2014 Election: President-Elect Responses to Member Questions

New to this year’s OPA Election process: Questions from OPA members! Questions were submitted to the OPA Elections Chair, Peg Richards Mosher, PhD. Dr. Mosher selected the following five questions for the candidates to respond to.

Lewis Stinson

This year’s candidates are Mary Miller Lewis, PhD and Bob Stinson, PsyD, JD, LICDC-CS, ABPP. To view their platforms, please click the candidate name.

1. What does the profession of psychology need to do to be viable in the future?

Dr. Mary Miller Lewis: In 2009, an APA Presidential Task Force recommended a number of areas for viability for the profession of psychology. While ideas also fit well with the current OPA strategic plan to be a viable organization in the future, there are a number of additional topics that should be addressed. Therefore, as President-Elect, I would focus on the following viability areas: (1) find ways to have economic viability, (2) demonstrate accountability for our work, (3) fully engage in integrated and primary care centers, (4) solve mobility barriers for practitioners, (4) increase public education, (5) take advantage of technology as both a training and practice tool, (6) provide education, training, and life-long learning opportunities that change with the changing needs of the marketplace, (7) more fully embrace and integrate all forms of diversity into research, practice and training, (8) learn to recognize opportunities for psychologists that are “outside the box” from traditional professional roles, (9) develop collaborative working relationships with other disciplines across research and practice, and (10) broaden the view of the public and politicians of what “psychologist” means. As the future of psychology continues to evolve, OPA needs to evolve in tandem. As OPA President-Elect, I would work to ensure that OPA’s strategic plan be a living, breathing document that changes in anticipation of, rather than in response to, changes in the psychology workforce and profession. In that way, the viability of psychologists in Ohio would be the centerpiece of the strategic plan that guides the work of OPA.

Dr. Bob Stinson: To secure the future of psychology, we must be active participants in the process of healthcare reform. Borrowing from APA, healthcare reform must go beyond covering the uninsured to include changes in the way healthcare is delivered in this country. Accomplishing the following are critical to the future of psychology:

  • Integrate mental and behavioral healthcare into primary care and other healthcare services for persons across the lifespan, with psychologists recognized as vital members of interdisciplinary healthcare teams.
  • Ensure access to quality mental and behavioral health promotion, screening and referral, prevention, early intervention, and wellness services for persons across the lifespan, with particular attention to at-risk populations.
  • Develop and maintain a diverse psychology workforce competent to develop and apply evidence-based behavioral and psychosocial assessments and interventions to address the current needs and changing demographics of our nation’s population.
  • Eliminate disparities in mental health status and mental healthcare through the use of psychological and behavioral research and services that are culturally and linguistically competent.
  • Ensure that quality mental and behavioral healthcare and access to psychologist providers are included in benefit plans for persons across the lifespan.

At the same time, we must be attentive to the importance of developing our next generation of psychologists. That means helping prospective students find and afford the “right” graduate program, advocating for lower-interest loans, engaging students in multiple platforms using modern technology, working to address the internship shortage, and creating new psychology positions in the reformed healthcare landscape described above.

2. Given limited financial resources, how should OPA make decisions regarding which member programs, services and benefits should be funded?

Dr. Miller-Lewis: The mission of OPA is to advance the creation, communication and application of psychological knowledge to benefit society and to improve people’s lives in Ohio. As President-Elect, I would work to directly target the financial resources of the organization at remaining consistent with our mission, vision, and strategic plan. Member feedback, careful analysis of past expense patterns, examination of effectiveness of expenditures, and consideration of potential future needs are all critical in determining the funding priorities of the organization. For example, past member surveys indicate that advocacy is the most critical component of OPA’s work, with continuing education a close second. As OPA President-Elect, I would support those programs continuing to be at the top of OPA’s financial priority list. I would also advocate a constant feedback loop with information regarding financial resources and expenditures of the organization being sent to members, and member opinion regarding those services coming back to OPA. As organizational needs can ebb and flow, dependent on the political issues at hand and the current needs of the members, it is judicious to continually assess these needs. I would also work with the OPA leadership, financial committee, and staff to examine ways OPA can increase transparency regarding the financial operations of the organization to facilitate this feedback loop with stakeholders. As President-Elect, I would work towards greater accountability through outcome measures of efficacy related to OPA strategic plan goals, and frequent communication of those results with data to OPA members.

