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How Have Things Changed

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“How Have Things Changed?” Psychologists Share Their Experiences in Dealing with the Coronavirus Pandemic

We asked a group of psychologists, “How have things changed for you in the shut-down and how are you doing at this point?” About half replied back in time for this issue. In this feature we report on how colleagues are managing the changes, mostly verbatim with some edited for length.

Dr. Gail Gillespie has been in private practice in New Orleans since 1996, specializing in evaluating and treating school-aged children and their families. “Existence in the time of a pandemic Gillespie said. “Because about 80% of my practice is face-to-face assessment, 80% of my business came to an abrupt halt. Thankfully I qualified for the Paycheck Protection Program and I am very grateful for the two months of income that will be replaced and forgiven. In the interim, I am catching up on my to-do list that I never thought I would have time to get to. This tech dinosaur has also learned how to do teletherapy and Zoom meetings, and I have finally created a weekly Zoom meeting demonstrating Emotional Freedom Technique which I am offering for free to front-line healthcare workers, gig workers, service industry folks, anyone who has lost their income, and anyone who has experienced the death or severe illness of a loved one due to Covid-19,” she said.

“In this time in which the entire earth has taken a pause – a once-in-a-lifetime opportunity of forced stillness – I am afforded the opportunity to re-assess my priorities. Living in the French Quarter, I am finally able to truly appreciate the amazing architectural beauty and history in which I am surrounded. For the first time I look forward to walking down Bourbon Street – because it is clean and completely empty! I am now more cognizant of what is truly important: quality human connection, stillness and self-reflection, exuberant experiences and adventure to be created, an appreciation for nature, and prioritizing activities that boost my immune system and reduce stress! I have gained clarity in what activities in my practice feed my soul and what activities that I am ready to release. I have honestly enjoyed this pause but am looking forward to manifesting a more quality, exciting and adventurous life!”

Clinical Neuropsychologist, Dr. Matthew Holcomb, is also in private practice in the New Orleans area. “The shut-down has been hard on a professional and personal level,” Dr. Holcomb said. “Professionally I was just starting to ‘hit my stride’ and my identity as a professional was starting to finally solidify. The momentum that I had built feels like it has stalled out. It’s also been a time for reflection, in that I have been solidly career focused for the last few years and COVID-19 has forced me to stop and take stock of where I am in life and the choices I’ve been making,” he said.

“Personally, its been an adjustment having so much free time on my hands. The first few weeks was wrapping up patient evaluations. Then some time getting caught up on some manuscript writing, but after that its been rough figuring out how to ‘fill my day.’ I routinely talk to some of my elderly patients about ‘having a plan’ for their retirement. Not being sedentary and making plans. I’ve realized how important that is at all ages and stages in life. Making a plan each night of things to do around the house (no matter how small) or goals to accomplish for the next day, or in the near term have been so helpful in getting me through the shutdown,” he said.

“Finally, I have spent a lot of time reconnecting with family. Happy Hour and game nights over zoom have created some treasured memories.”

Dr. Thompson Davis III, Professor of Psychology at LSU Baton Rouge and Director of the Laboratory for Anxiety, Phobia, & Internalizing Disorder Studies has revamped his desks.

“My new ‘mobile workstation’ at the kitchen table composed of my iPad linked to my laptop via Duet for use as a seamless second monitor so I can use my laptop while I zoom/team/etc. while I also have one of my children’s room monitors on hand to be sure things aren’t getting too wild! Confidential video meetings are of course done in a separate room,” Dr. Davis said.

“I think one of the biggest changes is that my work day and work week have extended and bled together (i.e., the day is longer and I’m working even more on weekends than before) as I and my wife trade off roles as telecommuters, preschool/kindergarten teachers, parents, spouses, etc.”

Dr. Alan Coulter, a licensed psychologist in practice now for his 51st year, maintained a small number of clients as a school psychologist providing organizational development consultation, before the COVID19 sequestration.

“My work was largely face-to-face involving travel,” he said. “In this new, temporary period, I have maintained those clients at about 75% of the previous activity level. Some of past work is ‘on hold’ until schools return to typical locations. Predictably, some new work with these clients has emerged focused on adapting to closed school buildings and physical distancing. Maintaining social emotional connections with clients has become a more deliberate task as everyone learns to ‘zoom’ as a way of routine communication. I expect this new form of doing my work to continue for six to twelve months. I agree with others, ‘We’ll get through this.’ And we’ll all learn new skills that will make us more effective and helpful to our communities.”

Dr. Bill McCown is Coordinator of the Psychology Program at University of Louisiana at Monroe and Associate Dean for Research, College of Business and Social Sciences, as well as a Licensed Clinical Psychologist.

“We are working our butts off! It is just nonstop. We are not in the front line but darn, it is incredible. Most college professors are keeping unbelievable hours. From what I’ve seen in every department, all are working nonstop in ways they could not have imagined a few months ago,” Dr. McCown said.

“We do everything we did previously: we prepare lectures, grade assignments, advise students, write letters of recommendation, conduct research. But we also have to find innovative ways to teach and reach students, many of whom are stressed and vulnerable.

“Today’s highlights: ‘My grandmother died. My father tested positive last week. Can I be late on assignment five?’ and (from an Intro Psych student) ‘Do you really think this virus stuff is real or is it made up? My parents are having an argument and I have to ask someone I can trust.’

“Each student and class is different and has unique needs. Fortunately, our deans, administration, and Supervising Boards realize the need for local solutions,” he said. The key has been that we have been given the freedom to respond locally. Academics are generally pretty creative people and their heart is in their work. Like psychologists, they can usually find really good solutions if given the chance.

“There is no manual for this sudden transition, no guru, no roadmap. Faculty creativity has been exceptional. So has student commitment and effort. I’m struck by the number of students who now have unexpected obligations. Some are taking care of siblings, others of sick family members. Many have stepped up to volunteer to help their communities in any way they can. Some are also working jobsany jobs they can find- to help support their families. It’s hard for these students to maintain the academic focus they had in March. But they are really trying,” he said.

“Many students turn to Psychology faculty for objective information. They trust us and ask all kinds of questions! They know our profession is evidence-based. We answer lots of questions. We help them read data and understand the risks and models. What we don’t know we look up or refer to someone who does.

“Other students, frankly want counseling or therapy from us now, probably for similar reasons. They know us and that we are believable. We are evidence-based. What we say makes more sense to them than what they hear on social media. Psychology faculty have to be especially careful to avoid any dual relationships. But what I’ve seen they’re doing a great job in being helpful to these students while also being mindful of ethical issues. We listen and make lots of careful referrals.

“Perhaps just as importantly, we convey a sense of optimism and reasonableness. This helps combat the gut feeling that everything is out of control. Life will get better.”

Dr. Katherine Robison practices in Metairie and works evaluating youngsters. “How have things changed in the shut down? I’m a school psychologist in private practice in the New Orleans area. With regard to my practice, I’m basically shut down since I can’t test kids ‘virtually.’ I am utilizing online or ‘remote administration’ rating scales, but this is a small part of the evaluation. I have used Zoom for a few tele therapy sessions, but it’s ‘not the same’ as an in-person session since I see children. I am happy to have finally caught up on reports!,” she said.

“On a personal level, I really miss being around people! But the shut-down has been good for me in some ways. I’m spending time outdoors and enjoying bike rides through City Park.”

Dr. Charles Burchell is a licensed Clinical Psychologist who has had a largely independent practice for over 35 years, and lived and practiced in Baton Rouge, New Orleans, and Texas. “I suppose my life mirrors that of many others that you know. Back in March, on the advice of my primary care physician, I changed to working from home at one parttime position; and my consulting practice is now one-hundred percent online. Professionally, I conduct business through a combination of mostly emails and HIPPAcompliant TeleHealth services. I’ve been attending more webinars and am planning to virtually attend a Forensic Psychology conference,” he said. Dr. Kim VanGeffen is in solo private practice in New Orleans. “COVID-19 has required adapting to many changes and a lot of flexibility, neither of which are my strong suit. I have switched to doing tele psychology and phone sessions although my billed hours have drastically dropped. Before the stay-at-home orders, I did a large amount of psychological testing which is not possible now. I look forward to seeing people in my office again as I find that I prefer face-to-face work over tele psychology. I am trying to maintain my natural optimism and to find as many of the silver linings in these clouds as I can. I am using the extra free time to catch up on office paper work which had been neglected for the past several months. I am also on the Board of Directors of LPA and our Board is spending a lot of time trying to provide services to our members during these trying times. Keeping busy and productive keeps me sane. I am also keeping in touch with family, friends and colleagues by email, on line gatherings and telephone chats which is very important when we are so isolated.”

Dr. Charles Burchell is a licensed Clinical Psychologist who has had a largely independent practice for over 35 years, and lived and practiced in Baton Rouge, New Orleans, and Texas.

“I suppose my life mirrors that of many others that you know. Back in

March, on the advice of my primary care physician, I changed to working from home at one parttime position; and my consulting practice is now one-hundred percent online. Professionally, I conduct business through a combination of mostly emails and HIPPAcompliant TeleHealth services. I’ve been attending more webinars and am planning to virtually attend a Forensic Psychology conference,” he said.

“On a personal note, I stopped attending religious services even before modifications in ritual and eventual cessation of public gatherings had been announced. I stopped going into WWOZ, the community supported FM radio station in New Orleans (online at wwoz.org) for my weekly Friday show, ‘Jazz From The French Market.’ Instead, like some others, I record the shows at home instead of a live presentation. I didn’t have a problem with feeling safe at ‘OZ; I just was, and am, obeying the ‘stay at home’ government recommendations. Going to the radio station would have been a weekly 180- mile trip.

“Of course socializing in person is nonexistent, so I call, text, FaceTime, IG, Facebook, tweet, and use Messenger to maintain that very human contact. This is especially useful for staying in touch with close friends (one whom I have known since age three) and my two adult children (one who currently lives in Rome, Italy).

“Days are filled with professional tasks, and watching all kinds of TV (including participating with a small group of friends for Netflix parties who used to meet up to see movies in theaters), more reading, and cleaning (no positive correlation here between motivation for housework and increased time availability). I’m more motivated to learn Italian on my Duolingo app; before the pandemic I might have time to use it two or three times a week or lessnow I’m up to 73 days straight!”

Dr. Traci Olivier is a pediatric neuropsychologist at Our Lady of the Lake Children’s Health Development & Therapy Center. She has a part-time practice at the Neuropsychology Center of Louisiana and serves as a local expert advisor for Cogstate cognitive science research company.

“As a pediatric neuropsychologist, my practice is primarily focused on neuropsychological evaluations.,” she said. “There has been much discussion in professional circles about the feasibility, validity, and ethical considerations of using telemedicine for psychological and neuropsychological testing. After much research and contemplation about using tele-testing, I decided not to pursue this avenue of service delivery. Therefore, my time has been dedicated to completing current evaluations (e.g., providing feedback, finalizing reports) and seeing new patients for initial visits – all via telemedicine, or video visits. The use of telemedicine platforms and the quietness around the office are perhaps two of the most significant changes that I have noticed. My practicum students are on hiatus for now, which is also a change. Interestingly, this time has been a welcome period of rest and refreshing – a time to catch up, contemplate priorities, and plan for the future. I realize that there are those who have become incredibly busy over the past several weeks, and for many, this is a time of significant stress. My heart goes out to those people. I am so blessed, however, to be able to use this time to plan and invest.

Dr. Jamie Landry, is married with two, energetic, fun-loving boys. She is in the Covington, Mandeville area and notes that she loves camping and the outdoors.

“With a part time practice focused on assessment, most of my work has been put on hold during the stay at home order. Like many others, I’ve been spending more of my time with my family, keeping my kids engaged in some educational activities and having some good old fashioned family fun. I’m doing well but look forward to achieving a sense of normalcy again.

Dr. Randee Booksh is a licensed clinical and neuropsychologist. “My small private practice is split between neuropsychological/psychological evaluations and therapy patients. I work with two other neuropsychologists who do the same and we share many resources, including a testing assistant, office space, and testing materials, etc.” Dr. Booksh said.

“So what has changed? I only go to the office to pick up supplies or mail. I see patients via telemedicine, which I had never done before, except an occasional emergency phone session. Now I see my established therapy patients and a handful of new patients and conduct some brief psychological evaluations when I feel I can answer the referral question via tools I can use during a video session. I cannot conduct neuropsychological evaluations this way. I’m working much fewer paid hours, but the work is harder. Everything I do at home takes longer than if I was at the office,” she said.

