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Features 4
Lynda Keen Membership Manager/Bookkeeper Sherry Reisman Director of Conventions & Non-Dues
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Walter Cubberly, PhD Past-President Board Members Ron Cohorn, PhD Patrick Ellis, PhD Richard Fulbright, PhD Charlotte Kimmel, PhD Joseph C. Kobos, PhD Suzanne Mouton-Odum, PhD Roberta L. Nutt, PhD Dean Paret, PhD Elizabeth L. Richeson, PhD Ollie Seay, PhD Jarvis Wright, PhD
From Normal Institute to State University: A History of Psychology at Sam Houston University A. Jerry Bruce
12 Forward – Reflections of Prescriptive Authority and the Evolution of Psychology in the 21st Century Patrick H. DeLeon
C. Alan Hopewell, PhD President-Elect Paul Burney, PhD President-Elect Designate
The Problem of Licensure Mobility Ronald F. Levant, EdD, ABPP
TPA BOARD OF TRUSTEES Deanna Yates, PhD President
VOLUME 54, ISSUE 1
Departments 2
FROM THE PRESIDENT Deanna Yates
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FROM TPA HEADQUARTERS: Board of Trustees Meeting David White, CAE, Executive Director
18 LAW: Forensic Services – Beware of the Pitfalls Sam A. Houston
20 Inside TPA 21 Student Division Update Mary Martin & LaDonna Saxon
EX-OFFICIO BOARD MEMBERS
22 Preview – 78th Legislature Richard M. McGraw, PhD Federal Advocacy Coordinator Melba J. T. Vasquez, PhD CAPP Representative Jerry R. Grammer, PhD Texas Psychology Foundation President Mary Martin Student Division Director
Joey Bennett, TPA Legislative Consultant
24 The Texas Sunset Act and the Practice of Psychology in Texas: A Time to Get Off of the Sidelines and Into the Game From the Cover M. David Rudd, PhD, ABPP
Photo by Kiki Pantaze
26 HPA Hapenings Patrick Elis, PhD, President
PUBLISHER Rector Duncan & Associates P.O. Box 14667 Austin, Texas 78761 512-454-5262 Stephanie Shaw Managing Editor Pat Huber Advertising Sales Julie Mangano Art Director The Texas Psychological Association is located at 1011 Meredith Drive, Suite 4, Austin, Texas 78748. Texas Psychologist (ISSN 0749-3185) is the official publication of TPA and is published quarterly.
27 TPA: Tracking Legislation for You David White, CAE, Executive Director
28 Report from the National Commission on Mental Health Dee Yates, PhD, President
29 PSY-PAC Contributors Paul Burney, PhD, PSY-PAC President
32 Classified Advertising 32 Advertisers’ Index
www.texaspsyc.org SPRING 2003
Texas Psychologist
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FROM THE PRESIDENT
Access to Care As I begin my year as TPA president, I am nearing the end of my year of service on the President’s New Freedom Commission on Mental Health. It is because of both my work on the Commission and my work in practice that I have chosen my year’s theme. It is Access to Mental Health Care. Did you know that one in five children in this country has a mental health disorder and one in ten has a serious emotional disturbance? Do you know that 80 percent of children in need of mental health services receive none?
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TPA begins to deal with these entities at the nd which children do you suppose are state level when negotiating contracts and the least likely to receive services? It is reimbursement rates for our members. We the children who are poor, minorities or livcannot afford to have our members leaving ing in rural or innercity settings. Did I just the profession because reimbursement rates make all that up? No. These are just some of are so low that they cannot meet overhead the findings coming out of the work of the expenses. It is time we take on managed Commission. I would like to be able to say care, not just for our own self-serving purthat the statistics are much better when it poses, but for our patients who depend on comes to adults, but they are not. Which our services. adults do you think are the least likely to The other new committee I have created receive services? That’s right — the poor, is the committee on public minorities, and those living in policy. I would like to see TPA rural or innercity settings. become more involved with There are several factors at community mental health play here including: a severe organizations such as the shortage of mental health Mental Health Association of providers, especially psychiaTexas and NAMI Texas. I trists; high managed care and would like to see where we malpractice insurance rates could work together with such which drive many providers organizations to support issues out of the field; a lack of true Deanna F. Yates common to us — issues that parity as mental health is T PA P r e s i d e n t reflect our concerns for our treated as less important than patients and their families. physical health; and the growing numbers You will find this issue of the Texas of the uninsured which threaten to bankPsychologist heavily devoted to legislative rupt state budgets. issues. This is a critical year for us and we During this next year as president, I are in a position to have a very good year would like to focus on access. During the legislatively. We have a strong lobby team convention, which will be held in Dallas at led by Rusty Kelly and Joey Bennett. the Galleria, I will be asking for presentations Financial support for the PAC over the that deal with some of these issues including: past three years has been the strongest services to children, services in schools, issues ever. We have done our homework, and dealing with women and minority cultures, we have the facts on our side. With your public mental health, evidence-based treathelp at the grassroots level, we will sucments and psychopharmacology. ceed in passing our prescriptive authority Within the structure of TPA, I have crebill, which will put us in an even stronger ated two new committees that I hope will be position when our practice act comes up ongoing. One new committee is the comin 2005. mittee on third party payers. It is time that 2
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Financially, TPA seems to have turned the corner and is getting back on track. When TPA made the decision to be a doctoral organization several years ago, we took a hit in membership revenues. But with the help of Walt’s forward thinking last year of beginning the sunset fund and the support of legislative grants from APA three years in a row, it appears that TPA is again becoming a strong organization. We have plans for strong membership recruitment this year as well as continued growth of the PAC and increasing funding streams for the Foundation. I look forward to success in the legislature this year and continued planning by the Sunset committee for the 2005 legislature. I look forward to a super convention in Dallas in November and to our Family Getaway being back in Cancun this summer. But most of all, I look forward to serving you as your president this year and making this a year to remember. ✯
ARTICLE REPRINTS Call Pat Huber at (512) 310-9795 for rates and information.
SPRING 2003
FROM TPA HEADQUARTERS
Texas Psychological Association Board of Trustees Meeting November 13, 2002 San Antonio, Texas David White, CAE Executive Director
The November 13, 2002 meeting of the Texas Psychological Association Board of Trustees was called to order by President, Walt Cubberly, PhD at 7pm at the Hyatt Regency Hotel in San Antonio.
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embers present were Drs. Suzanne Mouton-Odum, Ollie Seay, Ron Cohorn, Jarvis Wright, Walter Cubberly, Patrick J. Ellis, Elizabeth Richeson, Dee Yates, Joe Kobos, Charlotte Kimmel, Jose Torres, Sam Buser, Alan Hopewll, Paul Burney (exofficio) and Rick McGraw (ex-offico). Guests/Staff present were David White, CAE; Bob McPherson, PhD; Sherry Reisman; Joseph McCoy, PhD; Dean Paret, PhD; Roberta Nutt, PhD; Marsha Harman, PhD; Laura Barbanel, PhD; and Ron Levant, EdD and APA Secretary. The minutes of the September 7, 2002 meeting were approved as written. Marsha Harman, PhD shared with the board the issues that are facing TASP and the school psychologists. She also shared with the board the desire to have a closer working relationship with TPA and indicated that even though there might be some legislative issues that TPA would not support, TASP would like to open the lines of communication and work together on common issues. Dr. Cubberly thanked the board for all their hard work this year and recapped the events and programs that TPA has accomplished this year. He thanked them for all their support and passed out special President Awards to Rusty Kelly and Joey Bennett, TPA lobbyists; Ron Cohorn, PhD, PSY-PAC President; and Russ Newman, PhD, JD, Executive Director of APA Practice Directorate. He also gave a “Wise Elder” Award to Joe Kobos, PhD for his endless years of leadership at TPA. Dr. Cubberly shared the results of the 2002 elections and congratulated all the winners. They were:
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➤ Paul Burney, PhD – President-Elect Designate ➤ Richard Fulbright, PhD – Board Member (term ends 2005) ➤ Dean Paret, PhD – Board Member (term ends 2005) ➤ Roberta Nutt, PhD – Board Member (term ends 2005) Mr. White briefed the board on TPA’s membership status and finances. He indicated that he received word from APA that TPA has been approved for $25,000 for the legislative grant. Mr. White shared with the board that this year’s convention, TPA’s 55th Annual Convention, will have the highest turnout in over 5 years! A projected 600 will attend. He indicated that a post-convention video will be filmed with the hopes of using this video to market next year’s convention. Mr. White indicated that pre-filing of bills has already begun and over 250 bills had been filed for the next legislative session. Rusty Kelly and David White will be tracking these bills. Mr. White shared the survey and results that the Tele-health committee had completed. The board will review these documents and discuss at the next meeting. Mr. White shared with the board the increase in paperwork and the fact the TSBEP does not require APA approved workshops for license renewal. Mr. White recommended that TPA not renew their CE approval status with APA. After a discussion on the merits of this, the board passed a motion that TPA discontinue offering APA approved workshops to individuals and organizations and that we do not renew our 2003 accreditation. Mr. White shared with the board that he had researched the CE tracking service that
the Ohio Psychological Association has implemented. He indicated that he had gathered all the facts and would be putting a program together that models what OPA is providing. The TSBEP’s next board meeting will be in January and a formal presentation will be given to them at that time. Mr. White will submit the proposal to the TPA Board for final approval before taking it to TSBEP. Dr. Torres presented a diversity initiative program that he asked the board to consider and implement. This program would identify minority psychologists and encourage them to get involved with TPA at the committee and board level. The board reviewed this proposal and agreed to officially take action on it at the next board meeting. Dr. Cohorn communicated his concern that TPA award winners do not have to be TPA members. He encouraged that the 2003 awards committee revise the award criteria and set policy that all winners must be TPA members. The board agreed and TPA policy and procedures manual will be changed to reflect this criteria. Dr. Yates shared with the board her thoughts on next year and how she would like to see TPA function. She presented her 2003 committees and the dates for 2003 board meetings. She also indicated that there will be a board orientation and Legislative Day next year and encouraged all current and new board members to attend these programs. Dr. Yates indicated that if any board member would like to serve on a committee and/or Task Force (TF) to let her know, and she will assign them to that particular committee/TF. There being no further business, the meeting was adjourned at 9:30 PM. ✯ Texas Psychologist
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The Problem of Licensure Mobility Ronald F. Levant, EdD, ABPP Nova Southeastern University APA Recording Secretary
Psychologists seeking to obtain a license in another state, whether for the purpose of relocation, for a multi-state practice or for engaging in tele-health, might find themselves facing a real nightmare. The Board of Psychology in the new state might ask the psychologist to jump over many hurdles, such as producing notarized supervision forms when some of the supervisors have retired or passed on. As former APA President Pat DeLeon (2000) has observed, “few psychologists realize how difficult it is to get relicensed in a new state.”
