In the second 10 years of The National Psychologist, 2001-2011, the profession scored a couple of long-time goals, came to terms with national security issues that tested the patience of both sides of the issue and agreed to disagree on how best to deliver therapy.
During this 10-year period, many notables in the field of psychology died, as well as the founder, publisher and editor, Henry Saeman, who passed away at the age of 76 on May 13, 2003.
Psychology were able to claim victory over the medical profession when two states enacted prescriptive authority to appropriately trained psychologists and legislators in two additional states enacted similar legislation only to see the bills vetoed by the states’ governors. Victory was also hailed when Congress finally passed a national mental health care parity act, which prohibits insurance companies from treating mental health treatment differently from physical illnesses.
Enough psychologists were upset by the refusal of the American Psychological Association (APA) Council of Representatives to limit psychologists’ involvement in national security issues that they took the issue to an unprecedented referendum and overturned the council’s earlier policies. The referendum called for the end of psychologists’ involvement in interrogations at the nation’s military and CIA prisons and limited their activities to humanitarian and health care issues.
Alleging that the APA’s Practice Organization was not sufficiently representing the interests of practicing psychologists, several past leaders of the APA founded a new organization, the National Association of Professional Practicing Psychologists to advance an ambitious agenda.
The National Psychologist covered the activities of psychologists working in New York City and elsewhere in the aftermath of the Sept. 11, 2001, terrorist attack, kept an eye on developments within APA and reported on the growing presence of psychologists in Congress
The Task Force on Psychological Ethics and National Security (PENS)
The APA managed to get involved in one of the most contentious issues of the decade when the Board of Directors in February 2005 named a 10-member task force to propose adequate ethical guidelines for psychologists involved in national-security related investigations. The Task Force on Psychological Ethics and Nationaly Security (PENS) was created, among other things, to look at how the profession has responded to reports of torture at the Abu Ghraib Prison in Iraq and the Guantanamo Bay Detention Center in Cuba. The task force was charged with examining ethical dimensions of psychology’s involvement in national security investigations. The report that the PENS task force released in mid-2005 was quickly condemned in many quarters, including medicine and psychology.
Writing in the September/October issue, Gary Kaufmann, Psy.D., whose background is in police behavioral science, said the task force “did not fulfill its responsibility to think through and provide guidance on the complex ethical challenges that face psychologists who apply their training, skills and expertise in our nation’s service.” He faulted the task force’s conclusion that when psychologists serve in any position by virtue of their training, experience and expertise, the APA code of ethics applies, but when psychologist act in roles outside traditional health-service provider relationships, psychologists are not acting in a professional capacity as psychologists and are therefore not bound by the APA ethics code.
Indeed, the Council of Representatives at its August 2005 meeting attempted to strengthen the report by amending it to make it clearer that when there is a conflict between laws and the APA Code of Ethics, the latter always prevails. Another amendment said there is never an excuse to inflict torture under any circumstance and the third strengthened a requirement that psychologists be required to report violations of the APA Code of ethics to the APA.
In the same issue that Kaufmann’s critique appeared Stephen Behnke, Ph.D., J.D., director of the APA’s Ethics Office, defended the report and said that additional comments would be solicited before a final version is published. He admitted that “much work remains to be done by APA and its members.”
At the August 2006 Council of Representatives meeting, Steven Reisner, Ph.D., called the entire U.S. operation in Guantanamo “immoral” and psychologists should be precluded from any participation. He noted that the American Psychiatric Association had acted to prohibit its medical doctor members from participating in military activities in the Guantanamo prisons.
A letter to the editor in the March/April issue signed by Ghislaine Boulanger, Ph.D., and 46 other psychologists announced they would withhold their 2007 and 2008 dues to protest the APA’s failure to take action prohibiting psychologists from being employed in government facilities that do not subscribe to the Geneva Conventions. The signers said APA’s policies regarding psychologists employed in various detention facilities is tied to the U.S. government policy, which provides wide discretionary power for the president to interpret and apply the Geneva Conventions.
At the 2007 APA convention in San Francisco, around 400 demonstrators urging the Council of Representatives to ban psychologists from participating in interrogations of prisoners at Guantanamo Bay and other prisons failed to convince the delegates to change its 2004 resolution against cruel, inhuman or degrading treatment of prisoners. The Council of Representatives re-affirmed its support of the 3-year-old policy and turned back a resolution that would have limited psychologists at prisons to be responsible only for inmate health care.
Noted author Mary Pipher, Ph.D., of Lincoln, Neb., returned her 2006 Presidential Citation from the APA in protest of the organization’s reaffirmation that psychologists have a proper role in CIA detention centers. In a 2007 letter to APA President Sharon Brehm, Ph.D., Pipher called the reaffirmation “a terrible mistake.” She said as a matter of conscience she cannot keep an award from an organization that takes a stand on human rights “at odds with the United Nations, the Red Cross, the American Psychiatric Association and the American Medical Association.”
Articles and letters to the editor protesting the APA position of psychologists and national security continued to pour into The National Psychologist. In the January/February issues, Brad Olson, Ph.D., a research and consulting psychologist at Northwestern University, and Martha Davis, Ph.D., a visiting scholar at John Jay College of Criminal Law, said three of the reasons the APA advances for allowing psychologists to work in Guantanamo and other military and CIA prisons are based on myths. The first myth, they wrote, is that “if psychologists are restricted from involvement in detainee interrogations, they can be restricted from other work.” The defeated 2007 amendment would have prohibited unethical work in settings that violate the Geneva Conventions and international law, not ethical practice in legal settings, they wrote. Myth No. 2 is that the “presence of psychologists will prevent detainees from abuse.” “There is not evidence from independent observers that Behavioral Science Consultation Teams (BSCTs) protect detainees any more than other military officers,” Olson and Davis said. Thirdly, the pair said, is the myth that members of the APA Council of Representatives arrived at its 2007 interrogation policy after extensive deliberations with a wide range of experts and had given these issues a fair hearing. “In 2005, the APA council members sped through deliberations with a PENS Task Force that was heavily weighted with psychologists affiliated with the U.S. military and the procurement of Department of Defense contracts,” they explained.
In the same issue, a letter signed by more than 220 psychologists noted they were withholding 2008 APA membership dues because APA “continues to give institutional support to the U.S. military and other government agencies that operate detainee sites in which international standards of human rights are violated.”
