August 2009
The Future of Psychology at Tri-State Bob Grubbs, PhD, WSPA Vice-President
A s a relative newcomer to both the and practice styles to the lack of common protocols. Pacific Northwest and the language and patient treatment preferences. The keynote address for the second day of WSPA, a road trip to Idaho for In order to establish a good working the meeting, "Looking Forward: Future the Tri-State Psychological collaboration with a PCP, s in Psychology & Ethics" was Convention at the Coeur d'Alene Resort counseled paying attention to "the 3 R's": delivered by Dr. Steven Behnke, APA Ethics seemed like a good idea and it was in every Respect, Regular Con ehnke tried to dispel the idea respect: The weather and the Reciprocation. Regarding A Ethical Principles Code accommodations in Coeur d'Alene were emphasized the value of adopting a medical approved in 2002 is an immutable stone wonderful, and the presentations were first- anthropological perspective in developing a tablet; it should be viewed instead as a rate. The opening session by Dr. James Bray, relationship with what in many ways is working document subject to modification as APA President, on the Future of Psychology another culture for many of us – the primary experience dictates. For instance, there is a Practice set the tone for the meeting. Dr. health care system as it currently exists! He growing appreciation that the standard Bray gave an overview of the challenges also emphasized the importance of sending a prohibiting multiple relationships with a facing the APA today and the agenda that client, is very difficult to follow in small has been developed to try to meet them. rural towns, where it is difficult and ".The Ethical Principles Code should
The major theme of his talk was that potentially awkward to avoid all social be viewed.as a working document"
psychology and psychologists need to be contact with clients. Therefore, we are open to change with respect to the likely to see this document evolve. anticipated reforms in health care that are concise written report with specific The Saturday breakout sessions were being discussed in Washington. He outlined recommendations to a referring PCP as a divided between ethics and his plan to transform the APA so that it will critical follow-up to establish a working psychopharmacology. In the morning, Dr. respond quickly to issues as they arise in this relationship. Behnke presented on the ethical aspects of process. Perhaps one of his most important The other breakout sessions on Friday treating and evaluating children and families, messages was that treatment outcome included Dr. John Sommers-Flanagan, U. focusing on informed consent, assessment will be a part of any reform Mont., who presented on how to work confidentiality, and providing services at the package and that if we as psychologists don't effectively with parents through use of a request of third parties. Later, he described take the lead in defining these measures, brief consultation model. He also touched the legal and ethical aspects of supervision, they will be defined for us by others. on contemporary approaches to assessing specifically, the role of supervisor versus In the breakout session that followed, Dr. and intervening in adolescent suici sultant and therapist. Dr. John Bray gave an overview of recent ideation. Following, Dr. Nicole Prause, Courtney, a practicing medical psychologist developments in primary health care with Idaho St. Univ., presented her work on the at Children's Hospital in New Orleans, gave regard to changes in the delivery of care and treatment of women's sexual difficulties the psychopharmacology presentations; the how psychologists can integrate better into using new empirically supported treatment first was an introductory overview of the this system. He noted that while topic while the second focused primary care physicians (PCPs) on drugs approved within the currently provide initial past three years (covered in a treatment for 70% of mental separate article). health patients, they often fail to In summary, this was a well- diagnose mental disorders, organized and well-run particularly if the disorder conference which provided the presents with undifferentiated opportunity not only to interact somatic symptoms, like fatigue. with and hear from colleagues He identified a number of from all-over Washington and barriers that need to be neighboring states, but also addressed in developing with leaders from our flagship 1st row: Steve Behnke, PhD, JD, John Moritsugu, PhD, R.J. Smith, PhD, effective collaborations, ranging organization itself. And, the Darrelle Volwiler, PhD, Carol Moore, PhD, Wendi Biondi, MA, from differences in training/ Pamela Ridgeway, PhD, Stephanie Kuffel, PhD. weather was pretty nice for that theoretical orientations 2nd row: Debra Brown, PhD, Jane Harmon Jacobs, PhD, Tim Popanz, PhD, five-and-a-half-hour drive back (biomedical vs. psychosocial) James Bray, PhD, Laura Asbell, PhD, Andrew Forsythe, PhD, across the state to Seattle. Dave Scott, PhD, Kayleen Islam-Zwart, PhD Insurance CE Dinner—Page 8 2009 Fall Convention– Page 9
Meet WSPA Member
Name: Catherine A. MacLennan
Title: Licensed Psychologist, clinical and
711 N 35th Street, Suite 206 Current Hometown: Omak
Seattle, WA 98103 Telephone: (206) 547-4220 Original Hometown: Windsor, Ontario,
FAX: (206) 547-6366 Email: [email protected] Web Address: www.wapsych.org Workplaces: Private practice
The Mission of WSPA is to support psychologists and psychologists-in-training and to promote the practice of Educational Background: PhD from
psychology in order to maintain the vitality of the profession in the public interest. Fielding Graduate University 2008 WSPA EXECUTIVE BOARD
What do you do for fun? Read fiction, sit in
How long a member of WSPA? Student
Timothy J. Popanz, PhD or outside of my house in remote sagebrush member since 1997, and full member since Shannon Ledesma Jones, PhD Alejandra Suarez, PhD Robert Dale Grubbs, PhD Guilty pleasures: Watching mystery and cop
Leslie Anne Savage, PhD Why a member of WSPA? I joined as
Jevon Powell, PhD soon as I started my doctoral program. John Moritsugu, PhD Membership is important because WSPA Douglas Haldeman Diversity Officer If you were not in the field of psychology,
is the only organization that attends to the what would you do? Write fiction.
