New England Psychologist - December 2018

PRSRT STD U.S. POSTAGE

PAID

PERMIT #22 Palmer, MA 01069

Change Service Requested P.O. Box 5464, Bradford, MA 01835

DECEMBER 2018

AN INDEPENDENT VOICE FOR THE REGION’S PSYCHOLOGISTS

Forensic psychologists bring psychological science to court

By Phyllis Hanlon elevision shows give the impression that forensics involves allure and excitement while specially trained professionals unravel subtle clues to track down serial killers. But those who are in the field of forensic psychology tell a different story.

Shannon Bader, Ph.D, ABPP, chief of forensic evaluations for the state of New Hampshire, dismissed the notion of “glamour” in relation to forensic psychology; rather she noted that she occasionally gives testimony in court, but spends a significant amount of time reading, interviewing, and writing reports.

Bader said that her religious background, in part, led her to this particular field where prisoners and those with mental illness are considered “the least of these” and are “double stigmatized.” She sought to listen and figure out how to help these individuals.

“I continually see people who have fallen through the cracks. They might have been in foster care or did not receive good mental health treatment early in life,” Bader said. “If something had gone right in the person’s life, would things be different?”

Bader works with adults in criminal court. “If a patient is arrested, I question the person’s capacity to move forward

“If something had gone right in the person’s life, would things be different?”

Shannon Bader, Ph.D., ABPP, chief of forensic evaluations, state of New Hampshire

in court. I work with people recently arrested or someone transitioning to the community from prison,” she said. “I don’t change the outcome but provide good information. I give the court a full picture of the person.”

While Bader finds her chosen profession rewarding, she reported that there are some challenges, particularly regarding safety, but also related to personal balance.

“I see a lot of ugly things and have to keep centered so I can function on a daily basis,” Bader said.

Like all psychology niche areas, forensic psychology requires extensive education and experience as well as specialized training.

“You have to have good training. The courts and attorneys expect you to know what you are talking about. You have to have supervision and experience,” Bader said.

The American Academy of Forensic Psychology (AAFP) offers solid in-depth training, according to Bader. “Training alone is not enough, but a good introduction. You still need experience,” she said.

Early in her career, Lisa M. Rocchio, Ph.D, owner of a group practice in Johnston, Rhode Island, had a number of patients who faced civil charges and/or were involved Continued on Page 10

Outreach program has team approach to assist children exposed to trauma

By Catherine Robertson Souter ealizing that more must be done to reach out to children who have witnessed traumatic events, representatives from several agencies joined in Manchester NH to craft a unique outreach program.

Launched two years ago, ACERT, or the Adverse Childhood Experiences Response

Team, has experienced some amazing results. Several times each week, a member of the Manchester Police Department, a crisis service advocate from the Manchester YWCA and a community health worker from the Manchester Community Health Center (MCHC) head out to knock on doors of homes where children were exposed to trauma.

The plan, said program founding partner Lara Quiro-

ga, MEd, director of strategic initiatives for children at the MCHC, is to provide information for adult caregivers about services for children.

“The highest number of calls are due to domestic incidents but we have also responded to overdoses, suicides or attempts, sexual assaults, pretty much any call where a child is exposed to trauma,” said Quiroga.

Continued on Page 11

VOL. 26, NO. 10

Report: Corrections agencies reduce solitary confinement use

By Janine Weisman he total number of people spending time alone in a U.S. prison or jail cell for an average of 22 hours or more per day for 15 continuous days is decreasing.

So is the number of those with serious mental illness (SMI).

That’s according to the most comprehensive study

2016 report titled “Aiming to Reduce Time-In-Cell.”

“These reports provide evidence that some jurisdictions are able to maintain safety and security with far less use of solitary confinement than they had in the past,” said Yale Law School Professor Judith Resnik.

Numerous studies have documented the physiologi-

“These reports provide evidence that some jurisdictions are able to maintain safety and security with far less use of solitary confinement than they had in the past.”

Judith Resnik, Yale Law School professor Massachusetts-New Hampshire

of national data on the number of prisoners in restrictive housing — or what is more commonly known as solitary confinement.

“Reforming Restrictive Housing,” released in October from the Association of State Correctional Administrators (ASCA) and the Arthur Liman Center for Public Interest Law at Yale Law School, estimated that 61,000 people were in isolation in prisons in the fall of 2017. Of that number, more than 4,000 were people with SMI. That’s compared to the 68,000 people counted in isolation in the fall of 2015, of whom 5,443 were people with SMI, according to the Liman Center and ASCA’s December

cal and psychological harms attributed to solitary confinement, from chronic headaches, extreme dizziness, heart palpitations, irregular digestion and drastic weight loss to increased risk of suicide, hallucinations, insomnia, paranoia, post-traumatic stress disorder and hypersensitivity to noise and touch.

The Liman Center sent surveys to the 50 states, the Federal Bureau of Prisons (FBOP), the District of Columbia, and four jail systems in large metropolitan areas.

The 43 prison systems that provided data on prisoners in restrictive housing held 80.6 percent of the nation’s prisContinued on Page 11

INSIDE

Wounded Warrior Project commits $160 million to expand program...............Page 7 Study finds a biomarker that may predict onset of psychosis ....................Page 12 CE listings.................................................Page 14

2

New England Psychologist

December 2018

Group Term Life Insurance Essential financial protection for the ones you love.

If you were to die prematurely, would you leave enough assets to ensure that your surviving family could avoid financial hardship? Affordable Trust Group Term Life Insurance* can ease their burden and continue to cover many of the expenses you covered so well in life.

Knowing your options not only gives you peace of mind; it is sound financial planning. Even if you have coverage, The Trust can help you decide whether you have enough to meet changing life needs... and whether you are currently paying too much.

Use our calculator to quickly estimate your premium, get insurance plan details, and instantly download everything you need to apply — all at trustinsurance.com.

Term coverage at affordable premiums: • Available to psychologists and related individuals, regardless of association membership.

• Great supplement to your existing or employer-provided coverage.

• Added protection during child-raising years.

• Includes Living Benefits, Disability Waiver of Premium, and options for Inflation Safeguard and Accidental Death and Dismemberment.

Watch the Q&A video What You Need to Know About Life Insurance at trustinsurance.com. *

Available in amounts up to $1,000,000. Coverage is individually medically underwritten. Policies issued by Liberty Life Assurance Company of Boston, a member of the Liberty Mutual Group. Plans have limitations and exclusions, and rates are based upon attained age at issue and increase in 5-year age brackets.

The ones you love 10.25x12.75.indd 1

www.trustinsurance.com 1-800-477-1200

2/6/17 9:24 AM

December 2018

New England Psychologist

3

Long-time columnist shares insight, experiences in new book They say that it’s best to write what you know and let the bigger truths come from the personal ones. When Alan Bodnar, PhD, began writing for this publication’s predecessor, Massachusetts Psychologist in 1993, the plan was to shine a light on the life of a practicing psychologist and his relationships with his clients at institutions where he worked.

Over the past 25 years, however, as hospitals and agencies shifted and expansion led to New England Psychologist, he discovered that his columns were helping him understand that he was talking about more than one professional’s experiences in and outside of the therapy room.

Dr. Bodnar compiled a sampling of these columns for a book, “Simply Human; Reflections on the Life We Share” (Bodnar, 2018). He found himself reflecting on how these small stories went beyond the therapist/patient relationship and beyond his own relationship with the world.

As he explained to New England Psychologist’s Catherine Robertson Souter, the book encapsulated a growing realization that his years of individual columns coalesced into a message that is both timely and timeless.

You retired in 2015 after 40 years working for the Commonwealth of Massachusetts. Tell us about the career you write about for New England Psychologist.

I finished my Ph.D at Boston University and did a year of post-doc at Children’s Hospital and Judge Baker Children’s Center. I worked in outpatient

children programs at the old Boston State Hospital and then at Solomon Carter Fuller Mental Health Center until 1990 when all the privatization of outpatient mental health services and closing of hospitals started.

In 1990, the outpatient clinic I was working for privatized so I moved to work with adults with major mental illness for about a year and then they privatized that.

I then had a chance to get back to working with kids at the Gaebler Children’s Center, the state’s only psychiatric hospital for children.

That lasted for about six months and then Gaebler was closed. So, there was a period of 18 months where I changed jobs about three times.

I wound up at Westborough State Hospital in October of 1992 and I was there for 18 years until it closed in 2010 and the whole department bumped into Worcester State Hospital where I was for the last five years of my career.

How did you begin to write your column?

As hospitals were privatizing around me, I observed what was happening with the patients feeling betrayed, abandoned, at sea.

I felt a connection with these folks because I had been working with them and I was also moving around. I kept a couple of cardboard boxes filled with things I needed in the trunk of my car. I saw a metaphor there and so I wrote an article [for the Massachusetts Psychological Association newsletter] called “The Important Things” about the things

we carry with us; the books, our papers, the materials we need to do our work.

But most of all, it is our memories, affections, what we have learned, and what I hope our patients would carry with them even in this period of disruption.

Denise Yocum, Ph.D, the former publisher of NEP, was just starting Massachusetts Psychologist and she contacted me and asked if I would write a column.

What was the column’s focus at first?

In the newsletter article, I wrote about the experience of being dislocated. I felt a small bridge of empathy with these people (and I say small because I am not equating my inconvenience with the life-altering disruptions that our patients went through).

Denise wanted me to expand upon that in my column. She suggested we call it “In person.” The idea was to give the reader an idea of what it is like to work in this kind of setting or what the lives of people who are being treated in long-term settings are like through eyes of a psychologist.

My column is often about being with patients and trying to understand what they are trying to communicate, what they are feeling, and helping them articulate it and make whatever changes they’d like to make in their lives.

While you do that, you also have your own life going on. So, when someone is telling me about their sadness because a friend is dying three months after my own father died, I am thinking about that, too.

And, you are monitoring your own feelings to see if any of these would be useful to share.

You are always figuring out what is going in the room and what is going on in your head and when I write the column, I am trying to communicate that to the reading audience.

Out of your 253 columns written in the past 25 years, you selected 66 for the book. Some are serious, some are humorous. Some detail interactions with patients and others with the world at large. Why these columns?

Do they resonate more strongly with your personal life?

Well, they all have something to do with my personal life because the point of my column is that it is through my own eyes, filtered through my life experiences. Maybe those are the ones where I think I have found the right words to communicate the bridge that connects my personal life with the experiences of the people I am writing about.

We all have those bridges that we need to make with one another and that we can make with one another by realizing that our experience isn’t unique.

