B

Psychotherapy

U
L
O F F I C I A L P U B L I C AT I O N O F D I V I S I O N 2 9 O F T H E
A M E R I C A N P S Y C H O L O G I C A L A S S O C I AT I O N

www.divisionofpsychotherapy.org

In This Issue

L
Psychotherapy Research Science and Scholarship
The Center for the Study of Collegiate Mental Health:
A Novel Practice Research Network with National
Reach and a Pilot Study to Match

E
Feature
A Bright Future for Psychological Assessment

Early Career

T
Reflections of an Early Career Psychologist:
How I Ended up Working at a VA Medical Center and
its Unexpected Rewards

I
Ethics in Psychotherapy
The Mandatory Reporting of Suspected Child Abuse and
Neglect: Ethical Obligations, Dilemmas, and Concerns

Perspective on Psychotherapy Integration

N
Research on Psychotherapy Integration:
Throw Away the Manual

2009 VOLUME 44 NO. 4

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Division of Psychotherapy 䡲 2009 Governance Structure

ELECTED BOARD MEMBERS
Pr esi den t Professional Practice Diversity
Nadine Kaslow, Ph.D., ABPP Jennifer Kelly, Ph.D., 2007-2009 Caryn Rodgers, Ph.D., 2008-2010
Emory University Department of Psychiatry Atlanta Center for Behavioral Medicine Prevention Intervention
and Behavioral Sciences 3280 Howell Mill Rd. #100 Research Center
Grady Health System Atlanta, GA 30327 Albert Einstein College of Medicine
80 Jesse Hill Jr Drive Ofc: 404-351-6789 Fax: 404-351-2932 1300 Morris Park Ave., VE 6B19
Atlanta, GA 30303 E-mail: [email protected] Bronx, NY 10461
Phone: 404-616-4757 Fax: 404-616-2898 Ofc: 718-862-1727 Fax: 718-862-1753
E-mail: [email protected] Education and Training E-mail: [email protected]
Pr esi den t-el ect Michael Murphy, Ph.D., 2007-2009
Jeffrey J. Magnavita, Ph.D. Department of Psychology Diversity
Glastonbury Psychological Associates PC Indiana State University Erica Lee, Ph.D., 2008-2009
300 Hebron Ave., Ste. 215 Terre Haute, IN 47809 55 Coca Cola Place
Glastonbury, CT 06033 Ofc: 812-237-2465 Fax: 812-237-4378 Atlanta, Georgia 30303
Ofc: 860-659-1202 Fax: 860-657-1535 E-mail: [email protected] Ofc: 404-616-1876
E-mail: [email protected] E-mail: [email protected]
Membership
Se cretar y Libby Nutt Williams, Ph.D, 2008-2009 A PA C oun ci l Rep resen tati ves
Jeffrey Younggren, Ph.D., 2009-2011 St. Mary’s College of Maryland Norine G. Johnson, Ph.D., 2008-2010
827 Deep Valley Dr Ste 309 18952 E. Fisher Rd. 13 Ashfield St.
Rolling Hills Estates, CA 90274-3655 St. Mary’s City, MD 20686 Roslindale, MA 02131
Ofc: 310-377-4264 Fax: 310-541-6370 Ofc: 240- 895-4467 Fax: 240-895-4436 Ofc: 617-471-2268 Fax: 617-325-0225
E-mail: [email protected] E-mail: [email protected] E-mail: [email protected]
Tr easur er
Steve Sobelman, Ph.D., 2007-2009 Early Career Linda Campbell, Ph.D., 2008-2010
2901 Boston Street, #410 Michael J. Constantino, Ph.D., Dept of Counseling & Human
Baltimore, MD 21224-4889 2007, 2008-2010 Development – University of Georgia
Ofc: 410-583-1221 Fax: 410-675-3451 Department of Psychology 402 Aderhold Hall
Cell: 410-591-5215 612 Tobin Hall - 135 Hicks Way Athens , GA 30602
E-mail: [email protected] University of Massachusetts Ofc: 706-542-8508 Fax: 770-594-9441
Pa st P res id ent Amherst, MA 01003-9271 E-mail: [email protected]
Jeffrey E. Barnett, Psy.D., ABPP Ofc: 413-545-1388 Fax: 413-545-0996
1511 Ritchie Highway, Suite 201 E-mail: [email protected] S tu dent Devel op m ent Ch ai r
Arnold, MD 21012 Sheena Demery, 2009-2010
Phone: 410-757-1511 Fax: 410-757-4888 Science and Scholarship 728 N. Tazewell St.
E-mail: [email protected] Norm Abeles, Ph.D., 2008-2010 Arlington, VA 22203
Dept of Psychology 703-598-0382
Dom ai n Repr esentat iv es Michigan State University E-mail: [email protected]
Public Policy and Social Justice 110C Psych Bldg
Rosemary Adam-Terem, Ph.D. East Lansing , MI 48824
1833 Kalakaua Avenue, Suite 800 Ofc: 517-353-7274 Fax: 517-432-2476
Honolulu, HI 96815 E-mail: [email protected]
Tel: 808-955-7372 Fax: 808-981-9282
E-mail: [email protected]
STANDING COMMITTEES
Fel lows Educati on & Training Ps ychotherapy Practice
Chair: Jeffrey Hayes, Ph.D. Chair: Eugene W. Farber, PhD Chair: Bonita G. Cade, ,Ph.D., J.D.
Pennsylvania State University Emory University School of Medicine Department of Psychology
312 Cedar Bldg Grady Infectious Disease Program Roger Williams University
University Park , PA 16802 341 Ponce de Leon Avenue One Old Ferry Road
Ofc: 814-863-3799 Fax: 814-863-7750 Atlanta, Georgia 30308 Bristol, Rhode Island 02809
E-mail: [email protected] Ofc: 404-616-6862 Fax: 404-616-1010 Ofc: 401-254-5347
E-mail: [email protected] E-mail: [email protected]
Membership
Chair: Chaundrissa Smith, Ph.D. Past Chair: Jean M. Birbilis, Ph.D., L.P. Associate Chair: Patricia Coughlin, Ph.D.
Emory University SOM/ E-mail: [email protected] E-mail: [email protected]
Grady Health System Continuing Educati on Ps ychotherapy Resea rch
49 Jesse Hill Drive, SE FOB 231 Chair: Annie Judge, Ph.D. Chair: Susan S. Woodhouse, Ph.D.
Atlanta, GA 30303 2440 M St., NW, Suite 411 Department of Counselor Education
Ofc: 404-778-1535 Fax: 404-616-3241 Washington, DC 20037 Pennsylvania State University
E-mail: [email protected] Ofc: 202-905-7721 Fax: 202-887-8999 313 CEDAR Building
Past Chair: Sonja Linn, Ph.D. E-mail: [email protected] University Park, PA 16802-3110
E-Mail: [email protected] Associate Chair: Rodney Goodyear, Ph.D. Ofc: 814-863-5726 Fax: 814-863-7750
E-mail: [email protected] E-mail: [email protected]
Nominat ions and El ections
Chair: Jeffrey Magnavita, Ph.D. Program Past Chair: Sarah Knox, Ph.D.
Chair: Nancy Murdock, Ph.D. E-mail: [email protected]
Prof essional Awards Counseling and Educational Psychology
Chair: Jeff Barnett, Psy.D. Liai sons
University of Missouri-Kansas City
Committee on Women in Psychology
Finance ED 215 5100 Rockhill Road
Rosemary Adam-Terem, Ph.D.
Chair: Bonnie Markham, Ph.D., Psy.D. Kansas City, MO 64110
1833 Kalakaua Avenue, Suite 800
52 Pearl Street Ofc: 816 235-2495 Fax: 816 235-5270
Honolulu, HI 96815
Metuchen NJ 08840 E-mail: [email protected]
Tel: 808-955-7372 Fax: 808-981-9282
Ofc: 732-494-5471 Fax 206-338-6212 Associate Chair: Chrisanthia Brown, Ph.D. E-mail: [email protected]
E-mail: [email protected] E-mail: [email protected]
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PSYCHOTHERAPY BULLETIN PSYCHOTHERAPY BULLETIN

Published by the Official Publication of Division 29 of the
DIVISION OF PSYCHOTHERAPY American Psychological Association
2009 Volume 44, Number 4
American Psychological Association

6557 E. Riverdale
Mesa, AZ 85215
CONTENTS
602-363-9211 Editors’ Column ............................................................2
e-mail: [email protected] President’s Column ......................................................5
Council Report ..............................................................9
EDITOR
Jennifer A. Erickson Cornish, Feature ..........................................................................11
Ph.D., ABPP Eat Hearty at the Table that is Psychotherapy
[email protected] Division 29 Awards Ceremony and Social Hour ....14
ASSOCIATE EDITOR Psychotherapy Research, Science, and
Lavita Nadkarni, Ph.D. Scholarship ..................................................................17
The Center for the Study of Collegiate Mental
CONTRIBUTING EDITORS Health: A Novel Practice Research Network with
Diversity National Reach and a Pilot Study to Match
Erica Lee, Ph.D. and Feature ..........................................................................23
Caryn Rodgers, Ph.D. A Bright Future for Psychological Assessment
Education and Training Membership Application............................................26
Michael Murphy, Ph.D., and Early Career ................................................................27
Eugene Farber, Ph.D.
Reflections of an Early Career Psychologist:
Ethics in Psychotherapy How I Ended up Working at a VA Medical
Jeffrey E. Barnett, Psy.D., ABPP Center and its Unexpected Rewards
Practitioner Report Ethics in Psychotherapy..............................................31
Jennifer F. Kelly, Ph.D. The Mandatory Reporting of Suspected Child
Psychotherapy Research, Abuse and Neglect: Ethical Obligations,
Science, and Scholarship Dilemmas, and Concerns
Norman Abeles, Ph.D. and Susan Perspectives on Psychotherapy Integration ............35
S. Woodhouse, Ph.D. Research on Psychotherapy Integration:
Perspectives on Throw Away the Manual
Psychotherapy Integration Division 29 Bylaws Changes Ballot ..........................37
George Stricker, Ph.D.
2010 Nominations Ballot ............................................39
Public Policy and Social Justice
Washington Scene ........................................................47
Rosemary Adam-Terem, Ph.D.
Exciting Times for Those with Vision
Washington Scene Practitioner Report ......................................................52
Patrick DeLeon, Ph.D.
Practice Update — November 2009
Early Career Feature ..........................................................................55
Michael J. Constantino, Ph.D. and A Psychotherapist’s Self-Care Guide for Our
Rachel Gaillard Smook, Psy.D.
Current Economic Debacle: Some Suggestions
Student Features Student Feature ............................................................58
Sheena Demery, M.A. Discerning Group Therapy Dynamics: Five of
Editorial Assistant Irvin Yalom’s Therapeutic Factors in the Context
Crystal A. Kannankeril, M.S. of Wilfred Bion’s Group Conceptualizations
Feature ..........................................................................63
STAFF Acceptance and Commitment Therapy (ACT)
Central Office Administrator and Anusara Yoga: Parallel New Horizons
Tracey Martin
Question & Concerns – 2010 Convention Hotel......70
Website Candidates For APA President ..................................74
www.divisionofpsychotherapy.org References ....................................................................77
1
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EDITORS’ COLUMN
Jenny Cornish, Ph.D., ABPP, Editor
Lavita Nadkarni, Ph.D., Associate Editor
University of Denver Graduate School of Professional Psychology
Division 29 welcomes Carl Rodgers had submitted a paper to
Mark Hilsenroth as another journal, but decided against
the new editor (as publishing it there since the editor had
of January 2010) of insisted on a writing a type of disclaimer
Psychotherapy: Theory, statement to accompany it; this article
Research, Practice, was published in the first issue of the
Training. Of course, journal much to Gendlin’s delight.
Charles Gelso contin- Many other luminaries also published
ues as editor through- papers in the journal under Gendlin’s
out 2009, continuing tenure including Albert Ellis, Erika
to receive and act on Fromm, Victor Frankl, Timothy Leary,
submitted manu- and Hans Strupp. Gendlin’s philosophy
scripts, and working was to focus on new ideas; he recruited
with those submitted open-minded psychologists as consult-
through 2009 but not ing editors, and would often edit articles
yet brought to completion. Hilsenroth himself, cutting material that had al-
provided his vision for the journal, ready been covered in the literature.
which is published in this winter issue This philosophy resulted in a “colorful
of the Psychotherapy Bulletin. As a way of journal” that was useful to psychothera-
welcoming him, we interviewed the cur- pists from all theoretical orientations.
rent and former journal editors about Along with the journal, PIAP made
their recollections and their recommen- other inroads into the APA culture, in-
dations for the new editor. cluding establishing Division 29, and
thereby providing a professional home
The list of journal editors and their for psychotherapists. When APA finally
many historic accomplishments is im- accepted symposia related to psy-
pressive indeed. Eugene T. Gendlin was chotherapy, but didn’t publish the infor-
first editor, serving from 1964 – 1975. mation in the printed program, Len
Gendlin reports currently that he is Pearson and others put up notices ad-
“doing very well, writing a lot of philos- vertising the symposia everywhere
ophy, and actively participating in the around the convention, including the
international Focusing Network” (com- restrooms! When PIAP members
prising over 4,000 people including 800 weren’t invited to the exclusive APA
certified trainers, and accessible at parties for “important people,” they cre-
www.focusing.org). He recalls that be- ated their own. Needless to say, the sym-
fore the journal was established, other posia and parties devoted to
journals (and even the APA convention) psychotherapy were quite well at-
refused to publish most papers related tended. Thus Gendlin became friends
to psychotherapy. Together with with many psychologists, even those
Leonard Pearson and Larry Bookbinder, outside his own interest areas, such as
Gendlin established the journal by print- Ogden Linsley, a Skinnerian, and was
ing articles at the University of Wiscon- able to grow the journal accordingly.
sin Press and giving the first issue to Gendlin recommends that future editors
members of Psychologists for the Ad-
vancement of Psychotherapy (PIAP). continued on page 3
2
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continue to focus on new ideas, con- was that the editor was king, rather than
sciously try to avoid bias, and open authors, as was true in publications in
themselves to learning, as he did when which scientific data had to be pre-
journal editor. served. Rather, his approach was to pro-
duce a journal that was actually useful
Gendlin was followed by Arthur L. Kovacs to practitioners, educators, and students
from 1976 – 1983. Kovacs recalls being re- as well as researchers. The journal’s re-
cruited to the editor position by Stanley jection rate was 75 – 80% and often more
Graham, then Division 29 President. He than 300 papers a year were turned
found being editor a “wonderful chal- down; Freedheim personally wrote to
lenge” and worked to create a structure each author, acting as an educator and
for the journal that included developing describing in detail what was needed to
a review board, finding a new publisher, strengthen manuscripts, focusing on the
redesigning the cover and artistic presen- work itself rather than on the writers.
tation, developing procedures to solicit He was “hands on” and edited papers
manuscripts, and publishing papers liberally, cutting superfluous material
grouped by themes. He credits Gene and even correcting grammar and sen-
Gendlin for his pioneering approach to tence structure. He inherited a separate
publishing articles from a broad range of gender editor to “de-masculinize” arti-
theoretical orientations, and to establish- cles, but soon learned to do it himself.
ing an excellent journal from the begin- Freedheim’s policy was to have one spe-
ning. Kovacs hopes that the journal will cial issue each year, often focusing on
continue its proud tradition of stimulat- special populations such as ethnic mi-
ing submissions from a wide variety of norities. He also had a particular interest
theoretical perspectives and avoiding be- in papers from international authors,
coming a mouthpiece for any particular and established a program in the APA
popular approaches. It is notable that International Office to recruit volunteers
after 50 years in practice, Kovacs remains to assist authors for whom English was
in full time independent clinical practice a second language. Freedheim reports
and also continues to teach part time that he was once described by an author
at the California School of Professional as “a nice guy but tough.” He believes
Psychology. an editor’s task is to be judgmental, yet
Following Kovacs’ successful tenure as they must use wisdom coupled with
editor, Donald K. Freedheim took the diplomacy and the desire to help. His
helm until 1993. He was encouraged by advice to Hilsenroth includes the recog-
Carl Zimet to apply for the position, and nition of the crucial position of an editor,
found it very rewarding. Although who can decide what work becomes a
Freedheim had already edited several permanent record in the field. The place
publications including Professional Psy- of the editor is generally to “stay in the
chology, he recalls his appreciation to Ko- kitchen rather than the living room” of
vacs for teaching him about the journal, the Division. He also recommends ac-
and for his smooth transition into the tively seeking out manuscripts, using
editor position as a result. Freedheim re- various conventions as mine fields for
ports that Kovacs has always been inde- ideas and future authors.
fatigable, and would often type long
memos on the plane to and from Wash- Wade H. Silverman was editor from
ington. During that time, everything 1994 – 2004, following his tenure as Psy-
was in hard copy; Freedheim’s graduate chotherapy Bulletin editor from 1987 –
assistant eventually introduced him to 1993. He reports that being editor of the
the computer. Freedheim’s philosophy continued on page 4
3
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journal was the “crowning achievement Gelso’s “heroes.” Another important

of his career.” In his heart he was “al- special issue focused on race, culture,
ways an academic,” and he thoroughly and ethnicity in psychotherapy, and
enjoyed the “honor of disseminating Gelso specifically asked clinicians to
knowledge” to his peers. He pointed out present case data and the “inner work-
the need for strong clinical skills in the ings of psychotherapy” in a way that
editor role. He found it inspiring to re- was very helpful for journal readers.
ceive excellent journal articles, and he Fred Leong and Steve Lopez served as
loved interacting with his many helpful guest editors of that issue with the idea
reviewers and the wonderful members to help imbed multiculturalism into psy-
of the Publications Board. For about half chotherapy practice. During Gelso’s
his tenure, he was in independent prac- tenure as editor, the review process has
tice; obviously his organizational abili- been computerized, and he has aimed to
ties were very helpful. Overall, get feedback to authors within 60 days.
Silverman concludes by stating that The journal currently receives approxi-
being editor was a “very positive expe- mately 150 submissions each year, with
rience.” His main recommendation to an 80% rejection rate excluding invited
Hilsenroth is to develop a thick skin, papers. Gelso sees the editor’s role in
since often journal editors receive more part as soliciting “growing edge pa-
complaints than appreciative comments. pers,” thoughtfully reading and re-
sponding to each manuscript, and
Charles Gelso has served as editor since continuing the practice review (an-
2005, following his previous 6-year nounced in each issue). When asked to
tenure as editor of the Journal of Counsel- give suggestions to Hilsenroth, Gelso
ing Psychology. Gelso states that he has says “respond to each author respect-
“always loved this journal,” and its fully, actually read each manuscript, and
“great mesh between theory, research, respond uniquely to each author (no
and practice” along with the “hetero- form letters). Gelso also recalls advice he
geneity of theories” presented. He re- received from his mentor Sam Osipow:
ports that he has greatly enjoyed his “if you have an hour to spare, use it to
time as editor. He credits Gendlin for work on the journal.” We might add that
setting the tone for the journal, and has this is useful advice for the editors of the
tried as editor to be respectful, thorough, Bulletin as well! Finally, Gelso wants to
and thoughtful in responding to au- acknowledge the great debt of gratitude
thors. As a practitioner and teacher, owed to his to his two associate editors,
Gelso has focused on creativity, good Drs. Nick Ladany and Lisa Samstag, for
ideas, and clinical relevance in encour- the wonderful editorial job they did dur-
aging and reviewing submissions. High ing their tenure, which accompanied
points of his tenure include editing sev- Gelso’s tenure. He also wants to express
eral special issues and sections such as appreciation to the members of his edi-
the December 2007 republication of Carl torial board, who have made major, if
Rogers’ famous “necessary and suffi- silent, contribution to psychotherapy
cient conditions” paper along with 11 through their thoughtful reviewing.
short reaction papers. It was “such an
honor” publishing this 50 year retro-
spective and to show the great and en- Jenny Cornish and Lavita Nadkarni
during impact of this work by one of (303-871-4737, [email protected])

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PRESIDENT’S COLUMN
Nadine J. Kaslow, Ph.D., ABPP
Emory University Department of Psychiatry and
Behavorial Sciences, Grady Health Systems
Thank You to new members, clarifying the roles and
Division 29 responsibilities of our domain represen-
It is with mixed emo- tatives, updating our bylaws signifi-
tions that I write my cantly (which will soon go to a vote of
final newsletter col- the membership), and revising our poli-
umn as President of cies and procedures. All of these
the Division of Psycho- changes have resulted in more positive
therapy. I am proud of and open communication among the
our accomplishments this year, particu- members of the governance group.
larly those related to my main presiden-
tial initiatives: diversity and Without a doubt, one of the highlights of
psychotherapy supervision. We have my year has been the opportunity to in-
two special issues that will appear in teract with members of Division 29, via
Psychotherapy: Theory, Research, Practice, email, telephone, and at the APA con-
Training that are focused on these two vention. I have learned so much from
topics. Our board was very committed these interactions and am heartened by
to seriously grappling with the theme of the commitment that my colleagues in
diversity as it plays out in board dynam- psychology have to the advancement of
ics, divisional priorities, and our mem- high quality psychotherapy – theory, re-
bership. We have made dramatic search, practice, and training. During
improvements in our website, with this past year, I was honored to have had
more exciting changes to come in this the opportunity to work collaboratively
expanded information and networking and effectively with new friends and
portal (http://www.divisionofpsycho- long time friends on the Division 29
therapy.org/). Our programming at the governance. We have a wonderful team
APA convention was outstanding and and I am particularly grateful to my
well attended and our lunch with the presidential colleagues, with whom I
Psychotherapy Masters was once again spoke every week and emailed more
a big hit for not only the students and frequently: Drs. Jeffrey Barnett (Past-
early career psychologists in attendance, President), Jeffrey Magnavita (Presi-
but also the master psychotherapists. I dent-Elect), and Libby Nutt Williams
am delighted to announce the creation (President-Elect Designate). They have
of the Charles J. Gelso Psychotherapy helped us move the division forward in
Research Grant. Annually, this grant will exciting and innovative ways. I also
provide a small sum of financial support want to acknowledge the other mem-
to a psychotherapy process and/or out- bers of our Executive Committee, who
come researcher. The naming of this devoted considerable time and energy
grant highlights our respect and admi- to ensuring that our minutes were de-
ration for the outstanding job that tailed, our budget well balanced, and
Charles Gelso has done at the helm of
our voices heard on APA Council: Drs.
the journal, as next year will be his final
Jeffrey Younggren (Secretary), Steve So-
year in this role. Finally, we have made
belman (Treasurer), Norine Johnson and
a number of changes to enhance the in-
Linda Campbell (APA Council).
frastructure of our governance, includ-
ing creating an orientation manual for continued on page 6