At the February 2008 meeting, the APA Council of Representatives, in an effort to silence critics of a resolution passed a year earlier on the involvement of psychologists in U.S. Detention centers, replaced a paragraph of the resolution to better define what psychologists can and cannot do at such sites. Delegates voted to include wording that emphasizes an “unequivocal condemnation” of all techniques considered torture or cruel, inhuman or degrading treatment of prisoners. The action followed what some saw as a ambiguity that could be interpreted as allowing direct or indirect participation of psychologists in questioning of prisoners at Guantanamo and other detention centers.
In a September 2008 membership mail vote, the APA was directed to forbid psychologists to work in Guantanamo or other national security centers except in humanitarian roles. The vote was 8,702 votes in favor of a ban, 6,157 against and 15 abstentions. The membership vote was spearheaded by a cadre of psychologists led by Stephen J. Reisner, Ph.D., of New York over outrage that the APA Council of Representatives decline to pass bans similar to those adopted by other healthcare associations, following news reports of abuses at Guantanamo, Abu Ghraib and other military detention centers and “blacksites” operated by the CIA.
The mail referendum marked the first time it was used to overturn a council action. Reisner said the vote tells him that the APA is ripe for a change of leadership to restore the association as a voice with the “moral authority” to speak out against violations of human rights throughout the world and to be a champion of bringing mental health care to the underserved.
The ban was adopted in February 2009 by the APA Council of Representatives by a vote of 141-12, with six abstentions.
In a related matter, retired Army Col. Larry James, Ph.D., denied charges that he taught torture techniques to military interrogators while stationed at Guantanamo and Abu Ghraib. He has published a book, Fixing Hell, in which he explains his experiences at the two prisons. In the January/February 2009 issue, Col. Kathy Platoni, Psy.D, defended James and other military psychologists. “Though we have been witnesses of the personification of true evil and the most heinous of all transgression and offenses, there simply is no evidence to support the commission of crimes by military psychologists,” wrote Platoni, who served in war zones and Guantanamo. She added that the referendum approved by the APA membership forbidding psychologists from being involved in anything but humanitarian work at military and CIA detention centers “borders on lunacy.”
Stephen Soldz, Ph.D., of the Coalition for an Ethical Psychology, however, questioned James’s contention that all torture and prisoner abuse stopped under his watch. Soldz cited reports compiled by the Red Cross, FBI and nongovernmental organizations (NGOs) documenting abuses far into 2004, at least.
Meanwhile, in the July/August 2009 issue, The National Psychologist reported the Toledo, Ohio psychologist Trudy Bond, Ed.D., had sued the Louisiana State Board of Examiners of Psychologists claiming the board had refused to investigate James for alleged professional and ethical violations at two prison camps. The board had turned down her 2008 request for an investigation, claiming the statute of limitations had expired. A Louisiana district court judge dismissed the suit, upholding the board’s statute of limitations argument. On June 11, 2010 a unanimous Louisiana 1st Circuit Court decision held that Bond did not have legal standing to pursue court review of the Louisiana State Board of Examiners of Psychologists lack on action on the complaint she had filed against James.
In a June 18, 2009 letter to its membership, the APA board of directors conceded that psychologists were involved in designing and advising on torture techniques employed at national security centers such as Guantanamo and Abu Ghraib. At the same time, the board wrote that “some of our members continue to be disappointed and other angered” that the association did not take stronger action earlier to condemn the interrogation methods. “Although there are countless psychologists in the military and intelligence community who acted ethically and responsibly during the post 9/11era, it is now clear that some psychologists did not abide by their ethical obligations to never engage in torture or other forms of cruel, inhuman or degrading treatment,” the board wrote.
In a Viewpoint essay in the November/December 2009 issue, Bryant Welch, J.D., traced the history of the involvement of the military in APA affairs. He said the undue influence of the military began in the 1990s and into the early 2000s. “I saw APA shift into a regressed organizational state characterized by excessive fawning, limited creativity and ineffective interactions with the outside world. The lack of dissent by most was praised as evidence of ‘working together.’ Rational disagreements, in contrast, were quickly responded to with ad hominem attacks, some of them quite sadistic, against dissenters.” He said that since the APA had implemented the recent referendum passed by the membership, “it appears that the current leadership at APA has decided to batten down the hatches and wait until the storm has passed.”
Stephen E. Handwerker, Ph.D., a founder and chair of the Advancement of Human Welfare, Inc. and a member of APA Division 48 (peace psychology) called for the APA to implement the language of the 2008 referendum into the APA Code of Ethics in an essay in the January/February 2010 edition. He also called for an investigation by an independent body to pursue accountability for psychologists who participated in or otherwise contributed to torture or cruel or degrading treatment at military prisons. He also urged that the June 2005 PENS report be annulled or rescinded due to “severe and multiple conflicts of interest.
New Mexico became the first state on Feb. 14, 2002, to enact legislation granting psychologists prescribing authority. It passed the state senate by a 29-9 vote and the New Mexico House 56-11, both veto-proof margins. It was signed by Gov. Gary Johnson, who had earlier summoned representatives from psychology and psychiatry to see if an agreement could be worked out. Psychiatry fought the measure to the bitter end, but an agreement between psychologists and the New Mexico Medical Society became the cornerstone of the new law, which requires psychologists to complete 450 hours of classroom training and spend 400 hours treating no fewer than 100 patients under a physician’s supervision.
Buoyed by psychology’ success in winning prescribing authority in New Mexico in 2002, a record number of state psychological associations sought similar legislation in 2003-2004, including five new states and seven states that have attempted to gain such authority in years past .New states include Arizona, Oklahoma, Oregon, Wyoming and New Hampshire. State associations that will again seek RxP include Connecticut, Georgia, Illinois, Louisiana, Tennessee, Texas and Hawaii.
On May 6, 2004, Louisiana Gov. Kathleen Babineaux signed a bill granting the state’s medical psychologists the authority to prescribe psychotropic medications, ending a decade-long battle in that state’s legislature.
At the August 2004 APA convention in Hawaii, David O. Antonuccio, Ph.D., of the University of Nevada School of Medicine warned psychologists gaining prescribing authority to be on guard against the siren song of drug manufactures and urged psychology publications not to accept advertising from drug companies. He said the American Psychiatric Association (ApA) receives more money, around $13 million annually, from drug companies than it does from membership dues and that the American Medical Association receives $20 million annually from selling drug companies its mailing list of medical doctors.
