Vol. 24 No. 2 The Independent Newspaper for Practitioners March/April 2015 $9.02 million proposed to settle APA practice assessment suit By James Bradshaw, Associate Editor APAPO, are not required to admit any www.PracticeAssessmentSettlement.co guilt in misleading members about the m that will be maintained by an inde- The American Psychological nature of the assessments, which were pendent settlement administrator, the Association (APA) and the APA Practice revealed to be “voluntary” in 2010, Portland, Ore., offices of Epig Class Being “Liked” on Facebook Organization (APAPO) are to pay $9.02 prompting the legal actions. Action Claims Solutions Inc. million under a proposed settlement to The agreement also calls for renam- See Page 20. end a class action suit filed by APA ing the assessment as “APAPO Continued on Page 3 practitioner members who contend they Membership Dues” with accompanying were deceived into thinking they had to wording on annual dues billings to Medicare penalties catch pay an additional “practice assessment” emphasize that APAPO membership is a to maintain APA membership. recommended option for practicing uninformed psychologists off guard The settlement must be approved by licensed psychologist members to sup- have been astounded by the number of the U.S. District Court for the District of port APAPO’s advocacy efforts but is By Paula E. Hartman-Stein, Ph.D. experienced psychologists who have been Columbia before any claims for payment not required to keep APA membership. unaware of PQRS, paying little attention may be submitted, but the plaintiffs’ An APA news release announcing Despite repeated announcements and to the changes going on in healthcare and acceptance of the terms makes approval the settlement in January quoted 2015 warnings from the Center for Medicare remaining in their silos until immediately likely forthcoming. APA President Barry Anton, Ph.D., as and Medicaid (CMS) of the financial affected …. PQRS is not simple. It As in most negotiated settlements, saying, “APA and APAPO were never consequences to providers who do not requires time and study.” the agreement means that the defen- happy to be in litigation with their mem- participate in Physician Quality The New Jersey Psychological dants, officers of the APA and the bers. While we do not concede that there Reporting System (PQRS) in 2013, some Association (NJPA) has been proactive in was any wrongdoing on our part, this psychologists are angry, confused and providing resources and education for its agreement allows us to end the dispute shocked after receiving letters announc- INSIDE THIS ISSUE members. Without endorsing any specific and return to focusing our full attention ing an across-the-board penalty of 1.5 Suicide stirs conversion courses, Jane Selzer, executive director of on the goals and mission of the APA and percent in 2015. NJPA, negotiated discounts for the mem- therapy debate ...... Page 6 the APAPO.” During an informal poll conducted APA Council adopts Once approval is finalized, all during the February meeting of the See commentary Page 14 licensed psychologists who paid practice Cleveland Psychological Association primary care policy ...Page 7 bers in 2014 to purchase privately pro- assessments for any period from 2001 to (CPA), about half had received notices of ‘Sexual sobriety’ ignores duced webinars on PQRS basics for psy- the present will be eligible to apply for penalties. Thirty percent reported not chology. NJPA has also been dispelling victims ...... Page 15 reimbursement from the settlement fund. knowing what PQRS is. Psychologists misinformation appearing on a listserv Book Review Special Section Details will be available on the website have been eligible to obtain small bonus- Pages 1 - 4 B es for PQRS participation from 2008 to about PQRS, encouraging members to 2014. Detailed information about how to contact the APA Practice Organization or participate is contained on the govern- the CMS helpdesk for assistance. ment website, CMS.gov. Beginning in January all Medicare According to CPA President Nancy providers who failed to satisfactorily Duff-Boehm, Ph.D., “Education from the report one process measure on one Center for Medicare and Medicaid patient in 2013 began to receive a 1.5 Services (CMS) is buried in a sea of percent payment reduction on their information about labs and flu shots. It is Medicare patients throughout 2015. In an

very tempting for me to ignore my mes- article published in CPA’s February Address service requested service Address sages from CMS because so few pertain newsletter, Duff-Boehm called the 2013

requirement, “a toe-dabble meant to Permit # 40 # Permit to my practice. Professional organizations

desensitize providers to the idea that the Madelia, MN Madelia,

Gahanna, Ohio 43230 Ohio Gahanna, should be doing a lot more to inform and

PAID system is too overwhelming to broach.

620-A Taylor Station Rd. Station Taylor 620-A educate their members.”

U.S. Postage U.S. The actions recommended in some

PRSRT STD PRSRT Peter Kanaris, Ph.D., APA Council The National Psychologist National The Representative for New York, said, “I Continued on Page 4 Page 2 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T Page 3 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 comment from Tumlin, whose dogged to $2.7 million – 30 percent of the set- Settlement pending pursuit of the mandatory/voluntary ques- tlement – although the court can impose CPA director of professional tion precipitated the legal actions. a lower amount if it sees fit. affairs, Chuck Faltz, 76, dies court approval “It is no surprise that APA officials Any residual in the fund when all who defrauded their colleagues for a claims have been satisfied will be donat- The long-time director Continued from Page 1 decade would spend $9 million of the ed to the non-profit corporation Mental of professional affairs The practice assessment began as a organization’s money to escape account- Health America. for the California $50 annual charge on practicing mem- ability,” Tumlin said. “The settlement The settlement is one of two areas Psychological bers in 1985 enacted to fund efforts of saves them from having to tell the truth where APA hopes 2015 will resolve Association (CPA) and the Practice Directorate, a division of under oath, so they can now say they did long-standing disputes that have tar- leader in the long battle APA devoted to advocating for practi- nothing wrong and otherwise continue to nished its reputation. to gain hospital privi- tioners in such matters as licensing and stonewall the membership’s questions. In December, APA announced it has leges for psychologists insurance reimbursements. Psychologists deserve better than this.” hired Donald H. Hoffman of the Sidley in that state died Jan. 19. But, by 2000 those advocacy efforts Once the settlement is approved, the law firm of Chicago to conduct an inde- Faltz Chuck Faltz, Ph.D.,76, involved enough lobbying in Congress settlement administrator will be given pendent investigation of the participation was a long-time resident of Palo Alto. and state legislatures that APA’s attor- deadlines for notifying members who of psychologists in developing and Faltz was a passionate advocate for neys said the association’s tax-exempt are eligible for payments from the fund implementing torture methods used in psychology and once served as chief of status could be endangered. As a result, and outlining how to go about making questioning at terrorist detention facili- forensic mental health services with the the APAPO was created in 2001 as a claims. ties in Guantanamo and Abu Ghraib. San Mateo County Courts and Correct- legally separate entity (although its Eligible members will have four ions Department. He received numerous board members are the same as those of options: file for compensation from the The American Psychiatric Associa- accolades during his 20 years with CPA, the APA) with a 501(c)(6) tax status that fund, forego filing and seek no compen- tion and the Red Cross issued total bans including the organization’s Silver Psi gives less tax exemption than the sation, seek to be excluded from the set- against their members working at the Award for service, a Lifetime Achieve- 501(c)(3) status of the APA but allows tlement to pursue separate legal action facilities once the tortures were broader lobbying. ment Award, the American or file objections to the nature of the set- revealed, but the psychological associa- Psychological Association’s prestigious tlement. tion did not. APA officials said it could It was at that point that the manda- Heiser Award for Advocacy and a not sanction psychologists involved Presidential Citation from the APA for tory/voluntary nature of the charge to Individual compensation will be because they were not APA members practitioners came into question. APA his “herculean efforts” on behalf of psy- prorated according to how much each and it was felt that ethical psychologists chologists across the country. could not hinge membership eligibility member paid in APAPO dues. The four should work at the centers to eliminate to charges imposed for the support of a Contributions may be made in his individual psychologists who filed court abuses that had come to light. name to the Multiple Myeloma Research legally separate organization. But the actions representing the class of individ- APAPO charge continued to be billed to Foundation, 383 Main St., Fifth Floor, uals eligible for reimbursements will be Many APA members were critical Norwalk, Conn. 06851. practitioners annually along with regular paid an additional $5,000 each for their that a total ban was not imposed and APA dues, sometimes including defini- active participation in bringing the set- some even dropped their APA member- tions of which members “must pay the tlement about. (The settlement covers ships as a result. Earn 1 CE credit Practice Assessment.” three suits combined for court considera- Hoffman is to investigate any APA for reading After the legal actions were filed, tion, two filed in Washington, D.C., and involvement at the facilities and whether APA and APAPO officials said the intent another filed in California.) APA’s response was improperly influ- this issue. was only to indicate that members had The law firms of Tycko and enced by any government-related policy to pay the additional charges to be repre- Zavareei LLP of Washington, D.C., and or financial considerations. His report is See Page 22 sented by the APAPO and not as a Wexler Wallace LLP of Chicago, which expected by May 1. requirement for APA membership. represented the plaintiffs, will receive up for details. That intent was not widely known until 2010 when Timothy R. Tumlin, Ph.D., a clinical psychologist in Darien, Ill., began questioning why some APA officers were “encouraging” members to pay the assessment, which most thought was mandatory all along.

