PSYCHOTHERAPY

President's Message 3

Editor's Column 5

Feature Article

The Los Angeles Civil Unrest: A Report from the Task Force

on Trauma Response and Research 6

Feature Article

Factitious Disorders & Malingering: Choosing the Appropriate

Role for the Psychologist : 10

Winners of Karl Heiser Award ; : 13

1993 Professional Awards 13

Feature Article

Prescription Privileges: The Marketing View 14

Feature Article

Managed Care: Seizing The Moment.. 15

Feature Article

Managed Care - The Problem and Solution 16

Council of Representative Report 18

APA Highlights : 20

Feature Article

Some Conceptual Issues Linking Phannacotherapy and

Psychotherapy . .. 22

Bylaws of Division 29 and Ballot Insert

Committee Reports 23 .

Feature Article

Group Psychotherapy Training Program , :.35

Division Membership Survey ~ ;.~ 38

Call For Program Reviewers 41

VOL.27. NO.3

OFFICIAL PUBLICATION OFDIV.ISION 29 OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION

Fall 1992·1993

Division of Psychotherapy of the American Psychological Association 1992 Officers

OFFICERS

President

Reuben Silver, Ph.D. 510 Huron Rd. Delmar, NY 12054 Office: 518439-9413

Past President

Ellen McGrath, Ph.D. 1938 Del Mar

Laguna Beach. CA 92651 Office: 714497-4333

President Elect

Gerald Kooeher, Ph.D.

Dept. of Psy chiatry, Child rens H 0 s pi tal 300 Longwood Ave.

Boston, MA 02115-5737

Office: 617-735-6699

FAX: 617-232-8399

Treasurer

Allee Rubenstein, Ed.D., 1992-1994 Monroe Psychotherapy Ctr,

59-E Monroe Ave.

Pittsford, NY i 4534

Office: 716-586-0410

FAX: 716-586-2029

Secretary

Patricia S. Hannigan-Farfey, Ph.D;

1991·1993

24600 Center Ridge Rd., Suite 420, Westlake, OH 44145

Office: 216-871-6800, Ext. 19

MEMBERS·AT·LARGE Laura Barbanel, Ed.D., 1990·1992 Dept. of Ed ucation

CUNY Brooklyn College

Bedford Ave., & Ave .. H

Brooklyn, NY H210

Office: 718-624-6507

Ernst Beier, Ph.D .. }991·1993

44 Ww 'Third South, Apt.lt6lf/ South Sal! Lake City, UT 84101

Office: 80! -581-7390

MorrisGoodman, Ph.D. One Cypress St. Maplewood, NJ 07040 Office: 201-763-3350

Sandra Haber, Ph.D. , 1991-1993 211 W. 56th St., 1t21H

New York, NY 10019

Office: 212-840-7282

Ronald F, Levant, Ed.D~ 1991·1993 50 FrostSt.

Cambridge, MA 02140

Office: 617-354-3295

Usa M, PorclJe.Burke, Ph.D., 1992-1994 CSPP-LA

1000 Freemont Ave. Alhambra, CA 91803 Office: 818-284-2777

Wade Silverman, Ph.D., 1991-1992 Barry University

11300 Northeast Secon Ave. Miami Shores, FL 33161 Offi ce: 305 -899 -3273

Robert Weltz, Ph.D" 1990-1992 7566 Martinque Ave.

Boca Raton, FL 33433

Office: 407-392-6265

Carl Zimet, Ph.D., 1992-J994 4200 E. 9th Ave.

University of Colorado Medi cal School. Denver, CO 80262

Office: 303-270·8611

REPRESENT AT/VES TO APA COUNCIL

Donald K. Freedhehn, Ph.D.,

1990· Feb .. 1993 Dept. of Psychology Mather Memorial Bldg.

Case Western Reserve University, Cleveland, OB 44106

Office: 216-368-2841

Carol D_ Geodheart, Ed.D.,

1991 - Feb. 1994 21 Harper Rd.

Monmouth Jct., NJ 08852 Office: 201-246-4224

STANDING COMM/rrEES

Education arrd Training

Jeffrey HI nder, 'Ph,D., Co-Chair 2424 zi« Ave. South, Suite 200 Nashville, TN 37212

Office: 615-269-7601

Hans Strupp, Ph .D., Co-Clwi.r Dept. of Psych .. , Vanderbilt Univ, Nashville, TN 37240

Office: 615-322-0058

FeUows

Norman Abeles, Ph.D. Psychology Research Bldg. Michigan State University East Lansing, MI 48824 Office: 517-355-9564 FAX: 517-353-5437

Finance

Alic~ Rubenstein, MD., Chair Monroe Psychotherapy a.r.

59-E Mooroe Ave.

Pittsford, NY 14534

Office: 716-586-0410

Gentler Issues Commiue«

Gary Brooks, Ph.D., Co-Chair Psychology Service

116 B4,. DE Teaque VA Center Temple, TX 76504

Office: 817 -778-4811

Membership

Leon D. VandeCreek, P!J.D" Chair Dept. of Psychology

Indiana University of Pennsylvania, Indiana, PA 15705

Office: 412-357-4520

MuJJicuburoJ.AJfain

Usa M. Porche- Burke, Ph.D., Chair CSPP-LA, 1000 S. Fremont Ave. Alhambra, CA 91803:

Office: 818C284-2777

NomiMJionsrmd Ekclions Gerald Koocher, Ph.D_ Dept. of Psychiatry , Children s Hospital

300 Longwood Ave. Boston, MA 02115-5737 Office: 617-735-6699 FAX: 617-232-8399

Professional A wards Ellen McGrath,. Ph.D. 1938 Del Mar

Laguna Beach, CA 92651 Office: 714-497-5003

Professional Practice D1.vlsIoo ~ Psychotherapy Ellen McGralh, Ph.D. 1938 DelMar

Laguna Beach, CA 92651 Office: 714-497-5003

1992 Program Committee Norlne Johnson, Ph.D. 110 W. Squantum, #17 Quincy, MA 02171 Office: 617-471-2268

P"buctltions.Board Chair

Herbert J. Freudenberger, Ph .D.

IS East 87th St. .

New York, NY 10128:

Office: 212-427 -8500

S tudent De velopm e 1f1 Micha.el Carma, Ph.D. Barry University

11300 Northeast 2nd Ave., Box 21 Miami Shores, FL 33161

Office: 305-899-3275

This is my last col umn as President of this Division.

During my term of office I have had the pleasure of working with talented officers and Board members, and serving a Division dedicated to the public good. I have been especially grateful for the opportunity of serving during the AP A Centennial and during the 25th anniversary of the founding of our Division.

A President is in office for only one year. Accordingly, accomplishments during that tenure result from the efforts of previous administrations and from those that follow. Therefore, whatever we have achieved this past year is due, in no small part, to the efforts of the Officers who have preceded me and to those who will follow. Although there is always a danger in singling our individuals, I wish to acknowledge the fine efforts of our immediate Past President, Ellen McGrath, and our President-Elect, Gerry Koocher. I look forward to the leadership that he and our President-Elect designate, Tommy Stigall, will provide. The Division is in good hands.

Does Division 29 serve the membership appropriately? That question is difficult to answer without knowing the complex interests of our members. Unfortunately, we lack empirical data about the hopes, aspirations, and concerns of our membership.

But we do know some things about our members, thanks to the Profile of Division 29 members provided to me by the APA Office of Demographic, Employment and Educational Research. Compared to APA, our Division has a smaller percentage of members

PRESIDENT'S MESSAGE

under age 40 than APA has, 12% compared to 23%. Also, we do not do as well as AP A in attracting recent graduates into the Division, only 4% of our members have been out of school less than 5 years compared to 9% in APA. Although more women in Division 29 achieve Fellow status than is true for AP A in general, the percentage is smaller than I would like, 25 % versus 18%. In addition, the percentage of women members of Division 29 is less than for APA, 32% versus 38%. Clearly, we need to recruit more actively recent graduates and women, the two are likely to be highly correlated.

I was astounded to learn how few of my colleagues in Medical Schools belong to our Division, best estimate is that 3% of Medical School psychologists belong to Division 29. Since most of them also are engaged in psychotherapy, we also need to reach out to them.

PSYCHOTHERAPY BULLETIN

Pctl~=C. by :he

D :'ISIO_ T OF PSYCHOTHERAPY ~IERIC~T PSYC'dOLOGICAL ASSOCIATION

3815. T. 44th Street • - : . Arizooe 85018 • (602) 952-8656

'.AnE H. sn, rEIU fA.'l, Ph.D., Editor

CONTRIBlFI'ING EDITORS

Medical PsydlOJo " David Adams. Ph.D.

PSYCo1nrr:n ~ Mathilda Canter, Ph.D.

Washing-..on Sce::;ek ._ Patrick Del.eon, Ph.D.

Media. brltetin.g &. ~ hology Bruce Forman, Ph. D.

Professio.:cl -~. - _._ Leon VandeCreek, Ph.D.

Fma:J:ICe ~ __ .. _ Jack Wiggins, Ph.D.

GJoop _.1' ~ __ Morris Goodman, Ph.D.

S Il!:lI%Ahfse Harry Wexler, Ph.D.

STAFF

CemmJ. Office Administrator Pauline Wampler

Associa.re. Administrator Norma K. Files

3

Although more than 7 out of 10 of our members have a health service degree- 73% of whom received the degree in Clinical Psychology -almost all 94% of our mem bers provide some type ofhea1th care service. However, a significant proportion of our members also are involved in research-28%, education-44%, and administration-4S% .. So it seems to me that our members are practitioners, who do research, teach, and are in management positions.

Most of us belong to more than one Division. In fact, more than half are members of three or more Divisions. The Divisions with which our members are most likely to affiliate are Division of Independent Practice-38%; Division of Clinical-29%; Division of Psychoanalysis-1S %; and the Di vision ofFamil y Psychology-IO%.

Although most of our members do not hold the ABPP diploma, most of our Fellows do-56%. I was surprised to learn that less than three quarters of our members belong to State Associations. With the large number of us who designate ourselves as health care providers, I would have expected greater involvement with the State organization.

Does the Division adequately serve this diverse group of members? The resul ts of a survey reported by John Norcross earlier this year in theBulletin suggests that we do. Yet in specific areas the answer is less clear. For example, should we be more involved with political activities? Most members say "yes" when the question is posed in such a general manner. We need to know specifically how our members interpret the word "political". Of course, individuals within our Division are very active in the political arena. But I wonder how much the general membership knows about that activity. In the future, we plan to let you know about such doings on the part of our members.

Our Division is very responsive to the needs of our citizens. I am thinking about what our Task Force on Trauma did immediately following the Los Angeles riots. In response to a request from the Los Angeles Department of Mental Health - they know of OUI efforts in providing help to those families left behind during Desert Storm - the Task Force developed a programmed response to the rioting. That type of response to the public need should make us proud to be members of Division 29.

Our brochure, Psychotherapy With Children and Adolescents: A Guide For Parents, a product of the Task Force chaired by Alice Rubenstein, has been both a public service and a membership benefit. It is an excellent method for psychologists to inform the public about the practice of psychotherapy with that population.

I give our scholarly communications with our membership high grades. Our Journal, Psychotherapy, in my opinion, gives our members the kind of information important in the practice of psychotherapy. The Psychotherapy Bulletin is more than a newsletter; it is a first rate publication. Thanks are due to Don Freedheim,Editor of the Journal ,and Wade Silverman, Editor of the Bulletin and Editor Designate of the Journal.

We have just published an outstanding volume, History Of Psychotherapy. All who are interested in the field of psychotherapy will benefit from reading this book. The History Of Division 29, also published this year, lets you know how things were when we first began and the progress we have made.

At the grass roots level, we need addi tional ways of communication with our membership. Accordingly, in the months ahead, we will be organizing local activities for members of our Division. Affordable continuing education programs will be a high priority. Our Division is the one that should be in the forefront on issues that concern psychotherapy, be those issues scholarly, marketing, or political.

We have also established a Committee on Public Information about Psychotherapy. That Committee, in conjunction with OUI Marketing Committee, and perhaps in collaboration wi th the Practice Directorate, could help the public understand the value and need for psychotherapy. If successful, we will have a marketing tool of considerable appeal.

Almost 10% of our members work in hospitals.

Therefore, many of them see patients who have a severe mental illness. What should be the role of psychotherapy with that type of patient? To answer that question, we have asked our Education and Training Committee to consider that issue.

Psychopharmacology is another "hot" issue facing psychotherapists. By psychopharmacology I do not mean just prescription privileges. Should we be

4

providing training in psychophann for our members? Should we take a stand on prescription privileges? Although these are difficult questions, we have asked our Committee on Education and Training to address these concerns.

Division 29 does more. When you belong to Division 29, you belong to a community that cares about its members. Psychologists who are involved in psycho-

therapy as practitioners, educators, researchers, or administrators should belong to Division 29.

Throughout our history we have been concerned about matters that are important to psychotherapists. We will continue on that path in the future.

I am pleased to have had the opportunity to have served you this past year.

September, 1992

ED ITO R' S CO L U M N !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Wade Silverman

August 23, 1992, a day and night I surely won't forget. Evacuation orders on the radio ... Hurricane Andrew heading straight for my neighborhood. Load up the two cars, family and let's split. "No, you can't take your do Us with you but we will pack them in plastic bags and put them on an uppershelfinacloset" "Grab the photo albums." "I must pack my current patient files. H "Do you have the insurance papers?" "I must call my mother to tell her not to worry."

It wasdarkbefore our mini-caravan arrived at Bruce and Laura Forman's house. We unloaded can goods, bottled water, flashlights, three suitcases, and the remains from om refrigerator. It was going to be a long night

At approximately 4:10 a.m. it hiL Fierce wind whistling through tb.eporesofrhe bouse. Thatproverbial freight train sound man:hi:ng through the neighborhoods. We heard the groans ofbending steel. cod and metal projectiles b:iIling walls and cars, We went to the hallway and huddled rmder blankets IlIlIil the worst was over, finally to a Dl)[Ib eel sleep.

In the morning we sa . de-l1'2St2!.illl who had never experienced DC roofs, downed power lines, large trees S£reI;m across

lawns and in the streets e ~ sticks,

hoping to be one oftbose beds. There were omi • gns ~. way to om neighborhood. The tree- . ed street was no more ... Roofs in the yards o neigtbors., living rooms

open to the morning snn, was standing -

barely. Almost e .. ;'35 broken. There

were shards of glass e>eryv;ilere. Leaves were stuck

to the inside walls of the rooms and furniture was tossed about. The stench of mildew was already in the air. The wood floor that required two weeks of motel living to finish was warping. Our mattresses were soaked. The pool was filled with black-green water.

Marsha and I moved as much as we could over the next several days in a race with the looters who were rumored to hit the neighborhood at any time. Our most prized possessions were saved and, thus, our family legacy.

We are now waiting for the insurance adjuster to come to help decide our fate for the next several months. All of Dade County had no power so we moved one county north and got the last room in the Day's Inn. I called central office to tell them the Bulletin might be delayed for a few days - no mail in Dade County.

It is strange indeed to watch this all from the inquisitive eye of a social scientist who is a participant-ebserver. Iris interesting to see what is important to people, e.g., my teenage daughter's dolls, my nineyear old son's intendo, my wife's artwork, my 1975 Chicago Cub-Pittsburgh Pirate scorecard in which Rene Stennett went 7 for 7. Catastrophes unleash elemental forces in people as well as nature. There is price-gouging and the looting. But there are also the volunteers - people who traveled for miles to bring food, water and comfort. So many people called me, actually tracking me down in my motel room to show concern and offer aid.

Social support is not justa hypothetical concept, but a powerful source of healing. Friends and neighbors are the solution to post-traumatic stress. You can be sure of that beyond the .05 level of significance.

5

FEATU B.E A RllelE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

The los Ange'les Civil Unrest:

A Report. from the Task Force on Trauma Response and Research Regarding In,tervention in Large Scale Disasters

Jon T .. Perez-Liferlus Foundation Trauma Recovery Team

Ellin B lock-U ni ver sity of Cincinnati

Sandra L. Ernst-Barrington Psychiatric Center

Los Angeles was always considered a city of dreams and illusions; sometimes innovation, sometimes serious, but more often than not the city was viewed. by the rest of the country as benignly entertaining. Such important trends as surfboards, rollerblades, and Beverly Hills 90210 got their start in L.A. Even for those of us who were born and raised here there was a comforting sense of equality between what is and what might be. Or, as one of our East Coast colleagues recently commented, the city was seen as "The Land of Oz."

