Originally published: . Volume 8, No. 5. Source pages: 10.
In a House Concurrent Resolution (HCR 28) Representatives Hoffman, and Senators Thompson and Walsworth, put forth the motion to recognize October 2017 as Dyslexia Awareness Month and urged and requested schools and state and local educational agencies to address the significant educational implications of dyslexia.
The authors wrote, “… dyslexia is the most common learning disability and affects between eighty to ninety percent of all individuals who have a learning disability;” and that “… dyslexia is highly prevalent and persistent; it affects one out of every five persons; and”
“… the paradox of dyslexia is that individuals who have the disability may have weaknesses in decoding that result in difficulties in accurate or fluent word recognition, yet these individuals may exhibit strengths in the higher-level cognitive functions of reasoning, critical thinking, concept formation, or problem solving; and
“… great progress has been made in understanding dyslexia on a scientific level, including the epidemiology and cognitive and neurobiological bases of dyslexia;
“… early screening and diagnosis of dyslexia are critical to ensure that individuals with dyslexia receive focused, evidence-based intervention that leads to fluent reading, promotion of self-awareness and self-empowerment, and the provision of necessary accommodations to ensure school and life success.”
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Originally published: . Volume 8, No. 5. Source pages: 11.
by Susan Andrews, PhD
Professor Alexander Luria’s Successor, Professor Janna Glozman, volunteered a day of her New Orleans vacation to talk to a small, but dedicated, group of interested neuropsychologists on April 28, 2017. Professor Glozman was a student of Alexander Luria and later took over his position as Research Director of the Centre of Develop-mental Neuropsychology. She is also a Professor of Psychology and Leading Researcher at Moscow State University.
Dr. Darlyne Nemeth had the good fortune to be introduced to Dr. Glozman by Dr. Tony Puente last year when she was invited to speak at an international conference in Moscow. Dr. Nemeth toured Luria’s lab and discovered that Dr. Glozman planned to visit New Orleans for 3 days in late April as part of a cruise she was taking.
Dr. Glozman brought with her a Powerpoint presentation that described Alexander Luria’s “Life and Contribution to Psychology in the 20th and 21st Century.” Many of us know of Luria’s important contributions to the emerging field of neuropsychology during WW2. I think I can speak for the entire group this past Friday that none of us had any idea how far reaching his other contributions were to Psychology in general. This informal presentation turned out to be one of the most exciting days I have ever spent. I had to keep pinching myself as she showed us pictures of letters from Freud to Luria, pictures of Luria, herself, and luminaries as Piaget, Vygotsky, Pavlov, Picasso, Pribram, and Tony Puente. Several of us were frankly – “star struck.”
Luria was greatly influenced early in his career by psychoanalytic theory. His first book published in 1922 was Principles of Real Psychology. Luria became interested in the old word association test and in measuring the length of time before the subject makes a response to different words. This became the origin of the Lie Detector test. Dr. Glozman mentioned the KGB several times in her presentation and how several times Luria came close to being imprisoned. He even entered medical school and became a neurologist to avoid prison at one point.
Ivon Pavlov held Russian Psychology firmly in his grasp and nothing could be published without his approval. So, Luria’s book Nature of Human Conflict was published in English in 1932 but not in Russia. It was finally published in Russian in 2012. Pavlov said it was too “subjective.”
Luria became interested in Art Psychology due to his first wife, an actress, who introduced him to many artists. Later he became interested in Genetic studies and he was the first to use the twin method to study genetics. Genetics was declared a “False Science” in Russia in 1935. During this same period (1924 to 1935) Luria had started a program with Vygotsky of neuropsychological studies and they established the first lab of neuropsychology in the world at an old neurology hospital in Moscow. Each Monday, since 1924, Luria would assess medical patients with students. Dr. Glozman continues this tradition to this day. At one point, Luria had seen a number of Parkinson’s Disease patients and, with his genius for observation (like Piaget, for example), he observed that while the patients could not walk easily, they could climb stairs. He reasoned that this was because the walking was automatic and not much at the conscious level while one has to pay attention when climbing stairs.
Luria developed his battery of Neuropsychological tests between 1935 and 45. He finished his PhD in 1937 and entered medical school. He graduated with a diploma as a neurologist in 2 years and interned at the Institute of Neurosurgery. During World War II he was appointed Chief/Director of a Neurosurgical Hospital. His books on acquired traumatic aphasia come from his work in this period. When the war was almost over, he returned to Moscow and was decorated with the Order of Lenin in 1943 for his work in neuropsychological/neurological rehabilitation.
In the 1950’s, Luria became interested in Developmental Neuropsychology. He took over the Directorship of the Institute of Mental Retardation. Dr. Glozman continues this work today and described what she and Luria call “remediation” instead of “rehabilitation” of children who had never developed many of the skills or cognitive stages. Her recently published book, Developmental Neuropsychology was written in English and describes these techniques in detail. The book is available on Amazon.
In 1958, Luria became President of the International Neuropsychological Society. He only began to study memory in the 1970’s. He died of heart problems in 1977, leaving a huge legacy of psychological work. Dr. Glozman is President of the Luria Congress and has invited us all to this years congress in Russia on October 13-16; http://luria- congress.urfu.ru. I think she genuinely means it.
Enjoying a piece of neuropsychology history with Professor Janna Glozman. Bottom left and clockwise is Dr. Paul Harch, Patricia McElroy, Dr. Don Nemeth, Glozman’s friend, Dr. Janna Glozman, Dr. Darlyne Nemeth, and Dr. Susan Andrews on bottom right. Dr. Glozman was a student of Alexander Luria. (Photos courtesy of Dr. Andrews.) Dr. Paula Glozman (Photo courtesy Dr. Andrews)
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Slows down on way to Senate Floor SB38 Passes Senate H&W Unanimously
Senator J.P. Morrell’s bill to delete language requiring counselors to consult with someone under the medical board or nursing board, who prescribes psychiatric medications when treating individuals with serious mental conditions, passed unanimously out of the Senate Health and Welfare committee on April 26. It was scheduled for the Senate Floor for May 1 but is now scheduled for May 8 and subject to call.
