Author Archives: Susan

Bill to Create Services for Trafficking Victims Passes Senate and Goes to House Health & Welfare Committee

SB 145 by Sen. Ronnie Johns was heard in committee, amended and passed to the Senate Floor where it was supported by favorable vote of 38 yeas and no nays. In the House it was referred to the Committee on Health & Welfare. It passed the Senate on April 29.

If it were to become law, the measure provides that, subject to appropriation by the legislature, the Dept. of Children and Family Services, working in collaboration with the Dept. of Health, and the Family in Need of Services Assistance Program, with the assistance of the La. Alliance of Children’s Advocacy Centers, to create a coalition to develop a human trafficking victim services
delivery model.

The proposed law further provides that the model is to be developed with consideration of the recommendations of and collaborating with the La. Human Trafficking Prevention Commission and Advisory Board, and provide a multidisciplinary and agency approach that coordinates resources and improves the statewide response and delivery of services to victims.

The new would designate that the human trafficking victim services delivery model is to provide a plan to address and promote the following goals including but not limited to:

(1) Safe and sufficient placements. (2) Available and adequate funding sources. (3) Stakeholder partnerships. (4) Coordinated response. (5) Appropriate and responsive services.

The Dept. of Children and Family Services is to promulgate any rules necessary to implement the provisions of proposed law, and that the Dept. of Children and Family Services is to provide a report on the development of the coalition’s services delivery model to the Senate and House
Committees on Health and Welfare by June 30, 2020, and annually thereafter until completion of the model.

Measure to Prohibit Cherry Picking by Insurance Venders Involuntarily Deferred

HB 237, a measure put forth by Rep. Chad Brown and supported by the Governor, to prohibit
discrimination by health insurance issuers in the individual market and small and large group
market based on health status, and from imposing any preexisting condition exclusion with respect to the plan or coverage, was involuntarily deferred in Committee on Insurance. The measure also took on six amendments.

The proposed law, if it would have passed, requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

“Proposed law requires a health insurance issuer offering health insurance coverage in the
individual or group market to renew or continue in force the coverage at the option of the plan sponsor or the individual, as applicable, except that the issuer may nonrenew or discontinue health insurance coverage based only on a failure to pay premiums or contributions, an act or practice that constitutes fraud or an intentional misrepresentation of material fact under the terms of the coverage, or the issuer is ceasing to offer coverage in the market.”

The new law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from establishing rules for eligibility, including continued
eligibility, of any individual to enroll under the terms of the plan based on any of the following
health status-related factors in relation to the individual or a dependent of the individual:
(1) Health status.
(2) Medical condition, including both physical and mental illnesses.
(3) Claims experience.
(4) Receipt of health care.
(5) Medical history.
(6) Genetic information.
(7) Evidence of insurability, including conditions arising out of acts of domestic violence.
(8) Disability.
(9) Any other health status-related factor determined appropriate by the commissioner of insurance.

The proposed law prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage in La. from establishing lifetime limits on the dollar value of benefits for any participant or beneficiary.

Penguins: A Review

by Alvin G. Burstein

Penguins is literally spectacular. It immerses the viewer in the dramatic panorama of the Antarctica, not a frozen solitude, but the setting of an incredible avian migration and its complex context. If that were not enough to make it worth the price of admission, the
opening credits remind us of contributions by the Disney Wildlife Conservation Fund—about eleven million dollars in the last twenty-five years.

The film centers on the yearly return of thousands of Adéli penguins to Antarctica to breed and to nurture their young, spending months there until the fledglings are mature enough to  survive at sea. It is probably unsurprising that the inventive genius that gave us Mickey and Minnie Mouse, rodents transmogrified into quasi-humans to entrance their young audience,
would personify a penguin couple, Steve and Adeline and their tribulations as quasi-human parents. The narrative device, which wins the hearts as well as minds of the audience, is magnified by providing Steve with a self-awareness—questionable for the species—that his human voicing shares with the audience. With artful effect, Steve reveals himself as a Chaplinesque comedian bumbling his way through a series of trials and engaging our affections as he, like Charlie, manages improbably to win the heart of his inamorata.

In striking contrast with its elements of humor and romance, the film reminds us that nature has a harsh, unforgiving side, what Tennyson had in mind when he alluded to “nature, red in tooth and claw.” There is heart-stopping suspense as Steve, Adeline and their brood struggle to survive, not only violent and unpredictable weather, but murderous predators: petrels, leopard seals, and killer whales.

Some questions, maybe quibbles, arise about the film. It is presented as a bildungsroman, a coming of age story, centered on Steve’s transition from adolescence to adulthood. The focus on Steve, and, in particular, his gadabout nature, might seem an unintended endorsement of
male privilege. His self-awareness might seem to diminish the important role of instinctive unfolding in animal behavior illustrated by Lorenz and the ducklings that imprinted on him as their “mother.” The curious Adéli rite of collecting pebbles for the nest stands as an example of elaborate behavior that might challenge simplistic forms  of evolutionary psychology. Finally, one wonders if the exclusive focus on tenderness in Steve’s and Adeline’s relationship signals a prudish avoidance of documenting their copulation.