Morgan Sammons, Ph.D., then a Navy commander, echoed Antonuccio’s remarks, saying it was up to psychologists to insure direct drug company to consumer advertising didn’t distract from the profession’s primary responsibility, therapy. “It has to be us,” Sammons said, noting that the Federal Drug Administration is not going to crack down on exaggerated claims by drug companies. “No one else is going to do it; no one else is going to make sure our patients see the other side.”
Unsuccessful in stopping RxP legislation in New Mexico and Louisiana, the ApA created a seven-person presidential task force to “put an end to psychologists’ bid to win prescription privileges throughout the United States.”
In August 2005, George W. Albee, Ph.D., told a workshop at the APA convention that prescriptive authority for psychologists would doom the organization for abandoning its long history of research and clinical experience. He said that “poorly prepared professionals steadily gained control of APA’s governing council and board of directors” at the expense of researchers who continue to hold to non-medical theories about the nature of mental illness. “APA,” he said, “is firmly in the hands of the medical model/drug prescribing practice group that is killing the organization.”
The California Society of Clinical Psychopharmacologists filed suit in early 2006 in the U.S. District Court seeking the right to prescribe psychotropic drugs. The court denied the state’s request to dismiss the case and warned state attorneys not to file further “frivolous” motions to delay the case.
In the May/June 2006 edition of The National Psychologist, Glenn Ally, Ph.D., reported that 30 medical psychologists in Louisiana had written more than 10,000 prescriptions in the year since that state granted psychologists prescribing authority. And in New Mexico, Elaine S. LeVine, Ph.D., training director for the Southwestern Institute for the Advancement of Psychotherapy wrote that 30 psychologists had graduated from the program granting an advanced degree in psychopharmacology and another 20 were enrolled in the program.
Both chambers of the Hawaii Legislature approved a bill in mid-2007 to allow psychologists to prescribe in federally designated health centers, but it was vetoed by Gov. Linda Lingle.
A major push for prescriptive authority legislation in 2008 in California and Missouri went down to defeat, while the Tennessee Board of Examiners in Psychology approved rules allowing appropriately trained psychologists to consult with physicians on medication, an growing trend among the states. Tennessee joins California, Florida, Maine, Missouri, Vermont and the District of Columbia where psychologists are permitted to consult with physicians on medication. The practice is common in other states, as well, even when the law or regulations are silent on the subject of psychologist-physician collaboration.
The Louisiana Legislature in 2009 backed legislation that transferred licensure of medical psychologists from the Louisiana State Board of Examiners of Psychologists to the Louisiana State Board of Medical Examiners in recognition of the implicit medical components of the practice of medical psychology.
Both houses of the Oregon Legislature approved legislation in February 2010 giving properly trained psychologists the right to prescribe psychotropic medications. The prescription authority would not go into effect until July 1, 2011 to allow a task force to determine the level of training that would be required and the formulary contents. However, Oregon Gov. Ted Kulongoski vetoed the bill, but left the door slightly ajar for a pilot RxP program in 2011.
Psychologists Respond to Terrorists’ Attacks
Noemi Balinth,, Ph.D., June Feder, PH.D., Sandra Haber, Ph.D., were among hundreds of New York psychologists involved in helping victims of the Sept. 11, 2001 terrorist attack. Balinth worked eight days for the Red Cross that were filled with indelible remembrances, not least being “therapeutic” poker games in which no money changed hands with city firefighters as a way of distracting them and to help them think about counseling.
Ohio psychologist James Rodger, of the University of Akron, drove to New York to help, worked at ground zero wearing a hard hat and gas mask. Another Ohio psychologist, Kathy Platoni, Psy.D., accompanied three Dayton area police officers to New York City as part of a International Critical Incident Stress Foundation team to help restore many of the city’s 41,000 police officers to physical and mental health.
Norma Steuerle, PH.D., of Alexandria, Va., was killed in the plane that crashed into the Pentagon. U.S. Navy commander Robert Schlegel, husband of Dawn Schlegel, Psy.D., of Portsmouth, Va., was killed in the Pentagon.
Haber kept a moving diary of her work and shared it with readers of The National Psychologist.
Gary DeNelsky, Ph.D., and Philip G. Zimbardo, Ph.D., wrote Viewpoint articles. In “The day the psychology of America changed forever, DeNelsky wrote, “What happened that terrible Tuesday changed our lives a great deal, changed them immensely and probably changed them irreversibly. We will bounce back because the human spirit is if nothing else highly resilient and times does have a tendency to heal.”
Zimbardo, president elect of APA at the time of the attack, wrote on “good, evil and terrorism”, warning “We must individually and collectively refuse to adopt the terrorists devaluation of human life or they will win the next battle by giving into the kind of negative sentiments that their evil deeds have generated in us all.”
In March 2002, Leon J. Hoffman, Ph.D., of Chicago, warned against becoming over-saturated by media presentations of the 9/11 attack. He urged readers to absorb just enough news from print and electronic media “to stay informed.” He urged therapist to get plenty of sleep, eat well and don’t depend on drugs and alcohol to get through the day. “Few people are likely to be trauma experts. Don’t try, yourself, to become expert at what is impossible or irrelevant, such as memorizing the personal profiles of 50 Arab terrorists.”
U.S. Rep. Brian Baird, then a Washington State Democrat, who witnessed the hijacked American Airlines jet crash into the Pentagon from his seventh-floor congressional office, submitted a proposed constitutional amendment, dubbed the “doomsday” amendment that would allow governors to make temporary 90-day appointments to replace House members if disaster struck the capital building instead of waiting for special election as required by law. The proposal received one hearing, but failed to attract much support and died.
At its February 2003 session, meeting under an orange alert, a flight canceling snow storm and gathering war clouds, the APA Council of Representatives created a task force to study the psychological effects of efforts to prevent terrorism. The task force considered psychological processes that provoke terrorism, such as stereotyping, compartmentalization, enemy images, attribution error, self-fulfilling prophecies and group think.