Dr. Stinson: At a basic level, implicit in this question is an acknowledgement that financial resources are limited. That does not mean OPA’s financial resources must be static. It will be important—indeed, it needs to be a priority—that OPA develop additional revenue streams. Without creating and growing non-dues revenue streams, our organization will repeatedly be faced with the dilemma of de-funding programs, not supporting new initiatives, and/or raising dues. Suggestions have already been made for increasing members’ dues in the coming years. This organization cannot sustain on a model that conditions growth on taxing its already financially stressed membership. We need to “buy smart” (assessing on a regular basis the value of benefits purchased) and we need to add non-dues revenue streams so we can grow without taxing it to the members. Still, there will be a need to make decisions about what gets funded and what doesn’t. Those decisions should not be at the whim of a few. Those decisions should be made in reference to the wants and needs of our members and guided by the Association’s mission (advance the creation, communication, and application of psychological knowledge to benefit Ohioans), vision (e.g., advance the science and application of professional psychology, support the personal and professional lives of psychologists—from student through retirement), and values (e.g., working in collaboration with other organizations and leaders). As I said in my platform statement, we need to incorporate the membership’s needs and assets in realizing the mission, vision, and values of OPA.

3. What would you like to accomplish through governance restructuring and what evidence-based strategies would you favor to accomplish your goals?

Dr. Miller-Lewis: As OPA President-Elect, my examination of OPA governance and strategic planning will be cognizant of the changing demands of the association and field of psychology. The face of association governance is rapidly changing: associations are dealing with declining membership numbers, resulting in a smaller bottom line but an increasing amount of work to meet the goals of the organization. Rapid changes in technology, political climates, and membership composition are also influencing the role of association governance. Psychological associations such as APA, the California Psychological Association, and others are working to adapt governance to meet these challenges. As a member of the recent APA Good Governance Project, I was deeply involved in the assessment and proposal process that resulted in sweeping changes in the governance structure. I am currently a member of the OPA Governance Task force, and have worked with them to assess the opinions of both OPA leadership and members regarding current governance strengths and challenges. If the data continues to support change, then as OPA President-Elect, I would like to continue the work of the current OPA Governance Task Force. The data-driven focus would have the ultimate goals to streamline the governance structure, focus on strategic planning and continual alignment with the mission and strategic goals of the organization, while maintaining a feedback loop with members regarding the process. I would also strongly encourage the use of outcome measurement to assess the organizational effectiveness of any implemented governance changes, with data collected from all of the association’s stakeholders.

Dr. Stinson: OPA’s governance structure should follow the doctrine of “good governance,” as that term has been used in other domains—from business to international politics. “Good governance” is accountable, transparent, responsive, equitable, inclusive, effective, efficient, participatory, and follows established rules. These qualities are what the current structure and any proposed restructuring should be measured against. To the extent the qualities of “good governance” are not realized in OPA’s current governance structure, change is needed. What form that change takes should be based, not necessarily on what other states are doing or even on what APA is doing, but on the goal of realizing and maximizing the qualities of “good governance” that are not currently in existence within OPA. The Ohio Psychological Association has a strong reputation for being a leader. We can lead in our governance structure, too. Conversely, to the extent any proposed restructuring would neglect one or more of the characteristics of “good governance” (i.e., accountability, transparency, responsiveness, equity, inclusiveness, effectiveness, efficiency, participation, and following established rules), that proposal should be rejected or modified to incorporate the qualities of good governance. That is, OPA need not necessarily retain its current governance structure; nor must it necessarily rush to restructuring. The goal should be “good governance.” The issue, then, is to assess to what extent OPA is currently effectively realizing the principles of good governance. Where we are successful, we need to continue; where we are falling short, we need to improve or change.

4. How would you facilitate psychology’s presence at the table when rules are written for health care reform in Ohio?

Dr. Miller-Lewis: My role as OPA President-Elect would be to use the office to assert the right – and duty- of psychologists to be a vocal group at the table of health care reform in Ohio. There are numerous occasions in the past that psychologists have not at the table (e.g., Medicare physician definition rules) and the profession has suffered for missing those opportunities. I would proactively facilitate psychology’s presence by working to be actively engaged with the health care reform effort. As OPA President-Elect, I would continue sponsoring the OPA Health Care Reform Task Force, support OPA staff efforts at communicating information regarding health care reform to members via multiple avenues, initiate conversations about health care reform with OPA leadership, regional groups, and members, collect state-specific data from psychologists regarding the impact of the health care reform in their day-to-day work, and work closely with the APAPO to then ensure OPA brings national data to the health care reform discussions. It is critical to work with the Ohio Department of Insurance to participate in the rule-making process vis-à-vis public comment, active participation in public hearings, and written testimony based on the data collected by OPA. Further, I would like to see OPA funds directed towards direct advocacy with Ohio State Senators and Representatives to ensure understanding of the critical role psychologists play in improving patient care, particularly in integrated healthcare settings, preventative care, and holistic treatment planning, and ensure those roles are preserved in the health care rules.