In a series of exchanges over APA listservs, Tumlin and others questioned whether members had intentionally been misled to believe the APAPO assessment (which had grown to $137 a year by then) was mandatory. Kathleen C. Nordal, Ph.D., execu- tive director of the APAPO, finally issued a statement in April 2010 that the assessment was needed to fund the work of the APAPO, it was not required to continue APA membership. The National Psychologist sought Page 4 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T Page 5 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 MDInteractive, said he will charge the PQRS surprises many same $199 rate for 2015 for any psychol- ogists. Another option is to use the What’s the future of your practice? Continued from Page 1 Dementia Measures group if a psycholo- measures were so obviously correct, I felt gist has 20 patients with a dementia diag- Will you work harder and longer for less money? nosis, and at least 11 are Medicare Part B foolish not doing them and was glad to Will you struggle to fill your schedule? be reminded to do them. One example fee for service patients. last year was to assess depressed patients “For 64 patients with 230 sessions, it Will you enjoy your work or be drained by it? for suicidality and another required us to took me 11 hours to report my data,” said ask patients upon assessment whether or Bischmann, who used a registry for the . not they use tobacco, and if so, advise first time in 2014. “For 2015 as soon as “Wait and see” can be a risky strategy them to quit and offer help to do so.” the registry is updated, I will be reporting In early February, Pat Bach, Psy.D., it little by little.” Take charge of your practice now. Learn how to thrive, president of Psychologists in Longterm Some clinicians think they can wait until the end of the calendar year to do regardless of economic and political conditions – Care, organized a national conversation at this 2-day conference co-sponsored by: hour with three panelists, Amy Rosett, the screens and follow up plans with their Ph.D., private practitioner in Los Angeles patients. Bischmann said the measures The National Psychologist, The Practice Institute and who teaches seminars on PQRS, Dori are to be conducted at the time of the NASW-Ohio Chapter Bischmann, Ph.D., APA representative to clinical service. The data can be submit- the Physician Consortium for Perform- ted to the registry at one time. ance Improvement (PCPI) and me. Charlie Cooper, Ph.D., director of Building a Private Practice “Medicare is moving away from paying professional affairs for the North providers a fee based on the time spent Carolina Psychological Association, did a During Uncertain Times with patients. The idea is to focus on the cost analysis on registry reporting. In a quality, the ‘Q’ in PQRS,” Rosett said. phone interview, he said, “A psychologist June 12 – 13, 2015 She said, “People tend to overthink would need to do $9,950 of Medicare PQRS and make it more complicated. billing per year in order to break even Many of the measures are required only with the cost of a registry. If a provider is Mount Carmel East Hospital, Columbus, OH once per reporting period or per calendar using the claims-based method with 100 percent effectiveness, then the registry is year. If using claims-based reporting in Earn 12 CE credits bit.ly/June2015conference 2015, there are only six measures and an unnecessary cost. Providers should some can literally take 10 seconds.” work individual analyses to reflect their In 2015 there are 240 PQRS process own circumstances.” Presenters: Steve Walfish, Ph.D. and measures, 47 less than in 2014. Because fewer than nine measures are available The future of PQRS Pauline Wallin, Ph.D. for psychologists based on allowed cur- According to Bischmann, “The rent procedural terminology (CPT) codes, PQRS process is going to change and data from the claim forms will be ana- evolve. It is a relatively new strategy in Our goal is to deliver clarity and practical action steps lyzed by a process known as the MAV terms of measuring quality with a lot of for a profitable business, regardless of political or work ahead to develop meaningful meas- (Measure-Applicability Validation) that economic conditions. determines whether additional measures ures. CMS is moving toward reimbursing could be reported. in a way that financially rewards Panelists agreed the validation providers who show evidence of higher Get $50 discount off tuition. Use coupon code: 50off-tnp process should not prove problematic if quality and lower cost.” She urges psy- Before April 30, 2015 the reporting of six measures is done on chologists to participate, be involved and be part of the learning curve to be better at least 50 percent of eligible patients. More info and registration at: bit.ly/June2015conference Rosett said if the validation process indi- positioned when the quality initiatives are cates other measures were available, psy- more evolved and mandated. “Quality measures are here to stay.” chologists have the right to appeal. Continuing Education Credits: Psychologists are eligible to report CE ------on more than six measures if they partici- #333350— Social Workers - NASW is pate through a registry. “Currently Paula Hartman-Stein, Ph.D., is on recognized as a Continuing Education claims-based reporting is most popular,” Approver for social work CEUs by the the technical expert panel for the Elder said Bischmann. “CMS’s goal is to phase OCSWMFT Board. If you are audited Maltreatment Screening measure and out claims-based reporting. The big push provide the above number. This number chaired the first panel to develop meas- right now is registry reporting.” does not match the format for other ures for psychologists and social work- A downside of registry reporting is provider’s numbers because NASW is ers. She offers tracking templates for cost. APA has linked up with PQRSPRO a Continuing Education Approver rather claims-based and registry reporting and HealthMonix registry that gives psychol- than a provider. offers a set of DVDs: Achieve Success ogists who are APA members a discount- with PQRS: A Psychologists’ Guide for Counselors - NASW Ohio Chapter is an ed rate of $199 per year per provider, a Mastering the 2015 Measures that can approved Counselor CEU Provider by $100 savings. Paulo Andre, M.D., devel- provide two CE credits. Her website is: the OCSWMFT Board - #RCX071201 oper of another CMS vetted registry, www.centerforhealthyaging.com. Page 6 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T committee at all, Florida and Virginia. Strickland seeks Ohio teen’s suicide In Virginia, State Rep. Patrick Hope, D-Arlington, has reintroduced the leg- U.S. Senate seat islation that was defeated in committee last year. The Virginia Senate Educa- Ted Strickland, Ph.D., the first stirs conversion therapy discussion tion and Health Committee voted 7-8 psychologist to be elected to Congress and as a state governor, is seeking to By John Thomas, Associate Editor U.S. Supreme Court has turned down a in January to kill a bill sponsored by become the first psychologist to serve request for a hearing from opponents of State Sen. Louise Lucas, a Portsmouth in the U.S. Senate. The suicide of an Ohio transgen- the California law and a similar appeal Democrat, outlawing conversion thera- In making his announcement to dered teenager who was forced into has been filed by opponents in New py, but a similar bill in the Virginia run in the Ohio Democratic primary in conversion therapy treatment has jump- House is still under consideration. Jersey, following a lower court deci- May 2016, Strickland stuck to his In Florida, State Rep. David started the discussion about the need sion upholding its constitutionality. themes of being a member of a large for legislative bodies throughout the More recently, the Washington, Richardson, D-Miami Beach, is hoping rural Appalachian family and the prod- nation, including Congress, to prohibit D.C., City Council unanimously his bill will at least be assigned to a uct of a working-class background. the controversial practice for minors. approved banning conversion therapy committee for hearing, which it was “My father was a proud steelwork- The Dec. 28 death Washington, D.C., City Council approves denied last year. er and my hard-working mother devot- of Leelah Alcorn, 17, In Illinois, State Rep. ban on conversion therapy. ed her life to raising our family. I know of Kings Mills, a Kelly Cassidy, a Chicago how difficult it is to move up in this Cincinnati suburb, prompted the for minors in the nation’s capital. Democrat, and State Sen. Daniel Bliss, world, and the deck is increasingly Transgender Human Rights Institute of Council member Yvette Alexander, an Evanston Democrat, have intro- stacked against working people,” Princeton, N. J., and other groups to chair of the health committee, said the duced legislation in their respective Strickland said in his announcement to start an online petition drive to create a ban would end in the district what chambers calling for an end to conver- run against incumbent U.S. Sen. Rob federal law to prohibit conversion ther- nationwide “has been a problem for sion therapy for minors in that state. Portman, a Cincinnati Republican, apy for transgender, gay, lesbian and years.” serving his first term. bisexual youth. The petition, which The measure was sponsored by Cassidy introduced similar legisla- It appears Strickland and will be sent to President Obama and Mary M. Cheh. It was opposed by the tion during the last session of the Cincinnati Councilman P.G. Sittenfeld congressional leaders, has support from Family Research Council and Voices of Illinois legislature, but it failed 44-51. will face each other in the May 2016 more than half a million people. the Voiceless, an organization of ex- She later said that she had sought a Democratic Primary Election. gays, which said it will seek to over- vote too early. Equity Illinois said it Continuing, Strickland noted that Alcorn, who was born Joshua, See related story was creating an education program to “we are producing, building, creating committed suicide by stepping into the inform legislators on the negative and discovering more than ever before, path of a semi-trailer truck on Interstate Page 28 aspects of conversion therapy and con- and yet, for the middle-class, getting 71 near her home north of Cincinnati. turn the ban in court action. vince Gov. Bruce Rauner to sign the ahead has never been harder. I believe It appears that legislation banning The New York Legislature came bill when passed. that if you’re willing to work hard conversion therapy will be known as closest to approving such legislation every day and play by the rules, you shouldn’t have to go to bed worrying “Leelah’s Law” in her memory. when the lower house voted 86-28 last In Oregon, House Bill 2307 would about tomorrow.” Another national organization, the year to approve a bill sponsored by outlaw conversion therapy for minors, He said that the country needs to National Center for Lesbian Rights, State Sen. Brad Hoylman, a Manhattan but has yet to attract any sponsors. The create more living-wage jobs and recently announced the formation of Democrat. The measure, however, was Oregon Democratic Party endorsed invest in the kind of infrastructure proj- #BornPerfect: The Campaign to end never considered by the State Senate. such legislation in its platform adopted ects that benefit communities. Conversion Therapy. The San last year. Basic Rights Oregon is col- Strickland served one term as Ohio lecting signatures to force a vote on the Francisco-based group said its goal is In an editorial, The Journal News, governor during the Great Recession in to work with state legislatures to end a newspaper that circulates in the lower issue, known as the Youth Mental which Ohio lost thousands of jobs and the practice within five years. Hudson River counties of Westchester, Health Protection Act. lost by 2 percentage points to The story went international dur- Rockland and Putnam, readers were CE Republican John Kasich in 2010. ing the Golden Globe Awards event reminded that the state could be the when Jill Soloway, the creator of the first to enact a “Leelah’s Law.” series Transparency, dedicated the Hoylman has reintroduced the bill award to Alcorn and the transgendered (S121-2015) and the newspaper urged community. In her acceptance speech, that it be passed. “Children and their Soloway said she wanted the show to families must be protected from this teach its audience about “truth, authen- junk science,” the editorial said. ticity and love.” Hoylman’s bill has been referred Efforts by several states to ban to the Senate Higher Education conversion therapy during the last four Committee. or so years have largely failed after the Among the states that will see leg- California Legislature approved the islation seeking the ban on conversion first-in-the-nation law in 2012, fol- therapy are two where previous lowed by the passage of a similar attempts met failure by being defeated measure in New Jersey in 2013. The in committee or not being referred to Page 7 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 tact with mental health professionals in Mental health reporting requirement in New York challenged violation of the 14th Amendment’s equal protection clause and could deter By John Thomas, Associate Editor treatment for a sleep problem at weeks later returned for a 48-hour stay those who need mental health services Eastern Long Island Hospital. A por- that he claims was labeled “involuntary from seeking help. A Long Island man is suing New tion of the state’s Mental Hygiene Law admission” by the hospital. Montgomery claims his constitu- York Gov. Andrew Cuomo and other created under the SAFE Act requires The hospital, which is a defendant tional rights have been violated and is state officials seeking to overturn a mental health providers to report infor- in the suit, has refused to change the seeking treble damages, a declaratory portion of the state’s two-year-old mation on patients who may constitute admission to voluntary, which under judgment to strike down the mental SAFE Act that allows the confiscation a threat to themselves or the public. the SAFE Act would not have triggered health reporting provision of the SAFE of firearms on the basis on personal In his complaint filed in late the state’s action. Act, a preliminary and permanent mental health information. December in the U.S. District Court for The suit claims that law directly injunction on implementation of the Donald Montgomery, a military the Western District of New York in violates residents’ Second Amendment provision through the reporting system, veteran and retired police officer, Rochester, Montgomery said that he right to bear arms and the Fourth, Fifth an order requiring notification of any- claims that the SAFE Act’s mental visited the hospital in May 2013 th and 14 amendments by taking away one whose information was reported health reporting provision resulted in because he was having trouble sleep- that right without due process. under the system and an order to purge the Suffolk County Sheriff’s office tak- ing. He received a diagnosis of Montgomery also said the law dis- all electronic and paper records collect- ing four pistols he owns after he sought “depression: insomnia” and about two criminates against those coming in con- ed under the law. APA council adopts policy on psychologists in primary care By James Bradshaw, Associate Editor The discussion arose when the recommended in the federal healthcare one of the few items to draw much dis- council considered adopting as policy a reform known as Obamacare. cussion in a largely routine agenda