The National Alliance of Professional Psychology Providers
A respected group of practicing psychologists on July 1, 2006, unveiled a new organization to counteract what it sees as inaction by the (APA) and the professional community as a whole on issues to importance to practitioners. The National Alliance of Professional Psychology Providers (NAPPP) includes such luminaries and former APA officers as Nicholas Cummings, Ph.D., Sc.D., Jack Wiggins, Ph.D., Psy.D., and Stephen E. Berger, Ph.D., on its board of directors. Other board members include Michael A. Baer, Ph.D., James Childerston, Ph.D., Howard Rubin, Ph.D., John Caccavale, Ph.D., Matt Nessetti, Ph.D., Lenore Walker, Ed.D., and Stanley Graham, Ph.D., another past president of APA. Noting that it wanted the new organization that unifies practicing psychologists, the board said, “We are averse to slow, encompassing bureaucracies that can take years or never to produce results.”
Not all psychologists agreed that such a new organization was needed. Pat DeLeon, Ph.D., J.D., a former APA president, branded NAPPP as a divisive movement that will breed unnecessary disgruntlement in the psychology community. “It’s a waste of time and a waste of energy,” DeLeon said, adding that he resents former APA presidents using their prestige to criticize the association. Russ Newman, Ph.D., J.D., then-executive director of the APA Practice Organization, said the need for advocating for practicing psychologists is great enough to warrant any help NAPPP can provide and hoped the two organizations can work together.
By October, NAPPP launched a practitioner-owned provider network modeled on the Kaiser Healthcare plan. The initial target client base was the 2.5 million members of the Service Employees International Union, which with dependents totals 8 million potential behavioral health clients.
In the may/June issue, Graham wrote in a Viewpoint column, “As past president of APA and a current executive board member of NAPPP, I do not accept that the organizations cannot work together in common cause. I see no reason why cooperation should not be seamless in areas that concern the practicing psychologist.”
NAPPP announced a national media campaign to educate physicians and their patients on the value of the mental health services of doctoral psychologists. Part of the message will be to educate the public that primary care physicians are not trained mental health professionals and have only drugs at their disposal to help patients. Insurers like the arrangement with primary care doctors prescribing psychotropics because drug treatment costs less than therapy.
Ray Fowler, Ph.D., for 13 years the APA CEO announced he would retire at the end of 2002. Fowler is credited with invigorating a financially and administratively broke group into the principal psychology organization in the United States. The fallout from 9/11 contributed to a $5.5 million hit when subscriptions from foreign governments were stopped and that money diverted to their internal security. Low turnover and the recession were other factors. The loss nearly matched the $6 million loss the APA suffered in the late 1980s during the last year it published Psychology Today.
It was later revealed that Fowler had received $2.2 million on his retirement during a period when the APA was running a $1.3 million deficit. By the strangest of coincidences, the fact that Fowler had received what many thought to be an outrageous amount of money appeared in a gossip column in The Washington Post on the first day of the APA winter Council of Representatives in February 2004.
In mid-2002, Norman Anderson, Ph.D., was named the new APA CEO. He became the first African-American to head the organization. The only addiction Anderson has, he told the TNP, is a sometimes irresistible urge to eat Krispy Kream donuts.
APA borrows $120 million to get its financial house in order following 10 years of accumulated operating debt.
The APA Council or representatives expanded its members from 144 to 162, giving each state, Canadian provinces and American territories with psychological association voting privileges. Arkansas, Wet Virginia, Delaware, Idaho, South Dakota, Wyoming, Montana, Nebraska and Nevada were states gaining votes, as well as the District of Columbia. Canadian provinces gaining seat include British Columbia, Manitoba, Nova Scotia and Quebec. Ontario previously had a seat on council. Guam, Puerto Rico and the Virgin Islands also gained one seat each. As a result, California and New York representation went from three to two, while Illinois, New Jersey, Massachusetts, Ohio and Washington went from being represented by two members to one psychologist.
In 2003, the APA created a task force to take a look at its practice of not accepting military advertising in its publications, a policy adopted in 1990 in response to the-then policy that prohibited gays and lesbians from joining the military.
Meeting in Honolulu in August 2004, the APA Council of Representatives approved the most sweeping endorsement of gay rights by any mental health association in a pair of resolutions opposing any legal restriction on the rights of gays, lesbians or bisexuals to marry or rear children.
In 2007, Russ Newman, Ph.D., J.D., executive director of the APA Practice Directorate since 1993, resigned to become provost and vice president of academic Affairs for Alliant International University in California. Jack McKay, the long-time chief financial officer retired.
Katherine C. Nordal, Ph.D., a managing partner of an independent practice group in Vicksburg, Miss., was named executive director of the APA Practice Directorate in April 2008.
At the February 2010 Council of Representative meeting, delegates defeated a motion to exempt industrial/organizational psychologists from licensure.
A flap over whether the “required” practice assessment was mandatory for practitioners to maintain APA membership broke out in early 2010. After some stonewalling and considerable doubletalk, the APA and the Practice Organization finally agreed that the “required” assessment was not mandatory to maintain APA membership.
Mental Health Parity
Mental health parity legislation was approved by the Senate Health, Labor and Pension Committee by a vote of 21-0 in mid-1991, but was sidetracked as Congress dealt with the aftermath of 9-11 and the rash of mail containing anthrax. In December, the House of Representatives, at the urging of employer groups and insurance companies, killed the bill. In early 2002, Sen. Paul Wellstone, a Minnesota Democrat, and Pete Domenici, a New Mexico Republican, vowed a new effort to pass parity legislation, despite no support from the White House and continuing Republican opposition in the U.S. House.
Wellstone, his wife, daughter and five staff members are killed in a plane crash in northern Minnesota on Oct. 25, 2003.
An early 2006 report in The New England Journal of Medicine concluding that providing mental health coverage equal to medical coverage would save workers money without increasing employers’ insurance premiums gives new hope that a national parity law might be enacted soon.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act was approved in October 2008.
In the May/June 2009 issue, Bryant L. Welch, J.D., Ph.D., warned that mental health parity will remain an illusion as long as health maintenance organizations use the “medically necessary” standard for reimbursement. “One can have all the mental health care that is “medically necessary” under an 80-20 payment plan with no maximum limit on visits and still wind up with exactly zero mental health treatment if the insurance company determines the care is not medically necessary. In short, parity closes the barn door after the horse has already been stolen.”
In April 2010 a group of mental health carve outs filed suit seeking to block rules adopted to enforce the federal parity law. A judge denied a temporary restraining order.
Evidence-Based Practice in Psychology
At the 2005 APA convention, the Council of Representatives approved a proposal backing the use of Evidence-Based Practice in Psychology (EBPP) to promote effective psychological practice and enhance public health by applying empirical supported principles of psychological evidence in therapeutic relationships and interventions.