Oz.fndeed,

On April 29th, 1992, the illusion, and many others, burned. Beginning at approximately 4:00 p.m. local time violence erupted that would, over the next 72 hours, engulf a metropolitan area of approximately 5 million people and become the nation's largest civil upheaval since the Civil War. At last count, 51 dead, over two hundred seriously injured, several thousand arrests, and over 1 billion dollars in damages and losses were reported. Long simmering racial, ethnic, legal, and economic problems exploded that afternoon as the city waged war against itself. And with true L.A. style, the entire event was broadcast in realtime to the world.

The Task Force on Trauma Response and Research was active in several areas during and following the unrest. At this writing, several members continue to work on various aspects of the city 's recovery. What follows is a narrative account of selected Task Force activities as well as some of the theoretical and practical issues raised as a result those experiences. It is our belief that as Los Angeles' image of a dream factory was seen as an illusion, some professional illusions were also called into question as a result of what happened there ..

It is our hope to open a professional dialogue and exchange of ideas about intervening in large scale disasters and traumatic situations which appear to be

occurring with increased frequency in recent years. It is our firm belief that psychologists are uniquely positioned to offer services for affected populations, not only in direct service roles, but also in providing theoretical understanding and strategic, system level interventions. As our experiences in the Loma Prieta earthquake, the Gulf War, and now the Los Angeles unrest appear to indicate, if we intervene at the direct service level only, literally hundreds of thousands of people will not receive services. As we see it, our major role as a Task Force now is not primarily direct service, but formulation of more realistic, and hopefully more sophisticated intervention models utilizing tools and techniques that previously were beyond the scope of traditional clinical intervention. These developing models incorporate theories and practices from other psychological specialties including community, social, school, and industrial/organizational psychology.

Psychological trauma intervention has primarily been a reactive undertaking. After the earth stops shaking or the dust settles, psychological interventions begin. The interventions vary depending upon the nature of the trauma and the training and resources available to those providing the services, but they usually focus on providing written symptom information, group debriefing, and short term individualcounseling, Over the years, and to many mental health professionals' credit, psychological reactions totraumarie situations are increasingly being viewed by the professional and general public as "normal responses to abnormal situations." The social stigmas usually associated with traumatic responses are lessening as public awareness and education increases. This, in and of itself, is a major accomplishment. However, as we have seen consistently in our work in large scale disasters, this is only the beginning.

Throughout our work, we have noted that in traumatic situations, especially larger incidents, three intertwined phenomena occur: personal victimization, lack of control and chaos. These phenomena are the

6

roots from which the resulting individual reactions grow. And just as individuals have reactions to traumatic events, so do the systems that attempt to help those individuals. Los Angeles serves as an example of how these systems were, themselves, traumatized and how this parallel process affected direct services. Standard individual traumatic intervention targets the phenomena as treatment foci, but such intervention has not been extended to systems with the same success. It is for that reason we are now focusing most of our energy on delivery systems. We note that while Los Angeles serves as the example here, similar problems have been seen in every other disaster to which we have responded.

Leading up to the Rodney King verdicts there was a general sense in the community that there would be convictions on at least some, if not all the counts brought against the involved officers. Shock and disbelief were the most often reponed emotions as the verdicts were read. And no one was ready for the violent reaction that followed.

The entire emergency services system in Los Angeles was caught off guard. Law enforcement, fire departments, and city emergency services did not expect, and thus were initially unprepared for the violence that erupted' after the verdicts were read. The Los Angeles County Emergency Operations Center, which is the command center in the event of an emergency, was staffed only for routine operations. The police contingency plans for large scale unrest were not implemented f hours, And fire departments were not geared 10 disaster response levels. IronicaUy, it was tbeLostAnge1es media, particularly television and radio. ere:e first II) respond in force.

The media exercised . tomillions. The effects of ~ being assessed cooperaIirely' and representatives of important to understand

any disaster and psyc with them as part of protocol.

lein c; ~can. 'ark . .:....... disas:er response

As the unrest grew, SO control, and chaos, ~ one Task Force member

chy." This was said to

Task Force member watched the rioting come within a block of his home. Even as the unrest grew, Task Force members were preparing to respond. As much for professional reasons, this preparation was a personal way for us in Los Angeles to seek some control in the face of events over which we had none. As has been demonstrated in other disasters, it is critical to receive psychological assistance from people outside the affected area. We, who were in Los Angeles, were personally affected by what was going on around us. We were personally involved. Ourprofessionaljudgment and responses were influenced by our personal predicaments. There were several colleagues outside the area who helped those of us in Los Angeles to not only formulate a professional response, but also help with our personal recovery.

Forty-eight hours into the unrest we prepared what we believed was an appropriate initial response given our resources, which were three people on site and another six outside the area. We prepared written psychological information that was specific to the rioting for adults and children. This information was available in English and Spanish. Using our generic trauma recovery guidelines as templates, they were modified to meet the demands of the civil disturbance. We also decided that we would be able to offer some limited direct service capabilities, but that our focus should be on training others for delivering direct services, as well as helping systems already in place.

The requests for information and assistance began to come in on Saturday, May 2nd, 72 hours after the unrest began. Several media requested written information and some interviews were given regarding expected responses and methods of coping. The Los Angeles county Department of Mental Health (DMH) also called requesting written information for teachers and smdeats as classes were scheduled to begin again on Monday, The trauma guidelines and specific recommendations to teachers and administrators were prepared and delivered. It is oUI understanding this information was sent to every school district in Los Angeles County as well as several hundred of the schools in the most affected areas on Monday morning.

We were also requested to provide debriefings and trauma intervention training to local professionals, staff, and graduate students on Monday morning. Further, two major health care corporations in the area

7

requested written information, client debriefings, and organizational consultation as they attempted to formulate their responses. There were several other requests for direct services which also came in on Monday. All requests were triaged. Given our paltry resources in the face of such overwhelming need, we did as we had done in previous major disasters. We knew we were not the only ones engaged intrauma related psychological services, and through many telephone calls we were able to identify several other groups and organizations which could provide direct service, incl uding Los Angeles County Psychological Association's (LACPA) disaster response team. Most of the direct service requests were referred. to LACPA, except for those which requested racially or ethnically specific interventions. Those requests were referred to the Association of African American Mental Health Professionals and the Asian Pacific Counseling Center.

Our own interventions in the following two weeks consisted ofdirect debriefings to approximately three hundred people at local colleges, corporations, and health care agencies. Trauma training was given to approximately the same number of mental health professionals and graduate students. The trauma guidelines were sent to scores of agencies. We were also assessing the magnitude of the event, the services available, and continuing to modify system level intervention strategies based on the information we were receiving.

We found that there were a multitude of agencies and indi viduals providing direct service and no coherent coordination of these services. Community agencies and individuals that were delivering services were themselves victims. Asian, African American,and Hispanic agencies, as well as agencies in the rio areas were the most affected. The racial and ethnic tensions seen in the general population were also present in professionals delivering services. In our trainings and debriefings, the depth of mistrust, anger, and enmity between groups were very apparent. Unlike natural disasters, w here people rall y together in support against an external force, the unrest factionalized large segments of the population by racial, ethnic, and socioeconomic strata. Despite the initial appearance of multicultural cooperation in immediate physical clean up efforts, the wounds were deep, and the cooperation, for the most part, was transitory or ambivalent.

We decided our long range services could be utilized in coordination of services, but there was no

initial coordination agency or organization in place. At the end of the first week, however, DMH organized a special meeting to begin the process of assessment and coordination of services. The Department's new Director, Areta Crowell, Ph.D., understood the need for such coordination and assessment and acted accordingly. Following that meeting, and at their invitation, the Task Force decided to put its major focus on helping Dw-I respond.

Over the next few months we assisted DNlH in their response, specifically in their formulation of the Federal Emergency Management Agency (FEMA) grant for crisis counseling and related services. Their story deserves telling because of the problems they faced, their extraordinary efforts to meet tremendous needs, and what their experience may teach others.

Over the last ten years or so Dw-I has seen its operating budget out to the point that its services have been limited to primarily emergency care and services to the chronically mentally ill, When the unrest occurred it is our understanding the department faced further budget cuts ofbetween 10 and 30% depending upon state budget negotiations taking place in Sacramento, which as of this writing have yet to be finalired. Like the restofus, they were not prepared for the magnitude of violence and destruction which ensued.

A DIv1H task force was formed to respond immediately to the still growing unrest. It was tasked with coordination of direct services by DrvIH personnel as well as contract services: liaison with and services for the state office of emergency services, FEMA and the Red Cross; and also to provide a needs assessment. The task force worked continuously for at least the first week to coordinate activities, and basically twelve hour shifts for several weeks following that.

To make and overwhelming situation even worse, the unrest was only one of what would be five Presidentially declared California disasters in a year. The others were the Oakland fires, the Eureka, Yucca Valley, and Big Bear earthquakes, and the flooding in Los Angeles and Ventura Counties. Emergency management agencies were stressed beyond any contingency plan. The reality was a worse case scenario no one would have imagined.

First, federal guidelines specified the money is used for crisis counseling only. The purpose of this guideline was to ensure monies were used for crisis services

8

and not to bolster normal operating budgets. For most disasters crisis counseling is the major intervention. Not so for the unrest. It was clear to DMH that crisis counseling was a major component, but healing a community following such human conflict was unprecedented and req uired different, as yet unspecified intervention strategies. While FEMA also understood this, their guidance was limited to making sure the services were centrally managed, and that the services were "appropriate" to the need. The final decision would be made in Washington, D.C. by a panel of experts from FEMA and NIMH wi th whom DMH had only peripheral contact through the state and federal bureaucracies.

This first problem led directly into the second, DMH management is decentralized. The county is broken down into service areas and the service area directors have primary responsibility for their areas onl y. Further, management is separated into ad ul t and children services. In order to receive FEMA funding, a completely separate management structure would need to be formed that would be separate from and potentially supersede the existing one for service delivery specific to the rioting. Add to this the fact that existing DMH resources would be required to coordinate the whole operation, when they were already understaffed for their primary day to day care del ivery and those resources could not be funded under the grant guidelines. As many organizational psychologist could attest, the required changes would seriously strain any organization in the best of times, let alone during the afterma!b of !he unrest.

At this writing, the fin;!: nine month grant proposal was rejected, as D ill and ~ believed it might be. The initial 90 day grant \\<15 ertended so that services could continue, and the guidance FE 1A regarding the nine month proposal is bein .. ~ for

re-submission by early Sep . TIle D_IH

force is making more agonirin.:; rW"itii~;: bearing in mind the great D!ed Angeles attempts to recover

If there is a major cri ticism of this whole process, it is the need to have direct and ongoing communication linkages between governmental agencies, city, county, state, and federal bureaucracies must have a more open and flexible communication system to appropriately meet the exigencies of disaster response. Close, detai led guidance from FEMA and the grant selection committee directly to DMH could have averted the initial grant rejection and the new services would already be in place.

Now, four months following the unrest, the reasons for, and the long term effects of it remain controversial. The conflicts center, as did the unrest itself, along racial, ethnic, and socio-economic lines. What is not controversial, however, is that the conflicts continue and the potential for further upheaval is high. As a result, the interventions in place, as well as those awaiting FEMA funding are targeted at haling not just the traumatic reactions, but also the manifold conflicts which contributed to the unrest. All this is taking place in the face of a budget shortfall which could force further closures of critical programs, instead of equally critical program creation.

There is a postscript to all of the above, and one that, yet again we did not suspect. As we write this, Hurricane Andrew has just decimated much of southem Florida and parts of Louisiana. The initial figures are numbing: 250,000 homeless. over 20 billion dollars in property damages, and the relief efforts are already marred by miscommunications, lack of coherent lines of au thority, bureaucratic conflict, and overwhelming needs and limited resources. If we did not learn from LA., we fervently hope wedo so in Florida and Louisiana. Over the last several years, our experience indicates there will be other, as yet unknown disasters, and if there are not significant changes in delivery systems, disaster survivors will face further victimization even as they attempt to recover.

Division 29 welcomes nomina ·ODS or Distinguished Psychologist of the Year 1993 and the lack Krasner A ward for 1993.

Please send your nominations to:

Awards Committee Division 29 Central Office 3875 '. 44th Street, Suite 102 Phoenix, Arizona 85028-5435

9

FEATU RE. ARTICLE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Factitious Disorders & Mal'ingering:

Choosing the Appropriate Role for the Psychologist Dayid B. Adams

Ninety percent of spinal injuries are nonspecific and are relegated to diagnoses such as strain, sprain or myofascial pain. There is no consensus as to how such injuries are to be managed, but some treatment trends do emerge, such as nonsteroidal anti-inflammatory drugs, physical therapies, epidural injections ("block") and a variety of work-hardening and/or work -strengthening programs. There is not, however, unanimity of approach, and it is well documented that health care expenditures escalate as a result of repeated :MRIs, Cf-scans, myelograms, cr -myelograms, disco grams , EMGs and similar diagnostic approaches.

Even when there is a confirmed diagnosis of an HNP ("herniated disk"), there is not consensus as to whether a diskectomy, laminectomy, spinal fusion and/or the manner by which such procedures should proceed .. Some surgeons will state that unless there is nerve infringement, surgery should not proceed. Others feel that while the patient is young, non-obese and non-smoking that their response rate to surgery will be optimal. Surgeons are often referred to as conservative (those who use noninvasive procedures) or liberal/aggressive when they seek surgical solutions for most spinal injuries. This does not mean that there is not some degree of agreement as to the nature of the injury but conflicts as to the most appropriate means of management of that injury.

It is clear that these decisions can never be free of financial considerations. Surgeons do not generate the bulk of their income from outpatient care. Similarly, due to the escalation of professional liability insurance, no one wants to be in the position of a less than optimal surgical outcome, and aggrieved patient and a highly litigious situation. The surgical decision, the decision to treat, is based upon an admixture of diagnostic findings, economic considerations, patient risk factors and professional liability concerns.

The clinical decision making process does not differ in psychology. To make the decision not to treat has specific economic repercussions, but not every patient referred for treatment is an appropriate candidate. Chief among those are the patients for whom the psychotherapies will prove ineffective as well as those for whom there is no mental disorder which to treat.

Clinicians in tertiary care positions receive their referrals from other clinicians higher in the pathology chain (that continuum which the patient enters when he/she experiences and reports symptoms). The ER may triage to the primary care physician who may, in tum, refer to an internist and or surgeon. In our society, the patient reaches the psychologist only when blatantly unmanageable, recognizably in poor compensation, verball y demanding psychological care or simply presenting as someone who does not fit the diagnostic criteria of known pathophysiologic processes.

The patient is. too often, sent to the psychologist out of desperation, futility and through the frequently discussed diagnosis-by-exclusion process.

The consulting psychologist must deal with three immediate issues: a. what, if anything, can a psychologist offer this patient, b. if nothing can be offered this patient, will the referral source be disappointed, offended and unlikely to refer again, and; c. if nothing is wrong with the patient, is it tenable to make a definitive statement to that effect? Is, in fact, the patient malingering, and if not malingering in its formal definition, does the patient suffer from a factitious disorder? The remaining option is to behave-asthough a somatofonn disorder exists, thereby justifying treatment, offending no one, running minimal risk to the practice, but also assisting in the manipulative process of the patient and further contributing to the overwhelming status of the nation's health care expenditure.

In making the clinical decision as to that which is operating the patient, the psychologist assumes the role of being capable of differentiating between factitious, somatoform and feigned disorders. A psychologist who believes that factitious disorders and malingering are synonymous and/or that somatoforrn pain is not a state of discomfort for the patient, is, by definition, a compromised clinician. Factitious is not synonymous with fictitious, nor does the act of malingering constitute a. mental disorder.

Factitious Disorder involves voluntary amplification or production of physical and psychological

10

symptoms due to internal motivation such as unconscious need to maintain oneself in the role of patient. Factitious disorders are considered mental disorders and fall within the province of those psychological conflicts which warrant treatment. For complex reasons, the patient suffering from factitious disorder needs to be perceived as injured or ill in order to meet underlying, chiefly unconscious, needs. Patients with factitious disorder will willfully submit to painful, dehumanizing and even dangerous diagnostic and therapeutic procedures in order to meet these unconscious needs. In medical clinics, it is not unusual to fmd patients who have undergone multiple invasive procedures designed to treat conditions or disease processes which were found not to exist.