Washington, D.C. – An effort to work group product called The standards, under study for considered by the council at the session boost participation of psychologists in “Competencies for Psychology Practice three years, cover broad areas, such as held Feb. 20-22. primary care settings could have the in Primary Care.” the science related to the The first day of the session was opposite effect in some jurisdictions, The standards are intended to “Biopsychosocial Approach” for devoted to continuing efforts to stream- members of the APA Council of guide practicing psychologists in train- healthcare, interdisciplinary coopera- line APA’s decision-making process to Representatives were warned at the ing they could pursue to enhance their tion and building and sustaining inter- allow faster reaction to changing cir- February meeting in the Capital Hilton work in primary care settings, such as professional relationships. cumstances. The system of requiring Hotel. the patient-centered medical homes A footnote of the work group council approval for almost all decisive report issued in March 2013 and posted actions has led to great delays as mat- on the APA website notes: “This policy ters wind through the twice yearly describes competencies that serve as council sessions with each tabling or aspirational goals for psychologists in insufficient handling leading to at least primary care settings.” six months of inaction. The problem is that regulators in The intent is to have a 12-member some jurisdictions – notably Missouri – Council Leadership Team make many are interpreting the competencies as of the day-to-day, nuts-and-bolts deci- minimum requirements for psycholo- sions, including some on financial mat- gists to practice in primary settings. ters, while the council would set over- The Missouri Psychological all policy and retain ultimate fiduciary Association submitted an amendment responsibility. to the policy in an effort to make it At the end of the first day, an clear the guidelines were intended to optional confidential session was held encourage continuing education by in which APA’s general counsel, psychologists working in primary care Natalie Gilfoyle, outlined the $9.02 but are “aspirational” rather than million settlement of a class action mandatory. lawsuit filed against the APA and the The policy was adopted without APA Practice Organization (APAPO) amendment. over assessments charged practitioner Past experience shows that regula- members since 2001. (See story on tors vary greatly by jurisdictions in Page 1.) how they interpret ethical and profes- Ancillary to the council session, a sional standards. Many jurisdictions, movement was begun to organize the for example, adopt the APA Code of various caucuses of practicing psychol- Ethics by reference and despite the ogists into an unofficial “super caucus” “aspirational” nature of some sections to represent their general interests concerning best practices licensing when the need arises. board investigators may determine any The caucuses, which may lobby shortcoming to be an ethics violation. The competency standards was Continued on page 11 Page 8 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T changed the risk corridor program to ACA’s current beneficiaries: insurance companies allow unlimited federal funding. Congress called the revision a “taxpay- By Dana Beezley-Smith, Ph.D. Enrollment in the government 224 percent. er bailout” of insurers and, notwith- health insurance exchanges, he says, is Since the law’s passage, big carri- standing industry protests, recently Any legislation as lengthy and “driving the carriers’ increased vol- ers are also enjoying less competition. forced the program to be budget neutral complex as the Affordable Care Act ume.” Major insurers are bullish in this The Government Accountability Office from 2014 through 2016. (ACA) will differentially impact vari- second year of ACA enrollment, and reports that from 2010 to 2013, the Physician and policy analyst Scott ous interest groups. The law, as passed, 2014 earnings reports explain why. In average dominance of the three largest Gottlieb believes limits to the risk cor- was an outline of provisions, with late January, UnitedHealth announced insurers in states’ individual insurance ridors are likely to pose “earnings details to be determined through thou- 2014 profits of $10.3 billion and rev- markets increased from 83 percent to woes” for insurers. sands of pages of Health and Human enues of $130.5 billion, reflecting a 86 percent, and in 42 states, 75 percent Services (HHS) regulations. gain of seven percent over 2013. of the 2013 individual market was con- SCOTUS ruling Court rulings and congressional “To put that in perspective,” writes trolled by three or fewer carriers. The New York Times reports that modifications mean the law will con- Wendell Potter of the nonpartisan since the law’s passage, the relation- tinually evolve, affecting different Center for Public Integrity, “United’s Backstop provisions ship between the administration and stakeholders over time. According to share price was $30.40” when the ACA One reason for insurer optimism is insurance companies “has evolved into health policy experts, the biggest cur- became law. “Since then, the compa- that the ACA contains mechanisms that a powerful, mutually beneficial part- rent ACA beneficiaries are the nation’s ny’s price per share has increased an offset carrier losses in the exchanges. nership that has been a boon to the largest insurers. The industry’s contin- astonishing 375 percent ... more than Through what is collectively known as nation’s largest private health plans.” ued profitability, however, is not guar- either the Dow Jones or Standard and the “3Rs” – risk adjustment, reinsur- In return, insurance carriers are anteed. Poors averages has grown during the ance and risk corridors – insurers providing the administration “crucial Tom Haynes, president of insur- same period.” enrolling expensive individuals receive support” in legal challenges to the ance brokerage TBP Solutions, Other major carriers are also expe- financial support from more profitable ACA. The industry’s latest assistance explains that the five major publicly riencing dramatic market gains. Since insurers and from federal funds. comes as an amicus brief for the feder- traded insurance carriers, WellPoint, the law’s enactment, Humana’s shares However, two of these provisions, al government’s position in King v. UnitedHealth, Aetna, Cigna and have risen by 309 percent, Cigna’s by risk corridors and reinsurance, expire Burwell, the only one of four “subsi- Humana, are “some of the brightest 305 percent and Aetna’s by 290 per- Jan. 1, 2017, and insurers must then be dies cases” currently granted a shining stars of Wall Street — and cent. Anthem saw gains of 238 percent more fiscally stable. Concerned about Supreme Court hearing. Obamacare is a major reason.” and HealthNet’s share price increased insurer losses, the administration These lawsuits maintain that the Douglas Lindquist, who heads the administration illegally extended pre- Psychologist killed by Iraq veteran FBI’s El Paso office, said Fjordback mium subsidies intended only for resi- had reported an encounter last year in dents of cooperative states that built Timothy Fjordback, Psy.D., who same .380 handgun to kill himself. an El Paso supermarket in which their own insurance exchanges. In left private practice after the 9/11 Serrato served in the Ohio Serrato threatened him, saying some- 2012, with most states indicating defer- attacks because he wanted to help vet- National Guard from 1985 to 1993 and thing like, “I know what you did and I ence to the federal exchange, the erans, was fatally shot Jan. 6 by a gun- joined the Army in 2006. Authorities will take care of it.” Internal Revenue Service approved man subsequently identified as an could find no evidence that Fjordback “It was something in public at a subsidies for enrollees in all exchanges, Army veteran who served five months and Serrato had any work-related con- grocery store where Mr. Serrato including those established by HHS. in Iraq in 2007. nection at the clinic and said Serrato approached Dr. Fjordbak, who did not If the King plaintiffs prevail, insur- The Associated Press and other was not a patient there. recognize him, and he made a verbal ers could be deprived of most of the news agencies reported that Fjordback, But, one of Serrato’s neighbors threat, and that was the extent of the $32 billion they expect to earn this 63, was killed on the fourth floor of the told KVIA-TV Serrato was let go from report. As far as we can tell, that was year, and more than 57 million El Paso VA clinic at Fort Bliss by 48- his clerk/intern job at the clinic last the only connection that they had,” Americans in the individual and group year-old Jerry Serrato. Shortly after year and blamed it on Fjordback. Lindquist said. markets would be freed of the ACA shooting Fjordback, Serrato used the According to The New York Times, mandate to carry insurance. companies will not authorize further Should the government lose its Neurofeedback and insomnia LETTER sessions unless we send patients to a case, HHS, recognizing the financial The article on Insomnia clients psychiatrist for a med. referral? hardship of exchange pools populated (Jan/Feb issue) was informative but after about 20 to 30 sessions of neuro- Metabolic syndrome attached to with expensive enrollees, recently ruled missed a treatment modality that is feedback. Additionally I have a number SSRI’s seems to be something that we that carriers may exit federally estab- extremely effective in the treatment of of patients who have gone off their don’t concern ourselves with as we lished exchanges. The court scheduled insomnia. CPAP (continuous positive airway pres- treat the mind, and not the body. oral arguments for March 4. A ruling is Neurofeedback as a method of sure) machines after neurofeedback. As an integrative psychologist who expected in June. brain training is being utilized by thou- The reason we do not hear about has been practicing for almost 30 years, ------sands of practitioners all over the world neurofeedback so much is because Big I wish I had been taught about neuro- for successfully treating sleep issues. Pharma runs our airwaves! The United feedback in graduate school. Addition- Dana Beezley-Smith, Ph.D., is a We have specific regions of the brain States and New Zealand are the only ally, there is a ton of research on the clinical psychologist in private practice that are highly successful in resolving two countries that allow drug compa- effectiveness of this modality. serving children, adults and families in insomnia. In my practice, I have had nies to directly market to their con- Green, Ohio. She may be reached at numerous patients who have completely sumers. Is it surprising to us as psy- Divya Kakaiya, Ph.D. [email protected]. gone off all their sleep medications chologists that many of our insurance San Diego, Calif. Page 9 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 often effective for a limited time. Such The ethics of leadership in psychology was the case with Attila, who served as king of the Huns from 433-453. By Stephen A. Ragusea, Psy.D. Ethical Principles that in all our work chologists seem to agree that leadership However, as Gandhi pointed out, “all as psychologists we should act with may be described as a “basic tension through history…there have been It is often said that psychologists “Beneficence… Fidelity and between altruism and egoism.” That is, tyrants…and for a time they seem have the most complex and demanding Responsibility… Integrity… Justice… some leaders balance the development invincible but in the end, they always set of ethics of all the professions. and…Respect for People’s Rights and of themselves and their subordinates, fall. Think of it, always.” Therefore, Whether or not that is so, we are clear- Dignity….” raising the aspirations of both the lead- from both ethical and effectiveness per- ly obligated to behave ethically in our That’s a significant list of ers and the led in the process…. Other spectives, it appears that more altruistic professional lives, and certainly provid- demands. We’re just human, after all. leaders wield power to satisfy their leadership based on inspiration is usu- ing leadership is part of that profes- But, we psychologists tend to demand own needs and have little regard for ally superior to self-centered intimida- sional existence. a lot from ourselves. either helping the development of their tion in most realms. The essence of leadership may be It is noteworthy and perhaps sur- subordinates or behaving in socially For that reason alone, it is would examined in a variety of ways and the prising that nothing in the Ethical constructive ways.” be wise for all of us involved in leader- ethics of leadership in the field of psy- Principles of Psychologists and Code When considering ethical matters, ship roles to remember that we are pri- chology may similarly be perceived of Conduct (2002) specifically address- both psychologists and business profes- marily there to serve our profession from different perspectives. Think es our leadership roles. Yet, psycholo- sionals tend to embrace models of lead- and our patients, not ourselves. And, about the problems caused by ethical gists function in leadership positions ership such as Transformational research suggests that we lead best by mistakes made by leaders that are sig- wherever they work and that includes Leadership. Within that model, leaders sharing a vision that inspires others to nificant parts of our collective history. their efforts within psychological provide a vision for change and then action. For example, the words Nixon, organizations. So, we must look to endeavor to inspire the other members In so doing, we embrace our core Enron and Madoff bring forth a flood other sources for guidance on leader- of the group to pursue that transform- ethical principles of “Beneficence… of memories about ethical breaches of ship ethics. ing vision. This model is seen as Fidelity and Responsibility… leadership that clearly impacted the A literature review quickly reveals morally superior and stands in contrast Integrity… Justice… and…Respect for recent past. Within psychology, the that little psychological research has to other models of leadership that People’s Rights and Dignity….” And, name Abu Ghraib now has special been done on ethics in leadership, involve the direct control of others that is our ethical obligation. CE meaning and the debate within psy- despite its importance in our world. In through coercive transactions. Such References available from author chology about our leadership role there fact, it seems that the subject of ethical transactional models are tempting for a ------is ongoing. These are extreme exam- leadership is more likely to be consid- variety of reasons. For example they Editor’s note: This article was ples provided to emphasize the impor- ered by business scholars than psychol- have the advantage of being, at least originally published as a column for tance of ethical leadership. ogists. However, there has been some temporarily, expedient. “The Ethics Corner” in The Florida As psychologists, our ethical stan- research and scholarly writing done by Indeed, transactional leadership Psychologist. Stephen Ragusea, Psy.D,, dards provide us with much general psychologists, which we can peruse. has been utilized in organizations and is in private practice in Key West, Fla. guidance. We are advised by our On a fundamental level, we psy- nations throughout history and is very His email is: [email protected]. Subscribe to The National Psychologist for two-years and SAVE $$