One of the paradoxes of writing that I have learned is that the more personal you make your writing, the more universal the message. That is what I try to do.

I am not out to write a textbook about the way relationships develop between children and parents. I am about this is how it felt for me and this is what I

Q: What is the most cost effective way to recruit psychologists?

A: Place a help wanted ad in...

remember. I want you to read it and let it help you connect with how you experienced those same human universal moments.

I stress experience because I strive to write in a way that communicates how it feels to be in the situation and that prompts readers to be present to their own experiences in the same way.

The metaphor that captures what I try to do comes from something I learned from a philosophy professor in college: I don’t want to tell you what you will see when you look out the window. I want to bring you to the window so you can see for yourself.

What did you learn by putting this book together?

Well, my work has reinforced for me the idea that we are all really more alike than different, as Harry Stack Sullivan, the psychiatrist, famously said.

I wrote the book for the same reason I write the columns, to communicate that message to readers and not just as a message but as an experience that I had that will force them to think about their own experiences of connection with one another.

And (I mean) not just with family and friends, but with everyone with whom they come in contact. Lord knows in this world we are living in now, we need more of that. Not that my book will supply it, but it is the little bit I feel that I can do.

And it’s what we all need to find ways of doing.

It sounds corny, but just to make the world a better place. NEP

adverti s nepsy. ing@ com

4

New England Psychologist

IN PERSON

EDITORIAL

Home for the holidays

By Alan Bodnar, Ph.D n exile, the heart longs for home. You can hear the longing in the voice of the man from the other side of the world, who has been stuck in the hospital for a decade through a combination of mental illness and legal problems.

He recalls his childhood in a rural village and the spring where he filled a wooden bucket every day with fresh water for his family. That was long ago, and the world has changed.

The spring is still there, and it still draws people from throughout the region, but that is about the only thing that has remained the same.

Now, instead of using oaken buckets and carrying them on poles draped across their shoulders, people collect the water in plastic bottles that they haul up the hill to their waiting cars.

The man leans forward in his chair and shows you the photo on his cell phone.

It’s all there through a digital miracle that is yet another sign of change: the cars lining the road, people laden with water picking their way up the ravine, and more bottles lying in the dirt awaiting their turn to be filled and hauled.

This is the man’s home, and he longs to return, even if only for a visit, but his future is uncertain. For now, he has to be content with his FaceTime chats with his parents and siblings who keep him up to date on changes in the family.

These conversations are bittersweet for while they connect him with his loved ones for a brief time, they also remind him of the life he is missing. It’s especially hard during the holidays when the empty chair at the table is his own.

Stories like this one abound in a psychiatric hospital like ours, situated in a city that is itself part of an even larger population center. When people leave their homeland for the bright, shiny promise of a better life elsewhere, many of them still come to the United States in spite of our increasingly unwelcoming stance toward immigrants.

December 2018

And when their dream stalls and mental illness complicates their lives, they come or, more likely, are brought to us for help. When the nightly news reports stories of people anywhere in the world being displaced by war, famine, or natural disasters, it is not unusual for some of them to wind up on our doorstep.

We have experienced this situation with the survivors of Hurricane Katrina, the Lost Boys of Sudan, military and political functionaries from deposed regimes, and at least one member of a royal family in exile — all of them far from homes to which they cannot return, homes that no longer exist.

But you don’t have to come from a foreign country to which you cannot return or to be hospitalized for the treatment of mental illness to be separated from the place or the people that you call home.

Just try to book an airline ticket to your hometown on Thanksgiving or Christmas, and the inflated fares and crowded airports will remind you of the truth of the old crooners’ standby, “For the holidays, you can’t beat home sweet home.”

So, who are these people filling the airways and clogging the roads to get home, and what exactly do we mean by home anyway?

If you consider home the state of your birth or the town where you grew up, then 57 percent of us have never left according to a 2008 Pew Research Center survey based on the latest available statistics from the U.S. Census Bureau.

Thirty-seven percent of us still live in our hometowns and 20 percent of us remain in the states where we were born. Most of us who have left, 44 percent, moved for

better job or business opportunities, while most stayers remained because of family ties or because they thought their hometowns were good places to raise children.

The meaning of home is more complicated with respondents to the Pew survey defining home as the place they live now (26%), the place where they were born (22%), the place where their family comes from (18%), or the place where they went to high school (4%).

While the survey authors do not speculate on the reasoning behind these definitions of home, it doesn’t take much introspection to recall the way a visit to your hometown or perhaps a high school or college reunion can unlock a trove of memories and sense impressions that bring you back to the person you used to be and, in many respects, are still.

Even topography, what Annie Dillard calls “the dreaming memory of land as it lays this way and that,” shapes who we are and where we feel at home. And let’s not forget the “spirit of place” that can make a first-time visitor feel so much at home that he never leaves.

So we head home for the holidays or stay put if we are already there, responding to the tug of tradition or bonds of affection with family and friends. If circumstances prevent us from traveling or receiving our loved ones into our homes, we can connect as never before with the aid of digital technology.

It will never be enough, but perhaps there is yet another way home. I stumbled upon it in John Kaag’s new book, “Hiking with Nietzsche: On Becoming Who You Are,” in this quote by Hermann Hesse: “One never reaches home, but wherever friendly paths intersect the whole world looks like home for a time.”

Wherever we are for the holidays, may we never stray from those friendly paths for our own good and the good of all we meet along the way.

NEP

Alan Bodnar, Ph.D. is a psychologist formerly at the Worcester Recovery Center and Hospital.

Where is the leadership in Mass. compensation debate?

Psychologists in Massachusetts are letting down their fellow citizens, as more and more clinical psychologists refuse to accept traditional health insurance for payment. In an in-depth article in the Oct. 21, 2018 issue of the Boston Globe, Liz Kowalczyk details the challenges citizens in Massachusetts face in getting psychological care through their insurance provider or through the government’s Medicaid program.

The typical finger-pointing ensues in the article, with insurance companies and Medicaid claiming they are paying market rates ($72 for a 45-minute session) while trying to cut back on burdensome paperwork costs.

Psychologists and other therapists claim it’s still not enough, and the on-going need for justifying new blocks of therapy sessions to insurers is time-consuming and often frustrating.

But why is the Massachusetts Psychological Association silent on the issue? They appear to take no position on the matter, instead remaining on the sidelines while this debate plays out.

Nobody should be forced to provide services at a cost that doesn’t make financial sense to their own lives. The benefits of seeing patients who pay direct, cash out-of-pocket are hard to argue against.

However, shouldn’t there be a balance between a psychologist’s career goals and the needs of our fellow citizens and the local community in which we live?

If insurers aren’t paying what you think you’re worth, why do we not ban together as a group and demand higher reimbursement rates? And by the way, isn’t this a time where a state professional association should be leading the charge?

I don’t have any easy answers to this complex problem. But I do hope our state’s psychologist leaders work together to find one where psychologists are justly compensated for their services.

We need a solution that allows them to provide those services through the most common way people seek out their health and mental health care — through their health insurance plans.

By John M. Grohol, Psy.D.

Publisher:

Editor-in-Chief:

Contributing Writers:

Graphic Designer:

John M. Grohol, Psy.D. Psych Central Susan Gonsalves Alan Bodnar, Ph.D. Phyllis Hanlon Catherine Robertson Souter Margarita Tartakovsky, MS Eileen Weber Janine Weisman Karen H. Woodward

New England Psychologist is published 11 times a year (no August issue) by New England Psychologist, P.O. Box 5464, Bradford, MA 01835. It is mailed at no charge to all CT, ME, MA, NH, RI, and VT licensed psychologists. Distribution of this publication does not constitute an endorsement of products and services. The publisher reserves the right to reject any advertisement or listing considered inappropriate.

New England Psychologist accepts unsolicited articles, press releases and other materials for consideration as editorial items. Photographs will not be returned unless requested.

New England Psychologist assumes no responsibility for mistakes in advertisements, but will reprint that part of the advertisement that is incorrect if notice is given within 10 days of publication.

Reproduction of any part of this publication by any means without permission is prohibited. Back issues of New England Psychologist may be obtained by sending payment of $25.00 along with name and address to:

New England Psychologist P.O. Box 5464 Bradford, MA 01835 Tel. 978-225-3082 www.nePsy.com

December 2018

New England Psychologist

5

BOOK REVIEW

Book sheds light on doctor distress

By Claire Nana t’s difficult to imagine having someone’s life in your hands.

It’s also hard to imagine what could possibly prepare a person for the emotional cost of such an endeavor as an occupation.

And we often don’t. “Much of what we require doctors to do is shielded in secrecy,” writes Caroline Elton.

However, their stories need to be told. “As a psychologist, I saw how medical training often fails to acknowledge that doctors are people too, with their own thoughts, feelings, fantasies, and desires,” writes Elton.

In her book, “Also Human: The Inner Lives of Doctors,” Elton takes us inside the world of medicine, sharing the emotional complexity, suffering, and the impossibility of balancing competing human and professional demands.

Elton points to the New York University dean’s response after a final-year medical student jumped to her death: “Referring to research from the Mayo Clinic, he described a “national epidemic of burnout, depression, and suicide among medical students.”

Uncertainty, unimaginable challenges, and a turnstile that never stops demanding ever more perfection often results in long hours, work related anxiety, and despair at a clinical load that is well beyond

against the imposition of a new working contract.”

For Elton, a psychologist who has spent years working with doctors, being at the “edge” is all too familiar.

The first Wednesday in

“Also Human: The Inner Lives of Doctors”

By Caroline Elton Basic Books June 2018

saturation point.

Elton describes the tragic death of Rose Polge, a junior doctor in the UK who walked into the sea and drowned: “This tragedy received widespread newspaper coverage at least in part because it occurred when junior doctors had taken the unprecedented step of going on strike — the first in 40 years — in protest

August — the day when all first-year doctors start work — is just one example.

For Hilary, one of Elton’s patients, it also happened to be the day when she was left alone on her ward, with no supervising consultant to turn to while treating a patient that appeared to be dying — an experience that colored her feelings about her profession

positioned Riggs well for the future.

Speaking about his new role, Plakun said, “I am deeply honored and excited to take on the leadership of an institution to whose work and mission I feel so wholly committed.”

In addition to his long professional career at the Austen Riggs Center, where he oversaw development of the continuum of care and served most recently as associate medical director, Plakun is also a leader in organized psychiatry and psychoanalysis and author of more than 50 publications.