Overall, this Disneynature enterprise, Penguins, like travel in Disney World, is a confection. It is tasty, tasteful, delicious and informative, but its artfulness calls for quotation marks around “nature.”

Natural Chemical Helps Brain Adapt to Stress

Researchers at Vanderbilt University Medical Center have identified a natural signaling
molecule that activates cannabinoid receptors in the brain that play a critical role in
stress-resilience. The endocannabinoid family of signaling molecules that activate CB1
and CB2 cannabinoid receptors in the brain were investigated by Sachin Patel, M.D.,
Ph.D., the director of the Division of Addiction Psychiatry at Vanderbilt University
Medical Center. Patel indicated that finding ways to boost the signaling system could
represent a new treatment approach for many stress-linked disorders.

The endocannabinoids are endogenous ligands in the brain that activate CB1 and CB2.
While the endocannabinoids are a biochemistry topic too complex for this cursory look,
the effects of CB1 and CB2 have broad implications for the treatment and possible
prevention of disorders like major depression and PTSD. CB1 is found mostly in the
brain and central nervous system and to a lesser extent in other tissues. CB2 is mostly
found in peripheral organs and cells that service the immune system. CBD, which is now
generally available in several forms do not directly activated CB1 or 2; however, the
effects of CBD are foreshadowing the potential for treatment of not just mood disorders
but many other stress-related or stress-affected disorders, like diabetes, obesity,
memory, anxiety and neurodegenerative disorders.

Boosting this signaling system holds great promise. In fact, THC, the active compound
in marijuana, binds the CB1 receptor, which may explain why relief of tension and
anxiety is the most common reason cited by people who use marijuana chronically.
Patel and his colleagues previously have found CB1 receptors in the amygdala, a key
emotional hub in the brain involved in regulating anxiety and the fight-or-flight response.
They also showed in animal models that anxiety increases when the CB1 receptor is
blocked by a drug or its gene is deleted.

In the current study1 the researchers tested the effects of increasing or depleting the
supply of one endocannabinoid (2-AG) in the amygdala in two populations of mice: one
previously determined to be susceptible to the adverse consequences of acute stress,
and the other which exhibited stress-resilience. Augmenting the 2-AG supply increased
the proportion of stress-resilient mice overall and promoted resilience in mice that were
previously susceptible to stress, whereas depleting 2-AG rendered previously stressresilient mice susceptible to developing anxiety-like behaviors after exposure to acute
stress.

Taken together, these results suggest that 2-AG signaling through the CB1 receptor in
the amygdala promotes resilience to the adverse effects of acute traumatic stress
exposure and supports previous findings in animal models and humans suggesting that
2-AG deficiency could contribute to development of stress-related psychiatric disorders.
Marijuana use is highly cited by patients with PTSD as a way to control symptoms.
However, marijuana use in psychiatric disorders has obvious drawbacks including
possible addiction and cognitive side effects, among others. The Vanderbilt study
suggests that increasing production of natural cannabinoids may be an alternative
strategy to harness the therapeutic potential of this signaling system. For instance, once
levels of the endocannabinoids can be efficiently measured in humans, those identified
with low levels of the signaling system responsible for stress-related mood and anxiety
disorders could have their supply replenished without the complications of using
marijuana.

Rebecca J. Bluett, Rita Báldi, Andre Haymer, Andrew D. Gaulden, Nolan D. Hartley,
Walker P. Parrish, Jordan Baechle, David J. Marcus, Ramzi Mardam-Bey, Brian C. Shonesy,
Md. Jashim Uddin, Lawrence J. Marnett, Ken Mackie, Roger J. Colbran, Danny G. Winder,
Sachin Patel. Endocannabinoid signalling modulates susceptibility to traumatic stress
exposure. Nature Communications, 2017; 8: 14782

Governor Edwards Promotes Bi-Partisan Efforts and Announces Priorities

Governor Edwards announced his Legislative Agenda last month and said that he was excited to work in a bi-partisan manner, outlining key pieces of legislation that he would support. Included were a variety of health and education reforms.

Representative Chad Brown’s HB 237 would protect nearly 850,000 Louisianans with a preexisting condition by prohibiting health plans or health insurers from discriminating against a health insurance applicant based upon preexisting conditions or health status.

SCR 3 by Senator Blade Morrish and HCR 1 by Representative Nancy Landry provides for a
$1,000 pay raise for teachers or certificated personnel, a $500 pay raise for school support
or non-certificated personnel. Eliminating pay secrecy by prohibiting employers from taking actions against employees for inquiring about, discussing or disclosing their wages or another employee’s wages is another of the Governor’s objectives in SB 136 by Senator J.P. Morrell.

HB 391 by Rep. Franklin Foil establishes “The Veterans First Business Initiative”, a statewide
initiative designed to identify veteran owned businesses in Louisiana, create a veteran owned business designation that they can use, and produce a state database for Louisianans to search for various goods or services of veteran owned businesses.