interests of psychologists in private Carol Moore, PhD practice, and membership provides an Mary Lynne Courtney, PhD avenue to know and communicate with Elsa O'Connor, PhD Denise McGuiness, PhD Kathleen Bruhn, PhD CONSULTANTS & STAFF
Who are you besides a psychologist? A
Douglas M Wear, PhD Executive Director mom of healthy adults, a partner, and a Lucy Homans, EdD Director of Professional Affairs/Legislative Consultant Washington Psychologist
Editor: Dug Y. Lee, MA PsychoBabble by Joe Mills, PhD
[email protected] Staff: Cynthia Mason, PhD Joe Mills, PhD Meredith Mason, PhD The Washington Psychologist (WP) is a bimonthly publication. Article and advertising submission deadlines are January 1, March 1, May 1, July1, September 1 and November 1. WP invites news, feature stories, academic/clinical reports and creative works of interest to psycholo-gists. WP welcomes articles expressing the wide variety of views held by WSPA members. Authors' opinions do not necessarily represent the official position of WSPA. Readers with opposing points of view, or further information, on topics presented in the WP are invited to submit for possible publication or post on our website member forums. WSPA reserves the right to refuse to print or to allow to
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"Well, we call it ‘kleptomania,' and of course the farmers are mad at you." Washington Psychologist — August 2009 The Future of Psychology Practice
Timothy Popanz, PhD
invited leaders included those from broad rather than disease was areas of psychology practice and other discussed at length. The practice associations, including government, training organizations, consumers, insurers, xcuse me, can I ask you a question? The gentleman standing next to worsening health and health me in the elevator had been eyeing habits of Americans was tag, with the heading Summit on economics and businesses. I was invited as a explored as an example of the the Future of Psychology Practice. It was the representative of the WSPA, one of six inter-connectedness of last morning of the three-day Summit and I State, Provincial, and was headed down to hear summaries and Associations at the summit. All were asked U.S. will negatively affect your final presentations from the Summit's to identify: health within a generation). primary organizers: Drs. James Bray, Carol  Opportunities for future practice to Also, our mental health delivery Goodheart, and Margaret Heldring. My head meet the needs of a diverse public. systems are extremely out of was full of information and questions that  Priorities for psychologist practitioners balance, with almost all the morning—what had we accomplished? How in private and public settings. growth in mental health would the leadership be able to capture the spending focused on  Resources needed to address the excitement and broad, sometimes psychopharmacology. In order priorities effectively. revolutionary statements from the for gains in health to continue,  Partnerships and roles to implement the participants? Had I personally said enough psychologists need to diversify about the topics important to me—spoken on incentives---what is our "value- behalf of the "stakeholders" in my added" to health outcomes? We mind (e.g., health care reform, also have farmed-away most ".the need for a cultural value of
environmental public health, social mental health interventions to justice, and minority "transparency" was identified…"
general medicine and primary care So, it was with a pensive mind and serious Training for the marketplace I want to summarize my major heart—we came to the summit with the The "gaps" in the training of students and impressions from the summit and how I incredible expectation that we would figure early career psychologists were identified: believe these themes will influence the out "what's the future of psychology business of practice, technology, integrative/ future practice of psychology and WSPA, practice?"—that I heard this stranger-in-the- community health/ preventative rather than which is currently advancing its own three- elevator's question: "my daughter is thinking medical/ disease-model. In addition, the five year strategic plan. Here are the five management of chronic disease, which will primary themes that stood out to require more psychological practice in primary care, hospital-based practice, and Changing demographics and Medicare was discussed. Changing the diversity issues psychology degree to a general degree, with Our country's ethnic diversity later specialization and the need for more will continue to change internship/ residency sites were specifics dramatically in the next several addressed. decades. All health care Changing scope of psychological practice professions will need to This was a large topic during the summit demonstrate multicultural with many themes emerging: advocacy and competence; in fact there was public policy; creating working partnerships discussion during the summit to with other sciences, associations, and make this part of psychologists' consumers and "branding" psychology as a CE law requirements. Our behavioral science focused on health, current, non-integrated health nutrition, children's health, productivity, care system is designed to prevention, environmental public health, and Lucy Homans, EdD, Margy Heldring, PhD, Tim Popanz, PhD "fail"—to maintain health public safety. Although the flexibility of disparities, which are largely about becoming a psychologist. What should being a psychologist as a profession was based on socio-economic and racial/ ethnic I tell her to do? Is the future of psychology stressed, the need for a cultural value of status. Having psychologists participate "transparency" was identified. Psychology more within integrated health/ mental health APA's Presidential Summit on the Future has a perceived lack of value outside delivery systems (e.g., public and of Psychology Practice was held May 14 – traditional counseling. To improve our community health, military, VA systems, 17th in San Antonio, Texas. The summit's implicit promise of quality-based results, and prisons) was discussed as a way to goal was to engage the broader practice psychology practice needs to move away address these health disparities. psychology community in an agenda- and from solo one-on-one interventions and Creating health, not just health care priority-setting meeting to inform the work move toward collaboration, integration, and A systemic value shift toward defining of the APA Practice Directorate and the social policy work. The need for national health more broadly, including preventative APA Practice Organization. A total of 150 care based on the determinants of health Continued on page 10
Washington Psychologist — August 2009 Medicare Report Update & APA Practice Summit Impressions Lucy A. Homans, EdD
Director of Professional Affairs
and Lobbyist Report
n the June, 2009 WP, I are met and there is a question in the case as Morrison, a futurist, provided the global
printed an article about to whether those criteria have been met. In perspective that we have quickly become a
Medicare. As a result (and this case a Medicare provider is not relieved global population that is predominately
not surprisingly, given the of his/her requirement to file a claim with young, and significantly split between rich
arcane nature of Medicare), there Medicare. But, if the provider has given an and poor. Additionally, (as you all know) as
have been a couple of areas of "Advance Beneficiary Notice (ABN)" to a nation, Americans, for all we spend on
confusion. The confusion centers Medicare, then the provider may collect the health care, are not healthy. We suffer from
on the Medicare "opt out" full charge from the beneficiary if Medicare the chronic diseases of obesity, diabetes,
requirements and on non-covered denies the claim.
hypertension, heart disease and cancer. services. Here is the question An ABN is defined in Rule 40.24 of the William Emmert, from the Campaign for asked of me by one of our Medicare Benefits Policy Manual. ABNs Mental Health Reform, argued that on WSPA members: "My reading of allow beneficiaries to make appropriate average, Americans suffering from mental Medicare regulations indicates consumer decisions when they know in illnesses die 25 years younger than the that we can bill the client for advance that they may have to pay for a general population, in large part from the excluded services if the client service out of pocket. Again, ABNs are not chronic diseases listed above. Two statistics agrees and signs an Advanced needed when a service is categorically of note: 25% of tobacco consumed by B e n e f i c i a r y N o t i c e o f excluded from Medicare coverage. They Americans is consumed by the mentally ill; Noncoverage (ABN). This may be use d when providers and/or Native American population disagrees with your (June WP) beneficiaries believe that Medicare article and the (APAIT) Trust's recent notice will not cover payment. ".some services.may be
that we cannot bill for these services. Am I Finally, Ms. Pedulla describes misreading the regulation?" one more exception that does not categorically excluded ."
According to Diane Pedulla, JD, the "go- often occur. This is the situation
to" expert on Medicare at the APA Practice where a beneficiary refuses to
Organization, the confusion exists because authorize a provider to submit claims to dies before their 35th birthday. This suggests
of differences between Medicare's general Medicare. Ms. Pedulla has recommended (and was discussed at length in the small
rules, and Medicare's exceptions. In the vast that in cases like this, psychologists should groups) a significantly increased focus by
majority of cases, psychologists who are contact Mr. Frederick Grabau at the Centers psychology on fuller integration of mental
Medicare providers and who provide for Medicare & Medicaid Services (CMS) in health services with primary care services,
Medicare covered services to Medicare Baltimore, MD for additional information. with publicly funded health clinics and on
beneficiaries, must bill Medicare for those His telephone number is 410-786-0206 and access to treatment by diverse populations.
services. However, some services that h i s e m a i l a d d r e s s i s
Other speakers argued that psychology psychologists might provide to Medicare [email protected] rams must reconfigure to beneficiaries may be categorically excluded contact me by email if you have additional address future requirements of practice. To from coverage by Medicare. That these questions about the information offered in deliver appropriate and effective mental services are not covered at all by Medicare this article. health services, we must be a workforce of does not prohibit a provider from providing In May, WSPA President Tim Popanz, practitioners who develop and use evidence
the service. The example given me by Ms. PhD, WSPA member Doug Haldeman, PhD based treatment protocols who can work in a
Pedulla is cosmetic surgery. Medicare does and I had the opportunity to attend the APA variety of practice settings other than solo
not pay for facelifts.