“The telemedicine curve has been steep for me. I find it requires more preparation, a different kind of attention, and use of different tools. At the same time, I’m immensely grateful that it’s available and I know that I will continue to do some telemedicine indefinitely. Patients are significantly more distressed, with so many in crisis. Established patients with anxiety and trauma related disorders are really struggling and finding it difficult to maintain gains made in therapy, previously. I’m experiencing increased stress, anxiety, and fatigue too. I’m finding I need greater self-care to be prepared and able to meet the changing needs of the patients I see.

“Focus on the shared practice has shifted to when and how we will (eventually) reopen and what that will look like. We’ve developed a strategy to start low and go slow. We’ve written a safety plan, posted important safety guidelines on the wall, and removed chairs from the waiting room. We are staggering times and using alternate entrances, so patients don’t come in contact with each other. We’ve purchased lots of hand sanitizer, face shields, acrylic desk partitions, masks, Lysol wipes, etc. I cannot imagine trying to figure this out or implement it by myself. My colleagues and coworkers made it possible.

“As far as my home life, the biggest change is I spend a lot, and I mean a whole lot, of time with my husband. He’s an audiovisual technician, labor coordinator for conventions, and musician, so all of his work has cancelled for the remainder of the year. Luckily, we get along really well. Again, hooray for technology, but I’m sure getting tired of virtual family visits. I get dizzy when the grandkids run with the phone during Facetime and I can’t wait to put my hands on the bellies of my two pregnant daughters. Overall, I think I’m adapting very well. I’m extremely fortunate with many resources and it can still get overwhelming. I can’t imagine trying to do this alone.

Dr. Melissa Dufrene has worked full-time in private practice at her office in the Algiers neighborhood of New Orleans for the last 6 years. She primarily provides individual therapy, but also completes 1-2 testing cases per work. She is married with two young boys (ages 2 and almost 5).

“Since quarantine,” Dr. Dufrene said, “I have been seeing my clients via a telehealth platform (doxy.me). Fortunately, I had been using this platform as needed for several years. In that way, the transition was easy. However, I am now only working 20 hours/week because my two kids obviously are staying at home. This has required managing a strict schedule and coordination with my husband’s work, who works in an essential field,” she said. “For me, one of the greatest struggles has been the immediate shift between caring for the boys and diving right into my therapy appointments, then right back into parenting. This last week I took two days off because I felt I needed a respite from clients. I have also had to decline new clients and requests for other types of work. At the same time, I’m thankful for the strict scheduling that has been needed because it is keeping me very busy. I am also extremely thankful for the lovely weather that Louisiana has bestowed upon us in recent months. Clinically, this has been an interesting experience. My client’s responses to the current situation range from, “Nothing is going on. I’m bored and have nothing to talk about.” to significant emotional turmoil. My main points of emphasis with everyone has been empathetic support and normalization. I believe these approaches have provided immediate relief from the self-judgment that many people are battling. Quite frankly, I think one of the most important, and mutually beneficial aspects of therapy has been socialization.”

Dr. James (Pat) Thompson, is a clinical psychologist in Houston, but attended Tulane University his freshman year and maintains such a close connection to New Orleans that he is also licensed in Louisiana and is an active member of the Louisiana Psychological Association.

“These are indeed sad, weird, and frightening times for everybody and that includes psychologists. The COVID-19 crisis has changed everybody’s life,” Dr. Thompson said. “If someone had told me six months ago that I would be doing psychotherapy sessions entirely by telehealth, I would have thought they were schizophrenic.

If someone had told me six months ago that I would be frightened and wearing a mask every time I go to the grocery store, I would have thought they stopped taking their medication. If someone had told me six months ago that I would be instructing patients to avoid in vivo meetings with friends and family, I would have thought they were taking some bad drugs. If someone had told me six months ago that I would be telling patients to not attend Easter services in person, I would have thought they were off their rocker. If someone had told me six months ago that I would not be able to eat inside my favorite restaurants in Houston and/or New Orleans, I would have wondered if there was something in the water they were drinking,” he said.

“I visited my favorite place in the world, New Orleans, the weekend after Mardi Gras this year. When I arrived in New Orleans, there were no COVID-19 cases in Louisiana. On the day of my departure, while I was waiting for my plane at the Louis Armstrong Airport, the Times Picayune reported one case in Jefferson Parish which was subsequently transferred to the Southeastern Louisiana VA Medical Center. We all know what happened from there. If someone had told me six months ago that I would not be able to visit New Orleans, I would have laughed in their face.

“While I was in New Orleans in early March, I attended two public performances. I had a great time at both events. The first one was at the Fillmore and I saw the bands Sweet Crude and Rebirth Brass Band. I just learned today (4/30/2020) from an article in the Times Picayune that two of the band members of Sweet Crude were positive for COVID19. Today I also learned that rashes and blisters on the fingertips are some of the symptoms of COVID-19. About two weeks after I visited New Orleans, I developed these symptoms along with diarrhea and muscle pain. I went to my PCP and it was early in the crisis and they did not do a test for the virus. I am wondering if I was exposed and if I have antibodies. I called my PCP and she told me that tests for antibodies are not readily available.

“I have two patients who are positive for COVID-19. They are learning from me and I am learning from them.

“I am already missing New Orleans. I will miss attending the LPA convention and most likely the workshop in the fall. I missed attending the French Quarter Festival and am missing attending plays at Le Petite Theater. I will most likely miss the Tulane homecoming game and the Tulane Psychiatry conferences that I have been attending for the last few years. I cannot imagine what a season without the Astros, LSU Tigers, Tulane Green Wave, University of Houston Cougars and the Saints will be like,” he said.

“I remember the morning that Katrina was approaching New Orleans. I was gripped with fear and anticipation as I thought about what the storm might do to my favorite city. This crisis has the same feeling, but it is on a global scale.

“It is strange and awkward working with patients by telehealth. Sometimes it is difficult to hear what they are saying. Sometimes it is difficult for them to hear what I am saying. I am finding that some patients who suffer from severe problems communicating with other humans are very happy to be forced to stay at home and have no human contact. Other patients who have intact social skills are suffering deeply and report feeling like they are in prison in their own home.

“The impact on the African-American community and their rich culture, music and history in Houston and New Orleans makes me cry.

“This is a time for everyone to muddle through this crisis the best we can and to remain adaptable and cooperative. It is important to extend our help to others and reach out for help when we need it ourselves. I have opposed telehealth as a means of conducting psychotherapy for years. I am seeing its merits now and realize it has possibilities for the future after the virus has subsided. My motto now is to bend with the prevailing winds like a birch tree. We can get through this catastrophe together. United we will stand. Divided we will fall.”

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Legislature Could Dump 66% of Bills

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Legislators are slowly finding their way back to the 2020 legislative session after they suspended activities the second week in March due to the coronavirus cases in the region.

Required to adjourn on June 1, lawmakers will have less than 30 days to create a budget for the state, approve 300 or so appointees, and restructure state agencies that are scheduled for sunset. Only about a third of the bills previously filed will be addressed, reports Mark Ballard of the Advocate.

Only about a third of the bills previously filed will be addressed, reports Mark Ballard of the Advocate.

Ballard noted, “Senate President Page Cortez, R-Lafayette, and House Speaker Clay Schexnayder, R-Gonzalez, asked members to prioritize the legislation each had filed for what was supposed to be an 85-day session beginning March 9. About a third of the legislation will be heard with emphasis on measures dealing with COVID-19 responses, the economy and the budget. About a third of the proposed legislation will get a hearing, Cortez and Schexnayder said.”

The lawmakers have met very little during the interim and mostly to start the process of new bills that would be focused on combating the coronavirus and other problems related to the states economy and sinking oil prices.

Senate Bill 458, the ambitious set of changes to the psychology practice law initiated by the Louisiana State Board of Examiners of Psychologists (LSBEP) is not currently on the schedule. The measure is on hold after officers from the Louisiana Psychological Association (LPA) raised objections. A task force was established to develop a consensus regarding the measure and is still deliberating.

If passed SB 458 would make sweeping changes to the psychology law including a new set of regulations and fees for assistants, expanding the charter of the board, removing certain qualifications for serving, authorizing the board to conduct continuing education, exempting the board from Open Meetings Law for investigatory meetings, and formally establishing the position and duties of the Executive Director.

Some of the bills that have made it to the calendar include:

HB 243, by Rep. Lyons, exempts persons with disabilities from fees associated with obtaining medical records.

HB 473, by Rep. Duplessis, eliminates the 12-month mandatory minimum supervision period for defendants who elect to undergo treatment while participating in a drug division probation program.

HB 498, by Rep. Emerson, requires licensing boards to waive fees to applicants who meet certain criteria and to offer payment plans. Those applicants will qualify if they are receiving public assistance and earning less than 200 percent of the federal poverty guidelines.

HB 449, by Rep. Echols, provides relative to behavioral health services delivered via telehealth and regulation of such services by the La. Department of Health. Present law, the Louisiana Telehealth Access Act (R.S. 40:1223.1 et seq.), defines “telehealth”, in pertinent part, as a mode of delivering healthcare services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education, care management, and self-management of patients at a distance from healthcare providers. Proposed law amends this definition to provide that healthcare services delivered via telehealth include behavioral health services. Present law, the Behavioral Health Services Provider Licensing Law (R.S. 40:2151 et seq.), requires the La. Department of Health to promulgate rules and regulations for behavioral health services providers. Proposed law provides that such rules and regulations address the delivery of behavioral health services through telehealth.

Other measures that may or may not be heard include:

HB 45, HB 48, both by Rep. Miller, provides a deadline for Title 37 licensing boards reports to be submitted and shifts the receipt of reports and complaints to the legislative auditor instead of the House and Senate governmental affairs committees. HB 48 removes provisions requiring Title 37 licensing boards and commissions to give notice that complaints about actions or procedures of the boards may be submitted to the board or commission or to the House and Senate governmental affairs committees.

HB 138, by Rep. Wright, requires the use of video cameras in classrooms where special education services are provided to certain students with exceptionalities.

HB 195, by Rep. D. Miller, removes the requirement to submit proof of active hospital privileges for a new healthcare provider in a group practice who bills an insurer using the group practice’s identification number prior to credentialing.

HB 158 by Rep. Marino, authorizes the recommendation of medical marijuana to patients by physicians for treating several neurodegenerative diseases and conditions.

HB 338, by Rep. Duplessis, requires the reporting of certain physical and mental health information of an offender appearing before the committee on parole for a parole hearing. Proposed law retains present law and adds information regarding the physical, mental, or psychiatric condition of the offender, when available, to the list of information included in the report secured by the department.

HB 485, by Rep. D. Miller, provides admitting privileges to psychiatric mental health nurse practitioners for preparing and executing orders for the admission of patients to licensed psychiatric treatment facilities. Proposed law retains present law and adds psychiatric mental health nurse practitioners may admit persons with mental illness or suffering from a substance-related or addictive disorder pursuant to present law.

HB 505, by Rep. Bishop. Proposed law establishes the licensed profession of art therapist in La. Provides for licensure of art therapists by the La. State Board of Medical Examiners.

HB 663, by Rep. Hughes revises school discipline laws. Present law provides relative to student discipline. Proposed law provides a comprehensive revision of present law, applicable to all public schools, including charter schools.

SB 128, by Sen. Barrow, requires certain assessments of a student prior to suspension from school. Proposed law requires the principal, prior to suspending a student, to ensure that the student is assessed using an instrument, such as the Adverse Childhood Experiences Assessment developed by the Centers for Disease Control, that is designed to determine if the student has experienced trauma, and whether the student’s behavior may be better addressed in a manner other than through suspension.

SB 170, by Sen. F. Mills, provides relative to health care emergency visit alternative treatment reimbursement. Proposed law establishes an enhanced Medicaid reimbursement rate for hospitals that triage nonemergency Medicaid recipients presenting at the hospital emergency department to a hospital primary care clinic when such transition is appropriate.

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For Now, Behavior is the Key

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“There’s no magic bullet. There’s no magic vaccine or therapy. It’s just behaviors”, said Dr. Deborah Brix of the White House Coronavirus Task Force. “Each of our behaviors, translating into something that changes the course of this viral pandemic, over the next 30 days.”

The current crisis brings into sharp focus the limitations our health systems in fighting any new, stealth, and lethal virus. Behavioral intervention is not one of traditional medicine’s strengths––reflected in Medscape authors’ use of the term “non-pharmaceutical intervention” to describe social distancing.

While pharmaceutical treatments are being developed, the “behavioral immune system” and lifestyle interventions that support natural immunity are the key

The new virus is highly contagious, transmitted through the air, from those who are asymptomatic––estimated to be up to 50%. Since the virus may avoid our usual pathogen detection, efforts have been to raise our conscious awareness. Heightening this behavioral immune system–so we learn to automatically wash our hands, resist touching our eyes, or take three steps back from another–is becoming the new normal.

A second avenue of behavioral intervention is to support the innate immune system for individuals. Evidence is also mounting that the new virus might somehow bypass the innate immune defenses in some, or suppress immunity, an especially dangerous issue for older people and those younger people with deficiencies.