5
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Of course, much of the work of our or- possible. I have truly appreciated her
ganization rests on the shoulders of our guidance, wisdom, frequent emails, gen-
domain representatives. These individ- tle reminders, and thoughtful sugges-
uals consistently and impressively tions and insights.
stepped up to the plate to represent spe-
cific areas of interest related to psy- Because of the deep sense of connection
chotherapy: Drs. Caryn Rodgers and that I experience with members of the
Erica Lee (Diversity), Drs. Rosemary divisional governance, moving out of
Adam-Terem (Public Policy and Social the role of President is bittersweet. For-
Justice Domain Representative), Jennifer tunately, I am confident in the leader-
Kelly (Professional Practice), Michael ship abilities of my successor, Dr. Jeffrey
Murphy (Education and Training), Magnavita. I wish him the best and I
Libby Nutt Williams (Membership), will do my utmost to ensure a smooth
Michael Constantino (Early Career), and transition and another successful year in
Norm Abeles (Science and Scholarship). our division.
Dr. Jean Carter’s stewardship of the
Publications Board helped to ensure that What Makes for an Effective Leader
we offer our members the highest qual- As my term as Division 29 President
ity publications possible. Sheena De- draws to a close, it offers me the oppor-
mery, our Student Development Chair, tunity to pause and reflect on the ques-
was an outstanding spokesperson for tion of what makes for effective leaders.
student concerns and helped make our I grew a tremendous amount as a leader
division more welcoming to students. through my experiences with our mem-
bers and the governance group and I
Many significant divisional activities oc- trust that these learnings will serve me
curred under the leadership of chairs of well in future leadership roles. I believe
key committees and I am incredibly that much of the knowledge, skills, and
grateful to them for their contributions: attitudes that make for a competent and
Drs. Jean Carter (Publications Board), capable psychotherapist are parallel to
Charles Gelso (Editor of Psychotherapy: those required for effective leaders. I
Theory, Research, Practice, Training), Jenny hope these insights will encourage more
Cornish (Editor of Psychotherapy Bul- of you to become involved as leaders in
letin), Chris Overtree (Editor, Internet), our division, within APA and other pro-
Jeff Hayes (Fellows), Chaundrissa Smith fessional societies, in nonpsychology or-
(Membership), Jeffrey Magnavita (Nom- ganizations, in your home institutions,
inations and Elections), Jeff Barnett (Pro- as educators and scientists/scholars,
fessional Awards), Bonnie Markham and in your roles as advocates on behalf
(Finance), Eugene Farber (Education of a better world.
and Training), Annie Judge (Continuing
Education), Nancy Murdock (Program), Leadership is an action, not a position,
Bonita Cade (Psychotherapy Practice), and a process, not a task. Effective lead-
and Susan Woodhouse (Psychotherapy ers are intelligent and creative, have a
Research). strong work ethic and a high degree of
self-discipline, demonstrate a sense of
Governance members come and go on humor and capacity to be flexible and
an APA division board, but Tracey Mar- adaptable, and manifest undaunted cu-
tin, in our Central Office, remains a riosity. They recognize that the capacity
steady and permanent force in our or- to listen well is the cornerstone of good
ganization. She is the consistent thread leadership. Visionaries, strategic plan-
that keeps us connected and moving for- ners, and committed to action, they are
ward in the most productive manner continued on page 7
6
#"$!%

knowledgeable about themselves, the ties, experimenting, and taking risks.

people, the politics, and the issues. Able
to inspire, motivate, and guide others, I concur with the current zeitgeist that a
they are attuned to new opportunities collaborative approach to leadership is
and willing to take on novel challenges. optimal in most settings and situations.
They surround themselves with smart, This perspective means creating a sup-
dedicated, and capable people and are portive and positive workplace environ-
committed to retaining and developing ment, inspiring and communicating a
them. These interpersonally skilled, ver- shared vision, openly providing infor-
satile, and accessible individuals hold mation, conveying the rationale for deci-
onto their own values and high ethical sions, valuing and respecting others,
standards and maintain their integrity enabling others to act, strengthening
and honesty. They demonstrate loyalty people, and sharing power and leader-
to people and ideas. Capable leaders ship. Collaborative leaders master the
manifest wisdom with regards to their art and craft of empowerment. They em-
ability to see and understand issues, set power their team by actively listening to
priorities, and act prudently and coura- others, valuing the viewpoints of others,
geously. Fair, reliable, consistent, and developing people and organizational
sensitive in their dealings with others, capacity, looking for ways to advance
they are tenacious, motivated, and take the careers of those who work with
a lot of initiative. Competent leaders are them, putting themselves last, and not
able to on the one hand be reasoned and micromanaging. They encourage the
thoughtful, and on the other hand, dis- heart by recognizing individual contri-
play passion. They model values and be- butions and celebrating team accom-
haviors, focus on group and team plishments. They know that they gain
building, develop consensus, are inclu- power by giving it and that the more
sive, share power, delegate well, and are people feel power, the greater their satis-
competent at conflict management. faction in the workplace. They build
They create relationships that generate teams for the future.
clarity, commitment, and engagement.
A collaborative leadership style that in-
Effective leaders distinguish themselves
corporates the tenets of appreciative
as mentors; they are advisory by nature,
leadership is appealing. Appreciative
impart wisdom, care deeply about the
leadership represents a paradigm shift
career development of others, facilitate
based on the construct of appreciative
political navigation by their protégés,
inquiry, the art and practice of asking
can serve as objective consultants, and
questions that strengthen a system’s ca-
celebrate and reward their protégés suc-
pacity to apprehend, anticipate, and
cesses. People who are effective as lead-
heighten positive potential (David
ers are good communicators and engage
Cooperrider). Appreciative leaders en-
in all forms of social discourse at every
courage others to tell their story. Focus-
opportunity with those internal and ex-
ing on the system at its best, they see the
ternal to the organization. These indi-
positive behavior they want to develop,
viduals handle difficult conversations in
track the positive, and fan it across the
a straightforward and balanced fashion.
organization so people want to do more
They have the knack for avoiding mis-
of it. Appreciative leaders convey hope
takes that will haunt them forever, and
by creating inclusive communities;
when they make mistakes they ac-
searching for best practices; and creat-
knowledge and learn from them. In-
ing, validating, and spreading the mes-
deed, they consistently manifest
sage of hope (James Ludema). These
humility. Exemplary leaders challenge
the process by searching out opportuni- continued on page 8
7
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individuals combine effective manage- you see it. (Warren Bennis) • If you are
ment and leadership skills with high not coaching and teaching, you are not
emotional intelligence. Institutions popu- leading. (Jack Welch) • There is no limit
lated by effective leaders value perform- to what a (wo)man can do or where(s)he
ance management. Leaders in these can go if(s)he doesn’t mind who gets the
settings espouse a well-articulated vision credit. (Robert W. Woodruff) • A leader
and goals and ensure that bidirectional is a dealer in hope. (Napoleon Bona-
feedback processes are in place. These parte) • The best way to predict the fu-
processes support feedback that is direct, ture is to invent it. Remember, of course,
specific, developmental, positive, and there is a kind of growth in the leader-
presented in an appreciative fashion. In ship domains that only comes with
addition, they encourage people to be re- being a leader—in your work setting, in
ceptive to input feedback from their col- your community, or in another context.
leagues, subordinates, and superiors. (Alan Kay) • Don’t tell people how to do
things, tell them what to do and let them
General Electric’s (GE) model of leader- surprise you with their results. (George
ship (Jack Welch) is inspiring. It is based S. Patton) • Management is doing things
on the principle that optimal results right. Leadership is doing the right
occur when integrity and quality lay the things. ( Peter F. Drucker) • We have
foundation for all aspects of the organi- always believed that building strong
zation’s functioning and when the peo- leaders is a strategic imperative. When
ple and processes in the system facilitate times are easy, leadership can be taken
the creation of high quality products. To for granted. When the world is turbu-
support optimal results, leaders must lent, you appreciate great people. (Jeff
engage in the five Es: energy, energizers, Immelt)
edge, execute, and empathy. They must
have tons of positive energy and the There are many ways that you can be a
ability to energize others. They must leader within Division 29. You can run
have edge, the courage to make tough for an office. You can join a committee.
decisions. They must be able to executeYou can contribute to our journal, bul-
and get the job accomplished. Finally, in
letin, or website. You can apply for Fel-
the GE model, good leaders must have low status. Or you can engage in a
passion, a heartfelt and authentic enthu-
dialogue with me ([email protected])
siasm about life and work; a deep senseand other members of our leadership
of caring that their neighbors, employ-team about ways in which we can
ees, colleagues and friends win; and a strengthen our division, make it a more
love of learning and commitment to per-welcoming place, assure that we best
sonal growth. meet the needs of our members, have
a stronger voice within APA and for
The following are some of my favorite the public with regard to the value of
quotes. • Leadership is like beauty—it psychotherapy.
is hard to define but you know it when

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COUNCIL REPORT
Norine G Johnson, Ph.D. and Linda Campbell, Ph.D.
Division of Psychotherapy Council Representatives
President James Bray: APA ended the fiscal year with a deficit
Council started with of 4.9 million. It was made clear that for
a report by President 2009 a large deficit also loomed and that
James Bray on the APA could not afford to continue with
Summit of the future these large deficits. A board outline of
of psychology practice. APA’s plan to decrease the deficit by re-
Dr. Bray then filled ducing expenses in salary, reducing po-
Council in on his many sitions, and reductions in other areas
activities since the last was given. This will result in an impact
time Council met. on staff as there had to be staff layovers
in order to remain fiscally stable.
Norman Anderson’s
report: Considerable discussion occurred about
President Bray’s re- the budget item for Consolidated meet-
port was followed by ings in the Fall of 2010. The discussion
APA’s CEO Norman included the value of physically meeting
Anderson who gave an excellent update and the possibilities of finding other ways
on APA’s effort on Health Care Reform. such as electronic meetings for doing the
He stressed that APA’s priority activities work of Consolidated meetings. Discus-
included integrating mental and behav- sion then ensued about how to do the
ioral health care into primary care. He work of the organization differently.
further illuminated how the APA staff
was advocating to insure access to qual- Council accepted a budget projection
ity mental and behavior health promo- of $110,526,100 for 2010.
tion, develop and maintain a diverse Dr. Anderson asked Council to continue
psychology workforce, eliminate dispar- its work on the strategic plan. Votes
ities, increase federal funding, maintain were taken on the Goals of the organiza-
parity, and include strong privacy and tion and Core Values.
security records protection.
The three Goals were:
APA’s primary push remains with inte- Maximize organizational effectiveness;
grated health care. The organization’s Expand psychology’s role in advancing
advocacy staff is looking to secure a pro-health; and Increase recognition of psy-
vision in the health care bill to promote chology as a science. The Core Values
integrated, inter-professional care in pri-
(listed alphabetically) were: Diversity;
mary care settings; capacity building; Education and life-long Leaning; Ethics
and training programs to promote inter- and integrity; Excellence; Human wel-
disciplinary and team-based models. fare; Knowledge Dissemination; Profes-
sional practice; Scholarship; Science;
In a Senate bill, a section was included
Service, Transparency.
to expand funding to train psycholo-
gists, including in geriatric care, and a Council voted to receive the report on
definition of psychologists as health Interface between Psychology and
professionals. Global warming. This report and other
A significant portion of Council’s time reports can be found on APA’s web site.
was spent on financial issues. In 2008, continued on page 10
9
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A motion to propose language to Coun- and Change Efforts. The conclusion

cil that will resolve the discrepancy be- from the task force is that there is insuf-
tween the language of the Introduction ficient evidence to support the use of
and Applicability Section of the Ethical psychological interventions to change
Principles of Psychologists and Code of sexual orientation. These motions passed
Conduct and the Ethical Standards 1.02 Council practically unanimously.
and 1.03 so that these Standards can
never be used to justify, or as a defense Council voted that the delegates from
for, violating basic human rights was each of the four National Ethnic Minor-
passed. ity Psychological Associations be in-
vited to attend Council meetings for an
Council directed the Ethics Committee additional three years (2010-2012).
to revise the language in the Ethics.
A discussion about issues between APA
A motion was presented to approve a re- and the Insurance Trust occurred in
duction in the number of years in the Executive Session.
step up process of dues for Associate
members and Early Career psycholo- Council voted to support approving
gists. The motion was to decrease the the renewal of recognition of Assess-
number of years of reduced dues before ment and Treatment of Serious Mental
an early career or Associate member had Illness as a proficiency in professional
until needing to pay the full dues. Early psychology. And Council approved
career psychologists asked that the mo- an APA Designation Program for Post-
tion not be passed. doc Ed & Training Programs in
Psychopharmacology.
The bylaws will be revised so that a
member is dropped from membership
Archives: Council voted to reduce the
in the Association after non payment of
annual contribution to the Archives
dues in March instead of after a year that
of the History of American Psychology
could extend over two years.
to $20,000 in 2010 and that Council
The Media award for 2009 went to Car- must reauthorize the continuation and
oline Abraham and Nancy Shoot, re- amount of the annual contribution
porters with The Globe and Mail every 3 years beginning with the 2011
respectively, on mental health, stem re- contribution.
search, and genetics.
Dr. Barry Anton gave a report on the
Two motions on lesbian and gay bisex- APA National Conference on Under-
ual issues. Council voted to receive the graduate Education in Psychology. This
final report of the Task Force on the report is available on the APA list serve.
Appropriate Therapeutic Responses to Ninety thousand undergraduate
Sexual Orientation and on the Resolu- students graduate with a major in psy-
tion on the Appropriate Affirmative chology each year.
Response to Sexual Orientation Distress

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FEATURE
Eat Hearty at the Table that is Psychotherapy
Mark J. Hilsenroth, Ph.D.
Derner Institute, Adelphi University
I applied for the Edi- I also fully recognize that, in order to
torship of Psychother- have the most successful buffet experi-
apy: Theory, Research, ence, it must appeal to many different
Practice, Training be- palates, without shortchanging portion
cause, put quite sim- or content. As such, I believe the Editor
ply, I really love this of Psychotherapy must have a deep re-
journal. I love it be- spect for the diversity of perspectives in
cause it offers a smor- the field. I believe my own integrative
gasbord of all the essential elements of approach to treatment and research is
psychotherapy that I find so fulfilling. consistent with such a stance. It was
And I’m not talking about some skimpy with this goal in mind that I have assem-
haute cuisine sampling menu, but a bled an editorial board of psychologists
heavy buffet with a variety of different who represent an appreciation for the
foods, where one can come away feeling complexity of perspectives concerning
satisfied. And having eaten so heartily the treatment process. I wanted to in-
for almost the past two decades I clude people who don’t feel overly
wanted the opportunity to give back competitive with different theoretical
and help set this table for others in orientations, but rather possess a sense
search of a similar meal. of curiosity as to what others can offer
to their own perspective and approach.
Ever since I was a graduate student in In addition, as most approaches to ther-
the early 1990’s, when I used to borrow apy share similar constructs of interest
my graduate advisor’s (Len Handler) but not the labels for them, it was impor-
copy of the journal to the present, Psy- tant for me to find people who are able
chotherapy is the one journal that I try to to speak different theoretical “lan-
read cover-to-cover. I have found that, guages” and thus better able to effec-
even if an article is not in one of my ex- tively communicate to a broader
plicit areas of interest, my understand- community. While I have continued
ing of psychotherapy is expanded by it. about half of the previous editorial
Although, with my other responsibili- board, I also thought it important to in-
ties, it now may take me a month or two clude a healthy complement of new
to accomplish what used to only take a voices from these varying perspectives.
few days. Psychotherapy is still the one I believe such fresh appraisal will serve
journal I make certain to read in this to invigorate the suggestions, feedback
manner. I also try to read this journal in and discussion with authors during the
its entirety because my interests, both re- publication review process.
search and clinical, are highly consistent
I think this mix of perspectives is no bet-
with the content and breadth of the jour-
ter exemplified than in the three Associ-
nal that range the full spectrum of topics
ate Editors, or perhaps Executive Chefs,
in the field of psychotherapy. This is
who will be collaborating with me to or-
why I believe I fulfill one of the most im-
ganize this dining experience. First, I am
portant criteria for a new Editor of any
thrilled that Lisa Wallner-Samstag has
journal, an absolute passion for ‘what’
that journal does. continued on page 12
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agreed to continue on in this position; conversion of the review process to an

she provides some much appreciated electronic format. Not a small feat I’m
continuity to this transition. Lisa will sure, but essential in the times we live.
also continue her work coordinating In my term, the editorial office will ex-
book reviews for the journal and so this tend this process and become entirely
section will remain informative and “paperless”. Second, I believe the expan-
helpful to our readers. In addition to her sion of the editorial board and addition
editorial experience, Lisa’s work on of a second Associate Editor was a ne-
therapeutic alliance, rupture and repair cessity. Along these lines I want to thank
was among the first in these areas and is both the Publication Board and Execu-
well known to all of us. Next, I am very tive Committee of Division 29 for re-
excited to work with Heather Thomp- cently approving the funds for adding a
son-Brenner. Heather brings a myriad of third Associate Editor. Third, I believe
different experiences that in part derive the development of the Practice Review
from working closely with several lead- articles, summarizing extant research in
ing figures in psychotherapy research a clinically accessible manner, are a won-
from a range of different theoretical ori- derful addition that directly address the
entations, such as Drew Westen and main aims of the journal and I therefore
David Barlow. As such, Heather has de- plan to continue this series. I also plan
veloped the rare capacity to integra- to be proactive and try to obtain these
tively translate theoretical concepts into applied research summaries from the
both clinically applied research and top people across a number of different
practice initiatives that span different clinical areas.
approaches to treatment. She also has
experience in conducting research from Therefore, my goal will be to continue
several methodologies including prac- and extend the current positive direction
tice networks, field research, and ran- of the journal with a number of related
domized trials, as well as directing an initiatives. To begin, I have organized
applied research clinic for eating disor-
an “Author and Reviewer Resource
ders. Last, but certainly not least, I feel
Page” at the journal web site that will
very lucky to be able to work with Jessealso be linked with the division web
Owen. Jesse is a rising star in psy- page as a resource for all Division 29
chotherapy process and outcome re- members. On this page, are links to sev-
search. In particular, his work addresses
eral different resources to help authors
minority and gender issues in relation to
conduct their research. These include
focal process concepts, such as the ther-
free statistical programs to calculate
apeutic alliance and emotional expres- such things as effect size, reliable
sion, while employing cutting edge change, power estimates, etc. In addi-
statistical methods such as multilevel tion, there are links to help authors pres-
modeling. If you haven’t read one of hisent and format their research findings
articles in these areas yet, you will soon.
with aids such as the American Psycho-
Given his high level of early career pro-
logical Association (APA) Working
ductivity we are very lucky to have his Group on Journal Article Reporting
energy and forward thinking involved Standards (JARS) report, the Consoli-
in the leadership of our journal. dated Standards of Reporting Trials
(CONSORT) articles, checklists and flow
Concerning potential changes to Psy- chart, the Transparent Reporting of
chotherapy, I believe several important Evaluations with Nonexperimental De-
improvements have already been signs (TREND) articles and checklist, the
adopted by Charlie Gelso during his
term. First among these has been the continued on page 13
12
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Strengthening the Reporting of Observa- suggest that this section is for advanced
tional Studies in Epidemiology statistical time series analyses (although
(STROBE) statement, as well as report- such articles would be welcomed), but
ing standards for meta-analysis includ- rather for any reports on individual
ing the QUOROM statement (Quality of treatments that occur as part of an open
Reporting of Meta-analysis) and its re- effectiveness trial or RCT where the use
cent revision PRISMA (Preferred Re- of audio/videotape and collection of
porting Items for Systematic Reviews such measures are commonplace. In ad-
and Meta-analyses). In addition, given dition, I want to open an avenue for
that one of the primary aims of the jour- publication to those in full time private
nal is to provide research that has clini- practice who are interested in integrat-
cal utility for applied practice, I will be ing research measures into their clinical
inclined to expect that authors of empir- work. I believe such a series will be ex-
ical papers report effect sizes (i.e., d, g or tremely useful in efforts to bridge the
r). I would also like to see information gap between research and practice as
reported using the more straightforward well as provide important templates of
clinical significance variables for any how to integrate basic research into ap-
psychotherapy outcome research. That plied work at the individual case level.
is, clear and clinically relevant reporting
of the percent of patients in a study who Finally, one thing that has become very
demonstrated reliable change, moved clear to me since being named the In-
into a functional (i.e. normal) distribu- coming Editor of Psychotherapy is that I
tion, achieved clinically significant am not alone in my love of this journal.
change (i.e. reliable change and move- This same passion for the journal and
ment into a functional distribution) and what it does is a sentiment that has been
those who deteriorated in functioning. expressed to me by a number of mem-
Parallel in purpose to the Practice Re- bers of the division. What has come
view articles, I will be developing a se- across loud and clear to me from these
ries of “Evidence Based Case Studies” members and from the Division 29 lead-
and hope to eventually include one in ership is that the first goal of this journal
each issue. The goal of these Evidenced is to serve the interests of the member-
Based Case Studies will be to integrate ship. That is, the primary goal of my
verbatim clinical case material with term as Editor is not to focus on increas-
standardized measures of process and ing the research citation Impact Factor of
outcome evaluated at different times the journal, but rather to satisfy the var-
across treatment. That is, authors should ied interests and tastes of the Division 29
describe clinical vignettes highlighting members for real world clinically useful
key interventions and mechanisms of articles that address theory, research,
change regarding their specific ap- practice and training issues in psycho-
proach to treatment in the context of em- therapy. To this goal I am fully commit-
pirical scales. Also, I do not mean to ted and bid you all Bon Appetit!

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DIVISION 29 AWARDS CEREMONY AND

SOCIAL HOUR

Award for Best Empirical Research

Article Michelle Newman and
Awards Chair Jeff Barnett
Awards Chair Jeff Barnett, Div 29/APF
Early Career Award Winner Katherine
Muller, and President Nadine Kaslow

Awards Chair Jeff Barnett and

Publications Board Chair
Jeanne Carter

Awards Chair Jeff Barnett, Excellence

in Mentoring Award Winner Marvin
Goldfried, and President Nadine Kaslow

Distinguished Psychologist Award Winner

Norine Johnson and President Nadine Kaslow

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Awards Chair Jeff Barnett, Distinguished President Nadine Kaslow, Mathilda B.

Psychologist Award Winner Jon Carlson, Canter Education & Training Student
and President Nadine Kaslow Paper Winner Sarah Gates, and Awards
Chair Jeff Barnett

ENJOYING THE
SOCIAL HOUR!