He is a member of several journal editorial boards, and a past member of the Harvard clinical faculty.

In addition, he is a member of the American Psychiatric Association (APA) Board of Trustees representing New England and Eastern Canada.

Plakun has been honored as the Outstanding Psychiatrist in Clinical Psychiatry by the Massachusetts Psychiatric Society and by the American Psychoanalytic Association.

even 10 years later.

The transition from medical student to doctor is particularly fraught with challenges.

Students may excel academically while scoring poorly on their Situational Judgment Test (SJT), which often plays a role in determining their final placement, meaning they may end up living in a part of the country where they know no one.

Aside from judgment, medical students’ mental health is highly scrutinized and receiving a formal diagnosis (of depression for example) can mean being singled out as weaker and vulnerable.

The question Elton asks is: “What does the fact that it is nearly impossible to declare a history of previous psychological difficulties say about medical school culture?”

A major international review of 54 previous studies involving 17,000 physicians in training was published in the Journal of the American Medical Association.

It found that the extent of depressive symptoms in trainee doctors was extraordinarily high. An accompanying editorial argued that there is a fundamental mismatch between

the system of training for doctors and the current practice of medicine.

“Death, dying, distress, and disease are inescapable components of a doctor’s work,” writes Elton.

Psychological stress such as this often overwhelms our capacity, and yet the medical profession seems to give little attention to how to detect psychological stress, exhaustion, or overload.

One example Elton notes is certifying the death of a baby.

She writes, “A list of instructions is ideal for putting together a piece of furniture or guiding one through a new recipe, but it doesn’t begin to address the emotional complexities of certifying the death of a baby.”

Doctors often want to satisfy the expectations of their families and avoid their disappointment while also struggling with the desire to remove themselves from the burden of clinical responsibility.

And yet, as Elton writes, “There’s not a single study in a medical journal that describes how doctors can be pulled in two directions simultaneously.” NEP

of psychiatry at Harvard Medical School.

McLean OnTrack is a longterm outpatient program for adults 18 to 30 that specializes in the early recognition and treatment of schizophrenia and bipolar spectrum disorders and related conditions.

Lewandowski earned a bachelor’s degree in psychology from the University of Texas, graduated from the University of North Carolina with a Ph.D in clinical psychology, and completed her psychology internship post-doctoral work at McLean Hospital and Harvard Medical School.

She received her award at the annual Cognitive Remediation in Psychiatry conference held in New York City. NEP

your promotions, appointments, retirements and awards by sending an email to editor@nepsy. com. Please include the name and phone number of a contact person for verification and/or more information.

MILESTONES Eric Plakum named medical director/CEO at Austen Riggs Center Eric M. Plakum, MD has been appointed medical director/CEO of the Austen Riggs Center in Stockbridge, Mass.

Chair of the Austen Riggs Center Board of Trustees Lisa Raskin, Ph.D, said, “We are thrilled that Eric will be taking up the role of medical director/CEO. His unwavering commitment to the Center and demonstrated leadership throughout his distinguished career have helped to make Riggs what it is today.”

Former Medical Director/ CEO Andrew J. Gerber, MD, Ph.D, will be pursing another professional opportunity. Dr. Gerber, who joined the Riggs staff in 2015, was instrumental in establishing several strategic initiatives in areas including human development and suicide research and education, all of which have

Kathryn Eve Lewandowski, Ph.D. honored for cognitive remediation work Earlier this year, McLean Hospital’s Kathryn Eve Lewandowski, Ph.D. was recognized for her work in the field of cognitive remediation with the 2018 Science to Practice Award.

Created in 2013, the award is given annually to “individuals who have done exemplary work taking cognitive remediation from the research lab to the clinical practice setting.”

Lewandowski is director of clinical programming for the McLean OnTrackTM first-episode psychotic disorder clinic and an assistant professor of psychology in the department

New England Psychologist welcomes submissions of news items for this column from all of the New England states in our circulation area. Tell us about

For your surfing pleasure is available online at

6

New England Psychologist

December 2018

THE PRACTICAL PRACTICE

Networking still relies on personal interaction

By Catherine Robertson Souter etworking once meant going golfing with the sales team or chatting with local bank executives at a Chamber of Commerce event. But how has it changed in the technological age?

In many ways, it hasn’t.

While there are countless options for on-line networking through apps like “Linked-In,” a good old-fashioned handshake and shared lunch should never be overlooked.

“I think maybe early career psychologists and graduate students especially are missing out on going to conferences and networking events in person,” said Jacquelyn M. Reinert, Psy.D., LMHC, member-at-large for the New Hampshire Psychological Association Board of Directors.

“A lot of people rely on social media to bridge the gap but for me [meeting face-toface] is invaluable.”

Networking is not just about building your practice by selling yourself but also about building a community you can turn to for referrals or consultation or support.

Depending on your role, networking can also be a way to increase your knowledge base or awareness of new research, techniques, or advocacy issues.

“I find networking through professional organizations keeps me up on the latest issues facing our profession such as the EPPP-2, APA’s move to accredit psychology master’s degree programs, prescription privileges for psychologists, and the status of the interstate compact for telehealth and temporary practice across state lines,” said Anne Klee, Ph.D., president of the Connecticut Psychological Association.

“These are hot topics affecting our discipline and networking at professional events allows us to take the pulse of our colleagues and voice our questions and concerns.”

Building bonds with professionals, both in and outside of the world of psychology, can also be beneficial on a more personal level.

“In private practice, seeing clients one after another can be isolating,” said Ralph P. Balducci, Ph.D, regional director for the Connecticut Psychological Association.

“It’s important to foster your professional identity as a psychologist especially if you are working in private practice. It almost always leads to business but also it is important for that personal connection.”

For some people, chatting with strangers, finding common bonds, following up with an invite to lunch and checking in regularly may be second nature. For others,

walking into a party or conference alone, with just a stack of business cards to keep you company, can feel overwhelming.

Good networking is a soft skill, one that can be hard to quantify — but it can also be something you use all the time with everyone you meet and everywhere you go. Just by being the person a therapist

mother told you in middle school: look up, smile, ask questions, listen to the answer, and dress appropriately to make a good impression.

Bring that stack of business cards but don’t just hand them out to everyone you meet.

Focus instead on making connections before sharing contact information. Practice an elevator pitch — being able

“A lot of people rely on social media to bridge the gap but for me [meeting face-to-face] is invaluable.”

Jacquelyn M. Reinert, Psy.D., LMHC Board of directors, NH Psychological Association should be — someone who listens, someone who is open, concerned and patient, you are building your practice.

Those who know you may not need to come in. But chances are they will refer someone else down the line.

There are skills you can, of course, learn rather easily.

Many are the same ones your

to sum up what you do in 30 seconds, one minute and five minutes to get your message across quickly.

It’s important to follow up, said Balducci. He prefers hand-written notes, referencing the conversation and making a suggestion for future contact opportunities. He takes the time weekly to keep

his contacts current and to get out of the office.

Reinart said the first place to network is through professional associations because that is one of the groups’ main functions.

Universities may also host talks that provide social time or discussion groups. Making connections with people outside the mental health field can help in other ways, both with a better understanding of your own community and by explaining to them what you offer as they may need a referral at some point.

Look to your local chamber of commerce or Better Business Bureau for a listing of upcoming events.

Finally, try creating your own opportunities for networking. Invite colleagues to lunch and ask them to bring someone you have not met.

Bring in a speaker to your local library or a public space and invite professionals in your area. Be sure to include social time for attendees to network, of course. And, as Balducci pointed out, food is never a bad idea. NEP Catherine Robertson Souter is a freelance writer and social media agent based in New Hampshire. A contributor to New England Psychologist since its inception, she previously wrote for Massachusetts Psychologist among other media outlets.

Secondary trauma and the holidays for therapists

By Marie HartwellWalker, Ed.D or many of our patients with a history of trauma, the holidays stir up difficult memories and dashed hopes for the family that might have been – and wasn’t – and isn’t.

Pain they thought they were managing comes back anew because of idealistic and nostalgic holiday TV shows, music, and advertising. They come to us for support, solace, and review of the skills they are working so hard to master; skills that let them cope with their past and sustain a better present.

From the run up to Thanksgiving well into the post-holiday months of January and

February, the increased reactivity of patients puts additional stress on any clinician.

It is particularly difficult for therapists who have a personal history of abuse. If we don’t prepare for it, it can catch us unaware.

Secondary trauma is indirect experience of others’ traumatic material. Regular and repeated exposure can result in PTSD-like symptoms for the listener.

Some studies have shown that up to 15 to 39 percent of clinicians who are regularly exposed to client trauma material experience secondary trauma.

Further, the greater the percentage of survivors in a therapist’s caseload, the greater the number of reported secondary

trauma symptoms. That’s a reality throughout the year.

Are therapists more vulnerable during the winter months? I was unable to find studies that measure whether secondary trauma increases for therapists during the holidays.

I can tell you anecdotally from my experience as a supervisor in a large clinic that I found the greater number of patients going into crisis during the winter was hard on my staff.

If this is true for you, it is wise to take some time to think about how to take care of yourself over the next few months.

Factors that have been found to make therapists more vulnerable to secondary trau-

ma are insufficient self-care, inadequate training, an overwhelming or hostile workplace, and not having enough social support.

During the holidays, it’s particularly important that we pay attention to these stressors.

Self-Care While self-care is always important, it is particularly so during the winter holidays if your caseload has a high percentage of trauma survivors. It is even more essential if your own history of trauma may be triggered.

• Be more mindful than usual about the basics. Get seven to eight hours of sleep every night. Get outside and active – preferably every

day. Eat sensibly.

• Take care of your mental health. If you are being triggered, get back into therapy for yourself.

• Use your vacation days.

You need and deserve time off. Instead or (or in addition to) a week-long break, consider spreading vacation days out so you have threeor four-day work weeks.

Training Are you over your head with some of your clients?

Did you accept some patients you aren’t really prepared for because you needed to fill your productivity requirements? The holiday season is not the time to stress yourself Continued on Page 12

December 2018

New England Psychologist

7

Wounded Warrior Project commits $160 million to expand program

By Eileen Weber n November 7 in Thousand Oaks, Calif., a gunman walked into a bar and killed 11 people and himself. The 28-year-old suspect was a former Marine and it appears he may have suffered from post-traumatic stress disorder (PTSD).

As horrific as that incident is, it emphasizes the need veterans have when it comes to mental health care. One in three veterans suffers from some form of PTSD and more than 4,000 service members were diagnosed with traumatic brain injury (TBI) in the first quarter of this year alone, according to the Defense and Veterans Brain Injury Center.