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he problem arose because each state determined the qualifications for professional licensure. Although by 1977 all states had enacted a psychology licensure law, there was a great deal of variation in the requirements. The APA Practice Directorate used the APA Model Licensure law in an attempt to reduce some of this variation in order to promote mobility. However, many variations remain. Other professions have addressed this problem. The National Council of State Boards of Nursing has endorsed a model based on the driver’s license, in which mechanisms exist for mutual recognition and reciprocity. Licensure is recognized across state lines, with the nurse subject to the laws and rules of the new state. So too, the pharmacists facilitate mobility through uniform licensure requirements and a clearinghouse program which transfers the pharmacist’s license to the new state, verifying background information and screening for disciplinary actions. APA has attempted to address this problem. During the February 2001 meeting, the APA Council of Representatives (Council) gave formal approval to an ongoing strategic plan developed by the Committee for the Advancement of Professional Practice (CAPP) for helping to provide a climate within which existing mechanisms for professional mobility can continue to develop. CAPP, at Council’s request, had been implementing a strategic plan to provide a supportive environment for giving visibility to the existing mechanisms for professional mobility available through the National 4
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Register of Health Service Providers in Psychology (National Register), the Association of State and Provincial Psychology Boards (ASPPB) and the American Board of Professional Psychology (ABPP). CAPP conducted programs at the annual State Leadership Conference, disseminated invited articles to state and provincial psychological association newsletters and took other strategic actions. In February, Council approved the continuation of this plan, and as a result, additional articles on the status of the various mobility mechanisms have been, and will continue to be published, as appropriate, in APA and Practice Directorate publications (e.g., Smith, 2001, Sullivan, 2000-01), additional conference programs will be arranged, and meetings among parties of interest will be facilitated. In addition, the author and Jay Benedict, Associate Editors of the journal, Professional Psychology: Research and Practice, are preparing a special section on this issue. Background The information in this section of the column has been drawn from various APA governance documents. In February 2000, Council suspended its rules and approved a new business item, titled “Reciprocity of Licensure Among States”, introduced by Dr’s. Carol Goodheart, Ron Levant and 20 other Council Representatives. This item affirmed that the attainment of reciprocity of licensure and other mechanisms for professional mobility are urgently needed. It directed CAPP, as the lead group, and APA’s Board of Professional Affairs (BPA) to work
in collaboration with ASPPB to develop a plan to achieve this goal. In March, 2000, CAPP and the Practice Directorate made time available before the start of the State Leadership Conference for representatives of state psychology licensing boards and state psychological associations to meet in order to discuss mobility in a forum coordinated by ASPPB. This was the second consecutive year for this particular forum. At its meeting later in March of 2000, CAPP discussed the Council item and decided to convene a conference call among representatives of CAPP, BPA, and ASPPB to determine what would be most helpful in promoting mobility. This call took place in June 2000. It highlighted several relevant issues, including: the type of support that APA could provide, the potential implications of technology changes and tele-health for licensure, and the recognition that other organizations have also developed initiatives to facilitate licensure for psychologists moving to different states. Of considerable importance, the participants on the call noted that there are two different mechanisms for promoting professional mobility: Reciprocity, which refers to agreements between jurisdictions in which states are willing to recognize each other’s licensees based on comparable requirements for licensure, and Endorsement, which is a vehicle to recognize individuals as having met a high standard qualification, such as the Certificate of Professional Qualification (CPQ) developed by ASPPB, which is accepted by jurisdictions as meeting most of the qualifications for licensure. In the past SPRING 2003
10 years, only 10 states have entered into reciprocity agreements. This makes endorsement the more promising mechanism for promoting mobility since more than two dozen states are in various stages of recognizing the more recently developed CPQ. In July of 2000, CAPP continued discussion of this issue with representatives of ASPPB and the National Register. CAPP noted that decisions about licensure reciprocity and mobility are not the province of APA but rather of state and provincial psychology boards. CAPP also noted that BPA has a work group examining tele-health issues, and that these issues are clearly relevant to any consideration of reciprocity and mobility. CAPP felt that at the present time it could take two additional actions supportive of reciprocity and mobility: 1) provide a climate and create an environment in which existing mechanisms for mobility can flourish by informing members about the various mechanisms for mobility offered by ASPPB, the National Register, and the American Board of
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Professional Psychology (ABPP); and 2) inform Council of the distinctions between reciprocity and endorsement, and the status of the latter as being the mobility mechanism more widely accepted by states and provinces. As part of providing a climate to support existing mechanisms for mobility, CAPP offered to compile and disseminate to state and provincial psychological associations (SPPAs) invited articles written by ABPP, ASPPB, and the National Register about the various mechanisms and initiatives each has developed to promote licensure reciprocity and mobility. Each of the organizations was contacted and agreed to prepare a brief article suitable for publication in SPPA newsletters. These three articles were circulated in September of 2000 and have been reprinted in various SPPA newsletters. In October of 2000, CAPP reviewed the progress made in publicizing the various mechanisms for promoting mobility and the increasing acceptance that these mecha-
nisms were receiving, and decided that a continuation of the current strategy would be recommended to the Board and Council. In December of 2000, the Board of Directors approved the strategic plan prepared by CAPP. Mechanisms to Mobility: Implications for Practitioners At this point in time it seems clear that the need for mobility for psychologists will continue to increase. However, since we really don’t know how events will unfold in the future, all of the vehicles for increasing psychologists’ mobility should be supported. We need all of our “oars in the water,” so to speak. Readers are encouraged to contact the sponsoring organizations to learn more about each of the mobility mechanisms: the National Register, the ASPPB, and ABPP. As always, I welcome your thoughts on this column. You can most easily contact me via email: Rlevant@aol.com. ✯
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References DeLeon, P. (2000). The critical need for licensure
mobility.
Monitor
on
Psychology, 31(4), 9. Smith, D. (2001, May). Helping psychologists
on
the
move:
States
and
provinces make professional mobility easier for psychologists. Monitor on Psychology, 32(5), 73. Sullivan, M. J.
(2000-2001, Winter).
Directorate helps to promote mechanisms for mobility. Practitioner Focus, 13, 4, 16.
Ronald F. Levant, EdD, ABPP, is in his second term as Recording Secretary of the American Psychological Association. He was the Chair of the APA Committee for the Advancement of Professional Practice (CAPP) from 1993-95, a member of the Board of Directors of Division 42 (1991-94), a member at large of the APA Board of Directors (1995-97), and APA Recording Secretary (1998-2000). He is Dean, Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, FL.
2002 Distinguished Professional Contribution Awards Texas Psychologically Healthy Workplace Award Southwest Airlines Psychologist of the Year Harriet H. Arvey, EdD Outstanding Contribution to Education Cynthia de las Fuentes, PhD Outstanding Contribution to Science Ricardo C. Ainslie, PhD Outstanding Contribution to Public Service Alice Lawler, PhD Outstanding Public Contribution to Psychology Genevieve Hearon Texas Psychology Foundation Manuel Ramirez III Dissertation Award for Ethnic Minority Research Debra K. Roberts, PhD SPRING 2003
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From Normal Institute to State University: A History of Psychology at Sam Houston State University A. Jerry Bruce Sam Houston State University
Sam Houston State University Department of Psychology and Philosophy opens the fall semester of 2002-2003 for its fifth year in the Forensic Clinical Psychology PhD Program. Four students completed their internships in 2001-2002, and two are beginning theirs for 2002-2003 at various clinics across the country. All of the interns have received appointments to APA accredited internship sites. The first two degrees from the program were awarded August 10, 2002.
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he program faculty is earnestly working on a self-study with the hope that it will lead to APA accreditation for the program. At Sam Houston State University, this doctoral program has evolved from a number of other programs within psychology and rests on a history of commitment to the development of educational opportunities for persons within the region, the state, and the nation. In the year 1879, according to the American Psychological Association (APA) (Benjamin, 1979; Hearst, 1979), psychology joined the academic community as a separate independent discipline distinct from philosophy and physiology. Wundt in Leipzig, Germany, is usually considered the father of the new academic experimental psychology. In that same year, Sam Houston Normal Institute began classes in Huntsville, Texas (Sam Houston State University, 2000-2002). The purpose of the new normal institute was to train teachers. To quote from the first Sam Houston Normal Institute Catalogue (1879-1880): The object of this school is to elevate the standards of education throughout our state, by giving thorough instructions and special training to as many as possible of our present and future teachers (p. 9). In keeping with the stated purpose (i.e., to be thorough), psychology was offered as one of the areas of instruction. Oscar Henry Cooper was listed (p. 8) as the instructor for psychology. This same O. H. Cooper, in 1899, became president of Baylor University
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and later Hardin-Simmons College (Webb, 1952, p. 408). In all of the early catalogues psychology was listed as part of the curriculum. It might have been interesting to attend those early psychology classes taught at Sam Houston and to compare them with the psychology taught today. How much has it changed? Reed (1997) indicates that psychology, as taught in those early classes, was mostly philosophy of mind, study of the development of character, or education in morality. The Scottish School of Common Sense was a dominant theme. Philosophers/ psychologists such as Thomas Reid, Dugal Stewart, et al. were central in the texts. Goodwin (1999) notes that the first psychology textbook in the USA was Thomas C. Upham’s Elements of Intellectual Philosophy. It was published first in 1827 and several times thereafter, growing to a total of three volumes and changing its title to Elements of Mental Philosophy. The Sam Houston State University, Newton Gresham Library, has a copy dated 1850. It is a one-volume work entitled Elements of Mental Philosophy: Abridged and Designed as a Text-Book for Academies and High Schools. The chapter headings of Upham’s book read much the same as current day introductory psychology texts: sensation and perception, the sense of hearing, habits of sensation and perception, attention, memory, and disordered intellectual action, to name a few. But there are other chapter titles that reflect a difference: origins of knowledge in general, simplicity and complexness of mental states, original suggestion, moral reasoning, excited conceptions or apparitions, emotions of beauty, instincts, the
malevolent affections, etc. A passage that reveals the flavor of the early work: “The soul, considered in its relationship to external nature, may be compared to a stringed instrument. Regarded in itself, it is an invisible existence, having the capacity and elements of harmony” (p. 18). Nevertheless, psychology was there at the beginning of Sam Houston State University’s existence. An interesting note on psychology in the life of Sam Houston, the man, comes from Reed (1997) who relates that he had an interest in psychology. In the 1850’s, Sam Houston and several other leading senators invited John Bovee Dods to deliver a series of lectures on psychology. Reed says, “…Dods offered his psychology as a new science which he believed would become queen among the sciences because of the insights it would provide into the most important aspects of life: human beings’ relation to nature, to other people, and to the deity” (p. 1). Sam Houston State University was part of the normal school movement within Europe and the United States. The first state-supported normal school in the United States was opened in 1839, Lexington, Massachusetts (Harper, 1939). The movement grew from the notion that education of the populace was essential for a democracy. Daniel Webster noted this need clearly when he said, “On the diffusion of education among the people rests the preservation and perpetuation of our free institutions” (as cited in Harper, 1939, p.11). Colleges had emerged in this country much earlier. Harvard, founded in 1636, SPRING 2003