The measure is opposed by the Louisiana Medical Association and the Louisiana Psychological Association. While not public, sources indicate that the Louisiana Academy of Medical Psychologists, are also lobbying against the measure. The wording to be deleted by SB38 is: “However, nothing in this Chapter shall be construed to authorize any person licensed under the provisions of this Chapter to assess, diagnose, or provide treatment to any individual suffering from a serious mental illness, as defined by this Section, when medication may be indicated, except when a licensed professional counselor, in accordance with industry best practices, consults and collaborates with a practitioner who holds a license or permit with the Louisiana State Board of Medical Examiners or an advanced practice registered nurse licensed by the Louisiana State Board of Nursing who is certified as a psychiatric nurse practitioner.”
The language was added in 2011 when Senator Willie Mount advanced a measure, Act 320, that clarified Licensed Professional Counselors (LPCs) to assess, diagnose and treat those with serious mental disorders. Then in 2012, a bill by Senator Fred Mills passed, amended the 2011 language by adding “when medication may be indicated” and removed wording that required the patient be under “active care” of the consultant. Also added in 2012 was language about best practices. Nurses and the state Board of Nursing were added.
Submitting green cards for support were Cindy Nardini, Jackie Mims, Howard Brownell, and Tom Moore, from the Louisiana Counseling Association and the Louisiana Association for Marriage and Family Therapy. Jamee Steel and David Tatam from Tatam Group, and Eric Sunstrom, also noted cards in support.
Cards in opposition were Kevin Hayes from the Louisiana Psychological Association, and representatives of the Louisiana Medical Society, Dr. Bill Clark, David Broussard, Jeff Williams and Jennifer Marusak.
Present for information only were Dr. Darla Burnett from the LSBEP and Mary Alice Olsan for the LPC board.
Introducing the bill at last week’s Senate Health & Welfare Committee hearing, Senator Morrell said, “Essentially what the bill seeks to do, is, we erroneously amended the practice act a couple of years back and restricted the ability of mental health counselors and family therapists to provide mental health services.
“As you know in the state we always have the challenge of having services available, and rather than create a funnel with gatekeepers to prevent people having direct access to mental health counselors, as well as qualified family therapists, this seeks to free them up to provide those robust services across the state as we need them.”
Senator Claitor asked, “Will this in any way, make access to care, particularly as to drug abuse issues, more accessible in the prison environment?”
Cindy Nardini, with Louisiana Counseling Association replied, “… Yes, we do believe that the language that Senator Morrell was speaking of that was put in 2011 and 2012, did in fact decrease access to care. So that would include especially the rural and uninsured, so that would be rural clinics, that would be prisons…” Sen. Claitor said, “My issue is that, we’ve, so far we’ve locked people up and that’s where you get your mental health treatment, but you really don’t get your mental health treatment there. And if we could improve access there this would be a step in the right direction, …”
Testifying on behalf of the Louisiana Psychological Association, Mr. Kevin Hayes said, “Mr. Chairman you know this issue very well, for many years you in the house and Senator Mount in the Senate worked on these issues, and what this bill attempts to do is concerning to us. And we appreciate the author, Senator Morrell, has agreed to work with us after this meeting to try and get the stakeholders together.
“What is concerning to us, that the two pieces of the bill that’s being repealed, what’s being repealed is the provision that mental health counselors may not assess, diagnose, provide treatment to any individual suffering from a serious mental illness––that provision is being repealed, as well as the definition of what serious mental illness is.”
Mr. Hayes then listed some of the conditions––schizophrenia, bipolar, autism, and others. “So in fact what the bill is going to do, it’s going to allow mental health counselors to diagnose and treat those severe mental illnesses,” he said. “So our concern is, like I know it is in this committee to make sure the qualifications and training of these providers are sufficient to treat.” Chair Senator Mills invited Senator Morrell to close.
“Just one point of clarification,” Morrell said. “The reason why this language was so problematic, when it, that was passed in 2012 was that, prior to 2012, in the practice act of these groups, they could already address these issues.
“What happened in 2012 is we put language in the law that created a conflict between their practice act and their ability to address those different mental issues.
“And as Senator Mills knows, because we both have this, we’ve both dealt with this in nursing field. I take great umbrage at instances in which I believe one group creates a gatekeeper effect, where in order for a group to provide services they’re qualified to provide to do, they have to go through somebody else.
“And what I feel like this language did in 2012, I feel like it created it. It said, ‘Hey, you counselors can provide these services, but if you want to, you have to collaborate with psychologists.’
“It is very similar, and you guys know my position on this, where dealing with doctors and nurse practitioners. That we’ve created a system of clinics across the state where nurse practitioners are doing what they are trained to do, but they have to collaborate with a doctor that basically gets paid some cash just to sign off on what they normally do.”
Senator Morrell said he was committed to working with Mr. Hayes, but also indicated that the issue might not be resolved. He said he challenges groups to give him an example of a negative outcome. “They always say, ‘So and so is not qualified to do it.’ ‘Give me a case–give me a case where you had a counselor treat someone for schizophrenia and there was a bad outcome. In reality these don’t exist. It’s a boogeyman effect.”
According to documents from the Louisiana Psychological Association, members of the Legislative Affairs Committee have voiced concerns that the “recommended” training of an LPC is not sufficient to establish the privilege of diagnosing serious mental illnesses. Current law requires only one semester of abnormal psychology in order to become an LPC, noted the statements from the association. An LPC is currently able to function and perform to the full scope of their training and ability under their current statutory authority and there is no need to change it, according to the Committee members. There are also concerns related to psychological testing.
