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Dr. Buckner Awarded Grants: Alcohol, Drug Abuse and Microaggressions for Blacks

Dr. Julia Buckner, Professor in the Department of Psychology at LSU and the Director of LSU’s Anxiety and Addictive Behaviors Laboratory & Clinic, has been awarded two grants, totaling over $800,000, to study alcohol and drug abuse for Black persons including the impact of microaggressions.

Dr. Buckner is also a Clinical Associate Professor in the Department of Psychiatry at LSU-Health Sciences Center and a Visiting Professor at the London South Bank University School of Applied Sciences.  She is also a licensed clinical psychologist.

The first grant is for the project, “Black Hazardous Drinkers:  Ecological Momentary Assessment of Racial/Ethnic Microaggressions.” The agency is the National Institute On Alcohol Abuse and Alcoholism and the amount is $402,835.00.

According to the project materials, “Black persons are the second largest racial minority group in the U.S., accounting for over 13% (44 million) of the population. Black persons evince numerous health inequalities, particularly as it relates to alcohol consumption and negative affect (NA; e.g., sadness). Indeed, Black individuals evince the greatest increase in average daily volume of alcohol consumed such that it is 41% greater among Black compared to White individuals who consume alcohol.

“Further, Black Americans report increases in drinking frequency and heavy drinking episodes at rates greater than most other racial/ethnic groups. And when Black persons experience alcohol use disorder (AUD), their symptoms tend to be more chronic than non-Hispanic/Latin White individuals. Minority stress-based models
of substance use and mental health outcomes tend to propose that
marginalized groups such as Black Americans are vulnerable to risky substance use via the interplay of several domains including interpersonal (e.g., experiences of racial discrimination) and individual factors (e.g., emotional symptoms). Indeed, meta-analytic data indicate that racial discrimination is positively related to alcohol consumption, heavy/binge drinking, at-risk drinking, and
drinking-related problems among Black persons. […]

“There is a need to understand the proximal and longitudinal nature of MAs [microaggressions] and alcohol use motivation (i.e., greater alcohol craving, intention to drink, and coping-oriented motives for alcohol use) and drinking (i.e., greater alcohol consumption, greater frequency of drinking, and more negative consequences from drinking) among this health disparities group.”

The second grant is for the project, “Ecological Momentary Assessment of Racial/Ethnic Microaggressions and Cannabis Use among Black Adults.” The agency is the National Institute On Drug Abuse and the amount is $419,904.00.

From the materials, “Black individuals who use cannabis use cannabis more frequently and are more likely to use riskier cannabis use methods (e.g., blunts), associated with greater exposure to carcinogens and toxins and with greater risk for cannabis use disorder (CUD). In fact, Black individuals who use cannabis are more likely to meet criteria for CUD than White or Hispanic/Latin persons. This is concerning given rates of cannabis use (including daily use) appear to be increasing among Black adults in the U.S.

“Minority stress-based models of substance use and mental health outcomes propose that marginalized groups, such as Black Americans, are vulnerable to risky substance use via the interplay of several domains including interpersonal (e.g., experiences of discrimination) and individual factors (e.g., emotional symptoms). Yet, despite meta-analytic data indicating that racial discrimination (a source of significant minority stress) is positively related to adverse drinking outcomes among Black individuals, the impact of racial discrimination on cannabis use behavior among Black individuals has received little empirical attention. […] there is a need to understand the longitudinal nature of MAs and cannabis use motivation (i.e., greater cannabis craving, intention to use, coping-oriented motives for cannabis use) and cannabis use and related problems among this population.”

Dr. Buckner’s program of research primarily focuses on: (1) psycho sociocultural causal and maintaining factors implicated in substance use disorders and co-occurring anxiety substance use disorders; and (2) development and evaluation of empirically-informed treatment and prevention protocols for substance use disorders, including treatment for co-occurring anxiety-substance use disorders.

Dr. Buckner has had over 190 publications and she has utilized a variety of methodological procedures in her research, including ecological momentary assessment, affect and craving induction paradigms, attentional processing paradigms, technology-based interventions, and randomized clinical trials.

She has been involved in several NIH grants as PI, co-PI, consultant, and sponsor and is currently Project Director on a graduate education training grant from the US Department of Health & Human Services’ HRSA. She has also received awards from organizations such as the American Psychological Association, College on Problems of Drug Dependence, Anxiety Disorders Association of America, and Association for Behavioral and Cognitive Therapies (ABCT) Addictive Behaviors & Anxiety Disorders Special Interest Groups.