To increase prescription drug transparency, the governor will support legislation sponsored by Sen. Fred Mills, SB 41, to provide the regulatory framework necessary for the Louisiana Department of Insurance, Louisiana Board of Pharmacy, and Louisiana State Board of Medical Examiners to respond to consumer and provider complaints against PBMs. Pharmacy Benefit
Managers (PBMs) are third party administrators, “middlemen,” contracted by health plans, employers, and government entities to manage prescription drug programs on behalf of health plan beneficiaries. The three regulatory bodies will have specific licensure requirements that must be met to be in good standing and operation in Louisiana.

For HB 243, Rep. Dustin Miller and the Governor hope to address opioid-related harm through policy change to establish an enhanced data reporting of fatal and non-fatal drug overdoses where opioids were suspected or present. This legislation will create mechanisms for rapid surveillance of overdoses in the state, and lead to data-driven decisions for targeted prevention, ntervention, and treatment in areas of the state with the most prevalent challenges.

“I am proud of the momentum we are experiencing in the state of Louisiana,” said the Governor. “We have turned the $2 billion deficit I inherited at the start of my administration into a budget surplus….”

April is Cell Phone Distraction Month

April is Cell Phone Distraction Awareness Month. Scholars, researchers, psychologists, attorneys, counselors and others are asked make efforts to advise the public about the realities of cell phone distraction, explains Dr. Theodore S. (Scott) Smith from the University of Louisiana Lafayette.

Dr. Smith is Assistant Professor in the Psychology Department and leads research in his lab, The Louisiana Applied and Developmental Psychological Sciences Laboratory, where he is interested in how cell phone distraction affects the learning process, not only in the classroom. He also looks at how applicable distractions may affect driving behaviors and eyewitness memory. Smith has authored Cell Phone Distraction, Human Factors, and Litigation, published by Judges and Lawyers Publishing and which is becoming a popular resource for legal professionals.

The impact of cell phone distraction while driving is emphasized each year in April by the National Safety Council (NSC). The NSC says that the first time since the Great Recession, the U.S. has experienced three straight years of at least 40,000 roadway deaths. This is a 14 percent increase from 2014. Overall, this escalation of roadway injuries is the most dramatic seen in 53 years, said the Council.

Every day at least nine Americans die and 100 are injured in distracted driving crashes, according to the Council. Cell phones, dashboard touchscreens, voice commands and other in-vehicle technologies pose a threat to people’s safety. An NSC survey of the risky things drivers do while on the highway, found that 47 percent of people either text manually or work through voice controls, while driving.

Louisiana State University cognitive psychologist Dr. Melissa Beck also conducts research for “inattention blindness” that affects us when we are driving. Working with simulators at the Civil Engineering Department, Beck and her associates have published results of her studies in this area. She directs the Beck Visual Cognition Lab at Louisiana State University Psychology Department, where she and her researchers uncover the ways that visual attention and memory work or don’t work in various situations.

For Cell Phone Distraction Month, Dr. Smith also explained the serious issues of cell phone distraction in education. “While much emphasis has been placed on cell phone distraction and driving,” Smith said, “it is recognized that cell phone distraction affects both young and older students in the classroom.”

Technology has been advantageous to education since students can respond quickly through online formats, collaborate in real time regarding homework, and obtain references instantly, says Smith. But there are many issues now recognized.

“The assumption that students may disengage from their cell phones when entering a classroom is incorrect. Often students will utilize your cell phones in order to text,
resending receiving emails, and other tasks during classes. Multiple studies have indicated that as many as 90 to 95% of college students use their phones to send text messages during class on a constant basis,” Dr. Smith said.

“An effort to reduce or eliminate cell phone use in the classroom and at high school or college level has been difficult. Often students become physically and emotionally attached to their phones, perhaps reflective of addiction, and find themselves very socially awkward and fervently uncomfortable when they do not have their cell phones in their physical presence.”

“Another argument against technology in the classroom evolves around the discomfort that students have when other students are using their cell phones. Some student report being uncomfortable listening to a lecture when other students are texting or performing other activities not related to learning,” said Smith.

At the same time, Dr. Smith points out that there are numerous arguments in favor of technology in the class. “It’s been recommended that teachers may incorporate social media in daily teaching lessons, use clickers to quiz students during lecture, and encourage students to identify resources online during lecture, as opposed to having stagnant lectures limited to verbal talks.”

“Indeed, the argument for and against technology in the classroom will be ongoing.”

Finally, Dr. Smith reminds everyone to remember the potential harm related to cell phone distraction and driving. “This research has consistently indicated drivers pull their attention away from road conditions while driving, further prompting unsafe practices.”

He hopes that readers will consider the wide range impact of technology on their daily lives, including education and performance of daily tasks such as driving.

Legislature to Convene April 8

The 2019 regular Legislative Session will convene at noon, Monday, April 8. Bills currently being prefiled include a variety of issues. Below are some of those with interests to psychologists.