Self-care behaviors for natural immunity involve many lifestyle factors. One example is food choice. The immune system needs adequate vitamins A, B, C, K, Zinc and sunshine for D. Too much sugar, alcohol or caffeine is detrimental to the immune system, as is any amount smoking at all. Exercise boosts growth hormone and that enhances immunity. Lowering emotional stress supports immune functions. One of best and cheapest behavioral interventions for everyone is a simple and pleasant behavior–sleep. Yet, many in the U.S. don’t get their needed dose.

We have a myriad of ideas and methods for supporting the behavioral immune system and behaviors that increase the innate immune defenses. Even a 10% change in some aspect or another might be the difference between a person going to the hospital or staying out. For this special issue we cover topics for sleep, stress, and music, ideas for dealing with the pandemic and how psychology can help.

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Lullaby Blessings: Help for Families Stuck at Home

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Susie Marie, PhD

Musical Messages® – April 1, 2020

As infants, when we felt irritable and fussy, or were unable to relax and fall asleep, our mothers would wrap their arms around us, hold us close, and sing lullabies to us. These softly sung rhyming words, with their slow, steady, repetitive patterns of simple melodies, delivered with high pitched, deep emotional expression, in swaying triple meter, were the medicine we needed to drift into peaceful slumber.

The mother’s voice, la voix maternelle, has unmatched power to influence the growth and development of her young. Even before birth babies can recognize their mother’s voices, and as infants they prefer the voices of their mothers above all others. Mothers across the centuries and around the globe have used the power of their voices to influence their children through lullabies.

Lullabies are the vehicles through which mothers first teach their children important family stories and traditions, and share timeless cultural knowledge and values. Mothers also express their own troubles and worries, reassuring themselves and their little ones, through lullabies.

Gregor Roy MacGregor of Clan Gregor fought for years to reclaim family land that Robert the Bruce, King of Scotland, had granted to the chief of the Clan Campbell. When he was captured and killed in 1570, his widow composed and sang the lullaby Ba Mo Leanabh to her son. You can listen to her mournful tale here. https://www.youtube.com/watch?v=P7dW 1FtfS9Q

She sang of her plight while comforting her child, “On hush-a-bye, my little baby. Hush, my little baby, hush. Oh hush-abye, my little baby. My own little baby will go to sleep. Though I am without a flock of sheep, And the others all have sheep, Though I am without a flock of sheep, You, little baby, can go to sleep.”

She also sang of the strength of her devotion as she relayed the tragic truth of her child’s father’s fate, “Darling, of the people of the great world, They spilt your blood yesterday, They put your head on an oaken post. A little way from your corpse I breathlessly climbed the great mountain, I climbed and I descended. I would put the hair of my head under your feet, and the skin of my two hands.”

No matter what the circumstances of her life, a mother can establish a secure bond with her child through lullabies, which provide stabilizing comfort by modulating arousal and regulating behavior. Research on premature infants provides some of the most compelling evidence of the benefits of lullabies. Their breathing and heart rates improve, feeding and sleeping increase, they get better faster, and they are discharged sooner than babies deprived of “live” lullabies.

The electronic delivery of lullabies lacks impact for babies in hospitals and in homes. Babies want real, live females to sing their lullabies. One of the beautiful features of lullabies is that the lyrics are customized, adding special endearments and unique details, sometimes with silly words and intonations, that express love and affection, and the worth of each individual child. Babies need the intimate, personal interaction of traditional lullabies that mothers through-out the world have provided for centuries.

Screened presentations of lullabies, such as those available through Apps and YouTube, are generically produced, lack understanding of children’s social and developmental needs, and are promoted by unscientific testimonials. These productions have corrupted the classic definition of lullabies. They use male voices and instruments, and instead of lulling a baby to sleep, they function primarily as ways to settle a baby by signaling a specific family routine.

Children whose mothers sing lullabies to them through-out the first year of life have significant advantages over children deprived of such a rich musical heritage. Lullabied babies show greater growth across multiple developmental realms. Music activates many parts of the brain simultaneously, and establishes strong foundations for speech and language, mathematical and spatial skills, sensory and creative development. Dr. Nina Kraus of the Auditory Neuroscience Laboratory of Northwestern University aptly describes music as the “quitessential multimodal activity.”

The Polish composer Frederic Chopin gave the world a new musical form in 1844 when he completed his, a cradle song. (Le berceau is French for cradle.) He is thought to have been inspired by Louisetta, the child of his musician friend Pauline Viardot, and by a song from his childhood, “The moon now has risen, the dogs are asleep.”

German composer Johannes Brahms gave us his berceuse, Wiegenlied, a lied (art song) for piano and voice in 1868, which is best known as “Brahms Cradle Song,” one of his most popular works. He too was inspired by a friend who was a mother, Bertha Faber, when she gave birth to her second son. In 1877 Brahms incorporated this melody as the second theme of the first movement of his second symphony. The second theme begins at bar 82 and continues through-out the movement. You can hear that first movement here. https://www.youtube.com/watch ?v=uJ3AOeNfWy4

Brahms original lyrics were, “Good evening, good night, With roses covered, with cloves adorned, Tomorrow morning, if God wills, you will wake again. Good evening, good night, By angels watched, who show you in your dream, the Christ-child’s tree. Sleep now blissfully and sweetly, see the paradise in your dreams.” These words express Brahms’ appreciation of the ultimate security a mother provides, by protecting her child even beyond death through faith.

Today we know this piece, so popular in music boxes, as “Brahms Lullaby,” that begins “Lullaby, and good night” and continues “Lay thee down now and rest. May thy slumber be blest.” Twentieth century American lyricist William Engvick created new, simpler words for the melody, giving us “Close Your Eyes.” You can enjoy Rosemary Clooney’s version here. https://www.youtube.com/watch ?v=MOLOFTFatgc&feature=yo utu.be

In contrast to the peace and joy of the lullaby is the lament. A lament, as a passionate expression of grief that is prominent in Biblical texts, is an appeal to God for help. The initial wailing complaint is transformed through the process in which the petitioner addresses God, describes the suffering, pleads for divine assistance, expresses trust, and offers thanksgiving and gratitude, in anticipating of receiving relief.

Music therapists have developed “lullaments,” which combine both lullabies and laments, to help hospitalized children and their parents, and adult cancer patients in palliative care. Lullabies, which focus on attachment, nurturance, and growth, used together with laments, which emphasize detachment, sorrow, and loss, can help patients cope with uncertainty and fear of death. As our nation contends with the crises and tragedies of the coronavirus pandemic, lullaments can be an important resource to help ease suffering.

Lullabies, however, capture the blessings and fundamental freedom of a strong maternal bond. Perhaps we all need to envision ourselves embraced in a loving mother’s arms, lulled into peaceful sleep by the sounds of her sweet lullabies. Though the link below takes you to a lessthan-ideal digital format where I share a childhood memory and sing a lullaby inspired by roses, I hope that my Musical Messages® will help bring us emotionally close as we remain physically distant for the health of country.

Musical Messages®

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Sleep’s Gift to Immunity – Monocytes, Macrophages, and Natural Killer Cells

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“Sleep has been shown to be an important modulator of the immune response,” said Dr. Denise Sharon, MD, PhD, and Diplomate in Sleep Medicine. “Lack of sleep increases susceptibility to infection by decreasing immunity.” Dr. Sharon is a psychologist and physician and she now serves as Independent Consultant at Pomona Valley Medical Center’s Adult and Children Sleep Disorders Clinic.

Dr. Sharon previously served as Associate Professor of Medicine, Sleep Medicine Fellowship Faculty, and Assistant Clinical Professor of Pediatrics at the Tulane University School of Medicine in New Orleans, and also as director of the Comprehensive Sleep Medicine Center of the Gulf Coast.

“Sleep is a behavior,” Dr. Sharon explained, “and it is an important one for health.” Pointing to research by Besedovsky and others, “Sleep and immune function” in Pflugers Arch European Journal of Physiology, Dr. Sharon says, “Sleep supports the immune system through the initiation of an adaptive immune response.”

“There are two major types of immune response: innate and adaptive. Innate immunity is the first line of defense, the immediate generalized response to pathogens,” explained Dr. Sharon. “Adaptive or acquired immunity is an antigen-specific response and develops over time. The innate immune system cell types include monocytes, macrophages and dendritic cells. During sleep these undifferentiated immune cells peak in the peripheral blood and lymph nodes.”

“Growth hormone and prolactin are released during the same period of sleep and both enhance the proliferation and differentiation of the T cells, which are active in innate immunity. Natural killer cells–NK cells–are also affected by sleep,” she said, citing the research by Reis and others. “NK cells are part of the immune complement system whose activation is increased by sleep.”

“Sleep and immunity have a bidirectional relationship. The stimulation of the immune system triggers an inflammatory response that can induce an increase in sleep duration and intensity, but also sleep disruption. The enhanced sleep potentiates the immune system resulting in improved infection outcomes,” she said.

“Contrarily, sleep deprivation can lead to susceptibility to infections and if chronic to systemic low-grade inflammation,” she explained pointing to a 2019 study by Besedovsky and Lange, “The Sleep-Immune Crosstalk in Health and Disease” in Physiol Rev.

“There are huge numbers of people who are sleep deprived,” she said. “And it is a state in which negative emotion tends to prevail, like other strong need deprivation states.”

Clinical psychologist Dr. William Waters, long-time expert in the area of sleep would agree. “The whole country is sleep deprived,” he said in a previous interview. “You can’t do sleep deprivation research without feeling a little scared about traveling on the highway at night or early in the morning.”

Dr. Waters developed his interest in sleep during his years as Clinical Director at Louisiana State University throughout the 80s. An ABPP in clinical psychology with a strong psychophysiological background, Dr. Waters trained psychologists in sleep research and sleep medicine while Director and Full Professor at LSU. His first publication in the area of sleep was also in the 80s. He continues his interest at the Sleep Disorders Center at Ochsner Clinic in Baton Rouge.

“It’s not just sleep deprivation,” he said, “but the quality of sleep is very poor for many of those who actually do get enough sleep. For example, sleep apnea produces fragmented and light sleep that is not restorative, and causes the same functional decrements that are caused by sleep deprivation, including negative affect.”

Dr. Waters has worked in several areas of neuroscience research at the University of Missouri School of Medicine, LSU and the Pennington Biomedical Research Center. He holds fellowship positions in the American Academy of Sleep Medicine and he sits on the Board of Directors of the Louisiana Academy of Sleep Medicine. He is a Diplomate of the American Board of Sleep Medicine and the American Board of Professional Psychology.

Researchers have found that poor sleep patterns appear connected with a number of chronic illnesses, high stress hormones, hypertension, or a greater risk of diabetes and body mass.

“…And increased morbidity and increased mortality,” noted Dr. Sharon. “If we add intermittent hypoxemia, even mild, to the mix, the result is an inflammatory response that challenges the autoimmune system and contributes to plaque build-up.”

“Look for a middle-aged, overweight male or female,” said Dr. Waters, “and you are likely to find a problem with quality of sleep because they are likely to have sleep apnea. For psychologists, it is worth noting that sleep apnea will look a lot like depression,” he said.

As important as a full night of quality sleep is, the National Sleep Foundation’s data has revealed that 33.7 percent of responders said they did not get the amount of sleep they needed. And only 40 percent said they get a good night’s sleep every night or almost every night.

“The one thing that will reliably destroy sleep is stress,” Dr. Waters said. “No matter what the psychiatrists say, it is all continuous. If you want to take a point on the continuum and call it a disease you can. But stress–the psychophysiological responses–are aimed at getting you to deal with threat,” he said. “And then how likely are you to go to sleep?”

“Keep in mind that negative emotion is a stress response,” he said, “and therefore predictably disrupts sleep, delaying its onset, and making it light and interruptible. In other words, non-restorative.”

Helping a person get the rest and quality night sleep he or she needs was one of the first things that Dr. Sharon enjoyed in this specialty area. “Coming from psychiatry,” she said, “the first thing I liked about sleep medicine was instant gratification. The majority of our patients [obstructive sleep apnea, narcolepsy, restless leg syndrome] improve immediately after diagnosis and correct treatment with minimal if any side effects.”

“Sleep is the kind of area that clinical psychologists should be doing, it is just made for us,” Dr. Waters said. “We have a whole scientific discipline at our fingertips that is applicable.” He explained that the basic principles of behavior, applied to the treatment of sleep, is a perfect fit.

“Sleep hygiene and stimulus-control therapies are nothing more than applying what we know about sleep related behavior to make the person more likely to sleep,” he said. “Relaxation therapy is what we do to tone down activation. And remember that it is activation, particularly emotional activation, that causes insomnia and reduces the quality of sleep.”

