OFFICIAL PUBLICATION OF DIVISION 29 OF THE B APMERsICyANcPShYCHoOLtOGhICAeL rASaSOCpIATy ION www.divisionofpsychotherapy.org U In This Issue

A History of Division 29

Student Paper Award Abstracts L

Psychotherapy Integration Milestones in Psychotherapy Integration L

Psychotherapy Practice The Practice of Psychotherapy: Lost or Found? E Ethics in Psychotherapy Informed Consent with Culturally Diverse Clients T 2009 Nominations Ballot E I

2008 VOLUME 43 NO. 4 N Ⅲ Division of Psychotherapy 2008 Governance Structure ELECTED BOARD MEMBERS President Professional Practice Diversity Jeffrey E. Barnett, Psy.D., ABPP Jennifer Kelly, Ph.D., 2007-2009 Caryn Rodgers, Ph.D., 2008-2010 1511 Ritchie Highway, Suite 201 Atlanta Center for Behavioral Medicine Prevention Intervention Arnold, MD 21012 3280 Howell Mill Rd. #100 Research Center Phone: 410-757-1511 Fax: 410-757-4888 Atlanta, GA 30327 Albert Einstein College of Medicine Email: [email protected] Ofc: 404-351-6789 Fax: 404-351-2932 1300 Morris Park Ave., VE 6B19 Email: [email protected] Bronx, NY 10461 President-elect Ofc: 718-862-1727 Fax: 718-862-1753 Nadine Kaslow, Ph.D., ABPP Education and Training Email: [email protected] Emory University Department of Michael Murphy, Ph.D., 2007-2009 Psychiatry and Behavioral Sciences Department of Psychology Diversity Grady Health System Indiana State University Erica Lee, Ph.D. 80 Jesse Hill Jr Drive Terre Haute, IN 47809 55 Coca Cola Place Atlanta, GA 30303 Ofc: 812-237-2465 Fax: 812-237-4378 Atlanta, Georgia 30303 Phone: 404-616-4757 Fax : 404-616-2898 Email: [email protected] Ofc: 404-616-1876 Email: [email protected] Email: [email protected] Membership Secretary Libby Nutt Williams, Ph.D., 2008-2009 APA Council Representatives Armand Cerbone, Ph.D., 2006-2008 St. Mary’s College of Maryland Norine G. Johnson, Ph.D., 200 8-2010 3625 North Paulina 18952 E. Fisher Rd. 13 Ashfield St. Chicago, IL 60613 St. Mary’s City, MD 20686 Roslindale, MA 02131 Ofc: 773-755-0833 Fax: 773-755-0834 Ofc: 240- 895-4467 Fax: 240-895-4436 Ofc: 617-471-2268 Fax: 617-325-0225 Email: [email protected] Email: [email protected] Email: [email protected] Treasurer Steve Sobelman, Ph.D., 2007-2009 Early Career Linda Campbell, Ph.D., 2008-2010 2901 Boston Street, #410 Michael J. Constantino, Ph.D. , 2008-10 Dept of Counseling & Human Dev Baltimore, MD 21224-4889 Department of Psychology University of Georgia Ofc: 410-583-1221 Fax: 410-675-3451 612 Tobin Hall - 135 Hicks Way 402 Aderhold Hall Cell: 410-591-5215 University of Massachusetts Athens, GA 30602 Email : [email protected] Amherst, MA 01003-9271 Ofc: 706-542-8508 Fax: 770-594-9441 Ofc: 413-545-1388 Fax: 413-545-0996 Email: [email protected] Past President Email: [email protected] Jean Carter, Ph.D Student Development Chair 5225 Wisconsin Ave., N.W. #513 Science and Scholarship Michael Garfinkle, 2008 Washington, DC 20015 Norm Abeles, Ph.D., 2008-2010 Derner Institute Ofc: 202–244-3505 Dept of Psych Adelphi University Email: [email protected] Michigan State University 1 South Avenue Domain Representatives 110C Psych Bldg Garden City, NY 11530 Public Policy and Social Justice East Lansing, MI 48824 Ofc: 917-733-3879 Irene Deitch, Ph.D., 2006-2008 Ofc: 517-353-7274 Fax: 517-432-2476 Email: [email protected] 31 Hylan Blvd 14B Email: [email protected] Staten Island, NY 10305-2079 Ofc: 718-273-1441 Fax-1-718-273-1445 Email: [email protected] STANDING COMMITTEES Continuing Education Finance Program, continued Chair: Annie Judge, Ph.D. Chair: Bonnie Markham, Ph.D., Psy.D. Associate Chair: Chrisanthia Brown, Ph.D. 2440 M St., NW, Suite 411 52 Pearl Street Email: [email protected] Washington, DC 20037 Metuchen, NJ 08840 Ofc: 202-905-7721 Fax: 202 -887-8999 Ofc: 732-494-5471 Fax 206-338-6212 Psychotherapy Practice Email: [email protected] Email: [email protected] Chair: John M. O’Brien, Ph.D. 465 Congress St. Suite 700 Associate Chair: Membership Portland, ME 04101 Rodney Goodyear, Ph.D. Chair: Sonja Linn, Ph.D. Ofc: 207-773-2828 x1310 Email: [email protected] 2440 M St, NW, Suite 411, Fax: 207-761-8150 Washington, DC 20037. Email: [email protected] Education & Training Ofc: 202-887-8088 Chair: Jean M. Birbilis, Ph.D., L.P. Email: [email protected] Associate Chair: Patricia Coughlin , Ph.D. University of St. Thomas Email: [email protected] 1000 LaSalle Ave., TMH 455E Associate Chair: Minneapolis, Minnesota 55403 Chaundrissa Smith, Ph.D. Psychotherapy Research Ofc: 651-962-4654 Fax: 651-962-4651 Email: [email protected] Chair: Sarah Knox, Ph.D. Email: [email protected] Nominations and Elections Department of Counseling and Associate Chair: Gene Farber, Ph.D. Chair: Nadine Kaslow, Ph.D. Educational Psychology Email: [email protected] Marquette University Professional Awards Milwaukee, WI 53201-1881 Fellows Chair: Jean Carter, Ph.D. Ofc: 414/288-5942 Fax: 414/288-6100 Email: [email protected] Chair: Jeffrey Magnavita, Ph.D. Program Glastonbury Psychological Associates PC Chair: Nancy Murdock, Ph.D. Associate Chair: Susan Woodhouse, Ph.D. 300 Hebron Ave., Ste. 215 Counseling and Educational Psychology Email: [email protected] Glastonbury, CT 06033 University of Missouri-Kansas City Ofc: 860-659-1202 Fax: 860-657-1535 ED 215 5100 Rockhill Road Email: [email protected] Kansas City, MO 64110 Associate Chair: Jeffrey Hayes, Ph.D. Ofc; 816 235-2495 Fax: 816 235-5270 Email: [email protected] Email: [email protected] PUBLICATIONS BOARD EDITORS

Chair 2003-2008 Psychotherapy Journal Editor Internet Editor Raymond A. DiGiuseppe, Ph.D., Charles Gelso, Ph.D., 2005-2009 Abraham W. Wolf, Ph.D. Psychology Department University of Maryland MetroHealth Medical Center St John’s University Dept of Psychology 2500 Metro Health Drive 8000 Utopia Pkwy Biology-Psychology Building Cleveland, OH 44109-1998 Jamaica , NY 11439 College Park, MD 20742-4411 Ofc: 216-778-4637 Fax: 216-778-8412 Ofc: 718-990-1955 Ofc: 301-405-5909 Fax: 301-314-9566 Email: [email protected] Email: [email protected] Email: [email protected] Student Website Coordinator Laura Brown, Ph.D., 2008-2013 Psychotherapy Bulletin Editor Nisha Nayak Independent Practice Jenny Cornish, PhD, ABPP , 2008-2010 University of Houston 3429 Fremont Place N #319 University of Denver GSPP Dept of Psychology (MS 5022) Seattle , WA 98103 2460 S. Vine Street 126 Heyne Building Ofc: (206) 633-2405 Fax: (206) 632-1793 Denver, CO 80208 Houston, TX 77204-5022 Email: [email protected] Ofc: 303-871-4737 Ofc: 713-743-8600 or -8611 Email: [email protected] Fax: 713-743-8633 Jonathan Mohr, Ph.D., 2008-2012 Email: [email protected] Clinical Psychology Program Psychotherapy Bulletin Associate Editor Department of Psychology Lavita Nadkarni, Ph.D. MSN 3F5 Director of Forensic Studies George Mason University University of Denver-GSPP Fairfax, VA 22030 2450 South Vine Street Ofc: 703-993-1279 Fax: 703-993-1359 Denver, CO 80208 Email: [email protected] Ofc: 303-871-3877 Email: [email protected] Beverly Greene, Ph.D., 2007-2012 Psychology Psychotherapy Bulletin Editorial St John’s Univ Assistant 8000 Utopia Pkwy Crystal A. Kannankeril, M.S. Jamaica , NY 11439 Department of Psychology Ofc: 718-638-6451 Loyola College in Maryland Email: [email protected] 4501 N. Charles Street Baltimore, MD 21210 George Stricker, Ph.D., 2003-2008 Email: [email protected] Argosy University/Washington DC Phone: (973) 670-4255 1550 Wilson Blvd., #610 Email: [email protected] Arlington, VA 22209 Ofc: 703-247-2199 Fax: 301-598-2436 Email: [email protected]

William Stiles, Ph.D., 2008-2011 Department of Psychology Miami University Oxford, OH 45056 Ofc: 513-529-2405 Fax: 513-529-2420 Email: [email protected]

PSYCHOTHERAPY BULLETIN Psychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American Psychological Association. Published four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designed to: 1) inform the membership of Division 29 about relevant events, awards, and professional opportunities; 2) provide articles and commentary regarding the range of issues that are of interest to psychotherapy theorists, researchers, practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions; and, 4) facilitate opportunities for dialogue and collaboration among the diverse members of our association. Contributors are invited to send articles (up to 2,250 words), interviews, commentaries, letters to the editor, and announcements to Jenny Cornish, PhD, Editor, Psychotherapy Bulletin . Please note that Psychotherapy Bulletin does not publish book reviews (these are published in Psychotherapy , the official journal of Division 29). All submis - sions for Psychotherapy Bulletin should be sent electronically to [email protected] with the subject header line Psychotherapy Bulletin ; please ensure that articles conform to APA style. Deadlines for submission are as follows: February 1 (#1); May 1 (#2); July 1 (#3); November 1 (#4). Past issues of Psychotherapy Bulletin may be viewed at our website: www.divisionofpsychotherapy.org. Other inquiries regarding Psychotherapy Bulletin (e.g., advertising) or Division 29 should be directed to Tracey Martin at the Division 29 Central Office ([email protected] or 602-363-9211).

DIVISION OF PSYCHOTHERAPY (29) Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215 Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: [email protected] www.divisionofpsychotherapy.org OF PSYCHOTH N E O R I A S I P

V DIVISION OF PSYCHOTHERAPY Y I

D American Psychological Association 29 .

A 6557 E. Riverdale N M S

E Mesa, AZ 85215 S R A I C L www.divisionofpsychotherapy.org A A N PSYCHOLOGI C PSYCHOTHERAPY BULLETIN PSYCHOTHERAPY BULLETIN Published by the Official Publication of Division 29 of the DIVISION OF PSYCHOTHERAPY American Psychological Association American Psychological Association 6557 E. Riverdale 2008 Volume 43, Number 4 Mesa, AZ 85215 602-363-9211 e-mail: [email protected] CONTENTS Editors’ Column ...... 2 EDITOR Jennifer A. E. Cornish, Ph.D., ABPP President’s Column ...... 3 [email protected] Council Report ...... 7 ASSOCIATE EDIT OR Lavita Nadkarni, Ph.D. A History of Division 29 ...... 9 TH CONTRIBUTING EDITORS Division 29 40 Anniversary Celebration ...... 14 Diversity Letter to the editor ...... 16 Erica Lee, Ph.D. and Caryn Rodgers, Ph.D. Student Abstracts ...... 18 Education and Training Personal Reflections From Diverse Jean M. Birbilis, Ph.D., L.P., and Early Careers ...... 21 Mary M. Brant, Ph.D. The Federal Bureau of Prisons: Practitioner Report An Early Career Psychologist’s Perspective Jennifer F. Kelly, Ph.D. and John M. O’Brien, Ph.D. Psychotherapy Integration ...... 25 Psychotherapy Research, Milestones in Psychotherapy Integration Science, and Scholarship Norman Abeles, Ph.D., Sarah Knox, 2009 Nominations Ballot ...... 29 Ph.D., Michael J. Murphy, Ph.D., and Susan S. Woodhouse, Ph.D. Psychotherapy Practice ...... 33 The Practice of Psychotherapy: Lost or Found? Perspectives on Psychotherapy Integration Ethics in Psychotherapy ...... 36 George Stricker, Ph.D. Informed Consent with Culturally Public Policy and Social Justice Diverse Clients TBA Washington Scene ...... 45 Washington Scene Patrick DeLeon, Ph.D. A Vision For The Future—Integrated Care Early Career A Holiday Guide for Psychotherapists ...... 49 Michael J. Constantino, Ph.D. Book Review ...... 51 Student Features Financial Success in Mental Health Practice: Michael Stuart Garfinkle, M.A. Essential Tools and Strategies for Practitioners Editorial Assistant Crystal A. Kannankeril, M.S. Membership Application ...... 56

STAFF N OF PSYCHOTH ER IO A S I P V Y Central Office Administrator I D 29 . Tracey Martin A N M S E S R A

I L C A A Website N PSYCHOLOGI C www.divisionofpsychotherapy.org EDITORS’ COLUMN Jenny Cornish, Editor Lavita Nadkarni, Associate Editor

As we approach the of training, clinical, supervisory, and schol - end of our first year as arly experience on supervisors’ vies of ther - editors of the Psycho- apeutic techniques . In the same spirit of edu - therapy Bulletin, we wish cation and mentorship, we include the next to express our gratitude in a series written by early career profes - to the Division 29 sions; this one by a psychologist working Board of Directors, within the Federal Bureau of Prisons. Publications Board, and membership for Also included in this issue are papers on giving us the opportu - psychotherapy integration and on enhanc - nity to be involved with ing therapeutic effectiveness. An article on all of you. Thank you informed consent and cultural implica - for making our first tions should be useful for all our readers. year so pleasurable. Our Washington Scene contribution this issue provides important information on a In this issue, you will national health policy perspective related find the final column of our outgoing pres - to managed care. Finally, a useful holiday ident, Jeffrey Barnett, reflecting on his guide for psychotherapists is included. many successful initiatives, and a report Firsts for us in our new tenure as editors is from our APA Council Representatives. a letter to the editor, and an informative The Division of Psychotherapy benefits book review on Financial Success in Mental tremendously from the work of our amaz - Health Practice: Essential Tools and Strategies ing president and council representatives, for Practitioners . We find our first letter to along with the rest of our hard working the editor to be quite provocative, and board members . We hope you also enjoy while we disagree with the author, we are the history of Division 29 written by past- glad to begin a dialogue among members president Matty Canter, and the photos on its content. from our 40th anniversary celebration.

Consistent with our vision to support Best wishes for happy holidays! We are Division 29 as “an educational and scientific honored to be working on behalf of the organization,” we are pleased to present the Division of Psychotherapy and eagerly abstracts for our three student paper anticipate the upcoming issues of the awards. These include a meta-analysis of the Psychotherapy Bulletin in 2009 and beyond. impact of client treatment preferences on Please continue to send us your ideas, outcome; an article on older adults, sexuali - papers, letters, book reviews, photos, and ty, and psychotherapy related to ethnic and feedback! sexual minorities; and a paper on the effects

