Category Archives: Front Page Story

No Substantive Changes After Public Feedback on Proposed Rules from Psychology Board

After publishing over 19,000 words of new proposed regulations, the Louisiana State Board of Examiners of Psychologists conducted a public hearing on December 16. The board dismissed calls from the public for substantive changes.

Proposed rule changes include those for fees, registration and oversight of assistants, continuing education rules, training, credentials and scope of practice for neuropsychology, specialty designations, ethics for school specialists, and the rules for using an Emeritus title.

More than 20 individuals submitted criticism of the proposed rules, the majority of comments had to do with the oversight of assistants to psychologists.

As required by law, the State Board published a “Notice of Intent” of the changes in November 20 issue of the Louisiana Register. According to several sources attending the public meeting, the board members wanted to avoid “substantive” changes brought about by feedback, which would then require a second Notice of Intent.

Dr. Kim VanGeffen from the Public Affairs Committee of the Louisiana Psychological Association, noted, “The Board stated that they will be unlikely to make major changes to the Rules as, to do so, would require reposting the Rules and having another period of commentary. They may make what they would term minor changes.”

The Times asked Dr. Greg Gormanous, current chair of the State Board, to comment and he  agreed to provide individual feedback. ” I am offering my comment as an individual. Also I am stipulating that you include the entire quote,” Dr. Gormanous wrote.

“The public hearing on rule making initiated by LSBEP served its purpose. Written comments  were read into the record. The written comments were from many people who were attending virtually. LSBEP also requested oral comments from a member of the public who attended in person. When the hearing ended, the Board, being sensitive to public attendees, next devoted a substantial amount of time and discussed most of the comments. Those deliberations resulted in several important non-substantive tweaks,” he said.

The board appeared to ignore the requests to show evidence of a need for the new detailed oversight and management regulations for assistants, a problem voiced by many of those commenting.

Public comments also included details of managing assistants. According to VanGeffen, “The  Board explained that the process of registering assistants will require an ‘administrative review’  and not full approval of the Board,” said VanGeffen. “Some people commented that the current wording of the Rules suggests that one would have to employ the person first before submitting the application for registration.” Also, “Currently the Rules require that the supervisor be “on  site” while the assistant is performing services,” she noted. “There were a number of comments  about how this is not consistent with the new Medicare guidelines […]. “There were questions about whether ATAPs who are currently employed would be “grandparented.'”

The new regulations effort stems from the 2021 House Bill 477, legislation put forth by the  Louisiana State Board of Examiners of Psychologists, now Act 238.

HB 477, authored by Representative Joe Stagni, was a compromise measure following the downsizing of a 23-page bill introduced by the psychology board in 2020 and then again in 2021. Under pressure from opponents, the board agreed to substitute a fee bill, telling sources that without the increased fees the board would not be able to operate in the future. This  message resonated with the majority of those attending a special meeting of the Louisiana Psychological Association called for by petition of those opposing the measure.

According to the Notice of Intent, the proposed rule changes will increase revenue collections for the LSBEP by $21,000 for FY 23 and $18,050 in FY 24 and FY 25. The estimate is 420 assistants.

Also according to the Notice, the Board claims that benefits include a positive impact for licensed psychologists and also for competition.

“The proposed rule changes will benefit Licensed Psychologists by reducing their risks associated with hiring unqualified individuals to work with vulnerable populations…” And, “The proposed rule changes are anticipated to have a positive effect on competition and employment. Licensed Psychologists who utilize ATAP’s are able to serve a larger client base than if working independently.

Next, the Board is required to respond to all comments and submit a report to legislative oversight committees, House Committee on Health and Welfare and the Senate Committee on Health and Welfare, according to the Administrative Procedures Act.

“The agency shall issue a response to comments and submissions describing the principal reasons for and against adoption of any amendments or changes suggested in the written or oral comments and submissions. In addition to the response to comments and submissions, the agency may prepare a preamble explaining the basis and rationale for the rule, identifying the data and evidence upon which the rule is based, and responding to comments and submissions. Such preamble and response to comments and submissions shall be furnished to the respective legislative oversight subcommittees […]

Also, “Prior to the adoption, amendment, or repeal of any rule or the adoption, increasing, or decreasing of any fee, the agency shall submit a report relative to such proposed rule change or fee adoption, increase, or decrease to the appropriate standing committees of the legislature and the presiding officers of the respective houses as provided in this Section. […]

This review is to include numerous items including: “(3) The specific citation of the enabling legislation purporting to authorize the adoption, amending, or repeal of the rule or purporting to authorize the adoption, increasing, or decreasing of the fee. […] ” (ii) A summary of all comments received by the agency, a copy of the agency’s response to the summarized comments, and a statement of any tentative or proposed action of the agency resulting from oral or written comments received.”

The oversight subcommittees determine among other things, whether the rule change or action on fees is in conformity with the intent and scope of the enabling legislation, and whether the rule change or action on fees is acceptable or unacceptable to the oversight subcommittee.

The public meeting was held December 16 and according to the Administrative Procedures Act was required to be at least 35 days after the notice was published. The Notice was published November 20, 2022. According to the Act, “Any hearing pursuant to the provisions of this Paragraph shall be held no earlier than thirty-five days and no later than forty days after the after the publication of the Louisiana Register in which the notice of the intended action appears.”

 

 

 

 

 

 

 

Gov. Edwards Touts Positive Outcomes of Criminal Justice Reforms

In two press releases, Gov. John Bel Edwards touted the state’s improved criminal justice program after a November report by PEW and a bipartisan report by the Pelican Commission Institute highlighted significant improvements in Louisiana’s criminal justice reform outcomes.

In December, the Governor said the Pelican Institute, a conservative think tank, released an analysis of crime data in Louisiana that drew four conclusions:

1) Property crimes are decreasing in Louisiana 2) Increases in violent crime were a nationwide event in 2020, impacting almost every state 3) Violent crime increases in Louisiana were lower than in other southern states 4) Increases in violent crime are not correlated with criminal justice reforms or decreased incarceration rates.

According to the announcement, one of the key goals of bipartisan criminal justice reform was to reserve prison beds and law enforcement resources for more dangerous offenders.  Incarceration numbers for Louisianans convicted of non-violent crimes have dropped significantly thanks to bipartisan criminal justice reform, but Louisiana now has more people incarcerated for violent offenses than before criminal justice reform. According to the Pelican Institute analysis, violent offenders are also serving longer sentences now than they were before bipartisan criminal justice.

“This report proves that bipartisan criminal justice reform has actually helped Louisiana
fight the nationwide increase in violent crime by focusing our law enforcement resources on violent offenders,” said Governor John Bel Edwards. “Don’t let lazy narratives fool you. We have gotten smarter on crime, and tougher on violent crime. Conservative, liberal, and non-partisan experts all agree that our reforms have been successful, because the data proves it. We still have a lot of work to do to bring down crime rates, but we’re better off thanks to bipartisan criminal justice reform.”

In November, the Governor’s office pointed out that the Pew Charitable Trusts published
Gov. Edwards Touts Positive Outcomes of Criminal Justice Reforms, continued a story highlighting the transformative impact bipartisan criminal justice reforms have had on Louisiana in the five years since taking effect.

Reporting for PEW, Michelle Russell wrote:

“This fall marks five years since Louisiana enacted its landmark criminal justice reforms. Signed by Governor John Bel Edwards in 2017, the 10 bills passed with strong bipartisan majorities and followed the recommendations of the Louisiana Justice Reinvestment Task Force, an interbranch body of justice system leaders and stakeholders.

“The new laws included changes to sentencing, corrections, and community supervision. In the legislation, policymakers focused on ensuring adequate prison space for those who pose a public safety threat, strengthening probation and parole practices, eliminating barriers to reentering society, and reinvesting savings to reduce recidivism and support victims. Using the most recent publicly available data, here are five findings about how Louisiana’s system has changed since the reforms took effect.

“The state’s prison population has fallen 24%, driven entirely by a decline in people convicted of nonviolent offenses.

“Louisiana’s reforms sought to steer people convicted of less serious crimes away from prison and shorten the time incarcerated for those who could be safely supervised in the community.  In the summer of 2017, before the new laws took effect, there were about 35,500 people under the Louisiana Department of Corrections’ jurisdiction held in prisons or local jails throughout the state. By the summer of 2022, that number had fallen nearly a quarter to about 27,000. A report recently presented to lawmakers showed that the declining prison population was entirely driven by a reduction in people convicted of nonviolent offenses. That number shrank by about 11,000 between 2016 and 2021. Over the same period, the number of individuals who were incarcerated for violent offenses increased by almost 1,400.”

Dr. Susan Tucker, psychologist, was involved in these reforms. She was previously the Assistant Warden, licensed psychologist, and program developer at the Bossier Parish Correctional Center, designed the Steve Hoyle Intensive Substance Abuse Treatment Program. The program first began at the Forcht Wade Correction Center Keithville, Louisiana, and was relocated to the Medium Security Facility for the Bossier Sherriff located between Benton and Plain Dealing, LA.

Tucker’s programs earned state and national recognition, including a legislative commendation, the Residential Substance Abuse Treatment grant, and the governor’s grant for prevention. In 2010 the Vera Institute of Justice, an organization dedicated to improving justice systems through research and innovation, noted that the program, “…should be a model for the nation.”

In 2015, the Ash Center for Democratic Governance and Innovation of the John F. Kennedy School of Government at Harvard University has named Dr. Susan Tucker and her treatment programs as one of this year’s recipients of the prestigious Bright Ideas awards for innovation. 

 

 

 

 

State Board to Take Control Over Psychologists’ Assistants

The state psychology board is proposing new rules and regulations to govern the use of  assistants to Psychologists. The notice for new rules was published in the November issue of  the Louisiana Register. The proposed rules include the conditions for the use of assistants , the responsibilities of supervising psychologists, and the disciplinary activities that the board may engage in for those registered as assistants.

The new oversight conditions stem from the 2021 House Bill 477, legislation put forth by the Louisiana State Board of Examiners of Psychologists, now Act 238.

HB 477, authored by Representative Joe Stagni, was a compromise measure following the downsizing of a 23-page bill introduced by the psychology board in 2020 and then again in 2021. Under pressure from opponents, the board agreed to substitute a fee bill, telling sources  that without the increased fees the board would not be able to operate in the future. This message resonated with the majority of those attending a special meeting of the Louisiana  Psychological Association called for by petition of those opposing the measure.

The language reads:

§2354. Fees

(4) The board shall charge an application fee for the initial registration of each assistant to a psychologist that shall not exceed fifty dollars. The board shall adopt rules in  accordance with the Administrative Procedure Act to implement the provisions of this Paragraph.

Sources from both the state board and the Louisiana Psychological Association that supported  the measure acknowledged that the new regulation was an attempt to raise revenue for the board, which has been struggling financially for a number of years.

The public may submit comments and criticism to the boards office by noon on December 12.  According to the notice, “LSBEP will conduct a Public Hearing at Noon on December 16, 2022, at  the board office located at 4334 S. Sherwood Forest Blvd., Suite C-150, Baton Rouge, LA 70816.  All interested persons are invited to attend and present data, views, comments, or arguments,  orally or in writing.”

The Louisiana Register’s Notice of Intent for new rules and regulations includes the following: 

§1101. Conditions for Utilization of Assistants
A. Upon employment of an ATAP, [Assistant to a Psychologist] but prior to assisting in psychological duties, the Supervising Psychologist shall submit a complete application for initial  registration, required registration fee, and documentation on such form and in such manner as  may be prescribed by the board to demonstrate that the registrant meets all of the following criteria:
1. is 18 years of age or older;
2. possesses a minimum of a high school diploma or its equivalent;
3. is of good moral character as determined by a criminal background check conducted under  the authority of R.S. 37:2356.1 and the provisions of this Part;
4. is not in violation of any of the provisions of the La. Revised Statutes Title 37, Chapter 28.  Psychologists; or the Louisiana Administrative Code, Title 46, Part LXIII; or any provision governing the practice of psychology under the jurisdiction of the board;
5. is qualified, or will receive supervised training commensurate with the services to be performed and is under the direct and continuous supervision of the Supervising Psychologist  as defined in this Chapter.
B. Prior to the approval of any registration, the registrant shall initiate a criminal background check from the Louisiana State Police, Bureau of Criminal Identification and Information in accordance with this Part, and the criminal history records information report must be received  and cleared by the board.
C. Upon review of the application, the board shall notify the licensed psychologist of record that the application and evidence submitted for registration is satisfactory and the registration has  been approved; or that the application or evidence is unsatisfactory and rejected; or other pending status. If the application is rejected, a notice from the board shall include the reasons for the rejection.