Walter C. Buboltz, Jr. PhD, Professor, Director of Training Counseling Psychology, and his team of researchers at Louisiana Tech have worked to help unravel some of the complex issues in the area of sleep, for college students.

“Basically what we’re finding is people that have poor sleep quality tend to consume more food and weigh more over time,” said Dr. Buboltz, “Our hope eventually is to give them interventions or strategies to sleep better which would keep them healthier and decrease their weight.”

Dr. Janelle McDaniel, currently at University of Louisiana Monroe, and previously Assistant Professor and part of the team at Louisiana Tech, said, “It’s important to consider the interaction between different factors such as sleep and eating habits when thinking about wellness globally because treating one particular factor may not address underlying conditions.”

Dr. Buboltz and his team developed an intervention program for college students called the Step Program. “It’s basically training students to learn appropriate sleep habits, sleep hygiene and sleep education.”

Sleep hygiene, explained Dr. Buboltz, is “Doing things that promote sleep, like not drinking coffee past five, not working out at midnight or eating a lot of food before bed, but relaxing before going to sleep.”

Dr. Buboltz noted that their goal for these types of studies was learning about what’s appropriate. “Most people don’t know you’re supposed to sleep eight to nine hours a night. Most people don’t know about the amount of caffeine in food. Chocolate is actually worse for caffeine content than Coke! Colleges are bad about having intramural sports events at nine and ten o’clock at night and that prevents them from going to sleep.”

“We’re mainly focused on its effect on health,” Dr. Buboltz said.

With the overlap between major areas of psychology, psychophysiology, attention, emotion, Dr. William Waters finds this area to be perfect for those in psychology and the health promotion of patients. “The best clinician you can have is one with an integrated perspective,” he said.

Current research suggests that seven to nine hours of uninterrupted per night is necessary for the immune system to function optimally.

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Psych Board’s Ambitious SB 458 Filed in March

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A 23–page document, Senate Bill 458, outlining an ambitious set of changes to the psychology practice law was introduced on March 31. The legislative effort was initiated by the Louisiana State Board of Examiners of Psychologists (LSBEP) and is authored by Senator Jay Luneau from Alexandria.

If passed SB 458 will make sweeping changes to the psychology law including a new set of regulations for assistants, additions to the charter of the board, changing qualifications for serving, authorizing the board to conduct continuing education, exempting the board from Open Meetings Law for investigatory meetings, and formally establishing the position and duties of the Executive Director.

The measure is on hold after officers from the Louisiana Psychological Association (LPA) For Now, Behavior is the Key attended the public meeting of the board, held on Zoom, Friday, April 3, and raised objections. Attendees included current President Alan Coulter, President-Elect Erin Reuther, and Chair for Professional Affairs, Kim VanGeffen.

Following discussion on several matters regarding both how the bill was initiated and the content of the specific changes, Dr. Greg Gormanous, Chair of Legislative Affairs for LSBEP, put forth a motion to establish an Ad Hoc Legislative Collaborative Committee composed of members from LPA, the Louisiana School Psychological Association, and the Louisiana Academy of Medical Psychologists.

After discussion with LPA Pres. Alan Coulter, Dr. Gormanous also put forth a second motion to agree that SB 458 would not proceed forward unless and until participants in the Collaborative Committee arrived at a consensus, through good faith efforts.

The Times asked Dr. Gormanous, if the board had contacted any citizen in or citizen groups, for initiating legislation. He replied no. The Times also asked if the board had conducted a formal vote about filing legislation to which Dr. Gormanous also answered no.

SB 458 covers a variety of changes to the practice act. One of the significant areas a new category of “Registered Assistant to Psychologist.” This is to be, “§2356.4. Assistants to psychologists; registration, supervision, renewal, lapse, termination, reinstatement, and scope of practice.”

New language includes the following: “B. Upon employment of an assistant to psychologists, but prior to performance of psychological duties by the assistant to psychologists, the psychologist of record who is licensed under the provisions of this Chapter shall submit a complete application for registration, the registration fee, and other information as may be required by the board. The application fee for registration of an assistant to psychologist shall not exceed one hundred dollars.”

The board’s criteria for issuing a certificate of registration as an assistant to psychologist includes

“(5) Possess minimum qualifications commensurate with the services to be provided by the registrant as defined in the rules and regulations of the board.

“(6) Has supervised training commensurate with the services to be performed by the registrant as defined in the rules and regulations of the board.

“E. (1) The services and duties of a person registered under this Section as an assistant to psychologists is limited to psychological services authorized by the board, that are commensurate with their education and training, and under the direct and continuous supervision of the psychologist of record who is licensed under this Chapter.

“J. (1) The board may deny or revoke a registration that is in the best interest of public, health, safety, and welfare for any unethical, unlawful or other unprofessional conduct brought to the attention of the board under the jurisdiction of this Chapter. […]

“L. (1) The psychologist of record shall, during the month of July of each year, beginning in the year immediately subsequent to the initial registration of the assistant to psychologist, submit to the board a renewal application as prescribed by the board and renewal fee. The renewal fee shall be determined annually by the board and shall not exceed seventy-five dollars.

“N. The provisions of this Section shall not apply to medical psychologists utilizing assistants under the provisions of R.S. 37:1360.61 under jurisdiction of the Louisiana State Board of Medical Examiners.”

The new legislation would also make additions and changes to “Practice of psychology,” including:

“(a) Psychological research…

“(b) Psychological research and test development.

“(h) Provision of direct services to individuals or groups for the purpose of enhancing individual and organizational effectiveness.

“(i) Using psychological principles, methods and procedures to assess and evaluate individuals for the purpose of rendering an expert opinion and diagnosis in a legal setting.

“(j) Using psychological principles, methods, and procedures to assess and evaluate an individuals’ personal characteristics for individual development or behavior change or for making decisions about the individual.

“(k) Supervision and consultation related to any of the services described in this Chapter. […]

“Psychological services may be offered in a variety of settings including, but not limited to private and public clinics, hospitals, schools, universities, legal settings, that include civil, criminal and family court, and prison systems, government organizations and departments.”

The LSBEP also proposes to change the qualifications for board members, and remove the wording for board members to have practiced “for at least five years.” Then they seek to add the following: (b) No more than two early career psychologists shall hold a seat on the board at any given time.

Also under §2353, regarding organization, the proposal would make formal the position of executive director.

“(3) The board shall appoint an executive director who shall be an unclassified employee of the state. The executive director shall receive a salary determined by the board along with reimbursement for the actual and reasonable expenses approved by the board, in connection with the performance of official duties […].”

A listing of the duties includes: the daily operations of the board and implementation of board policy, the supervision and direction of all employees of the board, and the performance of complaint investigations.

Also under the section on organization, the board seeks to expand its charter. Some of the new duties are:

. “(8) Administer oaths, in the taking of testimony at any hearing before the board or appoint a designee by resolution or contract to administer oaths upon any matters relative to the duties of the board or violation of this Chapter.

“(9) Issue subpoena or appoint a designee by resolution, to require attendance, testimony, and the production of documents to enforce the laws and rules relative to the practice of psychology and to secure evidence of violations thereof.

“(10) Take emergency action in accordance with the provisions of R.S. 49:961: (a) If the board finds that the public health, safety, and welfare require emergency action and incorporates a finding to that effect in its order, a summary suspension, revocation or other action. […] (b) The board may delegate by resolution to the executive committee, the authority to issue an order of summary suspension when it is determined that the public health, safety and welfare requires emergency action. […]

“(13) Establish an executive committee with authority to establish through formal action to execute certain tasks and duties of the board, including but not limited to issuing subpoena and summary suspension authority, and utilized to facilitate the proper functioning of the board.

“(15) Provide education to licensees and to the public relating to the purpose of the board, applicable laws and rules, and public health, safety, and welfare as it pertains to the practice of psychology.”

SB 458 also lists numerous changes in authority to collect fees and to exempt meetings of the investigatory process from Open Meetings Law. The new language would be, “All proceedings in connection with any investigation by the board shall be conducted in closed session, and are exempt from the provisions of the Public Meetings Law pursuant to R.S. 42:17(A)(4).”

SB 458 can be found at https://legis.la.gov/legis/ViewDocument.aspx? d=1168057

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LSBEP Planning Changes in Law

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In the last week of February members of the La. Psychological Association reviewed a memo from the Board of Examiners of Psychologists on “Possible Housekeeping Legislation.” The three-page memo, obtained from an undisclosed source, included substantial changes to areas of the psychology law, said the source.

One of the significant areas listed in the memo is the goal to define “Registered Assistant to Psychologist.” The board notes that the psychologist and anyone under the supervision of that psychologist must conduct their activities in ethical and professional ways that meet standards required by the board. The authors of the memo write, “Clear authority to require registration of assistance will allow the board to enforce regulations that it promulgates, ensure the individuals who are being employed or qualified do not have a history of violent behavior, or other impairment that would prohibit them from interacting with vulnerable populations, with whom they are often alone.”

The board also notes that the changes they seek would allow them the authority to collect fees for registering assistants.

The memo also included a number of expansions to the authority of the board including the right to delegate to an employee or Executive Director subpoena authority.

The authors note that even though the board has authority to issue a summary suspension (of a license) there is no clear language in the law that gives the board the right to delegate that authority to a specific individual or executive committee.

This authority is outlined in Louisiana Administrative Procedures Act 49:956, they write, however there is no clear authority given to the board to delegate the authority to a specific individual or committee.

“Present law is also silent on the authority of the board to delegate duties to an Executive Director of the agency in order to effectuate the provisions of the Chapter.”

The board would also like to change the law to give itself clear authority to provide educational activities and to recuperate the cost of providing such education.

According to the memo the board would like to modify the definition of the practice of psychology. “This definition has been challenged in an attempt to exclude from licensure those individuals who practice in a forensic setting,” the board writes. The definition, authors say, should also be modified to include individuals engaged in education and training in a clinical setting such as university hospitals and clinics.

The LSBEP wants to change the definition of board member such that the qualification no longer includes a minimum of five years practice under Louisiana law. “This is unnecessarily restrictive and narrows the pool of qualified board members,” they write. “A new licensee may have been in practice for more than five years in another jurisdiction.”

The board is also seeking changes in the licensing requirements because they are outdated, they explain. They suggest changes are needed to match the current national standards for training and credentialing for licensure.

Adding the words “or otherwise restrict“ into the definition of the boards power to “suspend, deny or revoke” someone’s license, and so this would allow them to modify licenses in a less restrictive way where appropriate and allow some individuals to continue to practice in a limited capacity in contrast to completely revoking their license, the authors explain.

The board members also recommend changes to establish clear authority for them to collect applicable administration and maintenance fees, as related to application, registration and renewals.

The board is also seeking to change the definition of “Executive Committee” because the present law is not clear regarding the authority of the board to delegate certain functions.

Authors write they want to make additions or changes in matters of telepsychology including the authority to collect fees necessary to review or deny request to provide training via electronically means.

Also the LSBEP is seeking to further define and determine the differences between an “applicant” for licensure and a “candidate” for licensure because the board has been challenged with determining the level of due process rights of an individual once they are granted candidacy status.

The memo was obtained from an undisclosed source in Louisiana Psychological Association who said that the association was not in favor of major changes without more assessment of the suggestions by the members at the state association and the community at large.

The memo does not appear to be posted on the board’s website. However, according to the December minutes (posted January 10) legislative efforts were discussed briefly. “Dr. Gormanous expressed his opinion that the LSBEP should prepare to educate people, including new legislators if the Board is going to seriously consider statutory changes.” And, “The committee agreed that they would wait for ASPPB to publish recommendations for the ‘Elevator Speech’ and revisit that topic at that time.”

The minutes contained no reference to comments from the members about separation of powers.

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Community Health Centers Saved Louisiana’s Medicaid Program $645 Million, Boosted Economy by $772 Million, Report Says

FacebooktwitterredditpinterestlinkedinmailAccording to a new report released November 26 by Capital Link and sponsored by the Louisiana Primary Care Association, 35 Federally Qualified Health Centers (commonly referred to as Community Health Centers), are responsible for an annual $772 million economic impact on Louisiana’s economy.

The authors concluded that by servicing Medicaid patients at a 24% lower cost than private providers, managing chronic conditions, keeping patients out of the emergency room, and emphasizing the importance of preventive care, Community Health Centers saved the healthcare system $868 million.

Among the report’s additional findings:

•In 2018, Louisiana’s Community Health Centers saved Louisiana’s Medicaid program $645 million.

•Health centers reinvested in their communities by engaging in $416 million in direct health center spending, resulting in an additional $356 million in indirect and induced community spending.

•Louisiana’s Community Health Centers employed 3,149 individuals and spurred the creation of 2,635 additional jobs in their surrounding communities.