was followed by nine others before 1776 (Goodwin, 1999). These liberal arts colleges, however, were for the most part committed to training ministers, physicians, and lawyers. In Texas, the University of Texas was envisioned in 1839 but did not open for classes until 1883 (Battle, 2002). Austin College, first at Huntsville and later at Sherman, was one of the earliest colleges in Texas admitting its first students in the fall of 1850 (Austin College, n.d.). The two colleges that vie for the designation of Texas’ first college are Baylor University (Baylor University, n.d.) and Southwestern University at Georgetown (Southwestern University, 2002). Both trace their beginnings to the early 1840’s. The public schools, usually referred to as common schools in the United States during the nineteenth century, were poor indeed. The teachers were simply whoeverwas-available. The normal school movement was intended to develop and to improve public education. By improving the quality of the teachers, the quality of the schools would be assured. A further goal of the normal school was to make teaching a profession. According to Bowen (1981, p. 250), the use of the designation normal school, came from Austria where by 1774 Abbot Felbriger called his teachers’ college a Normalschule. This usage was followed in France when the government created the Ecole Normale for the purpose of training teachers. The word “normal,” as used here, is in reference to the idea of setting standards of normal practice. Perhaps one could think of it in terms of setting standards of minimum competency. In the 1840’s, the English established normal schools in order to create a body of schoolmasters to manage the schools throughout England (Bowen, 1981, p. 309). The movement to improve public schools was energetic and led to an increased numbers of states requiring education of all its children. By 1918, all states had compulsory education of some sort (Zenderland, 1998). During the first two decades of the SPRING 2003
twentieth century the normal schools began a rapid change to state teachers colleges. These changes required the institutions to expand their curriculum and to resist the temptation to become mere liberal arts colleges (Harper, 1939). In the west, most of the normal schools considered themselves colleges from the very beginning; in fact, they considered themselves more than colleges. For instance, at Sam Houston Normal Institute, the catalogues noted that at the normal school it was necessary not only to know what should be known, but one had to have the skills to teach it as well (Sam Houston Normal Institute, 18791880, p.10). The more classically oriented institutions looked askance at the newly emerging normal schools, but the normal schools took pride in their more down-toearth approach. Some universities and colleges began the development of education departments; but the majority, as the nineteenth century came to a close, resisted this tendency. Where education departments and positions were developed, other departments and colleagues usually considered the new departments and professors of pedagogy in a less than favorable manner. The faculty generally considered the new departments as tacked onto the university, not a real part of the college or university. If Sternberg and Lyon (2002) are correct, the bias against education still exits. To be associated with education, to do research in education, in fact to be involved in applied research of any sort, was and is seen as second-class activity in many psychological circles. The new normal schools were practical and applied schools. Harper (1939) notes that the early requirements for admission to the normal schools were a bit spotty. As time passed, the trend for admission requirements moved toward graduation from high school. By 1900, the national average of those matriculating in thirtyeight of the large schools was about 26 percent high school graduates (p. 105). Harper further indicates that a large percentage of the students had taught in pub-
lic schools already. At some of the normal schools, the average age was 24 years old. The goal of many of the graduates especially in the western schools was to move into the position of principal or superintendent of the schools. Nevertheless, it should be noted that it was not always easy to get into the normal institute. T. S. Stribling, a Pulitzer Prize winning novelist, related how the experience was for him: The college at Florence which I attended was a training school for teachers, but that made no difference to me because all roads led to Rome anyway. [He was intent upon becoming a lawyer at the time.] I recall some little difficulty matriculating. The prospective students had to pass examinations, designed mainly I think to block the path of ambition and arrest noble resolves. It was a two-year course. I wanted to enter the second year because I was in a hurry to reach the regular law course at the University. The teachers at the Florence Normal, backed by the results of the examination, wanted me to enter the first year. We argued and argued about it. I claimed that I failed because I had been out of school too long, three or four months—all summer in fact— and had let slip from mind, quite temporarily, much matter that I really knew. I don’t know why they finally let me enter the second year with conditions. I don’t know whether they thought one year of the Normal would be enough for me, or one year would be enough for the Normal (Cross & McMillan, 1982, p.77-78). As is common in universities with similar histories, psychology, and education at Sam Houston State University both grew from the normal school applied tradition and were closely related from the beginning. The college in which both education Texas Psychologist
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and psychology are housed today at Sam Houston State University is the College of Education and Applied Science. In 1923, Sam Houston Normal Institute changed its name to Sam Houston State Teachers College. The name again was changed in 1965 to Sam Houston State College. In 1969 the school adopted its present name, Sam Houston State University. It was not until 1962 that psychology was made available as a major course of study and received departmental status at Sam Houston State Teachers College. In that year, the Department of Education became the Department of Education and Psychology. And it was not until 1970 that psychology became an autonomous department. In its early years as a department it was considered a service department primarily for education students, though in that year, 1970, psychology had 85 majors. An autonomous department of psychology was created under the leadership of Jack Staggs (University of Houston) in the fall of 1970-1971. Billy Gene Waldron (North Texas University) was the chair of the new department during the earliest days. The faculty of the department during the earliest years was composed of individuals from wide geographical areas and from many of the various sub-areas of academic psychology. Some of the earliest hires were Patricia Altenburg, physiological psychology from University of Houston; A. Jerry Bruce, developmental psychology from University of Georgia; S. T. Kordinak, psychology of learning from University of Colorado; James A. Johnson, counseling psychology from Texas A&M University; Lois Picht, mental retardation from University of Northern Colorado; John Symonds, social psychology from University of Illinois; and James Patrick Weber, statistics and history of psychology from Michigan State University. Bill Waldron, the new department chair, had been a member of the Education and Psychology Department for several years. The department over the years continued to employ persons with the idea of maintain10
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ing diversity in terms of geographical area and sub-fields within psychology. Professors included: Cheryl K. Anisman (clinical/school psychology, Wayne State University), Mary Alice Conroy (forensic psychology, University of Houston), John Edens (forensic psychology, Texas A&M University), Richard Eglsaer (school psychology, University of Texas), Mac Griffith (personality, Baylor University), Marsha Harman (counseling/school psychology, University of Houston), Melanine Kercher (experimental psychology, Baylor University), Rick McNeese (physiological psychology, Texas Christian University), David Marcus (clinical psychology, Clark University), Rowland Miller (social psychology, University of Florida), Paul Neunuebel (clinical psychology, University of Missouri), Linda Parker (physiological psychology, Memorial University of Newfoundland), T. C. Sim (cognitive psychology, University of Nevada, Reno), Chris Wilson (physiological psychology, Texas Christian University), and others who could be added if adjunct, part-time, and temporary positions were included. Many of these persons have moved to other places, but the department, as Sam Houston State University in general, has had a remarkably low level of turnover. A. Jerry Bruce became chair of the Department of Psychology in 1976. He served in that position until August of 1999. Under his leadership, the department evolved from offering only an undergraduate major in psychology to include three master’s degrees and a PhD program. The number of majors at the undergraduate level increased from approximately 100 to over 500 majors in the fall of 1998. The psychology program was granted permission to offer the Master of Arts degree in the fall of 1981. It was in the December graduation of 1982 that the first M.A. was awarded. The M.A. programs grew to include one in General Psychology, one in Clinical Psychology, and one in School Psychology. Consistently over the years, about 20 people per year were admitted to the master’s level programs. In the spring of 1994, A. Jerry Bruce
proposed the idea of a doctoral program in forensic psychology to Dean Kenneth Craycraft, College of Education and Applied Science. As a result of this proposal, a meeting was held in the office of the Vice President for Academic Affairs. Vice President Bob Marks, Dean Kenneth Craycraft, Dean Tim Flannagan (Criminal Justice), and A. Jerry Bruce were at the meeting. Shortly thereafter, a committee was formed made up of faculty members from the College of Criminal Justice and the College of Education and Applied Science. This committee plus several additional committees under the urging of President Martin Anisman finally produced a proposal that was submitted to the Texas Higher Education Coordinating Board. In 1997 the Coordinating Board of Texas gave Sam Houston State University permission to offer the PhD in Forensic Clinical Psychology. The first class of eight students entered in the fall of 1998. Now in August of 2002, the first two graduates from this program join the ranks of doctoral level scientist/practitioners eligible for licensure as psychologists. Today Donna Desforges is chair of the Department of Psychology and Philosophy, Sam Houston State University. The faculty consists of 18 full-time members plus a number of part-time and adjunct positions. The doctoral program is coordinated by David Marcus and the master’s programs by Rowland Miller. Marsha Harman is the supervisor of the school psychology students. The department operates a Psychological Service Center under the direction of Mary Alice Conroy. With the beginning of fall semester, 2002, there are approximately 500 undergraduate majors, 60 master’s level students, and 40 doctoral students. At Sam Houston State University, psychology is committed to the proposition that psychology must be related to the world of real problems. From the College of Education and Applied Science, psychology reaches out to education (school program), to the mental health community (clinical program), and to the criminal justice system (forensic program). This SPRING 2003
does not mean that psychology is not also devoted to providing the best possible coverage of the basic discipline in all of its scientific rigor and academic quality. The position is taken that academic concerns and professional interests, theory and practice, both basic and applied approaches, can be and should be addressed in the psychology programs at Sam Houston State University. ✯
Haven, CT: Yale University Press. Sam Houston State University. (20002002). Sam Houston State University 2000-2002 undergraduate catalogue. Huntsville, TX: Author. Sam Houston Normal Institute (18791880). Sam Houston Normal Institute
Making a difference to education: Will psychology pass up the chance? APA Monitor, 33 (7, July/August), 76-78. Webb, W. P. (1952).
Historical Association. Upham, T. C. (1850). Elements of mental
1879-1880 catalogue. Huntsville, TX:
philosophy.
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Southwestern University. (2002). South-
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Texas, Vol.1. Austin, TX: The State
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Zenderland, L. (1998).
York:
Harper
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Measuring minds:
western History. Retrieved August 1,
Henry Goddard and the origin of American
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intelligence testing. Cambridge, UK:
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Cambridge University Press.
Histor y: An Over view. Retrieved on
Sternberg, R. J., & Lyon, G. R. (2002).
August 2, 2002, from http://www. austincollege.edu/vistors/welcome/ 150/history.htm Battle, W. J. (2002). University of Texas at Austin. In The General Libraries at the University of Texas at Austin and the Texas State Historical Association (Project Editors). Handbook of Texas Online. Retrieved July 26, 2002, from h t t p : / / w w w. t s h a . u t e x a s . e d u / handbook/online/ar ticles/view/UU/ kcu9.htm Baylor University. (n.d.) Excellence in Christian Higher Education. Retrieved July 30, 2002, from http://www.baylor. edu/about/default.asp Benjamin, L. T. (1979). A century of science. APA Monitor, 10 (2), 1, 3. Bowen, J. (1981). A history of Western education, Vol. 3: The modern west Europe and the New World. New York: St. Martin’s Press. Cross, R. K., & McMillan, J. T. (Eds.) (1982). Laughing stock: The posthumous autobiography of T. S. Stribling. Memphis, TN: St. Luke’s Press. Goodwin, C. J. (1999). A history of modern psychology. New York: John Wiley. Harper, C. A. (1939). A century of public teacher education. Washington, DC: National Education Association. Hearst, E. (1979). The first century of experimental psychology. Hillsdale, NJ: Lawrence Erlbaum. Reed, E. S. (1997). From soul to mind: The emergence
of
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Erasmus Darwin to William James. New SPRING 2003
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Forward – Reflections on Prescriptive Authority and the Evolution of Psychology in the 21st Century Patrick H. DeLeon Past President, American Psychological Association
It has been tremendously rewarding to watch up-close the maturation of psychology’s prescriptive authority (RxP) agenda. Over the past quarter of a century, I have had the opportunity of being personally involved within the public policy (e.g., political) process. Further, I have been most fortunate to have been elected to a number of American Psychological Association (APA) governance positions. This has been very satisfying — both personally and professionally. The caliber of colleagues I have worked with has been simply outstanding. Across the nation, we really do care about what is best for our patients. Psychology is one of the “learned professions” and as such, we have much to offer to society. The psychosocial aspects of health care, not to mention of education, are extraordinarily important. In my judgment, the profession of psychology has a special societal responsibility to provide proactive vision and effective leadership. We must appreciate the transformations that are occurring within society and ensure that psychology’s considerable expertise is appropriately utilized. The 21st Century will be an era of: educated consumers; an explosion of technology in the health care arena; and systematic utilization of objective, data driven, clinical decision making. This is the essence of the RxP agenda.