By contrast, patients who are malingering are consciously aware of their moti ves, They feign symptoms in order to secure financial remuneration, to avoid demands made upon them, to escape responsibility or to deliberately control the behavior of others. Malingering differs from Conversion or other Somatoform Disorders by the conscious reproduction of symptoms for external incentives. There is less likely to be a symbolic, underlying psychological conflict tied to symptoms. Symptom relief is not obtained by suggestion, hypnosis or amobarbital interview, as it frequently is in Conversion Disorder.

Factitious Disorder and Malingering do not occur concurrently. The patient is either driven by unconscious needs to simulate a disorder or does so for specific and conscious secondary gain. A malingering patient will insure that no true danger comes to him! her. A patient suffering from factitious disorder may place themselves at risk, Ie to control tbeimpulse to act-out the role of the patient.

The potential for malingering be considered in

approximately 10% of cases ofpersooal m"

overview of malingering i~.l.v1l~

1. Patient being direcdy refared for evaluation

2. Marked d.iscrepaDcy ed dis-

ability and objective fuv~ ''''

3. Lack of cooperation .. ' ill: e\'"<llnation or

recommendations

4. PresenceafAnlIis:Jcii!'pu.~"'-'-'.I.

a. history of truancy

b. often initiated physical fights

c. used a weapon in more than one fight

d. forced someone into sexual activity with him or

her

e. was physically cruel to animals

f. was physically cruel to other people

g. deliberately destroyed other's property

h. frequent lying (other than to avoid abuse)

i. has stolen with or without confrontation of a

victim

j. deliberately engaged in firefighting

k. repeatedly fails to honor financial obligations 1. is unable to sustain consistent work behavior

m. impulsive behavior, such as moving with no plan and having no fixed address for month or more

n. reckless regarding the safety and/or well being of self and others for whom responsible.

Malingering involves a motivation for symptom production that is external, whether for financial gain, escape from work, escape from otherresponsibilicy(ies) etc.: the malingering individual is consciously aware of their goal.

Diagnostic Criteria for Factitious Disorder with Physical Symptoms:

1. Intentional production or exaggeration of physical (but not psychological) symptoms

2. A psychological need to assume the sick role with an absence of external incentives

3. May occur in absence of other psychological clinical disorders.

Diagnostic Criteria for Factitious Disorder with Psychological Symptoms:

1. Intentional production or exaggeration of psychological (but not physical) symptoms

2. A psychological need to assume the sick role with an absence of external incentives

3. May occur in absence of other psychological clinical disorders.

Diagnostic Criteria for Conversion Disorder:

1. A loss of, or alteration in, physical functioning suggesting a physical disorder

11

2. Temporal relationship between a psychological conflict or need, and occurrence or exacerbation of symptoms

3. Patient is not conscious of intentionally producing the symptom

4. Symptom is nota culturally sanctioned response pattern and cannot be explained by known physical disorder

5. Symptom is not limited to pain or to a disturbance is sexual functioning.

Diagnostic Criteria for S om ato form Pain Disorder:

1. Preoccupation with pain for at least six months

2. Either a) or b):

a. Evaluation uncovers no organic pathology or pathophysiologic mechanism to account for pain

b. When there is organic pathology, complaints are grossly in excess of expected.

Psychological indices of malingering have been variously classified to include:

1. A histrionic or dramatic presentation

a. theatrical presentation

b. eagerness to discuss symptoms

c. extreme severity of symptoms

d. indiscriminate endorsement of symptoms

e. a "clowning" of fantastic quality to presentation

2. Deliberateness and carefulness

a. examiner must repeat questions

b. slower rate of speech

c. more hesitations in response to questions

d. extensive use of qualifiers

e. vague, nonspecific responses

3. Inconsistent with diagnosis

a. symptoms which appear and disappear suddenly

b. rare quality of symptoms

c. unusual combination of symptoms

4. Inconsistency of self-report

a. contradictory symptoms

b. disparity between reported and observed symptoms

5. Endorsement of obvious symptoms

a. more positive than negative symptoms

b. more blatant than subtle symptoms

6. Subtle psychological symptoms and behaviors

a. high body tension shown by movement

b. excessive display of emotional extremes

c. averted gaze, allowing them to "gather"

thoughts

d. less assertive and dominant during evaluation

e. higher voice pitch; whining sounds

f. longer latency of verbal response

g. "nose up" associated with expressing an opinion

h. "rubbing" the nose while affirming a past event

i, hand over mouth or facial shielding suggests

insecurity

j. clasping hands in order to hide movement

k. more speech errors

1. less precise and more circumstantial speech m. shorter, terser answers

n. posture incongruent with portrayed emotion

or complaint

o. self-grooming involving the hands

p. smiling for inappropriately long periods

q. nonrevealing of self-experiences

r. not holding to the task at hand

Symptom Amplification: Descriptive or Avoidant

When a referral is made to a psychologist in which malingering is suspected, the referring clinician will often refer to the patient's "symptom amplification," "conscious embellishment", or "intential magnification". The terms are designed to impart to the reader of the medical records that the patient's complaints are highly suspect and under voluntary control and designed to elicit specific gain.

Why the avoidance of the term, malingering? For the referring physician, the avoidance is based upon a training process in which there remains the lingering fear that "something has been overlooked", "that an obscure pathologic process could account for this unusual constellation of symptoms" , and/or "that it is unpalatable to take time from patient care for depositions and court appearances".

These reasons to avoid malingering as a descriptor apply no less to psychologists to whom the patient is

12

ultimately referred. Additionally, the psychologist may feel less comfort in disappointing the referral source. Unlike clinicians, attorneys are trained to provide the best professional service and to allow decisions of truth and honesty to be determined by courts and juries. An attorney can serve his client without addressing the issue of malingering. A psychologist, however, cannot serve that patient without addressing the issue.

In the competitive health care marketplace, where it is common to express appreciation for the receipt of a

referral, the psychologist must be certain that the expression of the appreciation is not in the form of inaccurately diagnosing a nonexistent disorder and/or failing to detect/report malingering because such an action may impact subsequent referrals.

The author wishes to acknowledge the extensive work of Dr. Randall Price of Dallas, TX, for his research, writing and teaching in this complex and critical area of clinical practice.

WINN E RS OF KA R l HEISE R A WA RD !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

We congratulate the following members of Division 29 for winning the Karl Heiser Award. The award is given to those individuals who have made significant contributions to the advocacy of the discipline of Psychology. The panel that chose the winners limited its consideration to those who made their national impact before 1970.

*Jules Barron, Ph.D. - New Jersey Bruce Bennett, Ph.D. - Illinois Theodore Blau, Ph.D. - Florida Ernst Beier, Ph.D. - Utah

Nicholas Cummings, Ph.D. - California Patrick DeLeon, Ph.D. - Hawaii Gordon Derner, Ph.D. - New York Raymond Fowler, Ph.D. - D.C.

Herbert 1. Freadenberger, Ph.D. - New York Morris Goodman. Ph.D. - New York

Melvin Gravitz, Ph.D .• D.C.

Evelyn Hill, Ph.D. - Maryland

Arthur Kovacs. Ph.D. - California

1993 PROFESSIONAL AWARDS Distinguished Psychologist Arnold A. Lazarus, Ph.D.

The Division of Psychotherapy was proud to present the Distinguished Psychologist Award to Arnold Lazarus. Ph.D. This award is presented to a memberwhohasmadean outstanding contribution to the field of Psychology in eith Training.

Marvin Metsky, Ph.D. - New Jersey Stanley Moldawsky, Ph.D .• New Jersey Sidney Orgel!, Ph.D. - New York Robert Resnick, Ph.D .. Virginia Clarence J. Rosecrans, Ph.D. - Alabama Yin Rosenthanl, Ph.D. - Illinois

A. Eugene Shapiro, Ph.D. - Florida "'Max Siegel, Ph.D. - New York Suzanne Sobel, Ph.D. - D.C. Robert Weitz, Ph.D .• Florida

Jack G. Wiggins. Ph.D. - Ohio Diane Willis. Ph.D .. Oklahoma

* Deceased

Jack D. Krasner Memorial Award John Norcross, Ph.D.

Division 29 was proud to present the Jack Krasner Award to John Norcross, Ph.D. This award is given to a member who has received his or her degree in the last ten years. It recognizes outstanding early career achieve-

.' Practice, Research or ments.

13

F EATU REA RTIC LE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Prescription Privileges: The Marketing View

Bruce D. Forman

Regardless of how each of us might feel about prescription privileging for psychologists and the issues involved, I believe that we must consider the impact on the market position of psychologists, individually and as a profession.

A major obstacle facing psychologists now and in the future concerns our market for providing services. Since most practicing psychologists are employed in the private sector we must enhance our position to assure survival. Managed care has been the bane of mental health industry and it looks as if the trend toward limiting access to menta} health services and reducing payments to providers will continue. With the advent of prescription privileges psychologists could present themselves to managed care entities as providers of more comprehensive services and ascend to a more favorable position as providers. Since we would be in a posi tion to offer thorough diagnostic and treatment services we would gain a competeti ve edge. Also, we could get reimbursed for additional procedures that are rendered to patients.

Having prescription privileges will give psychologists access to financial support from pharmaceutical companies. Drug manufacturers are in the business of making and selling drugs. Their ability to get products to consumers depends almost exclusively on those who prescribe. For years they have been happy to provide financial resources to those who have made it possible for them to sell their products. We could use this support to underwrite the cost of promoting training, research, and lobbying efforts which further the discipline and our capability of maintaining and increasing our share of the mental health market.

Prescription privileges will give us parity with other health providers such as podiatrists, optometrists, and dentists, who already have prescription privileges. We will benefit from improved status in the eyes of the

service consuming public and other health care providers which will increase referrals to psychologists because of the enhanced image.

Administration of medication is also consistent with the biological disease model underlying medical practice. Since making interventions based on this model is comfortable to primary care physicians the work of psychologists wi II increase in acceptability by treating physicians because there is a shared perspective concerning patients. This should result in greater cooperation and better treatment for patients, which in turn should increase referrals to psychologists. This would be particularly true in areas where no psychiatrists are available.

Finally. dispensing medications increases the tangibility. of psychological services. Marketing professionals have known for years that transforming a service into something tangible makes it easier to market. In addition, literature on satisfaction with physician services indicates that when a person visits a physician and reeei ves a prescription for medication, satisfaction is higher than when no prescription is given. This is true even when the medication was given for a secondary or minor complaint.

While there may be many pros and cons surrounding the issue of psychologists having the legal right to write prescriptions, I think a case can be made in support just on the marketing issues. I believe it will be easier for psychologists to get the right if we take the position that prescription privileges are good for psychology because it will give us more political clout and more options, both of which can insure the viability of the profession. And I think this it true irrespective of our individual views of whether or not we may desire prescription privileges personally.

14

The headline in the WaB Street Journal (August 14, 1992) read "Psychologist Court Corporate Business." The article went on to describe the "integrated care" model that has been developed by the Practice Directorate of AP A. This marketing effort on behalf of psychology is designed to provide a system whereby psychologists can communicate more directly with employers. particularly large employers who provide mental health care as part of their health care benefit package. While the article presented a mixed reaction to the APA plan, it did reveal that the Practice Directorate is ceasing the moment in terms of managed care.

FEATURE ARTICLE

Managed Care: Seizing The Moment Patricia S. Hannigan-Farley

The opportunity that the Practice Directorate effort is seizing on behalf of psychologist-practitioners of psychotherapy is the slowly growing disillusionment with managed care companies in providing cost containment in the area of mental health. The managed care approach initially decreased actual outlays for mental health services predominantly by limiting access to inpatient and outpatient services. Certainly if services are directly limited then costs will go down. These cost savings were especially noticeable in the area of inpatient hospitalization. As practitioners, the incursion of managed care carne somewhat suddenly and, in general. we were unprepared for its demands despite the fact that we were told it was coming as it arrived on the scene.

The other moment that the Practice Directorate bas seized is the momentum to utilize more cost -effecti ve outpatient treatment rather than expensive inpatient treatment, The reasoning is that psychology is a heavily outpatient-based profession..ln tbelasl. survey conducted in 1989 of Divis:imi rnem1:x!ls,.s-'tk Sla!OO they provided outpatient ~ -

The decisions by professionals on the level of impairment which necessitates a level of intervention is viewed as very subjective. Decisions about what constitutes the adequate level of functioning to complete treatment is also seen as very subjective.

Secondly, treatment of mental illness tends to be more intensive and lengthy so episodes of care are more expensive when compared to episodes of medical care. For example, treatment of flu may require two physician office visits and a prescription.

Total expenditure approximately $110. Treatment fer-an adjustment disorder with depressed mood may take 24 office visits resulting in a total expenditure of $2160.00

Thirdly, the efficacy of various treatment interventions has not been well established. Our science is still rather young in establishing conclusively from empirically-based studies the efficacy of psychotherapy for certain conditions. In addition, the efficacy of certain provider groups (psychiatrists, psychologists, social workers) has likewise lacked conclusivity as to the preeminence of anyone provider group over another. Employers who pay for health care benefits reason that if all types of providers are equally effective, then cost is a legitimate criterion to use in distinguishing among them.

A result in the health care finance arena is that data is being generated about actual practice patterns from information submitted on billing forms. This information is being used as parameters of efficacy and appropriateness of treatment. Standardization of treatment protocols according to diagnostic categories is being developed from this information.

The Division of Psychotherapy has been involved with me Practice Directorate in development of the strategy of addressing concerns and issues about managed care. In February, 1992 a Marketing Technical Group was convened which utilized the expertise of several Division members. More recently, the Division is involved through its Employee Benefits Committee in staying abreast of the fast moving events in the managed care area and the steadfast work of the

15

Practice Directorate. The Division is working to contribute to the development of the regional managed care coalition in collaboration with the Ohio Psychological Association and the Practice Directorate. The other states involved include Illinois, Indiana and Michigan. This effort is designed to be a pilot project to be replicated in other areas of the country since the provision of health care services tend to be a regionally-based phenomena.

How can you get involved? Elsewhere in this B ulletin, there is a one-page information survey which is being distributed. Take Three Minutes And Complete It, Please! Itis designed to update the 1989 AP A

survey data and to identify the involvement of our members in managed care arrangements. Thank you, in advance, for your response. This information will further help the Employee Benefits formulate responses to managed care issues.

Return your survey to:

Employee Benefits Committee Division of Psychotherapy 3875 N. 44th Street, Ste. 102 Phoenix, Arizona 85018

FEATU RE A ancts !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Managed" Care

The Problem and Solution

Stanley R. Graham

The perpetrators of managed care are largely the same kind of individuals who accomplished the levered buyouts and mergers of the unregulated 1980's much to the detriment of our current economy. They are opportunistic business men who have seen an opportunity to profit from the errors of American business which they probably instigated. At a time in the past when it seemed useful for American business to absorb the health insurance cost for its employees, the corporate business of the United States undertook to absorb this cost of its employees. They did this in a manner which allowed them to escape taxation and to deliver benefits to their employees at what they believed was a moderate cost, utilizing their purchasing power and their capacity to bargain collectively for large numbers of employees. They did not reckon with the tremendous escalation of medical cost. Despite the advantages of ERISA which allowed them to evade state regulations in most cases, they found themselves dealing with explosive cost. The attempt of the insurance companies to over use utilization review, added to these costs dramatically and presented an opportunity to move to a more intensive control by the aforementioned opportunistic business people.

