Psychotherapy Bulletin

Psychotherapy Bulletin

“Oh then I saw her face”

Visionary Leadership

One of the surprisingly positive aspects of the COVID-19 experience has been society’s growing awareness of the importance of quality mental health services and the adverse consequences of our traditionally reactive, individual-oriented approach.  On a personal level, we have been very pleased with the recent increase in media attention to this critical aspect of our lives with colleagues demonstrating highly visual leadership roles in a wide range of areas, including improving Olympic athletic performance, addressing social isolation due to the pandemic, family and child-rearing dynamics, maximizing virtual educational activities, and successfully increasing the nation’s vaccination rate.

During our Uniformed Services University (USU) health policy seminar, APA President Jennifer Kelly stressed the critical importance of addressing the social determinates of Health Disparities and “working upstream” in a preventive fashion, especially on a population/public health basis.  She pointed out, for example, that 42% of African American adults suffer from hypertension, compared with 28.7% of White adults. Twenty-one and a half percent of Hispanic adults have diabetes, compared with 13% of White adults.  American Indians and Alaskan Natives continue to die at higher rates (5.5 years less than the U.S. all races), with their suicide rate being 300-600% higher than among their non-Native peers.

Jennifer concluded by highlighting her Presidential initiatives, which include several “summit” meetings, a special issue of the American Psychologist, her convention programmatic focus, and developing systematic recommendations for APA policy development.  Without question, for all Americans, the environment in which one lives has a direct impact upon one’s quality of life, including health status, and the availability of health services.  Forty percent of Navajo households do not have access to running water, and up to 30% do not have electricity.  Is it any wonder that the pandemic highlighted our nation’s historical health disparities?

Eileen Sullivan-Marx, President of the American Academy of Nursing (AAN), noted in her Nursing Outlook President’s Message “Beyond Physical Healing: Centering on Mental and Emotional Health”: “And yet, while the physical toll of the virus will start to recede, another side of the pandemic will grow. We are familiar with the mental and emotional toll the pandemic has taken on patients, their families, healthcare professionals, and the world as a whole.” Similar to Jennifer, she also emphasized the importance of addressing historical Health Disparities, as well as the extent to which the stress, despair, and trauma, as a result of the pandemic, weighs heavily on clinicians. And, urging a major shift in society’s attitude, she called for Leading by Example: Normalizing Mental Health Needs: “The profession can continue to be open about our lived experiences with mental health and wellness during the pandemic and beyond. Exercising empathy for our colleagues and fostering environments around us that allow for honest conversations is where nursing leadership can play a significant role… When we learn that we are ‘not OK,’ we should feel empowered to seek help from others.”

Perhaps most impressively, on June 21st, Robin McLeod participated in the White House Conversation: Mental Health Professionals and the COVID-19 Vaccination Efforts. She shares:

“Last Wednesday evening, I received a call from Jared Skillings asking if I would be willing to have my name submitted for consideration to speak on a White House panel with the U.S. Surgeon General Vice Admiral Vivek Murthy. YES!  I’d be willing to do that!! Later the next day, I was notified by the White House that my name had been selected. Now it was real! What an incredible honor. Jared Skillings spent time talking with me over the next few days, generating ideas (motivational interviewing!) and celebrating this opportunity to connect APA with the White House. It took me a while to get over the shock of what was about to happen. As I spent time over the weekend thinking about what I might say as a speaker on the panel, I hoped to draft a message that would have an impact on leading more people to get vaccinated and showcasing the integration of psychological science and practice for a broader audience. The moderator of the panel was kind enough to send the questions he was going to ask, providing a clear framework for what the message might be.

“By Monday morning, I had written a draft of talking points, and Jared shared this with the APA Practice team, who also provided great suggestions for revisions and additions. Jared and his team deserve the credit for helping me fine-tune the message in such a powerful way. On Monday morning, after Jared publicly announced that I had been selected to speak, my email inbox was filled with so many people sending positive and supportive messages. And, my home Division 42, provided such strong support as the hours counted down to speaking time. I cannot recall a time when I felt so nervous in anticipation of this opportunity. All of the support pouring in gave an extra boost to me feeling ready to go when the webinar began.

“My message was that psychological practice, backed by psychological science, supports motivational interviewing (MI) as an evidence-based and culturally sensitive way to intervene to help vaccine-reluctant individuals move toward accepting the vaccine. My primary talking points were:

  • Vaccine-hesitant adults tend to fall into two categories: fear of vaccine-related health risks or fear of allowing the government to be in control of their body.
  • What DOES NOT work is to argue with patients, trying to convince them to get vaccinated.
  • What DOES work is motivational interviewing.
  • Start by assessing readiness for change to clarify what Motivational Interview interventions to use.
  • Ask permission to have a conversation about the COVID vaccine.
  • Use scaled questions to encourage patients to talk OUT LOUD about the possibility of moving toward getting vaccinated.
  • All of this must be delivered within genuine, compassionate, emphatic curiosity about the patient’s mixed feelings about the COVID vaccine.