§1103. Responsibilities of Supervisors
A. The Supervising Psychologist:
1. is responsible for the registration and renewal of an assistant to a psychologist in conformity  with this Chapter on such form and in such manner as prescribed by the board;
2. directs the provision of psychological services to clients;
3. is administratively, clinically, ethically, functionally, and legally responsible for all activities of the Assistant to a Psychologist;
4. is accountable for the planning, course and outcome of the work. The conduct of supervision  shall ensure the welfare of the client, and the ethical and legal protection of the assistant;
5. is responsible for general communication regarding the needs of the clients and services rendered;
6. is responsible for continuing professional supervision of the ATAP;
7. provides general professional supervision of the ATAP that shall include one cumulative hour  per week as a minimum for direct supervisory contact:
B. Neglect in maintaining the above standards of practice may result in disciplinary action  against the supervisor’s license to practice, including suspension or revocation.

§1109. Exceptions to the Registration of an Assistant to a Psychologist
A. The provisions of this Section shall not apply to the following:
1. a medical psychologist utilizing assistants under the provisions of RS 37:1360.61 under the  jurisdiction of the Louisiana State Board of Medical Examiners.
2. an individual licensed under this part as a licensed specialist in school psychology who is  providing services defined under RS 37:2356.3.

§1107. Denial, Revocation, or Lapse of a Registration for an Assistant to a Psychologist
A. and take such actions permitted under RS  37:2351-2378, et al in matters involving the ATAP and/or their supervisor. The board has the authority to conduct investigations
B. The board may deny or revoke the registration of an assistant to a psychologist (ATAP) that is  in the best interest of public health, safety, and welfare for any unethical, unlawful, or other  unprofessional conduct under the jurisdiction of the board.
C. Immediate action may be taken to administratively suspend an ATAP’s registration in the  event information is received that the action(s) of an ATAP is causing harm to clients, is  otherwise likely to cause harm to future clients or patients, or the action(s) is unethical or  unlawful. Such action may be taken in instances including but not limited to falsifying  information in an application; and/or receipt of information involving an arrest, warrant for an  arrest, or conviction of the ATAP. 

 

 

 

 

 

 

 

UNO’s Dr. Harshaw Studies Tylenol

University of New Orleans psychology professor Dr. Christopher Harshaw is uncovering the  possible link between a common pain reliever and developmental disorders. His findings have  been published in the October issue of Pharmacology, Biochemistry and Behavior, as reported  by UNO Campus news.

Dr. Harshaw was awarded a oneyear grant from the Louisiana Board of Regents for the  research, which focused on the developmental reaction that mice have to acetaminophen, best known by its popular brand name version, Tylenol.

In the UNO article, Harshaw said, “Several epidemiological studies have linked the use of acetaminophen in infants and young children to attention deficit and autism spectrum disorder  in humans. Studies in animals have also shown long-term changes in brain in behavior after  exposure to acetaminophen early in life. Most had nevertheless neglected the question of how acetaminophen interacts with inflammation early in life. We emphasize that, though  provocative, our results do not support a simple conclusion regarding the relative danger vs.  safety of (acetaminophen exposure) early in life.”

What are the most important applications of his findings?

“Though our results are provocative, we emphasize the need for caution. That is, the results of  our initial study do not support a simple conclusion regarding the relative danger of APAP  [acetaminophen] early in life for humans. First, our study has a number of limitations. We thus  plan to replicate these results and refine our methods in future experiments. Critically, we also  documented a significantly protective effect of APAP against a novel inflammation-induced morphological change in these same mice (see Harshaw & Warner, 2021). Given that a number  of prior studies have reported neuroprotective effects of APAP in specific contexts and brain cell types,” he explained, “future studies must investigate potential beneficial effects of APAP  against changes in the developing brain induced by early-life inflammation.”

As stated at the conclusion of the paper, “A key implication of our findings is that no simple  conclusion regarding the relative safety vs. danger of APAP early in life is yet possible. In fact, it  may be that inflammation and APAP constitute a developmental Scylla and Charybdis. Further  research is needed, however, to ascertain the veracity and boundaries of this claim, including  the conditions—genetic, epigenetic, and experiential—that may interact to canalize atypical  developmental trajectories in response to these common early life exposures” (Harshaw &  Warner, 2022).”

What are some more of his recent publications?

“My lab’s recent papers have focused on the effects of early life exposures on behaviors relevant to Autism Spectrum Disorders (ASDs) in mice. In particular, we’ve focused on exposure  of the mother to antibiotics (during pregnancy and nursing) and exposure of the pups to  acetaminophen early in development. Our paper on antibiotic (ABx) exposure found significant  differences in microbiome diversity following perinatal ABx that were far more pronounced in  male than in female offspring. We also found a number of subtle differences in behavior in these pups during the early postnatal period. However, we also showed that some of these  behavioral differences were, in fact, the result of significant deficits in temperature regulation in these animals, induced by ABx,” said Dr. Harshaw.

“Our paper on acetaminophen (APAP) examined how APAP interacts with inflammation early in ife to influence ASDrelevant behavior. This is an important question given that confound by  undication is a significant issue in the human epidemiological literature and early life sickness  and infection are also risk factors for neurodevelopmental disorders. We found distinct effects  of inflammation and APAP, with APAP increasing social caution in males but not females. We  also found significant interaction between inflammation and APAP, with ‘two hit’ inflammation +APAP females showing significantly greater levels of anxiety and ‘two hit’ males showing  levated levels of social avoidance.”

Can he tell us about his laboratory?

“My laboratory is called the Mechanisms Underlying Sociality (MUS) Lab and is located in the  Department of Psychology at the University of New Orleans (UNO).  It consists of a ‘wet lab’,  rooms in the animal facility, and office space. I currently have three Ph.D. students and a  number of undergraduate RAs in my lab. Two of the Ph.D. students are conducting their own  experiments in rodent models, and one is conducting a study examining the thermal correlates of social anxiety in human participants.”

What is his agenda for the coming years?

“In the coming years I plan to continue to focus on exploring the mechanisms underlying effects of early-life APAP on behavior. Using funds from the Louisiana Board of Regents (BoR), for  example, we recently purchased an Agilent ‘Seahorse’ mitochondrial analyzer and a vibratome  for slicing unfixed brain tissue. We will soon begin examining whether APAP induces long-term  mitochondrial damage in specific populations of neurons early in life.”

What is it like at UNO and how are things with the new chair?

“UNO is a great place to teach and conduct research–I am excited about continuing my career  here! The new chair, Dr. Refinetti, has also done a great deal to stabilize and grow the  department. Under his leadership the Department is in a far better position to adapt and meet  the changing needs of our students and community.”

Dr. Harshaw earned his Ph.D. in Developmental Science, with a specialization in Developmental  Psychobiology, at Florida International University in Miami. Since the Fall of 2017 he has been  an Assistant Professor in the Department of Psychology at the University of New Orleans.

Dr. Stewart Champions the Whole Person Approach for Female Athletes

Pennington Professor and psychologist Dr. Tiffany Stewart is leading two new studies that will  reveal more connections between physical resilience and psychological health in female  athletes.

“Female athletes face a unique mix of stresses to their mental, physical, hormonal and immune  health during training and competition,” said Dr. Stewart to Pennington news. Stewart is the Director of the Behavior Technology Laboratory at Pennington Biomedical Research Center.  “For too long, sports have focused solely on the results – wins, losses, faster times, and higher  scores – while ignoring athletes’ mental health. But mental resilience and emotional well-being  are every bit as important to succeeding in athletic endeavors or life overall.”

Dr. Stewart’s Behavior Technology Laboratory at LSU’s Pennington Biomedical Research Center  is dedicated to Translational Science. She and her team take health behavior change programs  and the accompanying technologies from laboratory settings and transform them into  programs that everyone can use. The Lab has pioneered the development and testing of e- health technologies in order to bring health behavior tools to those who need it most wherever  they are in the world, reported 225 Magazine.

The new research is supported by two awards from the Wu Tsai Human Performance Alliance,  whose founding members are Stanford University, Boston Children’s Hospital, UC San Diego,  the University of Kansas, the University of Oregon, and the Salk Institute.

According to Stewart, one project will recruit 500 female athletes and assess overall mental  health and resilience. Included will be measures of mood, anxiety, body image, social support,
excessive training, sleep, and injury at four points during a 12-month period.

The second study, will focus on 50 of LSU’s female athletes. Scientists will measure mental,  physical, hormonal and immune resilience factors during periods of normal, moderate and high stress.

“It’s time we looked at our athletes from a person-centered focus, not solely a performance- centered focus,” Dr. Stewart said. “We need a core paradigm shift that includes health and well-being for the long-term. We need to hand our athletes mental health and resilience skills, and  we also need to look at a shift in athletics’ culture and environment,” she said.

Why is it important that the paradigm shift include mental health? “We are still very much a  performance based sport environment,” Dr. Stewart said. “I think mental health as a key piece  of the whole athlete has been missing from not only helping our athletes be the best they can  be on the playing field but in life- thriving in and out of sport,” she said.

“Our model all along has been a ‘push through no matter what’ model–with expectations that  in athlete will persevere physical and mental ailments to get the job done. But in seeing what  has happened through Covid and what happened in the Olympics–world class athletes leaving  the floor due to mental health struggle, for example, Simone Biles–we have come to an impasse on the push through model,” she said.

“It’s an organic moment to address the health and well-being of the whole athlete for the good  of performance but also for the good of the life of the athlete outside of sport. Some of our  work to come is also focusing on athlete transition out of sport–into life,” Dr. Stewart said.

Why are these research projects so exciting? “These projects are so exciting and important  because while research has steadily increased and improved to investigate how to help athletes perform better, there has been little research on psychological performance, mental health,  and resilience in athletes and even Dr. Stewart Champions the Whole Person Approach for Female Athletes, continued further- women are underrepresented in these studies,” said Dr.  Stewart.

These two studies were funded specifically to study female athletes. Little research has been  done on resilience-based strategies for athletes, especially for female athletes. These projects  are the first step towards developing skills training for athletes to better cope with stress,  especially chronic stress. And- the ability to bounce back from tough things, e.g. injury, tough  life events, etc.,” Dr. Stewart said.

225 Magazine noted that for the past 20 years, Dr. Stewart’s team has worked with high  performance populations such as U.S. Army Soldiers and NCAA female athletes, in an effort to optimize their health and performance.

“Athletes are not immune to struggles with mental health,” Dr. Stewart said. “The pressure to  perform at all costs is more intense than ever. This leaves athletes at risk for consequences  such as less than optimal eating habits, exercise, sleep, as well as more serious mental health outcomes, including depression, anxiety, and even suicidality. These difficulties can last a  lifetime if not addressed. Proactive, mental health skills training specific to athletes is needed in  order to build positive mental coping and resilience skills.”

Dr. Stewart’s team has worked with female collegiate athletes over the years in an NIH-funded  trial with a program called the Female Athlete Body Project, according to the report in 225  Magazine. The next phase of work will include the final development and testing of the  S.C.O.R.E. (Sport Carried Forward for Resilience and Enrichment) Program- a digital platform  and smartphone application to assist athletes in mental and physical thriving.

“The aim is to provide tools and evidence-based coaching to help athletes at all stages of their  career to bounce back from difficult challenges and optimize their lives, mentally and physically, moving forward.”

Dr. Stewart has explained that research suggests that disordered eating among female athletes  is prevalent, and is especially dangerous in female athletes because it increases risk for the  Female Athlete Triad––low energy availability/disordered eating, menstrual disorders, and decreased bone mineral density/ osteoporosis and subsequent injury.

Dr. Stewart’s work has also attracted multimillion dollar funding from the National Institutes of  Health and the Department of Defense to understand and help soldiers. She develops programs and technologies to improve nutrition, fitness, and sleep of U.S. Army Soldiers and  their family members.

In 2018, the Pennington Biomedical Research Foundation honored their 30-year relationship  with the U.S. Defense Department, by hosting a special Scientific Dinner. Dr. Stewart joined with leaders of the Louisiana National Guard to celebrate the 140 studies and 100 papers that have  come as a result of joint projects and efforts to improve the health of military warfighters.

“Every day, soldiers and their families make sacrifices for our freedoms,” Dr. Stewart said. “At  Pennington Biomedical, we are looking at the health of the whole soldier. We want our men and
women in uniform to be ready for whatever they may face during their service, and that means  optimization of physical and mental health and resilience, as well as the families that support  them.”

According to Pennington, they are one of the Defense Department’s top nutrition research  contributors. “With 30 years of collaboration and $80 million in DOD funding to date, Pennington Biomedical has improved and continues to advance warfighter nutrition, fitness,  sleep, technology, body weight, body fat and metabolism.”

Stewart’s Healthy Eating, Activity, and Lifestyle Training Headquarters or H.E.A.L.T.H., is part of the  Weight Measurements and Standards for Soldiers Project.

The work is an ongoing, collaborative effort between Pennington and the Department of Defense, designed to aid Soldiers in  maintaining healthy weight status, fitness status, combat readiness, and Warfighter  performance.

H.E.A.L.T.H. includes programs to aid soldiers’ family members in reaching overall health and  fitness goals and incorporates cutting edge interactive technology such as with the Internet and  Smartphones, so soldiers and their family members can use it wherever they are in the world.  The project is considered a population health program, used and tested in two projects, at Ft.  Bragg, NC, and New England Reserves, and is being tested in the Louisiana Army National  Guard, according to Pennington.