The action created considerable controversy. In the September/October issue, Thomas A. Habib, Ph.D., of San Juan Capistrano, Calif., said the decision gave health maintenance organizations one more reason to deny payment for psychological treatment. He wrote that psychology isn’t ready “for the strait jacket imposed by evidenced-based treatment. We are a young profession that is very much evolving. Our scope of treatment, the human condition, is much broader and more dynamic. He added that research shows that “it isn’t what we do that affects treatment outcome but qualities within the patient-therapist relationship.”
Habib blamed the influence of academics for the development of evidence-based treatment and charged that they had hijacked the APA by “tapping into psychology’s obsessive search for legitimacy and our collective professional doubt.”
In the same issue, Frank M. Dattilio, Ph.D., a faculty member of the Department of Psychiatry at Harvard Medical School, wrote that, with the advent of evidence-based treatment, there has come some reluctance on the part of many, evened seasoned therapists, to do what comes naturally. Instead, many feel compelled to follow a step-by-step procedure that almost appears “mechanized” or “wooden” at times.
More comments questioning the wisdom of relying on evidence-based therapy appeared in Letters to the Editor column in the November/December issues. Ken Harwood, Ph.D., of Jacksonville, Fla., wrote that a new generation of therapists can do therapy the “right” way , and feel secure (if not smug) in their performances, while often bringing no more than superficial change for the complex human being sitting across from them. This is a sad time for psychology!”
David H. Barlow, Ph.D., of Boston, Mass., wrote, “Let’s join together to vigorously advocate for the fundamental right of licensed psychologists to treat patients based on their judgments of what is best for patients, rather than having this decided by low-level bureaucrats. The problem is not the existence of new sophisticated psychological treatments; it is bureaucrats attempting to tell us how to practice.”
Paul Meehl, PH.D., 82, of Minneapolis died on Feb. 14, 2003. He was an early clinical psychologist and president of APA. Feb 14, 2003.
Ted Blau, Ph.D.,of Tampa, former president of the APA, the first practitioner on the APA board of directors and president of the APA, died Jan 28, 2003. He was a member of the Dirty Dozen.
John W. Gardner, Ph.D., of Palo Alto, Calif., the only psychologist to serve in a President’s cabinet and founder of Common Cause, died on Feb 18, 2002.
Neil Miller, Ph.D., of New Haven, Conn., died on March 23, 2002. He was a recipient of the nation’s highest scientific honor, the National Medal of Science. He was a president of APA in 1960.
Charles Kiesler, Ph.D., of San Diego, died on Oct. 11, 2002. He was the CEO of APA, 1975-1979.
Magda B. Arnold, Ph.D., of Tucson, died in October 2002. She was the author of Emotion and Personalty.
Erika Fromm, Ph.D., 93, of Chicago, who as a youth was mesmerized by a speech by Adolph Hitler, went on to become widely known in the application of hypnosis to help people work through issues. She died in June 2003.
Jerry Clark, Ph.D., was running for president of the APA when he died in September 2003 at the age of 90. He was the oldest member of the APA Council of Representatives and had twice served as president of the California Psychological Association.
Henry Saeman, founder and managing editor of The National Psychologist in 1991, died May 13, 2003, at the age of 76. He suffered from Myelofibrosis, a rare blood disorder. He was for 18 years the executive director of the Ohio Psychological Association, following a career as a newspaper reporter. He was honored by the APA’s Division 31 as the first-ever award as Outstanding Executive Director of a state psychological association.
In 2002, he was inducted into the Psychology Academy of the National Academies of Practice, the first non-psychologist ever elected to this elite group. Born in Regensburg, Germany in 1927, Henry was a passenger on one of the last ships to cross the Atlantic from Germany before the United States entered World War II. His mother died in the Holocaust. He is survived by his wife, Mitzi, and their son Marty, who is now managing editor of The National Psychologist.
Ira Polonsky, Ph.D., 64, was murdered on Nov. 1, 2005, in his Vallejo, Calif., office. He was a long-time and respected columnist for The National Psychologist. His killer has never been caught.
George Albee, Ph.D., 84, of Longboat Key, Fla., died July 8, 2006. He was influential and recognized for his early advocacy of prevention and other proactive approaches to mental health. He died July 8, 2006.
Jay Haley, widely acclaimed as a pioneer of strategic family therapy, master teacher and an advocate for hypnosis in 1960s, died in February 2007 at the age of 83.
Jacqueline C. Bouhoutsos, Ph.D., of Los Angeles, whose pioneering studies of therapist-patient sex culminated in legislation making the practice illegal, died on May 22, 2008 at age 83, following a 15-year battle with Alzheimer’s disease.
Army Maj. Eduardo Caraveo, Ph.D., was killed on Nov. 5, 2009 in the shooting rampage at Fort Hood in Texas.
Reginald Jones, Ph.D., 74, professor emeritus of the African American Studies Department at the University of California-Berkley, died Sept. 24, 2005. Jones was often called “the father of African American psychology. He was a recipient of the APA’s Award for Distinguished Career Contributions to Education and Training in 2003.
Albert Ellis, Ph.D., 92, the founder of Rational Emotive Behavior Therapy, died July 24, 2007. He was considered one of the most important psychologists of all time, coming in second only to Carl Rogers and ahead of Sigmund Freud.
Pat Gardner, Georgia pa executive director of the Georgia Psychological Association for 25 years announced her bid to run for that state’s House of Representatives. She handily won the election.
Two-term U.S. Rep. Brian Baird, Ph.D., a Washington State Democrat, caught a lucky break when a well-funded Republican challenger dropped out of the race in 2002.
Ted Strickland, Ph.D., the first psychologist elected to Congress, is gerrymandered out of his Ohio Sixth District, forcing him to run in a new district that follows the Ohio River from Youngstown to Portsmouth. The new district is shaped like a banana and appears yellow on redistricting maps. It is referred to as the “banana republic.”
With the 2002 election of Tim Murphy, Ph.D., a Pennsylvania Republican, and Diane Watson Ed.D.,, a California Democrat, the ranks of psychologist increased to five. Ted Strickland, Ph.D., and Brian Baird, Ph.D. and Tom Osborne, Ph.D., a Nebraska Republican were reelected. Strickland, Baird and Murphy created Congressional Mental health Caucus that claimed 72 members.
