New to this year’s APA 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.
This year’s candidates are Colin Christensen, PhD, David Hayes, PhD, AABP, and Suzanne LeSure, PhD. To view their platforms, click here.
1.) A number of proposed changes to the APA governance structure have been presented. Which changes do you believe are critical for improving the responsiveness of APA to the needs of psychologists in general and those in clinical practice in particular?
Dr. Colin Christensen: I support the APA Good Governance Project and believe that three proposed changes in particular will be useful for supporting the needs of psychologists. 1. “Enhance the Use of Technology.” Taking advantage of technological developments will permit APA to communicate more effectively and efficiently with member psychologists. For example, OPA recently used SurveyMonkey to help conduct a cultural assessment of the organization. APA can use similar tools to survey its membership and be better attuned to its needs.
2. “Leadership Pipeline & Development.” It can be challenging for a national organization to stay in touch its members across the country. OPA has taken steps at the statewide level to develop a leadership pipeline for OPA to groom new leaders for the organization. One way it has done this is through the use of Leadership Forums in which early career psychologists and others are invited to trainings to develop their leadership skills and meet other psychologists interested in becoming active with OPA. I believe that APA would benefit from a similar systematic approach to bringing in a broad base of new leaders for its organization.
3. “Triage System.” APA is a large and complex organization. This being the case, it can be difficult for APA to respond in a nimble manner to quickly developing challenges and opportunities it may face. The development of a triage team is necessary to ensure that APA is in a position to address quickly breaking issues.
Dr. David Hayes: APA’s Good Governance Project (GGP), which addresses a governance system that has not changed fundamentally since 1945, proposes changes that are crucial to the viability of organized psychology. APA Council, the “Congress” of APA, is modeled on an institution designed to make change difficult. (BTW, that approach is working at both the Congressional and the APA Council level.) APA governance, designed for a smaller organization and a slower world, has inevitably fallen short in terms of responsiveness, agility, and effectiveness. The most important changes in the structure of governance would enable APA to respond quickly to issues that don’t permit the current multi-year process of debate, deliberation, and delay. These changes would empower the Board of Directors, the “Executive Committee” of APA, to take action on issues that often become mired in partisan, dilatory argument. The most recent example of change by Council that is helpful to psychologists in clinical practice focuses on the need for less constrained lobbying by Practice for practitioners.
Dr. Suzanne LeSure: This is a great question, because the proposed changes in APA governance are clearly the most important issue facing Council this year. Some of these changes have already been approved by Council, but from my perspective the two most important changes lie ahead: The first is the proposed changes in Council structure. Diligent work, including small table discussions led by our very able Cathy McDaniels Wilson, has resulted in a winnowing down of models. I will work toward and support a model of Council that preserves a strong role for State Associations and the many Divisions that represent those in clinical practice, both in the organization of the proposed Council Leadership Team and in the organization of Council itself.
The second important change which will impact responsiveness is the implementation of an APA governance-wide triage system to move issues forward in a timely way. I have often heard Ohioans say that APA is “a day late and a dollar short” on issues facing psychologists in the trenches. The proposed use of technology to poll, track and manage urgent and emergent issues will be of critical importance in improving responsiveness to the entire membership of APA.
2.) In the past year, the APA Council has taken significant steps to address the shortages of APA accredited internships. How does APA need to address continuing concerns regarding employment prospects for psychologists who do not have an APA accredited internship?
Dr. Colin Christensen: I currently work at an APA-accredited internship site. To answer this question, I spoke with three of our psychology interns. We are all aware that there are far more applicants to APA-accredited internships than there are slots available for those interns. This has been an ongoing problem for a number of years. This means that each year there are a number of highly qualified individuals who have spent four or more years of their life pursuing a course of training for their career only to be left out of the system.
The interns told me that should they have failed to obtain an APA-accredited internship, it would have become their responsibility to document that the internship that they obtained is equivalent to an APA-accredited internship. One of the problems they reported, however, is that it is very challenging to determine the exact criteria that make an internship equivalent to an APA-approved internship.
First and foremost, APA must continue to work diligently to ensure that there are enough APA-accredited internships for qualified applicants. Until that day is here, however, I would urge that APA at a minimum develop a very clear and explicit process to guide interns as to what their internship experience must entail to be considered equivalent to an APA-accredited internship. To assist interns at non-accredited sites, it would also likely be beneficial for APA to offer a credential bank that tracks their counseling hours in a secure location.