HB 53 by Representative Moss sets requirements for youth suicide prevention, intervention, and postvention, in-service training for school employees and services available to
students. Proposed law requires the governing authority of each public and approved nonpublic secondary school that issues student identification cards to have printed on the cards the phone numbers for the National Suicide Prevention Lifeline hotline, the Crisis Text Line, and a local suicide prevention hotline. Proposed law is applicable to charter schools. Present law requires BESE to adopt guidelines for in-service training of school employees in suicide, and the board is to identify suitable programs and requires coordination with LDH in identification of such programs.

HB 193 by Rep. Bacala revises procedures relative to students investigated for making threats of violence or terrorism. The present law provides relative to a student reported to a law enforcement agency for a threat of violence or terrorism and provides for a judicial hearing on whether the student should undergo a mental health evaluation. Present law requires the law enforcement agency to file a petition with the appropriate judicial district court for a mental health evaluation. The proposed law instead provides that if the law enforcement agency determines that the threat is credible and imminent, it shall report it to the district attorney, who may file such a petition.

HB 211 by Rep. Horton limits the number of hours per day of certain behavioral health services reimbursable by Medicaid. “CPST services” means community psychiatric support and treatment services and “PSR services” means psychosocial rehabilitation services. The proposed law limits Medicaid reimbursement for behavioral health providers who furnish CPST and PSR services by providing that the following types of providers shall be limited to a maximum combined total of 12 reimbursable hours of CPST services and PSR services per provider, per day, regardless of the number of patients seen by the provider for those services: (1) Psychologists. (2) Advanced practice registered nurses. (3) Physician assistants. (4) Licensed clinical social workers. (5) Licensed professional counselors. (6) Licensed marriage and family therapists. (7) Licensed, certified, or registered addiction counselors.

HB 237 by Rep. Chad Brown prohibits discrimination by health insurance issuers in the individual market and small and large group market based on health status, from imposing any preexisting condition exclusion with respect to the plan or coverage. And the proposed law requires a health insurance issuer to include mental health and substance use disorder services, including behavioral health treatment, and preventive and wellness services and chronic disease management.

HB 248 by Rep. Chad Brown provides for parenting coordinators in child custody proceedings. Present law (R.S. 9:358.1) authorizes the court to appoint parenting coordinators in certain child custody cases for one-year terms and apportion the cost between the parties. Proposed law authorizes the appointment of parenting coordinators prior to entering a judgment establishing custody and extends the initial term of appointment to up to two years. Present law (R.S. 9:358.2) prohibits the appointment of a parenting coordinator in family violence cases unless there is good cause shown. Proposed law instead allows the court to name a parenting coordinator when there has been domestic abuse or a history of perpetrating family violence if the parties consent after consultation with an attorney or domestic violence advocate. Present law (R.S. 9:358.3) provides the qualifications for parenting coordinators and requires three years post degree experience and 20 hours of continuing education every two years. Proposed law changes present law to five years post-licensure experience and 10 hours of continuing education and further extends the qualifications to include Louisiana attorneys.

HB 296 by Rep. Hoffmann provides for the training of peace officers and first responders with respect to interacting with Alzheimer’s and dementia patients. Proposed law requires the bureau of emergency medical services and the Council on Peace Officer Standards and Training to create a dementia training program in cooperation with the Department of Health. Provides for the creation of an initial training program and updates to the continuing education program.

HB 320 by Rep. Simon provides for student access to applied behavior analysis providers in schools. Present law prohibits a public school governing authority from denying student access to behavioral health service providers at school during school hours if requested by the student’s parent or legal guardian. Proposed law adds “applied behavior analysis providers” to present law definition of “behavioral health service provider” in order to allow access to such providers for students in school upon the parent’s request. In addition, proposed law requires public school governing authorities to make their policies available to the public, that behavioral health evaluations include recommendations for applied behavior analysis services. Provides that present law and proposed law shall not supercede present law relative to the licensing of behavioral health services providers or any regulation of the La. Dept. of Health related thereto or present law relative to the practice of behavior analysts.

HB 336 by Rep. Lyons adds certain school-based psychologists and social workers to those providers exempt from behavioral health provider licensing requirements––the Behavioral Health Services Provider Licensing Law. Proposed law retains present law and also exempts from behavioral health services licensure requirements an individual who provides school-based health services through a public school governing authority and who meets both the following criteria: (1) He is a certified school psychologist or a licensed master’s social worker. (2) He is enrolled in the La. Medicaid program under the Early and Periodic Screening, Diagnostic, and Treatment program.

HB 541 by Rep. Cox amends the Post-Conviction Veterans Mentor Program for incarcerated veterans. With regard to the purpose of the program, those veterans who are eligible and willing to participate in the program could serve as mentors for military to civilian transition services programs or to first-time offenders housed in a parish jail, and could serve as parish jail HiSET tutors. The secretary of DPS&C is to establish the Post-Conviction Veterans Mentor Program for incarcerated veterans, and adopt regulations and guidelines as it deems necessary for administration of the program. If the offender is granted parole and released, the offender shall be required to participate in all programs and services available to veterans that are determined to be necessary for the offender by the committee on parole and comply with other requirements specified in proposed law.

