As a Division 42 Member at Large, I bring the practice, leadership, advocacy, business and media expertise necessary to advance the interests of both Psychologists in independent practice as well as Psychology as a field. For the past eight years, my incorporated independent practice (as a clinical psychologist/clinical health psychologist) has been located in several women’s primary care, ob/gyn and oncology settings.  As a result of this practice model, I understand the unique clinical, business, and contractual issues involved in building highly successful collaborations with health care providers. In addition, for the past two years, I have had the pleasure of serving on the Division 42 Task Force on Health Care for the Whole Person.  This group is committed to enhancing the skills, tools and resources for psychologists in independent practice who are interested in collaborative care for adults and children.  Work with the Division as well as several leadership positions in Division 38 (Health Psychology), with the APA Committee on Women in Psychology, advocacy experience and as well as extensive work with women and men across the life span with health and mental health concerns allows me to appreciate the essential and challenging roles that we practicing psychologists can and do play.

I believe that Division 42 and APA need to address a host of critical issues confronting independent practitioners to ensure that our effective treatment approaches reach a broader range of adults and children with health and psychosocial concerns, and to ensure the future of our profession.  First, it is essential that we promote innovative practice models to increase access to and visibility of our services as well as revenue streams “out of the office.”  Two important promotional strategies include: 1) effective and ongoing collaborative partnerships with health professionals; businesses and industry; public and private educational systems; and other community groups; and 2) extensive presence in varied media outlets such as print, TV, radio, online and web cast.  Second, we need to further reduce barriers to comprehensive treatment from psychologists in independent practice through legislative policies aimed at both parity for health and mental health services and promoting patient’s choice of providers under insurance contracts.

As your Member at Large, I will advocate that Division 42 continue to: 1) offer highly applied continuing education workshops (at convention, on line, across the country) and “tool boxes” to ensure that psychologists have the resources necessary to develop innovative and successful collaborations with a broad range of professionals, organizations and communities; 2) create opportunities for psychologists in independent practice to actively work with media to bring our effective skills to the public; and 3) work with the APA Practice Directorate to promote federal and state legislation which reduces barriers to treatment and emphasizes fair reimbursement rates and mechanisms.

1. History

In 2001-2001 I was the Chair of Division 42’s Taskforce on Guidelines. At that time, a guideline on “Geropsychology”, the language of which put practitioners in some danger, was being proffered for acceptance by the COR. With the aid of a lawyer, we rewrote the document and offered it as a substitute. I’m told, the amended document set the standard for aspirational language for future guidelines. In 2002-2005 I was elected member-at-large.

2. Experience relevant to the position I’m seeking:

My service as member-at-large, by definition, is relevant. Roughly 30 years as an independent practitioner in private practice gives me a realistic background in the travails and vicissitudes of the independent practitioner. Additionally, active participation on the Division 42 list has provided an awareness of the concerns of my colleagues across the United States.

3. The most critical issue confronting independent practitioners:

As the often-quoted Pogo said, “we’ve met the enemy, and he is us”. We are being marginalized as a profession and much of the responsibility for that lies with our own behavior. Many would rather rage at the dark than light a candle. One example of this is the practice of opting out of managed care instead of negotiating on an individual basis for higher fees. This has promoted the creation of panels where we are largely absent and the masters level practitioner prevails. As a Virginia practitioner, I was one of the original plaintiffs in a lawsuit against several managed care companies. On the issue of breach of contract, we prevailed.

Another example is quitting the APA. No matter how strongly we may differ among ourselves, the answers provided by our very talented staff to various legal and administrative questions and, sometimes, the financial aid makes membership worthwhile. Information provided by the staff of the Practice Directorate has on many occasions obviated the need for reinventing the wheel. The collaboration of the APA and Red Cross afforded many of us the honor of participating in disaster relief in New York and at the Pentagon in the aftermath of 9/11.

4. How can Division 42 address these issues?

The short answer is, “I don’t know.”

The optimistic and long and boring answer is: There is no substitute for getting up close and personal with your federal and state legislators. Forthrightly making our opinions known to legislators who recognize our names and faces has prevented a lot of legislative mischief and silliness in Virginia. We don’t always win, but our success is greater than the amount of money we have. In Virginia, where I am president of the Virginia Academy of Clinical Psychologists, we more active members compensate for our (self-induced, psychologist-created) impecunious circumstances by activities too various for a campaign speech limited to 500 words. The more extraverted among us, however, need to get busy.