2 PRESIDENT’S COLUMN Jeffrey E. Barnett, Psy.D., ABPP

As I write this last ing this ad hoc committee was approved column as President of for the remainder of 2008 and for 2009. Our the Division of Psycho- former students who we have appointed to therapy I am amazed our new committee are Rachel Gillard with how quickly the Smook, Chair, Patricia Gready, and Shreya year has gone by. It’s Hessler . They are moving forward with been an exciting, busy, their work as I write this. I know they are and productive year. also looking for other Division 29 early I’ve had the opportunity to work with such career psychologists to join them on this an amazing group of colleagues, doing committee. If you are interested in getting meaningful work. Our joint efforts to involved, please contact Rachel at advance the Division of Psychotherapy [email protected] . and to advance psychotherapy have been challenging, stimulating, rewarding, and For me, a great highlight of the APA enjoyable. What follows are an account of Convention was Division 29’s 40th many of the activities of the past year as Anniversary Celebration events. At our well as some final thoughts about Division Awards Ceremony , Matty Canter shared 29 and about psychotherapy. her reflections and perspectives on 40 years of Division 29. Her presentation was truly I find myself still reflecting back on our remarkable and a very poignant and recent APA Convention with warmth and important historical record for us all. Please pride. We had an outstanding Division 29 see it elsewhere in this issue. We also had a convention program. Our convention co- great celebration at the Division 29 Social chairs, Nancy Murdock and Chris Brown, Hour. There we honored all past Division did an expert job putting together a stimu - 29 award winners and Past Presidents of lating and comprehensive program for our Division 29 who were in attendance. Please members. Since they have a two-year com - see the great photographs from these mitment to serving in these roles I very events included in this issue . much look forward to our 2009 APA An important initiative I began this year is Convention in Toronto as well. We also had our international student initiative. Many our annual Lunch With the Masters event international psychology students have which , despite some of the logistic difficul - very limited access to needed resources ties of a convention spread out over a large and many lack the financial means to area , was still a great success. During this access them. Division 29 has access to a event, Mike Constantino, our Early Career larger number of subscriptions to our jour - Psychologists domain representative on nal for our members than the number of our Board of Directors, Jeffrey Magnavita, members of the division at present. Thus, our incoming President-Elect, and I met we are able to offer subscriptions to the with several early career psychologists (two journal to international students at no cost former students of mine and one a former to them or to the division. All other student of Jeffrey’s). Their energy and Division 29 materials will be accessed enthusiasm about psychotherapy, their online by them via the website (which will careers, and the Division of Psychotherapy offer may more resources for students once were inspiring. Together we created, on an it is redesigned). We will also offer our new ad hoc basis, a new Early Career international student members two new Psychologist Committee for Division 29 resources of potentially tremendous value, (hard to believe we haven’t had one thus continued on page 4 far!). At our recent Division 29 Board meet - 3 an online mentoring program with mem - become a Silver Sponsor of the upcoming bers of the division and an online peer-to- National Multicultural Conference and peer program to enable them to connect Summit, to be held January 15-16, 2009 in with other student members of the divi - New Orleans, Louisiana. A number of the sion. It is hoped that each of these will be a division’s leaders will be there representing great success and be rewarding for all Division 29 and several are participating in involved. Our incoming 2009 Student presentations there. For more information Development Chair, Sheena Demery, will and to register for this important event visit be coordinating the peer-to-peer program. http://www.multiculturalsummit.org/ . Our Early Career Psychologist committee Look for our advertisement in the summit will be coordinating the mentoring pro - program, and our flyers in their attendees’ gram. I encourage all Division 29 members packets. Division 29 is also participating in to consider becoming an online mentor to APA President-elect James Bray’s an international graduate student in psy - Convention Within a Convention initiative chology. The obligation will likely only be at the upcoming APA Convention. This e-mail contact on a periodic basis. The ben - looks to be a way to provide much more efit and value may be tremendous. If you programming of interest that focuses on are willing to share a little of your time, the needs and interests of psychotherapists expertise, and support with an internation - in the areas of practice, education and al graduate student in psychology please training, research, and theory. Your let me know. Please contact me at drjbar - Division 29 Board of Directors has also [email protected]. In your message please approved supporting the APA Practice include the following: Name and degree, e- Summit that will be held in 2009. Division mail address, professional areas of interest. 29 is very well represented on the planning Thank you in advance for your willingness committee of this important event and we to support and assist our newest Division look forward to actively participating in the 29 members and these future members of Summit. This is another of APA President- our profession. elect (and Division 29 Fellow) James Bray’s initiatives. Division 29 Fellow Carol We’ve had so much more going on this year Goodheart is a co-chair of this initiative in Division 29. Our various Domain and Division 29 Board member Jennifer Representatives have been serving the divi - Kelly is on the planning committee. sion in these new roles that we implemented Incoming Division 29 President-Elect, this past year. Several are ending their terms Jeffrey Magnavita, is our liaison on the at the end of 2009. Please consider running Practice Summit E-mail list that will be for office in Division 29. See the call for nom - active during the planning process. I am inations in the center spread of this issue. In sure we will be sharing more information addition to electing a new President-Elect with you about the APA Practice Summit as and a new Treasurer for 2010, we will be it becomes available. electing new Domain Representatives for the Board of Directors for Professional We have a new Division 29 motto: Be Practice, Membership, Education and Connected! and we are presently develop - Training, and one of our two Diversity ing a new Division 29 logo. We are also Domain Representatives. If you would like pleased to announce that our student paper information about any of these positions awards (the Mathilda B. Canter Education please contact me or contact the psychologist and Training Award; the Donald K. presently serving in that role (see the inside Freedheim Student Development Award; covers of this issue for that information). and, the Student Diversity Award) will now provide a $250 cash prize to each win - This year , your Division 29 Board of Directors voted to have the Division continued on page 5 4 ner. Please see the abstracts for each of our bers will be able to obtain CE there online. 2008 award winning student papers in this issue. This year the Division 29 Publications Board has gone through a process of solic - This year we began the tenure of our new iting nominations for a new journal editor Editor and Associate Editor of to continue the fine work Charlie Gelso has Psychotherapy Bulletin, Jenny Cornish and done throughout his tenure as Editor. Lavita Nadkarni, respectively. As you will Charlie will serve as Editor through the have seen in recent past issues , and as is end of 2009. Also, during 2009 our new clearly evident in the present issue, Jenny Editor will begin his work, set up his edi - and Lavita are doing an outstanding job. I torial office, select his editorial board, and am appreciative of the great work they are begin accepting manuscripts. Following doing for Division 29 and you, our mem - the review of candidates’ materials and the bers, and look forward to their continued interview process, upon the recommenda - service. We also have a new Interim tion of the Publications Board, the Internet Editor, Past President of Division Executive Committee and the Board of 29, Abe Wolf . Abe is doing an amazing job Directors have enthusiastically approved for the division in ways that are not readi - the appointment of Mark Hilsenroth as our ly evident since so much work is going on incoming journal Editor. Please join me in behind the scenes. Together with Laura welcoming Mark to his new role. As you Brown, Abe is leading the division’s will see in the next issue of the Bulletin , he Website Redevelopment Task Force. brings a wealth of experience, talents, Funding for the redesign and redevelop - ideas, and creativity that make him ideally ment of our website was approved at our suited for this position. recent Board meeting and this important work is moving forward. I also express my Division 29 is in excellent shape financially, thanks to Internet Editor, Abe Wolf, for his despite the tough economic times we are in ongoing work on Psychotherapy E-News the at present. Our Treasurer, Steve Sobelman, division’s online e-newsgram. If you’re not and our Finance Committee Chair, Bonnie receiving it , please send me an e-mail and Markham, and committee members Ron I’ll make sure you receive this important Fox, Carol Goodheart, and John Norcross communication from your division. (what a great group!) have done an out - standing job in managing our financial Our journal , Psychotherapy: Theory, resources. We continue to put money into Research, Practice , Training under the lead - the division’s long term reserves each year ership and direction of our fine editor, to further build the division’s financial sta - Charles Gelso has continued leading the bility. This is especially important consid - way in our profession. It is the must-read ering current economic conditions. In addi - journal for those with an interest in the tion to the great job these individuals have field of psychotherapy. In addition to done I would be remiss if I didn’t mention Charlie, I express my thanks to our fine that a significant part of the division’s associate editors, Nicholas Ladany and financial health is due to the success of our Lisa Wallner Samstag, and all the Editorial fine journal. The licensing agreements with Consultants and ad hoc reviewers whose libraries and research institutions, and the contributions are clearly evident to all who individual downloads of individual arti - read this fine publication. Members are cles, have greatly enhanced the division’s strongly encouraged to use the journal for financial health. continuing education credit. See the At our recent Board meeting I appointed a announcements and easy to follow instruc - task force to update the division’s bylaws tions in each issue of the journal. As our website is redesigned and updated mem - continued on page 6 5 and policies and procedures. This task innovate, and to help our members to “Be force of Jean Carter (Chair), Mike Murphy, Connected.” and Steve Sobelman will review these doc - uments, recommend all needed changes to One additional initiative this past year was bring them in line with recent changes in to hold our Mid-Winter Board Meeting in the division’s structure and mission, and conjunction with Psychologists in bring all needed bylaws changes to you for Independent Practice (Division 42). In approval. For example, we will need to addition to great collegial interactions and include the new Early Career Psychologists an outstanding CE workshop provided by Committee as a Standing Committee in our Division 29 Fellow, Donald Meichenbaum, bylaws. Additionally, the Finance a significant amount of planning for the Committee has recommended a number of upcoming APA Practice Summit took place changes in policies and procedures to bring as the two divisions’ boards held joint them in line with our Board-approved working groups during the meeting. It was financial policies and practices. We are also a successful meeting and hopefully will updating the Division 29 mission state - serve as a model for further collaboration. ment to ensure that it is current and consis - tent with our actual mission. I’ve greatly enjoyed to opportunity to serve as your president. It has been a rewarding, Our Membership Committee, Chaired by enjoyable, and very educational experience. Sonja Linn, has been working diligently I’ve learned so much about our profession this year on membership recruitment and and about the field of psychotherapy. It is retention. They sent a membership recruit - clear to me that the future of psychotherapy ment letter to historically black colleges is bright. The level of scholarship and inno - and are in the process of contacting all for - vation I see in our field is truly inspiring. mer members of the division who resigned One has only to look at the work of the divi - in the past year. The division is reaching sion’s 2008 award winners, the authors in out to other organizations whose missions our journal, and the presenters on our con - are consistent with ours and with whom vention program. I’m also proud to turn we share many members. We are collabo - over the President’s gavel to my dear friend rating on continuing education with the and colleague, Nadine Kaslow, who begins Society for Psychotherapy Research. As a her tenure as President of the Division of result, all Division 29 members will be able Psychotherapy in January 2009. I know the to attend their annual conference and division is in able hands and I look forward receive CE for attendance at the SPR mem - to contributing to its continued success in ber rates. We have also reduced the student anyway I can . membership fee in the hope of further encouraging student participation in Best wishes to all – Division 29. The new fee for student mem - bership is $20 (reduced from $29). Jeff

As you have read, the Division of Psychotherapy has worked to collaborate,

6 COUNCIL REPORT Norine G. Johnson, Ph.D. & Linda Campbell, Ph.D.

This fall , APA passed related to publication such as the petition for a new Licensing/Royalities/Rights . policy to prohibit psy - chologists from work - Council received a report from APA’s ing in detainee setting General Counsel, Nathalie Gilfoyle indicat - in which International ing activity since February 2008. The pri - Law or the U.S. Consti- mary new developments were : Marriage tution are violated, Cases: Appeal to the Supreme Court of CA unless the psychologists and APA vs AbeBooks, Inc. The expanded are working directly for report can be read on line at APA’s site. the persons being APA’s position was in support of reversing detained or for an inde - the trial court decision that upheld as con - pendent third party stitutional California’s Family Code defin - working to protect ing civil marriage as the union between a human rights on the man and a woman. We recommend that position of psychology you read the APA summary as the legal passed. Although not on the Council arguments were extremely well defined Agenda specifically for August 2008 the and used psychological research to argue petition and the issues it spoke about were effectively the harm of such legal restric - nevertheless in the forefront of Council tions. APA vs AbeBooks, Inc resulted in members’ minds. The Board of Directors AbeBooks dropping its opposition to and many other Boards and Committees APA’s registration of APA BOOKS. within APA are working hard to develop Practice and Professional Issues policies that meet the members’ intent in Dr. James Bray, APA President-Elect, is the passing of the petition to amend APA holding as his primary presidential policy. initiative a Summit on the Future of Psy- chology Practice in mid May of 2009. The American Psychological Association Funds were allocated to support this activ - under the direction of the CEO Norm ity. We encourage all Division 29 members Anderson is conducting a thorough review who are involved and/or interested in pro - of purpose and activities of the association fessional practice issues to email either of in order to develop a strategic plan: us with your ideas regarding psychology Mission and Vision. Council voted on a practice—now and in the future. new mission statement : “The mission of the APA is to advance the creation, com - Dr. Pierre Ritchie argued effectively for munication and application of psychologi - APA providing financial support so that a cal knowledge to benefit society and psychologist could—for the first time be an improve people’s lives.” Discussion will integral part of the WHO revision of the continue at the February Council meeting. International Classification of Diseases As always Linda and I welcome your reac - and related Health Problems . This passed tions and recommendations. with significant financial support from Council. The 2009 Budget was reviewed and voted on. Council approved a $116 plus million Approval of specialties : Operating under dollar budget. The major revenue sources the currents rules and guidelines regarding continue to be our publications and areas continued on page 8 7 Specialties and Proficiencies in Institutional Review Boards and Psy- Professional Psychology, Council voted to chological Science as amended; Report of adopt the revised Principles for the the Task Force on Recommending Changes Recognition of Proficiencies in Professional to the APA Convention That Would Appeal Psychology. Council then approved two to Scientists; The Task Force on Mental proficiencies: a) the Psychological Health and Abortion ; Task Force on Treatment of Alcohol and other Resilience and Strength in Black Children Psychoactive Substance Disorders , b) and Adolescents ; Evidence-Based Practice Police Psychology , and one specialty: with Children and Adolescents ; Report of Forensic Psychology . Council voted to the Task Force on Gender Identity and grant an extension of the recognition of Gender Variance. both a) Psychopharmacology and b) Behavioral Psychology as proficiencies in Council voted to establish committees on : professional psychology for a period of one Education and Training Awards, Scientific year until August 2009. Awards, and Public Interest Awards. There was already a committee for the awarding Further, members of Council expressed of Professional Practice Awards. concern about the number of specialties and proficiencies and asked that the A resolution on transgender, gender identi - Commission for the Recognition of ty, and gender expression non-discrimina - Specialties and Proficiencies in tion was passed and is available on the Professional Psychology (CRSPPP) engage APA web-site. in further study of the role, purpose , and function of proficiencies in the taxonomy We thank you again for allowing us to of psychology, building on the work of the represent the Division of Psychotherapy Board of Directors Taxonomy Task Force, on Council and encourage you to let us providing updates as appropriate to the know your interests and concerns for APA Board of Directors. and its policies.

Council voted to receive several reports Norine Johnson, Ph.D. that you may access on the APA web site: [email protected] & [email protected] The 2007 APA Presidential Task Force on

8 A HISTORY OF DIVISION 29

Presented by Mathilda B. Canter on 8-15-08 as part of the Celebration of the 40th Anniversary of the Division of Psychotherapy, APA Convention, Boston, Massachusetts

