Psychotherapy Bulletin

Psychotherapy Bulletin

“Please Don’t Take Him Just Because You Can”

2018 Was A Great Year:

In March, the APA Practice Leadership Conference (PLC) celebrated its 35th anniversary with over 300 colleagues honoring Katherine Nordal during her final PLC. “During my career, I have tried to embody and facilitate this affirming, strategic collaboration between practice and other parts of our discipline, connected groups and organizations, policymakers and stakeholders. It is with gratitude and great pleasure that we bring to you this conference whose theme, Advancing Practice Together, synthesizes my past, our experience and your future. Thank you for your many contributions to professional psychology and to the patients and public we serve.” APA President Jessica Henderson Daniel and CEO Arthur Evans paid a well-deserved warm tribute to Katherine. The Congressional Honorees that year were U.S. Senator Christopher Murphy and Representative Judy Chu.  

Robin McLeod, now the Inaugural Senior Director for Strategic Relations and Leadership for APA, led a discussion on Pathways to Advocacy highlighting personal stories of association membership engagement, talking about how they became personally and professionally involved in regulatory and legislative advocacy in their SPTAs and APA. Elena Eisman focused upon How Psychology Is Responding to the Opioid Crisis: State, Federal, and Professional Responses. And, Beth Rom-Rymer hosted, along with Hawaii’s Ray Folen, The Revolution in Health Care: Prescribing Psychologists. “In 1998, Guam passed its prescriptive authority legislation. This United States territory was the first United States entity to pass legislation that would give psychologists, with specialized training, the authority to prescribe psychotropic medications…. (T)he prescriptive authority movement is moving ahead, if not with alacrity, then with steadfast progress. In 2002, New Mexico was the first state to give psychologists prescriptive authority. Louisiana became the second state in 2004. It took another ten years, but Illinois became the third state, in 2014, to give psychologists, with specialized training, prescriptive authority. Then, in quick succession, came Iowa in 2016 and Idaho in 2017. Hawaii is hoping to pass its prescriptive authority legislation in 2018 and Connecticut (among other states) is hoping to introduce prescriptive authority legislation in 2018…. However, we who have fought the battle and won, understand that each state is unique in its prescriptive parameters…. (Legislative advocacy is forever).” 

Appreciating the Societal and Public Health Benefits of RxP:

Bob Ax, longtime Bureau of Prisons psychologist, and “Dr. Bob” Resnick, former APA President, appreciate how psychology obtaining RxP would significantly benefit those who have all too often been underserved or unable to obtain needed care, primarily due to their environmental or social circumstances. Most recently, they have been working within the Division 55 (Society of Prescribing Psychology) governance to formally urge the APA Committee on Accreditation to require a 3-credit hour course in clinical psychopharmacology and urging that the VA and federal Bureau of Prisons follow DOD’s lead. This reflects an internal grassroots effort enthusiastically supported by Susan Farber, Kevin McGuinness, Kathy McNamara, Division President David Shearer, Randy Taylor, and Mike Tilus. 

Taking an interprofessional perspective, they have noted that within social work education, courses exist in Social Work Practice and Psychopharmacology. From a historical frame of refence, decades ago when the NIMH first proposed support for exploring non-physician RxP educational endeavors, only social work applied for funding. Under David’s leadership, Division 55 has begun awarding Honorary Fellowship to colleagues who have made an unusual and outstanding contribution to the maturing field, including Michael Smyer, who chaired the original APA ad hoc Task Force on Psychopharmacology; John Sexton, one of the first two DOD Prescribing Psychologists; and the late Floyd Jennings, who was the first authorized federal Prescribing Psychologist back in 1989, then within the Indian Health Service. 

Steve Ragusea consistently points out that when those from other disciplines who oppose RxP for psychologists testify before their state legislatures, they almost never proffer objective data supporting their position and often seem to ignore or seriously downplay the difficulties that many marginalized members of society have in obtaining mental health care. During the Pennsylvania legislative session this Fall, the President of the Pennsylvania Medical Society submitted testimony for the record consistent with Steve’s observation. “The House Professional Licensure Committee recently held a public hearing on the merits of House Bill 1000, a measure that would grant prescribing privileges to psychologists. While the Pennsylvania Medical Society (PAMED) is sensitive to the challenges patients face when seeking mental health care services, we strongly disagree with the notion that allowing psychologists to prescribe psychotropic medications will have any positive impact on improving access to care and could potentially be detrimental.” 