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PSYCHOTHERAPY RESEARCH, SCIENCE, AND

SCHOLARSHIP
The Center for the Study of Collegiate Mental Health:
A Novel Practice Research Network with National
Reach and a Pilot Study to Match
Benjamin D. Locke, Amy L. Crane,
Caitlin L. Chun-Kennedy, and Astrid Edens
The Pennsylvania State University
Approximately 13% of senting with depression had doubled
the 14 million students and the number of students reporting
enrolled in United suicidal ideation had tripled over the
States’ colleges seek same period. In addition, 80% of coun-
help from their seling center directors believed that
colleges’ counseling there has been an increase in the number
center, and a high of students with severe psychological
proportion of these problems on their campuses and 96%
students have diag- believed that the number of students
nosed mental illnesses with significant psychological concerns
(American College was a growing concern (Rando & Barr
Health Association, 2009). Given such numbers, it is clear
2008). It is estimated that psychotherapy will continue to play
that 10% of college a critical role in the future of collegiate
students seriously mental health. What remains strikingly
consider suicide each out of focus, however, is exactly how
year, 1.5% attempt higher-education professionals (includ-
suicide, and 1100 stu- ing those providing treatment) are to
dents actually commit monitor and understand nuanced
suicide, making suicide trends at the national level while also
the second leading addressing the needs of practitioners
cause of death among and researchers within tight budget re-
college students strictions. Because many published sta-
(American College tistics on college student mental health
Health Association, are retrospective, anecdotal, survey-
2008; Suicide Preven- based (with low response rates), and dif-
tion Resource Center, ficult to generalize, they cannot be used
2004). College and to accurately describe the nature of stu-
university mental dents in treatment, inform the training
health professionals of practitioners, direct resource alloca-
have argued that today’s college stu- tion efforts, educate public-policy
dents are presenting with more severe efforts, or serve to evaluate the effective-
and frequent psychopathology than pre- ness of various treatments.
vious generations. This trend was illus-
trated by Benton, Robertson, Tseng, The Center for the Study of Collegiate
Newton, and Benton (2003) when they Mental Health (CSCMH) was estab-
examined the rates of client concerns, as lished in 2005 to meet the needs of clini-
reported by counselors in a college cians, researchers, and administrators
counseling center over 13 years, and working in college student mental
found that the number of students pre- continued on page 18
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health by employing techniques more the data-collection tasks, which forces

commonly seen in “business intelli- the research effort to be short-lived and,
gence” such as integrating data collec- more often than not, resented by practi-
tion into “point of service” contacts and tioners who view it as interfering with
using technology to efficiently pool data clinical service. CSCMH sought to avoid
collected at multiple separate locations this problem by choosing to standardize
for the purpose of ongoing aggregate the data gathered during routine clinical
analysis and reporting. CSCMH repre- practice. Once each counseling center
sents a collaborative, long-term, multi- makes the initial changes to their forms,
disciplinary effort blending the expertise research-related data collection becomes
of mental health treatment providers, a part of “business as usual” for the fore-
psychological researchers, information seeable future.
science and technology leaders, and in-
dustry partners to pursue the related Even with these steps in place, the most
goals of accurately describing college significant threat to the integrity of data
student mental health at a national level, standardization efforts is the gradual
conducting large-scale psychotherapy erosion of data standards over time re-
research, and improving the range of sulting from modifications made by in-
clinical tools available to practitioners in dividual centers. To address this,
the higher education setting. This effort CSCMH partnered with Titanium Soft-
is best be described as “mental health ware, the largest provider of electronic
informatics”—an infrastructure and re- scheduling and medical records soft-
lated processes that are capable of pro- ware for counseling centers to build the
ducing a constant flow of high quality, standardized data points (the SDS and
anonymous, aggregate national data CCAPS) into Titanium Schedule, the
readily available for multiple purposes. software used by many counseling cen-
ters for day-to-day business and data
A practice research network, like management. The implementation is
CSCMH, is dependent on a sense of standardized in that pre-defined ques-
community and shared ownership. To tions and answers cannot be changed or
achieve this, CSCMH hosted a confer- edited, but it is also quite flexible be-
ence and follow-up dialogues in 2006 in- cause non-required questions can be
volving more than 100 counseling turned on/off or re-arranged and new,
centers, which led to the creation of the non-standardized, items can be added to
first Standardized Data Set (SDS) in meet each center’s needs. As a result,
2007. The SDS is a data dictionary which each participating center gathers high
defines a broad range of data points to quality, standardized data as part of rou-
be used by participating centers, thus al- tine clinical service without any addi-
lowing for “apples to apples” compari- tional research burden. With these key
son of data generated during clinical steps accomplished (i.e., collaboration,
service. The SDS covers a broad range of operational data standardization, and
issues such as client/counselor demo- centralized distribution of standards) a
graphics, mental health history, and a data “infrastructure” has been estab-
multi-dimensional psychometric instru- lished which can be gradually refined
ment, for assessment and outcomes, and added to over time. Further, the in-
called the Counseling Center Assess- frastructure can support the future de-
ment of Psychological Symptoms ployment of large-scale, time-limited,
(CCAPS). research initiatives with relatively minor
additional effort.
The Achilles heel of data collection in a
clinical setting is the burden imposed by continued on page 19
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The SDS and CCAPS were made avail- as atheist, 3% as Jewish, 1% each as
able via Titanium Schedule in January of Muslim, Hindu, Buddhist, and 11% pre-
2008 and participating centers gradually ferring not to identify their religion or
converted over to using the new stan- identifying some other religion.
dardized materials by September of A key characteristic of the 2009 Pilot
2008. In order to assess the data stan- Study which differentiates it from all re-
dardization effort and to explore the lated survey research in the field, is that
usefulness of the data, a pilot test of the the 28,000+ students in the dataset rep-
CSCMH infrastructure was conducted resent the entire population of students
in January, 2009 in which anonymous, seen at the 66 counseling centers – a fact
standardized data from the past semes- which dramatically enhances the gener-
ter were pooled for over 28,000 students alizability of findings when compared to
from 66 universities. This pilot test effec- a typical survey with a response rate of
tively produced the largest dataset on just 25-30%. The data drawn from such a
college students in treatment with just large, diverse, and complete population
four months of data collection. Though can be reliably generalized to other cen-
substantial, this accomplishment repre- ters. For example, institutional charac-
sents only one-quarter of the current teristics accounted for less than 5.3% of
theoretical capacity of CSCMH’s collab- the variance across the nine CCAPS sub-
orative research network and strongly scales in use at the time. The largest in-
underscores the potential of this re- stitutional impact was on the Academic
search model to quickly and accurately Distress CCAPS subscale (5.3%), the
gather vast amounts of data related to next largest was Depression (4.8%), and
mental health, psychotherapy, and re- the remaining subscales ranged between
lated issues. 1.5% and 4.2%. Even the subscale of
Substance Use, which readers might be-
The majority of students in the pilot lieve should vary significantly by insti-
study (65%) were women with 44 indi- tution, was only impacted 0.4% by
viduals identifying as transgender. In- institutional characteristics across the
ternational students comprised 4% of entire sample. Thus, counseling centers
the sample and represented 169 coun- tend to see the same types of clients and
tries. Among domestic students, 8% problems regardless of their parent
were African American, 6% were Asian institution.
American, 70% were European Ameri-
can, 6% were Latino, 3% were multi-eth- A wide variety of findings from the
nic, 5% were of some other ethnicity, and study are reviewed in the 2009 Execu-
2% did not report their ethnicity. Ap- tive Summary (http://www.sa.psu.
proximately 18% of the students were in edu/caps/pdf/2009-CSCMH-Pilot-
their 1st year of college, 19% were soph- Report.pdf) including baseline data on
omores, 22% were juniors, 23% were prevalence and severity, alcohol and de-
seniors, and 15% were graduate stu- pression, academics, suicidality, sexual
dents; class standing was not reported orientation, and much more. However,
by or applicable to 3% of students. Het- one of the topics we were most excited
erosexuals comprised 89% of the sam- to examine was psychotherapy outcome
ple, 2% were gay, 1% were lesbian, 3% data. Could such a large and naturalistic
were bisexual, 1% reported questioning dataset, gathered without the level of
their sexual orientation, and 3% opted rigor typically employed in psychother-
not to self-identify. The sample was pre- apy research, be used to detect symptom
dominantly Christian (53%), with 13% change in clients receiving psychother-
of students expressing no religious pref- apy? Psychotherapy research has leaned
erence, 10% identifying as agnostic, 5% continued on page 20
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increasingly towards rigor, and away therapy outcomes were completely nat-
from relevance, as researchers carefully uralistic: clients had multiple uncon-
screen clients, standardize interventions trolled diagnoses with a broad range of
via manuals, and carefully select/train severity, were coping with scores of un-
therapists to treat clients in a consistent, controlled environmental stressors, and
replicable manner (Gelso, 1985). While therapists varied in theoretical orienta-
rigor helps to ensure our ability to detect tion, experience, and the actual treat-
change, it conversely produces less rele- ments used. Of course, there are pros
vant therapies and the results become and cons to each approach (Borkovec &
increasingly hard to generalize to “real Castonguay, 1998); however, the fact
life” clinical settings. that we were able to detect moderate
and large effect sizes from such natura-
The pilot study data happened to in- listic data, suggests that there may be a
clude multiple administrations of the great deal to learn about psychotherapy
CCAPS for more than 1500 students, outcome research and treatment effec-
representing measurements taken prior tiveness via methodologies that focus on
to and during/post-treatment, which large-scale data collection in ecologically
were used to preliminarily assess psy- valid settings with naturally presenting
chotherapy outcome. Preliminary analy- clients.
ses of these pre-post data indicated that,
with an average of approximately 6 The 2009 CSCMH Pilot Study represents
weeks between CCAPS administrations, an important “proof-of-concept” for a
student-clients exhibited a statistically promising new research methodology
significant decrease in depressive symp- that offers the opportunity to gather vast
toms, with a moderate effect size (d = amounts of data related to many aspects
.41). Additionally, students who initially of collegiate mental health including
presented with a higher level of self-re- many aspects of naturalistic psychother-
ported depressive symptoms, relative to apy practice and research. Indeed, the
the rest of the sample, exhibited an even 2009 CSCMH Pilot Study just scratches
more pronounced improvement in de- the surface of what is possible with
pressive symptoms, with a large effect large-scale practice research networks.
size (d = .87) (Boswell, 2009). To read more about CSCMH and our
early findings, please visit our website
Effect sizes reported in meta-analytic re-
at: http://www.sa.psu.edu/caps/re-
views of psychotherapy effectiveness,
search_center.shtml.
across a wide range of treatments and
diagnoses, have ranged from .22 to 1.05 A key challenge in creating and sustain-
(Lambert & Ogles, 2004). One particular ing collaboration in provider-based re-
meta-analysis conducted by Lipsey and search networks is ensuring that the
Wilson (1993) reported an average treat- network is designed not only for scientific
ment effect of .47. Importantly, larger ef- purposes but also to meet the needs of
fects sizes (e.g., larger than 1.05) have participating treatment providers
been demonstrated in some compara- (Borkovec, 2004). CSCMH currently has
tive outcome trials, which rigorously over 140 registered counseling centers
focus on optimizing internal validity by that have actively participated in
excluding clients with some co-morbid CSCMH’s development via decision-
disorders and implementing manual- making activities at two national confer-
ized treatments, thereby maximizing the ences, listserv dialogues, and an advisory
researchers’ ability to detect treatment board comprised of counseling center
effects. In contrast, the CSCMH data
used to preliminarily explore psycho- continued on page 21
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representatives. In addition, CSCMH health in a naturalistic setting. Consider

strives to give back to participating cen- that within just a handful of years and
ters in a variety of ways including profes- minimal funding, CSCMH now has the
sional development; refined “data capacity to examine treatment outcome
products” such as individualized reports data on hundreds of thousands of clients
(to compare an institution to national per year, as well as the mental health
numbers) and two recently released needs of groups who are chronically un-
CCAPS instruments (62 and 34 item ver- derserved in our literature (e.g., racial
sions) which utilize a normative clinical and sexual minorities, international,
sample of 22,000 students; and a variety first-generation, and military-enlisted
of relevant publications drawn directly students). In the coming years, CSCMH
from the daily business of practitioners. will continually refine its standardized
By actively striving to meet the needs of materials, examine collegiate mental
participating centers with refined prod- health and psychotherapy outcomes
ucts drawn from their raw materials from a variety of perspectives, and give
(data), the CSCMH effort can be concep- back to the clinicians who make the re-
tualized as data-driven economy that search possible while also providing a
generates a mutually beneficial interde- range of accurate and up-to-date data to
pendence for practitioners and scientists. the public. Most importantly, CSCMH
will work to understand and address
The 2009 CSCMH Pilot Study offers an collegiate mental health via a national
exciting peek over the horizon—an op- practice research network which ac-
portunity to consider what the field tively seeks to fuse science and practice
might discover if we invested in the nec- together.
essary resources to build large-scale col-
laborative research infrastructures to References available on-line at www.divi-
examine psychotherapy and mental sionofpsychotherapy.org

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APA’s Division of Psychotherapy

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

We ask members of the Division to nominate articles for consideration by April

15. Nominations should include the complete citation for the article, and should
be emailed to the Chair of the Research Committee, Dr. Susan Woodhouse, at
[email protected].

A selection committee appointed by the Chair of the Research Committee, in

consultation with the President of the Division, will evaluate all nominated ar-
ticles, and will make a recommendation to the Division’s Board of Directors by
June 1. Upon approval by the Board, the author(s) of the winning article will be
notified so that they may be recognized and receive the award at the upcoming
APA Convention. Accompanying this award is a plaque.

All methods of research will be equally valued (experimental, quasi-experimental,

qualitative, descriptive/correlational, survey). Current members of the Research
Committee and the Selection Committee will not be eligible for the award, so no
articles by members of the Research Committee will be considered. Also, com-
mittee members will recuse themselves from voting on articles by current or
former students, as well as collaborators. Self-nominations are accepted.

The criteria for the award are:

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

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FEATURE
A Bright Future for Psychological Assessment
Hale Martin, Ph.D.
University of Denver Graduate School of Professional Psychology
With the rise of man- ing. In personality assessment, the Per-
aged care over the sonality Assessment Inventory (PAI;
past 20 years, psycho- Morey, 1991) offers a psychometrically
logical assessment has sound alternative to the second version
seen hard times. From of the Minnesota Multiphasic Personal-
what some saw as an ity Inventory (MMPI-2), which was pub-
over-emphasis on as- lished in 1989 (Butcher, Dahlstrom,
sessment in the 1970s Graham, Tellegen, & Kaemmer, 1989) as
and 1980s (e.g., testing indiscrimi- a revision of the original MMPI (Hath-
nately), the pendulum swung to ar- away & McKinley, 1943). Furthermore,
guably under-use of assessment in the newest version of the MMPI was re-
serving clients of the mental health serv- leased in 2008, the MMPI-2-RF (Tellegen
ice. This swing was accentuated by the & Ben-Porath, 2008). It is a shorter test
forces behind managed care (e.g., work- than the MMPI-2 or PAI, with substan-
ing to maximize the impact of limited tial changes in structure from the earlier
funds) (Finn & Martin, 1997). However, versions of the MMPI. Its publisher,
there are those who persevered in prac- Pearson, provides evidence of its strong
ticing assessment, believing that it of- psychometric properties. Thus, cogni-
fered responsible and effective service to tive and self-report measures have made
some clients. Much of their work was significant advances in the past 20 years.
done outside the confines of managed
care because insurance reimbursement In recent years the Comprehensive
was time-consuming to arrange and System of the Rorschach, a performance-
based measure of personality promul-
poorly compensated. In reaction to this
gated by John Exner (Exner, 2003; Exner &
difficult time for assessment, many
Erdberg, 2005; Exner & Weiner, 1995) has
training programs around the country
demonstrated validity (see Hiller et al.,
de-emphasized training in assessment.
1999) and reliability (see Acklin et al., 2000)
However, recently there have been de- and has won many converts, including
velopments in assessment that bode courts of law (see McCann, 1998). The crit-
well for its future. First, research to im- icisms of the Rorschach Inkblot Method
prove testing instruments has continued that flared in the late 1990s and early 2000s
unabated. For example, new intelligence (see Wood et al, 2003) have been ad-
tests have emerged that attempt to bet- dressed head on by those who use and re-
ter capture our growing understanding search the Rorschach (see Martin, 2003).
of the slippery construct of intelligence. Updated norms (Exner & Erdberg, 2005), a
The Differential Abilities Scale, already large international sample gathered from
in a second edition (Elliot, 2007), a re- 13 different nations (Shaffer, Erdberg, &
vised edition of the Stanford-Binet, Fifth Meyer, 2007), research addressing reliabil-
edition (Roid, 2006), and the fourth edi- ity and validity issues (Hsiao, W. C.,
tions of the Wechsler Intelligence Scale Meyer, G. M., Abraham, L. M., Mihura, J.
for Children and the Wechsler Adult In- L., & Viglione, D. J., 2009; Mihura, Meyer,
telligence Scale (Wechsler, 2003; Wech- Bombel, & Dumitrascu, 2008), new publi-
sler 2008) have added to the arsenal of cations that fine tune scoring issues
instruments to assess cognitive function- continued on page 24
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(Viglione, 2002), and research exploring tion to help clients grow from the insight
solutions to the problem of variability in and experience provided by the carefully
protocol length (Dean, Viglione, Perry, & tailored assessment process. By fanning
Meyer, 2007) among many other studies the curiosity clients have about them-
have all contributed to the continuing evo- selves, clients feel invested in the oppor-
lution of a valuable assessment tool. The tunity to understand themselves in ways
extensive flow of research seems to have that have proved elusive in life, and even
somewhat quieted the major critics of this sometimes in psychotherapy. Therapeu-
assessment instrument. tic Assessment is a semi-structured as-
sessment process. It harnesses the
Finally, a plethora of new measures have insights available from traditional testing
been developed in recent years, ranging instruments but offers them back to a
from the Adult Attachment Projective client in a novel but clinically informed
(George & West, 2001) to the Trauma manner. A growing base of empirical
Symptom Inventory (Briere et al., 1995), study supports its efficacy with a variety
to the Wechsler Individual Achievement of clients with different types of prob-
Test-II (Wechsler, 2001). New measures lems. As well as being an effective inter-
promise better tools to assess attach- vention itself, Therapeutic Assessment is
ment, trauma, eating disorders, atten- particularly well suited to the role of a
tion deficit disorder, learning disabilities consultation. For difficult or puzzling
and a myriad of other problems that cases when psychotherapy is unfocused
clients sometimes face. It is clear that the or seems stuck, a Therapeutic Assess-
tools of assessment cover a broader ment consultation offers an opportunity
range and are better developed than to clarify, deepen and enhance the work.
ever before. Finn advocates a strong collaborative re-
lationship with referring professionals in
However, the most important develop-
best serving their clients.
ment in the recent history of assessment
is the rise of the collaborative or thera- One important innovation that Finn has
peutic model of assessment. This new added to the assessment process is a
approach represents a significant new step between data collection and discus-
paradigm for assessment that captures sion of results. This “assessment inter-
the phenomenological, interpersonal vention” session goes beyond the
Zeitgeist in psychology. Constance Fis- intellectual exercise of traditional assess-
cher was the first modern voice to effec- ment by creating an in vivo experience
tively advocate that assessment can be of some important aspect of the test
used to directly benefit the client. Her findings that the client and assessor can
book Individualizing Assessment (1985) work with in the relationship in the
was ground breaking and caught the eye room. Guided by insights the testing has
of Stephen Finn. It catalyzed much of provided, it can be a powerful interven-
Finn’s thinking, leading to empirical in- tion in the hands of a skilled assessor.
vestigations, integration of knowledge The assessment intervention actualizes
from other areas of psychology, and ul- the emerging insight that “left brain”
timately the articulation of what he calls understanding is not enough to unhook
Therapeutic Assessment (see Finn, 2007). clients from ways of living that do not
Therapeutic Assessment is an approach work well for them. It leverages Allan
to assessment that seeks to maximize the Schore’s (2003) revolutionary under-
substantial therapeutic impact assess- standing that communication to the
ment can have. Beginning by focusing on “right brain” is essential to reach certain
what clients want to know about them- patterns of behavior. It also parallels the
selves, the assessment fosters collabora- continued on page 25
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work of Diana Fosha (2000) whose bril- tings where research suggests it is more
liant synthesis and refinement of recent effective in producing positive change
psychodynamic thinking promises enor- than other traditional treatment modal-
mous advancement of treatment. Her ities (Little & Smith, 2009).
Accelerated Experiential Dynamic Psy-
chotherapy focuses on affect in the ther- Others, like Len Handler (2006) and Car-
apy session and offers ways to access the oline Purves (2002), have recognized
right brain in facilitating change. It is anthat their work dovetails with this new
exciting time in psychology with dove- paradigm, and clinical assessment is en-
tailing developments on many fronts, hanced by new knowledge generated by
and it is fortunate that assessment is a burgeoning number of talented re-
near the forefront of innovation. searchers and clinicians. Programs at the
annual meetings of the Society for Per-
Another difference between traditional sonality Assessment, the preeminent in-
assessment and Therapeutic Assessment ternational personality assessment
is evident in the feedback session, which organization, are evidence of increasing
Finn calls the summary/discussion ses- study and focus on the collaborative/
sion to emphasize that both client and therapeutic approach to assessment.
assessor are active participants. In Ther-
apeutic Assessment this step brings full The new paradigm offered by Collabora-
circle the collaboration started at the be- tive/Therapeutic Assessment is begin-
ginning of the process by presenting ten- ning to have an impact on training. While
tative answers to the client’s own many training programs still lament the
questions. The therapeutic impact of the lack of focus and opportunity in assess-
session is enhanced in that it follows the ment, others such as the Graduate School
assessment intervention session, which of Professional Psychology at the Univer-
already has informed the right brain. sity of Denver, are experiencing an in-
Now the insights are put into words a creased interest and emphasis in
client can understand. The session is assessment, perhaps even the leading
structured to maximize the therapeutic edge of a renaissance of psychological as-
value to a client and to help the client sessment. There are now students coming
move forward in life. Finn even advo- into the mental health field who are ex-
cates writing stories for young children cited about assessment and who have a
that capture their dilemma and offer good training foundation that incorpo-
new productive avenues. rates the new paradigm while also
re-taining the wisdom and usefulness
Therapeutic Assessment has been of traditional assessment. Advanced
adapted to children, adolescents, cou- training in Therapeutic Assessment is
ples and families. Finn’s book In Our available through Finn’s Center for
Client’s Shoes (2007) is a significant con- Therapeutic Assessment in Austin, Texas
tribution to the evolution of Therapeutic (www.therapeuticassessment.com).
Assessment. Work by Finn, Deborah
Tharinger and their students at the Uni- Thus, with all these developments, the
versity of Texas at Austin (Tharinger et pendulum of assessment’s value is
al., 2007) researches and establishes the primed to swing back strongly from
application of Therapeutic Assessment where it was pushed the past 20 years.
to children and families, an intervention With an array of new reliable and valid as-
that is geared to help change the stories sessment instruments, assessment has
families hold about their children to be much to offer to offer to today’s mental
more accurate and offer hope for posi- health practitioners and their clients. Iden-
tive change. Therapeutic Assessment tification of problems and issues that can
has also been applied in inpatient set- continued on page 26
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at times be exceedingly difficult to tease coming years may well be exciting times
apart Furthermore, in managed care’s for psychological assessment.
search for effective, time-limited interven-
tions surely the accumulating, impressive References available on-line at
evidence that Therapeutic Assessment of- www.divisionofpsychotherapy.org
fers will surely soon be recognized. The

O
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The only APA division solely dedicated to advancing psychotherapy

