THE TABLET: Newsletter of Division 55 American Society for the Advancement of of the American Psychological Association Pharmacotherapy (ASAP) http://www.division55.org/TabletOnline.htm Volume 11, Issue 3 Editor: Laura E. Holcomb, Ph.D., MSCP November 2010 SPECIAL DOUBLE EDITION Water Buffalo Theology and RxP LCDR Michael Tilus, Psy.D., MSCP Kosuke Koyama‘s covered that there is much in the Bible position ourselves as Koyama describes delightful book about water! He theologized that God the people of Thailand did during the called Water Buf- rules from a place above the rains and monsoon season, as hiding under some falo Theology re- the floods. (Koyama‘s God stays dry.) room, avoiding the rain, as if ―watching flects on the late At the close of his little book, Koyama God‘s rain out there.‖ Above others, Japanese-American theologian‘s experi- generalized on the method he had been away from others, or in the rice paddy ence of being sent early in his mission- using in his efforts to understand what with the water buffalo- these images ary career by his Japanese church to he believed the Bible has to say to the inform our thinking about culture, and Northern Thailand. Up to that point, culture of northern Thailand. Missionar- our theologizing about culture, our psy- Koyama had spent most of his life in a ies, he reported, must find a place chologizing (my word) about theology, fairly comfortable urban setting, but where they are ―sandwiched between‖ and maybe even our own RxP Culture. now suddenly found himself in a place of the Bible and the culture to which God Strict biological reductionism keeps thousands of rice paddies. As he rode has called them. He continues on to say ―God dry‖ by insisting that its postulates around his new ―parish‖ on his motor they must then engage in a two-way are irrefutable and immutable. Psychia- scooter, Koyama discovered that most exegesis, working at two interpretive try holds the DSM in a god-like fashion, of the people he saw spent all their days exercises: They have to interpret the by verse and criterion, with determi- standing in shallow rice water, alongside questions and answers of the culture in nants that push people into that preor- massive water buffalos. During the on- which they find themselves, and they dained box. RxP may fall into the same slaught of the monsoon season, these all must bring those questions and answers two-way exegesis of being another holy day work schedules were usually fol- to the Bible, in order to interpret anew tablet that has its ―above‖-like refer- lowed with periods of more rain, during what God has to say about such mat- ence, feels no rain, and knows no peo- which everyone had to find some way of ters. ple. Or it can be the brief, 10-minute staying dry. I think I understand Koyama‘s interpre- visit ―away from‖ others who are in the Koyama made a decision to read the tative questions and the ―sandwich‖ rain, practicing their science from a cul- Bible as if he were standing alongside his metaphor, as they appear to highlight tural position which is ―god-like above parishioners, in a rice paddy, trying to my sense of what psychology, psychia- the rain,‖ never allowing themselves or maneuver that behemoth water buffalo. try, religion, and sometimes, RxP, do to their thinking (theologizing, psychologiz- He reports that suddenly passages of some degree. However, as opposed to ing, RxP-izing) to ―get in the rice paddy scripture and visual images leaped out at Koyama‘s theological need to have a with the farmer and his water buffalo.‖ him that he had never really considered ―God that stays dry,‖ I want a ―God that (continued on pg. 6) before. Koyama reported that he dis- gets wet.‖ Theologically, we could also Page 2 THE TABLET: Newsletter of Division 55 SPECIAL DOUBLE EDITION Table of Contents SPECIAL FEATURE SECTION: RXP IN THE INDIAN HEALTH SERVICE ASSISTANT EDITOR– LCDR MICHAEL TILUS, Psy.D., MSCP Water Buffalo Theology and RxP Mike Tilus, Psy.D., MSCP 1 Suicide Prevention at Spirit Lake Health Center Antonette Halsey, BS, MMgt 14 How a Medical Psychologist Enhances Teamwork and Patient Care LuAnn J. Stromme, DNP, FNP-BC 16 An Model of Collaboration Around Adolescent Asperger's Deb Hanson, LICSW 18 Combining Western Medicine and Traditional Native Healing Marissa Taylor, RN, BSN 20 The Perspective of a Northern Plains Dakota Elder and Social Worker Joanne Streifel, LICSW 23 A Pharmacy Director‘s View of Collaboration with a Prescribing Psychologist Cynthia Gunderson, R.Ph. 26 A Tag Team Approach with a Family Practice PCP and a Medical Psychologist Candelaria Martin, M.D. 27 My Experience as a Prescribing Psychologist at the Fort Peck Unit Bret Moore, Psy.D., MSCP, ABPP 30 A Prescribing Psychologist‘s