I
am particularly pleased to be given the opportunity to formally express my sincerest appreciation to former APA President Ron Fox who has understood this nexus from the very beginning and who has personally been there on behalf of all of psychology every step of the way. Without Ron’s effective leadership, we would never have come this far, this fast (cf, DeLeon, Sammons, & Fox, 1995). Historical Glimpse As described in several chapters in this volume, the prescriptive authority movement is evolutionary, and received its first real impetus little more than 15 years ago, in Senator Daniel K. Inouye’s November, 1984, suggestion to the Hawaii Psychological Association that they adopt an entirely new legislative agenda, one which he felt would fit very nicely into that year’s programmatic theme: “Transcending Traditional Boundaries.” At that time, 39 states allowed optometrists to utilize diagnostic drugs (4 states having authorized the use of therapeutic drugs) and 18 states allowed nurse practitioners to prescribe, generally under some form of supervisory arrangement with a physician (DeLeon, Fox, & Graham, 1991). Today, the 12
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non-physician landscape has drastically changed with all states allowing these professions to effectively utilize medications and an increasing number recognizing physicians’ assistants and clinical pharmacists. It is expected that by the year 2005 the number of non-physicians practicing in primary care will equal the number of primary care physicians. Drug companies are now overtly advertising to an enlightened public. Hand held pocket computers contain the most upto-date information on drug interactions. During the year of my APA Presidency, I was pleased that the national leadership of psychology and clinical pharmacy actively explored areas of common interest and concern — including RxP training and collaborative practice. As I traveled across the nation visiting with state associations, I also sensed developing interest at the grass roots level in fostering collaborative practice opportunities and legislative endeavors. A vision of the future The 21st Century will be an era of the educated consumer and a time when our nation will experience an unprecedented impact of technology upon our health care delivery and educational systems. For exam-
ple, objective (e.g., data driven) clinical protocols will become increasingly common; telehealth care and Web-based distance learning will make traditional time and distance considerations almost inconsequential; and the all important behavioral, environmental, and cultural aspects of service delivery will finally be accorded their appropriate priority. At the same time, there is also every indication that we will see unprecedented changes in the manner in which health care services are delivered. Economic concerns, including the costs inherent in ensuring that practitioners are able to access the most advanced scientific knowledge available, will strongly encourage interdisciplinary care and provide enhanced opportunities for psychology within primary health care systems. For some senior clinicians, the traditional feefor-service practices will flourish. Future generations of psychologist clinicians, however, will undoubtedly experience a very different working environment. In my judgment, these expected changes go to the essence of psychological training and service delivery — we are, above all else, behavioral scientists. For psychology to actively participate in shaping the nature of this monumental shift in focus within our nation’s health care sysSPRING 2003
tem, it is critical that our profession’s national leadership proactively work to ensure that our clinical and scientific skills are increasingly recognized and valued by society and by our nation’s health policy experts. It is important that professional psychology never lose sight of the fact that the essence of the RxP agenda is fundamentally a social policy agenda; e.g., ensuring that all Americans have access to the highest possible quality of care. It is equally important to appreciate that this is a psychology agenda (DeLeon, Sammons, & Sexton, 1995). The concerns that have been raised over the past two decades by members of other professions are in the larger scheme irrelevant. The underlying policy discussion is, and always has been, about where the profession of psychology collectively wants to evolve. It is not about the future or preferences of any other profession. It is also important to note here that this is an agenda that involves all of psychology, not just professional psychology. Fundamentally, the prescriptive authority agenda is an educational agenda — in spite of the fact that it was initiated by, and fostered by, the front-line practicing clinician community. If one reflects upon the history of professional psychology, one soon appreciates that psychology is a relatively young profession and further, that its members are only in the beginning stages of their personal involvement in the public policy (e.g., political) process. This latter point is particularly salient, for it is through the public policy process that institutional and societal changes ultimately evolve. Although the discipline of psychology dates back to the founding of Wundt’s laboratory in 1879, it was on September 21, 1970 that classes began at the first independent professional school of psychology — the California School of Professional Psychology (CSPP). This was to become the era of the Doctor of Psychology degree (Psy.D.), the first program being launched in the Department of Psychology at the University of Illinois at Champaign-Urbana in 1968. In many ways, this particular educational movement would ultimately lay the foundation for the interest SPRING 2003
of future generations of clinicians in ensuring that their services would be reimbursed and readily accessible to the public. Today, there are 48 accredited Psy.D. programs, most of which are within professional schools, the latter graduating 58% of all clinical students. Upon reflection, it also becomes clear that at every stage in professional psychology’s development there have been those both within the profession, and external to psychology, who have actively resisted any change in the status quo (Resnick, 1997). This was the case when psychology sought to provide psychotherapy; independently diagnose and treat; and receive reimbursement for services rendered, regardless of the location (e.g., inpatient care). Change is always unsettling and there can be no question that the movement towards the professional degree (Psy.D.), in particular, represented a major shift in psychology’s fundamental identity and inherent value system. This is a shift that even today some more traditional psychologists continue to actively resist. It is impossible to predict with any sense of certainty where the future will evolve. Accordingly, in my judgment, it is absolutely critical that those who genuinely care about the profession and who are willing to be responsive to society’s pressing needs, as well as being sensitive to the broader changes evolving within society, become intimately involved in shaping our collective future. Focused Debate As is described in-depth elsewhere in this impressive and most timely publication, the RxP agenda has now been thoroughly debated and discussed in the classroom, in our professional journals, at state and national convention gatherings, in various State legislative venues, in the halls of Congress and throughout the APA governance. At every step of the way, the underlying concept of appropriately trained psychologists obtaining independent prescriptive authority has always been endorsed by psychology and nearly unanimously (DeLeon & Sammons, 1998). In 1989, APA’s Board of Professional Affairs (BPA), under the chairship of Norma Simon, held a special retreat meeting on the
issue, hearing from a wide range of experts and perspectives. BPA ultimately recommended that focused attention on the responsibility of preparing the profession to address current and future needs of the public for psychologically managed psychopharmacological interventions be made APA’s highest priority. In 1990, the APA Council of Representatives established an ad hoc Task Force on Psychopharmacology, with at most only two Council members expressing opposition. Two years later, this Task Force, under the chairmanship of Michael Smyer, submitted their report to Council. In their judgment, practitioners with combined training in psychopharmacology and psychosocial treatments could be viewed as a new form of health care professional, one which would be expected to bring to health care delivery the best of both psychological and pharmacological knowledge and which possessed the potential to dramatically improve patient care and make important new advances in treatment. As future developments would demonstrate, the proactive vision of these earlier colleagues is most impressive. Over three consecutive convention meetings of Council — 1995, New York; 1996, Toronto; and 1997, Chicago — APA’s highest elected body of governance (e.g., the Council of Representatives) voted overwhelmingly to make obtaining prescriptive authority APA policy, including endorsing a model legislative bill and training curriculum. Further, the APA College of Professional Psychology was authorized to develop an appropriate national examination, suitable for use by the State and Provincial licensing boards. The examination has now been taken by approximately 50 postdoctoral psychopharmacology graduates. During these deliberations within the APA’s governance, the Committee for the American Psychological Association of Graduate Students (APAGS) adopted a formal resolution of support for RxP. This was particularly significant, as APAGS is the future of the profession. As one reviews the chapters in this historic book, one gets a first hand sense of how a steadily increasing number of dedicated Texas Psychologist
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and visionary colleagues have truly made a difference in the lives of many of our nation’s citizens, often behind the scenes and at great personal sacrifice. They have been willing to move the profession into uncharted waters. If one is honest with oneself and focuses upon the unique needs of any subset of our nation’s population — whether this be children, the elderly, women, ethnic minorities, those residing in rural America, or those in need of chronic or long term care — it is clear that they are not receiving the quality of care that every one of us would desire for our own loved ones. Further, it readily also becomes evident that the systematic and enhanced availability of psychological expertise would be most beneficial. In my judgment, any other conclusion would be simply intellectually dishonest. The underlying policy questions become: Is professional psychology willing to assume this clinical responsibility? We must also ask: Have we matured sufficiently to become one of our nation’s bona fide health care professions? (DeLeon, Bennett, & Bricklin, 1997; DeLeon, Robinson-Kurpius, & Sexton, 2001). The Bigger Picture For those who have not taken a careful and candid look at the status of our current health care delivery system, we would suggest they review several landmark reports recently released by the Institute of Medicine (IOM). The IOM has served as a highly respected health policy “think tank” for the Congress and various Administrations, since it was chartered in 1970 by the National Academy of Sciences, acting under the Academy’s 1863 Congressional charter responsibility to be an advisor to the Federal government. In 1999, the IOM released a highly controversial report that found that each year, between 44,000 and 98,000 Americans died in hospitals, as a result of medical errors. The report noted that medications are the most frequent medical intervention. Encouraging interdisciplinary collaboration, the report further described how merely by having clinical pharmacists participate during daily hospital rounds, the rate of preventable adverse drug events relating to prescribing decreased sig14
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nificantly (66 percent) within major teaching facilities. We would remind the reader that these patients were under the clinical care of licensed physicians and were being treated in licensed health care facilities. Another far reaching IOM report (IOM, 2001) addressed the extent to which the current American health care system lags significantly behind other segments of the economy in utilizing advances in relevant technology and in ensuring that scientific advances are employed in a timely fashion. The American health care delivery system is in need of fundamental change. Americans should be able to count on receiving care that meets their needs and is based on the best scientific knowledge. Yet there is strong evidence that this frequently is not the case. The lag between the discovery of more efficacious forms of treatment and their incorporation into routine patient care is unnecessarily long, in the range of about 15 to 20 years. Even then, adherence of clinical practice to the evidence is highly uneven. Accordingly, to profess (as some in organized medicine have done) that our highly trained and dedicated clinicians will become “public health hazards” when they obtain the clinical responsibility to independently prescribe is simply absurd. This is an emotionally charged argument that for generations has been used against a wide range of non-physician health care providers. It simply has no basis in fact and, not surprisingly, is overtly contradicted by objective study after study. In all candor, it has always seemed somewhat strange to me that medicine would even consider making this particular policy argument. The key to providing quality care is the ability to make an accurate clinical diagnosis. If any of the non-physician disciplines were inherently dangerous, one would expect that those public institutions (e.g., the state legislatures and regulatory and licensing boards) that have a long and distinguished track record of protecting the public, would prohibit psychology (for example) from being licensed to diagnose. Yet since 1977, psychology has been licensed (or certified) in all states, and today, psychology is recognized as an independent profession under every one
of the federal government’s healthcare delivery and reimbursement programs. Essentially, the “public health hazard” argument has long ago been deemed moot at best, and at worst irresponsible, in that it impedes portions of our citizenry from receiving the most appropriate care. A related perspective is provided by our academic colleagues involved in establishing quality psychopharmacology training modules. These professionals have described the extent to which organized psychiatry has systematically attempted to prevent their courses from even being offered. This brings to mind the worst of the anti-intellectual eras in our nation’s history. As an individual who grew up in a family that highly valued education, the thought that any segment of our society would affirmatively attempt to prevent anyone from bettering oneself through education, is simply unconscionable. For the RxP agenda, the relevant educational question is: “what aspects of the current psychopharmacology didactic training programs (conducted by medicine, nursing, or pharmacy) should be incorporated into psychology’s already extensive knowledge base in order to improve the functioning of psychology’s clinicians?” The answer is not: “One should go to medical school.” It is the underlying mission of our nation’s educational system to develop courses that are relevant to societal needs. By employing up-to-date technological advances within education (e.g., virtual training modalities), these can be readily adopted to the unique circumstances of practicing clinicians, graduate students on internships, and those interested in re-specializing. Given the intensity of the opposition, one can only conclude that we must be making a difference. That is what a learned profession must strive to do. Quality education is the strength of our profession and our nation. A Personal Aside Over the past several years, I have had the distinct honor of serving as the commencement speaker at three separate psychophamacology graduating ceremonies. These have all been very special events. Our senior colSPRING 2003
leagues had agreed to go back to school, with all of the accompanying self-doubts, stressors, and anxieties. But they survived and did very well. At graduation time, they were rightfully proud of their newest accomplishments. The graduates began to publicly share how much they had learned and how they now saw their patients from an entirely different perspective. Prior to enrolling in their psychopharmacology training, their peers all agreed that they were excellent therapists. Now, they described themselves as bringing something qualitatively different to those patients for whom medication might be clinically useful – a fundamentally psychological approach to psychotropic interventions. They had become, in fact, an entirely new breed of clinician with a highly unique perspective. The prophetic vision of our earlier governance policy reflections was being fulfilled. Most importantly, society was being well served (DeLeon & Wiggins, 1996). It has been my observation in talking with colleagues across the nation over the past three decades, that the overwhelming majority of practicing psychologists originally went into the field because they wanted to be able to make a meaningful difference in the daily lives of those they would eventually serve. During my presidential year, on a weekly basis, I reached out to those in the membership who were not involved within the APA governance. These were very moving and inspiring discussions. There can be no question that our field possesses extraordinary talent and dedication. Countless colleagues are making contributions at the local level every day. Psychological principles are being effectively utilized in an increasingly wide range of forums — sports psychology, health psychology, psychology and the law, etc. Our professional future is only limited by our collective vision and willingness to take a chance. Those of us who have been fortunate to gravitate to positions of national psychology leadership must now fulfill our unique responsibility. Historically, psychology’s nationally elected officials seem to have not appreciated the policy importance of their positions. We must, for example, ensure that society becomes aware of, and can readily SPRING 2003
avail itself of, the most up-to-date psychological expertise. To cite but one example, it is clear that it never occurred to our graduate students when they entered the field that our health care delivery system would have established arbitrary barriers to making their services readily available to those in need, under the rubric of being a “medical care system.” We must work to change that. We must strive to ensure that the most up-to-date scientific knowledge (including that of the behavioral sciences) is effectively utilized throughout the health care delivery system. In seeking to accomplish this laudatory objective, we will come to appreciate the importance of true interdisciplinary collaboration and training. Psychology is but one of the health professions. We must, for example, learn to become team players within the primary health care arena. Above all else, organized psychology requires proactive leadership at the national level in furtherance of these goals. Within our universities, psychology continues to be one of, if not the, most popular undergraduate majors and every year extraordinarily bright seniors apply for advanced training. When President Carter established his landmark Presidential Commission on Mental Health, there were approximately 59,900 members and affiliates of the APA. A decade later (1988), APAGS was established by the APA Council of Representatives. As we enter the 21st Century, the comparable APA membership numbers have grown to 155,000, with APAGS possessing 59,700 members. These are very impressive numbers, and they speak well for the future of the profession. But I would reiterate that a promising future exists only if those of us in leadership positions fulfill our responsibilities. Collectively, we must possess a vision that is consistent with evolving national trends. We must also work together to ensure that our vision and dreams for psychology become reality. We must never forget that we are all one family. In this light, it was with great personal pleasure that I was able to have the RxP agenda become one of my APA Presidential initiatives and convention programmatic themes, admirably co-chaired by Department of Defense (DoD) Psychopharmacology
Fellows Anita Brown, Chuck Faltz, Ray Folen, and Sandy Rose Mahalo. A Step Forward During the Congressional deliberations on the Fiscal Year 1989 Appropriations bill for the Department of Defense, the conferees directed the Department to establish a demonstration pilot training project under which military psychologists would be trained and authorized to issue appropriate psychotropic medications under certain circumstances. On June 17, 1994 then APA President Bob Resnick and I attended the graduation ceremonies at the Walter Reed Army Medical Center of the first two DoD Psychopharmacology Fellows, U.S. Navy Commander John Sexton and Lt. Commander Morgan Sammons. This federal program caused considerable consternation (to put it mildly) within the psychiatric community and ultimately graduated 10 Fellows. Numerous external evaluations of the prescribing practices of the DoD Fellows have been extraordinarily laudatory (Newman, Phelps, Sammons, Dunivin, & Cullen, 2000). These dedicated individuals have visually demonstrated to the public, and perhaps more importantly to their own peers, that professional psychologists can be successfully trained to safely and cost-effectively utilize psychotropic medications. Listening to their words, they definitely have made a difference in the lives of their patients. From a more global perspective, a number of the Fellows have been intimately involved in the “grassroots” state-based legislative movement. Others have been on the cutting edge of developing psychology’s civilian postdoctoral psychopharmacology training modules. Most importantly, each of them has provided a living face to the previously purely abstract concept of psychology’s RxP agenda. We owe them a tremendous debt of gratitude. They were willing to go where no one else had tread before (DeLeon, Sammons, & Fox, 2000). Forward glances First, for the Practitioner — Obtaining in-depth knowledge about the rapid advances occurring within pharmacy and the Texas Psychologist
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expanding appreciation of the biological basis of various mental health and emotional disorders is the fundamental key to improved quality of care. Prescriptive authority opens up entirely new market places and provides the profession with the legal standing to insist upon the recognition of the psychosocial aspects of mental health care. Those who already prescribe (either within the federal jurisdiction or as “learned collaborators” with primary care physicians) clearly indicate that from their personal experiences, ensuring that those receiving psychotropic medications received the appropriate dosage is a high priority. Those colleagues interested in serving individuals with chronic or severe mental disorders will find historical artificial programmatic barriers removed. Those interested in working with nursing home populations will find ready access to patients and their families with significant psychological needs. And those interested in focusing upon unique population subsets, for example women or children, will again find that their fundamental psychological approach will provide a unique and welcomed perspective. The DoD Fellows have truly taught us that above all else: The power to prescribe is also the power to un-prescribe (or modify) inappropriate or excessive medication regimens. For the Scientist It is difficult to fathom any limit on the newest scientific problems to be systematically explored, particularly within the area of therapeutic effectiveness. What, for example, is the most effective therapeutic approach for women with depressive symptoms? How should hyperactive children be assessed and treated? What about depression related to serious physical diagnoses, such as cancer or needing dialysis care? What are the long term developmental effects of being treated with psychotropic medications? The history of clinical medicine’s training resources would suggest that graduate departments of psychology and professional schools that are involved in these psycho-physical investigations will do very well.
