Originally published: . Volume 5, No. 9. Source pages: 2.
A rumor’s going around. I think it might have started with David White, the LPA Executive Director, who can be totally excused for not knowing the difference between a dual role and a conflict of interest. But then the rumor gained steam, latching on to other motivations, until finally, it was stated with conviction in a letter from Joe Comaty to the Assistant Director of Boards and Commissions, Ms. Robinson.
“One of the candidates currently running has a direct conflict of interest,” Comaty wrote.
Cognitive psychology tells us that an idea catches on because it’s simple, emotional, and because of our automatic, lazy think brain. Shame, shame. Conni Patterson had a dual role, not a conflict of interest, but apparently it is becoming the complaint du jour.
I checked with her about it and turns out she had a very small job with the board to help out on a few investigations. She resigned, and expects any of the very few cases she worked on to be closed very soon, if not now.
But that is not the point. People should check out their “arrows.” Patterson’s primary goal in aiding the board would be the same goal if she were sitting on the board, to help figure out the truth.
“A conflict of interest is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest,” write Bernard Lo and Marilyn Field, and the Committee on Conflict of Interest in Medical Research, Education, and Practice, part of the Institute of Medicine at the National Academies.
In our profession, primary interests might include scientific truth, client welfare, or investigation validity. Secondary interests, can include financial goals, but also and more diabolically, psychological goals such as status, power, or even protection of group identity.
Patterson had a dual role, not a conflict of interest, and a simple analysis shows us we would not expect a conflict of goals in this situation. (By the way, most board members have dual roles.)
In his letter to Boards and Commissions, Dr. Comaty said that Patterson would have to recuse herself and this would impair the board’s performance.
Recuse onself? Does he mean like recusing oneself after searching one’s conscience and finding that a personal goal conflicts with a primary goal?
Like in 2009 when the psychology board, made up of LAMP-Political Action Committee members, made a decision to sit by and do nothing while their own legislation was being passed, legislation that diluted the psychology practice act? Like that? The way no one recused themselves?
Or in 2012, when Comaty was approached by representatives of medicine and medical psychology to change his decision, so that psychology interns could be supervised by professionals without a state psychology license? That way? The way he didn’t recuse himself?
Or, in 2012 when LPA sent Phil Griffin to ask the psychology board if they’d discuss ways to bring psychology back from the medical board, and they said they were happy with things the way they were. The way the medical psychologists (MPs) on the board didn’t recuse themselves. That way?
Or how the board decided that in the case of MPs, it was okay that continuing education was delivered by a Political Action Committee, just don’t do it again. That way?
There is no more clear evidence that MPs have different goals in regard to independent clinical psychologists, than the current collaboration clause for counselors (and soon to be marriage and family therapists) where MPs will be collaborating with counselors for clients who have a serious mental illness, but clinical psychologists will not.
In December 2010, pushed by then Executive Director Jaime Monic, the board asked the Attorney General to answer a question, “Is there a conflict of interest when a psychologist is a member of the Psychology Board and is simultaneously licensed as a medical psychologist with Medical Examiners Board?”
The Attorney General’s office said all they could rule on was dual-office holding. But then they said the propriety of a public board member’s conduct is governed by Louisiana Code of Governmental Ethics, and gave them the address and the phone number and wrote, “We further recommend that you seek an advisory opinion from the State Board of Ethics on this issue.”
But no one ever did. Go figure.
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Originally published: . Volume 5, No. 9. Source pages: 9.
The Louisiana State Board of Examiners of Psychologists held a closed meeting with the Board Advisory Counsel on April 7. The agenda indicated that the group was to meet from 9:30 am to 11 am. The exception to open meetings law was listed as LSA-R.S. 42:6.1, but no specific exemptions were listed. Main exemptions allowed include discussions of character, professional competence, mental health of a person; collective bargaining strategies or prospective litigation; security plans, investigative proceedings; or extraordinary emergencies such as natural disasters or epidemics. There does not appear to have been a description in the minutes for this closed meeting.
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Originally published: . Volume 5, No. 9. Source pages: 3.
Senator Martiny’s bill to allow the state psychology board to issue a provisional license to those who are being supervised for a psychology licensure, will be heard on the House Floor May 7.
The measure has moved quickly from the Senate where it passed with a vote of 36 to 0. It was heard in the House committee on April 23 and reported favorably, 12 to 0. It is scheduled for the House floor and expected to pass easily.
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Originally published: . Volume 5, No. 9. Source pages: 9.