Preparing for this talk accepted, were denied assistance in con - has been a delightful trip ducting elections, and in general felt that down memory lane for they were not receiving the support they me, and I am grateful for had been led to expect. After much discus - the opportunity to tell sion, in 1966, they drew up a petition to you what I hope you will form a Division. Among the signers were find a very interesting Ron Fox, David Orlinsky, Ted Blau, Hans story . Strupp, Aaron Canter, Carl Zimet, Walter Klopfer, Al Ellis, Erika Fromm , Jules Barron, Once upon a time, actually, at the APA Stanley Graham, and Jack Wiggins... Convention in 1960, a group of psycholo - Familiar names? gists got together and formed an organiza - tion called Psychologists Interested in The petition was submitted, and on the Advancement of Psychology (PIAP), September 4, 1967, the APA Council of because they felt that there was no place in Representatives established Division 29, APA representing their interests. They the Division of Psychotherapy!! And there were a dedicated, energetic, enthusiastic was joy in Mudville, for finally practition - group, who presented programs, gave ers had a home of their own in APA!!! Our workshops, and started to establish a first President (1967-68) was Fred Spaner, journal, which they entitled Psychotherapy: who was followed by Ted Blau and then Theory, Research, Practice . Vin Rosenthal. Ron Fox served as our first Treasurer - a three year term, with Al Ellis In 1963, PIAP was invited, by unanimous and Max Siegel among the Board members. vote of its Board, to become a Section of the Division of Clinical Psychology—Division As President Jules Barron wrote in the 12. The invitation was accepted, and all Psychotherapy Bulletin , in 1973: “Since our PIAP members—about 600 of them by inception as a Division,...we have been a then —joined the Section, and for the first significant force in the psychological revo - time in the history of the American lution. While fighting for the legitimacy of Psychological Association, psychotherapy professional psychology we have tried to was officially recognized! Their dues were maintain our scientific heritage.” And we $5 at the time. In 1964, the first issue of still do so! Psychotherapy was published, with Eugene Gendlin as Editor. The Editorial Board It is impossible for me to tell a 40 year his - was quite impressive, including such tory in the 25 minutes allotted to me. So I respected psychotherapists as Rollo May, shall just say here that the Division has Erik Dreikurs, Sid Jourard, Hans Strupp, been very active in all of its major areas of Clark Moustakus, James Bugenthal, interest: practice, teaching, training psy - Charlotte Buhler, Art Kovacs, etc.. . ! chotherapists, and research! And I’d like to point out some highlights, many of which But as time went on, the Section leaders you probably are not even aware: were not happy with Division 12, since they had difficulty having their programs continued on page 190 In addition to being the first home in APA • We were one of the first, if not the first, for practitioners, 29 was to have a Committee for Women, estab - lished in 1974, with Joy Kenworthy as • First division to hold a Midwinter chair. Actually, the Old Boys’ Board had Meeting!—more about that later . turned down a request in 1971 by then- • First division to have a Central Secretary Leah Gold Fein, to form the Office.....This was located first in the committee, saying we didn’t need one. New York area, with Gloria Gottsegen But it only took us a few years to raise in charge, but she had to resign when their consciousnesses and say yes in she left for Australia. We moved to New 1974. With Rachel Hare-Mustin, Jersey, where Jack Krasner, and then Hannah Lerman, Annette Brodsky, Ben Fabrikant, with the help of Rhoda Jacquie Resnick, Gloria Gottsegen, Schneider, took over. How many of you Aphrodite Clamar, and myself.. we remember that Kinderkamack Rd. were a very active and effective group, address? In 1986, the office moved to over the years, to the point where in Phoenix and hired The Administrators 1991 then Chair, Carol Goodheart, (Pauline Wampler ). And since 1999 requested that the committee be sunset - Tracey Martin has been taking great ted—it was—and that a Gender Issues care of us! Committee be established—it was, too! • Division 29 was the first division to The division was a leader in bringing prac - have a Hospitality Suite at Convention titioners into APA Governance! In fact, Ted and hold conversation hours and Blau was the first practitioner elected to programs there (in 1971, participants serve as president of APA in 1977. Ted told included George Albee, Albert Ellis, me that many people said that Abraham Hans Strupp, Al Mahrer...just to give Maslow was really the first practitioner/ you an idea of the caliber of presen - president, but that he AND MASLOW ters...... not shabby!) . thought that that was ridiculous!! After Ted came Max Siegel, Nick Cummings, Stanley • First division to offer Student Travel Graham, Jack Wiggins, Ron Fox, etc. , etc. Awards for paper submissions— (1971) Among the recipients I noted Vicky Mays, The division was also a leader in involve - Lynn Rehm, and our President-elect, ment over the years in practitioner issues Nadine Kaslow!!! like insurance (Jack Wiggins), professional schools, practice guidelines, education and • First division to have a Student training, coalition building among practice Development Committee—more about divisions, giving financial support to a that later broad spectrum of professional activities.... • First division to establish an Ethnic I have only 25 minutes, so I had to make Minority Affairs Committee! Our first some choices, and I am going to use the Chair was Maxine Rawlins, followed by rest of my time telling you about a few G. Rita Dudley-Grant, and then Lisa Division 29 initiatives that I think were Porche-Burke. Rita told me, when we very special and that many of you may not met last month at a Policy and Planning know about: Board retreat, that the 1985 Journal spe - cial issue: Psychotherapy with Ethnic MIDWINTER MEETINGS : Ron Fox told Minorities , edited by Maxine and Rita , me that the new Division could not afford represented the first time any journal Board meetings in the sunny South, where published an issue on ethnic minorities. they wanted to meet. So what they did was 10 continued on page 11 hold workshops, and since they were a Burke. That year, more than 275 student well-known and highly respected group of affiliate members were recruited, 49 of psychotherapists, they took in enough them ethnic minorities (in 1985, there had money to pay for their Board meetings! In been only six.) In1988 , we created a 1970, President Vin Rosenthal had the idea Student Paper Competition, with the win - that they really should invite the Division ners receiving a monetary award and the membership to join in, and so the first offi - opportunity to present at the APA cial Midwinter Meeting of the Division of Convention. By then, we had 406 student Psychotherapy was held in Tampa, Florida affiliates , 100 of them ethnic minorities! in 1970. It was publicized as “29 in the Ellin Bloch and two very active student Sun ,” and in fact it WAS—it was 29 committee members, Scott Mesh and degrees, breaking a 101 year record!! David Pilon, were invited by the then- (During the 1978 Midwinter meeting in Office of Educational Affairs to come to Scottsdale, Arizona, chaired by Ron Fox, APA to discuss student recruitment, and with me as Local Arrangements chair, we Scott and David were invited to address experienced a 100 year flood....but Division the Division Leadership Conference. 29 people are usually very kind, and I Division 29 funded their work with APA. remember so many comforting me by say - And in August 1988, APAGS, the APA ing “You don’t have to shovel rain....”!!) Graduate Students was formed.... and has become such an important part of APA and In 1981, Division 42, the Division of our pipeline! I think we did well..... Independent Practice was established, and in 1982 we invited them to attend DESERT SHIELD/DESERT STORM our Midwinter meeting in Monterey, In 1990, in response to the Persian Gulf California. It was a very successful meet - Crisis, and under the leadership of ing, and there was such a great overlap in President Norman Abeles, the Division the membership of the two divisions, that sponsored a project run by Ellin Bloch and we decided to share sponsorship, and the Jon Perez of the LIFE PLUS FOUNDA - 1983 Midwinter Meeting at the Greenbrier TION, which was providing psychological in West Virginia was the first official joint support and educational materials, at no meeting of 29 and 42. In 1984 we met in San cost to the families of those in the military. Diego, with Division 39 overlapping their Congress and the Department of Defense meeting with ours. And in 1987, at the showed much interest in this program. In request of Gloria Gottsegen, Division 43 August of 1990, Ellen McGrath, our was added as a limited sponsor. If imita - President-elect, was invited to Fort Bragg tion is the highest form of flattery, we cer - to run a support group for the wives of ser - tainly were flattered, and as more and vicemen. On her return, she requested the more Midwinter Meetings were held by establishment of a TASK FORCE ON other groups, the competition for atten - TRAUMA RESPONSE AND RESEARCH; dance grew, agendas changed, and ulti - this was done, with Ellin Bloch and Jon mately our regular Midwinter meetings Perez as co-chairs. They developed a net - came to an end. work of volunteer psychologists to help those affected by DESERT SHIELD and STUDENT DEVELOPMENT assess the outcomes of the interventions. COMMITTEE In 1986, President Suzanne Sobel estab - With PROJECT ME of Tucson, Arizona, the lished this committee, with Ellin Bloch as Division published materials disseminated chair , to recruit and focus on the special through FAMILY LIFE UNITS of the needs and interests of students. At that Department of Defense. And the Division time, our Ethnic Minority Affairs funded a pilot study by Ellen McGrath and Committee was chaired by Lisa Porche- continued on page 1121 Harry Wexler examining data from mili - me that it was as a result of working with tary wives regarding attitudes and stress Ellin Bloch, Ellen McGrath, and Jon Perez reduction. that he created the Disaster Response Network, as APA’S Centennial gift to the Then, in 1991, Desert Shield became nation in 1992! DESERT STORM, and significant contribu - tions were made by Division 29 to the gov - Through the years, the division has been ernment and the public. The Task Force active, at first as the sole voice for practice in was divided into three sections: the APA divisions. In 1972, it instructed its 1. COMMUNITY INTERVENTIONS (co- Council Representatives to vote against giv - chaired by Ellin Bloch and Jon Perez) : ing Masters level psychologists full mem - They mobilized support groups at com - bership in APA. The division was an orga - munity levels for families separated by nizer of coalitions to deal with the many the conflict; they served as consultants areas of common concern. Its Education and to local groups; and they acted as media Training Committee, (when chaired by spokespersons As a measure of their Tommy Stigall) became part of the Joint impact, let me tell you that at the time Commission on Professional Education in of the L A RIOTS, the Secretary of Psychology. It was a leader in fighting for Health and Human Services and the LA the establishment of Fellow criteria that Director of the Department of Mental were appropriate for practitioners. Health both called them in to help!! 2. EDUCATION SECTION (co-chaired by The Division was a co-plaintiff with CAPPS Alice Rubenstein and Dennis Embry) : (Committee for the Advancement of They had been working on a book for Psychological Professions and Sciences ) in principals and counselors in schools the Blues suit, supported the suit against the with lots of kids coping with military American Psychoanalytic Association, the separations. Division 29 provided fight for hospital privileges, etc. We support - $5,000 to fund this effort, and the mate - ed the establishment of the California School rial was sent to the Department of of Professional Psychology, The Wright Defense and ALL military base schools State University School of Professional in the United States and Europe—with Psychology....etc., etc. a research questionnaire! 3. GENERAL APPLICATIONS IN TRAU - We have a proud history of publications MA (co-chaired by Harry Wexler and from our very beginnings, monitored by a Wade Silverman) : Their commitment distinguished series of Publication Boards, was to research, their focus on how psy - an excellent journal, and a fine Bulletin. chologists need to respond to natural Early in our history , we had Al Mahrer’s and man-made disasters! edited series of Creative Contributions to Psychology; an Early Audiotape Series, The division worked with the APA Practice brochures, position papers, the History of Directorate to coordinate and develop edu - Psychotherapy , which Don Freedheim edited cational material which was given to all for the Centennial, a Videotape Series on members of the U. S. Congress, for distrib - Psychotherapy , etc., etc. We even had Fran ution to their districts! The Practice Pepitone-Rockwell who was charged with Directorate “forgot” to list the division as a deleting sexist language in our journal....! co-sponsor, but we knew what we had done! It was fun looking at the Early Career Award winners! The first winners, in 1986, Charlie Spielberger gave Presidential were Annette Brodsky and Gerry Koocher! Citations to Ellin Bloch and Ellen McGrath Others were Jacquie Resnick, Gary for their superb work in response to the VandenBos, Ron Levant, Raymond 12 Gulf Crisis. And Jack Wiggins told continued on page 13 DiGiuseppe, G. Rita Dudley-Grant, Alice practice and research.....Jules Barron said it Rubenstein, Lisa Porche-Burke, John in 1973—and in 2008 his words still hold Norcross, Abe Wolf, and Nadine Kaslow.... true. Now it’s the APF/Division 29 Early Career Award....we were pretty good at recogniz - So this is the end of my Once Upon a Time ing talent! story....and May the Division Live Happily—and Productively—Ever After.....!! My time is up, so let me close by saying: 29 is STILL different from other divisions—it Thank you. is in the forefront of helping to connect

CALL FOR NOMINATIONS APF DIVISION 29 EARLY CAREER AWARD The American Psychological Foundation (APF) provides financial support for innova - tive research and programs that enhance the power of psychology to elevate the human condition and advance human potential both now and in generations to come. Background: The Division of Psychotherapy fosters collegial relations between psychologists interested in psychotherapy, stimulates the exchange of information about psychotherapy, encourages the evaluation and development of the practice of psychotherapy, and educates the public regarding the service of psychotherapists . The APF Division 29 Early Career Award recognizes promising contributions to psychotherapy, psychology, and the Division of Psychotherapy by a Division 29 member with 10 or fewer years of post-doctoral experience.

AWARD : One $5,000 award will be given annually

ELIGIBILITY CRITERIA Applicants must be: • Members of Division 29, • Be within 10 years of receiving his or her doctorate, and • Demonstrate promising professional achievement related to psychotherapy theory, practice, research, or training

APPLICATION MATERIALS The following are the required application materials: • A nomination letter written by a colleague outlining the nominee’s career contributions (no self-nominations are allowed) • A current vita

APPLICATION PROCEDURES Application materials must be submitted online at http://forms.apa.org/apf/grants/

DEADLINE : January 1, 200 9

Please direct questions to Emily Leary, Program Officer, at [email protected] . 13 DIVISION 29 40TH ANNIVERSARY CELEBRATION August 16, 2008 Boston, Massachusetts – APA Annual Convention

Division 29 Past Presidents and Past Award Winners

40 th anniversary celebration cake

Armand Cerbone, Linda Campbell, Jeff Barnett

14 N OF PSYCHOTH ER IO A S I P V Y I D 29 . A N M S E S R A

I L C A A N PSYCHOLOGI C

Linda Campbell and Matty Canter

Rita Dudley-Grant and Laura Barbanel

Mamta Dadlani, Caryn Rodgers and Mike Constantino

Hanna Levenson and Jenny Cornish

15 LETTER TO THE EDITOR

Dear Editor: psychological distress and marital or fami - ly stress. I believe it is unethical to require Barnett and Goncher (2008) pose the people to participate in a procedure which question: “Psychotherapy for the psy - may be harmful to them when there is no chotherapist: Optional activity or ethical clear personal reason for them to be in it, imperative?” They come down on the side and when there is no clear research support of ethical imperative. I do not believe it is for the rationale leading to participation. ethical to require graduate students to have psychotherapy. I briefly present two argu - Second, the authors’ argument seems to ments below. rest on a particular view of the kind of psy - chotherapy required—something like a The putative reason for requiring psy - self-exploration approach geared to chotherapy of potential psychotherapists is achieving a general kind of personal tune that it is supposed to increase effectiveness. up. However, what if the student were to Yet, overall, the literature does not support choose to go to a cognitive-behavior thera - this. One study cited by Barnett and pist to overcome a smoking habit? What if Goncher on the benefits of personal psy - the student saw a solution-focused thera - chotherapy is that of Bellows (2007). They pist who used the miracle question and fail to mention that this study was of the scaling to help decide what area of clinical perceptions of benefit from psychoanalytical - specialization to choose? Would any of ly-oriented psychotherapists. Since psycho - these count? Or, would Barnett and analysis has long held that it is important Goncher require students to participate in for therapists to have their own therapy, this a particular kind of psychotherapy? If so, result is not surprising. Other studies cited would that be ethical? are also of therapists’ perceptions of bene - fits. However, research that has looked at There are more arguments but I shall stop the actual relationship of personal therapy here. I should note that there is evidence to therapist efficacy has repeatedly failed to that psychotherapists who are suffering demonstrate any relationship (Beutler, emotional problems can be less effective. Machado, and Neufeldt, 1994; Beutler et al., Clearly they need to deal with those prob - 2004). Beutler et al. (2004) said “…we con - lems. However that is a different issue. clude that there is no persuasive evidence As a relevant disclosure, I have had sever - for a positive relationship between the act of al experiences where I went to psychother - receiving personal psychotherapy and treat - apy when I needed help for a personal ment outcome” (p. 277). issue. In particular, I had three years of therapy when I was in graduate school for To make matters worse, there is reason to an anxiety problem. One therapy experi - believe that psychotherapy can be harmful. ence for this ultimately was negative and Lambert and Ogles (2004) conclude “…the made the problem worse. Another experi - evidence suggests that psychotherapy can ence later on was beneficial. Unfortunately, and does harm a portion of those it is in terms of the idea that being in the intended to help. A relatively consistent client’s role helps to understand how to be portion of individuals (5 to 10%) deterio - a good therapist, I don’t think I learned as rate. ..” (p. 158). In one national survey of much from the positive experience as I did therapists’ perceptions of the benefits of from the negative experience. Yet I would personal psychotherapy, Buckley, Karasu, not require students to have negative expe - & Charles (1981) found that although most riences in order to be better therapists. respondents reported positive effects, 38% also reported negative effects, including continued on page 17 16 In conclusion, psychotherapy for the E. Bergin & S. L. Garfield (Eds.), beginning psychotherapist should be an Handbook of psychotherapy and behavior optional activity. Not only is it not an ethi - change (4 th ed., pp. 229-269). New York: cal imperative, to require psychotherapy is Wiley. unethical. Beutler, L. E., Malik, M., Alimohamed, S., Harwood, T. M., Talebi, H., Noble, S, & Arthur C. Bohart Wong, E. (2004). Therapist variables. In Saybrook Graduate School M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and References behavior change (5 th ed., pp. 227-306). Barnett, J. E., & Goncher, I. (2008). Psy- New York: Wiley. chotherapy for the psychotherapist: Buckley, P., Karasu, T. B., & Charles, E. Optional activity or ethical imperative? (1981). Psychotherapists view their per - Psychotherapy Bulletin, 43(3) . 36-40. sonal therapy. Psychotherapy: Theory, Bellows, K. F. (2007). Psychotherapists’ Research and Practice, 18 , 299-305. personal psychotherapy and its per - Lambert, M. J., & Ogles, B. M. (2004). The ceived influence on clinical practice. efficacy and effectiveness of psy - Bulletin of the Menninger Clinic, 71 , 204- chotherapy. In M. J. Lambert (Ed.), 226. Bergin and Garfield’s handbook of psy - Beutler, L. E., Machado, P. P., & Neufeldt, chotherapy and behavior change (5 th ed., S. A. (1994). Therapist variables. In A. pp. 139-193). New York: Wiley.

CALL FOR NOMINATIONS APF Rosalee G. Weiss Lecture for Outstanding Leaders The American Psychological Foundation’s Rosalee G. Weiss Lecture honors an outstanding leader in psychology or a leader in the arts or sciences whose work and activities has had an effect on psychology. The lecture is delivered at the annual APA convention; the 2009 Convention will be held in Toronto . The APA Divisions of Psychotherapy (29) and Independent Practice (42), administer the lectureship in alter - nate years . The lecture was established in 1994 by Raymond A. Weiss, Ph.D., to honor his wife, Rosalee G . Weiss, Ph.D. The lecturer receives a $1,000 honorarium .

ELIGIBILITY CRITERIA The nominee must be an: Outstanding leader in arts or science whose contributions have significance for psychol - ogy, but whose careers are not directly in the spheres encompassed by psychology; or, Outstanding leader in any of the special areas within the sphere of psychology.

NOMINATION MATERIALS Self-nominations are welcomed. Letters of nomination should outline the nominee’s credentials and contribution. Nomination letters and a brief CV should be forwarded to the Division 29 200 9 Awards Chair: Jeffrey E. Barnett, Psy.D., ABPP 1511 Ritchie Highway, Suite 201 Arnold, MD 21012 Phone: 410-757-1511 Fax: 410-757-4888 E-mail: [email protected] Deadline : January 1, 200 9 17 STUDENT ABSTRACTS

Diversity Award Older Adults, Sexuality and Psychotherapy: Implications for Ethnic and Sexual Minorities Arien Murzacz, City College of the City University of New York

Abstract cal. This review of the literature on older Very little research adults and sexuality uses work from the exists that looks at past two decades to examine: the stereo - sexuality and sexual health among adults types and myths related to sexuality and over 65, and even less specifically address - aging; the biological, social and psycholog - es the sexual experiences and attitudes of ical factors that can affect sexual function; ethnic and sexual minority older adults. and the ways in which psychotherapy can Professional training rarely includes spe - be used to promote healthy sexuality and cific information on working with older sexual expression among older adults, adults, but given the growing number of especially older adults who are members adults over 65 in the U.S., it is increasingly of ethnic and/or sexual minority groups. likely that therapists will have older adult Guidelines for taking a sexual history are clients, and it is important that these pro - offered, along with suggestions for talking fessionals have the knowledge, attitude about sexuality and sexual concerns with and skills that will enable them to provide clients who identify as members of minor - psychotherapy to older adults around a ity groups. myriad of sexual concerns, not just physi -

Mathilda B. Canter Education and Training Student Paper Award The Effects of Training, Clinical, Supervisory, and Scholarly Experience on Supervisors’ Views of Therapuetic Techniques Jenelle M. Slavin Abstract Derner Institute of This study examines psychotherapy tech - Advanced Psychological niques characteristic of prototypic practice Studies among expert psychodynamic-interper - Adelphi University sonal (PI) and cognitive-behavioral (CB) supervisors. These supervisors rated inter - Mark J. Hilsenroth ventions as being characteristic of an ideal Derner Institute of session from each respective approach to Advanced Psychological treatment using the Comparative Psycho- Studies therapy Process Scale (CPPS; Hilsenroth, Adelphi University Blagys, Ackerman, Bonge, & Blais, 2005). Mathew D. Blagys Results demonstrated that supervisors’ Erik H. Erickson Institute of the Austen number of years in post-graduate clinical Riggs Center & Harvard Medical School practice, training, and supervising trainees as well as amount of scholarship relates to Mark A. Blais the techniques they view as the most figur - Department of Psychiatry al. Further, experience within a given Massachusetts General Hospital & Harvard Medical School continued on page 19 18 orientation tends to lead to a greater these findings is discussed in relation to endorsement of techniques within that ori - past research. entation, although this finding is more uni - form for CB supervisors than PI supervi - Please visit the Division of Psychotherapy web - sors. Finally, differential types of experi - site (www.divisionofpsychotherapy.org) for the ence lead to differential focusing on specif - complete text of Jenelle Slavin’s award winning ic techniques. The clinical importance of paper.