Summit on the Future of practice, including primary care clinics, and However, this does not Psychology in San who will be a ble to prescribe. Ironically, prevent a Medicare Antonio. Additionally, m ental health services have never enjoyed beneficiary from arranging one of the Summit co- more visibility and less stigma than they do to have one and to pay the chairs was WSPA now, and y et psychology may be unprepared provider privately. antage of the opportunities Please refer to Rule 40.19 Heldring, PhD. No offered us now. in the Medicare Benefits doubt the others will Please know that it is impossible to distill Policy Manual. Medicare's provide their own all the infor mation provided to us at the APA rules on claims filing and impressions of the su mmit into one short article. Summit on limits on charges do not summit. Here are mine. information was discussed at the WSPA apply to categorically The two and one-half Council strategic planning retreat recently. excluded items or services. SPA intends to incorporate what we have Another exception is if structured with major learned into that plan, where appropriate, the service is not categorically excluded presentations followed by small group and into our other regulatory and advocacy from Medicare coverage, but which may be discussions. The major presentations efforts. Thank you. noncovered in a specific case. One example provided a global focus, and the small might be a situation where a service is groups' tasks were to take that global covered only when certain clinical criteria information and apply it to psychology specific issues. For example, Mr. Ian Washington Psychologist — August 2009 Notes From the Social Issues Human
Judy Weber, PhD &
Rights Committee
Li Ravicz, PhD
Co-Chair, Social Issues &
Human Rights Committee
How can we promote our profession, gain greater visibility and
provide a vital public service at the same time?
Watch this space for details of plan that will focus on just those goals by 1) encouraging a culture of service while 2) recognizing and supporting 2) psychologists who give back to their community. Judy Weber, PhD and Li Ravicz, PhD are the co-chairs of the SIHR committee. Other active members are Arthur Lewy, PhD and Shelley Mackaman, PhD We are looking for additional members to join our committee. Please contact either Li ([email protected]) or Judy ([email protected]) if you are interested in joining the committee. Editor's Note: In the June WP article, Developing A Culture of Service, this editor mistakenly excluded certain key players. The arti-cle was the result of the joint efforts of committee members Arthur Lewy, Tim Popanz, Li Ravicz, Shelley Mackaman, and Judy Weber. I Have a Voice Samantha Slaughter, PsyD
toward licensure, requiring them to either do fall under the current laws. As it turns out, a postdoc, something they were not planning T he psychologist licensing laws are changing on September 1, 2009. the Board had received several inquiries Here is a brief summary of the on doing when they started school under the about this portion of the law. While this changes. current laws, or they have to stay in school statement took care of people like me, it did Currently, an applicant must have at least longer in order to be placed at a not address current students. Melanie and I 300 hours of practicum experience with 100 preinternship site. Either way creates a huge presented our case regarding current students hours of supervision. This must be followed financial burden on students, many of whom and discussed possible recommendations for by a predoctoral internship of at least 1500 are already graduating with $150,000 to the Board. The Board members asked us to hours to be completed in 24 months (WAC $250,000 of debt. come to the next meeting with specific 246-924-040) and then an additional 1500 As I was beginning my licensure process, examples of students who were caught in the hours in internship. Under these rules, some I was not sure if I would be caught by these gap and how the new laws would negatively students completed multiple practica or new laws. I met all the current state impact them. extended their interships in order to meet the requirements, but there was no guarantee These examples were not hard to find. minimum 3300 hours of supervised that I would be licensed by September 1. At After compiling the stories from many experience for licensure. the same time I was applying for licensure, I students, I sent the examples to the Board. Under the new requirements to be in effect was approached by the trainees at the Melanie and I then attended the meeting in this upcoming September, an applicant must Fremont Community Therapy Project May. We were allowed to sit in on the sub-still have 300 hours of practicum experience (FCTP), where I am the Assistant Director, committee work related to licensure laws. and 1500 hours of intership. Yet, the new about the new licensure laws. Trainees at We debated, asked and answered questions, laws dictate how the remaining 1500 hours Cancer Lifeline, where I am a Clinical and discussed possible ways to remedy the needed for licensure are to be achieved. Program Manager, also expressed their situation. In the end, Mr. Calkins helped the They must be obtained in one of the concerns to me about the new laws. Melanie Board draft two policy interpretations. The following two ways, or a combination of the Mitchell, PsyD (a recent doctoral program first states that students who have practicum two: and FCTP graduate) and I decided to hours that also meet the supervision and 1. Complete a preinternship of up to 1500 approach Washington's Examining Board of education requirements for preinternship hours between practicum and internship Psychology and see what could be done to may count these hours as preinternship (WAC 246-924-053) help students caught in the transition from hours. The second states that students who 2. Complete a postdoc of up to 1500 hours old to new laws. began doctoral programs prior to the 2007 after internship (WAC 246-924-059) We met with the Examining Board twice. academic year will be able to argue their The changes in the laws mean that there At the meeting in March, Mark Calkins, case before the Board to be excused from are many students currently in school who Assistant Attorney General, presented a preinternship or postdoctoral requirements are caught in the middle. They have drafted statement to the Board stating that as that did not exist at the time they practicum hours that will no longer count long as an application was pending, it would Continued on page 13
Washington Psychologist — August 2009 True Confessions of Your New ECP Co-Chair

Erik R. Jackson, PhD
Co-Chair, Early Career
Psychologist Committee
A s an early career Fortunately, the benefits of WSPA in- including the well-supported goal of having psychologist transi- volvement for early career psychologists the unique views of an ECP voiced on every tioning into a leader- was a germ first planted in my head by my committee. In turn, I was thrilled to have ship position within internship training director at the Seattle VA seasoned members such as Andy Benjamin WSPA (cannily, the co-chair of (I hope that many of you reading were also and Carla Bradshaw join the ECP commit-the ECP committee), I wanted to informed to these benefits during your train- tee. In addition to addressing seminal issues introduce myself by way of pro- ing, and, for supervisors reading, you know related our field's identity, viability, and viding some arguably navel- what to do!). Adding to this germ, I transi- integration into the 21st Century (and what gazing background, but with the tioned from part-time employment as a reha- roles we wish to play in these transforma-larger aim of illuminating some bilitation clinical psychologist into full-time tions), it was encouraging to find that my themes (e.g., Values, Debt, Loss, employment as a private practitioner. I ECP-related concerns were not only respect-Renewal!) that I've heard ech- joined a vibrant, community-oriented group fully heard, but also enthusiastically dis-oed from ECPs known to me practice that provided even more exposure cussed both personally and profession- to the ways that I could re-engage with those For example, the goal of providing ECPs ally. Throughout my education – issues that actually have personal and pro- more affordable WSPA membership and an eventual westward expansion fessional meanings. This exposure came attendance at conferences continues to be a from my youth in the Deep from my co-workers who were members of commitment realized by the organization, South to graduate school in St. WSPA, including both current and former echoing the obstacles outlined by previous Louis and eventually to intern- leadership (i.e. our current President, Tim ECP sampling and what I'm hearing from ship at the Seattle VA and both member and non-member ECPs. I postdoctoral fellowship at the Univer- am encouraged by the incorporation of sity of Washington – I fondly recall "the otherwise appealing goal to "give
additional means to reduce the financial the process of discovering what I burden on ECPs by offering free Con- found satisfying and meaningful to me back," had somehow diminished"