•Last year, Louisiana’s Community Health Centers provided primary care, oral health, and behavioral health services to over 444,000 patients across the state.

Health centers continue to serve as the providers of choice for those who have recently gained access to health insurance coverage through Medicaid expansion.

The report said that Community Health Centers are known for providing high quality preventive and primary health care to patients, and they also work to stimulate economic growth and generate cost savings for both urban and rural communities across Louisiana.

“Year after year, health centers continue to demonstrate that they are critical components of Louisiana’s healthcare safety-net,” said Gerrelda Davis, Executive Director of the Louisiana Primary Care Association.

 “This report confirms that health centers are proven leaders in meeting the needs of patients at an affordable cost to taxpayers.  The federal government has no program with a better return on  investment than it does with the Health Center Program.”

Thirty-five Community Health Centers were included in this analysis.  Economic numbers were derived using health center audited financial statements and statistics as reported on the 2018 Uniform Data System.  An integrated economic modeling software called IMPLAN was used which applies the “multiplier effect” to capture the direct, indirect, and induced economic effects of health center business operations.  I is widely used by economists, state and city planners, universities, and others to estimate the impact of projects and expenditures on the local economy.

The Louisiana Primary Care Association (LPCA) represents 38 federally funded, private, non-profit and public Community Health Centers (including two Look-Alikes) across Louisiana that serve over 444,000 patients annually.  LPCA promotes community-based health services through advocacy, education, and collaboration with community partners. Their goal is to ensure that every Louisianan has access to affordable, quality, primary care services.  For more information, visit www.LPCA.net. Facebooktwitterredditpinterestlinkedinmail

Dr. Melissa Beck Helps Lead “LSU MIND” Group

FacebooktwitterredditpinterestlinkedinmailShowcased in one of the cover features of LSU Research magazine, cognitive psychologist Dr. Melissa Beck is being called a “collaborative champion,” for her skill in developing cross-discipline research and teamwork.

Dr. Beck is professor of psychology at LSU and leads the Beck Visual Cognition Research Lab, where she conducts innovative and interdisciplinary research on visual attention and memory.

Dr. Beck serves on the executive committee for the LSU MIND group, or the Multidisciplinary Initiative for Neuroscience Discovery. “She’s been described as ‘the glue’ for various cross-campus collaborations,” reported Elsa Hahne at the LSU Office of Research & Economic Development.

In an interview with Hahne, Dr. Beck said, “When I first came to LSU, I was doing basic science research with my graduate students while also doing applied collaborative research at the Human Factors Group at the Naval Research Laboratory at the Stennis Space Center in Mississippi. We were looking at how pilots allocate attention to digital maps while they’re flying and how their expertise develops. I learned how to take basic research and apply it to different areas while working with people who aren’t cognitive psychologists.”

Beck is aware of how little other disciplines know about psychologists’ skills. She told Hahne, “At all universities, silos get created. Someone in engineering might think psychology is therapy— and it is!—but there’s also this huge other area of psychology called cognitive science. It doesn’t occur to them that we have all of these people with skills and the ability to study interesting problems that are related to business or marketing or engineering. We could collaborate, but people don’t understand what our skills are, and vice versa. Not unless we have conversations.”

Dr. Beck and her team of researchers have worked to uncover the “inattentional blindness” that impacts automobile drivers, the ways that visual attention and memory work or don’t work in various situations. With the aid of grants from the United States Department of Transportation (USDOT) and working through LSU’s University Transportation Center for the Gulf Coast Center for Evacuation and Transportation Resiliency, Beck and her students are able to study human responses in a driving simulator.

Housed in the LSU Department of Civil and Environmental Engineering, “The simulator consists of a full-sized passenger car––a Ford Fusion with no wheels,” she said, “combined with a series of cameras, projectors and screens to provide a high fidelity virtual environment. Realtime Technology Inc. manufactured the simulator,” Beck explained.

“Lately,” Dr. Beck told Ms. Hahne, “I’ve been working with faculty members in construction management and architecture on a grant submission to look at how architects and engineers communicate with each other around design. People from different disciplines have different conceptualizations of what they do. For example, they might cognitively perceive a building differently. So, how do we get them to communicate well with each other? It’s kind of meta, because the very thing we want to study— cross-discipline communication—is necessary during our collaboration.”Facebooktwitterredditpinterestlinkedinmail

ASPPB Quietly Advances the EPPP-2 Plan with Jan 1 Launch

FacebooktwitterredditpinterestlinkedinmailLast month the Association of State and Provincial Psychology Boards (ASPPB) quietly posted a message that the new Part 2 of the national licensing exam will officially launch on January 1, 2020. ASPPB officials first announced the new test, the EPPP-2, in 2017 as optional for its member jurisdictions. Then as resistance mounted, ASPPB’s Board of Directors decided that they would combine parts and make the entire exam mandatory, this coupled with a 100% fee increase. An outcry followed, then ASPPB backpedaled and made the roll-out optional––for the time being.

The upcoming January launch begins a “voluntary adoption” program, a carrot and stick for the controversial new test product, whose scientific basis is coming under more and more scrutiny.

The new test is optional––but whether it remains that way is highly doubtful, some say. In this article we review the behind-the-scenes decisions and interests impacting the test and those hoping to become licensed psychologists.

The National Exam

The current test, called the Examination for Professional Practice in Psychology or EPPP, is the national licensing exam required for candidates seeking a state psychology license.

ASPPB purchased the rights to the exam sometime around 2013, and since then the EPPP is the top money making product for the non-profit corporation. The EPPP-2, first priced at $600 then lowered to $450, would increase testing revenues for ASPPB by 75%, boosting the firm’s yearly income by $3,750,000.

The current EPPP is expensive at $600 plus administration fees. At a recommended 50th percentile cut-off, many candidates have to take the test more than once. The test contains 225 items, with a fourhour time limit. To compare, physicians pay $605 for an eight-hour exam, and Social Worker candidates pay about $250 for a 170-item exam.

On-going criticisms about the scientific validity, the practical usefulness of the new exam, and the possible discriminatory impact of the entire EPPP selection approach, appear to have done little to deter ASPPB from its goal.

In the latest of a list of scientists voicing concerns, researchers lead by University of North Texas professor Jillian Callahan, PhD, are set to publish a critique in the flagship journal of the American Psychological Association, The American Psychologist.

Based on a pre-publication draft of the article, the authors will be addressing the need for stronger scientific methods in the EPPP-2 development, the suitability of the test for its intended use, impact on minorities, and legal vulnerabilities.

ASPPB has gone through several roll-out efforts, first to persuade and encourage member jurisdictions to accept the new test, and then to force the new exam on states.  The current effort, “voluntary adoption,” includes a fee of only $100 for Part 2 of the exam for “Beta Candidates.” After the “beta exam” closes in 2021, this fee will be $300 for early adopters. After January 1, 2022, the fee increases to $450.

It is not clear what happens to those states who refuse to accept the EPPP-2 for its candidates. ASPPB officials note, “… At this time, it is optional for licensing boards (jurisdictions) to sign on to require the EPPP (Part 2 – Skills).”

Since ASPPB owns the tests, they will likely make the combined exam mandatory again, said one insider.

Only nine of 64 possible jurisdictions have joined in to “adopt” the additional exam so far, totaling only 14% of ASPPB “members.” These are Arizona, Guam, Nevada, Newfoundland and Labrador, and Prince Edward Island. Starting in February, Missouri has signed on and starting in March, Manitoba has signed on as early adopters. Finally, Georgia has agreed to be an early adopter starting November 2020.

Show Me the Money

The ASPPB is a private, nonprofit, 501(c) tax-exempt corporation located in Tyrone, Georgia. The company states its mission is to “Facilitate communication among member jurisdictions about licensure, certification, and mobility of professional psychologists.”  The “members” are about 64 regulatory boards from across the United States and Canada. These boards pay dues to be a member of ASPPB.

Tax records indicate that ASPPB grossed $6,686,286 in 2017; $5,973,841 in 2016; and $5,284,952 in 2015.

Total revenue for 2017 was $6,645,731 and for 2016 was $5,933,473.  For 2015, revenues were $5,254,097.

Over the last five years, from 2012 to 2017, total revenues have increased from $4,274,419 to $6,645,731 or 55%.

Assets and balances for 2017 were listed at $8,629,194. In 2016 assets totaled $8,462,637, and in 2015 totaled $7,712,532.

Of total revenues in 2017, ASPPB spent 2,268,203 on salaries and other types of compensation.  Records indicate they have 12 employees and the highest compensated is the CEO, Dr. Steven DeMers, at $270,784. Another four employees’  salaries fall between $134,771 and $111,823. Board members receive between $6,800 and $12,800.

All listed compensation for 2017 together totals $839,747.  An additional $1,098,096 was paid to Pierson Vue Minneapolis for exam administration.

To compare, in 2016 they listed 12 employees, again the most highly compensated was Dr. DeMers at $243,842. Others fell between $131,949 and $125,860.

ASPPB’s main income producing product is the national exam for psychologists, with revenue of $5,378,524 in 2017. This was 80% of total revenues for the year.

In 2016 exams and related fees grossed $5,296,421, or 89% of all ASPPB venues. In 2015 this amount was $4,775,213 and in 2014 it was $4,826,421.

The company has some other products, such as the Psychology Interjurisdictional Compact (PSYPACT), a service to coordinate psychologists working across state lines. This product generated $357,708 in 2017.

The organization spends liberally on the other activities including $1,169,743 on travel, $978,143 on other salaries and wages, $240,951 on other employee benefits, $375,418 on information technology, and $240,143 on conferences.

While many members are government officials, ASPPB does not follow open meetings laws. Deliberations and decisions are private. “If you are not a member or staff of an ASPPB Member Psychology Regulatory Board or an individual member, you are not eligible to access this section of our website,” they write. Their conferences are also closed and for members only.

This arrangement––where a corporation, formed of state board representatives, operates as a test publisher, with influence and special access to government officials, and also a captive market––seems ripe for conflict of interest. The Times asked one CPA to look over the information and he said, “Of course there is influence and COI.”

“With a lot of cash sitting on the balance sheet, the strategy is to maximize expenses,” said an MBA in reviewing the information for the Times. “The extra profits are likely to go into perks rather than price cuts,” he said.

Scientific Criticisms Continue to Mount 

In the latest of a series of criticisms, University of North Texas professor Jillian Callahan, PhD, and coauthors will address concerns about the scientific quality of the new exam in an upcoming issue of The American Psychologist.

In the pre-publication draft posted on the internet, the authors write, “… the EPPP Part 2 has yet to be subjected to a broader validation process, in which the suitability of the test for its intended purpose is evaluated. Implementation of the EPPP Part 2 before validation could have negative consequences for those seeking to enter the profession and for the general public …” And, “For jurisdictions implementing the EPPP Part 2, failure to gather and report the evidence required for use of a test in a forensic context may also open the door for legal challenges.”

Other critics have pointed to similar problems, one being the lack of the need for additional test hurdles.

“There is no evidence that the public is facing some sort of previously unheard of crisis in terms of safety from currently practicing psychologists,” said Dr. Amy Henke. In 2016, while serving as a director for the Louisiana Psychological Association, Henke took the lead to pass a Resolution opposing the new test. She pointed out that multiple checks on competency already exist for psychologists and appear to be working to protect the public.

“Trainees are already held to high standards through a variety of benchmarks,” Dr. Henke wrote in the Resolution, “including but not limited to: APA approval of doctoral programs, multiple practicums where competency is repeatedly assessed, completion of formal internship training (also approved and regulated by APA and APPIC), and supervised post-doctoral hours obtained prior to licensure. There is no evidence to suggest this is not sufficient for appropriate training.”

Henke and others pointed to existing multiple hurdles that candidates already must clear, including two year’s supervision, a written exam, oral exam, background check, and jurisprudence exam. Additionally, the law allows the board to require additional physical and psychological assessments whenever needed.

However, Dr. Emil Rodolfa, from Alliant University and also then a program developer at ASPPB, questioned if these standards are enough, saying that supervisors have “… difficulty providing accurate evaluations of their supervisees to others who may have to evaluate the supervisee’s competency.”

Henke also said, “I am particularly concerned about regulatory boards encroaching ownership of training standards. The goal of a regulatory board, in my personal opinion, is to provide the least restrictive amount of guidelines possible in order to protect the safety of the public.”

Rodolfa disagrees and said, “Licensing boards have a mandate to ensure that the professionals they license are competent. Competence is comprised of the integrated use of knowledge, skills, attitudes and values.”