SB 19 by Senator Boudreaux. Present law authorizes the Louisiana State Board of Medical Examiners (LSBME) to regulate perfusionists, medical psychologists, genetic counselors, and polysomnographic health professionals. Proposed law provides that the LSBME, in addition to any other requirements established by regulation, shall require an applicant, as a condition of licensure to submit a full set of fingerprints, in a form and manner prescribed by the board, permit the board to request and obtain state and national criminal history record information on the applicant, and pay, in addition to all other applicable fees and costs, such amount as may be incurred by the board in requesting and obtaining state and national criminal history record information on the applicant.

SB 78 by Sen. Martiny. Present law provides for student behavioral health services to be provided during school hours if requested and paid by a student’s parent or legal guardian. Proposed law retains present law and adds “behavior analyst” to the definition of “behavior health provider” and “evaluator.” Further includes “applied behavior analysis” in
the definition of “behavioral health services.”

SB 107 by Senator Gatti proposes that any benefit payable to a sheriff or deputy sheriff which provides coverage for temporary or permanent disability to all sheriffs or sheriff’s deputies who suffer an injury or disease arising out of and in the course and scope of their employment shall include coverage for post traumatic stress injury. Proposed law provides that the following definitions shall apply to benefit payable to a sheriff or deputy sheriff: (1) “Post traumatic stress injury” means those injuries which are defined as “post traumatic stress disorder” by the most recently published edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association. (2) “Psychiatrist” shall have the same meaning as it is defined pursuant to present law. (3) “Psychologist” shall have the same meaning as it is defined pursuant to present law. Proposed law provides that any sheriff or deputy sheriff who is diagnosed by a psychiatrist or psychologist with post traumatic stress injury, either during employment or thereafter, shall be presumed, prima facie, to have a disease or infirmity connected with his employment.

SB 139 by Sen. Gatti provides for the “Louisiana Healthy Workplace Law” which prohibits workplace bullying or harassment. Proposed law provides for the following purposes: (1) To provide legal relief for employees who have been harmed, psychologically, physically, or economically, by deliberate exposure to abusive work environment; (2) To provide a legal incentive for employers to prevent and expeditiously respond to abusive mistreatment of employees in the workplace.

SB 160 by Sen. Boudreaux provides for definitions regarding opioid addiction, its treatment and those healthcare professionals certified to conduct such treatment. Proposed law provides for the responsibilities of the licensing boards for nurse practitioners and physician assistants to become certified to administer medically-aided treatments for those addicted to opioids. Proposed law provides for the outline of treatment offered for opioid addiction through the program sanctioned by the U.S. Department of Health and Human Services.

Psychologists Travel to Advocacy & Leadership Conference at APA

Four psychologists talked with members of Congress about legislation impacting the public and involving healthcare. Representing the Louisiana Psychological Association (LPA) were Drs. Alan Coulter, LPA President-Elect; Lucinda DeGrange, LPA Council Representative; Amanda Raines, Early Career Psychologist Representative; and Lacey Seymour, Louisiana Federal Advocacy Coordinator. The psychologists also attended a black tie dinner honoring Louisiana Senator Bill Cassidy sponsored by the Psychology Political Action Committee, held in March in Washington, DC.

While in D.C. the psychologists helped lobby for legislation, said Dr. Seymour. These efforts included these topics:

1) to ensure access to mental health and substance use disorder treatment;

2) to pass the Medicare Mental Health Access Act, H.R. 884. The bill removes a roadblock that hampers and delays mental health treatment for Medicare beneficiaries by ending unnecessary physician sign-off and oversight of psychologists’ services. Private sector health plans, the Veterans Health Administration, and TRICARE all allow licensed clinical psychologists to practice independently in all inpatient and outpatient settings. Medicare should, too; and

3) to pass the Mental Health Telemedicine Expansion Act, H.R. 1301. The Mental Health Telemedicine Expansion Act would make it easier for older adults to obtain mental health care in their own home by removing current-law restrictions on the use of telehealth services.

“Senator Cassidy has been a supporter of mental health legislation on both a federal and state level,” Dr. Seymour told psychologists in a recent letter. “Since his election, Senator Cassidy has championed legislation that addresses access to mental health care for our most vulnerable citizens by removing barriers to care.”

Senator Cassidy has promoted measure to helped access to services through integration of primary and behavioral care. Among his achievements, Senator Cassidy worked to design and pass the “Helping Families in Mental Health Crisis Reform Act of 2016” and first advocated mental health reforms while he served in the House of Representatives.

In 2015, he introduced mental health reform legislation that became the template for the Mental Health Reform Act of 2016. He helped strengthen accountability at HHS by creating an Assistant Secretary of Mental Health and improved interdepartmental activities related to those with serious mental illness.