Donald K. Freedheim Student Development Award The Impact of Client Treatment Preferences on Outcome: A Meta-Analysis Joshua K. Swift, Oklahoma State University Jennifer L. Callahan, University of North Texas

Abstract PRPTs compare clients who refused ran - While including client domization and were given a preferred preferences is thought treatment to clients who agreed to ran - to be an integral part domization. Given these factors, it was of best practice stan - deemed important that a to-date meta-ana - dards (APA, 2006), lytic review be conducted , specifically there is little agree - comparing the effects from various study ment in the research as designs . to whether including client treatment prefer - PsychInfo , ProQuest , and relevant journals ences has a positive were searched for research articles compar - effect on treatment out - ing the outcome effect of matching or not come (Glass et al., matching clients to a preferred treatment. 2001; King et al., 2005). A total of 2 6 studies were deemed eligible Although previous for inclusion. Results from the studies reviews have been con - were averaged and compared using the r ducted examining the statistic and computed using the preference effect, the findings of these Comprehensive Meta-Analysis-2 program reviews have been less than conclusive due (Borenstein et al., 2005). Overall effect sizes to a number of shortcomings. Specifically, were calculated comparing (1) dropout previous reviews have either failed to use a rates and (2) outcomes between preference statistical procedure to summarize the matched and unmatched clients. The Q- findings (box count method only) or have statistic was used to compare effect differ - failed to account for differing study ences between the various study designs. designs [match/no-match trials, partially randomized preference trials (PRPTs) , ran - Twenty-six studies were included in the domized controlled trials (RCTs )]. Study analysis, representing over 2,300 clients design may particularly confound the (1,240 clients received their preferred treat - results of previous research given that the ment , while 1,116 did not). Results from the differing designs use various methods to meta-analysis indicated that clients who assign clients to preference conditions. For received their preferred treatment were example, while RCTs when used to study about half as likely to drop out ( OR = 0.58, preference effects compare clients who by CI .95: 0.10-0.18, p < .05), and on average chance were randomized to their preferred showed greater improvement in outcomes treatment to clients who were by chance (r = .15, CI .95: .09 to .21, p < .001). Study randomized to a non-preferred treatment, continued on page1290 design was found to be a significant moder - References ating variable [ Q (2) = 7.72, p < .05] , and American Psychological Association post-hoc comparisons indicated that PRPTs Presidential Task Force on Evidence- resulted in lower effect size estimates when Based Practice. (2006). Evidence-based compared to match/no-match trials [ Q (1) = practice in psychology. American 5.06, p < .05] and RCTs [ Q (1) = 5.56, p < .05]. Psychologist, 61, 271-285. In short, this meta-analysis found that Borenstein, M., Hedges, L. V., Higgins, J. there was a significant effect on treatment P. T., & Rothstein, H. R. (2005). outcome in favor of clients who received Comprehensive Meta-Analysis, Version 2. their preferred treatment. Although signif - Englewood, NJ: Biostat. icant , the found effect size was small, indi - Charles, C., Gafni, A., & Whelan, T. (1997). cating that preferences are only one of a Shared decision-making in the medical number of factors contributing to success - encounter: What does it mean? (Or it ful therapy outcome. Further, given the takes at least two to tango). Social small effect size it can be deduced that Science & Medicine, 44, 681-692. leaving all decision-making in the hands of Glass, C. R., Arnkoff, D. B., & Shapiro, S. J. the client may be counterproductive in (2001). Expectations and preferences. some cases . On the other hand , it can be Psychotherapy, 38, 455-461. recommended that clinicians at minimum King, M., Nazareth, I., Lampe, F., Bower, include client preferences in the treatment P., Chandler, M., Morou, M., et al. decision-making process , possibly through (2005). Impact of participant and physi - using a shared decision-making model cian intervention preferences on ran - (Charles, Gafni, & Whelan, 1997). Further domized trials: A systematic review. research is needed to address these limita - Journal of the American Medical tions and to explain why the outcome Association, 293, 1089-1099. effect in favor of clients who received their preferred treatment was observed.

20 PERSONAL REFLECTIONS FROM DIVERSE EARLY CAREERS Michael J. Constantino (Series Editor) University of Massachusetts, Amherst, Massachusetts This is the fourth installment of a 4-5 part series that focuses on first- hand accounts from early career psychologists (ECPs) in diverse positions that value psychotherapy practice, training/teaching, and/or research. In these papers, the authors will (a) describe the nature of their position, (b) outline how they got to their current position, (c) share the most satisfying aspects of their job, (d) discuss the most challenging aspects of their job and how they have negoti - ated such challenges, and (e) provide pearls of wisdom for achieving and succeeding in their type of position.

THE FEDERAL BUREAU OF PRISONS: AN EARLY CAREER PSYCHOLOGIST’S PERSPECTIVE Kenneth R. Liberatore, Ph.D.* Federal Correctional Complex, Lompoc, CA *Opinions expressed in this article are those of the author and do not necessarily represent the opinions of the Federal Bureau of Prisons or the Department of Justice.

Clinical practice within In many BOP institutions, doctoral-level the correctional environ - psychologists function as front-line ment is a complex enter - providers of mental health services to prise (Magaletta, Patry, inmates. Departments range in size from a Dietz, & Ax, 2007). As an single individual to as many as 10 psychol - early career psychologist ogists, and operate from a community psy - (ECP) working for the chology framework. In this framework, the Federal Bureau of Prisons (BOP), the expe - correctional environment is the community riences thus far have provided me the and psychologists provide direct services opportunity to work clinically with a to inmates and consultative services to staff diverse population of inmates arrested for who interact with the inmates while oper - and/or convicted of federal offenses. ating the correctional institution. Direct Starting with my predoctoral internship at inmate services may include crisis inter - a Federal detention facility in Los Angeles, vention; long-term, short-term, and group and continuing in my current job in therapies; psychological assessments; and Lompoc, California, the BOP has given me comprehensive substance abuse treatment. a vast set of experiences and the chance for Most inmates are self-referred, while some growth as both a clinician and a correction - are sent by other staff, or are advised by the al worker. At this point in my professional Federal Courts or parole boards to seek career, I could not have asked for more. treatment. …Consultative services to staff may range from personnel interviews, POSITION DESCRIPTION employee assistance counseling, and men - My current employment at the Federal tal health consultation to hostage negotia - Correctional Complex (FCC) in Lompoc, tion or crisis support. (United States California, is in the position of Staff Department of Justice, Federal Bureau of Psychologist. As stated on the Bureau of Prisons, n.d.) Prisons (BOP) website (www.bop.gov ): continued on page2212 The Psychology Services Department at sealed the deal for me. Later, as I steadfast - FCC Lompoc currently operates with three ly navigated my way through the APPIC Staff Psychologists; one Drug Abuse internship process, my top-ranked Programs Coordinator (a doctoral-level choice—and where I ended up attending— psychologist supervising nine Drug was the Metropolitan Detention Center Treatment Specialists); and the Chief (MDC) in Los Angeles. Psychologist. Duties are divided among me and these clinicians. My specific MDC-LA represented an excellent experi - responsibilities include: conducting admis - ence as a predoctoral clinical psychology sion/orientation and psychological screen - internship. A Federal jail facility housing ings of newly designated inmates; provid - male and female inmates of all security lev - ing brief and long-term counseling for els (minimum, low, medium, and high secu - adjustment symptoms and crisis interven - rity), MDC-LA represented the opportunity tion services when necessary; providing I was waiting for, and it allowed me to take routine follow-up to inmates suffering advantage of further learning the funda - from severe and persistent mental illness; mentals of correctional psychology and conducting suicide risk assessments and BOP employment via three outstanding monitoring inmates placed on suicide pre - rotations (i.e., General Population; Mental cautions watch status; referring inmates for Health; and Forensic Evaluation). A great psychiatric consultation; coordinating year, however, did have to come to an end, treatment of inmates with Health Services, and with baited breath I searched for my Unit Team, and Correctional Services staff; postdoctoral experience. Would it be a fel - conducting psychological testing and assess - lowship? A job with (hopefully) postdoctor - ment; serving as Program Coordinator for al hours supervised by a California-licensed the complex’s Suicide Prevention Program; psychologist? Ultimately, the search led me and providing Employee Assistance to FCC Lompoc (one of my first options)—a Program (EAP) services to institution staff . correctional complex consisting of a medi - um-security institution, a low-security insti - ROAD TO CURRENT POSITION tution, and two satellite camps (minimum- Looking back, I can trace my road to BOP security). employment to my second year of gradu - ate school when my interest was piqued in MOST SATISFYING ASPECTS OF a particular full-time field practicum at a POSITION local jail (Twin Towers Correctional What makes working at FCC Lompoc (and Facility) in Los Angeles. This practicum, for the BOP) most satisfying—aside from the unfortunately, was discontinued before I West Coast climate!—is the level of respect applied. Regardless, I focused on attaining bestowed upon Psychology Services staff, its still functioning half-time internship, something I have not directly witnessed in and the following year was chosen to par - other practicum and internship experiences. ticipate in their 2005-2006 internship class. For example, we are seen as “correctional During a six-month rotation at the Twin workers first,” a specific tenet of the BOP Towers Women’s Forensic Outpatient involving the fact that all employees, regard - Program, I was fortunate to have a won - less of position, are part of the Bureau fami - derful supervisor who introduced me to ly and, thus, trained as correctional workers the BOP through her own experiences as a primarily. That is to say, employees partake former BOP intern. Her descriptions of the in training (known as “Introduction to many benefits of an internship through the Correctional Techniques”) for three weeks at BOP (e.g., a foot-in-the-door to potential the Federal Law Enforcement Training BOP employment; forensic psychology Center in Glynco, Georgia. There new psy - experience), coupled with my enthusiasm chologist employees are trained in the after reviewing the internship’s brochure, 22 continued on page 23 correctional aspects of BOP employment Additionally, one could bring up concerns alongside correctional officers, nurses, about worker safety within the correction - educators, and other various staff from al environment. In my case, though, I have institutions across the country. This excel - not yet felt any issue with safety, as staff lent training prepares one for the inter- members take the security of the institu - department (and interdisciplinary) rela - tion very seriously. Employees from each tions that continually occur once re-inte - and every department work on a unified grated into the home facility. front to overcome concerns with regard to worker safety; case in point: when staff In addition to the respect and rapport members are notified of assistance among staff, I am incredibly humbled by required anywhere in the institution, every - the clinical experiences that I have encoun - one responds immediately. I repeat: everyone tered. The range of services that I have responds. been able to provide (e.g., crisis interven - tion; brief counseling; individual and group On a positive note, I have viewed challenges psychotherapy; confrontation avoidance; not only as learning experiences, but also as suicide risk assessment)—all under direct chances to enhance my expertise in dealing supervision—have been conducted with with a wide array of situations. Such situa - such a variety of clientele (i.e., inmates), tions abound routinely, and I look forward that I feel well prepared as I progress in my to them enthusiastically. own realm of job responsibilities. The clin - ical supervision that I have received has PEARLS OF WISDOM been vital, assisting me in making the cor - If I could offer guidance to those interested rect interventions, and fortunately enough, in clinical practice within corrections (at I have not felt overwhelmed or “in over my any level – local, state, or federal), I would head.” begin by recommending discussing the option with a number of practitioners MOST CHALLENGING already working in these locations. One ASPECTS OF POSITION person’s opinion could provide an Of course, one does face challenges when informed, yet skewed perspective regard - working in a correctional environment, be ing the correctional environment, whereas it at either the local, state, or federal level. three or four or more viewpoints add more At times, working clinically with clients data for what could be a significant career who have a high incidence of Axis II psy - decision. Furthermore, it would be impor - chopathology, most notably antisocial per - tant to consider not only the environment sonality disorder (Hare, Hart, & Harpur, where you would be working, but the 1991; Hare, 1996), can be difficult, especial - clientele you would likely encounter who ly when treating comorbid Axis I sympto - present with a variety of problems (e.g., matology (e.g., major depressive disorder; adjustment disorders; anxiety, mood, and schizophrenia). Clinical supervision is the psychotic disorders; comorbid Axis II dis - key to success, particularly when encoun - orders). Above all – and this applies to any tering novel situations, which can occur on profession within any employment setting a routine basis. I can remember a specific – self-care is vital to success at your job. If instance in the Special Housing Unit in you are not achieving some sort of balance which supervision—provided via tele - between your professional life and your phone due to the time-constrained nature personal life, your chances of experiencing of my seeking consultation—served to burnout increase dramatically. Take care of assist me in making what turned out to be yourself! (Your coworkers, and loved ones, effective interventions. Experiences such as will thank you.) these make the challenges easier to con - front efficiently. continued on page 2243 There are over 400 doctoral-level psycholo - Hare, R. D., Hart, S. D., & Harpur, T. J. gists employed in the BOP, and I am proud (1991). Psychopathy and the DSM-IV to serve as one of them. As my experiences criteria for antisocial personality disor - so far have demonstrated, there will der. Journal of Abnormal Psychology, always be opportunities to learn and to 100 (3), 391-398. grow as a professional clinician and as a Magaletta, P. R., Patry, M. W., Dietz, E. F., correctional worker. I look forward to the & Ax, R. K. (2007). What is correctional challenge—and to the rewards—that come about clinical practice in corrections? with providing mental health services to Criminal Justice and Behavior, 34 (1), 7-21. inmates in the correctional environment United States Department of Justice, requiring these interventions. Federal Bureau of Prisons (n.d.). Mental health care careers & Psychology Services. References Retrieved October 11, 2008, from Hare, R. D. (1996, February 1). Psycho- http://www.bop.gov/jobs/hsd/ pathology and antisocial personality psychology_services.jsp. disorder: A case of diagnostic confu - sion. Psychiatric Times, 13 (2). Retrieved October 1, 2008, from http://www.psy - AUTHOR NOTE chiatrictimes.com/display/ I welcome any follow up communications article/10168/54831 . or questions at [email protected].

CALL FOR NOMINATIONS Distinguished Psychologist Award The APA Division of Psychotherapy invites nominations for its 2009 Distinguished Psychologist Award , which recognizes lifetime contributions to psychotherapy, psychology, and the Division of Psychotherapy. Letters of nomination outlining the nominee’s credentials and contributions should be forwarded to the Division 29 200 9 Awards Chair:

Jeffrey E. Barnett, Psy.D., ABPP 1511 Ritchie Highway, Suite 201 Arnold, MD 21012 Phone: 410-757-1511 Fax: 410-757-4888 E-mail: [email protected]

The applicant’s CV would also be helpful. Self-nominations are welcomed.