Henke and others point out that the evidence from disciplinary statistics suggests that problems are very rare. For the most recent year with records, total reported disciplinary actions across the U.S. and Canada range from 159 to 222, with only nine to 17 licenses being revoked nationally. (See table.) Data from the ASPPB Disciplinary Data System: Historical Discipline Report show rates of disciplinary actions for psychologists to be consistently low. For an estimated 106,000 psychologists nationwide, the disciplinary rates remain around 1–2 per 1,000.

Louisiana’s rate is similar to the national average. For the year 2018–2019 there were two disciplinary actions. For the year 2017–2018 there were also two disciplinary actions. And for the year 2016–2017 there were three disciplinary actions and in 2015– 2016 there was one disciplinary action which is on appeal. And from 2014–2015 there was one disciplinary action.

Critics argue that a second test can have very little impact on such a low disciplinary rate.

Other criticisms center around the poor scientific quality of the test for making high-stakes decisions about candidates’ careers. In 2009 Brian Sharpless and Jacques Barber authored “The Examination for Professional Practice in Psychology (EPPP) in the era of evidence-based practice,” for Professional Psychology: Research and Practice.

“Professional psychology has increasingly moved toward evidence-based practice,” said the two authors. “However, instruments used to assess psychologists seeking licensure, such as the Examination for Professional Practice in Psychology (EPPP), have received relatively little empirical scrutiny.” They write, “… there is a paucity of criterion, predictive, and incremental validity evidence available.”

Dr. DeMers responded in the same journal attempting to clarify issues and giving some information not published. He agreed with some of the recommendations, according to the summary of his article.

Industrial-Organizational Psychologist Dr. William Costelloe, Chair of the I-O and Consulting Psychology Committee of LPA, told the Times, “… predictive validation studies must be conducted.” This type of research proof is not optional, he said. “Well conducted, scientifically based predictive validation studies must be conducted if the EPPP2 is intended to be used as a selection tool,” Costelloe said.

In April 2018, ASPPB CEO, Dr. Stephen DeMers, met with members of the Louisiana State Board of Examiners of Psychologists and representatives of Louisiana Psychological Association (LPA). After the meeting, Dr. Kim VanGeffen, Chair of LPA Professional Affairs, said, “Dr. DeMers acknowledged that, currently, there is not really any research on the validity of the EPPP-2,” VanGeffen said. “There do not seem to be any plans to obtain predictive validity nor does the EPPP2 committee believe that establishing this type of validity is necessary,” she said.

Dr. Marc Zimmermann, past LSBEP board member and Chair of the LPA Medical Psychology Committee, also attended. “He [Dr. DeMers] stated that there is no predictive validity,” said Zimmermann. “He also threw in that none of the national tests had predictive validity. He reported that content validity was the accepted standard because a test with predictive validity could not be constructed,” said Dr. Zimmermann. “… DeMers had the temerity to try to sell us something that does not meet the standard that psychological tests being published are expected to have.”

Other critics are concerned about the discrimination aspects of the EPPP. In a December 2018 study of New York psychologist candidates, Brian Sharpless, PhD, demonstrated that the EPPP has differing fail and pass rates for different races. Blacks had a failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07% and Asians had a failure rate of 24%. The difference is large enough for African-Americans and Hispanics to constitute discrimination.

The study, “Are demographic Variables Associated with Performance on the Examination for Professional Practice in Psychology (EPPP)?” is published in The Journal of Psychology: Interdisciplinary and Applied.

ASPPB’s Rough Roll-Out

Keeping its members cooperative with its product plans has been difficult for ASPPB. In 2016 the firm announced the EPPP–2 and told its members, licensing boards across the United States and Canada, that the use of the new test would be “optional.”

However, amid criticisms ASPPB did an about face in late 2017 and announced that the new exam would be mandatory after all, and be combined with the current test. And, the price would increase 100%, from $600 to $1200.

“The ASPPB Board of Directors, based on a number of factors, including feedback from our member jurisdictions and input from our legal counsel, has determined that the EPPP Part 2 is a necessary enhancement, and therefore an essential component of the EPPP,” wrote DeMers.

Objections mounted, mostly from student and early career psychologist organizations.

In July 2018, Dr. Amy Henke, now serving on the Louisiana State Board of Examiners of Psychologists (LSBEP), and LSBEP members of sent a blistering letter to the ASPPB Board of Directors, to the ASPPB members, and to the administrators of state psychology boards across the US and Canada.

Objections from Henke and others involved technical and scientific issues, but also the criticism that there is no problem that the new test needs to solve.

“LSBEP does not believe that data exists demonstrating that psychologists are not already held to high standards of competence,” they wrote. “The data that exists in terms of complaints and disciplinary actions toward psychologists also does not support the theory that competency problems abound in the field of psychology.”

The LSBEP also criticized ASPPB’s role and said that the decision is “…an overstep.”

“We are concerned that ASPPB has lost sight of their original mission, which from this board’s understanding was limited to facilitating communication between various member jurisdictions,” the LSBEP members pointed out, and that mandatory decisions on EPPP-2 do not fit this role but rather the role of a vendor providing a product.

Following this, in August 2018, ASPPB President Sharon Lightfoot, PhD, announced that the ASPPB Board of Directors voted to rescind their 2017 decision to mandate the second exam.

“We will continue toward launch of the Enhanced EPPP in 2020,” Lightfoot said, “and make it available to states and provinces interested in serving as early adopters. We are lifting the requirement for use of the Enhanced EPPP and are lifting the deadline for implementation.”

In December 2018, ASPPB decided to use a carrot and stick approach for the new exam. According to an October 24, 2018 letter from Lightfoot, if Louisiana chooses to decline the use of EPPP-2, individuals here will not be allowed to take EPPP-2 even if they wish to do so.

“Only applicants who are registered through a jurisdiction that has adopted the Enhanced Exam, and who have passed the knowledge portion of the exam, will be allowed to take the skills portion of the exam,” said Lightfoot.

Also, those test-takers from compliant states will pay reduced fees as a reward for early adoption of the additional exam, while those from late adopters will pay $450.

Sources at the Louisiana State Board of Examiners believe ASPPB is forcing states to use the EPPP-2 by prohibiting individuals from taking the exam in a state which does not require its use. They say this would make it difficult for psychologists who obtain licensure in a state which does not use the EPPP-2 to obtain licensure in a state which does use the EPPP-2. This policy, if adopted, is punitive, they say.

Is Resistance Futile?

ASPPB appears to be doggedly maintaining it’s commercial course, despite the mounting criticisms that the second exam is not scientifically well-constructed or actually needed for public safety. One source close to the state board said they see very little way to avoid having to accept the new exam eventually–– that efforts to stop ASPPB were futile.

If critics are correct, and the second exam is wasteful spending, the cost and additional regulatory hurdle will be born entirely on the backs of new psychology license hopefuls.Facebooktwitterredditpinterestlinkedinmail

Dr. Kaplan Delights Audience of Psychologists and Nutritionists at Fall-Winter Workshop in BR

FacebooktwitterredditpinterestlinkedinmailDr. Bonnie Kaplan, clinical psychologist and winner of the 2019 Excellence in Complementary and Alternative Medicine award, delighted audiences at the Fall-Winter Workshop of the Louisiana Psychological Association, held November 1 in Baton Rouge.

Kaplan presented her work in nutritional mental health and laid out a convincing and interesting picture of how mental illness often involves nutritional deficiencies. LPA President, Dr. Alan Coulter, said, “Bonnie Kaplan, our keynote speaker, inspired us all with startling facts and practical recommendations.”

Nutritionists from the Louisiana Academy of Nutrition and Dietetics attended along with the psychologists from around the state. Monica McDaniels, MS, RDN, LDN, and board member on the Louisiana Board of Examiners in Dietetics and Nutrition, and Liaison to Louisiana Academy of Dietetics and Nutrition, also attended and was welcomed by Dr. Coulter.

Dr. Kaplan joined local experts including McNeese’s Dr. Linda Brannon, author of the popular textbook, Health Psychology, Dr. Susan Andrews, author of Stress Solutions for Pregnant Moms, and Dr. Charles Frey, IV, expert in chronic pain conditions, for the one-day event, “Advances in Health Psychology.”

Kaplan treated the audience to a strong theoretical argument about the prevalence of mental illness. Prior to 1750, she explained, only one percent of the population suffered from mental and emotional disorders. Now that figure has risen to over 20 percent. She said, “Is anyone still believing that this increase is solely due to more referrals and more sensitive diagnoses?”

She laid out the foundational theory and current research for the role of nutrition in the brain and the linkage and evidence for mental disorders in cognitive functioning.

Kaplan said that the role of nutrients in the brain is not a mystery and should be taught in elementary school or at least in medical school, but it is not.

She pointed out that 48% of the caloric intake of all Canadians, and likely even higher for Americans she said, is completely empty of nutrients. She asked the question, “What happens when we eliminate one half of the nutrients in our diets?”

Kaplan made the case that depression, irritability, social withdrawal, self-mutilation, inability to concentrate, and other mental health symptoms originate after six months of nutrient deprivation.

Her work revolves around multiple nutrients supplements and she made the case that magic bullet thinking it’s not helpful. Multi-nutrients are required as a foundation because the nutrients are synergistic and in work in combination. Past research has resulted in the misleading idea that single nutrients are not effective or less effective than desired. The situation is compounded by individual differences, which also can impact results.

Benefits of nutritional treatment for mental conditions especially include resilience to stress PTSD and ADHD, she explained. Kaplan reported on post-disaster research with victims of earthquakes, floods, massacres, and fires and how nutritional treatment was equal or better to other types of support.

Kaplan also spoke about the emerging field of nutritional mental health as it relates to inflammation, the microbiome, oxidative stress and mitochondrial function in patients. She encouraged the audience to think of epigenetic effects of nutrients and the importance of these elements in total health.

Her message included the idea that an individual presenting with a psychiatric disorder should be evaluated for suboptimal nutrition as a first step, and assured psychologists and the nutritionists in the audience that this is within the scope of practice for all those wanting a thorough review of the origin of the symptoms.

Dr. Kaplan lives in Canada and lectures internationally on the importance of improving nutrient intake to prevent and treat psychiatric symptoms. As a researcher, she questioned the longstanding paradigm of single nutrient research to establish the scientific basis for a broad spectrum micronutrient approach, eschewing industry funding in order to safeguard the integrity of her research. She has published widely on the biological basis of developmental disorders and mental health – particularly, the contribution of nutrition to brain development and brain function. She has also established two charitable funds in support of nutrient research, so far distributing $750,000 for clinical trials at universities in Canada, the United States and New Zealand.

Dr. Kaplan is a professor emerita in the Cumming School of Medicine at the University of Calgary. In the late 1990’s, she challenged the conventional model of psychiatric research by studying the role of nutrition in mental illness and brain disorders. She dealt with skepticism and attacks on her work for over fifteen years, resolutely meeting and exceeding calls for evidence. Her research provided the initial groundbreaking data showing that treatment with a broad spectrum of micronutrients, carefully formulated, could be used instead of psychotropic drugs to treat bipolar disorder and ADHD.

In 2013, Dr. Kaplan became one of the founding members of the International Society of Nutritional Psychiatry Research (ISNPR.org), an organization that emphasizes the importance of nutrition “above the neck.” In 2016, she retired from full-time academic work, but is still passionate about supporting young researchers who are studying nutrition and mental health. To help them do so, Dr. Kaplan has established two donor-advised charitable funds, one in Canada and one in the United States.Facebooktwitterredditpinterestlinkedinmail

Endowed Chair of Psychology Established at University of Tampa Honoring Dr. Janet Matthews

FacebooktwitterredditpinterestlinkedinmailIn November, Dr. David Stern, University of Tampa Provost, announced the creation of the Janet R. Matthews Endowed Chair of Psychology, established by Dr. Lee Matthews, honoring his wife, Janet, who passed away in March.

According to the official announcement, the endowed chair is the first in the University’s history to be named after a UT alumna or alumnus, and the first endowed chair outside the Sykes College of Business. The endowment will be used to support a new faculty chair position in the Department of Psychology, within UT’s College of Social Sciences, Mathematics and Education.

Dr. Stern said that the creation of an endowed chair in psychology is a “wonderful addition to one of our strongest and most popular programs.”

“It will enable us to recruit an accomplished teacher-scholar whose work will enhance our reputation, attract students who want the opportunity to study and collaborate in research with the chair holder and will be a fitting honor for two of our alumni who have had nationally renowned careers in psychology,” Stern said.

The honor commemorates Janet and Lee Matthews meeting as freshmen at The University of Tampa (UT) in 1962, where they married as undergraduates and went on to become established and renowned clinical and academic psychologists. More than 55 years after meeting, Janet and Lee had planned to make a significant gift to UT and, in honor of Janet, established the Endowed Chair, said Stern.

Jack Geller, dean of the College of Social Sciences, Mathematics and Education, said the gift will substantively impact both faculty and our students in psychology.

