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The MPA Spring Convention and Other Learning Opportunities Christopher Sterling, Psy.D. E njoyment of learning is one of the most rewarding experiences of our profession. To add to this excitement, this year’s Annual Spring Convention on March 28 will address the topic of Autism Spectrum Disorders. Attendees at this year’s spring convention will enjoy two excellent presenters: Dr. Ira Glovinsky and Ms. Beth Osten, M.S., OTR/L. Glovinsky and Osten will provide up-to-date information about new developments regarding diagnosis and treatment of Autism Spectrum Disorders. This will be a rare opportunity to hear and learn from two presenters each of whom has decades of experience – all while in the comfort of MSU’s Henry Center in East Lansing. Ira Glovinsky is a licensed psychologist with a background in psychology and special education. He graduated from The University of Michigan with a Ph.D. in Special Education with a specialty in emotional impairments in children, and then went on to receive his license in psychology. Glovinsky is presently on the Ph.D. faculty of the Interdisciplinary Center for Developmental and Learning Disorders (ICDL) Graduate Program where he teaches courses in Human Development and Individual Differences. He is also the Associate Dean of Academic Affairs for the ICDL Graduate Program. Dr. Glovinsky worked closely with Dr. Stanley Greenspan and together they published two books on bipolar patterns and mood swings in young children (Children and Babies with Moodswings, 2002; Bipolar Patterns in Children, 2007). He has also published articles on pediatric bipolar disorder in refereed journals. Glovinsky’s background includes work in neonatal intensive care and in early intervention for preschool aged children with emotional disturbances. He has directed two clinical preschool programs including one at Hawthorn Center, a children’s psychiatric hospital in Northville, Michigan and The Village Education Center. He has a specialty in autism spectrum disorders and is certified in Developmentally Based, Individual Difference, Relationship Based (DIR) treatment, one of two professionals to be certified in DIR in Michigan. He is a Fellow of the Michigan Psychological Association and a member of the American Psychological Association and Society for Research in Child Development. Presenting with Dr. Glovinksy will be Beth Osten, MS, OTR/L, who has more than three decades of pediatric experience. Osten received her undergraduate degree from the University of Washington, Seattle, and her master's degree from the University of Illinois at Chicago. Her graduate studies focused on sensory integration theory and practice, as well as on infant motor development. She brought this expertise to her practice in clinical, research and academic settings, including Beth Osten & Associates, Michael Reese Hospital, the Illinois 1 The Michigan Psychologist – 1st Quarter 2014 Institute for Developmental Disabilities, and the University of Illinois at Chicago. Beth Osten specializes in sensory processing and motor disorders in infants and young children, including children on the autism spectrum. She helped to develop the Test of Infant Motor Development, a diagnostic motor evaluation for premature and young infants. Currently, she is a faculty member and lecturer with both the ICDL and the Profectum Foundation, which trains parents and practitioners in developmental and behavioral interventions. She has presented both nationally and internationally on topics including infant motor development, care to the high-risk infant, sensory integration, the treatment of autism spectrum disorder, and the DIR model. After Dr. Glovinsky and Beth Osten review the early history of Autism Spectrum Disorder, contemporary theory will be presented. And the complex information processing related to “underconnectivity” will be discussed. Participants will learn to translate this information and apply it to the early signs of the disorder, especially after 12 months of age. The presenters will also discuss the DSM-V as it relates to Autism Spectrum Disorder. In addition, clinicians and therapist will be introduced to components of treatment of children with Autism Spectrum Disorder and their families. The importance of relationships to treat Autism Spectrum Disorder will also be addressed. Recent practical concerns have been a focus of the Program Committee’s attention. On May 17, 2014, MPA will bring Dr. Steven Walfish to present on two topics: the complexities of closing a practice due to retirement, moving, or other life changes, and issues regarding billing and collection. This presentation will allow clinicians to sign up for either or both topics. It is hoped this will allow Michigan Psychologists to pick and choose the topics they are most interested in learning. Learning opportunities will continue through 2014 as coming seminars will be addressing the Affordable Care Act, ICD-10, and Identity and Culture. Keep in touch on the MPA website for dates. Contact Christopher Sterling, Psy.D. at [email protected]. Position Available: Master’s Level Behavioral Psychologist Position available for a full time Master’s Level Behavioral Psychologist to provide quality psychological services to traumatic brain injured clients at our TBI facility in Caro, Michigan. The selected candidate will work within a multi-disciplinary team and be capable of working independently to provide diagnostic and therapeutic services. Experience in traumatic brain injury and behavior management is preferred and a master’s degree in psychology is required. The Lighthouse, Inc. offers competitive salary and an excellent fringe benefit package. For immediate consideration on this rewarding career opportunity send resume to: Attn: Clinical Director, Lighthouse Inc., P.O. Box 289, Caro, MI 48723. Phone: 989-673-3979 E-mail: [email protected] Available: Luxurious Office Space Elegant building with atrium, fountains, cafeteria, mirrored elevator, marble staircase and other appealing features. Located on Northwestern Highway corridor between Middlebelt & 14 Mile Road. (248) 737-0040. 