, they will have to apply for an Interjurisdictional Practice Certificate (IPC)" (Alex Siegel, asiegel@asppb.org)." Our personal congratulations to Steve DeMers, former ASPPB Executive Director; Gerald O'Brien, President); and Mariann Burnetti-Atwell, CEO for their vision and persistence in successfully implementing this very important and timely APA Council Policy. "Make me warm all over" (Don Ho). Aloha,
Pat DeLeon, former APA President – Division 42 – May, 2019
Sent from my iPhone
Tuesday, June 4, 2019
ALOHA
“TINY BUBBLES IN THE WINE”
The Modern Era of Technology: Back on April 27, 2004, President George W. Bush highlighted the importance for the nation of our health care system embracing the exciting potential of utilizing the advances in the communications and technology fields to provide the highest quality, cutting-edge care to our citizenry. “Today we’re going to talk about (how) to make sure America is innovative and is a leader in the world, and that is how to make sure our health care system works better. And there are some fantastic ideas as to how to do that. The way I like to kind of try to describe health care is, on the research side, we’re the best…. Except when you think about the provider’s side, we’re kind of still in the buggy era…. There’s a lot of talk about productivity gains in our society, and that’s because companies and industries have properly used information technology. If properly used, it is an industry-changer for the good. It enables there to be a better cost structure and better quality care delivered, in this case in the health field. And, yet the health care industry hasn’t touched it, except for certain areas. And one area that has is the Veterans Administration…. And one of the reasons the Veterans Administration is doing so well in changing, kind of, behavior… is because of our Secretary, a Vietnam Vet, a really decent guy, and who is doing a fabulous job, Tony Principi.” Senior VA psychologists will recall that Secretary Principi attended the VA Psychology Leadership Conference, sponsored now by APA, Division 18, and AVAPL, during my APA Presidency.
Webinars: Ray Folen, Executive Director of the Hawaii Psychological Association (HPA): “In the mid-90’s psychologists at Tripler Army Medical Center were providing counseling and psychotherapy using inexpensive videophones that – by today’s standards – offered unimaginably low bandwidth. The video was often slow and pixelated, but it was sufficient – if barely so – to deliver needed services to those located in distant parts of the world. These early pioneering efforts demonstrated the utility and efficacy of this communications medium. Since then, of course, access to high bandwidth connectivity has increased tremendously, resulting in broad coverage and improved quality. The DOD and VA now embrace telehealth and, in particular, the use of behavioral telehealth.
“Videoconferencing for training and educational purposes has followed an evolutionary path similar to behavioral telehealth services. Compared to behavioral telehealth, though, the videoconference centers of the 90’s had greater bandwidth (still pathetically low in today’s terms). These centers were rare to find and required significant amounts of money, time and effort to operate. Videoconference sessions were highly complex events, typically requiring a dedicated videoconference room with $50K of equipment, full-time technical staff and extensive pre-session preparation. Despite all this effort, conference calls failed more often than not due to a myriad of technical problems: frozen screens, lost audio, lost connections, etc. As a result, these rooms were dark and unoccupied 95% of the time – it was simply too much trouble.
“The extraordinary changes in technology and bandwidth since that time have made videoconferencing available to just about anyone with a computer or smart device. Recently, HPA completed what may be our 100th videoconference session – an all-day in-person workshop that was simultaneously broadcast via the web to HPA members who attended the event from the comfort of their office or home. To date, 98% of our videoconference webinar workshops, presentations and meetings have been problem-free. They require a computer, a separate microphone and camera, and decent Wi-Fi connectivity. If Wi-Fi is not available, a cell phone with a ‘hot spot’ has provided an adequate Wi-Fi connection, as webinar platforms like ‘Zoom’ are very forgiving of variations in bandwidth and connectivity; audio and video quality has consistently been good.
“HPA now has highly-regarded researchers and authors giving presentations to us from all over the world. Costs are very low, given that a presentation via webinar requires no travel time or travel expenses. Almost without exception, invitations to present have received a positive response. The webinar format has become extremely popular with our members, who are now receiving excellent training in a very convenient format at very low cost.”
