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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

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www.divisionofpsychotherapy.org

In This Issue

A History of Division 29

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Student Paper Award Abstracts

Psychotherapy Integration

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Milestones in Psychotherapy Integration

Psychotherapy Practice
The Practice of Psychotherapy: Lost or Found?

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Ethics in Psychotherapy
Informed Consent with Culturally Diverse Clients

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2009 Nominations Ballot

2008 VOLUME 43 NO. 4


Division of Psychotherapy 䡲 2008 Governance Structure
ELECTED BOARD MEMBERS
President Professional Practice Diversity
Jeffrey E. Barnett, Psy.D., ABPP Jennifer Kelly, Ph.D., 2007-2009 Caryn Rodgers, Ph.D., 2008-2010
1511 Ritchie Highway, Suite 201 Atlanta Center for Behavioral Medicine Prevention Intervention
Arnold, MD 21012 3280 Howell Mill Rd. #100 Research Center
Phone: 410-757-1511 Fax: 410-757-4888 Atlanta, GA 30327 Albert Einstein College of Medicine
Email: drjbarnett1@comcast.net Ofc: 404-351-6789 Fax: 404-351-2932 1300 Morris Park Ave., VE 6B19
Email: jfkphd@aol.com Bronx, NY 10461
President-elect
Ofc: 718-862-1727 Fax: 718-862-1753
Nadine Kaslow, Ph.D., ABPP Education and Training Email: crodgers@aecom.yu.edu
Emory University Department of Michael Murphy, Ph.D., 2007-2009
Psychiatry and Behavioral Sciences Department of Psychology Diversity
Grady Health System Indiana State University Erica Lee, Ph.D.
80 Jesse Hill Jr Drive Terre Haute, IN 47809 55 Coca Cola Place
Atlanta, GA 30303 Ofc: 812-237-2465 Fax: 812-237-4378 Atlanta, Georgia 30303
Phone: 404-616-4757 Fax: 404-616-2898 Email: mmurphy4@isugw.indstate.edu Ofc: 404-616-1876
Email: nkaslow@emory.edu Email: edlee@emory.edu
Membership
Secretary
Libby Nutt Williams, Ph.D., 2008-2009 APA Council Representatives
Armand Cerbone, Ph.D., 2006-2008
St. Mary’s College of Maryland Norine G. Johnson, Ph.D., 2008-2010
3625 North Paulina
18952 E. Fisher Rd. 13 Ashfield St.
Chicago, IL 60613
St. Mary’s City, MD 20686 Roslindale, MA 02131
Ofc: 773-755-0833 Fax: 773-755-0834
Ofc: 240- 895-4467 Fax: 240-895-4436 Ofc: 617-471-2268 Fax: 617-325-0225
Email: arcerbone@aol.com
Email: enwilliams@smcm.edu Email: NorineJ@aol.com
Treasurer
Steve Sobelman, Ph.D., 2007-2009 Early Career Linda Campbell, Ph.D., 2008-2010
2901 Boston Street, #410 Michael J. Constantino, Ph.D., 2008-10 Dept of Counseling & Human Dev
Baltimore, MD 21224-4889 Department of Psychology University of Georgia
Ofc: 410-583-1221 Fax: 410-675-3451 612 Tobin Hall - 135 Hicks Way 402 Aderhold Hall
Cell: 410-591-5215 University of Massachusetts Athens, GA 30602
Email : steve@cantoncove.com Amherst, MA 01003-9271 Ofc: 706-542-8508 Fax: 770-594-9441
Ofc: 413-545-1388 Fax: 413-545-0996 Email: lcampbel@uga.edu
Past President Email: mconstantino@psych.umass.edu
Jean Carter, Ph.D Student Development Chair
5225 Wisconsin Ave., N.W. #513 Science and Scholarship Michael Garfinkle, 2008
Washington, DC 20015 Norm Abeles, Ph.D., 2008-2010 Derner Institute
Ofc: 202–244-3505 Dept of Psych Adelphi University
Email: jcarterphd@aol.com Michigan State University 1 South Avenue
Domain Representatives 110C Psych Bldg Garden City, NY 11530
Public Policy and Social Justice East Lansing, MI 48824 Ofc: 917-733-3879
Irene Deitch, Ph.D., 2006-2008 Ofc: 517-353-7274 Fax: 517-432-2476 Email: michaelsg@verizon.net
31 Hylan Blvd 14B Email: abeles@msu.edu
Staten Island, NY 10305-2079
Ofc: 718-273-1441 Fax-1-718-273-1445
Email: ProfID@AOL.COM

STANDING COMMITTEES
Continuing Education Finance Program, continued
Chair: Annie Judge, Ph.D. Chair: Bonnie Markham, Ph.D., Psy.D. Associate Chair: Chrisanthia Brown, Ph.D.
2440 M St., NW, Suite 411 52 Pearl Street Email: brownchr@umkc.edu
Washington, DC 20037 Metuchen, NJ 08840
Ofc: 202-905-7721 Fax: 202-887-8999 Ofc: 732-494-5471 Fax 206-338-6212 Psychotherapy Practice
Email: Anniejudge@aol.com Email: drbonniemarkham@hotmail.com Chair: John M. O’Brien, Ph.D.
465 Congress St. Suite 700
Associate Chair: Membership Portland, ME 04101
Rodney Goodyear, Ph.D. Chair: Sonja Linn, Ph.D. Ofc: 207-773-2828 x1310
Email: goodyea@usc.edu 2440 M St, NW, Suite 411, Fax: 207-761-8150
Washington, DC 20037. Email: jobinport@aol.com
Education & Training Ofc: 202-887-8088
Chair: Jean M. Birbilis, Ph.D., L.P. Email: sglinn@verizon.net Associate Chair: Patricia Coughlin, Ph.D.
University of St. Thomas Email: drpcoughlin@gmail.com
1000 LaSalle Ave., TMH 455E Associate Chair:
Minneapolis, Minnesota 55403 Chaundrissa Smith, Ph.D. Psychotherapy Research
Ofc: 651-962-4654 Fax: 651-962-4651 Email: csmit33@emory.edu Chair: Sarah Knox, Ph.D.
Email: jmbirbilis@stthomas.edu Nominations and Elections Department of Counseling and
Associate Chair: Gene Farber, Ph.D. Chair: Nadine Kaslow, Ph.D. Educational Psychology
Email: efarber@emory.edu Marquette University
Professional Awards Milwaukee, WI 53201-1881
Fellows Chair: Jean Carter, Ph.D. Ofc: 414/288-5942 Fax: 414/288-6100
Chair: Jeffrey Magnavita, Ph.D. Email: sarah.knox@marquette.edu
Program
Glastonbury Psychological Associates PC Chair: Nancy Murdock, Ph.D. Associate Chair: Susan Woodhouse, Ph.D.
300 Hebron Ave., Ste. 215 Counseling and Educational Psychology Email: ssw10@psu.edu
Glastonbury, CT 06033 University of Missouri-Kansas City
Ofc: 860-659-1202 Fax: 860-657-1535 ED 215 5100 Rockhill Road
Email: magnapsych@aol.com Kansas City, MO 64110
Associate Chair: Jeffrey Hayes, Ph.D. Ofc; 816 235-2495 Fax: 816 235-5270
Email: jxh34@psu.edu Email: murdockn@umkc.edu
PSYCHOTHERAPY BULLETIN PSYCHOTHERAPY BULLETIN
Published by the Official Publication of Division 29 of the
DIVISION OF PSYCHOTHERAPY American Psychological Association
American Psychological Association
6557 E. Riverdale
2008 Volume 43, Number 4
Mesa, AZ 85215
602-363-9211 CONTENTS
e-mail: assnmgmt1@cox.net
Editors’ Column ......................................................2
EDITOR
Jennifer A. E. Cornish, Ph.D., ABPP President’s Column ................................................3
jcornish@du.edu
Council Report ........................................................7
ASSOCIATE EDITOR
Lavita Nadkarni, Ph.D. A History of Division 29 ........................................9
Division 29 40TH Anniversary Celebration ........14
CONTRIBUTING EDITORS
Diversity Letter to the editor ................................................16
Erica Lee, Ph.D. and
Caryn Rodgers, Ph.D. Student Abstracts ..................................................18
Education and Training Personal Reflections From Diverse
Jean M. Birbilis, Ph.D., L.P., and Early Careers ..........................................................21
Mary M. Brant, Ph.D.
The Federal Bureau of Prisons:
Practitioner Report An Early Career Psychologist’s Perspective
Jennifer F. Kelly, Ph.D. and
John M. O’Brien, Ph.D. Psychotherapy Integration ..................................25
Psychotherapy Research, Milestones in Psychotherapy Integration
Science, and Scholarship
Norman Abeles, Ph.D., Sarah Knox, 2009 Nominations Ballot ......................................29
Ph.D., Michael J. Murphy, Ph.D., and
Susan S. Woodhouse, Ph.D.
Psychotherapy Practice ........................................33
The Practice of Psychotherapy: Lost or Found?
Perspectives on
Psychotherapy Integration Ethics in Psychotherapy........................................36
George Stricker, Ph.D. Informed Consent with Culturally
Public Policy and Social Justice Diverse Clients
TBA
Washington Scene ..................................................45
Washington Scene
Patrick DeLeon, Ph.D. A Vision For The Future—Integrated Care
Early Career A Holiday Guide for Psychotherapists ..............49
Michael J. Constantino, Ph.D.
Book Review ..........................................................51
Student Features
Financial Success in Mental Health Practice:
Michael Stuart Garfinkle, M.A.
Essential Tools and Strategies for Practitioners
Editorial Assistant
Crystal A. Kannankeril, M.S. Membership Application......................................56

STAFF
Central Office Administrator N O F P S Y C H O THE

Tracey Martin
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EDITORS’ COLUMN Jenny Cornish, Editor
Lavita Nadkarni, Associate Editor