“The Janet R. Matthews Ph.D. Endowed Chair of Psychology, along with the associated Drs. Janet and Lee Matthews Psychology Student Award, is by far the most comprehensive gift to date in the College of Social Sciences, Mathematics and Education,” Geller said.

In recognition of the gift, UT has also established the Drs. Janet and Lee Matthews Psychology Award, which will be given annually to an outstanding rising senior psychology major.   “Endowed chairs are among the most generous and critical gifts in higher education and support academic excellence,” said Ronald Vaughn, UT president. “And having it named after two esteemed psychologists brings prestige to the University and will certainly help us attract outstanding faculty.

Dr. Lee Matthews spoke at the ceremony. “This gift is to honor all of our former professors at The University of Tampa, who not only encouraged us, but set an example of the meaning of what it was to be an undergraduate teacher and mentor,” Dr. Matthews said. “And, the ‘non-academic lessons’ that Janet and I obtained such as supporting the local community, building
relationships and supporting future generations were all values that we learned at The University of Tampa.”

“Janet’s experience at UT resulted in her becoming a mentor to generations of undergraduate students,” Matthews said. “After 35 years of teaching, more than 37 of her former undergraduates had doctoral degrees in psychology, and at the time she became Emerita Professor, there were another 19 former students in doctoral programs. In addition, around 25 of her former students obtained other graduate degrees, in counseling, psychology, and social work.”

“Janet’s vision for the endowed psychology chair was so that future generations of UT students would have the same opportunities to be encouraged and mentored to pursue further education in psychology and/or related fields as was provided to us by our former professors,” he said. “It was not only academically, but the ‘nonacademic lessons’ we obtained such as volunteer involvement in the local community, a sense of responsibility, a ‘can I help you’ attitude, building relationships, and supporting future generations. I hope you can see that these were all values that we learned at the University of Tampa and still exist to this day in the current students and why we are donors.”

Dr. Janet Matthews, “cherished and esteemed” colleague to many in the psychology community, died March 31, 2019, in Metairie, Louisiana, after a struggle with cancer. The outstanding service and accomplishments of her life left an “indelible mark on her colleagues, her students, her profession, and her community,” said a message from the Louisiana Psychological Association upon her passing.

Dr. Matthews was a clinical and neuropsychologist, and held the diplomat in clinical from the American Board of Professional Psychology. She served as Full Professor at Loyola University, served on the Board of Directors of the American Psychological Association, and was named Distinguished Psychologist by the Louisiana Psychological Association, among many other achievements. Facebooktwitterredditpinterestlinkedinmail

How Do You Save A Trillion Dollars?

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by Julie Nelson

Imagine that a patient with psychosis is given nutrients. She improves her quality of life to such a degree that she no longer needs yearly hospitalizations, which, along with other expenses, amounted to $500,000 of medical and disability costs over a fiveyear period.

Dr. Bonnie Kaplan, Professor Emerita in the Cumming School of Medicine at the University of Calgary, and expert in the field of nutritional mental health, says this type of prevention might save lives and money. Kaplan publishes widely on the biological basis of developmental disorders and mental health – particularly, the contribution of nutrition to brain development and brain function. She will speak to Louisiana psychologists this November.

In her “Hospitalization cost of conventional psychiatric care compared to broad-spectrum micronutrient treatment,” in International Journal of Mental Health Systems, Kaplan points to dramatic savings for those patients that respond to nutritional interventions.

Nutrition is one of the innovations in illness prevention that has been neglected for decades. Other neglected approaches include behavioral treatments for lifestyle based illnesses, equally as cost-effective.

Prevention requires tools that are often unfamiliar because educational, behavioral, and social interventions, not usually considered to be part of medicine, may be most effective for many diseases,” said Hamilton Moses and co-authors in, “The Anatomy of Health Care in the United States,” in an article of the Journal of the American Medical Association.

While medical costs are driven by chronic disease, these costs are not due to an aging population, even though age is often cited as the cause. Moses shows that about 80 percent of the total health care cost is accounted for by individuals under 65, and relate to psychological, social and behavioral factors. The CDC estimates that three lifestyle factors––poor diet, inactivity, and smoking––account for 80 percent of heart disease and stroke, 80 percent of type 2 diabetes, and 40 percent of cancer.

“Behavioral intervention is the foundation for lifestyle medicine,” writes Dr. John Caccavale, author of Medical Psychology Practice and Policy Perspectives. “Of the top four classes of medical problems in America–– metabolic disorders, respiratory disease, cardiovascular disease, and mental disorders––physicians will have great difficulty demonstrating that they are improving patient health by utilizing medications as a first-line treatment for these classes of disorders,” writes Caccavale.

“I think wellness/prevention are areas where there is tremendous need in primary care,” said primary care psychologist Dr. Michelle Larzalere. But, rarely is this need addressed.

“For both physical and mental health, the need to work on active problems is often so high that wellness/prevention get shorted on attention,” Larzalere said.

“The health habits that most reduce the preventable component of the most prominent causes of morbidity and mortality in the US––for example, refraining from smoking, eating a healthy diet, getting regular exercise, and limiting alcohol consumption––are behaviors that psychologists can really impact positively. Unfortunately, at least in my experience, other needs are so great that it is hard to make time for wellness/prevention initiatives unless there is a specific plan put in place.”

Author of Health Psychology, Dr. Linda Brannon said, “The division of health into mental and physical health is a false dichotomy that we need to get over. I think that many providers address the presenting problem to the extent that they do not look beyond it.”

For decades now, psychological scientists have known that behavior is the key to costs. Larzelere explained that psychological scientists have repeatedly shown that resulting savings by including prevention behaviors can produce savings between 30 and 60 percent in medical use costs.

To put this in perspective, a 10 percent reduction in medical/surgery costs nationwide––by treating the mental or behavioral component––would exceed the entire current national mental health budget, she explained.

She is correct. According to federal agency, The National Health Expenditure Accounts, healthcare spending reached $3.5 trillion in 2017, for both public and private sources. This is $10,739 per person, and accounts for 17.9 percent of the Gross Domestic Product.

A 10% savings, as Larzelere suggests, would result in a savings of $350 billion. The U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration estimates treatment spending from all public and private sources to total $280.5 billion in 2020.

Estimating at the low end of the range of expected savings, a conservation goal of 30%, would come to $1 trillion.

Gains in quality of life and productivity would be added on top of that.

Some Current Problems

Is all this spending doing anyone any good?

A pattern of poor health outcomes and high costs reflects the country as a whole. The United States ranks 50th out of 55 industrialized countries in a measure of life expectancy and medical care spending, according to Bloomberg, who concluded the U.S. is the “least-efficient” health-care system in the world.

Louisiana typically falls at the bottom of the states in health ranking. In the most recent report from America’s Health Rankings, an annual analysis of the United Health Foundation, Louisiana ranked No. 50. The state ranked last in both behaviors and community & environment categories, No. 47 in clinical care, and No. 48 in health outcomes.

Louisiana has its challenges. Nearly 21% of the population of the state is at the poverty level or below, when only 12-1/2% of the citizens nationwide fall at this level. Over 41% of the citizens in Louisiana fall at 200% of the poverty level or below, compared to 29.75% nationwide.

Health is woven into a complex set of social and psychological behaviors, not a single cause. “Socioeconomic status is one of the most powerful predictors of all cause mortality,” says Dr. Chris Leonhard, health psychologist and Professor at the Chicago Professional School at Xavier. “New Orleans is a startling example of this,” Leonhard said. “Life expectancy at birth in the Tremé where the average household income in 2010 was about $26,000 is 55 years, while in Lakeview, the average 2010 household income was $75,000, and life expectancy at birth is 80 years.”

But money is flowing. The state paid $10.7 billion on behalf of about 1.9 million Medicaid recipients, according to the Louisiana Department of Health. During the fiscal year 2017– 2018, about 39.6 percent of Louisiana’s citizens were enrolled in the Medicaid program and payments were made on behalf of 1,876,908 recipients.

Using other federal data, this time from Medicare, a concerning picture emerges. According to an analysis by Blake Kruger and Jeremiah Brown, Louisiana spends the most on Medicare beneficiaries per capita than any other state. At the same time, Louisiana reports greater disparities in health status and death rates than other states.

Kruger and Brown investigated the associations between healthcare intensity, healthcare spending, and mortality in Louisiana Medicare beneficiaries. They defined healthcare intensity to be synonymous with the hospital care intensity index, a combination of inpatient days and physicians’ services.

The researchers found no association between healthcare intensity and spending. Nor did they find any association between spending and mortality.

“We also observed no association between health-care spending and age, sex, and race-adjusted mortality,” the researchers wrote. And, when they compared healthcare intensity to age, sex, and race-adjusted mortality, they could find no meaningful associations. Nor did they find that more spending made any difference in survival when adjust for smoking, inactivity, or obesity.

While the lack of an association between healthcare intensity and spending could indicate that outpatient care in Louisiana is becoming more highly utilized, the findings could also reflect that spending more on healthcare in Louisiana does not improve rates of survival or health outcomes for Louisianans.

Healthcare: Designed for You by Special Interests

The sheer size and complexity of the healthcare industry would suggest that innovations like nutrition or lifestyle therapy would be challenging, and new treatments even more unlikely because of the political power yielded by the industry giants. Over the last years the pharmaceutical industry, Blue Cross/Blue Shield, the American Hospital Association, and the American Medical Association were the some of the highest contributors to Congress.

Psychology and other groups have not been able to garner a place at the medical table to push for new methods. California Attorney David Ries of Human Capital Specialists tried to persuade federal Rule makers to include psychologists in the bonus plan for Accountable Care Organizations (ACOs) but failed. He told the Times that the final Rules were very disappointing, and said, “The broad recognition of the importance of behavioral health to overall wellness indicates that ACOs are unlikely to achieve their treatment objectives …”.

These special interests exert themselves not only through direct lobbying, but the medical-pharmaceutical-hospital-insurance industrial complex has a firm hold on the prices and services in this country, through the “CPT Codes” and the “Relative Value Scale Update Committee” or RUC. These groups decide what services are allowed and how much they are reimbursed.

The CPT codes, short for Current Procedural Terminology, control what services are allowed and reimbursed. The codes are created by three hundred “Advisors and Experts,” primarily from the American Medical Association’s House of Delegates, representing medical specialties, who work to influence an “Editorial Panel,” composed of representatives from medical societies, insurance companies and government. This panel conducts secret meetings to decide on which healthcare services are paid for, and which are not.

Dr. Tony Puente, Past-President of APA, was one of the two outsiders allowed to participate in the CPT process. “Essentially,” he said, “the CPT tries to divvy it up in a way that is theoretically and empirically, and diplomatically and politically, correct.” Participants must sign a strict AMA (American Medical Association) confidentiality agreement declaring, “I will not disclose, distribute or publish confidential Information to any party in any manner whatsoever.”

The CPT system is dominated by organized medicine. “Every seat at the table has a vested interest, mostly not supporting your proposed code,” said Dr. Travis Thompson, professor, psychologist, and leader in the Association for Behavior Analysis International. It took him and colleagues three years to muscle through codes for the treatment of autism.

While the CPT approval is a first leg of a long journey, another element of this behindthe-scenes influence is the panel known as AMA/ Specialty Relative Value Scale Update Committee, or RUC. Since 1991 members of the RUC establish the value or price for the CPT codes. Somehow this is not considered price-fixing.

To decide on reimbursement, 28 voting members of the RUC, representing medicine specialties such as anesthesiology, cardiology, neurology, neurosurgery, obstetrics, oncology, psychiatry, and so on, meet and decide how much each service is worth, and how much will be paid.

Control of the CPT and RUC have helped shaped health care toward high technology and high prices, less primary care, and no prevention.

A dramatic example of flawed decisions in the medical/pharma industrial complex is the opioid crisis. Twenty years after a marketing blitz convincing physicians that opioids were safe and effective, now one of the deadliest medical mistakes of modern times.

Despite the flood of legal opioids into the society, the CDC reported no change in pain that would meaningfully have ever driven the prescribing: “…there had not been an overall change in the amount of pain that Americans reported.”

The CDC did find that psychological and physical treatments for pain were beneficial, but these non-medical approaches are rarely integrated into treatment programs. Behavioral approaches were often the more appropriate treatment. “It is now widely accepted that pain is a biopsychosocial phenomenon,” clinical health psychologist and Past-President of the Southern Pain Society, Dr. Geralyn Datz said, and that must be treated as such.

Louisiana Follows the Leaders

Louisiana may have the most to gain from prevention and innovations, but there is a long way to go from where the state is currently.