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City ______State______Zip ______Credit Card Number Phone: ______Fax: ______Expiration Date Email address ______Signature (required for credit card use)______Return this completed form with payment to: The National Psychologist, 620-A Taylor Station Rd., Gahanna, Ohio 43230 or call toll-free 800/486-1985; or see our website at: www.nationalpsychologist.com tnp3/15 Page 10 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T NPR interview or two, if they care to But the damage had been done. Both of learn more about it. But these review- us sent multiple requests to FIP’s slow- Online journals ers didn’t. Nor did they recuse them- responding and double-talking main selves, since admitting “I don’t know” office before everything finally disap- is about as rare in psychology as it is in peared – including the erroneous ver- can be predatory Congress. dict of “rejected” that was inexplicably By Judith Schlesinger, Ph.D. which we’ll get to later. But to a public The inevitable result was this: slapped on my piece, for all to see. eager for such “news,” a snappy sound Rather than addressing my actual work That’s why it surprised me, several I recently had a dismaying experi- bite can suffice; many Internet writings and the myriad supports I cited, they months later, when FIP asked me to be ence with the online journal, Frontiers exist simply to feed the bottomless kept pointing to what they were famil- a guest editor on “the special topic of in Psychology (FIP). I offer it here only content maw, regardless of quality or iar with, no matter how irrelevant – my choice.” Apparently their algo- as a cautionary tale, since your mileage truth. much like the drunk who hunts his rhythms don’t calculate prior bad expe- may differ. OJs claim that their peer review keys under the street lamp, instead of riences when churning out new invita- This decade has seen a seismic process legitimizes the entire enter- where they fell, because “the light is tions. And as I said, my unfortunate explosion of new online journals (OJs) prise. Although I once served as a peer better there.” Most bizarrely, the experience could well be a fluke. But I in every conceivable area, since they reviewer for FIT, and did a careful and reviewers kept complaining that I was choose not to cross that particular fron- have distinct advantages over print responsible job, this is not always the opinionated, although an opinion piece tier again. publications. For one thing, instead of case. is what I agreed to write. There are many legitimate OJs out requiring expensive subscriptions, they Incessant OJ recruitment is flatter- Despite every conciliatory conces- there, but it never hurts to be cautious. may provide “open access,” material ing until you realize how many invita- sion I could manage, they only became Jeffrey Beall is an academic research for free. For another, since they vet and tions have nothing whatever to do with more intransigent about the “wrong- librarian who’s been watching this phe- publish articles so fast, they help aca- your specialty – they might as well be ness” of my opinion. After the third nomenon for six years and offers a demics pile up those all-important cita- addressed to “Dear Occupant.” But FIP round of back-and-forth, I e-mailed the long list on his blog of “predatory pub- tions. was running a “special topic” on genius editor to withdraw my article from fur- lishers” to avoid. The blog is Scholarly They also provide a wider pres- and pathology, which is my expertise, ther consideration. I freely admit I was Open Access (http://scholarlyoa.com). ence across cyberspace and often trum- so I agreed to furnish a 2,000-word somewhat less than diplomatic in my Also on the blog search for and read pet this “impact factor” when they ask opinion piece on the topic. Like most assessment of the reviewers’ resistance. the article “The Dark Side of you to participate. Meanwhile, their academic writing, no money was But I figured that was okay, since this Publishing” by Declan Butler. credibility is enhanced by journalists involved. What was new was that any- was a private communication. ------who enjoy the new convenience and thing above 2,000 words required me Except … that it wasn’t. Suddenly economy of trolling for “scientific to pay them for the privilege of pub- my backstage message appeared on the Judith Schlesinger, Ph.D., is a psy- breakthroughs” with which to regale lishing it. site, displaying my frustration to the chologist, writer, musician and produc- their readers. To be fair, it didn’t help that I have whole interested world, including the er who put three decades of research In fact, that research may not be a minority point of view. This made it reviewers, who were now even less into her groundbreaking book The groundbreaking – or even particularly harder for FIP to recruit people familiar likely to respect my point of view (or Insanity Hoax: Exposing the Myth of scientific – at all. Growing alongside with my work, although anyone can me, for that matter). To her credit, the the Mad Genius. Her website is: the legitimate opportunities are vanity Google my book and professional and editor phoned me on a Sunday to apol- www.theinsanityhoax.com. Her email presses and scams of various kinds, popular writing, and even listen to an ogize for her breach of confidentiality. is: [email protected].

In what was billed at the nation’s mental health care professionals and largest-ever mental health workers’ Kaiser mental health workers hold one-week strike not enough people are completing the strike, members of the National Union more than 700 other Kaiser workers on handle the increased case load, the lengthy licensing process necessary to of Healthcare Workers walked off their the picket lines union charges. provide care. jobs in mid-January for a week at Those employees included medical Under the Affordable Health Care Kaiser, she added, is not the only Kaiser Permanente in California. social workers, speech pathologists, Act, Kaiser added 250,000 new clients mental health care provider suffering The 2,600-member union was audiologists, health educators and reg- last year. from a shortage of workers. She said protesting the company’s alleged fail- istered dieticians, who also reported The union claims that Kaiser is the state’s university system is also try- ure to adequately staff mental health problems caused by inadequate shifting resources that allows a shorter ing to serve too many patients with too clinics and charged that mental health staffing, the union’s primary concern. wait time for patients to see a mental few therapists. patients had been victims of Kaiser’s The union’s action against the health counselor, but then have to wait “chronic failure to provide its members healthcare giant follows by a few five or six weeks for a follow-up For its part, Kaiser said it contin- with timely, quality mental health months Kaiser’s paying a $4 million appointment. ues to provide quality care to mental care.” fine to the California Department of health clients and criticized the union Press accounts reported that the Managed Care for mental health viola- April Dembosky, a reporter for the for its walkout and refusal to accept a union, which has been without a con- tions. The agency charged that many San Francisco NPR station KQED who contract during the latest round of tract for five years since breaking off Kaiser patients seeking mental health has been following the story, said part negotiations. from the Service Employees care were forced to wait for weeks. of the problem seems to be that as a Kaiser has agreements with nearly International Union, staffed 65 picket result of campaigns that have sought to 30 unions covering nearly 100,000 lines at 35 Kaiser locations during the Despite agreeing to drop an appeal reduce stigma around mental health workers. The National Union of Health walkout. The strikers, which included of the state’s charges and pay the $4 services more people with mental Workers is affiliated with the psychologists, therapists and social million fine, Kaiser has not made any health problems are seeking treatment. California Nurses Association, which is workers, were joined at one point by improvements in hiring enough staff to She said there is a shortage of affiliated with the AFL-CIO. Page 11 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 those grants are needed to keep the Practice cacuses doors open at state association offices. As a result, a “very small states” cau- coming together cus split off from the caucus of State/Provincial/Territorial Continued from Page 7 Psychological Representatives to lobby for or against specific council actions, against the grant cuts. generally represent the specific inter- Those efforts, with the support of ests of a particular APA division or many other members, successfully group of council members. That means staved off the cuts and allowed those in the case of practitioner members, the states to maintain local offices. efforts are often splintered into diverse In a session of the “very small areas, such a psychoanalysis, independ- states” representatives before the full ent practice, clinical psychology, mili- state, provincial and territorial caucus tary psychology, etc. session, it was noted that no efforts Representatives of the practice have been made since to cut the organi- caucuses began collecting contact zational grants, meaning there is no information so that practice as a whole need to continue the very small states could be informed and called together caucus. It was disbanded by a unani- for united action whenever needed. mous vote with the note that it could One “splinter” was eliminated always be revived if the need arose. entirely in a caucus meeting the night before the council session. Belt-tight- A few benefits ening of the APAPO budget in 2011 threatened to reduce funds available for of subscribing: “organizational grants” to smaller * Earn 1 CE credit for states to $150,000 – a 40 percent cut. reading each issue For states with fewer than 200 * Reduced fees for TNP psychologists because of small geo- sponsored workshops and graphic size, such as Rhode Island, or sparse population, such as Montana, conferences Terrific Teaching Tools Emotions Emotions Our brightly Chart colored emotions Flashcards chart and flashcards help children learn and express emo- tions in therapy, at school and at home. Create your own games with these 11 cards, flexible therapy & teaching tools. (8-1/2 x 11) $9.95 + $2.95 p&h 1 page (8-1/2 x 14) To order go to: $2.50 + $2.95 p&h www.terrificteachingtools.com click on “Health and Science” then click on “Emotions” or call: 1-614-861-8000