As we approach the of training, clinical, supervisory, and schol-


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

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

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

As I write this last ing this ad hoc committee was approved


column as President of for the remainder of 2008 and for 2009. Our
the Division of Psycho- former students who we have appointed to
therapy I am amazed our new committee are Rachel Gillard
with how quickly the Smook, Chair, Patricia Gready, and Shreya
year has gone by. It’s Hessler. They are moving forward with
been an exciting, busy, their work as I write this. I know they are
and productive year. also looking for other Division 29 early
I’ve had the opportunity to work with such career psychologists to join them on this
an amazing group of colleagues, doing committee. If you are interested in getting
meaningful work. Our joint efforts to involved, please contact Rachel at
advance the Division of Psychotherapy Rachel@birchtreetherapy.com.
and to advance psychotherapy have been
challenging, stimulating, rewarding, and For me, a great highlight of the APA
enjoyable. What follows are an account of Convention was Division 29’s 40th
many of the activities of the past year as Anniversary Celebration events. At our
well as some final thoughts about Division Awards Ceremony, Matty Canter shared
29 and about psychotherapy. her reflections and perspectives on 40 years
of Division 29. Her presentation was truly
I find myself still reflecting back on our remarkable and a very poignant and
recent APA Convention with warmth and important historical record for us all. Please
pride. We had an outstanding Division 29 see it elsewhere in this issue. We also had a
convention program. Our convention co- great celebration at the Division 29 Social
chairs, Nancy Murdock and Chris Brown, Hour. There we honored all past Division
did an expert job putting together a stimu- 29 award winners and Past Presidents of
lating and comprehensive program for our Division 29 who were in attendance. Please
members. Since they have a two-year com- see the great photographs from these
mitment to serving in these roles I very events included in this issue.
much look forward to our 2009 APA
An important initiative I began this year is
Convention in Toronto as well. We also had
our international student initiative. Many
our annual Lunch With the Masters event
international psychology students have
which, despite some of the logistic difficul-
very limited access to needed resources
ties of a convention spread out over a large
and many lack the financial means to
area, was still a great success. During this
access them. Division 29 has access to a
event, Mike Constantino, our Early Career
larger number of subscriptions to our jour-
Psychologists domain representative on
nal for our members than the number of
our Board of Directors, Jeffrey Magnavita,
members of the division at present. Thus,
our incoming President-Elect, and I met
we are able to offer subscriptions to the
with several early career psychologists (two
journal to international students at no cost
former students of mine and one a former
to them or to the division. All other
student of Jeffrey’s). Their energy and
Division 29 materials will be accessed
enthusiasm about psychotherapy, their
online by them via the website (which will
careers, and the Division of Psychotherapy
offer may more resources for students once
were inspiring. Together we created, on an
it is redesigned). We will also offer our new
ad hoc basis, a new Early Career
international student members two new
Psychologist Committee for Division 29
resources of potentially tremendous value,
(hard to believe we haven’t had one thus
far!). At our recent Division 29 Board meet- continued on page 4
3
an online mentoring program with mem- become a Silver Sponsor of the upcoming
bers of the division and an online peer-to- National Multicultural Conference and
peer program to enable them to connect Summit, to be held January 15-16, 2009 in
with other student members of the divi- New Orleans, Louisiana. A number of the
sion. It is hoped that each of these will be a division’s leaders will be there representing
great success and be rewarding for all Division 29 and several are participating in
involved. Our incoming 2009 Student presentations there. For more information
Development Chair, Sheena Demery, will and to register for this important event visit
be coordinating the peer-to-peer program. http://www.multiculturalsummit.org/.
Our Early Career Psychologist committee Look for our advertisement in the summit
will be coordinating the mentoring pro- program, and our flyers in their attendees’
gram. I encourage all Division 29 members packets. Division 29 is also participating in
to consider becoming an online mentor to APA President-elect James Bray’s
an international graduate student in psy- Convention Within a Convention initiative
chology. The obligation will likely only be at the upcoming APA Convention. This
e-mail contact on a periodic basis. The ben- looks to be a way to provide much more
efit and value may be tremendous. If you programming of interest that focuses on
are willing to share a little of your time, the needs and interests of psychotherapists
expertise, and support with an internation- in the areas of practice, education and
al graduate student in psychology please training, research, and theory. Your
let me know. Please contact me at drjbar- Division 29 Board of Directors has also
nett1@comcast.net. In your message please approved supporting the APA Practice
include the following: Name and degree, e- Summit that will be held in 2009. Division
mail address, professional areas of interest. 29 is very well represented on the planning
Thank you in advance for your willingness committee of this important event and we
to support and assist our newest Division look forward to actively participating in the
29 members and these future members of Summit. This is another of APA President-
our profession. elect (and Division 29 Fellow) James Bray’s
initiatives. Division 29 Fellow Carol
We’ve had so much more going on this year Goodheart is a co-chair of this initiative
in Division 29. Our various Domain and Division 29 Board member Jennifer
Representatives have been serving the divi- Kelly is on the planning committee.
sion in these new roles that we implemented Incoming Division 29 President-Elect,
this past year. Several are ending their terms Jeffrey Magnavita, is our liaison on the
at the end of 2009. Please consider running Practice Summit E-mail list that will be
for office in Division 29. See the call for nom- active during the planning process. I am
inations in the center spread of this issue. In sure we will be sharing more information
addition to electing a new President-Elect with you about the APA Practice Summit as
and a new Treasurer for 2010, we will be it becomes available.
electing new Domain Representatives for
the Board of Directors for Professional We have a new Division 29 motto: Be
Practice, Membership, Education and Connected! and we are presently develop-
Training, and one of our two Diversity ing a new Division 29 logo. We are also
Domain Representatives. If you would like pleased to announce that our student paper
information about any of these positions awards (the Mathilda B. Canter Education
please contact me or contact the psychologist and Training Award; the Donald K.
presently serving in that role (see the inside Freedheim Student Development Award;
covers of this issue for that information). and, the Student Diversity Award) will
now provide a $250 cash prize to each win-
This year, your Division 29 Board of
Directors voted to have the Division continued on page 5
4
ner. Please see the abstracts for each of our bers will be able to obtain CE there online.
2008 award winning student papers in this
issue. This year the Division 29 Publications
Board has gone through a process of solic-
This year we began the tenure of our new iting nominations for a new journal editor
Editor and Associate Editor of to continue the fine work Charlie Gelso has
Psychotherapy Bulletin, Jenny Cornish and done throughout his tenure as Editor.
Lavita Nadkarni, respectively. As you will Charlie will serve as Editor through the
have seen in recent past issues, and as is end of 2009. Also, during 2009 our new
clearly evident in the present issue, Jenny Editor will begin his work, set up his edi-
and Lavita are doing an outstanding job. I torial office, select his editorial board, and
am appreciative of the great work they are begin accepting manuscripts. Following
doing for Division 29 and you, our mem- the review of candidates’ materials and the
bers, and look forward to their continued interview process, upon the recommenda-
service. We also have a new Interim tion of the Publications Board, the
Internet Editor, Past President of Division Executive Committee and the Board of
29, Abe Wolf. Abe is doing an amazing job Directors have enthusiastically approved
for the division in ways that are not readi- the appointment of Mark Hilsenroth as our
ly evident since so much work is going on incoming journal Editor. Please join me in
behind the scenes. Together with Laura welcoming Mark to his new role. As you
Brown, Abe is leading the division’s will see in the next issue of the Bulletin, he
Website Redevelopment Task Force. brings a wealth of experience, talents,
Funding for the redesign and redevelop- ideas, and creativity that make him ideally
ment of our website was approved at our suited for this position.
recent Board meeting and this important
work is moving forward. I also express my Division 29 is in excellent shape financially,
thanks to Internet Editor, Abe Wolf, for his despite the tough economic times we are in
ongoing work on Psychotherapy E-News the at present. Our Treasurer, Steve Sobelman,
division’s online e-newsgram. If you’re not and our Finance Committee Chair, Bonnie
receiving it, please send me an e-mail and Markham, and committee members Ron
I’ll make sure you receive this important Fox, Carol Goodheart, and John Norcross
communication from your division. (what a great group!) have done an out-
standing job in managing our financial
Our journal, Psychotherapy: Theory, resources. We continue to put money into
Research, Practice, Training under the lead- the division’s long term reserves each year
ership and direction of our fine editor, to further build the division’s financial sta-
Charles Gelso has continued leading the bility. This is especially important consid-
way in our profession. It is the must-read ering current economic conditions. In addi-
journal for those with an interest in the tion to the great job these individuals have
field of psychotherapy. In addition to done I would be remiss if I didn’t mention
Charlie, I express my thanks to our fine that a significant part of the division’s
associate editors, Nicholas Ladany and financial health is due to the success of our
Lisa Wallner Samstag, and all the Editorial fine journal. The licensing agreements with
Consultants and ad hoc reviewers whose libraries and research institutions, and the
contributions are clearly evident to all who individual downloads of individual arti-
read this fine publication. Members are cles, have greatly enhanced the division’s
strongly encouraged to use the journal for financial health.
continuing education credit. See the
At our recent Board meeting I appointed a
announcements and easy to follow instruc-
task force to update the division’s bylaws
tions in each issue of the journal. As our
website is redesigned and updated mem- continued on page 6
5
and policies and procedures. This task innovate, and to help our members to “Be
force of Jean Carter (Chair), Mike Murphy, Connected.”
and Steve Sobelman will review these doc-
uments, recommend all needed changes to One additional initiative this past year was
bring them in line with recent changes in to hold our Mid-Winter Board Meeting in
the division’s structure and mission, and conjunction with Psychologists in
bring all needed bylaws changes to you for Independent Practice (Division 42). In
approval. For example, we will need to addition to great collegial interactions and
include the new Early Career Psychologists an outstanding CE workshop provided by
Committee as a Standing Committee in our Division 29 Fellow, Donald Meichenbaum,
bylaws. Additionally, the Finance a significant amount of planning for the
Committee has recommended a number of upcoming APA Practice Summit took place
changes in policies and procedures to bring as the two divisions’ boards held joint
them in line with our Board-approved working groups during the meeting. It was
financial policies and practices. We are also a successful meeting and hopefully will
updating the Division 29 mission state- serve as a model for further collaboration.
ment to ensure that it is current and consis-
tent with our actual mission. I’ve greatly enjoyed to opportunity to serve
as your president. It has been a rewarding,
Our Membership Committee, Chaired by enjoyable, and very educational experience.
Sonja Linn, has been working diligently I’ve learned so much about our profession
this year on membership recruitment and and about the field of psychotherapy. It is
retention. They sent a membership recruit- clear to me that the future of psychotherapy
ment letter to historically black colleges is bright. The level of scholarship and inno-
and are in the process of contacting all for- vation I see in our field is truly inspiring.
mer members of the division who resigned One has only to look at the work of the divi-
in the past year. The division is reaching sion’s 2008 award winners, the authors in
out to other organizations whose missions our journal, and the presenters on our con-
are consistent with ours and with whom vention program. I’m also proud to turn
we share many members. We are collabo- over the President’s gavel to my dear friend
rating on continuing education with the and colleague, Nadine Kaslow, who begins
Society for Psychotherapy Research. As a her tenure as President of the Division of
result, all Division 29 members will be able Psychotherapy in January 2009. I know the
to attend their annual conference and division is in able hands and I look forward
receive CE for attendance at the SPR mem- to contributing to its continued success in
ber rates. We have also reduced the student anyway I can.
membership fee in the hope of further
encouraging student participation in Best wishes to all –
Division 29. The new fee for student mem-
bership is $20 (reduced from $29). Jeff

As you have read, the Division of


Psychotherapy has worked to collaborate,

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

This fall, APA passed related to publication such as


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

Council voted to receive several reports Norine Johnson, Ph.D.


that you may access on the APA web site: norinej@aol.com & lcampbel@uga.edu
The 2007 APA Presidential Task Force on

8
A HISTORY OF DIVISION 29

Presented by Mathilda B. Canter on 8-15-08 as part of the Celebration of


the 40th Anniversary of the Division of Psychotherapy, APA Convention,
Boston, Massachusetts

Preparing for this talk accepted, were denied assistance in con-


has been a delightful trip ducting elections, and in general felt that
down memory lane for they were not receiving the support they
me, and I am grateful for had been led to expect. After much discus-
the opportunity to tell sion, in 1966, they drew up a petition to
you what I hope you will form a Division. Among the signers were
find a very interesting Ron Fox, David Orlinsky, Ted Blau, Hans
story. Strupp, Aaron Canter, Carl Zimet, Walter
Klopfer, Al Ellis, Erika Fromm, Jules Barron,
Once upon a time, actually, at the APA Stanley Graham, and Jack Wiggins...
Convention in 1960, a group of psycholo- Familiar names?
gists got together and formed an organiza-
tion called Psychologists Interested in The petition was submitted, and on
the Advancement of Psychology (PIAP), September 4, 1967, the APA Council of
because they felt that there was no place in Representatives established Division 29,
APA representing their interests. They the Division of Psychotherapy!! And there
were a dedicated, energetic, enthusiastic was joy in Mudville, for finally practition-
group, who presented programs, gave ers had a home of their own in APA!!! Our
workshops, and started to establish a first President (1967-68) was Fred Spaner,
journal, which they entitled Psychotherapy: who was followed by Ted Blau and then
Theory, Research, Practice. Vin Rosenthal. Ron Fox served as our first
Treasurer - a three year term, with Al Ellis
In 1963, PIAP was invited, by unanimous and Max Siegel among the Board members.
vote of its Board, to become a Section of the
Division of Clinical Psychology—Division As President Jules Barron wrote in the
12. The invitation was accepted, and all Psychotherapy Bulletin, in 1973: “Since our
PIAP members—about 600 of them by inception as a Division,...we have been a
then —joined the Section, and for the first significant force in the psychological revo-
time in the history of the American lution. While fighting for the legitimacy of
Psychological Association, psychotherapy professional psychology we have tried to
was officially recognized! Their dues were maintain our scientific heritage.” And we
$5 at the time. In 1964, the first issue of still do so!
Psychotherapy was published, with Eugene
Gendlin as Editor. The Editorial Board It is impossible for me to tell a 40 year his-
was quite impressive, including such tory in the 25 minutes allotted to me. So I
respected psychotherapists as Rollo May, shall just say here that the Division has
Erik Dreikurs, Sid Jourard, Hans Strupp, been very active in all of its major areas of
Clark Moustakus, James Bugenthal, interest: practice, teaching, training psy-
Charlotte Buhler, Art Kovacs, etc... ! chotherapists, and research! And I’d like to
point out some highlights, many of which
But as time went on, the Section leaders you probably are not even aware:
were not happy with Division 12, since
they had difficulty having their programs continued on page 10
9
In addition to being the first home in APA • We were one of the first, if not the first,
for practitioners, 29 was to have a Committee for Women, estab-
lished in 1974, with Joy Kenworthy as
• First division to hold a Midwinter chair. Actually, the Old Boys’ Board had
Meeting!—more about that later. turned down a request in 1971 by then-
• First division to have a Central Secretary Leah Gold Fein, to form the
Office.....This was located first in the committee, saying we didn’t need one.
New York area, with Gloria Gottsegen But it only took us a few years to raise
in charge, but she had to resign when their consciousnesses and say yes in
she left for Australia. We moved to New 1974. With Rachel Hare-Mustin,
Jersey, where Jack Krasner, and then Hannah Lerman, Annette Brodsky,
Ben Fabrikant, with the help of Rhoda Jacquie Resnick, Gloria Gottsegen,
Schneider, took over. How many of you Aphrodite Clamar, and myself.. we
remember that Kinderkamack Rd. were a very active and effective group,
address? In 1986, the office moved to over the years, to the point where in
Phoenix and hired The Administrators 1991 then Chair, Carol Goodheart,
(Pauline Wampler). And since 1999 requested that the committee be sunset-
Tracey Martin has been taking great ted—it was—and that a Gender Issues
care of us! Committee be established—it was, too!

• Division 29 was the first division to The division was a leader in bringing prac-
have a Hospitality Suite at Convention titioners into APA Governance! In fact, Ted
and hold conversation hours and Blau was the first practitioner elected to
programs there (in 1971, participants serve as president of APA in 1977. Ted told
included George Albee, Albert Ellis, me that many people said that Abraham
Hans Strupp, Al Mahrer...just to give Maslow was really the first practitioner/
you an idea of the caliber of presen- president, but that he AND MASLOW
ters......not shabby!). thought that that was ridiculous!! After Ted
came Max Siegel, Nick Cummings, Stanley
• First division to offer Student Travel Graham, Jack Wiggins, Ron Fox, etc., etc.
Awards for paper submissions—(1971)
Among the recipients I noted Vicky Mays, The division was also a leader in involve-
Lynn Rehm, and our President-elect, ment over the years in practitioner issues
Nadine Kaslow!!! like insurance (Jack Wiggins), professional
schools, practice guidelines, education and
• First division to have a Student training, coalition building among practice
Development Committee—more about divisions, giving financial support to a
that later broad spectrum of professional activities....

