This blog has been developed as a way to stay in better communication and dialog with members and friends of the Division of Psychoanalysis (39) of the American Psychological Association by writing about current issues facing psychoanalysis and psychoanalytic psychology as a profession, treatment, and way of thinking.
meetings are usually sultry affairs and never more so than when APA selects a
southern city to hold its Annual Convention. That was never more true than this
August, on surely one of the hottest (take-your-breath-away hot) weeks of the
year. The other thing about Orlando is that it is big, very big. While I was
able to eventually find my way around, I never had any clear sense of where I
was in the hotel, constantly surprised to find myself lost and found without
knowing exactly how I got there. The Convention Center was somewhat more
navigable, thanks largely to the fact that about 80% of the place was
unoccupied and APA meetings there took up only a compact fraction of the
thing about August Board meetings is that a large portion of our time is spent
welcoming visitors; and this year was no exception. We had four guests: Don
Bersoff, Katherine Nordal, Doug Haldeman, and Nadine Kaslow.
is president-elect of APA and he came to tell us about his initiatives as
president. He wants to highlight the role of psychologists working with
military personnel, reservists and their families to address medical, physical,
and psychological impact of war as well as issues of suicide, domestic
violence, and sexual victimization.
He asked the
Division to provide him with some of our program hours for next year’s Annual
Convention in Hawai’i. This has become a routine practice in recent years as
presidents have tried to carve out program time to advance particular concerns.
Since APA is busy revising how is allocates Division hours, we will have to
wait until the fall before knowing if we can support Dr. Bersoff’s request.
initiative is to invite and retain academics and researchers within APA. While
this is a laudable goal, and Dr. Bersoff agreed the psychodynamic researchers
were included in this initiative, I cannot but be wary of the attitude so ably
expressed by Alan Kazdin last year that practitioners are of only marginal use
to APA. It is certainly no surprise that researchers and practitioners both
feel misunderstood by the other (the Division has had and continues to have
similar complaints from each group) and I will welcome an effort to genuinely
address these concerns.
APA Practice Organization
Nordal had some uncommonly cheerful news to offer as the Practice Directorate
is getting ready to launch a new public education campaign that specifically
addresses psychotherapy as a viable and effective treatment for emotional
problems. She warned us that we may not like the ads, assuring us that market
testing of ads typically finds that the public likes what the psychologist
hates and vice versa. Regardless, this new campaign is an extension of previous
efforts; but the addition of a specific focus on psychotherapy is a real step
forward. We have a long way to go to break the hold of Big Pharma over the
public’s imagination; but perhaps this will help. The ads directly take on the
drug ads by having a physician “prescribe” psychotherapy for the patient’s
While we are
on the subject, APA Council passed a motion “Resolution on Recognition of
Psychotherapy Effectiveness,” which is the first time APA has gone on record
endorsing the effectiveness of psychotherapy. The resolution is worth reviewing
and noticing how many of the citations are from psychodynamic researchers. The
full text is at http://www.apa.org/news/press/releases/2012/08/resolution-psychotherapy.aspx.
Thanks to APA past-president Melba
Vasquez and Council Representative Linda Campbell for spearheading this
Never one to
leave us feeling too cheerful,
however, Katherine reviewed the increasing threats to adequate reimbursement
and in particular the likely impact of Medicare cuts as insurance companies
gleefully follow a “race to the bottom” in limiting compensation. While there
are some ways to hit back under the protection of parity and other
laws/regulations, psychotherapists are facing continued ratcheting of rates
downward. There remains the (slight) possibility that a review of Medicare
codes scheduled this year to address “psychotherapy” and the relative value of
this code compared to every other will result in a slight uptick in the
perceived relative value.
If you want
more information, read on, but it gets tedious about now. I actually
participated in the review of the “psychoanalysis” code last year and have some
idea how it works. First of all, this is a process dominated by American
Psychiatric Association and the overall code revision is more or less
controlled by the American Medical Association. The value of “psychotherapy”
will be computed against the relative value of every other code, that is, every
other medical procedure. The medical codes are equally geared up, of course, to
protect the relative value of “their” codes and one of the ways this is
accomplished is by invoking two mantras dear to the heart of bureaucracy:
technology and new and innovative procedures. Since “psychotherapy” does not
typically claim to rely upon new technologies and innovations, it tends to lose
out in the valuation game.