Since joining the Division more than 30 years ago, I have hoped to become one of its Members-at-Large, knowing that I could bring to that role my in-depth experience with psychological practice at all levels including APA, Divisions and State Psychological Associations.

For decades I was an informed, concerned Division member, attending Board meetings as a representative of other practice divisions and discussing matters of mutual concern with my many friends and colleagues on the Division 42 Board. More recently, I joined the Fellowship Committee and served as a member and then as its Chair and Past-Chair. I have extensive service in other practice divisions and in APA, as well as in my state and regional associations. Those experiences equip me to serve productively on our Board.

My service in APA is especially relevant. After several terms as representative to APA Council, as Chair of a Committee (CSFC) and member of a Board (BAPPI), I believe I understand how APA works and how our Division can most effectively interact with it. Together with my experience engaging with many of APA’s leaders, that can make all the difference in the world to the smooth functioning of the Board. My experience shepherding the 2007 Fellowship class through the Board process was an excellent example, and heightened my eagerness to serve.

Several critical issues now face us:

escalating problems with managed care, Medicare and de-escalation of our fees;

clarifying the role of psychologists in interrogations and mending the tremendous internal rifts that have opened in our Division and Association as a result of efforts to grapple with this crucial subject.
enhancement of our role as psychologists in relatively new areas of practice including trauma and prescribing:

the importance of positioning ourselves as primary care providers and as experts on health and mind-body issues;

and--probably the most important newly-emerging issue-- mastering the new technologies to allow us to expand our functioning onto national and international scales;

Division 42 addresses these issues by continually asserting itself as a major player within APA. We have the expertise, the seasoned personnel and the willingness to consider, consult and lead. I believe I am one of those who can best help the Division handle these tasks. My energy, knowledge and devotion to our kinds of psychological practice will, I believe, make me an effective member-at-large.

My lifetime of experience in advocacy and 29 years in independent practice would be assets to Division 42 at this time.

I have been a member of 42 since shortly after its inception and deeply appreciate the resources it provides e.g.:

1) Constant broadening of horizons in unanticipated ways.

2) Opportunities for friendship with amazing colleagues

3) Participation in the Online List which not only puts powerful resources immediately at your fingertip but provides a strong sense of community

4) Invaluable compilation of practice gems in the Independent Practitioner.

5) Venue for promoting practice agenda.

Many events juxtapose with and strongly affect Independent Practice. Among issues that require our careful attention:

• Health care finance reform.
• Health care delivery reform.
• Electronic mental health medical records.
• Effects of the nascent economic recession.
• Privatization of mental health services.
• Roll back of government and insurance financing of mental health services and training.
• Clinical content of graduate school programs
• Unreasonable barriers to practice and service imposed by managed care and management systems.
• Need for resources and training to meet treatment needs of our returning veterans,
• Treatment and preventive services to counteract the increasing violence and child abuse in our society.

Independent Practice will address these issues with our characteristic creativity and innovativeness. Our efforts, informed by our understanding of both human motivation and behavior in addition to an understanding of business, should be especially effective. We must add to those understandings a respect for and familiarity with the Legislative and Regulatory realities which shape independent practice and the critical need for our members to invest with their dollars in themselves and their profession.

Relevant Experience:

• Founding President of the NC Consumers Council,
• Chair [2 terms] , NC Psychological Association’s Insurance Committee.
• Chair, NC Psychological Association’s Building Committee,
• Founding President NC Coalition of Mental Health Professionals,
• Advisory Board National Coalition of Mental Health Professionals,
• APA Inter-Divisional Task Force on Managed Care and Health Care Policy,
• Board of NC Psychoanalytic Foundation,
• Local Boards and Committees to Provide Low Fee Mental Health Services

Awards and recognitions:

• APA Heiser Award 1999
• North Carolina Psychological Association’s Mary Clarke Award 2001
• YWCA of the Triangle’s Academy of Women Health and Human Services Award 2001.