“We agree that there is a shortage of all providers of mental health services…. Each of these professionals plays a role in the continuum of patient care with each having their own unique set of clinical skills. Although these individual disciplines see patients with mental health challenges, they are not universally interchangeable…. (I)t is important to remember that the connection between mental health and physical health is undeniable, with each often manifesting itself in the other…. Make no mistake, psychologists play a critical role in helping patients through a multitude of mental health challenges and are adept at recognizing when a patient may benefit from medical intervention through medication. In today’s practice climate, coordinating care, where a physician and a psychologist work together to optimize mental health treatments, is very common…. This model of coordinated care, having been adopted by many healthcare systems across the Commonwealth, is having a positive impact. PAMED believes that embracing this care model, and further expanding its reach, is a far more effective approach than simply expanding the number of prescribers. In the end, what is most important is that patients receive the highest quality of care possible and that their treatment is appropriate for both their physical and mental well-being.” 

Steve responds: “These are the same arguments organized medicine made more than 50 years ago when psychologists sought and obtained independent licensure and the same arguments used when psychologists sought and obtained third party reimbursement. During that half century, psychologists have proven to be premier mental health providers. And, during the last 25 years, doctors of psychology have been prescribing safely and effectively in other states as well as in the military. It’s no longer a hypothetical argument, we have proven our competency as prescribers. The arguments from organized medicine are old, worn out, and spurious.” 

A Living Legacy:

We were very pleased to learn that our longtime colleagues Alan Kraut and his wife Jane Steinberg have established a Family Fund which recently donated $100,000 to support an Association for Psychological Science (APS) annual convention plenary session showcasing how psychological science can contribute to the public good. APS President Wendy Wood noted: “This gift will help APS highlight the many ways that psychological science contributes to human well-being and the resolution of significant problems facing individuals, communities, and organizations around the world.” 

The first program will be scheduled next year during the APS Annual Convention in San Francisco. It is expected to feature an invited speaker or speakers. Topics might include the use of psychological science in improving public policy, education, business, information technology, the environment, or health. The program might explore successful widespread dissemination efforts that improve public awareness of high-quality psychological science, including psychological research that has been strengthened through collaboration with scientists from other disciplines or with members of the public to better inform the nature and methods of research questions and approaches. 

For over 35 years, Jane was senior staff at the National Institute of Mental Health and the NIH National Center for Advancing Translational Sciences. And Alan, after serving at APA for nine years, during which time he hosted APA’s first convention $1,000 a plate Black Tie Fundraiser dinner and was APA’s first Executive Director for Science, became the founding APS Executive Director where he served for nearly 30 years, retiring in 2016. His retirement “gig” was another six years at the helm of the Psychological Clinical Science Accreditation System (PCSAS), a system that recognizes PhD programs in clinical psychology that adhere to a Clinical Science training model. 

The National Academy of Medicine (NAM):

Victor Dzau, NAM President, recently reasserted NAM’s commitment to reducing greenhouse gas emissions as a foundational action to ameliorate climate change and its adverse impact on human health and equity. “The National Academy of Medicine (NAM) is fully committed to the reduction of emissions of CO2 and other greenhouse gases as the single most important step all organizations must take to slow the pace of climate change. The vast majority of CO2 emissions stems from the combustion of fossil fuels and deforestation. The 2024-2028 NAM Strategic Plan (forthcoming in January) calls for the Academy to address climate change as an urgent, existential threat to human life, health, and well-being as a top priority. The NAM’s internal organizational commitment is to reduce emissions by 50 percent by 2030 and achieve net zero emissions by 2050. Accordingly, the Academy is working with the National Academies of Sciences, Engineering, and Medicine, the broader organization of which it is a part, to reduce the organization’s scope 1, 2, and 3 emissions and divest from fossil fuel interests.” 

“Externally, the NAM launched the Action Collaborative on Decarbonizing the U.S. Health Sector in 2021 with the goal of significantly reducing the 8.5 percent of the U.S. carbon emissions currently generated by health care institutions and the health industry’s supply chain organizations. The Action Collaborative has published a list of Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems and hosted a series of recorded Carbon Accounting 101 Clinics for health care delivery organizations. In 2024, public and private leaders of the Action Collaborative are embarking on an ambitious national effort to mobilize the entire health sector to reduce emissions. Together with the National Academies, the NAM is participating in the new Climate Crossroads initiative, which will take a powerful multidisciplinary approach to addressing the climate crisis. Extensive resources on decarbonization and other climate change issues are available from the National Academies….” 

2023 Has Been a Very Special Year:

Longtime VA psychology historian Rod Baker was pleased to announce that his colleague Walter Penk was one of seven individuals chosen to receive the Spirit of Hope Award from the Department of Defense this Fall at the Pentagon. This special recognition honors individuals and organizations whose work benefits the quality of life of Service Members and their families. A pioneer in developing the scientific foundation for the designation of PTSD, Walter is the first psychologist to be so recognized. “My happiness depends on you. And whatever you decide to do” (Jolene, Dolly Parton). 

Aloha, 

Pat DeLeon, former APA President – Division 29 

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Cite This Article

DeLeon, P. (2023). “Please Don’t Take Him Just Because You Can”. Psychotherapy Bulletin, 58(4), 51-54.

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