LPA representatives were not available for comment.
Dr. Mary Feduccia, past President of the Louisiana Counseling Association and Government Relations chair for LCA said, “Our bill, SB38, seeks to amend current law and remove the requirement that we consult and collaborate with a medical professional, either a psychiatrist, medical psychologist, psychiatric nurse practitioner, or a regular physician, when we have a client with one of 12 “serious mental illnesses”. This has created an access to care issue for citizens needing to avail themselves of the services of an LPC or LMFT. It takes the client's wishes out of the process of treatment.”
Mr. Howie Brownell, LAMFT Government Relations Chair explained, “This law has not improved the welfare of clients or the therapists and counselors who serve them. The LPC Board gets regular calls dealing with the confusion and misperceptions generated by the SMI language. This law will not stop collaboration among mental health professionals on the client's behalf. That consultation and collaboration is required by their respective professional ethical codes. This bill will just allow the therapist and their client to decide what's in the client's best interest, together.
Some of the objections to SB38 are related to misinterpretations of the intent of the bill, Dr. Feduccia said. “Some psychologists have opposed the bill because they are not convinced that LPCs and LMFTs have the competencies to deal with clients with serious mental illnesses. This bill has nothing to do with the competency level of the counselor. The authority to assess, diagnose, and treat clients with one of the twelve identified serious mental illnesses will not be changed by passage of this bill.
Another misinterpretation relates to psychological testing. “This bill is not intended to provide the capability to use psychological tests for diagnosis, nor do counselors want to do that,” Feduccia said. “It is realized and accepted that psychologists will continue to provide the psychological testing when needed.”
Some psychologists who are not prescribers, have expressed complaints about the language that Morrell hopes to delete. One remarked that the LPC that works in their office is required to consult with a medical psychologist but not with a regular psychologist, who is qualified to make decisions about when to refer for medication consults.
Senator J.P. Morrell speaks to Senator Fred Mills about removing clause requiring Counselors and Marriage & Family Therapists to consult with prescribers under the medical board. LPC Board Executive Director Mary Alice Olson (L) and Ms. Cindy Nardini (R) listen to discussion. The bill passed out of the Senate committee last week. Senator Fred Mills listens to Mr. Kevin Hayes, who serves in governmental relations for the Louisiana Psychological Association. In the top left, Senator Morrell and Ms. Cindy Nardini, who spoke for the Louisiana Counseling Association.
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Originally published: . Volume 8, No. 5. Source pages: 2.
by Times publisher, J. Nelson I was reading one of my APS journals and ran across a study on first- mover disadvantage. The study had to do with negotiation and a host of related psychological factors––anchoring, judgment, interpersonal interactions, and so forth.
The authors were controlling for SVO––social value orientation. SVO varies from the proself side (self-centered and egotistic) to the prosocial side (altruistic). As we might expect, this is a mediating variable in negotiations. The interesting thing to me was the author’s reference to other findings that those high in proself characteristics aren’t as high in problem-solving. This is not surprising of course, stated as win-win and win-lose.
Since it is the political season I’ve been watching the Legislature––a combination of negotiation, poker, hypnosis and hide the thimble. I began to wonder what percentage of the people (probably most, especially of those who are there by choice) fall into the proself group.
While I think that, at least on the surface, these men and women are endeavoring to solve problems, I’m not convinced that they have a process that can: 1) identify the right problems to solve; 2) generate alternative solutions that can be reviewed without motivated reasoning; 3) analyze the impact of a solution on people (including the invisibles); and 4) measure the results and see if there is any actual evidence for a decision.
I watched Senator Morrell say he wanted some evidence, and it was a sobering question.
[Julie Nelson is a licensed psychologist, journalist, organizational consultant, and publisher of the Times. She also holds other various positions in the community. However, her opinions here are those of her own, and do not represent any group or association. She and the Times receive no money compensation other than paid advertizing. Email her at drj@drjulienelson.com, ––she welcomes feedback.]
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Originally published: . Volume 8, No. 5. Source pages: 2.
Nancy Arnold, the Administrative Coordinator for Graduate Studies at LSU Psychology strikes again. This time she pointed out that in the article on Dr. Beck (page 10 in our April issue), we reported that Rebecca Goldstein was a graduate student. However, Ms. Arnold informed us that Goldstein received her PhD in 2016. We are sorry for any confusion regarding Dr. Goldstein’s credentials and thank Ms. Arnold once again. Please send corrections or clarifications to the Times psychologytimes@drjulienelson.com
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Originally published: . Volume 8, No. 5. Source pages: 3.
A measure proposed by Representative Franklin Foil, prohibiting the use of corporal punishment in all public elementary and secondary schools for students with exceptionalities, except gifted and talented students.
The measure has passed the House with a vote of 96 yeas and 0 nays, after leaving the committee with a 10 to 0 favorable vote. It will next go to the Senate and is scheduled for May 8.
According to the digest, present law allows local school boards discretion in the use of corporal punishment for students and requires the boards to adopt rules and regulations to implement and control its use. Proposed law prohibits the administration of corporal punishment to students with exceptionalities, except gifted and talented students, and makes present law and proposed law applicable to charter schools.
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Originally published: . Volume 8, No. 5. Source pages: 5.
Bill to Create Commission on Human Trafficking Passes Senate Floor 33-0
Senator Ronnie Johns’ measure to create the Louisiana Human Trafficking Prevention Commission and Advisory Board in the Office of the Governor, SB 42 passed the Senate Floor on April 17 with 33 yeas and 0 nays. It is pending in the House committee for Administration of Criminal Justice.
The bill seeks to assist state and local leaders in developing and coordinating human trafficking prevention programs, and asks that officials conduct a continuing comprehensive review of all existing public and private human trafficking programs to identify gaps in prevention and intervention services.