All five congressional psychologists were handily returned to Washington in the November 20204 elections.
Ted Strickland, Ph.D., and Tom Osborne, Ph.D., announced in mid-2005 that they would not seek re-election in 2006, instead opting to run for governor in their respective states. Strickland was handily nominated in the 2006 primary as the Democratic candidate for Ohio, governor, but Osborne was defeated.
Strickland was swept to office in the November 2006 election. But, the departure of Strickland and Osborne reduced the number of psychologists serving in Congress from five to three. In 2010, Baird announced he would not seek a seventh term in Congress, further reducing that number to two.
Names in the News
Albert Ellis, Ph.D., 92, one of the leading clinical practitioners, was dismissed from the New York City institute bearing his name in the fall of 2005. The father of Rational Emotive Behavior Therapy founded the institute in 1959 to promote his then-revolutionary form of therapy. The board of the institute said Ellis was dismissed when his nursing care costs amounted to an alleged improper “excess benefit” under tax laws, jeopardizing the institute’s nonprofit status. Ellis filed suit seeking reinstatement.
Elizabeth Loftus, Ph.D., the nation’s most controversial repressed memory skeptics, learned in mid-2005 that the California Supreme Court would hear her appeal to determine if she could be sued for invasion of privacy and defamation. In a complicated and drawn-out case, Loftus was charged by Nicole Taus for invading her privacy by identifying her in court documents, depositions and in other ways during the psychologist’s attempt to prove that Taus’s recovered memory of early childhood sexual abuse was false.
The case had dogged Loftus for many years and was responsible for her decision to leave the University of Washington in the fall of 2002 to move to the University of California at Irvine.
In February 2007, the California Supreme Court said that actions Loftus took to discredit a case study article describing repressed memories may be “considered beyond the pale” and ordered a trial court to consider whether those actions constituted an invasion of privacy. The invasion of privacy was the only issue upheld by the court. It threw out other claims, including public disclosure of private facts, defamation and intrusion into confidential juvenile court records.
Loftus was accused of misrepresenting herself during interviews with Taus’s former foster mother by claiming she was an associate and supervisor of the psychiatrist that had reported the recovery of the alleged repressed memory. Later, Loftus’s insurance company agreed to pay Taus $7,500 in exchange for dropping the invasion of privacy allegation.
Comparing the state of psychology today to a dysfunctional family that can’t take a vacation because they can’t agree on which airline to take, Ron Fox, Ph.D., challenged delegates to an APA convention to get over their fascination with disciplinary navel lint, and tackle the real problems of the world. Fox called psychology’s failure to develop into a strong, relevant and robust profession “one of the tragedies of our times.
He said that failure was not caused by disagreement with science, effectiveness of treatments or charlatans and sham psychologists. Rather, he explained, “Our tragedy and great failure is that we know so little about how to help our fellow man and are poorly positioned to apply what we do know.” He listed prevention of war, how to deal with poverty, how to cope with racism and the reduction of human misery as areas psychology should be taking the lead instead of “clogging the channels of too much of our scholarly discourse.”
Michael F. Hogan, director of the Ohio Department of Mental Health, was named chair of the President’s New Freedom Commission on Mental Health, created by President George W. Bush. It was the first presidential initiative in the mental health arena in 25 years, when Rosalynn Carter headed a similar study group.
“Services have to be made more available at all levels – at the individual consumer level, at the state level and at the national level,” Hogan told The National Psychologist.
He and commission members logged thousands of miles to Washington, D.C., Los Angeles, Chicago and Oregon during the year-long study. “If I had been able to collect frequent flier miles, I could go a long way, but when you work for t he government, you don’t get them.”
In its final report, the commission said the nation’s mental health system is in a shambles, with the quality of care varying greatly from one state to another. The commission called on Congress to pass a meaningful parity bill, and said the solution to the nation’s mental health delivery system is not necessarily more money, but imposing greater flexibility in using existing resources.
Wars, Soldiers, Veterans and Psychology
As the United States entered into a two-front war in Afghanistan and Iraq, reports of serious mental health issues among the troops began to emerge. One of the first reports was in an article in January/February 2004 issue about a psychologist who had served for 184 straight days in a remote field hospital in Turkistan on the Afghanistan border.
Air Force Maj. Steven J. Byrnes, Psy.D, told the annual convention of the Ohio Psychological Association of his experiences in working in sub-freezing temperatures at 6,000 feet identifying troops brought to the hospital with signs of stress and behavioral problems following the daily fire fights as part of the United States’ effort to eradicate elements of the Taliban in Afghanistan.
In addition to attending to the mental health needs of soldiers brought to the hospital, Byrnes said he also had to be alert to the needs of fellow officers in the medical corps and military officials when they showed signs of stress brought on by too much work in an area that offered no television, radio or other diversions.
A year later, the Department of Defense, noticing the high rate of soldiers reporting mental health problems months after leaving the Middle East war fronts, announced a new program that would provide evaluations for troops returning from Iraq and other hot spots to include follow-up assessments two to four months after leaving a combat zone. The program was started following research showed that troops were more likely to show signs of mental stress months after leaving rather than immediately leaving combat situations.
In the November/December 2005 issue, Kenneth Reich, Ed.D., and Jaine Darwin, Psy.D., both of Boston, announced a mission to provide free mental health services to families of military personnel assigned to the wars in Iraq and Afghanistan. The aim of the project, known as SOFAR (Strategic Outreach to Families of all Reservists), is to head off a massive amount of trauma because of the vulnerability of family members.
“These families are incredibly dispirited and unlike regular Army family members they’re incredibly isolated, Darwin told The National Psychologist.
SOFAR has assembled a group of experts to publish a pamphlet that will help teachers, parents and pediatricians identify trauma in children and a model workshop to educate teachers in dealing with trauma.
In November 2006, Barbara Romberg, Ph.D., of Washington, D.C., founder and executive director of Give An Hour, put out a plea for therapists to volunteer one hour a week to provide free mental health counseling to returning soldiers and their families.
In May 22007, Retired Col. Will Wilson, Ph.D., said there is a strong initiative by the military to enlist the aid of civilian psychologists to help military psychologists that are overwhelmed and understaffed from constant rotation in and out of war zones.
Wilson said it was undecided if civilian psychologists would be sent to the front lines or would serve only on bases in the United States and elsewhere.