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For the Educator These should be extraordinarily energizing times, particularly for those colleagues interested in interdisciplinary collaboration. Those who have been involved from the earliest days in the development of the RxP agenda have consistently agreed that for psychology to retain its fundamental behavioral science identity (and its psychological approach to utilizing medications), it is important that psychopharmacology training be obtained at the post-doctoral level. This policy orientation is reflected in the requirements for taking the national College of Professional Psychology examination. Accordingly, one should expect a rapidly expanding educational market, not only for formal training leading to an advanced psychopharmacology degree, but also for the soon to-be required (by licensing boards) continuing education modules, “hands-on” training for those on their clinical internships, and for members of other professions (e.g., advanced practice nurses, clinical pharmacists, and clinical social workers) who are interested in the broad behavioral health area. With increasing reliance upon Web-based virtual teaching environments, I cannot see any limit to the development of future educational activities in this field. As non-physician clinicians become more involved in serving diverse subpopulations (e.g., the elderly and children) there will be an ever-expanding need for quality educational modules targeting practicing clinicians. As a nation, we are experiencing a virtual explosion of scientific knowledge; while information presently doubles every 5 years, it is projected to soon double every 17 days, with traffic on the Web already doubling every 100 days (Jerome, et al., 2000). Legislative Forays Today there are 31 State psychological associations possessing prescriptive authority task forces. Enacting RxP legislation is a very high priority for the Committee for the Advancement of Professional Practice (CAPP) which annually makes available discretionary financial support for these legisla-
tive activities. In the next several years, it is projected that over a quarter of the State legislatures will grapple with formal RxP bills. During his RxP Council briefing at the San Francisco annual convention, Russ Newman indicated that soon APA will have spent in excess of $1 million on this legislative agenda. Relevant legislation has already been enacted into public law in Guam (1998) and Indiana (1993) – admittedly, perhaps not exactly the wording that professional psychology desires, but the underlying policy message is definitely there. The passage in 2000 of RxP legislation by the New Mexico House of Representatives, on a vote of 37-21 clearly indicates we have come a very long way indeed, since the introduction of the Hawaii RxP study resolution in 1985 (S. Res. 159) (Burns, DeLeon, Chemtob, Welch, & Samuels, 1988; DeLeon, Folen, Jennings, Willis, & Wright, 1991). The maturation of the profession as a public policy force: What has been particularly exciting from my public policy vantage point has been watching those colleagues who are supportive of the RxP agenda become personally engaged, both within the governance of their own state psychological association and their State legislatures. This is the best of our Democratic way of life. Enthusiastic citizens actively participating in the public policy (e.g., political) process on behalf of a policy agenda to which they are firmly committed. Considerable energy is oftentimes first spent educating fellow psychologists as to the value of the RxP movement. Soon a small, but definitely dedicated, group of like-minded colleagues surfaces. Survey after survey demonstrates that with concerted educative effort (and often a personal visit from one of the DoD psychopharmacology Fellows), approximately three quarters of the local state psychological association membership eventually becomes supportive. However, it remains those select dedicated few who will spend the necessary personal time with their individual State legislators and remaining reticent colleagues to ease their concerns. Frequently, these individuals have not previously been involved within their local psychological association SPRING 2003
governance in the past and now they bring the necessary enthusiasm and energy for an entirely new agenda. Ultimately, they will make a real difference to a revitalized state psychological association. Not surprisingly, the external medical opposition within the legislative arena remains consistent; most often expressed in the form of spreading emotional “public health hazard” allegations. Organized psychiatry and medicine frequently appear to spend considerable financial resources. On the other hand, efforts to work collaboratively with various potential stakeholders (e.g., clinical pharmacists, advanced nurse practitioners, consumer groups, educational institutions, and leaders of community health centers) turn out to be surprisingly successful. Ultimately, the key to legislative success is a belief in ourselves and persistence. I have no doubt that psychology’s RxP agenda is good for the future of professional psychology and good for the nation. Equally importantly, it is highly consistent with evolving national trends – both within the various health professions and in society in general. The number of Americans who use the Internet to retrieve health-related information is estimated to approximate 70-100 million annually. Currently, over half of American homes possess computers. These numbers continue to increase. The highly educated consumer of the 21st Century will value our scientific and clinical expertise, as long as we ourselves value our extensive training and clinical skills and if we ensure that society becomes increasingly aware of our potential contributions. Extraordinarily bright students are seeking careers in psychology. They simply will not be held back by historical artifacts or barriers. From my vantage point, psychology’s RxP agenda is foremost an agenda for the future and one of hope and optimism. As a profession, we are evolving out of nearly a decade of despair and frustration verbalized by practitioners as they began to come to grips with managed care and external demands for clinical accountability. The RxP agenda is a positive one; it provides a creative vehicle for constructive professional accomplishSPRING 2003
ments. It is a policy agenda around which all aspects of psychology can productively coalesce. In my judgment, time is definitely on our side. Aloha. ✯
Reprinted (1999) in L. A. Pagliaro & A. M. Pagliaro (Eds.), Psychologists’ neuropsychotropic drug reference (pp. xxi-xxvii). Philadelphia: Brunner/Mazel. DeLeon, P. H., Sammons, M. T., & Fox, R. E. (1995, November). A commentary: Canada is not that far north. Canadian Psychology,
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Welch, B. L., & Samuels, R. M. (1988).
(1995). Focusing on society’s real needs:
Psychotropic medication: A new technique
Responsibility and prescription privileges?
for psychology? Psychotherapy: Theor y,
American Psychologist, 50(12), 1022-1032.
Research, Practice, and Training, 25, 508-
DeLeon, P. H., Sammons, M. T., & Fox, R. E. (2000).
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DeLeon, P. H., Bennett, B. E., & Bricklin, P. M.
Kazdin (Ed.), Encyclopedia of psychology:
(1997). Ethics and public policy formulation:
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Verhaltensmedizin (2000), 21. JG.(1), 7-14].
Willis, D. J., & Wright, R. H. (1991). The
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human: Building a safer health system. L. T.
lution of professional practice. Journal of
Kohn, J. M. Corrigan, & M. S. Donaldson
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Press.
(1991). Prescription privileges: Psychology’s
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next frontier? American Psychologist, 46,
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384-393. Reprinted in J. A. Mindell (Ed.),
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Issues in clinical psychology (pp. 63-73).
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Dubuque: Wm. C. Brown Communications, Inc. (1993). DeLeon, P. H., Robinson-Kurpius, S. E., &
Jerome, L. W., DeLeon, P. H., James, L. C., Folen, R., Earles, J., & Gedney, J. J. (2000). The coming of age of telecommunications in
Sexton, J. L. (2001). Prescriptive authority for
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In M. T. Sammons & N. B. Schmidt (Eds.),
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Dunivin, D. L., & Cullen, E. A. (2000).
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Resnick, R. J. (1997). A brief history of practice
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463-468. Reprinted with permission of the author.
xvii-xxiii). Washington, DC: Taylor & Francis.
Texas Psychologist
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LAW
Forensic Services – Beware of the Pitfalls Sam A. Houston
The interplay between psychology and law in today’s society makes it almost certain that at some point in your career you may be called by a lawyer to give forensic testimony and/or possibly render a legal opinion — especially if you provide family therapy or counseling. According to the TSBEP newsletter, complaints regarding psychologists who perform forensic child custody evaluations represent the fastest growing segment of complaints received by the Texas State Board of Examiners of Psychologists.
T
he rule governing forensic services is Rule 465.18 of the Texas State Board of Examiners of Psychologists Rules of Practice. If you have access to that rule, I would recommend that you review it, particularly if you intend to engage in forensic services. The rule requires that any licensee providing forensic services must comply with all applicable board rules concerning such services, whether specifically acting as an expert witness or as a factual witness. In general, the rule requires the following: 1. You must demonstrate appropriate knowledge of, and competence in, all underlying areas of the testimony. 2. Any reports or recommendations must be based on information and techniques sufficient to provide appropriate substantiation for each of your findings. 3. You must decline to render opinions in areas in which you are not competent.
4. You should not render a written or oral opinion about the psychological characteristics of an individual without an examination, unless the opinion contains a statement that you did not conduct an examination. If you do render such opinions, you must clarify the limits of the reliability and validity of the opinions. 5. If providing forensic services by court appointment, you must not accept an appointment for both evaluation and therapeutic intervention for the same case. 6. If you interview or examine an individual for the purpose of providing forensic services, you must inform the individual of the specific purpose of the interview or examination. In the event there are multiple parties, you must obtain and document written informed consent from all adult participants unless informed consent is precluded by court order.
7. In child custody cases, you must not accept a case for forensic evaluation if you have a prior relationship with the child or parents, unless ordered to do so by court order. These are just some of the main points of the rule. I recommend that you review the rule and make certain that you are familiar with the appropriate requirements. It is important to be very careful in any situation involving litigation as complaints are often made by the aggrieved party to a child custody case. Thoroughly document information regarding consent and conversations in compliance with the rule. If you would like a copy of Rule 465.18, please e-mail me at shouston@crusescott.com. Also, please call me at 713/650-6600 if you are interested in applying for our telephone consultation program. ✯
Texas A&M Begins New Program
T
exas A&M is launching its primarily web-based Psychopharmacology program with its second cohort beginning in April. This program, with the curriculum based on APA guidelines, is a 450-hour didactic program. Courses are offered primarily in a web-based format with video lectures, readings and assignments, online study sessions with instructors and online tests. Reading material includes conventional textbooks and articles with regular assignments and questions for review. There will be several extended weekends between modules when students will meet in Dallas for review, exams and live lectures. The final weekend of the program will be a review intended to help prepare students to take the APA national exam in psychopharmacology.
