The Mentors’ Corner is a regularly featured column in the Independent Practitioner (IP) that highlights discussions from the MENTORS listserv. In each issue of the IP, questions and answers pertinent to the Division 42 Student/Early Career Psychologist members will be addressed. If you are currently not signed on to the listserv, we encourage all members to participate and share in the stimulating discussions that take place. The Division consists of members who have a wealth of knowledge and various areas of expertise that should be shared with our new colleagues.

It is important to note that the opinions expressed on the listserv and within this column reflect individual perspectives and ideas only. As noted on the listserv, there is more than one means to an end. This column is intended to highlight important topics and to generate additional areas of thought and insight for our members.

Division 42 Mentor Program:
Division 42’s mentoring program, Colleague to Colleague, is growing. If you are interested in being paired with a mentor to assist you to be successful in your practice, or if you are interested and willing to share some of your knowledge and expertise with a colleague, please contact the coordinator of our mentoring program, Frank Froman, at frankf@adams.net.

Subject: Decrease in Reimbursement

Elisa Linscott: For those of you on Midlands Choice Provider Panel who have experienced the recent decrease in reimbursement rates, what are your thoughts?  I have not looked at my contract, which probably states they can do this, but doesn’t there seem to be something fundamentally wrong with this?

Mitchell Hicks: I noted a small decrease from BCBS, and I can’t say that I’m surprised by it.  Medicare reduced their rates, and so they might as well also - monkey see, monkey do.  You can be certain that the contract indeed authorizes them to do whatever they want, and authorizes you to do nothing about it.  Equitable.  You have two choices - eat it or quit the panel... if you like eating, quitting may not be an option.  Indeed they are counting on it.  

Christopher Kaeppner: Anthem cut reimbursement rates in Ohio by 10-15% for mental health providers last January (right after a large pool of county employees switched to this provider).  Their company literature claims that over 90% of mental health providers accept Anthem though it appears that many are leaving the panel or not accepting new Anthem patients.
There was local news investigation and the governor, Ted Strickland (a psychologist no less) was interviewed and was concerned.  He called for more data on the issue and apparently the Ohio Department of Insurance will be doing an investigation.

As a solo provider, I have gone round after round with Anthem and other companies to negotiate reasonable rates.  Wow what a pain but hopefully, the investigation will help.

Any updates or success stories from other states would be appreciated.

Elisa Linscott: I wonder if the Nebraska Dept. of Insurance would look into the cut.  What makes the DOI investigate the issue…the fact the Governor is a psychologist or because it is deemed unfair?

Christopher Kaeppner: In this case, I believe the governor called for it.  Your question though led me to check on the status of the investigation with the ODI and I’ll be interested to learn what the results are.  However, I think consumer/provider complaints can contribute to a call for investigation as well. Good luck in Nebraska!

Subject: Clinical Post-Doc v. Job

Megan Mayberry: I am currently on internship and I am hoping to get my license after getting my PhD in July. Primarily my clinical focus is on adolescents and young adults. I am wondering if anyone has any experience or thoughts about trying to get a job that will give the required post doc supervision to get licensed. Additionally, how have others found clinical post docs and/or jobs that are willing to hire clinicians who need the required supervision hours? I will complete my internship this year and I am hoping to get my clinical license in Illinois, any thoughts on the job scene in Chicago would also be greatly appreciated.

Valerie Domenici: I am also interested in hearing ideas/suggestions for post-doctoral employment. I have completed my internship, but despite an exhaustive 4 months of searching (sending resumes/applications to every VA, hospital, CMHC, and student counseling center in the Buffalo area), I haven’t been able to secure even one interview. Inquiries into private practice have not been able to solve the billing-without-a-license issue. Are there more creative solutions people have come up with to get their post-doc hours?

Esther Freeman: Have you been applying for jobs or for postdoctoral fellowship training? If only for jobs I would strongly encourage you to apply for postdoctoral training. Not only would it enable you to get your hours and supervision for residency requirement, but it will be an asset for you over the long haul. Organizations looking to hire psychologists these days really like people with some specialty training. If you have already been looking into postdoctoral training and have not found anything, you might want to consider contacting established clinicians who would be willing to take you into their practices as a post doc. It would differ between states how this would be handled, but in some areas it can easily be done and provide a little income for you and a little for your supervising psychologist.

Susan D. Odom: In response to the post regarding finding a job after internship or seeking a formal post doc -- I can share my experience. I obtained an APA accredited post-doc in a medical academic setting. Accepting the formal post-doc has turned out to be a very good decision. The specialized training has been very helpful and significantly expanded the range of my clinical skills. All of my post-doc hours and supervision have been carefully documented, so I’m pretty sure that I will not experience any licensing problems -- I like having the confidence that comes with completing an APA-approved post-doc as well as internship. I received support for taking the EPPP, gained experience in a variety of settings, and had time to think about and consult with others about next steps. Various supervisors shared their experiences, giving me some insight into different career paths and professional development issues; I know a lot more about what I do and don’t want in my career. I can now seek a job without needing supervision -- that makes me a more viable candidate.

The only caveats I have to add to this glowing recommendation are these: it is very expensive to move multiple times, so finding a post-doc in the place you want to settle is a good idea. Inquire whether the post-doc institution hires their post docs after the training period ends. Make sure you get solid information, not vague innuendo. Accept only the rotations you want -- if you are offered rotations that you don’t want, be sure to ask if there are alternatives.