Over 100 other teaching tools for all ages available on our website Page 12 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T Page 13 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 Risk Management Sorting through professional liability insurance

By Rachel Brusstar ments or incidents that occurred while your occurrence policy was in place, Professional liability insurance: the even if you allow the policy to lapse. difference between claims-made and For example, if a client you saw occurrence coverage, limits of liability, while your policy was in place files a extended reporting period ... the list complaint with your state licensing goes on when you’re looking at profes- board after your policy expiration date, sional liability insurance, and you may you can still seek coverage under your not fully understand what it is that occurrence policy. The same limits of you’re purchasing. liability that you had in place during The prospect of purchasing insur- the treatment dates will still apply, and ance can be daunting, and you don’t you don’t have to pay an additional fee always know where to begin, what to ensure that you’ll be covered. coverage options to look for or which A claims-made policy provides company to choose. coverage for claims while the policy is The one thing you do know is that in effect. If you want to have coverage you’re required to carry professional for the policy period after the expira- liability iInsurance. tion date, you would need to purchase Professional liability insurance an extended reporting period endorse- provides coverage for the professional ment or “tail coverage.” services you can legally provide as Price is also certainly an important a psychologist. This means that you’ll determination when purchasing insur- be covered in the event of a claim or ance. Occurrence form policies tend to suit that arises as a result of the treat- start at a higher base premium, but the ment you provided to a client price will stay the same from year to In today’s litigious society, you year. A claims-made policy will typi- can’t guarantee that you’re immune cally start at a lower premium than an from a liability claim, no matter how occurrence policy for the first year of good your intentions as a clinician. coverage. However, the premium will While there are many coverage increase each year until you reach the options included in a professional lia- “mature” rate. It’s also important to bility insurance policy, there are just keep in mind the premium that might two main options for types of policies: be owed for a “tail.” Occurrence Form Coverage and Claims We know there are many factors Made Coverage. that go into selecting professional lia- An occurrence form policy pro- bility insurance to protect your prac- vides life-time coverage for the period tice. You’ve worked too hard to go the policy is in effect. This means that without the appropriate coverage. you’ll still have coverage for any treat- Before making a decision, there are many factors to consider, and you want Psychologist imprisoned for fraud to be sure that you’re making the cor- Keenan R. Farrell, Psy.D., of rect choice for your business. Chicago, has been sentenced to 88 Occurrence policies tend to be rec- months in federal prison for billing ommended by insurance professionals Medicaid for psychotherapy services to if there is an option, as you’re truly skilled nursing home patients that he getting coverage for a lifetime, when never performed. you purchase an occurrence policy. As part of the scheme, Farrell, 55, CE submitted more than 31,000 Medicare ------claims over several years for psy- chotherapy services for nursing home Rachel Brusstar is a licensed patients he never saw, including many insurance agent and the marketing who were deceased at the time he sup- manager for CPH and Associates, a posedly saw them. leader in providing professional liabili- In addition, Farrell will serve two ty insurance for the mental health and years on probation and be required to social service fields. Her email is: pay $1,525,496 in restitution. [email protected]. By Paula E. Hartman-Stein, Ph.D. PQRS: a quality vaccination for behavioral healthcare he hue and cry among many called the commercial insurance companies and that all that counts? psychologists notified of a Physician the AMA engaged in a vociferous Whether we think participating in I 1.5 percent reduction in pay- Quality PQRS improves the quality of care of T debate. The AMA stance was that “best ments from the Centers for Medicare Reporting practice” measures should reflect basic our patients or not, the government and and Medicaid (CMS) this year as a Initiative (PQRI). competencies of healthcare that fill third-party payers think so. The penalty for not participating in a gov- An article in gaps of care based on research. Department of Health and Human ernment quality assurance program is the Journal of Commercial payers advocated for Services announced in January 2015 the perhaps understandable given the tight Hartman-Stein the American “aspirational measures” that would sup- goal of tying 85 percent of all fee-for- finances of most practices. Medical posedly raise quality a few notches. service payments to quality and cost But there have been ample warn- Association (Oct. 17, 2007) gave The AMA and non-MD providers were measures by 2016 and 90 percent by ings that changes connected to the momentum to quality reporting by not- allies on this point and the AMA stance 2018. Physician Quality Reporting System ing the public’s interest in healthcare prevailed. At the meeting all specialties The question of participation in the (PQRS) were coming, including the quality but still no standardized or con- were created equal and voted on all 73 quality movement in U.S. healthcare penalties that will grow to 2 percent sistently accurate quality measurements proposed measures. Because of the vote has principles similar to those found in next year for non-participants. existed. CMS then hired contractors at that meeting, psychologists, social the vaccination debate. We vaccinate Some psychologists who knew such as Quality Insights of workers and physical therapists were our children not only to protect their about the penalties chose not to partici- Pennsylvania that formed panels of pro- included in the bonus system in 2008. health but also for the health of the pate, criticizing its relevance and view- fessionals to create and modify “meas- In the past seven years, measures children around them. Some PQRS ing it as a conspiracy against mental ures” that are similar to best practices. have come and gone, more expert pan- measures have been created to increase health practitioners. A brief history The number of measures has els have appeared with financial penal- the safety and health of the population might give some perspective. grown from 73 in 2007 to 287 in 2014, ties arriving in 2015. Besides the finan- as well as lower costs. Screening for Crossing the Quality Chasm: A with 40 measures retired in 2015. The cial carrot and stick process, pressure to and educating about weight, smoking, New Health System for the 21st rules change over time, but in 2015 participate began in another way in elder abuse, pain, what meds a person Century, published in 2001, is an early providers must report on nine across at 2014 with the creation of the Physician is taking and mood are aspects of publication that aligned incentives in least three public health domains (if Compare website. All providers who behavior patterns that keep people healthcare payments to accountability there are nine available based on CPT accept Medicare payments can find healthy, out of hospitals and maybe and called to close the quality gap codes). their name on this public site in addi- even needing less meds. What a con- between research evidence and prac- PQRS initially offered small finan- tion to address, gender, year of gradua- cept! Aren’t psychologists supposed to tices of care. cial incentives to encourage buy-in. The tion from a doctoral program, and help their patients have healthier life In 2004 the Ambulatory Care highest bonus was 2 percent for report- notice of PQRS participation in 2013. styles, not just deliver protocols to treat Quality Alliance (AQA), a national ing three quality measures on 80 per- In the near future quality ratings will be mental health symptoms? coalition of more than 135 organiza- cent of eligible patients in 2009 and published for individuals and group If neither financial penalties nor tions, formed to improve healthcare 2010. practices. performance ratings are sufficiently quality. In March 2007 CMS convened a Who’s to blame for so many not motivating to participate in PQRS, con- In December 2006, health econo- panel for Psychology and Social Work anticipating the penalties or the website sider whether you have any responsibil- mist Jim Hahn informed Congress for to develop three “best practices.” I data? Is it the individual practitioners ity to improve the overall health of your the need to align payment with quality became chair, appointed by APA for not staying abreast of the growing patients and prevent medical problems rather than quantity of services due to Division 12, Clinical psychology, quality movement in healthcare? Is it via life style changes, similar to an the projected growth in Medicare over because of my work in 1990 on the their professional associations for not immunization but without chemicals. If the next 40 years. Also in 2006 the Resource-Based Relative Value Scale alerting them sufficiently? Or is it CMS the answer is yes, then participate in Institute of Medicine (IOM) called for study at Harvard that determined reim- itself for burying PQRS notices in a PQRS, a flawed system that is bound to variable physician payments based on bursement. mountain of other bureaucratic notices? improve and someday may even come quality. At that time there was no infra- The committee consisted of two Who gets the blame really doesn’t close to measuring quality of care. structure for clinicians to report what other mental health practitioners and a matter. Those who didn’t get an early CE they did and no measures of quality of nurse with a master’s in public health. start in PQRS should begin catching up ------care. The initial measures were screens for immediately because PQRS or another On Dec. 20, 2006 President George depression and cognitive impairment iteration is here to stay. Paula Hartman-Stein, Ph.D., is a W. Bush signed the Tax Relief and and the motivational interview tech- Some psychologists who have been practitioner, consultant and Medicare Health Care Act that authorized a quali- nique of getting the patient’s acceptance aware of the carrot-stick system chose correspondent for The National ty reporting system by CMS to reward of a treatment plan. to forego participation in PQRS Psychologist, who teaches others how clinicians if they met reporting require- At a historic meeting of the AQA because the money involved was small to navigate PQRS. Her website is: ments, giving birth to PQRS, initially in October 2007, representatives from potatoes in the grand scheme. But is www.centerforhealthyaging.com. By Omar Minwalla, Psy.D. ological treatment for perpetration- ‘Sexual sobriety’ focused management, clinical resolu- tion and psychological integration. he focus of traditional sex leaves victims untreated Clinical treatment would also include addiction-compulsivity relational, family and social considera- treatment models tends to be tional system in models and their suffering is being dis- tions, as indicated, in a perpetration- T an intimate rela- honored by the complete omission, on diagnosing and stopping specific victimization and post-traumatic clini- sexual behaviors, termed “sexual sobri- tionship or fami- silence and denial that pervade existing cal context and conscious framework. ety.” From a treatment perspective, it is ly system, is treatment models. They are dishonored The American Psychological correct and necessary to implement pathology and by the professional practice of being Association’s Intimate Partner Abuse behavioral containment and stop harmful, which satisfied with simple behavioral control and Relationship Violence Working destructive or problematic behaviors. is more accurate over specific sexual patterns (sexual Group concluded: However, this is where most treat- in description sobriety) as the primary objective of Minwalla “We suggest that those involved in ment ends, rather then also treating the then simply treatment. partner violence have specialized treat- other patterns of abuse of human “compulsive pornography use.” Victims need recognition of the ment needs and that those who treat beings and violations of human rights, The process of gaslighting an inti- patterns of harm and abuse they experi- them must do so with sensitivity and termed “sex addiction-induced perpe- mate partner – the intentional psycho- ence and have endured, which goes from a base of knowledge that comes trations” (SAIP). logical manipulation of victim’s reality way beyond the Pollyanna descriptions from specialized training. The problem is sexual acting out over time – is a form of emotional and of “hurt and betrayal” caused by spe- Psychologists who do not have the req- disorders are not just sexual behaviors psychological abuse and torture, erod- cific sexual acting out behaviors. uisite training potentially endanger but are also abusive conduct patterns ing and damaging the victim’s survival Furthermore, female victims are violat- their clients, and likely commit an ethi- and complex pathologic systems, instincts and intuition, regardless of ed further by being labeled “co-sex cal violation. Those who are teaching which often include elaborate deceptive sexual behaviors. Clearly, there exist addicts” routinely by professionals and psychologists-to-be but who do not compartmentalized sexual-relational many symptoms of pathology, beyond “educated that they have a disease of teach them about partner violence are realities and systems of abusive covert the single symptom of “lack of control self-perpetration” rather than being abrogating their responsibility and risk management. of specific sexual behaviors” or “com- afforded therapeutic intervention for perpetrating the conditions which fos- These are patterns of methodical pulsivity.” Sexual sobriety alone is an abuse and assessment and treatment for ter this problem. planning over time, careful construc- inadequate treatment model. consequent acute and complex trauma Perpetration requires treatment and tion of manipulation of others and cog- Sex addiction-induced perpetration (C-PTSD). appropriate clinical intervention, not nitive schemas well maintained in (SAIP) is clinical pathology. However, The Sex Addiction-Induced defensive denial, silence and profes- order to keep a compartmentalized within traditional treatment models Trauma Model (SAITM) accounts for sional avoidance. Clinical pathology reality protected from discovery. It there exists no established diagnostic or the clinical management and treatment that contributes to serious harm and takes pre-planning to sexually act out clinical formulation for SAIP and no of both sexual behaviors and SAIP. violation of others and human rights in many instances, sometimes requiring treatment, methodology or clinical par- According to the model, sex addiction- requires an organized clinical method- days of strategizing against the integri- adigm that accounts for and treats compulsivity disorders are defined as ology and direct clinical management, ty of vital relational stability and fami- SAIP. This is a serious omission in the “a complex system of sexual, personal- not undefined, underdeveloped or ly infrastructure required for health. field and in clinical practice. ity and masculinity pathology, which squeamish clinical approaches. Maintaining a compartmentalized The reality here is that the preoc- may include the maintenance of a After all and in fact, it is these sexual or relational reality within a cupation with diagnosing and treating deceptive, compartmentalized sexual- dynamics of sex addiction-induced per- family system and relational intimate these complex pathologies as simply relational reality, sexual-relational act- petrations that often “induce trauma,” life takes profound energy to orches- “compulsive” or impulse control disor- ing out behaviors and other patterns of do more human damage and accrue trate and maintain, requiring careful ders and focusing on treating sexual perpetration, abuse and violation that more human cost than sexual acting out and skilled methodology. This is not behaviors, while avoiding and omitting causes serious PTSD and C-PTSD behaviors alone ever possibly could. simply impulsive or compulsive sexual the proper diagnosis of abuse and (SAIT) in victims. CE behavior. covert violence, leaves dynamics of The model proposes clinical man- References available from author A disorder of chronic lying in a serious pathology untreated. agement that includes assessing and family system is pathology and This also means that the people diagnosing sex addiction-induced per------requires treatment, regardless of sexual harmed, the victims of these dynamics petrations and providing appropriate Omar Minwalla, Psy.D., is a acting out or not. Chronic patterns of of abuse, are rendered invisible. Their safety, stabilization and clinical de- licensed psychologist and clinical sex- establishing and maintaining a decep- trauma and experiences are not being escalation for victims. Clinical man- ologist. He is clinical director of The tive, compartmentalized sexual-rela- accounted for in clinical treatment agement would also provide method- Institute for Sexual Health. His website is: www.theinstituteforsexualhealth.com and his email address is: Be sure to see our website at: www.nationalpsychologist.com [email protected]. Page 1-B Vol. 24 No. 2 BOOK REVIEW SPECIAL SECTION March/April 2015