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#"$!%

EARLY CAREER
Reflections of an Early Career Psychologist:
How I Ended up Working at a VA Medical Center and
its Unexpected Rewards
Jay L. Cohen, Ph.D.
John D. Dingell V.A. Medical Center
Disclaimer: This essay port and the therapeutic alliance. I was in
does not represent the my final year of graduate training, in
views of the John D. 2005-06, while completing my clinical in-
Dingell VA Medical ternship, when I first applied for tenure-
Center or the Depart- track positions. Those who have been in
ment of Veterans this position may have had the experience
Affairs. that very little feedback is provided when
you don’t make the interview short-list.
In the Beginning The little feedback I did receive suggested
As a first semester graduate student in I needed more seasoning, a post-doc, as
clinical psychology at a Midwestern sci- well as some time to elapse so that some
entist-practitioner Ph.D. program, I took of my papers would move from “in prep”
a required research seminar co-taught to “in press.” Fortunately, in the spring of
by multiple faculty. The seminar was 2006, one of my graduate professors with
created with the intention of jump-start- an NIH-funded study offered me a post-
ing students on ideas and helping shep- doctoral research associate position. My
herd them toward developing their primary challenge would be to integrate
master’s theses. In one of the first my interest in psychotherapy research
classes, the instructors offered to share with his research program on the study of
how they had gone about the “system- pain and emotion.
atic” process of developing their thesis.
Each proceeded to tell fantastic stories I hit the ground running. In addition to
the grant-funded study on coping skills
about being in the right place at the right
for rheumatoid arthritis, we developed
time (“It was serendipitous…“; “I was at
a pilot intervention for individuals with
a dinner party with the chair…“; “I
fibromyalgia. I also oversaw a novel sin-
joined a lab and that was what they
gle session emotional disclosure inter-
were doing…“).
vention that would become masters’
With this memory in mind, I would like theses for at least two of his graduate
to share how I think I got here, and the students. Things were happening, and I
unique challenges and opportunities that was beginning to see myself as an aca-
working in a Veterans’ Affairs (VA) Med- demic professional. In the early winter, I
ical Center presents for an early career had seen a posting for a position at a rel-
psychologist. When I started my graduate atively prestigious university, but I rec-
training, my vision for what my career as ognized that I had not yet developed the
a psychologist would look like included track record I was seeking, nor was I li-
a tenure-track position in a Psychology censed to immediately provide the clin-
Department, with a small part-time pri- ical supervision often sought by clinical
vate practice. Although genuinely in- programs. However, as spring arrived,
vested in developing my clinical skills, the position remained unfilled and I
my primary focus was on building a re- submitted my materials. I was very ex-
search program in the area of social sup- continued on page 28
27
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cited to send out what I thought was an that point had to do with substance use.
impressive package of research and Yet, in researching these LRC positions,
teaching statements, CV, and reprints. I it became apparent that it involved
received very favorable feedback this working with individuals with serious
time, including a phone call from the mental illness (SMI). Although I consid-
search committee chair. She shared that ered myself a well-rounded clinician (for
although they were looking specifically a post-doc, anyway), I had little experi-
for someone with expertise in psy- ence working with an SMI population.
chopathology research, they really liked Further, these positions were new to VA,
my application. She encouraged me to so it was difficult to find an existing Re-
consider them that fall as she anticipated covery Coordinator to get a better sense
a position posting that might be a better of what he or she was doing. What I was
match. I felt as good as one could feel able to determine in this initial foray into
when being turned down. I was getting VA job hunting was that the LRC was
closer. supposed to serve as a local consultant
to Mental Health and facility leadership,
In late spring of 2007, shortly after sens-
as each facility was expected to trans-
ing that I was moving in the right direc-
form their mental health services to one
tion, I received a note from a former
guided by a recovery-oriented philoso-
supervisor at my clinical internship. He
phy of care. It was literally a position
had been conversing with a colleague at
shrouded in mystery. The job descrip-
the VA Medical Center in Detroit, who
tion was vague, expectations were not
shared that there were openings for psy-
well-defined, responsibilities were
chologists. He encouraged me to in-
broad in scope, and there was little legit-
quire. At this point, I was pleased with
imate power. In other words, it was the
the career trajectory I had been on in the
perfect job for which I had been prepar-
previous nine months. I had felt that I
ing the last eight years of my life.
was genuinely building a career, and
that I was close to completing the moun-
I am a staff psychologist and Local Re-
tainous climb from first-year clinical stu-
covery Coordinator at the John D. Din-
dent to tenure-track professor. My plan
gell VA Medical Center in Detroit, MI.
was to complete a full second year of the
But that title alone does not at all de-
post-doc, expecting to apply for and
scribe what I do, with whom I interact,
land a tenure-track position sometime
and what skills I use as a psychologist to
during that year. The VA positions of-
enjoy success. To do so, I must first
fered a unique opportunity, but would
briefly describe the recovery movement
certainly deviate from a carefully con-
in VA.
structed and cultivated career path. On
the other hand, I always believed that
What is Recovery?
one has to take advantage of opportuni-
Space limitations will not allow me to do
ties when they present themselves. It
justice to describing the concepts of re-
was possible that these VA positions just
covery and recovery-oriented care.
might allow for the type of research and
Briefly, recovery is a broad construct
teaching opportunities and clinical chal-
with many different definitions. Recov-
lenges that would satisfy the clinical sci-
ery is a movement, but is also one’s per-
entist in me.
sonal experience. It is a movement that
The position I was being encouraged to began and continues to be driven by
apply for was called a Local Recovery grassroots organizations that advocate
Coordinator (“LRC”). My only experi- for the rights and empowerment of
ence with the term, “recovery” up until continued on page 29
28
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those with serious mental illness. Recov- areas for the process of engaging in sys-
ery is also the personal journey of indi- tem transformation and recovery imple-
viduals living with mental illness; there mentation: (1) Facility Infrastructure
are many outstanding first-person ac- Change, (2) Training/Education, (3) Clinical
counts of recovery in memoirs, essays, Program Development, (4) Working with
and blogs by esteemed individuals such Veterans/Grass Roots Development, and (5)
as Judi Chamberlin, Pat Deegan, Dan Community Outreach.
Fisher, Fred Frese, and Elyn Saks.
I quickly realized that I would have to
In 2003, President Bush formed a New form partnerships and teams—for many
Freedom Commission on Mental reasons, but mostly, that for change to be
Health. That same year, the State of Con- sustainable, people had to believe in it.
necticut formed the first comprehensive Most people (including myself) are am-
state mental health strategic plan adopt- bivalent about change. There had to be
ing recovery. In 2005, the VHA Office of buy-in, and that would only happen if
Mental Health Services (OMHS) everyone was part of the process. The
adopted these concepts in their strategic success of the transformation efforts
plan. The publishing of the Handbook depend upon a coordinated effort of
of Uniform Mental Health Services in stakeholders, including facility leader-
VA Medical Centers and CBOC’s (Hand- ship, program coordinators, front-line
book 1160.01) in September 2008 out- providers, support staff, and our Veter-
lines expectations to transform mental ans. I cannot summarize here the work
health services to one guided by a recov- that this entailed, but suffice it to say
ery-oriented philosophy of care. that critical partnerships have been
formed between VA and Veteran con-
One of the major steps taken by VA to
sumers. Recovery is about inclusion and
ensure that medical centers would be
empowerment—and what I am most
able to engage in transforming mental
proud of is the role I have played in en-
health services was to fund the hiring of
couraging and empowering our Veter-
an LRC at each medical center through-
ans, many with substantial talents,
out the country. It was within the con-
skills, and abilities, to develop an effec-
text of this culture and systems
tive voice. I serve as a liaison to the Vet-
transformation that I was hired in Octo-
eran’s Mental Health Consumer
ber, 2007. I was new to this VA. It was
Advocacy Council, which has become a
my first “real” job. The position was
key partner with Mental Health and
new to the facility, as it was to VA med-
Medical Center leadership.
ical centers across the country. People
weren’t really sure what to do with me
In addition to local roles, there are also re-
or what to make of me. For my part, I
gional and national relationships. For ex-
was learning about recovery and recov-
ample, I worked closely with my fellow
ery-oriented care and how I was sup-
colleagues at medical centers throughout
posed to “change the system.” I was
our network (VISN 11) to establish the
getting used to working within a large,
VISN 11 Recovery Advisory Committee.
complex organization, with many stake-
This team meets biweekly via phone to
holders. This was quite different than
develop educational activities, as well as
the context and structure in which I was
planning for programmatic implementa-
able to accomplish things in graduate
tion of recovery best practices in medical
school, on post-doc, or academia in gen-
centers throughout our VISN. I chaired
eral. Pretty soon, I had formed a basic
this Committee during its first year, and
outline for transforming mental health
services. I had identified five component continued on page 30
29
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currently serve as the VISN LRC Point of Training Committee and the Professional
Contact with the Psychosocial Rehabilita- Standards Board. I also make time to
tion Section of the VHA Office of Mental work on research projects and write (I am
Health Services (OMHS). This group has the site PI for a VA grant-funded RCT,
been very effective in advocating for studying the impact of peer support on
training and education for staff and Veter- the management of depression).
ans and for putting recovery on the
agenda of local decision-makers. In addi- What I think I have Learned
tion, linking with psychologists across the It has been an exhilarating ride, with op-
VA landscape has been a great way to en- portunities for using the full range of my
gage in personal and professional devel- professional skills and ample opportu-
opment. There are many leadership nity for developing new skills and com-
development opportunities within VA, petencies. The position continually
and there is at least one excellent organi- evolves, and I remain aware of continu-
zation (AVAPL) that encourages psychol- ally defining and redefining myself.
ogists to take active leadership roles in the
I encourage fellow members of the Early
VA community. Career Psychologist community to en-
Looking Back and Planning Ahead gage in personal development. Know
I have come to see the LRC position as a who you are and who you want to be. My
hybrid of Clinical-Community-Industrial/ philosophy is grounded in the belief that
Organizational Psychology. I have struc- the greatest moments of learning occur
when one is engaged in sharing one’s
tured my activities based on the five
knowledge with others. I did not expect,
components identified above and the
when I was preparing for a career in aca-
corresponding workgroups of our re-
demia, that the vast majority of my
cently established Recovery Implemen-
“teaching moments“ would occur with
tation Team. I oversee peer support and
Veteran consumers of mental health serv-
family education programming and
ices who are learning to become peer
have become an advocate for Veterans
counselors. Yet, I dare say I have learned
and their families and consumers of
more from them than I could possibly
mental health services. I work with an
learn in the lab—about resiliency and
incredible team of VA employees and strength, loyalty, and honor, and courage.
Veterans who have worked tirelessly to I have learned that techniques may be
transform ideas into programs. what we do, but healing moments often
A typical week for me includes meetings come from who we are.
with Veterans and Veteran advocacy Working at VA is not for everyone. It is a
groups, training and education of staff, community, and one has to enjoy being
training and informal supervision of our a part of that community and all it en-
Veteran Peer Facilitators, meetings with tails. The people we work with and the
mental health and facility leadership to people we serve and work for are like
develop and implement evidence-based family. And that presents a unique set of
and recovery-oriented programming, challenges. The opportunities for per-
training and supervision of clinical psy- sonal and professional development,
chology interns, outreach events, en however, are endless, and the rewards
gaging in individual and group psy- are great.
chotherapy, and medical center commit-
tee activity (e.g. , strategic planning and Correspondence regarding this article
customer service steering committees). I should be addressed to [email protected].
serve on the Psychology Education and

30
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ETHICS IN PSYCHOTHERAPY
The Mandatory Reporting of Suspected Child Abuse and
Neglect: Ethical Obligations, Dilemmas, and Concerns
Katherine Barteck, MA, MS, Holly Vanderwalde, B.S.,
and Jeffrey E. Barnett, PsyD., ABPP
Loyola University Maryland
Concerns about child cific requirements, and limits of each
abuse and neglect are state’s law can vary (and thus our obli-
relevant for all psy- gations vary) a careful reading of the rel-
chotherapists. These evant laws in one’s own jurisdiction is of
are significant prob- great importance. Smith (2008) provides
lems that affect many links to each state’s laws at http://
minors with whom www.smith-lawfirm.com/mandatory_
we will come in con- reporting.htm.
tact professionally. An
estimated 794,000 chil- Child abuse and neglect are of vital im-
dren were reported to portance for psychotherapists to attend
be victims of maltreat- to due to the negative impact they may
ment and an esti- have on children throughout their lives.
mated 1,760 children Childhood experiences of abuse and
died as a result of neglect are found to relate to adolescent
abuse or neglect in delinquency (Ryan & Testa, 2005), later
2007 (USDHHS, 2009). academic difficulties (Eckenrode, Laird,
With abuse and neg- & Doris, 1993), and an increased likeli-
lect being so prevalent hood of participation in risky behaviors
and potentially so such as substance abuse (Moran,
dangerous for the vic- Vuchinich, & Hall, 2004) and sexual
tims, it is important activities leading to teen pregnancy
that psychotherapists (Herrenkohl et al. 1998). Additionally,
understand their obligations in abuse abuse and neglect are associated with in-
and neglect situations. creased difficulty in school including
lower achievement and decreased
Why We Have Reporting Requirements school attendance (Gilbert et al., 2009a).
Minors are considered a vulnerable pop- These children also experience increased
ulation; individuals who rely on others risk of behavior problems and delin-
for their care and well being, and as a re- quency, depression, suicidal ideation
sult, are afforded special protections and attempts, post-traumatic stress dis-
under the law in every state that are con- order, and somatic issues and concerns
sistent with obligations set under the (Gilbert et al., 2009a).
federal Child Abuse and Prevention and
Contrary to some prevalent stereotypes,
Treatment Act (CAPTA, 2003). These
child abuse and neglect victims and per-
laws typically mandate that educators,
petrators do not fit any specific profile.
public safety officers, and licensed health
As a result, psychotherapists must be
professionals have an obligation to re-
vigilant about assessing for signs of
port all suspected abuse and neglect of
child abuse and neglect with every pop-
minors that they learn of in their profes-
sional roles. But, since the wording, spe- continued on page 32
31
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ulation. For instance, in 2007 approxi- about yelling at one’s child out of anger
mately 32% of victims of child maltreat- “I wish you were never born?” How
ment were younger than 4 years of age, about screaming loudly at your child
24% of victims were between the ages of with your face one inch away from his
4-7, 19% were between the ages of 8-11, own?” In essence, where does one draw
and 25% were between ages 12-17 (USD- the line as to when a reportable event
HHS, 2009). In addition, boys (48.2 %) has occurred and when the event falls
were almost equally as likely as girls below the reportable threshold and it is
(51.5%) to be victimized. Of all reported just a treatment issue?
victims, 46.1% were White, 21.7% were
African-American, and 20.8% were His- First, the threshold of physical abuse can
panic. Asian children had the lowest rate be difficult to pinpoint, especially when
of victimization. Mothers acting alone parents retain the right to use corporal
were the perpetrators in 39% of child punishment. Twenty-one states “ex-
maltreatment cases, fathers acting alone pressly exclude reasonable corporal
were responsible for nearly 18% of vic- punishment from cases requiring re-
tims, and children were maltreated by port” (Mathews & Kenny, 2008, p. 59).
both parents in nearly 17% of cases. What is “reasonable” is clearly open for
interpretation. Further, corporal punish-
All licensed mental health professionals ment is a form of discipline that clini-
have an obligation to report all sus- cians should expect to encounter with
pected or reported abuse or neglect of some regularity in their practices (Giles-
minors they come in contact with in Sims, Straus, & Sugarman, 1995). It is
their professional roles (although in therefore important to differentiate dis-
some states these reporting require- cipline from abuse. According to Gilbert
ments are present even outside our pro- et al. (2009b), signs of abuse “include
fessional roles). One might therefore ask bruises away from bony prominences:
what ethical issues, dilemmas, and con- on the head, neck, face and buttocks,
cerns exist since these requirements are trunk and arms; large bruises; clusters of
dictated in law and appear to be quite bruises; and bruises that carry the im-
clear. Relevant issues include the vague- print of an implement” (p. 170). How-
ness of most laws, the inadequate train- ever, it is also a myth that physical child
ing most psychologists receive in abuse usually results in injuries that re-
assessing the presence of abuse and neg- quire medical attention (Gilbert et al.,
lect, challenges with determining just 2009b). And, although bruises are com-
what is and is not abuse and neglect, mon in abused children, they are also
and the role of each psychologist’s deci- very common in school-aged children
sion making process. who have not been abused (80%)
(Gilbert et al., 2009b). In fact, the accu-
Ethical Issues and Concerns rate detection of actual physical abuse is
One challenge in complying with this so complicated that a new pediatric spe-
obligation is that many psychotherapists cialty has emerged. In November 2009,
are not adequately trained to address the first medical board exam will be of-
this important responsibility. Although fered in a new official specialty, child
trained to report all suspected abuse and abuse pediatrics (Klass, 2009).
neglect, we are not often trained to assess
for them. For example, when is spank- Another indicator of abuse rather than
ing one’s child abuse? What if the child discipline is the presence of additional vi-
is so sore she cannot sit in her seat at olence in the home. Domestic violence
school? What if it leaves a mark? What continued on page 33
32
#"$!%

and child abuse are highly correlated and has a tumultuous relationship with
(Banks, Landsverk, & Wang, 2008). In fact, his parents does not meet the threshold
in selected states mandated professionals of reporting. However, if the child meets
must report the exposure of a child to do- the diagnosis for moderate to severe de-
mestic violence (Mathews & Kenny, pression and symptoms are directly
2008). Any type of violence in the home linked to how the parent relates to the
warrants additional investigation into child, reporting should likely occur.
other types of violence, and additional
vigilance about possible future violence Fourth, the definition of “perpetrator”
(Banks, Landsverk, & Wang, 2008). can limit the obligations of a psychother-
apist to report suspected abuse. In most
Second, the difference between neglect states the perpetrator must be a specific
and poverty is another area of confusion. person such as a “parent, caregiver, or
It is important to note that most US juris- other individual having care custody, or
dictions exclude poverty-based neglect control of the child, or a person who is
(Mathews & Kenny, 2008) as a form of responsible for the care of the child”
child maltreatment. A parent cannot be (Mathews & Kenny, 2008, p. 55). Various
held criminally responsible for not being states also include anyone living in the
able to provide for his/her children. home, any family member, teachers, or
However, if a parent-client has been pro- clergy. Some states also require report-
vided referrals and assistance in utilizing ing regardless of the relationship of the
social services and charitable organiza- perpetrator to the victim.
tions, a report may still need to be made if
the caregiver is neglecting the child by not There are other challenges psychologists
seeking assistance or using the assistance face regarding deciding if they should
as it was intended. In fact, in 2007, 59% of make a report or not based on the word-
verified child maltreatment cases were ing of relevant statutes. For example,
neglect (USDHHS, 2009). some states require reporting if the
“child’s health or welfare is harmed.”
Third, what constitutes emotional harm Others mention a “substantial risk of
is difficult to determine. Children usu- being harmed.” Just how the psycholo-
ally do not present for mental health gist is to assess these and determine the
treatment without some type of emo- threshold for reporting is not clear. How
tional difficulties. The state of Wisconsin much harm or potential for harm is
has comprehensively defined emotional enough to warrant filing a report? Many
harm as “harm to a child’s psychological laws define neglect as being when
or intellectual functioning. . . evidenced “proper care and attention” are not pro-
by one or more of the following charac-
vided to the minor. Whose definition of
teristics exhibited to a severe degree:
proper is to be followed? The definitions
anxiety; depression; withdrawal; out-
of abuse and neglect are not entirely
ward aggressive behavior; or a substan-
clear and appear subject to interpreta-
tial and observable change in behavior,
tion and subjective appraisal. The role of
emotional response or cognition that is
cultural differences further complicates
not within the normal range for the
this. Many clinicians’ judgments and de-
child’s age and stage of development”
cisions in these matters are impacted by
(as cited in Mathews & Kenny, 2008, p.
social norms, cultural beliefs, and values
59). This definition is important in that
(Lewit, 1994; Sternberg, 1993). Most
it recognizes that the effect of emotional
statutes allow the professional to use his
abuse must be present through severe
or her judgment in making these deci-
clinical symptomology. For example, a
child who suffers from mild depression continued on page 34
33
#"$!%

sions. But, basing such decisions on a consequences for all involved. Each psy-
gut feeling or some other subjective chotherapist should carefully consider
judgment or impression seems not to be their obligations in this regard.
the most appropriate method to use in
such high stakes situations. Recommendations
• Actively utilize the informed consent
Reasons for Not Reporting process to ensure that clients under-
There are a number of factors that profes- stand all limits to confidentiality that
sionals consider when deciding on mak- exist and the extent of your reporting
ing a mandated report. Egu and Weiss requirements. Ensure that informed
(2003) report that the perceived level of consent is an ongoing discussion and
severity of the suspected abuse has a sig- provide illustrative clinical examples
nificant impact on reporting decisions. As to help clients understand what is or
perceived level of severity decreases, con-is not a reportable offense.
cerns about the psychotherapeutic rela- • Utilize assessment measures and do not
tionship appear to increase and concerns rely on your subjective appraisal of
for the minor’s safety decrease. The na- symptoms of abuse or neglect such as the
ture of the suspected abuse is also a sig- Conflict Tactics Scales (Straus, 2007). Ob-
nificant factor (Brosig & Kalichman, 1992) tain needed training to assess for the
with sexual abuse being reported more presence of abuse and neglect. Under-
often than any other type of abuse stand the role of bias and stereotypes and
(Warner & Hansen, 1994). The profes- the impact of culture, religion, SES, and
sional’s level of familiarity with the re- other diversity factors. Know the system
porting process (Alvarez et al., 2005) and in your local jurisdiction. Beyond know-
comfort with it (Vullimany & Sullivan, ing the reporting statutes, know the serv-
2000) are relevant as well. Characteristicsices available and how reports are
of the family involved in the abuse also handled. Attempt to collaborate with the
impact professionals’ decisions about re- client when making a report. This can as-
porting to include socioeconomic status sist in preserving the therapeutic alliance
and racial minority status (Benbenishty & and in promoting the client’s autonomy.
Chen, 2003). Further, VanBergeijk (2007) • Utilize colleagues, the American Psy-
reports the three major factors impacting chological Association, and state
whether or not suspected abuse and neg- ethics committees for consultation
lect are reported are the professional’s when unsure of how to proceed in a
confidence level that the abuse occurred, given situation.
• Document all client contacts, suspi-
the professional’s affiliation with the in-
stitution where the abuse was reported, cions of abuse and neglect, your deci-
and the number of obstacles a psy- sion making process and deliberations,
chotherapist person needs to overcome to your assessment and factors consid-
ered, and the reporting process fully.
file a report. Each of these factors must be
considered in addition to the challenges • Work with your local professional as-
addressed earlier regarding the wording sociations to remove the ambiguity
of mandatory reporting statutes, how to present in many laws by including
actually assess for the presence of abuse more operationalized definitions of
or neglect, and how to decide if a behav- abuse and neglect in mandatory re-
porting statutes.
ior is a reportable offense. But, failure to
make mandatory reports due to personal
discomfort, biases, or subjective judg- References available on-line at
ments may have far reaching effects and www.divisionofpsychotherapy.org

34
#"$!%

PERSPECTIVES ON PSYCHOTHERAPY
INTEGRATION
Research on Psychotherapy Integration:
Throw Away the Manual
Paul L. Wachtel, Ph.D.
City College and the Graduate Center, City University of New York
The evolution of psy- are obvious—patients deserve to receive
chotherapy integration treatments that have been shown to be
confronts at this point effective rather than being simply what
in the development of the therapist likes to practice or “feels”
the integrative move- to be effective . Moreover, not only is it
ment an intriguing and important to demonstrate the effective-
somewhat contradic- ness of therapy but, at least as impor-
tory challenge. On the one hand, there tant, to improve the effectiveness of
are many indications that large numbers psychotherapy. And to do so, we need to
of therapists identify as integrative and keep refining and extending our knowl-
eclectic and attempt to work in this fash- edge, a process in which knowledge is
ion (e.g., Norcross, Karpiak, & Santoro, gained not only by learning new things
2005; Norcross, Hedges, & Castle, 2002). but by learning what old things we
On the other hand, integrative therapies thought we knew are actually not so.
have suffered because less research has
The bad reasons underlying the call
been conducted on their effectiveness for evidence-based practice should be
than “pure form” therapies (Goldfried, equally obvious, though—as a reflection
1991). One reason that the latter is the of the very reason they are problem-
case is because the criteria for meaning-atic— they are often buried under obfus-
ful outcome research that have been in- cations and skilled public relations.
creasingly emphasized in our journals, Health and mental health care in this
in our graduate schools, and in our country are dominated by large profit-
funding agencies are remarkably inap- seeking corporations. As I write these
propriate for investigating integrative words, the effort to create a more sane
approaches, as they are for a wide swath and just system for funding health care
of the therapies currently being prac- is proceeding in the Congress, and by
ticed (see, for example, Westen, the time these words are published it
Novotny, & Thompson-Brenner, 2004). may even be the case that some of the
In what follows I wish to discuss this worst abuses of the system will have
state of affairs and to explicate not only
been modified at least a bit. But the cor-
why such increasingly consensual crite- porate dominance of health care, alas, is
ria as manuals and a focus on a single unlikely to change in the time frame rep-
diagnostic category are often inappro- resented by publication lag. This corpo-
priate but also why the insistence on rate dominance, with its corollary of
these criteria in fact reflects a crude, lim-
vast sums for propaganda and lobbying,
ited, and often ideologically driven un- ensures that debate and discussion
derstanding of science. about issues vital to both our field and
our society do not proceed on a level
We live in an era in which—for good
playing field. As everyone other than
reasons and bad—there is an increasing
the likes of John Roberts or Samuel Alito
call for evidence for the practices that
therapists engage in. The good reasons continued on page 36
35
#"$!%

understands, money talks; and when because it revealed itself in more overt
money talks, in the person of large, form, was the response of APA to House
wealthy corporations, the voices of flesh and Senate resolutions condemning an
and blood human beings—such as those article appearing in the Psychological
whose suffering it is our business to re- Bulletin ( Rind, Tromovitch, & Bauser-
lieve—are drowned out. man, 1998) that reviewed the available
research on the psychological conse-
The contours of this corporate influence quences of sexual relations between
are not very difficult to see in the overt adults and children and found consider-
political realm of debate on national ably less evidence for enduring harm
healthcare policy. Harder to evaluate is than is commonly assumed. In response
how the policies and grant criteria of the to this political pressure, in a highly un-
federal agencies that fund psychother- usual maneuver, APA requested that the
apy research might be influenced by the American Association for the Advance-
millions of dollars worth of lobbying ment of Science (AAAS) conduct a re-
and campaign contributions directed to view of the study. After studying APA‘s
the members of Congress who hold the request, the AAAS Committee on Scien-
purse strings for these agencies’ budg- tific Freedom and Responsibility refused
ets. To what degree is it pure coinci- to review the article, commenting that it
dence that, as discussed below (see also was not appropriate to “second-guess
Wachtel, in press; Westen, Novotny, and the peer review process” and indicating
Thompson-Brenner, 2004), the criteria that “after examining all the materials
for funding of psychotherapy outcome available to the Committee, we saw no
research tend to favor studies of the very clear evidence of improper application
kinds of treatments—brief and cheap— of methodology or other questionable
that benefit the bottom lines of insur- practices on the part of the article’s
ance companies and managed care cor- authors.” They went on to express
porations? To ask such a question is not “grave concerns with the politicization
to cast aspersions on those who set the of the debate over the article’s methods
policies and criteria for these agencies. and findings.” (Rind, Tromovitch, &
They are simply human, no different Bauserman, 2000).
from the rest of us. Huge quantities of
research in areas such as the sociology of This instructive incident was capable of
knowledge make it clear that scientific providing clear observational data, as it
discourse and procedure do not operate were, because it occurred after the fact;
in a vacuum, but are strongly shaped by the article had already been published.
the social context in which they operate, The influences I was primarily dis-
as well as that that social context is in cussing above are more in the realm of
turn strongly shaped by the power rela- what in legal discourse is called prior re-
tions that hold within—and maintain— straint. That is, my concern is with the
that context. An equally substantial studies that never see the light of day be-
body of research in cognitive science cause their proposed methodology does
and cognitive social psychology makes not fit the ideological strictures that
it clear that when people are in this way silently and covertly shape and constrict
influenced by a host of background vari- our thinking. Whether those strictures in
ables, they are very often unable to con- some part reflect the political and eco-
sciously notice or report that influence. nomic influences I have pointed to is at
One illustrative example of the influence this point speculative. But the existence
of Congressional pressure and broader and nature of those strictures is not. For
social climate that is easier to document, continued on page 41

36
#"$!%

DIVISION 29 BYLAWS CHANGES BALLOT

Dear Division of Psychotherapy Colleagues,
The Division of Psychotherapy Board of Directors requests your approval of the revisions to the by-
laws of the Division of Psychotherapy that are presented on our website: www.divisionofpsy-
chotherapy.org. Periodically, organizations need to update their bylaws to ensure that they reflect
their actual structure and workings. For example, since the last time the bylaws were updated the
division changed its governance structure so that instead of members-at-large on the board, we
now have domain representatives to ensure representation of all areas of psychotherapy on our
board. Thus, we have developed this revised set of bylaws for your approval. Further, bylaws are
by design intended to be broad and general. In some areas changes are suggested to make the by-
laws less detailed and specific.