The text also indicates the need to increase coordination among public and private programs to strengthen prevention and intervention services.
The new board is to make recommendations with respect to human trafficking prevention and intervention and also develop a state needs assessment and a comprehensive and integrated service delivery approach that meets the needs of all human trafficking victims.
Another goal is to establish a method to transition human trafficking service providers toward evidence-based national best practices focusing on outreach and prevention.
The need is to develop mechanisms to promote public awareness of human trafficking, including promotion of the national twenty-four-hour toll-free hotline telephone service on human trafficking.
This goal includes promoting training courses and other educational materials for use by persons required to undergo training on the handling of, and response procedures for, suspected human trafficking activities, and to develop a framework to collect and integrate data and measure program outcomes.
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Originally published: . Volume 8, No. 5. Source pages: 5.
A bill seeking to remove requirements for the use of a value- added assessment model in determinations made with regard to school and district accountability and teacher evaluations remains pending in the House Education Committee.
HB 532 would change the use of a value-added assessment model for school and district accountability and teacher evaluations, a program designed in part by psychologist and professor, Dr. George Noell. The Value-Added Teacher Preparation Program Assessment Model was shown to have predictive validity for children’s successes. During 2003 through 2008, the Board of Regents worked with Dr.Noell, who researched and developed aspects of the program.
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Originally published: . Volume 8, No. 5. Source pages: 7.
Representative Hoffman offered a House Concurrent Resolution (HCR 16) to recognize June 2017 as Post-Traumatic Stress Injury Awareness Month.
His resolution urged the Louisiana Department of Health and the Department of Veterans Affairs to increase efforts to educate survivors of abuse, crime, and natural disaster; service members; veterans and their families; and the general public about the causes, symptoms, and treatment of post-traumatic stress injury.
He noted that “the brave men and women of the United States Armed Forces who proudly serve this great nation risk their lives to protect our freedom and that combat stress has historically been viewed incorrectly as a mental illness caused by a pre-existing flaw of character or ability, and the word "disorder" carries a stigma that perpetuates this misconception.
In the resolution, Hoffman also wrote that post-traumatic stress injury (PTSI) can occur as a result of severely traumatic events including, without limitation, sexual assault, child abuse, high-impact collisions and crashes, natural disasters, acts of terrorism, and military combat; and PTSI is a common injury to the brain that is treatable and repairable.
He noted that referring to the complications from post-traumatic stress as a disorder perpetuates the stigma of and bias against mental illness, and this stigma can discourage the injured from seeking proper and timely medical treatment.
Destigmatizing PTSI and honoring the bravery of persons recovering from this injury can favorably influence those affected and encourage them to seek help without fear of retribution or shame; and proper and timely treatment can improve health outcomes and diminish rates of suicide among people with PTSI, he wrote.
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Originally published: . Volume 8, No. 5. Source pages: 7.
HB 159 by Representative Dustin Miller has easily moved forward, passing the House 97 to 0. The measure would require mental health rehabilitation providers meeting certain criteria to be licensed in accordance with the Behavioral Health Services Provider Licensing Law.
The measure updates parts of present law known as the Behavioral Health Services Provider Licensing Law, R.S. 40:2151 et seq., authorizes the La. Dept. of Health (LDH) to provide for the health, safety, and welfare of persons receiving behavioral health services through licensure and regulation of behavioral health services providers.
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Originally published: . Volume 8, No. 5. Source pages: 7.
As published in the Louisiana Register for April, Rebekah E. Gee MD, Secretary of the Louisiana Department of Health, published an Emergency Rule, noting a budget shortfall and the elimination of psychosocial rehabilitation services for youth, in the Medicaid Program.
Gee wrote, “As the result of a budgetary shortfall in SFY 2017, the Department now proposes to amend the provisions governing children’s behavioral health services in order to terminate coverage and reimbursement of psychosocial rehabilitation services to youth. This action is being taken to avoid a budget deficit in the Medical Assistance Program. It is estimated that implementation of this Emergency Rule will reduce expenditures in the Medicaid Program by approximately $5,844,004 for state fiscal year 2016-2017.”
She wrote that effective April 1, 2017, the Department would amend the provisions governing children’s behavioral health services to eliminate coverage and reimbursement for psychosocial rehabilitation services to youth.
The Department of Health, Bureau of Health Services Financing and the Office of Behavioral Health, through collaborative efforts, provide coverage of behavioral health services for children and youth through a comprehensive system of delivery covered under the Medicaid Program, noted the rule. On March 22, the Senate Committee on Health and Welfare held and oversight hearing and nullified the Emergency Rule.
Senator Fred Mills wrote, “The committee held that the Emergency Rule was not in conformity with the intent and scope of the enabling legislation, was not in conformity to all applicable provisions of law and of the constitution, is lacking in merit, and is unacceptable. The committee further held that the Emergency Rule caused imminent peril to the public health, safety, and welfare of more than 40,000 children with significant behavioral health needs.”
He wrote that after a “thorough hearing on the matter, including a presentation by the department and public testimony, the committee, by unanimous vote, rejected the Emergency Rule on the grounds set forth in R.S. 49:953(B)(1) and R.S. 49:968(D)(3).”
“By transmittal of this written report of committee action and pursuant to R.S. 49:953(B)(4)(c) the Emergency Rule eliminating the psychosocial rehabilitation services for youth program on April 1, 2018 shall hereby be null and without effect.”
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Senate Bill 38 appears to be triggering some old turf issues between the counseling and at least some segments of licensed psychology. Over the last decades these turf issues have included diagnosis of the more serious disorders and psychological testing.
One of the most dramatic issues regarding testing resulted in the Louisiana State Board of Examiners filing a lawsuit in 1995 against Boyd J. Atterberry, a licensed professional counselor from Houma. Mr. Atterberry used tests such as the Wechsler, the Bender Gestalt, and the Woodcock-Johnson, saying that his actions fell within the counselors practice act.