Deadline is January 1, 2009

24 PSYCHOTHERAPY INTEGRATION Milestones in Psychotherapy Integration George Stricker Argosy University, Washington DC

The current series on with the developments of psychoanalysis. psychotherapy integra - This can be seen as a forerunner of tion was introduced Theoretical Integration, as well as an early three years ago with an predecessor of the important later work by article that outlined the Dollard and Miller (1950), who attempted major categories of this to translate the languages of learning theo - field (Stricker, 2005). To ry and psychoanalysis to each other. By review, these are doing this, they hoped to get beyond the Common Factors (those aspects of psy - limitations of jargon and show the under - chotherapy that are present in most, if not lying similarities of the phenomena all, therapeutic systems), Technical approached by each theory. Unfortunately, Integration (a combination of techniques neither the proponents of psychoanalysis are drawn from different therapeutic sys - nor those of learning theory were ready for tems without regard for any specific theo - this, and the contribution was not as influ - retical approach), Theoretical Integration ential a step toward integration as it (an attempt to understand the patient by deserved to be. developing a superordinate theoretical framework that draws from a variety of dif - At about the same time as French’s early ferent frameworks), and Assimilative work, Rosenzweig (1936) presented the Integration (treatments are drawn from dif - first formulation of what came to be known ferent approaches but remain guided by a as Common Factors. He noted that there unitary theoretical understanding). The were some features that were present in all series that followed this initial presentation approaches to therapy. These included the has presented several different variations of therapist ’s personality and ability to these approaches, as well as some indica - inspire hope; interpretations, which pro - tion of the evidence for them. In this article, vide alternative and more plausible way of I will review some of the historical mile - understanding problems, whether or not stones in the development of psychothera - they are true; and the synergistic effects of py integration. In doing so, I will present an one change on others. Rosenzweig also abbreviated and idiosyncratic selection of used the term Dodo Bird effect to apply to references. The reader wishing a more com - the lack of difference in effectiveness of the prehensive historical account should refer various therapeutic approaches, and it was to the work by Goldfried, Pachankis, and this finding, which continues to be repli - Bell (2005). cated to the present day, that led him to identify common factors that can account Before psychotherapy integration was for common effects. identified as a movement and an approach to psychotherapy, there were some proto- The most important work in the area of integrationist articles that were very influ - Common Factors, and the one most often ential. The first of these was by French cited in the psychotherapy integration lit - (1933), a prominent psychoanalyst, who erature, is the first of the landmark vol - noted the contributions that had been umes by Frank (1961). This work was far made by Pavlov and learning theory and more ambitious than simply seeking com - wondered how these might be reconciled continued on page2256 mon factors in psychotherapy, as it sought first fully realized example of Theoretical to discover the common factors in all heal - Integration. It not only was important as a ing processes, including such things as work of integration, it also made psy - faith healing and shamanism along with chotherapy integration an acceptable form psychotherapy. Among the factors identi - of treatment, and led to a series of works fied were an emotionally charged healing that now could be classified together rather relationship; a healing setting; a myth than viewed as unconnected and discrete based on a rational and credible conceptu - apostasies. Perhaps the most important al scheme to explain symptoms; and a heal - aspect of Wachtel’s integration was the pre - ing ritual. Certainly these are all present in sentation of his system, Cyclical psychotherapy, but they also exist in the Psychodynamics, which contained the other healing processes. notion of a cyclical rather than a linear process of causality. Thus, it was possible The first work that might be classified as for insight to lead to behavior change, as Technical Integration was introduced by psychoanalysis long had held, but also for Lazarus (1976) in the form of Multimodal behavior change to lead to insight, so that Therapy. Lazarus refers to this as an eclec - it was reasonable to intervene at either tic approach, although an argument might point in order to produce change. be made that it is assimilative integration, with social learning theory providing the Shortly thereafter, Goldfried (1980) pre - organizing theory and other interventions sented an important article that also might being assimilated. However, the difficulty be classified within the Common Factors in classification is indicative of a more area. He recognized the difficulty in recent problem, as the four categories usu - achieving integration at the level of theory, ally employed have somewhat fuzzy which often provided incompatible formu - boundaries. In any case, Lazarus provided lations, or at the level of technique, which an excellent example of an approach to also were quite disparate. Instead, he psychotherapy that did not hold rigidly to looked for commonalities at an intermedi - any single orientation, but drew interven - ate level that he referred to as clinical strat - tions from many orientations in develop - egy. Orientations that differed widely in ing a flexible approach to treatment. theory and in preferred interventions were compatible at this middle strategic level, The 1960s and 1970s were noteworthy for which included processes such as provid - numerous unconnected examples of inte - ing feedback and corrective emotional grationist efforts, as the Zeitgeist seemed experiences . prepared for a departure from single school approaches to psychotherapy. The important work of Wachtel and Interestingly, one of the most important Goldfried set the stage for the establish - contributions of that period, the Cognitive- ment of a professional organization that Behavioral approach (CBT) of Beck (197 6), promised to provide a reference group actually is an integration of cognitive theo - for the growing number of professionals ry with the existing behavioral approach, who were interested in psychotherapy but it rarely is viewed as being part of psy - integration. The Society for the Exploration chotherapy integration because it has of Psychotherapy Integration (SEPI) was emerged as the most popular single school established in 1983 and has grown into an at the present time. international organization that hosts an annual conference and publishes the The preparation of the field for integration Journal of Psychotherapy Integration, a came to fruition with the watershed book quarterly journal that contains the most by Wachtel (1977), an integration of psy - chodynamic and behavioral thought in the continued on page 27 26 current contributions to the area of integration uses a relational psychodynam - psychotherapy integration (for further ic theory as the organizing theory but information about SEPI, see http:// incorporates interventions from CBT and www.cyberpsych.org/sepi/). The contrib - humanistic-experiential theories to supple - utors to this series of articles all have been ment standard psychodynamic interven - SEPI members, and their work is indicative tions when it is indicated clinically. of the creativity and enthusiasm that char - acterizes the organization and the area. One indication of the maturity of a field of study is the publication of compendia that Prochaska’s (Prochaska & DiClemente, bring together many diverse contributions 1984) Transtheoretical approach might be within the field. For psychotherapy inte - viewed as belonging within Theoretical gration, there are two such volumes. The Integration, because it provides a metathe - first is the second edition of a Handbook ory of the therapeutic process, or within (Norcross & Goldfried, 2005) that brings Common Factors, because it identifies together scholarly contributions in all the common stages in therapy. This again areas mentioned in this review as well as a points to the difficulty in classification that great many other promising approaches. has emerged (Stricker & Gold, 2006b). The The second is a Casebook (Stricker & Gold, most influential aspect of the Trans- 2006) that has many clinical contributions theoretical approach is the stage theory, from the authors referred to in this review, and within that, the notion that some as well as contributions from several oth - patients are in a precontemplative stage ers. These two books have been used and not yet ready to consider change. They together in graduate courses in require a different set of interventions than Psychotherapy Integration, and the pres - patients who have progressed to later ence of such courses is another sign of the stages of change, such as preparation or development of psychotherapy integration action. as a recognized approach to treatment.

Beutler also presented an important work In this day of evidence-based practice, that falls within Technical Integration something also should be said about the (Beutler & Clarkin, 1990). His approach, evidence for psychotherapy integration. Prescriptive Psychotherapy, is a matching The most comprehensive review can be approach that identifies critical patient pre - found in Schottenbauer, Glass, and Arnkoff sentations and, on the basis of research, (2005). Without going into a great deal of prescribes specific interventions for each detail, their review found that psychother - presentation. For example, a patient who is apy integration had substantial support in high on reactance and does not easily 9 studies, some support in 13 studies, and accept direction from others would be best preliminary support in 7 studies . suited to an expressive therapy such as a psychodynamic approach, whereas a References patient low on reactance would respond Beck, A. T. (1976). Cognitive therapy and the better to a more directive approach such as emotional disorders . New York: CBT. International Universities Press. Beutler, L. E., & Clarkin, J. F. (1990). The last major class of approaches to psy - Systematic treatment selection: Toward chotherapy integration, assimilative inte - targeted therapeutic interventions. New gration, was presented by Messer (1992). York: Brunner/Mazel. He provided the theoretical structure for Dollard, J., & Miller, N. E. (1950). this approach, which later was instantiated Personality and psychotherapy . New by works such as that of Gold and Stricker (2001). Their assimilative psychodynamic continued on page 28 27 York: McGraw-Hill. Prochaska, J. O., & DiClemente, C. C. Frank, J. (1961). Persuasion and healing . (1984). The transtheoretical approach: Baltimore, MD: Johns Hopkins Crossing the traditional boundaries of ther - University Press. apy. Homewood, IL: Dorsey Press. French, T. M. (1933). Interrelations Rosenzweig, S. (1936). Some implicit com - between psychoanalysis and the exper - mon factors in diverse methods of psy - imental work of Pavlov. American chotherapy. American Journal of Journal of Psychiatry, 89 , 1165-1203. Orthopsychiatry, 6 , 412-415. Gold, J., & Stricker, G. (2001). Relational Schottenbauer, M. A., Glass, C. R., & psychoanalysis as a foundation of Arnkoff, D. B. (2005). Outcome assimilative integration. Journal of research on psychotherapy integration. Psychotherapy Integration, 11 , 43-58. In J. C. Norcross, & M. R. Goldfried Goldfried, M. R. (1980). Toward the delin - (Eds.), Handbook of psychotherapy inte - eation of therapeutic change principles. gration (pp. 459-493). New York: American Psychologist, 35 , 991-999. Oxford University Press. Goldfried, M. R., Pachankis, J. E., & Bell, Stricker, G. (2005). Perspectives on psy - A. C. (2005). A history of psychothera - chotherapy integration. Psychotherapy py integration. In J. C. Norcross, & M. Bulletin, 40 (4), 8-11. R. Goldfried (Eds.), Handbook of psy - Stricker, G., & Gold, J. (Eds.). (2006a ). A chotherapy integration (pp. 24-60 ). New casebook of psychotherapy integration . York: Oxford University Press. Washington, DC: American Lazarus, A. A. (1976). Multimodal behavior Psychological Association. therapy . New York: Springer. Stricker, G., & Gold, J. (2006 b). Overview: Messer, S. B. (1992). A critical examination An attempt at a meta-integration. In G. of belief structures in interpretive and Stricker, & J. Gold (Eds.), (pp. 293-302). eclectic psychotherapy. In J. C. A casebook of psychotherapy integration . Norcross, & M. R. Goldfried (Eds.), Washington, DC: American Handbook of psychotherapy integration Psychological Association. (pp. 130-165). New York: Basic Books. Wachtel, P. L. (1977). Psychoanalysis and Norcross, J. C., & Goldfried, M. R. (2005). behavior therapy: Toward an integra - Handbook of psychotherapy integration . tion. New York: Basic Books. New York: Oxford University Press.

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28 2009 NOMINATIONS BALLOT Dear Division 29 Colleague: Division 29 seeks great leaders! Bring our best talent to the Division of Psychotherapy (29) as we put our combined talents to work for the advancement of psychotherapy. NOMINATE YOURSELF OR SOMEONE YOU KNOW TO RUN FOR OFFICE IN THE DIVISION OF PSYCHOTHERAPY. THE OFFICES OPEN FOR ELECTION IN 2009 ARE: • President-elect • Treasurer • Domain Representatives for: Membership, Psychotherapy Practice, Education and Training, Diversity All persons elected will begin their terms on January 2, 2010 Domain Representatives are voting members of the Board of Directors. They are responsible for creative initiatives and oversight of the Division’s portfolios in Membership, Psychotherapy Practice, Education and Training and Diversity (one of two Diversity Representatives). Candidates should have demonstrated interest and investment in the area of their Domain. The Division’s eligibility criteria for all positions are: 1. Candidates for office must be Members or Fellows of the division. 2. No member many be an incumbent of more than one elective office. 3. A member may only hold the same elective office for two successive terms. 4. Incumbent members of the Board of Directors are eligible to run for some position on the Board only during their last year of service or upon resignation from their existing office prior to accepting the nomination. A letter of resignation must be sent to the President, with a copy to the Nominations and Elections Chair. 5. All terms are for three years, except President-elect, which is one year. Return the attached nomination ballot in the mail. The deadline for receipt of all nominations ballots is December 31, 2008. We cannot accept faxed copies. Original signatures must accompany ballot. EXERCISE YOUR CHOICE NOW! If you would like to discuss your own interest or any recommendations for identifying talent in our division, please feel free to contact the division’s Chair of Nominations and Elections, Dr. Jeffrey Magnavita at 860-659-1202 or by Email at [email protected] Sincerely, Jeffrey E. Barnett, Psy.D. Nadine Kaslow, Ph.D. Jeffrey J. Magnavita, Ph.D. President President-elect Chair, Nominations and Elections NOMINATION BALLOT President-elect Treasurer ______

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Fold Here. 31 APA’s Division of Psychotherapy is pleased to announce: THE DISTINGUISHED PUBLICATION OF PSYCHOTHERAPY RESEARCH AWARD

In consultation with the Division 29 Board of Directors, the Division 29 Research Committee is seeking nominations for The Distinguished Publication of Psychotherapy Research Award. This award recognizes the best empirical (i.e., data-based ) published peer reviewed article on psychotherapy in the preceding calendar year . Articles appearing in any journal (i.e., they need not have appeared in the Division’s journal) are eligible for this award .

We ask members of the Division to nominate articles for consideration by April 15. Nominations should include the complete citation for the article, and should be emailed to the Chair of the Research Committee, Dr. Susan Woodhouse, at [email protected] .

A selection committee appointed by the Chair of the Research Committee, in con - sultation with the President of the Division , will evaluate all nominated articles, and will make a recommendation to the Division’s Board of Directors by June 1. Upon approval by the Board, the author(s) of the winning article will be notified so that they may be recognized and receive the award at the upcoming APA Convention. Accompanying this award is a plaque.

All methods of research will be equally valued (experimental, quasi-experimen - tal, qualitative, descriptive/correlational, survey). Current members of the Research Committee and the Selection Committee will not be eligible for the award, so no articles by members of the Research Committee will be considered. Also, committee members will recuse themselves from voting on articles by cur - rent or former students, as well as collaborators. Self-nominations are accepted.

The criteria for the award appear below. • the rationale for the study and theoretical soundness • the methods • the analyses • the explanation of the results • the contribution to new knowledge about psychotherapy (e.g., the work is innovative, creative, or integrative; the work advances existing research in a meaningful way); greater weight will be given to novel/creative element than to methodological/statistical rigor • relevance to psychotherapy practice.

N OF PSYCHOTH ER IO A S I P V Y I D 29 . A N M S E S R A

I L C A A N PSYCHOLOGI C 32 PSYCHOTHERAPY PRACTICE The Practice of Psychotherapy: Lost or Found? By Patricia Coughlin, Ph.D., Philadelphia, PA

Some in our profession depressants (SSRIs) revealed that the great have suggested that the majority of patients received no clear bene - practice of psychothera - fit over that achieved by placebo (Kirsch, py is lost ; that the need Deacon, Huedo-Media, Moore, & Johnson, for our services is declin - 2008). The United Kingdom, which had ing, and that we are spent $300 million pounds on these pre - deceiving students into scriptions in the previous year , recently thinking they have a announced (Alan Johnson, Health future in the field (Cummings, 2008). Is there Secretary, personal communication, 200 8) any real evidence to support such claims? A that 3600 therapists will be trained in the review of recent literature suggests that the next 3 years in order to increase patient opposite is true—that the need and demand access to talking therapies, which are more for psychotherapy is greater than ever. effective, efficient, and pose far fewer risks Perhaps our own state of passivity and res - than medication. ignation is the problem, rather than some - thing “out there.” Not only has therapy proven more effective than medication for many psychiatric It is important to remind ourselves that the patients, but research suggests that the evidence to support the efficacy of psy - majority of physical complaints reported to chotherapy is overwhelming and generally primary care physicians and emergency far more compelling than that of most med - rooms are psycho-social, rather than organic, ical interventions (Smith & Glass, l977; in nature (Kroenke, 2003; Reid, Rayforth, & Lipsey & Wilson, l993; Wampold, 2001) . Hotopf, 2001). Often, as little as one session Research also demonstrates that some of short-term dynamic psychotherapy can forms of emotionally focused psychothera - alleviate suffering and avert costly medical py are highly cost effective as well clinically treatment (Abbass, et al, 2008 ). effective (Abbass, 2002, 2003) . In fact, Dr. Abbass has been able to substantiate that So, the good news is that psychotherapy short-term dynamic psychotherapy (at least works. The sobering news is that it has as practiced by him) saves three dollars for been very difficult to prove that one form every one dollar spent on treatment. Not of therapy is more effective than others. only do patients go off their medications The research suggests that the therapist , and drastically reduce their reliance on the rather than the therapy, is the more potent medical system, but those who were unem - variable when considering outcome (Blatt, ployed and on disability resumed employ - et al, l996; Crits-Cristophe, et al, l99l; ment after an average of only 8 sessions Luborsky, McLellan, Diguer, Woody, & (Abbass, 2003). The cost savings for the 89 Seligman, l997). Therapists vary widely in patients studied was well over $400,000.00 their level of skill and effectiveness over and that savings was duplicated in each of time and across patients. While we may the three years following completion of a 15 not like to acknowledge it, some of us are session treatment. really good at what we do, some are down right awful , and most are just average. At the same time that psychotherapy is receiving such strong support, the largest As Atul Gawande (2007) pointed out in his meta-analysis of the effectiveness of anti- continued on page3334 essay on this sensitive topic, the bell shape et al, l997). If we continue to fail in our curve seems to pop up everywhere, includ - training of therapists in this way, we could ing the effectiveness of health -care get “lost .” However, if we heed the call and providers. In his essay on the subject add this focus on personal development to (Gawande, 2007), he concluded that the our training programs, we will enhance the average practitioner is fine for the average therapeutic experience for all involved. patient. In other words, if you have a mild or garden variety case of anxiety or depression, References your average psychologist can help you. Abbass, A. (2002). Intensive Short-term However, if a patient suffers from a complex dynamic psychotherapy in a private disorder that is difficult to treat, like somati - psychiatric office: Clinical and cost zation or borderline personality disorder, effectiveness. American Journal of not just any psychologist will do. Some pro - Psychotherapy, 56, 225-232. duce far better outcomes , more often , than Abbass, A. (20023). The cost effectiveness others. It really matters who you consult. of short term dynamic psychotherapy. Journal of Pharmacoeconomics and out - Gawande (2007) found that physicians who come research, 3 , 535-539. achieved the best results were the most pas - Abbass, A., Joffres, M.R. & Ogrodniczuk, sionate and determined; simply refusing to J.S. (2008). Brief Treatment and accept average results , and pressuring Crisis Intervention , February , 2-7. themselves and their patients to work hard Blatt, S.J. Sanislow, C.A., Zuroff, D. C. & to achieve the very best results possible. Pilkonis, P.A. (1996). Characteristics of Evidence suggests the same is true of psy - effective therapists: Further analyses of chotherapists (Wampold, 2001). The thera - data from the National Institute of Mental pist’s passion for his/her craft, persistence Health treatment of depression collabo - in achieving positive results, ability to man - rative research program. Journal of Con- age the therapeutic relationship, form a sulting and Clinical Psychology, 64 , 162-171. solid working alliance, deal with barriers Crits-Cristophe, P., K. Baranackie, J. and obstacles to collaboration, and be open Kurcias, A. Beck., K. Carroll, K. to feedback, as well as being a life long Perry, L. Luborsky, A. McLellan, G. learner, are all factors characteristic of the Woody, L. Thompson, D. Gallagher & most effective therapists . While the results C. Zitrin. (l99l). Meta-Analysis of thera - of clinical trials suggest that “common fac - pist effects in psychotherapy outcome tors ,” like those just outlined, have the studies. Psychotherapy Research, 1, 81-19. greatest impact on outcome, what is clear is Cummings, N.A. (2008). Are graduate stu - that these common factors are “not so com - dents being deceived? The National mon” (Weinberger, l995). Psychologist, July/August, 14. Gawande, A. (2007). The Bell Shaped What does all this mean? What is the take Curve. Better: A Surgeon’s notes on home message? It is clear—in order to Performance. NY: Metropolitan Books. enhance your effectiveness as a therapist Kirsch, I., B.J. Deacon, T.B. Huedo-Media, and as a teacher or supervisor of other T.J. Moore, B.T. Johnson. (2008). Initial therapists, it is essential to focus on the severity and antidepressant benefits: A development of these core competencies. Meta-analysis of data submitted to the Who you are in your being and how you Federal Drug Agency. PloS Medicine , conduct yourself, particularly your ability 5(2) e45. to create and maintain an emotional con - Kroenke, K. (2003). The interface between nection with your patient, is far more physical and pyshcological symptoms. important than what you do. In my own Journal of Clinical Psychiatry Primary experience, this attention to the person of Care Companion , 5 (Suppl 7), 11-18. the therapist is neglected in practice, as Lipsey, M. & Wilson, D. (l993). The efficacy well as in the research literature (Luborsky, continued on page 35 34 of psychological, education, and behav - care: a retrospective cohort study. ioral treatment: Confirmation from British Medical Journal, 322, 767. meta-analysis. American Psychologist, 45, Smith, M. & Glass, G. (l977). Meta-analy - 1181-1209. sis of psychotherapy outcome studies. Luborsky, L., A.T. Mc Lellan., L. Diguer, American Psychologist, 32 , 752-760. G. Woody & D.A. Seligman. (1997). The Wampold, B. E. (2001). The Great Psychotherapist Matters: Comparison Psychotherapy Debate. New Jersey: of outcomes across 22 therapists and 7 Lawrence Erlbaum Associates. patients . Clinical Psychology: Science and Weinberger, J. (1995). Common factors Practice, 96. aren’t so common: The common Reid,W., C.T. Rayford, M. Hotopf (2001). factors dilemma. Clinical Psychology, Medically unexplained symptoms in V2N1 , 45-69. frequent attenders of secondary health

REQUEST FOR PROPOSALS Randy Gerson Memorial Grant The American Psychological Foundation (APF) provides financial support for innov - ative research and programs that enhance the power of psychology to elevate the human condition and advance human potential both now and in generations to come. APF is requesting applications for the Randy Gerson Memorial Grant . The grant has been created to advance the systemic understanding of family and/or couple dynam - ics and/or multi-generational processes. Work that advances theory, assessment, or clinical practice in these areas shall be considered eligible for grants through the fund. Preference will be given to projects using or contributing to the development of Bowen family systems. Priority also will be given to those projects that serve to advance Dr. Gerson’s work. AMOUNT : One grant of $6,000 for pre-doctoral work ELIGIBILITY : All applicants must be graduate students in psychology enrolled full time and in good standing at accredited universities . PROPOSAL CONTENT (Not to exceed 7 pages (1 inch margins, no smaller than 11 point font) : Describe specifically how the program is based on and applies current psychological research and knowledge and answer the following questions: • What is the project’s goal? Please give an overview of the proposed program and how it fulfills the goals of the Gerson program. • What are the intended outcomes, and how will the project achieve them? • How will the results of the project be disseminated (published paper, report, monograph, etc.) • What is the timeline for accomplishing the activities associated with the proposed project? • What is the total cost of the project? Please provide a full budget and justification . Indirect costs (e.g., overhead) are not permitted.