tinuing Education credits via a number as a trainee and nascent psychologist. of programs (e.g., CEs in the WP, Chap- For me, my goals included broadening the Popanz). Witnessing the issues these com- ter events with topics relevant to ECPs), as positive impact of our field into medical mitted individuals devote their energies to well as further consideration of reducing fees populations and the often stigmatized and has helped renew my professional identity for students. disenfranchised individuals with whom I and my optimism about our potential as I hope that such exposure to the benefits worked clinically. I envisioned future roles agents for change. While initially an inter- and community provided by WSPA may in which I could act within a multi-faceted ested, but otherwise fairly, shall we say, inspire other ECPs to become more involved professional identity, that of a clinician and "observational" member of WSPA, my in- and join us in the process of moving psy-an a socially-conscious, legislatively- creased involvement as co-chair is proving chology toward directions that are meaning-informed advocate. Yet, somewhere along instrumental to how I think of myself as a ful to each of us. To facilitate mentorship for the line, these values admittedly ebbed away. psychologist and as a private practitioner. ECPs with experienced psychologists, to To be honest, it seemed as if my professional Nowhere was this more evident for me provide opportunities for ECPs to easily identity was in danger of being bound by the than at the Council Retreat this Spring, after develop professional presentation skills by job description of whatever position was accepting the warm invitation to co-chair the pairing with engaging members of the Public paying the rent. How did this happen? While ECP committee. Despite the encouragement Education committee, to provide internet I could go on to disclose the likely precipi- and support provided by several WSPA access to useful practice materials – these are tating role of my own neuroses in this pre- Council members, including my co-chair among the several goals that our committee dicament, I'll preserve some privacy and Dawnn McWatters and car-pool mate/ hopes to offer early career psychologists, and proceed to what I think is a more common cheerleader Stacey Prince, I must admit that I am pleased to be a part of it. I welcome you dilemma, particularly for ECPs. upon arriving at the retreat, my inner dia- to share your thoughts and needs with the Now I'm sure this will be scandalously logue closely resembled the following: Are ECP committee and myself (or even con-shocking for some, but, for me, somewhere my perspectives new, or even relevant? sider joining the committee) to address your between navigating graduate school, practica How can I possibly represent the needs of needs and, possibly, like me, even re-(i.e., low-paying employment), and the, um, such a diverse group? Does the future of this invigorate your own professional identities. "invigorating" APPIC match process, incur- organization rest on my shoulders (which, ring moving expenses and student loan debt, strangely enough, were not bequeathed with completing the pre-doctoral internship, tran- inter-ECP telepathy upon my acceptance of sitioning to post-doctoral work (not to men- the co-chair position)? Will coffee be tion the time and cost of the licensure proc- served? ess) and securing a steady income, the notion Fortunately, these mental imps were of voluntarily exerting energy to the other- quickly cast-out as it became evident that wise appealing goal to "give back," had the needs and interests of Early Career Psy- somehow diminished, despite my ideals. chologists did not actually end at my com- Does this dilemma resonate with any ECPs mittee's door; they have, in fact, grown even out there? more central in the organization's focus, Washington Psychologist — August 2009 Chapter 1 Honored With Presidential Citation—May 2, 2009
Presidential Citation tion of our Early Career Washington State Psychological Association Psychologist Project; and Whereas Chapter 1 of the Washington State Whereas Chapter 1 consis-Psychological Association demonstrates tently participates in asso- innovation through community creative programming, and collaboration; wide and develops strong and leaders in positions such as President and Chairs of Whereas Chapter 1 models excellence by Ethics & Leadership De-educating its members on clinical skills, velopment; practice management, ethics, and diversity; and Chapter 1 is hereby awarded this Presidential Whereas Chapter 1 serves as a role model Citation of Excellence. for the entire association through its chapter Beth Fitterer, PhD, Chapter 1 President-Elect, Carol Moore, PhD, practices which were a model for the crea- Chapter 1 President, Tim Popanz, PhD Psychopharmacology Update Bob Grubbs, PhD
At the recent Tri-State Psychological Con- ket. and Aplenzin (bupropion hydrobromide) are vention, Dr. John Courtney, PsyD, MP, gave The introduction of "old wine in new bottles." a presentation on psychopharmacological (desvenlafaxine) provides an interesting Valproic acid (Depakote, Divalproex so-drugs that have been approved over the past example of the contribution of genetics/ dium, Depakene) often produces nausea and 2-3 years by the FDA. With one or two ex- ethnic heritage in determining the response vomiting; Stavzor is a delayed-release for-ceptions, these "new" drugs represent refor- to a drug. Pristiq is a metabolite of Effexor mulation that makes use of an acid-resistant, mulations of existing drugs designed to ad- (venlafaxine), meaning that in most people, soft-gelatin capsule that reduces the occur-dress a problem or shortcoming of the "old" an enzyme converts venlafaxine into des- rence of these GI effects. With Aplenzin, drug. For example, abuse of psychostimu- venlafaxine. The activity of this enzyme is Bupropion (Wellbutrin, Zyban) is formulated lants prescribed for treating ADHD is a well- inhibited by a variety of other drugs and is as the hydrobromide salt instead of hydro-documented issue. Vyvanse, which is dextro- also defective in many people as the result chloride to take advantage of the known anti-amphetamine combined chemically with the of inherited genetic mutations. People of epileptic activity of bromide salts to address amino acid lysine was designed to address Asian and African heritage carry the highest the tendency of bupropion to produce sei-this problem. It is a pro-drug – inactive as risk of having mutations that cause this en- zures. taken – that requires the action of an enzyme zyme to be ineffective. The bottom line is Finally, we come to Nuvigil (armodafanil), in the GI tract to cleave the lysine from the that, together, these factors have contributed a refined version of Provigil (modafanil), amphetamine to activate it. Any attempt to to difficulties in dosing and achieving pre- which is classed as a CNS stimulant, al-abuse this drug – by smoking or injecting it – dictable results with Effexor. While Effexor though its mechanism of action is unclear will produce no effect since the activating and Pristiq are both equally effective at in- and differs somewhat from that of ampheta-enzyme is not present in the blood. On the hibiting serotonin reuptake, Pristiq is better mine. Many drugs, including amphetamine, other hand, ProCentra, which was approved than Effexor at inhibiting norepinephrine citalopram, and modafanil, possess a struc-for use just this year, offers only one advan- reuptake. Whether this difference will trans- tural feature that makes it possible to form tage over other forms of dextroamphetamine late into better efficacy in treating depres- mirror-image molecules during their synthe-on the market: it tastes like bubble-gum. sion remains to be seen. sis. Usually, the pharmacological activity of One of the more controversial new drugs Another new drug that is the metabolite of one form is much stronger/better than for the now in wide-spread use to aid with smoking a well-known antipsychotic agent is Invega mixture. This seems to be the case with Cel-cessation is Chantix (varenicline). This drug (paliperidone). There is little pharmacologi- exa (citalopram – the mixture) versus is a partial agonist for nicotine receptors, cal difference between Invega and its parent Lexapro (escitalopram). For Nuvigil, how-which means that it produces a weak activa- drug, risperidone (Risperdal). Both are ever, the only relevant pharmacological dif-tion of the receptor (not enough to produce classed as atypical antipsychotics and share ference between it and Provigil is that it lasts the nicotine "high") and so avoids triggering the same benefits and risks of other drugs in longer so that dosing will be less frequent. It the craving mechanism that commonly ac- this class: They should not be used to treat is FDA approved for the treatment of narco-companies abstinence. Unfortunately, there dementia-related psychosis and they have a lepsy, shift work sleep disorder, and obstruc-are now many reports of mood instability propensity to induce weight-gain and hyper- tive sleep apnea/hypopnea syndrome, but as and depression associated with the use of glycemia in addition to the usual spectrum with Provigil, there are likely to be many this drug in some individuals. Because of the extrapyramidal side effects common to most off-label uses. severity of these adverse responses, there is antipsychotics. now talk of pulling this drug from the mar- Stavzor (valproic acid delayed release) Continued on page 13
Washington Psychologist — August 2009 Insurance Companies, Regulators, Compliance…
There is Something You Can Do!