Mr. Atterberry argued that the counselor practice act supported his actions. He pointed to the definition of the practice of mental health counseling, sections on “Appraisal,” which include tests of language, educational and achievement tests, adaptive behavioral tests, and symptoms screening checklists or instruments, as well as tests of abilities, interests, and aptitudes, as noted in the act.
The counselor practice act also states “…nothing in this Chapter shall be construed to authorize any person licensed hereunder to administer or interpret tests in accordance with the provisions of R.S. 37:2352(5), except as provided by Title 46, Part LXIII, Chapter 17, Section 1702(E) of the Louisiana Administrative Code, or engage in the practice of psychology.”
The trial judge determined that Atterberry was in violation of the psychology practice act.
Skirmishes continued. In 2008, the Licensed Professional Counselor (LPC) board proposed rules that included assessment and the use of the term “psychological.” This drew strong objections from the psychology board.
But by 2009 the LPC board had adopted a policy to clarify boundaries in a “Position Statement on Appraisal Activities: Clarification of the Distinction between Appraisals and Psychological Tests.” LPCs may not perform intellectual, personality/emotional, or neuropsychological testing. But those qualified by the counselor board can be authorized to use tests of language, education and achievement; adaptive behavioral tests; symptom checklists; and tests of abilities, interests and aptitude.
For many psychologists this truce is working.
However, the Louisiana State Board of Examiners of Psychologists (LSBEP), Chair Darla Burnett, PhD, MP, published an agenda for discussion of SB 38 which included an item, “Review and Discuss SB 38 MORRELL – Relative to potential concerns regarding privileges for Licensed Professional Counselors to perform psychological testing and diagnose severe mental health disorders.” This view seems to have triggered some in the psychology community to view that SB 38 was aimed at psychological testing.
However, SB 38 does in fact have to do with the second turf conflict area, independent diagnosis and treatment of serious mental conditions.
The original practice act of the mental health counselors contains some circular and sometimes vague language. “Mental health counseling services" means those acts and behaviors coming within the practice of mental health counseling as defined in this Chapter,…”
And, “(10) "Practice of mental health counseling" means rendering or offering to individuals, groups, organizations, or the general public by a licensed professional counselor, any service consistent with his professional training …”
Both sides have interpreted the language to support its own view. In the psychology community the objections have often been voiced by Dr. Joe Comaty, who has held positions of authority in state government and also on the psychology board. Comaty, a medical psychologist, has taken a firm stand at times on qualifications of LPCs.
In a 2012 newsletter the Legislative Affairs Chair of the Louisiana Association for Marriage and Family Therapy noted to members, “Dr. Joseph Comaty has been the main psychologist advocating against LPCs and LMFTs in Louisiana.” The author also expressed concerns that the psychology board had allowed this, pointing to ethical requirements for a public board to remain neutral.
So strong were these sentiments that in 2015 Dr. Comaty failed to be confirmed to a second term on the state psychology board. While no group acknowledged blocking his Senate confirmation, it was reported that the counselors were a factor in that action.
In 2010, resolving these conflicts by clarifying the counselors’ scope of practice became the goal of Senator Willie Mount, who put forth a bill to remove some of the vague language in the counselors’ practice act.
Mount offered a bill that would have changed the definition of "mental health counseling" from “assisting an individual or group, through psychotherapy and the counseling relationship, to develop an understanding of personal problems, to define goals, and to plan actions reflecting his or their interests, abilities, aptitudes, and needs as these are related to personal and social concerns, educational progress, and occupations and careers …”
The new language defined mental health counseling, “…includes facilitating human development and wellness throughout the lifespan, and the prevention, assessment, diagnosis, treatment planning and treatment, including psychotherapy, of mental, emotional, behavioral, social and addiction disorders.
The bill never made it to committee. So instead, Senator Mount created the Behavioral Health Professionals Working Group and told psychologists and counselors to resolve their scope of practice differences and develop areas of collaboration. She also directed them to “Identify any additional recommendations which may expand public access to presently absent behavioral health services while avoiding service duplication and redundancy.”
The group failed to meet the goals. Over nine meetings and interim discussions no solutions were reached.
According to the Working Group’s final report, the core of differences revolved around diagnosing mental illness. “The counselors believe that the current statute authorizes counselors to diagnose and treat mental and emotional disorders.” However, the authors wrote, “The psychologists disagree and hold that the current practice act for counselors granted a limited diagnostic scope of practice to counselors that is commensurate with their current master’s degree level of training.”
The psychologists serving where all affiliated with medical psychology and included Dr. Comaty, Dr. Darla Burnett, and Dr. Jessica Brown. They suggested that LPCs place themselves under the psychology board, an idea that was met with dismay by LPCs. Later Comaty wrote to the Senate Committee saying “… LSBEP’s patient efforts to bring its legitimate concerns to the attention of the LPC board have been met with intransigence.” Senator Mount said in a hearing that her goal in establishing the Working Group “…was simply to provide the most optimal starting point possible which would maximize the chances of successful compromise and collaboration.” However the participants of the working group were not successful, “to my dismay,” she said.
The failure of the Working Group prompted the Senator to send a letter to both communities criticizing the lack of a clear resolution and warning them that she would submit a bill to consolidate the boards in order to force cooperation.
“The constant bickering between these two boards is not in the best interest of either profession. Psychologists and LPCs have a real opportunity to develop some innovative practice techniques if the two regulatory boards would spend even half the time collaborating on how to make their professions better as they have spent on senselessly fighting with each other,” Mount wrote.
“With the history of senseless conflict and fighting and the failure of the professions to take advantage of the opportunity provided by the working group, I am left with no other options other than to introduce legislation to consolidate these boards.”
Mount made good on her threat and proposed a bill for consolidating the psychology and LPC board, SB 268. It was strongly opposed by both sides.