I will note,
however, that our team that addressed the value of the “psychoanalysis” code,
made the argument that psychoanalysts are treating far more troubled
individuals with far fewer resources (e.g., hospitalization) than in the past
and proposed that this constitutes an innovation, and secondly that our
“technology” has changed in that analysts are much more open, emotionally
available, and so on. It was amusing to consider that relational approaches in
psychoanalysis can be touted as a “new technology” that all analysts have embraced. More to the point, however, these
arguments carried the day and “psychoanalysis” may be in for an uptick in
relative value once the government completes its reviews of the other codes up
for examination, including “psychotherapy.”
APA Candidates for President Elect
The next two
guests were candidates competing to become APA president-elect beginning in
2013. Both Doug Haldeman and Nadine Kaslow are Division 39 members and both described
their plans should they be elected. While Doug is well known to us, having run
for president last year, Nadine is also a long time member of the Division.
candidates addressed the failure of APA to fully implement the policy on
psychologist participation in illegal detention settings and both promised to
review and do their utmost to carry out the policy. Doug addressed the need to
develop one “final” policy on psychologist involvement in interrogations, which
he felt would supersede the PENS Report. Nadine spoke forcefully on what she
sees as a failure of leadership on the part of APA and a need to fully address
and apologize for this failure, specifically a failure to align our
organization solidly behind the other professional organizations that took much
more forceful measures to oppose involvement of behavioral and psychiatric
interventions with detainees.
Nadine Kaslow, PhD
Kaslow work at Emory University School of Medicine has been primarily in the
area of family violence, cultural diversity, women’s issues, and training
concerns, including supervision. She is the editor of Family Psychology. Her presidential initiatives include addressing
the role of psychology within a health care system that will greatly change as
a result of impact of ACA, developing new and innovative ways to ensure that graduate
students and ECPs are able to successfully navigate the “pipeline” (graduate
school to internship to postdoctoral to career), and working to sustain APA’s
vision as an organization dedicated to science, practice, and public service. Nadine’s
campaign information may be accessed at http://www.nadinekaslow.com/campaign/.
Doug Haldeman, PhD
Haldeman at the University of Washington has worked and taught primarily in the
area of cultural and sexual diversity. He has been instrumental in bringing
issues of cultural, ethnic, and sexual diversity to the forefront of APA policy
including development of APA Guidelines for Psychotherapy Practice with Lesbian,
Gay and Bisexual Clients. His presidential initiatives include expanding the
definition of family in research and treatment efforts (that is, to provide a
more inclusive and culturally sensitive definition of family), addressing the “mind-body”
connection in developing comprehensive approaches to treatment (for example,
including the role of exercise, diet, body work and breathing techniques, and
so on), and developing interventions to address “ordinary life traumas,” such
as bullying, subtle racism/sexism/ageism, etc. Doug’s campaign information may
be accessed at http://president.drdoughaldeman.com/.
candidates are extremely well versed in APA governance and politics, an
essential for success of any presidency. While we had set aside time to discuss
possibility of endorsing one or the other candidate, the BoD quickly came to
the decision that both candidates would be excellent in various ways and we
voted to support each of them.
remember to vote (balloting begins on September 14) and we urge you to vote for
both of these candidates. Also remember to completely fill out your ballot.
Although I have no idea why APA uses the Hare system, or how it works the one
thing I know (or have been told) is that filling out the ballot completely
actually helps elect your preferred candidate.
We also had
some basic housekeeping items to announce.Shortly after the Spring Meeting, Tamara McClintock Greenberg announced
she was resigning from the Board and from editorship of InSight. This left some important positions to fill and Marsha
McCary was appointed by the Board to complete Tamara’s term on APA Council.
