- Please describe your contributions to the independent practice of psychology, including any positions held and committee work past and/or currently you have made to Division 42.
I have always had a small independent practice since 1974, simultaneous with the management positions I have held as a mental health clinic director, community health center executive director, and academic dean. I was the first Asian American to be licensed as a clinical psychologist in Massachusetts. This duality of these roles has enabled me to appreciate the different challenges independent practitioners face in maintaining a business, marketing, and developing their niche.I have contributed to the independent practice of psychology through my service on the Massachusetts state licensing board as well as my legislative advocacy for parity, clinical training, and supervision, and policy work of training guidelines have all contributed to advancing practice. I believe that we need an integrated approach to reflect the complexities and expertise brought by practitioners, and to build bridges between and within psychology to overcome the many polarized debates between practice and science that occur.
- If APAPO no longer exists in its current form, how do you envision the role of legislative advocacy for psychologists in the future? What measures will you prioritize in order to advance, defend and protect the practice of psychology?
The new structure of APA proposes to present a unified psychology to the public with its breadth of expertise as practitioners, educators, policymakers, and scientists. It proposes to direct its advocacy and legislative initiatives to include the needs of scientists and other non-clinical practitioners. Practitioners are rightfully skeptical that this might diminish the advocacy for practitioner issues. I believe we can ensure that practitioner issues remain central if we examine the policies and practices that guide the formation of this new structure. The inclusion of practitioners in APA governance is important to ensure that their voices will be heard. I would convene an ongoing advisory group to hear concerns and have continued input to how this is being implemented. I would want us to work closely with the newly formed presidential workgroup on Expanded APA Advocacy Model to ensure that the new structure will address the practice of psychology.
- Please state your position and how you intend to address each of these important APA governance concerns (150 words maximum for each):
a) The Good Governance Project, particularly the delegation of fiscal andoperational responsibilities exclusively to the APA BOD
The Good Governance Project, particularly the delegation of fiscal responsibilities, was intended to enable the council to devote its time to policymaking and big picture issues—not to abrogate its fiduciary responsibility. Toward this end, I would support CLT to expand its communicating and facilitating roles to enable the council to actualize this responsibility. We need to do more work between council meetings given the magnitude of issues presented to the council (1000 page agenda books). I would support using workgroups to do work between meetings to enable the council to be more productive when they do meet. We can have a review process to keep council informed of issues before they come to the floor of the council and to ensure the inclusion of diverse perspectives. I would promote more communication, transparency, and accountability with the council, and promote new ways to change in how we conduct our business (e.g., timelines for submitting NBIs).
b) Accreditation of Masters programs in psychology
It is a fact that Masters’ programs in psychology already exist. Doctoral programs depend on them for revenue. Graduates are already practicing, albeit not considered within the discipline of psychology. This failure to give them any career pathway in psychology only results in their competing with us as other types of mental health professionals. We no longer have a say in defining their scope of practice. Accrediting Masters’ programs is a first step toward using a tiered system, not unlike that of nurses or physician assistants to define the MA scope of practice and address the thorny issues of independent practice. We can maintain the title of “psychologist” for those with a doctoral degree (at least in the US). We must proceed because CACREP criteria already eliminate psychologists as qualified to supervise the very MA students that we train.
c) Development of treatment guidelines
The PTSD treatment guidelines, the first of other treatment guidelines to come, was both a hallmark of defining effective psychology practice and a detriment in its inability to address the complexity of treatment within the framework of evidence-based practice. Many concerns about addressing variability in patient populations and contexts and treatment modifications to such variables were considered the domain of professional practice guidelines. In addition, the narrow definition of what constitutes scientific evidence was inconsistent with the broader definition of evidence-based practices in psychology defined in 2005. They fail to acknowledge the importance of “on the ground” realities about treatment known to practitioners, and privileges RCTs as the gold standard for defining practice. What I propose would be a commission or workgroup to take a comprehensive approach of all treatment guidelines—one that brings together the expertise of practitioners and diverse researchers, and explicitly links clinical and professional practice issues.
- What do you see as additional vital area(s) facing the independent practice of psychology? How do you plan to confront these areas during your presidency?
Independent practitioners will need to rethink and expand their skills given the current trends that pose dilemmas about whether the independent practice can remain as it currently is. I plan to confront these areas by emphasizing psychologists as leaders to manage change. We need to examine whether independent practitioners can remain eligible as providers with the changing reimbursement patterns. We need to form alliances and partners across disciplines as psychology impacts health in terms of pain management and compliance, the law in terms of custody and fitness, and well-being in sports and fitness programs. We need to examine how telepsychology can expand access to bridge geographic distances, but be mindful of the potential abuses to privacy and ethics in such things as internet therapy. I would propose a forum for practitioners to think the opportunities for independent practice in today’s environment rather than standing guard to keeping it as it is.