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This program does not qualify a psychologist to prescribe. It meets the APA guidelines for didactic instruction in psychopharmacology intended to prepare a psychologist to consult on medications. Before a psychologist will be able to prescribe, he/she will have to complete a preceptorship, pass the national exam and the Texas Legislature will have to pass legislation that gives psychologists prescriptive authority. When the law is passed our state board (TSBEP) will need to work out the specific requirements for prescriptive authority certification. If you are interested in beginning the A&M program in April, contact Dee Yates at 210-494-1991 or go to the website at http://cecoe.tamu.edu/psypharm. ✯
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LAS UPDATE
The Executive Committee for the Capital Area Psychological Association (CAPA) has invited TPA’s legislative lobbyist, Joey Bennett, to address CAPA and update them on upcoming legislative issues. CAPA is increasing their legislative awareness and liaison work for the current session.
T he Fort Worth Area Psychological Association (FWAPA) sponsors a number of discussion groups each Friday at a local cafe as well as CE offerings, a mix which has proven both effective and popular. Dean Paret, PhD, is not only the legislative liaison for FWAPA, but is also a newly elected TPA Board Member. As a current student in the Texas A&Mpsychopharmacology program, he liaisons between FWAPA and TPA on these and other issues. FWAPA also sponsors a great annual Christmas party. The Rio Grande Valley Psychological Association (RGVPA) is now directed by Mary De Ferreire, PhD, a native of the Rio Grande Valley. RGVPA has been instrumental in addressing diversity and mental
SPRING 2003
health/mental retardation issues, among others. RGVPA has been well represented at TPA and annual convention activities. Dr. De Ferreire is aided with legislative efforts by the Rio Grande liaison officer, Joseph McCoy, PhD. The Dallas Psychological Association sponsored an extremely successful HIPAA workshop, which was provided by the TPA Director of Professional Affairs, Robert McPherson, PhD. Dr. McPherson also led this workshop at a variety of sites around the state. DPA also publishes an excellent newsletter. One outstanding contribution to the newsletter was recently provided by Lane Ogden, PhD, who is not only a psychopharmacology graduate but is also a newly elected member of
the PSY-PAC Board. Richard Fulbright, PhD, is the DPA legislative liaison and is also a newly elected TPA Board Member. The South Plains Association of Psychologists (SPAP), under the direction of Catherine Matthews, PhD, has been exceptionally active with meeting their legislative representatives. They are planning to bring at least 10 SPAP members and sponsor two students at TPA’s Legislative Day in Austin, scheduled for February 25. The Bexar County Psychological Association (BCPA) provides specific emphasis upon student and newly licensed psychologist recruitment. Each fall, BCPA hosts a reception and offers membership discounts for joining.
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INSIDE TPA Mary De Ferreire, PhD, current President of RGVPA, was accepted into the “National Register of Who’s Who in Executives and Professionals” this January for reaching a level of recognizable success in her respective field of psychology. Dr. De Ferreire is the Founder/President of “International and Multicultural Psychological Services, a private practice, now 31 months in existence in the Rio Grande Valley. Joseph C. Kobos, PhD, ABPP of San Antonio was recently elected to a second term as Treasurer of the American Board of Professional Psychology. ABPP has been certifying Specialists in Psychology by examination since 1947. Psychologists who wish information about the application and examination process may contact ABPP at www.abpp.org. Tom Kubiszyn, PhD has just been appointed to the APA’s Committee on Psychological Tests and Assessment (CPTA) as the Board of Professional Affairs (BPA) representative for a three year term (2003-2005). CPTA has responsibility for (a) addressing issues that affect testing and assessment practices, (b) reviewing and revising of the Standards for Educational and Psychological Testing, (c) providing technical assistance to other APA boards and committees around testing and assessment issues, (d) monitoring and making recommendations regarding policy and legislation that may affect testing and assessment, (e) monitoring the use of testing and assessment in all settings, and (f ) promoting the appropriate use of tests and sound assessment practices. Collin County Psychological Association (CCPA) is beginning the 11th year as a Local Area Society of TPA. The President of CCPA reports that membership has consistently grown and participation has never been stronger. CCPA offers monthly meetings, referral services on the web, pro bono services, community involvement and awards for graduate research. Building a strong network of psychologists who connect with each other for support, mentoring and referral has been the primary mission of CCPA! CCPA also provides workshops and seminars twice a year and invites all psychologists in the North Texas area to participate. Please visit CCPA at www.psychselect.com/ccpa for
more information, future programs and location, and a listing of members for referral. Bruce Mansbridge, PhD has announced the opening of the Austin Center for the Treatment of Obsessive-Compulsive Disorder on Bee Cave Road in Austin. The center has an affiliated psychiatrist and has just hired a full-time licensed professional counselor from Seattle with extensive experience with children and adolescents. Rick McGraw, PhD has been elected by APA Board and Council of Representatives to the APA Rural Health Committee. The committee’s mission is to address the full breadth of issues affecting the health of persons living in rural and frontier America. Dr. McGraw’s term shall last for 3 years. The committee will identify, study, and attempt to ameliorate health and mental heath problems that may yield to the special knowledge and competence of psychologists. The committee will identify and develop programs to meet the needs of residents in these areas. Dr. McGraw is a Past-President of the Psychological Association of Greater West Texas, Past-President of Texas Psychological Association (TPA), current APA Federal Advocacy Coordinator for TPA, and a member of APA Business of Practice Network Steering Committee. Mariana Wainer, PsyD announces the opening of her office in the practice of psychotherapy in Houston. Until recently, she was in private practice in New York City where she was also a faculty member at the Institute for Infants, Children and Families (JBFCS). Previously, she was the director of the Therapeutic Nursery at the Karen Horney Clinic. Dr. Wainer provides psychotherapy in both English and Spanish, and treats adults, adolescents and children/infants. Congratulations to David White, TPA’s Executive director, for finishing the 2003 Motorola Austin marathon! This is a huge commitment and accomplishment. Rio Grande Valley Psychological Association meetings: February 7, dinner honoring Dr. Bert Levine. Dr. Levine has been a member of Texas Psychological Association for 50 years!
THANK YOU Texas Psychological Association would like to thank all of its sponsors and exhibitors from the 2002 Annual Convention. Gold American Professional Agency Texas A&M University Silver Remuda Ranch
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Bronze APAIT (APA Insurance Trust) Behavioral Health Consultants Comprehensive h Software/ Therapies Psyquel San Gabriel Psychological Services Senior Connections, Inc
Spring Creek Horse Farm Cadwalder Behaviorial Clinics The Psychological Corporation UHS Neurobehavioral Systems Vericare W.B. Saunder, Mosby, Churchill Livingstone
SPRING 2003
STUDENT DIVISION UPDATE
News for the New Year: New Student Officers! Mary Martin & LaDonna Saxon
Student Student Student Student
President: President-Elect: Representative: Treasurer:
Mary Martin LaDonna Saxon Andrea Brose LaTisha Braddock
Contact Contact Contact Contact
Mary at: martin272@juno.com LaDonna at: lcs0014@unt.edu Andrea at: broseandrea@hotmail.com LaTisha at: latishabraddock@hotmail.com
We are all looking forward to our year of service with TPA. We are providing you with our contact information. From time to time we will be asking for input from our fellow members in order to increase student involvement in TPA.
W
e would also like to increase student membership and attendance at the annual conference (don’t forget, it’s in Dallas this year, November 6-8). The call for papers will be heading your way soon. So, if you’ve been working hard on a research project, here’s your chance to show off all of your hard work. Regarding TPA’s annual conference, we would like to know if you find it helpful to have all the convention workshops geared
SPRING 2003
toward students scheduled on the same day (this usually includes the Student Business Meeting, the Internship Mixer, and Getting into Graduate School: What You Need to Know.) If so, what day is best in terms of your ability to attend? Further, are there any other topics that you want to know more about? Please drop us an email with your feedback. Our goals for this year also include increasing the number of Texas internship sites who send representatives to our annual conference to meet with students. So, if there is any particular site you are interested
in, let us know. We realize that not every site will send a representative, but we’ll certainly try our best to elicit their participation. Also, we’d like to revitalize the TPA student division website. So, if there is any information that you would find particularly useful, let us know. We make no guarantees to fulfill everyone’s desires, but we will give it our best effort. We need input from our colleagues in order to reach our goals. So, please take a moment to send us your ideas. We look forward to hearing from you. ✯
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Preview – 78th Legislature Joey Bennett TPA Legislative Consultant On January 14, 2002, the 78th Regular Session of the Texas Legislature began. What also began was a new era in Texas politics. The November elections were a landslide victory for Republicans. Republicans won all statewide offices, retained control of the Texas Senate and gained control in the Texas House for the first time since Reconstruction. With the reelection of Governor Rick Perry, the election of David Dewhurst to the office of Lieutenant Governor and the election by the members of the House of Tom Craddick to the Speaker’s office, Republicans also hold all three of the state’s top offices. Perry was elected to his first full term after succeeding George W. Bush in the Governor’s office two years ago. Perry recorded a convincing 30 point victory over a heavily financed Democratic opponent. Dewhurst was elected after serving four years as Commissioner of the General Land Office and now presumes the duties of presiding over the Texas Senate. And, Craddick, a 34 year House veteran, was elected Speaker of the House by his peers on a 148-1 vote. The 31 member Senate increased their majority and now hold a 19-12 seat advantage over the Democrats. Shortly after the beginning of the session, Dewhurst appointed his committee chairs and members. And, in keeping with the traditional bipartisan nature of the Texas Legislature, Dewhurst has appointed many Democrats to key chairmanships and roles in the various committees. Most, if not all, of the issues pertaining to our industry will be under the jurisdiction of the Senate Health and Human Services Committee. It will be chaired by veteran Senator Jane Nelson, a Republican from Flower Mound in the Dallas/Fort Worth Metroplex. Other members of the committee are: Senators Kyle Janek (R, Houston); John Carona (R, Dallas); Bob Duell (R, Greenville); Mario Gallegos (D, Houston); Jon Lindsay (R, Houston); Bill Ratliff (R, Mt. Pleasant); Royce West (D, Dallas) and Judith Zaffirini (D, Laredo). 22
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The Republicans in the 150 member House of Representatives now hold an 88-62 seat majority. At the deadline for this article, the House had not appointed committee members and chairs. With 34 incoming freshmen, and the retirement of over 20 long serving veterans, there will be wholesale turnover in heads of committees. We can certainly expect to see new chairs and substantial turnover in the membership of committees such as Appropriations, Ways and Means, Public Health, Human Services, and Higher Education, to name just a few. Public Health, the committee of jurisdiction over our issues in the House, will have a great deal of turnover. The chair from last session, Patricia Gray, a Democrat from Galveston, decided to retire. Furthermore, three other members of the nine-member committee did not seek reelection, leaving the possibility of only five members of the committee returning. That however could certainly change with the change in leadership. Now, I would like to briefly discuss some of the key issues we will be facing this session as an Association, and some of the larger issues that will be faced by lawmakers this year. As far as our Association, we will have several major issues, including attempting to give the authority to prescribe medication to properly trained doctoral level psychologists. The House Committee on Public Health conducted an interim study on programs and treatment options for mental illness. TPA had extensive input during the hearing and the production of the report. The committee agreed with many of our positions, including the argument that there is a shortage of qualified mental health care providers to prescribe medications for the mentally ill. They concluded in short that qualified mental health care professionals can be properly trained to prescribe safely, and this in turn can be used to improve access to mental health care and a better system overall for the delivery of mental health care.