US: A Review

by Alvin G. Burstein

Jordan Peele’s follow-up, Us, to his highly acclaimed Get Out shares its predecessor’s blend of horror and comedy, but is more thought provoking. Race is not a critical focus for this second film. Us left me thinking about the relationships among horror, terror and the surreal. The ethical questions it raises are not about race, but about cloning, raised by invoking the agesold eerie fascination with doppelgangers. That it intends to provoke moral unease is evidenced by the opening reference to Jeremiah, 11:11. There Jeremiah, the angriest of the biblical prophets, thunders, “Therefore thus saith the Lord, Behold, I will bring evil upon them, which they shall not be able to escape; and though they shall cry unto me, I will not hearken unto them.” In other words, “God is not forgiving.” That is a view alien to contemporary Western religion.

Horror flics present the audience with scenes that are shocking, on the edge of repellant, but do not directly impact the viewer. Terror, on the other hand, is an internal state, panic on steroids, anxiety exploded into a meltdown of the ability to function. Why is the genre a huge money-maker in the entertainment biz? The psychoanalytic pioneer, Ottto Rank, argued that the experience of being born is overwhelmingly traumatic. One is pummeled out of uterine placidity, a cushioned function like today’s near self-driving autos, into a new space of glare and clatter, gasping, for the first time, for breath. Absent verbal capacity to record, this unspeakable terror remains buried in our minds, emerging only in highly attenuated forms. Horror flics, like rollercoasters, provide a way of playing with terror, a form of catharsis. Surrealism is the label for the plastic arts or literature that deliberately violate logic and physical laws. Salvador Dali’s melting clocks and Franz Kafka’s Metamorphosis come to mind. Surrealism plucks at the strings of terror, forcing us into a struggle to understand, to defy confusion, to defuse the threat of incomprehension.

To explain this surreal film would be a contradiction in terms. I can label some of its disparate elements, in addition to the elements named above. There are opening references to realities like the existence of myriad abandoned tunnels under our continent and the 1968 happening of six or seven million Americans literally joining hands across the continent. There is also a reference to a fictional failed government effort to clone humans for military purposes. There is a bloodied prophet holding a ragged sign containing a reference to the prophet’s jeremiad. There are cages full of laboratory rabbits. There are dopplegangers trying to stab to death their originals and, later, forming a human chain across Santa Cruz. And there is a fairground Hall of Mirrors with a marquee bearing the words Find Yourself.

I don’t think it’s a spoiler to add that the plot unfolds when the protagonist, as a young child, strays from her family, enters the hall of mirrors, and falls down that rabbit hole. And a final question: Is Us a surreal mockery of Jeremiah’s ranting, or a jeremiad directed at us?

 

Stress Solutions

by Susan Andrews, PhD

What do Obesity, Chronic High Stress, Heart Disease, Diabetes, Hypertension, and Depression have in common?

IF you guessed Sleep Deprivation, my hat’s off to you. And, IF you get 7 to 8 hours of sleep a night, raise your hand high. While there is no “magic number” of hours that we should sleep, it is now firmly established that you cannot lose weight if you do not sleep a solid 7-8 hours a night. Research says the average American misses 200-300 hours of needed sleep each year. This is known as a sleep debt.

Studies suggest that healthy adults have a basal sleep need of 7 to 8 hours every night. Where things get complicated is the interaction between the basal need and sleep debt. For instance, you might meet your basal sleep need on any single night or a few nights in a row, but still have an unresolved sleep debt that may make you feel more sleepy and less alert at times, particularly in conjunction with circadian dips, those times in the 24-hour cycle when we are biologically programmed to be more sleepy and less alert, such as overnight hours and midafternoon.

Cortisol is not the only factor that inhibits weight loss but it is a big one. Some physicians are willing to flatly state that you cannot lose weight if you do not get to bed early and get a solid 7 or 8 hours. What getting a good night’s sleep can do for you:

  • A good night’s sleep has a positive effect on your blood pressure, meaning that for most of us it goes down at night. If your hours of sleep are interrupted or too short, your blood pressure may never fall low enough.
  • Insulin resistance is reduced by good sleep. Dr. Michael Breus, a psychologist and sleep specialist, emphasizes the fact that even short-term sleep loss (being awake for approximately 36 hours) can cause blood glucose levels to be higher than normal.
  • A routine schedule for sleeping will help your body keep its internal biological clock running smoothly. You will be more alert, with good reaction time and physical ability, in other words, less accident prone.

 

Psychologists can help by exploring the sleep habits in the patients they are treating. A study in the Journal of Clinical Sleep Medicine, looking at adults with insomnia, found that more than 85% of the study sample who completed 3 or more sleep-focused treatment sessions were able to nod off faster and stay asleep longer. A 6- month follow-up revealed that those patients who had 3 or more sessions spent significantly less money on health care and had fewer doctor visits – compared to the 6 months before their therapy sessions focused on sleep habits. The weekly therapy sessions included relaxation exercises and education on topics such as activities to avoid doing 2 hours before bedtime (like exercise, heavy meals, and smoking). Now, the focus of ways to improve your sleep are adding the need to put your cell phone or other blue light generators down 30 minutes to an hour before bed.