Sunday, August 23, 2009, 6:00-9:00 PM Four Seas Restaurant, 714 S King St, Seattle, WA 98104 This is a specially developed WSPA program/dinner event scheduled as a result of yet further recent reductions in reimbursement rates for psy-
chologists. Its purpose is to provide some expert knowledge and advice on how you can deal more effectively, legally, and ethically with insurers and
regulators. Please join us for this special Sunday evening dinner event. Group practices are especially encouraged to be well represented.

Program Description ( includes dinner and 2– hour program- up to 2 CE applied for. Note: subject mater may preclude CE being offered)
Have more time for patients. Improve patient outcomes. Lower your risks. Make your practice even more successful. In this fast-paced seminar led
by industry experts, you get the tools and training you need to deal more effectively with insurance companies and regulators. You will learn how
to negotiate with insurance companies and improve your contracts, benefit your practice and stay in compliance.
Jeff Coopersmith is president of Coopersmith Health Law Group and
Dwight Johnson is the Director of Provider Contracting at Coop-
the former Chief Counsel and Director of Enforcement at the Washington ersmith Health Law Group. Dwight has an extensive background in State Office of the Insurance Commissioner. As Chief Counsel, Jeff cre- provider contracting. His experience includes six years as the Assis- ated the first systematic prosecution of the insurance industry in state tant Director of Provider Contracting at Regence BlueShield, where history. He won record fines and refunds, and forced insurers to change he was responsible for all provider contracting, and five years with their business practices to benefit physicians and patients. In Congress, Premera BlueCross where he was responsible for all hospital and Jeff was in charge of health-care issues for a Member of Congress during ancillary contracting in Washington and Alaska. In addition to his a major overhaul of the Medicare system. extensive experience on the payer side, Mr. Johnson also worked for many years on the provider side. Jeff speaks widely about how medical practices and hospitals can improve profitability, reduce the many risks associated with non-compliance, and Dwight applies his broad knowledge of healthcare contracting in his develop positive working relationships with insurance companies and work, which includes provider-payer negotiations, contract review, regulators. He is a board member of the Washington Health Foundation fee schedule analysis and development, claims process examination, and was recently profiled in the 2009 annual health law edition of the discussions with brokers and work with regulatory agencies. The King County Bar News. Jeff was named as a SuperLawyer by Washing- goal of his efforts is to create resolution out of conflict, allowing ton Law & Politics in 2008 and 2009. providers and payers to come together in delivering care to the mu-tual clients they serve Free Parking Available!
For registration or more information including learning objectives, please visit our website at http://www.wapsych.org
Insurance Companies, Regulators, Compliance…There is Something You Can Do!
(up to 2 CE applied for. Note: Subject mater may preclude CE being offered)
Please register online at www.wapsych.org if possible. Registration form and payment must be received in the office one week before
the program date to qualify for early rate. Cancellations may be made two weeks prior to the event.
Registration Fees (Payment must be received in the WSPA office by August 19th, 2009) Members Non-Members Student Members TOTAL ENCLOSED: Check#: Please make checks payable to WSPA Credit Card Type: Email: (Required) Please mail registration and payment to: WSPA Business Office 711 N 35th St, Suite 206 Seattle, WA 98103 Billing Address: Or Fax: (206) 547-6366 Note Re: Continuing Education Credits- The Washington State Psychological Association (WSPA) is approved by the American Psychological Association to sponsor Continuing Education for psy-
chologists. Workshops offered by WSPA are recognized continuing educational activities under the rules adopted by the Washington State Examining Board of Psychology and the Licensed Counselors
Advisory Committee. WSPA maintains responsibility for the programs. Any comments, concerns, or complaints should be directed to Doug Wear, PhD, Executive Director, at the WSPA Office. Important
Only those who attend the workshops and complete the evaluation forms will receive continuing education credits. Please note that APA CE rules require that we only give credit to those who
attend entire workshops.
Washington Psychologist — March 2009 Jessica Henderson Daniels, PhD, ABPP
Christopher Martel, PhD, ABPP
Jeffrey N. Younggren, Ph.D., ABPP
Jessica Henderson A Fellow of the American Daniels, PhD, ABPP Psychological Association is Director of Train- and a Distinguished Mem- ing in Psychology in ber of the National Acad- the Department of practitioner and emy of Practice, Dr. Psychiatry and Asso- Younggren is a clinical ciate Director for ate Professor in and forensic psychologist LEAH (Leadership who practices in Rolling Education in Adoles- Hills Estates, California. cent Health) Training He is also an associate Program in the Divi- clinical professor at the sion of Adolescent Medicine, both at Children's the Department of Psychology at the University of California, Hospital Boston. An Associate Professor of University of Washington. He has co- Los Angeles, School of Medicine. Dr. Younggren Psychology in the Department of Psychiatry at authored several books and numerous served as a member and chair of the Ethics Commit- Harvard Medical School, she is also Adjunct peer reviewed articles and chapters on tees of the California Psychological Association and Associate Professor in the Clinical Psychology behavioral treatment for depression and is the American Psychological Association. He con- Program at Boston University. Her 32 years in an international workshop leader and sults to various licensing boards on ethics and stan- the Department of Psychiatry and 17 years in speaker. dards of care, and he qualifies as an expert in crimi- the Division of Adolescent Medicine will pro- nal, civil and administrative proceedings. Dr. vide the background for her presentations. Younggren testified regarding the fallibility of mem-ory secondary to trauma and post traumatic stress disorder before the United Nations Bosnian War WATCH YOUR MAIL FOR THE FALL CONVENTION BROCHURE
Crimes Tribunal in the Hague. For more information or to register, go to after Aug 15. WORKSHOPS
All CE's are applied for.
Keynote: The Psychologist in Primary Health
-The Wellness Workbook: CBT for Chronic BA Principles, Techniques and Competence,
Settings: Partners in Pediatric and Adolescent Low Back Pain Kelly Carpenter, PhD & Tamara Christopher Martel, PhD, ABPP – 3.0 hours -
Medicine, Jessica Henderson Daniels, PhD,
Altman, PhD - 3.0 hours. ABPP – 3.0 hours Sports Concussion in Youth: Current Issues,
Multiple perspectives of PTSD treatment with
Keynote: Adolescent Cultures and Psychologi- Management, Return to Play Decisions, and
ethnic minority populations and how our
cal Practice: Vernacular and Classical Cul-
Prevention, Mark Mariani, M.D – 1.5 hours
practices may be enhanced by knowing how
tures in Perspective, Jessica Henderson Daniel,
healing is done in war torn communities
PhD, ABPP – 3.0 hours Pediatric Psychopharmacology - John Holttum, around the world, Carla Bradshaw, PhD & John
MD – 1.5 hours Van Eenwyk, PhD—1.5 hours Working with Dying: Practical, Clinical &
Medical Considerations in End-of-Life Care.