2 The Michigan Psychologist – 1st Quarter 2014 TLC Childhood Trauma Practitioner’s Conference I feel better! July 14 - 18, 2014 Lansing Center, Lansing, Michigan 3Q@TL@SQ@HMHMF@MCBDQSHƥB@SHNMENQOQ@BSHSHNMDQRVGNVNQJ in schools, organizations, agencies or private practice. (MBKTCDRKTMBG@MC"$R%NQBNLOKDSD@RRDLAKXHMENQL@SHNM and a brochure go to, RS@QQSQ@HMHMFNQFBNMEDQDMBD. Robin Karr-Morse • Keynote Speaker Ghosts from the Nursery: Tracing the Roots of Violence Robin Karr-Morse, author of “Ghosts from the Nursery,” will explain how the brain develops; the biological roots of violent and aggressive behavior; the relationship between child neglect and abuse and current incarceration rates; how to prevent the expanding rate of incarceration and preventive social policies that help families build healthy kids. What Professionals Have Said “TLC has the best trainers and remains the most valuable resource for my work in private practice and with children at school. Out of all my university courses and SURIHVVLRQDOGHYHORSPHQWHƱRUWVWKH7/&FRQIHUHQFHVKDYHWDXJKWPHWKHPRVWŞ Libby Christensen, Private Practice, Nappanee, Indiana ŝ,MXVWZDQWWRVD\KRZZRQGHUIXOWKH7/&WUDLQLQJZDV0\FRZRUNHUDQG,OHIW IHHOLQJUHDOO\HQHUJL]HGDERXWEULQJLQJPDQ\RIWKHWKLQJVZHOHDUQHGEDFNWRRXU GLVWULFW:HFDQśWZDLWIRUWKHQH[W7/&&KLOGKRRG7UDXPD3UDFWLWLRQHUśV$VVHPEO\Ş Michael R. Markowitz MSEd, School Psychologist, Dublin, Ohio ŝ7KH7/&FHUWLƲFDWLRQSURJUDPKDVEHHQUHPDUNDEOH,DPVHHLQJFKDQJHVLQWKH FKLOGUHQDQGIDPLOLHV,VHUYH,KLJKO\UHFRPPHQG7/&WRRWKHUFOLQLFLDQVŞ Melanie Chung-Sherman, Lewisville, Texas The National Institute for Trauma and Loss in Children (TLC) www.starr.org/conference2014 Q 877.306.5256 3 The Michigan Psychologist – 1st Quarter 2014 Meet Your President: Tamara McKay, Ph.D. Jack P. Haynes, Ph.D. Dr. Tamara McKay began her involvement with and commitment to MPA as a student during her Wayne State University graduate program years. I know from my own direct experience at that time that Tamara was actively participating at MPA workshops and conferences. As the new MPA president Tamara has particular interest in diversity and in the restructuring of the Diversity Committee. Tamara also values MPA increasing its emphasis on social justice and social responsibility. It is clear in speaking with Tamara that she is not only committed to MPA but also to psychology and broader social advocacy concerns that should involve psychologists. Tamara has been interim director of CAPS since 2012, employed by the University of Michigan-Flint since 2007. She works in a clinical setting supervising providing mental health services and disability services -- physical and psychiatric disabilities, temporary or chronic, under ADA accommodations. She is involved in training as well as advocacy. Section 504 comes into play in terms of having an accessible campus. Tamara often works with students with chronic exposure to poverty and violence, which can be significant factors. At the present time Tamara does not have a private practice. Tamara completed her Ph.D. in the Wayne State University Clinical Psychology program in 2011 and is in the process of preparing for taking the EPPP examination. Her training also has been as a generalist, working mostly with adult clients, but also some children and adolescents. experience. She also has a teaching background, recently having taught in the U of M-Flint Psychology Department. Tamara is from a small town in Genessee County, also living one year in Lansing and three years in Detroit. She feels that part of her identity as a psychologist is understanding community psychology. She grew up aware that context matters. She thinks deeply about the interaction of individual differences, personality development, and environment. Tamara has a 20-year-old son who is a college student at a private school out of state. In the little time she has for hobbies and other pastimes, Tamara likes to watch movies, likes to fish (no ice fishing), crochets, and is learning to knit. She also works on her house in her spare time. Tamara welcomes and encourages input from and broader participation by MPA members. She looks forward to a thoughtful and active year as MPA President. She can be contacted at [email protected]. To comment or to reach Jack Haynes, Ph.D., email him at [email protected] Psychology was a career change for Tamara. She began in public administration in the not-for-profit sector. Her current work combines her clinicallybased training and skill with her administrative 4 The Michigan Psychologist – 1st Quarter 2014 FROM THE OFFICE OF THE PRESIDENT: Advocacy Tamara McKay, Ph.D. The best way to find yourself is to lose yourself in the service of others. --Mahatma Gandhi health issues in Michigan (see MPIC’s Members page for a complete listing). Never believe that a few caring people can't change the world. For, indeed, that's all who ever have. --Margaret Mead It occurred to me that others may want information about organizations with which to become affiliated. Some may benefit from mentoring on how to get involved in advocacy efforts and how to make an impact in their communities, for instance students and early career professionals. If you have information to share or would be interested in becoming a mentor, please contact me directly. Advocacy is a profoundly rewarding way to make a contribution to the world and be a part of something greater than ourselves. In my candidacy statement for President-Elect, I wrote, “MPA plays a vital role in providing public education and advocating for many important issues. The individual and collective expertise of our members has transformative power for our clients, communities, and the state of Michigan.” Psychologists make a difference in the lives of so many in a multitude of ways. While the day-to-day work of supporting and treating clients consumes so much of our time and energy, we still find a way to use our expertise to be advocates for others. These are commendable and noble endeavors. It is a privilege to belong to a group of professionals that give so much and use their power for good. I thank you for all that you do. In December, 2013, the Michigan Partners in Crisis (MPIC) held an annual convention where it reviewed the progress of its efforts to address issues related to Mental Health Courts and related legislation. A summary of MPICs 2013 Initiatives and Outcomes can be found on the website here. It was humbling to witness the passion and dedication of so many. It was also enlightening to find out more about other associations and organizations that address mental Of course, the most immediate way of increasing your level of involvement is to join one of the MPA Committees. MPA is a volunteer organization and relies heavily on members’ contributions to sustain its efforts. A full list of Policy Committees can be found under the “About MPA” tab on the web site. Thank you to everyone that has shown an interest in the vacant Chair positions. The Board is reviewing that material and will announce new Committee Chairs following the March meeting. It isn’t easy to maintain involvement in these activities as the practice setting and parameters continue to evolve. But this work is incredibly important, so please be encouraged, remain committed, and stay the course. You make a difference! For those interested in mental health legislation, a Legislative Tracking Report is available at www.michiganpsychologicalassociation.org/docs/MP