The Wounded Warrior Project (WWP) has been helping veterans in a number of ways to assimilate back into civilian life. The Florida-based organization announced in October it will be committing $160 million over the next five years to expand its program for those suffering from PTSD and TBI. The Warrior Care Network (WCN), WWP’s healthcare system of PTSD treatment centers, would break out the funds accordingly: $65 mil-

lion to Massachusetts General Hospital in Boston; $45 million to the Rush University Medical Center in Chicago: $25 million to Emory Healthcare in Atlanta; and $20 million to “Operation Mend” at UCLA Health in Los Angeles.

An additional $5 million would go to pilot projects in

physical healthcare and even career counseling. While many veterans also benefit from the Department of Veteran Affairs (VA), WWP supplements that care as an additional stop-gap.

Lt. Gen (Ret.) Mike Linnington, the organization’s CEO, put it this way.

“We’re not trying to replace

“We reach out to the vets who need help. If we take care of our warriors and their families, it’s a long-term sustainable process.”

Lt. Gen (Ret.) Mike Linnington, CEO, Wounded Warrior Project

Boston and Chicago. These funds will not only supply the two- and three-week courses in the program, but also enhance the existing facilities.

Veterans will receive this level of care free of charge.

Originally delivering backpacks bedside to injured veterans, WWP has developed a broad range of mental and

the VA. We’re a gap filler for what the VA provides,” he said. “We reach out to the vets who need help. If we take care of our warriors and their families, it’s a long-term sustainable process.”

Mike Richardson, vice president of Independence Services and Mental Health at WWP, echoed Linnington’s

CT & MA remain skeptical of need for assisted outpatient treatment

By Phyllis Hanlon orty-seven states in the country have implemented assisted outpatient treatment (AOT) legislation, aka outpatient civil commitment. Maryland, Connecticut, and Massachusetts are the only holdouts but the Treatment Advocacy Center (TAC) is hoping to convince these states to join the rest of the nation.

Frankie Berger, advocacy director at TAC, explained that AOT is somewhat misunderstood because of the way it is structured. “It’s the same outpatient behavioral mental health that is given, [but] without a court order,” she said.

Under AOT a judge orders adults with severe mental illness with a history of non-compliance, repeated hospitalizations or arrest to undergo outpatient treatment; the community, in turn, is committed to delivering those services to the patient.

“It’s not about punishing.

It’s about care,” Berger said.

Connecticut has well-funded mental health services and delivery processes for people who voluntarily seek treatment. “But there is no court supervision for those who

have no insight into their condition,” Berger said. “They are effectively locked out of access to getting good care.”

Both Massachusetts and Connecticut have the oldest law structure in the country

point how closely the WCN works with the VA. “In almost every single case, a warrior will have a two- to three-week course and then follow up with the VA,” he explained. “This gives the best result.”

Richardson added that the intensive program is a lot like being back in the military. Veterans start their day early with some form of physical activity and it’s non-stop from there.

Anchored in evidenced-based therapy, the intense treatment isn’t solely self-focused. Family members are included.

“The group holds each other accountable,” he said.

“Everything from wellness and nutrition to therapy — all of it gets jammed in.”

Karter Elliott, a former Marine who lives in Florida, finished his course at Massachusetts General Hospital in September. After several tours in Iraq and Afghanistan, he suffered traumatic events that influenced how he reacted to minor issues.

If he was woken from sleep, he would “freak out.” He had to find the exit in a building or a restaurant, never keeping his back to it. He slept with his gun.

Elliott had PTSD. He and his wife decided it was time to seek help.

“I became so numb to it I didn’t even realize how much it bothered me,” he said. “It carried over dramatically into every aspect of my life. My only regret is that I waited so long to go.”

Addressing his struggles head on made a huge difference. He said the best part was actually seeing the progress not just in himself but in other veterans.

Linnington noted the expansion of this program is because of people like Elliott.

He said the response was “off the charts positive.” While it started as a three-year pilot program, it wasn’t as intensive.

Over time, it became clear an expansion was necessary.

“This program has a 96% satisfaction rate,” he said.

“That’s unprecedented!” NEP

and Berger respects the practices that are working in those states.

But she said that without AOT, there are two options: inpatient treatment in a restrictive setting or incarceration if the person begins acting dangerously. It’s less restrictive and more humane to deliver court-supervised community treatment, she said.

Diana Lejardi, public information officer for the Connecticut Department of Mental Health and Addiction Services (DMHAS), noted that her state already has a robust mental health addiction services system, as well as laws that allow involuntary commitment to a hospital when community treatment won’t help.

Eileen Weber has been a freelance writer for several years with a master’s degree in journalism and a professional background in publishing.

Based in Fairfield, Conn., she has written numerous articles for magazines, newspapers, and web sites.

Continued on Page 13

Legal Advice for Psychologists

Please contact Attorney Kerstein at 617- 965-9698.

60 Walnut Street, Wellesley, MA 02481

We provide legal counsel in the following areas: • Licensing Board Complaints • MassPRO Medical Audits • Professional Liability • Patient Confidentiality • Provider Agreements • Medicare Compliance • Partnerships / Corporations • Malpractice Defense • Employment Contracts • Family Law • Trusts & Estates • Civil / Criminal Litigation

Attorney Milton L. Kerstein of Kerstein, Coren & Lichtenstein, LLP provides legal services to psychologists and other mental health professionals.

We offer quality legal services in a caring and confidential environment.

FREE CONSULTATION! As a service to the readers of New England Psychologist, we offer one FREE fifteen-minute consultation to discuss any general legal concerns you may have.

8

New England Psychologist

December 2018

Connecticut ranks high on study of psychopathy by location

By Susan Gonsalves ashington D.C. has the highest number of psychopaths, according to a nation-wide study. But Connecticut ranked second overall and first per capita.

The research, conducted by Ryan Murphy, Ph.D., research assistant professor at Southern Methodist University, also showed the states with the most psychopaths were clustered in the Northeast and Mid-Atlantic regions.

Murphy said that he expanded on research that argued in favor of mapping psychopathy to the Big Five personality traits (extraversion, neuroticism, agreeableness, conscientiousness and openness to experience).

His study “Psychopathy by U.S. State” used a sample of 1.6 million people across the

country and calculated how frequently they exhibited the personality traits.

In addition to D.C. and Connecticut, the top five includes California, New Jersey and New York and Wyoming, tied for fourth.

The states with the least amount of psychopathy in the study were West Virginia, Vermont, Tennessee, North Carolina, and New Mexico.

Maine landed in seventh place while Massachusetts was 15th, Rhode Island, 29th, and New Hampshire, 39th.

“To my knowledge, it’s the first estimate of psychopathy for each individual U.S. state,” Murphy said. “The methodology would make it possible to measure each state over multiple years because the Big Five personality tests are quite common.”

Murphy said that D.C.’s ranking could be explained

by either its high population density or by the type of person attracted to high-powered positions.

He said what surprised him most about the results was that D.C. was such “an extreme outlier.” Its standardized psychopath score of 3.48 was almost double Connecticut’s 1.89.

Murphy also was surprised that the measure showed a close relationship with the percentage of the state’s population living in an urban area, but not with the murder rate.

“Both are predicted in some sense by theory but I would have thought the murder rate would have been the one of the two to have a close relationship,” he said.

Previous research published in the Journal of Personality and Social Psychology divided the country into sections. The western U.S. was considered to be relaxed and creative, the Midwest classified as friendly and conventional and the mid-Atlantic and northeast

called temperamental and uninhibited.

John Huber, Psy.D. describes the study as “kind of a letdown” and said he doesn’t buy into stereotyping regions (i.e. southern hospitality vs. hostile New Yorkers, for example).

Also based in Texas, Huber is a clinical forensic psychologist who has appeared on more than 300 radio, 30 national TV programs, and is host of “Mainstream Mental Health Radio,” which is broadcast nationally.

The study is flawed, he believes, because the wrong tools were used. Huber noted that he thinks the Hare PCL would be a more appropriate measure.

“I don’t think we can specifically say just because you live in one geographic area that you are more likely to be a psychopath,” Huber said, noting that he goes in the courtroom and works with true psychopaths.

“If I was in D.C. or

Connecticut, I wouldn’t say, ‘oh, my goodness, there are psychopaths all around me.’

There are psychopaths around everybody...all of the time,” he said.

Huber added every person has felt offended or angry enough to commit violence but most are able to restrain themselves. For some people, though, “all the dominoes line up and they react in a lethal manner.”

On the positive side, the study generated a lot of discussion and got people talking about mental health issues who may not have otherwise, he said.

Huber, chairman of the non-profit, Mainstream Mental Health, said that any attention that can “de-mystify” some of the beliefs people have about mental health is important.

Murphy feels his study is important in another way.

“It is a small contribution to geographic psychology, which is a growing field,” he said. NEP

Judge Rotenberg Center continues controversial skin shocks treatment TWO PROGRAMS, ONE STANDARD OF EXCELLENCE THE CENTER FOR BEHAVIOR DEVELOPMENT • Autism • Severe Maladaptive Behavior • Dual Diagnosis of Mental illness/Intellectual Disability/Traumatic Brain injury • Postraumatic Stress Disorder • Physical Disability • Ages 6-21 THE CENTER FOR BASIC SKILLS • Autism • Intellectual Disability • Physical Disability • Sensory Impairments • Medical Needs • Ages 6-21 For over 30 years, Evergreen Center has provided living and learning environments for persons with autism and intellectual and developmental disabilities including physical disabilities, behavior disorders and complex health needs. Evergreen Center offers a highly competitive salary commensurate with local and national standards, an excellent benefit package, a retirement plan with company contribution, and tuition support/educational loan repayment programs.

r Ca

thr in g

ough Compe

ten

ce

For More Information Contact The Director Of Family Services & Admissions Evergreen Center Inc., 345 Fortune Boulevard, Milford, MA 01757 Phone: (508) 478-2631 • Email: Services@evergreenctr.org www.evergreenctr.org Equal Opportunity Employer Our Partners in Education Masters Degree or Post Masters BCBA Course SEQUENCE

Masters Degree in Education Cambridge College.edu

By Janine Weisman t’s not clear when the U.S. Food and Drug Administration (FDA) will issue a final ban — if at all — on electrical stimulation devices for treating self-injurious and aggressive behaviors.

But there is no doubt about how firmly a Massachusetts school embraces using a device to deliver either 15.25 or 44 millilamps of electric current to the arms or legs of individuals with intellectual disability and autism, many of whom also have psychiatric disorders.