The Ethics of Private Practice but worth mentioning. For one thing, (2014) by Jeffrey E. Barnett, Jeffrey Ethics text is invaluable reference while they include some sample docu- Zimmerman and Steven Walfish. ments (such as a client termination let- with legal involvement are particularly rural environment where contact with Oxford University Press. New York, ter), they fail to include a sample of helpful. clients outside of the therapy sessions N.Y. Paperback $45. one of the most important documents, The organization of the book is is highly probable. The authors include The Consent to Treatment Form. Given also commendable, in large part a couple ethical decision-making mod- Review by Susan D. Rego, Ph.D. the technological changes in our world because of the summary at the end of els to help determine if a multiple rela- and the advent of social media, such a each chapter. These summaries include tionship is ethical, i.e., does no harm to “What do I do? I just got a sub- document would be very useful, espe- a list of “Ethical Challenges,” “Key the client. They also repeatedly stress poena.” cially for professionals who have prac- Points to Keep in Mind,” “Practical that when in doubt about any ethical “How do I handle confidentiality ticed for many years and are not well Recommendations,” “Pitfalls to Avoid” issue, consult a trusted colleague or when the parents of a teenager I’m see- versed in how to use email and other and “Relevant Ethics Code Standards.” mentor. ing want to talk to me?” technological advances as ethically as The importance of having a net- “A longtime client wants to invite possible. They are succinct and practical, work of trusted colleagues to consult me to lunch. Do I say ‘yes’?” My other complaint is that the providing psychologists and other men- with is a key point in the book and These are but a few of the ethical index is incomplete. For example, it tal health professionals with a quick bears repeating. The authors make the dilemmas psychologists in private prac- was difficult to find “Telepsychology” reference for a multitude of ethical point that practitioners tend to overesti- tice face on a regular basis. The Ethics in the index although it was discussed questions and concerns; particularly mate their capabilities and need input of Private Practice answers these and in some detail in the text. helpful when a practitioner needs from colleagues in order to practice many more ethical questions in well- Overall, though, these are minor answers quickly and doesn’t have the ethically and competently. organized, concise manner. The book criticisms. The Ethical Practice of time to scour the text for the relevant They suggest that clinicians who offers a useful, accessible and compre- Psychology is an excellent addition to information. The text too is reasonably don’t regularly consult with their peers hensive reference guide to the ethical any mental health practitioners’ refer- accessible. tend to rationalize problematic behav- challenges of psychology private prac- ence library. Even though the list price The chapter on multiple roles and ior and are more at risk of sliding down tice. of $45 for the paperback is rather boundaries is especially thought-pro- the “slippery slope” into unethical The multitude of ethical dilemmas steep, it is well worth the price. voking. The authors freely acknowl- behavior. that psychologists face in private prac- Psychologist Robert Wicks, edge that this area is not black and Throughout the book, Barnett, tice are explored, from starting a prac- Psy.D., says it best in his endorsement white, as some practitioners may Zimmerman and Walfish make a num- tice to retirement. of this book, “Reading the chapters is believe, but is nuanced and situational- ber of helpful suggestions, including The authors include chapters on like having a series of sessions with a ly specific. Having multiple relation- the recommendation that a practitioner general clinical practice, documenta- wise mentor who is helping you raise ships with one client may be fine, but create a “professional will” which tion, dealing with third parties and con- and weigh the most important options with others, harmful. names a colleague who would be fidentiality, financial issues, staff train- at hand before making a professional Sometimes multiple relationships responsible for communicating with ing, advertising and professional devel- decision.” are unavoidable or even therapeutically clients should the practitioner be opment. The sections on informed con- helpful, especially for practitioners in a unable to practice for an extended peri- sent and how to ethically handle cases References available from author od of time. This individual would assist patients with continuity of care issues. ------Clients would be informed of this Susan D. Rego, Ph.D., is a arrangement as part of informed con- licensed psychologist in private prac- sent. tice in Bethlehem, Pa. She specializes They also suggest that practition- in treating adults with depression, anx- ers who offer sliding fee scales have iety and eating disorders and offers patients sign an agreement to inform clinical consultation to mental health the clinician if their financial situation professionals. She serves as chair of should change, and they offer some the Ethics and Continuing Education excellent suggestions and an invaluable Committees for The Lehigh Valley reference for developing a social media Psychological and Counseling policy, a cutting edge issue which Association. She may be reached by deserves more of our ethical attention. email at: [email protected]. My criticisms of the book are few, Page 2-B T H E N A T I O N A L P S Y C H O L O G I S T March/April 2014 altered by decisions on a purely ration- BOOK REVIEW SPECIAL SECTION al level. Progressing, as Webb suggests we do, from what we have been told we Book on giftedness valuable for clinicians are to what we “really” are is in con- temporary terms a process, in dialogue, Searching for Meaning: Idealism, es his readable (if lengthy) treatment of is over Dabrowski’s larger theoretical of arriving at a differently-organized Bright Minds, Disillusionment, and such issues directly to a GT audience. view. While TPD includes considera- experience of ourselves. Webb’s exer- Hope by James T. Webb, Ph.D., (2103). For the practicing psychologist, tion of the social context of human cises are poignant, but may perhaps be Tucson, Ariz. Great Potential Press. this book provides a profound insight development, it is still a primarily most effectively done in conversation $24.95 into the GT world, a compelling intrapsychic theory, relying on con- with a trusted friend (or therapist). description of giftedness as a critical cretized metaphors such as dynamisms Although the way Webb makes Review by Thomas S. Greenspon, Ph.D. contextual treatment variable, and a and developmental potentials, describ- personal sense of the phenomena asso- valuable bibliotherapy tool for GT ing emotions as autonomous inner ciated with giftedness may be debat- Intellectual giftedness is a personal clients. forces which direct development. able, the basic issues he brings into quality which arouses both admiration To understand existential depres- There is also an implied maturity focus are not, and they are worth being and enmity. We stand in awe of people sion, Webb makes extensive use of morality, in which individuals are aware of in clinical settings. Giftedness who bring us stunning advances in Kazimierz Dabrowski’s Theory of ranked on a scale of human emotional entails a minority status for gifted indi- medicine or technology, yet the same Positive Disintegration (TPD) and of levels. Since well before Dabrowski’s viduals, who are hence vulnerable to individuals may have endured teasing the positive psychology and existential death in 1980, realms of inquiry from feelings of alienation and differentness. and bullying as “nerds” early in life. therapy literature. contemporary psychoanalysis to attach- Academic environments which do not Many children we call gifted and Dabrowski observed that intellec- ment theory and even developmental adequately challenge gifted students talented (GT) grow up with a sense of tual prowess frequently comes with neurobiology have shifted away from can have serious effects on their sense estrangement and aloneness. When super-stimulatabilities, commonly innate drives to affect regulation as a of agency or personal empowerment. combined with the nuanced awareness referred to as overexcitabilities (OE). prime source of motivation, and from The resulting anxiety can be para- common to giftedness, existential con- Children exhibiting OEs can easily be intrapsychic mechanisms to relational, lyzing; it is crucial that psychothera- cerns about such things as meaning- misdiagnosed with ADHD or anxiety- intersubjective systems views of affec- pists be aware of this. A major context lessness and personal finitude arise, related disorders (see Webb, et. al, The tive development. for effective relief is the experience of accompanied by feelings of anxiety and National Psychologist, July/August Although profound hopelessness a safe, understanding relational home depression. Jim Webb, a preeminent 2012). and depression can certainly lead to for the profound emotional states that psychologist in the GT realm, address- If I have a difference with Webb, it reassessment and renewed sense of occur. purpose, such episodes are not com- Webb’s book itself provides such monly viewed as representing intrapsy- an empathic connection for his gifted chic positive disintegrations. The anti- readers, and it can help interested dote to existential emotional estrange- clinicians provide it for their gifted ment, a disconnection, is the renewed clients as well. Definitely recommend- hope of connection engendered by the ed reading. emotional attunement of an empathic ------other. Webb argues additionally that as Thomas S. Greenspon, Ph.D., is a humans we invent ideals – “the illu- psychologist, marriage and family ther- sions around which we organize our apist and author in private practice in lives” (p. 29). Awareness of a discrep- Minneapolis with his wife, Barbara. ancy between these ideals, or what They work with gifted and talented ought to be, and what is, can open the individuals, couples and families and door to existential depression. are former co-presidents of the Minnesota Council for the Gifted and He offers exercises with which to Talented. Tom teaches a course on inti- challenge these ideals and their origins, macy and couple therapy at the as he himself acknowledges having Minnesota Institute for Contemporary done in response to conservative stric- Psychotherapy and Psychoanalysis. tures in his own upbringing. His email is: Rather than attempting to distin- [email protected]. guish reality from illusion, more con- temporary theory privileges a phenom- enological focus on the differing ways we might make sense of our experi- ence, as shaped by our particular rela- tionship matrix. Ongoing themes in our developmental relationships result in emotional convictions that form our sense of reality, which is not easily Page 3-B March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T Page 4-B T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 BOOK REVIEW SPECIAL SECTION terms while always remaining ethical in start” practices in these difficult times. Valuable tips on building a practice what we do. ------I wish I had the idea of publishing How We Built Our Dream Practice, and two psychiatrists. We did just that, this book based on my 43 years of busi- William C. Wester II, Ed.D., is a Innovative Ideas for Building Yours by complete with play therapy rooms, ness and clinical experience. I do not practicing psychologist in Cincinnati, Dave Verhaagen, Ph.D., and Frank rooms with two-way mirrors and a spe- hesitate in recommending How We Built Ohio. He is an ABPP diplomate in Gaskill, Ph.D. (2014) TPI Press, The cial kitchen for ourselves and staff. Our Dream Practice, especially for Counseling and Family/Couple and an Practice Institute LLC. $29.95. In addition to my business and mar- those new to our field. Those who have ABPH diplomate in Clinical Hypnosis. keting experience, I was vice president been around for a while may be able to His email is: [email protected]. Review by William C. Wester II, Ed.D. for academic affairs and dean of a local use some of the suggestions to “jump college for several years, giving me a This book brought back many won- well-rounded background for evaluating derful memories of when I built my this book. It is divided into four sections Book on DSM is lively reading “dream practice.” I was in a small group with 10 chapters: Build the Foundation, The Book of Woe. The DSM and the other reviewers overlook the fact that owned by the psychology chairpersons Create a Culture, Think Abundance, Unmaking of Psychiatry by Gary none of the DSMs provide boundaries to of Xavier University, Miami University Niche Down, Connect with Your Comm- Greenberg. Blue Rider Press, New York “mental disorder.” So there has been and the University of Cincinnati. We had unity, Market Relationally, Present Pow- 2013, hardcover. $28.95. nothing to expand. The “Not Otherwise a pretty impressive letterhead. erfully, Lead Well, Innovate Constantly Specified” category of DSM-IV and the As these individuals aged they and Build It and They Will Come. Review by Roger Peele, M.D. became interested in selling the practice. The authors base their practice on “Unspecified” category, of DSM-IV and and Marilou Tablang-Jimenez, M.D. Two of us bought it and moved offices FIRE – Fun, Innovation, Relationship DSM-5 respectively, provide clinicians a In 1850, the diagnosis of drapeto- several times. My partner became ill and and Excellence – and all 30 clinicians diagnosis for anyone who is mentally mania was proposed to describe a I bought her shares. We had always been work outside managed care. They clear- distressed or disabled. So long as we known as Behavioral Sciences Associ- ly discuss ideas for running a practice behavior of “Negroes running away have no adequate definition of the “nor- ates. I changed the name to Behavioral and how to hire the right people. They from their plantations.” After providing mal mind,” there is not going to be an Science Center Inc. and began to sell market in a variety of ways: free talks to us with this history and reminding us adequate definition of “mental disorder.” shares – the split was 70/30. the community and special divisions and that homosexuality was a mental disor- DSMs’ foundations were deter- My dream was to build our own programs within their practice. der until 1973, the reader is made aware mined largely by consensus and less fre- building to house about 30 psychologists They go on to say that you need to that medical diagnosing can, at times, quently by votes, not by science. For let the practice flow from your dreams, be appallingly wrong. Gary Greenberg, a many, that consensus organizes psy- from your unique calling and mission journalist and psychotherapist, reviews chopathology, an organization upon and from your personal and professional the development of DSM-5, including which empirical results of treatment are values. They seem to have lots of fun in its important tributaries. His interviews based. Greenberg exposes cracks in the their practice and have made their wait- with the DSM-5 developers provide foundation, none of which, however, ing room just as fun and comfortable. quotes DSM historians will find useful, reach the dangers of drapetomania. The authors stress the importance of as they cannot be found elsewhere. Furthermore, while Greenberg ques- finding your niche and being willing to While most writings on the devel- tions many aspects of the development say no to a referral if the issue is outside opment of DSM-5 will cure insomnia, of DSM-5, he is quite unclear as to what your field of practice. Having such a not Greenberg’s, especially for those he would prefer. Retain DSM-IV- large group has the advantage of refer- who like to read about conflicts. His TR? An alternative to the DSMs? This ring within the practice. lively writing style, his ear for irony and book pervades a negative critique of the They don’t get distracted if some- his sense of humor make for an interest- process that went into the development thing does not work for them. They ing read. Some will also welcome his of DSM-5, but suggests no alternative. stress presenting powerfully when giv- negative slant on the motivations and Near the end we are told that Allan ing free talks to the community. Their creditability of DSM developers, if not Francis, editor of DSM-IV, asked leadership team needs to lead well and on psychiatrists more generally. Greenberg, “Why do you hate psychia- continue to develop skills and ideas. A key theme of the book is not trists so much? Is it because I pinched The last chapter is Build It and new: DSMs are not valid. What will not your cheek?” Readers will raise the They Will Come, which stresses taking be clear to readers is that the American same question, but Greenberg pro- risks, being bold and dreaming big. The Psychiatric Association has never vides no answer. authors reference many sources. claimed the DSMs are valid. DSM-I’s ------Some references from the business (1952) goal was reliability, not community could have also been includ- validity. The reliability goal of the Roger Peele, M.D., is chief psychia- ed, such as Revolutionary Retailing: The DSMs became even clearer with DSM- trist for Montgomery County gover- Complete “Wise Guys” Guide to Small III (1980). Moreover, no one has mment in Maryland. He was on DSM-III Business Management and Marketing by claimed that DSM-5 has an increase in (1980), DSM-IIIR (1987), DSM-IV Robert Kramer. validity over the prior DSMs. (1994) and DSM-5 (2012) Work Groups Those of us who have owned a The key issue in Greenberg’s book and Task Forces. His email address is: practice or are just starting out need to is the degree to which DSM-5 expands [email protected]. Marilou Tablang- realize that in addition to our profession- the concept of mental disorder. While Jimenez, M.D., is medical director of the al skills and calling, we are running a he captures these conflicts well, he and Montgomery County Crisis Center. business and need to think in those Page 16 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T unconscious effort to avoid facing Ethics for Psychologists clients’ disappointment or their own feelings. Holding the therapeutic frame with Closing a practice: practical, ethical and clinical dimensions every client through the very last ses- sion is critical. Failure to do so risks By Janet T. Thomas, Psy.D. NASW Center for Workforce Studies Another challenge involves the undoing the positive impact of work provides a helpful checklist for private potential for accelerated clinical work. done. After closing their practices with Opening a psychology practice is a practitioners (2012). Impending termination may awaken careful thought and planning, psychol- monumental endeavor requiring energy, past losses or clients may talk about ogists can begin the transition into the drive and determination. The skills Ethical Considerations issues that they had put off, feeling that next phase of their lives. CE required for clinical work are neces- Ethical responsibilities to clients this will be their last opportunity. sary, but not sufficient for initiating and continue through closing a practice and Former clients who receive notification Full references available from author sustaining such an entrepreneurial the termination of therapeutic relation- letters may request another session to ------endeavor. In addition to attending to ships. For example, APA Ethical say goodbye or to resume treatment. the practicalities, independent practice Standard 10.10 states that, “prior to ter- One psychologist described her Janet T. Thomas, Psy.D., licensed demands continual marketing and self- mination, psychologists provide preter- work during the weeks preceding her psychologist, has been in independent promotion to remain in the forefront mination counseling and suggest alter- retirement as “some of the most emo- practice in Saint Paul, Minn., since for referral sources and accessibility to native service providers” (2010, p. 14). tionally intense work I have ever 1991. She provides clinical and ethics prospective clients. Ethical Standard 3.12 requires psychol- done.” (C. O. Geiger, Oct. 3, 2014). consultation to mental health profes- Terminating a practice requires a ogists to “plan for facilitating services Consultation with colleagues at sionals, including those in the process complete reversal of the momentum in the event that psychological services this stage is helpful, if not imperative. of closing practices. She may be con- cultivated. This phase requires knowl- are interrupted” (APA, 2010, p. 7). Psychologists approaching their final tacted through her website located at: edge of tasks and challenges associated Notification includes providing sessions may experience impulses to www.janettthomas.com. with the practical, ethical, clinical and information about plans for mainte- transgress normal boundaries in an personal dimensions of discontinuation. nance, storage and access to records Closing a practice, like opening one, (Standard 6.02). Likewise, the termina- requires careful planning, diligent tion process has implications for confi- Special offer: effort and emotional preparation. dentiality and informed consent. Clients must authorize communi- 2015 Appointment Calendar Practical Considerations cation with future treatment providers Once the decision to close is made, (Standard 4.05) and be informed about for Mental Health Professionals the process begins with setting an end factors that may influence decisions This 8 1/2 by 11 inches calendar book date and working backward to deter- about participating in current treatment, has a durable cover. Unique features: mine the timing of other steps. such as the psychologist’s plan to appointment times in 15-minute intervals Notification of clients is among close. 