The changes to the Division 29 bylaws that you are being asked to approve are:
In Article I, Section B is changed, updating the mission of the division. Further, Section C has been
removed since APA legal counsel advises that this is not actually accurate or relevant. These are is-
sues addressed in the APA bylaws and not needed in a division’s bylaws.
In Articles II through V, wording is cleaned up to ensure accuracy and clarity.
In Article VI the bylaws are updated to authorize the board to conduct business and vote via e-mail
and other electronic means. This allows greater efficiency and timeliness of the board’s work and
reduces expenses for the division. With this proposed change, Section G (4) is no longer needed so
it being removed. Section J is redundant due to being addressed elsewhere.
In Article VII, Section L, the wording is changed to create greater clarity and to ensure fairness.
In Article VIII, Section B, the sentence being removed is redundant with information provided else-
where.
Article X, Section A, as was written was inaccurate. It is being changed to reflect current dues practices.
The division sets its dues, not APA. In Section E the wording is changed to create greater clarity.
Article XI has been revised to reflect the actual structure of the division’s governance and the role
and mission of each committee. All terms of office, number of members on each committee, and
roles and duties have been updated for accuracy and consistency. The definition of diversity has
been updated to reflect the definition provided in the most current version of the APA Ethics Code.
In Articles XI and XIII the wording has been updated to reflect clarity and accuracy.
Article XIV has been updated to authorize a student member to serve on the Publications and Com-
munications Board. The Publications Board and Board of Directors find this to be an important
change for the future of the division, ensuring student input in all deliberations about the division’s
publications.
In Article XV the suggested wording change clarifies duties and responsibilities with regard to
amendments.
New Article XVI adds a conflict of interest statement.
Thank you for your careful reading of these proposed bylaws and for your ongoing support of Di-
vision 29. We respectfully request your approval of the revisions to the bylaws. You may indicate
your vote using the ballot in this issue of the Psychotherapy Bulletin.
On behalf of the Division 29 Board of Directors,
Jeffrey Barnett, Psy.D., ABPP
Division 29 Past-President

BALLOT – DIVISION 29 BYLAWS CHANGES

YES! I accept all the bylaws changes as proposed by the Division 29 Board of Directors

NO! I reject all the bylaws changes as proposed by the Division 29 Board of Directors
37
#"$!%

Name (Printed)
______________________________________

Signature
______________________________________

FOLD THIS FLAP IN.

Fold Here.

__________________________________
__________________________________
__________________________________

Division29
Central Office
6557 E. Riverdale St.
Mesa, AZ 85215

Fold Here.
#"$!%

2010 NOMINATIONS BALLOT

Dear Division 29 Colleague:

Division 29 seeks great leaders! Bring our best talent to the Division of Psychotherapy (29) as we
put our combined talents to work for the advancement of psychotherapy.

NOMINATE YOURSELF OR SOMEONE YOU KNOW TO RUN FOR OFFICE IN THE

DIVISION OF PSYCHOTHERAPY. THE OFFICES OPEN FOR ELECTION IN 2010 ARE:
• President-elect • Representatives to APA Council (2)
• Domain Representatives for Early Career, Science & Scholarship, and Diversity
All persons elected will begin their terms on January 2, 2011

Domain Representatives are voting members of the Board of Directors. They are responsible for
creative initiatives and oversight of the Division’s portfolios in Early Career, Science & Scholar-
ship, and Diversity (one of two Diversity Representatives). Candidates should have demon-
strated interest and investment in the area of their Domain.

The Division’s eligibility criteria for all positions are:

1. Candidates for office must be Members or Fellows of the division.

2. No member may be an incumbent of more than one elective office.
3. A member may only hold the same elective office for two successive terms.
4. Incumbent members of the Board of Directors are eligible to run for a position on the Board
only during their last year of service or upon resignation from their existing office prior to
accepting the nomination. A letter of resignation must be sent to the President, with a copy
to the Nominations and Elections Chair.
5. All terms are for three years, except President-elect, which is one year.

Return the attached nomination ballot in the mail. The deadline for receipt of all nominations ballots
is December 31, 2009. We cannot accept faxed copies. Original signatures must accompany ballot.
EXERCISE YOUR CHOICE NOW!
If you would like to discuss your own interest or any recommendations for identifying talent in our
division, please feel free to contact the division’s Chair of Nominations and Elections, Dr. Libby
Nutt Williams at (240) 895-4467 or by Email at [email protected]
Sincerely,

Nadine Kaslow, Ph.D. Jeffrey J. Magnavita, Ph.D. Elizabeth Nutt Williams, Ph.D.
President President-elect Chair, Nominations and Elections

NOMINATION BALLOT
President-elect Council Representative
____________________________________ ____________________________________
____________________________________ ____________________________________

Domain Representative – Early Career Domain Representative—Science & Scholarship

____________________________________ ____________________________________
____________________________________ ____________________________________

Domain Representative—Diversity
____________________________________
____________________________________

Indicate your nominees, and mail now! In order for your ballot to be counted, you must put
your signature in the upper left hand corner of the reverse side where indicated.
39
#"$!%

Name (Printed)
______________________________________

Signature
______________________________________

FOLD THIS FLAP IN.

Fold Here.

__________________________________
__________________________________
__________________________________

Division29
Central Office
6557 E. Riverdale St.
Mesa, AZ 85215

Fold Here.
#"$!%

those strictures derive from a second of science are not widely challenged,
ideological thrust, emanating from when these students graduate, they will
within our own profession, and the ad- in turn teach still another generation of
vocates of this second interest group students what they themselves were
have been far from covert or subtle. Or- taught, and the tight circle of restricted
ganizing “task forces,” these advocates knowledge will be further perpetuated.
have, to this point, successfully man-
aged to dominate the field’s understand- Now, I am aware that in referring to
ing of and criteria for what constitutes “empirically validated” treatments I am
appropriate research on psychotherapy not using the rhetoric du jour. The
outcome, and their views are closely names of these lists keep mutating like
paralleled in the policies of funding they are in a race with the flu virus. In a
agencies such as NIMH. Here we may relatively brief span of years we have al-
add, apropos the above discussion, that ready had “well established,” “probably
efficacious,” “empirically validated,”
there is little likelihood that these criteria
will be countered or undermined by the “empirically supported,” and “evi-
insurance lobby, because, whether coin- dence-based” as the label for the lists,
cidental or not, the task force positions and it is unclear what the flavor of the
fit their needs hand in glove. day will be tomorrow. Such rapidly
shifting sands suggest a fundamental
The criteria, assumptions, and standards unease with what is being perpetrated
I wish to discuss here have, further, been that is being repeatedly covered over by
associated with “lists” of therapies strategic rebranding. The basic product,
whose evidence comports with those however, has remained largely the same
standards, and, because these criteria
have become influential in funding Now strictly speaking, as these advo-
agencies as well, they operate as self-ful- cates present it, these are not lists of
filling prophecies which virtually ensure those therapies that have been validated
that treatments presumed not to have and those that have not, but only the for-
empirical support will continue (at least mer; how one views the latter (the ther-
by the standards currently being prom- apies not on the list) is left up to the
ulgated) to be empirically unsupported. perceiver. But as Chevy Chase well cap-
If one of the criteria for empirical valida- tured on Saturday Night Live, with his
tion is that the treatment be manualized, sign-on for his faux news report (“I’m
(I discuss other problematic elements in Chevy Chase....and you’re not!”), stating
the EVT paradigm in Wachtel, in press), one thing can quite readily evoke the
then by fiat and definition, not by data, neural circuits that represent its implicit
treatments that are not manualized opposite. The list-makers may not say
cannot be designated as empirically that those therapies that are not listed as
validated. This is the case, if one stays validated on their lists have been show
within these highly tendentious criteria, to not be valid; but if they think as psy-
even if—as in many instances is the chologists, not logic-choppers, the impli-
case—there is a very large and impres- cation is obvious.
sive body of data that demonstrate their
effectiveness (see, for example, Shedler, This confusion is problematic for a num-
in press). In graduate schools around the ber of different reasons. First, the advo-
country, the new generation of clinicians cacy groups that have promulgated
and researchers is being very largely these lists have done so not simply as a
taught the dogma of “empirically vali- summary for cutting edge researchers, a
dated” and manualized treatments— kind of abstract to an article whose im-
and if the limits of this advocacy version continued on page 42
41
#"$!%

plications are really only clear if one has These days they make their sales pitch
“read the full article” (that is, if one is so- in the classroom, where the teaching of
phisticated enough about the nature and manualized treatments often dominates
the limits of the research). Rather, they the curriculum of training programs in
have advocated making these lists our field.)
widely available to the general public,
supposedly to guide people in choosing In the investigation of integrative thera-
more wisely the kind of therapy they peutic approaches, the limits of the
will seek. Indeed, they have more than traditional EVT methodology are espe-
advocated this; they have done it. cially severe. A growing number of
prominent researchers have commented
Such an approach to disseminating in different ways on the limits of prom-
knowledge is difficult to distinguish ulgating lists of supposedly validated
from the ads from drug companies that treatments or on the limits of the
saturate the airwaves (which also, after methodological assumptions on which
all, are based on data – and also, very those lists are based (e.g., Westen,
often, primarily on the data congenial to Novotny, & Thompson-Brenner, 2004;
the conclusions they wished to reach in Goldfried & Wolfe, 1996, 1998; Trier-
the first place). Do these ads make pa- weiler & Stricker, 1998). Rather than list-
tients more savvy consumers? Perhaps ing the brand names of the therapies
in certain ways. But in “liberating” the that have made the cut according to the
consumer from reliance on their doctors’ EVT methodology, many of these critics
knowledge and expertise, and substitut- have suggested, it is more productive to
ing their amateur night understanding focus on the fundamental principles
in its place, it is not clear that patients of therapeutic change (e.g., Beutler,
are in fact well served. Having more in- Clarkin, & Bongar, 2000, Bohart, 2000,
formed patients is a good thing. Doctors Castonguay & Beutler, 2003, Rosen &
are not infallible, and they are often Davison, 2003). I have myself written on
overworked and potentially prone to these issues in a forthcoming book
neglect a possibility that should be in- (Wachtel, in press). I will therefore limit
cluded in the mix of considerations. But myself to a single issue here, a kind of
it is far from clear that advocacy adver- sample of the larger set of issues that
tising is the best guarantor of useful have concerned many critics of this
knowledge or sophisticated understand- “EVT list” movement. That issue is the
ing. (Of course, it can be countered that
requirement that a therapy be manual-
the doctors too are often informed more
ized in order to even consider it with re-
by agents looking to sell a product than
gard to empirical validation or support.
by disinterested research. Where do the
doctors themselves learn much of what
Strictly speaking, the advocacy groups
they know about the medications they
to which I have been referring rarely
prescribe? Often from “seminars” in
state that a manual is a requirement.
lovely vacation spots that are sponsored
Usually the language is some version of
by drug companies, or at dinners in
“a manual or some other means of en-
posh restaurants, where an industry rep
suring that the treatment being admin-
treats a group of doctors to filet mignon
istered is the treatment the investigators
while informing them of the company’s
latest product and the “research” that claim to be evaluating.” On the face of
supports it. In contrast, those in our field it, this is a perfectly reasonable demand.
who inform therapists about the thera- The problem with “manuals or some
pies on “the list” don’t need to take other appropriate means of evaluating”
them out to dinner to sell their wares. continued on page 43
42
#"$!%

is that in the real world this so often noted that a broader statement on evi-
comes down to “manuals or no research dence-based practice approved by the
grant.” Westen et al (2004) and a variety entire APA Council of Representatives in
of other commentators have noted that 2005 (http://www2.apa.org/practice/
if one looks at the daily realities of ap- ebpstatement.pdf)—in contrast to the
plying for research grants, it is easier for statements by the Division 12 task forces
a camel to pass through the eye of a nee- or a number of its members in separate
dle than for an investigator to get a sub- publications—does not specify manuals
stantial grant to investigate the outcome as a requirement. This does not, how-
of a non-manualized treatment. Thus, ever, alter the state of affairs in granting
what we have is a caricature of science agencies or in classrooms in large num-
in which prejudices cannot be chal- bers of clinical programs).
lenged because the prejudices are
woven into the criteria for investigating In explicating why manualization is not
those prejudices. This is science by essential for the aim for which it was
methodological fiat rather than science originally introduced—namely, ensur-
by observation. The observations never ing that the treatment nominally being
get made, because by a self-fulfilling evaluated is the treatment actually being
prophecy, certain therapeutic ap- evaluated—I wish to return to a study I
proaches (namely, non-manualized conducted many years ago which I had
treatments) are not deemed worthy of largely forgotten about until I began
receiving grants to investigate their thinking about the limitations of the
efficacy, and so their efficacy remains dogma of manualization. In a study
unexamined and, of necessity, undocu- published in 1970, Jean Schimek and I
mented. Especially is this the case (Wachtel, & Schimek, 1970) were inter-
for many integrative therapeutic ap- ested in the effects of emotionally toned
proaches. By their very nature, integra- incidental stimuli on the mood, fan-
tive approaches tend to be more tasies, and thought processes of individ-
complex. After all, they contain elements uals. In contrast to most studies to that
from several different approaches, and point, which, if they investigated inci-
there are likely to be many more options dental or subliminal stimuli, tended to
and choice points for the integrative use very specific, discrete content (par-
therapist than for the therapist who fol- ticular words, pictures, etc) we were in-
lows a manual or a strictly laid out terested in the impact of a factor that
singular path. Given that a very signifi- influences so much of our daily life—the
cant percentage of therapists describe emotional tone of the various stimuli we
themselves as integrative or eclectic encounter in the course of the day. To
(Norcross, Karpiak, & Santoro, 2005; this end, we created an experimental
Norcross, Hedges, & Castle, 2002), and situation in which subjects were admin-
that in many respects integrative prac- istered several TAT cards and partici-
tice represents the cutting edge of our pated in various other measures while,
field, this is a serious issue. We need to through the walls from next door, came
be able to evaluate these integrative ap- sounds indicating either an argument or
proaches, and in order to do so, we need a happy gathering with laughter. Sub-
to extricate ourselves from the method- jects could not hear any specific words,
ological stranglehold that has been cre- but they could pick up the emotional
ated by the EVT list mindset and has tone of what was going on. After careful
come to be equated in the minds of and intensive debriefing, only 3 out of
many in our field with the idea of em- 60 subjects indicated that they thought
pirical validation itself. (It should be continued on page 44
43
#"$!%

the sounds they were hearing had any- cantly from one condition to the other.
thing to do with the study they were
participating in (many thought it was a Applying this experience to the realm of
television playing next door), but almost psychotherapy outcome research, the
all, when their attention was directed implication is that instead of requiring a
after the fact to thinking about what manual, one might do just as well (and,
they had heard, could reliably indicate since it permits more approaches to be
what the emotional tone was. Thus, al- seriously evaluated, might do better)
though the stimuli were, for most sub- simply by asking therapists identified
jects, not in focal awareness, they were with the particular approaches being
incidental, not subliminal, and what was evaluated in the study to determine, in
registered was affective tone not explicit blind ratings based on tapes or tran-
content. scripts, how much the work in the ses-
sion actually conformed to what should
One chief aim of the study was to assess go on in such a therapy. Especially does
angry content in the TAT stories the sub- this strategy make sense when one takes
jects told and to compare the degree of into account that in fact it is never “the
such content in the two experimental manual” that enables the determination
conditions. To this end we made elabo- of whether the nominal approach was
rate efforts to spell out very explicitly actually followed but rather it is the
what the criteria would be for angry adherence checks—determining if the
content. In essence, we were trying to therapists followed the manual—that
create a “manual” for the scoring of the are the real methodological safeguard.
stories. This approach to the assessment Thus, what I am suggesting essentially
was tedious and laborious, but even entails simply using adherence checks
more important, after spending quite a without a manual, adherence checks
bit of time on this effort, we were both based, as were the ratings of anger in the
very discouraged; the scoring using the study I just described, on the human ca-
successive versions of the “manual” had pacity to detect relational and emotional
very low inter-rater reliability and did phenomena with a subtlety and adroit-
not discriminate very well between the ness that is often more than the sum of
two experimental conditions. (Through- the parts of a manual (again on this
out the process of attempting to develop point, see Polanyi). In this fashion, “non-
this manual, the raters were blind as to manualized” treatments, such as many
which condition the stories being rated in the realm of integrative psychotherapy,
came from; the tallying of these scores may be seen to be much more accessible
was always done by a separate party). to rigorous evaluation than the dogma
Finally, almost in desperation, we of the EVT criteria would suggest.
turned to a more “naive,” less method-
ologically “fancy” approach—we sim- Even better perhaps than the approach I
ply said, let’s see what happens if the have just described is the employment,
instructions are simply “rate how angry again without the treatment being man-
the stories seem,” without any specific ualized, of ratings based on measures
or detailed guidelines for what to look such as the Psychotherapy Process Q-
for or check off (that is, without a “man- Sort [PQS] (Jones, 2000; see also Ablon &
ual”). This approach, which relied, es- Jones, 1998, Jones & Pulos, 1993), an in-
sentially, on what Michael Polanyi (1956, strument designed not to detect the
1967) has called tacit knowledge, presence of brand name packages, but
worked like a charm. The reliabilities rather of very specific kinds of com-
were quite satisfactory and the degree of ments and behaviors. It is ironic that ad-
anger rated in the stories varied signifi- continued on page 45
44
#"$!%

vocates of the EVT list approach, who, standing. The psychotherapy integra-
under the banner of precision and speci- tion movement evolved in good part as
ficity, advocate restricting the patient a counter to this “turf war” approach to
sample to a single Axis I diagnosis, place science and to our field . For this alter-
such enormous emphasis on the anoint- native to evolve further, and to be en-
ing of rather global “packages” of inter- abled to develop empirical foundations
ventions, which, when closely as fully as possible, attention must be di-
examined, often represent a hodge- rected to exposing further the limita-
podge of actual elements and interven- tions of the false science that has
tions (Shedler, in press; Wachtel, in restricted funding of integrative re-
press; Westen, et al, 2004). search and led to the miseducation of
much of a generation of graduate stu-
The PQS approach addresses itself not dents. The scientific investigation of
to validating brand names, but to exam- what really accounts for success or fail-
ining the processes and specific inter- ure in psychotherapy is too important a
ventions that account for therapeutic public need to be sacrificed to a crude
success. The brand name approach un- caricature of the scientific method.
derlying the EVT lists reflects thinly dis-
guised turf wars rather than science and References available on-line at www.divi-
yields consistently superficial under- sionofpsychotherapy.org

45
#"$!%

CONGRATULATONS TO
THE DIVISION OF PSYCHOTHERAPY
2009 DISTINGUISHED PSYCHOLOGISTS!
Dr. Jeffrey Barnett made the following remarks in awarding Norine G. Johnson, the re-
cipient of the Division of Psychotherapy’s 2009 Distinguished Psychologist Award:
I will offer some information regarding Norine’s participation in the division
in consideration of her nomination for 2009 Distinguished Psychologist of the
Division of Psychotherapy.
Norine was a member of the Board as an elected member at
large for two terms and during that time, supported the divi-
sion in advancing psychotherapy in APA and in psychological
practice. She has been a Fellow of the Division for over ten
years. She was director of the Dept. of Psychology for 18 years
at Kennedy Memorial Hospital for Children where she special-
ized in advancing psychotherapy in working with children.

Dr. Johnson was 2001 President of APA during 9/11 and devoted much of her
presidency to the development of psychological services for those affected by
the tragedy and the advancement of psychology as a health profession. During
her presidency, she also planted the seeds of what has come to be known as the
re-sequencing of training, specifically the role of the post doctoral experience
in training. These years later, Norine’s proposal has come to fruition in the
Council vote for re-sequencing the training requirements. Norine was instru-
mental in the development and adoption of the Guidelines for Psychological
Practice with Women and Girls. She also was the sponsor of the Council item
to officially change the term “therapy” to “psychotherapy” as used by psy-
chologists and in official documents of APA. This was an extremely important
action that promoted the continued primary stance of psychotherapy in the
practice of psychology. Lastly, Dr. Johnson is in her second term of represen-
tation of our Division as Council Representative. Norine Johnson has made
singular and significant contributions to the division and on behalf of the di-
vision in the advancement of psychotherapy. Additionally, Norine has been a
strong advocate for advancing psychotherapy internationally.
Jon Carlson, PsyD, EdD, ABPP is Distinguished Professor, Psy-
chology and Counseling at Governors State University and a
psychologist at the Wellness Clinic in Lake Geneva, Wisconsin.
Jon has served as editor of several periodicals including the
Journal of Individual Psychology and The Family Journal. He holds
Diplomates in both Family Psychology and Adlerian Psychol-
ogy. He has authored 150 journal articles and 50 books includ-
ing Time for a Better Marriage, Adlerian Therapy, Inclusive Cultural
Empathy, The Mummy at the Dining Room Table, Bad Therapy, The Client Who
Changed Me, Their Finest Hour, Creative Breakthroughs in Therapy, and Moved by the
Spirit. He has created over 250 professional trade video and DVD’s with leading
professional therapists and educators. In 2004 the American Counseling Associ-
ation named him a “Living Legend.” Recently he syndicated an advice cartoon
On The Edge with cartoonist Joe Martin. Jon and Laura have been married for
forty-two years and are the parents of five children.