Skin shocks — not to be confused with the voluntary depression treatment known as electroconvulsive therapy (ECT) — are designed to make a patient stop an undesirable behavior by causing them to associate it with pain.

Contingent skin shock delivered via a Graduated Electronic Decelerator (GED) “has changed the lives of those that have been approved for its use,” said Glenda P. Crookes, executive director of the Judge Rotenberg Educational Center in Canton in an email to New England Psychologist.

JRC contends that a 1987 consent decree gives it the

permanent right to use GED shock treatment as an aversion therapy on patients so long as an individual’s treatment plan is reviewed by a probate court.

Before that court approval, JRC clients were restrained and overmedicated but now cases of extreme aggression and severe self-harming behaviors at the residential facility are rare, Crookes said.

“These clients are now free of medication and restraint and have access to things that they had not been possible previously,” Crookes wrote.

“They are living in the community, getting an education, visiting with their families, working, volunteering, etc.”

Massachusetts Probate Court Katherine A. Field agrees with JRC, which appears to be the only facility in the country that uses GEDs for this population.

In a June 20 ruling, Field denied a 2013 petition by the Executive Office of Health and Human Services to terminate the consent decree and regulate JRC like any other provider DDS oversees in Massachusetts.

The case was argued over 44 days between October 2015 and October 2016 with 788 documents, photographs

and videos and testimony from nearly 30 witnesses.

Massachusetts Attorney General Maura Healey’s office has appealed Field’s decision on behalf of the commissioners of DDS and the Department of Early Education and Care.

Even though the prevailing wisdom among those who work with clients with autism and intellectual disabilities has moved toward positive behavioral interventions and support, Field found that the state failed to show professional consensus that skin shocks breach the accepted standard of care.

In her 50-page decision reviewing findings of fact, Field cited JRC data that showed a reduction in the average monthly occurrence of aggressive behaviors from 457.52 pre-GED to 7.99 after.

Field also cited “credible testimony” from several former clients and parents who credited skin shocks with a significant improvement in their behavior.

The judge acknowledged expert testimony regarding the developments in psychoContinued on Page 9

December 2018

New England Psychologist

9

Global mental health crisis to cost trillions by 2030

By Eileen Weber n October, a report published in The Lancet warned that if the current mental health crisis continues, it could cost as much as $16 trillion globally by 2030. That may seem like an astronomical number. But as Shekhar Saxena, MD, FRCPsych, DAB, MRC, Psych, a lead co-author of the report explained, the total is a combination of direct and indirect costs.

“The direct cost is the actual management of the disorder and the indirect is the opportunities lost by those living with the illness,” he said. “For example, they might not be able to work. It’s calculating the money they might have earned. It’s this indirect cost that is so high.”

Vikram Patel, MBBS, Ph.D, professor of global health and social medicine at Harvard University and co-author with Saxena, acknowledged the

“As far as mental health is concerned, every country, in my view, is a developing country.”

Vikram Patel, MBBS, Ph.D, professor of global health and social medicine, Harvard University

Skin shocks treatment Continued from Page 8 tropic medications that were unavailable before the consent decree took effect. While Field said JRC might want to review whether such drugs should warrant a revision of its policies, she said there was no evidence at the hearing that they would be more effective than the current aversive treatment.

“In addition, psychotropic drugs have the potential for side effects, some of which can be quite serious,” Field wrote.

Field cited the American Psychological Association Division 33 guidelines allowing for the use of highly restrictive or aversive procedures “only in instances in which there is an immediate physical danger to self or others, or there may be permanent sensory of other physical impairment, or the client may be prevented from receiving necessary medical, surgical, or emergency medical services, or the frequency or intensity of the problematic behavior prevents adequate participation in normal activities appropriate for the individual’s circum-

stances and personal goals.”

Also cited was an Association for Behavior Analysis textbook that deemed mild electric shock as an effective and efficient means of reducing self-injurious behaviors.

There was conflicting testimony at the hearing over the degree of pain experienced

by JRC clients who received a two-second skin shock from a GED. Some experts described the shocks as extremely painful.

The mother of one client and a physician who is the father of another client “both testified that the shock hurt but was brief,” according to Field’s decision.

Field’s decision makes no acknowledgement of a proposed ban by the FDA on electrical stimulation devices.

The proposed ban published in April 2016 would apply to new devices and those already in use and indicates the federal agency “has determined that these devices present an unreasonable and substantial risk of illness or injury that cannot be corrected or eliminated by labeling.”

high cost of care was surprising and noted that the age of onset makes a big difference in functionality.

“The loss of work opportunity is different for someone with a mental illness than someone with another type of disease,” said Patel. “You’re going to have far fewer working years if something hits you in your twenties as opposed to someone who gets diabetes in their fifties.”

The report also found that in many countries, the mentally ill often suffer violations of their human rights – incarceration and torture are just two examples. Bringing attention to these kinds of abuse and discrimination is a key factor in proper treatment.

“One important recommendation is to look at mental health as more comprehensive,” noted Saxena. “Mental health involves all of us. We need to be focused on what can be done rather than on what should have been done.”

Mental health disorders have been on the rise around the world for more than two decades. According to statistics from the World Health Organization, millions of peoThe proposed ban indicates the FDA determined that individuals subjected to skin shocks experience varying degrees of pain and the potential for burns, ulcers, anxiety, panic, depression, and undesired self-restraint.

The FDA also found that assessing the psychological adverse effects of skin shocks on people with intellectual and developmental disabilities is difficult because of their diminished ability to communicate.

FDA Commissioner Scott Gottlieb acknowledged the proposed final ban was still a priority in an Oct. 17 post on the agency’s website. FDA bans devices only on rare occasions when deemed necessary to protect public health.

“We believe these products present an unreasonable and substantial risk to public health that cannot be corrected or eliminated through changes to the labeling,” Gottlieb stated.

But when will the final ban finally happen?

FDA spokeswoman Sandy Walsh said: “The FDA is still in the process of finalizing the rule and we cannot speculate on timing.” NEP

ple around the world have mental disorders with as many as 300 million suffering from depression alone.

And as the population increases and ages, the probability of mental health issues like depression, anxiety, and dementia also rises.

But as Patel points out, healthcare systems have not adequately responded to global mental health needs. There is a significant gap between the care that’s required and the care that’s received. The mentally ill receive no treatment up to 85 percent of the time in low-income countries while high-income countries can be as much as 50 percent.

“The disparities are huge,” he said. “As far as mental health is concerned, every country, in my view, is a developing country.”

For this report, close to 30 experts in psychiatry, pub-

lic health, neuroscience, and other related fields gave several recommendations, most importantly, in reframing how we look at mental health.

They felt strongly it should be a community effort with friends, family, and colleagues — not just a clinical one. Seeing it as more of a global public good and less of a biomedical issue could make all the difference in treating mental disorders in the future.

“What is the matter with the person,” said Patel, “is different than what matters to the person.” NEP Eileen Weber has been a freelance writer for several years with a master’s degree in journalism and a professional background in publishing.

Based in Fairfield, Conn., she has written numerous articles for magazines, newspapers, and web sites.

Experience Quality Trainings in the Application of EMDR Therapy A two part course offering 40 CE Credits • Effective and efficient treatment for trauma and other adverse life experiences • Empirically validated in over 24 randomized studies • Recommended in both domestic and international treatment guidelines • Recommended by the World Health Organization for the treatment of PTSD in children, adolescents, and adults

● Tampa FL Feb 22-24, 2019 Jun 21-23, 2019 ● Portland ME Mar 1-3, 2019 Jul 12-14, 2019 ● Charlotte NC Mar 22-24, 2019 Jul 26-28, 2019 ● Philadelphia PA Apr 12-14, 2019 Aug 9-11 , 2019 ● Jacksonville FL May 17-19, 2019 Oct 18-20, 2019

Visit www.emdr.com for further information, domestic & International schedules, research, referrals & media publications 40 CE Credits

The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing.

Bessel van der Kolk, MD Boston University School of Medicine EMDR Institute Inc PO Box 750 ● Watsonville ● CA 95077 831-761-1040 ● www.emdr.com

10

New England Psychologist

December 2018

Forensic psychologists bring psychological science to court Continued from Page 1 in criminal litigation, which led her into forensic psychology.

“The area of trauma psychology lends itself to legal involvements,” she said. Roc-

relied on her grounding in psychological assessment and testing. However, she still had to learn specific language, methods, rules of process, and boundaries.

In addition to her role as a forensic psychologist, Rocchio maintains a clinical practice

“I bring psychological science to the jury, judge, and attorney.”

Lisa M. Rocchio, Ph.D,, council representative, Rhode Island Psychological Association chio is APA council representative for the Rhode Island Psychological Association and treasurer, Division 56, Trauma Psychology.

This work taught Rocchio about the legal system and how it endorses issues related to violence against women and violence in general.

During her first few cases, Rocchio consulted with an experienced colleague and

that draws on distinctly different skills. “But each [role] informs my work in the other,” she noted.

Rocchio treats older adolescents and adults in her private practice where she works to establish treatment goals on behalf of the client. She uses a strength-based approach in helping patients make connections between past experience and current difficulties with a

focus on improving function.

On the forensic side, Rocchio’s client is the attorney.

“My job is to provide answers to psycho-legal questions and be objective. I work for either the plaintiff or the defense.”

Rocchio reviews extensive third-party information, conducts evaluations and gives the court her opinion.

In her clinical practice, Rocchio meets with clients for an hour on a regular basis, but the forensic work involves intensive eight to twelve-hour interviews with the person over a couple of days.

The forensic work gives Rocchio a sense of satisfaction at being able to assist the legal system in terms of understanding complex psychological issues.

“I bring psychological science to the jury, judge, and attorney,” she said.

Forensic work can be draining so it’s important to maintain a balance in your personal life, according to Rocchio.

When you are also juggling a clinical practice, it becomes imperative to “reconnect with things that give you pleasure.”

She said, “At its core trauma challenges your sense of hopefulness and meaning in life.”

Psychologists contemplating a career in forensic psychology should be sure to have a firm foundation in psychological assessment, be comfortable with the legal

career aligns with their vision, said Maney.

Schooling can involve various paths and forensic psychologists must have a doctoral degree and be licensed.

Some states have specific requirements as well.

For instance, in Massachusetts, psychologists who want to serve as a public sector forensic psychologist must obtain certification as a Designated Forensic Psychologist (DFP).