TO APPLY : Submit a CV, two recommendation letters, and proposal online at http://forms.apa.org/apf/grants/ by February 1 , 2009. Questions about this program should be directed to Emily Leary, Program Officer, at [email protected] . 35 ETHICS IN PSYCHOTHERAPY Informed Consent with Culturally Diverse Clients Jeffrey E. Barnett, Psy.D., ABPP Independent Practice, Arnold, Maryland and Loyola College in Maryland and Ian Goncher, M.S., Loyola College in Maryland According to the U.S. about participation in the professional rela - Census Bureau (2002), tionship” (Barnett, Wise, Johnson-Greene, by the year 2025, 40% & Buckey , 2007, p. 179) Practicing psychol - of adults and 48% of ogists and those in graduate training are children in the United routinely involved in diverse professional States will be from a relationships and perform a myriad of pro - racial , ethnic, or cultur - fessional roles. Regardless of the profes - al minority group. The sional role or relationship, psychologists rate of population are ethically and legally bound to initiate growth for racially , eth - these relationships only after completing nically, and culturally the process of informed consent (APA, diverse youth is project - 2002 ; Knapp & VandeCreek, 2006). ed to substantially sur - pass population growth Informed consent brings with it several for White youth. For other important benefits, including “pro - instance, between 1995 moting client autonomy and self-determi - and 2015, population nation, minimizing the risk of exploitation growth is expected to be 74% for Asian and harm, fostering rational decision-mak - American youth, 19% for Black youth, and ing, and enhancing the therapeutic 17% for Hispanic youth, as compared to alliance” (Snyder & Barnett, 2006, p. 37). 3% for White youth (Snyder & Sickmund, 1999). With this increasing racial , ethnic, What does the Ethics Code Say? and cultural diversity as well as the unique Principal E: Respect for People’s Rights health related needs of specific diverse and Dignity of the APA Ethics Code (APA, populations, mental health service systems 2002) states: and psychotherapy providers are routinely Psychologists are aware of and respect cul - challenged to develop and implement tural, individual, and role differences, strategies to provide all racial , ethnic, and including those based on age, gender, gen - cultural groups with efficacious treatment der identity, race, ethnicity, culture, nation - with the intention of eliminating the dis - al origin, religion, sexual orientation, dis - parities in the quality of care minorities ability, language, and socioeconomic sta - receive (U.S. D.H.H.S., 2001). The process tus, and consider these factors when work - of initiating effective treatment for clients ing with members of such groups. from diverse backgrounds begins at the Psychologists try to eliminate the effect on outset of the therapeutic relationship. their work of biases based on those factors, and they do not knowingly participate in Informed Consent: What is it exactly? or condone activities of others based upon Informed consent has been defined as: “a such prejudices. (p. 1063) shared decision-making process in which the professional communicates sufficient Although this principle is aspirational in information to the other individual so that nature, it is essential that psychologists she or he may make an informed decision continued on page 37 36 adhere to this guidance to provide optimal diverse clients. According to the APA’s care to our patients from diverse back - Guidelines on Multicultural Education, grounds. This includes initiating an Training, Research, Practice, and informed consent process that is mindful Organizational Change for Psychologists of racial , ethnic , and cultural differences (2003) “Psychologists are encouraged to that can influence the presentation of recognize that, as cultural beings, they may appropriate information to the client . For hold attitudes and beliefs that can detri - example , the enforceable Standard 3.01, mentally influence their perceptions of and Unfair Discrimination, (APA, 2002) states interactions with individuals who are eth - that “In their work-related activities, psy - nically and racially different from them - chologists do not engage in unfair discrim - selves” (p. 382). One effective bias reducing ination based on age, gender, gender iden - strategy is engaging in increased contact tity, race, ethnicity, culture, national origin, with individuals from diverse back - religion, sexual orientation, disability, grounds (Pettigrew, 1998). socioeconomic status, or any basis pro - scribed by law” (p. 1064). Additionally, psychologists must enhance their cultural competence to effectively The APA Ethics Code’s (APA, 2002) inform diverse populations. As Sue (1998) Standard 3.10(a), Informed Consent, points out, “one is culturally competent states: “Psychologists obtain appropriate when one possesses the cultural knowl - informed consent to therapy or related pro - edge and skills of a particular culture to cedures, using language that is reasonably deliver effective interventions to members understandable to participants” (p. 1065). of that culture” (p. 441). More recently, More specifically Standard 10.01a, Informed Whaley and Davis (2007) defined cultural Consent to Therapy, states “When obtain - competence as : ing informed consent to therapy as a set of problem-solving skills that include required in Standard 3.10 , Informed (a) the ability to recognize and understand Consent , psychologists inform clients/ the dynamic interplay between the her - patients as early as is feasible in the thera - itage and adaptation dimensions of culture peutic relationship about the nature and in shaping human behavior; (b) the ability anticipated course of therapy, fees, involve - to use the knowledge acquired about an ment of third parties, and limits of confi - individual’s heritage and adaptational dentiality and provide sufficient opportu - challenges to maximize the effectiveness of nity for the client/patient to ask questions assessment, diagnosis, and treatment; and and receive answers” (p. 1072). (c) internalization (i.e., incorporation into The content of informed consent will vary one’s clinical problem-solving repertoire) depending on many circumstances. How- of this process of recognition, acquisition, ever, informed consent generally implies and use of cultural dynamics so that it can that the person (1) has the capacity to con - be routinely applied to diverse groups . (p. sent, (2) has been informed of significant 565) information concerning the procedure, Psychologists should learn how cultures and (3) has freely and without undue vary and form each person’s worldview. influence expressed consent (Gross, 2001) . Additionally, psychologists must under - What Should Psychotherapists Do? stand how this may influence the provision Before psychotherapists can initiate a prop - of appropriate information in the consent er informed consent procedure with indi - process and the ensurance of the under - viduals from diverse backgrounds, they standing of the therapeutic process. For must first become knowledgeable of their own possible biases when working with continued on page 38 37 example, it may be important to under - assess the level of interpreter competence stand that a component of mainstream cul - using mental health language. For written ture in the United States is a preference for consent documents this is done by having individuals who are independent, achieve - them translated both forward and in ment focused, and have their own person - reverse by two separate experts in the lan - al goals for which they strive (Fiske et al., guage that is used. Furthermore, the prac - 1998; Oyserman, Coon, & Kemmelmeier, ticing psychologist must take precautions 2002). By contrast, many individuals with regarding maintaining confidentiality origins in cultures of East Asia may prefer when using an interpreter. inter-dependence with others, an orienta - tion toward communal harmony, confor - Beyond the common element of language mity to societal norms, and they may sub - in properly informing diverse populations, ordinate their personal goals and objec - there are underlying concepts of informed tives to the will of the group (Fiske et al., consent that can be influenced by cultural 1998). Thus, psychologists should be cog - factors. Perhaps most importantly is the nizant of how differing societal norms may concept of autonomy. Autonomy is defined affect a client’s autonomy during the as the patients’ right to self-determination. informed decision-making process. It mandates specifically that informed con - sent be free of undue outside influence and An essential aspect of cultural competence be made with a thorough understanding of within the informed consent process is lan - what will transpire in treatment. However, guage. According to the U.S. Census the approach to autonomy varies within Bureau (200 8), a large number of different cultures ( Akabayashi, Fetters, & Americans speak a language other than Elwyn, 1999; Pelligrino, 1992 ). For exam - English in their home. This includes 32 mil - ple, differing from the traditional Western lion Spanish speaking Americans and it is approach of self-directedness in decision- estimated that over 2.5 million speak making, many Asian Americans may tend Chinese, 1.9 million French, 1.1 million to have a family or group orientation. For German, 1.4 million Tagalog, 1.1 million example, within the Chinese culture, for Vietnamese, and 1 million speak Korean, many, the concept of self is a relational one Italian, or Russian. Psychotherapists must (Ho, 1995), and family relationships tend to understand these linguistic differences and emphasize harmonious interdependence how they may limit their ability to make (Fan, 1997). Additionally, Fan (1997) states consent truly informed. One strategy to that within the Chinese culture, individu - combat linguistic misunderstandings in als are part of family units and autonomy the informed consent process is the use of frequently requires family determination. an interpreter. Interpreters have been Kagawa-Singer (1999) noted that many shown to be helpful in breaking language Asian-Americans’ health related decisions barriers for individuals with limited are made by consensus, which suggests English fluency when seeking treatment that the inclusion of family members, pro - from primarily English language health viding explanations on the procedures and care providers (Kaufert & Putsch, 1997). agreement to participate, should be incor - However, the use of an interpreter could porated in the process of informed consent. potentially lead to further problems in the These suggestions could translate to many informed consent process, including inter - in the Hispanic community given the high pretive errors, biases, and other common allegiance to the family that many report as problems of language interpretation well (Avila & Avila, 1995). Similarly, Shaibu (Simon, Zyzanski, Durand , Jimenez, & (2007) found a collectivistic orientation Kodish , 2006 ). Thus, psychologists must during the informed consent process with ensure that the client understands the individuals in Botswana that included the information in the consent agreement, and continued on page 39 38 extended family being privy to informa - solve “all” or “most” of today’s problems . tion to make a collective decision about According to Hill (1997), strong religious participation in research. Furthermore, commitment is one of the most pervasive Shaibu (2007) found that women often con - cultural strengths of many African- sulted male relatives before consenting to Americans. Additionally, Goldston, research participation. Each client’s level of Molock, and Whitbeck (2008) suggest that acculturation and their resulting needs and in Asian -American and American Indian preferences should be actively assessed cultures, their spiritual views could influ - from the outset of the professional relation - ence their help seeking and coping behav - ship and respected during the informed iors. Goldston and colleagues (2008) assert consent process and throughout the dura - that “People of different cultural back - tion of the relationship. grounds understandably may not seek help or respect intervention efforts if they Many Asian American families have a do not perceive that their faith or beliefs hierarchal/patriarchal decision-making will be honored or respected” (p. 26). process that often does not seek the input of others (Tien, 2003). This could impact Hawkins and Bullock (1995) discuss reli - the voluntary nature of clients seeking gion and spiritually as a neglected piece of treatment and their ability to ask questions informed consent. It is suggested that psy - about the treatment process. Thus, the chotherapists share spiritual and religious client may not receive information that information with their clients when, dur - could influence their consent to treatment. ing a thorough intake process, the impor - These findings highlight the need for psy - tance of each client ’s religion and spiritual - chotherapists to have an understanding of ity is uncovered. This will allow each client the culturally dynamic nature of autonomy to make an informed choice about partici - and how this pertains to the informed con - pating in treatment (Hawkins & Bullock, sent process. 1995).