The managed care organizations approached the business corporations saying "we will control your cost by becoming in effect gatekeepers and disallowing what we felt were excessive or inappropriate

costs." "The corporation will save a great deal of money and the client would be better served". The deal being made between the employer and managed care organizations eliminated any effective say for the two most concerned parties, that is the patient and the doctor. I believe that this was not primarily aimed at the psychotherapist of psychologist as a cost factor because we know that outpatient psychotherapy is perhaps 2% of the entire medical bill, but it is probably the easiest to control since we in psychology prefer to think as ourselves as something between tenured professors and journeymen philosophers. I think perhaps that the first aim of managed care was to deal with the technique of unbundling which is the physician's method of separating the various procedures of medical treatment into specific elements and billing for each of the separate components. The medical profession has available any number of courses or manuals which instruct the physician the process of unbundling, thus particularly effected in terms of the enumerable laboratory costs which the doctor uses to defend him or herself against claims of malpractice or negligence. We in psychology find it not particularly meaningful to deal with any concept of unbundling because our service is homogeneous and of one fabric, at least to the evaluator. Moreover, we have continued to deal with the issue on a rather amateurish basis with no consistent method or plan to resist the invasion of our profession. We are part time amateurs dealing with rather amateurish basis with no consistent method

16

or plan to resist the invasion of our profession. We are part lime amateurs dealing with rather laugh professional businessmen whose objective is narrow and clear. They have the advantage of being able to say, "deliver your clients to us, we will provide them with adequate services, we will monitor theseservices and we will reduce your cost." So far they have not reduced the cost. They probably have been one of the chief factors of escalating cost 25% - 30% a year.

There are of course other factors which contribute to rising costs, the continued problem of malpractice, and the continuing problem of what I believe is a degree of hanky panky which does require more effective moni taring. There is a greattendenc y at least on a part of a number of physicians to exploit hospitalization and overutilization of medical services so that the addictive population and the adolescent population of patients spend far too much time in the hospital running up the enormous percentage of psychiatric billing for health services. Much of this is unnecessary.

We in psychology have continued [0 focus on our basic opponent which are psychiatrists who are for the most part, are in the same dilemma. We are perhaps a bit behind them in that we have not invested the many, many millions of dollars that they have to preserve their professional integrity and their economic base. We have attempted to run our profession on the cheap dealing with the problem with volunteers that devote a fraction of their time to the defense of the profession. If we continue to do so we will probably wind up a vague group of technicians who slide out of the professional category and into a level of service which does not merit the 8, 10, 12 years of education we go through to provide a service to the pubJi and maintain oursel ves as respectable professionals. 'hat is; ID be done? I think we have to stan fighting fire with fire.

The parallel professions are mlrh .

They providemuch Iargeram o.

butions. They hire professionals, ".-.,.".,..,,'" relations people, and lobbyis '"Je eqosls of the business people who hare petpetr'""'c..Xrl Wis rli-i""""",_ upon our profession and om toopee up our wallets.

years; however, y t profession.

We havesbaredi::.. patients who

have become tbampl:sts. We have alkrwed a massive

certification of addicts, alcoholics and fanner patients who have become the deliverer of services for which we have spent more than a decade qualifying ourselves. We are going to have to be realistic about the fact that we must pay to develop the kind of legal and financial and business structures that have swallowed us up .. We have to be able to go to the legislature and stop the deregulated control of health care by corporations who have gotten themselves into a financial bear trap and are trying to solve the problem by reneging on their contracts to provide adequate health care to their employees.

The fact that the health industry has become the largest money cow in the U.S. has drawn all manner of individuals who provide no health care services into control and subsequent financial domination of the area. We have got to stop fighting with psychiatry and reach a basis of cooperation which allows us to join resources and inhibit the exploitation of these groups that contribute nothing to health care. We have go to create some kind of system where the doctor and the patients continue to have a primary say in the delivery of services. The most logical of course is the institution of caps rather than utilization review. If you have for example, a thousand dollar cap on insurance, you allow the client a reasonable looksee into the therapeutic process. Thereafter the client can decide for him or herself whether continued treatment is appropriate. The 650 dollars it takes to open up any case in an insurance company's folder need not be expended. The odds are that the self-regulating forces would probably act for the best interest and eliminate millions of dollars to an industry that does not need to exist. The whole concept of a business person with a vested interes controlling the health of whole classes of employees bas proven over and over again to be unmanageable. When yon eliminate the doctor and tbe patient from primary decision making you most cerminly place yourself in position where decisions are going to be made in the best interests of the stockholders and manager of the corporations. This has nothing to do with the health- of the individual being served and certainly nothing to do with the integrity of the provider of these health services. When you eliminate the free lunch you eliminate a world of hanky panley and corruption of the relationship between the patient and the therapist.

Coming from an era before insurance paid a great part of the deli very of psychological services, I can tell

17

you that it worked a lot better. I think that we have become addicted to large checks from insurance companies. I believe that we are going to have to come out of our ivory tower if we have any hope of dealing with the ethics of opportunistic business people. I think that we are going to have to develop the economic resources appropriate to the task, this means the free ride is over. We cannot have a fraction of our providers paying the load for all of us. We cannot have dues and other assessments that are inadequate for the cost of a professional staff. We cannot have our professional staff underpaid and overworked. Our professional staff has become a training ground so as our young staff members become experts in legislative legal and

administrative processes they become valuable and are hired away for much more money. We are constantly burning out our underpaid undermanned staff by req uiring them to go against armies of high salaried educated professionals who have all of the economic resources in the world. If you are going to sell your services, you must admit that you are a professional. In order to retain our position as a profession rather than as simply technologists, we are going to have to compete for the best and the brightest full-time professional players. The cost will be substantial but failing to do this will bring about the demise of professional psychology.

co U NCll OF RE PRESE NTATIVE REPO RT !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

August, 1992

Carol D. Goodheart

The American Psychological Association Annual Convention was exceptional this year on two accounts. First, we held a spectacular centennial celebration. Second, we adopted a new Ethics Code. The Council of Representatives deliberations during this convention resulted in the passage of quite afew items that will be important to members of our Division.

Council approved the revised AP A Ethics Code and approved the contingency funds to mail a copy of the new code to each member of APA. Because the code is a living document and a teaching document it is subject to ongoing amendment, in order to reflect the aims and standards of the Association. Indeed, many proposed amendments and substitute amendments were debated, including the areas of barter, exploitive relationships, descriptions of education and training programs, fairness in teaching, assessing student and supervisee performance, understandable language, Forensic issues, and the large catchall category of "other". The reader may remember that the areas of sexual harassment and sexual intimacies between psychologists and former patients were of particular concern in debate at the preceding Council meeting in February. As the debate quiets down and the new Ethics Code goes into effect, it will be important for all members of the Division to take a bit of time to read it. The code is the standard to which all of us (practitioners, researchers, educators) can and will be held under the law.

By a unanimous vote, Council empowered the CEO, Raymond Fowler, to negotiate the terms \U1d condi-

tions of the Partnership Buy-Out of Trammel-Crow. the general partner for our AP A headquarters building in Washington, D.C. Our building is now 100% leased. The successful leasing of the property, well ahead of the initial projections, has given rise to this buy-out opportunity earlier than had been expected. APA has consulted with real estate consultants and real estate attorneys on this important step. The Board of Directors, the Finance Committee and the Council have all been briefed. Final ratification and approval will be made by the Board of Directors and the Council. Ownership of our building is both an investment and our endowment for the future.

The Council passed a cost adjustment to maintair:

Special Assessment operations. There will be a $I~ increase in 1993 and a$5 increase in 1994 and 1995 for those licensed psychologists who are subject to the Special Assessment. These increases are necessary tc support the marketing, national health insurance initiatives and a catch-up increase for a break-ev budget in 1993, as well as to maintain current operationallevels in the assessment-supported budget.

The APA Position Statement on Managed Care anc Utilization Review was adopted. Because the issu surrounding managed care are of such great concern ~ so many members of our Division, the entire text this resolution follows.

Whereas government officialdom, representativ of industry and employer groups, and representati of managed care (MC) and utilization review (UP

18

companies are increasingly and aggressively promoting managed care as a solution to the nation's health care delivery problem;

And Whereas objective data as to the efficacy of MC and UR approaches to the nation's health problems when adequate quantity and high quality of care are held constant is not extant;

And Whereas degradation in the quantity and quality of care occasions rising concern;

And Whereas the media and the courts (see New Republic, "Managed Care: A Sick Joke"; American Psychiatric News, December 20, 1991; New York Times, "Do They Want my Wife to Die?", April IS, 1992) have documented flagrant abuses by some MC and UR programs exempt from all state mandates as to benefit structure and regulation of service provisions and state controls as to the standards of care;

Therefore Be It Resolved:

1. The American Psychological Association calls upon the Congress and/or the President to develop objective data demonstrating that managed care and utilization review can effect economic savings while maintaining acceptable levels of quantity and quality care before commi tting to such programs as a solution to current problems in health care delivery.

2. The American Psychological Association believes that the exemption of any MC or UR program from state-mandated benefits and/or state-mandated controls is demonstrably contrary to the public interest unless such mandates and/or controls are replaced by federal controls and mandates offering the same or greater protection.

3. The American Psychological Assocllci lieves that all managed care and utilizarian programs should be held to the sam hi sta::rl.a:rrls performance required of credentialed - c...'"'rS - me states in which MC and UR services are off;:red; snd the AP A urges its state affiliates ro oed

in a legislative process igaed

regulation. In Jegislati of tds: _ p;' pro .. .....,.., ........ ......., responsibility mproreet theinvolvemen ofall of Represent:atires 0 Association requests. logical associatka -

ands Council Psychological - ro stale psycho-

a) take a leadership role in developing the legislative process and contest; and

b) also take a leadership role in developing effective coalitions of health disciplines to address the increasingly serious problem in order to protect the public interest.

4. The American Psychological Association further asks the Congress and the Administration to develop minimum standards for federally-sponsored national MC and UR programs as the most efficacious way to avoid the numerous problems currently affecting the quantity and quality of care that has developed under Medicare. Hopefully, such action at a federal level will also help diminish the spate of litigation which we believe MC and UR programs have already begun to engender.

Formal status was granted to Liaison/Observers from Non-represented Constituencies. Those States and Divisions who do not have a seat on Council may appoint a L/O to receive all except confidential materials, attend Council sessions, and request to speak to agenda items of direct concern to their constituencies. They will not vote or be reimbursed for expenses.

Turning to financial business, Council approved the prelim inary break-even 1993 budget and the Financial Forecast, which is a recommendation for the long range financial goals of the Association. Planning funds were approved for The Second Century Assembly, the National Conference on Postdoctoral Education and Training and the National Conference on Women's Health.

A group of California psychologists were cited for their outstanding work to calm Los Angeles in the \11~ of the Rodney King trial verdict riots. Division mem.bersmay linda list of the psychologists who were

oared in the AP A Monitor.

All in all, it was a busy and productive set of meetings. As an added item of information, you may be interested to know that Donald Freedheim, your other Council Representative, is this year's Chair of the Committee on International Relations in Psychology, and that I am serving on the Committee on Structure and Function of Council. Please contact either one of us if you have any questions about Council or if you have an issue you would like us to present to Council on the Division's behalf.

19

Reuben Silver, PhD. presents Life Time of Service Award 10 Jerome D. Frank, PhD.

APA HIGHLIGHTS President's Reception

Awards Reception

Jack Krasner Award Recipient, John Norcross, Ph.D. and 1992 Distinguished Psychologist, Arnold Lazarus, PhD.

Student Paper Competition Winner, Gail Goldman with Division 29 President, Reuben Silver, PhD.

Gerald Koocher, Ph.D., President Elect presents plaque to outgoin President Silver.

20

APA HIGH LIG HTS !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Past President's Breakfast

Graduate Student's Reception

21

F EATU REA RTIC L E !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Some Conceptual Issues

Linking Pharmacotherapy and Psychotherapy

T. Richard Saunders

In a previous article that appeared in The Psychotherapy Bulletin (Saunders, 1992), I attempted to argue that the decisions involved in psychologists seeking psychopharmacology prescription privileges are too broad and far-reaching in their implications for any snap professional judgment, whether pro or can. The purpose was to advocate a deliberate, step-wise approach to psychopharmacology that can be helpful to our professional deliberations.

The topic of psychopharmacology raises two relatively distinct topics. One is education for psychologists in psychopharmacology, and the other is prescribing privileges for psychologist. The frrst of these can be addressed without the second, but the second issue cannot be responsibly addressed without the first This article is addressed to conceptual issues in psychopharmacology education, but also argues the value of psychopharmacology practice, as related to the traditional position of psychotherapists as agents of change. The problem of psychopharmacology education is largely internal to the field of psychology, the problem of prescribing privileges necessarily invol ves political considerations external to the field.

These substantive issues can be posed as questions concerning psychotropic medications and psychology:

(1) In the present state of the art, what training in psychotropic medication is appropriate for psychologists, at both the graduate and the post-graduate levels; and

(2) What models can be developed for the psychopharmacology training of psychologists, which can be tested for their safety and efficacy?

Hopefully, the deliberations of the AP A Task Force on Psychopharmacology, practical experience with the Department of Defense psychopharmacology training program, and the model psychopharmacology training curriculum under development at Wright State University (DeLeon, 1992) will all contribute to answering these important questions. Moreover, the proposed National College of Professional Psychology (e.g. Graham, 1992) may prove to be an ideal

educational vehicle for post-graduate psychopharmacology training.

Political and Professional Considerations

Welch (1990) has repeated the adage that in political/professional affairs, the perfect is often the enemy of the good. What this means in practical terms is that when professional dilemmas are debated in a political context, perfectionism is frequently a self-defeating frame of reference for the discussion. Ideally, clinicians should have all the knowledge possible on psychopharmacology, together with any other modes of intervention. Unfortunately, if this ideal is adhered to, practitioners will remain closeted forever in training programs, and no one will be able to practice.

The fact is that psychologists have been doing extremely competent work in the field ofpsychopharmacology for more than thirty years. Numerous psychologist and related professionals such as diMascio (Lipton,diMascio, & Killam, 1978) and Levitt (I 975) have made sterling contributions to the field of psychopharmacology, and the APA Division of Psychopharmacology and Substance Abuse (28) has long been an active and respected component of the APA membership. Psychologists do not need legislative or other permission to become knowledgeable in the field of psychopharmacology. Indeed, I would argue that ignorance of the field is to our own professional detriment as wen as to the potential detriment of our patients.

A Generic Model of Behavior change

Is there a broad perspective on behavior change, including psychopharmacology, that psychologists can endorse? Iwould assert that as far as treatment goals are concerned, components of such a broad model have existed at least since the 1960's (e.g., Ford & Urban, 1963). These are independent of an) particular focus of practice, whether biological or otherwise. In providing patient care, therapists intend (1) to restore stability to the personal life of the patient; (2) to diminish undesirable behavior an experiences for the individual treated; and (3) tc

22

BYLAWS OF DIVISION 29

PROPOSED CHANGES TO BE PRESENTED TO TIlE MEMBERSHIP (That which is deleted is in brackets ... that which is added is underlined)

ARTICLE II: MEMBERSHIP

tlJ·

,

The Minimum qualifications for election to the category of Student Affiliate shall be enrollment in a doctoral program which includes training in psychotherapy and which is offered in a departrnentof psychology or [in a professional] school of professional psychology situated in a college or universi ty of higher learning which is regionally accredited [.] or in a re gionall y accredited. free standing- school of professional psycholog-y.

E.

RA UONA LE: Clarifies that doctoral students at regionally acc reditedfree standing schools of Professional Psychology are eligible to become student members.

>I< >I< >I<

F. As described in Article VII of these bylaws, there shall be a [Committee on Fellows and a] Membership Committee. [The Committee on Fellows shall be charged with evaluating nominees for the award of Fellow status by the Division.] L I [t]he Diyision's Membership Committee shall [review new applications for Member, Associate Member, or Student Affiliate status. A two-thirds (2/3) vote of these Committees shall [be required to constitute a recommendation from either of them to the Board of Directors about the status of nominees/ applicants.] determine the membership status for each aQPlicant and accept new members. The Board of Directors shall be notified about such determinations.

F. RATIONALE.: Simplifies the procedure for election of Members.

* * >I<

G. As described in Art.icle VII of these bylaws. there shall be a Committee on Fellows. The Committee on Fellows shall be charged with evaluating nominees for the award of Fellow status by the Division and for recommending fellow status to [the board of directors and] AP A Membership Committee.

G. RATIONALE.' Codifies current procedure for election of Fellows.p Z

***

H. The Secretary sball be responsiblefnrcomnnmicating the Actions of the Division to [nominees for FeTIow status and 10] applica:nts: for the status of Member, Associate Member, or Student

Affiliate in a . cl.. •

ARTICLE V: OmCERS

B. The President shall be the Member or Fellow of the Division who has just completed [his/her] s term as President-Elect. [He/She] The President shall succeed to office by declaration at the close of the year after [hislher] election as President-Elect and shall serve for one (1) year. The President shall preside at all meetings of the Division, shall be the chairperson of the Board of Directors, and shall perform all other usual and customary duties of a presiding officer. The President shall cast a vote at meetings of the Board of Directors only when [hislher] tlllU vote would make or break a tie.