During the same time, important testimony from Department of Health and Hospitals Deputy Secretary Kathy Kliebert was included in hearings, regarding LPCs diagnosing.
Senator Cheek asked Ms. Kliebert, “Can an LPC bill Medicaid?” Kliebert said “…individual practitioners are not able to bill for those services.” She continued, “One of the things we’re doing in developing our new Louisiana Behavioral Health Care Partnership is developing a system that would allow the individual practitioners to bill in accordance with their scope of practice.”
Senator Cheek commented about the gap in services in the state and asked if an “all hands on deck” approach was what was needed? To this Kliebert said, “I totally agree. We have problems in terms of getting the provider capacity we need for mental health in Louisiana. We know that. Whatever we can do to get people the right level of services and the right credentialed counselor works for everybody.” “That is one of the things we’re trying to do in our reform of our managed behavioral care that we’re moving to, is to be able to do that,” Kliebert said. “To be able to allow them–the practitioners–to bill in those individual locations, at schools, in home services, where they need those services, vs. us having to provide more expensive clinic- based services or more expensive institutional services.”
Senator Cheek asked, “Can LPCs diagnose across the full spectrum?” Kliebert said, “No, not according to their current scope of practice… That clarification of the scope of practice would certainly help in our future, because we’re quoting what is in scope of practice.”
Mount backed off the effort to consolidate the boards, which some viewed later to be a maneuver to lay the foundation for the counselor bill. Others considered it a sincere effort to increase providers for the Medicaid system.
The measure, SB 268, passed and became Act 320. But along with clarifying the counselors’ scope of practice, behind the scenes negotiations resulted in a collaboration and consultation clause, for psychiatric prescribers under the medical board.
Psychologists were not included in those that could provide consultation and collaboration to LPCs. The Legislative Chair for LPA at the time was Dr. Brown, who handled negotiations. Shortly afterward Brown quit LPA and was listed as a medical psychologist on the state medical board list.
In 2012, the counselors engaged Senator Mills to help soften the language through SB216. The paragraph was amended to include “when medication may be indicated.” The language requiring that the patient be under “active care” of a medical professional was deleted. Also the requirement for consulting was softened with “in accordance with industry best practices, consults and collaborates…”
And advanced practice registered psychiatric nurse practitioners were added, “licensed by the Louisiana State Board of Nursing.”
In 2014 the Marriage & Family Therapists clarified their scope of practice, and the same consultation and collaboration language, for medication, was added.
There have been no known recent turf battles over psychological testing between psychologists and counselors. However, recently a physician asked the medical board if she could sign off on psychological testing and the medical board agreed, if the physician judged herself as qualified.
In 2014 Dr. John Fanning (L) spoke for the Louisiana Psychological Association and Dr. Jacqueline Mims, LPC (R) also testified regarding qualifications. Representative James is center.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.
Originally published: . Volume 8, No. 4. Source pages: 9.
Every morning you wake up, and similar to over 95% of the U.S. population, before going to the restroom or even saying good morning to your spouse, you perform a select behavior, not typified of people 40 years ago. That is, you check your cell phone for calls, texts, emails, and other communication. Indeed, cell phones have become a definitive part of our culture.
We have expanded how we use cell phones, encompassing their use not only for communication, but for ordering food, setting up schedules, checking weather, logging activities, and many other uses. As cell phones enhance our lives and make our lives efficient, they must similarly be viewed not only as a tool, but as a device that has implications.
Fifty years ago, the government, psychologists, and human development specialists were concerned and worried about the effects of television on human development. Several proposed that television would reduce children’s likelihood to play, promoting obesity, and also offer an increased influence over childhood cognitive development, as children’s minds may be influenced by what they saw on television.
Today, these same concerns apply to cell phones.
Cell phones have changed how children communicate, incorporating emoji images and texts messages into daily communication mediums. “Meeting up” has been replaced with FaceTime and synchronous texting. The daily demand to meet face-to-face to establish relationships, solve problems, and enhance rapport represents a secondary alternative to purely electronic transmittals.
Definitively, cell phone use has affected how children learn. E- books have replaced paper books. Pen-and-paper tests replaced online exams. Internet searches have replaced gathering a pocketful of nickels and heading to the library to copy an article. However, children are able gather information quickly,
check for spelling and grammar easily, and assess for plagiarism problems more easily than the past.
Even parenting is affected: A fourth of household accidents relate to parental cell phone use and concurrent failure to monitor children.
Consider the features that most often accompany addiction for substances, such as the need to obtain a substance, increasing amount of substance needed to become satiated, and loss or replacement of socialization, all revealing concurrent feelings perhaps attributable with cell phone use. Consider the circumstance, in which your cell phone is lost—you most likely become agitated, your blood pressure will rise, you become irritable, you stop all activities until your cell phone is found or replaced. Cell phone addiction represents a real behavioral concern, representing an area of research focus among numerous cognitive and clinical psychologists today.
Time will dictate how these new communication patterns will affect relationships, development and conflict resolution.
Perhaps the most frequently considered effect of cell phone use on day-to-day life is how cell phones distract us from our daily lives. Defined, distraction refers to something that prevents someone from giving full attention to something else.
Researchers have examined effects of cell phone use on distracted walking. Greater than 1,000 accident happen annually that are associated with individuals failing to pay attention to their environment while walking. The Pew Research Center reports that 53 percent of adult cell phone users have directly fallen or been pushed by a distracted walker.
While distracted walking represents an area of concern, cell phone use while driving represents a momentous public health concern. Statistically, based on the National Highway Traffic Safety Administration (NHTSA) 10 percent of all drivers aged 15-90 were distracted at the time of a reported fatal crash. Moreover, the frequency of these risky behaviors is not decreasing. The NHTSA reports that the percentage of drivers texting or manipulating their hand-held devices increased from 1.7 percent in 2013, to 2.2 percent in 2014. Considering a .05 percent increase every years, NHTSA data suggests that it is estimated that about 4% of drivers aged 16 to 24 are texting while driving.