Dr. David Hayes: APA Council’s 2012 action to provide grant money to increase the number of APA-accredited internships and to speed of the process of accreditation for sites already in the accreditation process is an appropriate and vital step in addressing the current internship shortage crisis. The question of how to deal with employment for psychologists who do not have APA-approved internships requires carefully balancing reducing unnecessary obstacles on the one hand and attending to appropriate quality control on the other. The problem is complex, and APA response must respect this complexity.
Dr. Suzanne LeSure: In spite of the number of students who are unable to find an APA internship, various groups within APA have supported the requirement of APA- accredited internships to qualify as a health service provider. Council attempted to increase accredited internships through the “Stimulus Package” of 2012, but many psychologists without APA-accredited internships are suffering limitations in mobility and employability. As a former State Board member, I value rigorous internship requirements and the ease of evaluating a candidate with an APA accredited internship. However thirty years ago, I accepted a non-accredited internship to pursue pediatric psychology.
An Ohio psychologist, Todd Finnerty, asked Council for a resolution stating all pre-doctoral internships leading to graduation from APA‐accredited programs and state licensure are equal. The proposed resolution argues that the APA Model Act recognizes internships that are “equivalent” and that there is no empirical evidence supporting a better trainee outcome in APA accredited internships in a program that otherwise meets the requirements for graduation from an APA-accredited doctoral program.
All psychologists deserve APA’s support in the pursuit of their scope of practice. While an APA-accredited internship is aspirational, the paucity of internships blocks our pipeline. In addition, there will always be new and emerging fields of study within psychology without the “maturity” of being at an accreditation point. Currently, I favor a carefully crafted resolution supporting those psychologists who did not complete an APA-accredited internship. This is an example of a complex issue for which I would seek guidance from all of you.
3. What is the one most pressing state (Ohio) issue and how would you like to see APA help?
Dr. Colin Christensen: I think that the one most pressing state issue that Ohio has is our need for a full-time lobbyist to effectively advocate for our concerns to the legislature. As a group, psychologists have tended to focus on doing excellent clinical work, while neglecting the necessity of interacting with our legislators. In today’s economic climate, that approach is no longer an option.
A full-time lobbyist would permit OPA to advocate more effectively with our legislature. The implementation of the Affordable Care Act (ACA) in Ohio is one of the biggest challenges and opportunities that psychologists will likely face in our lifetime. Having an effective lobbyist to guide us through this process is essential.
In the past, APA has assisted OPA by funding our lobbyist for specific projects. This has been helpful, but not sufficient. I would like to see APA help Ohio by assisting us to develop a plan to fund a lobbyist on an ongoing basis. One way to do this might be through a matching program in which APA matches each dollar that OPA commits to help fund our lobbyist.
Dr. David Hayes: Psychologists in Ohio are facing unrelenting pressure on reimbursement levels. To be effective, this problem must be addressed at the federal, macro, level. The most important contribution that APA can make has already begun – APAPO recently hired a new director for its PAC, a woman who formerly was the Executive Director of one of the two most effective (and richest) physician PACs in the country. Effective PACs are vital in creating access to decision makers, and access to decision makers – legislators – is the only way for us to affect decisions that affect our pocketbook issues. We must not shrink from the reality of the political processes that shape the world in which we practice, whether in the public sector, as private practitioners, or as members of interdisciplinary teams.
Dr. Suzanne LeSure: The most pressing Ohio issue is ensuring the financial viability of our members in clinical practice. Although those in private practice are often the first to be vulnerable to changes in the reimbursement landscape, all psychologists are at risk. From psychologists facing retirement, to institutions considering the feasibility of internship programs, to the attraction of the best and brightest to our academic programs, all of us are impacted by the issue of financial viability. The recent list-serve discussion of RVUs for supervision of interns is an example. (Although RVU is really a measure of consumption of resources, many employers use it as a measure of productivity because it is linked to payment.)
The arm of APA most able to help is the American Psychological Association Practice Organization (the APAPO.) The APAPO is the part of APA funded by your practice assessment and its mission is to serve the interests and needs of practicing psychologists. Current APAPO priorities are Medicare payment; physician definition in Medicare; and access to HITECH incentive payments to support our transition to electronic medical records. I wholeheartedly support those three issues as priorities. Commercial carriers as well as government entities use Medicare definitions and rates to inform their rates and policies; and without the ability to switch to electronic medical records we will increasing find ourselves out of the health care loop. We need APA help with these priorities.
4.) Our current Council Rep has routinely reported on the work of Council. Which two issues on which Council is working resonate most with you and how would you like to see them resolved?
Dr. Colin Christensen: First, I would like to see the APA Council work to implement the recommendations of the Good Governance Project. It is my belief that this will help make the Council a more effective and efficient deliberative body. The Council will then be in a position to advocate more successfully for the needs of psychologists and our clients.