Judge Caldwell Reverses His 2017 “Reeks” Decision

Two lawsuits involving Dr. Eric Cerwonka have resulted in decisions in recent months.

In 2017 Cerwonka appealed the results of a decision by the state board that revoked his license. At a preliminary hearing for a Motion to Stay, Judge Michael Caldwell of the 19th Judicial District Court vacated and made void the Board’s decision. Caldwell was reported to say, in a sidebar discussion, “I read the briefs and I read the pleadings. I just can’t send this up to the Court of Appeals, the violations of Due Process are rampant.”

However, in February Judge Caldwell reversed his 2017 decision.

This came after the Board’s attorney, Ms. Amy Lowe, appealed to the State of Louisiana First Circuit Court of Appeal to argue two of the due process matters: 1) the board used attorneys from the same law firm, and 2) the board’s prosecuting attorney had been previously involved with Cerwonka in a child custody case and fee dispute.

In April 2018, the Court of Appeal agreed with Lowe and the matter was then returned to district court for further proceedings.

In another lawsuit, related to the LSBEP complaint, a husband and wife brought a civil suit against Cerwonka in the 15th Judicial District in Lafayette. The plaintiffs sought damages for injuries due to alleged sexual misconduct and malpractice by Cerwonka.

That trial ended in October 2018 when the Lafayette jury concluded that there was no cause of an injury to either the wife or the husband due to Cerwonka’s actions.

However, the jury did find that “… Dr. Cerwonka was negligent, i.e., acting below the level of the ordinary employee, under similar circumstances by the members of his profession,” in his treatment of the wife. No negligent acts were attributed to Cerwonka for the husband and the jury awarded no damages to either the husband or the wife plaintiff.

On January 29, 2019, shortly before Judge Caldwell gave his February decision, the attorneys for the couple who had filed the Lafayette civil suit, submitted a Motion and Order to File Amicus Curiae Brief–a Friend of the Court, with Judge Caldwell in Baton Rouge.

In the 36-page Brief, the attorneys for the Lafayette couple, Edward Walters, Jr. and J.E. Cullens, Jr., presented arguments and opinions against Cerwonka, including excerpts from the Lafayette trial and depositions.

Currently, the LSBEP is also waiting on another legal battle over time limits, which has been on appeal but apparently dormant since 2015.

The time limits case, Dr. Cerwonka’s case, and another investigation of Dr. Alicia Pelligrin which was dismissed under the encouragement of the Board’s general council, contributed in part to skyrocketing legal fees coming out of the Board’s 2014, 2015, and 2016 complaints subcommittee.

According to public records the Board’s escalating legal fees stemmed primarily from fees from the Board Prosecutor, held at that time by Mr. James Raines. Over 2015 to 2016, and into January 2017, Mr. Raines prosecuted 16 cases. Three of these 16 cases amounted to $146,987 of fees from Mr. Raines.

The Board worked in closed meetings during 2018 to create reforms to its complaints subcommittee process. Mr. Raines no longer appears to be one of the Board’s contract attorneys.

Dr. Moore Top Vote Getter for State Psychology Board

Dr. Michelle Moore received the top number of votes in the recent election to fill an upcoming seat on the Louisiana State Board of Examiners of Psychologists. The position is the 2019–2014 opening left by the normal completion of service by current Chair Dr. Jesse Lambert.

Dr. Moore received 111 of the 225 votes cast, of a possible 791 who received ballots. Dr. Gina Beverly received the next highest number of votes, 73. Drs. Lauren Rasmussen and Lisa Tropez-Arceneau received 35 and 24 votes respectively. Dr. Moore will be recommended to the Governor by the Louisiana Psychological Association, as the top vote getter, sources said.

In a related story, current LSBEP member Dr. Leah Crouch will be resigning due to an upcoming relocation to Korea this May, as was announced at the most recent LSBEP meeting. Another election will be scheduled, reported Dr. Kim VanGeffen.

Dr. Michelle Moore has been a consistent figure in the psychology community and holds several prestigious positions including Clinical Associate Professor of Psychiatry, LSU Health Sciences Center, New Orleans, LA, Department of Psychiatry, Section of Psychology, and Training Director of Clinical Psychology Internship Program.

From 2016 to present her research and scholarship has included: Working with ReNEW Charter School Network to provide needed clinical services to students either in special education or seeking evaluations for possible special education services; Primary Investigator and Mentor, Asian-American Mental Health among Medical Students; and Primary Investigator, Collaborating with Community Partners Collaborating with other psychology faculty at LSUHSC to assess the effectiveness of utilizing professionals in the New Orleans community to train psychology interns on various specialty topics.

Her publications include “An Examination of an Interactive Substance Abuse
Prevention Program for High School Students,” Journal of Child and Adolescent Substance Abuse; “Finding Your Voice Through Publications.” Louisiana Psychological Association; and Colorful Emotions: A Workbook to Help Children Express Their Feelings.