The program is disseminated Army-wide as part of the U.S. Army Surgeon General’s  Performance Triad Initiative to improve nutrition, fitness, sleep, overall health, and resilience for our technologically advanced fighting force and their families.

Dr. Stewart and her team work to distribute information in the broader community. In 2019 she applied her innovations for a community health program at the Knock Knock Children’s Museum, in Baton Rouge. The program was a collaborative effort between the Baton Rouge  Mayor’s Healthy BR Initiative, the Museum, Pennington, and other community organizations, noted officials.

Dr. Stewart and her team provided the program called “Sisu & You: Healthy Kids and Healthy  Family Workshop.” Sisu is the Finnish word for resilience. “How we view our bodies is a key component of successful health behaviors and significantly affects our quality of life,” said the  developers.

Dr. Stewart is also an inventor and entrepreneur, and named 2015 Woman of Excellence by the  Louisiana Legislative Women’s Caucus Foundation. She was also commended by the Louisiana  Legislature in a House Concurrent Resolution for her work and research, and for “spearheading  unique, large, multi-site prevention studies that have included the development and  deployment of novel approaches for health behavior change, …”.

In the private sector, Stewart was a Founder and Chief Scientific Officer of Body Evolution Technologies Inc., a venture capital-funded entrepreneurial project dedicated to taking e-health  assessment, prevention, and treatment programs and technologies from the lab to those who  would benefit most, “… especially among young women as they face enormous pressures  concerning body-image, weight, eating behavior, and self-esteem.”

In an interview with Huffington Post Healthy Living in 2012, Dr. Stewart said, “I’m a scientist first  and foremost, as well as a clinical psychologist, Now I find myself an entrepreneur. My mission  is to bring scientific tools to the people who need them most. So many things are developed in  science that get great results but stay in the academic realm, like programs for the prevention  of eating disorders,” she said. “The work I do is dedicated to translating scientific tools into  popular formats that can engage young people to change their health behaviors — their eating,  exercise, body image and self-worth.”

Stewart said that the majority of the general population struggles with body image and it is  critical to health.

“Even in the scientific literature, body image is thought about as an appearance-based thing,”  Stewart explained. “No one has ever talked about body image in the context of health. But it  certainly affects our health, influencing our eating, our fitness and social habits. With everything we’re doing, we’re looking for a place where appearance and health can meet and basically be happy together.”

 

 

 

 

 

 

Dr. Claire Houtsma Recognized for Early Career Contribution in Suicide Prevention

Dr. Claire Houtsma, a research scientist in suicide prevention, was honored this spring by the Louisiana Psychological Association with their Early Career Psychologist Award.

Dr. Houtsma is the Suicide Prevention Coordinator at Southeast Louisiana Veterans Health Care System. She is a licensed Clinical Psychologist and the Core Investigator at South Central Mental Illness Research, Education and Clinical Center.

Dr. Houtsma is also Adjunct Assistant Professor in the Department of Psychiatry and Behavioral  Sciences, Tulane University, School of Medicine, and Research Assistant Professor in Section of Community Population Medicine, Louisiana State University Health Sciences Center, School of Medicine.

The Times asked Dr. Houtsma what she views are her most important contributions at this point in her career.

“My most important contributions have probably been in the area of firearm suicide  prevention,” Dr. Houtsma said. “My research related to firearms has been designed to clarify  contexts under which risk for firearm suicide is heightened, as well as to develop and test  interventions that reduce risk for firearm suicide. I am particularly proud of my projects that  have involved active collaborations with Veteran and civilian firearm owners,” she said.

“Through my work with the Veteran-Informed Safety Intervention and Outreach Network  (VISION), I collaborated with firearm owning Veterans and civilians to create a suicide prevention learning module, including a PowerPoint slide deck and brief video, that can be used in Louisiana firearm training courses,” said Dr. Houtsma. “I am currently working with a number of firearm course instructors to test the acceptability and effectiveness of this learning module.”

Spokesperson for the Louisiana Psychological Association, Dr. Amanda Raines, said, “The impact that Dr. Houtsma will make on the field of psychological science is best reflected in her timely  and innovative program of research. At a time when suicide remains the 11th leading cause of  death in the United States, her program of research aims to identify and examine risk factors that underlie firearm suicide,” Raines said. “In addition, her body of work focuses on the  development and dissemination of novel methods of prevention and intervention. To date, Dr. Houtsma has published 28 peer-reviewed articles and presented her work at various local and  national conferences. Further, she serves as a co-investigator or principal investigator on six  federally funded projects.”

Dr. Houtsma’s work is ongoing. “I am also in the midst of recruiting for a study that will examine the feasibility and acceptability of peer-delivered lethal means counseling among  firearm owning Veterans,” Dr. Houtsma said. “This study will evaluate whether conversations about implementing safer firearm storage practices are acceptable among Veterans and  whether they actually lead to behavior change. I feel these projects are among the most important contributions I have made so far because they focus on a population at high risk for firearm suicide, use a partnered approach in research design and implementation, and provide  practical outcomes that may help save lives now,” she said.

Dr. Houtsma has authored numerous important studies. For her article, “The Association  Between Gun Ownership Dr. Claire Houtsma Recognized for Early Career Contributions in  Suicide Prevention, continued and Statewide Overall Suicide Rates,” the aim was to “expand on extant research by examining the extent to which gun ownership predicts statewide overall  suicide rates beyond the effects of demographic, geographic, religious, psychopathological, and  suicider-elated variables.” According to the abstract, “By extending the list of covariates utilized,  considering those covariates simultaneously, and using more recent data, the study sought to present a more stringent test. Gun ownership predicted statewide overall suicide rates, with the full model accounting for more than 92% of the variance in statewide suicide rates. The correlation between firearm suicide rates and the overall suicide rate was significantly stronger  than the correlation between non-firearm suicide rates and the overall suicide rate.”

Another article by Dr. Houtsma, “The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates,” examined the impact of three state laws––permit to  purchase a handgun, registration of handguns, and license to own a handgun on suicide rates. According to the abstract, “They used 2010 data from publicly available databases and state  legislatures to assess the relationships between the predictors and outcomes. The Results  largely indicated that states with any of these laws in place exhibited lower overall suicide rates and suicide by firearms rates and that a smaller proportion of suicides in such states resulted  from firearms. Furthermore, results indicated that laws requiring registration and license had significant indirect effects through the proportion of suicides resulting from firearms. The latter  results imply that such laws are associated with fewer suicide attempts overall, a tendency for  those who attempt to use less-lethal means, or both. Exploratory longitudinal analyses indicated a decrease in overall suicide rates immediately following implementation of laws  requiring a license to own a handgun.”

In Dr. Houtsma’s “Moderating Role of Firearm Storage in the Association Between Current Suicidal Ideation and Likelihood of Future Suicide Attempts Among United States Military  Personnel,” researchers hypothesized that how soldiers store their firearms would moderate  the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, and that this relationship would be explained by fearlessness about  death, noted the abstract. “There were 432 military personnel who endorsed current ownership of a private firearm and who were recruited from a military base in the southeastern United States (94.5% National Guard). Firearm storage moderated the relationship between suicidal  ideation and the self-reported likelihood of engaging in a future suicide attempt, but this relationship was not explained by fearlessness about death. Individuals who reported keeping  heir firearms loaded and stored in an unsecure location exhibited higher mean levels of fearlessness about death. Findings highlight the need for research examining contributors to  suicide risk in the context of firearm storage and provide support for suicide prevention efforts  involving restricting means.”

Dr. Houtsma regularly shares information and research at conferences across the country. Examples include:

Houtsma, C., Powers, J., Raines, A. M., Bailey, M., Constans, J. I., & True, G.  (November, 2022). Adaptation and evaluation of a lethal means safety suicide prevention module for concealed carry courses. Symposium talk submitted to the National Research  Conference on Firearm Injury Prevention, Washington, D.C.

Houtsma, C., Sah, E., & Constans, J.  I. (November, 2022). The firearm implicit association test: A validation study. Symposium talk  submitted to the National Research Conference on Firearm Injury Prevention, Washington, D.C. 

Houtsma, C., Tock, J. L., & Raines, A. M. (November, 2022). When safe firearm storage isn’t  enough: Comparing risk profiles among firearm suicide decedents. Symposium talk accepted at  the annual meeting of the Association for Behavioral and Cognitive Therapies (ABCT), New York  City, New York.

Houtsma, C., Anestis, M. D., Gratz, K. L., Tull, M., Butterworth, S. E., Richmond, J., & Forbes, C.  (November, 2021). The role of opioid use in distinguishing between suicidal ideation and attempts. Symposium talk presented at the annual meeting of the Association for Behavioral  and Cognitive Therapies (ABCT), Virtual Conference.

Houtsma, C. (August, 2021). Feasibility and acceptability of Caring Contacts for suicide prevention among veterans recently separated from military service. Symposium talk presented at the Mississippi Health Disparities Conference, Biloxi, Mississippi.

Dr. Houtma is the investigator or coinvestigator for numerous grant projects including: Demonstration Project – Office of Mental Health and Suicide Prevention (OMHSP) Title: Measuring Feasibility and Effectiveness of a Lethal Means Safety Suicide Prevention Module in  Concealed Carry and Firearm Safety Classes, and Veterans Rural Health Resource Center FY22  Project – Office of Rural Health (ORH) Title: Preventing Firearm Suicides Among Rural Veterans  by Engaging Military Caregivers.

In her career so far, what is she most thankful for?

“I am endlessly thankful for the mentors who have helped me reach my goals,” Dr. Houtsma  said. “My graduate school mentor, Dr. Michael Anestis, provided me with the skills, encouragement, and support I needed to become a successful, research-oriented graduate  student. He has continued to be a mentor to me after graduate school and I am so grateful to know I can reach out to him for guidance as I navigate my career. I am also thankful for the  mazing mentors I gained during my clinical internship year. Drs. Amanda Raines, Laurel Franklin, Gala True, and Joseph Constans were critical in Dr. Claire Houtsma Recognized for  Early Career Contributions in Suicide Prevention, continued helping me transition from trainee  to early career psychologist,” she said.

“The Department of Veterans Affairs (VA) is a fantastic workplace,” Dr. Houtsma said, “however,  it is not always clear how to forge a research career in this setting. My mentors at the Southeast Louisiana Veterans Health Care System have provided invaluable assistance, reassurance, and  support in moving my research program forward within VA. I feel very lucky to have such amazing people on my team and I wouldn’t have achieved success as an early career  psychologist without them,” she said.

Does Dr. Houtsma have any advice for other early career psychologists?

“I would encourage other early career psychologists to stay in close contact with their mentors,” she said. I have found it immensely helpful, not only in navigating the minutia of research  studies, but also in determining how to balance work-life priorities. I realize not everyone has  the opportunity to gain desired mentorship in a naturalistic way, so I would encourage early  career psychologists to reach out to others in your field who have careers you admire. I have  gained mentorship from individuals at other institutions, simply by reaching out via email or  Zoom. It’s very hard to make it on your own in this field and the good news is, you don’t have  to!”

What has Dr. Houtsma enjoyed the most?

“Working with and learning from Veterans and firearm owners,” she said. “My work with VISION  as exposed me to the world of community-engaged research and I have found this to be an  extremely informative and rewarding experience. Being able to connect with individuals for  whom firearm suicide is a very real and personal experience reminds me why I’m doing this  work and reinforces my passion to find solutions,” said Dr. Houtsma.

 

 

 

 

 

 

Dr. Dickson Honored for Distinguished Service

Dr. Amy Dickson has been named recipient of the 2022 Award for Distinguished Service in  Psychology by the Louisiana Psychological Association, announced at the spring convention. Dr.  Dickson is Assistant Professor at Louisiana State University Health Sciences Center, (LSUHSC),  Department of Psychiatry, New Orleans, Louisiana. She is a license Clinical Psychologist, Infant Team Director, and Psychology Section Deputy Chief.

“This award is given to an individual who has made significant contributions to the professional  field of psychology in Louisiana and beyond by their professional service, particularly in the area of diversity, or demonstrated community involvement in support of less privileged or oppressed groups,” said Dr. Amanda Raines, spokesperson for the Association.

“Dr. Dickson works to support some of the most vulnerable populations in our community,”  said Dr. Raines. “She works with the Department of Child and Family Services where she provides services to families involved in the court due to suspected abuse and neglect of  children. In her previous role as Director of the Victims Assistance Program for the Department  of Psychiatry at LSUHSC, Dr. Dickson managed a crisis hot line to assist families in the New  Orleans area impacted by violence. In addition, she has worked as the co-director for the Harris  Infant Mental Health program at LSUHSC for the past 17 years where she has trained social work interns, psychiatry fellows, and psychology interns to have a deeper understanding for the mental health needs of young children,” said Dr. Raines.

Dr. Dickson is the Psychology Section Deputy Chief and the Child Coordinator of the Psychology  Internship Training Program at LSUHSC. She is a Child-Parent Psychotherapy trainer and she is  the Director of the Orleans Parish Infant Team which treats children ages 0-5 years in the foster  care system. She is part of a Safe Baby Court and trains around the country on infant mental  health and court team work.