Furthermore, forensic psychologists can become board certified in 15 specialty areas by the American Board of Professional Psychology (ABPP) after extensive experience and passing an exam.

Maney emphasized that the journey is lengthy with many years of schooling, training, doctoral and fellowship programs.

“There are lots of steps along the way, but in the end it’s worth it,” she said, noting that every day brings new and exciting challenges. NEP Phyllis Hanlon has been a regular contributor to New England Psychologist since 1999. As an independent journalist, she has also written for a variety of traditional and alternative health magazines and business consumer and trade publications. She also serves as writer/editor for custom publications.

How about a little EXTRA help filling an open position?

Week News ly lette

r

Want weekly clinical news and updates about everything happening in the field of psychology? www.eepurl.com/gfdTL

Delivered once a week straight to your inbox!

system, the language, different policies and expectations, and be familiar with licensing laws, said Rocchio.

For Shannon Maney, Psy.D, ABPP, licensed psychologist in Massachusetts and New Hampshire, her path to forensic psychology was established by the time she was in high school.

With an interest in both psychology and law, she knew she would pursue this career, even though she wasn’t quite sure all that forensic psychology entailed.

After completing all the necessary schooling and practical experience requirements, Maney fulfilled her dream and now works for the courts, specializing in criminal competencies and responsibility, violence and sex offender risk assessment, malingering, substance abuse and overall risk management.

She also sees patients in her Stoughton, Massachusetts private practice.

Since 2003, Maney has also been an adjunct professor, teaching psychology courses to undergraduates. Her first task is to dispel any myths and misconceptions.

“Some students think forensic psychology is criminal profiling,” she said. “We don’t go to crime scenes.”

Those who are interested in forensic psychology should figure out early on if this

Advertise in

Plus, reach extra job seekers at

Contact us at advertising@nepsy.com

December 2018

New England Psychologist

11

Outreach program has team approach to assist children exposed to trauma Continued from Page 1 Studies have shown that children exposed to trauma have higher incidences of substance abuse and mental and

Since it takes time for the effects of adverse childhood trauma to show up, the issue has not received enough attention thus far.

“There has always been a need,”” said Jessica Sugrue,

“A child with six adverse childhood experiences has a 4,600% increased risk of using intravenous drugs later in life.”

Lara Quiroga, Med, director of strategic initiatives for children, Manchester Community Health Center

physical health issues later in life.

“A child with six adverse childhood experiences has a 4,600% increased risk of using intravenous drugs later in life,” said Quiroga. “That is terrifying.”

M.S., another founding partner and CEO of Manchester YWCA. “We have seen that these children are the missing piece of the puzzle but we don’t see the direct impact right away. But with advances in research, we are now able to

get the funding. It is really pay now or pay more later.”

In the summer of 2015, Quiroga’s team at Project Launch, an initiative of the Substance Abuse and Mental Health Service Administration (SAMHSA) that promotes positive behavioral health for children through age eight, was contacted by the Manchester Police Department about setting up an outreach project to help children who experience violence and trauma each year in the city.

“Resources are available to help victims,” said Quiroga, “but there are not necessarily programs in place to help children who are exposed. In 2014, the more than 400 children exposed to domestic violence [in Manchester] got no advocacy.”

After looking at models of domestic abuse response teams, organizers decided to try a similar approach with children and ACERT was born.

Report: Corrections agencies reduce solitary confinement use Continued from Page 1 on population. They reported that 49,197 individuals — 4.5 percent of those in their custody — were in restrictive housing.

The median percentage of the population held in restrictive housing was 4.2 percent; the average was 4.6 percent.

The percentage of prisoners in restrictive housing ranged from 0.1 percent in Colorado to 19 percent in Louisiana.

Only three New England states — Connecticut, Massachusetts and Rhode Island — were among the 33 states plus the FBOP that broke down the number and percentages of those in restrictive housing by sex.

The median for the percentage of males with SMI in restricted housing in the Liman report was 7.9 percent.

For women the rate was 0.8 percent.

Sketching a national picture of how well correctional institutions are doing in managing the subpopulation of people with SMI is complicated. Resnik noted there was wide variation in definitions of mental health conditions classified as serious and in policies governing holding individuals in

restrictive housing.

Rhode Island reported 16 men with SMI in restrictive housing out of a total of 140 men with SMI in the custodial population — or 11.4 percent in the recent Liman report.

That’s even though only 2.7 percent of the total population of 2,852 were held in restrictive housing.

“We have a very robust definition for SMI,” said psychologist Louis Cerbo, Ed.D., clinical director of behavioral health for the Rhode Island Department of Corrections (RIDOC). “Our numbers for SMIs are going to be a little bit elevated.”

RIDOC’s SMI definition includes post-traumatic stress disorder and three personality disorders — borderline, schizotypal and schizoid. The state also considers an individual’s history of psychiatric hospitalizations, suicide attempts, and self-injurious behaviors, Cerbo added.

Another factor, Connecticut and Rhode Island have unified systems that combine their jail and prison populations. As a result, their percentages of individuals in restrictive housing are much higher than in Massachusetts which reported only its prison population.

“If you did not include the jail, and I’ll be ultra conservative, I would say that number would be half,” Cerbo said of the SMI restrictive housing data.

Connecticut had 2.3 percent of its overall custodial population in restrictive housing in the fall of 2017 but 10.7 percent of its men with SMI were placed in it. Zero percent of women with SMI were in restrictive housing.

In contrast, Massachusetts reported overall rates of 5 percent of men and 3.9 percent of women in restrictive housing. Among the subpopulation with SMI, the rates were 1.6 percent men and zero percent women.

RIDOC did not provide data on people with SMI in the fall of 2015 for the Liman Center’s 2016 report because officials were manually tracking this subpopulation and working on significant IT programming changes to be able to aggregate data.

Cerbo said he would expect to see Rhode Island’s restrictive housing numbers go down for the next Liman Center report in two years.

That’s because a new residential treatment unit that opened in February 2018 for inmates with SMI has already

Each team member has a role. The police officer handles safety and any legal issues that may arise in sharing of extra information. The crisis service advocate works with the adult victim to explain and provide information on services while the health worker will engage with the child to redirect focus away from the discussion among the adults.

“We are not there to provide treatment or to question a child about how they are feeling about the event,” said Quiroga. “The main goal is to get a release signed so that the agencies can contact them directly.”

As of August, the team had deployed 205 times, visiting 725 families and 1,100 children. Of those, 815 children from 440 families were referred to services. Because of privacy laws, it is not possible to track families to see how many actually receive treatment.

The program received additional funding from the U.S. Department of Justice’s Bureau of Justice Assistance in October. Once the money is accepted by the Governor and Executive Council, it will be used to expand the program to train other first responders, to increase shifts for teams and to work with community agencies to ensure that additional services are available for the children.

“Sustainability is key,” Sugrue added. “We have three years to build the program up to scale but the goal is to create a sustainable model of practice.” NEP

shown a decrease in recidivism of behavioral problems.

Inmates placed in the unit have disciplinary time suspended and meet with clinicians for one-on-one and group therapy and are provided a balanced schedule of structured and unstructured hours out of their cell.

Additionally, as part of a revision to the inmate code of discipline completed last February, RIDOC reclassified more than 40 infractions that used to warrant punitive segregation for one to 10 days — including cutting in line, noise disturbances, and displaying pornography — and instead made them punishable by loss

of privileges.

Loss of privileges could mean temporarily being unable to have visitors, participate in recreation activities or use electronic devices or watch television. Other levels of infractions were also moved down to lower levels of punishment that resulted in more loss of privileges and less confinement.

Only the most serious infractions, considered predatory and violent in nature — escape, sexual assault, arson, hostage taking, rioting and drug trafficking inside a facility — remain punishable by 31 to 365 days of confinement under RIDOC policy. NEP

Catherine Robertson Souter is a freelance writer and social media agent based in New Hampshire. A contributor to New England Psychologist since its inception, she previously wrote for Massachusetts Psychologist among other media outlets.

Special Hospital Issue

will publish in advertis May the 27th ing@ nepsy.co annual directory m on New England psychiatric hospitals and units.

12

New England Psychologist

December 2018

Study finds a biomarker that may predict onset of psychosis

By Margarita Taratovky, MS ndividuals at risk for psychosis exhibited a pattern in their brains that predicts whether they will have schizophrenia, according to a recent study published in the journal Nature Communications.

The key takeaway, according to Hengyi Cao, Ph.D, a

whether and how fast [individuals] convert to full psychosis.”

Specifically, Cao and his colleagues viewed fMRI images of 182 individuals at high risk for psychosis (along with 120 healthy controls). Risk was assessed using the Criteria of Prodromal Syndromes, which is based on the Structured Interview for Prodromal Syndromes.

“Psychotic disorders are devastating mental disorders without a really effective treatment strategy so far.

This is chiefly due to the biological complexity of such disorders.”

Hengyi Cao, Ph.D., postdoctoral research assistant, Yale University.

postdoctoral research associate at Yale University and first author of the study, is that “Our study, for the first time, shows a functional ‘trait’ abnormality in the brain system that already exists before the onset of psychotic disorders in those at high risk, and such abnormality can predict

It includes questions about the presence of positive symptoms, such as delusions, hallucinations, grandiose ideas and disorganized communication.

Nineteen participants would go on to have full-fledged psychosis.

The researchers found increased connectivity in the

cerebello-thalamo-cortical circuitry – a circuitry that plays a central role in error processing, Cao said.

They found the same pattern in a second sample, which included 50 individuals diagnosed with schizophrenia.

(This sample also included 49 patients with bipolar disorder, 40 patients with attention deficit hyperactivity disorder, and 123 healthy controls.)

“The hyper connectivity in this circuitry implies a strong link between dysfunction in error processing and psychosis,” Cao said.

This may be because of deficits in error detection, whereby “greater errors are generated in brain functioning,” he said. Or, he noted, it may be due to a compensation effect from excessive error input from the upstream cerebral cortex.

Cao was surprised that higher connectivity in the cerebello-thalamo-cortical circuitry predicted a shorter conversion time.

“Among those who later converted to full-blown psychosis, half of them converted within eight months” — explaining almost 25 percent of variance in conversion time. “Only one method can explain so much of variance I think is really amazing.”

Secondary trauma and the holidays pared in the future.

• Mindfulness and stress reduction training websites may help you manage a stressful caseload.

Continued from Page 6 this way.

• Consider transferring any client you really aren’t prepared to handle.

• Resist the pressure to take on clients you don’t feel quite adequate to treat.