A-Tracking-Report.pdf. To comment on this column, contact Tamara McKay, Ph.D. at [email protected] 5 The Michigan Psychologist – 1st Quarter 2014 EXECUTIVE DIRECTOR’S REPORT: Be a Better You by Taking Care of You Cheval Breggins, MBA – Executive Director Many of my friends and associates stated that they were less busy during the winter season because once they returned home they were in for the day. The severe winter season was too much, even for avid winter lovers. Now, time springs forward and so does our life within a day. Tax season has replaced skiing season. Many people have added additional tasks on the calendar. We have replaced severe winter and holiday shopping with the tax season and the “good weather” activities. Regardless of the change of seasons, what did not change were our methods for managing stress and time. Liam E. Bennett wrote an article entitled, Stress and Time Management: Managing Your Busy Life and suggests that the management of stress and time are tied together. As we add activities to our life calendar, we begin to think that and behave as if we cannot back away from responsibilities and commitments. These thoughts and actions not only increase our stress level, but we begin thinking and acting as if we have to accept the current level of stress -- which is not true. We have family, work, and personal obligations that take time and raise the stress level. We may have a significant other, children, grandchildren, and aging parent obligations and responsibilities that cannot be eliminated or reduced. Liam Bennett suggests that we brainstorm options that allow us to better manage responsibilities resulting in making life easier for us. We could collaborate with other parents to establish a car pool system for the children and grandchildren. We could ask our significant other to adjust their schedule to pick up one or two of our commitments. We could ask siblings to assist in the care of aging parents. Now that we have left the house for the day, managing stress and time are often major issues for our professional or work life. Bennett states that the development and assessment process of our calendar is paramount. Make sure we give ourselves time to really get something done and not schedule meetings or tasks on top of each other. Remember a Smart goal or objective must be Realistic. We must prioritize our meetings and tasks. We only have so many work hours in one day and you may not be able to do it all (build Rome, for instance) in one day. When developing the calendar, build in time to work in peace and quiet. Your quiet may require some lowvolume, soft, and relaxing music in the background. Before, during, and after work we may have religious, community, or children event obligations that require your time. Managing stress and time becomes an issue when we overcommit in our personal life. Yes, Liam Bennett said this, but I am sure we have our own testimonials. We must ask ourselves how many volunteer opportunities can we take on and continue to be effective. We must have a plan for each personal obligation that includes recruiting others to become part of the team immediately or as your replacement. We must provide opportunities for others to serve, while we serve in an advisory capacity. This article may have described some of your patients or colleagues. As experts in the helping 6 The Michigan Psychologist – 1st Quarter 2014 profession, you must help you. If you are struggling managing time and stress, you can become unhappy - even if the weather is good according to your standards. Not only will you become unhappy, you will be less effective in all that you do. Work to improve your stress and time management. Taking care of yourself will result in a better you taking care of others. Your comments welcomed. and suggestions are always I welcome your input, questions and concerns about MPA; you can contact me at [email protected] or call me at 517-391-0182. MPA Spring Convention March 28, 2014 - MSU Henry Center - 3535 Forest Road , Lansing, Mi 48910 Join Us This Spring To Learn About Topics Important To Every Psychologist 2014 SPRING CONVENTION – AUTISM SPECTRUM DISORDERS PRESENTERS: Ira Glovinsky, Ph.D. Beth Osten, M.S., OTR/L Welcome to the 2014 Spring Convention of the Michigan Psychological Association. We’re pleased to announce that our presenters will be Dr. Ira Glovinsky and Ms. Beth Osten. They will provide information on current research, diagnosis, and treatment of Autism Spectrum Disorders. The Spring Convention is an excellent opportunity to reconnect with colleagues and network with psychologists from across Michigan. The convention is also where we honor psychologists in Michigan that are recipients of both the Distinguished Psychologist Award and the Beth Clark Award, as well as acknowledge the new MPA Fellows. There will be time during the luncheon to find out about the activities of MPA by speaking with Committee Chairs and other Committee members. As always, there will be vendors at the Spring Convention offering products and services of value to psychologists. If you’re not already a member of MPA, please talk with any member of the Board of Directors and/or Committee member about how to join and become involved with this wonderful organization. Presenters Ira Glovinsky, Ph.D. Dr. Ira Glovinsky is one of two persons certified in the state of Michigan in Developmentally Based, Individual Differences, Relationship Based Therapy (DIR), a treatment model that is used with children on the autism spectrum. He specializes in pediatric mood disorders and Autism Spectrum Disorder. His work with infantile autism disorder started in the 1970s. He has co-authored two books with Dr. Stanley Greenspan, Bipolar patterns in Children and Children and Babies with Mood Swings. He has published articles and monograph chapters on pediatric bipolar disorder. Dr. Glovinsky is the Chief Academic Officer of the Interdisciplinary Council for Development and Learning, an online doctoral program offering a Ph.D. in Infant Mental Health and Developmental Disabilities. He is presently in private practice in West Bloomfield, Michigan and heads a multidisciplinary center, Glovinsky Center for the Family. 