Dr. Dickson also consults to local child protection agencies, and sees clients at the Behavioral  Sciences Center and at a federally qualified health clinic Dr. Dickson considers the training of others to be one of her important contributions. “Training the police to respond to incidents of  violence involving children was incredible work,” said Dr. Dickson. “I was able to ride along on shifts with police officers, often at night and attend their daily staffings. I got to know many  officers on a personal level and could hear the stress of their job and their helplessness, at  times, when confronted with various scenarios. The officers truly wanted to help the families  and often did not know how. Getting to work with these families, who would not have come to  the attention of mental health professionals, was immensely rewarding,” she said.

Dr, Dickson co-directs the Harris Infant Mental Health training with Dr. Joy Osofsky. According to their website, the LSUHSC Department of Psychiatry began the Harris Center for Infant Mental  Health over a decade ago. The Center offers training to predoctoral psychology interns (through an APA approved infant-child internship), child psychiatrists (as a required part of their  residency training program), post-doctoral psychologists, social workers, and other professionals seeking infant mental health specialization.

The officials note that the program is multidisciplinary and unique in fulfilling requirements for  psychology and child psychiatry training programs, being the first predoctoral internship in  infant mental health recognized and approved by both the American Psychological Association  (APA) and Association of Psychology Postdoctoral and Internship Centers (APPIC). The child  psychiatry rotation began as a six-month experience, explained officials. However after learning how much residents were benefitting from the rotation, the child psychiatry faculty at LSUHSC  made it a mandatory part of training. All trainees, from all disciplines, consistently rank their  experience in the Harris Center for Infant Mental Health a top part of their training, according to
officials.

Dr. Dickson noted her role after Hurricane Katrina. “The police reached out to our team as they  were so traumatized during and after the hurricane and they had built trust in us after working  together for so many years. They let us come and hear their stories and provide support. That is a tough group to get to open up and we all felt honored to join those brave individuals on their  healing journey,” she said.

For the Orleans Parish Permanency Infant and Preschool Program, Dr. Dickson has conducted  extensive relationship-based evaluations to assess whether parental rights should be  terminated, or children ages 0-5 years should be reunited with their biological parents as part  of a state funded multidisciplinary team. She also conducted out-patient relationship-based  family therapy with all available caregivers and their infants, individual therapy with the young  children and their parents, psychological evaluations with the caregivers, and/or developmental evaluations with the children if needed. Her services include providing court testimony as an  expert witness as needed and supervising the trainees. She presents to local child protection  agency staff on a variety of mental health topics. Dr. Dickson has been a provider to Zero to  Three funded Court Team since 2007. She has been the Program coordinator since July 2002 and Director since March 2004.

“I was able to provide evaluations when I saw undiagnosed learning disabilities or disorders,”  said Dr. Dickson, “work with the children’s teachers to help them understand that the child’s  response was often due to their trauma versus oppositional behavior, and helped change the  way each family functioned as they understood the impact of their life events on them and  could treat each other in a more compassionate and supportive manner. The program enabled  me to build connections with so many people who never would have connected to someone like me before.

Due to our grants, we were able to see people free of charge. I still keep in touch with some of  my earliest clients as they call to tell me about their own children now and they have referred friends and family members. It’s so wonderful to hear from them.”

In her work at the Harris Infant Mental Health Program, Dr. Dickson has been co-director since  2010. Her services include conducting out-patient family therapy with parents and their infants.  She assists in the coordination and teaching of a weekly didactic seminar on infant mental  health to a yearly group of fellows. She supervises trainees and has been part of the Harris Professional Development Network since 2008. She has also been part of the Child Welfare  Professional Development Network within the Harris network and the Fatherhood Engagement  Committee.

“I enjoy watching people make substantial, positive changes in their lives and seeing the ripple  effects of those changes as ensuing generations and family members and friends benefit from  the clients’ greater emotional health and positive functioning,” she said. “Learning from each  other, we all benefit.”

“My work in child protection is also immensely rewarding,” Dr. Dickson said. “These caregivers  rarely have a supportive person in their life and many later thank the team for all they have  learned. It is always hard to see a child injured, but it is also hard to see a parent who was not  protected themselves. Child abuse work is hard, and all the professionals who choose to work  in this area truly want to help. Building shared knowledge, learning from one another, and  providing emotional support not just to my team and the families- both biological and foster- but also my foster care caseworkers and the attorneys has made us all better at our jobs and  better able to find new ways to keep families together or connected to one another in healthier  ways.”

Her many accomplishments and recognitions include:

Featured Poster Presentation at the  Annual ISTSS

Conference: Childhood Maltreatment and Developmental Delay in Miami, Florida  November 6, 2014

One of New Orleans City Business’ Power Generation for 2003 YLC: Volunteer of the Year 2002

Project Leader of the Year 2001

Project (NRP) of the Year 2000

Commendation from Total Community Action for work with local Head Starts

Commendation from CASA for volunteer teaching to incoming classes

Commendation from NCTSN for work given on published materials

Dr. Dickson’s publications include:

Zeanah, P., Larrieu, J., Osofsky, J., Dickson, A., & Zeanah, C.H. (2021). Enhancing Developmental  Trajectories: The Critical Importance of Increasing & Supporting Evidence-Based Services for  Louisiana’s Most Vulnerable Citizens.

Hines, E.N., Thompson, S.L., Moore, M.B., Dickson, A.B., & Callahan, K.L. (2020). Parent-child  separation due to incarceration: Assessment, diagnosis, and treatment considerations. Zero to  Three, 40(4), 22-29.

Family Time Resources: A Series of Publications for Foster Care Workers, Foster Parents, CASAs,  Judges, Parents, and Attorneys- in collaboration with the Harris Professional Development  Network committee members, October 2020.

Hines, E., Thompson, S., Moore, M., Dickson, A. & Callahan, K. (2020) Parent-child separation  due to incarceration: Assessment, diagnosis & treatment considerations. Zero to Three Journal,  40 (4), 22-29.

Dr. Dickson said she is grateful to the many people who have trained her over the years, but  she is most thankful for Dr. Joy Osofsky.

“I have been taught by many fabulous people who are so good at what they do,” Dr. Dickson  said. “I have had the incredibly good fortune of being mentored by Dr. Joy Osofsky who has  exposed me to so many wonderful learning opportunities and provided the grants and vehicles  to be able to do such meaningful work. LSUHSC is involved in great community work, and I feel  so grateful to have landed here to be exposed to such wonderful opportunities and people who
keep the work challenging and interesting and relevant to society.”

Dr. Dickson believes you should never stop training. “Listen to the community members,” she  said. “Learn that despite your advanced training, we can always learn from others. Our team  has never entered a system thinking we know the answers. Even when called into help, we learn the most from listening and observing and then partnering with others to see what will be  beneficial. We co-create wonderful interventions together when we do this. I have definitely  learned more from my clients and colleagues than they have learned from me,” Dr. Dickson  said.

Dr. Dickson said, “I love going to work each day. My colleagues and trainees are awesome, and  you never know what will happen that day. Kids, in particular, are so unpredictable and can  bring such joy. I love to watch people heal from their traumas and fully engage again and find  joy, meaning and happiness. It is a humbling experience to be a part of someone’s journey and I feel grateful every day that I get to do the work I do.”

 

 

 

 

 

 

 

State Psychology Board Embarks on Major Overhaul of Rules & Regulations

In their February minutes, posted on July 11, the state psychology board outlined major  changes and updates they intend to make to the regulatory law governing psychologists.

Central to these changes is the new section of administrative Rules on registration of assistants  to psychologists, including regulations on who may be an assistant, their credentials, how the  board will investigate complaints, and how to regulate supervision of the assistants.

According to the minutes, board members discussed numerous changes and additions to the  rules and regulations for psychologists. The following excerpts (Italicized) were included in the  reporting.

Chapter 11: Assistants to Psychologists (registration) –

Define “Assistant to a Psychologist” (ATAP), “General Professional Supervision”, “Continuous Professional Supervision”, “Supervisor” or “Supervising Psychologist”

Establish minimum criteria for an ATAP to qualify for registration (age, high school diploma, Criminal Background Check).

Establish titles that may be used when identifying ATAP’s. Clarify the boundaries that establish the  legal functional authority of the Supervising Psychologist, and the responsibility that the Supervising  Psychologist has for their clients.

Establish clear criteria to ensure that the Supervising Psychologist is responsible for ALL activities (administratively, clinically, ethically, functionally and legally) of the ATAP including registration,  renewal, directing the provision of psychological services, the outcome of work, the welfare of the  client, general communication and disclosures to clients, services delivered by ATAP’s, and  advertisement.

Define the minimum criteria of general professional supervision (direct, in person) to ensure the  welfare of the client, and the ethical and legal protection of the assistant.

Clarify that a registration is not a property right of the ATAP; shall not be construed to allow the ATAP to independently engage in the practice of psychology; or render any diagnosis; or sign any  evaluations or reports as the provider of record; or independently advertise psychological services; or assign or delegate psychological duties to others;

Define those activities an ATAP may perform with regard to psychological testing/scoring.

Outline the statutory authority of the board to conduct investigations in matters involving the ATAP  and/or their Supervisor; […]

The minutes also included discussion and possible changes in numerous other chapters of the rules  and regulations.

Chapter 3: Training Requirements

Update language for identifying acceptable accrediting bodies for doctoral-level psychology programs. Update standards to ensure training equivalence in the nine profession-wide competencies equivalent to the current American Psychological Association (“APA”) Commission on Accreditation Implementing Regulations. The new APA training requirements include competence in  supervision prior to graduation, which allow the board to eliminate the hurdle of additional  experience post licensure prior to engaging in supervision.

Provide a clause in consideration of individuals trained prior to 2015, that they will be assessed  under the training standards in place at the time of their graduation.

Classify specialty designations into “Health Service Psychology” and “General Applied Psychology”.  Necessary to provide a fair and consistent review of individuals who are graduates of programs  without APA Accreditation; necessary to provide an alternate route to licensure for individuals not trained in a Health Service area of psychology; and necessary to make clear that individuals who  attend graduate programs without internship training do not meet the criteria for practice in a  Health Service area of psychology.

Clarify current training requirements for the registration of a Clinical Neuropsychology specialty consistent with Houston Conference Guidelines; also clarifies those overlapping areas that do not  require the registration of a Clinical Neuropsychology specialty.

Chapter 7: Supervision Requirements –

Provide a definition for “General Professional Supervision” to clarify that which is the direct, in person supervision required as part of training.

Provide a definition for “Continuing Professional Supervision” as ongoing supervision which  establishes the legal and functional responsibility of the licensed psychologist for the client and the services provided to a client by a supervisee.

Clarify that the Supervisor owns or is an employee of the entity employing the supervisee to quantify  legal functional responsibility of the licensed psychologist for the client and the services provided to a client by a supervisee.

Chapter NEW: Telepsychology and Telesupervision

Facilitate the process for a Louisiana Licensed Psychologist to provide psychological services via  telecommunications.

Chapter 8: Continuing Professional Development

Add a requirement that (2) of the 40 hours that are currently required must be within the area of multiculturalism or diversity.

Remove the categorical requirement in consideration of the least restrictive requirements for license  renewal.

Define activities that are “automatically approved” by the Board as Workshops, Conference Workshops/Training Activities that have Board approved sponsors.

Chapter 9: Licenses (Emeritus)

Create a retired status for licensees: “Psychologist Emeritus: Retired”.

Create definitions, criteria and a procedure for requesting the status.

Create a procedure to return to practice.

Provide that “Psychologist Emeritus: Retired” are exempt from Continuing Education requirements.

Provide a procedure and requirements for renewal of a Psychologist Emeritus.

Chapter 15: Complaint Adjudication process – Draft changes were not ready for presentation.

Chapter 19: Public Information (petitions to the board)

Dr. Gibson presented draft amendments to Chapter 19 which establish a procedure for any  interested person to petition the LSBEP to request the adoption, amendment, or repeal of a rule according to Title 49. Section 953.C(1).

Chapter 40: LSSP CPD Requirements –

Ms. Monic presented previously approved changes to Chapter 40 which will reduce the number of  continuing education hours required for the renewal of a license from 50 to 40 hours.

******
[Editor’s Note: Minutes are available at the board’s website which
include all notes on discussion of new rules.]

 

 

 

 

 

 

 

Legislative Auditors Review Strengths, Weaknesses of State Psychology Board

A performance audit by the Louisiana Legislative Auditors Office has found problems in the  complaints process of the state Psychology Board. The audit, led by Ms. Emily Dixon, Performance Audit Manager, and begun in August 2021, examined the Board’s processes for  licensing, monitoring, and enforcement. The performance of the board was compared to the requirements set forth in the Psychology Practice Act, and found to be in compliance with “most best practices.”

However, the auditors found numerous problems with the complaints committee performance. They said that the average time for resolving a complaint was 338 days and that the Board had  no internal time frames for accomplishing its investigations. The auditors also stated that the  board had no “disciplinary matrix,” and no way to track the nature and outcomes of complaints  or to analyze the data. They also found numerous errors, inconsistencies, and lack of follow up.