Local research suggests these estimates are low. Research completed at our Forensic Cognition Laboratory, University of Louisiana at Lafayette (ULL), shows that 35 percent of younger drivers report to using a cell phone while driving.
However, research shows that this number is still perhaps even greater. Research Assistant, Ms. Lauren Short, and I are examining and comparing perceived versus observed cell phone use while driving among college students. We placed dashcam cameras in students’ cars to observe actual driving by students. Preliminary data suggest that 95 percent of the participants use their cell phone while driving, at least on an occasional basis. Moreover, preliminary data suggests that while driving approximately 15 percent of the time driving, or nine minutes out of every 60 minutes driving, is associated to cell phone distraction.
Does a quick text or answering an important call really make a difference? Yes, very much so. Consider the distance that a car travels while you return the simple text. A vehicle travels the length of a football field in five seconds. Checking a text message equates 15 seconds, or traveling three football fields, blindfolded.
April is Distracted Driving Awareness month, offering an opportunity for not only the general public, but also
psychologists and others in our field to consider how cell phone distraction affects human behavior across a variety are areas, such as development, cognitive, social, and others.
One valuable resource is the Forensic Cognition Laboratory at ULL Lafayette. The lab evaluates not only how cell phone distraction affects driving behavior, but also learning, parenting, and socialization.
Cell phones represent a technological advancement, perhaps equitable to fire or the wheel. While it has enhanced our lives, we must similarly be aware that it offers a distraction, limiting our ability to perform daily tasks and behaviors. As specialists in human behavior, we must be aware of the potential for addiction and also impaired parenting, communication, task-behavior, parenting and relating.
April offers an opportunity to remind ourselves and perhaps others of the encompassing effects of cell phone usage.
[Editor’s Note: Dr. Smith, along with his lab researchers, has authored Cell Phone Distraction, Human Factors, and Litigation, published by Judges and Lawyers Publishing. Cell Phone Distraction addresses a wide variety of topics on this topic and has been vetted by a variety of law libraries, including, Yale, Texas A & M, and Standford, and also internationally, becoming incorporated into law libraries in both Singapore and Malaysia. Dr. Smith can be reached at Theodore S. Smith, tss1065@louisiana.edu)]
Dr. Scott Smith
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This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.
Originally published: . Volume 8, No. 4. Source pages: 11.
Dr. Scott Smith, originally from Shreveport, earned his doctorate from Texas A&M. He has lived in Lafayette for about 20 years with his wife, a Nurse Administrator, and two children, one who is in high school and the other is a freshman at Louisiana Tech. Smith’s background is in Educational Psychology and he is currently Assistant Professor at University of Louisiana Lafayette where he teaches several courses, including a graduate level course in professional ethics. He has authored, Cell Phone Distraction, Human Factors, and Litigation, published by Lawyers and Judges Publishing Company, a company focusing on litigation-based publications, in 2016.
Dr. Smith also directs the Forensic Cognition Laboratory at the University. “I primarily concentrate on how cognition applies to the courts,” said Smith, “such as eyewitness testimony, judicial decision-making, memory, and other aspects. I also focus on reasons why students with disabilities fail or are successful with education. Lastly, I am completing research with a graduate student on head injury protocols for athletes, with a particular emphasis on high school athletes.
He has about five students in his lab currently, including Lauren Short, who is particularly knowledgeable about this topic, he said. “I am attempting to create another generation of researchers with skills and knowledge about this topic.”
How did Dr. Smith become interested in cell phone distraction? “About six years ago, I was teaching a class, and a student, in which I knew was failing the class, was always on their cell phone during class. I asked the student to put up their phone and the student, bluntly and rudely, asked, ‘Do you really know if cell phone use limits my ability to pay attention to your lecture?’ I stated humbly, ‘No.’ After that, I completed a study, later published in CyberPsychology, on the effects of verbal cell phone use and texting on both true and false memory for learning.”
Smith and his team looked at two types of memory. “First, there is true memory, or your memory for events that really happened,” he said. “Second, I looked at false memory, or memory for events that did not happen, such as additions, deletions, and confabulations. What did I find? Cell phone distraction affects true and false memory very differently. Persons on their phone or texting have poorer true memory in comparison to persons without distraction. In contrast, false memory is greater in distracted persons than persons that are not distracted. Essentially, if distracted, you tend to recall fewer true details, and recall more details that are false.
How has his book, Cell Phone Distraction, Human Factors, and Litigation, been received? “I feel it has been received very well,” Smith said. “It has been vetted in law libraries across the Nation, including Yale, Baylor, Texas A & M and others. Additionally, it has been placed in libraries in Asia. Furthermore, it has good sales. It reached #2 in the Personal Injury, Law category on Amazon.”
Related to cell phone distraction, what does he think people least understand about the effects of cell phone use? “First, people do not realize how cell phone use affects their socialization, particularly in comparison to the past,” he said. “People often today forego face-to-face communication to send a post on Facebook or offer multiple texts. This affects the ability for people to practice negotiation and the ability to establish rapport.”
“Second, people do not realize how cell phone use affects learning, particularly learning processes. The days of traditional hard and soft cover books is quickly ending,” he said. “Libraries are getting away from holding books, to places for people to access computers. For young children, and even today’s college students, study materials are accessed through their cell phone, and tests similar through the same format. Information can be accessed quicker from the Internet. There is a concern that information may not be processed deeper, considering past learning styles.”
“Third, alongside the last discussion, cell phones in my prediction affect our ability to suspend award or accept that time is needed to process information. Cell phones enable us to demand immediate feedback through texts or calls or emails. Learning itself demands consolidation. And, personal communication requires processing time. Cell phones dissuade these natural processes.