• First division to establish an Ethnic I have only 25 minutes, so I had to make


Minority Affairs Committee! Our first some choices, and I am going to use the
Chair was Maxine Rawlins, followed by rest of my time telling you about a few
G. Rita Dudley-Grant, and then Lisa Division 29 initiatives that I think were
Porche-Burke. Rita told me, when we very special and that many of you may not
met last month at a Policy and Planning know about:
Board retreat, that the 1985 Journal spe-
cial issue: Psychotherapy with Ethnic MIDWINTER MEETINGS: Ron Fox told
Minorities, edited by Maxine and Rita, me that the new Division could not afford
represented the first time any journal Board meetings in the sunny South, where
published an issue on ethnic minorities. they wanted to meet. So what they did was

continued on page 11
10
hold workshops, and since they were a Burke. That year, more than 275 student
well-known and highly respected group of affiliate members were recruited, 49 of
psychotherapists, they took in enough them ethnic minorities (in 1985, there had
money to pay for their Board meetings! In been only six.) In1988, we created a
1970, President Vin Rosenthal had the idea Student Paper Competition, with the win-
that they really should invite the Division ners receiving a monetary award and the
membership to join in, and so the first offi- opportunity to present at the APA
cial Midwinter Meeting of the Division of Convention. By then, we had 406 student
Psychotherapy was held in Tampa, Florida affiliates, 100 of them ethnic minorities!
in 1970. It was publicized as “29 in the Ellin Bloch and two very active student
Sun,” and in fact it WAS—it was 29 committee members, Scott Mesh and
degrees, breaking a 101 year record!! David Pilon, were invited by the then-
(During the 1978 Midwinter meeting in Office of Educational Affairs to come to
Scottsdale, Arizona, chaired by Ron Fox, APA to discuss student recruitment, and
with me as Local Arrangements chair, we Scott and David were invited to address
experienced a 100 year flood....but Division the Division Leadership Conference.
29 people are usually very kind, and I Division 29 funded their work with APA.
remember so many comforting me by say- And in August 1988, APAGS, the APA
ing “You don’t have to shovel rain....”!!) Graduate Students was formed.... and has
become such an important part of APA and
In 1981, Division 42, the Division of our pipeline! I think we did well.....
Independent Practice was established, and
in 1982 we invited them to attend DESERT SHIELD/DESERT STORM
our Midwinter meeting in Monterey, In 1990, in response to the Persian Gulf
California. It was a very successful meet- Crisis, and under the leadership of
ing, and there was such a great overlap in President Norman Abeles, the Division
the membership of the two divisions, that sponsored a project run by Ellin Bloch and
we decided to share sponsorship, and the Jon Perez of the LIFE PLUS FOUNDA-
1983 Midwinter Meeting at the Greenbrier TION, which was providing psychological
in West Virginia was the first official joint support and educational materials, at no
meeting of 29 and 42. In 1984 we met in San cost to the families of those in the military.
Diego, with Division 39 overlapping their Congress and the Department of Defense
meeting with ours. And in 1987, at the showed much interest in this program. In
request of Gloria Gottsegen, Division 43 August of 1990, Ellen McGrath, our
was added as a limited sponsor. If imita- President-elect, was invited to Fort Bragg
tion is the highest form of flattery, we cer- to run a support group for the wives of ser-
tainly were flattered, and as more and vicemen. On her return, she requested the
more Midwinter Meetings were held by establishment of a TASK FORCE ON
other groups, the competition for atten- TRAUMA RESPONSE AND RESEARCH;
dance grew, agendas changed, and ulti- this was done, with Ellin Bloch and Jon
mately our regular Midwinter meetings Perez as co-chairs. They developed a net-
came to an end. work of volunteer psychologists to help
those affected by DESERT SHIELD and
STUDENT DEVELOPMENT assess the outcomes of the interventions.
COMMITTEE
In 1986, President Suzanne Sobel estab- With PROJECT ME of Tucson, Arizona, the
lished this committee, with Ellin Bloch as Division published materials disseminated
chair, to recruit and focus on the special through FAMILY LIFE UNITS of the
needs and interests of students. At that Department of Defense. And the Division
time, our Ethnic Minority Affairs funded a pilot study by Ellen McGrath and
Committee was chaired by Lisa Porche- continued on page 12
11
Harry Wexler examining data from mili- me that it was as a result of working with
tary wives regarding attitudes and stress Ellin Bloch, Ellen McGrath, and Jon Perez
reduction. that he created the Disaster Response
Network, as APA’S Centennial gift to the
Then, in 1991, Desert Shield became nation in 1992!
DESERT STORM, and significant contribu-
tions were made by Division 29 to the gov- Through the years, the division has been
ernment and the public. The Task Force active, at first as the sole voice for practice in
was divided into three sections: the APA divisions. In 1972, it instructed its
1. COMMUNITY INTERVENTIONS (co- Council Representatives to vote against giv-
chaired by Ellin Bloch and Jon Perez): ing Masters level psychologists full mem-
They mobilized support groups at com- bership in APA. The division was an orga-
munity levels for families separated by nizer of coalitions to deal with the many
the conflict; they served as consultants areas of common concern. Its Education and
to local groups; and they acted as media Training Committee, (when chaired by
spokespersons As a measure of their Tommy Stigall) became part of the Joint
impact, let me tell you that at the time Commission on Professional Education in
of the L A RIOTS, the Secretary of Psychology. It was a leader in fighting for
Health and Human Services and the LA the establishment of Fellow criteria that
Director of the Department of Mental were appropriate for practitioners.
Health both called them in to help!!
2. EDUCATION SECTION (co-chaired by The Division was a co-plaintiff with CAPPS
Alice Rubenstein and Dennis Embry): (Committee for the Advancement of
They had been working on a book for Psychological Professions and Sciences) in
principals and counselors in schools the Blues suit, supported the suit against the
with lots of kids coping with military American Psychoanalytic Association, the
separations. Division 29 provided fight for hospital privileges, etc. We support-
$5,000 to fund this effort, and the mate- ed the establishment of the California School
rial was sent to the Department of of Professional Psychology, The Wright
Defense and ALL military base schools State University School of Professional
in the United States and Europe—with Psychology....etc., etc.
a research questionnaire!
3. GENERAL APPLICATIONS IN TRAU- We have a proud history of publications
MA (co-chaired by Harry Wexler and from our very beginnings, monitored by a
Wade Silverman): Their commitment distinguished series of Publication Boards,
was to research, their focus on how psy- an excellent journal, and a fine Bulletin.
chologists need to respond to natural Early in our history, we had Al Mahrer’s
and man-made disasters! edited series of Creative Contributions to
Psychology; an Early Audiotape Series,
The division worked with the APA Practice brochures, position papers, the History of
Directorate to coordinate and develop edu- Psychotherapy, which Don Freedheim edited
cational material which was given to all for the Centennial, a Videotape Series on
members of the U. S. Congress, for distrib- Psychotherapy , etc., etc. We even had Fran
ution to their districts! The Practice Pepitone-Rockwell who was charged with
Directorate “forgot” to list the division as a deleting sexist language in our journal....!
co-sponsor, but we knew what we had
It was fun looking at the Early Career
done!
Award winners! The first winners, in 1986,
Charlie Spielberger gave Presidential were Annette Brodsky and Gerry Koocher!
Citations to Ellin Bloch and Ellen McGrath Others were Jacquie Resnick, Gary
for their superb work in response to the VandenBos, Ron Levant, Raymond
Gulf Crisis. And Jack Wiggins told continued on page 13
12
DiGiuseppe, G. Rita Dudley-Grant, Alice practice and research.....Jules Barron said it
Rubenstein, Lisa Porche-Burke, John in 1973—and in 2008 his words still hold
Norcross, Abe Wolf, and Nadine Kaslow.... true.
Now it’s the APF/Division 29 Early Career
Award....we were pretty good at recogniz- So this is the end of my Once Upon a Time
ing talent! story....and May the Division Live
Happily—and Productively—Ever After.....!!
My time is up, so let me close by saying: 29
is STILL different from other divisions—it Thank you.
is in the forefront of helping to connect

CALL FOR NOMINATIONS


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

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

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

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

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

DEADLINE: January 1, 2009

Please direct questions to Emily Leary, Program Officer, at eleary@apa.org.

13
DIVISION 29 40TH ANNIVERSARY CELEBRATION
August 16, 2008
Boston, Massachusetts – APA Annual Convention

Division 29 Past Presidents and Past Award Winners

40th anniversary
celebration cake

Armand Cerbone, Linda


Campbell, Jeff Barnett

14
N O F P S Y C H O THE
O

RA P Y
D I V I SI
29

ASSN.
AMER I
C
A
N PSYCHOLOGI C

AL
Linda Campbell and Matty Canter

Rita Dudley-Grant and


Laura Barbanel

Mamta Dadlani, Caryn


Rodgers and
Mike Constantino

Hanna Levenson and


Jenny Cornish

15
LETTER TO THE EDITOR

Dear Editor: psychological distress and marital or fami-


ly stress. I believe it is unethical to require
Barnett and Goncher (2008) pose the people to participate in a procedure which
question: “Psychotherapy for the psy- may be harmful to them when there is no
chotherapist: Optional activity or ethical clear personal reason for them to be in it,
imperative?” They come down on the side and when there is no clear research support
of ethical imperative. I do not believe it is for the rationale leading to participation.
ethical to require graduate students to have
psychotherapy. I briefly present two argu- Second, the authors’ argument seems to
ments below. rest on a particular view of the kind of psy-
chotherapy required—something like a
The putative reason for requiring psy- self-exploration approach geared to
chotherapy of potential psychotherapists is achieving a general kind of personal tune
that it is supposed to increase effectiveness. up. However, what if the student were to
Yet, overall, the literature does not support choose to go to a cognitive-behavior thera-
this. One study cited by Barnett and pist to overcome a smoking habit? What if
Goncher on the benefits of personal psy- the student saw a solution-focused thera-
chotherapy is that of Bellows (2007). They pist who used the miracle question and
fail to mention that this study was of the scaling to help decide what area of clinical
perceptions of benefit from psychoanalytical- specialization to choose? Would any of
ly-oriented psychotherapists. Since psycho- these count? Or, would Barnett and
analysis has long held that it is important Goncher require students to participate in
for therapists to have their own therapy, this a particular kind of psychotherapy? If so,
result is not surprising. Other studies cited would that be ethical?
are also of therapists’ perceptions of bene-
fits. However, research that has looked at There are more arguments but I shall stop
the actual relationship of personal therapy here. I should note that there is evidence
to therapist efficacy has repeatedly failed to that psychotherapists who are suffering
demonstrate any relationship (Beutler, emotional problems can be less effective.
Machado, and Neufeldt, 1994; Beutler et al., Clearly they need to deal with those prob-
2004). Beutler et al. (2004) said “…we con- lems. However that is a different issue.
clude that there is no persuasive evidence As a relevant disclosure, I have had sever-
for a positive relationship between the act of al experiences where I went to psychother-
receiving personal psychotherapy and treat- apy when I needed help for a personal
ment outcome” (p. 277). issue. In particular, I had three years of
therapy when I was in graduate school for
To make matters worse, there is reason to an anxiety problem. One therapy experi-
believe that psychotherapy can be harmful. ence for this ultimately was negative and
Lambert and Ogles (2004) conclude “…the made the problem worse. Another experi-
evidence suggests that psychotherapy can ence later on was beneficial. Unfortunately,
and does harm a portion of those it is in terms of the idea that being in the
intended to help. A relatively consistent client’s role helps to understand how to be
portion of individuals (5 to 10%) deterio- a good therapist, I don’t think I learned as
rate. ..” (p. 158). In one national survey of much from the positive experience as I did
therapists’ perceptions of the benefits of from the negative experience. Yet I would
personal psychotherapy, Buckley, Karasu, not require students to have negative expe-
& Charles (1981) found that although most riences in order to be better therapists.
respondents reported positive effects, 38%
also reported negative effects, including continued on page 17

16
In conclusion, psychotherapy for the E. Bergin & S. L. Garfield (Eds.),
beginning psychotherapist should be an Handbook of psychotherapy and behavior
optional activity. Not only is it not an ethi- change (4th ed., pp. 229-269). New York:
cal imperative, to require psychotherapy is Wiley.
unethical. Beutler, L. E., Malik, M., Alimohamed, S.,
Harwood, T. M., Talebi, H., Noble, S, &
Arthur C. Bohart Wong, E. (2004). Therapist variables. In
Saybrook Graduate School M. J. Lambert (Ed.), Bergin and
Garfield’s handbook of psychotherapy and
References behavior change (5th ed., pp. 227-306).
Barnett, J. E., & Goncher, I. (2008). Psy- New York: Wiley.
chotherapy for the psychotherapist: Buckley, P., Karasu, T. B., & Charles, E.
Optional activity or ethical imperative? (1981). Psychotherapists view their per-
Psychotherapy Bulletin, 43(3). 36-40. sonal therapy. Psychotherapy: Theory,
Bellows, K. F. (2007). Psychotherapists’ Research and Practice, 18, 299-305.
personal psychotherapy and its per- Lambert, M. J., & Ogles, B. M. (2004). The
ceived influence on clinical practice. efficacy and effectiveness of psy-
Bulletin of the Menninger Clinic, 71, 204- chotherapy. In M. J. Lambert (Ed.),
226. Bergin and Garfield’s handbook of psy-
Beutler, L. E., Machado, P. P., & Neufeldt, chotherapy and behavior change (5th ed.,
S. A. (1994). Therapist variables. In A. pp. 139-193). New York: Wiley.