The auditors sampled internal documents from fiscal years 2019 through 2021. During this  three year time, LSBEP received 71 complaints and closed 63 of these complaints. Eight, or 12.7%, resulted in a public, disciplinary action. There was one, non-public, impaired psychologist procedure and 11 Letters of Education, also nonpublic. According to this data, 43 of the cases  were dismissed with no action. A total of 85.7% were either dismissed or received a letter with  educational information.

The auditors found that the board required an average of 338 days to resolve a complaint. The  time ranged from eleven days to more than three years. Eight (12.7%) of the 63 complaints took more than two years to resolve, and an additional 13 (20.6%) of the complaints took more than  one year to resolve.

” […] LSBEP has not established internal timeframes for resolving complaints, and its process for tracking complaints does not record accurate and complete information. As a result, the Board  cannot ensure that it is investigating and resolving complaints in a timely manner,” they said.

The auditors found that LSBEP’s process for tracking complaints included inaccuracies and inconsistencies.

“LSBEP tracks complaint information in a spreadsheet, an investigation log, and a complaints  log. However, we compared these three documents to each other and to LSBEP’s paper  complaint files and Board meeting minutes that contain complaint outcomes, and found that  none of the tracking documents were accurate or complete. For instance, the spreadsheet did  not include all complaints, incorrectly listed some closed complaints as open, and did not  include all instances of disciplinary action.

“[…] we found that three Letters of Education were sent to the licensees more than five months  after the Board voted to send them.” And, “… we identified five complaints that LSBEP did not ensure were fully closed. These five complaints included one licensee who was never sent a Letter of Education that the Board voted to send in June 2019 about mandatory reporting of  abuse.” The auditors sound that four complaints were never presented to the Board for closure.”

The auditors also found that “LSBEP has not adopted a disciplinary matrix that aligns with  regulatory best practices to ensure that disciplinary actions are consistent and appropriately  escalated based on the number and/or severity of violations.”

 The auditors found the following categories and percentages of allegations. (See Audit Exhibit below.) The most frequent category of 25% came in from allegations of “Substandard Care,  Negligence, or Malpractice.” This was followed by 20% for “Unprofessional Conduct, Discrimination, or Rude Treatment.” Next was “Failure to Maintain or Provide Accurate Patient  Records” at 16%, “Multiple Relationships or Conflict of Interest,” and ‘Practice Without  License, Misrepresentation of Credentials, or Practice Outside of Scope,” both at 14% of allegations.

The auditors noted, “According to LSBEP, staff create separate spreadsheets to track the compliance of each disciplined licensee and use calendar reminders for monitoring specific  activities.

“However, these processes are not formalized in policy and staff have not followed them consistently. In addition, the Board does not have a process for systematically and periodically  monitoring whether all disciplined licensees have performed required corrective actions,  reimbursed disciplinary costs as ordered, and continue to comply with ongoing Board restrictions.”

The auditors noted that, “LSBEP did not report four (44.4%) of the nine adverse actions it issued during fiscal years 2019 through 2021 to the NPDB in accordance with federal law.”

The auditors recommended that the Psychology Board require all licensees to undergo a background check, Instead of just new licensees. And, they recommended that the Board query  the National Practitioner Data Base for enforcement information when making license decisions and for continuous monitoring.

The auditors also indicated that the Legislature may want to authorize the Psychology Board to  impose fines for discipline and administrative noncompliance.

In a response, the Board agreed with all the auditors’ recommendations. Specifically, they  agreed to “… establish a system where complaints are prioritized and investigated on a case-by- case basis considering risk to the public in accordance with the Audit, the Act, LAPA, and other  applicable law and oversight. This system will ensure complaints are processed within reasonable time periods, factoring in the complexity of the case. These procedures are  currently in practice, but not explicitly stated in policy. Additionally, the board has recently hired two full-time employees including in-house counsel whose primary focus is on the complaint  adjudication process. Timeframes for internal monitoring will be determined to ensure compliance.”

The Board agreed to “… establishing a process for tracking complaints that includes  documenting the status, nature, and outcome of all complaints; periodically reviewing open  complaints; and regularly analyzing complaint data to assess compliance with agency policy and identify opportunities for improvement. Over the past 3 years, the board has worked to  improve financial stability in order to employ staff who can develop these processes understanding that this is vital to operations and best practice.”

The 37-page report is available online at https://app.lla.state.la.us/publicreports.nsf/0/dd11af03beda7797862588540052a678/$file/0002f3.pdf?openelement&.7773098

 

 

 

 

 

Dr. Lin Named 2022 Janet Matthews, PhD, Outstanding Psychology Mentor

Dr. Hung-Chu Lin, Professor of Psychology at the University of Louisiana Lafayette, has been  named by the Louisiana Psychological Association as the 2022 Janet R. Matthews, PhD, Outstanding Psychology Mentor.

“This award recognizes and honors Dr. Janet R. Matthews for her lifetime of mentoring work  and the impact she had on psychologists in Louisiana,” said Dr. Amanda Raines, spokesperson  for the Louisiana Psychological Association, at the group’s spring convention.

Dr. Raines announced that the Association was honoring Dr. Lin for 2022. “Her dedication to  supporting, encouraging, and guiding undergraduate and master’s level psychology students is  truly remarkable,” said Dr. Raines.

“Each semester, she mentors an average of 15 undergraduate and graduate students in her  lab,” said Raines. “Students not only learn critical thinking skills but how to design sound  research studies, test hypotheses, and communicate findings. In the classroom, Dr. Lin creates  a space that is welcoming and accessible for those with learning disabilities and/or non- conforming identities. She further assists students who are facing financial hardships or  experiencing psychological distress. In summary, she provides essential, foundational  experiences, through her research and teaching, to facilitate the growth and development of  her students.”

As well as a professor at University of Louisiana Lafayette (ULL) Dr. Lin is also the Chair of the  Institutional Review Board and she holds the endowed SLEMCO/LEQSF Regents Professor in  Liberal Arts.

Her research focus includes the development of emotions, parenting, attachment relationships, and developmental disabilities. She runs the Developmental Science Laboratory (DSL), which  takes an interdisciplinary approach to examine the complexity of adjusted and maladjusted developmental processes.

She is a Sponsored Collaborator with The Developmental Risk and Cultural Resilience Laboratory at Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical  School. Among her other collaborators are the Cecil J. Picard Center for Child Development and  Lifelong Learning, College of Behavioral, Social, and Health Sciences, Clemson University, and the Cognitive Science of Language & Education Lab, Department of Psychological Science, the  University of Texas Rio Grande Valley.

Dr. Lin earned her doctorate in developmental psychology from the University of Connecticut  and it is a board certified specialist of academic pediatric dentistry in Taiwan and holds a DDS  degree from the school of dentistry in the national Taiwan University.

Also this year the ULL Graduate School selected Dr. Lin as the recipient of the 2022 Outstanding Master’s Mentor Award.

In ULL News, Dr. Amy Brown, department head for Psychology, said, “She is very supportive of  the professional development of her master’s students: encouraging them to apply for grants  and awards, and to present research at conferences. In interacting with graduate students, Dr.  Lin is warm and supportive, but also holds high standards—she expects hard work and improvement, and creates an environment where students feel empowered to work hard and succeed.”

Dr. Lin directs the Developmental Science Laboratory (DSL) where interested faculty and  students take an interdisciplinary approach to studying The complexity of adjusted and  maladjusted developmental processes. The DSL projects include:

•The long-term physical and mental sequelae of adverse childhood experiences.
•The relation between adverse childhood experiences and sexual self-esteem.
•Mindfulness and resilience as protective factors for individuals with childhood trauma.
•Social stigma (explicit and implicit) towards individuals with developmental disabilities/LGBTQ populations.
•Perceived parental behaviors, relational identity, and internal working models.
•The development of empathy and understanding of theory of mind.
•Using simulation paradigms to observe emotional responses and physiological arousal.
•Interpersonal problems, emotional regulation, and anxiety disorders.

Dr. Lin said to ULL News, “No words can express how rewarding and fulfilling it is to grow along  with my research children academically, professionally, and personally,” Lin said. “I’m grateful to play a role in these students’ lives as they pursue their academic and personal development.

“As a mentor, I constantly question and examine my preconceived assumptions and beliefs  about mentees and strive for bias-free mentoring. By actively listening and discerning, I convey  my unconditional respect and emphatic care with affirmation, understanding, and acceptance.”

What does she believe are the most important characteristics that have supported her in being  such a successful mentor?

“Being grateful to play a role in these students’ lives as they pursue their academic and  personal development,” said Dr. Lin. “Being unconditionally respectful to individual differences  in students’ competencies, learning styles, communication patterns, and personality qualities. Being clear when setting goals and expectations for their works while maintaining flexibility to tackle with unexpected events.”

What are some of the most enjoyable experiences she has had as a mentor to her students? “To grow academically and personally together with them,” Lin said.

Dr. Lin sets out her methods and philosophy in her Mentorship Statement, including:

“Unconditional respect for individual differences. Mentees come from various racial/ethnic and sociocultural backgrounds. Every one of them displays distinctive approaches to learning and  dispositional characteristics when tackling challenges or stressful situations. As a mentor, I constantly question and examine my preconceived assumptions and beliefs about mentees and strive for bias-free mentoring. By actively listening and discerning, I convey my unconditional  respect and empathic care with affirmation, understanding, and acceptance. At the core, each  mentee is a unique individual; thus, my mentoring is tailored to the uniqueness of the  individual’s needs to maximize the mentee’s academic progress and personal growth.

“Mentoring is like parenting. It was at the end of a departmental award ceremony a couple of  years ago when one of my mentees (who was recognized as the outstanding graduate for that  academic term) introduced me to her mother, ‘Mom, I’d like you to meet my research momma!’  Feeling tremendously touched and proud, I regarded this title of research momma beautifully  represented my relationships with my mentees.”

UUL News reported that Madeline Jones, master’s candidate in psychology, describes Dr. Lin as  “an amazing mentor” who “has given me strength and confidence throughout my time in this  program. I would describe my relationship with Dr. Lin as one filled with mutual respect,  kindness, communication, support, and positivity. I attribute my success as a graduate student to her qualities as a mentor, especially her resourcefulness, efficiency, and determination.”

Five of Dr. Lin’s researchers have been accepted to various doctoral programs around the  country. Madison Holmes has been accepted to the PsyD program at Mercer University.  Maddison Knott has been accepted to the doctoral program in clinical psychology at Southern  Mississippi University. Lindsey Held has been accepted to the doctoral program in experimental psychology with a concentration on developmental psychology at the University of Alabama.  Kylie Garger has been accepted to the doctoral program in developmental psychology at the  University of North Carolina at Chapel Hill. Michelle Grisham has been accepted to the doctoral  program in developmental psychology at the Northern Illinois University.

Reviewed publications with student coauthors include:

Lin, H.-C., & Janice, J. (2020). Disengagement is as revealing as prosocial action for young children’s responding to strangers in distress: How personal distress and empathic concern come into play. International Journal of Behavioral Development;

Flynn, N. S., Harrington, J. H., Knott, K. M., & Lin, H.-C. (2020). Job satisfaction in direct support professionals: Associations with self-efficacy and perspective-taking. Societies;

Lin, H.-C., Bourque, J., Zeanah, P., & McFatter, R. (2018). Perceptions of stress and enrichment in  caregivers of children with autism spectrum disorder: Implications for community support. Societies.;

Conference Presentations with Student Coauthors (All Peer Reviewed) include:

Lin, H.-C., Held, L., & Malley, K. The Associations between adverse childhood experiences,  emotion regulation, and adult distress symptoms. Poster proposal accepted to be presented at  the 2019 International Convention of Psychological Science, March, 7-9, 2019, Paris, France.

Lin, H.-C., McDermott, M., Zeanah, P., & Held, L. (2019, March). Posttraumatic stress disorder in the association between childhood trauma and somatic symptoms. Poster proposal accepted to
be presented at the 2019 SRCD Biennial Meeting, March 21-23, 2019, in Baltimore, Maryland,  USA.

Lin, H.-C., Knott, M., LaHaye, L., Flynn, S., Stringfellow, S. Latiolais, B., & Holmes, M. (2019, May).  Difficulty in emotion regulation exacerbates the association of adverse childhood experiences with depressive symptoms. Poster proposal accepted to the 31st Convention of the Association  for Psychological Science, May 23-26, 2019, Washington D.C., USA.

Lin, H.-C., Hughes, A., Held, L., Malley, K., Kinsland, M., & Barker, N. (2019, May). The role of  difficulty in emotion regulation in the association of adverse childhood experiences with  attachment insecurity. Poster proposal accepted to the 31st Convention of the Association for  Psychological Science, May 23-26, 2019, Washington D.C., USA.

How did she make the shift from dentistry to psychology?