• Make a New Year’s resolution to get further training in the treatment of trauma so you will be better pre-

Workplace If you are in a challenging or hostile workplace environment, the new year may be the time to seriously think about finding another job. Do what you can to make your job a little less taxing during the holiday and post-holiday season:

• Manipulate your schedule if you can so you don’t see many patients with PTSD in the same day. If most or all of your patients are trauma survivors, don’t see individuals who are in maximum stress back to back. Manage your schedule so that you see people in varying states of recovery hour to hour.

• Talk directly with your supervisor about whatever support you would find

ut

o Check

pro.psychcentral.com

This discovery is also notable because the sample was so heterogeneous, Cao said.

As part of the North American Prodromal Longitudinal Study (NAPLS 2), participants were recruited from eight study sites across the U.S. and Canada, with different demographic variables, including age, gender, race and years of education.

They also received different treatment, and had different clinical diagnoses, he said.

Moreover, these findings are noteworthy because they are “paradigm-independent.”

In other words, according to Cao, “an fMRI paradigm… is a psychological experiment in which a certain brain function is tested.”

He gave this example: During a working memory paradigm, participants take a working memory test as researchers scan their brain function. This study included five different paradigms.

Cao said that the study’s findings provide direct evidence for the “cognitive dysmetria” theory of schizophrenia, which was proposed by Nancy Andreasen in the mid 1990s.

Andreasen’s theory postulates that a disruption namely in the cerebello-thalamo-cortical circuitry pro-

duces “cognitive dysmetria,” or impairments in processing, coordinating, and responding to information.

For his next study, Cao is recruiting subjects for an error-processing cognitive task. His aim is to understand what is driving the hyper connectivity in the cerebello-thalamo-cortical circuitry — whether it reflects an error detection deficit or a compensation effect.

Ultimately, the key message of this research is that “psychosis is predictable, and we can use image-based biomarkers to predict the onset of psychosis,” Cao said. It’s critical because early intervention tends to have a better prognosis.

“Psychotic disorders are devastating mental disorders without a really effective treatment strategy so far. This is chiefly due to the biological complexity of such disorders,” Cao said.

“Biomarkers per se mark the biological processes that underlie psychotic disorders, which help unravel their complex biological mechanisms.”

helpful during this time.

• Arrange to meet with some colleagues to provide mutual support as you all manage client holiday stress and the impact it has on you.

• Resist participating in discussions about negative aspects of your workplace.

The negativity will only add to your stress.

what you so willingly do for them. Ask for help with holiday tasks when you need it.

Turn to them for comfort and care.

Transition from your work day to the rest of your life with some kind of intermediary activity that focuses on the positives in the season.

Listen to holiday music in the car. Pay attention to the scenery and decorations. Do your workout to the beat of holiday tunes. Call a friend for a quick and friendly chat before leaving the office.

We therapists have a reputation, probably deserved, for not taking sufficient care of ourselves when we are stressed or overworked. Givers by nature, we are vulnerable to giving too much, especially when our clients are struggling.

If you are feeling overstressed or concerned that your own issues may be triggered, do take care of yourself. You deserve the same empathy and support from you as you are giving to your clients. NEP

Your Personal Supports Managing feelings of being triggered or stressed is exhausting. It may be tempting to isolate. Don’t. Sharing some joy in the season is the antidote to feeling down.

Emphasize the positive in your personal life. Participate in holiday rituals and activities that give you joy with your partner and kids. Call your relatives to wish them a happy holiday. If you are alone or at a distance from family and friends, do some volunteer work to make the holiday brighter for others. Enjoy the camaraderie of being with other people who are also trying to make a difference.

Let your friends do for you

NEP

Margarita Tartakovsky, MS, is a Florida-based freelance writer and an associate editor at PsychCentral.com.

December 2018

New England Psychologist

13

The biggest mistake therapists make when diagnosing PTSD

By Jason Drwal, Ph.D hether PTSD treatment is your niche or not, you have probably seen trauma survivors in your practice. Diagnosing posttraumatic stress disorder (PTSD) is not always as straightforward as other disorders. One multinational survey of PTSD across 20 countries found that the majority of individuals with PTSD had experienced four or more traumas (Karam et al., 2014). Deciding what qualifies as a criterion A stressor for PTSD is one of the most overlooked challenges in diagnosing PTSD. Diagnosing PTSD is complicated Diagnosing PTSD is more complicated than diagnosing depression or other disorders.

When a person suffers from depression, the therapist only needs to assess symptoms. It doesn’t matter whether these symptoms were caused by a divorce, job loss, or an abusive childhood.

As you probably realize, PTSD is a different animal.

The DSM-5 specifies that no symptoms count toward a PTSD diagnosis unless they have been caused by a quali-

fying trauma, known as a criterion A stressor (because it is the first criterion listed in the DSM-5 for PTSD).

The DSM requires us to be part detective and part clinician when it comes to determining the causes of our patients’ symptoms. I’m sure you’re familiar with this idea but before you even start to say to your patient, “I think you could have PTSD,” you should stop yourself and think carefully about the reality of a criterion A trauma.

Most clinicians think it is more straightforward than its actuality. Why do I say this?

As a psychologist who works with veterans and has seen many trauma survivors, I have seen the PTSD diagnosis misapplied, often because of a failure to carefully evaluate criterion A. What Is criterion A? It is a traumatic event that involved the risk of death, serious injury, or sexual violence. It could also be seeing these events happen even though you were not the victim of them. An example would be coming across a car accident and seeing a dead body. It could be hearing about a close friend or loved one going through a trauma,

Assisted outpatient treatment Continued from Page 7 Connecticut created an Assertive Community Treatment (ACT) team, an evidence-based practice, to build relationships with individuals

whose experiences with outpatient clinics have not been positive.

The ACT team includes mobile crisis units that consistently reach out to the homeless. While their efforts might

for example, a mother hearing about the details of her son being killed in a roll-over car accident.

Or, it could be indirect exposure, as when healthcare workers or first responders hear about traumas from victims over and over.

Take your time in evaluating criterion A To diagnose PTSD, you have to understand the traumatic event and make a judgment call about whether there was an actual threat or something disturbing enough to fit some form of criterion A. It sounds simple. Sometimes it is; other times it’s not.

Some events are clear criterion A no-brainers: a combat tour involving fire fights, a sexual assault, childhood sexual abuse, being mugged at knifepoint, a head-on car accident.

Other traumatic events are clearly not criterion A: a bitter divorce, public humiliation, getting fired from your job, losing custody of your children.

At other times, it’s unclear whether an event meets criterion A. Suppose a police officer tells you that during a routine traffic stop he thought someone was going to pull out be rejected initially, there may be a time when the person says yes, according to Lejardi.

Lejardi added that police are trained to work with people in emotional distress and know when to send the person to the emergency room. “We have a whole system in place,” she said.

In FY2018, the ACT team

a weapon; however, the person only reached for an ID. This could meet criterion A, but then again, you could argue that there never was a threat and a PTSD diagnosis is out the window.

This is where you have to understand why the person thought the situation was life threatening. Was there any reason why the officer thought there could have been a weapon? Would other police officers have reacted similarly?

Was the threat a gross misperception or distortion of reality? Does the officer perceive threats everywhere, which might indicate generalized anxiety?

You have to understand the person to understand if it fits criterion A. Get the context when assessing criterion A I once saw a client who was told by another clinician that his trauma didn’t meet criterion A because it wasn’t life threatening. My client, who was a soldier deployed oversees, was threatened by a local resident.

The possible criterion A event happened when the resident didn’t threaten to kill my client but grabbed his wrist

treated 751 different individuals and the mobile units took 8,000 calls for nearly 6,000 individuals.

In Massachusetts, Representative Kay Khan (D - 11th Middlesex District) has been actively pursuing an AOT law since 1998 when she filed H.B. 1792. This bill came before a number of committees,

Subscription/Change of Address Form Psychologists licensed to practice in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont automatically receive a free subscription to New England Psychologist. If you are licensed in a New England state and do not receive the publication, please mail or email (addresschange@nepsy.com) a copy of your license to us with the address you want the paper to be mailed to. Paid subscriptions for other professionals or agencies may be purchased by sending a subscription form with a check for $60 to: New England Psychologist, Subscriptions, P.O. Box 5464, Bradford, MA 01835

and screamed in his native language. At first, I agreed that the latter event didn’t meet PTSD criteria. It was a bad event, but nowhere near as bad as what most service members describe about their deployments oversees.

But over time, I started to understand that the threat was more complicated and real to my patient than I initially realized. This individual harassed, threatened to stab, flashed weapons from afar, and menacingly stared down my patient.

After understanding the context, I realized that the threat to my client was not just about a single event, but about a series of intimidations and threats.

My client really thought he was going to be shot, stabbed, or brutally beaten. He never was assaulted, but it shook him so badly that he could never excise the fear from his mind.

Cases like this one are the reason I take my time to explore criterion A and understand the context of the event.

If you do a thorough job establishing criterion A, you’ll not only better diagnose PTSD, you’ll better understand your clients. NEP but resulted in no definitive action.

In January 2071, Khan filed H.3587, “An Act to increase effectiveness and improve outcomes for treating persons with severe mental illness in our communities.”

The bill was sent to a study order on August 9, 2018. She said, “I will consider refiling the bill during the next session, which is a decision to be made by January.” NEP Phyllis Hanlon has been a regular contributor to New England Psychologist since 1999. As an independent journalist, she has also written for a variety of traditional and alternative health magazines and business consumer and trade publications. She also serves as writer/editor for custom publications.

Please send me a subscription to New England Psychologist. 1 year — $60. Prepayment required.

Name Street City

Advertise in State

ZIP+4

___ Please check here if change of address and enclose mailing label.

"

Advertising@ nepsy.com

14

New England Psychologist

December Dec. 1: Integrated Assessment of Youth. Newton, MA. 8:30-5 pm, $155, 7 CEs. Case presentations highlighting the role of developmental trauma; including how we measure adulthood and its forensic implications; ethical issues in assessment of youth; and the trajectory of adolescent social and neurological development.

Co-Sponsored by The Department of Psychology, Massachusetts Mental Health Center and William James College.

Contact www.williamjames. edu/academics/lifelong/ce/

Dec. 5: Functional Neuroanatomy Review. Shrewsbury, MA. 8:30-4:30 pm, $250 BIAMA members, $275 non-members, 6.5 CEs. Participants will review the structures and functions of the central nervous system (CNS), including the cerebral hemispheres and subcortical structures (brain stem and spinal cord). Participants will also learn the basic neuropathology of CNS lesions and the common associated functional sequelae, related to both congenital and acquired disorders. Sponsored by Brain Injury Association of Massachusetts. Contact biama.org/ abitraining2 to register.