46
#"$!%

WASHINGTON SCENE
Exciting Times for Those with Vision
Pat DeLeon, Ph.D.
Former APA President
Action In The Far the House. All in all, we remain opti-
West: For those of us mistic, look forward to a 2010 Hawaii
who appreciate the Gubernatorial race, and are determined
broader public policy as ever to see RxP become a reality in
and particularly, the our state.
public health aspects
of psychology obtain- In Oregon, Robin Henderson reports:
ing prescriptive au- Oregon had a wild ride this year in pur-
thority (RxP), the efforts of visionaries in suit of prescription privileges. We en-
Hawaii and Oregon this past legislative tered the Session strong, with HB 2702,
session were truly exciting. After the and bipartisan support from every key
Governor vetoed their bill in July, 2007, healthcare legislator in Oregon. Starting
Robin Miyamoto and her colleagues on the House side of the building, pro-
were successful in having their commu- ponents and opponents battled through
nity health center-oriented legislation details in Rep. Mitch Greenlick’s Health-
pass the Hawaii Senate in March by a care Committee—the same committee
wide margin. Jill Oliveira Gray: that was crafting Oregon’s landmark
omnibus healthcare bill—HB 2009. It
The HPA RxP committee was encour- was tough to get hearings scheduled,
aged by an even stronger endorsement but Rep. Greenlick was a co-sponsor of
this year by the Hawaii Primary Care HB 2702, and safely shepherded the bill
Association, who announced that they through his Committee. On the House
were not only going to support the RxP floor, HB 2702A enjoyed strong support
bill, but rather, make RxP one of their from House members, passing easily
top three legislative initiatives for 2009. with a vote of 47-11 for journey to the
In addition, continued support and in- Senate. Oregon’s two psychologist leg-
creased lobbying efforts by the Mental islators, Rep. Phil Barnhart and Rep. Bill
Health Association of America, Hawaii Kennemer gave passionate speeches
Medical Services Association (HMSA), about the bill and why this version was
and the local chapter of the National As- right for Oregon. Victory was sweet—
sociation of Social Workers, helped to but the battle was just beginning to in-
diffuse the classic turf war between psy- tensify. The journey was not as easy in
chologists and psychiatrists and focus the Senate. Opponents of our bill used
on the issue of access to care in med- traditional means to obfuscate the facts
ically underserved areas. Hawaii’s SB around safety and training, and sent
428 SD1 passed out of the Senate with an many Senators scrambling for the hills
overwhelmingly supportive vote of 21- with the sheer volume of information
4. Unfortunately, due to the recent elec- both sides brought to the table. People
tion year that managed to stir things up from all over the country sent e-mails in
in the legislature there were some unan- favor and opposed to the issue, creating
ticipated changes we had to contend new small fires to extinguish each day.
with given new members and shifting Our lobbying team … remained well on
committee position appointments. In the top of the issues … but at the end of the
end, SB 428 SD1 despite its success in the
Senate, could not maintain its traction in continued on page 48

47
#"$!%

battle, this was not to be our year … ship. As our nation’s health care system
Under intense political pressure, Ore- advances into the 21st century, with its
gon’s psychologists were asked by key ever sophisticated communications
legislators to agree to one last work- technology (e.g., computerized records
group, staffed by a professional mediator, and virtual realities), psychology could
to sort through the details of prescribing and should play a major role in ensuring
in Oregon. Psychiatrists proposed a large, that patients become truly “educated
unwieldy process for consideration, and consumers.”
psychologists proposed a small, time-
limited workgroup with three psycholo- Health Literacy: During the first days of
gists, two psychiatrists, a primary care the Obama Administration the Congress
physician, and a pharmacist. Our version enacted the President’s far-reaching Eco-
prevailed, and passed the Senate 23-4. A nomic Stimulus proposal, The American
disappointed House concurred a few Recovery and Reinvestment Act of 2009
days later, emphasizing their desire that (P.L. 111-5). This legislation incorporated
this bill prevail in February, 2010 and the Health Information Technology for
strengthening their resolve to see this Economic and Clinical Health (HITECH)
through. Now Oregon will move to the Act, with the goal of promoting the
interim work of the mandatory work- widespread adoption of health informa-
group. Senator Laurie Monnes-Anderson tion technology (HIT) for the electronic
and Rep. Bill Kennemer will personally sharing of clinical data among hospitals,
oversee these proceedings and guarantee health care providers, and other-health
that a bill will be presented in the Febru- care stakeholders. The Stimulus legisla-
ary, 2010 special session. Thanks to all tion raised the budget of the HIT
around the country who have supported National Coordinator’s office from
us—we’re doing our very best to bring approximately $66 million in FY’09 to
RxP to Oregon. $2 billion, with numerous health policy
experts suggesting that the federal
The Importance Of Addressing Soci- government’s overall investment for
ety’s Needs: Former APA State Advo- HIT would reach $19+ billion as a result
cacy guru, Mike Sullivan reflecting upon of the stimulus package. This is a very
psychology’s RxP quest: It is no coinci- impressive accomplishment for the new
dence that the first states to enact pre- Administration and one with many long
scriptive authority are states that term policy implications, including
traditionally have been ranked at or heralding the era of “educated con-
near the bottom in the nation on meas- sumers,” as the unprecedented advances
ures of health and mental health for occurring within the communications
their citizens. Offering a new solution to and technology fields are finally directly
enormous mental health and public applied to our nation’s health care arena.
health problems made psychologists
credible and persuasive to their legisla- The Institute of Medicine (IOM) has
tors and governors. As a result, prescrib-been studying an interesting (and often
ing psychologists in New Mexico and overlooked) aspect of this evolution.
Louisiana have been able to offer quality In 2004 and 2009, the IOM published
care to underserved citizens in their reports exploring what might be consid-
states... by practicing a psychological ered a “silent epidemic”—Health Liter-
model of pharmacotherapy. acy. “Clear communication is critical to
successful health care.” Today, nearly
As members of our nation’s educated half of all American adults, 90 million
elite, psychologists have a societal re- people, have difficulty understanding
sponsibility to provide visionary leader- continued on page 49

48
#"$!%

and acting upon health information. to accelerate the development and de-
That is, they possess limited health liter- ployment of HIT. Some analysts, how-
acy which is more than reading, as it in- ever, are concerned that these systems
cludes writing, numeracy, listening, could actually increase health care dis-
speaking, and conceptual knowledge. parities by helping mainly those indi-
Approximately 40 million citizens can viduals and communities with greater
perform simple and routine tasks using resources, noting that underserved pop-
uncomplicated materials, with an addi- ulations generally include ethnic mi-
tional 50 million adults able to locate in- norities, people in lower socioeconomic
formation in moderately complicated groups, and individuals with lower ed-
texts, make inferences using print mate- ucational and reading levels. These pop-
rials, and integrate easily identifiable ulations also tend to have limited access
pieces of information. However, they to computer technology.
find it difficult to perform these tasks
when complicated by distracting infor- A major focus of the Economic Stimulus
mation and complex texts. Over 300 legislation is to encourage hospitals and
studies, conducted over three decades practitioners to more actively engage in
and assessing various health-related ma- HIT. Yet, this is within the overall con-
terials, such as informed consent forms text that studies have consistently
and medication package inserts, have shown that more than 80 percent of In-
found that a mismatch exists between ternet users report searching online for
the reading levels of the materials and health information. The rate for those
the reading skills of the intended audi- with chronic conditions is 86 percent.
ence. Most of the materials exceed the More than half of consumers (58 per-
reading skills of the average high school cent) who search for online health infor-
graduate. mation report that what they found
affected their health decisions, with 39
There is the definite expectation at the percent reporting the information
health policy level that the increasing changed the way they cope with a
use of emerging interactive health infor- chronic condition or manage pain. Thus,
mation technology (HIT or eHealth) will it is vitally important to provide individ-
help to improve the quality, capacity, uals with the skills essential for accu-
and efficiency of the health care system. rately responding to the potentials of
This should increase the capacity to pro- eHealth, while keeping in mind the
vide tailored and individually cus- “three-click rule.” That is, one must get
tomized treatment protocols, improve users to the information in three clicks
clinical decision making and adherence or face the real possibility of simply los-
to clinical guidelines; provide reminder ing them.
systems for patients and clinicians,
thereby improving compliance with pre- eHealth literacy is growing in impor-
ventive service protocols; and help pre- tance. Consumer-directed electronic
vent many errors and adverse events. tools are transforming the way that con-
Currently, adults receive only about half sumers receive and utilize information.
of recommended health care services Two types of skills are necessary for
and less than 50 percent of adults receive eHealth—general skills and specific
the preventive and screening tests called skills. General skills apply to a number
for in guidelines for their age and sex. A of different contexts and settings and in-
recent Commonwealth Fund survey clude traditional literacy (reading, writ-
found that the highest-rated strategy by ing, and numeracy), media literacy
health care opinion leaders to improve
the quality and safety of health care was continued on page 50

49
#"$!%

(media analysis skills), and information books, pamphlets, and websites. They
literacy (information seeking and under- are, therefore, unable to understand that
standing). Specific skills include such one may have to triangulate pieces of in-
things as computer literacy (IT skills), formation from different sources to
health literacy (health knowledge com- build an entire picture.
prehension), and science literacy (sci-
ence process and outcome). The specific skills involved in eHealth
include computer literacy, science liter-
Forty percent of Americans have low lit- acy, and health literacy. Computer liter-
eracy, making it difficult for them to acy is a general awareness of and skills
function in everyday society. Thus, if in using computer-based technology to
eHealth interventions are largely text- solve problems. It relates to both com-
based, 4 out of every 10 people who puters and to the kind of technologies
might benefit from the intervention will that surround the use of computers,
have a great deal of difficulty reading such as the use of a keyboard, mouse, or
the material. In case of mathematical lit- printer. Science literacy is an under-
eracy (numeracy), one-quarter of the standing of the nature, aims, methods,
U.S. 15-year olds scored at or below the application, limitations and politics of
lowest proficiency level. To the extent creating knowledge in a systematic
that eHealth involves simple mathemati- manner. Approximately 17 percent of
cal calculations such as addition or sub- Americans are considered able to under-
traction, or an understanding of numbers, stand basic science. Thus, 83 percent
those with low numeracy skills will likely lack an understanding of the cumula-
find it difficult to understand the informa- tive, dynamic nature of scientific knowl-
tion presented, reading maps, or under- edge. They are not aware that science
standing simple charts. Media literacy can be understood and used by non-sci-
refers to the skills necessary to think crit- entists and they are unfamiliar with sim-
ically and to act based on information ple science terminology, the process of
from media-based messages. Media lit- discovery, or how scientific knowledge
eracy places information in a social and is translated into practice. Finally,
political context and considers issues eHealth demands health literacy skills.
such as the marketplace, audience rela-
Seventy-three percent of individuals
tions, and the role of the medium in the
with a chronic condition have searched
message. Those with low media literacy
online for information and those with
lack awareness of bias or perspective in
chronic conditions were more likely
media pronouncements, both in terms of
than others to report that the results of
what is being presented and what is not
an online search influenced their health
presented. They also have difficulty un-
and care behavior related to their condi-
derstanding that the media has both ex-
tion. In designing a seamless system for
plicit and implied messages and they
the future, we must not forget that those
have difficulty deriving meaning from
with low health literacy have difficulty
media messages. The third general skill,
following simple self-care directions or
information literacy, involves a more
prescription instructions. eHealth liter-
general understanding of information.
acy is growing in importance. “A major
An information literate person knows
goal [in implementing HIT] is to moti-
how information is organized, how to
find information, and to use information vate behavior change that will lead to
in a way that others can learn from. Low improved health. However, the people
information literacy individuals are un- who are experts in behavior modifica-
able to see connections between infor- tion and behavior change don’t seem to
mation from multiple sources such as continued on page 51
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have played a major role to date.” We quality health care, and our nation’s
were very pleased to see colleagues overall quality of life could not be
Dyanne Affonso, Eric Chudler, and clearer.
Jessie Gruman actively involved in
shaping the IOM views. The interrela- Aloha,
tionship between education, access to Pat DeLeon, former APA President

CALL FOR NOMINATIONS

DIVISION 29 EARLY CAREER AWARD
American Psychological Foundation (APF)
APF provides financial support for innovative research and programs that en-
hance the power of psychology to elevate the human condition and advance
human potential both now and in generations to come. It executes this mission
through a broad range of scholarships and grants. For all of these, it encourages
applications from individuals who represent diversity in race, ethnicity, gender,
age, disability, and sexual orientation.
The Division 29 program recognizes an early career psychologist for promising
contribution to psychotherapy, psychology, and the Division of Psychotherapy.
Its description, application requirements, and procedures appear below.
Description
This program supports the mission of APA’s Division of Psychotherapy (Division
29) by recognizing Division members who have demonstrated outstanding
promise in this field early in their career. Recognized achievements may be in
the areas of psychotherapy.

Program Goals Nomination Requirements

Encourage further development and Nomination letter written by a
continuing contributions of early- colleague outlining the nominee’s ca-
career professionals in this field reer contributions (self-nominations
not acceptable)
Funding Specifics Current CV
One $2,500 award presented annually
Submission Process and Deadline
Eligibility Requirements Submit a completed application
Division 29 membership online at
Within 7 years post-doctorate http://forms.apa.org/apf/grants/
Demonstrated achievement related by January 1, 2010.
to psychotherapy theory, practice,
research or training Questions about this program should
be directed to Kim Palmer Rowsome,
Evaluation Criteria Program Officer, at
• Conformance with stated program [email protected].
goals and qualifications
• Applicant’s demonstrated
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PRACTITIONER REPORT
Practice Update — November 2009
Jennifer F. Kelly, Ph.D.
Independent Practice and Atlanta Center for
Behavioral Medicine, Atlanta, Georgia
The primary mission icy issues that will be considered by the
of the Practice Do- APA and APA governance, and business
main of Division 29 is of practice and advocacy issues that
to focus on the issues will be addressed by the APAPO and
related to practice. Committee for the Advancement of Pro-
Following is an up- fessional Practice. In addition, we collab-
date of the progress orated with non-psychology groups to
and challenges en- incorporate a broader public perspective
countered in 2009. As most of you know, into our work. We believe that develop-
the Practice community continues to ing partnerships with these outside
face substantial challenges in a number groups will be key to implementing our
of critical areas, but at the same time practice agenda.
Practice has scored several hard fought
victories. At the Summit we identified new mod-
els and venues for practice, looked at
Probably one of the greatest achieve- ways to expand opportunities and iden-
ments of APA as it relates to Practice was tified opportunities that traverse tradi-
the APA Presidential Summit on the tional practice domains. A primary
Future of Psychology Practice held outcome of the Summit was to develop
May 14-16, 2009 in San Antonio, Texas. a clear agenda for the future of our
The Summit was a collaborative effort multi-faceted and diverse practice com-
among different partners of the practice munity. The Task Force met for the final
community. In addition to assembling meeting in September 2009, and a report
leaders in the practice of psychology, with the noted recommendations will be
other professionals who are critical completed and forwarded to Council.
stakeholders in the practice of psychol-
ogy participated. The following objec- Of equal, if not greater, importance to
tives were addressed: Practice is the ongoing legislative advo-
cacy program undertaken by the APA
1. Models and opportunities for future Practice Organization’s government re-
practice to meet the needs of our di- lations department. There have been nu-
verse public merous legislative successes over the
2. Priorities for psychologists practic- past year that impact on the Practice of
ing in private and public settings Psychology. They include the following:
3. Resources needed to effectively ad- The Health Information Technology.
dress the priorities The Health Information Technology bill
4. Roles of various practice groups in has passed with several major compo-
implementing the priorities nents contributed by psychology’s leg-
islative advocacy team. Included in the
5. Key partnerships to implement our
bill is strong privacy protection for pa-
agenda
tients obtaining psychological services.
During the Summit, we addressed pol- continued on page 53

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Medicare. There is both positive and tion over the Medicare portion of health
negative news concerning Medicare re- reform, also passed a bill favorable to
imbursement. Congress has reversed psychology.
two Medicare payment cuts that were
scheduled to occur this year. In addition, The key provisions in health care reform
we have been successful in getting a pertaining to professional psychology
provision to reduce the mental health are the 5 percent restoration of the
beneficiary co-payment (from 50% down Medicare reimbursement rate cut, inte-
to 20%) which will achieve parity with grated care, and replacing the Medicare
medical care by 2014. Unfortunately, The “sustainable growth rate” (SGR) pay-
Centers for Medicare and Medicaid Serv- ment formula. It is good to know that
ices (CMS) have announced changes in the 5 percent Medicare restoration pro-
2010 to Medicare’s payments for the vision has the support of both House
practice expense portion of numerous and Senate committees of jurisdiction.
services including those commonly billed For integrated care, the Practice Organi-
by psychologists. It is expected that zation favors the Senate HELP Commit-
Medicare payments for psychological tee bill as it includes broad provisions
services will be reduced on average by for care integration throughout the new
7% based on the practice expense health system. This integration fully in-
changes. Efforts are underway to attempt corporates all providers, including men-
to modify these reductions. tal and behavioral health providers. It is
anticipated that the Senate will still ad-
Health Care Reform. APA has been in- dress the scheduled 21 percent SGR cut
volved in the ongoing healthcare reform to Medicare provider reimbursements
debate to ensure that psychological serv- by the end of the year. However, most
ices are a core benefit in all health plans likely it will be a one-year fix, as origi-
in the new health system and integral to nally intended by Senator Max Baucus’
patient care in all settings. On October (Chair of the Senate Finance Committee)
13, 2009, the Senate Finance Committee health care reform bill.
passed its bill after months of consider-
ation. Health care reform legislation has This will be my last column as my term
now been approved by all five congres- as member-at-large/Practice Domain
sional committees of jurisdiction. The Representative will end in December
House bills and the Senate Health, Edu- 2009. It has been an honor to be a part of
cation, Labor and Pensions (HELP) the Division. Finally, I would like to thank
Committee bill all include key provi- Drs. Bonita Cade and Dr. Patricia Cough-
sions that are favorable for professional lin for their service to Division 29 by serv-
psychology. In addition, the Senate ing on the Practice Domain Committee.
Finance Committee, which has jurisdic-

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DIVISION 29 CALL FOR NOMINATIONS

DISTINGUISHED PSYCHOLOGIST AWARD
The APA Division of Psychotherapy invites nominations for its 2010 Distinguished Psychologist
Award, which recognizes lifetime contributions to psychotherapy, psychology, and the
Division of Psychotherapy.
Letters of nomination outlining the nominee’s credentials and contributions should be
forwarded to the Division 29 2009 Awards Chair:
Nadine Kaslow, Ph.D., ABPP
Emory University Department of Psychiatry and Behavioral Sciences
Grady Health System
80 Jesse Hill Jr Drive . Atlanta, GA 30303
E-mail: [email protected]
The applicant’s CV would also be helpful. Self-nominations are welcomed.
Deadline is January 1, 2010

DISTINGUISHED CONTRIBUTIONS TO TEACHING AND MENTORING

Each year, Division 29 honors a psychologist who has contributed to the field of psychotherapy
through the education and training of the next generation of psychotherapists by presenting the
Division 29 Award for Distinguished Contributions to Teaching and Mentoring. This award is
given annually to a member of Division 29 who exerted a significant impact on the development
of students and/or early career psychologists in their careers as psychotherapists.
Both self-nominations and nominations of others will be considered. The nomination packet
should include: • offering general advice with respect to
1) a letter of nomination, sent electronically, professional development (e.g., graduate
describing the individual’s impact, role, school, postdoctoral study, faculty posi-
and activities as a mentor; tions), awards, and publications
2) a vitae of the nominee; and, • treating student/colleagues with respect,
3) letters of reference for the mentor, written spending time with them, providing
by students, former students, and/or col- open communication lines, and gradu-
leagues who are early career psychologists. ally moving the student into the role of
Letters of reference for the award should colleague.
describe the nature of the mentoring rela-
tionship (when, where, level of training), The award recipient will receive a cash award
and an explanation of the role played by of $250 to help offset travel expenses to the
the mentor in facilitating the student or col- APA convention for the year the award is
league’s development as a psychothera- conferred and an award plaque.
pist. Letters of reference may include, but Individuals who were nominated in previous years
are not limited to, discussion of the follow- for the Teaching and Mentoring Award may carry
ing behaviors that characterize successful over their complete application to a subsequent
mentoring: year by writing a letter to the Chair of the Profes-
• helping students to select and work sional Awards Committee requesting resubmis-
toward appropriate goals sion of the previous application. This letter must
• providing critical feedback on be received by March 15 of the year of the award.
individual work
• providing support at all times, espe- The letter of nomination must be emailed to
cially encouragement and assistance the Chair of the Professional Awards Com-
in the face of difficulties mittee. Deadline is March 15, 2010. All items
• assisting students in applying for must be sent electronically. The Award is to
awards, grants, and other funding be presented at the APA annual convention.
• assisting students in building social Division 29 2010 Awards Chair:
network connections, both with Nadine Kaslow, Ph.D., ABPP
individuals and within organizations Emory University Department of
that are important in the field Psychiatry and Behavioral Sciences
• serving as a role model and leader for Grady Health System
teaching, research, and academic and 80 Jesse Hill Jr Drive , Atlanta, GA 30303
public service in psychology E-mail: [email protected]

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FEATURE
A Psychotherapist’s Self-Care Guide for
Our Current Economic Debacle: Some Suggestions
Leon J. Hoffman, Ph.D., ABPP, FAGPA, CGP
Private Practice, Chicago, Illinois
How are the current economically chal- tency they deserve? After all, the role of
lenging times affecting the way we psy- excellent psychotherapists is the same as
chotherapists practice? that of excellent parents. That is, to pro-
vide well for those in their care. Perfec-
I have some suggestions pertaining to tion is never the goal; rather, the goal is
this and any other “life ambush” to always adequacy.
which we are exposed. The current eco-
nomic debacle is but one. Other life chal- Some further questions may be helpful,
lenges might include terrorist attacks, or albeit anxiety-provoking.
other sudden, unexpected health, mari-
tal, occupational, natural (Katrina), and How do you function under this eco-
legal assaults. Some psychotherapists nomic siege? Do you find yourself jealous
may be currently experiencing one, or of any of your patients or colleagues? Do
more, of these ambushes. We should re- you envy them their successes? Not all
mind ourselves, and help our patients to psychotherapists have financially thriv-
realize, that financial distresses are not ing patients. If you do, what special
the only losses that may result from stresses do you feel when you treat them?
these financially challenging times. If you are suffering economically and
Some of the most pernicious results of your patient is thriving financially, do
these difficulties are not financial, but you notice any lapse of judgment or dis-
emotional. tortions in your usual wisdom that pre-
dispose you to moral, ethical, and
Our psychological responses to these perhaps even legal risk? Do you feel sur-
puzzling times contribute significantly vivor guilt because you are doing well
to our anxieties. It is crucial to under- while some of your colleagues are suffer-
stand those anxieties. We must be able ing more than you and may even have
to discriminate between whether the lost their jobs? Do you experience antici-
anxieties we feel are “merely” discom- patory anxiety from awaiting that “knock
fort or actually signal danger. We help on the door” announcing that you are
our patients to recognize this distinction. next to lose something?
Many psychotherapies encourage pa-
Are your patient case load and referral
tients to become curious, to be reflective.
flow diminishing? Are your fees and re-
That is a goal of this article—to help us
ceivables down? Are patients asking to
as psychotherapists to explore and
end their psychotherapy, reduce the fre-
study our circumstances. Please remem-
quency of their needed sessions, or re-
ber: Diagnosis first, treatment second.
duce their fees? Do patients simply not
First we evaluate, then we act.
show up, begin to come late, attempt to
In what ways are your psychotherapy reschedule often, or not pay their bills
practices influenced by current eco- promptly? Does the area of the country
nomic uncertainties? How do you main- in which you practice affect your spe-
tain your centeredness and balance so cific patient population (e.g., Detroit and
that your patients receive the consis- continued on page 56

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the auto industry)? Are patients relocat- to do so; it is even more so in these try-
ing? What provisions are you making ing times.
for their continuing psychotherapy in
order to minimize disruptions in their Whatever our life stresses, they should
care? These and plenty of other night- never become the patients’ burden. So,
marish scenarios are enough to cause let’s lighten the load—for us, and for
anxiety in even the most stalwart of psy- them. All patients deserve and need an
chotherapists. attentive, rested, balanced psychothera-
pist. Our focus must always be on them
Are you noticing increases in negative, and their needs. Anything interrupting
or ambivalent, or aim-attached counter- that must be identified and removed.
transferences? What provisions have you
made, if indicated, for your own supervi- A well-tuned bicycle wheel with its cus-
sion, consultation, and psychotherapy? Is tomary forty-two spokes provides an
your self-esteem as a psychotherapist apt metaphor. These spokes are needed
flagging? How do you visualize improve- to keep the rim from crumbling when it
ments? How do you maintain your focus meets any unusual impacts in the course
and emotional equanimity under such of its use. Well-adjusted spokes are re-
difficult circumstances? quired to keep the wheel “in true.”
When a wheel is “out of true,” it is easy
So, okay. Enough questions. Now it’s time to diagnose which spokes need what
for some answers. Well, at least a few sug- kind of attention. Pretty simple, actually.
gestions. After all, these comments are If only it was that easy for people who
meant to inform and support us. get out of adjustment, psychotherapists
included.
No one is immune from being human.
Let us take a deep breath, or two, and re- What “spokes” are in your wheel (life)?
member that our need, as well as that of Examples of spokes include work, love
our patients, is to learn to soothe our- relationships, religious or spiritual in-
selves. Such self-soothing may not be an volvement, philanthropy, playing a mu-
easy task in such trying times, but if we sical instrument, singing in a chorus,
don’t know how to do so, how can we making ceramics or rugs, painting,
expect to help our patients to do so? dance, chess, etc. Sublimations, in short.
None of us is in this alone. While sub- These involvements help absorb the
groups are the nucleus of cohesive shocks to which we are exposed.
groups, few psychotherapists during
today’s economic uncertainties would The spoke’s function is to absorb the
find it difficult to locate colleagues with shocks that the bicycle wheel may en-
whom to commiserate. counter on impact. Similarly, psy-
chotherapists must have enough
These may be especially important times well-adjusted “spokes” in their lives to
to be attentive to our use and possible be able to absorb the impacts to which
abuse of electronics. “Keeping it they are exposed. Not to do so courts
human” will always pay dividends in disaster when one becomes the victim of
our profession. Trust me on this! This is life ambushes.
also a time to pay special attention to the
contracts (agreements) that one has with Do you pay careful attention to your
one’s patients. It is also crucial to pay sleep, dietary, physical activity, and sex-
meticulous, scrupulous attention to ual regimens? Has your weight changed
one’s boundaries, both professional and recently? Are you careful to minimize
personal. It has always been necessary continued on page 57
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any tendencies to act out, such as get the care we need for ourselves. We
overeating, overspending, abusing sex deserve and require it. High-quality care
or alcohol, or using drugs? Is your con- is what our patients expect and deserve.
centration and ability to focus acceptable Nothing less is acceptable. To offer this,
and at your typical level? Are your rela- we ourselves need to be balanced and
tionships with your friends and family centered. Our patients will be the bene-
adequate, nourishing, and as they usu- ficiaries.
ally have been? Are you spending time
in nature and involved in music and the This is a time to come together. There is
arts? Do you make time for reading? Are much to celebrate, even during times of
you finding excuses and rationalizations adversity, for those willing to look. This
for any of the above? Are you exploring is a time to congregate, in community,
your resistances to being balanced and a not a time to isolate and withdraw. It is
psychotherapist “in true”? a time for interaction, not inaction or
seclusion. There are ample reasons for
Well-trained psychotherapists treating optimism. We will survive, thrive, and
well-prepared, committed patients, es- even prevail. The only thing that is per-
pecially those psychotherapists who manent is change. If we are not here to
have managed to avoid, or at least min- treat patients in need, who will be?
imize, third-party involvement will al-
ways have much to offer that patients I hope that you, my colleagues, take
will need. There is no competition for a these suggestions to heart and make
skilled psychotherapist and a committed them yours. Our future, and that of our
patient in need. Fees can always be ad- patients, is bright. If you think I am
justed, and even some pro bono work wrong, what would you prefer to be-
can help everyone maintain continuity lieve? If the above hasn’t convinced you,
for a period of time. Resilience may be and you remain recalcitrant and incon-
more important than ever now. solable, please remember that you can
always contact me, and together we will
One of my patients who recently became make it through. Some of our suffering
a new mother has become involved with is optional.
what some parents do these days—
namely, “nanny search.” They seek a Dr. Hoffman is a clinical psychologist in pri-
nanny who will best provide for their vate practice, specializing in individual and
child’s wellbeing. We psychotherapists group psychotherapy, supervision, and con-
also need to provide for our wellbeing. sultation. His office is located at 111 North
What sense does it make to know what Wabash Avenue, Suite 2122, Chicago, Illi-
our patients need, and seek it for them, nois 60602. He can also be reached at 312-
but not to do so for ourselves? We must 332-1262 or [email protected].