B. RA TIONALE: Changes improve sentence structure and clarify current procedures.

***

C. XThe President-Elect shall be a Member or Fellow of the Division, elected for a term of one (1) year. The President-Elect shall be a member of the Board of Directors with vote and shall perform the duties which are usual and customary for a vice president. In the event that the President fails to serve his/her term for any reason whatsoever, the President-Elect shall succeed to the unexpired remainder thereof and continue to serve through his/her OWl: scheduled term. The President-Elect shall serve as chair of the Committee on Nominationsl.; ~ assuming that post while Chair DesilWale.

C. RATIONALE: Codifies current procedure.

***

D. The Past President of the Division shall be the most recently retired President of the Division, [He/she] Th~ Past Presigent shall serve a one year tenn as a member of the Board of Directo with right to vote].] ~ ang serve as Chair of the Committee on Awarda.

D. RATIONALE: Specifies the length of the term o/the Past President and responsibility as tl:

Chair oj the Committee on Awards.

***

E. The Secretary shall be a Member or Fellow of the Division. elected for a term of three (3) years During [his/her] lbm term, [he/she] the Secretary shall be a member and the secretary of Board of Directors, with the right to vote; shall safeguard all records of the Division; shall k _ the minutes of the meetings of the Division and of the Board of Directors and [Administrativ Executiye Committee; shall maintain coordination with the Central Office of the Ameri Psychological Association; shall issue calls and notices of meetings; shall inform the mem ship of actions taken by the Board of Directors; shall notify applicants for membership fellowship about the status and outcome of their applications; shall issue an annual report; s keep and maintain a book of the extant policies of the Di vision based upon actions of the Boaz of Directors and shall perform all other usual and customary duties of a secretary.

***

E. RATIONALE: Improves the sentence structure.

F. The Treasurer shall be a Member or Fellow of the Division, elected for a term of three (3) years.

During [his/her] 1hM term [s], [he/she] the Treasurer shall be a memberofthe Board of Directors with right to vote; shall oversee custody of all funds and property of the Di vision; shall di rect disbursements as provided under the terms of these bylaws; shall oversee the keeping of books of account; shall aid the President and the Board of Directors in the preparation of an annual budget; shall make an annual financial report to the Division; and in general shall perform the usual and customary duties of Treasurer. The Treasurer shall serve as Chair of the Finance Committee.

F. RATWNALE: Improves the sentence structure and codifies current procedures.

***

ARTICLE VI: BOARD OF DIRECTORS

G. There shall be an [Administrative] Executiye Committee of the Board of Directors. The [Administrative] Executive Committee shall be composed of the Officers of the Division (president, President-Elect, Past President, Secretary and Treasurer). The Editor of the Division's Newsletter shall be a member of the [Administrative] Executiye Committee ex officio without vote. The [Administrative] Executiye Committee shall meet on the call of the President or any other three (3) Officers. Upon election of a President-Elect Designate, a Secretary Designate, or a Treasurer Designate, these persons shall become members of the [Administrative] Executive Committee ex officio without vote and attend any meetings of the [Administrative] Committee which take place between their election and their assumption of office. The President may also invite any other member of the Division to attend an [Administrative] Executiye Commi ttee meeting should [he/she deem] the invitee's attendance [to] be deemed important to the purposes of a scheduled meeting.

The duties of the [Administrative] Executiye Committee shall be:

1. To supervise the affairs of the Division between meetings of the Board of Directors, managing those affairs within policies set by the Board and implementing actions directed by the. Board.

2. To review matters on the agendas of meetings of the Board of Directors and to make recommendations about these matters to the Board.

3. To negotiate the terms of any contract entered into by and between the Division and any external organization hired to provide administrative and/or publishing services to the Division with policies set by the Board and to [S] s.upervise and evaluate the performance of such organizations.

4. Upon majority vote of the [Administrative] Executive Committee, to declare an emergency and to hold a mail or telephone ballot of the Board of Directors upon any proposed course of action it shapes to respond to the matter which constitutes such an emergency.

G. RATW ALE: Changes the name of "Administrative Committee" to "Executive Committee."

There is no change in the functioning of the Committee.

***

PROPOSED CHANGES BALLOT
your vote by checking the appropriate box.
APPROVE DISAPPROVE
Article II. E 0 0
Article II, F 0 0
Article II, G 0 0
Article II, H 0 0
Article V, B 0 0
Article V, C 0 Q
Article V, D 0 0
Article Y, E 0 0
Article Y, F 0 0
Article VI. G 0 0
Article VI, (H) I 0 0
Article VII, A 0 0
Article VII, B 0 0
Article VII, (H) I 0 0
Article XI, B 0 0
Article XI, C 0 0
Article XI, D 0 0
Article XI, E 0
Artic1eXLF Q 0
. . Ii! xrr. A Q 0
Q 0
:\::: - l=. G Q 0
-i"! E 0 0 F. The Treasurer shall be a Member or Fellow of the Division, elected for a term of three (3) years.

During [his/her] l:hiU. term [s], [he/she] the Treasurer shall be a mem ber of the Board of Directors with right to vote; shall oversee custody of all funds and property of the Division; shall direct disbursements as provided under the terms of these bylaws; shall oversee the keeping of books of account; shall aid the President and the Board of Directors in the preparation of an annual budget; shall make an annual fmancial report to the Division; and in general shall perform the usual and customary duties of Treasurer. The Treasurer shall serve as Chair of the Finance Committee.

F. BATlQNdLE: Improves the sentence structure and codifies current procedures.

***

ARTICLE VI: BOARD OF DIRECTORS

G. There shall be an [Administrative] Executive Committee of the Board of Directors. The [Administrative] Executive Committee shall' be composed of the Officers of the Division (president. President-Elect. Past President. Secretary and Treasurer). The Editor of the Division's Newsletter shall be a member of the [Administrative] Executive Committee ex officio without vote. The [Administrative] Executive Committee shall meet on the call of the President or any other three (3) Officers. Upon election of a President-Elect Designate, a Secretary Designate, or a Treasurer Designate, these persons shall become members of the [Administrative} Executive Committee ex officio without vote and attend any meetings of the [Administrative) Committee which take place between their election and their assumption of office. The President may also invite any other member of the Division to attend an [Administrative] Executive Committee meeting should [he/she deem] the invitee's attendance Ito] be deemed important to the purposes of a scheduled meeting.

The duties of the [Administrative] Executive Committee shall be:

1. To supervise the affairs of the Division between meetings of the Board of Directors. managing those affairs within policies set by the Board and implementing actions directed by the Board.

2. To review matters on the agendas of meetings of the Board of Directors and to make recommendations about these matters to the Board.

3. To negotiate the terms of any contract entered into by and between the Division and any external organization hired to provide administrative and/or publishing services to the Division with policies set by the Board and to [S] £upervise and evaluate the performance of such organizations.

4. Upon majority vote of the [Administrative] Executive Committee, to declare an emergency and to hold a mail or telephone ballot of the Board of Directors upon any proposed course of action it shapes to respond to the matter which constitutes such an emergency.

G. BATTONA LR: Changes the name of "Administrative Committee" to "Executive Committee."

There is no change in the functioning of the Committee.

* '" '"

***

[H]l Actions of the [Administrative] Executiye Committee shall be subject to the review of Board of Directors at its Annual and Mid-Winter meetings. [Actions of the Board of shall be subject to the review ofthe membership at the membership's Annual and Midmeetings.]

1. RATWNALE:

PRO.' Board action should not be subject to the approval of the very few members w attend the Annual or Mid-Winter meetings. Were this Bylaw to have been us chaos would result.

CON: Actions of a Board should always be subject to approval !Jy the membership.

ARTICLE Vll: NOMINATIONS AND ELECTIONS

A. There shall be a Committee on Nominations and Elections which shall consist of the Elect [as Chair] who shall assume the Chair while President-Elect DesiIDlate. and four _ members. two elected by the Board of Directors from among its members and two appoi by the person who shall be President in the year that the election shall occur. [President] among the membership at large. The latter shall not themselves be members of the Board. Committee shall be responsible for implementing the principles set forth in these bylaws. the policies adopted by the Board of Directors which govern the holding of the elections 0 Division, including the election of Officers, Representati yes to AP A Council, and Mem Large. The elections of the Division. as conducted by the Committee on Nominations. [also be conformed] confOnTI to the bylaws and to the policies of the American Psycholog Association.

A. RATIONALE: Proposal reflects current procedure. Change clarifies the time wher President-Elect assumes the Chair of the Nominations and Elections Committee.

**'"

B. The Committee on Nominations shall distribute a nominating ballot to all Members. Felk and voting Associate Members of the Division. The ballot shall provide spaces toenter names of three possible nominees for any office which is [subject of a] to be filled ir i forthcoming election. The nominations ballot shall be accompanied by a statement no .. the members of the Division about the Division' s eligibility criteria for standing for ele . Those criteria are: 1. Candidates for office must be Members or Fellows of the Division. 2.No member may be an incumbent of more than one elective office. 3. A member may only hold the same elective office for two successive terms. 4.lncwnbent members of the Board of Directors are eligible to run for some position oc Board only during their last year of service or upon resignation from their existing office to acce,ptini the nomination. A letter of resignation must be sent to the President with Ii '. to the Nominations and Elections Chair.

B. RATIONALE: Clarifies the procedure and the time that resignation must occu~ by a B member who wishes to run/or office.

'" '" '"

C. RATIONALE: Gives the President the authority to appoint members 0/ Committees.

PRO: Current Bylaws required Board approval. The President has very little say over appointments. Since the Board only meets twice a year, there can be a delay in appointing members to the Committees and thus delay the work that should be done. Presidents probably will wish to consult with many people, inc luding current chairs, but the President should have the authority to make appointments.

X CON: Too much power would be vested in the President.

***

D. The President-Elect shall appoint [, with the advice and consent of the Board of Directors, in consultation with the current chair,] a Chair-Designate who shall serve as a member of the appropriate Committee during the year preceding the one in which he or she shall serve as Chai r and shall assume the duties of the Chair in the year in which the President-Elect becomes President.

D. RATIONALE: Gives the President the authdrity to appoint members of Committees.

PRO: Current Bylaws required Board approval. The President has very little say over appointments. Since the Board only meets twice a year, there can be a delay in appointing members to the Committees and thus delay the work that should be done. Presidents probably will wish to consultwitn many people, inc luding current chairs, but the President should have the authority to make appointments.

X CON: Too much power would be vested in the President.

***

E. The President shall appoint [with the advice and consent of the Board of Directors.] a Chair for each Ad Hoc Committee or Task Force he or she creates during the year of his/her presidency.

E. RATmNALE: Gives the President the authority to appoint members of Committees.

PRO: Current Bylaws required Board approval. The President has very little say over appointments. Since the Board only meets twice a year, there can be a delay in appointing members to the Committees and thus de lay the work that should be done. Presidents probably willwisb to consultwithrnany people, including current chairs, but the President should have the authority to make appointments.

X CON: Too much power would be vested in the President.

* * *

F. The Standing Committees of the Division of Psychotherapy shall be:

6. The Committee [for Women] on Gendyr Issues. which shall consist of a minimum of three (3) members of the Division. The Committee shall be responsible for fostering awareness of gender issues in the activities of the DivisiGn and for mcommenoing policies ano programs designed to educate in this area. [the participation of women members in the activities of the Division and of recommending policies and programs designed to enhance such participation.]

* * *

H. The Chair of the Nominations and Elections Committee shall be responsible for submitting APA in a timely fashion the slate to be included in the APA election mailing.

H. RATIONALE: Assigns responsibility to the Chair of Nominations and Elections Commix: for submission of slate to AP A.

* * *

[Hj], The Officers, Representatives to APA Council, and Members-At-Large shall be elected e:preferential vote of the Members, Fellows, and voting Associate Members of the Di vision a mail ballot. [Said ballot shall provide space for the voter to submit a validating signature.] ~ Chair of the Nominating Committee shall have responsibility for:

1. Overseeing the mailing of the nominations ballot in a fashion which is consonant with policies of the American Psychological Association;

2. Overseeing the count of the nominations [vote];

3. Notifying the candidates and Board of Directors of the APA results of the [electionj g of nominees;

4. Announcing the [election] nominations results at the next subsequent membership me

5. Disseminating results to candidate and providing exact tally [of the vote].

I. RATIONALE: Clarifies ambiguities.

* * *

ARTICLE XI: COMMITTEES

B. All Committee meetings shall be open to all members of the Division except at such tim the Committee may, by majority vote, declare an executive session for the purpose! discussing a matter of personnel or a legal consultation. In the conduct of Committee bus' the Chair of the Committee shall be responsible for notifying the members of the call fo; meeting, for establishing the agenda therefore, and for serving as presiding officer. The C::.. shan cast a vote only to make or resolve a tie. A majority of the voting members of a Co

shall constitute a quorum, and unless as specified elsewhere in these bylaws, a majority of those present and voting at a Committee meeting shall be sufficient to adopt any resol

B. RATIONALE: Broadens the reasons for an executive session of a Committee.

***

C.

While the President, [with the concurrence of the Board of Directors,] or the Committee C with the concurrence of the President may add other persons to the Division Committee, f persons serving as voting members of Standing Commi ttees or of Ad Hoc Commi ttees orForces must be Members or Fellows of the Division. Except as otherwise provided in - Bylaws, the members of the Division's Committees shall be appointed by the President ~ nomination of the Chairs of such Committees]. Committee members shall serve unn' successors are appointed and seated. In the case of a vacancy occurring on a Committee

. to the death. resignation, or incapacity of a Committee member such vacancy shall also be: by the President [upon nomination of a successor by the Chair of the Committee in Ques:

7. The MultiCultural Affairs Commi nee [for Ethnic Minorities I, which shall consist of minimum of three (3) members of the Division. The Committee shall be responsible for fostering the participation of ethnic minority members in the activities of the Division and of recommending of policies and programs designed to enhance such participation.

F. 6 & 7. RATIONALE: Brings the names of the 2 committees in line with their function.

***

8. The Committee on Professional Awards, chaired by the immediate Past President. [which] shall consist of [minimum of three (3) Past Presidents of the division] the President. President-Elect. and such other Past President whom the Chair of the Committee shall ~. The Committee shall [be responsible for recommending] recommend to the Executiye Committee and the Board of Directors recipients of professional Diyisional awards of such a nature as are consistent with the aims and purposes of the Division [and for nominating awardees to the Board of Directors]. The bestowing of any such award by the Board shall require an affirmative vote of two-thirds (2/3) of Board members present and voting.

F. 8. RATWNALE: Clarifies the composition of the Committee on Professional Awards.

***

ARTICLE XU: LWSONS

A. The President-Elect shall, in the year in which he or she serves as President-Elect, identify those external organizations and Boards and Committees of the American Psychological Association which in his or her view merit the appointment of a liaison. observer. or monitor from the Di vision of Psychotherapy [ . ]; .@Cl make such apPOintments forme year ofhi s or her Presidency,

A. RATWNALE.· Codifies current procedures.

***

ARTICLE xnr. SECTIONS

D. If a Section desires to publish ajoumal, such activity, according to the bylaws of the AP A, shall require approval from the Di vision's Publications Board and Board of Directors, and from the AP A Council of Representatives.

D. RATWNALE: COdifies current procedures.

***

G. A Section may be dissolved by:

1. A finding by the Secretary that the number of Section members has declined below percent (3%) of the membership of the Division;

2. An affirmative vote of two-thirds (2/3) of the voting mem bers of the [Executive Corn Board of Directors sustaining a resolution that the purposes or activities of a previo t approved Section have become inconsistent with the aims and purposes of the Divisi with those of the American Psychological Association.

3. A vote by a majority of the members of a Section to so dissolve. Such vote shall be condu, in the same manner described for the conduct of the Division's elections as described - Article VII, Section C of these bylaws.

G. RATIONALE: Corrects a typo. There was no "Executive Committee" in the old Byla

***

ARTICLE XIV : PUBLICATIONS

E. The Editors of the Division's publications shall be appointed for fixed terms of five (5) ~ for the Editor of the Journal and three (3) years for Editor of the newsletter. Their appoinm; shall be made upon recommendation of the Publications Board, with the concurrence 0:

President and the Executive Committee. and ratification by a majority vote of the Boa:

Directors. They shall serve as members of the Board of Directors, ex officio and without' The Editor of the newsletter shall serve in addition, as a member of the [Administra; Executive Committee, ex officio without vote. Editors shall be eligible to succeed themse;

E. RATIONALE: Codifies current procedures.

***

encourage the development of effective pattern of thought and action.