CALL FOR NOMINATIONS


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

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

NOMINATION MATERIALS
Self-nominations are welcomed. Letters of nomination should outline the nominee’s
credentials and contribution. Nomination letters and a brief CV should be forwarded
to the Division 29 2009 Awards Chair:
Jeffrey E. Barnett, Psy.D., ABPP
1511 Ritchie Highway, Suite 201
Arnold, MD 21012
Phone: 410-757-1511 Fax: 410-757-4888
E-mail: drjbarnett1@comcast.net
Deadline: January 1, 2009

17
STUDENT ABSTRACTS

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

Abstract cal. This review of the literature on older


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

Mathilda B. Canter Education and Training Student Paper Award


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

Donald K. Freedheim Student Development Award


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

Abstract PRPTs compare clients who refused ran-


While including client domization and were given a preferred
preferences is thought treatment to clients who agreed to ran-
to be an integral part domization. Given these factors, it was
of best practice stan- deemed important that a to-date meta-ana-
dards (APA, 2006), lytic review be conducted, specifically
there is little agree- comparing the effects from various study
ment in the research as designs.
to whether including
client treatment prefer- PsychInfo, ProQuest, and relevant journals
ences has a positive were searched for research articles compar-
effect on treatment out- ing the outcome effect of matching or not
come (Glass et al., matching clients to a preferred treatment.
2001; King et al., 2005). A total of 26 studies were deemed eligible
Although previous for inclusion. Results from the studies
reviews have been con- were averaged and compared using the r
ducted examining the statistic and computed using the
preference effect, the findings of these Comprehensive Meta-Analysis-2 program
reviews have been less than conclusive due (Borenstein et al., 2005). Overall effect sizes
to a number of shortcomings. Specifically, were calculated comparing (1) dropout
previous reviews have either failed to use a rates and (2) outcomes between preference
statistical procedure to summarize the matched and unmatched clients. The Q-
findings (box count method only) or have statistic was used to compare effect differ-
failed to account for differing study ences between the various study designs.
designs [match/no-match trials, partially
randomized preference trials (PRPTs), ran- Twenty-six studies were included in the
domized controlled trials (RCTs)]. Study analysis, representing over 2,300 clients
design may particularly confound the (1,240 clients received their preferred treat-
results of previous research given that the ment, while 1,116 did not). Results from the
differing designs use various methods to meta-analysis indicated that clients who
assign clients to preference conditions. For received their preferred treatment were
example, while RCTs when used to study about half as likely to drop out (OR = 0.58,
preference effects compare clients who by CI.95: 0.10-0.18, p < .05), and on average
chance were randomized to their preferred showed greater improvement in outcomes
treatment to clients who were by chance (r = .15, CI.95: .09 to .21, p < .001). Study
randomized to a non-preferred treatment, continued on page 20
19
design was found to be a significant moder- References
ating variable [Q (2) = 7.72, p < .05], and American Psychological Association
post-hoc comparisons indicated that PRPTs Presidential Task Force on Evidence-
resulted in lower effect size estimates when Based Practice. (2006). Evidence-based
compared to match/no-match trials [Q (1) = practice in psychology. American
5.06, p < .05] and RCTs [Q (1) = 5.56, p < .05]. Psychologist, 61, 271-285.
In short, this meta-analysis found that Borenstein, M., Hedges, L. V., Higgins, J.
there was a significant effect on treatment P. T., & Rothstein, H. R. (2005).
outcome in favor of clients who received Comprehensive Meta-Analysis, Version 2.
their preferred treatment. Although signif- Englewood, NJ: Biostat.
icant, the found effect size was small, indi- Charles, C., Gafni, A., & Whelan, T. (1997).
cating that preferences are only one of a Shared decision-making in the medical
number of factors contributing to success- encounter: What does it mean? (Or it
ful therapy outcome. Further, given the takes at least two to tango). Social
small effect size it can be deduced that Science & Medicine, 44, 681-692.
leaving all decision-making in the hands of Glass, C. R., Arnkoff, D. B., & Shapiro, S. J.
the client may be counterproductive in (2001). Expectations and preferences.
some cases. On the other hand, it can be Psychotherapy, 38, 455-461.
recommended that clinicians at minimum King, M., Nazareth, I., Lampe, F., Bower,
include client preferences in the treatment P., Chandler, M., Morou, M., et al.
decision-making process, possibly through (2005). Impact of participant and physi-
using a shared decision-making model cian intervention preferences on ran-
(Charles, Gafni, & Whelan, 1997). Further domized trials: A systematic review.
research is needed to address these limita- Journal of the American Medical
tions and to explain why the outcome Association, 293, 1089-1099.
effect in favor of clients who received their
preferred treatment was observed.

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

THE FEDERAL BUREAU OF PRISONS:


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

Clinical practice within In many BOP institutions, doctoral-level


the correctional environ- psychologists function as front-line
ment is a complex enter- providers of mental health services to
prise (Magaletta, Patry, inmates. Departments range in size from a
Dietz, & Ax, 2007). As an single individual to as many as 10 psychol-
early career psychologist ogists, and operate from a community psy-
(ECP) working for the chology framework. In this framework, the
Federal Bureau of Prisons (BOP), the expe- correctional environment is the community
riences thus far have provided me the and psychologists provide direct services
opportunity to work clinically with a to inmates and consultative services to staff
diverse population of inmates arrested for who interact with the inmates while oper-
and/or convicted of federal offenses. ating the correctional institution. Direct
Starting with my predoctoral internship at inmate services may include crisis inter-
a Federal detention facility in Los Angeles, vention; long-term, short-term, and group
and continuing in my current job in therapies; psychological assessments; and
Lompoc, California, the BOP has given me comprehensive substance abuse treatment.
a vast set of experiences and the chance for Most inmates are self-referred, while some
growth as both a clinician and a correction- are sent by other staff, or are advised by the
al worker. At this point in my professional Federal Courts or parole boards to seek
career, I could not have asked for more. treatment. …Consultative services to staff
may range from personnel interviews,
POSITION DESCRIPTION employee assistance counseling, and men-
My current employment at the Federal tal health consultation to hostage negotia-
Correctional Complex (FCC) in Lompoc, tion or crisis support. (United States
California, is in the position of Staff Department of Justice, Federal Bureau of
Psychologist. As stated on the Bureau of Prisons, n.d.)
Prisons (BOP) website (www.bop.gov): continued on page 22
21
The Psychology Services Department at sealed the deal for me. Later, as I steadfast-
FCC Lompoc currently operates with three ly navigated my way through the APPIC
Staff Psychologists; one Drug Abuse internship process, my top-ranked
Programs Coordinator (a doctoral-level choice—and where I ended up attending—
psychologist supervising nine Drug was the Metropolitan Detention Center
Treatment Specialists); and the Chief (MDC) in Los Angeles.
Psychologist. Duties are divided among
me and these clinicians. My specific MDC-LA represented an excellent experi-
responsibilities include: conducting admis- ence as a predoctoral clinical psychology
sion/orientation and psychological screen- internship. A Federal jail facility housing
ings of newly designated inmates; provid- male and female inmates of all security lev-
ing brief and long-term counseling for els (minimum, low, medium, and high secu-
adjustment symptoms and crisis interven- rity), MDC-LA represented the opportunity
tion services when necessary; providing I was waiting for, and it allowed me to take
routine follow-up to inmates suffering advantage of further learning the funda-
from severe and persistent mental illness; mentals of correctional psychology and
conducting suicide risk assessments and BOP employment via three outstanding
monitoring inmates placed on suicide pre- rotations (i.e., General Population; Mental
cautions watch status; referring inmates for Health; and Forensic Evaluation). A great
psychiatric consultation; coordinating year, however, did have to come to an end,
treatment of inmates with Health Services, and with baited breath I searched for my
Unit Team, and Correctional Services staff; postdoctoral experience. Would it be a fel-
conducting psychological testing and assess- lowship? A job with (hopefully) postdoctor-
ment; serving as Program Coordinator for al hours supervised by a California-licensed
the complex’s Suicide Prevention Program; psychologist? Ultimately, the search led me
and providing Employee Assistance to FCC Lompoc (one of my first options)—a
Program (EAP) services to institution staff. correctional complex consisting of a medi-
um-security institution, a low-security insti-
ROAD TO CURRENT POSITION tution, and two satellite camps (minimum-
Looking back, I can trace my road to BOP security).
employment to my second year of gradu-
ate school when my interest was piqued in MOST SATISFYING ASPECTS OF
a particular full-time field practicum at a POSITION
local jail (Twin Towers Correctional What makes working at FCC Lompoc (and
Facility) in Los Angeles. This practicum, for the BOP) most satisfying—aside from the
unfortunately, was discontinued before I West Coast climate!—is the level of respect
applied. Regardless, I focused on attaining bestowed upon Psychology Services staff,
its still functioning half-time internship, something I have not directly witnessed in
and the following year was chosen to par- other practicum and internship experiences.
ticipate in their 2005-2006 internship class. For example, we are seen as “correctional
During a six-month rotation at the Twin workers first,” a specific tenet of the BOP
Towers Women’s Forensic Outpatient involving the fact that all employees, regard-
Program, I was fortunate to have a won- less of position, are part of the Bureau fami-
derful supervisor who introduced me to ly and, thus, trained as correctional workers
the BOP through her own experiences as a primarily. That is to say, employees partake
former BOP intern. Her descriptions of the in training (known as “Introduction to
many benefits of an internship through the Correctional Techniques”) for three weeks at
BOP (e.g., a foot-in-the-door to potential the Federal Law Enforcement Training
BOP employment; forensic psychology Center in Glynco, Georgia. There new psy-
experience), coupled with my enthusiasm chologist employees are trained in the
after reviewing the internship’s brochure, continued on page 23
22
correctional aspects of BOP employment Additionally, one could bring up concerns
alongside correctional officers, nurses, about worker safety within the correction-
educators, and other various staff from al environment. In my case, though, I have
institutions across the country. This excel- not yet felt any issue with safety, as staff
lent training prepares one for the inter- members take the security of the institu-
department (and interdisciplinary) rela- tion very seriously. Employees from each
tions that continually occur once re-inte- and every department work on a unified
grated into the home facility. front to overcome concerns with regard to
worker safety; case in point: when staff
In addition to the respect and rapport members are notified of assistance
among staff, I am incredibly humbled by required anywhere in the institution, every-
the clinical experiences that I have encoun- one responds immediately. I repeat: everyone
tered. The range of services that I have responds.
been able to provide (e.g., crisis interven-
tion; brief counseling; individual and group On a positive note, I have viewed challenges
psychotherapy; confrontation avoidance; not only as learning experiences, but also as
suicide risk assessment)—all under direct chances to enhance my expertise in dealing
supervision—have been conducted with with a wide array of situations. Such situa-
such a variety of clientele (i.e., inmates), tions abound routinely, and I look forward
that I feel well prepared as I progress in my to them enthusiastically.
own realm of job responsibilities. The clin-
ical supervision that I have received has PEARLS OF WISDOM
been vital, assisting me in making the cor- If I could offer guidance to those interested
rect interventions, and fortunately enough, in clinical practice within corrections (at
I have not felt overwhelmed or “in over my any level – local, state, or federal), I would
head.” begin by recommending discussing the
option with a number of practitioners
MOST CHALLENGING already working in these locations. One
ASPECTS OF POSITION person’s opinion could provide an
Of course, one does face challenges when informed, yet skewed perspective regard-
working in a correctional environment, be ing the correctional environment, whereas
it at either the local, state, or federal level. three or four or more viewpoints add more
At times, working clinically with clients data for what could be a significant career
who have a high incidence of Axis II psy- decision. Furthermore, it would be impor-
chopathology, most notably antisocial per- tant to consider not only the environment
sonality disorder (Hare, Hart, & Harpur, where you would be working, but the
1991; Hare, 1996), can be difficult, especial- clientele you would likely encounter who
ly when treating comorbid Axis I sympto- present with a variety of problems (e.g.,
matology (e.g., major depressive disorder; adjustment disorders; anxiety, mood, and
schizophrenia). Clinical supervision is the psychotic disorders; comorbid Axis II dis-
key to success, particularly when encoun- orders). Above all – and this applies to any
tering novel situations, which can occur on profession within any employment setting
a routine basis. I can remember a specific – self-care is vital to success at your job. If
instance in the Special Housing Unit in you are not achieving some sort of balance
which supervision—provided via tele- between your professional life and your
phone due to the time-constrained nature personal life, your chances of experiencing
of my seeking consultation—served to burnout increase dramatically. Take care of
assist me in making what turned out to be yourself! (Your coworkers, and loved ones,
effective interventions. Experiences such as will thank you.)
these make the challenges easier to con-
front efficiently. continued on page 24
23
There are over 400 doctoral-level psycholo- Hare, R. D., Hart, S. D., & Harpur, T. J.
gists employed in the BOP, and I am proud (1991). Psychopathy and the DSM-IV
to serve as one of them. As my experiences criteria for antisocial personality disor-
so far have demonstrated, there will der. Journal of Abnormal Psychology,
always be opportunities to learn and to 100(3), 391-398.
grow as a professional clinician and as a Magaletta, P. R., Patry, M. W., Dietz, E. F.,
correctional worker. I look forward to the & Ax, R. K. (2007). What is correctional
challenge—and to the rewards—that come about clinical practice in corrections?
with providing mental health services to Criminal Justice and Behavior, 34(1), 7-21.
inmates in the correctional environment United States Department of Justice,
requiring these interventions. Federal Bureau of Prisons (n.d.). Mental
health care careers & Psychology Services.
References Retrieved October 11, 2008, from
Hare, R. D. (1996, February 1). Psycho- http://www.bop.gov/jobs/hsd/
pathology and antisocial personality psychology_services.jsp.
disorder: A case of diagnostic confu-
sion. Psychiatric Times, 13(2). Retrieved
October 1, 2008, from http://www.psy- AUTHOR NOTE
chiatrictimes.com/display/ I welcome any follow up communications
article/10168/54831. or questions at krliberatore@bop.gov.

CALL FOR NOMINATIONS


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

Jeffrey E. Barnett, Psy.D., ABPP


1511 Ritchie Highway, Suite 201
Arnold, MD 21012
Phone: 410-757-1511 Fax: 410-757-4888
E-mail: drjbarnett1@comcast.net

The applicant’s CV would also be helpful.


Self-nominations are welcomed.