2015 from 7 am to 8 pm; DSM-5/ICD-9-CM/ICD- the first considerations. The amount of 10-CM; Licensing Board Do’s & Dont’s (new); How to Use the ICD-10-CM (new); notice depends on circumstances pre- Clinical and Personal Challenges Appointment Calendar cipitating the closing. Serious illness or Client needs, including those relat- for mental health legal terms; CE record acceptance of a new position, for ed to therapist self-disclosure, session Mental Health Professionals form; more. example, may necessitate minimal content and time of termination, are Special price: $27.00 (includes p&h) notice. When the departure is planned, generally paramount in psychologists’ Ohio residents add 7.50% per book sales tax psychologists can establish a timeline clinical decisions. A decision to close a Cover: Navy Blue taking into account the types of treat- practice, however, is based on the psy- Please send me ______copies of the 2015 Appointment Calendar. ment they provide and client needs. chologist’s needs, a significant depar- That timeline may range from six ture from normal practice. Additionally, Name ______weeks to six months, and may be more psychologists have their own emotional protracted with longer-term clients, as responses. They may experience anxi- Address ______in a psychoanalytic practice. How far ety, guilt, ambivalence, excitement and City ______State ______Zip ______to go in notifying former clients also sadness. will vary. Psychologists must manage these Phone ______Email ______Other notifications include referral feelings, distilling out what would be sources, liability insurance companies helpful to share with each client. PAYMENT:____ Visa ____ MasterCard _____ Discover ____ Check enclosed and licensing boards. NPI numbers Clients may experience anger, disap- must be deactivated and provider pointment, indebtedness and gratitude, Acct # ______Exp. Date ______CVV Code _____ agreements terminated according to all with potential to stir emotions in the contractual requirements. psychologist. One retiring psychologist Signature ______Many authors offer suggestions commented, “It’s really hard when you about managing the emotional are grieving yourself, and you have to Order online: www.nationalpsychologist.com (McGurk, 2005) and practical aspects listen to your professional eulogy hour Mail: OPP, 620-A Taylor Station Rd., Gahanna, OH of closing a practice (Blakelee, 2014; after hour.” (P. L. Layton, personal 43230 or Phone: 1-800-486-1985 Heller, 2007; Holloway, 2003). The communication, Sept. 19, 2014). Page 17 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 Page 18 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T By Darlyne G. Nemeth, Ph.D., M.P., “Impact of Prescription Privileges on M.P.A.P. Psychological Practice” and the panel and Joseph Tramontana, Ph.D. How medical psychology was comprised of three Louisiana pre- In the November/December, 2014 scribing psychologists, one undergradu- edition of The National Psychologist, an ate assistant who was researching psy- article, written by Julie Nelson, Ph.D., really works in Louisiana chopharm training and me as the non- entitled, “Be careful what you ask for: prescriber. After telling the audience psychology at all levels. I now know needs of Louisiana citizens. I look for- RxP and psychology in Louisiana,” was how great I believed it was having psy- how to gracefully interact with medical ward to a very positive future for med- highlighted. As a follow-up, we wish to chologists to whom I could refer my and other healthcare professionals in a ical psychology and healthcare psychol- offer our personal and professional clients if I believed they needed psy- very collaborative way. Integrated ogy in our state and beyond. experiences of the collaborative nature chotropics, I told the following story: healthcare is the model of the future. of Act 251. During my clinical internship year, Having gone through the M.S.C.P. pro- Statement of Joseph Tramontana, a psychiatrist on the interdisciplinary gram, I can say that it provided an Ph.D., clinical psychologist and presi- Statement of Darlyne G. Nemeth, faculty admitted something to me at excellent precursor for what will soon be dent of the Louisiana Psychological Ph.D., M.P., M.P.A.P., clinical, medical “Happy Hour.” He said: “Joe, I am so the national standard. Association: and neuropsychologist and Louisiana’s impressed with the training film you To this day, I continue to consult Many years ago, I subscribed to the Representative to APA Council: made with that autistic boy. You know so and collaborate with medical practition- Prescribing Psychologists’ Register and As a member of the Louisiana much more about behavior than me. I’m ers for the benefit of my patients. One took the first course or two of their cor- Psychological Association, currently going to tell you something that if you absolutely marvelous result is the ease respondence curriculum, hoping that one serving as the APA Council repeat, I will deny. Psychiatrists study of sharing information. For example, day clinical psychologists would get Representative, and as a member of the medicine which they don’t practice – in many physicians have told me that, after privileges to prescribe psychotropic Louisiana Academy of Medical order to practice psychology, which they referring to a psychiatrist, they never medications to our patients. At some Psychologists (LAMP), I am in a unique don’t study.” heard from that practitioner again. This point, I lost interest, believing that it position to offer updated practice infor- This psychiatrist later became chief lack of feedback to the attending physi- would never happen. All along, howev- mation. My current practice at the of psychiatry at a state medical school. cian was one of the reasons why so er, I believed that, with appropriate psy- Neuropsychology Center of Louisiana The audience loved the quote and one of focuses on clinical, medical and neu- ‘Such collaboration (among medical doctors, RxP the panel members asked me to repeat it. ropsychological issues. Having been in In September 2012, prior to Illinois the first graduating psychopharmacology psychologists and non-RxP psychologists) is truly passing its RxP law, I was invited by class of the California School of a model for integrated healthcare.’ Beth Rom-Rymer, Ph.D., to participate Professional Psychologists (CSPP), I am in two workshops in Illinois (Chicago many neurologists and neurosurgeons chopharmacology training, psychologists in a unique position to offer perspective. and Springfield) to help in their efforts. supported our Louisiana law. would be the ideal providers for this Becoming a medical psychologist More specifically, one presenter was a Now, most physicians are very treatment. After all, I doubt any psychol- was not easy. First of all, there was the Louisiana prescriber (who was moving pleased with the information I provide ogist would disagree that we are the arduous three-plus years of post-doctoral to Illinois) and the other was me as a and feel comfortable picking up the most highly trained mental health disci- master’s training (M.S.C.P.) and two non-prescriber to talk about prescribing phone and calling me when the need pline. practicums, one with a neurologist and in Louisiana. arises. Oftentimes, for example, the When the prescription law passed in another with an internist. It was a multi- Rom-Rymer primarily wanted me to attending physicians and dentists will Louisiana, I was pleasantly surprised. year commitment. After graduating in show psychologists who were leery ask me to run drug/drug interaction pro- When I evacuated to Baton Rouge after 1999, I continued my full-time practice, about the movement that non-prescribers files to make sure that there will be no Hurricane Katrina, the CSPP was pro- while studying for the PEP exam. Upon are NOT “second class citizens” in the problems with medications that they viding psychopharmacology classes in successful completion of the PEP exam, psychology community. I shared all of choose to add. This level of collabora- Baton Rouge. When I learned that they I practiced with introductory supervision the above information about why I chose tion is truly remarkable. were offering the first semester (bio- and restriction for several years. not to pursue RxP privileges and let As remarkable is the level of col- chemistry and neurochemistry), which Eventually, with enough experience, I them know how effectively I work with laboration I experience with my clinical could count as 30 CEU hours without was granted the advanced practice desig- prescribers on a cross-referral basis, not psychology colleagues. Now, they are any commitment to complete the entire nation (M.P.A.P.). just within my office but throughout the free to consult a medical psychologist, program, I enrolled. One of my best experiences was the state. The workshop attendees also rather than a psychiatrist or non-psychi- At the time, I was writing the first collegiality I shared with so many other enjoyed the above story. atric medical practitioner. We work of my published books on hypnosis, and psychologists. For me, graduate school While I agree with Dr. Nelson’s together to develop a treatment program realized that I did not write one word was a competitive experience. Although concerns about many Medical that is in the best interest of the patient. that whole semester because I was I survived, there were many scars. The Psychologists (MPs) being regulated The attending physician, however, is always studying. I decided that because most healing process occurred during under the medical board, not the psy- never left out of the loop, so to speak. of my age and other interests (writing), I the years that I participated in the mas- chology board, along with a number of Such collaboration is truly a model did not want to further pursue privileges. ter’s degree program in clinical psy- psychologists’ concerns about Act 251, I for integrated healthcare. As one can Since, I was sharing office space with chopharmacology. There, I experienced disagree with some of her interpretations expect, there were many unfortunate dif- two prescribers and did not feel the need a collaborative model, which was truly about the chronology that led to that out- ficulties that led to this current state of for me to prescribe to be so great. remarkable. Even to this day, my friend- come. equilibrium. Any form of change is usu- Perhaps if I were in my 30s, 40s, or ships with my classmates have endured. I serve now as president of LPA, ally fraught with resistance and misun- even 50s, I might have viewed it differ- I know that I can call on any of them for last year was president-elect and for two derstanding. When change occurs, there ently. assistance and guidance. years before that was on the LPA are always unintended consequences. Shortly thereafter, I was asked to This collaborative model needs to There are now more than 60 medical participate on a panel at the 2008 APA’s be the basis for all graduate training in psychologists serving the mental health annual convention. The topic was Continued on next page Page 19 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 STUDENT VOICES By Samantha Sanderson (www.concussionconnection.com). Concussions complicate doctoral studies Being in a doctoral program with a One month before starting my doc- concussion is far from ideal, but I have toral program at Wright State exactly what I had in mind. much better. I was determined not to learned a lot about myself through this University in Dayton, Ohio, I was rear- I experienced anxiety and acute let my concussion steal my higher edu- process. If you find yourself in a simi- ended by a double tractor semi on my stress for which I received therapy and cation as it stole my sports career. My lar situation, my advice is to seek out way home from work. The next day, I had difficulty with attention and best friend/roommate is in my program services, advocate for yourself, know which was a Saturday, I experienced a memory. I developed a tremor in my and she was a tremendous support. She that you are not alone and believe that headache, nausea, fatigue and soreness. hands that affected my writing, and I helped me study, complete assignments you will get better. My mom wanted me to go to the had and remem------doctor due to her concern that I may vision Students who wish to contribute to ber impor- have suffered another concussion. As a problems “Student Voices” are encouraged tant dates. Samantha Sanderson is a third former Division I soccer player, I suf- that In addition, year doctoral student in clinical psy- fered multiple concussions, which made my to contact [email protected] my dad chology at the Wright State University resulted in a lengthy recovery and the ability to with their topic ideas bought me School of Professional Psychology in end of my soccer career. Although I read and a Dayton, Ohio. She is passionate about didn’t share her concern, I promised my ability to switch from looking up LiveScribe smartpen, which helped me working with collegiate student-ath- her that if I didn’t feel better by during class to looking down to take with lectures during my first year. letes. As co-founder of Concussion Monday I would go to the doctor. Sure notes very difficult. Fortunately, I Finally, I found support online and Connection, she strives to raise aware- enough, I went to the doctor and was spoke with my professors and they started a website with another athlete ness of the psychological impact of diagnosed with a concussion. were all understanding and supportive who has a history of concussions in concussions. She may be reached at: Unfortunately, one month was not of my situation and my recovery. order to bring awareness to the psycho- [email protected]. long enough for me to fully recover so After one year, I started to feel logical effects of concussions I started my doctoral program while I Once the client realizes they are speak- was still symptomatic. Between class- Why you cannot afford to practice without an office assistant ing directly with the therapist they will es, meetings, appointments and driving By Larry Waldman, Ph.D. decides to call your office that morning, be tempted to “tell their story.” This the 150-mile roundtrip to Columbus for did they decide to call just that day or presents a difficult situation, as the ther- For the past 20 years that I have treatment, the first semester was not had they been thinking about calling for apist is reluctant to cut off the conversa- presented to mental health providers on some time? Obviously, the latter. When tion. Thus, the solo therapist is spending how to develop, manage and market a that prospective new client calls, what more time without compensation, not to private practice, I have always asked RxP in Louisiana do they want? They want to speak with mention teaching the client they are members of the audience to raise their a knowledgeable person and schedule willing to work for free. Moreover, if Continued from prior page hand if they practice without an assis- their first appointment quickly. What during the “free scheduling phone ses- tant. Depending on the group and loca- Executive Council’s Board of Directors. they don’t want is to get a recording sion,” the client implies they might be tion, typically half or even more of the When the above “manipulations” were telling them to leave a message. suicidal, the therapist is now also faced providers acknowledge practicing solo. occurring, I was not involved in state When that prospective client finally with the duty to protect a client they When I question why this is the leadership. One of the goals of my presi- makes that initial call and gets a record- have never seen. case, the most common reason is cost. dency has been to recruit some of the ing what are they likely to do? Many Providers seeing only a few clients My response is always: “You cannot MPs who left LPA to re-join. Nelson’s will leave a message but many of them per day might get by working solo. But, afford to practice without an assistant.” constant attacks/criticisms of LAMP in will make another call – to the next ther- they are likely to remain small because On my three busiest days I see eight her newspaper, The Psychology Times, apist on their list. Again, one cannot they will have insufficient time to mar- to 10 patients. If I had to pull charts, re- makes that a difficult task. afford to be without an assistant. When ket their practice to make it a larger file them, answer the phone, collect, I can reiterate, however, that I new patients call my office they get a thriving one. reschedule clients, schedule new clients, believe having prescription privileges live person who can answer all their ------return “shopping calls,” make new files, for psychologists is a great enhancement questions and schedule them promptly. type letters, etc. I could see only half to our ability to provide quality services The first question I ask every new Larry F. Waldman, Ph.D., ABPP, is that many patients. Thus, I cannot afford to our clientele. client is, “How did you find me?” a licensed Arizona psychologist who has to be without an assistant. In conclusion, medical psychology (Every mental health provider should practiced in the Paradise Valley area of Aside from the cost issue there are really works in the state of Louisiana. ask this question.) I cannot tell you how Phoenix for the last 35 years. He is several other reasons why working with Patients are better served. Collegiality is many times they answer “Your office author of several books on treating ado- an assistant is necessary. enhanced on all levels and psychology’s was the first to answer my call.” lescents, marital issues and marketing a If you are running a one-person contribution to integrated healthcare is (Strangely, many new clients have private practice. His website is: shop, I believe you are sending a mes- even more robust. reported they never receive a return call http://topphoenixpsychologist.com. sage you are “small potatoes,” as my ------from other therapists. Those other thera- Dad used to say. To me it suggests a pists are busy filing and making charts.) This excerpted article originally lack of professionalism. I would think Nemeth may be reached at When the solo provider finds the was published in the November 2014 twice before using any service profes- [email protected] and Tramontana time to call back the prospective new issue of The Clinical Practitioner, the sional – attorney, financial consultant, at [email protected] client, assuming the client has not made online newsletter of the National CPA, etc. who worked alone. an appointment with another provider, Alliance of Professional Psychology When that prospective new client the conversation is likely not to be brief. Providers. Page 20 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T By Karla Steingraber, Psy.D. gets me out of the office and some turn Things I learned in 7 years as an ECP into friends. I just wish I would have Previously I wrote about the first started doing it sooner. three things that I’ve learned in my home town (if you’ve never heard of a ing experience. seven years of being an ECP: the newcomers’ club I highly recommend I used to hate “networking.” It was Get a mid-career buddy or mentor importance of getting involved, how you look it up online. These can be a so difficult “advertising” myself and I joined the council of my state it’s not about the location and the value great way to meet people in the same what I do. Elevator speeches – blech! I association and volunteered for a cou- of consulting. Here are three more boat as you who plan fun activities). avoided it, thinking I could get by just ple of projects and several mid-career things I learned. Regardless of what you choose, by doing good work. I found out the psychologists made themselves avail- get your face out there. Meet people. It hard way that that takes a lot able to me. It’s been really amazing. I Expand Your Horizons does not have to be purely on a profes- longer than the alternative. had been feeling so isolated and with This may mean joining a state sional level, it can be social (though I When you put effort into getting to just a little effort on my part I was association and getting involved in Second of a 3-part series know others they get to know you. rewarded incredibly. leadership – which has been the most They will actually think of you when I cannot thank these people rewarding for me – joining a consulta- suggest you conduct yourself profes- their friend or colleague needs a thera- enough as they’ve been tremendous tion group, your local chamber of com- sionally). When you start to get more pist. A personal referral goes very far. mentors, consultants and friends. merce, finding a group of diverse pro- fully integrated in your neighborhood And, of course like most things, it gets They’ve helped me with difficult fessionals or a newcomers’ club in your or in the town where you work it will easier over time. Now I actually enjoy eventually result in an enhanced work- it. Meeting new colleagues for lunch Continued on next page