We intend to make a very strong push to pass legislation that will allow properly trained doctoral level psychologists the ability to prescribe medication. We are optimistic about our endeavor, but there is a great deal of hard work to be done. There are certainly other issues we will be following during the session that affect our industry, such as scope of practice issues, issues affecting the Board of Examiners of Psychologists, medical malpractice reform and prompt payment to health care providers. There are a huge number of issues the Legislature will have to face before the biennial session ends on June 2nd. First in everyone’s mind is the state budget. For the first time since the 1991 session, the state is looking at a budget deficit. Comptroller Carole Keeton Strayhorn has told lawmakers that to meet the current services demand of the current $114 biennium budget, there is a budget shortfall of $9.9 billion. This gives lawmakers only two choices — to cut services or find new revenues. This is an issue that could define the session and, in all likelihood, lead to a special session. Other major issues include Medicaid reform. With approximately $25 billion of the state’s $114 billion budget going to Medicaid payments, there could be a push to increase the eligibility requirements of those available for enrollment to bring down the overall cost of the program. Another major issue is reform of homeowners insurance. Already declared an emergency issue by the Governor, this promises to take front stage early, with the question of how much more or less regulation the state should provide to stabilize the market. A couple of other major issues that will receive a great amount of attention are: reform of the public school finance system, water rights, electric utility restructuring, campaign reform and transportation. It will definitely be interesting, and I feel it will also be a very productive session for the people of Texas. ✯ SPRING 2003
The Texas Sunset Act and the Practice of Psychology in Texas: A Time to Get Off the Sidelines and Into the Game M. David Rudd, PhD, ABPP Baylor University
As many of us are aware, the Texas State Board of Examiners of Psychologists (TSBEP) is subject to Chapter 325 of the Government Code, also known as the Texas Sunset Act (501.005, Application of the Sunset Act). In essence, this provision in our current Act allows for the TSBEP to be abolished when the existing chapter [501] expires on September 1, 2005. In anticipation of the sunset process, the Texas Psychological Association has already formed a working group, a group that has been active over the past year reviewing our current practice act and charting a strategy for revisions in the next legislative session. Let me extend, and encourage all of you to do the same, a word of thank you to all of the committee members for taking time away from their demanding schedules and families in order to take on this critically important task.
T
he sunset review process is vitally important for all of us concerned about the practice of psychology in Texas. For lack of a better way of saying it, our practice Act will be open for revision during the next legislative session. Many groups, with a range of motivations, have an interest in the practice of psychology and will likely offer numerous recommendations. As we start the sunset process, it’s important to remember the central mission and motivation of the TSBEP to protect the public. That protection comes in the form of the practice Act, an Act that does some very basic things in order to establish regulatory authority. The Act provides for such things as the composition of the Board, a definition of the practice of psychology, articulates Board powers and duties, defines complaint procedures, licensure requirements, disciplinary procedures, among a host of others. It’s also important, however, to remember that psychologists are indeed a part of the public and you have a voice that should be heard during the review process. After almost five and a half years on the Board, I’ve always been a bit surprised at the general consensus among licensees that the Board has limited accountability. That is certainly not, nor should it ever be, the case. The TSBEP is a small state agency charged with the regulation of the practice of psychology. This includes the provision of licenses, renewal and disciplinary review. Accordingly, it is accountable to the public, including those individuals licensed by the 24
Texas Psychologist
Board. Remember that the TSBEP is not a political entity, it’s an agency charged with protecting the public. The TSBEP is organized by and functions entirely according to the authority established in the practice Act. The sunset process is, for the most part, a political process, one that provides for democratic review and input. Revisions to the Act will be accomplished in the legislature, not by the Board. The legislative process provides an avenue for input for the full range of constituencies that have an interest in the practice of psychology. As a result, it’s important for psychologists to step off the sidelines and into the game. In the last five and a half years I’ve heard many concerns voiced about the structure and function of the TSBEP, with most being extremely insightful and important. Naturally, recipients of psychological services have different complaints than licensees, but all are concerned that the profession be regulated in a consistent and fair manner, holding professionals to the highest standards. Often times state agencies such as TSBEP and regulatory process become cumbersome and bureaucratic because the acts from which they derive their authority are vague and incomplete. In a sense, this provides loopholes or a little wiggle room for the agency and legislature, particularly with respect to adequate funding to accomplish the mission. Agencies and regulatory bodies are most accountable when their roles are well defined and specific. When this hap-
pens, their goals are clear and the necessary staffing and resources needed to accomplish those goals are similarly unambiguous. It’s important to recognize that Boards are provided the authority to write and enforce rules through their respective practice acts. Poorly written and vaguely defined provisions in an act can foster a scope of authority beyond the intent of the act itself. The next several years provides a unique opportunity to more clearly define areas that have been identified as problematic for both the public and the profession. What’s most important is to have adequate representation of those affected by the Act, including the broad public constituencies mentioned above. This means not just recipients of services but professionals and students alike. Each area of the Act will be reviewed and refined. It’s likely that entirely new sections will be added that reflect the evolution of professional psychology and lay a foundation for the next several decades. The next several years are critical for professional psychology. It’s likely to be a period of unprecedented professional change. Accordingly, we’ll need a practice act that is well-reasoned, professionally informed, far reaching and anticipatory in nature, detailed and specific, and one that not only holds professionals accountable to the highest standards of ethical and professional practice but their governing Board similarly accountable. Now is the time to step off the sidelines and into the game. ✯ SPRING 2003
The Texas Psychological Foundation The mission of the Texas Psychological Foundation is to fund initiatives that advance the field of psychology and research to the benefit of all Texans. An example of recent Foundation activity was the Town Hall on School Violence at the TPA Annual Convention in October, 2001. The Town Hall brought a diverse group of professionals including judges and school leaders along with teens and parents from the community to establish a framework to deal with violence in the school setting. The Foundation accepts gifts, memorials that honor colleagues, family members and friends, and bequests from estates. Gifts or bequests may include cash, securities or insurance proceeds. The Foundation is available to assist individuals in establishing memorials or bequests from an estate. All contributions to the Foundation are tax deductible. The Foundation accepts both general and earmarked contributions. Earmarked donations can be made to the following designated funds: ❑ Schoenfeld-McCann-Schmidt-Ehrisman Fund for Ethics Education: Provides education in ethics in the field of psychology in the state of Texas. ❑ Rose Costello Education Fund: Provides awards for furthering education in psychology. ❑ Roy Scrivner Gay, Lesbian and Bisexual Issues Award: Provides an annual award for the best student paper on gay & lesbian research issues. ❑ Bo and Sally Family Psychology Research Award: Provides awards for research projects related to family psychology. ❑ TPA/TPF-Student Merit Research Awards: Given to one graduate student and one undergraduate student to defray costs of meritorious research projects. ❑ Alexander Award: Provides an award for the best paper submitted by a graduate student in psychobiology, psychophysiology and related areas. ❑ Manuel Ramirez III Dissertation Award for Ethnic Minority Research: Provides awards for research projects related to Minority Psychology.
Texas Psychological Foundation The following individuals have generously contributed to the Texas Psychological Foundation in 2002. We thank each of you for your kind support. Joseph C Kobos, PhD, President Barbara Abrams, EdD Amos Bruce, PhD Sam Buser, PhD Sean Connolly, PhD Jim Cox, PhD William M. Erwin, PhD Ronald Garber, PhD Linda M. Ingraham, PhD Charles McDonald, PhD Robert McPherson, PhD Muriel Meicler, PhD Harriet T. Schultz, PhD Robert M. Setty, PhD Robbie N. Sharp, PhD Ann P. Vreeland, PhD
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Please complete the following to make a contribution or request further information:
NAME
ADDRESS
CITY
ZIP
IN HONOR OF
AMT. OF DONATION
CONTACT ME TO DISCUSS A DONATION
Make check payable to Texas Psychological Foundation and mail to 1011 Meredith Dr., Ste. 4, Austin, TX 78748.
Texas Psychologist
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HPA Happenings Patrick Ellis, PhD, President
T
he Houston Psychological Association continues to actively serve its members, the Houston community and the psychological/mental health fields in Texas. In the past year, HPA has provided a number of outstanding CE and educational opportunities for the membership, other mental health professionals, and the public. Topics have included the insanity defense, psychologists’ portrayals in the movies and psychopharmacological treatments for mood disorders. One of the Association’s most informative and interesting CE offerings was by Andrea Yates’ attorney, George Parnham. Mr. Parnham discussed the Andrea Yates case, the insanity standard in Texas and how psychologists can address this issue in Texas. Perhaps our Association’s most significant contribution this past year was last May’s Violence: Prevention, Intervention, & Activism conference. HPA will present a second conference to the Houston community this May again addressing the important issue
of violence titled, Violence 2: Prevention & Resilience. Other community services include: two informative videos written and produced by members on teenage pregnancy and violence that aired on the Houston Access cable TV channel, our free Speakers’ Bureau and our Information and Referral service. Our Speakers’ Bureau, Information and Referral service, and videos can all be accessed by the general public at our website: www.hpaonline.org. Through our monthly newsletter our membership is kept informed of important issues affecting mental health and psychology, and we have recently begun spotlighting an area legislator and a member in each issue. HPA has also been active in the political arena. We have had a number of fundraisers for our legislators at the local and state level, and several more are being planned for the upcoming year. Our membership will be actively participating in the year’s TPA 2003 Legislative
Day, and we challenge other LASs to come to Austin en masse! In order to prepare our membership for Legislative Day, HPA has asked David White, TPA’s Executive Director, and Joey Bennett, TPA’s lobbyist, to speak at our January CE luncheon. This promises to be an informative presentation and should generate enthusiasm and excitement for the event. Finally, our Association recognizes the importance of social activities and the importance of recognizing the contributions of members and other individuals in the community who advocate for mental health and psychology. Each year at our Spring Social, awards are presented for Psychologist of the Year, Lifetime Achievement, Legislator of the Year, and the President’s Award. One of the best attended events is the Association’s annual Holiday Party with food provided by the HPA Executive Committee. In keeping with the social and fun aspects of the Association, HPA sponsored its first ever HPA Night at Astros Ballpark this past baseball season. HPA looks forward to providing future first-class services to the membership, the Houston community and the mental health field. HPA’s ability to provide these services is only made possible by the dedication and enthusiasm of its members. ✯
For TPA Membership Information visit www.texaspsyc.org 26
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SPRING 2003
TPA Tracking Legislation for You David White, CAE, Executive Director
H
ave you ever wondered how lobbyists stay abreast of all the proposed legislation that is introduced during a legislative session? Did you know that there are over 5,500 bills introduced every session and during the current session there could easily be over 6,000 bills introduced. Well, as part of your membership, we, the TPA staff and leadership, monitor all of these bills to determine if they will affect you as a psychologist in any manner. I would like to give you a brief overview of how we go about monitoring bills on your behalf. But before I do, let me first state that the best tracking mechanism we have is YOU. That is right, if you hear, or read, of certain legislation that is being proposed that has a direct impact on the profession call me immediately! I can research that particular bill and add it to my tracking system. There are two main legislative tracking services in Austin that many of the lobbyists use to monitor bills. Both of them are WEB based and work in the same manner but have different ‘bells and whistles’ for the searches and tracking. In short, all proposed bills and amendments are downloaded into a database. At that point, you can search on the text of the bills for key words or phrases. This will locate all bills that have a match on your words. SPRING 2003
In the service that TPA staff utilizes, the location of the bill that was found as a match will appear with the bill caption
upon a successful search. You then can determine if the bill is important, and if it is, can easily read all the text of the bill. The system then gives you a plethora of infor-
mation on the author, financial notes on the bill, amendments, and where the bill is in the process getting passed into law. You can go to the state’s WEB site and do your own searches on bill. Go to the following site: http://www. capitol.state.tx.us and follow the prompts to do your search. This site is free and will give you the full text of all bills that have been introduced. My primary responsibility during the session is to monitor, educate, and inform the Board and membership on what bills are being filed and the progress that is being made. Therefore, I will be writing a weekly update that will be posted on our WEB site giving you the latest on TPA’s legislative activities. Only members will be able to access this page since this will be password protected. You will go to http://www.texaspsyc.org and log into the “government relations” page. Your password will be the same as the username/password combination you use to log in to the member portal area of the site. The 78th Legislature will be a busy session and many major decisions will be made that will affect you and your families. Take part in the legislative process...come to TPA’s Legislative Day on February 25th. Check http:///www.texaspsyc.org for all the details or call (512) 280-4099. Texas Psychologist
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PSY-PAC
I would like to welcome our new PSY-PAC Board Members, Cheryl Hall, Ph. D. and Lane Ogden, Ph. D. Drs. Hall and Ogden will serve through 2005. PSY-PAC’s other Board Members are Tom Lowry, Ph. D., Tim Branaman, Ph. D. and James Quinn, Ph. D. Dr. Lowry will serve through 2003 and Drs. Branaman and Quinn will serve through 2004.