Deadline is January 1, 2009

24
PSYCHOTHERAPY INTEGRATION
Milestones in Psychotherapy Integration
George Stricker
Argosy University, Washington DC
The current series on with the developments of psychoanalysis.
psychotherapy integra- This can be seen as a forerunner of
tion was introduced Theoretical Integration, as well as an early
three years ago with an predecessor of the important later work by
article that outlined the Dollard and Miller (1950), who attempted
major categories of this to translate the languages of learning theo-
field (Stricker, 2005). To ry and psychoanalysis to each other. By
review, these are doing this, they hoped to get beyond the
Common Factors (those aspects of psy- limitations of jargon and show the under-
chotherapy that are present in most, if not lying similarities of the phenomena
all, therapeutic systems), Technical approached by each theory. Unfortunately,
Integration (a combination of techniques neither the proponents of psychoanalysis
are drawn from different therapeutic sys- nor those of learning theory were ready for
tems without regard for any specific theo- this, and the contribution was not as influ-
retical approach), Theoretical Integration ential a step toward integration as it
(an attempt to understand the patient by deserved to be.
developing a superordinate theoretical
framework that draws from a variety of dif- At about the same time as French’s early
ferent frameworks), and Assimilative work, Rosenzweig (1936) presented the
Integration (treatments are drawn from dif- first formulation of what came to be known
ferent approaches but remain guided by a as Common Factors. He noted that there
unitary theoretical understanding). The were some features that were present in all
series that followed this initial presentation approaches to therapy. These included the
has presented several different variations of therapist’s personality and ability to
these approaches, as well as some indica- inspire hope; interpretations, which pro-
tion of the evidence for them. In this article, vide alternative and more plausible way of
I will review some of the historical mile- understanding problems, whether or not
stones in the development of psychothera- they are true; and the synergistic effects of
py integration. In doing so, I will present an one change on others. Rosenzweig also
abbreviated and idiosyncratic selection of used the term Dodo Bird effect to apply to
references. The reader wishing a more com- the lack of difference in effectiveness of the
prehensive historical account should refer various therapeutic approaches, and it was
to the work by Goldfried, Pachankis, and this finding, which continues to be repli-
Bell (2005). cated to the present day, that led him to
identify common factors that can account
Before psychotherapy integration was for common effects.
identified as a movement and an approach
to psychotherapy, there were some proto- The most important work in the area of
integrationist articles that were very influ- Common Factors, and the one most often
ential. The first of these was by French cited in the psychotherapy integration lit-
(1933), a prominent psychoanalyst, who erature, is the first of the landmark vol-
noted the contributions that had been umes by Frank (1961). This work was far
made by Pavlov and learning theory and more ambitious than simply seeking com-
wondered how these might be reconciled continued on page 26
25
mon factors in psychotherapy, as it sought first fully realized example of Theoretical
to discover the common factors in all heal- Integration. It not only was important as a
ing processes, including such things as work of integration, it also made psy-
faith healing and shamanism along with chotherapy integration an acceptable form
psychotherapy. Among the factors identi- of treatment, and led to a series of works
fied were an emotionally charged healing that now could be classified together rather
relationship; a healing setting; a myth than viewed as unconnected and discrete
based on a rational and credible conceptu- apostasies. Perhaps the most important
al scheme to explain symptoms; and a heal- aspect of Wachtel’s integration was the pre-
ing ritual. Certainly these are all present in sentation of his system, Cyclical
psychotherapy, but they also exist in the Psychodynamics, which contained the
other healing processes. notion of a cyclical rather than a linear
process of causality. Thus, it was possible
The first work that might be classified as for insight to lead to behavior change, as
Technical Integration was introduced by psychoanalysis long had held, but also for
Lazarus (1976) in the form of Multimodal behavior change to lead to insight, so that
Therapy. Lazarus refers to this as an eclec- it was reasonable to intervene at either
tic approach, although an argument might point in order to produce change.
be made that it is assimilative integration,
with social learning theory providing the Shortly thereafter, Goldfried (1980) pre-
organizing theory and other interventions sented an important article that also might
being assimilated. However, the difficulty be classified within the Common Factors
in classification is indicative of a more area. He recognized the difficulty in
recent problem, as the four categories usu- achieving integration at the level of theory,
ally employed have somewhat fuzzy which often provided incompatible formu-
boundaries. In any case, Lazarus provided lations, or at the level of technique, which
an excellent example of an approach to also were quite disparate. Instead, he
psychotherapy that did not hold rigidly to looked for commonalities at an intermedi-
any single orientation, but drew interven- ate level that he referred to as clinical strat-
tions from many orientations in develop- egy. Orientations that differed widely in
ing a flexible approach to treatment. theory and in preferred interventions were
compatible at this middle strategic level,
The 1960s and 1970s were noteworthy for which included processes such as provid-
numerous unconnected examples of inte- ing feedback and corrective emotional
grationist efforts, as the Zeitgeist seemed experiences.
prepared for a departure from single
school approaches to psychotherapy. The important work of Wachtel and
Interestingly, one of the most important Goldfried set the stage for the establish-
contributions of that period, the Cognitive- ment of a professional organization that
Behavioral approach (CBT) of Beck (1976), promised to provide a reference group
actually is an integration of cognitive theo- for the growing number of professionals
ry with the existing behavioral approach, who were interested in psychotherapy
but it rarely is viewed as being part of psy- integration. The Society for the Exploration
chotherapy integration because it has of Psychotherapy Integration (SEPI) was
emerged as the most popular single school established in 1983 and has grown into an
at the present time. international organization that hosts an
annual conference and publishes the
The preparation of the field for integration Journal of Psychotherapy Integration, a
came to fruition with the watershed book quarterly journal that contains the most
by Wachtel (1977), an integration of psy-
chodynamic and behavioral thought in the continued on page 27
26
current contributions to the area of integration uses a relational psychodynam-
psychotherapy integration (for further ic theory as the organizing theory but
information about SEPI, see http:// incorporates interventions from CBT and
www.cyberpsych.org/sepi/). The contrib- humanistic-experiential theories to supple-
utors to this series of articles all have been ment standard psychodynamic interven-
SEPI members, and their work is indicative tions when it is indicated clinically.
of the creativity and enthusiasm that char-
acterizes the organization and the area. One indication of the maturity of a field of
study is the publication of compendia that
Prochaska’s (Prochaska & DiClemente, bring together many diverse contributions
1984) Transtheoretical approach might be within the field. For psychotherapy inte-
viewed as belonging within Theoretical gration, there are two such volumes. The
Integration, because it provides a metathe- first is the second edition of a Handbook
ory of the therapeutic process, or within (Norcross & Goldfried, 2005) that brings
Common Factors, because it identifies together scholarly contributions in all the
common stages in therapy. This again areas mentioned in this review as well as a
points to the difficulty in classification that great many other promising approaches.
has emerged (Stricker & Gold, 2006b). The The second is a Casebook (Stricker & Gold,
most influential aspect of the Trans- 2006) that has many clinical contributions
theoretical approach is the stage theory, from the authors referred to in this review,
and within that, the notion that some as well as contributions from several oth-
patients are in a precontemplative stage ers. These two books have been used
and not yet ready to consider change. They together in graduate courses in
require a different set of interventions than Psychotherapy Integration, and the pres-
patients who have progressed to later ence of such courses is another sign of the
stages of change, such as preparation or development of psychotherapy integration
action. as a recognized approach to treatment.

Beutler also presented an important work In this day of evidence-based practice,


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

Bulletin ADVERTISING RATES


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Division of Psychotherapy (29) Forces, Standing and Ad Hoc Committees,
6557 E. Riverdale Liaison and Representative Roles) materials
Mesa, AZ 85215 will be published at no charge as space allows.

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

Domain Representative – Membership Domain Representative – Diversity


_______________________________________ _______________________________________
_______________________________________ _______________________________________

Domain Representative – Domain Representative –


Education & Training Psychotherapy Practice
_______________________________________ _______________________________________
_______________________________________ _______________________________________

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.
29
Name (Printed)
______________________________________

Signature
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31
APA’s Division of Psychotherapy is pleased to announce:

THE DISTINGUISHED PUBLICATION OF


PSYCHOTHERAPY RESEARCH AWARD

In consultation with the Division 29 Board of Directors, the Division 29 Research


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

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


15. Nominations should include the complete citation for the article, and should
be emailed to the Chair of the Research Committee, Dr. Susan Woodhouse, at
ssw10@psu.edu.

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


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

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


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

The criteria for the award appear below.


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

N O F P S Y C H O THE
O
RA P Y
D I V I SI

29
ASSN.
AMER I

C
A
N PSYCHOLOGI C
AL

32
PSYCHOTHERAPY PRACTICE
The Practice of Psychotherapy: Lost or Found?
By Patricia Coughlin, Ph.D., Philadelphia, PA

Some in our profession depressants (SSRIs) revealed that the great


have suggested that the majority of patients received no clear bene-
practice of psychothera- fit over that achieved by placebo (Kirsch,
py is lost; that the need Deacon, Huedo-Media, Moore, & Johnson,
for our services is declin- 2008). The United Kingdom, which had
ing, and that we are spent $300 million pounds on these pre-
deceiving students into scriptions in the previous year, recently
thinking they have a announced (Alan Johnson, Health
future in the field (Cummings, 2008). Is there Secretary, personal communication, 2008)
any real evidence to support such claims? A that 3600 therapists will be trained in the
review of recent literature suggests that the next 3 years in order to increase patient
opposite is true—that the need and demand access to talking therapies, which are more
for psychotherapy is greater than ever. effective, efficient, and pose far fewer risks
Perhaps our own state of passivity and res- than medication.
ignation is the problem, rather than some-
thing “out there.” Not only has therapy proven more effective
than medication for many psychiatric
It is important to remind ourselves that the patients, but research suggests that the
evidence to support the efficacy of psy- majority of physical complaints reported to
chotherapy is overwhelming and generally primary care physicians and emergency
far more compelling than that of most med- rooms are psycho-social, rather than organic,
ical interventions (Smith & Glass, l977; in nature (Kroenke, 2003; Reid, Rayforth, &
Lipsey & Wilson, l993; Wampold, 2001). Hotopf, 2001). Often, as little as one session
Research also demonstrates that some of short-term dynamic psychotherapy can
forms of emotionally focused psychothera- alleviate suffering and avert costly medical
py are highly cost effective as well clinically treatment (Abbass, et al, 2008).
effective (Abbass, 2002, 2003). In fact, Dr.
Abbass has been able to substantiate that So, the good news is that psychotherapy
short-term dynamic psychotherapy (at least works. The sobering news is that it has
as practiced by him) saves three dollars for been very difficult to prove that one form
every one dollar spent on treatment. Not of therapy is more effective than others.
only do patients go off their medications The research suggests that the therapist,
and drastically reduce their reliance on the rather than the therapy, is the more potent
medical system, but those who were unem- variable when considering outcome (Blatt,
ployed and on disability resumed employ- et al, l996; Crits-Cristophe, et al, l99l;
ment after an average of only 8 sessions Luborsky, McLellan, Diguer, Woody, &
(Abbass, 2003). The cost savings for the 89 Seligman, l997). Therapists vary widely in
patients studied was well over $400,000.00 their level of skill and effectiveness over
and that savings was duplicated in each of time and across patients. While we may
the three years following completion of a 15 not like to acknowledge it, some of us are
session treatment. really good at what we do, some are down
right awful, and most are just average.
At the same time that psychotherapy is
receiving such strong support, the largest As Atul Gawande (2007) pointed out in his
meta-analysis of the effectiveness of anti- continued on page 34
33
essay on this sensitive topic, the bell shape et al, l997). If we continue to fail in our
curve seems to pop up everywhere, includ- training of therapists in this way, we could
ing the effectiveness of health-care get “lost.” However, if we heed the call and
providers. In his essay on the subject add this focus on personal development to
(Gawande, 2007), he concluded that the our training programs, we will enhance the
average practitioner is fine for the average therapeutic experience for all involved.
patient. In other words, if you have a mild or
garden variety case of anxiety or depression, References
your average psychologist can help you. Abbass, A. (2002). Intensive Short-term
However, if a patient suffers from a complex dynamic psychotherapy in a private
disorder that is difficult to treat, like somati- psychiatric office: Clinical and cost
zation or borderline personality disorder, effectiveness. American Journal of
not just any psychologist will do. Some pro- Psychotherapy, 56, 225-232.
duce far better outcomes, more often, than Abbass, A. (20023). The cost effectiveness
others. It really matters who you consult. of short term dynamic psychotherapy.
Journal of Pharmacoeconomics and out-
Gawande (2007) found that physicians who come research, 3, 535-539.
achieved the best results were the most pas- Abbass, A., Joffres, M.R. & Ogrodniczuk,
sionate and determined; simply refusing to J.S. (2008). Brief Treatment and
accept average results, and pressuring Crisis Intervention, February, 2-7.
themselves and their patients to work hard Blatt, S.J. Sanislow, C.A., Zuroff, D. C. &
to achieve the very best results possible. Pilkonis, P.A. (1996). Characteristics of
Evidence suggests the same is true of psy- effective therapists: Further analyses of
chotherapists (Wampold, 2001). The thera- data from the National Institute of Mental
pist’s passion for his/her craft, persistence Health treatment of depression collabo-
in achieving positive results, ability to man- rative research program. Journal of Con-
age the therapeutic relationship, form a sulting and Clinical Psychology, 64, 162-171.
solid working alliance, deal with barriers Crits-Cristophe, P., K. Baranackie, J.
and obstacles to collaboration, and be open Kurcias, A. Beck., K. Carroll, K.
to feedback, as well as being a life long Perry, L. Luborsky, A. McLellan, G.
learner, are all factors characteristic of the Woody, L. Thompson, D. Gallagher &
most effective therapists. While the results C. Zitrin. (l99l). Meta-Analysis of thera-
of clinical trials suggest that “common fac- pist effects in psychotherapy outcome
tors,” like those just outlined, have the studies. Psychotherapy Research, 1, 81-19.
greatest impact on outcome, what is clear is Cummings, N.A. (2008). Are graduate stu-
that these common factors are “not so com- dents being deceived? The National
mon” (Weinberger, l995). Psychologist, July/August, 14.
Gawande, A. (2007). The Bell Shaped
What does all this mean? What is the take Curve. Better: A Surgeon’s notes on
home message? It is clear—in order to Performance. NY: Metropolitan Books.
enhance your effectiveness as a therapist Kirsch, I., B.J. Deacon, T.B. Huedo-Media,
and as a teacher or supervisor of other T.J. Moore, B.T. Johnson. (2008). Initial
therapists, it is essential to focus on the severity and antidepressant benefits: A
development of these core competencies. Meta-analysis of data submitted to the
Who you are in your being and how you Federal Drug Agency. PloS Medicine,
conduct yourself, particularly your ability 5(2) e45.
to create and maintain an emotional con- Kroenke, K. (2003). The interface between
nection with your patient, is far more physical and pyshcological symptoms.
important than what you do. In my own Journal of Clinical Psychiatry Primary
experience, this attention to the person of Care Companion, 5 (Suppl 7), 11-18.
the therapist is neglected in practice, as Lipsey, M. & Wilson, D. (l993). The efficacy
well as in the research literature (Luborsky, continued on page 35
34
of psychological, education, and behav- care: a retrospective cohort study.
ioral treatment: Confirmation from British Medical Journal, 322, 767.
meta-analysis. American Psychologist, 45, Smith, M. & Glass, G. (l977). Meta-analy-
1181-1209. sis of psychotherapy outcome studies.
Luborsky, L., A.T. Mc Lellan., L. Diguer, American Psychologist, 32, 752-760.
G. Woody & D.A. Seligman.(1997). The Wampold, B. E. (2001). The Great
Psychotherapist Matters: Comparison Psychotherapy Debate. New Jersey:
of outcomes across 22 therapists and 7 Lawrence Erlbaum Associates.
patients. Clinical Psychology: Science and Weinberger, J. (1995). Common factors
Practice, 96. aren’t so common: The common
Reid,W., C.T. Rayford, M. Hotopf (2001). factors dilemma. Clinical Psychology,
Medically unexplained symptoms in V2N1, 45-69.
frequent attenders of secondary health