it is more popular among younger world empathy followed by spending The power of ‘Like’ on Facebook users. more time communicating face-to-face In an as yet unpublished study pre- with others, less time using email and By Larry D. Rosen, Ph.D. I’m fond of and objects toward which I sented at the American Psychological less time playing video games. You get exhibit a smoldering passion. But give Association convention in August the best empathy from your friends Michael, a young high school stu- me a sunny day and some good music 2012, doctoral students Alexander who are actively doling it out online dent I am mentoring, celebrated his and there are few things I don’t like – Spradlin and John Bunce, Mark but are not big gamers or big emailers. seventeenth birthday recently. I saw which makes the button a notoriously Carrier, Ph.D., and I surveyed 1,390 The next time you are alerted by him a day or two later and wished him easy impulse click.” adults about their media usage, their Facebook that it is someone’s birthday, a belated congratulations and made From his excitement, it is clear level of “real world” empathy don’t just shrug and pass it by. Post a arrangements to take him out to dinner that “Like” meant a lot more to expressed face to face, their empathy happy birthday message on their wall, to celebrate. I asked how his birthday Michael than just a 127 impulse clicks expressed in any online modality and and don’t forget to click “Like” as was and he grabbed his smartphone by his Facebook friends. It meant much their perceived social support. The well. It does feel good and that’s really and excitedly showed me a long string more. I am sure that he would not results were interesting. what life is about, isn’t it? Having of Facebook posts on his wall. friends and knowing that they care and As I was reading them he said, ... it made Michael feel more than want the best for you. “Did you see that I got 129 ‘likes’? The best birthdays may simply That’s the most ever! Wow! What a liked; it made him feel loved. include a lot of well wishes (and birthday!” When I mentioned that “Likes”) on Facebook followed up by everyone was alerted that it was his voice this aloud, but it made Michael First, as you might guess, being gathering your all-important bonding birthday on the right side of their feel more than liked; it made him feel better at dispensing real-world empathy social capital from your real life friends Facebook pages he shrugged and said, loved. makes you feel more supported by your in the real world. It’s all about feeling “I know that, but it still feels great.” In a recently published study from real-world friends. However, so does better and gathering those feelings Michael demonstrated an interest- my lab on the impact of technology being better at dispensing virtual empa- wherever you can. They are real and ing phenomenon that appears to have and media use on psychological disor- thy. Is it the same? Not really. Real- they are important. amazingly strong power: The power of ders (which also formed the basis for world empathy is six times more ------“Like” (with apologies to Huey Lewis). my 2012 book, iDisorder: important than virtual empathy in mak- According to Facebook’s Help Understanding Our Obsession with ing someone feel supported BUT virtu- Larry Rosen, Ph.D., is a professor Center, “Like” is a way to give positive Technology and Overcoming Its Hold al empathy DOES make you feel sup- at California State University, feedback or to connect with things you on Us), we asked about the use of the ported – even when you know a social Dominguez Hills and the author of five care about on Facebook. You can like “Like” button on Facebook. media birthday “Like” most likely books on the psychology of technologi- content that your friends post to give The results surprised me. An came from being announced to all your cal social media. He may be reached them feedback or like a page that you amazing 52 percent of the teenage Facebook friends. by email at [email protected] and his want to connect with on Facebook. Facebook users of the iGeneration Further, using a path analytic website is www.DrLarryRosen.com. He So, what is it about having so (born in the 1990s) clicked “Like” model, we were able to show two is currently writing a book entitled, many people click “Like” on my daily or even several times a day. The important results: (1) spending more The Distracted Mind with neuroscien- friend’s birthday that made Michael Net Generation young adults were a time using social networks (Facebook) tist, Adam Gazzaley, MD, Ph.D., of the feel so excited and so happy? Victor close second with 45 percent followed and engaging in instant message chats University of California, San Pineiro of the website Big Spaceship closely by 32 percent of Gen Xers and predicted more ability to be virtually Francisco. sees it this way: 24 percent of Baby Boomers. It empathic and (2) being better at dis- “ ‘Like’ is a vast expanse, covering appears that Facebook users of all ages pensing virtual empathy was the best things I feel lukewarm about, things enjoy using the “Like” button, although predictor of being able to express real- Page 21 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 ECPs need mentors, consultants and friends Florida’s ‘Baker Act’ Continued from prior page keep you out of a lot of trouble if you have first figured out who you are and clients and they’ve supported me in my Sheriff wants more spent your true unconscious motivations for professional growth. They have intro- becoming a psychologist. duced me to others and opportunities I for mental illnesses If you don’t think you can afford it would not have been able to get so ask if you can afford the alternative – early on in my career on my own. Now getting into a heap of trouble with a Florida’s “Baker Act” that has been in effect since 2005 allows judges, law I am very integrated in the profession. I patient. A cheaper alternative would be enforcement officers, physicians or mental health professionals to seek up to 72 have gained a lot of confidence. And to read Freud, starting with page 1 of hours of involuntary institutionalization of persons who evidence signs of mental the cherry on this fine sundae is that Volume 1 and going through to the last illness and pose harm to themselves or others or self-neglect. they refer patients to me. page of Volume 23. It will take you The law was named for a Florida state representative, Maxine Baker, who had a strong interest in serving the mentally ill and sponsored the bill. Go to analysis some time and it may not always be The sheriff of Pinellas County, Bob Gualtieri, testified in February to a State I know, I know. This one is going palatable but you will learn about Senate subcommittee that what is needed to make the law protect the general pub- to ruffle a few feathers. I cannot human behavior, human psychology lic and those with mental illness is more money to hire mental health case man- emphasize enough the value of doing and yourself in the process in a way agers to follow up on Baker Act evaluations and see that the mentally ill get the your own intensive insight-oriented that is absolutely priceless. And if services they need. therapy early on in your career. You you’re squeamish about the terminolo- Gualtieri said more mentally troubled people need to be sent to hospitals learn about your psychological gy of ‘oral,’ ‘anal,’ ‘phallic’ and ‘oedi- instead of jails and law officers need better training on dealing with those who strengths and weaknesses, your blind pal’ – well I suggest you rush off to have mental problems. About 5,000 persons booked into the Pinellas County Jail spots. therapy. between 2011 and 2014 had been evaluated under the Baker Act the same year. I walked into analysis during grad To be continued … “Preventing the next bad act is monitoring them, case managing them and at school thinking I was only following a ------the same time also respecting their rights,” Gualtieri said in an interview with professor’s recommendation to us all WFTS ABC Action News of Tampa, Fla. and that I would walk out a week later Karla Steingraber, Psy.D., is a Gualtieri has been leading a move for mental health reform following the with a stamp of approval. It was mind- licensed clinical psychologist with arrest of Christian Gomez for the New Year’s Eve beheading of his mother. The blowing how much I learned about Aprioris Psychological Health Services sheriff said Gomez was off his medication despite a mental illness diagnosis and myself in those few years (and even in Skokie, Ill. She may be reached at: had not been checked on by any case managers. after I had left analysis). It will help to [email protected]. Page 22 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T Arizona seeks return of court- C.E. Quiz (earn one CE credit) appointed psychologists to board The Arizona State Legislature is considering a bill to change the way You can earn one (1) continuing and Code of Conduct (2002) specifical- Model (SAITM) complaints about psychologists education (CE) credit for studying each ly addresses: b. Sexual Sobriety Model appointed by family courts are handled. issue of The National Psychologist a. leadership roles c. Sexual Compulsivity Model Under legislation enacted in 2009, (TNP). This offer is made possible in b. respect for people’s rights d. Compartmentalized Sexual- when a judge in a family court appoints collaboration with Professional c. justice Relational System Development Resources, a provider d. fidelity a psychologist to work with contending parties, any complaints about poor per- approved by the American Psycholog- (Ethics) Closing a practice: practical, formance, ethical violations and other ical Association to sponsor continuing 4. Within the ______leadership ethical and clinical dimensions problems go to the judge rather than education credits for psychologists. model, leaders provide a vision for 8. Which one of the following consid- the Arizona Board of Psychologist Under this agreement, Professional change and then endeavor to inspire the erations concerning the process of clos- Examiners. That law prevents the Development Resources reviews TNP other members of the group to pursue ing a practice represents a significant board from considering complaints content in advance, selects substantive that transforming vision. departure from normal practice? articles, formulates the CE quiz and against court-ordered psychologists a. transactional a. Closing a practice, like opening maintains responsibility for the CE pro- unless a court finds a “substantial b. tyrannical one, requires careful planning, diligent gram. basis” to refer the complaint. c. transformational effort and emotional preparation After reading the articles marked State Sen. Steve Smith, a Maricopa d. transitory b. The timeline for giving notice to with a "CE" symbol in this issue, com- Republican, sponsor of SB 1439, said clients can be shortened to suit the con- plete the quiz by going to he introduced legislation to make all Sorting through professional liability venience of the psychologist www.pdresources.org/tnp and select the complaints referred to the psychologist insurance for needed coverage c. It is not necessary to notify issue for which you wish to take the licensing board because “many fami- 5. Which one of the following state- referral sources, liability insurance CE test. There will be a $10 fee for lies, particularly those in divorce cases, ments about professional liability insur- companies and licensing boards each quiz you take. Once you success- feel that their complaints aren’t being ance is accurate? d. A decision to close a practice is fully pass the test (requires 80% cor- handled properly because a judge may a. You can only guarantee that based on the psychologist’s needs, rect), you will be able to print your cer- not have the background to evaluate you’re immune from a liability claim if rather than those of the client tificate of credit instantly. Professional their concerns properly.” Development Resources maintains your intentions as a clinician are good secure records of your credits. b. An occurrence form policy pro- vides life-time coverage regardless of National Psychologist Quiz the time the policy was in effect Quiz Vol. 24 No. 2 c. A claims-made policy provides Submit Online & Save! March/April 2015 coverage only for claims that occur while the policy is in effect d. There is no way to have liability Save time & money by submitting your CE quiz online. Medicare penalties catch uninformed coverage after you allow a policy to Online test fee $10 (versus $15-$25 if mailed). Instant results. psychologists off guard lapse 1. Beginning in January 2015, all Medicare providers who failed to satis- PQRS: a quality vaccination for Learn how @ www.pdresources.org/tnp factorily report one process measure on behavioral healthcare one patient in 2013 began to receive a 6. According to Hartman-Stein, the ______payment reduction on their question of participation in the quality OR Use Form Below to Submit by Mail Medicare patients throughout 2015. movement in U.S. healthcare has prin- a. 1% ciples similar to those found in the Name: b. 1.5% ______. Address: c. 0.5% a. DSM-5 debate d. 2% b. vaccination debate City: State: Zip: c. carrot and stick process Ohio teen’s suicide stirs conversion d. morass of CMS beurueacrtic Phone: Email: therapy discussion notices Profession: 2. Which of the following states were the first in the nation to successfully ‘Sexual sobriety’ leaves victims State(s) of Licensure: License #: pass laws banning conversion therapy? untreated a. Florida and Virginia 7. The ______Mail quiz and payment b. Illinois and Oregon proposes clinical management that ($15 TNP Subscriber/$25 Non-Subscriber) to: c. Connecticut and Pennsylvania includes assessing and diagnosing sex d. California and New Jersey addiction-induced perpetrations and Professional Development Resources providing appropriate safety, stabiliza- PO Box 550659 | Jacksonville, FL 32255 The ethics of leadership in psychology tion and clinical de-escalation for vic- Make checks payable to Professional Development Resources. 3. According to Ragusea, nothing in tims. Please allow 3-4 weeks for processing. the Ethical Principles of Psychologists a. Sex Addiction-Induced Trauma Page 23 T H E N A T I O N A L P S Y C H O L O G I S T March/April 2015 Question and Answer brochures: Employment “Questions and Answers about Clinical The mobster and the shrink Hypnosis” and “Questions and Answers Albany, & NYC licensed psycholo- about Clinical Psychology and Whitey Bulger, the Boston mob- Bulger had been on the FBI’s Most gists to perform evaluations in our Psychological Healthcare” Written in ster serving two life sentences for rack- Wanted list for 16 years. He fled busy offices throughout NYS. Contact layman’s terms so clients can easily eteering, including direct involvement Boston in 1995 after being tipped off [email protected], apply to: learn about these aspects of psychologi- in 11 murders, traded autographed that his arrest was imminent. Bulger http://jobs.medcruiter.com/Company/ cal treatment. Cost: $27/100; $50/200. mugshots with a prison psychologist in was a brutal crime lord during the IMA/JobSearch . 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The psychologist was removed Join Peeradigm 30 DAY FREE ********** mobster persuaded the woman psychol- from the prison but reportedly is still TRIAL Meet with your peers in live, ogist, who has not been identified, to on the payroll. online meetings. Bring a case to review Lily Billing Medical: Specializing in lobby for the cell change and to let him Authorities are investigating or come with a professional/practice mental health medical billing. Instead write to Catherine Grieg, who is serv- whether she attempted to make money question. Share and learn new of a costly in-house hire, my reason- ing time in a Minnesota prison for har- from the photos and whether she will approaches to therapy and assessment able fees will save you headaches and boring a fugitive – Bulger. face any employment discipline or for ongoing professional support and money. I provide the highest quality Bulger and Grieg were arrested in criminal charges. Bulger’s notoriety development. For all licensed mental service and maintain an exemplary rep- Santa Monica, Calif., in 2011 after has made his likenesses valuable. A health professionals. See our website at: utation for my clients and myself. portrait of him as a young inmate at www.peeradigm.com or email us ar: Contact: Lily Azizi, Medical Biller, Child therapy games, toys, books, Alcatraz, reportedly drawn by a fellow [email protected] call: 310.701.8049 email: puppets, dolls, sand, sand trays, minia- inmate there, has been posted on eBay ********** [email protected]. tures, and more. Visit us at for bids. References upon request. www.childtherapytoys.com. Save 10% Johnny Depp will play Bulger in ********** by using coupon code "National an upcoming movie. Psychologist" when you check out. ********** Page 24 March/April 2015 T H E N A T I O N A L P S Y C H O L O G I S T What’s happening across the USA New Jersey judge rules group Alabama – The Alabama many of its older psychologists to Department of Mental Health is closing retirement. cannot claim homosexuality is a disorder the North Alabama Regional Hospital Michigan — Two “limited- A New Jersey Superior Court filed the suit against JONAH in mental health facility near Decatur in license” masters-level psychologists in judge has ruled misrepresenting homo- November 2012 on behalf of two for- June, but state officials told The Ann Arbor have filed suit in Detroit’s sexuality as a disorder in marketing mer JONAH clients, Benjamin Unger Tuscaloosa News that positions are federal court seeking unnamed com- conversion therapy services violates the and Chaim Levin, and two parents of available at three state facilities in the pensatory damages and attorney fees state’s consumer protection act, a sig- former clients. The suit also names Tuscaloosa area for the 150 employees after they were forced by state regula- nificant development made in advance JONAH’s founder Arthur Goldberg and whose jobs are affected. About 40 are tion to remove advertisements from of a scheduled June civil trial involving counselor Alan Downing as defendants. eligible for retirement, and the depart- Psychology Today. Judy Seldin and a Jersey City group promoting a cure The suit claims that the group used ment’s commissioner, Jim Reddoch, Karen Gottschalk claim their free- for same sex attractions. deceptive practices to lure plaintiffs said the state will work to find private speech rights were breached by a state In a suit filed by the Southern into their costly services for gay-to- sector jobs for those who don’t want to regulation that forbids so-called “limit- Poverty Law Center (SPLC) against straight therapy that can cost in excess move from Decatur to Tuscaloosa. ed license” psychologists to advertise Jews Offering New Alternatives for of $10,000 a year. The SPLC said the California – Steven E. Clark, under certain circumstances. State reg- Healing (JONAH), Superior Court judge’s ruling marked the first time a director of the University of California, ulation requires master-level psycholo- Judge Peter F. Barsio, Jr. found that it court has ruled that it is fraudulent as a Riverside’s Presley Center for Crime gists to practice under supervision of is a “misrepresentation in violation of matter of law for conversion therapists and Justice Studies, has been awarded a already certified psychologists before (New Jersey’s Consumer Fraud Act) in to tell clients that they have a mental two-year $300,000 grant to create the striking out on their own and before advertising or selling conversion thera- disorder that can be cured. UC Consortium on Social Science and gaining the right to advertise. py services to describe homosexuality, not as being a normal variation of the Law. Members of the consortium New Hampshire – The New human sexuality, but as being a mental are international experts in a range of Hampshire Psychological Association illness, disease, disorder, or equivalent topics in the intersection of law and has hired Robert P. Blaisdell as execu- thereof.” social science, including inequality and tive director. Blaisdell, a professional The National Psychologist is pub- The judge also ruled that JONAH diversity, crime, juvenile justice and lobbyist since 1998, was formerly sen- lished six times a year in January, is in violation of the consumer fraud legal decision-making, according to a ior vice president of Demers and March, May, July, September and act if it offers specific success statistics university news release. Among topics Blaisdell Inc., a consulting company. November. Business and editorial to be studied are how witnesses make for its services when “client outcomes offices are at: 620-A Taylor Station Rd., decisions about reporting crime, how New York– The New York State are not tracked and no records of client Gahanna, Ohio 43230 Tel: 614-861- jurors make decisions in criminal and Psychological Association has created a outcomes are maintained” because 1999, Fax: 614-861-1996; civil trials and how judges make deci- Division of Cognitive Behavior “there is no factual basis for calculating email: [email protected]; sions and exercise judicial discretion. Therapy, bringing to 17 the number of such statistics.” Part of the evidence in Website: www.nationalpsychologist.com This publication is intended to Delaware – The Christina divisions in the organization. To fully the June trial will claim that JONAH implement the new division, 50 keep psychologists informed about Care Health System closed the Herman has misrepresented that their conver- practice issues. Contributions and let- NYSPA members need to join. On-line Rosenblum Child and Adolescent sion therapy works based on bogus sta- ters are invited. Editors reserves the Center in Wilmington on Feb. 20 and is registration for joining the new division tistics. right to edit submissions for clarity progressively shutting down its other ends Sept. 1. In an earlier ruling in February, the and/or length. Publication staff is not outpatient psychiatric services in an Pennsylvania – Susan Schecter- judge ordered that several of JONAH’s responsible for opinions or facts in overhaul of its behavioral health servic- Cornbluth, Ph.D., a Temple University witnesses – some of the country’s most bylined articles. es. Christina officials say the plan is to psychology professor, has been ordered prominent conversion proponents, Copyright 2015 by Ohio Psychology Publications, Inc. All rights move psychologists, social workers and to cease practicing psychology in including widely known supporter therapists who work in the outpatient Joseph Nicolosi, Ph.D., of the National reserved. Articles may be copied for Pennsylvania following an investiga- personal use, but proper notice of copy- programs to primary care practices for Association for Research and Therapy tion that alleges she lied under oath in right and credit to The National of Homosexuality (NARTH) – will not earlier diagnosis of mental illnesses. a in Bucks County court saying she Psychologist must appear on all copies. Iowa — The Iowa Psychological was licensed to practice in the be permitted to testify as defense This permission does not apply to Association has received a $50,000 Keystone state and New Jersey. She experts in the upcoming trial. The reproduction for advertising, promo- grant from the Telligen Community was charged with felony perjury and judge also excluded key conversion tion, resale or other commercial pur- Initiative to help fund its psychologist released on bond in early February. She therapy supporter Christopher Doyle, a poses. internship training program, which allegedly told a Bucks County court therapist associated with the The classified advertising rate is brings postdoctoral psychologists to that she was licensed to practice in International Healing Foundation and $9.00 per typeset line; about 35 charac- Iowa for one year of supervised clinical New Jersey and therefore didn’t need a Voice of the Voiceless; James Phelan, ters per line; six line minimum charge. Display advertising rates and mechani- work. The grant will allow one post- license to practice in Pennsylvania. She MSW, a frequent NARTH spokesper- doctoral psychologist to be placed in son, and John Diggs, M.D. cals are available upon request. The has entered into a consent agreement National Psychologist is not responsi- Ames under the supervision of Warren Judge Barsio said they were being and order with the Pennsylvania ble for content or claims made in paid excluded because their research is Phillips, Ph.D., a clinical psychologist Bureau of Professional and Occupa- advertising. unscientific and rests on the false at Central Iowa Psychological Services. tional Affairs admitting to never being Martin Saeman, M.S.W.,Managing Editor Phillips said one of the goals of the authorized to practice psychology any- premise that homosexuality is a disor- James Bradshaw, Associate Editor training program is to lure young psy- where as a profession or occupation, der. John Thomas, Associate Editor chologists to the state, which is losing according to an affidavit. The Southern Poverty Law Center ISSN 1058-6776