Federal officials at the Center for Medicare and Medicaid Services (CMS) have declined to qualify the plans for privatization of six state-owned hospitals that serve the uninsured and poor. The rejections involve the LSU-run hospitals in New Orleans, Lafayette, Houma, Lake Charles, Shreveport and Monroe. "To maintain the fiscal integrity of the Medicaid program, CMS is unable to approve the state plan amendment request made by Louisiana," the federal agency said in a statement as reported by the AP.
In a statement from DHH Secretary Kathy Kliebert, she said, "CMS noted that they support the mission of the public-private partnerships and the effort to create equality in the delivery of health care to the residents of Louisiana. This denial by CMS is in stark contrast to earlier approval of four SPAs for the public-private partnership with Our Lady of the Lake (OLOL) in Baton Rouge. The SPAs for OLOL were approved in July of last year and included advance lease payments for four clinics to be operated by the private partner.”
Both Governor Jinday and Kliebert said they will appeal the decision.
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Originally published: . Volume 5, No. 9. Source pages: 3.
Representative Walt Leger’s bill to change the terms used to refer to individuals with disabilities has passed both the House and Senate and is headed back to the House. The April 30 vote on the Senate floor was 36 to 0 after minor amendments. It will return for final approval in the House. The law will call for changes in the names of agencies, institutions, private organizations, and other entities. The measure notes the linguistic paradigm known as "person first language", which emphasizes a person's humanity over any condition or characteristic the person may have, to be employed wherever possible to refer to persons with disabilities and other persons with exceptionalities.
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Originally published: . Volume 5, No. 9. Source pages: 10.
Tulane Psychology is introducing a new program in Behavioral Health this spring. The announcement noted that the program was developed to provide students with training needed for basics of Behavioral Health. A second goal is to provide a more in-depth understanding of the major areas of concentration at a graduate level to those who are new to psychology.
The Behavioral Health 4+1 has 2 tracks, one Applied and one General. The applied track includes study in science about the interplay between psychology, health, and illness, prevention, and health care delivery and system components, among others. The General track provides the greater number of domains of knowledge in psychology beyond behavioral health.
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Originally published: . Volume 5, No. 9. Source pages: 4.
An effort to add Licensed Professional Counselors to the list of professionals who serve on the clinical team that is sometimes appointed to work in lieu of a sanity commission, failed to pass in a 4 yea, 5 nay vote, on April 23. Testimony was heard in the House Committee on Administration of Criminal Justice.
Speaking in favor of the bill was Dr. Jacqueline Mims, who provided information and outlined for the legislators some of the differences between the mental health professions. She said, “None of us received specific training in forensic counseling or psychology,” and explained her own experience of over 19 years with the Baton Rouge City Court. She noted her doctorate in counseling psychology and also a doctorate in special education. She is currently enrolled in forensic psychology she explained. Dr. Mems currently serves on the Licensed Professional Counselors Board of Examiners.
Dr. John Fanning, president of Louisiana Psychological Association, testified in opposition to the measure, saying that the sanity commission issues would likely involve persons with major mental illness, and this would fall outside of the scope for counselors’ in their current law.
Filing cards for information were Executive Director Kelly Parker and Deborah Harkins, Esquire, for the Louisiana State Board of Examiners of Psychologists, and in opposition were a representative of the Louisiana Defense Lawyers, the Louisiana Criminal Defense Lawyers, and the Baton Rouge District Attorney.
The close 4 – 5 vote came with 5 members absent due to a traffic accident on I-10 at that same time.
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Originally published: . Volume 5, No. 9. Source pages: 10.
The National Institute of Mental Health has granted Tulane University a five-year, $3.13 million grant to study the causes of Major Depressive Disorder, said a Tulane announcement last fall.
Dr. Jinying Zhao, associate professor of epidemiology at the Tulane School of Public Health and Tropical Medicine and principal investigator. According to the announcement, the researchers will attempt to identify alterations of genetic makeup, called “epigenetic” changes, that may cause the disorder. “Epigenetic changes are related to many psychosocial, behavioral and/or environmental factors,” says Zhao in the announcement. The researchers will compare the DNA of twin pairs only one of which has Major Depressive Disorder.
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Originally published: . Volume 5, No. 9. Source pages: 4.
Senate Bill 649 by Senator Mills to create the Louisiana State Health Care Profession Institute, with a 32-member council, was amended and passed the Senate floor on April 23 in a 35 to 2 vote. It will be heard by the Committee on House and Governmental Affairs. Those to be represented on the Council of this new Institute include individuals from medicine, dentistry, nursing, optometry, physical therapy, speech-language, dietetics, vocational rehabilitation, and occupation therapy. Included from mental health areas will be the executive director of the psychology board, the chair of the Medical Psychology Advisory Committee, individuals from licensed professional coun- selors, social work, marriage & family, and behavior analysts.