Heather Carmichael Olson, PhD – 3.0 hours Renee Katz, PhD, G. Andrew Benjamin, JD, PhD, Judith Gordon, PhD - 3.0 hours Morning Keynote:
Losing Our Minds: Americans Failed Medical
Behavioral Activation for Depression: A
Model of Psychotherapy , Peter Hunsberger,
The Technology of Psychology:
Treatment Who's Time Has Come, Again,
PhD – 1.5 hours -Using web-based CBT to supplement
Christopher Martel, PhD, ABPP – 1.5 hours face-to-face therapy for PTSD, Tamara
Altman, PhD & Kelly Carpenter, PhD Psycho-education 101 for Parents of
-Coping with Breast Cancer: Delivering an Teens: Adolescent brain research, problem-
APAIT Risk Management Workshop – 6.0
empirically supported group intervention on
solving with classic developmental issues and
the web Brenda Stoelb, PhD & Kelly Carpenter, emotional regulation, Laura Kastner, PhD - 3.0
*This event is pending approval by the Washington State Psychological Association (WSPA). WSPA is approved by the American Psychological Association to sponsor Continuing Education for psychologists. Workshops offered
by WSPA are recognized continuing educational activities under the rules adopted by the Washington State Examining Board of Psychology and the Licensed Counselors Advisory Committee. WSPA maintains responsibility for this
program and its content. Any comments, concerns, or complaints should be directed to Doug Wear, PhD, Executive Director, at the WSPA Office, (206) 547-4220. Important Notice: Please note that APA CE rules require that we
only give credit to those who attend entire workshops. Those arriving more than 15 minutes after the scheduled start time or leaving before the workshop is completed will not receive CE credit.
For more information,
please call the WSPA Office at (206) 547-4220.
Washington Psychologist — March 2009 WSPA Spring Retreat Lynnette Lewis
The setting was beautiful. The Alta Vista and distributed and answers collected from a sional organization feels like a family is Resort can be found in the national forest at variety of sources. What is important to quite special to Mt. Rainier and is nestled among beautiful Washington psychologists? Where should me. I am both trees next to a lively creek. It began as a the WSPA concentrate its energy and re- excited and hum- recreation lodge in the 1920s and now boasts sources? bled to be a part cabin-like suites with fireplaces and kitch- During this weekend the council took of a group that ens. The weather was perfect. The morning those answers and turned them into topics cares so deeply air was crisp and the with key and works afternoon sun warm. points and well together. It's the perfect place to get away from it all that will be A special and play in nature. But used to create thanks to the the hardworking mem- eat's strate- bers of the WSPA strategic plan. gic planning council were not there While it facilitator, Rya to relax. There was a seemed to me Kellogg lot of work awaiting a daunting (ryankell [email protected]), a Seattle-based them. And they were Small-groups work: Shannon Ledesma Jones, PhD, task, we were consultant who works with nonprofits and Carla Bradshaw, PhD, John Moritsugu, PhD, more than up to the Sally Wing, PhD, Jane Harmon Jacobs, PhD very fortunate government agencies on organizational de- to have a velopme nt, strategic planning and process This was my first council retreat and I was- process called Open Space. Open Space facilitation. n't sure what to expect. What does one do on provided enough structure to keep everyone a council retreat? People were arriving from on task while at the same time providing the all over the state. Some had started driving flexibility to allow the individual members before dawn. There was an air of anticipa- to work in the areas they were most passion- tion and excitement. Old friends greeted one ate about. Working in small groups, every- "Future" continued from page 3
another. Some people have been attending one had the opportunity to really express licensure was one specific change discussed these retreats for years. New attendees were what was important to them. The result was to address these needs. eagerly welcomed. There was a real sense of seen not only in the body of work they cre- Economic and health reform issues excitement about the beautiful setting, the ated but also on the faces of the members at Our economic and health reform issues are work to be done, and the chance to get to- the end of the retreat. Everyone had a explicitly interwoven, since U.S. health care chance to share their experience of the proc- costs are such a large part of our overall One of the first tasks the council was given ess and the comments were universally posi- expenditures. "Out of balance" economics was to create a vision statement for the tive. was one major theme during the summit— It was inspiring to be with a group of that costs and savings for health care are people who clearly care so deeply about accrued in different places and that non- both their professions and the work of the integration is rewarded. This coupled with organization. More than once, when given the fact that most "mental health" will be the option to leave something for another paid for by the government through day or another committee, the group chose Medicare/ Medicaid, creates the need for to stay and finish what they had started. I psychologists to focus on pay for felt a real sense of energy and purpose in performance or creating effectiveness and the room. And when there was down time, measurement data—how do we make the council members made good use of it people's lives measurable better? This to enjoy the beautiful setting, catching up "value added" thinking in health care will with old friends and making new ones. determine how and where psychologists I remember at one point in the process Full council strategic planning practice and reimbursement rates. We may just looking around at all of the passionate also need to create a new set of practice WSPA. There were so many ideas about dedicated people and thinking that it felt like guidelines not based on the medical DSM. In what should be included. This is one of the having a family in my profession. I am a general, psychologists need to define the times when the group showed how well it relative newcomer to psychology, just fin- work that needs to be done legislatively, works together to compromise and find the ishing up my 3rd year of grad school. I am partner and join coalitions and work common elements. The result was a state- also new to Washington, having moved here collectively on health care reform. ment that seemed to satisfy and inspire eve- 3 weeks before my first classes started. I Now, to get back to the father standing ryone in the room. So far so good! attended my first WSPA convention during next to me in the elevator, "should my The main objective of this particular retreat my first year of school and became a com- daughter become a psychologist?" was to work on a strategic plan. The strategic mittee member in my 2nd. I've always felt "Yes," I answered after a thoughtful pause. planning work group (which I am proud to that being involved in my professional or- "The future of psychology is a good one. be a part of) had been working hard to pre- ganization was an important part of being a Tell your daughter, yes." pare for this retreat. Surveys were designed professional. So finding that my profes- Washington Psychologist — August 2009 Youth Suicide: Statistics and Strategies
Sue Eastgard, MSW, Executive Director, Youth Suicide Prevention Program

The latest data indicates that far too many self-esteem; not believing that one is His parents, Scot and Leah, did not attend are dying. Between 2003 and 2007, 539 worthy of being loved, valued or cared a bereavement support group or talk with a Washington State children, teens and young counselor; instead they engaged in adults between the ages of 10 and 24 ended And we understand that there are protec- "involvement therapy" trying to convince their lives by suicide. This translates to an tive factors that can increase support for the Legislature to require public schools to average of two youth suicides each week in young people and reduce their risk for sui- include content in their health curricula on our state. And this only reflects those deaths cide, such as: mental illness, depression and suicide pre- that the county medical examiner or coroner  Safe and welcoming school environ- vention. While this specific effort was not could substantiate as a suicide. What about successful, they were able to secure funds the child who was playing the "choking for the development of a youth suicide pre-  Family love and acceptance game" alone with a belt in his closet or the vention plan. The University of Washing-  Individual coping and social skills, like adolescent whose car slammed into a tree, ton's School of Nursing took the lead on emotion regulation and distress toler- without any evidence of attempting to stop?? writing the plan and it has been the "map" The latest data also tells us that too many for the state's suicide prevention efforts ever  Positive peer relationships teens are unhappy and don't feel as though they have adults who they can turn to. From  A sense of purpose Our objectives are to build public aware- the Healthy Youth Survey that is conducted  Being affirmed as a worthwhile person ness about the issue, to offer professional every two years in voluntary public schools  Ability to connect with others training and to support communities taking across the state, we learned that 1/3 of Wash- The Youth Suicide Prevention Program of action. We believe that we need to train ington State 10th graders reported feeling so Washington State (www.yspp.org) began in "gatekeepers" – adults working on the front sad or hopeless almost every day for two 1995 in response to a suicide of a young lines with youth – to recognize depression weeks or more that it effected their "usual" man who was living in south Snohomish and suicidal behaviors and intervene. We activities. Nearly 30% of 10th graders re- County. He was bright, popular, and ath- believe that we need to recruit young people ported that they did not have (or they were- letic, and according to his parents, had no into our prevention efforts because youth n't sure) that they have adults to turn to for obvious reason to be depressed. Trevor hung will more likely reach out to their peers be-help when feeling sad or hopeless. himself with the jumper cables from the fore talking with an adult. We believe that We understand that these factors contribute trunk of his car and we will honestly never schools and communities need to get in-to suicidal behavior: know exactly why he ended his life. When volved in prevention BEFORE a young per-  Loneliness, social isolation, emptiness, we look back and dissect the last days of his son takes his/her life. invisibility, and/or a lack of connection life, we can see some warning signs. Trevor But the sad statistics tell us that we still  Negative feelings, including despair, reportedly gave a friend his favorite baseball have plenty of work to do. We need more depression, hopelessness and despera- cap and indicated that he didn't need it. He champions for this cause – more people asked another friend, "If you were going to speaking out and advocating for resources,  The desire to escape an unbearable kill yourself, how would you do it?" He sat curricula, and training. Trevor may never sullenly in the family kitchen – partially situation or state of mind have asked for help directly, but what if his hidden under a hooded sweatshirt – annoy- parents and friends had known the warning Either a lack of control or an attempt to ing his mother with his lack of communica- signs and known what to do – maybe he gain control over one aspect of their life tion. But there were no calls from the school would be alive today. Interpersonal conflicts or problems with counselor or any of Trevor's teachers or his significant others or caregivers football coach suggesting that there were  Dislike or a disgust with oneself; low problems or reason for concern. Member Happenings
Please send relevant "Member Happenings" info to [email protected]
Executive Board and Council Nominations 2009
Executive Board and Council Nominations 2009

WSPA Leadership Nominations Due September 15, 2009

Nominations may be submitted for the following open positions on the Executive Board and Council of Representatives for WSPA.