I think there is also essentially universal agreement that the means employed should be as safe as possible and as rapid as feasible. It does not matter whether those means are primarily biological, psychological, social, or an appropriate combination of these, as Lazarus (1978) demonstrated some time ago.

Potential Benefits of Psychotropics

As a pragmatic issue, I think it is important to recognize that few psychologists of mature years now practicing are likely themselves to prescribe psychotropic medications. Of course, there is always a risk! benefit ratio, and this is an essential consideration to each individual practitioner in making appropriate clinical decisions. No basic text on psychopharmacology fails to take this factor into account (Baldessarini, 1977; Gitlin, 1990).

To my way of thinking, there is every reason to expect some benefits from psychotropic medications, properly applied undercorrectcircumstances, Briefly, I might list these as follows: (1) alleviation of patient suffering due to direct relief from unwanted, interfering, or painful affects; (2) arrest of specific symptom patterns that can potentially be minimized through psychotropics; (3) some patients through psychotropic medication can be helped to avail themselves better of alternative forms of intervention, when those same patients might not otherwise be treatable in the least restrictive environment.and (4) psychotropics may offer a prospect of shortening treatment significantly, at least in some circumstances. This brief listing of

benefits, of course, does not change the fact that psychotropics are in no way a panacea for all forms of behavioral abnormality.

In closing, it seems to me that one of the chief difficulties psychopharmacology as a field raises for us as psychologists is the crucial matter of professional identity. Adding psychopharmacology to our armamentarium of skills may well change patterns of training as well as practice over the next several decades. However, assuming the position of the ostrich with regard to the potential importance and positive patient benefit from psychopharmacology is grossly self-defeating.

I am confident that to the general public, the crucial question about psychopharmacology and psychology will be whether psychologists have the necessary skills and training to intervene safely and effectively? A variety of psychotherapists have acknowledged the importance of psychopharmacology as a part of our knowledge base (e.g., Wiggins, 1992). This position has also been endorsed recently by the oversight group within the AP A Practice Directorate.

I hope psychologists can proceed to answer the questions about graduate and post-graduate psychopharmacology education, and of a testable psychopharmacology training model. Decisions about prescription privileges for those psychologists who are appropriately trained will be made by state legislatures, which have already spoken to this issue in relation to other heal th field, such as optometry and podiatry. As Cummings (1992) has stated, only our own reluctance to adapt our practices to the needs of the public will ultimately stand in the way.

COMMITTEE REPORTS

Education & Training Jeffrey Binder

Program on special section of Psych otherapy : "Recommendations for Improving Psychotherapy Training Board on Experiences - Manualized Training". All manuscripts are now complete. They will be sent to a subcommittee, who will review them and extract common themes. Hans and I will, then, write a position statement to accompany the manuscripts, based on the responses from the subcommittee of reviewers.

In response to a request by Reuben Silver, a subcommittee is being formed to address the following questions: (1) potential role of the Division is educating members about the role of pharmacology in psychotherapy; and (2) the role of psychologists in retreat of the severely and personnally mentally ill. The subcommittee will be chaired by Robert Weitz.

23

"

T.hetheme is

iversity"

Sponsored by

The Divisions of PSYCHOTHERAPY (29) INDEPENDENT PRACTICE (42) FAMILY PSYCHOLOGY (43)

of the

AMERICAN PSYCHOLOGICAL ASSOCIATION

Convention Coordinator Barbara Williams. Ph.D.

Associate Coordinator WI!I!am R.Fishburn. Ed.D.

Proqram Chair Vera S. Paster. Ph.D.

Conunulnq Education Chair Jean A. Carter. Ph.D.

March 11 ~ 14. 1993

Hyatt Islandia Hotel on Mission Bay San DleQo. California

Division 29: President· Reuben 1. Sliver. Ph.D.

President~Elect· Gerald P. Koocher, Ph.D.

Division 42: Presldent- Richard H. Mikesell. Ph.D.

Prestdent-Bfect- Karen Zaqer. Ph.D.

Division 4.'3: President· Carol Philpot. Psy .. D.

President-Elect· Robert J. Wellman. Ph.D.

Brochures contamtns all proqrarn Information and convention reqistration will be mailed well in advance of the meertns.

HOTEL RESERVATION FORM Joint Meeting of Divisions 29, 42 and 43 of

The American Psychological Assoclation- March 11.14, 1993

Reservation deadline: February 19, 1993 (Group rates after deadline will be based on availablity) Hyatt Islandia Hotel, San Diego California

Reservations: 1-800-233-1234

This form must be received NO LATER THAN February 19,1993 and must be accompanied by an advance deposit or credit card number in the amount of one night's room rate. All reservations will be filled on a first come, first served basis. Any reservations received after the cutoff date will be accepted on a space availability basis. Failure to cancel your reservations within 72 hours prior to your arrival date will result in forfeiture of your advance deposit.

All rates are subject to a 9% city occupancy tax.

Arrival Date: _

Departure Date:

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[] Hyatt Islandia Hotel Room $125 single or double [1 Marina Suite $160

[] 1 Bedroom Suite $250

These rates will be in effectfrom M(Uch 7-16, 1993

Please print

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Amount of deposit $ -----------------

Detach, complete and return directly to the hotel. lnfarmaiion subject 10 change without notice.

Hyatt Islandia Hotel 1441 Quivira Road

San Diego CA 92109-7898

25

Gender Issues Committee Gary Brooks

1. Worked with President Reuben Silver to identify appropriate Committee Co-Chair. Selected Glenace Edwall, Ph.D., of The University of Minnesota Hospital & Clinic to be Co-Chair. Dr. Edwall is an excellent choice because of her long experience with women's issues, her activities within Division 35, her former position of Training Director of the Doctor of Psycho 1- ogy Program at Baylor University, and a positive past working relationship with the Gender Issues Committee Co-Chair.

2. Developed a symposium for the 1992 Convention - "Deadly Consequences of Gender Socialization," that was to include a featured presentation by Dr. Deborah Prothrow-Stith, former state Public Health Director of Massachusetts. Funding for travel expenses (not honorarium) was to be shared by the Committtee budget and money from the AP A Committeeon Violence and Youth. The symposium was approved for the APA program and placed in a highvisibili ty time slot.

3. Worked with a University of Texas Do: student on a dissertation research project to pr empirical support for theories about men's behapsychotherapy. Efforts would be made to 1'\permission to use Division 29 members as informants.

4. Worked closely with the Gender Concerns ; mittees of AP A Divisions 42 and 43 to coort program and research activities. Participated i; Symposia at the 1992 Mid-Winder Conferenceder Concerns in Therapy: Unfinished Business "Gender and Divorce: Clinical Issues and TheStrategies". Will participate in six gender-IT: programs at the APA annual convention.

5. Wrote an article "Is There a Place for ~ Therapists" for the Psychotherapy Bulletin.

Program Committee

Norine Johnson

The committee wished to thank Anne Mello for all her wonder assistance in bringing this year's program to fulfillment. We will miss her knowledge, thoroughness and patience. We also want to thank Reuben Silver for his guidance and support and all the members of the Board of Directors, reviewers and program submitters who made this program possible.

This year's program was particularly strong as was appropriate to celebrate APA's Centennial year and the Division's 25th year. We dedicated the program to Jules Barron in memory of his innumerable contributions to the Division and psychology.

The program featured four Symposiums on Psychotherapy Theory, Research, Training and Practice: Past, Present and Future, chaired by Donald Freedheim,

Gerald Koocher, Ellen McGrath and Reuben S. two invited addresses that continued the centetheme; a conversation hour with students; a; invited State of the Arts address by Patricia Haru.., Reuben Silver, chaired a conversation hour witt presidents of the division and our social heir awards presentation.

The Hospitality Suite program as assemble:

Yvonne Jenkins contained more programming ever before while still providing opportunitie committee meetings and social gatherings.

It was a pleasure working with all of you and = forward to working with next year's President. G_ Koocher on the 1993 program.

26

Membership Report

Leon VandeCreek

New Members For August 1991 .. July 1992

AP A Referrals Direct *MRM Total

Membership Totals August 1, 1992

Members 267 33 33 333
Associates 14 7 0 21
Totals 281 40 33 354
*l\1RM. Membership Recruitment Mailing.
Sent out 1500 applications at random. Members:

Associates:

Fellows:

Total:

4949 230 196 5375

Division of Psychotherapy Membership History

... , ..

4373 4594

..•••.• 40"43 .. - ••.•••...••..••..

4069 4069

1985 1986 1987 1988 1989 1990 1991 1992

h/U! MEMBERS

ASSOCIATES _ FELLOWS

Nominations & Elections

Gerald Koocher

Results of the election are as follows:

President-Elect:

Tommy Stigall, Ph.D.

M embers-At-Large:

Norine Johnson, Ph.D. Wade Silverman, Ph.D. Suzanne Sobel, Ph.D.

Representative to APA Council:

Donald Freedheim, Ph.D.

27

Student Development Michael Carifio

1) Planning for student proctor participation during August convention in CE workshops.

2) Selected & informed winner of student paper competition, arranged for award presentation.

3) Announcements for 1993 student papercompetition to be distributed at August convention.

4) Hospitality suite planning for committee mee. & student paper competition paper presentar,

5) Applications for student development rnec ship continue to be received.

6) Invitations for student conversation hour sent _ lected, APA, APAGS, & 29 student affiliate mem;

Call For Nominations

The Publications and Communications Board has opened nominations for the editorships of the J ournal of Abnormal Psychology, the Journal of Applied Psychology, the Journal of Comparative Psychology, the Attitudes and Social Cognition section of the Journal of Personality and Social Psychology, Professional Psychology: Research and Practice, and Psychological Review for the years 1995-2000. Susan Mineka, Ph.D., Neal W. Schmitt, Ph.D., Gordon G. Gallup, Jr., Ph.D., Abraham Tesser, Ph.D., Ursula M. Delworth, Ph.D., and Walter Kintsch, Ph.D., respectively, are the incumbent editors. Candidates must be members of APA and should be available to start receiving manuscripts in early 1994 to prepare for issue published in 1995. Please note that the Publications and Communications Board encourages more participation by members of underrepresented groups in the publication process and would particularly welcome such nominees. To nominate candidates, prepare a statement of one page or less in support of each candidate.

For the Journal of Abnormal Psychology, submit nominations to Judith P. WoreIl, PhD, Chair, Editor Search Committee, Department of Educational and Counseling Psychology, 235 Dickey Hall, University of Kentucky, Lexington, KY 40506-0002.

For the Journal of Applied Psychology, submit nominations to Carl E. Thoresen, PhD, School of Education,Sr.anfordUniversity,Stanford,CA94305- 3096.

For the J oumal of Comparative Psychology, mit nominations to J. Bruce Ovennier, Ph.D., E1:... Hall- Psychology, University of Minnesota, 76 River Road, Minneapolis, MN 55455.

For JPSP: Attitudes, submit nominations to WL Mischel, Ph.D.,JPSP: Attitudes Search Commiz, Chair, American Psychological Association, - FirstS treet, NE,Room 2004, Washington, DC 200 4242.

For Professional Psychology: Research and P::-_ rice, submit nominations to Normal Abeles, Ph., Department of Psychology, Michigan State U ni: sity, Psychology Research Building, Room - Bogue Street, East Lansing, MI 48824.

For Psychological Review, submit nom in atioc, Alan E, Kazdin, Ph.D., Department of Psychok-, Yale University, P.O. Box llA Yale Station.X Haven, CT 06520-7447.

Names of members of search committees wil, printed in faU issues of the Journals and in theA' Monitor. First review of nominations will be-=December 15, 1992.

28

Employee Benefits

Patricia Hannigan-Earley

The Employee Benefits ad hoc committee has been active in the following areas:

1. Participation in the Practice Directorate's Technical Marketing Group: Dr. Hannigan was invited to part of a working focus group convened by the Practice Directorate in February to provide some direction in the area of marking psychologist's services to employers and other health care benefit purchasers.

2. Sponsorship of a Mid-West Regional Coalition on Managed Care: The committee obtained one hour in the Hospitality Suite at the annual 1992 convention to convene the state representatives of seven mid-west states for the initiation of a Mid-West Regional Coalition on Managed Care in cooperation with the Ohio Psychological Association. This group will set the agenda for a full day meeting in the Fall to be supported by the Practice Directorate and the Division.

3. Contact with the National Institute of Mental Health: Dr. Hannigan has been in communication with Bernard S. Arons, M.D., Associate Director of Mental Health Financing, Division of Applied and Services Research, National Insti tute of Mental Health. He is spearheading efforts to devise a model mental health benefits plan.

4. Presentation to Third Party Administrators: Dr.

Hannigan gave a presentation on mental health services, in particular the services of psychologists to the annual meeting of the Quitclaim Association in Chicago, Illinois on June 14 and IS, 1992.

5. Psychologists Managed Care: There has been communication between the committee chair and a group of psychologists in managed care settings to discuss the feasibility of their relationship with the Division, perhaps in terms of becoming a section of the Division.

Marketing of History of Psychotherapy

Jackson Rainer

1. Advertisement prepared by APA Publications Office for History of Psychotherapy.

2. Marketing booth sent to American Orthopsychiatric Association National Convention, May, 1992.

3. Advertisement placed for inclusion in fall issues of Journal of Pastoral Care, Journal of Marital and Family Therapy, N AS W News, and American Journal of Orthopsychiatry.

APA Centennial Celebrations

Gloria Gottsegen

1, Division 29 contributed $1,000 to the Centennial 4. A special issue of Psychotherapy on The Future of

Gold Circle Fund and will have the Division name Psychotherapy was guest edited by John C.

inscribed on the Gold Circle wail in the lobby of the Norcross.

new AP A building.

2, The Division sponsored History of Psychotherapy:

A Century Edited by Donald Freedheim, (Associate Editors: H.1. Freudenberger, J.W. Kessler. S.B. Messer, D.R. Peterson, H.H. Strupp and PL. Wachtel).

3. The Division sponsored A History of the Division of Psychotherapy by Mathilda B. Canter.

5. A Past President's breakfast on the occasion of the Division's 25th anniversary is being held at the Centennial.

29

Psychotherapy With Medical & Surgical Patients

David B. Adams

The committee members were sent the initial mission statement requesting that they edit that statement as they deemed appropriate. The editorial comments and recommendations were then compiled, and a final mission statement was completed and forwarded to ad hoc committee members (Drs. Linda Abeles, Lauren Ayers, Cynthia Belar, Jean Holroyd, Nadine Kaslow, Edward Sheridan, and Jan Wallander.) In effect, the mission statement must be a compromise between recommendations among committee members. The first year's focus of the committee will be to create a viable brochure for physicians and surgeons, respectively, on the use of psychotherapeutic treatment in acute and chronic illness as well as those patient's contemplating or undergoing invasive procedure(s). That brochure is under preparation.

Ad Hoc Committee on Psychotherapy for Medical & Surgical Patients

Mission Statement

Goals:

A. Insure adequate training of psychologists on the psychological, psychophysiological and somatopsychological impact of acute and chronic illness, including the psychological sequelae of medical or surgical treatment.

B. Promote appropriate education of psychologist in the understanding of the psychological, psychophysiological and somatopsychologic sequelae associated with physical injury and illness.

C. Educate employers and employees as to the causative role of psychological factors, and the psychological factors in morbidity and recovery of both illness and injury.

D. Promote physician, surgeon and other health care provider detection of psychological factors affecting physical recovery.

E. Educate physicians and surgeons regardin; tive selection of psychological referral, p _ means of patient preparation for referralcient tracking of referral outcome.

F. Assist patients and their families in unders., the importance of the psychological co: which their injury and/or illness occurs.

G. Facilitate patient adaptation to chronic irr, siduals, chronic disease processes, bandic; conditions and/or progressi ve/degenerative nal physiologic conditions.

Objectives:

1. Assess (through a representative sample) :. rent utilization of psychological services b. cians and surgeons in both outpatient and irr settings.