Change is inevitable and presently unfolding with unprecedented speed. Our vigorous participation in shaping that change and our leadership and support of our professional organizations in doing so is essential. Our survival is at stake.

What has been your history of service to Division 42?

I have completed three types of service. First, I have written two serial columns for the IP. The first one (2003–2005), was designed to help practitioners to launch a website and included usability studies of members’ websites. This column won the Best of Bulletin award for 2003. I am currently writing the second column entitled “The Child Clinician’s Corner”. Second, I completed a usability study of the Division’s website in 2005. Third, I have completed several presentations for the division at APA.

What experience have you had relevant to the position you are seeking?

I have been a practitioner for 18 years; for 13 of these years I have had my own independent practice (including now); I also currently direct a university based outpatient training clinic and was previously active as an examiner for the American Board of Professional Psychology. Since 9/1998 I have delivered 144 continuing education workshops for practicing psychologists across the country; I believe my interactions with colleagues in these trainings has helped me to understand the issues on most practitioners’ minds. I am also currently serving on the Board of Directors of the Pennsylvania Psychological Association as the Communications Board Chair (oversight of the listserv, website, public education and bulletin) and am one of two state liaisons to APA’s Public Education Committee. Finally, I have completed 156 public education projects since 9/1998 and won PA’s Psychology in the Media award in 2006. My complete CV is available on my website: www.helpingfamilies.com.

What are the most critical issues confronting independent practitioners?

I want to focus on two issues, one of which I believe is on most clinicians’ minds and one which may be less obvious. The obvious one is to expand the breath and dept of third party reimbursements for our services. Clearly, human welfare is advanced and costs are reduced when our evidence-based services are brought to bear in an unfettered fashion. The less obvious issue is the need for us to do public education. Most people have no idea what we do and how effective we can be at understanding and healing psychological pain, nevermind the tremendous benefits that accrue from such. Imagine how many of our professional problems would evaporate if the public, including legislatures, knew the truth of us? I believe this is our most important challenge, and one we have a great deal of control over.

How do you propose that Division 42 address these issues?

The short answer is “I’m not sure.” I would be a rookie to Division 42 governance and appreciate that I would need to allow those with experience on the board, and our members, to educate me about the most effective methods for reaching our shared goals. I believe I would approach this learning with a fresh, enthusiastic and open mind. That said, working with state and national legislators would seem to be key, as would creating synergy with APA’s Public Education Committee.

I am both flattered and pleased to run for the position of Member at Large of the Board of Directors of Division 42. I have been an active member of this division for many years having served as the Co-Chair of the of the Division 42 Task Force on the Specialty Guidelines for Forensic Psychology and most recently as the Division 42 Liaison to the committee that is currently revising those same guidelines. In addition, I have just completed a term as Chair of the Division 42 Fellows Committee. Also, I have been active in APA serving as a member and chair of the Ethics Committee and two terms on the Committee on Accreditation. Because of my commitment to the goals of Division 42, my experience in APA governance, and my 35 years of independent clinical and forensic practice, I believe that I am well qualified to accept greater responsibility in the leadership of our division.

I believe that this is a critical time for professional psychology. We are under siege from a variety of directions. To our front, medicine is opposed to our obtaining expanded professional roles for psychologists; at our back, allied mental health professions are gradually absorbing legal rights to provide services that have historically been associated exclusively with the roles of a psychologist. In addition, remuneration for psychologists has barely changed in recent years in part due to a glut of psychologists on the market. The law of supply and demand truly does work. How can we possibly expect insurance companies to adjust their reimbursement rates when they can easily contract with a market filled with a variety of hungry mental health professionals who are willing to work at rates lower than those charged by automobile mechanics? We simply will not be able to make a change without addressing the source of the problem.

In light of the above, Division 42 and APA must continue to work on defining expanded roles for professional psychologists. In that spirit, we MUST: obtain prescriptive authority in more states for those psychologists interested in providing this service and move into new markets including greater roles in forensic services and health care roles. Finally, we must address the politically sensitive issue of how some graduate programs flood the market with new psychologists who, after years of work and substantial expense, find themselves unable to earn a living due to a lack of opportunity. I love my profession and believe the future is bright, but I believe we must confront these matters aggressively. I ask for your support in helping me accomplish this.