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STUDENT FEATURE
Discerning Group Therapy Dynamics:
Five of Irvin Yalom’s Therapeutic Factors in
the Context of Wilfred Bion’s Group Conceptualizations
Phillip Causey
Pacifica Graduate Institute
In The Theory and that may be experienced as uncomfort-
Practice of Group Psy- able if exposed. Thus the group mental-
chotherapy, the existen- ity is often in contradiction to the group’s
tial psychotherapist conscious aims of growth and progress
Irvin Yalom (1995) de- and is in contradiction to the individuals
scribes 11 therapeutic that comprise it. In Bion’s words it is “the
or primary factors of failure to afford the individual a full life”
group therapy. These (Bion, 1959, p. 54). Group mentality is an
factors are “natural lines of cleavage” “anonymous collaboration” of group
that “divide the therapeutic experience” members, who contribute “selectively
(p. 1). Drawing from years of research unconscious elements,” as well as ex-
during and after World War II, the psy- pressing the “the unanimous but unspo-
choanalyst Wilfred Bion used Kleinian ken aims and beliefs of the group”
concepts to develop group therapy inno- (Bleandonu, 2000, p. 70).
vations (Bleandonu, 2000, p. 69). This
paper will explore 5 of Yalom’s 11 thera- Group culture is simply the function of
peutic factors in the context of Bion’s in- the conflict between the individual’s
novations (1959). needs or desires and the group mental-
ity. According to Bion, group emotional
Yalom’s therapeutic factors are discern- activity interacts between two levels.
ments of complex human experiences The first is the work group, which de-
occurring in groups. According to Yalom scribes only one aspect of group mental
change happens in groups as an “inter- activity. Work group occurs when all
play of human experience,” which is individuals in the group are in touch
synonymous with Yalom’s therapeutic with reality and can cooperate with each
factors (Yalom, 1995, p.1). The following other. It is marked by cohesiveness in
therapeutic factors will be examined: in- addressing group dynamics, working
stillation of hope, universality, impart- towards goals, attunement to one
ing information, altruism, and the another, and symbolic interactions. Con-
corrective recapitulation of the primary sequently, the work group is “character-
family group. ized by its awareness of the dimension
of time, and the need for progress”
Bion (1959) held that groups consisted of (Bleandonu, 2000, p. 71). A work group
and should be regarded as the interplay allows for individuals to be therapeuti-
of individual needs, group mentality, cally addressed, promoting therapeutic
and group culture (p. 55). Group mental- progress and growth. The second level is
ity can be thought of as the unknown in- the basic assumption group, which
fluences on the group, the unanimous avoids uncertainty or anything anxiety
expression of the will of the group (Bion, provoking as well as growth promoting.
1959, p. 59). It operates as a uniformity of Basic assumptions turn the group, un-
group members in that it allows individ-
uals to deny feelings, especially those continued on page 59

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consciously, into anti-thinking and anti- however it seems to be demonstrated in

feeling, contesting the work group thus a more pronounced manner in the basic
therapeutic progress. assumption mentalities. For example in
the assumption of dependence, the hope
Bion (1959) demarcated the basic as- is that the leader will provide security
sumption group aims into three types: and satisfy all needs. In the pairing
pairing, dependence, and fight or flight. group the hope is for a messianic savior,
Dependence is when the group is solely an idea or person that will rid all difficul-
dependent on the facilitator to the point ties and despair. The messiah will instill
that if a group member is not relating to hope, as long the messiah is never actu-
the leader everything else feels frustrat- alized, remaining unborn. In Bion’s
ing. Pairing involves two people in the (1959) words, “the Messianic hope must
group engaging with one another, ignor- never be fulfilled” (p. 151). Hope func-
ing the presence of the other members. tions to inspire groups and acts as a
Fight or flight essentially entails the group adhesive in that it garners atten-
uniting of the group to fight or get away dance. In Bion’s model the basic assump-
from a threat (discomfort/anxiety). A tions tend to offer hope that might
leader is usually chosen to lead the eva- benefit the work group mentality. Per-
sion or fight. Bion noticed that groups haps the hope instilled in the basic as-
unite with little trouble “around any sumption mentalities is necessary for the
proposition that expresses violent rejec- cohesiveness of the work group. In short,
tion of all psychological difficulty, or of- the hope of the basic assumptions might
fers means of avoiding difficulty by advance or be a necessary facet required
creating an external enemy” (Blean- for the work group to be possible.
donu, 2000, p. 73). In other words,
groups are biased towards superficiality. Universality is the idea that there is no
If an individual is incongruent in action, thought, or feeling outside the
thought or action with the basic assump- realm of other people’s experience. In
tion, the individual will feel uncomfort- the early phases of a group, members
able and marginalized. Additionally, the often feel alone and uniquely troubled.
If, however, members learn that certain
basic assumptions do not have a con-
frightening problems, impulses, or
flicted relationship with one another;
thoughts are also experienced by other
rather the different basic assumptions
members, they can feel relief. Universal-
oscillate in the same group. The conflict
ity could be an aspect of the work group
exists between the work group and the
and/or the basic assumption groups, as
basic assumptions.
it could be an operation of avoidance,
The first of Yalom’s therapeutic factors, pairing, or dependence. For example, if
the instillation of hope, has a place in the group wanted to avoid the feelings
both work group mentalities and basic of disgust or fear associated with a per-
assumption group mentalities. In terms son’s fantasies the group might univer-
of hope, Yalom describes individuals in salize it in order to do so; the group
group therapy on a coping-collapse con- would act as if there is no problem with
tinuum, which is not unlike Bion’s frag- a destructive fantasy since it is universal,
mentation and integration (1970). Yalom and the group would relate to the mem-
says, “hope is required to keep the pa- ber without attuning to the sense of iso-
tient in therapy so that other therapeutic lation associated to the fantasy. The
factors may take effect” (Yalom, 1995, p. group might focus upon the content of
5). In Bion’s model hope exists to some the member’s fantasy without attuning
degree, as it is a motivating factor for in- to the underlying feelings. A cohesive
dividuals’ desires to attend therapy, continued on page 60
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group, on the other hand, is more likely ever, the process of advice giving con-
to attune to a member’s sense of alone- veys “mutual interest and caring” (p.
ness and consequently to offer needed 11). Information can be of benefit early
support. in the therapeutic group’s meetings as
long as it influences the move into work
Yalom (1995) categorizes imparting in- group mentality. However, information
formation into direct advice and didactic can become a type of resistance if it
instruction. He warns the reader, “when serves to avoid anxiety during the work
therapists or patients retrospectively ex- group mentality.
amine their experience in interactional
groups therapy, they do not highly value The basic assumption group can be in-
didactic information or advice” (p. 8). terpreted as essentially defending
Thus imparting information must be against felt anxiety. Felt anxiety then
strategic; otherwise it could operate as a would be essential for the work group to
flight mechanisms or feed the patients’ progress. Using anxiety is crucial to not
dependence on the therapist as the only only see the group’s defense structures
worthy imparter of information. The in use as well as comment on their active
group could also perceive information presence, but more importantly to facil-
as a messiah. For example, group mem- itate work group mentality. For exam-
bers might believe that if they just hear ple, if the group is defending against
the right idea and/or concept all will be anxiety by talking about a football game
better. This optimism is out of touch or focusing on the facilitator, the facili-
with reality; if information is to be of tator might address the group as a
benefit it must anchor the group in real- whole, commenting on the superficiality
ity, not in theoretical ideas or irrelevant or diversion from doing work by focus-
facts. Bion (1959) commented on ad- ing on him/her, and subsequently al-
dressing the group as a whole, prefer- lowing the group members to
ring simplicity and precision when experience anxiety by provoking silence.
making interpretations, rather than Often members will begin to express
using terms such as “group culture” or feelings or offer feedback in order to re-
“mentality.” Bion focused on what was duce their anxiety produced by silence.
taking place in the group as well as of- Imparting information can be antitheti-
fered a degree of transparency in how he cal when it functions in two ways. First,
reached such interpretations. Accord- reason may promote rationalization and
ingly, interpretations are often aimed to intellectualization by possibly heighten-
frame group interactions, or if in work ing those defenses. Second, it might pre-
group mode the group’s and individ- clude one’s growing tolerance of and
ual’s dynamics (p. 60). If imparting in- navigation through anxiety produced by
formation takes the focus away from the uncertainty and irrationality, or stunt the
group or makes the group process more individuals and/or group development
abstract than concrete, it would be more of the higher level functioning, such as
likely a function of the basic assumption “negative capability, that is, when a man
mentality. is capable of being in uncertainties, mys-
teries, doubts, without any irritable
Yalom (1995) points out that didactic in- reaching after fact and reason.” (Keats &
struction can be an “initial binding force Scrubber,1899, p. 277).
in the group until other therapeutic fac-
tors become operative” (p. 10). Explicit According to Yalom (1970), altruism is
advice, according to Yalom (1995), has essential for healing in groups. It func-
little direct therapeutic value, as the con- tions in two ways. First, members tend
tent usually carries little weight, how- continued on page 61

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to give by receiving in this way mem- both the basic assumption group men-
bers interact by offering support, in- tality and the work group mentality. In
sight, challenges to self-deception or the basic assumption mentalities, the fa-
distortions, how they are impacted, and milial conflicts might emerge but not be
suggestions. Second: attended to and/or perpetuated by ei-
a sense of life meaning ensues but ther freezing them “into rigid, impene-
cannot be deliberately, self-con- trable system that characterizes” their
sciously pursued: it is always a deriv- family structure or just not working
ative phenomenon that materializes through them. Ideally, work group will
when we have transcended our- be evident when those familial conflicts
selves, when we have forgotten our- are worked through correctively such
selves and become absorbed in that fixed roles are constantly “explored
someone (or something) outside and challenged, and ground rules for in-
ourselves. The therapy group im- vestigating relationships and testing
plicitly teaches its members that new behavior” is continually encour-
lesson and provides a new counter- aged (Yalom, 1995, p. 14). Thus work
solipsistic perspective. (Yalom, 1995, group entails working through unfin-
p. 13) ished business, whereas the basic as-
sumptions might be the reliving of the
Work group mentality requires both giv- conflicts by dependence on the parent,
ing, which translates into the cohesive- pairing off with a certain group (family)
ness of the group instilling focus such member (possibly illuminating an emo-
that a member who might need atten- tionally incestuous relationship), or flee-
tion receives it, and transcendence. By ing from or fighting something that
giving to others, a transcendent experi- might have been intolerable to the fam-
ence is possible for group members in ily system consciously or unconsciously.
which a life meaning ensues. In the basic assumption mentality, when
familial dynamics emerge they can be
Corrective recapitulation of the primary potentially useful for the work group
family group involves the recreation of mentality if their emergence elucidates
familial dynamics in the group. Psy- those very early familial conflicts, which
chotherapy groups resemble families in
is necessary for them to be worked
many ways, providing parental and au-
through. In other words, not until issues
thority figures, sibling competition and
are acted out or experienced by the
rivalry, potent emotions, and the com-
group can the group address them. So
plexity of intimate feelings from empa-
early familial conflict might be dis-
thy to hostility. Additionally a complex
played and identified in both basic as-
web of familial patterns and entangle-
sumptions mentalities and work group
ments become evident: dependence
mentality; the difference being the work
upon the leader, opposition to the
group mentality displays an attunement
leader, suspicion of the leader resulting
in the inciting of parental disagree- to those conflicts as well as corrective or
ments, seeking of attention even if it is growth promoting challenges and ex-
negative attention, selflessly attempting plorations of those conflicts.
to deny one’s own needs in order to ap-
pease the leader, and so on. Group ther- In the context of Wilfred Bion’s (1959)
apy allows for familial conflicts to arise, approach to and conceptualization of
whereas in individual therapy those group dynamics, 5 of Yalom’s 11 thera-
conflicts might not as readily and obvi- peutic factors theoretically function in
ously emerge (Yalom, 1995, p. 14). both the basic assumption group and
Early familial conflicts may be relived in continued on page 62

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work group. What is of importance is ics. By integrating Yalom’s therapeutic

the utilization of what takes place in the factors with those of Bion’s ideas it
basic assumption mentalities for the seems both would benefit as one could
transition into work group mentality, “establish a reasonable base from which
leading to group progress. Seemingly to begin to delineate,” which variables
unproductive basic assumption group are significantly related to a successful
time might be crucial for productive group therapy outcome (Yalom, 1995,
times such that what takes place in that p. 4).
time could have therapeutic value when
used as a contrast to or an illumination References available on-line at
of roles, conflicts, defense structures, in- www.divisionofpsychotherapy.org
trapsychic, and or interpersonal dynam-

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We know that the economic difficulties of the times have had impact on APA
members. In order to provide additional assistance for our members and those
who wish to become members of Division 29, we have created a new process
for requesting dues reductions related to economic hardships and retirement.
Please find the form online on our website at http://www.divisionofpsycho-
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by the President and Treasurer of the Division. Forms may be faxed to our
Central Office at (480) 854-8966 or sent via email to [email protected].

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FEATURE
Acceptance and Commitment Therapy (ACT) and
Anusara Yoga: Parallel New Horizons
Tara Eastcott
University of Denver Graduate School of Professional Psychology
Yoga is increasingly humans’ capacity for language mires us
being considered as in inevitable suffering via our ability to
an adjunctive or even recall painful memories, imagine the
primary therapy for possibility of horrific future events, or
numerous physical and just replay negative thoughts about our-
psychological illnesses, selves. Some approaches to psycholog-
including ADHD ical treatment focus on altering or
(Jensen & Kenny, 2004); posttraumatic eliminating unwanted thoughts and
stress disorder (Wills, n.d.); and sub- feelings as the sole goal of treatment.
stance abuse (Shaffer, LaSalvia & Stein, Rather than attempting to alter the form,
1997). We have yet to determine which frequency or content of thoughts and
mental illnesses and/or populations feelings, ACT seeks to change our rela-
yoga may benefit, and how to ideally tionship to our private experiences
combine yoga with psychotherapy. (thoughts, feelings, physical sensations)
Studies examining yoga’s efficacy rarely through altering the social and verbal
specify the style of yoga being utilized; contexts in which they occur. ACT uses
and when they do, there is typically a combination of mindfulness, accept-
no theoretical justification for the pair- ance, commitment and behavioral
ing. I suggest that we should examine change interventions. Psychological
whether specific pairings of yoga styles health is measured according to one’s
with psychotherapeutic approaches that ability to accept the present moment and
are philosophically compatible may be take action towards one’s valued life di-
more beneficial than simply adding rections, rather than by one’s symptoms
yoga to therapy without this level of dis- or how we feel about ourselves.
crimination. Towards this end, I will
outline the similarities between Accept- Anusara Yoga is a developing style
ance and Commitment Therapy (ACT) founded in 1997 by John Friend.
and Anusara yoga, and discuss how “Anusara” means “flowing with Grace”;
pairing them may provide more benefit “flowing with Nature”; or “following
than either can offer alone. your heart.” The Hatha yoga founda-
tion means that poses or asanas are per-
ACT and Anusara formed in accordance with precise
Acceptance and Commitment Therapy biomechanical principles of alignment
(ACT) is a developing form of psycho- and are coupled with a Tantric philoso-
logical intervention that emerged in the phy. The three principles of Tantric phi-
late 1990’s and recognizes itself as one of losophy most prominent in Anusara are:
the third wave of behavioral therapies.
ACT is steeped in classical behavioral 1) belief in the universe as a concrete
analysis, with the addition of Relational manifestation of the divine, which is
Frame Theory (RFT), a psychological ultimately good
model that explains how human cogni- 2) connecting with the divine to foster
tion and language impact human behav- greater freedom and creativity for
ior and experience. ACT suggests that continued on page 64
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the joy of it 6) Committed Action: value-directed be-

3) connecting with the divine through havior (Hayes, Strosahl, & Wilson,
alignment of the mind and body as 1999).
they are, rather than by subjugating
them. The five principles of Anusara are ap-
plied to each pose in the order listed:
The Universal Principles of Alignment
1) Opening to grace: intention to align
outline how the body should ideally
from within with the present mo-
move in order to maximize the experi-
ment, the universal divine, and one’s
ence of oneness with one’s true essence,
desires.
or nature, which is seen as complete,
2) Muscular energy: drawing energy
fully conscious, peaceful, and blissful.
inwards towards a focal point in the
Anusara differs from some other styles
body.
of yoga in that it focuses more on accept-
3) Inner Spiral: an expanding spiral of
ance of the body, whatever its state,
energy drawing in towards the core.
rather than trying to overcome or sub-
4) Outer Spiral: a narrowing energy spi-
due it.
ral moving away from the core and
Theoretical Similarities balancing the inner spiral.
5) Organic Energy: the expansion of en-
Use of Principles/Processes ergy from the focal point in the core
Both ACT and Anusara operate accord- to the periphery of the body, balanc-
ing to interconnected principles or ing muscular energy (Keller, 2001;
processes, rather than rules. Both empha- Friend, n.d.).
size that rules inevitably fail to account
for situational variables and individual Values
variability in a way that is ultimately While there are no glaring similarities be-
harmful to people. Below is a very brief tween the ACT processes and Anusara
overview of the six core principles of principles on first glance, delving into
ACT and the five principles of Anusara. rhetoric of each uncovers some striking
parallels. One critical similarity has to do
In ACT the six core processes are seen as with the ultimate value in the work. As
interdependent and are highlighted as Hayes (2002) describes it, the question at
necessary rather than in any particular the heart of ACT is essentially: Given the
order: distinction between yourself (self as con-
1) Acceptance: willingness to experience text) and the stuff you are struggling with
things as they are. and trying to change (your thoughts and
2) Present Moment: ability to focus one’s feelings), are you willing to have that
attention on the present. stuff—fully and without defense (present
3) Values: verbal representations of de- moment and acceptance), as it is, not as
sired life outcomes that can guide what it says it is (defusion)—and do what
overall life direction, without stipu- takes you (committed action) in the direc-
lating specific terminal outcomes. tion of your chosen values (values), in this
4) Self as Context: the immutable point time and this situation (being present)?
of view from which we can observe Now consider how the Anusara web
our internal and external experi- site (n.d.) describes the essence of its
ences taking place. practice:
5) Defusion: relating to thoughts as
Anusara yoga is flowing with Grace
what they are (internal streams of
by saying “yes” to the whole magi-
verbal behavior), rather than what
they say they are. continued on page 65

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cal spectrum of life. It is a willing- which view unwanted thoughts and

ness to be aware of all parts of our- feelings as “problems” to be eradicated
selves-the light and the dark, the full through psychotherapy, ACT argues that
rainbow of sensation, perception, this agenda is unworkable. ACT utilizes
emotion, and thought. Saying yes to present moment experience, defusion,
life means to openly sense and know and acceptance to help people better dis-
each moment fully without prejudg- criminate between what our minds tell
ing it. We simply open our hearts us is true and possible, and what we can
with love to the present moment experientially learn to be true and possi-
without clinging or pushing. Then ble in the present moment.
from this spacious place of percep-
tion we discern whether something Similarly, and contrary to some other
is life-enhancing or not. Whatever styles of yoga, Anusara does not view
we encounter, whether it is auspi- the body and thoughts as corporeal
cious or malicious, good or bad, up- “problems” to be overcome, but rather
lifting or disheartening, we respond suggests alignment with and opening to
in ways that are more life-affirming. these facets of human existence in order
To be in the flow is to feel the mo- to more clearly connect with the divine.
ment fully and then to choose to act As the Anusara web site (n.d.) describes:
in ways that celebrate the essence of “Our thoughts, desires, passions and
life, Spirit, and our hearts (Anusara emotions are not obstacles to spiritual
Principles, ¶ 6). awakening which need to be squelched
or eliminated, but instead they are God-
Both approaches begin by drawing our given means of glorifying and expand-
attention to the each present moment to ing our experience of the Supreme”
contain a range of experiences, encour- (Anusara Philosophy, ¶ 4). Asana prac-
aging us to be with those experiences tice can be used to discover the actual
willingly and without judgment, in limits of the body, versus the limits of
order that we can more clearly discern the body as communicated by the mind,
how to actively live in accordance with just as ACT helps people to make a dis-
our values. Though different language tinction between the mind’s story about
is used, I would argue that “self as con- reality and experienced reality. In both
text” awareness as described in ACT is cases, this result is not achieved by re-
experientially equivalent to being in jecting thoughts or feelings, but by ac-
“Grace” in Anusara. Hayes (1984) states knowledging their presence and then
that: “the qualities of a metaphysical prioritizing the data gained through di-
God can be understood as a metaphori- rect experience.
cal extension of the experienced quali-
ties of seeing-seeing-from-perspective- Values and Community
behavior” (p. 106). (See Hayes 1984 for The discourse in ACT and Anusara
more on self as context and spirituality). is also remarkably similar in its des-
In ACT and Anusara being able to expe- cription regarding how the work is
rientially connect with self as context or conceptualized within a community of
Grace is viewed as critical to the rest of practitioners. As Hayes (2005) writes:
the work. We want a theory of human behav-
ior that allows us truly to make a dif-
Defining the Problem
ference in our homes, schools,
ACT and Anusara both to some extent
workplace, and clinics…a technol-
redefine what is defined as the “prob-
ogy that works, a theory that works,
lem” in their respective fields. Contrary
to many other theoretical orientations, continued on page 66
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basic principles, AND a powerful psychotherapeutic experientials. ACT

linkage to our deepest human de- often focuses on helping people to re-
sires…We are using ACT / RFT to main in contact with painful emotional
create an ACT / RFT community experiences; this may include awareness
that is open, non-hierarchical, di- of physical sensations but not an overt
verse, committed, sharing, caring, focus on the body. Through Anusara, an
and just plain fun…By appealing to individual can deepen his/her present
the better nature of our clients (e.g., moment awareness with a more primary
self-acceptance, mindfulness, values, focus on the body that includes, but fo-
commitment) we seem to be creating cuses less on, thoughts and emotions.
change in the clinic” (¶ 1-2). Through yoga practice, ACT clients can
have another experience of how moving
Anusara yoga endorses a remarkably towards and into discomfort can ulti-
parallel commitment to human desire, mately help them to attain greater free-
diversity, expansiveness and enjoy- dom and alignment with their values.
ment, as described below. Thus Anusara can provide further em-
Anusara yoga’s remarkable growth bodied contact with the processes of
is due in large part to its uplifting ACT.
philosophy, epitomized by a ‘cele-
bration of the heart’ that looks for Ultimately Anusara encourages practi-
the good in all people and all things. tioners to utilize asana practice to trans-
Consequently, students of all levels late its lessons to daily life. It is this
of ability and yoga experience are translation process where ACT might be
honored for their unique differences, most beneficial. Anusara teaches to ap-
limitations, and talents. This celebra- proach and move through physical dis-
tory vision sets the basis for a yoga comfort in navigating physically
school in which the harmony and joy challenging poses. While it acknowl-
of a tightly knit community of highly edges painful thoughts and feelings, the
trained teachers and fun-loving stu- practice is not explicitly focused on un-
dents is exalted. This community tangling from these particular discom-
feels like it has the tightness of a forts. Anusara teaches how to move into
family, yet the looseness of a merry a pose when we are frightened and
band of bohemian artists. (Anusara think we cannot do it, but this behavior
About, ¶ 2) is generally trained only in yoga classes
or individual practice. The idea is to take
ACT and Anusara Working Together those lessons of moving and living into
Beyond exploring the philosophical sim- our lives, but those skills may not gen-
ilarities between ACT and Anusara, it is eralize well to topographically different
also critical to consider the practical and actions (speaking versus doing an asana,
actionable implications of these paral- for example) or other contexts (the
lels. More than many other approaches workplace versus the yoga studio.
to therapy, ACT focuses on experiential Through metaphors, and cognitively-fo-
interventions. ACT argues that experi- cused experientials, ACT provides fur-
ence is more useful in fostering behav- ther tools for more consistently and fully
ioral change than simple verbal living one’s values, and trains values-
exchange or instruction, and that experi- oriented behavior across a broader
ential exercises are best for loosening the range of contexts than Anusara alone.
grip that language often has upon our ACT can thus generalize and reinforce
behavior. The asanas of Anusara yoga Anusara’s lessons.
could thus provide a useful extension of continued on page 67
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Future Research tials, for example, whose lessons can be