“We’ve got people in Guantanamo, people on aircraft carriers, people all over the world and they’re getting worn out. They’re not getting a chance to stabilize of time to get their lives in order before they go back into situations that are very demanding,” Wilson told The National Psychologist. There is also a danger that many military psychologists will leave the service when their enlistments are up rather than consider making the military a career, he said.
In July 2007, a leader of the Veterans for America (VFA) said his organization and the Army have agreed to establish the Warrior Transition Brigade in a program that will train officers to recognize mental health problems among the troops they lead. The training, said Steve Robinson of the VFA will be introduced in all aspects and stages of military life starting in basic training and throughout the soldier’s professional development. He said the concept is important for those faced with wartime trauma on the battlefield and finally to personnel assisting soldiers returning home.
In the September/October 2007 issue, then-Navy Capt. Morgan T. Sammons, Ph.D., wrote a lengthy article about his experiences as a psychologist in Fallujah, Iraq, in 2006 and 2007.
“I treat a great deal of acute and chronic stress in theatre, using a basic cognitive framework that relies heavily on reducing affective response to distressing recollections and re-interpreting emotional and physical reactions to traumatic recollections,” Sammons wrote.
In the January/February 2008 issue, five psychologists talked and wrote about the intricacies of psychological treatment of soldiers and veterans. Greg M. Reger, Ph.D., a clinical psychologist at Madigan Army Medical Center; Col. Gregory A. Gahm, Ph.D., an Army psychologist, and the late Art Aaronson, Ph.D., a psychologist at the Veterans Affairs hospital in Dayton, told of their work using virtual reality to treat post traumatic stress disorder (PTSD) and other conditions affecting veterans and soldiers.
All agreed that using virtual reality to treat PTSD and other war-related mental health issues offered additional valuable tools in treating soldiers and veterans.
“In addition, virtual reality may help undercut a significant barrier to care, namely stigma, by providing a non-traditional treatment that may be a preferable option for service members who are reluctant to go to mental health facilities and ‘talk to a shrink,’” Reger and Gahm wrote.
In the same issue was an article about President Bush signing the Joshua Omvig suicide prevention bill that provides improved screening and treatment for at-risk veterans. The law was named after a 22-year-old soldier from Grundy Center, Iowa, who committed suicide in December 2005 after he returned from Iraq.
Other articles in the special section dealt with he need for more Navy psychologists and the need for psychologists to be alert to the possibility of signs of sexual abuse by female veterans of Middle Eastern wars.
In May 2008, retired Army Col. Will Wilson, Ph.D., spoke of both the importance and the difficulty in convincing soldiers leaving the service of the many resources available to them to address any mental health or other issues.
“How do you inform returning veterans about the whole process, the whole system put in place to help them? How do you get people in touch with resources that are in place to serve their needs? I’ll be damned if I know,” Wilson said.
Wilson explained that most returning veterans are coming from a high intensity environment and “they’re decompressing. Some of that energy can manifest itself not only in initial joy and enthusiasm but a certain amount of post-combat reaction, or as it is better known, depression, he added.
Many veterans will turn to drink or other harmful substances to treat mental health issues if they are not aware of the many resources available to them to confront their issues, Wilson said.
At the 2008 APA convention, Heidi Squire Kraft, Ph.D., told a workshop of her experiences as a Navy psychologist in Iraq. What she encountered, she explained, was beyond the traditional boundaries of psychology, including Marines dying in her arms, trying to keep a Marine sitting on a toilet with a rifle under his chin from committing suicide, facing mentally ill Marines who were armed with weapons and bombings going off all around.
At the same convention, Morgan Sammons, Ph.D., reported that there was a movement underway in Congress to allow the Veterans Administration offer mental health services to families of veterans at the same level now provided former military personnel. He said the largely volunteer corps of psychologist offering free care to veterans’ families was welcome, but that it was too uncoordinated and scattered to insure that duplication did not occur and that appropriate treatment was being delivered.
In a November 2008 update, Give an Hour Executive Director Barbara Romberg, Ph.D., reported that in a year the organization had grown to nearly 2,000 professional volunteers and a steadily growing number of private individuals who donate an hour a week to provide mental health services to veterans and their families. Around 6,500 hours of mental health services were provided in the last year and Romberg expects 5,000 members by summer 20209.
She also reported that the Eli Lilly had awarded the organization a $1 million grant to help increase its reach.
Squire Kraft would later write in a column for The National Psychologist that military personnel are not afraid of most things that would terrify the average person. “They define the word ‘brave’ in 15 different ways. But many are truly afraid to seek mental health care. The culture in which they were trained has had zero tolerance for mental health perfection and the popular belief is that their careers will be harmed with evidence of treatment on their records.”
Wilson, too, would later write about a survey that Cappella University conducted and its unexpected findings. He said that the veterans in the survey reported the therapy and help they were receiving in a variety of mental health settings was beneficial, while those providing the therapy and help thought they might not have helped at all.
In May 2009, The National Psychologist reported on the ongoing study in Western Pennsylvania conducted by Washington and Jefferson College’s Combat Stress Intervention Program (CSIP) in Washington, Pa. The program hopes to develop a plan that could be used nationally to address barriers to health care and provide valuable resources for veterans.
Michael Crabtree, Ph.D., a professor of psychology at the college, said 750 National Guard and reserve troops have completed an extensive 60-question survey as part of the CSIP. Results of the survey show that the average military experience of those surveyed was nearly 15 years. Forty-three percent were at least 40 years old, reflecting a mature population and the same percentage that reported mild to severe stress, emotional issues, drug and alcohol or family problems.
In the same issue, Penny F. Pierce, Ph.D., RN, a retired Air Force reserve officer with 33 years of military experience, wrote in a Viewpoint article about the increasing number of women serving in the nation’s wars. Since the end of the Persian Gulf War in 1991, she has been part of a University of Michigan study researching the wartime experiences and outcomes of women in the air Force and female solders in the Army serving in Iraq and Afghanistan.
“Our studies,” she wrote, “have found that women who are younger, in the junior ranks or deployed to the theater are more likely to report sexual harassment or assault, suggesting the work environment and the male-dominated hierarchical structure of military organizations present unique challenges.”