Subject: Ph.D. v Psy.D.

Michael Woodmansee: Hi, I am an undergraduate student in RI and will soon be applying to graduate schools. My intention is to get into a Clinical or School program. I have been trying to get a good concept of the differences between working with a Ph.D and a Psy.D. My professors all have compelling reasons why the Ph.D is a wise choice (they are all Ph.Ds) and I would love to gain the perspective of someone currently working as a Psy.D. Any advice or opinions you could offer are welcomed. I have looked at University websites as well as the APA site, but they all tend to be very general and perhaps not “real world” oriented. Thank you for any info you can provide.

Frank Cushing: In practical terms, it might not matter which degree unless your plan is to teach at a University. In the private practice world or in other clinical settings, the most significant credential is a LICENSE to practice....and either the Ph. D or Psy. D gets you there. Many Psy. D. programs are more expensive but also may take more students and usually have a defined program to follow to get the degree....Many times university based Ph.D. programs are heavily invested in research and not as invested in getting you completely finished with the degree in a reasonable time period (like 4 years). Some programs have been known to add “requirements” as you go along and it is not unheard of to take 6 or 7 years to finish a Ph.D. If you are going into the real world to practice, that is a lot of lost income.

I believe that other than the possible expense and if one is research oriented and wants to teach/do research at a major university, the Psy.D. is the way to go. Many Psy.D.’s teach at the college or even graduate level and I taught at the U of Illinois College of Medicine with some Psy.D.’s. If you want to get in, get good clinical training and get out in a timely manner to start your life, the Psy.D.is definitely worth exploring... Regardless of which degree you pursue, make sure the program and your subsequent internship and post doctoral fellowship year are all APA approved programs.

Jess Anderton: I tend to agree with Frank in that the Psy. D. is a generally less research-oriented degree, more oriented to practice (although I completed a formal dissertation in my program).  As far as the expense--that will vary greatly, depending on the program. My program was designed for returning professionals (I was previously a school psychologist, specialist level) and the financial aid incentives were wonderful.  My program was APA accredited, and housed in a traditional university (not a separate professional school).

I have not had trouble completing any licensure requirements, and I am currently teaching adjunct for a local university.  I do not plan on seeking a full-time professor position, however, because my interests lie more towards clinical work.

Your graduate program will be an enormous investment of your time, efforts, money, etc. My advice is to choose carefully based not on whether it is a Ph.D. or Psy.D., but instead on how well the program fits your individual needs. Consider their training philosophy/approach, the internships/job settings their graduates end up in, financial aid incentives, the satisfaction of current students, the research interests of the faculty, the location of the school, etc.

Furthermore, although the traditional route is to go from undergrad to graduate school, I believe there is great value in “real-world” work experience between the two. It allows you to learn something about the areas of psychology you do (and do not) want to focus on.  Another option is to interview professionals in the areas you may be interested in your local area, and seek advice as to what they like/don’t like about their jobs and about their own training experiences. I believe that most people would be happy to take a few minutes to talk to you.

Abi Reaser: Another note…you mentioned looking into a school OR clinical program and I wanted to introduce you to the idea of a COMBINED program. My program at Florida State University (PhD) is one of about 10 APA approved combined programs in the country. It is in School and Counseling, which may appeal to you. There are others, as well, all combined in different aspects.  I really liked not having to choose and becoming proficient in both pathways.

Subject: New APA Division

Kathy Afrasiabi-Evans: I am one of your fellow graduate students with an urgent and important request. My faculty adviser, Ruthellen Josselson and her colleague have been very involved in collecting signatures to petition to found a new Division for Qualitative Inquiry in APA. In September, they sent in 902 signatures and thought they had succeeded since this far surpassed the goal of 831 signatures which are needed to initiate the petition to Council at their December meeting. APA has just verified (by checking every signature) the eligibility of the signatures and ruled that they are 80 short. If they don’t get these 80 by December, then they have to wait another whole year to start the process with APA Council. Ruthellen is a wonderful author and psychologist and her desire to add this new division is shared by many who believe research does not have to be quantitative to be meaningful and powerful.

Jeff Barnett: Can you please explain why APA needs another division? We already have 56 of them. Aren’t these issues being adequately addressed in divisions that already exist? How will this proposed new division really make a difference?  One concern I have is that each new division that is created gets a seat on APA’s Council of Representatives. That dilutes the voice of the state psychological associations. There’s increasingly less representation by the states over time. Most of the major decisions impacting the profession of psychology happen on the state level and in the state legislatures. Strong state associations and strong representation of their issues and needs on APA Council are essential.  

Kathy Afrasiabi-Evans: Here are some of the reasons for having this division:

1. There is no existing division where the kinds of interests specified in this group’s mission statement are central.
2. Qualitative Inquiry is marginalized within APA and, while it is sometimes conducted, is given short shrift within existing divisions.
3. There is a need for qualitative researchers to have a venue in which to discuss the emergence of this work and debate its various manifestations.
4. The counterargument to “too many divisions already” is that any organization to grow must be allowed to grow.
5. The counterargument to the importance of the state associations is that while state associations have particular importance in regard to professional issues, this kind of division is interested in research rather than practice and issues about research traditions and epistemologies have not been of particular interest on state association agendas.