The goal of the Institute is to consider needed improvements in health care professions and recommend reforms, and to modify or eliminate antiquated scope of health care profession issues.
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In an effort to help engage those in the north part of the state and connect to the activities in Baton, the Red River Institute (RRI) began its April 4–5 Spring Conference with a panel discussion featuring Mary Alice Olsan, Executive Director of the LPC (Licensed Professional Counselor) Board of Examiners, Dr. Tom Caffery, member of the Legislative Committee for Louisiana Association of Marriage and Family Therapists, and Mark Reynaud, Chair of the Marriage & Family Therapy Advisory Committee. This, RRI Director Tom Moore, Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), explained to the Times.
“This was a rare opportunity for licensees to spend a full hour and half with three individuals who are the most knowledgeable in the state regarding current regulatory and legislative issues,” he said. “Many topics were covered including the implications of current scope of practice legislation for Licensed Marriage and Family Therapists and the ‘why’s and wherefore’s’ of the mandatory collaboration restrictions placed on LPCs and LMFTs by Act 320 that was passed three years ago,” he said.
He explained that LPCs in the northern part of the state sometimes feel distanced from the activities in Baton Rouge. “Licensees up here in ‘the other Louisiana’ always value the opportunity to dialogue directly with the people that are making decisions that affect their ability to practice,” he said.
The conference hosted a full house for the event. The clinical portion of the program Saturday afternoon featured Dr. Tom Caffery from Southeastern Louisiana University and Mark Reynaud, MA, from Baton Rouge who presented on attachment theory in marital therapy and the Gottman approach to working with couples struggling with infidelity.
“Many licensees are still confused by LCA’s (Louisiana Counseling Association) sponsorship and support of Act 320, a law that placed restrictions on the practices of LPCs and LMFTs by imposing mandatory collaboration with medical practitioners,” he noted. “Our panel would have been a great way for LCA to answer some lingering questions and clear the air. I really hope we can set something up in the future for a representative of LCA to be with us.”
The mission statement of the Institute is to foster a healthy professional culture for all mental health professionals, Moore said. “The Witchdoctor’s Ball on Friday evening was a celebration of the art and science of talk therapy and a call to action to prevent the further medicalization of the mental health profession.”
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Originally published: . Volume 5, No. 9. Source pages: 4.
The measure to create a new professional, art therapist was assigned to the House Health and Welfare Committee on March 10 and has not advanced or been heard. Authored by Representative Bishop from Lafayette, House Bill 634 would establish a new mental health professional in art therapy, to be licensed under the LPC board.
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Originally published: . Volume 5, No. 9. Source pages: 10.
[Editor’s Note: Dr. Mendoza, author of We Do Not Die Alone, is investi- gating a new line of research and asking practitioners for help. She is interested in hearing from those who may have had first-hand experience in the therapy room with evil. Those interested in providing feedback or opinions may reach her at mamphd12@yahoo.com.
Once again the news tells us that someone diagnosed with a mental illness has committed a heinous crime and people have died. An act of evil has occurred but no one will call it that. Evil is that which hurts ourselves or others. It is the absence of good. There is evil. We see it and hear about it every day.
But is there a relationship to mental illness? We know that hundreds of years ago people who were mentally ill were viewed as evil and as possessed by the Devil. People were banished, locked up, ostracized, tortured and killed for having a mental illness. Everyone was frightened of them. The mentally ill were the scapegoats for evil acts. Are they still today? In the 21st century, we no longer label people with mental illness as bad or evil. Evil is not a synonym for mental illness. However, severe mental illness can bring with it a lack of control, an altered sense of reality and the inability to use good judgment. Just as extreme narcissism leads to a lack of empathy and concern for others.
Over the years, research as conducted by Milgram and Zimbardo has proven that anyone is capable of committing evil acts given the right environment, time and situation. Of course, none of us want to think about that, much less believe that about ourselves. Hannah Arendt, philosopher and political theorist, coined the phrase that describes this in her book, Eichmann in Jerusalem as the “banality of evil.” The term refers to ordinary people like you and me who committed acts of pure evil. These were people who under normal circumstances would never have thought of killing anyone let alone mass murder.
In our work as therapists, we rarely, if ever, think about the concept of evil. Well, we may think of it but dare not say it out loud. For most of us the word evil immediately invokes religious thoughts of Satan and the devil. When I began to ask colleagues about their experiences with evil, they were always taken aback and looked puzzled at the mere mention of the word. They would respond with statements such as “I believe that man is basically good,” or “I don’t believe in evil.” Indeed, I believe that our profession works very hard not to ever use the word evil. It is certainly a loaded word with many connotations and reflects a judgment call on our part. But do we ever even take time to reflect on the concept of evil? Most of us have worked with victims of evil but have we ever worked with someone that we thought was evil?