It is important to note that psychologists Acquiring and Maintaining Cultural should never succumb to generalizations Competence: Several Models to Guide when discussing informed consent, and Psychotherapists always ask clients about their preferences The United States is becoming increasingly from the outset . Additionally, psycholo - diverse, gaining a multitude of cultures gists should assess each client’s individual and customs with each passing year that level of acculturation from the outset to will increasingly expand our exposure to help guide how to proceed with the racial, ethnic, and culturally diverse informed consent process and the assess - clients. Cultural competence has been ment or treatment that follows. defined as the knowledge and information obtained about individuals and groups Another culturally important aspect to the that is integrated and incorporated into informed consent process is the use of reli - clinical standards, skills, service approach - gious or spiritual practices in treatment. es, and procedures that match the cultural Many people in the United States report experiences and traditions of clients and strong faith traditions that may impact that increase both the quality and appro - treatment decisions. Recent Gallup Polls priateness of health care services and (2007 ) found that 93% of those surveyed health outcomes (Delphin & Rowe, 2008 ). believe in “God or a universal spirit”. Development of cultural competence is an Eighty-two percent of those surveyed iden - ongoing process and does not have an tified religion as either “very important” endpoint (Delphin & Rowe, 2008). Thus, (5 6%) or “fairly important” (2 6%) and 59% stated that they believe that religion can continued on page 40 39 psychologists should not view cultural identity into informed consent to better competence development as a singular understand the dynamic nature of multi - event, but should strive to continually cultural identity in the United States. develop and enhance their competence through ongoing training. Additionally, Sue and Sue (1999) developed a broad con - psychologists should refer and adhere to ceptual framework for understanding tenants of APA’s Multicultural guidelines racial/cultural identity, The Racial/ (APA, 2003). Cultural Identity Development model (R/CID), which can be used by clinicians Several models have been developed to to facilitate a better understanding of cul - assist clinicians in considering the dynam - turally different attitudes and behaviors. ic nature of culture and how it relates to However, clinicians should not ignore the potential clients. Hays ’ (1996) ADRESSING many within-group differences of racial/ model is described as a framework that culturally diverse populations. Clinicians will help psychologists “explore the influ - are directed to identity development mod - ence of diverse cultural factors on their els encompassing African Americans own identity, world view, and work with (Cross & Vandiver , 2001; Helms & Cook, clients, and consider the influences of cul - 1999), Asian Americans (Sodowski, Kwan, & tural factors on their clients, particularly Pannu, 1995), Latino/Hispanic Americans , factors related to minority-group status” and others (Ruiz, 1990). These models (p. 188). Using the most salient cultural incorporate within-group differences and influences psychologists need to consider will help facilitate a better understanding in their professional work as delineated by of racial and cultural themes that may the American Guidelines for Providers of affect the informed consent process . Psychological Services to Ethnic, Linguis- tic, and Culturally Diverse Populations Conclusions/Recommendations (APA, 1993), Hays (1996) organized these • Always assess each client’s language factors in an acronym that forms ADRESS - competence and ability to comprehend ING . Included in the model are Age information presented . and generational influences, Disability, • When using translators, always discuss Religion , Ethnicity, Social status, Sexual confidentiality issues and assess transla - orientation, Indigenous heritage, National tor language competence . origin, and Gender. According to Hays • Gain cultural competence through (1996), the ADRESSING acronym : ongoing training, exposure to diverse groups, review of the relevant literature, provides a framework for psychologists to and by abiding by the multicultural (a) explore the influence of diverse cultural competence guidelines (APA, 2003). factors on their own identity, world view, • Develop a cadre of colleagues from and work with clients; and (b) consider the diverse backgrounds and consult with influence of cultural factors on their clients, them when questions about various particularly factors related to minority- groups arise. group status, which psychologists of dom - • Assess spiritual and religious prefer - inant cultural identities might be inclined ences from the outset . to overlook . (p. 188) • Assess each client’s level of accultura - tion and make appropriate accommoda - The informed consent process is an ongo - tions rather than applying rigid stereo - ing endeavor that may need to be updated types . as treatment progresses (Barnett, Wise, • Respect clients’ preferences for family Johnson-Greene, & Buckey, 2007) . Thus, involvement in the informed consent clinicians are encouraged to review and incorporate models of racial and cultural continued on page 41 40 process. Bioethics , 11 , 309-322. • Use existing identity models to gain an Fiske, A.P., Kitayama, S., Markus, H.R., & enhanced understanding of each client ’s Nisbett, R.E. (1998). The cultural matrix dynamic racial and cultural identities. of social psychology. In D.T. Gilbert & • If unsure about cultural preferences DO S.T. Fiske (Eds.), The handbook of social NOT assume. ASK! psychology (4th ed., Vol. 2, pp. 915– 981). New York: McGraw-Hill. Gallup . (2007). Religion . Retrieved August References 22, 2008, from http://www.gallup.com/ Akabayashi, A., Fetters, M., & Elwyn, T. poll/1690/Religion.aspx (1999).Family consent, communication, Goldston, D.B., Molock, S.D., & Whitbeck, and advance directives for cancer dis - L.B. (2008). Cultural considerations in closure: a Japanese case and discussion. adolescent suicide prevention and psy - Journal of Medical Ethics , 25 , 296-301. chosocial treatment. American American Psychological Association. Psychologist , 63 (1), 14-31. (2002). Ethical principles of psycholo - Gross, B.H. (2001). Informed consent. gists and code of conduct. American Annals of the American Psychotherapy Psychologist, 57, 1060-1073. Association, 4, 24. American Psychological Association. Hawkins, I.L., & Bullock, S.L. (1995). (2003). Guidelines on Multicultural Informed consent and religious values: Education, Training, Research, Practice, A neglected area of diversity. and Organizational Change for Psyc- Psychotherapy, 32, 293-300. hologists. American Psychologist , 58 , Hays, P.A. (1996). Culturally responsive 377-402. assessment with diverse older clients. Avila, D.L., & Avila, A.L. (1995). Mexican Professional Psychology: Research and Americans. In N.A. Vacc, S.B. Devaney, Practice , 27 , 188-193. & J. Wittmer (Eds.) Experiencing and Helms, J.E., & Cook, D.A. (1999). Using counseling multicultural and diverse race and culture in counseling and psy - populations . Bristol, PA: Accelerated chotherapy: Theory and process . Boston: Development. Allyn & Bacon. Barnett, J.E., Wise, E.H., Johnson-Greene, Hill, R. (1997). The Strengths of African- D., & Buckey, S. (2007) Informed American Families. University Press: Consent: Too much of a good thing or New York. not enough? Professional Psychology: Ho , D. (1995) Selfhood and identity in Research and Practice , 38 (2), 179-186. Confucianism, Taoism, Buddhism, and Cross, W.E., Jr., & Vandiver, B.J. (2001). Hinduism: contrasts with the West. Nigrescence theory and measurement: Journal for the Theory of Social Behav ior; Introducing the Cross Racial Identity 25 , 115-138. Scale (CRIS). In J.G.Ponterotto, J.M. Kagawa-Singer, M. (1999) Cancer and Casas, L.A.Suzuki, & C.M. Alexander Asian American cultures. Asian (Eds.), Handbook of multicultural counsel - American and Pacific Islander Journal of ing (2nd ed., (pp. 371–393). Thousand Health , 6, 383–399 Oaks, CA: Sage. Kaufert, J.M. , & Putsch, R.W. (1997). Delphin, M.E., & Rowe, M. (2008). Communication through interpreters in Continuing education in cultural com - health care: Ethical dilemmas arising petence for community mental health from differences in class, culture, and practitioners. Professional Psychology, power. The Journal of Clinical Ethics , Research and Practice , 39 (2), 182-191. 8(1), 71–87. Fan R.P. (1997). Self-determination vs. Knapp, S.J., & VandeCreek, L.D. (2006). family-determination: two incommen - surable principles of autonomy. continued on page 42 41 Practical ethics for psychologists: A posi - (Eds.) Handbook of Multicultural counsel - tive approach . Washington , DC: ing (pp. 93-122). Thousand Oaks, CA: American Psychological Association. Sage Oyserman, D., Coon, H.M., & Sue, D.W., & Sue, D. (1999). Counseling the Kemmelmeier, M. (2002). Rethinking culturally different: Theory and practice individualism and collectivism: (3 rd ed.). New York: Wiley. Evaluation of theoretical assumptions Sue, S. (1998). In search of cultural compe - and meta-analyses. Psychological tence in psychotherapy and counseling. Bulletin, 128 , 3–72. American Psychologist, 53 , 440–448. Pellegrino, E.D. (1992). Is truth telling to Tien, L. (2003). Confucian past, conflicted the patient a cultural artifact? JAMA , present: Working with Asian American 268 , 1734 1735. families. In L. Silverstein & T. Goodrich Pettigrew, T.F. (1998). Applying social psy - (Eds.), Feminist family therapy: chology to international social issues . Empowerment in social context (pp. 135- Journal of Social Issues, 54 , 663–675. 145). Washington, DC: American Ruiz, A.S. (1990). Ethnic identity: Crisis Psychological Association. and resolution. Journal of Multicultural U.S. Census Bureau (2002). Demographic Counseling and Development , 18 , 29-40. Trends in the 20th Century. Census 2000 Shaibu, S. (2007). Ethical and Cultural special reports. , Washington, DC: U.S. Considerations in Informed Consent in Department of Commerce 70–74. Botswana. Nursing Ethics , 14 (4), 503-509. U.S. Census Bureau. (200 8). Statistical Simon C .M., Zyzanski S ., Durand E ., Abstract of the United States , Section 1. Jimenez, X., & Kodish, E. (2006). Population . 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42 DIVISION 29 BOARD OF DIRECTORS MEETING September 26 –27, 2008 • Washington, D.C.

Tracey Martin

N OF PSYCHOTH ER IO A S I P V Y I D 29 . A N M S E S R A

I Jeff Barnett, Jean Carter L C A A N PSYCHOLOGI C and Nadine Kaslow Jeffrey Magnavita, Jennifer Kelly and Jeff Barnett

Find Division 29 on the Internet. Visit our site at www.divisionofpsychotherapy.org

43 44 WASHINGTON SCENE A Vision For The Future—Integrated Care Pat DeLeon, Ph.D., former APA President

A National Health Substance-Use Conditions was released in Policy Perspective : In which the IOM concluded that their 2001, the Institute of Quality Chasm framework is, in fact, Medicine (IOM) issued applicable to health care for mental and its far reaching report substance-use conditions. This newest Crossing the Quality report noted that these conditions are the Chasm: A New Health leading cause of combined disability and System for the 21 st death of women and the second highest for Century which proposed an exciting and men. “Effective treatments exist and con - highly creative strategy for improving tinually improve. However, as with gener - health care overall, attracting considerable al health care, deficiencies in care delivery traction both in the United States and prevent many from receiving appropriate around the world. The IOM framework treatments. That situation has serious con - proffered six aims of High Quality Care: sequences—for people who have the con - Safe—avoiding injuries to patients from ditions; for their loved ones; for the work - the care that is intended to help them; place; for the education, welfare, and jus - Effective—providing services based upon tice systems; and for our nation as a scientific knowledge to all who could ben - whole.” Five psychologists served on the efit and refrain from providing services to Committee issuing this report and the those not likely to benefit (i.e., avoiding assistance of Jalie Tucker, then-Chair of the underuse and overuse, respectively); APA Board of Professional Affairs, was Patient-centered—providing care that is expressly noted. respectful of and responsive to individual patient preferences, needs, and values and Health care for mental and/or substance- ensuring that patient values guide all clini - use conditions historically has been more cal decisions; Timely—reducing waits and separated from general health care relative sometimes harmful delays for both those to other specialties. In addition, there are who receive and those who give care; some significant differences, including: the Efficient—avoiding waste, including waste implications of a mental or substance-use of equipment, supplies, ideas, and energy; diagnosis for patient decision-making; the and, Equitable—providing care that does more common use of coerced treatment; not vary in quality because of personal greater variation in the types of providers characteristics such as gender, ethnicity, licensed to diagnose and treat these illness - geographical location, and socio-economic es; the need for linkages with a greater status. The IOM concluded that the current number of health, social, and public wel - American health care system is in need of fare systems; a less-developed quality mea - fundamental change. surement infrastructure; less widespread adoption of information technology (IT); Each year, more than 33 million Americans and a differently structured marketplace use health care services for their mental for consumers and purchasers of mental health problems or conditions resulting health/substance-abuse care. “Although from their use of alcohol, inappropriate use science continues to advance our knowl - of prescription medications, or, less often, edge about the etiology of mental and sub - illegal drugs. In 2006, Improving the continued on page 46 Quality of Health Care for Mental and 45 stance-use problems and illnesses and how emphasize that the vast majority of prob - to treat them effectively, health care for lems found in the quality of health care are these conditions—ike general health care— not the result of poorly motivated, uncar - frequently is not delivered in ways that are ing, or unintelligent health care personnel, consistent with science—in ways that but instead result from numerous barriers enable improvement and recovery. More- to high-quality care imposed by the deliv - over, care is sometimes unsafe; more often, ery systems in which clinicians work. it is not delivered at all. The gap between what can and should be and what exists is Highly significant for the future, the IOM so large that, as with general health care, it also found that while the use of electronic constitutes a ‘chasm’….” health records, decision support, and other information technology [IT] applications is With psychology’s increasing presence in growing in general health care, their use in integrated care, one reoccurring IOM mental health and substance-use health theme is particularly noteworthy; i.e., that care is more limited, including its use in mental, substance-use, and general illness - supporting the delivery of mental health es are highly interrelated, occurring togeth - and substance-use therapy over the World er approximately 20% of the time, especial - Wide Web, by e-mail, and through other ly with respect to chronicity. Improving technology-mediated interactions. “Health care delivery and health outcomes for any care providers’ ability to quickly obtain one of the three depends upon improving information on a patient’s health, health - the others . The report recommends that care, and potential treatments, and share primary care providers and specialty men - this information in a timely manner with tal health/substance-use providers should other providers caring for the patient, is transition along a continuum of evidence- essential to the delivery of safe, patient- based coordination models from: (1) for - centered, coordinated and effective care…. mal agreements among mental, substance- (A) strong IT infrastructure (is) critical to: use, and primary health care providers to • Supporting consumers in illness self- (2) case management of mental, substance- management and marketplace choices; use, and primary health care to (3) co-loca - • Supporting providers in the delivery of tion of services and then to (4) delivery of evidence-based clinical care; services through clinically integrated prac - • Coordinating care across clinicians, set - tices of primary and mental health/sub - tings, and time; stance-use providers. Organizations • Facilitating performance and outcome should adopt models to which they can measurement; and most easily transition from their current • Educating clinicians.” structure, that best meet the needs of their patient populations, and that ensure The President of the Institute of Medicine: accountability. Health care for general, “As the Committee has concluded, mental, and substance-use problems and improving our nation’s general health, and illnesses must be delivered with an under - the quality problems of our general health standing of the inherent interactions care system, depends upon equally attend - between the mind/brain and the rest of the ing to the quality problems in health care body. In conducting its deliberations, the for mental and substance-use conditions…. IOM committee, like many expert panels Dealing equally with health care for men - before it, was confronted by the “destruc - tal, substance-use and general health con - tive” and “artificial, centuries old separa - ditions requires a fundamental change in tion of mind and body” that was criticized how we as a society and health care system by former APA President Ron Levant and think about and respond to these problems by the 1999 Surgeon General’s report on Mental Health . The IOM continues to continued on page 47 46 and illnesses. Mental and substance-use ing electronic medical record (EMR) sys - problems and illnesses should not be tems. Participation in the HI-IQ program is viewed as separate from and unrelated to a partnership between HMSA, the EMR overall health and general health care. vendor, and the health care provider to Building on this integrated concept, this support innovative, technological advance- report offers valuable guidance on how all ment. In this spirit, HI-IQ funds were orig - can help to achieve higher quality health inally intended to cover up to 50% with a care for people with mental or substance- limit of $20,000 for a single provider for ini - use problems and illnesses. To this end, the tial start-up EMR product costs (including Institute of Medicine will itself seek to software and reasonable training and incorporate attention to issues in health installation costs ). However, because care for mental and substance-use prob - HMSA understands the unique situation lems and illnesses into its program of gen - faced by providers on the Neighbor eral health studies.” Islands, we have increased our assistance for providers who are starting new prac - Hawaii’s Insurance Plan : Hawaii Medical tices on Neighbor Islands to reduce their Service Association (HMSA) is the Blue costs for EMR systems… To qualify for the Cross/Blue Shield plan of Hawaii, cover - HI-IQ program, providers must be inde - ing over 700,000 individuals (approximate - pendent, MHSA participating health care ly 58% of the State). Over the years, HMSA providers or belong to a health center that has been a positive voice on behalf of insti - is an HMSA participating health center….” tuting proactive, patient-centered changes for Hawaii’s health care delivery system; APA’s Forward Movement : Nina Levitt— including, for example, recently testifying “A very exciting new initiative was recent - in favor of the Hawaii Psychological ly launched by the Education and Practice Association prescriptive authority (RxP) Directorates, with support from the Public legislation. “During our meeting, you Interest Directorate, on integrating health asked if HMSA was receptive to having care and the utilization of psychologists non-physicians apply for our innovative and psychology trainees in our nation’s health information technology support federally qualified health centers (FQHCs). program, HI-IQ. I am writing to confirm The FQHCs include community health cen - that HMSA is indeed interested in having ters, migrant health centers, low-income non-physicians apply for the program. housing health centers and school-based HMSA recognizes the tremendous and val - health centers. With over 7,000 sites nation - ued support provided to physicians by wide, this initiative promises to improve physician extenders. On January 1, 2008 the quality of mental and behavioral health HMSA expanded HI-IQ to include care for those in our country most in need Physician Assistants, Nurse Practitioners, of services. In September of this year, in APRNs, and Mid-wives. ” conjunction with the Committee on Rural Health, chaired by Clark Campbell, an all- “HI-IQ extends HMSA’s ongoing efforts to day meeting was hosted during the Fall improve health and general well-being in Consolidated meetings, attended by repre - Hawaii by supporting technological devel - sentatives from the Department of Health opment in the health care community. HI- and Human Services. Board of Education IQ is divided into two components: a hos - Chair Gil Newman discussed their matur - pital component that will invest $30 mil - ing efforts in California, including obtain - lion over three years, starting in 2007, to ing student financial support. ” Integrated support facility-based projects, and a care will become a major future agenda for provider component that will invest $20 psychology. million to support health care providers – continued on page 48 physicians and non-physicians – in acquir - 47 Personal Involvement Makes All The the Labor, Health and Human Services, Difference: From Col. Robin Squellati, and Education subcommittee; and Defense Senator Inouye’s 18th DOD Nurse Fellow: health. Provisions in both appropriations bills were included, because there was After almost a year in Senator Inouye’s interest from Americans. The Chairman office, I can truly say that this experience is and the Ranking minority member of the the highlight of my 28 years of nursing. As subcommittee work closely to develop a a United States Air Force Colonel, I have bill that both Democrats and Republicans had the opportunity to serve in a variety of will support. One of my most memorial nursing roles, but none can compare to the times in the Senate was the evening that the impact on America that a Senate staffer Medicare bill was passed. When Senator has. Since this is a Presidential election Kenney appeared on the Senate floor, the year, and healthcare is one of the top con - clapping lasted at least three minutes. cerns of Americans, I have been able to hear health policy analysts from several Relationships between Members, office major organizations. Each has their own staff, majority and minority committee views on healthcare reform, but controlling members, and lobbyists are extremely the cost and improving the quality of care important. It takes 60 votes to pass a bill in are paramount. The Commonwealth Fund the Senate, so people have to work togeth - ranked the United States last out of six er. Talking over a cup of coffee or giving a industrialized countries for quality, access, thank you to those who support you goes a efficiency, equity, healthy lives, and cost long way. This is one lesson that I intend to control. Even though we spend more than take back to the military. Nothing is more any other nation, our outcomes are poor. important in any organization than the Another significant observation involves people. Caring about each other, and sup - disciplines actually preventing progres - porting common interests is not done near - sion of their members. Nurse practitioners ly enough. would like to practice according to their full scope of care, nurse educators would During the nurse’s year in Senator rather not turn away 42,000 nursing stu - Inouye’s office, we visit Hawaii. When I dents during the country’s most severe visited Hilo, I knew I wanted to live and nursing shortage, psychologists are seek - work in their community. I came back and ing prescriptive authority (RxP) in many enrolled in a doctorate in Healthcare states; and dental hygienists would like to Administration, so that I could teach at the expand their scope of practice, similar to University of Hawaii at Hilo. Teaching the dental hygienists in Australia. Each of next generation of nurses is a way for me to these goals would benefit countless give back to a profession that I’ve very Americans. The problem is often that some much enjoyed. Until I worked in this office, in the discipline do not want to fight for the I had not even considered a Ph.D. Senator real goal—improved patient care. If the Inouye’s staff and those who came to visit focus was the mission, and all healthcare have encouraged me. Every American professionals worked together to achieve should be as fortunate to be surrounded by the best outcomes for patients, instead of motivating individuals . internal battles, we could easily improve our healthcare. Pat DeLeon, former APA President – Division 29 – November, 2008 My role has focused primarily on health in

48 A HOLIDAY GUIDE FOR PSYCHOTHERAPISTS Leon J. Hoffman, Ph.D., ABPP

The period from just before Thanksgiving engaged, married or divorced or change to just after New Year’s is unrepresentative jobs. Pretty simple actually. of other times of the year. Cultural, reli - gious, social and business pressures on Some practitioners may work in ways that patients are unlike those of any other time. might not find these recommendations fit - ting. My comments are meant to encourage Decades ago in my psychotherapy practice colleagues to consider such contingencies and in my hospital work, I observed that when streamlining their practices. many patients fell prey to these inordinate pressures. Patients with tendencies to act - I have always found it useful to observe ing-out and impulsivity proved to be most this “moratorium” and I am aware of no ill at risk. They were likelier to be triggered effect on any of my patients. Rather they by such influences, causing them to engage have found it helpful. in costly and painful re-enactments of ear - lier life traumata. The basic tenet might be that if something feels urgent, be curious about that. Think They might have overeaten, overspent, and feel, but resist acting. Anything that over-imbibed alcohol, used drugs more or seems important can probably wait for a engaged in reckless sexual behaviors—all few weeks. It is a win/win situation. in the interest of alleviating anxieties of which they were generally unaware. When It is not unusual that a patient asks me awareness is raised, re-enactment and act - when considering some major action dur - ing-out become unnecessary and irrelevant. ing that time, “Are we in the moratorium To help the patients reduce their risks of period yet?” They enjoy having a chance to unnecessary loss and pain, it occurred to act reasonably. me to recommend (gently and with some humor) that they refrain from making any These recommendations may apply as well major life decisions from the weekdays to many of us psychotherapists. preceding Thanksgiving until approxi - mately January 15. It seemed to me that by then the “holiday dust” would have set - tled. Any transferences or distortions relat - Leon J. Hoffman, Ph.D., is in private practice ed to holiday memories, fantasies, expecta - and can be reached at Suite 2122, 111 North tions, disappointments, hopes and dreams Wabash Ave., Chicago IL 60602 might more safely be assumed to be less treacherous in influencing a patient. Reprinted with permission. This article was originally published in The National Patients are encouraged not to buy or sell a Psychologist , November/ December 2007. house, intentionally get pregnant, get www.nationalpsychologist.com