She noted that highlighting gender-related issues and problems is not to say that women are uniquely vulnerable, weak or otherwise unsuitable to carry out their duties. “It is plausible, and there is some evidence to suggest, that women may fare well in these challenging situations in part because they are extraordinarily adept at establishing new social networks and more freely disclose emotions.
The Army announced in late 2009 that it was collaborating with the National Institute of Mental Health in a five-year $50 million study of suicide and mental health among military personnel. The first part of the study looked at the records of soldiers who committed suicide between 2004 and 2009, compared to a control group of soldiers from the same period who did not, but have other characteristics that would be important for purposes of comparison.
The survey will be conducted with several thousand soldiers every month over three consecutive years, covering about 90,000 service members. Investigators will also survey 100,000 new recruits a year over a three-year period and continue to follow them over time.
In hopes of reducing the level of PTSD, the Army said it would train soldiers to be as fit mentally as they are physically before being sent into wars or other dangerous assignments. Adopting research into “emotional resilience” conducted by Martin Seligman, PH.D., of the University of Pennsylvania, the Army is training 150 sergeants a month at Penn in an intensive course in positive resilience. “I believe the Army is moving in the right direction,” Seligman told The National Psychologist. “I’d call it foresighted, training never given before in history. They (soldiers) can come out of the Army both physically and psychologically fit.”
Psychologists Respond to Hurricane Katrina
Psychologists from around the nation responded massively to the victims of Hurricane Katrina in Louisiana and Mississippi, although the APA was slow in offering aid to gulf area psychologists displaced by the storm. The American Board of Pediatric Neuropsychology (ABPdN) aided those psychologists with a web-based clearinghouse to connect those separated from their homes and practices with other willing to provide them with help.
Two weeks after the Aug. 29 hurricane made landfall, the APA was still working to set up a similar clearinghouse, but realizing the enormity of the situation and how far behind the organization was in its response reluctantly agreed a link to add the pediatric board’s website. John Courtney, Ph.D., executive director of APBdN, said the size of his organization made it easier to set up a website with pertinent information and that the huge size of the APA probably prevented it from doing a quicker job of responding.
He urged psychologists who had threatened to resign from the APA to protest its slowness in responding to its members’ concerns not to resign, but to realize that few organizations are able to put together an effective program in the face of such wide-spread devastation.
Sherrie Bourg Carter, Psy.D., in a letter to the editor, lambasted the APA for its failure to respond quickly to the needs of the psychologists living in the areas affected by Katrina. She noted that both the American Bar Association and the National Association of Criminal Defense Lawyers had responded within a couple of days to help their members. She called the lack of a quick response to the needs of affect psychologists “shameful.”
Michael Gerber, Ph.D., a San Luis Obispo County (Calif.) Behavioral Health Services psychologist, was docked two days pay for ignoring his employer’s order that he provide no services other than financial to the Katrina victims. “There was nothing I could do for the county (by staying) that would equal providing services to those people in need,” said Gerber, who spent two weeks in the New Orleans area.
Jim Quillen, Ph.D., president of the Louisiana Psychological Association, reported in mid-October 2005 that as many as 500 licenses psychologists remained unaccounted for since Katrina hit. He said it was hoped that the missing psychologists had simply dispersed to other states and had lost touch with the association.
In an interview with The National Psychologist, John Caccavale, Ph.D., told of his two-week experience working in the Cajundome, the University of Louisiana’s 13,000–seat sports and concert arena in Lafayette. He said the most common problem among evacuees was post-traumatic stress disorder.
“You have people who lost everything and they knew it, then they’re locked away in these facilities. You can imagine living in a structure with no natural light and martial law with the National Guard in uniform,” Caccavale said.
Several months after Katrina, and Hurricane Rita by then, three gulf area psychologists wrote of their experiences during and after the storms.
Janet R. Matthews, Ph.D., and her husband Lee H. Matthews, Ph.D., for the first time in living for 20-plus years in New Orleans, fled the hurricane in their car with two medically needy cats and lived in Arkansas for nine days before being allowed to return. They found their house under water and rented a fishing camp about an hour south of New Orleans to live in while clean-up activities progressed in the city,
“It was built half way into a bayou and they felt its rocking and flooding during Rita,” they recall.
The couple found a small apartment to rent while their home was gutted and renovated, but Lee H. Matthews was pretty much out of a job since the agencies he had worked for previously had been wiped out. Janet had her job as a professor at Loyola University, which didn’t reopen until January 2006.
“My 22 years on the faculty have given me a good sense of the students,” Janet recalled. “These students are working hard and are dedicated to the university but they show various PTSD symptoms. They do not concentrate as well as before, often look dazed and are concerned about the upcoming hurricane season.”
Mardi Allen, Ph.D., of Mississippi, a former president of the Association of State and Provincial Psychology Boards, recalled driving back into New Orleans following the evacuation.
“Hoping that it was a horrible nightmare that would seen vanish, but confronted with reality, the sight of mile-long lines of people waiting for the next gasoline truck to bring a delivery to one of the very few open gas stations created a feeling of extreme pain. In the more than 90 degree heat, high humidity and constant roar of helicopters overhead, visions of third world emergencies were evoked as families had to separate to stand in different lines to get ice and a hot meal,” Allen wrote.
She noted that more than 80 percent of the state’s psychologists were in Katrina’s path. “Some lost their homes and practices; others felt lucky with only severe roof and structural damage to homes or practices.
Joanne Steuer, Ph.D., of Los Angeles, joined with about 20 other therapists and drove through the rural south, “maps in hand, hoping gasoline would be available, seeking shelters and administrative centers with v ague addresses and gathering supplies from local the local Walmart. Katrina was a test of our resiliency, flexibility, and, yes, our training. No one was prepared for the chaos, the crowds, the physical devastation or the emotional impact.”
She wrote that the team worked in shelters, on the steps of the Astrodome, in a jail in New Orleans, in administrative centers and in parking lots surrounded by bugs, noise and heat.
“We did not do psychotherapy,” Steuer wrote.
Armed with a map, a rental car, a phone and an expense card with deployment instructions, Kathy Sexton-Radek, Ph.D., of professor of psychology at Elmhurst College, wrote of her experiences as a first responder throughout the New Orleans area.
“The crisis/triage work involved helping victims to relax to reduce their physical arousal and to provide support,” she wrote. “I found that useful interventions varied from the individual level of mediation of disagreements among residents at a shelter to the system level of attendance and consultation at administrative meetings for rescue workers.”
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