REQUEST FOR PROPOSALS


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

TO APPLY: Submit a CV, two recommendation letters, and proposal online at


http://forms.apa.org/apf/grants/ by February 1, 2009.
Questions about this program should be directed to
Emily Leary, Program Officer, at eleary@apa.org.

35
ETHICS IN PSYCHOTHERAPY
Informed Consent with Culturally Diverse Clients
Jeffrey E. Barnett, Psy.D., ABPP
Independent Practice, Arnold, Maryland and Loyola College in Maryland and
Ian Goncher, M.S., Loyola College in Maryland
According to the U.S. about participation in the professional rela-
Census Bureau (2002), tionship” (Barnett, Wise, Johnson-Greene,
by the year 2025, 40% & Buckey, 2007, p. 179) Practicing psychol-
of adults and 48% of ogists and those in graduate training are
children in the United routinely involved in diverse professional
States will be from a relationships and perform a myriad of pro-
racial, ethnic, or cultur- fessional roles. Regardless of the profes-
al minority group. The sional role or relationship, psychologists
rate of population are ethically and legally bound to initiate
growth for racially, eth- these relationships only after completing
nically, and culturally the process of informed consent (APA,
diverse youth is project- 2002; Knapp & VandeCreek, 2006).
ed to substantially sur-
pass population growth Informed consent brings with it several
for White youth. For other important benefits, including “pro-
instance, between 1995 moting client autonomy and self-determi-
and 2015, population nation, minimizing the risk of exploitation
growth is expected to be 74% for Asian and harm, fostering rational decision-mak-
American youth, 19% for Black youth, and ing, and enhancing the therapeutic
17% for Hispanic youth, as compared to alliance” (Snyder & Barnett, 2006, p. 37).
3% for White youth (Snyder & Sickmund,
1999). With this increasing racial, ethnic, What does the Ethics Code Say?
and cultural diversity as well as the unique Principal E: Respect for People’s Rights
health related needs of specific diverse and Dignity of the APA Ethics Code (APA,
populations, mental health service systems 2002) states:
and psychotherapy providers are routinely Psychologists are aware of and respect cul-
challenged to develop and implement tural, individual, and role differences,
strategies to provide all racial, ethnic, and including those based on age, gender, gen-
cultural groups with efficacious treatment der identity, race, ethnicity, culture, nation-
with the intention of eliminating the dis- al origin, religion, sexual orientation, dis-
parities in the quality of care minorities ability, language, and socioeconomic sta-
receive (U.S. D.H.H.S., 2001). The process tus, and consider these factors when work-
of initiating effective treatment for clients ing with members of such groups.
from diverse backgrounds begins at the Psychologists try to eliminate the effect on
outset of the therapeutic relationship. their work of biases based on those factors,
and they do not knowingly participate in
Informed Consent: What is it exactly? or condone activities of others based upon
Informed consent has been defined as: “a such prejudices. (p. 1063)
shared decision-making process in which
the professional communicates sufficient Although this principle is aspirational in
information to the other individual so that nature, it is essential that psychologists
she or he may make an informed decision continued on page 37

36
adhere to this guidance to provide optimal diverse clients. According to the APA’s
care to our patients from diverse back- Guidelines on Multicultural Education,
grounds. This includes initiating an Training, Research, Practice, and
informed consent process that is mindful Organizational Change for Psychologists
of racial, ethnic, and cultural differences (2003) “Psychologists are encouraged to
that can influence the presentation of recognize that, as cultural beings, they may
appropriate information to the client. For hold attitudes and beliefs that can detri-
example, the enforceable Standard 3.01, mentally influence their perceptions of and
Unfair Discrimination, (APA, 2002) states interactions with individuals who are eth-
that “In their work-related activities, psy- nically and racially different from them-
chologists do not engage in unfair discrim- selves” (p. 382). One effective bias reducing
ination based on age, gender, gender iden- strategy is engaging in increased contact
tity, race, ethnicity, culture, national origin, with individuals from diverse back-
religion, sexual orientation, disability, grounds (Pettigrew, 1998).
socioeconomic status, or any basis pro-
scribed by law” (p. 1064). Additionally, psychologists must enhance
their cultural competence to effectively
The APA Ethics Code’s (APA, 2002) inform diverse populations. As Sue (1998)
Standard 3.10(a), Informed Consent, points out, “one is culturally competent
states: “Psychologists obtain appropriate when one possesses the cultural knowl-
informed consent to therapy or related pro- edge and skills of a particular culture to
cedures, using language that is reasonably deliver effective interventions to members
understandable to participants” (p. 1065). of that culture” (p. 441). More recently,
More specifically Standard 10.01a, Informed Whaley and Davis (2007) defined cultural
Consent to Therapy, states “When obtain- competence as:
ing informed consent to therapy as
a set of problem-solving skills that include
required in Standard 3.10, Informed
(a) the ability to recognize and understand
Consent, psychologists inform clients/
the dynamic interplay between the her-
patients as early as is feasible in the thera-
itage and adaptation dimensions of culture
peutic relationship about the nature and
in shaping human behavior; (b) the ability
anticipated course of therapy, fees, involve-
to use the knowledge acquired about an
ment of third parties, and limits of confi-
individual’s heritage and adaptational
dentiality and provide sufficient opportu-
challenges to maximize the effectiveness of
nity for the client/patient to ask questions
assessment, diagnosis, and treatment; and
and receive answers” (p. 1072).
(c) internalization (i.e., incorporation into
The content of informed consent will vary one’s clinical problem-solving repertoire)
depending on many circumstances. How- of this process of recognition, acquisition,
ever, informed consent generally implies and use of cultural dynamics so that it can
that the person (1) has the capacity to con- be routinely applied to diverse groups. (p.
sent, (2) has been informed of significant 565)
information concerning the procedure,
Psychologists should learn how cultures
and (3) has freely and without undue
vary and form each person’s worldview.
influence expressed consent (Gross, 2001).
Additionally, psychologists must under-
What Should Psychotherapists Do?
stand how this may influence the provision
Before psychotherapists can initiate a prop-
of appropriate information in the consent
er informed consent procedure with indi-
process and the ensurance of the under-
viduals from diverse backgrounds, they
standing of the therapeutic process. For
must first become knowledgeable of their
own possible biases when working with continued on page 38
37
example, it may be important to under- assess the level of interpreter competence
stand that a component of mainstream cul- using mental health language. For written
ture in the United States is a preference for consent documents this is done by having
individuals who are independent, achieve- them translated both forward and in
ment focused, and have their own person- reverse by two separate experts in the lan-
al goals for which they strive (Fiske et al., guage that is used. Furthermore, the prac-
1998; Oyserman, Coon, & Kemmelmeier, ticing psychologist must take precautions
2002). By contrast, many individuals with regarding maintaining confidentiality
origins in cultures of East Asia may prefer when using an interpreter.
inter-dependence with others, an orienta-
tion toward communal harmony, confor- Beyond the common element of language
mity to societal norms, and they may sub- in properly informing diverse populations,
ordinate their personal goals and objec- there are underlying concepts of informed
tives to the will of the group (Fiske et al., consent that can be influenced by cultural
1998). Thus, psychologists should be cog- factors. Perhaps most importantly is the
nizant of how differing societal norms may concept of autonomy. Autonomy is defined
affect a client’s autonomy during the as the patients’ right to self-determination.
informed decision-making process. It mandates specifically that informed con-
sent be free of undue outside influence and
An essential aspect of cultural competence be made with a thorough understanding of
within the informed consent process is lan- what will transpire in treatment. However,
guage. According to the U.S. Census the approach to autonomy varies within
Bureau (2008), a large number of different cultures (Akabayashi, Fetters, &
Americans speak a language other than Elwyn, 1999; Pelligrino, 1992). For exam-
English in their home. This includes 32 mil- ple, differing from the traditional Western
lion Spanish speaking Americans and it is approach of self-directedness in decision-
estimated that over 2.5 million speak making, many Asian Americans may tend
Chinese, 1.9 million French, 1.1 million to have a family or group orientation. For
German, 1.4 million Tagalog, 1.1 million example, within the Chinese culture, for
Vietnamese, and 1 million speak Korean, many, the concept of self is a relational one
Italian, or Russian. Psychotherapists must (Ho, 1995), and family relationships tend to
understand these linguistic differences and emphasize harmonious interdependence
how they may limit their ability to make (Fan, 1997). Additionally, Fan (1997) states
consent truly informed. One strategy to that within the Chinese culture, individu-
combat linguistic misunderstandings in als are part of family units and autonomy
the informed consent process is the use of frequently requires family determination.
an interpreter. Interpreters have been Kagawa-Singer (1999) noted that many
shown to be helpful in breaking language Asian-Americans’ health related decisions
barriers for individuals with limited are made by consensus, which suggests
English fluency when seeking treatment that the inclusion of family members, pro-
from primarily English language health viding explanations on the procedures and
care providers (Kaufert & Putsch, 1997). agreement to participate, should be incor-
However, the use of an interpreter could porated in the process of informed consent.
potentially lead to further problems in the These suggestions could translate to many
informed consent process, including inter- in the Hispanic community given the high
pretive errors, biases, and other common allegiance to the family that many report as
problems of language interpretation well (Avila & Avila, 1995). Similarly, Shaibu
(Simon, Zyzanski, Durand, Jimenez, & (2007) found a collectivistic orientation
Kodish, 2006). Thus, psychologists must during the informed consent process with
ensure that the client understands the individuals in Botswana that included the
information in the consent agreement, and continued on page 39
38
extended family being privy to informa- solve “all” or “most” of today’s problems.
tion to make a collective decision about According to Hill (1997), strong religious
participation in research. Furthermore, commitment is one of the most pervasive
Shaibu (2007) found that women often con- cultural strengths of many African-
sulted male relatives before consenting to Americans. Additionally, Goldston,
research participation. Each client’s level of Molock, and Whitbeck (2008) suggest that
acculturation and their resulting needs and in Asian-American and American Indian
preferences should be actively assessed cultures, their spiritual views could influ-
from the outset of the professional relation- ence their help seeking and coping behav-
ship and respected during the informed iors. Goldston and colleagues (2008) assert
consent process and throughout the dura- that “People of different cultural back-
tion of the relationship. grounds understandably may not seek
help or respect intervention efforts if they
Many Asian American families have a do not perceive that their faith or beliefs
hierarchal/patriarchal decision-making will be honored or respected” (p. 26).
process that often does not seek the input
of others (Tien, 2003). This could impact Hawkins and Bullock (1995) discuss reli-
the voluntary nature of clients seeking gion and spiritually as a neglected piece of
treatment and their ability to ask questions informed consent. It is suggested that psy-
about the treatment process. Thus, the chotherapists share spiritual and religious
client may not receive information that information with their clients when, dur-
could influence their consent to treatment. ing a thorough intake process, the impor-
These findings highlight the need for psy- tance of each client’s religion and spiritual-
chotherapists to have an understanding of ity is uncovered. This will allow each client
the culturally dynamic nature of autonomy to make an informed choice about partici-
and how this pertains to the informed con- pating in treatment (Hawkins & Bullock,
sent process. 1995).