Dec. 6: Movie + Dialogue Night showing the film 13th.

Watertown, MA. 7-10 pm, $55, 3 CEs. The title of Ava DuVernay’s documentary refers to the 13th Amendment to the Constitution. This film will be used as a vehicle to become aware of and learn more about the impact of political and legislative decisions on African Americans and the prison system, as a legacy and continuation of slavery in modern times. Contact 617-924-9255 or register

at www.therapytrainingboston. com

Dec. 9: The Film: The Shape of Water: The Emergence of Voice. Newton, MA, 1-4 pm. We will view the film, The Shape of Water, and discuss it both from a Jungian symbolic perspective, and also as an iconic example of a mute woman finding her voice. Led

by Michelle Seligson, M.Ed., IAAP. Sponsored by C.G. Jung Institute-Boston. Learn more at: www.cgjungboston.com

Dec. 9-10; 2019: 1/31, 2/1, 2/3, 2/4, 3/10, 4/12: EMDR Therapy Training: The Complete Course (all dates mandatory). Queens, NY. $1800, 49 CEs. This is a hands-on clinical skills training for using EMDR and integrating it with your psychotherapy approach -with adults as well as children.

Sponsored by Trauma Institute & Child Trauma Institute with R. Cassidy Seminars. For more information, visit www. childtrauma.com/training/emdr or call 413-774-2340.

January 2019 Jan. 7: Assessment of Youth with the MMPI-A-RF and the R-PAS: Including Aspects of Developmental Trauma and Psychodynamically-informed Cognitive Assessment. Newton, MA. 8:10-5 pm, $155, 7 CEs. Data will be presented demonstrating the validity and reliability of the measures presented as well as their application to the target patient population. Co-Sponsored by The Department of Psychology, Massachusetts Mental Health Center and William James College. Contact www.williamjames.edu/academics/lifelong/ce/

CONTINUING Education New England Psychologist prints as many continuing education conferences as space allows.

Listings with incomplete information will not be printed. CE credits listed are for psychologists. Deadline for submission is the 1st of each month for the following month’s issue. CE Listing correspondence to: New England Psychologist Attn: Continuing Education P.O. Box 5464 Bradford, MA 01835 ce@nepsy.com

Jan. 7-Feb. 3: Post Certificate Course: Advanced Parenting Coordination (Online Only Option) 2019. Newton, MA. $475, 12 CEs. Advanced Parenting Coordination is a post-certificate course offered in a blended learning format.

Participants in this advanced training will learn advanced strategies and techniques to work effectively with difficult clients including those with personality disorders, and manage cases where children resist contact with a parent and where young children are involved. See website for details and pre-requisites. Sponsored

by William James College.

Contact www.williamjames. edu/academics/lifelong/ce/

Jan. 11-12: Winter Clinical Intensive: Accessing the Symbolic in an Age of Managed Care. Newton, MA. $250 ($125/student), 11 CEs. This two day seminar will focus on how clinicians can bring an appreciation and attention to psychic dynamics and symbolic capacity in our patients in the context of managed care requirements. Sponsored by C.G. Jung Institute-Boston.

Learn more at: www.cgjungboston.comw

Jan. 28–Feb. 24, Mar. 1-2: Mental Health and Juvenile

December 2018

Justice 2019. Newton, MA. $1100, 28 CEs. Mental Health and Juvenile Justice is designed for professionals engaged in providing services to youth and families involved in the juvenile justice system who aspire to improve outcomes for youth and families through enhancing their programs and services, and by more effectively partnering with public and private agencies and providers (state, local, tribal or other).

Sponsored by The Center of Excellence for Children, Families and the Law at William James College. Contact www. williamjames.edu/academics/ lifelong/ce/

Upcoming Mar. 22: Advanced clinical skills for trauma-informed evaluation, treatment planning, and supervision/consultation. Introduction to progressive counting (PC).

Northampton, MA, $50, 6.5 CEs. This 1-day workshop offers hands-on clinical skills training & advanced clinical skills for trauma-informed evaluation, treatment planning/ contracting, clinical supervision/consultation, and more.

Sponsored by Trauma Institute & Child Trauma Institute

Continued on Page 15

Selling out a conference just got easier With New England Psychologist CE programs can be promoted to licensed psychologists cost effectively.

Reach 100% of psychologists in all six New England states.

Why pay the cost of direct mail pieces when you can reach the same audience at a fraction of the cost?

Contact New England Psychologist today at ce@nepsy.com.

December 2018 with R. Cassidy Seminars. For more information, visit www. childtrauma.com/training/attachment-dissociation or call 413-774-2340.

Mar. 23: Happiness in Dark Times: The Role of Positivity When under Great Distress.

Newton, MA, $150, 6 CEs. This program addresses a chronic need in patient/client populations of every age: how to create foundations of hope and resilience while under chronic or acute stress. Sponsored by William James College. Contact www.williamjames.edu/academics/lifelong/ce/

New England Psychologist Mar. 27-28: Attachment and Dissociation Assessment and Treatment: An Introduction to Foundational Skills.

Northampton, MA, $300, 13 CEs. This workshop will provide tools to both assess and work with attachment trauma and dissociation, as well as offer a structured approach to ensure client readiness and proper preparation for trauma work. Sponsored by Trauma Institute & Child Trauma Institute with R. Cassidy Seminars.

For more information, visit www.childtrauma.com/training/ attachment-dissociation or call 413-774-2340. NEP

15

THE QUICK FIX

For

comprehensive

CE listings check out

CLASSIFIEDS Office Space BACK BAY (Boston): Parttime furnished psychotherapy office with stunning Boston views. Shared waiting areas, bathrooms, kitchen & free gym access. Many referrals and optional administrative/ billing support available. Free private practice start-up or expansion business consultation. $176 + /month per 4-hour/week block. Parking for additional fee. Please contact: backbayalliance@gmail. com or 617-230-3002.

BOLTON, MA: Established group practice in a beautiful country setting. Professional office building, easily accessible to major highways.

Flexible availability. Contact LeighTuttle@Protonmail.com FRAMINGHAM, MA: Office suite with spacious waiting room has up to 3 days per week of open time in one furnished office available for May 1, 2019 - April 30, 2021.

Starting sooner is also negotiable. Contact Maryrose Coiner PhD: mccoiner22@ gmail.com or 508-620-9948.

HARVARD SQUARE (Cambridge): Furnished part-time psychotherapy office sublet in Victorian house/ office building. Shared waiting area/bathrooms/kitchen.

Many referrals and optional administrative/billing support available. Free private practice start-up or expansion business consultation.

$176 + month per 4-hour/ week block. Please contact: harvardsquarealliance@gmail. com or 617-230-3002.

HINGHAM, MA: Office space PT/FT available. Desirable Derby St., Hingham location.

Established, multidisciplinary South Shore practice. Please contact: Steven Allison PsyD at stevenallison@comcast.net or 781-540-9624.

NATICK, MA: Spacious office rental share in downtown Natick, MA for licensed psychologist. Flexible part or full-time rental. Reasonable rates. Contact Elizabeth at epines@rcn.com or 508-284-6449.

NEWTON, MA: Beautiful office space along the Charles River in Newton Upper Falls, MA. PT/FT available, please email Jotham: jotham@ think-diff.com NEWTONVILLE, MA: Office available in Newtonville office suite. PT/FT beginning 1/1/19. Ideal for individual or couples therapy. Please email Colleen: drcolleencasey@ gmail.com STONEHAM, MA: Sunny bright office in psychotherapy office suite, PT, friendly colleagues, shared referrals, support & billing services, near 128-93. Contact Paul at 781-438-5550 X15.

Recruit a PSYCHOLOGIST with your help wanted ad in

Help Wanted Part-Time Psychotherapist Cambridge / Boston Private Practice. Seeking independently licensed psychotherapist (LICSW, PhD, PsyD) with solid psychodynamic and/or cognitive-behavioral experience to join private practice with offices in Cambridge & Boston.

Competitive compensation, excellent colleagues & beautiful office setting. Prefer candidates with Friday or

adve @nepsrtising y.com

Saturday availability. Email cover letter/resume to clinicalallianceservices@ gmail.com

Please check out all of the help wanted ads on Psych Central Professional:

pro.psychcentral.com/jobs

Classified Form All classified advertising runs in the next available print edition and on nepsy.com Deadline is 12th of every month (except for Aug./Sept. issue, which is Aug. 1).

For all other advertising deadlines and rates, including Help Wanted and CE ads, please email us at: advertising@nepsy.com.

Office space/groups forming: $65 per column inch ($55 if submitted online).

Products/services: $160 per column inch ($140 if submitted online).

A column inch contains approximately 20 words; minimum of 1 inch for all ads.

Save money by submitting online! http://www.nepsy.com/classifieds/ Please fill out the below form completely and legibly. Payment must accompany ad (make check payable to New England Psychologist) and mail to: Classified Ads, New England Psychologist, PO Box 5464, Bradford, MA 01835.

Town & State: ____________________________________________________________________________________________ Ad Copy: ________________________________________________________________________________________________ ________________________________________________________________________________________________________ Name: __________________________________________________________________________________________________ Address: ___________________________________ ____________________________________________ Phone: ___________ Email:

________________________________________Payment of $_____ is enclosed.

"

16

New England Psychologist

December 2018

Measure Executive Function

Strengths & Weaknesses

in adults 18 & older with the new

Author Team

Deficits in executive function skills can impair problem solving, reasoning, and adaptive behavior, making even the simplest tasks a challenge.

®

Goldstein & Naglieri

Ensure those in your care receive the best support with the newest measure of executive function available.

• Use the CEFI Adult’s nine comprehensive scales to guide targeted intervention • Interpreting results has never been simpler with our acclaimed easy to read report options • Rely on highly accurate results based on extensive norming

MHS.com/CEFIadult

Exce ence I n A s s elsls m e n t s

Jack A. Naglieri, Ph.D.

&

Sam Goldstein, Ph.D.

Special Offer!

Receive a FREE copy of

Dr. Naglieri and Dr. Goldstein’s “Handbook of Executive Functioning” ($90 value) with purchase of any CEFI Adult Kit* Available for a limited time while supplies last.

Go to www.mhs.com/CEFIAdult for more details or contact your MHS consultant