Any full member in good standing may be nominated. The deadline is September 15, 2009.
Vice-President (ascension to Presidency 2012) Secretary (two year term)
Member-at-Large (two year term) Student Representative (two year term)
Consulting Psychologists (two year term) Public Agency Work Setting (two year term)
Private Agency Work Setting (two year term) School Psychologists (two year term)
Please send nominations or requests for additional information to Past President Alex Suarez, Ph.D. at
or via regular mail to: Alex Suarez, 2326 6th Ave, Seattle Wa 98121
Washington Psychologist — August 2009 Washington Psychologist — August 2009 TRAINING & CE
University of Washington Profes-
Consultant Position, 1 Day Per Week, Seattle Office Space. 2
Flexible. We have openings in Skilled Peaceful spaces in Seattle for
sional and
Nursing & Rehabilitation Centers in Shelton, Continuing Education
Stanwood, Poulsbo, Everett, Marysville and bodywork:144 sq ft or 350 sq other locations. Assessment, brief therapy ft, furnished, waiting room, Earn a certificate in Psychological Trauma, and behavior management with older access to kitchen, phone, Geriatric Mental Health, and more. Learn po p ul at io n. C on s u lt a ti on wi th access to bathroom, utilities from leading clinicians and researchers and multidisciplinary team for psychological in clu d ed, ea sy str ee t earn CEUs. Psych. Trauma courses are issu es impacting care. Training, materials, parking.$130mo or $190mo for conveniently offered in an online + class- and clinical support provided. Insurance 1 day per wk. Open to neg. 2-6 room combined format. For more informa- billing provided. Our ARNPs provide days per wk. 206-527-0908. tion, visit www.extension.washington.edu. medication management. Please call The Lantern Group at (206) 526-8376 for more MEMBER HAPPENING Laura Kastner
is to help parents understand their teens from "Voice" continued from page 5
a developmental and brain science perspec- y e a r s , tive so that they can become "cool-headed" commenced their training. Their applications Laura Kast- and choose more effective approaches for will initially be denied because they will not ner has handling typical challenges like defiance, meet the new requirements, but they can been treat- rule-breaking, school problems and sub- request a Brief Adjudicative Proceeding ing families stance use. during which they would present evidence to with teen- Kastner has given hundreds of presenta- the Board as to why they should fall under agers and tions on adolescence in public lectures in the the current laws instead of the new ones. t e a c h i n g , community and in her teaching capacity at There is no guarantee the Board will approve t r a i n i n g , University of Washington, where she is a the application, but the opportunity is there. and writing clinical associate professor in both psychol- Details on these policy interpretations can be about them. ogy and psychiatry and behavioral sciences. found at http://www.doh.wa.gov/hsqa/Her most She sees a direct link between her theoretical Professions/psychology/default.htm. It r e c e n t orientation, which emphasizes family sys- should be noted that these policy book, co- tems, developmental psychology, attachment interpretations are drafts only; they must be a u t h o r e d theory and community psychology, and her signed by the Secretary of State. However, with writer training at University of Virginia. Wanting to the Board does not foresee any reason why J e n n y get evidence-based and relevant information they would not be signed. Wyatt, was published in June by ParentMap into the hands of parents, her other two That is the nuts and bolts of the new laws
and is entitled, Getting to Calm: Cool- books were also focused on family interac- and how they affect current doctoral
headed strategies for parenting tweens and tions, practical ways to solve typical prob- psychology students. This process was an
teens. Since hormonal changes and the re- lems and the importance of a securely at- amazing and enriching experience. It is really
modeling of the prefrontal cortex render tached parent-child relationship (The Seven easy to vilify those in charge and assume that
most teens moody, emotionally reactive and Year Stretch: How families work together to they do not care about what happens, that
impulsive, it has become more explicitly grow through adolescence; The Launching maybe they are writing laws and making
clear that parents need to be the ones to take Years: Parenting strategies from senior year changes without thinking about the
the lead on keeping interactions calm enough to college life).
outcomes. I have to say that this is NOT the for useful problem-solving. Laura's mission case with the Washington Examining Board of Psychology. Melanie and I found all the members willing to hear our side of the story. They were open and welcomed our input. "Update" continued from page 7
This experience has taught me that I do indeed have a voice in what happens in my For more detailed information about these www.depressionforums.org, that provide chosen profession. I could have fretted and and other medications, I recommend several potentially useful information on the spec- complained about the changes, but instead I websites: www.rxlist.com, trum of effects produced by psychopharma- chose to talk to those involved and see if I www.epocrates.com, www.drugs.com, are cological drugs. Finally, as Dr. Courtney could help make some changes. This relatively user friendly and provide compre- reminded us, no matter what the pharmaceu- experience has empowered me. I intend to hensive information, including drug interac- tical industry comes up with next, it will continue being involved in WSPA and APA tion and adverse effects data. For anecdotal never replace the need for psychotherapy. in whatever ways I can. I know I can make a accounts of client experience with specific difference. Any questions? I can be reached medications, there are online forums, such as at [email protected] Washington Psychologist — August 2009 ETHICS CONSULTATION LINE Psychologists' Support
Diane DeWitt, PhD 206-920-6006 New in Washington?
New to practice?
Pamela Ridgway, PhD 509-353-9885 Trying to balance career and family?
Call us for a mentor.
Jan Tackett, PhD Have knowledge to share? Be a mentor.
Call us to volunteer.