7 The Michigan Psychologist – 1st Quarter 2014 Beth Osten, M.S., OTR/L Ms. Beth Osten, M.S., OTR/L is a prominent pediatric therapist with 40 years of experience working with children with Autism Spectrum Disorders and other developmental challenges. She has been an international presenter on infant mental health topics. She has presented and worked with Dr. Stanley Greenspan as a contributor to the “Diagnostic Manual for Infancy and Early Childhood”. Her work also contributed to “Psychodynamic Diagnostic Manual” (2006). She is presently the director of a large multidisciplinary pediatric therapy practice in the Chicago area. Agenda 8:30 a.m. 9:00 - 10:30 a.m. 10:30 - 10:45 a.m. 10:45 - Noon Noon - 1:30 p.m. 1:30 - 3:00 p.m. 3:00 - 3:15 p.m. 3:15 - 4:15 p.m. 4:15 - 4:45 p.m. 5:00 - 5:30 p.m. 6:00 p.m. Registration & Continental Breakfast Historical perspective of Autism Margaret Creak’s Nine Points to Minshew’s Complex Information Processing Break Biology, Socio-emotional, and Neurodevelopmental Disorder of relating, communication Lunch & Learn and Awards Treatment using a team approach Break Team treatment continued Working with grieving parents Questions, Wrap-up and Evaluations Annual Meeting Meet & Greet — Beggar’s Banquet, 218 Abbot Rd., East Lansing, MI 48823 Register at the MPA Website by clicking here BOOK REVIEW Cheating Parents: Recovering from Parental Infidelity by Dennis Ortman, Ph.D. (2014) Reviewed by Jim Windell We all know the names: General David Petraeus, Tiger Woods, Arnold Schwarzenegger, John Edwards, and President Bill Clinton. Famous men – and fathers – who had affairs. But in all the media coverage of these affairs, what gets forgotten is a very simple and direct question: What happens to children when a parent is unfaithful? Those are the questions that psychologist Dennis Ortman asks – and answers – in his latest book, Cheating Parents: Infidelity. Recovering from Parental In a recent interview, Ortman was asked about this book and how he came to write it. “It’s really a follow-up to my previous book, Transcending Post-infidelity Stress Disorder: The Six Stages of Healing,” Ortman said. “What I noticed was that there wasn’t much of anything written about the impact on the children of an unfaithful parent. I 8 The Michigan Psychologist – 1st Quarter 2014 found in couples therapy that people often said that their parents were unfaithful.” He also noticed that as children in a home in which there is an unfaithful parent that the children go along with the pretense and secrecy. “Often these kids don’t really realize what was going on until maybe decades later,” Ortman pointed out. “That’s what I call the time bomb effect.” What he means by the time bomb effect is that the repercussions of living in a family with parental infidelity show up when the children become adults and they are in intimate relationships. “I found that there are usually three kinds of later responses to being the child of a cheating parent,” Ortman said. “They may feel angry or depressed and not know the reason. They may experience confusion about sex and appropriate boundaries in relationships. And especially, they may find it difficult to trust others and themselves.” In the latest of his five books, Dennis Ortman, a Sterling Heights psychologist and former priest in the Archdiocese of Detroit, writes about the patterns in family where cheating has taken place, but he also writes about the effect on the grown-up child’s future parenting styles, and about these now-adult children of the unfaithful getting help. “Unless they heal from their childhood wounds,” he said, “they will either mimic or compensate by going in the opposite direction of their own parents in the ways they relate to their children. Some become strict, authoritarian parents who want to protect their children with rigid rules. Others become emotionally over-involved, seeming to be more friends than parents of their children. Still others become emotionally disengaged, offering little closeness or guidance.” Dennis Ortman has a graduate degree in theology from the Gregorian University in Rome and a doctorate in clinical psychology from the University of Detroit-Mercy. He has published three previous books on recovery from dual diagnosis and infidelity. In addition to working as a psychologist in private practice for 20 years, he has given workshops around the country on the meeting of Freud and Buddha, a mindful approach to therapy and addiction, and recovery from dual diagnosis and the trauma of infidelity. Prior to this book, he published a book about his personal journey: Waiting for the Archbishop: Memoirs of a Former Priest in Transition In the newest book he offers advice for parents who have experienced an infidelity in their family. “They need to help themselves before they can help their children,” he said. “They need to calm their own emotional storms, resolve their own difficulties, and make wise decisions so they can have the energy and clear thinking to address their children’s needs.” Professional help, he suggests, is often needed. Ultimately, though, he has found that adult children of unfaithful parents need to grieve the losses from their childhood and learn to forgive their parents. To contact Dennis Ortman, you can email him at [email protected]; to comment on this article, you can contact Jim Windell at [email protected]. Have you just published a book or article? When you publish a book or an article, let us know so we can inform the MPA membership of your scholarship and success. Send an email to the editor at [email protected] to let us know what you have had published. 9 The Michigan Psychologist – 1st Quarter 2014 ;Y\Z[:WVUZVYLK7YVMLZZPVUHS3PHIPSP[`0UZ\YHUJLPZ UV^H]HPSHISL[V(33WZ`JOVSVNPZ[Z *V]LYHNLH[L]LY`Z[HNLVM`V\YJHYLLY ;OL;Y\Z[OHZ`V\JV]LYLK^OLU`V\»YLWYV]PKPUN WZ`JOVSVNPJHSZLY]PJLZ¶HZHZ[\KLU[PUZ\WLY]PZLK WVZ[NYHK\H[L^VYRPUYLZLHYJOHUKLK\JH[PVUPU WYVMLZZPVUHSWYHJ[PJL¯PUL]LY`^H``V\NL[HU LU[PYLYPZRTHUHNLTLU[WYVNYHT 5VHZZVJPH[PVUTLTILYZOPWYLX\PYLK[VHWWS` )YVHKJV]LYHNLH[HMMVYKHISLYH[LZ -YLLYPZRTHUHNLTLU[JVUZ\S[H[PVUZ ,_JLSSLU[J\Z[VTLYZLY]PJL (]HYPL[`VMWYLTP\TKPZJV\U[Z 6W[PVUHS)\ZPULZZ6MÄJLPUZ\YHUJL 4V]L`V\YJV]LYHNL[V;OL;Y\Z[HUKZH]L 0M`V\»YLPUZ\YLKI`HUV[OLYJHYYPLYP[TH`IL[PTL[VZ^P[JO0[»ZLHZ`HUKHMMVYKHISLHUK`V\JHUTHRL[OL [YHUZP[PVU^P[OUVNHWPUJV]LYHNL-VYKL[HPSZJHSS\ZH[ )`7Z`JOVSVNPZ[Z-VY7Z`JOVSVNPZ[Z w w w . a p a i t . o r g • 1 - 8 7 7 - 6 3 7 - 9 7 0 0 * Insurance provided by ACE American Insurance Company, Philadelphia, PA and in some jurisdictions, other insurance companies within the ACE Group. The product information above is a summary only. The insurance policy actually issued contains the terms and conditions of the contract. All products may not be available in all states. Surplus lines insurance sold only through licensed surplus lines producers. Administered by Trust Risk Management Services, Inc. ACE USA is the U.S.