Quest to Provide Culturally-Sensitive Care Mimi Sa, Psy.D., MSCP 32 Medical Psychologist to the Passamaquoddy Tribe Jack Martinez, Psy.D., MSCP, CCS 36 Journey to RxP at Fort Thompson Johna Hartnell, Ph.D. 38 Standing Rock and Other Motivations for Becoming a Medical Psychologist Anthony Tranchita, Ph.D. 40 My Tenure as a Psychologist for the Indian Health Services Vincent Barnes, Ph.D. 42 GENERAL CLINICAL ARTICLES AND COLUMNS From the Editor– Passing the Torch Laura Holcomb, Ph.D., MSCP 3 President‘s Column Owen Nichols, Psy.D., MBA 4 Interview with Robert M. Julien, M.D., Ph.D. Judith Julien, Ph.D. 45 Threats Within the Ranks: Violence Across the Deployment Cycle Robert Younger, Ph.D., MP, ABPP 49 Antipsychotics in Geriatric Patients: The Risk of Early Death G. Channing Harris 52 Psychiatric Taxonomy, Psychopharmacology and Big Pharma Lisa Cosgrove, Ph.D. 60 A Glimpse at an Evolving Practice Environment Pat DeLeon, Ph.D., JD, ABPP 64 Molecular Nutrition: A Missing Link in Pediatric Pharmacotherapy? Susana Galle, Ph.D., MSCP 68 The Self-Medication Question in Response to Stimulant Medication for ADHD: Brian J. Bigelow, Ph.D., C. Psych., 74 Who is at Risk for Addiction? ABPP Remembering Scott Borrelli Beth Rom-Rymer, Ph.D. 80 2011 Division 55 Midwinter Conference Information 81 Congratulations (to PEP Passers, Election Winners, Award Winners) 82-83 The Tablet, November 2010 Volume 11, Issue 3 Page 3 From the Editor– Passing the Torch Laura E. Holcomb, Ph.D., MSCP [email protected] You may have In addition to the wonderful articles ners, PLLC in Cedar Hill, TX, that pro- noticed that about the IHS, there were also enough vides professional mental health and this issue is a submissions of other types of informa- organizational behavior training, busi- bit larger than tive articles to fill an entire issue of The ness consulting, and psychological as- usual (OK, Tablet, with a range of fascinating clinical sessments. He is an APA Accreditation that‘s an un- topics. A special thanks to Mark Muse, Site Visitor, and has been a director of derstatement!). Credit is due largely to Ed.D., MP, ABMP for facilitating an inter- APA-approved psychology internships the vision and initiative of Mike Tilus, view with Dr. Robert Julien, author of and APPIC postdoctoral fellowships in who proposed a special feature section the recently updated (12th edition), A the past. on RxP in the Indian Health Service Primer of Drug Action, led by his wife Dr. Dr. Calvert will be assisted by Nicholas (IHS), and was willing to serve as Assis- Judith Julien. You won‘t want to miss Patapis, Ph.D., MSCP, who will serve as tant Editor for this section of this issue Dr. Julien‘s pre-conference workshop Associate Editor. Dr. Patapis completed in order to make this possible (Thank and presentation at the Division 55 Mid- his master‘s in clinical psychopharmacol- you, Mike!). You may have noticed the Winter Conference in DC in March, ogy in 2009 at Fairleigh Dickinson Uni- announcements of multiple awards he 2011 (see pg. 81). versity. He is in private practice in Phila- has received for his work with the IHS, This issue ends my 2 year tenure as edi- delphia, specializing in clinical psychology in prior issues of The Tablet. Please read tor of The Tablet. I have enjoyed having and forensic neuropsychology, and is a his article, Water Buffalo Theology and this opportunity to contribute to Divi- psychologist at Wordsworth Academy. RxP, to learn the inspiring ―back-story.‖ sion 55 and the RxP cause. He has authored numerous book chap- Thanks to all of the dedicated and de- ters and peer-reviewed publications on In 2011, your new Tablet editor will be termined professionals who have con- forensics and substance abuse. He was a James Calvert, Ph.D., MSCP. He com- tributed articles to the special feature National Institute on Drug Abuse Clini- pleted the master‘s in clinical psy- section on RxP in the Indian Health Ser- cal Research Fellow at the Treatment chopharmacology in 2007 at Fairleigh vice. Your stories paint a rich picture of Research Center, Department of Psy- Dickinson University. He is a licensed the spirit and needs of the Native chiatry, University of Pennsylvania Medical Psychologist in Louisiana. He is American people, and of the work you School of Medicine. a Board-Certified Diplomate-Fellow in are doing to deliver care to them under Psychopharmacology by the Prescribing Please welcome James and Nicholas by often challenging circumstances. I hope Psychologists‘ Register (PPR) and the submitting lots of articles for The Tablet that more psychologists with RxP train- International College of Prescribing Psy- in 2011. Thanks to all who have submit- ing will consider bringing expertise and chologists.