It is hoped that this paper will highlight best expressed through certain asanas,
other important questions for us to con- and vice versa? Where ACT has demon-
sider as we explore how yoga can be uti- strated treatment efficacy, can the addi-
lized in the treatment of mental illness. tion of Anusara increase this benefit?
Areas for potential future inquiry in- Are there certain mental illnesses that
clude but are not limited to the follow- might most benefit from yoga? Are all
ing. Given the parallels between ACT styles of yoga equally beneficial to men-
and Anusara, what are the specific ways tal health?
in which each can inform and support
the practice and development of the References available on-line at
other? Are there certain ACT experien- www.divisionofpsychotherapy.org

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NOTICE TO READERS

Please find the references for the articles

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CALL FOR FELLOWSHIP APPLICATIONS

DIVISION 29—PSYCHOTHERAPY
Jeff Hayes, Chair, Fellows Committee

The Division of Psychotherapy is now APA Membership Committee and the

accepting applications from those who APA Council of Representatives. The
would like to nominate themselves or following are the requirements for initial
recommend a deserving colleague for fellow applicants:
Fellow status with the Division of Psy- • Completion of the Uniform Fellow
chotherapy. Fellow status in APA is Blank;
awarded to psychologists in recognition
of outstanding contributions to psychol- • A detailed curriculum vita (please
ogy. Division 29 is eager to honor those submit 3 copies);
members of our division who have dis- • A nominating letter (self-nominat-
tinguished themselves by exceptional ing letter should also be sent to en-
contributions to psychotherapy in a va- dorsers);
riety of ways such as through research,
practice, and teaching. • Three (or more) letters of endorse-
ment of your work by APA Fellows,
The minimum standards for Fellow- at least two of whom must be Divi-
ship under APA Bylaws are: sion 29 Fellows who can attest to
the fact that your “recognition”
• The receipt of a doctoral degree has been beyond the local level of
based in part upon a psychological psychology;
dissertation, or from a program pri-
marily psychological in nature; • A cover letter, together with your
c.v. and self-nominating letter, to
• Prior membership as an APA Mem- each endorser.
ber for at least one year and a Mem-
ber of the division through which Those members who have already at-
the nomination is made; tained Fellow status through another di-
• Active engagement at the time of vision may pursue a direct application
nomination in the advancement of for Division 29 Fellow by sending a cur-
psychology in any of its aspects; riculum vita and a letter to the Division
29 Fellows Committee, indicating in
• Five years of acceptable profes- your letter how you meet the Division
sional experience subsequent to the 29 criteria.
granting of the doctoral degree;
• Evidence of unusual and outstand- Initial Fellow Applications can be at-
ing contribution or performance in tained from the central office or on-
the field of psychology; and line at APA:
• Nomination by one of the divisions Tracey Martin
which member status is held. Division of Psychotherapy
6557 E. Riverdale St.
There are two paths to fellowship. For Mesa, AZ 85215
those who are not currently Fellows of Phone: 602-363-9211
APA, you must apply for Initial Fellow- Fax: 480 854-8966
ship through the Division, which then Email : [email protected]
sends applications for approval to the continued on page 69
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#"$!%

DEADLINE FOR SUBMISSION: Completed Applications should be

The deadline for submission to be con- forwarded to:
sidered for 2010 is December 15, 2009. Jeff Hayes
The initial nominee must enclose a Uni- Chair, Division 29 Fellows Committee
form Fellow Application, nominating let- 307 Cedar Building
ter, three or more letters of endorsement, Penn State University
updated CV, along with a cover letter, University Park, PA 16802
and three copies of all the original mate- Email: [email protected]
rials. Incomplete submission packets Phone: 814-863-3799
after the deadline will not be considered
for this year. Those who are current Fel- Please feel free to contact me or other
lows of APA who want to become a Fel- Fellows of Division 29 if you think you
low of Division 29 need to send a letter might qualify and you are interested in
attesting to your qualifications and a discussing your qualifications or the
Fellow process. Also, Fellows of our
current CV.
Division who want to recommend a
deserving colleague should contact me
with their name.

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Find Division 29 on the Internet. Visit our site at

www.divisionofpsychotherapy.org

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QUESTION & CONCERNS – 2010 CONVENTION HOTEL

October 6, 2009
TO: APA Members
FROM: APA Board of Directors
Subject: Manchester Hyatt – 2010 Convention Hotel

Some members have raised concerns Hyatt management, there is no labor dis-
about APA’s planned use of the Man- pute at the hotel and there are no picket
chester Hyatt as a headquarters hotel lines. APA staff has confirmed that there
during the 2010 San Diego convention. were no picket lines at the hotel during
The purpose of this memo is to let mem- two recent visits to the property. Unite
bers know that we are aware of two Here has been unsuccessful in its efforts
areas of concern: the possibility of labor to unionize the hotel’s employees. There
issues at the hotel—apparently un- are occasional demonstrators from the
founded based on our research—and the Unite Here union; these demonstrations
hotel owner Doug Manchester’s politi- do not involve Hyatt employees as best
cal activities in support of Proposition 8. we can tell. It is also important to note
that there is no evidence that there has
Please see below for new information in been any wrongdoing on the part of the
response to a communication from hotel or its management vis-à-vis the
Unite Here, a labor union, about the treatment of its employees. The Man-
Manchester Hyatt. A number of ques- chester Hyatt Hotel provided APA a
tions that arose when the union con- statement that it “warrants and repre-
tacted some of the APA Divisions have sents that it has had no unfair labor prac-
been forwarded to us via numerous list tice charge or complaint pending or
servs. In an effort to ensure that all threatened against it. The hotel has fur-
members have access to the same infor- ther stated in writing that the hotel has
mation we are responding to the ques- “never received any notification from the
tions we’ve received to date via this National Labor Relations Board about
memo. As more information becomes any group of associates within the hotel
available we will continue to share it. or within any department of the hotel,
who have expressed an interest in organ-
In a second section of this memo we are
izing and there is not currently and has
also providing information about Mr.
never been an organized labor election
Manchester’s political activities and
campaign underway.”
how we plan to respond to them. This
information was first shared with nu- Q: Unite Here has claimed that the
merous list servs last week but we in- housekeepers at the Manchester Hyatt
clude it again for the benefit of those are forced by management to clean
members who did not see it. more rooms than housekeepers at other
Hyatt hotels and that they were hold-
Questions and concerns about ing lunch hour protests. Is this true?
allegations being made by Unite Here. The Hyatt Corporation says this is a
Q. Are there picket lines at the Man- distortion of the facts. The Manchester
chester Grand Hyatt? What is the na- Hyatt participates in a corporate program
ture of the labor dispute? that assigns “credits” to rooms depend-
The Manchester Grand Hyatt is a non- ing on whether the guest is staying over
union hotel. According to Manchester continued on page 71

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(1/2 credit) or checking out (1 credit). http://www.unionfacts.com/articles/

Room attendants work between 14 and democracyElections.cfm
15 credits per eight-hour workday. The
national standard for rooms cleaned in an Questions about APA’s use of the
eight-hour day varies from 13 to 20, ac- Hyatt as a convention hotel given Mr.
cording to “Hotel Management and Op- Manchester’s political activities
erations,” by Denney G. Rutherford,
Q. What is the background of the issue
PhD, and Michael J. O’Fallon, PhD (2007,
with the Manchester Hyatt?
John Wiley and Sons Inc.)
Doug Manchester, a San Diego business-
Hyatt says before the program was insti- man and owner of the Manchester
tuted at the Manchester property, some Hyatt, donated $125,000 to an organiza-
housekeepers learned about it second- tion supporting Proposition 8, the Cali-
hand, which resulted in confusion among fornia state ballot initiative that in 2008
staff. Hyatt says there was a brief period amended the state Constitution to re-
of time in 2006 when workers were gath- strict the definition of marriage to one
ering across the street from the hotel to man and one woman. This was a per-
protest the new work policies. However, sonal donation from Mr. Manchester.
according to the Hyatt, once the new The hotel is operated and managed by
work policies were fully explained to the the Hyatt Corporation, which had noth-
hotel’s staff, the protests ended. ing to do with this contribution. How-
ever, as a result of Mr. Manchester’s
Hyatt also reports that the turnover rate donation, several prominent lesbian,
among housekeepers at the Manchester gay, bisexual and transgender (LGBT)
hotel is under 5 percent. organizations have called for a boycott
of this hotel.
Q. There have been reports that Unite
Here’s tactics and activities have been Additionally, the union Unite Here,
improper. Hyatt says one thing and which has been trying unsuccessfully to
the union another, so which should we unionize this hotel, has called for a boy-
believe? cott. Some LGBT organizations are sup-
There is information available about porting the union’s call for a boycott.
Unite Here’s goals and activities on the
Web. Likewise, Hyatt has posted infor- Q: What is APA’s position on Mr.
mation regarding its relationship with Manchester and his opposition to
same-sex marriage?
the union. Also provided below are links
for web pages to third party entities APA has been a strong advocate for full
which monitor union activities and civil rights for LGBT people for nearly 35
labor issues, some of which have raisedyears. We are proud of that record of ad-
serious concerns about Unite Here’s vocacy based on the social science re-
management and tactics. search on sexual orientation. APA has
supported legal benefits for same sex cou-
Individual members can read these ples since 1997 and civil marriage for
reports based on their interest level. same-sex couples since 2004. Most no-
http://www.unitehere.org/ tably, we have adopted policy statements,
lobbied Congress in opposition to the
http://www.hyattpressroom.com/wel- Defense of Marriage Act and the
come.asp?status=0 Federal Marriage Amendment, and filed
http://www.unionfacts.com/unions/u amicus briefs supporting same-sex
nionProfile.cfm?id=511 marriage in legal cases in Oregon, Wash-
http://unitehereexposed.com/index.cfm continued on page 72
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ington, New Jersey, New York (three no bottom-line effect on the Hyatt (the
times), Maryland, Connecticut, Iowa, hotel would still get its money), the Board
and California. In California, the APA opted to meet its contractual obligations
brief was cited by the state Supreme but also use the San Diego meeting as an
Court when it ruled that same-sex mar- opportunity to communicate APA policy
riage was legal in May 2008. positions on LGBT rights generally and
same-sex marriage specifically to both a
While we strongly disagree with Mr. California and national audience. Ideas
Manchester’s position vis-à-vis proposi- for how we will do this are outlined in a
tion 8, our decision to abide by our con- subsequent section below.
tract with the Hyatt is based on our
belief that the large expense of failing to Additionally, the Global Hyatt Corpora-
abide by the contract would be more tion has a long history of supporting di-
productively spent on funding for APA versity and has enjoyed a good standing
activities in support of psychology and with the LGBT community. The Human
the application of psychology to help Rights Campaign, the largest U.S. LGBT
disadvantaged groups including the advocacy organization, has named the
LGBT community. We see the San Diego Hyatt Corporation one of its “Best
convention as an important opportunity Places to Work” every year since 2003;
to call attention to the social science re- Diversity Inc. and the Advocate maga-
search on sexual orientation, the abilities zine have named Hyatt among the top
of gay and lesbian parents, and the ben- companies for LGBT employees.
efits of marriage for all people.
At the same time, Board members are
Q. Given APA’s position supporting sensitive to the impact of this issue on
equal marriage for LGBT people, why LGBT and other members, and have
is the association still planning to use heard the concern expressed about the
this hotel? Manchester Hyatt being a headquarters
APA signed a contract with the Man- hotel during the 2010 APA convention.
chester Hyatt in 2004 in order to reserve If individual members choose not to stay
both sleeping and meeting rooms for the at the Hyatt there will be other lodging
2010 convention. It is typical that such options available to them.
agreements contain substantial penalties
for cancellations; such penalties protect Q. Why can’t APA cancel its contract
both the host organization (APA) and with the Manchester Hyatt and use an-
the hotel, and are standard in the indus- other property? Haven’t other organi-
try. The APA Board of Directors decided zations canceled plans to meet there?
in February, when it was informed by The Manchester Hyatt has indicated to
Unite Here of the boycott efforts, that APA that it would enforce the terms of
APA would have to honor its contract the contract were APA to cancel. Those
with the Manchester for two reasons: terms involve a penalty of more than $1
million if we were to cancel now. That
The official Board policy is not to cancel amount escalates closer to the conven-
hotel contracts unless there is imminent tion dates. Some organizations have re-
danger to attendees or staff; and in a portedly canceled plans to meet at the
time of serious financial crisis, cancella- Hyatt. Those organizations may have
tion of the contract would cost APA had different contract provisions than
more than $1 million due to its contrac- contained in the APA/Hyatt agreement.
tual obligations. Other organizations, including the
Rather than take an action that would be National Education Association, the
prohibitively expensive to APA and have continued on page 73

72
#"$!%

American Public Health Association, the individual members may choose not to
American Historical Association and the stay in the property. We respect that per-
California Association for Health Serv- sonal choice.
ices at Home, held meetings at the prop-
erty despite the call for a boycott. Like Q. What will APA do to call attention
APA, these organizations are supportive to the science related to same-sex
of LGBT rights and workers’ rights. marriage?
The convention provides an unprece-
Q. What about members or divisions of dented opportunity to bring the weight
APA who refuse to meet in the Man- of scientific research to the public debate
chester at the convention? What is your about same-sex marriage. APA has sup-
message to them? ported legal benefits for same-sex cou-
Initially, some groups within APA moved ples since 1997 and civil marriage for
to support a boycott of the hotel to same-sex couples since 2004.
protest Mr. Manchester’s support of
Proposition 8. APA believes that in the APA’s President-elect Carol Goodheart,
end, a boycott, although a strong sym- EdD, has appointed a governance and
bolic gesture, would not achieve the de- staff work group to assist in developing
sired results; the Manchester Hyatt Hotel a positive approach to the opportunity
would receive the same revenue— presented by the Convention. As a start-
whether the rooms are used by our mem- ing point, the work group has devel-
bers or not—because of major contractual oped the following plans, which have
penalties that APA would have to bear if been approved by the Board of Direc-
we cannot fill our room block. Further- tors. Additional ideas for potential pub-
more, if too many groups asked to move lic education activities are welcome.
out of the Hyatt, there would not be
enough space to house them in other ho- • A press conference with speakers
tels near the Convention Center. All and briefing papers focusing on the
meeting space in the near-by Marriott latest, best science around sexual
and Hilton hotels is already reserved. orientation and the mental health
There are some large rooms available in benefits of marriage;
the convention center but very few rooms • A plenary program focused on
that would work well for a small group, same-sex marriage and the diverse
i.e. a division meeting. Other hotel space, public debate going on in our na-
if available at all, would likely be a sig- tion about it;
nificant distance from the Convention
Center and would require payment for • A presidential citation to a leader in
meeting rooms. (Divisions normally get the movement for same-sex mar-
meeting space at the headquarters hotel riage;
at no charge because of our sizable room • Informational packets on APA poli-
block at the hotel). cies on sexual orientation and mar-
riage rights issues for attendees and
For all of the above reasons, APA has
the public.
asked groups not to formally boycott the
hotel. Instead, we are asking APA divi- In summary, the goals of the Board of
sions and other entities to focus on pos- Directors and the work group are to give
itive actions to highlight APA’s policies our members full information, respect
and to educate the public on the science the personal choices of convention atten-
related to same-sex marriage. At the dees, publicize the social science re-
same time, we recognize there is no sin- search on sexual orientation, and
gle point of view and understand that demonstrate fiscal responsibility.

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#"$!%

CANDIDATES FOR APA PRESIDENT

Ronald. H. Rozensky, Ph.D., ABPP
I am honored to have peutic services as a major component of
been endorsed by Di- quality, cost effective healthcare.
vision 29 for President
of the American I am a Fellow of our Division and am
Psychological Associa- board certified in Clinical Psychology
tion. I have been a [ABPP] reflecting having sought peer
strong advocate for review of both my assessment and
psychology and psy- psychotherapy competencies. I teach the
chotherapy and greatly appreciate this Advanced Psychotherapy graduate sem-
opportunity to provide information re- inar at the University of Florida and
garding my efforts on behalf of psychol- maintain a large outpatient psychother-
ogy, to briefly acquaint you with my apy practice in our hospital-based clinic
professional activities, leadership expe- that includes graduate student and intern
riences, and vision for our future. level trainees. Our students awarded me
both their Classroom Teacher of the Year,
My work on healthcare reform over the and twice, the Supervisor of the Year
past year is a case study in my advocacy awards. The supervisory award states,
for psychology. I have been involved di- “For dedication to and excellence in su-
rectly in the actual writing of healthcare pervision.” For me there is no better tes-
reform recommendations in my role as timony to my commitment to advancing
Chair-Elect, and now Chair, of the Advi- psychotherapy in education, training and
sory Committee on Interdisciplinary Com- practice than that expressed by my own
munity Based Linkages (Services) within students. I have published five books and
HRSA’s Bureau of Health Professions. numerous chapters and journal articles,
The Committee, appointed by the Secre- the majority focused on the application
tary of Health and Human Services, of psychotherapeutic principles to the
makes yearly recommendations to the treatment of medically ill patients across
Secretary and Congress; it is part of my the lifespan.
responsibility to advocate so that psy-
chology is seen as an integral part of the My leadership experiences include APA
healthcare system and deserving of Council and Board of Directors, Presi-
funding for education, training, and dent of the Illinois Psychological Asso-
services. We must take every opportu- ciation, chairing both the Boards of
nity to assure that assessment and psy- Professional and Educational Affairs,
chotherapy are mentioned within the current Chair-Elect of CRSPPP, and chair
healthcare reform discussion and I have of two APA presidential initiatives each
had the opportunity to do just that. highlighting psychological treatment in
healthcare.
My committee participated in writing a
letter to Congress regarding the role of all As APA President I will continue to ad-
health professions, including psycholo- vance the science and practice of psy-
gists, as key to a quality focused, inte- chotherapy. I have the experience and
grated healthcare system. I have skills to advocate for inclusion of our
portrayed psychology as a strong, essen- psychotherapeutic services in the details
tial member of the healthcare team, an in- of healthcare reform. That will be a key
dependent profession providing patient role for the next president of our associ-
care to the fullest extent of our license ation. I would appreciate your #1 vote.
and scope of practice with psychothera- www.RozenskyforAPAPresident.com
74
#"$!%

Melba Vasquez, Ph.D., ABPP

I appreciate the endorse- I previously worked at two university
ment from Division 29 counseling centers as senior psycholo-
for APA President. I gist and as internship training director
have had a strong (Colorado State University and Univer-
commitment to advance sity of Texas at Austin). I’ve taught var-
psychotherapy ious doctoral courses in supervision and
throughout my career training of psychotherapy. I helped to
and will continue this endeavor. plan and coordinate the Supply and De-
mand Conference and the Competencies
The provision of psychotherapy is the Conference, both of which yielded im-
basis of my work. Providing psychother- portant directions for the training of
apy is an activity that is profound in its psychotherapy.
meaning and effectiveness as a change
process. The evolving evidence base helps Scholarship
us to more fully understand the factors I have authored/coauthored over 30
that contribute to therapeutic effective- books, journal articles and chapters in
ness. We must ensure that these services the areas of ethics in psychotherapy,
are fully included and funded in the multicultural competency, and psy-
evolving health care reform systems. chotherapy with women and with men.
I am currently completing a volume,
Leadership Multicultural Theory as part of the APA
As a member of the Board of Directors, I Theories of Psychotherapy Series. I have
have advocated consistently for the served on the editorial boards of practice
Practice Directorate, and the APA Prac- journals such as Professional Psychology:
tice Organization. I currently Chair the Research and Practice, The Counseling Psy-
Task Force to revise the Model Licensing chologist, and Ethics and Behavior.
Act, whose charge is to bring the MLA
in line with other APA policies including Advocacy
proposing increase in licensure mobility, I have participated in activities with the
and ensuring that the doctorate is the Association for the Advancement of Psy-
level of credential required for the title chology such as raising funds for legisla-
“psychologist” and the independent tors and in making visits to Congress.
practice of psychology. Those efforts have included extending the
restoration of Medicare outpatient mental
I served as Chair of the Board of Profes- health reimbursement cuts, and ensuring
sional Affairs, and as member of the that health care reform integrates psy-
Committee for the Advancement of Pro- chological services. While serving as
fessional Practice. I also served on the president of the Texas Psychological As-
Ethics Committee, as member of the Ex- sociation, I helped ensure that our prac-
amination Committee for the Associa- tice laws remained intact during the
tion of State and Provincial Psychology 12-year sunset review. I have received an
Boards, and helped to develop the oral Advocacy Award from the Association
exam for licensure in Texas. for the Advancement of Psychology
Education and Training (2008), and the APA Karl F. Heiser Presi-
I completed a psychotherapy videotape dential Award for Advocacy (2007).
series as part of the APA DVD Videotape I would very much appreciate the #1
project, focusing on multicultural psy- vote from members of the Division.
chotherapy. These series are available Please visit my website www.melba
for training students about psycho- vasquezforapapresident.com.
therapy skills.
75
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#"$!%

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PUBLICATIONS BOARD EDITORS

Chair : Jean Carter, Ph.D. 2009-2014 Psychotherapy Journal Editor
5225 Wisconsin Ave., N.W. #513 Charles Gelso, Ph.D., 2005-2009
Washington DC 20015 University of Maryland
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Jenny Cornish, PhD, ABPP, 2008-2010
Jonathan Mohr, Ph.D., 2008-2012 University of Denver GSPP
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Email: [email protected] Lavita Nadkarni, Ph.D.
Director of Forensic Studies
Beverly Greene, Ph.D., 2007-2012 University of Denver-GSPP
Psychology 2450 South Vine Street
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Christopher E. Overtree, Ph.D.
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PSYCHOTHERAPY BULLETIN
Email: [email protected]

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

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