Fourth, while cell phones are beneficial, they obviously are distracting. They affect walking, with many accidents having an origin with both walking and using a cell phone. Also, obviously, they particularly affect our ability to drive. David Strayer, a researcher out of the University of Utah, equates cell phone use to drunk driving. In my opinion, this represents an accurate depiction.”
What are some of the misperceptions people have about cell phone distraction
and driving? “First, people think that they are excellent dual taskers. Humans have limits regarding their ability to process information. People may “get by” dual tasking, or using their cell phones and driving, but their ability to perform both is indeed equivalent to a drunk driver assuming that he is able to drink and drive.”
“Second, people think hands-free phones solve the problem, or that ear buds or speakerphones equate to distraction free driving. This is false. Driving requires touch or haptic, visual, and cognitive demands. Speakerphones may reduce haptic demands, but there still is the attentional demand. The attentional demand through cell phone use reduces the ability to make critical thinking decisions. It increases reaction time. It also prompts a series of dangerous behaviors, such as following too close, frequent breaking and inconsistent speed.”
Should we try and eliminate cell phones? “No. That is not reasonable,” he said. “They enable us to communicate, access information, and keep in touch with the world. However, any tool must be used wisely.”
Dr. Smith notes that the research is mixed when it comes to legislation. “Some studies show that states with strict restrictions result in fewer cell phone related accidents and other students have failed to show any differences pre- and post-legislation.”
What has been effective? “Research has shown that educational interventions have been effective, particularly if focused towards children and young adults less than 25. Public awareness, followed by educational interventions have showed some success.
“The cell phone will not fade away. However, as a tool, people must critically evaluate when it is okay and not okay to use this tool.”
The National Safety Council sees the most dramatic increase in auto deaths in 53 years.
This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.
Originally published: . Volume 8, No. 4. Source pages: 12.
Manchester by the Sea is not a chick flic. It is a dark story with sparse flashes of humor that serve to highlight the essential darkness. It pivots on issues of male bonding. Of the females portrayed, the one that provides the most gratification to the men in the story is a fishing boat, the Claudia Marie.
The movie opens with the central character, Lee Chandler, struggling to unclog a toilet for an impatient woman occupant of the building in Boston where he is the janitor. Lee goes on to deal with a plumbing crisis in another apartment whose snarky tenant provokes Lee’s ire, leading to a consequent rebuke from his employer. The emphasis on cleaning up messes is a signal that anger, in Freudian terms an anal issue, will be key in the film.
The next day, Lee learns that his brother, Joe, in nearby Manchester is gravely ill. Before Lee can get to the hospital, Joe dies. We see Lee’s farewell kiss on his brother’s cold cheek. Lee goes on to search for Joe’s son, Patrick, and his breaking the news of his father’s death to the teenager. In another reference to anger, when Lee finds Patrick the boy is embroiled in a hockey rink exchange of fisticuffs.
A tangled, hard-to-follow series of flashbacks provide context. Earlier, living in Manchester, Lee’s drunken carelessness caused a house fire in which his two young children died. When the police decide that Lee will not be charged, he seizes an officer’s gun and attempts suicide. It requires several officers to restrain him.
In other flashbacks, we learn that Lee’s embittered wife, Randi, left him and remarried. We also learn that the initial
diagnosis of Joe’s cardiac problems had panicked his wife, Elise, who deserted him and their son, Patrick.
In the main story line, Lee learns that his brother’s will designates him as Patrick’s guardian. Lee and Patrick try to become reacquainted and to resolve complications. One focus of their struggle is where to live. The boy does not want to leave Manchester and his hometown friends. On the other hand, Lee feels like an outcast in Manchester and wants to return to Boston where he has no past.
Another fraught issue is what to do with the Claudia Marie, an old fishing boat has taken generations of Chandlers on all male fishing expeditions, now decrepit and in need of expensive repairs. Lee cannot see a way of paying for them; Patrick is adamant about keeping the boat.
Patrick persuades Lee to abet him in his sexual adventures with high school girlfriends. The single mother of one of the girls tries unsuccessfully to arouse Lee’s interest. Her awkward efforts and the teenagers’ clumsy, error prone sexual scrambles provide comic relief. Additional comic relief flickers when Patrick’s mother invites her son to dinner. The hyper-religious new husband is markedly unenthusiastic about acquiring a son.
In poignant contrast to these humorous elements, Lee’s former wife, newly pregnant, accidentally encounters him and attempts to apologize for her initial lack of forgiveness. Lee cannot accept the tenderness. He responds with mute avoidance.
In another meaningful scene, one that echoes with the movie’s opening, we see Lee, alone and feeling misunderstood, having a drink in a bar. He thinks one of the locals is staring at him and provokes a fight that leaves him bruised and battered.
The focus returns to the Claudia Marie. To Patrick’s delight, Lee realizes that his brother’s collection of expensive rifles can be sold to raise the money to repair the boat. Lee also persuades an old friend in Manchester to adopt Patrick, permitting the boy to finish high school in Manchester and freeing Lee to leave town. Patrick, grown fond of his surrogate dad, tearfully asks why Lee can’t stay. Lee confesses that he “can’t beat it”—can’t find a way to accept closeness. The movie ends with Lee and Patrick fishing on the refurbished boat. Lee tells his nephew that he will look for a new apartment with a guest bedroom, hinting at the possibility of a relationship, albeit an attenuated one.
Manchester by the Sea is remarkable in its depiction of male bonding, of the kind of tenderness than can exist between men. In contrast, it is unremitting in its depiction of flawed women. That misogyny made me wonder.
The movie clearly stresses the connection between Lee’s angry outbursts and his depression. His self-hate like all depression, is self-directed anger.
Guest Columnist, Dr. Alvin Burstein
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This article is part of a historical newspaper archive. Read the original issue for its original layout, photographs and graphics.