Aaron Turner, PhD 206-277-6134 Bruce Arnekley, EdD Nancy Huenefeld, PhD When leaving a voicemail message, please give several times and dates when you can Sally Baird, PhD Elsa O'Connor, PhD, EdD be reached directly for a return call. Andy Benjamin, JD, PhD Anne Purcell, PhD (206) 328-8409 LOW-COST REFERRALS FOR THE PUBLIC
Antioch Community Counseling
Argosy Psychology Center
and Psychology Clinic
2601-A Elliott Avenue, Seattle 2326 Sixth Avenue, Seattle Evaluations: Yes Evaluations: Yes Sliding scale, master's and doctoral Sliding scale, master's and doctoral student therapists student therapists Fremont Community Therapy
City University Counseling Center Project
11900 N.E. First Street, Bellevue
3417 Fremont Avenue N, Seattle Evaluations: Yes Sliding scale, master's student Sliding scale, doctoral practicum/ intern therapists, no crisis The Psychotherapy Cooperative
2711 E. Madison, Seattle Please contribute to this important referral resource list for psycholo- gists by informing us of additional non-profit (non-agency) sites offer- Sliding scale, volunteer therapists, ing low-cost therapy and/or evalua- no crisis/CD/history of hospitaliza- tions. We are looking for sites throughout WA state. You can send site information to [email protected] "Anxiety Thursdays" Disorder-Specific Support Groups. On-going monthly groups for patients in cognitive behavior therapy for OCD, Social Phobia, Panic Disorder, and Trichotillomania. $50/session or $200/six sessions. David J. Kosins, PhD, Certified Cognitive Therapist and UW Depts. of Psychology and Psychiatry Clinical Instruc- tor, with 19 years experience conducting CBT groups for anxiety disorders. Contact David J. Kosins at (206) 285- 0900 or [email protected] Washington Psychologist — August 2009 Help us celebrate A Primer for Parents: Teen Brain Changes, Normative Developmental Challenges and ments too…send Emotional Regulation Laura Kastner, Ph.D. us an article about
Most of us who see adolescents and their hormones and the teen's super-sensitivity to families in our practices want parents to have dopamine, a lot of extra fuel can be added to what you are doing! skills and knowledge about adolescent the fire of teen emotions. The dominance of development for handling the norma y in the emotional region of Doug Wear, PhD
challenges of the teen years. Sure, we can the brain during high arousal situations has Executive Director
provide parent counseling as part of our been called an "amygdala hijack."
treatment. But there is virtually always a Neuroscience research helps explain why Laura Kastner has recently writ-time crunch for addressing all of our agenda really good teens can still seem rather ten a book and shares the adja-( a n d t h e i r s ) , i s n ' t t h e r e ? brainless on a r andom Saturday night. When cent article in hopes that it and/or My co-author, Jennifer Wyatt, and I wrote a teen forgets to call home, jumps into a her book can be of help to mem-this book for parents to help them friend's car with a six pack, gets a tatto o ber psychologists seeing parents w i t h o u t or teens in their practices. She also will be presenting on this i s s u e s o f ".a teen forgets to call home, jumps runs out the door topic at the Fall Convention on into a friend's car with a six pack." when the parent October 17 so do not miss that. I am sure many other members are doing research which relates to teen moodiness, helps to know about the "amygdala" hijack. something just as exciting. We want to emotional reactivity and risk-taking; It doesn't excuse, but it does help to explain. share that in the WP. If you would like to be management approaches for 14 of the It also helps parents understand why they featured, please do write something up and
biggest hot-button issues; and the critical need to "get to calm" and cool down their send it to us. We wish to prominently pre- importance of the parent-teen relationship. own emotions, so that they can access their sent our members' accomplishments in this We titled our book Getting to Calm thinking brains and choose productive ways publication whenever we can!
because we wanted to underscore the role of to approach and manage their teen. emotions in relationships. Neurobiological Melt downs happen in perfectly ordinary research helps us understand teen behavior, families who lack mental disorders or together to grow through adolescence; The and it also helps us understand why loving significant psychosocial stressors. Add a Launching Years: Parenting strategies from family members can have their buttons few risk factors, and the probability senior year to college life), and the positive pushed and interact in harmful ways. increases that there will be emotional parent feedback we received seemed to Around the age of 13 and the beginning of dysregulation, communication problems, indicate that parents benefitted from learning puberty, the structural remodeling of the and more complicated teen difficulties. about meta-cognition and interpersonal prefrontal cortex in the teen brain begins. Parents will need even more support for "process" as much as we psychologists did The prefrontal cortex helps make possible their own emotional self control and shrewd i n g r a d u a t e s c h o o l ! the executive functioning skills of planning, choice of parenting strategies. But even in Although Getting to Calm was written for
reasoning, impulse control and weighing normal circumstances, most parents need parent readers, I hope that health providers—
risks and rewards. In a process called more skills for coping with teen challenges especially psychologists—can use it as an
pruning, up to 40% of the neural branches than they had ever imagined.
educational manual to buttress their own role are sloughed off in this region. Despite the In Getting to Calm, we cite the great in supporting families during this wild and
elegant brain growth that occurs during the psychologists' shoulders we stand on when wonderful developmental period. Read more
next decade (thanks to environmenta
mphasize the importance of emotional and/or order your own copy at experience and the wiring of neurons over regulation—Gottman, Goleman, Seligman, www.parentmap.com/gettingtocalm . time), the brutal truth is that until maturation and many others. Psychologist readers will is complete in the early twenties, cognition recognize principles of cognitive, Contact information: and decision making are compromised by behavioral, and family systems therapy Laura Kastner, Ph.D. this construction project. Furthermore, the wending their way through our practical [email protected] role of emotions becomes critical in the recommendations for handling the tough [email protected] understanding of teen behavior, since situation s that parents face like sexuality, emotions often trump cognition in any of substance use, rudeness, and disappointing us—and even more so for teens. grades. On e of the most unique ways we In all humans, the limbic area, and make our points is by providing parent-child specifically the amygdala, is activated by scripts, with "process" notes in the side NEED TO ADVERTISE?
highly arousing emotional events that trigger margin. Readers can see how the thoughts fear and anxiety. Emotional flooding and and emotions of parents drive what they say "fight and flight" reactions can happen even and do, thereby influencing the outcome of Amanda Collins at acol- more readily for teens, because they lack the an interaction. This teaching method was [email protected] established inhibitory mechanisms which used in our two other parenting books (The to place your ad in the next edition! help reign in impulses. Along with sexual Seven Year Stretch: How families work Washington Psychologist — March 2009 CHANGE SERVICE REQUESTED
Calendar of Events For more information, other meetings and updates, check the Calendar of Events at www.wapsych.org. Future of Psychology Insurance CE Dinner—Seattle New Graduates Licensing Executive Board Meeting—Seattle Council Meeting—Seattle New ECP Co-Chair Oct 16-18 Fall Convention—Seattle Psychopharmacology Update Council Retreat A Primer for Parents

Source: http://www.yspp.org/about_suicide/documents/WAPsychologistNewsletter.pdf


A Compendium of Case Studies that helped to shape the REACH Guidance on Chemical Categories and Read Across Edited by Andrew Worth and Grace Patlewicz EUR 22481 EN The mission of IHCP is to provide scientific support to the development and implementation of EU policies related to health and consumer protection. The IHCP carries out research to improve the understanding of potential health risks posed by chemicals, physical and biological agents from various sources to which consumers are exposed.


COMMISSION DE LA TRANSPARENCE 20 mars 2013 DIVARIUS 20 mg, comprimé pelliculé sécable B/14 (CIP : 3400936011250) B/28 (CIP : 3400936011311) Laboratoire CHIESI SA paroxétine (mésilate) Code ATC (année) N06AB05 (antidépresseurs) Motif de l'examen Renouvellement de l'inscription