2. Develop a brochure for employer. employefamily members of psychological factors a:: physical conditions and the recovery proce

3. Develop a brochure for physicians and 5'':alerting them to indices of poor psyche response 10 medical care, assisting in the d:. tiation between fear and deliberate noncom; and related forms of psychological co-rnor-

4. Provide continuing education semina, somatization, factitious disorders and malin, including workshops, seminars, brochure monographs.

5. Identify key psychologist wishing to partie; a nationally based medical-surgical edu - program through sem inars and Di vision spa: educational materials.

30

1992 Mid-Winter Convention Final Report Tommy T. Stigall

The 23rd Annual Mid-Winter Convention was held at Amelia Island Plantation, Amelia Island, Florida. The convention dates were Friday, February 21, through Sunday, February 23. Board and Committee meetings were held on Wednesday afternoon and Thursday preceding the convention. The boards of the three Divisions met for lunch and a joint business meeting on Thursday.

1992 Committee

The following persons served as members of the 1992 Mid-Winter Committee:

Tony T. Stigall, Coordinator

Barbara Williams, Associate Coordinator Charles T. McDonald, Program Chair

Leon VandeCreek, Continuing Education Chair Victor Nahmias, Past Coordinator

Convention Registration

The convention was well-attended. A total of 393 persons were preregistered.

Members Non-Members Students Spouses

Other

Division 29 Division 42 Division 43 Total

198 196 108 316

38 12 67

7 440

Fiscal

The Final Operations Statement summarized operatingexpenses and net profit in theamountof$4,419.16 to be divided equally among the three divisions. This amount represented a 100 percent increase in convention profit, compared to the previous year.

Program

The Program Committee reviewed 127 program proposals and accepted 81 for the final convention program, comprising over 100 hours of scheduled presentations. Dr. McDonald utilized 24 program reviewers and has recommended increasing the number of reviewers to 30 for future conventions in order to reduce the individual workload and speed up the review process. The early announcement date and July 15 deadline for submissions greatly facilitated the program review and planning process. A program

innovation this year was the audiotaping of presentations at no cost to the convention. In the future, a "permission to audiotape" option should be incorporated in the program proposal form.

Continuing Education

Dr. VandeCreek selected five proposals for Category I continuing education workshops. Student proctors were recruited to assist with the workshops, and this practice should be continued. A total of 142 persons registered for the workshops held on Thursday, Friday, and Saturday. Attendance at each of the workshops is indicated as follows:

Thursday

Advances in Psychological Assessment: the MMPIIIandMMPI-Adolescent. YoussefBen-Portb,Ph.D. (Attendance 32)

Friday

Short- Term Psychotherapy: Three Models with Video Illustrations, Michael F. Hoyt, Ph.D. (Attendance 34)

Saturday

Risk Management: Avoiding Professional Liability Suits, Bruce Bennett, Ph .D. and Patricia Bricklin, Ph.D. (Attendance 21)

The Future of Psychology: Multidisciplinary Treatment of Panic and Anxiety Disorders, Richard Samuels, Ph.D., Dan Egli, Ph.D., and David V. Sheehan, M.D. (Attendance 35)

Exhibits

Eight exhibits were confirmed following solicitation from a large number of potential exhibitors by Dr. Williams. The Committee recommends that future contracts with exhibitors should include a specific clause that all exhibits are subject to approval by the Mid-Winter Committee. Central Office maintains a listing of potential exhibitors and will add to the list any recommendations received. Of the 1992 exhibitors, only Conference Book Service was present in 1991:

American Professional Agency APA Insurance Trust

31

publicizing individual program sessions 0: events;

2. Policy for a possible increase in per diem ~ bursement from the present $50.00 per de lowance;

3. Possible change in current policy of requir;. category I CE workshop attendees to regis., the entire convention.

American Psychological Association Conference Book Service, Inc. Encyclopedia Britannica, North America Professional Resource Press Psychological Assessment Resources Three Wishes Press

Special Events

All of the scheduled special events were wellattended and successful, including the Welcome Reception and Opening Session on Friday evening, the Awards Breakfast and Distinguished Psychologists Panel on Saturday morning, and the Presidential Reception Saturday night. The Saturday evening Dinner preceding the Presidential Reception also was wellreceived. A new programming format was introduced this year with a full day of scheduled activities for women on Sunday. Drs. Mattie Canter and Evelyn Hill were co-chairs of this very popular Women's Leadership Development Day. A similar event for men is being considered for the 1993 convention.

Policy Issues

Several policy issues were identified by the MidWinter Committee as needing further study and clarification. these issues will be addressed by the 1993 Commi ttee, with recommendations to be made to each of the three Divisions:

1. Policy regarding requests to obtain mailing lists of convention preregistrants to be used by

1993 Site Selection

The 1993 Mid-Winter Convention will be March 10-14 at the Hyatt Islandia Hotel on r..:. Bay, San Diego, California. This site was se following review of a number of alternative site visits to six properties in the Mission Bay area ~ Williams and Pauline Wampler and Michelle L of the Administrators.

Acknowledgements

Appreciation is expressed to the Presidents three Divisions, Drs. Richard H. Mikesell, Philpot, and Reuben Silver, for their important bution to the con vention planning process and SL for the work of the Mid-Winter Committee. Sthanks go to The Administrators, and especial! > othy Rice who served as the Central Office rna' for the entire Mid-Winter Convention effort, success of the Mid-Winter Convention contin, reflect the outstanding support and assistance vided by Pauline Wampler and her staff.

APA International Committee

Ernst Beier

I attended the CIRP meeting in Washington D.C. on May 1st and 2nd. The meeting was largely devoted to review the various action programs of CIRP around the world, such as a Training Project in Czechoslovakia, a South African student Exchange Program, Russian American cooperation problems (of course, in psychology) the Brussels Congress, the Red Americana Workshop and the ClRP program for the Centennial. Part of the time was devoted to discuss individuals who would be selected for specific awards for their activi ty in the international area. I was able to present a three point program:

1) To ask clinical psychologists (DIY 29,42and43) who, on their own, are planning to travel abroad, whether they are willing to offer a lecture or a workshop to the psychologist of the host country they ar planning to visit, without recompense (but possible tax advantage).

2) To ask CIRP to help with names of indivi, active in the countries Psychological Associatic of the names of persons associated with the uni: ties of the countries which would be visited, in . to facilitate such "learned export".

3) To obtain names of individuals at universit, various countries whom we would send a ques naire asking for the nature of clinical training work opportunities in their countries.

The committee liked the idea and suggestec contacts would be made available to us, however did not want to be the direct sponsor. I was tol; Fran Culbertson is working on a similar interna; questionnaire, concerned with woman issues. : tacted her and we shall meet at the APA com',,and decide how wecan best work together on this _

32

merican Psychological Association Division of Psychotherapy

Task Force on Men's Roles and Psychotherapy

Ronald F. Levant

The Task Force includes the following members of the Division: Drs. Ronald Levant, Herbert Freudenberger, Michael Gottlieb, Victor Nahmias, William S. Pollack, Murray Scher, John Currie, Gary Brooks, Michael Andronico, James Dean, James Campbell, and Silvio Silvestri. The mission of the Task Force has been to encourage clinical work and empirical scholarship on the changing roles of men, and on the relationship between aspects of the traditional male role and men's physical and mental health. A particular concern has been on men's under-utilization of psychotherapy.

The accomplishments of the Task Force over the past four years include the following:

1. Organizing seven symposia at Mid-Winter Conventions 1989, 1990, 1991, and 1992; organizing nine symposia at APA Conventions 1989, 1990, 1991 and 1992. One of these, a symposium on Men, Emotions, and Intimacy at the 1991 APA Convention, was a smashing success, drawing a standing room only audience of over 700 people, and receiving local and national press coverage, including a four page article in People Magazine.

2. Developing a Special Series on Men's Roles and Psychotherapy for the Journal, Psychotherapy, published Fall. 1990 (VoL 27, Number 3).

3. Writing articles for The Psychotherapy Bulletin.

Gary Brooks wrote a piece titled "Men's Studies and Psychotherapy: A Current Perspective on the Status of the Men's Movement," which has generated more than 30 calls and letters.

4. Linking up with the emerging network of APA members interested in men's studies, including the Men Treating Men Bulletin and the Society for the Psychological Study of Men and Masculinity.

5. Obtaining a listing for men's studies in the APA Convention program.

I would now like to list the programs developed for the current year. For 1992, two programs were presented at the 1992 Mid-Winter Convention: (1) A ReGathering ofPsycho!ogists Studying Men and Masculinity, co-chaired by Gary Brooks and Ron Levant; and (2) Intergender Dialogue, a workshop co-facilitated by Ron Levant, Barbara Wainrib, Gary Brooks, and Penelope Russianoff,

For the 1992 Annual Convention, three symposia have been presented on the regular program, one had been accepted for the regular program but will be postponed until next year, and one will be presented in the Hospitali ty Suite. The regular program symposia are listed below:

"Toward a New Psychology of Men," Chaired by Ronald F. Levant. Participants: Joseph Pleck, "Gender Role Strain, Social Constructionism and Masculinity." William Pollack, "Boys Will Be Boys: Development Traumas of Masculinity - Psychoanalytic Perspectives." James O'Neil, "Gender Role Conflict Research: New Directions to Understand Men's Violence." Richard Eisler, "Conceptualization, Measurement,and Preliminary Validation of the Masculine Gender Role Stress Scale." Ronald F. Levant, "Agenda for Research and Intervention: Excesses, Deficits, Work. and Relationships." Gary Brooks, "Men's Physical and Mental Health Problems in Ethnocultural Perspective."

"Snips and Snails and Puppy Dog Tails: Men and Shame," Chaired by Martin R. Wong. Participants:

John M. Schneider, "Men's Grief and Shame." Richard F. Lazur, "Warrior Child: Narcissistic Injuries of the Male Sex Role." Martin R. Wong and Richard W. Osborne, "Shame and Male Gender Identity." Thomas L. Fiester, "Shame and Countertransference in Male to Male Psychotherapy." Warren Spielberg, "Why Men Must be Heroic." Ellen McGrath. Discussant

"Economics, Racism, Sexism: Psychotherapy of African-American Men and Women," Chaired by

33

Richard F, Lazur, Participants: Ron Hall, "Correlations of Cutaneo-Chroma for Gender Roles in African-American Community," Richard Majors, "Cool Pose: Adaptation to Gender Role Dysfunction," Richard Tyler, "Preliminary Findings on Cool Post Attitudes and Behaviors in Urban High School Students," Sunya Williams McLaughlin, "Contextual consideration of Black Male Sexism in Black Male/ Female Relationships," Radhia A. Jaaber, "Effect of Oppression ofBlack Men and Women's Gender Roles and Relationship Violence,"

The program that was accepted but is being postponed is:

"Deadly Consequences of Gender Socialization:

Implications For Psychotherapists," Chaired by Gary R, Brooks. Participants: Deborah Prothrow-Stith, "Deadly Consequences: How Violence is Destroying our Teenage Population," Lenore Walker, "Deadly Consequences of Gender Socialization: Violence against Women," Ellen McGrath. "Deadly Consequences of Gender Socialization: Women and Depression," Gary Brooks. "Deadly Consequences of Gender Socialization: Young Men and High-Risk Behavior."

And, the program to be presented in the HaspSuite, is:

"The Men's Movement: What It's All A:

Chaired by Silvio Silvestri, Participants: Gary B"Pro-Feminism, Masculinism, and Drumming Overview of the Men's Movement." Glenn = "Costly Conceptions of Masculinity: Rectifyc Failures of Psychology, "Ronald F. Levan:. Critique of the My thopoetic Men's Movement," ~ Silvestri, "Men From Dysfunctional Familie Contradiction in Terms," William S, Pollack. --:: fining Masculinity: Toward a New Consir, Manhood."

In addition, there will be a meeting of the Task :c in the Hospitality Suite on Sunday August 16 3:00-3:50 pm. This meeting is open to any inte members of the Division.

Finally, I would like to report that the Taskf-orce additional programs for the future, including the Winter and Annual Conventions in 1993; more E:" for the Psychotherapy Bulletin" and a Mid- Wine treat for men at the Mid-Winter Convention, 19S

FOR WOMEN ONLY!

RESER VB TIME FOR:

THE SECOND ANNUAL WOMEN'S LEADERSHIP DAY

AT THE MID-WINTER CONFERENCE-1993

HY ATT ISLANDIA, SAN DIEGO, CA

OUR FIRST WOMEN'S LEADERSIDP DAY WAS SO SUCCESSFll., WE ARE BACK WIT:AN EVEN BETTER PROGRAM!

RELAXATION, DISCUSSION, NETWORKING, FUN

LOOK FOR DETAILS IN THE NEXT Bll-LETIN

34

r

CALLFO

VI:ti:::ub~~~fenta1 Health Ser• presenta,tions for its Fifth be eld April 15-17. 1993, in 1993 theme for the conference

is:

Psycbotherapy with People of Color:

Innovations, Creative Interventions, and Complications

We are looking for workshops (90 minutes) and seminars (3 hours) of innovative and creative work being done with people of color. This annual conference has become a national showcase for discussion

and sharing of issues and information about psychotherapy with people of color. For more information, instructions on how to submit a proposal for a presentation, or information about the conference, please call or write:

Richard K. Onizuka, Ph.D.

Coalition For Multicultural Mental Health Services (CMMHS)

P.O. Box 101356 Denver, CO 80250-1356 (303) 643-8487

ANNOUNCEMENTS

AI Mahrer, PhD .• professor of psychology at the University of Ottawa, was the recipient of the 1992 Award for Excellence in Research, and was named as the Researcher of the Year by the University of Ottawa. Dr. Mahrer has been a member of Division 29 for many many years.

GROUP PSYCHOTHERAPY TRAINING PROGRAM ~~~~!!

D.C. Commission on Mental Health Services Uy John F. Borriello, Ph.D .• Director

The Group PsychotilerapyTrainingProgram (GPlP) of the D.C. Commission on _1~ Health Services (CMHS) was founded in 19"75. <> ams is the product of the merger on Octobec 01.987 of Saint Elizabeth's Hospital. a compo em of. m. and the D.C. mental health system.

Forthe psychologist, the GPTP' sprerequisite training is a Ph.D. or Psy.D. from and APA-accredited program and an AP A-accredited intemsbip. Based upon the performance of the feedback from our graduates, this prerequisite training is crucial, We have leamed from them that such training equips the resident with a systematic body of psychological knowledge that can be applied and fine tuned in the clinical situation. It also provides the trainee with a critical inquiry approach that helps to mitigate against the acceptance of quackery. With such training, the resident enters the GPTP with a psychological understanding of humans and a language that enables communication with other residents and staff. A major weakness is many of today's residents is a lack of group dynamics knowledge that the GPTP rectifies. Besides the academic training noted above, we want

candidates who are open-minded, are intrigued by new ideas, ha ve a thirst for knowledge and are curious about groups. We avoid accepting applicants who are entrenched in individual psychotherapy theory and technique. We have found that such applicants tenaciously cling to the belief that group psychotherapy is nothing but a transposition of'individual psychotherapy theory and technique to the group. It has been our experience that such applicants resist learning about the devalue group dynamics. We have also come to realize that poor candidates for our program are those applicants who present in admissions interview an impermeable approach to the treatment situation or espouse and glorify a particular theory and technique to cure psychological distress.

The setting within which the GPTP exists is a large Mental Health System which includes an Acute Care Psychiatric Hospital, three Community Mental Health Centers, Day Hospitals. Forensic inpatient and outpatient facilities, Child and Youth Services inpatient, outpatient and forensic facilities, schools and therapeutic nurseries. In the coming year, a local university counseling center will also be available. The patient

35

content area was incorporated into the group p therapy and group dynamics seminars. The' year includes a weekly Advanced Group P_ therapy Literature has been incorporated in the psychotherapy seminars. Residents learn ab roles and functions of other mental health prof, als by attending the treatment team meetings 0 of their patients. This learning is especially when the resident is in the independent pr Residents have reponed that this learning fac. their competent handling of severe crisis ir independent practices. For instance when a member is suicidal of in need of medication or - talization. In our jurisdiction the latter is not a pr since the group psychotherapist can admit pati. the hospital if qualified (licensed and privilegec independent ?? of clinical psychology by the tal).

populations available represent the majority of the DSM-III-R diagnostic categories.