-based retail operating division of the ACE Group, a global leader in insurance and reinsurance, serving a diverse group of clients. Headed by ACE Limited (NYSE: ACE), a component of the S&P 500 stock index, the ACE Group conducts its business on a worldwide basis with operating subsidiaries in more than 50 countries. Additional information can be found at www.acegroup.com/us. 10 The Michigan Psychologist – 1st Quarter 2014 What is Evidence Based Practice in Psychology? Jared Lyon Skillings, Ph.D., ABPP – Spectrum Health System Health Service Psychologists (clinical, counseling, and school) are faced with difficult questions on a daily, or even hourly, basis. Some questions are broad, such as What kind of intelligence test should I administer?, or How frequently should this patient attend psychotherapy to achieve the maximum benefit? Some questions are specific, such as Would a cognitivebehavioral or a feminist psychotherapeutic approach be better for a young, domestically abused Latina?, or Which screening test is most effective for assessing depression with diabetic patients? resistance to EBPP particularly by older psychologists (Aarons & Sawitsky, 2007). A recent article (Lilienfeld, et al, 2012) highlighted six common reasons for resistance, including misunderstanding about what EBPP is, discomfort with reviewing the technical psychotherapy literature, or even misconceptions about human nature that prevent EBPP adoption. Anecdotally, some psychologists may feel that they are being asked to change practice patterns or become a technician rather than clinician. Others are concerned about the validity of the treatment outcome research. Such questions are not only difficult, but they can be exhausting for the psychologist in a busy clinical practice. There are several ways to answer such questions, including for instance, personal or professional experience, following recommendations from a present or former supervisor, or consultation with colleagues. In the past 10 years, another recommendation has been to examine the empirical literature and apply the findings to your clinical question. This method has become known as evidence based practice (EBP). From developmental and stages-of-change perspectives, resistance to new ideas is expected. However, resistance to EBPP is surprising in light of two facts: (1) EBPP does not necessarily require a change in methods (i.e., content), but rather a change in the process of how to answer clinical questions, and (2) psychology has been grounded in empiricism since its inception. EBP gained popularity in medicine about 20 years ago, and it has now become a vital piece of the medical culture (Straus, et al., 2010). EBP has gained momentum in professional psychology in the past 10 years, with notable progress after the APA Presidential Task Force on Evidence-Based Practice in 2006. This taskforce defined Evidence Based Practice for Psychologists (EBPP) as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (APA, 2006). On initial reflection EBPP seems like a balanced approach to decision-making, encouraging psychologists to review research, while considering their own level of expertise and their patients’ characteristics. However, there has been notable 1. EBPP suggests a standardized process for answering clinical questions. It does not require psychologists to adopt any new treatment or assessment methods. EBPP has three primary components, like a “3-legged stool” (Spring, 2007). The first leg is empirical evidence, which includes evaluation of efficacy/effectiveness of psychology intervention and assessment methods. The second leg is clinical expertise, which includes the psychologist’s clinical skills and judgment to understand the patient’s unique condition(s) and needs. The third leg is the patient’s values and preferences, which can greatly influence assessment or intervention methods. All three of these components are important in answering difficult clinical questions. Therefore, EBPP is a process or an approach to clinical decision-making; it advocates for evidence-based care, not particular tests or psychosocial interventions. 2. The first leg of EBPP (the application of empirical evidence to clinical questions) stimulates the most resistance from practicing psychologists. This is 11 The Michigan Psychologist – 1st Quarter 2014 somewhat surprising, given that psychology has been grounded in empirical evidence since Wilhelm Wundt founded the first psychology laboratory in 1879. In fact, one of the best examples of utilizing empirical data in psychological practice is assessment instruments. The first intelligence test developed in the early 1900s by Binet & Simon was standardized (albeit, crudely by today’s standards). Nowadays, great care is taken by test developers to gather large, representative samples and make administration instructions nearly foolproof; nevertheless, psychologists should compare their patient to the standardization sample to ensure the test is appropriate (e.g., Can the items of this test be read aloud to a visually-impaired patient, or not?). This is EBPP. It is considering the empirical evidence, the psychologist’s clinical skills, and patient characteristics to make a reasoned judgment towards high-quality patient care. Finally, it is important to differentiate EBPP from two related, but distinct, movements: the Empirically Supported Treatments (EST) movement, and the competency movement. EBPP is a more comprehensive notion than both EST and competency movements. Conceptually, EBPP considers the entirety of the assessment or intervention process, as well as clinician and patient/family characteristics. A psychologist with an EBPP mentality will ask “What is the research evidence that will lead to the best outcome for this patient?” On the other hand, the EST movement focuses only on interventions; EST research usually asks “Is this treatment effective for this disorder/condition?” This focus on treatment (and exclusion of clinician factors) may be the reason that the pharmacology industry has strongly encouraged the EST movement. Thirdly, the competency movement (e.g., Fouad, et al., 2009) focuses almost exclusively on clinician characteristics and abilities. Competency research focuses on clinician skill and its impact on treatment outcome. care, the APA Division 12 - Clinical Psychology website includes a fairly comprehensive list of psychological treatments, including a brief description of each treatment, strength of the research support, key research references, clinical resources, and training opportunities. References Aarons, G. A., & Sawitzky, A. C. (2006). Organizational climate partially mediates the effect of culture on work attitudes and turnover in mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 33, 289-301. APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271-285. Fouad, N. A., Grus, C. L., Hatcher, R. L., Kaslow, N. J., Hutchings, P. S., Madson, M., Collins, F.L., & Crossman, R.E. (2009). Competency benchmarks: A model for the understanding and measuring of competence in professional psychology across training levels. Training and Education in Professional Psychology, 4(Suppl.), S5–S26. Lilienfeld, S.O., Ritschel, L.A., Lynn, S.A., Cautin, R.A., Latzman, R.D. (2012). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33(7), 883-900. Spring, B. (2007). Evidence-based practice in clinical psychology: What it is; why it matters; what you need to know. Journal of Clinical Psychology, 63, 611-631. Straus, S. E., Richardson, W. S., Glasziou, P., & Haynes, R. B. (2010). Evidence-based medicine: How to practice and teach EBM (4th ed.). New York: Churchill Livingstone. To comment on this article, contact Jared Skillings, Ph.D. at [email protected]. To learn more about evidence-based practice, there are many free online resources. Psychologists are encouraged to review APA’s EBPP taskforce report. Duke University has developed an online tutorial for any health care professionals who wish to learn the basics of evidence-based practice. For psychological 12 The Michigan Psychologist – 1st Quarter 2014 Notes of a Psychology Watcher ADHD: Eyes Wide Shut Steven J. Ceresnie, Ph.D. Book Review: Hinshaw, Stephen P., and Scheffler, Richard M. “The ADHD Explosion. Myths, Medication, Money, and Today’s Push for Performance.” New York: Oxford University Press, 2014. slamming the medication treatment for this serious psychiatric disorder. The following are some headlines of these stories: Myths about ADHD persist. Too many people continue to believe it’s a cop out, an unvalidated condition related to society’s penchant for overmedicalizing defiance or a convenient label intended to cover over social problems. These myths destroy any hope of providing systematic educational, behavioral, and medical care for the youth, families, and adults who desperately need help. Medications are still viewed suspiciously for behavioral and psychiatric conditions, a position unfortunately fostered by the ease of getting an ADHD diagnosis and securing pills for performance enhancement in too many quarters of society – and by overreliance on medication as the only treatment worth pursuing. To deal with ADHD better than we do now, we must alter our attitudes as well as our educational and healthcare practices (Hinshaw & Scheffler, page 168). “Risky Rise of the Good-Grade Pill.” Schwarz, Alan. The New York Times, June 9, 2012. This book, written by Stephen P. Hinshaw, Ph.D., Professor of Psychology at the University of California, Berkeley, and Richard M. Scheffler, Ph.D., Distinguished Professor of Health Economics and Public Policy in the School of Public Health and the Goldman School of Public Policy at the University of California, Berkeley, could not have come at better time. For the past two years, the media --- The New York Times, The Wall Street Journal --- have been awash with articles attacking the validity of ADHD, and “Ritalin Gone Wrong.” Sroufe, L. Alan. The New York Times, January 28, 2012. “Drowned in a Stream of Prescriptions.” Schwarz, Alan. The New York Times, February 2, 2013. “A Nation of Kids on Speed.” Cohen, Pieter & Rasmussen, Nicholas. The Wall Street Journal, June 16, 2013. Now these exposes about ADHD are nothing new. Some of these reports are critically examined in “The ADHD Explosion,” with some surprising results. Scientologists, where their founder L. Ron Hubbard lectures us about the between-lives period, when thetans are transported to Venus to have their memories erased, have waged a 40-year war against Ritalin; and against psychology and psychiatry, along with sympathetic mental health clinicians through the Citizens Commission on Human Rights, a LosAngeles based nonprofit organization formed by the church in 1969 to investigate mental health abuses. Scientologists have used their considerable fortune to sue drug companies and the American Academy of Child and Adolescent Psychiatry, among others. When Scientologists announce their legal challenges to protect children, the media shines a bright light on these efforts. When all the lawsuits are dropped because of no merit, not a word of their dismissals reach the public (Wright, 2013). 13 The Michigan Psychologist – 1st Quarter 2014 Hinshaw and Scheffler’s book has four fundamental messages: (1) Although often ridiculed, ADHD represents a genuine medical condition that robs people of major life chances. Its economic consequences are huge, totaling hundreds of billions of dollars annually in terms of special education services, juvenile justice and substance abuse costs, plus low work productivity and employment lapses in adults. (2) Only diligent and thorough assessment can distinguish ADHD from other mental health conditions, chaotic home environments, or the aftereffects of maltreatment. Yet, ADHD is too often diagnosed in extremely cursory fashion. This lack of careful evaluation, fueling both overdiagnosis and underdiagnosis contributes to a national crisis. (3) ADHD medications are effective in reducing the condition’s core symptoms, at least in the short run, but the most genuine gains are achieved by combining medication with skillbuilding approaches. (4) Rates of ADHD and medication treatment vary dramatically across states (and, for treatment, across the world), related to family and cultural values, health care systems, medical portrayals and advertisements, and, in particular, variations in school policies linked to demands for achievement and performance. The authors list ten major goals for improving the science and practice related to ADHD in the future. Each of these goals roughly corresponds to a chapter in the book: (1.) Ensure that ADHD is recognized as biological, cultural, and contextual in nature. (2.) Demand that ADHD be diagnosed carefully by professionals who know their business. (3.) Ensure that ADHD be treated by clinicians (and paraprofessionals) who are versed in evidence-based interventions. (4.) Set realistic national quotas for stimulants, balancing the need for prescriptions for legitimate cases of ADHD with the reality of ever-greater diversion of the medications for neuro-enhancement or pleasure. (5.) Alter educational practices to promote more individualized approaches. (6.) Facilitate partnered systems of cure, and coordinated payment mechanisms, across insurers, schools, and employers. (7.) Convey a different set of media images about ADHD, emphasizing the reality of daily struggles and triumphs. (8.) Encourage information exchange across scientists and clinicians internationally. (9.) Continue to recognize that ADHD exists well beyond white, middle-class boys, revealing itself across gender, race and ethnicity, and the age span. 10.)Recognize that fostering human potential, reducing stigma and enhancing economic productivity go hand in hand. This book provides a corrective emotional and cognitive experience through an even-handed discussion about the controversies surrounding ADHD. The authors make clear what is known about ADHD, and distill the complexities about the personal and social costs of