“Indeed, I have a degree in Doctor of Dental science (DDS). My certified specialty is Pediatric  Dentistry. I had worked at the National Taiwan University Hospital for 10 years,” Dr. Lin said. “A  large part of my work as a pediatric dentist involved behavioral management to help my child  patients comply to and gain positive experiences from dental procedures. I also observed many teenagers suffering from myofascial pain dysfunction syndrome. I became increasingly  interested in behavioral sciences and the intricate connections between mind and body to an  extent that I made a big career change and came to the US to study developmental psychology.  I miss practicing in dentistry (I enjoyed it so much), but I also have been extremely happy with  what I am doing now as a researcher and a teacher. Psychology is such an exciting field that  keeps amazing me,” Dr. Lin said.

 

 

 

 

 

Dr. Constans Recognized for Contributions

Dr. Joseph Constans, clinical psychologist and Senior Manager for Suicide Prevention within the Department of Veterans Affairs, has been recognized by the Louisiana Psychological Association for the 2022 Contributions in Psychological Science Award.

Presenting the award and spokesperson for the association, Dr. Amanda Raines explained that  this honor is given to those in the psychological community who have used their time and resources to expand and propagate the knowledge of psychological concepts through rigorous research and the publication of these findings.

“Dr. Constans was recently promoted to Senior Manager for Suicide Prevention within the Department of Veterans Affairs where he manages the suicide research portfolio for the Office  of Research and Development,” Dr. Raines said.

“Previously he served as the Associate Chief of Staff for Research at the Southeast Louisiana  Veterans Health Care System where he successfully led the activation of our state of-the-art  research program following the devastation caused by Hurricane Katrina. Dr. Constans’ own  program of research involves understanding and modifying belief systems in trauma-exposed  individuals prone to either homicidal or suicidal violence,” she said.

“In his role as the Senior Manager for Suicide Prevention at the Department of Veteran Affairs,  Dr. Constans is instrumental to the Office of Research and Development, where he maintains  the suicide research portfolio,” said Dr. Raines.

She also explained that Dr. Constans has published over 50 peer-reviewed manuscripts and  book chapters, serves as an ad hoc reviewer for over 20 peer reviewed journals and has secured funding for over $12 million in grants.

“I’m truly honored,” Dr. Constans told the Times, “that my colleagues selected me as the  recipient for the Louisiana Psychological Association 2022 Contributions in Psychological  Science Award. The Boulder model served as the framework for my graduate education in  clinical psychology, and I continue to strongly support the scientist/practitioner approach.  Therefore, I am particularly grateful to have received this award.”

Dr. Constans is also Clinical Professor in the Department of Psychiatry and Neurology at Tulane  University School of Medicine, and a Clinical Assistant Professor in the Department of Psychiatry at Louisiana State University School of Medicine.

He is a member of the Tulane University  Violence Prevention Institute (VPI), which focuses its research on violence both in the local  community and across the globe. The Violence Prevention Institute mission is to be “an equity- focused hub supporting communities to foster transformative research, training, and advocacy  to address systemic, structural, and interpersonal violence.” Local research has shown that the prevalence of sexual assault and domestic violence in the New Orleans area needs to be  addressed with research and community collaboration.

Dr. Constans is a member of both the Internal Advisory Committee at the Louisiana Clinical and  Translational Science Center, whose objective is to transform the clinical and translational  research efforts of our region away from the status quo, to a unified, comprehensive approach  targeting the theme of “prevention, care and research of chronic diseases in the underserved  population.”

He also serves on the Advisory Board at Louisiana Violent Death Reporting System in the  Louisiana Office of Public Health.

Dr. Contans is also the President of Louisiana Veterans Research and Education Corporation.  Dr. Constans’ evidence-based methods utilized to combat anxiety disorders are rooted in  Cognitive Behavioral Therapy (CBT) for which he publicly advocates. He is passionate about  serving his clients and the psychological community through research and treatment. His  federally-funded research program is designed to understand and treat emotional disorders,  and his extensive training with some of the early pioneers of CBT, including Drs. Andrew Mathew and Edna Foa, grant him the expertise which catalyzes this research.

In addition to his boots-on-the-ground work, Dr. Constans has been able to gather the  Resources needed to fund research integral to his expertise. To facilitate his research surrounding trauma-exposed individuals, where he studies the thought process behind their  belief systems and strives to achieve modification in this area, Dr. Constans has procured over  $12 million in grants. This research is instrumental in preventing homicidal and suicidal  violence, and his commitment to this work is evidenced in the 50-plus peer-reviewed  manuscripts and book chapters he has published to date.

Working with the VA and Department of Defense, he has served as the Principal Investigator or  Co-Investigator on countless studies and has been an ad hoc reviewer for over 20 peer- reviewed journals. He also has reviewed various grants funded by both the federal government  and private entities.

Dr. Constans’ research includes the following major areas.

Understanding attention, judgment, and memory bias in pathological anxiety:

Constans, J. I. & Mathews, A. M. (1993). Mood and the subjective risk of future events. Cognition  and Emotion, 7(6), 545-560.

Constans, J. I., Foa, E. B., Franklin, M. E., & Mathews, A. (1995). Memory for actual and imagined  events in OC checkers. Behaviour Research and Therapy, 33(6), 665-671.

Constans, J. I., Penn, D. L., Ihen, G. H., & Hope, D. A. (1999). Interpretive biases for ambiguous  stimuli in social anxiety. Behaviour Research and Therapy, 37(7), 643-651.

Peters, K., Constans, J. I., & Mathews, A. (2011). Experimental modification of attribution  processes. Journal of Abnormal Psychology, 120(1), 168-173.

Cognitive bias and neuropsychological deficits associated with PTSD:

Constans, J. I., Foa, E. B., Franklin, M. E., & Mathews, A. (1995). Memory for actual and imagined events in OC checkers. Behaviour Research and Therapy, 33(6), 665-671.

Constans, J. I., Penn, D. L., Ihen, G. H., & Hope, D. A. (1999). Interpretive biases for ambiguous  stimuli in social anxiety. Behaviour Research and Therapy, 37(7), 643-651.

Peters, K., Constans, J. I., & Mathews, A. (2011). Experimental modification of attribution  processes. Journal of Abnormal Psychology, 120(1), 168-173.

The prevention of death, including homicide and suicide:

Wamser-Nanney, R. A., Nanney, J. T,  & Constans, J. I. (2019). PTSD Symptoms and Attitudes Towards Guns. Journal of Interpersonal Violence.

Wamser-Nanney, R. A., Nanney, J. T., Conrad, E., & Constans, J. I. (2019). Childhood Trauma  Exposure Among Victims of Gun Violence. Psychological Trauma: Theory, Research, and Policy, 11(1), 99-106.

Wamser-Nanney, R., Nanney, J. T., & Constans, J. I. (2019). The Gun Behaviors and Beliefs Scale:  Development of a new measure of gun behaviors and beliefs. Psychology of Violence, 10(2),  72–181.

Wamser-Nanney, R.A., Nanney, J.T, & Constans, J.I. Trauma Exposure and Attitudes Towards  Guns. Psychology of Violence. Manuscript submitted for publication.

Dr. Constans told the Times, “When I began my professional career in the Veterans Health Administration 1993, I thought I’d last about 5 years in the organization. Now, almost 29 years  later, I’m still a VA employee. Reflecting on why my prediction was so inaccurate and why I have  stayed with this organization for so long, I can say that a primary reason is because of the  opportunities that the VA provided me in pursuing a career as a clinician scientist,” he said.

Dr. Constans specializes in the non-medical treatment of a variety of emotional disorders  including Post Traumatic Stress Disorder, Panic Disorder, Obsessive-Compulsive Disorder, Social Anxiety Disorder, Generalized Anxiety Disorder, mild to moderate depression, and stress- related emotional issues.

After completing his undergraduate studies in Psychology at Louisiana State University (LSU),  Dr. Constans went on to receive his M.S. at Colorado State University and a PhD in Clinical  Psychology from LSU. He then completed his internship at the Medical College of Pennsylvania.

What does he view to be his most important contributions? “There have been three phases in  my career as a clinician scientist,” Dr. Constans said. “For the first 15 years of my career, I  investigated how biases in judgment and attention served as causative or maintaining factors  for psychopathology, particularly posttraumatic stress disorder.

“In the second phase, beginning approximately 10 years ago, my focus evolved from studying  the sequelae of trauma to one that is concerned with prevention. My interests became and remain the prevention of suicide and homicide with a particular emphasis in understanding  how beliefs and behaviors surrounding firearms contributes to violent death,” he said.

“The third part of my career was and is as an administrator for scientific endeavors. I served as  the Associate Chief of Staff for Research at the New Orleans VAMC from approximately a year after Hurricane Katrina until October of 2021. In this administrative position, I was able to  advance and grow the scientific mission in our healthcare facility, and hopefully during this  time, I served as a particularly strong advocate for psychological science,” he said.

“Now, I working for Office of Research and Development in VA’s Central Office, developing and  managing the suicide prevention research portfolio, allowing me to assist in the advancement  of psychological science to address an important public health issue,” Dr. Constans said.

 

 

 

 

 

 

Dr. Cohen’s Newest Research in Clinical Psychological Science

Dr. Alex Cohen, clinical psychologist and professor at Louisiana State University (LSU), continues his efforts to adapt behavioral technologies for investigating a wide range of clinical issues,  including suicidality, depression, psychosis, mania, and anxiety. His newest publication is “High Predictive Accuracy of Negative Schizotypy with Acoustic Measures,” published recently in the  flagship clinical journal, Clinical Psychological Science. He is widely recognized for his work using automated computerized analysis of behavior and has been featured in top psychology and  psychiatry journals.

In an interview with the Times, Dr. Cohen said, “I think we are pushing the boundaries of what  clinical science can do in measuring symptoms of serious mental illness.

“Psychology has not sufficiently addressed many areas of human suffering, and innovation is  needed. I believe that Psychology can’t fulfill its potential alone, and will require cooperation between other academic disciplines, and also community partners, big tech, advocacy and political groups, business, government regulators, law enforcement and above all, people from  the communities we are serving,” he said.

“Finding ways to cooperate and overcome the inevitable ‘tower of babel’ problem between  these groups, in my opinion, is essential to solving many of the big problems that we face right  now. Who else is trained so effectively in bringing people together? I think psychology can  occupy a central role in coordinating these efforts.”

What does he think are the major and most important findings of this new study? “We were  trying to use objective vocal data to predict personality traits associated with psychosis risk,” Dr. Cohen said. “Given the nature of our data, we used supervised machine learning. Our models  were highly accurate, generally 85% or so in classifying people with versus without the traits.

“More importantly, we were exploring how this kind of model building should be done, and this  problem extends well beyond psychosis risk research. Our models didn’t actually predict  personality traits or psychosis risk, but rather, people’s report on ‘gold-standard’ self-report  scales. Predicting psychosis risk and predicting scores from a gold-standard measure are not the same, and our secondary analyses speak to this.

“Generally speaking, ‘gold standard’ measures are good enough for many purposes in  psychology. If the goal is highly accurate prediction using objective data however, our measures are often inadequate. This is an unrecognized obstacle to implementing predictive analytics into psychology,” Dr. Cohen said.

This most recent work was a collaboration with the LSU Department of Psychology, the LSU  Center for Computation and Technology, the Department of Psychiatry at University of Utah,  and Department of Psychology at University of Central Florida.

Dr. Cohen worked with Dr.  Christopher Cox on this project, an Assistant Professor of Psychology at LSU. Dr. Cox is involved in various research endeavors, including focusing on experimental machine learning tools, exploring the context sensitivity of semantic knowledge, building computational models of reading.

What was it like collaborating with Dr. Cox? “Dr. Cox is one of the most thoughtful people I have  had the pleasure to work with,” said Dr. Cohen. “He is extremely bright and methodical, and  cares deeply about students and learning. He seems to operate on a higher level of consciousness than most, and it wouldn’t surprise me if he sees the world in streams of binary  data like Neo from the Matrix movies.”

Dr. Cohen is also an adjunct professor at Pennington Biomedical Research Center and LSU  Health Sciences, where he manages a team of doctoral students and graduate assistants. His  current research projects focus on understanding and helping those with severe mental illness,  notably schizophrenia, and those at risk of developing various psychotic-spectrum disorders.

Dr. Cohen’s current research projects are multi-tiered. He is currently working on a project that  involves adapting biobehavioral technologies for use in assessing mental well-being. This  project involves a highly constructed collaboration between industry and academia and uses  “Big Data” methods to measure and predict cognitive, affective, and behavioral states in those with serious mental illness.

A few years ago, LSU helped Dr. Cohen and some of his colleagues to commercialize his  technologies for “digital phenotyping.”

“Digital phenotyping involves quantifying aspects of mental health using complex, objective  data streams,” he said. “In our case, these data are from automated language, facial, vocal,  location and movement analysis from a smart phone. Since then, we have created an app using  these technologies to support clinical trials. We are starting to explore digital phenotyping to  support clinical management of patients with serious mental illness, and I am proud to have community partners in Baton Rouge for this. The methods used in our clinical psychological science paper were central in advancing these technologies.”