This is the ideal setting within which to learn about group psychotherapy. There is a ready resource of potential group members both native and foreign born. The degree of psychological?? range from mild to severe and acute to chronic. These allow for the formation of a variety of psychotherapy groups both short and long term, heterogenous and homogenous, symptom focussed, and same sec focussed with either a psychodynamic, interpersonal, humanistic, behavioral, cognitive or rational-emotive orientation.

For the reader who may be interested in establishing a group psychotherapy training program, our experience dictates that the program be located in and be a component of a large mental health system whose director and staff believe in the worth of group psychotherapy as an effective treatment modality. Having such a mental health system director and staff not only help guarantee the survival of the program, but also the recruitment of bright group psychotherapy interested psychologists.

The primary task of the GP1P is to graduate competent psychologist-group psychotherapists. The program is full time for two years with a stipend that is comparable with other post-doctoral residencies in the country. Our experience indicates that two years provide both patients and residents the opportunity to experience the strengths and weaknesses of group psychotherapy.

For example, among other things, the residents come to learn: a) an essential ingredient of keeping chronic patients in the community is not intensive but extensive group psychotherapy, b) medication is relevant for group psychotherapy to be effective with acute psychotics and c) most younger ?? psychotic patients are reluctant to commit to group psychotherapy for more than a year and prefer a problemfocussed approach.

Components are didactic, experiential, practicum, supervision and electives. When first developed, the first year didactics included a Group Psychotherapy Literature Seminar, a Group Dynamics Literature Seminar. and A General Systems Theory Seminar. With feedback from the residents over the years, the general systems theory seminar was dropped and its

The experiential component has remained the over the years, it consists of a Professional De ment Group and a Group Relations Conferenc, consider this one of the most important com pone provides the opportunity for the resident to exp tially learn about group dynamics which is the c . stone of the GP1P. We emphasize group dyr _ training because the group is the medium th: which the patient is encountered. Knowledge of z: dynamics enhances the group psychotherapy ~

All residents participate in the Professional [ opment Group. This group meets weekly over tl" year period with hour and a half sessions. Its las provide the residents the opportunity to talk _ their development as professional psychologist-, psychotherapists while at the same time learn _ group dynamics. This group is conducted by a c.;. psychologist who is not a staff member of the C· In past years a psychiatrist-psychoanalyst and worker both trained in group dynamics and = psychotherapy conducted this group but fee; from the residents indicated that they wanted a (: psychologist that was not a faculty member or ~_ visor. The residents have taught us that a non-fa member provides greater freedom to deal w., issues. especially authority, inherent in any = convened for a extended period of time.

In the first year. residents participate as memb a Group Relations Conference (GRC). Duri; second year, residents join theGRC staff and fu-

36

as a small, large and/ primary task of this opportunities for the here• :- small.Iarge and intergroup dynam-

ics. bersbip of this conference comes from

psycho , psychiatry, social work, nursing, creative

arts, pastoral counseling and administration. Among the group dynamics learned are membership, group formation and development, overt and covert forces that enhances or impede group task accomplishment, role differentiation, norms and mores, authority, cohesion, cooperation, competition, pressures to uniformity, leadership, followership, and scapegoating,

The practicum component focusses supervision for all clinical activities. Supervision is both individual face-to-face and groop and brings into focus the multicultural dim~ The belief of the program is that supervision sboold provide opportunity for the resident to monitor his g:oup psychotherapist behavior and to fine mne - as r sessions proceed. We want the resident to be.able r ~ what has gone

on from a group d~ . e. As experience

is gained in the progr - choose whichever

theory or method bi::s. end the supervision

facilitates implementation mastery. Supervision can be either live, audio-visual recorded or protocols of sessions. Both the supervisor and resident decide which type is to be followed.

The pool of supervisors come from the CMHS staff and consultants. All the consultants are clinical psychologists and in private practice. Including the consultants, there are approximately 100 licensed psychologists in the CMHS. Seventy-three are privileged in the independent practice of clinical psychology. Thirty-four of these 73 are privileged in group psychotherapy as a 12 psychiatrist-psychoanalysts. This large supervisor pool is another reason why a group psychotherapy training program is best located in a large mental health organization. The residents average about ten different supervisors over the two year period. Supervision can focus technique or countertransference or system dynamics or group dynamics or client psychodynamics or a combination of any of the above. Feedback from the residents indicates that they appreciate the variety of supervisory formats from which they can choose.

Please make te :::is '::'ou are interested in Division 29's sponsorship of a

Comb.ci::::.g r . on Program for AP A's Annual Convention.

The Proposals mtJSt in the Central Office by December 10,1992.

Yo may address all proposals to:

~orine G. Johnson, Ph.D. 1993 Program Chair

The Division of Psychotherapy (29) Central Office

3875 N. 44th Street, Suite 102 Phoenix, AZ 85018C

37

1992 Division Membership Survey I (Please Print Clearly)

I

I Name Phone ---------

I

I Mailing Address

I City/State/Zip

I Would you like to be included in a Directory of Service Providers? 0 Yes 0 No

I

I Full-Time Work Setting: Check only one.

I

I 0 University or Medical School/Teaching

I 0 University of Medical/Student Services I 0 Private Practice/Individual

o Private Practice/Group

II· Managed Care Organization: Specify:

o Community Agency/Public

I 0 Community Agency/Private

I 0 Hospital

I 0 Research Setting

I 0 Other: Specify:

I

I Part-Time Work Setting: Put a number 2 next to appropriate setting above, if applicable.

llf you are in practice in any setting, what managed care networks do you belong to: Please list by name: _ I additional sheets if necessary.

11.

I

12.

I

I 3.

I What do you charge for the following services?

I Individual Psychotherapy (50 Min) $ (75 Min) $ -----

I Group Psychotherapy: Time Frame: Fee: $

I

I Family Therapy:

I

I Psychological Evaluation:

I I I I I I

Time Frame: Fee: $

Other: Specify

Return to:

Division 29 Central Office 3875 N. 44th Street, Suite 102 Phoenix, AZ 85018

38

r --------------------------1

I OrvlSION 29 Change of address Form I

I !

I set: us informed of any changes in your address I

I I

I arne I

I I

I Title I

I I

I Company I

I I

I A~re~ I

I City St I

I Zip I

I Poe Date I

I I

I Please to: I

I I

II ..... = ';ISYCHOTHERAPY . Central Office II

- ..... S . e 102

I I

I I

I or FAX - --...:: _ I

L J

ERAPY BULLETIN

ADVERTISING CLOSING DATES:

Sept. I, Dec. 1, Feb 1, May 1 PREFERRED MATERIALS:

Camera Ready Copy.

RATES: Ix 4x
Full Page $150 $125
One- half Page 90 75
One-Quarter Page 50 40
Cover - 3 175 150
Cover - 4 (1/2) 175 150 Phoenix, AZ - _ (602) 952-8656 Fax #: (602) 952-&:. ...

39

TASK FORCE ON CHILDREN & ADOLESCENTS !!!!!!!!!!!!!!!!!!!2 Marketing Brochure for Children & Adolescent Therapy Availabl-

r-------------------------------

I Children & Adolescent Order Form

I Please Print:

I I I I I I I I I I I

I Please return to:

I Alice Rubenstein, Ph.D.

I DIVISION 29 - Central Office 3875 N. 44th st. - Suite 102

: Phoenix, AZ 85018-5435

L Ph~~602-952-~~~X#602-952-8230 _

It's always difficult for parents to make the decision to put a child in therapy. Now there's a brochure you can use to make it easier for parents to make the decision and to encourage them to address children's problems early with outpatient therapy rather than laterwhen expensive hospitalization may be required.

Produced by the Division 29 Task Force on Children and Adolescents, "Psychotherapy with Children & Adolescents: A Guide for Parents" explains what child and adolescent therapy is, how to tell when your child needs therapy, what parents can expect from therapy and how to find a child/adolescent therapist. It addresses questions such as whether parents should expect the child to discuss therapy sessions or not, - how to tell if child and therapist are compatible. confidentiality and parent contact with the therapist and insurance reimbursement.

Task Force Chair Dr. Alice Rubenstein and her committee have succeeded presenting this information in a clear, concise way addressing most of the questions and fears parents have about putting a child in therapy. The resulting attractive tri-fold brochure is available for you to use in educating parents in your community. The brochure is also an excellent educa-

tional piece for professionals such as pediatricia; school counselors and dentists to give to parewhen referring to you.

There is space on the back page for you to personal, the brochure with your name, address and phone ocber so that it also becomes a marketing tool for ~. practice. This area can either be professionally prin; on your brochures or can be left blank for personaliz:. with anameandaddress stamp or label. Prices for A: mem bers are as follows:

Division 29 Member Prices

Quantity 100

200

500 1000

No Imprint 522.50 37.95 68.95 128.95

Imprinted w/Name/ade:$40.00

50.00

80.00 150.00

Non-members may also order at these slightly Ii; prices:

Quantity 100

200

500 1000

No Imprint $30.00 50.00 85.00 160.00

Imprinted wfName/adL' s 50.00

65.00 100.00 185.00

Name ___

Company __

City _

Address _

5t _

Zip _

o Payment Enclosed

o VISA

Card No. _

o MasterCard

Exp. Date _

40

CALL FOR PR OG RAM REVI EWE RS !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Di visi _~ ·5 program has been particularly exciting over the years because of your participation. If you are willing to a reviewer for the Division of Psychotherapy (29) 1993 Convention Program, please fill in the

Revie Form below. It is especially important you include your areas of interest and expertise.

The deadline for submissions this year is December 10th, 1992. As soon as basic data from the program submissions is entered into our computer, program proposals will be mailed out for review. For your information and consideration of being a reviewer...the time framefor review of proposals will be approximately December 27 to January 8th.

Please mail the completed form below to:

~ mine G. J ohnson 393 Program Chair

Tbe Di v ision of Psychotherapy (29) Centra Office

3S-: _ - Street, Suite 102

PbI~·:::...::..7.. 850 18

1------------------------------1

I (clip and mail) I

I I

I D flSION OF PSYCHOTHERAPY (29) I

: REVIEWER FORM :

I I

I .:.REVIEWER for the Division of Psychotherapy (29) 1993 Convention I

I Program. I

I (please. I

I I

j

I I I

I I I I I I j

I I

I I I I

I Form RECEIVED by November 5th, 1992. I

L ~

N~ __

B -

E~. Phone

F.. ..= _

Areas of imerest.

41

CALL FOR PROGRAMS

ANNUAL CONVENTION

AMERICAN PSYCHOLOGICAL ASSOCIATION TORONTO, C-ANADA

AUGUST 20-24 , 1993

Proposals must be received b)' December 10, 1992

Division 29's Themefor the 1993 convention is Psychotherapy Through The Life Cycle.

Program proposals that address Psychotherapy for children, adolescents, adults and or the elderly are invited.

Please send Programs for Division 29 to:

Norine G. Johnson, Ph.D., Program Chair c/o Division of Psychotherapy Central Office 3875 N. 44th Street, Suite 102 Phoenix, Arizona 85018

(602) 952-8656 FAX (602) 952-8230

42

Division of Psychotherapy of the American Psychological Association 1992 LIAISONS

AdministratiFe Liaison ~tathilda Canter, Ph.D. ~5 £. :';1cDanaid Dr. Pi:oeni", AZ 85018

O:Sce: 602-840-2834

B .",PPl Montso»

Ir e ne Deitch, Ph.D. : - 3 _::cerwarth Ave ..

_~ Island, NY 103014543 . ~: ']8-390-7744

, \ Ludson

__ """ \1. Porche-Burke, Ph.D.

::: :- -:.....~iOOO S. Fremont Ave. _-_- _-::-::-'-. CA 91803

- .::. = ~ :8-284-2777

Lillis:; ~ UJ AP A Centenn ial

... Zcbar Got:tsegen, Pb.D. ~~ '5."' Je.\ Lago, 37A ~ ~ r- FL 33433 ~ -_ -!.87-0980

Observer to APA & CAPP Practice Directorate

EUen McGrath Ph.D. 1938 Del Mar

Laguna Beach. CA 92651 Office: 714497-5003

REPRESENTA nVESTOJCPEP

Tommy T. StlgaU, Ph.D. The Psychology Group 701 S. AcadianThruway Baron Rouge, LA 70806 Office: 504-387-3325

Arhtur WeIns Ph.D.

Oregon Health Services University 3181 SW Sam Jackson Park Rd. Portland, OR 97201

Office: 503-279-8594

EDn-ORS OF PU.BLlCA nONS

Psych otherapy/o umal Donald K. Freedhelm, Ph.D. !)eptofPsychology

Mather Memorial Bldg

Case Western Reserve University Cleveland, OH 44106

Office: 216-368-2841

Psyc hotherapy Bulletin Wade H. Silverman, Ph.D . Barry University

11300 Northeast Second Avenue Miami Shores, FL 33161

Office: 305-899-3273

MID-WINTER MA.RCH 10-14, 1993

Convention Coordinator Barbara Williams, Ph.D

Associate Coordinator William R. Fishburn. &I.D

Program Chalr Vera S. Paster, Ph.D

ContinuIng Education Chair Jean A. Carter, Ph,D

A.dolescents and

'i.-l>emtein, Ed.D. ~ ~~hotherapy Center : ~ ;=<JOe Avenue

F: ,,- ,~ ~-y

• -.- -: 5-586-0410

T • ~ era 011 Aging

'a-=.1D Abeles, Ph.D., Co-Chair -::;:: :~logy Research Bldg. :':~:;:gm State University

:::E Lansingv Ml 48824

~ :'Sce: 517-355-9564

Carl Elsdorfer, Ph.D., Co-Chair Dept. Of Psychiatry, D-28

P.O. Box 016960 .

:\liami, FL 33136

Office; 305-545-6319

Task Force on American I nJian Mental Health

Diane WiJIis, Ed.D.

Child Study Ctr. University of Oklahoma 1100 NE 13th St. Oklahima City, OK 73117 Office: 405-271-6876

Task Force on Men's Roles and Psychotherapy

Ronald Levant, Ed.D. 20 Forest Notch Cohasset, MA 02025 Office; 617-383-2256

Task Force on Trauma Response & Research

RUin Bloch, Ph.D., Co-Chair Dept. of Family Medicine Mail Location 582

University of Cincinnati Med, Ctr, Cincinnati, OH 45227

Office; 513~5584020

Jon Perez, Ph.D., Co-Chair Life Plus Foundation

6421 Coldwater Canyon Ave. North Hollywood, CA 91606 Office: 818-769-1000

DIVISION OF PSYCHOTHERAPY (29) Central Office

3875 N. 44th Street, Suite 102 Phoenix, Arizona 85018 (602) 952-8656

FAX: (ro2) 952-8230

43

M OF PSYCHOT.t,.

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29

DIVISION OF PSYCHOTHERAPY American Psycholagica! Association 3875 N. 44th St., Suite 102

Phoenix, AZ 85018

OaJ~184361QC H CS OR ABRAHA~ W ~ LF DEPT .,OF PSYCH A

CLEVELAND HETR E H SP

33'35 SC f/ANT ON RO

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Non-Profit Organization U.S. Postage PAID Phoenix, AZ 85018 Permit No. 311

Division of Psychotherapy (29) Highlights

- -

... _- --

. - .. ~ ....

---- - -------.,

~~~Edge

..... --:.

. -......

- --

Division 29 is the APA division specifically committed 10 support the various components of effective psychotherapy: education, training, research and practice. The following are highlights in these arenas of unique Division activities for the past six months:

• The History of Psychotherapy received excellent reviews and was made available only 10 29 members for a significant discount; it has sold 1374 copies.

• The Trauma Response and Research Committee worked quite actively in the Los Angeles riots. Hurricane Andrew and Hurricane Iniki providing assistance, training and collecting research data.

• The Trauma Committee is developing a Trauma Hotline with Los Angeles print and electronic media to provide psychological support and information during a disaster.

• The Child and Adolescent Treatment Brochure . has sold 57,800 copies, the best selling brochure the Division has ever produced and one of the most effective marketing tools.

• The 29 Publication Board developed articles on psychotherapy for College newspapers - another marketing tool.

• The History of the Division of Psychotherapy was published and is available to all 29 members.

• The new Committee on Public information is developing a brochure explaining to the public current issues in psychotherapy.

• The research project on gender differences in depression, supported by Division 29, published the pilot study results in the summer Bulletin; data from the full study has been analyzed and is prepared for publication.