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003 will be an exciting legislative year for TPA and PSY-PAC. It is anticipated that both the House and Senate will introduce a prescription authority bill this session. Other important matters are: protecting psychology as a doctoral level profession, a more collaborative and integrated health care delivery system and our continued preparation for Sunset Review in 2005. This committee has been renamed the Sunrise Committee emphasizing that we will be successful in protecting and strengthening our practice act. This committee has worked hard and has done a tremendous job in preparation. There are four very important ways in which you can support the legislative efforts of TPA. First, it is important to become a regular and active contributor to PSY-PAC. I encourage all psychologists to make a
$100.00 minimum yearly contribution. Dr. Ron Cohorn, Past President of PSY-PAC, stated at our annual conference that in 2002 approximately 17 individuals provided 80% of PSY-PAC contributions. Psychologists historically have given less to their respective PACs than any other profession, and it will take a concerted effort by all of us to change our image. In a future article, I will provide a chart comparing the national contribution levels of the different professions. Second, our Legislative Day will be Tuesday, February 25th in Austin at the Capitol Marriott. Our goal is to have 100 psychologists be present, so mark that date on your calendar and plan to be there. Several local area societies are planning on chartering a bus for their members. Third, get to personally know your legislators. Many local area societies invite leg-
islators to their meetings. This is a great way to meet them, find out what their interests are and how you can support them and for them to find out what is important to you. TPA is in the process of accumulating a list of legislators that psychologists know. This information is very helpful in our legislative efforts and you can forward the information to TPA or to me. Fourth, be a grassroots advocate for areas of interest that are important to you and to our profession. It is an honor to be your PSY-PAC President. Do not hesitate to contact me for more information. The PSY-PAC Board Members are listed on TPA’s Web Page for your convenience. J. Paul Burney, PhD President PSY-PAC
Report from the National Commission on Mental Health Deanna Yates, PhD, President
I
n April, the final report from the President’s New Freedom Commission on Mental Health is due to be sent to the President. So where is the Commission in their deliberations right now? Reports to the full Commission have been made by several subcommittees, including: the subcommittees on Rural Health, Evidencebased Practices, and Interface Between Mental Health and General Medicine to name just a few. Many of the subcommittees are still working on their reports to the full Commission. What have the subcommittees reported? Some subcommittees have asked for broad sweeping changes in the system, while others have more specific recommendations focusing on a few issues. Specifics of the reports are included in the minutes of the meetings and posted to the website at www.mentalhealthcommission.gov. There is still much work to be done in the subcommittees as well as by the full Commission. Some issues, like workforce shortages, which cut across all subcommittees, have not been dealt with as yet. While 28
Texas Psychologist
access to care is clearly an issue being dealt with by the Rural subcommittee, it is a much larger issue affecting the country. For example, it has been reported that 80 percent of children in need of mental health services in this country are not receiving services. This is an issue not only with respect to insufficient providers, but also in schools where many services are provided (or not provided), in the prevention of suicide among youth, and in Medicare/Medicaid funding. If those 80 percent did begin receiving services, where would the money come from? This example points out how intertwined many of the issues are. What will the final report look like? What will be the findings of the Commission? Will the recommendations be heard and acted upon? These questions will need to wait to be answered. In the final analysis, there are no simple answers. President Bush will have an immense job on his hands if we are going to change the face of the mental health delivery system in this country. Like you, I look forward to the results. ✯ SPRING 2003
PSY-PAC
2002 PSY-PAC Contributors (January 1, 2002 – December 31, 2002) Paul Burney, PhD, PSY-PAC President Thank you for your year 2002 contribution(s) to PSY-PAC, the Texas Psychological Association’s Political Action Committee. As a supporter of PSY-PAC, you are among the special group of individuals who make the sacrifice to protect and enhance the practice of psychology in Texas. Thanks to your donation(s), psychology is still a doctoral level profession and we have initiated the process of obtaining prescription privileges. However, PSY-PAC is not limited to these issues. Our lobbyist and Central Office staff are constantly monitoring all legislation and responding appropriately. Without your contribution(s), psychologists would have no voice in the Texas political process. Please make a personal commitment to contribute regularly to PSY-PAC. Again, thank you for your support. You are appreciated.
$4000
$100 - $499
Steven Schneider, PhD
Ramona Aarsvold, PhD Laurence Abrams, PhD Kyle Babick, PhD Barbara Beckham, PhD Peggy Bradley, PhD James Bray, PhD Ray H. Brown, PhD Sam Buser, PhD Betty Cartmell, PhD Sean Connolly, PhD Donna Copeland, PhD Jim Cox, PhD Maria Concepcion Cruz, PhD Walter Cubberly, PhD Caryl Dalton, PhD Michael Duffy, PhD, ABPP Wayne Ehrisman, PhD Patrick J. Ellis, PhD Ronald Garber, PhD Humberto S. Gonzalez, PhD Jerry R. Grammer, PhD Andrew Griffin, PhD Charles A. Haskovec, PhD Sophia K. Havasy, PhD A.S. Helge, PhD Sheila Jenkins, PhD Kevin Jones, PhD Joseph Kenneally, MS Kenneth Kopel, PhD Nancy A. Leslie, PhD Marcia Lindsey, PsyD William Lucker, PhD Ann Matt Maddrey, PhD
$3000 Paul Burney, PhD
$2000 Walter Bordages, PhD Ron Cohorn, PhD James B. Quinn, PhD
$1000 - $1999 Tim Branaman, PhD King Buchanan, PhD Patricia Driskill, PhD Mark Foster, PhD Richard Fulbright, PhD Cheryl L. Hall, PhD Ethel W. Hetrick, PhD C. Alan Hopewell, PhD Angela Ladogana, PhD Elizabeth L. Richeson, PhD Kevin G. Smith, PhD Jarvis A. Wright, Jr., PhD Mimi Wright, PhD Deanna Yates, PhD
$500 - $999 Morton L. Katz, PhD Lane Ogden, PhD Mark Rider Thomas A. Van Hoose, PhD
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Joseph McCoy, PhD Charles McDonald, PhD Richard M. McGraw, PhD Robert McPherson, PhD Charles B. Middleton, PhD Leon Morris, EdD Lee L. Morrison, PhD Suzanne Mouton-Odum, PhD Michael C. Pelfrey, PhD J. Randall Price, PhD Shelley Probber, PsyD John Pinkerman, PhD Lynn Rehm, PhD Shannon E. Scott, PhD Robbie N. Sharp, PhD Jana Swart, PhD David S. Wachtel, PhD Richard L. Wall, PhD John W. Worsham, Jr., PhD
Under $100 Barbara Abrams, EdD Bruce Amos Carolyn Anderson, PhD Ruth Baer, PhD Elizabeth Barry, PhD Connie Benfield, PhD M. Lee Berryman-Tedman, PhD Ronald Boney, PhD Robert Braun, PhD Glenn Bricken, PsyD Barry Bullard, PsyD Jane Carr, MA
Leslie Crossman, PhD C. Munro Cullum, PhD Sally Davis, PhD Jessica Del Rio Caren Cooper Dillard, PhD Alan B. Frol, PhD Sylvia Gearing, PhD Steven G. Gray, PhD Dennis Grill, PhD Linda M. Ingraham, PhD Harry F. Klinefelter, III, PhD Karen Krause, PhD Rebecca LeBlanc, PhD Victor E. Loos, PhD Sam Marullo, PhD Glen McClure, PhD Muriel Meicler, PhD Robert W. Mims, PhD Dorothy C. Pettigrew, PsyD Janet Bond Rexroad, EdD Allison L. Sallee, MA, LMFT Ollie Seay, PhD Robert M. Setty, PhD Debbi S. Wagner-Johnson, BA B. R. Walker, PhD Colleen A. Walter, PhD Patricia D. Weger, PhD Mark J. Wernick, PhD Deborah Whitehead Gleaves, PhD Alison Wilson, PhD Connie S. Wilson, PhD Eirene Wong-Liang, PhD Margot B. Zuelzer, PhD Texas Psychologist
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NEW MEMBERS
BECOME A
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The following individuals joined TPA between September 27, 2002 and January 28, 2003. TPA welcomes all of our new members.
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The Center for Anger Resolution, Inc. 2524 Nottingham Houston, Tx 77005 1-877-NO ANGER Fax: 713-526-4342 newton@angerbusters.com 30
Texas Psychologist
www.angerbusters.com
Doctoral Members Laura Avila, PhD Steven Bailley, PhD James Besyner, PhD, ABPP Brock Boekhout, PhD Stephanie Carrera, PhD Kim Copeland, PhD Cecily Cornelius-White, PsyD Joy Crabtree, PsyD Jeffrey Dersh, PhD Michelle A. Emick, PhD Sarah Haley, PhD Robin Hilsabeck, PhD Tommie Hughes, PhD Jennifer Imming, PhD Patricia Kaminski, PhD Michael Karcher, EdD, PhD Elizabeth Katz, PhD Joel Marcus, PsyD JoAnn McMillan, PhD Angela Morrissette, PhD Margaret P. Norris, PhD George S. Park, PhD Ralph Payne, PhD Greg Pina, PhD Sandra Prince-Embury, PhD Judy Rambur, PsyD Laurie Robinson, PsyD Josue’ Romero, PhD Bonnie Rudolph, PhD Rose Signorello, PhD Randy J. Smith, PhD Jill Squyres, PhD Victoria Van Wie, PhD Alisha Wagner, PhD Carol Walser, PhD Curtis E. Wills, PhD James R. Womack, PhD Associate April Brown, MS Vidal Guevara, MA Carla Hilland, MS Student Ashley Barnes, PhD Brian Batten J. Alison Bess
Shannon Bolt Andrea Brose, MA Claudia Burns, BA Jeannette Calzada Sheri Collinsworth Jeff Cooper Daniel Davila, II Shelley Dry Alia Fons, MEd Janine Gauthier, PhD Julie Gibson Vickie Goins, MA Deltina Hay Rebecca Jackson, MS Shaunda Johnson, MEd Beryl Kaminsky Manisha Kapadia, PhD Shannon Kershaw, MEd Kristie Kirkpatrick, MA Eileen Lopez, MS Lanita Martin, MEd Mary May, MS Donna McCurley, MS Cynthia McMahon, MS Andrew Miller, MS Naomi Moller, MA Brandy Moore Kathleen Murphy, MA Stella Nelms, MA Lizette Ojeda Amanda Parsons, BA Cynthia Denise Porter, MEd, LPC Bernard Ramsey, MA Saori Rivera David Runyon LaDonna Saxon Jennifer Snyder, MEd Sabera Sobhan, MA Don Spurgeon Michelle Steinley-Bumgarner Ellen Tunnell Adam J. Vaughn Alba Villanueva Veronica Villela Jamie Wilson, BS Michael Worsley
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SAMPLE LETTER Please use this letter as a guide to write your legislator(s) if you support the psychologists’ prescriptive authority movement.
January 21, 2003 The Honorable xxxxxxxxxxx Texas House of Representatives P.O. Box 2910 Austin, Texas 78768 Dear Representative xxxxxxxx: I am writing to express my support for House Bill xxx by Representative xxxx, relating to the prescriptive authority of certain psychologists. This bill would allow qualified doctoral level psychologists the authority to prescribe psychotropic medications to their patients. As a practicing psychologist, I have seen an increasing need for greater access to medication for mental health care
SPRING 2003
patients because of a shortage of qualified mental health care providers. Having properly trained psychologists prescribing medication would help to alleviate this problem. The training would be extensive and rigorous, ensuring only the best and most qualified psychologists would be certified to prescribe. I sincerely believe this is one solution to the shortage of mental health care providers that would allow for greater cost containment and more continuity of care for mental health care patients. I appreciate your consideration of this very important legislation. Please do not hesitate to contact me if you would like to discuss this issue further. Sincerely, Dee F. Yates, PhD President Texas Psychological Association
E-mail Updates Does TPA have your e-mail address?
@
If not, you could be missing out on important announcements about upcoming CE opportunities and
numerous other important updates. If you have not been receiving
announcements from us via e-mail, then we don’t have your current
address. To have your e-mail address added, send your updated address to admin@texaspsyc.org.
Texas Psychologist
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Texas Psychologist
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