Just as in trauma work we talk about “Large T” and “little t” trauma to describe the nature and impact of the trauma. We can think about evil in much the same way. There is a continuum of acts from “little e” evil to “Big E” evil. “Big E” evil refers to acts of cruelty such as war, genocide, torture. While little e evil refers to harmful behaviors we do to ourselves such as cutting, not eating or eating too much, not taking needed medication, as well as to others in the form of self- serving manipulations, belittling and bullying.
I am gathering data from different groups of mental health professionals about their views on evil and mental illness. If you could take a few moments to answer the following questions:
Do you believe there is evil? How do you define evil? Do you believe you have treated victims of evil? If so, was it “Big E” or “little e” evil?
Have you ever treated someone you believed to be evil?
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Originally published: . Volume 5, No. 9. Source pages: 5.
SB 194 by Senator Mills passed the Senate easily on April 7, in a 39 to 0 vote, after being reported favorably out of committee. It was read by title in the House and referred to the House Health & Welfare Committee.
SB194 would replace the titles, of Counselor Intern with “Provisional Licensed Professional Counselor” and also the title of Marriage and Family Therapist Intern with “Provisional Licensed Marriage and Family Therapist.”
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Dr. Laura Choate 2013 American Counselors Association
Dr. Laura Choate, Louisiana State University Associate Professor, and Licensed Professional Counselor, has added an extremely useful and practical book to her growing repertoire of works that focus on the interventions with girls and women, college student wellness, and preparation of those in the counseling and psychotherapy fields.
In Eating Disorders and Obesity, Choate has gathered an impressive group of contributors who lay out the foundational knowledge, techniques, and practical applications needed for practitioners working with those who struggle with eating disorders.
The book is not just for those working directly with those who have disordered eating patterns, but Choate provides critical information and insights for anyone in health services, education, or community health. She and contributors show the problems are embedded in our culture, including the family, schools, and media. In this, the authors point to the pervasive and unavoidable push toward disordered eating in our culture, especially for girls and women, but also for boys and men.
While Choate and contributors realize the need for understanding this complex problem from the mixture of biology, environment, and individual psychology––that all must be taken into account by the insightful therapist––this volume focuses on the practical techniques and perspectives that a therapist or counselor needs to work competently and ethically within a comprehensive framework.
“I am not alone in acknowledging the pervasiveness of cultural pressures regarding eating, weight, and shape that leave very few individuals unscathed,” Choate writes in her introduction. “These pressures influence individuals to varying degrees depending on the genetic vulnerability and their exposure to environmental risks.”
Pointing to these pressures and their results, such as the fact that 46 percent of all 9th to 12th graders are actively trying to lose weight, she writes in her introduction of the reason for the text.
“Because I want my children and all others to be equipped with the skills they need to stay healthy and resilient in the face of the cultural pressures surrounding eating, weight, and shape, this book is dedicated to assisting counselors and their clients to become empowered to effect positive change in this area within the multiple systems (family, school, community) in which they are embedded.”
“Eating disorders and obesity are a preventable public health concern,” she concludes, “and considerable efforts are necessary to prevent their initial onset and progression. Counselors are in a position to provide effective prevention programs in school, mental health, and college and university settings, and it is my hope that this book will provide them with essential resources for putting these programs into practice.”
Eating Disorders and Obesity is logically divided in to four sections. The first, “Foundations,” includes key information about the sociocultural context for eating disorders, about how effective interventions must include information about media, family, peers, and about gender differences and issues of race and ethnicity.
Section two is “ Assessment and Practice Frameworks for Eating Disorders and Obesity.” This section includes chapters that outline how the concerns of clients are linked into treatment planning, assessment, and where a client falls on the continuum of care, which can range from prevention to intensive treatment. A focus on school counselors, who are involved at a critical period of the emergence of eating disorders and how they play an important role in early detection, is explained. School based interventions are also included in this section.
The next part, “Effective Prevention and Early Intervention for Eating Disorders and Obesity,” lays out essential information about prevention and public health. Included is a description of prevention programs for children, for young adults and college students, and also a “culturally adapted guided self-help program…”
The final section outlines the approaches for those who need more intensive therapy, “Effective Treatments for Eating Disorders and Obesity.” In this part, contributors lay out the evidenced-based programs and psychosocial outpatient treatments for eating disorders and obesity which fall within the counselors scope of practice. Authors clarify the overlap between major approaches, but also set out some of the distinct approaches, including enhanced cognitive-behavioral therapy. One of the major benefits of the text, here the contributors provide research about which particular treatments work with which subpopulation of clients.