Dr. Cohen is in collaboration with an international consortium involved in researching the links  between disturbances in natural speech and symptoms of mental illness and genomics. Pattern recognition and advanced machine learning are being utilized in this research. In addition to  these projects, he facilitates research investigating how emotion, cognition, motivation, and  social functions in those predisposed for developing serious mental illness and those already combating serious mental illness. This project uses “small data” and basic psychological science  methods are used, including self-report, behavioral and electrophysiological measures, and performance measures.

Dr. Cohen has been working for nearly 20 years on these innovations, and explains that with  the help of many colleagues, “… we are getting closer – though this process has been anything  but time efficient.”

“What I have found is that digital data and symptoms ratings rarely agree,” he said. “Using  machine learning, one can engineer solutions that show impressive agreement in one setting,  but they don’t generalize. What is considered flat and unresponsive speech in one setting by  one group of people is considered unremarkable in another setting for other people. That is one major thing we found in the CPS paper, and have replicated in a number of other studies.”

“Why don’t they agree? Are clinicians wrong? Are digital technologies missing a critical human  element? The answer is, of course, both. So we are trying to develop methods for optimizing and evaluating these digital technologies. This field is huge right now, but I am afraid many of  the solutions being proposed are superficial and will fade quickly. I think my colleagues and I  are in a unique position to advance this field.”

Some of Dr. Cohen’s recent work helps to explain these complexities. • Cohen, A. S., Rodriguez,  Zachary Warren, K. K., Cowan, T. M., Masucci, M. M., Granrud, Ole Edvard Holmlund, Terje B  Chandler, C., Foltz, P. W., & Strauss, Gregory, P. (2022). Natural Language Processing and  Psychosis: On The Need for Comprehensive Psychometric Evaluation. Schizophrenia Bulletin, In Press.

“Evaluation of digital measures falls far short of what is expected of most psychological tests,” Dr. Cohen said. “This is part of a themed issue Brita Elvevåg and I are finalizing for the journal  Schizophrenia Bulletin.”

• Cohen, A. S., Cox, C. R., Tucker, R. P., Mitchell, K. R., Schwartz, E. K., Le, T. P., Foltz, P. W., Holmlund, T. B., & Elvevåg, B. (2021). Validating Biobehavioral Technologies for Use in Clinical Psychiatry. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.503323

“In this paper,” he said, “we compare evaluation of objective measures in other areas of science (e.g., physics, computer sciences, engineering) to that of psychology. There are some critical differences, particularly surrounding how ‘resolution’ is handled. The upshot is that psychology  should do a better job of defining exactly when, where and how a phenomenon is occurring. . . at least with respect to validating objective measures.”

• Cohen, A. S., Schwartz, E., Le, T. P., Cowan, T., Kirkpatrick, B., Raugh, I. M., & Strauss, G. P.  (2021). Digital phenotyping of negative symptoms: the relationship to clinician ratings. Schizophrenia Bulletin, 47(1), 44-53. https://doi.org/10.1093/schbul/sbaa065

“In this paper, we demonstrate how objective technologies often disagree with what a clinician  says. We attempt to unpack why that is – with the idea that neither is inherently wrong. Rather,  they are looking a different phenomenon,” he said.

• Cohen, A. S., Cowan, T., Le, T. P., Schwartz, E. K., Kirkpatrick, B., Raugh, I. M., Chapman, H. C., &  Strauss, G. P. (2020). Ambulatory digital phenotyping of blunted affect and alogia using objective facial and vocal analysis: Proof of concept. Schizophrenia Research, 220, 141–146.  https://doi.org/10.1016/j.schres.2020.03.043

“In this paper, we evaluate a method of evaluating aspects of psychosis using smart phone  technologies. We are currently trying to implement these technologies with Capitol Area Human Services District ––though, in early stages.”

Besides pushing the boundaries of what clinical science can do in measuring symptoms of serious mental illness, what was the most enjoyable thing for about the work for Dr. Cohen?

“This is a necessarily multidisciplinary endeavor, and I really enjoy being challenged by my students and colleagues. When trying to objectify aspects of mental illness, we need to be very  mindful of the role that demographics, culture and other individual differences play. I am blessed to have a network of colleagues from a variety of walks of life that can help challenge us to create culturally appropriate, and ultimately better, measures.”

 

 

 

 

 

 

 

Dr. Slaton Named 2022 Distinguished Psychologist by LPA

Dr. Karen Slaton, who has been at the forefront of psychology’s transition to integrated health care for most if not all of her career, and engaged in practice, research, and teaching, has been named the 2022 Distinguished Psychologist by the Louisiana Psychological Association.

Dr. Slaton is the Program Manager of Behavioral Medicine/Health Psychology/Primary Care  Mental Health Integration at the Southeast Louisiana Veterans Health Care System. She developed and manages the Primary Care Mental Health Integration Program at the Care  System. She implements the Veterans Administration mandated effort to fully integrate  behavioral health as part of the extended Patient Aligned Care Team. This team consists of  psychiatry, social work, nursing and psychology, and is essential in assuring veteran access to same-day care.

Dr. Slaton also coordinates behavioral medicine services, such as services for pain, palliative  care, cardiology, physical medicine & rehabilitation, and integrated health services (including  yoga and hypnosis).

Dr. Slaton also serves in additional roles including Health Behavior Coordinator, Pain Psychologist, Complimentary Integrated Health VISN lead and Lead Tobacco Cessation Clinician.  She provides health promotion and disease prevention services to veterans such as tobacco cessation and weight loss coaching.

She trains other clinicians in the Interdisciplinary Pain Program, Bariatric Treatment Team, and  Controlled Substances Oversite Board. She collaborates in other teams and committees  including Health Promotion and Disease Prevention Committee, Women’s Health Committee,  Employee Wellness Committee, and the Opioid Safety Initiative.

Dr. Slaton is Clinical Assistant Professor of Behavioral Sciences at Tulane University School of  Medicine and Clinical Assistant Professor of Medicine at Louisiana State University Health  Sciences Center School of Medicine. She provides invited lectures to trainees in the Tulane  School of Medicine Clinical Psychology Internship Training Program and the LSU School of  Medicine Physical Medicine and Rehabilitation Residency Program.

Dr. Slaton is an APA accredited clinical psychology internship and postdoctoral fellowship  Training Committee Member, providing didactic training and supervision to interns and post- doctoral fellows in the areas of primary care mental health and behavioral medicine.

Dr. Slaton is a nationally Approved Consultant in Clinical Hypnosis and a Registered Yoga  teacher.

Dr. Slaton has also owned and operated her own private practice through Northshore  Psychological Services, LLC, Covington, and the Center for Wellness and Peak Performance, LLC,  Covington. She provides a wide range of psychological services including psychotherapy, assessment and evaluation, consultation, and professional training. Her areas include posttraumatic stress disorder, marriage, couples and relationship counseling, food, weight and  body image issues including eating disorders and bariatric psychology, depression, anxiety,  sport and performance psychology, clinical and sports hypnosis, personal growth and  development and counseling patients with medical illness.

Dr. Amanda Raines announced the award in April, at the annual meeting of the Louisiana  Psychological Association. “This award is given to an individual who has made significant  contributions to psychology research, practice, or both, during the course of their career,” said Raines. “This year we are recognizing Dr. Karen Slaton. Dr. Slaton currently serves as the  Program Manager for Primary-Care Mental Health Integration and the Health Behavior  coordinator at the New Orleans VA. She is actively involved in more local and regional committees within the VA than I can count,” Raines said.

“She maintains academic appointments at Tulane and LSU and actively stays involved in both  training and research related endeavors. Dr. Slaton is certified by the American College of  Sports Medicine as an Exercise Physiologist and by the American Society of Clinical Hypnosis. She is also a certified & registered yoga teacher and somehow manages to incorporate all of  these skills into her integrative practice at the New Orleans VA.”

Dr. Slaton’s research includes:

Slaton, K. (2000). An investigation of the relationship between  parental bonding and body image disturbance among male and female college students. Dissertation.

Slaton, K. & Lyddon, W. (2000). Cognitive-experiential reprocessing and rape: A case study.  Journal of Cognitive Psychotherapy, 14, 189-200.

Slaton, K. & Westphal, J. (1999). The Slaton-Westphal functional assessment inventory for adults  with serious mental illness: Development of an instrument to measure functional status and psychiatric rehabilitation outcome. Psychiatric Rehabilitation Journal, 23, 119-126

Raines, A. M.,  Primeaux, S. J., Ennis, C. R., Walton, J. L., Slaton, K. D., Vigil, J. O., Allan, N. P., Zvolensky, M. J.,  Schmidt, N. B., & Franklin, C. L. (2021). Posttraumatic stress disorder and pain
in veterans: Indirect association through anxiety sensitivity. Manuscript submitted for publication.

Vigil, J.O., Slaton, K.D., Raines, A.M., & Franklin, C.L. (2018, September). Examining the Effects of a Comprehensive Pain Rehabilitation Program among Veterans. Poster presented at the annual meeting of the Southern Pain Society, Atlanta, GA.

Lyddon, W., & Slaton, K. (2001). Promoting healthy body image and the prevention of eating disorders among adolescent women. In C. Juntunen & D. Atkinson (Eds.), Counseling strategies  for developmental concerns. Thousand Oaks, CA: Sage Publications.

Her training lectures are  numerous, and include: Use of Hypnotic Language in Non-hypnosis Clinical Encounters.  Presented at 6th Dabney Ewin, MD FACS Hypnosis Lecture. 2022 Tulane Brain and Behavior Conference.

Primary Care Psychology. Presented to Psychology Interns at Tulane University School of Medicine and Southeast Louisiana Veteran Health Care System.

Motivational Interviewing: Effective Communication with Veterans. Presented at the Southeast  Louisiana Veterans Health Care System 2020 Fall Women’s Health Summit.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

Behavioral Intervention for Chronic Pain. Presented at LSUMC Physical Medicine and Rehabilitation Resident Didactic Lecture.

Motivational Interviewing. Presented to the LEND program staff at Louisiana State University  School of Medicine.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

“My career as occurred in phases,” Dr. Slaton said, “I started in academic medicine at Tulane School of Medicine and like many of my Tulane colleagues, left after hurricane Katrina for  private practice. I enjoyed a thriving practice in Covington for almost a decade before joining  the New Orleans VA 10 years ago. I always say I have the best job ever! I work as a clinical health psychologist in various medicine services and have the privilege of serving Veterans in honor of my grandfather who was awarded the Medal of Honor for his service in WWII,” she said.

“I’m lucky to be able to provide clinical hypnosis to Veterans and to teach hypnosis at the National level for the VA, teach a weekly yoga class to Veterans, lead the Primary Care Mental  Health Integration team, and serve the facility as a consultant for patient education. However,  my favorite part of all is training the next generations of psychologists in our APA accredited  internship and fellowship programs,” Dr. Slaton said

 

 

Cybersecurity Expert Offers Essential Ideas for Defending Yourself and Your Clients

by Leslie Todd, LCSW, ACSW
AFCC Correspondent

Those of us who work with victims of intimate partner violence or vengeful ex-partners have  seen how badly technology can be misused to harm our clients. And we also know that just as  private citizens, we have to be on guard against cyber shenanigans. Then there’s our offices, our
electronics files, our phones….it’s pretty daunting, right?

Fortunately, there are folks who specialize in educating us so we can keep our clients and ourselves safe. 

Steven Bradley began his career with the FBI, starting a task force which investigated  technology and cyber-related crimes. Later, he worked with state coalitions and local domestic  violence/sexual assault center as a liaison between law enforcement and community partners  to better support survivors and victims. Today, he works with Our Family Wizard to promote  healthy communication between co- parents via technology. He has been an international  trainer for over 25 years, and recently presented at the AFCC-LA State Conference on March  18th on this subject. He agreed to share further information with The Psychology Times regarding handling the very difficult cyber abuse issues our clients may bring in—and tips for  protecting ourselves as well.

First, let’s start with Bradley’s pet peeve: people who don’t use passwords, or use them poorly.  Your first defense against hacking is to have a complex password, and to keep it private. Too  many of us still use lazy and highly guessable ones like “12345” or “password”– and many  people don’t even put a password on their smartphones. If you worry about not being able to  keep up with all your passwords (and no, you should not use one password for everything),  then allow your device to generate a complex password which will then be stored for you. And  do NOT tape it to your laptop or otherwise leave it handy for others to discover.

So—sloppy security starts with sloppy passcode management. If you have a client who is  endangered or may be at risk of being stalked, have them list ALL their social media and other  sensitive sites and discuss changing their passwords and security questions to things the stalker could not possibly know. That means no birthdays, pet or child names, or any other easily-guessed information. Remember to have them check medical portals as well.

Thanks to “the internet of things,” it is possible that your client is being monitored via a car’s nav system or some other device. Make sure you discuss with your clients what technologies are being used such as Bluetooth, GPS, On-Star, etc.