She is a member of the American Psychological Association; Association of Psychologists in Academic Health Centers; Louisiana Psychological Association; Southeastern Psychological Association; and Association of Psychology Postdoctoral and Internship Centers.

“In my current role as Training Director for the internship program at LSU Health Sciences Center, School of Medicine,” Dr. Moore said in her statement, “I have the pleasure of directly training students and trainees who are the future of our profession. Being in this position, I would bring a unique perspective to the Board from the graduate program applications we review, the training of psychology interns and fellows and how we are preparing individuals for independent practice. […]”

And, “Our licensing requirements exist to protect the public and ensure that we are bringing ethically minded psychologists into practice in Louisiana. We also want the public to feel confident about the practice of psychologists across the state and for all of those currently practicing to have great respect for upholding their responsibility as a psychologist. As psychologists, we should always ensure that we have a seat at the table and are ready to have our voices heard.”

Gov. Announces Work Training Program For Medicaid Recipients

Gov. Edwards announced the creation of a work training program for Medicaid recipients. He joined Dr. Rebekah Gee, secretary of the Louisiana Dept. of Health (LDH) and Louisiana Delta Community College Chancellor Dennis Epps to sign a Memorandum of Understanding (MOU) to officially create a collaborative pilot work training initiative between LDCC in Monroe and LDH. The overall goal of the pilot is to develop a work training promotion program model that can be customized by communities across Louisiana.

“We are excited to be able to announce this pilot program that will build on the existing success of the State’s Medicaid Expansion efforts,” said Gov. Edwards. “It offers a practical and Louisiana-specific approach to connect expansion recipients to viable training opportunities that will lead to better jobs and better-earning potential. Creating a program that is helpful but not punitive is something we have consistently been working on. State lawmakers came together and spoke loud and clear on this issue. And with the recent court decisions against the faulty design of similar programs in other states, we are even more convinced that this is the correct path to take. I want to thank everyone who has made this possible and especially Rep. Katrina Jackson and Representative Frank Hoffman for their leadership and guidance in this effort.”

The pilot will include two LDCC campuses – the main campus in Monroe and the campus in the city of West Monroe. The first invitations to participate will be distributed this summer and will continue throughout the year. The pilot will be implemented in two stages, and the time participants will have to complete the program depends on which course of study they select. A total of five training programs will be offered:

Certified Nurse Assistant (CAN)/Behavioral Health Technician (239 Hours); Commercial Vehicle Operations (CVO) (160 Hours); Environmental Services Technician (120 Hours); Forklift & OSHA 10 (Wagner Special) (24 hours); Mortgage Documents Specialist (18 Hours)

Argosy University Folds; APA Pledges to Support Doctoral Students Caught Up

Officials at the American Psychological Association said they will do what they can to support students at the 10 doctoral programs at Argosy campuses across the country following the closing of that university in March.

“With the mandated closing of Argosy University, the American Psychological Association has pledged to do everything it can as an accreditor to facilitate the transition of psychology doctoral students into other APA-accredited programs at the institutions standing ready to receive them,” noted the press release by K. Mills on March 10.

Sources stated that Argosy has been struggling financially for some time. On February 27 the Washington Post reported, “Court documents attribute the missing money to the financial unraveling of Dream Center Education Holdings, a nonprofit group that acquired Argosy, South University and Art Institute campuses in 2016. The Los Angeles company struggled to turn the for-profit colleges into thriving nonprofit schools, and spent months trying to close and sell campuses to meet financial obligations. When it fell short, Dream Center in January entered into receivership, a form of bankruptcy.”

The court-appointed receiver sent a letter to the Education Department showing cash flow where Argosy used $4.2 million of financial aid funds to pay staff, $2.1 million to pay vendors, and $1.7 to fund operations, according to the Post.

Dr. Margaret Smith, now with the Chicago School at Xavier, said, “I previously taught for 10 years at the Illinois School of Professional Psychology at Argosy University Chicago and have been concerned since students reached out to me when the receivership occurred. It’s been a highly traumatic experience for the doctoral students enrolled in the program, as well as faculty who’ve been there prior to it ever being Argosy, when they were a free standing program.”

According to the APA press release, “The American Psychological Association has been working with programs, institutions and the Department of Education in an effort to ensure that psychology doctoral students affected by Argosy’s alleged misdeeds are able to complete their degrees,” said APA President Rosie Phillips Davis, PhD. “Our No. 1 concern is that these students and their teachers are not further penalized by the rapid demise and closing of the Argosy campuses. Some of these students were months away from graduating and entering the workforce to provide mental health care and other vital contributions to society. The top priority for the Department of Education and institutions around the country must be to ensure that the futures and the investments by these students are not jeopardized.”

Responding to calls and emails from affected students, faculty, and other concerned parties. APA established a Psychology Student Action Center (psychstudentactioncenter@a pa.org and 202-336-6014) to direct members of the Argosy community to appropriate resources and created a webpage with referral information and FAQs.