The writing is consistent across the chapters but maintains the authors’ voice, a real plus because so many of these authors are high-level theorists and practitioners of international recognition.
The chapters are also balanced between research information, insight for the reader, and practical, usable information to help technical expertise for treatment. One of the benefits of the book is that readers are helped to be aware of pitfalls in this complex area of work, with its multiple slippery slopes.
Each chapter is nicely summarized at the end with chapter highlights, a well-stated conclusion, references, and in many of the chapters, recommended readings or resources.
All toll, 42 contributors help make this book a comprehensive review with strong practical help for the counselor or psychotherapist working in any setting.
One of most engaging chapters, co-authored by Choate, is “Ethical and Legal Issues in counseling Clients With Eating Disorders.” Choate and coauthors explore the serious and ethically complex issues for those assisting this population.
“Eating disorders (EDs) are serious biopsycholsocial issues with severe consequences, including a range of potentially lethal medical complications. The rate of mortality in clients with anorexia nervosa (AN) is among the highest of all psychiatric conditions.” … “In additional, suicidality has been correlated with both AN and bulimia nervosa.”
She points out that despite the lethal risks, people with these disorders are often not motivated to seek treatment, a set of conditions that present “… several legal and ethical dilemmas for the counselor.”
The writers point to numerous challenges, such counselors reporting they felt their appearance was monitored by the clients, that power struggles were common with this population, and how difficult it is for some counselors to understand the “ego-syntonic nature of the client’s symptoms, how they prefer their emaciated state.” The authors point specificity to issues with scope of competence in this complex area and how important it is to have a depth of real understanding into the complicated social systems involved.
The edited Eating Disorders and Obesity offers some of the most respected names in the field. This is just a sampling of the board base of experience that goes into the work includes the following experts.
Dr. Linda Smolak, Emerita Professor of Psychology at Kenyon College, coeditor of Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment (American Psychological Association), and author of Body Image: A Handbook of Science, Practice, and Prevention, (Guilford Press) helps launch the work with chapter one “Sociocultural Influences on the Development of Eating Disorders and Obesity.”
Dr. Margo Maine, clinical psychologist working in the field for 30 years, coeditor of Treatment of Eating Disorders: Bridging the Research-Practice Gap, (Elsevier), Effective Clinical Practice in the Treatment of Eating Disorders: The Heart of the Matter (Routledge), and The Body Myth: Adult Women and the Pressure to be Perfect (Wiley), and Father Hunger: Fathers, Daughters and the Pursuit of Thinness (Gurze), and Body Wars: Making Peace With Women’ Bodies (Gurze), coauthors the chapter two in this volume, “Gendered Considerations in the Treatment and Prevention of Eating Disorders.”
Dr. Niva Piran, professor of counseling psychology at the University of Toronto, and recipient of the Florence Denmark Distinguished mentorship Award from the Association of Women in Psychology, author and researcher, provides the chapter, “Prevention of Eating Disorders in Children: The Role of the Counselor.”
Other authors include those from Centre for Clinical Interventions Eating Disorder Programme in Perth, West Australia, Dr. Anthea Fursland, clinical psychologist, and Dr. Hunna Watson, research psychologist, at the Princess Margaret Hospital for Children in Perth, both who serve on the streering committee of the National Eating Disorders Collaboration in Australia.
This work adds to Choate growing list of contributions in this area. She authored the 2008 book, Girls' and Women’s Wellness: Contemporary Counseling Issues and Interventions, and the 2013 work, Adolescent Girls in Distress: A Guide for Mental Health Treatment and Prevention. She has published over 20 articles in peer-refereed journals including the Journal of Counseling and Development, Counselor Education and Supervision, and the Journal of Mental Health Counseling. She was the 2004- 2006 editor of the Journal of College Counseling, and an editorial board member of the Journal of Counseling and Development.
Dr. Choate currently serves on Louisiana Licensed Professional Counselors Board of Examiners, and is a National Board Certified Counselor and a Board Approved Supervisor in Louisiana. She was the 2009-2010 chair of the American Counseling Association Publications Committee.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.
Originally published: . Volume 5, No. 9. Source pages: 5.
Two bills both updating procedures for emergency custody orders, SB 185 and HB 330, are advancing easily. Mental Health law will be change to allow coroner or judges to include the use of email or fax for delivering an order for custody. The proposed law provides that the order for custody shall be delivered to the appropriate law enforcement agency by hand, facsimile, or other electronic means, including but not limited to e-mail.
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