Bradley stresses that we should all keep our Bluetooth OFF unless we are actively using it,  because it is easily hacked. Also public access internet, such as in hotels or cafes, is highly  vulnerable to hacking. Malicious software can be installed, including tracking devices. And  remember to check the location services in a phone’s settings to be sure you or your client is  not giving away your location. Bradley noted that when he was to meet an abused client at  court, he would first meet with them near the courthouse in a fast-food place, where they  would both then turn off their location and Bluetooth settings. After court, they would return to  the same fast-food place or gas station and turn them back on. That way, anyone monitoring  would only track them to the innocuous site and not know about Court or other more sensitive destination.

Also, check with your vulnerable client to see if they have devices that were provided by the  suspected person. If a cellphone has been provided by the abusive party, ask your client to  consider using a donated or new cell phone. Same for a computer. If the client is looking for a  new place to live or making travel plans, ask them to use a computer at a public library.

The client should also update all privacy settings on any dating sites and social media sites  (Twitter, Facebook, LinkedIn, Pinterest, TikTok, etc.) and be very wary of what they post. Remember that pictures and images can be searched as well as names and words.

Another way to safeguard a phone is to choose an optional service, like Google Voice, to keep a  personal number safe. Some of these services will let you forward calls and messages to up to five different phones while you simple have one phone number. That way, if the client’s number is compromised, they can log in and change one phone number instead of having to contact the phone company to change many.

Other than tracking people, cyber-hacking can allow the bad guys to “spoof” your phone. This  means that you may answer a call which looks like it’s coming from your mom, but it is really  the hacker. Spoofing allows threatening texts to show up from anonymous numbers (or  highjacked ones, like Mom’s.) In one of my high-conflict divorce cases, each of the spouses was  spoofing their OWN phones with threats ostensibly from their ex.

As a mental health professional, you may have tried to secure your office space and your files— but your cellphone and your car may betray you. Bradley points out that a judge may feel safe  in her courtroom, but once she gets in her car, she is as vulnerable as the next person unless  she takes cyber precautions to safeguard her devices (including her car). In a world where our  clients can Google images of our home and family, we need to keep this in mind.

If you do work with court systems or government agencies, you should know that they often  publish records online. Ask them how they protect or publish your records and request that access to your files is sealed or restrict to protect you and your client’s safety.

Bradley lives in this cyberworld everyday, but understands that we are far less aware than he is. He notes that he most common mistake he sees professionals make is to brush off a client’s suspicion that someone may be monitoring them. Since abusers love to make their clients feel  or look crazy, we should be wary not to add to the gaslighting. Abusers can use highly subtle  methods that will make your client sound paranoid. For instance, I had a client who would frequently find she had a flat tire in the morning. She assumed she was hitting nails around a  construction site—until her mechanic pointed out the frequency and types of punctures and boldly asked her if she was going through a divorce. Bingo. She ended up seeking counseling,  and we discovered many more dangerous indications of stalking.

Bradley’s talk was such a hit at our AFCC-LA State Conference that we are going to have him  return to do a half-day training later in the year, specifically for mental health and legal  professionals. We’ll be sure to publicize that event. Meanwhile, if you’d like a handout from  Bradley on this basic information, email me at Leslie.todd@leslietodd.com and I’ll pass it along to you.

[Editor’s Note: Leslie Todd served as the founding President of the Louisiana Chapter of the  Association of Family and Conciliation Courts (AFCC). Her contributions were acknowledged by AFCC  when they named her an “AFCC Ambassador,” a designation exemplifying the collegial and  collaborative spirit of AFCC membership.]

 

 

 

 

Experts Point to Alarming Trend of Increased Opioid Related Overdose Fatalities

A new report warns of soaring overdose deaths from the opioid crisis. Authors from the  Lancet’s, “Responding to the Opioid Crisis in North America and Beyond: Recommendations of  the Stanford-Lancet Commission,” published in February, said that in the USA and Canada, 2020 was the worst year on record for fatal opioid overdoses. The US overdoses rose 37%.

The Centers for Disease Control and Prevention (CDC) said that provisional data analysis  estimates for the 12 months ending in May 2021, there were 75,387 deaths from opioid toxicity.

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of  drug overdose deaths, said the CDC, with 72.9% of opioid-involved overdose deaths involving  synthetic opioids. And, overdose deaths involving psychostimulants such as methamphetamine  are increasing with and without synthetic opioid involvement.

Also in February, Medscape reported a surge in the rate of Black Americans dying from a  combination of opioids and cocaine, an increase of 575%. The rate for White Americans  increased by 184%.

A recent analysis in the American Journal of Epidemiology, found that in the South, deaths from  cocaine and opioids increased 26% per year among Black people, 27% per year among Latinx  people, and 12% per year among non-Hispanic Whites.

Dr. Marc Zimmermann is a neuropsychologist and medical psychologist in Baton Rouge, with over 30 years experience. He  is noted for his work in forensic psychology having testified in multiple states and jurisdictions, and he has been a consultant to many chemical dependency programs such as the Serenity Center and Lane Recovery Solutions. He is also a staff member at PTI in Baton Rouge.

Dr.  Zimmermann said that according to the Louisiana Department of Health, the bulk of all  recorded opioid overdose deaths occurred in the parishes of Southeast Louisiana. St. Tammany Parish experienced an average of over 47 opioid overdoses a year and Jefferson Parish  averaged over 71 opioid overdoses a year.

While their age-adjusted rates are not as high as St. Tammany and Jefferson Parishes, Orleans  and East Baton Rouge Parish experienced high average numbers of deaths from opioid  overdoses during the same time period.

Dr. Tiffany Jennings is a Louisiana native who is the Rural Health Coordinator for the Louisiana  Psychological Association and in full time private practice. Dr. Jennings has worked in a variety  of settings, including outpatient, inpatient, state and Federal agencies. She was previously an  Assistant Professor, Department of Neurology, at Ochsner LSU Health Shreveport and a Neuropsychologist at Overton Brooks VAMC in Shreveport, and for the US Army’s Traumatic  Brain Injury Clinic at Fort Polk in Leesville.

How serious does she feel the opioid crisis is in rural settings for Louisiana? “The opioid crisis  continues to be a serious crisis that has not shown any signs of abating,” Dr. Jennings said.

“The COIVD-19 may have exacerbated the crisis. The Louisiana Dept of Health’s website notes  an increase in fatal and nonfatal opioid overdoses as people are ‘cut off from services and  disconnected from support systems, have made it difficult for individuals to seek help.’

“The Louisiana Opioid Surveillance Program has noted an increase in deaths from overdose,”  she said. “This was noted to be in part due to availability of synthetic opioid drugs, which are  much more powerful than morphine. This results in a higher chance of death from use –– such  as fentanyl.”

Has she seen any changes over the last couple of years? “There’s been several high-profile  lawsuits against drug manufacturers for their alleged role in the opioid crisis,” Dr. Jennings said. “I believe there currently four US companies in the process of settling, to the tune of  approximately $26 billion. This has certainly brought attention to the extent of the current  opioid epidemic.

“Many insurance agencies, including Medicaid, expanded telehealth access due to the ongoing  COVID-19 pandemic. Unfortunately, I have not seen much change with regard to access to service for rural health settings in Louisiana. There continues to be a wait list to see Medicaid providers. Reimbursement remains an issue. Also, those in rural areas may not have the  technology to fully utilize telehealth services,” Dr. Jennings said.

The Lancet Commission Report pointed to the lack of accessible, high-quality, non-stigmatising, integrated health and social care services for people with opioid use disorder in the USA. The  authors recommended reforming public and private health insurance systems to address this issue, including cutting off funding for care that is likely to be harmful.

Dr. Geralyn Datz is a licensed Clinical Health and Medical Psychologist and a national educator  of healthcare providers, attorneys and the public. Dr. Datz is licensed in Louisiana, Alabama, and Mississippi, and specializes in pain psychology, forensic assessments, and public speaking. She is President and Clinical Director of Southern Behavioral Medicine Associates PLLC, in Hattiesburg, Mississippi, a group specialty practice devoted to treating patients with chronic  pain, She is a past president of the Southern Pain Society, and previously with New Orleans Veteran Affairs Medical Center and Pennington Biomedical Research Center

We asked Dr. Datz if there is adequate treatment available? “No there is not,” she said. “The  treatment of opioid use disorder is a very large, systems based issue that right now is in dire  straits and vastly underfunded. The short answer is that we need more insurance reimbursed  programs, and the treatment needs to extend well beyond ‘rehab’ as it is traditionally defined. Private treatment centers are one component of treatment, but cannot meet the needs of this  diverse population, which often has serious mental health issues and/or comorbid pain  conditions. There are effective treatment models like Pain Rehabiliation Programs, that help
people with medical conditions come off of opioids, but sadly these are no longer reimbursed  by insurance.

In addition, the treatment of opioid misuse is ideally multidisciplinary and  requires medical and mental health follow up, which frequently does not occur. The Commissions comment on using the Chronic Disease Model for treatment, and in healthcare, is exactly on point.”

Is treatment covered by funding such as insurance for those who need help? “.Again…no. There  are wide ranges in what insurance will and will not cover in treating opioid overuse and addiction. Often, comorbidities, such as pain or severe or even mild mental illness, are left  untreated. In addition, there are variations between what private addiction centers will accept which insurances if any at all. As a result, care ends up being parsed out for opioid-dependent  individuals and not as effective. Furthermore, many individuals do not have insurance coverage at all, further complicating the problem,” Dr. Datz said.

“The 2008 Mental Health Parity and Addiction Equity Act was designed to make treatment of  mental health and substance abuse conditions as easily and fairly reimbursed as medical conditions. This Act was a step in the right direction but is still not fully realized. A recent report  showed that many insurances are non compliant, and showed wide disparities between  behavioral health care and medical/ surgical healthcare. Mental health parity needs increased  attention, and enforcement, in order to address the public health needs that we are now facing.”

Dr. Jennings agrees. “Given the number of deaths from opioid overdose, I would say there is not nearly enough treatment, recovery and support systems in place for this population. This is especially true of those in rural settings,” she said.

“The state has enacted laws in an attempt to better regulate prescriptions and to reduce the chance of ‘doctor shopping’ for those addicted or who have developed a tolerance to their pain medication. Government agencies on federal and state levels are holding providers accountable for illegal prescriptions for opioids,” said Dr. Jennings.

“Louisiana is expecting to receive approximately $325 million from a national settlement of  opioid lawsuits. The intention is to divide monies into addiction treatment, response and recovery services. The goal is to send the monies–divided up over a 20-year period–to local  agencies that directly work with those suffering from opioid addiction,” she said.

“For some patients, education into the nature of chronic pain and their ability to manage pain  can be helpful. There are evidence based psychotherapy treatments (such as Cognitive  Behavioral Therapy for Chronic Pain) that can be used to help a patient manage pain. For  patients in need of an increase in structure or level of care, there is certainly a need for  agencies that provide this care. Again, insurance and location can often be a barrier to treatment.”

Pain costs society up to $635 billion annually, according to the CDC, and is the number one  reason for disability. Pain is becoming better understood as a multifaceted phenomenon with  psychological factors.

In 2016, CDC authors published Guidelines and said that there was no evidence for a long-term  benefit of opioid pain medications. The authors found strong evidence for serious risks, including overdose, opioid use disorder, and motor vehicle injuries. The CDC said that other  treatments, including psychological approaches, had long-term benefits, without the high risks of opioids.

“It is now widely accepted that pain is a biopsychosocial phenomenon,” Dr. Datz, told the Times  in a previous interview. “The Guidelines are really exciting because they explicitly state that  physicians should be using nonpharmacological strategies including cognitive behavioral  therapy as well as exercise for patients with pain,” Datz said.

“This is a departure from the traditional belief that pain was primarily physical, and to be only  treated by medical means, which was the biomedical model,” Datz said.

“The benefits of pain psychology are that the person experiencing chronic pain ultimately has more control over their pain process, their reaction to it, and their life,” Datz said. “This is  accomplished by teaching patients about how their expectations, their attention, and their  stress levels interact with chronic pain and can greatly exacerbated.”

“A large body of research,” said Datz, “has shown that use of structured cognitive behavioral  therapy, and in particular cognitive behavioral therapy combined with physical therapy, as happens in functional restoration programs, are extremely effective ways of dramatically  improving physical function, mental health, and overall well-being in patients with chronic pain,” she said.

“Unfortunately, these methods have been sorely underused, partly due to insurance coverage  issues. With the advent of the ACA however, this is getting a lot better. Also, I think providers and patients are more open to these ideas now that the opioid epidemic has become such a  hot topic nationally,” she said. Among the key messages of the Lancet Commission report, the authors noted that “The profit motives of actors inside and outside the health-care system will  continue to generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.”

Dr. Datz will be presenting “Forced Opioid Tapers and the Culture of the Opioid Crisis: Time to revisit pain psychology” at the American Academy of Pain Medicine in Scottsdale Arizona on  March 19. She will speak about how the approach of using pain psychology during opioid  therapy is not new, but is enjoying a renewed urgency in the context of rising rates of opioid  tapers and the safety issues surrounding preventable side effect from forced opioid tapers.

Lancet Commission authors warned that pharmaceutical companies based in the USA are  actively expanding opioid prescribing worldwide, and are using fraudulent and corrupting tactics that have now been banned domestically.