“I hoped to convey how important it is to meet patients where they are, to be present and engaged with them as they wrestle with the ambiguity with which we all live. We want our empathic curiosity to encourage patients to look for information that will strengthen the internal voice that wants to be healthy and safe and wants the same for their family, and that sees vaccination as the way to do that. Ultimately, we want them to become confident that they are making a good choice in getting vaccinated. As a clinician, by helping them increase their confidence, you can help drive the change toward vaccination (https://www.youtube.com/watch?v=tzFS63G5sP8&t=5s).” Dan Abrahamson and I virtually watched Robin participate, and we were extraordinarily impressed by her professionalism, compassion, and leadership. Mahalo.

Interesting Perspectives – The White House, Retirement?, Escaping Isolated Silos

Christy Mitchell (Major, USAF, NC): “The White House Conference briefing did a fine job of highlighting psychologists and other mental health professionals as leaders in the community. I was enlightened to hear Robin McLeod’s experience working with adults and children who had different views of the COVID vaccine. I was especially intrigued by her use of motivational interviewing as an evidence-based intervention to promote informed health choices amongst the communities she worked with. Her experience reminded me of the significance psychologists and nurses have as health ambassadors to various communities. Prior to enrolling in the Doctor of Nursing Practice (DNP) program at USU, I served in the capacity of a perioperative nurse and acted as a health ambassador providing information to patients on topics from pain control to surgical site care. Although I provided no direct care to those patients, I provided them with information to make the appropriate choices in their healthcare. As I listened to the rest of the panel speakers, I realized that psychologists, clinical counselors, and therapists share the same mission as nurses: to provide complete patient care beyond physical interactions. We must build trust through honesty, respect, and compassion. Combining these aspects of care with the physical interactions will provide a meaningful movement towards good patient choices and improved health.”

Mike Sullivan: “As someone who has done many presentations at State and APA conventions over the years, I recently had a novel experience: pre-recording one on Zoom. Color me old-fashioned.  I prefer in-person gatherings. However, I was honored to be invited by Rod Baker and Pat to be part of their Division 55 symposium on ‘Meaningful Retirement – Growing Awareness.’ Along with Ruth Paige, we reprised and updated the first such panel in 2014, which Rod and Pat have continued since with various guest participants. Their initiative grew in 2021 with the publication of a small and wise volume of first-person accounts entitled Retirement Experiences of Psychologists [Cambridge Scholars Publishing]. Biased though I may be as a contributor, I was absolutely fascinated to read about the retirement journeys described in the book. The truth is that there is nothing ‘retiring’ about the lives of these psychologists even after retiring. Withdrawing, receding, or retreating from life (i.e., ‘retiring’) is the exact opposite of what our adventurous and productive, and courageous colleagues are doing. There is far too little attention given to the creative ways retired psychologists are continuing their productivity and finding meaning and purpose in life after their formal careers are allegedly finished. Long live (senior) citizen psychologists!”

Ray Folen, HPA Executive Director: “For our 2021 legislative effort, the Hawai’i Psychological Association (HPA) combined forces with the National Association of Social Workers – Hawaii Chapter (NASW-HI) and the Hawaiian Islands Association of Marriage and Family Therapists (HIAMFT). This newly formed Behavioral Health ‘Hui’ jointly advocated for legislation in a number of important areas, to include a statutory requirement that insurance companies add phone-only behavioral health services to their list of reimbursable telehealth procedures. The Hui shared the cost of a lobbyist, which resulted in significant cost-savings for all three organizations. Working together also yielded a three-fold increase in our collective voice, which greatly enhanced our ability to connect constituents with their elected representatives.

“The collaboration was so productive and satisfying that in March we began to discuss the possibility of holding an annual interdisciplinary convention. This would be a first in many decades for Hawai’i psychologists, so we polled the HPA membership to gauge the level of support for the idea. A great majority of members reported being in favor. Our combined annual two-day convention is now scheduled for October of this year, and we expect the event will generate increased revenues and also result in significant cost savings.”

“Now I’m a believer” (The Monkees).

Aloha,

Pat DeLeon, former APA President – Division 29 – July 2021

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Cite This Article

DeLeon, P. (2021). Oh then I saw her face. Psychotherapy Bulletin, 56(3), 27-32.

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