Second, APA has made some excellent beginning steps to help address the internship crisis for psychology. It is my belief that APA must strive to follow up on this start to address the issue in a more systematic and ongoing fashion. One way to do this is to provide more guidance to APA-approved internship sites throughout the reaccreditation process. For example, it is suggested that APA provide greater clarity to sites regarding the documentation that is needed for reaccredidation. By streamlining and simplifying the APA-accreditation process, it is likely that more internship sites will submit to the process, thus helping to alleviate the APA-accredited internship shortage.
Dr. David Hayes: The Good Governance Project is currently the most important matter before Council. Practice related issues, fundamentally important to Ohio and to other state associations and practice-related APA divisions, do not receive appropriate representation at the level of Council at this point. Instead, current governance treats practice versus science issues as a zero sum game, ignoring and obscuring the ways in which each contributes to the other. This structural problem needs to be resolved by embracing the one unit/one vote principle proposed by the GGP. Council has also been proactive on issues of inclusion and addressing the fact that Council does not represent the increasing diversity of our country. I would like to see this matter resolved by ongoing attention to correcting this failure.
Dr. Suzanne LeSure: While Council is full of interesting and important reports, there are three issues I will follow very closely:
a. APA is responding on a variety of levels to the integration of psychology with health care: The APAPO is monitoring the impact of the Affordable Care Act on psychologists, seeking good access to care and fair treatment of psychologists. The Board of Directors recently approved funds supporting the development of a several web based toolkits for health based practice. Several Divisions are collaborating on a project identifying good system design for youth in health/mental health setting. This integration must translate to general office practice in Ohio as well as to integrated care settings.
b. Like it or not, rapidly developing technology is here. We need APA support to adapt: Council recently passed guidelines for telepsychology that are quite consistent with our new Ohio rules. APAPO is advocating for psychology’s inclusion in stipends for initiating electronic medical records. The APA Board recently received the petition to create the Society for Technology and Psychology. Changes in third party requirements and reimbursement patterns due to technology will influence all of us.
5.) How will you keep OPA leadership and OPA members informed of the work of Council and issues within APA?
Dr. Colin Christensen: Our current APA Council Representative, Cathy McDaniels-Wilson, Ph.D., has done an excellent job of keeping OPA leadership and members informed of the work of Council and APA. One way that she has done this is by maintaining friendly and open relationships with her OPA colleagues. I would continue Dr. McDaniel-Wilson’s approach of maintaining cordial relationships with my fellow members and encouraging open and frank discussions about issues facing APA. It has been my experience that the best way to share important information is to get to know people on a personal basis and discuss important topics with them.
Toward that end, I will continue to meet with the Regional Representatives of OPA at OPA’s Board meetings to share topics of mutual interest. As OPA’s Council Representative to APA, I would use these meetings to learn about the concerns of the regions to convey to APA and would encourage my regional representative colleagues to share important information about APA with their regional organizations.
It is not always possible to share information one on one. I would also take advantage of technology to broadcast the work of Council and APA on a wider basis. One way to do this would be to follow the lead of Michael Ranney, MPA, OPA’s Executive Director, and send out regular email updates to OPA members about the workings of the APA Council. Another way to disseminate breaking updates regarding APA Council is through Twitter with a link to an article on OPA’s website.
Dr. David Hayes: There is a long history of a close and effective working relationship between OPA and OPA leadership and APA, including OPA’s contributions to APA’s federal advocacy agenda. I have been part of that work, and I would of course continue that as Council Rep. OPA has a structural approach to keeping its leadership in the loop about the work of Council – OPA’s Council Rep is a member of OPA’s Executive Committee. It also is important to keep OPA members up to speed about the issues before Council and within APA. These matters can be addressed by regular updates after Council meetings, but by using other social media channels as well.
Dr. Suzanne LeSure: Cathy McDaniels-Wilson has been a model for thorough and professional coverage of Council business and I will keep up her good work. My plan is to be present at all meetings of the OPA Board and relevant events/committees of OPA. “Showing up” is important to me and the most important aspect of my platform is access and transparency. I promise complete coverage of Council events through the list-serve, website and newsletter on a regular basis. I invite each of you to communicate concerns and questions to me directly, through email or phone. Communication is a two way street and I hope to carry your concerns back to APA and to advocate for channels for member communication.. When representing you in the past, I made myself available to do presentations on campuses and at regional association meetings. I will do that again. I feel honored that two past Presidents of APA, Gerry Koocher and Alan Kazden have written personal notes to me, praising my efforts at communication with psychologists in Ohio on behalf of APA and I want to maintain that standard.