It is important to note that psychologists Acquiring and Maintaining Cultural


should never succumb to generalizations Competence: Several Models to Guide
when discussing informed consent, and Psychotherapists
always ask clients about their preferences The United States is becoming increasingly
from the outset. Additionally, psycholo- diverse, gaining a multitude of cultures
gists should assess each client’s individual and customs with each passing year that
level of acculturation from the outset to will increasingly expand our exposure to
help guide how to proceed with the racial, ethnic, and culturally diverse
informed consent process and the assess- clients. Cultural competence has been
ment or treatment that follows. defined as the knowledge and information
obtained about individuals and groups
Another culturally important aspect to the that is integrated and incorporated into
informed consent process is the use of reli- clinical standards, skills, service approach-
gious or spiritual practices in treatment. es, and procedures that match the cultural
Many people in the United States report experiences and traditions of clients and
strong faith traditions that may impact that increase both the quality and appro-
treatment decisions. Recent Gallup Polls priateness of health care services and
(2007) found that 93% of those surveyed health outcomes (Delphin & Rowe, 2008).
believe in “God or a universal spirit”. Development of cultural competence is an
Eighty-two percent of those surveyed iden- ongoing process and does not have an
tified religion as either “very important” endpoint (Delphin & Rowe, 2008). Thus,
(56%) or “fairly important” (26%) and 59%
stated that they believe that religion can continued on page 40
39
psychologists should not view cultural identity into informed consent to better
competence development as a singular understand the dynamic nature of multi-
event, but should strive to continually cultural identity in the United States.
develop and enhance their competence
through ongoing training. Additionally, Sue and Sue (1999) developed a broad con-
psychologists should refer and adhere to ceptual framework for understanding
tenants of APA’s Multicultural guidelines racial/cultural identity, The Racial/
(APA, 2003). Cultural Identity Development model
(R/CID), which can be used by clinicians
Several models have been developed to to facilitate a better understanding of cul-
assist clinicians in considering the dynam- turally different attitudes and behaviors.
ic nature of culture and how it relates to However, clinicians should not ignore the
potential clients. Hays’ (1996) ADRESSING many within-group differences of racial/
model is described as a framework that culturally diverse populations. Clinicians
will help psychologists “explore the influ- are directed to identity development mod-
ence of diverse cultural factors on their els encompassing African Americans
own identity, world view, and work with (Cross & Vandiver, 2001; Helms & Cook,
clients, and consider the influences of cul- 1999), Asian Americans (Sodowski, Kwan, &
tural factors on their clients, particularly Pannu, 1995), Latino/Hispanic Americans,
factors related to minority-group status” and others (Ruiz, 1990). These models
(p. 188). Using the most salient cultural incorporate within-group differences and
influences psychologists need to consider will help facilitate a better understanding
in their professional work as delineated by of racial and cultural themes that may
the American Guidelines for Providers of affect the informed consent process.
Psychological Services to Ethnic, Linguis-
tic, and Culturally Diverse Populations Conclusions/Recommendations
(APA, 1993), Hays (1996) organized these • Always assess each client’s language
factors in an acronym that forms ADRESS- competence and ability to comprehend
ING. Included in the model are Age information presented.
and generational influences, Disability, • When using translators, always discuss
Religion, Ethnicity, Social status, Sexual confidentiality issues and assess transla-
orientation, Indigenous heritage, National tor language competence.
origin, and Gender. According to Hays • Gain cultural competence through
(1996), the ADRESSING acronym: ongoing training, exposure to diverse
groups, review of the relevant literature,
provides a framework for psychologists to and by abiding by the multicultural
(a) explore the influence of diverse cultural competence guidelines (APA, 2003).
factors on their own identity, world view, • Develop a cadre of colleagues from
and work with clients; and (b) consider the diverse backgrounds and consult with
influence of cultural factors on their clients, them when questions about various
particularly factors related to minority- groups arise.
group status, which psychologists of dom- • Assess spiritual and religious prefer-
inant cultural identities might be inclined ences from the outset.
to overlook. (p. 188) • Assess each client’s level of accultura-
tion and make appropriate accommoda-
The informed consent process is an ongo- tions rather than applying rigid stereo-
ing endeavor that may need to be updated types.
as treatment progresses (Barnett, Wise, • Respect clients’ preferences for family
Johnson-Greene, & Buckey, 2007). Thus, involvement in the informed consent
clinicians are encouraged to review and
incorporate models of racial and cultural continued on page 41
40
process. Bioethics, 11, 309-322.
• Use existing identity models to gain an Fiske, A.P., Kitayama, S., Markus, H.R., &
enhanced understanding of each client’s Nisbett, R.E. (1998). The cultural matrix
dynamic racial and cultural identities. of social psychology. In D.T. Gilbert &
• If unsure about cultural preferences DO S.T. Fiske (Eds.), The handbook of social
NOT assume. ASK! psychology (4th ed., Vol. 2, pp. 915–
981). New York: McGraw-Hill.
Gallup. (2007). Religion. Retrieved August
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Pellegrino, E.D. (1992). Is truth telling to Tien, L. (2003). Confucian past, conflicted
the patient a cultural artifact? JAMA, present: Working with Asian American
268, 1734 1735. families. In L. Silverstein & T. Goodrich
Pettigrew, T.F. (1998). Applying social psy- (Eds.), Feminist family therapy:
chology to international social issues. Empowerment in social context (pp. 135-
Journal of Social Issues, 54, 663–675. 145). Washington, DC: American
Ruiz, A.S. (1990). Ethnic identity: Crisis Psychological Association.
and resolution. Journal of Multicultural U.S. Census Bureau (2002). Demographic
Counseling and Development, 18, 29-40. Trends in the 20th Century. Census 2000
Shaibu, S. (2007). Ethical and Cultural special reports., Washington, DC: U.S.
Considerations in Informed Consent in Department of Commerce 70–74.
Botswana. Nursing Ethics, 14(4), 503-509. U.S. Census Bureau. (2008). Statistical
Simon C.M., Zyzanski S., Durand E., Abstract of the United States, Section 1.
Jimenez, X., & Kodish, E. (2006). Population. Retrieved August 22, 2008,
Interpreter accuracy and informed con- from http://www.census.gov/prod/
sent among Spanish-speaking families www/statistical-abstract.html
with cancer. Journal of Health U.S. Department of Health and Human
Communication, 11(5), 509-522. Services. (2001). Mental health: Culture,
Snyder, H., & Sickmund, M. (1999). race, and ethnicity—A supplement to men-
Juvenile Offenders and Victims: tal health: A report of the surgeon general.
1999National Report. Washington, DC: Rockville, MD: U.S. Department of
Office of Juvenile Justice and Health and Human Services, Substance
Delinquency Prevention. Abuse and Mental Health Services
Snyder, T.A., & Barnett, J.E. (2006). Administration, Center for Mental
Informed consent and the process of Health Services.
psychotherapy. Psychotherapy Bulletin, Whaley, A. L., & Davis, K. E. (2007).
41, 37–42. Cultural competence and evidence-
Sodowsky, G.R., Kwan, K.K., & Pannu, R. based practice in mental health ser-
(1995). Ethnic identity of Asians in the vices: A complementary perspective.
United States. In J.G. Ponterotto, J.M. American Psychologist, 62, 563–574.
Casas, L.A. Suzuki, & C.M. Alexander

42
DIVISION 29 BOARD OF DIRECTORS MEETING
September 26–27, 2008 • Washington, D.C.

Tracey Martin

N O F P S Y C H O THE
O
RA P Y
D I V I SI

Jeff Barnett, Jean Carter


29

and Nadine Kaslow


ASSN.

Jeffrey Magnavita,
AMER I

C
A

Jennifer Kelly and Jeff


N PSYCHOLOGI C
AL

Barnett

Find Division 29 on the Internet. Visit our site at


www.divisionofpsychotherapy.org

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

A National Health Substance-Use Conditions was released in


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

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

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

49
Call for Nominations
DIVISION 29 AWARD FOR DISTINGUISHED
CONTRIBUTIONS TO TEACHING AND MENTORING
Each year, Division 29 honors a psycholo- public service in psychology
gist who has contributed to the field of • offering general advice with respect to
psychotherapy through the education and professional development (e.g., gradu-
training of the next generation of psy- ate school, postdoctoral study, faculty
chotherapists by presenting the Division 29 positions), awards, and publications
Award for Distinguished Contributions to • treating student/colleagues with
Teaching and Mentoring. This award is respect, spending time with them, pro-
given annually to a member of Division 29 viding open communication lines, and
who exerted a significant impact on the gradually moving the student into the
development of students and/or early role of colleague.
career psychologists in their careers as
psychotherapists. The award recipient will receive the follow-
ing: (1) an invitation to make a 45-minute
Both self-nominations and nominations of presentation at the APA convention the year
others will be considered. The nomination the award is conferred; (2) a cash award of
packet should include: $200 to help offset travel expenses to the
1) a letter of nomination, sent electronical- APA convention for the year the award is
ly, describing the individual’s impact, conferred; and (3) an award plaque. These
role, and activities as a mentor; are based on the assumption that the award
2) a vitae of the nominee; and, recipient will attend the APA convention the
3) letters of reference for the mentor, writ- year the award is conferred. If the award
ten by students, former students, and/or recipient does not attend the APA conven-
colleagues who are early career psychol- tion, then he/she shall receive an awards
ogists. Letters of reference for the award plaque.
should describe the nature of the men-
toring relationship (when, where, level Individuals who were nominated in previous
of training), and an explanation of the years for the Teaching and Mentoring Award
role played by the mentor in facilitating may carry over their complete application to a
the student or colleague’s development subsequent year by writing a letter to the Chair
as a psychotherapist. Letters of reference of the Professional Awards Committee request-
may include, but are not limited to, dis- ing resubmission of the previous application.
cussion of the following behaviors that This letter must be received by March 15 of the
characterize successful mentoring: year of the award.
• helping students to select and work
toward appropriate goals The letter of nomination must be emailed
• providing critical feedback on to the Chair of the Professional Awards
individual work Committee. Deadline is January 1, 2009.
• providing support at all times, especial- All of items must be sent electronically.
ly encouragement and assistance in the The Award is to be presented at the APA
face of difficulties annual convention. Division 29 2009
• assisting students in applying for Awards Chair:
awards, grants, and other funding
• assisting students in building social Jeffrey E. Barnett, Psy.D., ABPP
network connections, both with indi- 1511 Ritchie Highway, Suite 201
viduals and within organizations that Arnold, MD 21012
are important in the field Phone: 410-757-1511 Fax: 410-757-4888
• serving as a role model and leader for E-mail: drjbarnett1@comcast.net
teaching, research, and academic and

50
BOOK REVIEW
Financial Success in Mental Health Practice:
Essential Tools and Strategies for Practitioners
Published by APA Books, 2008
Authors: Steven Walfish and Jeffrey E. Barnett
Miguel E. Gallardo, PsyD, Associate Professor of Psychology, Pepperdine University