The National Academy of Medicine (NAM) of the National Academies of Sciences, Engineering and Medicine has developed an impressive series of webinars addressing a wide range of critical global topics. This June the Culture of Health (on which Hortensia de los Angeles Amaro, Velma McBride Murry, and I have the honor of serving) will be hosting Messaging to Advance Health Equity in Public Policy. Co-Director Ivory Clarke effectively keeps stressing to the committee the importance of the community voice – ensuring that communities are continuously brought to the table and their unique expertise elevated if policy makers want to succeed. “Health equity is crucial and health inequity is costly. Communities across the country are deploying action strategies to reduce health inequities.” Value-based messaging has proven effective in creating common ground to advance necessary change [https://nam.edu/event/messaging-to-advance-health-equity-in-public-policy/].
Under the visionary leadership of Morgan Sammons, the National Register has initiated a series of cutting-edge Clinical Webinars for health service psychologists, including this May Psychopharmacology Training and Legislation Update. “Webinars have become a quite effective vehicle for educating and disseminating valuable information to far-flung communities of psychologists. Gery Rodriguez-Menendez, Chair of the Clinical Psychopharmacology Department at the Chicago School of Professional Psychology, and I are conducting a webinar during which we will discuss the Illinois path to RxP legislative success and name the critical factors that any state could use to achieve RxP success. We will also be discussing the Illinois model of training for the prescribing psychologist that reflects our statutory requirements.
“The Chicago School of Professional Psychology is the only School, nationally, whose faculty are training psychology students, who have chosen to become prescribing psychologists, at the predoctoral level. Pursuant to the February, 2019 decision by the APA Council of Representatives to support the predoctoral training in Clinical Psychopharmacology, we expect that schools, nationwide, will begin to train predoctoral psychology students in Clinical Psychopharmacology, following our lead and that of NOVA Southeastern University, whose faculty trained predoctoral psychology students in the early 2000’s.
“Every day, I receive calls from practicing psychologists. They have decided to begin their training to become prescribing psychologists because of the dire shortages of psychiatrists and of other healthcare professionals who have competence in diagnosing mental illness and prescribing psychotropic medications. A 2015 study by Princeton University researchers found that when advanced practice nurses were granted independent prescriptive authority in their states, the suicide rate, in those states, plummeted by 12%. I believe that we will see similar statistics in the states in which we have independently prescribing psychologists” (Beth Rom-Rymer, APA Board of Directors).
Licensure Mobility: One of the most significant consequences of the growing impact of technology on the health care field is the critical importance of licensure mobility for practitioners. “PSYPACT is operational! The Psychology Interjurisdictional Compact (PSYPACT) is an interstate compact designed to facilitate the practice of tele-psychology and the temporary in-person, face-to-face practice of psychology across state boundaries. PSYPACT allows psychologists to provide electronic psychological services from their home compact state to a patient in a distant compact state without having to be licensed in the distant state. It also allows psychologists to temporarily physically go into another compact state to provide face-to-face psychological services without having to be also licensed in that distant state. Legislative action by states is needed to adopt PSYPACT into law in their state. PSYPACT became operational once seven states adopted it. Now the PSYPACT Commission will be set up to develop the bylaws and oversee PSYPACT. This commission will be made up of one delegate from each compact state.
“As of May 1st 2019, PSYPACT is alive! The following states have adopted the necessary legislation: Arizona, Utah, Nevada, Colorado, Missouri, Nebraska, Georgia, Oklahoma, and Illinois (effective January 1st 2020). There is also active legislation in Rhode Island, New Hampshire, North Carolina, Texas, the District of Columbia, and Pennsylvania. Psychologists in these states are urged to contact their own legislators to support PSYPACT. For psychologists in compact states who want to provide interjurisdictional tele-psychology services to patients in other compact states, they will have to apply for an E.Passport and for those who want to temporarily provide in person, face-to-face services in other compact states, they will have to apply for an Interjurisdictional Practice Certificate (IPC)” (Alex Siegel, asiegel@asppb.org).” Our personal congratulations to Steve DeMers, former ASPPB Executive Director; Gerald O’Brien, President); and Mariann Burnetti-Atwell, CEO for their vision and persistence in successfully implementing this very important and timely APA Council Policy. “Make me warm all over” (Don Ho). Aloha,
Pat DeLeon, former APA President – Division 42 – May, 2019
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