people who suffer with ADHD. References Wright, L. (2013). Going Clear: Scientology, Hollywood, and the Prison of Belief. New York: Alfred A. Knopf. To comment on this book review, contact Steven J. Ceresnie, Ph.D., at [email protected] 14 The Michigan Psychologist – 1st Quarter 2014 Licensing Reform near in Michigan Jeffrey Andert, Ph.D., ABPP Chair, MPA Licensure Committee Licensing Reform. We are on the verge of two legislative and administrative changes which have the potential to be the most significant changes in licensing for Psychologists since the inception of the Michigan Public Health Code in 1978. Relative to other states, Michigan has held the distinction of having the highest number of Master’s trained practitioners in psychology without recognizing them as equals with other Master’s trained mental health professionals (MSWs and LPCs). We have also been one of the few states without a continuing education requirement for our profession. The two pending developments address these respective concerns. psychology as a Doctoral-level profession through a change in title for Master’s-level licensure to “Licensed Psychological Associate” (LPA) and 2.) Parity for those trained with a Master’s degree in psychology with other Master’s-level mental health providers through the ability to practice independently. Scope of practice is defined as psychotherapy for LPAs versus the broader scope of practice of psychology for LPs as well as continued supervision of LPAs by LPs for psychological testing. The bill allows current LLPs to be “grandfathered” as LPAs or retain the LLP as they prefer. SB 273. As MPA’s elder stateswoman regarding all psychology-related legislation, Dr. Judith Kovach, points out that MPA has been working for 21 years to resolve the problems with our two-tiered licensing law. Confusion among the public regarding the definition of “Psychologist,” the same scope of practice for both levels of licensure, the permanent supervision requirement for LLPs as well as the inability of LLPs to advertise and practice independently remained as unresolved issues over that time. Legislative action was necessary to rectify these concerns. As a result of this effort, our lobbyists and the support of a number of legislators, SB 273 was passed by the Senate 34-3 on January 30, 2014 and was referred to the House for consideration. The bill will be reviewed by the House Regulatory Reform Committee and may be heard for a House vote this spring. Following passage, the Board of Psychology will be charged with the responsibility of writing Administrative Rules, which will elucidate the implementation of the legislative changes. At least one year is anticipated for this process to establish the new licensure title. The most recent action involved extensive discussions over several years with stakeholders in the psychology licensure definition. MPA and the Michigan Association of Professional Psychologist (MAPP), which represents the interests of Master’s level practitioners, reached a compromise on draft legislation in 2011 which was subsequently revised and introduced in 2013 as SB 273. The essential components of SB 273 are: 1.) Affirmation of MPA requests our members contact their local State Representatives to encourage their support of SB 273. Continuing Education Rules. While continuing professional education requirements are common in most professions and for psychologists across the country, they have been a source of considerable debate in Michigan for many years. MPA has encouraged the Board of Psychology to adopt a 15 The Michigan Psychologist – 1st Quarter 2014 continuing education requirement for licensure. Demonstration of continued education is viewed as a means of promoting the highest standards of practice. The Board of Psychology has consistently endorsed continuing education. However, the initial plan to adopt a model of Continuous Professional Development with a personalized educational plan was determined to be inconsistent with language in the Code defining “Continuing Education.” A revision was developed which includes a range of educational options for each licensing period. These options include workshop attendance, teaching, achieving diplomate status, and professional writing. The Board of Psychology passed the CE Administrative Rules in December, 2013. At this time, Licensing and Regulatory Affairs (LARA) staff are developing procedures for implementation, including reporting requirements. Future Directions. Each of these licensing changes is the result of MPA’s commitment over many years. Following the implementation of these new rules, future MPA initiatives will assist in their success for the benefit of our profession. Adoption of the new LPA title will necessitate education of the public regarding the qualifications and independent practice status for our Master’s trained colleagues. As with any new title, negotiations will be necessary with health insurers to obtain recognition. Promoting membership in MPA by Master’s-level practitioners expands our role as the professional association for all psychologyrelated practitioners. In turn, MPA’s experience in advocating for psychology with insurance companies can be of benefit in the process of promoting parity for LPAs. MPA has a role in educating licensed providers as well as the public regarding these changes. As an experienced provider of continuing education in coordination with APA, the new CE rules provide MPA additional opportunities for professional development activities. MPA has the opportunity to educate our members regarding these requirements and provide a means of documenting continuing education activities to meet licensure requirements. Jeffrey Andert, Ph.D., ABPP, can be contacted at [email protected] Transforming Loss James Windell How does a therapist end up producing a documentary film? There is no simple answer, according to Judith Burdick, M.A., L.L.P., a Bingham Farms therapist, who has conceived and produced the film Transforming Loss. It was, she points out, a 20-year journey which started when she was a 31-year-old widow whose husband was killed in a scuba diving accident. As the mother of two young children, she had to find a way to grieve – and to heal. The process led her to get an undergraduate degree in psychology from the University of Michigan and a Master’s Degree in clinical psychology from The Center for Humanistic Studies in Detroit. As a therapist, she has specialized in grief and loss work. She recalls when she was first widowed that there were only a few books available to someone who had suffered a significant loss. “I think I was given ten copies of When Bad Things Happen to Good People,” she recalls. However, about four years ago she began to think about a film. 16 The Michigan Psychologist – 1st Quarter 2014 “There wasn’t a film I had ever seen that was like what I envisioned in my head,” she said in a recent interview. “It would have been helpful to see the kind of film I began thinking about when I first became a widow. I was trying to write a book, but it wasn’t coming together. But I began to think that a movie would be more powerful.” She said as she thought about a film she knew what she wanted and she started looking around for the right team. It took a year or two and all the while she was making contacts and learning. Between friends and various connections she made, the project started to come together. “I finally thought it should be about universal loss and how people transform loss,” she said, “as opposed to just being about widows.” The result is the 50-minute film “Transforming Loss,” which has been shown at various film festivals and has garnered a few awards already. It will air on WTVS-TV on March 30, 2014 at 4:00 pm. The film depicts six people who sustained significant losses of loved ones – husbands, wives, children, and parents. “Some of these people were former patients,” Burdick says, “and I found others by reaching out and talking to other therapists and friends. I was looking for people who had a great story to tell.” Each of the people in the film – including a man who lost his wife and two sons when a drunk driver stuck them and a mother of four whose husband committed suicide – talk about how they suffered a painful loss but then transformed their loss into healing and have been able to move forward. With Transforming Loss appearing in more places and now scheduled for a PBS-TV showing, Burdick is excited about the prospect of reaching a wider audience and helping more people learn about the grief process and showing them with the lives of real people what healing looks like. “This film examines and demonstrates the many positive ways people cope with tragic loss through death,” Judith Burdick says about her film. “These individuals have not only survived their profound losses, but have become more than who they were before. As a part of the healing journey, they have all chosen to help others. This is the gift and the hope depicted in the larger story.” To reach Judith Burdick, you can reach her through her website www.TransformingLossDocumentary.com; To comment on this column, you can contact Jim Windell at [email protected]) BOOK REVIEW Also For Psychologists Review of Speak, Memory: An Autobiography Revisited by Vladimir Nabokov (1966) Reviewed by Jack P. Haynes, Ph.D. This column is based on books that I have read and that I review. These books are of particular interest for psychologists, though they are not written by psychologists nor are they specifically psychology texts. Another book that I have experienced of particular merit and interest is the autobiography Speak, Memory by the highly praised Russian man of letters Vladimir Nabokov. Acclaimed by many as one of the foremost 20th century authors, Nabokov’s 17 The Michigan Psychologist – 1st Quarter 2014 autobiography appears on more than one list of “best books of the century.” The book was written in English and is the 1966 final edition of his 1951 autobiography. It is based on 37 early years of Nabokov’s life---from age three to age 40 when he emigrated to the U.S.; his full life spanning from 1899 in St. Petersburg, Russia to his death in Switzerland in 1977. Several chapters of this beautifully written book are essays published in various magazines during the 1940s, and organized into an autobiography in 1951 under a different title. Nabokov was not very well known until his 1955 novel, Lolita, and the movie version a few years later. He then was afforded time and financial resources to revise his ’51 autobiography. Nabokov was fascinated by chess, was an expert in and apparently obsessed by butterflies, and he enjoyed and employed puns and other literary constructions which have provided critics with challenges. One example of his playfulness is his inclusion in Speak, Memory of a fictitious review of the work by him -- Chapter Sixteen/the Appendix. Nabokov grew up in Russian aristocracy in the later days of the czars. He presents as having had a happy childhood, and he focuses on beautifully described and loving portraits of family, including governesses. He talks of his schooling at Cambridge and later struggles to succeed as a writer. The memoirs are only roughly arranged chronologically, and are not particularly linear. His life is colorful, as are his descriptions, seen in his statement, “A colored spiral is a small ball of glass, this is how I see my own life.” After his family left Russia because of the revolution, he lived in England, Germany, and France, later fleeing to the United States. There are several themes that run through his autobiography, which also run through his works. These themes include a confessional mode, aesthetics, memory and time, and freedom. Nabokov seems very focused on time and its passage but seems unresolved about it. He states that his true birthday came at age four when he realized that his parents predated him. At one point he talks about the prison of time. At another point he states that he does not believe in time. Nabokov appears to want to transcend time through a focus on aesthetic bliss, literature being a product of that bliss. Nabokov displays an anti-Freudian bent, referencing Freud in Chapter One as medieval and also as crankish, and Freud’s followers as mystic. The Freudian references are in passing but Freud and Nabokov both seem to focus on desire, imagination, and memory. Nabokov seems resistive or antagonistic to myths and systems which explain and overwhelm individual experience. Nabokov appears to view Freud as stifling the individuality of experience which Nabokov seems to experience as a determinism that is antagonistic to freedom. I found Nabokov’s intensity, erudition, and perceptions fascinating. His autobiography, like several of his works, is complex and provocative, and it could be read more than once with benefit. You can comment on this article by contacting Jack Haynes, Ph.D. at [email protected] 18 The Michigan Psychologist – 1st Quarter 2014 The Sustaining Members of MPA John Braccio East Lansing, MI Mark Kane Big Rapids, MI Margaret Buttenheim Ann Arbor, MI Nancy Kulish Birmingham, MI Janet Fulgenzi Saginaw, MI John O'Leary Birmingham, MI Jack Haynes Bloomfield Hills, MI Ruth Rosenthal East Lansing, MI Dennis Jacobs Bloomfield Hills, MI Russell Scabbo Alma, MI Editor: James Windell, M.A. Editorial Board: Steven Ceresnie, Ph.D. Jack Haynes, Ph.D. 19 The Michigan Psychologist – 1st Quarter 2014 Carter Schumacher Birmingham, MI Carol Schwartz Franklin, MI Raymond Skurda Mt. Clemens, MI Christopher Sterling Grosse Pointe, MI