As I reflect on the deliv- I have never appreciated that mindset, and


ery of mental health believe it limits and debilitates some stu-
practice nationally, it is dents and psychologists from striving to
clear to me that the achieve all of the above. Additionally, the
times are changing. authors have tailored the book around
Moreover, in a time twenty “Private Practice Principles” that
when some are begin- serve as the backdrop. I found the princi-
ning to question the pos- ples to be very helpful as I began the book
sibility of the independent practitioner as and as reminders throughout. As a result,
an avenue towards financial and profes- this is a great book for professors to use in
sional independence, Walfish and Barnett their classes as the examples and informa-
have outlined, and in many ways, provid- tion provided can be incredibly helpful to
ed a strong sense of hope to those in doubt. those who may still be sorting through the
I was pleased to have reviewed this book pros and cons of private practice.
and believe it to be a well-timed, and one
of the best, books I have read in the areas of I also appreciated the authors’ perspectives
practice development and financial plan- on helping readers understand that inde-
ning for practitioners. I believe this book pendent practice is a culmination of sever-
will serve as a resource to students, early al skill sets, not on simply being a good
career psychologists, and practitioners clinician or a good business person.
across the professional developmental life- Walfish and Barnett do a nice job address-
span. It is within this context that I will ing how important it is for the independent
share my comments and review. practitioner to refine and transform their
mindset, and skill set, as therapists. Their
The authors begin with an analysis of honest discussion about the importance of
mindset. From my perspective, addressing having a strong set of clinical competen-
one’s level of comfort in earning a decent cies, combined with strong skill sets in
living is foundational to engaging and being a business owner, is invaluable. This
embracing a career as an independent particular aspect of the book can be
practitioner. I have been, and remain, con- extremely helpful for those readers who
cerned that as a profession, we are limiting are unsure whether or not independent
our own capacity to deliver services and practice is the right decision for them.
simultaneously earn a living. For too long Their discussions about the various types
people have questioned the mindset of of practices one can create in the book can
psychologists who want to earn a good liv- be helpful to those readers who are
ing as a provider of mental health services. attempting to find the best fit for their own
There seems to be the assumption that if individual needs and levels of comfort in
one wants to make money, pay off school becoming business owners. The various
loans without living month to month, own independent practice options in Chapter 9
a home, have a nice car and take a vacation can be useful as readers reflect on the vari-
once or twice a year, that some how this ous culmination of skills necessary to cre-
takes away from one’s “commitment” to ate a practice. The outcome of their insights
the “real” purpose of being a psychologist. continued on page 52
51
and experiences is that there is not a one and I found myself reflecting on the prac-
size fits all approach to creating and being tice principles and pondering some of the
successful in practice. While I believe their questions raised throughout. The book
discussions on this issue can be helpful for flows in a developmental way that I think
students, I also found myself really learn- will make sense to the reader and to the
ing a lot of new information as a profes- person delving into this process for the first
sional. As a result of reading this book, I time. From my perspective the most useful
was reminded of my graduate school train- aspect of this book is the hands-on
ing and what information was missing approach the authors take throughout the
from that equation. volume. In particular, I found the informa-
tion contained in chapters 6-10 extremely
While I believe that many graduate pro- helpful as I believe these chapters contain
grams have begun to bridge the gap complex information that is easy to under-
between real world professional endeavors stand and with helpful examples. The
and graduate training, particularly as it information in these chapters seemed to
relates to practice, I also believe we are still resonate with me more than when I have
behind in fully preparing our students for read similar information in other practice
a life outside of graduate training in the related books. The authors address the
area of independent practice. Walfish and importance of accounting, taxes, working
Barnett provide excellent information for with insurance companies, or not, engag-
the student just beginning to think about ing in other areas of the field, and long-
practice options after graduate school, to term financial planning in a way that is
facilitating the transition for the newly easily understood and practical. Some of
graduated professional. Additionally, the the more complex issues such as, account-
information in this book can also be useful ing, taxes and dealing with insurance com-
to the more seasoned professional who has panies stand out as information that can be
been concerned about taking a “chance” on challenging to individuals thinking about
establishing their own business. As I practice, yet Walfish and Barnett have
reflected on my own process of beginning managed to present this information in
a small practice as a professional, I found way that I think readers will comprehend.
myself tapping into the various resources I was particularly impressed with the
around me. I was fortunate to have suc- details the authors’ provide in familiariz-
cessful people in practice provide some ing the reader with insurance claim forms
guidance to me along the way. As I read the and delineating the information line by
book, all of the information I compiled as I line. Additionally, the sample letters they
was beginning my own practice from provide to insurance companies, when cor-
numerous individuals, is included in this responding with insurance companies and
volume. There is no stone unturned that clients, setting and changing fees, provid-
Walfish and Barnett have not touched ing superbills and understanding the pit-
upon. Their 45 years of experience is evi- falls associated with insurance work, was
dent in this volume. Of most importance valuable to me as the reader. I learned a
for me as a reader, was that I was able to great deal from reading this book and was
take some of the examples they provided able to use some very practical aspects of
throughout the book, and use them in my this book into my practice.
own practice as a template. The book is
The authors’ pay particular attention in
practical and user friendly.
addressing the multitude of ways that inde-
The book has clearly defined language and pendent practitioners can diversify their
ideas throughout. It is easily understood professional life. As we reexamine the inde-
and the authors do a nice job of spelling pendent practice of psychology today, it is
out many ideas, concepts and processes for clear that today’s practitioners are engaged
the reader. The book is very well organized continued on page 53
52
in a variety of professional roles. I appreci- The authors have also done an exceptional
ated Walfish and Barnett devoting some job including research throughout the fabric
attention to this aspect of being and becom- of the book. This book is not simply based
ing an independent practitioner. The on the author’s experiences, it is based on
author’s address directly the many ways some very important research to substanti-
that independent practitioners can earn a ate the authors recommendations and
living outside of managed care, and in addi- reflections. While the authors’ experiences
tion to a fee-for-service practice. This is a should not be underestimated and represent
very important aspect to this book as it pro- powerful voices in compiling the informa-
vides the reader with some realistic options tion in this book, it is the research compo-
that individuals across the professional life- nent that provides another foundation to
span can take advantage of. Additionally, the volume that expands its utility to pro-
these discussions can be very helpful to stu- fessional training programs for professors
dents who are weighing their options as to use in classes. Additionally, the qualita-
they begin to create a professional identity. tive interviews with therapists throughout
the book highlight scenarios in a very effec-
Over the years, I have followed listserv dis- tive way to demonstrate some the principles
cussions, attended, and participated in, var- and concepts discussed. I have always val-
ious presentations on beginning a practice, ued hearing the professional experiences of
and the information in this book addresses other therapists as they deal with issues that
all the questions I have seen participants I am attempting to address. I found the
and attendees ask on listservs and in pre- interviews to be a nice snapshot into some
sentations. What I most appreciate about of the personal experiences of therapists
the book is the authors’ realistic world view from across the country. The multitude of
on practice. While they provide information voices throughout, add to the books credi-
that is useful, they are not attempting to bility and reliability.
paint an unrealistic picture of practice. The In a time when we are reflecting on the
authors’ help the reader sort through some delivery of services in psychology, and the
very challenging questions about beginning multitude of ways that psychologists
a practice and what it means to delve into impact society, Walfish and Barnett have
an area of the field that demands a certain kept alive the endless possibilities of work-
mindset and skill set. Although the authors ing in independent practice in this changing
discuss some very important aspects related landscape. They have provided an enor-
to practice, this book is not a book that mous amount of information that will equip
attempts to “glorify” independent practice, everyone who reads this book with useful
but more attempts to paint a realistic picture information, regardless of where one falls
of what one can expect as they move for- on the professional life-span. The more sea-
ward. Walfish and Barnett have taken their soned independent practitioner will benefit
own internal processes, professional experi- from the chapters on strengthening one’s
ences and transformed them into deliberate retirement and closing a practice. Every
and thoughtful questions and information reader will benefit from this practical vol-
in this volume. I appreciated the frank dis- ume on thriving as an independent practi-
cussions about both the benefits of indepen- tioner. This book is a must have for gradu-
dent practice, combined with some of the ate training programs hoping to prepare
more challenging discussions that people their students for life outside graduate
need to know. A valuable aspect of this book school to early career psychologists build-
is the authors’ belief that readers need to ing their careers, to seasoned practitioners
know both the intricate details of succeed- wanting to tighten up their business and
ing in practice, while also providing the inti- economic futures. I hope you find this book
mate details of the struggles associated with as valuable as I did.
practice.
53
The Society for General Psychology
Division 1
AMERICAN PSYCHOLOGICAL ASSOCIATION

CALL FOR NOMINATIONS FOR AWARDS FOR YEAR 2009


Deadline: February 15, 2009

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

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

There are no restrictions on nominees, and self-nominations as well as nominations


by others are encouraged for these awards.

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

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

For the William James Book Award, nominations materials should include: a) three
copies of the book (dated post-2004 and available in print; b) the vita of the
author(s); and c) a one-page statement that explains the strengths of the submission
as an integrative work and how it meets criteria established by the Society. Specific
criteria can be found on the Society’s website (http://www.apa.org/divisions/
div1/awards.html). Textbooks, analytic reviews, biographies, and examples of
continued on page 55

54
applications are generally discouraged. Nomination letters and supporting materi-
als should be sent to John D. Hogan, PhD, Psychology Department, St. John’s
University, Jamaica, NY 11439.

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

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

The 2010 Arthur W. Staats Lecture for Unifying Psychology is to be announced in


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

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

General Comments may be made to


Dr. MaryLou Cheal, Awards Coordinator
127 E. Loma Vista Drive
Tempe, AZ 85282.

55
N O F P S Y C H O THE
O
THE DIVISION OF PSYCHOTHERAPY

RA P Y
D I V I SI

29 The only APA division solely dedicated to advancing psychotherapy

ASSN.
AMER I

M E M B E R S H I P APPLICATION
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A
N PSYCHOLOGI C

AL
Division 29 meets the unique needs of psychologists interested in psychotherapy.
By joining the Division of Psychotherapy,you become part of a family of practitioners,scholars,and students who exchange ideas in order to advance psychotherapy.
Division 29 is comprised of psychologists and students who are interested in psychotherapy.Although Division 29 is a division of the American Psychological
Association (APA),APA membership is not required for membership in the Division.
JOIN DIVISION 29 AND GET THESE BENEFITS!
FREE SUBSCRIPTIONS TO: DIVISION 29 INITIATIVES
Psychotherapy Profit from Division 29 initiatives such as the
This quarterly journal features up-to-date APA Psychotherapy Videotape Series, History
articles on psychotherapy. Contributors of Psychotherapy book, and Psychotherapy
include researchers, practitioners, and Relationships that Work.
educators with diverse approaches.
Psychotherapy Bulletin NETWORKING & REFERRAL SOURCES
Quarterly newsletter contains the latest news Connect with other psychotherapists so that
about division activities, helpful articles on you may network, make or receive referrals,
training, research, and practice. Available to and hear the latest important information that
members only. affects the profession.

EARN CE CREDITS OPPORTUNITIES FOR LEADERSHIP


Journal Learning Expand your influence and contributions. Join
You can earn Continuing Education (CE) cred- us in helping to shape the direction of our cho-
it from the comfort of your home or office — sen field. There are many opportunities to
at your own pace — when it’s convenient for serve on a wide range of Division committees
you. Members earn CE credit by reading and task forces.
specific articles published in Psychotherapy
and completing quizzes. DIVISION 29 LISTSERV
As a member, you have access to our Division
DIVISION 29 PROGRAMS listserv, where you can exchange information
We offer exceptional programs at the APA with other professionals.
convention featuring leaders in the field of
psychotherapy. Learn from the experts in
personal settings and earn CE credits at VISIT OUR WEBSITE
reduced rates. www.divisionofpsychotherapy.org

MEMBERSHIP REQUIREMENTS: Doctorate in psychology • Payment of dues • Interest in advancing psychotherapy

Name _________________________________________________ Degree ______________________


Address _____________________________________________________________________________
City __________________________________________ State __________ ZIP ________________
Phone ____________________________________ FAX ____________________________________
Email _______________________________________________________
If APA member, please
Member Type: 䡵 Regular 䡵 Fellow 䡵 Associate provide membership #
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䡵 Check 䡵 Visa 䡵 MasterCard
Card # _______________________________________________ Exp Date _____/_____

Signature ___________________________________________
Please return the completed application along with payment of $40 by credit card or check to:
Division 29 Central Office, 6557 E. Riverdale St., Mesa, AZ 85215
You can also join the Division online at: www.divisionofpsychotherapy.org

56
PUBLICATIONS BOARD EDITORS
Chair 2003-2008 Psychotherapy Journal Editor Internet Editor
Raymond A. DiGiuseppe, Ph.D., Charles Gelso, Ph.D., 2005-2009 Abraham W. Wolf, Ph.D.
Psychology Department University of Maryland MetroHealth Medical Center
St John’s University Dept of Psychology 2500 Metro Health Drive
8000 Utopia Pkwy Biology-Psychology Building Cleveland, OH 44109-1998
Jamaica , NY 11439 College Park, MD 20742-4411 Ofc: 216-778-4637 Fax: 216-778-8412
Ofc: 718-990-1955 Ofc: 301-405-5909 Fax: 301-314-9566 Email: axw7@cwru.edu
Email: DiGiuser@STJOHNS.edu Email: Gelso@psyc.umd.edu
Student Website Coordinator
Laura Brown, Ph.D., 2008-2013 Psychotherapy Bulletin Editor Nisha Nayak
Independent Practice Jenny Cornish, PhD, ABPP, 2008-2010 University of Houston
3429 Fremont Place N #319 University of Denver GSPP Dept of Psychology (MS 5022)
Seattle , WA 98103 2460 S. Vine Street 126 Heyne Building
Ofc: (206) 633-2405 Fax: (206) 632-1793 Denver, CO 80208 Houston, TX 77204-5022
Email: Lsbrownphd@cs.com Ofc: 303-871-4737 Ofc: 713-743-8600 or -8611
Email: jcornish@du.edu Fax: 713-743-8633
Jonathan Mohr, Ph.D., 2008-2012 Email: nnayak@uh.edu
Clinical Psychology Program Psychotherapy Bulletin Associate Editor
Department of Psychology Lavita Nadkarni, Ph.D.
MSN 3F5 Director of Forensic Studies
George Mason University University of Denver-GSPP
Fairfax, VA 22030 2450 South Vine Street
Ofc: 703-993-1279 Fax: 703-993-1359 Denver, CO 80208
Email: jmohr@gmu.edu Ofc: 303-871-3877
Email: lnadkarn@du.edu
Beverly Greene, Ph.D., 2007-2012
Psychology Psychotherapy Bulletin Editorial
St John’s Univ Assistant
8000 Utopia Pkwy Crystal A. Kannankeril, M.S.
Jamaica , NY 11439 Department of Psychology
Ofc: 718-638-6451 Loyola College in Maryland
Email: bgreene203@aol.com 4501 N. Charles Street
Baltimore, MD 21210
George Stricker, Ph.D., 2003-2008
Email: Crystal.Kannankeril@gmail.com
Argosy University/Washington DC
Phone: (973) 670-4255
1550 Wilson Blvd., #610
Email: cakannankeril@loyola.edu
Arlington, VA 22209
Ofc: 703-247-2199 Fax: 301-598-2436
Email: geostricker@comcast.net

William Stiles, Ph.D., 2008-2011


Department of Psychology
Miami University
Oxford, OH 45056
Ofc: 513-529-2405 Fax: 513-529-2420
Email: stileswb@muohio.edu

PSYCHOTHERAPY BULLETIN
Psychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American Psychological
Association. Published four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designed to:
1) inform the membership of Division 29 about relevant events, awards, and professional opportunities; 2) provide
articles and commentary regarding the range of issues that are of interest to psychotherapy theorists, researchers,
practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions; and, 4)
facilitate opportunities for dialogue and collaboration among the diverse members of our association.
Contributors are invited to send articles (up to 2,250 words), interviews, commentaries, letters to the editor, and
announcements to Jenny Cornish, PhD, Editor, Psychotherapy Bulletin. Please note that Psychotherapy Bulletin does
not publish book reviews (these are published in Psychotherapy, the official journal of Division 29). All submis-
sions for Psychotherapy Bulletin should be sent electronically to jcornish@du.edu with the subject header line
Psychotherapy Bulletin; please ensure that articles conform to APA style. Deadlines for submission are as follows:
February 1 (#1); May 1 (#2); July 1 (#3); November 1 (#4). Past issues of Psychotherapy Bulletin may
be viewed at our website: www.divisionofpsychotherapy.org. Other inquiries regarding Psychotherapy Bulletin
(e.g., advertising) or Division 29 should be directed to Tracey Martin at the Division 29 Central Office
(assnmgmt1@cox.net or 602-363-9211).

DIVISION OF PSYCHOTHERAPY (29)


Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215
Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: assnmgmt1@cox.net
www.divisionofpsychotherapy.org
DIVISION OF PSYCHOTHERAPY
N O F P S Y C H O THE

American Psychological Association


O

RA P Y
D I V I SI

6557 E. Riverdale
Mesa, AZ 85215
29

ASSN.
AMER I

www.divisionofpsychotherapy.org
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