Dr. Stinson: First, I would point out that the process is already underway and we need to become more involved immediately. The Patient Protection and Affordable Care Act and The Healthcare and Education Reconciliation Act of 2010, collectively referred to as the ACA, were signed into law March 23, 2010. The full text of the law is 907 pages. OPA must be a key in synthesizing that information and educating psychologists of its impact and requirements. How many of us have a compliance program in place as required by the ACA? Do we even know about the requirement of a compliance program?

According to the State of Ohio’s Healthcare Overview Home Page, “The State of Ohio is currently analyzing the legislation and determining Ohio’s next steps.” OPA must be involved in changing and creating policies that impact on Ohio psychologists. Arguably, the ACA will be the most influential piece of healthcare legislation in our careers. We cannot stand by idly and wait to disseminate information after others make decisions. We need to work with our state legislators and senators as the state laws and rules are being created. We need to partner with other national and state stake-holder to provide a united front. If we are not invited to the table, we need to assert our need to be involved and insist that our voice be heard. Advocacy for psychology as it relates to the implementation of ACA must be a priority for OPA. It is simply too important not to be.

5. How will OPA be actively involved in working with APA to increase the opportunities for graduate students to obtain APA accredited internships, especially in Ohio?

Dr. Miller-Lewis: The internship match crisis continues despite the $3 million stimulus package passed by APA in 2012. In 2014, only 79.8% of students matched to any internship site, with 62.3% matching to an APA- or CPA-accredited site. OPA has already been actively involved in trying to understand and resolve the internship crisis state-side. As President-Elect of OPA, I would continue the work that OPA has started, and work closely with APA and APAGS on the following: (1) Directly communicate with doctoral programs on how to prepare students early for the match and how to support students, financially and emotionally, if they do not match, (2) identify grants for non-APA-accredited internship sites to become APA-accredited and offer workshops to assist them with that grant-writing process, (3) invite the APA Commission on Accreditation to hold a workshop in Ohio about developing accredited internships, (4) hold open forums for clinical sites on how to become APA-accredited, (5) create a page on the OPA website that links to the APA and APAGS information regarding the internship crisis, as well as articles specific to Ohio, (5) provide workshops for students on how to prepare for the match and what to do if you are not matched, (6) publish articles about the internship crisis, how to engage in self-care during the process, and stories of success and challenges, and (7) work with the OPA Advocacy Committee, OPAGS, OPA Insurance Committee, and other parties to try to facilitate reimbursement by insurance companies for services provided by interns.

Dr. Stinson: Google “psychiatry shortage” and you will see that everyone everywhere, including in Ohio, is talking about the “crisis” we are in because of the shortage of psychiatrists. According to the American Psychiatric Association, in 2011 (the last year for which I have data), there were 6,201 psychiatric residents. That is a national crisis? This year, only 2,474 psychology interns landed accredited internships. Psychology has a crisis! But outside of psychology, few people are aware. OPA—working with APA and other organizations—must educate on the value of psychology, demonstrating the need for psychologists, and insist on a call to action to address the psychology internship crisis.

Some have cited to the free-standing professional schools as the source of psychology’s problem, insisting the schools pump out too many students, flooding the market. However, fewer than 4,000 psychology students submitted internship ranking lists this year. We do not have a problem with too many students. We have a problem with too few internships, and too little understanding of the need for and value of psychologists.

APA has funded an internship stimulus package in the amount of up to $3 Million per year to help non-accredited internships acquire accredited status. OPA needs to be instrumental in helping Ohio secure its share of those funds. OPA needs to work with APA and advocate for reimbursement of services provided by interns, making interns more desirable and cost effective. And OPA needs to challenge APA to support qualified students for whom APA-accredited internships are not available.