In the most recent Louisiana Medicaid Annual Report, the top 10 provider types, ranked by payment, were first, hospitals, at $1.3 billion, and second, pharmacy, at $726 million. Dentists were third at $162 million, then mental health rehabilitation at $140 million, nurse practitioners at $115 million, and behavioral health rehabilitation agencies at $114 million. Distinct psychiatric hospitals were next at $76 million and freestanding mental health hospitals at $69.7 million.

In comparison, all other providers, which include chiropractic, personal care attendants, physical and occupational therapy, psychology, social work, and other services, totaled only $917,000.

In a 2018-2019 Combined Behavioral Health Block Grant Plan, published in late 2017, the state noted that the number of persons being served was only 3.29% of the estimated prevalence. The estimated number of children/youth with serious emotional disorders was 38,803 and only 1,370 had been served. The prevalence estimate for adults with serious mental illness was 192,019 and only 7,590 had been served.

Access to care and rates have been a problem nationally, with nearly half of all providers not offering services to Medicaid patients. Nationwide, Medicaid fees are about 72 percent of Medicare, which is about 80 percent of private pay. And this amount comes to an even smaller portion of what some practitioners charge in a fee-for-service setting.

In a list of “Specialized Behavioral Health Services CPT Code” and reimbursements, effective last year, the fee structures provide little in the way of reimbursement for health and behavior, or any clear mechanism for integrated services. The “health and behavior” services pay between $12 and $15 and are only listed for a psychiatrist, nurse/physician’s assistant, medical psychologist, or a psychologist. None were listed for clinical social workers or counselors.

Some codes and fees are listed for psychotherapy. Individual psychotherapy is reimbursed at $69.76 for psychiatrists for 45 minutes, $55.81 for nurse practitioners and physician assistants, $55.81 for psychologists, and $48.83 for social workers, counselors, and marriage and family therapists. And group therapy, a valuable therapy mode for many issues, is paid at only $23.23 to $18.58 and there is no reimbursement for the social worker or counselor listed on the current fee schedule. The low pay may account for why only about 130 psychologists are listed as providers on the current Medicaid rolls, and many of these are agency staff.

These misaligned incentives seem likely to impact those who have the least options to find better care in the private sector.

Finally, physician researcher Dr. Martin Makary has shown that medical error, unrelated to the illness or injury, is the third cause of death nationwide, following only heart disease and cancer deaths.

To conclude, Louisiana spends more than other states while there is no positive relationship between the money spent and health outcomes. Nationwide, the costs are staggering, while many chronic diseases are on the rise. Overall, the system looks to be more like a money-laundering scheme than a set of effective health services.

States like Louisiana with a high percentage of citizens at or near the poverty level, would benefit most from prevention and new, inventive treatments. “A bright new future of understanding, preventing, and treating mental disorders awaits us,” writes Bonnie Kaplan.

But just how long is that wait going to be?Facebooktwitterredditpinterestlinkedinmail

Dr. Coulter, Dr. Reuther to Serve as President, President-Elect for Louisiana Psychological Association

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Top: Dr. Alan Coulter at a conference. He is currently serving as President of the LPA. Below: Dr. Erin Reuther presenting. She is the current President-Elect

The Louisiana Psychological Association announced its newly elected officers to their Executive Council, who began serving last month. The 2019–2020 Council are Drs. Alan Coulter (President), Dr. Erin Reuther (President-Elect), and two new Directors, Dr. Christopher Parkinson and Dr. Amanda Raines. Returning officers are Dr. ValaRay Irvin (Secretary), Dr. William Costelloe (Treasurer), Dr. Bridget SonnierHillis (Director) and Dr. Kim VanGeffen (Director).

Dr. Alan Coulter will serve as the 2019– 2020 President. He is the Director of Program Area for the School of Allied Health Professions, Human Development Center, at LSU Health Sciences Center. He is the Director of Educational Innovations for the Human Development Center and LAS*PIC, and the Principal Lead for the TIERS Group. Dr. Coulter served on the President’s Commission on Excellence in Special Education, was a member of the National Monitoring Stakeholders Group, a recipient of Child Advocacy Award from the National Association of School Psychologists, and a past president of the National Association of School Psychologists.

Dr. Erin Reuther will serve as PresidentElect. She is a Pediatric Clinical Psychologist at Children’s Hospital-New Orleans and obtained board certification (ABPP) in Clinical Psychology in 2015. Dr. Reuther earned her doctoral degree from Louisiana State University in Baton Rouge where she focused on research in anxiety and cognitive-behavioral treatment with children and adults. She completed her clinical internship at the University of Florida-Shands Hospital in the child/pediatric track, where she further specialized in exposure with response prevention for OCD, CBT for anxiety, and health psychology working with inpatient and outpatient pediatric and adult clients with medical illnesses including gastroenterology disease, pediatric diabetes, and those preparing for surgery.

For her service, Dr. Reuther will focus on “… communication of all that LPA does to advocate for the profession, including direct coordination and communication with APA and national efforts, interacting with governmental agencies to educate and advocate for the profession, keeping psychologists in Louisiana informed of best practices, and organizing psychologists together.”

Newly elected were Dr. Christopher Parkinson and Dr. Amanda Raines.

Dr. Parkinson is a Clinical Psychologist with an emphasis in Health Psychology from Rosalind Franklin University of Medicine & Science. He completed his internship at the Gulf Coast Veterans Healthcare System and his postdoctoral residency in Health Psychology and Pain at the Southeast Louisiana Veterans Healthcare System. He currently holds a staff position at the SLVHCS as the Palliative Care Psychologist engaged in clinical care, program development, training, and research. He also serves as adjunct clinical instructor within the Department of Psychiatry and Behavioral Sciences of the Tulane University School of Medicine. He is the 2018 recipient of the LPA Early Career award.

Dr. Raines serves as a Clinical Investigator at the Southeast Louisiana Veterans Healthcare System and as Assistant Professor in the Department of Psychiatry at Louisiana State University. Her doctorate is in clinical psychology from Florida State University and her internship and residency was with LSVHCS. Her research focuses on identifying and empirically examining risk and maintenance factors as well as the development of novel interventions that can be used to treat and prevent anxiety and related pathology. She has published over 75 peer-reviewed manuscripts and was the Early Career Psychologist delegate to the 2019 Practice Leadership Conference of the American Psychological Association.Facebooktwitterredditpinterestlinkedinmail

Dr. Bianchini (L) and Dr. Greve (R) receive awards from Dr. Chafetz. The two were honored last month for their distinguished contributions in psychological science by the Louisiana Psychological Association

Psychologists Honored for Distinguished Contributions

FacebooktwitterredditpinterestlinkedinmailThe Louisiana Psychological Association has named Dr. Johnny Matson, Drs. Kevin Bianchini and Kevin Greve, Dr. Susan Tucker, Dr. Julie Nelson, and Dr. John Sawyer for their outstanding contributions in the psychology community. The awards were announced at the 71st Annual Convention and Business Meeting of the Association, held June 14 and 15 in Metairie.

For the prestigious 2019 Distinguished Psychologist Award, the association named Dr. Johnny Matson of Louisiana State University (LSU). Dr. Matson is Professor of Psychology and Distinguished Research Master at LSU and a top cited scholar who has been named by Thompson Reuters as one of the “Most Influential Scientific Minds of our Time.”

Dr. Matson is an expert in autism, mental disabilities, and severe emotional disorders in children and adolescents, and has produced more than 700 publications and 38 books. He has authored the International Handbook of Autism and Pervasive Developmental Disorders, Practitioner’s Guide to Applied Behavior Analysis for Children with Autism Spectrum Disorders, Practitioner’s Guide to Social Behavior and Social Skills in Children, and many others.

He has served as Editor-in-Chief for Research in Autism Spectrum Disorders (Oxford England), Editor-in- Chief for Research in Developmental Disabilities (Oxford, England), and Associate Editor for Journal of Mental Health Research in Intellectual Disabilities (London). Among his many professional activities, Matson has been a guess expert on ABC’s 20/20, consulted with the Alabama, California, Georgia, Illinois, Iowa, Louisiana, Missouri, Virginia, and the US Departments of Mental Health. He has been a guess expert on CBS Eye-to-Eye and consulted for the DSM III-R Educational Testing Service. He has served on the President’s Committee on Mental Retardation, and consulted to the US States Department of Justice, and the US Department of Education.

The state psychological association named Kevin Bianchini, PhD, ABN and Kevin Greve, PhD, ABPP, as the 2019 recipients of the Contributions to Psychological Science Award.

The joint award acknowledged the two applied scientists and their roles in the systematic development of validity science based upon criterion-groups research, and the development of the rules for malingered pain related disability, explained Dr. Michael Chafetz, Awards Committee Chair. “Their scientific influence in our field has had considerable impact, and we are grateful for their outstanding contributions,” said Chafetz.

Dr. Kevin Bianchini is a board certified Neuropsychologist and Clinical Psychologist who has been in practice in Louisiana for 23 years. He was the Director of Neuropsychology for Bancroft NeuroHealth, a residential brain injury rehabilitation facility in Louisiana. He has remained involved in the rehabilitation of patients with acquired brain injury and pain throughout his career. He is actively involved in research and has published more than 75 articles in peer-reviewed professional journals on psychological factors and work related injuries, neurological rehabilitation, brain damage, neuropsychological assessment and symptom validity assessment.

Dr. Bianchini is a Diplomate of the American Board of Professional Neuropsychology. He holds adjunct faculty appointments at Tulane University Medical School, Department of Psychiatry and Neurology, and at the University of New Orleans, Department of Psychology. He is the managing partner of Jefferson Neurobehavioral Group, which has offices in Metairie, New Orleans, Baton Rouge, Lafayette, and Houston.

Dr. Kevin Greve has published more than 110 papers in peer-reviewed neuropsychology, psychology, and medical journals including papers on the assessment of the effects of traumatic brain injury and chronic pain. He is also the author of 10 chapters in edited books and has made more than 100 scholarly presentations at state, regional, national, and international conferences. Dr. Greve has served on the editorial board of The Clinical Neuropsychologist, Archives of Clinical Neuropsychology, and Assessment. He periodically serves as an ad hoc reviewer for several other journals.

He retired from full-time employment in the Department of Psychology at the University of New Orleans in May 2012, at the rank of University Research Professor after 21 years of service. He continues to be affiliated with the University of New Orleans as Emeritus Research Professor and holds a number of other academic positions. Dr. Greve is now in the full-time practice of clinical psychology and clinical neuropsychology. He conducts approximately 150 psychological evaluations a year typically related to traumatic brain injury, chronic pain, dementia, depression, post traumatic stress disorder, and the psychological effects of medical illness.

Dr. Susan Tucker is the 2019 recipient of the Award for Psychology in the Public Interest. Dr. Tucker, has been a key figure in reforms in the state correctional system. She is Psychologist and Assistant Warden at the Bossier Sheriff’s Office, where she has focused on treatment and research showing innovations that reduce recidivism and that are based in the fact that most inmates have a substance abuse problem but few get the right kind of treatment. She launched the Steve Hoyle Intensive Substance Abuse Program at the facility to offer intensive treatment, skill development, educational opportunities, and post release support and care. “We thank her for her outstanding work that is certainly in the public interest,” said Chafetz.

Her effective and creative treatment approach has achieved a significant reduction in recidivism, from an expected first year rate of 18 percent to only 3 percent. Tucker has earned state and national recognition for these achievements, including from the Vera Institute of Justice who said the program “…should be a model for the nation.” Dr. Tucker’s work was also honored by the Ash Center for Democratic Government and Innovation at the John F. Kennedy School of Government at Harvard.

Dr. Tucker was commended by Louisiana legislators for her work and the related cost savings of $15 million by earned “good time credits” through participation and successes in the psychological programs designed by Tucker. Legislators pointed to multi-million dollar cost savings to the state because of shorter incarceration times of those offenders who participated in the psychological programs.

Julie Nelson, PhD, received the award for Distinguished Service in Psychology. She was cited for her service as LPA President and for her journalism and publishing of The Psychology Times. She is a consulting psychologist and owner of PSI, Inc. and serves the petrochemical industry in Gulf south region providing validity research and organizational development activities.

Dr. John Sawyer was named Early Career Psychologist. John Sawyer, PhD, ABPP is a board-certified neuropsychologist trained to evaluate children, adolescents, adults, and geriatrics. He is the Co-Director of the Cognitive Disorders and Brain Health Program at Ochsner Health System, where he has led several clinically-focused research projects aimed at using telehealth and electronic medical record technology to provide care to individuals with dementia and their care partners while limiting the need for disruption of routine for hospital or clinic visits. His work will be presented at the upcoming meeting of the National Academy of Neuropsychology.

The LPA Awards Committee is chaired by Dr. Chafetz and committee members include Drs. Kim VanGeffen, Beth Arredondo, and Brian Mizuki. LPA is the state affiliate of the American Psychological Association.Facebooktwitterredditpinterestlinkedinmail