Kristi Pikewiecz was appointed by Henry Seiden for the Publications Committee
to assume role of editor of InSight.
Tamara conceived and launched our online newsletter, InSight, and her contributions in this role as well as her work on
the BoD and APA Council will be missed.
previously announced, we will be welcoming a new BoD member in January, Dana Castellano,
as secretary (who helpfully subbed as secretary for part of the August
meeting). While Past President Mary Beth Cresci, Secretary Dennis Debiak, and
Members-at-Large Marilyn Charles and Jill Bellinson will be completing their
terms at the end of the year, they will return as newly minted members in
January, with Marilyn as APA Council Representative and Mary Beth, Dennis, and
Jill serving as Members-at-Large.
And All the Rest . . .
be able to delve further into some of the following issues by reading reports
on the web site, but I want to highlight some important news and initiatives.
have a new Task Force, Psychoanalysis and the Humanities, with Spyros Orfanos
as chair. Frank Summers has been working with Spyros and other task force
members to increase integration of the humanities in our overall mission, for
example, to have a wider range of the liberal arts professions represented as
both presenters and participants at our meetings.
the budget situation for 2013 is uncertain at this point, the BoD approved in
principle a request from the Multicultural Committee (and an initiative from
Frank Summers as incoming president) to greatly increase support for minority
graduate students and ECPs to attend the Spring Meeting. This is part of our
larger commitment to diversity and development of a new generation of members
and leaders to keep the mission of the Division alive and revitalized by being
more inclusive in reaching out to new members. While we will need to plan and
evaluate this investment (for example, should we focus more on ECPs versus
graduate students, we have certainly found that reaching out with financial
support has paid dividends in retaining those awarded support as members, and has
led to their increased involvement in Division leadership.
the Multicultural Committee has worked with the Awards Committee to develop a
new award that will be announced in 2013 for members who have made significant
contributions in the area of racial, cultural and sexual diversity.
Fund for Psychoanalysis initiative has been successful in that we currently
have more than enough in pledges to begin thinking about the actual mechanics
of distributing funds once available. We still need some contributions to get
us “over the top” and hope to be in operation by 2014. Dennis Debiak reported
on some of the details we will need to address before sending out a “call” for
BoD approved a contribution to the 2013 Child Mental Health Summit. In the two
years since the last Summit, Jill Bellinson has been working actively with this
group and has been able to make the case that psychoanalytic thought and
treatment need to be represented at the Summit next year. Her participation
with this group has yielded significant recognition of the importance of a
psychoanalytic perspective within APA governance.
had what we hope is only the first of many future meetings of Division members
who are also Directors of Clinical Training (DCT) as they came together to
share their troubles, concerns, and successes in maintaining psychoanalytic
theory and training as part of their graduate programs. There was a lively
discussion and a wide range of experiences, from those who felt the
accreditation process by the Committee on Accreditation (CoA) to be wholly
biased against psychoanalytic programs, to those who had more positive (or at least
neutral) experiences. Nancy McWilliams has previously written about this
meeting and her summary can be found on our web site under Education and
Training Committee Reports. The important point is that our Division may help
spearhead efforts to both assist DCTs in their task of coping with CoA, as well
as work to have more influence with CoA. We are also considering either
including internship directors in these discussions or developing separate
venue, since they are facing similar concerns in meeting APA accreditation
standards while being true to a psychoanalytic vision for training interns.
Publications Report is also on the web site but some quick observations. First
of all, the journal has vastly improved on a number of measures, with the most
understandable being that it is the third most cited psychoanalyticjournal, that is, our journal articles have
been cited by other articles at a rate that places us third (and ahead of JAPA!).
Also, our editor, Elliot Jurist, reported substantial submissions from graduate
students and early career professionals applying for the Stephen Mitchell
Prize, a vast increase over past years.
There were many
other issues discussed at the meeting, some of which may be found under
committee reports on the web site, some of which I will address in future
blogs. As always, you may comment directly at this site, or write to me at email@example.com. Hope the rest of your
summer goes well.