49 Call for Nominations DIVISION 29 AWARD FOR DISTINGUISHED CONTRIBUTIONS TO TEACHING AND MENTORING Each year , Division 29 honors a psycholo - public service in psychology gist who has contributed to the field of • offering general advice with respect to psychotherapy through the education and professional development (e.g., gradu - training of the next generation of psy - ate school, postdoctoral study, faculty chotherapists by presenting the Division 29 positions), awards, and publications Award for Distinguished Contributions to • treating student/colleagues with Teaching and Mentoring. This award is respect, spending time with them, pro - given annually to a member of Division 29 viding open communication lines, and who exerted a significant impact on the gradually moving the student into the development of students and/or early role of colleague. career psychologists in their careers as psychotherapists. The award recipient will receive the follow - ing: (1) an invitation to make a 45-minute Both self-nominations and nominations of presentation at the APA convention the year others will be considered. The nomination the award is conferred; (2) a cash award of packet should include: $200 to help offset travel expenses to the 1) a letter of nomination, sent electroni cal - APA convention for the year the award is ly, describing the individual’s impact, conferred; and (3) an award plaque. These role, and activities as a mentor; are based on the assumption that the award 2) a vitae of the nominee; and, recipient will attend the APA convention the 3) letters of reference for the mentor, writ - year the award is conferred. If the award ten by students, former students, and/or recipient does not attend the APA conven - colleagues who are early career psychol - tion , then he/she shall receive an awards ogists. Letters of reference for the award plaque. should describe the nature of the men - toring relationship (when, where, level Individuals who were nominated in previous of training), and an explanation of the years for the Teaching and Mentoring Award role played by the mentor in facilitating may carry over their complete application to a the student or colleague’s development subsequent year by writing a letter to the Chair as a psychotherapist. Letters of reference of the Professional Awards Committee request - may include, but are not limited to, dis - ing resubmission of the previous application. cussion of the following behaviors that This letter must be received by March 15 of the characterize successful mentoring: year of the award. • helping students to select and work toward appropriate goals The letter of nomination must be emailed • providing critical feedback on to the Chair of the Professional Awards individual work Committee . Deadline is January 1, 2009 . • providing support at all times, especial - All of items must be sent electronically. ly encouragement and assistance in the The Award is to be presented at the APA face of difficulties annual convention. Division 29 2009 • assisting students in applying for Awards Chair: awards, grants, and other funding • assisting students in building social Jeffrey E. Barnett, Psy.D., ABPP network connections, both with indi - 1511 Ritchie Highway, Suite 201 viduals and within organizations that Arnold, MD 21012 are important in the field Phone: 410-757-1511 Fax: 410-757-4888 • serving as a role model and leader for E-mail: [email protected] teaching, research, and academic and 50 BOOK REVIEW Financial Success in Mental Health Practice: Essential Tools and Strategies for Practitioners Published by APA Books, 2008 Authors: Steven Walfish and Jeffrey E. Barnett Miguel E. Gallardo, PsyD, Associate Professor of Psychology, Pepperdine University

As I reflect on the deliv - I have never appreciated that mindset, and ery of mental health believe it limits and debilitates some stu - practice nationally, it is dents and psychologists from striving to clear to me that the achieve all of the above. Additionally, the times are changing. authors have tailored the book around Moreover, in a time twenty “Private Practice Principles ” that when some are begin - serve as the backdrop. I found the princi - ning to question the pos - ples to be very helpful as I began the book sibility of the independent practitioner as and as reminders throughout. As a result, an avenue towards financial and profes - this is a great book for professors to use in sional independence, Walfish and Barnett their classes as the examples and informa - have outlined, and in many ways , provid - tion provided can be incredibly helpful to ed a strong sense of hope to those in doubt. those who may still be sorting through the I was pleased to have reviewed this book pros and cons of private practice. and believe it to be a well -timed , and one of the best, books I have read in the areas of I also appreciated the authors ’ perspectives practice development and financial plan - on helping readers understand that inde - ning for practitioners. I believe this book pendent practice is a culmination of sever - will serve as a resource to students, early al skill sets, not on simply being a good career psychologists, and practitioners clinician or a good business person. across the professional developmental life- Walfish and Barnett do a nice job address - span. It is within this context that I will ing how important it is for the independent share my comments and review. practitioner to refine and transform their mindset , and skill set , as therapists. Their The authors begin with an analysis of honest discussion about the importance of mindset. From my perspective, addressing having a strong set of clinical competen - one’s level of comfort in earning a decent cies, combined with strong skill sets in living is foundational to engaging and being a business owner, is invaluable. This embracing a career as an independent particular aspect of the book can be practitioner. I have been, and remain, con - extremely helpful for those readers who cerned that as a profession, we are limiting are unsure whether or not independent our own capacity to deliver services and practice is the right decision for them. simultaneously earn a living. For too long Their discussions about the various types people have questioned the mindset of of practices one can create in the book can psychologists who want to earn a good liv - be helpful to those readers who are ing as a provider of mental health services. attempting to find the best fit for their own There seems to be the assumption that if individual needs and levels of comfort in one wants to make money, pay off school becoming business owners. The various loans without living month to month, own independent practice options in Chapter 9 a home, have a nice car and take a vacation can be useful as readers reflect on the vari - once or twice a year, that some how this ous culmination of skills necessary to cre - takes away from one’s “commitment” to ate a practice. The outcome of their insights the “real” purpose of being a psychologist. continued on page 5521 and experiences is that there is not a one and I found myself reflecting on the prac - size fits all approach to creating and being tice principles and pondering some of the successful in practice. While I believe their questions raised throughout. The book discussions on this issue can be helpful for flows in a developmental way that I think students, I also found myself really learn - will make sense to the reader and to the ing a lot of new information as a profes - person delving into this process for the first sional. As a result of reading this book, I time . From my perspective the most useful was reminded of my graduate school train - aspect of this book is the hands -on ing and what information was missing approach the authors take throughout the from that equation. volume . In particular, I found the informa - tion contained in chapters 6-10 extremely While I believe that many graduate pro - helpful as I believe these chapters contain grams have begun to bridge the gap complex information that is easy to under - between real world professional endeavors stand and with helpful examples. The and graduate training, particularly as it information in these chapters seemed to relates to practice, I also believe we are still resonate with me more than when I have behind in fully preparing our students for read similar information in other practice a life outside of graduate training in the related books. The authors address the area of independent practice. Walfish and importance of accounting, taxes, working Barnett provide excellent information for with insurance companies, or not, engag - the student just beginning to think about ing in other areas of the field, and long- practice options after graduate school, to term financial planning in a way that is facilitating the transition for the newly easily understood and practical . Some of graduated professional. Additionally, the the more complex issues such as, account - information in this book can also be useful ing, taxes and dealing with insurance com - to the more seasoned professional who has panies stand out as information that can be been concerned about taking a “chance” on challenging to individuals thinking about establishing their own business. As I practice, yet Walfish and Barnett have reflected on my own process of beginning managed to present this information in a small practice as a professional, I found way that I think readers will comprehend. myself tapping into the various resources I was particularly impressed with the around me. I was fortunate to have suc - details the authors’ provide in familiariz - cessful people in practice provide some ing the reader with insurance claim forms guidance to me along the way. As I read the and delineating the information line by book, all of the information I compiled as I line. Additionally, the sample letters they was beginning my own practice from provide to insurance companies, when cor - numerous individuals, is included in this responding with insurance companies and volume. There is no stone unturned that clients, setting and changing fees, provid - Walfish and Barnett have not touched ing superbills and understanding the pit - upon. Their 45 years of experience is evi - falls associated with insurance work, was dent in this volume. Of most importance valuable to me as the reader. I learned a for me as a reader, was that I was able to great deal from reading this book and was take some of the examples they provided able to use some very practical aspects of throughout the book, and use them in my this book into my practice. own practice as a template. The book is The authors’ pay particular attention in practical and user friendly. addressing the multitude of ways that inde - The book has clearly defined language and pendent practitioners can diversify their ideas throughout. It is easily understood professional life. As we reexamine the inde - and the authors do a nice job of spelling pendent practice of psychology today, it is out many ideas, concepts and processes for clear that today ’s practitioners are engaged the reader. The book is very well organized continued on page 53 52 in a variety of professional roles. I appreci - The authors have also done an exceptional ated Walfish and Barnett devoting some job including research throughout the fabric attention to this aspect of being and becom - of the book. This book is not simply based ing an independent practitioner. The on the author’s experiences , it is based on author’s address directly the many ways some very important research to substanti - that independent practitioners can earn a ate the authors recommendations and living outside of managed care, and in addi - reflections. While the authors ’ experiences tion to a fee-for-service practice. This is a should not be underestimated and represent very important aspect to this book as it pro - powerful voices in compiling the informa - vides the reader with some realistic options tion in this book, it is the research compo - that individuals across the professional life- nent that provides another foundation to span can take advantage of. Additionally, the volume that expands its utility to pro - these discussions can be very helpful to stu - fessional training programs for professors dents who are weighing their options as to use in classes. Additionally, the qualita - they begin to create a professional identity. tive interviews with therapists throughout the book highlight scenarios in a very effec - Over the years, I have followed listserv dis - tive way to demonstrate some the principles cussions, attended, and participated in, var - and concepts discussed. I have always val - ious presentations on beginning a practice, ued hearing the professional experiences of and the information in this book addresses other therapists as they deal with issues that all the questions I have seen participants I am attempting to address. I found the and attendees ask on listservs and in pre - interviews to be a nice snapshot into some sentations. What I most appreciate about of the personal experiences of therapists the book is the authors’ realistic world view from across the country. The multitude of on practice. While they provide information voices throughout, add to the books credi - that is useful, they are not attempting to bility and reliability. paint an unrealistic picture of practice. The In a time when we are reflecting on the authors’ help the reader sort through some delivery of services in psychology, and the very challenging questions about beginning multitude of ways that psychologists a practice and what it means to delve into impact society, Walfish and Barnett have an area of the field that demands a certain kept alive the endless possibilities of work - mindset and skill set. Although the authors ing in independent practice in this changing discuss some very important aspects related landscape. They have provided an enor - to practice, this book is not a book that mous amount of information that will equip attempts to “glorify” independent practice, everyone who reads this book with useful but more attempts to paint a realistic picture information, regardless of where one falls of what one can expect as they move for - on the professional life-span. The more sea - ward. Walfish and Barnett have taken their soned independent practitioner will benefit own internal processes, professional experi - from the chapters on strengthening one’s ences and transformed them into deliberate retirement and closing a practice. Every and thoughtful questions and information reader will benefit from this practical vol - in this volume. I appreciated the frank dis - ume on thriving as an independent practi - cussions about both the benefits of indepen - tioner. This book is a must have for gradu - dent practice, combined with some of the ate training programs hoping to prepare more challenging discussions that people their students for life outside graduate need to know. A valuable aspect of this book school to early career psychologists build - is the authors’ belief that readers need to ing their careers, to seasoned practitioners know both the intricate details of succeed - wanting to tighten up their business and ing in practice, while also providing the inti - economic futures. I hope you find this book mate details of the struggles associated with as valuable as I did. practice. 53 The Society for General Psychology Division 1 AMERICAN PSYCHOLOGICAL ASSOCIATION

CALL FOR NOMINATIONS FOR AWARDS FOR YEAR 2009 Deadline: February 15, 2009

The Society for General Psychology, Division One of the American Psychological Association is conducting its Year 2009 awards competition, including the William James Book Award for a recent book that serves to integrate material across psychological subfields or to provide coherence to the diverse subject matter of psychology, the Ernest R. Hilgard Award for a Career Contribution to General Psychology, the George A. Miller Award for an Outstanding Recent Article on General Psychology, the Student Poster Award and the Arthur W. Staats Lecture for Unifying Psychology , which is an American Psychological Foundation Award managed by the Society for General Psychology .

All nominations and supporting materials for each award must be received on or before February 15, 2009 .

There are no restrictions on nominees, and self-nominations as well as nominations by others are encouraged for these awards.

The Society for General Psychology encourages the integration of knowledge across the subfields of psychology and the incorporation of contributions from other dis - ciplines. The Society is looking for creative synthesis, the building of novel concep - tual approaches, and a reach for new, integrated wholes. A match between the goals of the Society and the nominated work or person will be an important evaluation criterion. Consequently, for all of these awards, the focus is on the quality of the contribution and the linkages made between diverse fields of psychological theory and research.

Winners of the William James Book Award, the Ernest R. Hilgard Award, and the George A. Miller Award will be announced at the annual convention of the American Psychological Association the year of submission. They will be expected to give an invited presentation at the subsequent APA convention and also to pro - vide a copy of the award presentation for inclusion in the newsletter of the Society (The General Psychologist ). They will receive a certificate and a cash prize of $1000 to help defray travel expenses for that convention.

For the William James Book Award, nominations materials should include: a) three copies of the book (dated post-2004 and available in print; b) the vita of the author(s); and c) a one-page statement that explains the strengths of the submission as an integrative work and how it meets criteria established by the Society. Specific criteria can be found on the Society’s website (http://www.apa.org/divisions/ div1/awards.html ). Textbooks, analytic reviews, biographies, and examples of continued on page 55 54 applications are generally discouraged. Nomination letters and supporting materi - als should be sent to John D. Hogan, PhD, Psychology Department, St. John’s University, Jamaica, NY 11439.

For the Ernest R. Hilgard Award , nominations packets should include the candi - date’s vita along with a detailed statement indicating why the nominee is a worthy candidate for the award and supporting letters from others who endorse the nom - ination. Nomination letters and supporting materials should be sent to Thomas Bouchard, PhD., Psychology, N249 Elliott Hall, University of Minnesota, 75 E. River Road, Minneapolis, MN 55455.

For the George A. Miller Award , nominations packets should include: a) four copies of: a) the article being considered (which can be of any length but must be in print and have a post- 2004 publication date); b) the curriculum vitae of the author(s); and c) a statement detailing the strength of the candidate article as an outstanding contribution to General Psychology. Nomination letters and support - ing materials should be sent to Donald Dewsbury, WJBA Award chair, Department of Psychology, University of Florida, Gainesville, FL 32611-2250.

The 2010 Arthur W. Staats Lecture for Unifying Psychology is to be announced in 2009 and given at APA’s 2010 Annual convention. Nominations materials should include the nominee’s curriculum vitae along with a detailed statement indicating why the nominee is a worthy candidate for the award including evidence that the nominee would give a good lecture. They should be sent to Harold Takooshian, PhD, Psychology-916, Fordham University, New York NY 10023 .

Candidates for the Student Poster Award should submit their poster abstract to the Division One Posters upon call for APA Convention Programs.

General Comments may be made to Dr. MaryLou Cheal, Awards Coordinator 127 E. Loma Vista Drive Tempe, AZ 85282.

55 N OF PSYCHOTH ER IO A S THE DIVISION OF PSYCHOTHERAPY I P V Y I D The only APA division solely dedicated to advancing psychotherapy 29 . A N M S E S

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I L C A A N PSYCHOLOGI C Division 29 meets the unique needs of psychologists interested in psychotherapy. By joining the Division of Psychotherapy, you become part of a family of practitioners, scholars, and students who exchange ideas in order to advance psychotherapy. Division 29 is comprised of psychologists and students who are interested in psychotherapy. Although Division 29 is a division of the American Psychological Association (APA), APA membership is not required for membership in the Division. JOIN DIVISION 29 AND GET THESE BENEFITS! FREE SUBSCRIPTIONS TO: DIVISION 29 INITIATIVES Psychotherapy Profit from Division 29 initiatives such as the This quarterly journal features up-to-date APA Psychotherapy Videotape Series, History articles on psychotherapy. Contributors of Psychotherapy book, and Psychotherapy include researchers, practitioners, and Relationships that Work. educators with diverse approaches. Psychotherapy Bulletin NETWORKING & REFERRAL SOURCES Quarterly newsletter contains the latest news Connect with other psychotherapists so that about division activities, helpful articles on you may network, make or receive referrals, training, research, and practice. Available to and hear the latest important information that members only. affects the profession. EARN CE CREDITS OPPORTUNITIES FOR LEADERSHIP Journal Learning Expand your influence and contributions. Join You can earn Continuing Education (CE) cred - us in helping to shape the direction of our cho - it from the comfort of your home or office — sen field. There are many opportunities to at your own pace — when it’s convenient for serve on a wide range of Division committees you. Members earn CE credit by reading and task forces. specific articles published in Psychotherapy and completing quizzes. DIVISION 29 LISTSERV As a member, you have access to our Division DIVISION 29 PROGRAMS listserv, where you can exchange information We offer exceptional programs at the APA with other professionals. convention featuring leaders in the field of psychotherapy. Learn from the experts in personal settings and earn CE credits at VISIT OUR WEBSITE reduced rates. www.divisionofpsychotherapy.org MEMBERSHIP REQUIREMENTS: Doctorate in psychology • Payment of dues • Interest in advancing psychotherapy

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