The Banshees of Inisherin

A Review
by Alvin G. Burstein, PhD

In 1963, when I moved from the University of Michigan to the Neuropsychiatric Institute of the  University of Illinois, I met one of the last giants of Psychology, Ernest A. Haggard, who held a  professorship there and a prestigious career investigator’s award from the National Institute of  Mental Health. In contrast to the contemporary trend of increasing specialization in psychology, Haggard’s research was wide ranging. It included studies of fleeting changes in facial  expression, details of responses to Rorschach’s test, and the effects of confinement on  submariners and of social isolation on inhabitants of farms on the fjords of Norway.

This last study was much on my mind as I watched The Banshees of Inisherin because of its  letting, a fictional isolated island off the coast of Ireland. I was also drawn to the film, which has  been characterized as a black tragicomedy, because of its reception. Released by Searchlight  Pictures in 2022, it won multiple awards at the 79th Venice International Film Festival and, more remarkably, a 15-minute standing ovation.

It was written and directed by Martin McDonagh. It stars Colin Farrell as Padriac, Brendon Gleeson as Colm, and Kerry Condon as Siobhan, Padriac’s sister. Each of them is stunningly  effective in leading the audience through the tale.

The story centers on a rupture of the previously close relationship between the two men.  Heretofore, they have met regularly to drink and talk at the isolated island’s pub. With no  warning, Colm tells Padriac that he wants nothing more to do with him. Padriac is devasted, and unable to account for the change, seeks fruitlessly somehow to restore it. Colm ultimately tells  his former companion that, if Padriac persists in attempting to relate to him, Colm will  amputate one of his own fingers. When he does so, the unspeakably horrid event shocks Padriac, but doesn’t forestall his efforts. The horror ratchets up with Colm’s hacking off four  more fingers and flinging them at Padriac’s door.

Padriac’s pet burro dies as a result of ingesting one of the digits. Grief-stricken and enraged,  Padriac tells Colm that he will burn down the latter’s cottage while Colm is in it, warning Colm to make sure his former friend’s dog is outside. Padriac carries out his threat, rescuing the dog,  only to learn that Colm escaped the inferno.

Colm suggests to Padriac, that, with the burning of his cottage, their feud might end. Padriac  eesponds that would have been the case only if Colm had died in the fire. In a cryptic ending, as Padriac turns to leave, Colm thanks him for looking after his dog, and Padriac responds. “Any  time.”

Judge Rules Ms. Monic Entitled to Immunity

The conclusion of a drawn-out legal dispute over a psychologist’s due
process rights concluded with a US District Court judge confirming that the
psychology board, as well as the board’s employee, Ms. Jaime Monic, are both
entitled to immunity under the 11th Amendment, which bars individuals from
suing a state in federal court.

The lawsuit was brought by Dr. Eric Cerwonka who alleged violations of his
Constitutional rights to due process, when his license was suspended without
a hearing and amid other alleged irregularities by the investigations
subcommittee of the Louisiana State Board of Examiners of Psychologists.

A jury trial had been scheduled for June 4, 2020, but Judge Michael Juneau ruled in February on a Motion for Summary Judgment and arguments by Atty. Gen. Jeff
Landry, ending the dispute. A representative from Cerwonka’s legal firm said that there would be no appeal.

The Louisiana State Board of Examiners of Psychologists is the law enforcement and regulatory agency for the practice of psychology.

In August 2017, Dr. Cerwonka filed a lawsuit in the United States District Court Western District of Louisiana Lafayette division. In his complaint, Cerwonka and his attorneys alleged that the board acted on an interim basis before any hearing had taken place, that Cerwonka was denied a proper opportunity to defend himself against specific charges, that an emergency action was taken because he exercised his right to
free speech, and that evidence was manipulated and obtained illegally. Among these and other violations of his rights, he and his attorneys also noted that the prosecuting
attorney for the board had previously represented Cerwonka in a hotly contested custody battle and that the attorney had information that, allegedly, was used in the board’s prosecution.

In January 2018, Cerwonka and his attorneys amended the complaint against the psychology board to include Executive Director Jamie Monic.

In March 2018, Magistrate Judge Carol B. Whitehurst recommended dismissal based on lack of federal jurisdiction, writing, “The Eleventh Amendment bars an individual from
suing a state in federal court unless the state consents or Congress has clearly and validly abrogated the state’s sovereign immunity.”

United States District Judge Robert James agreed, and issued a Judgment on April 18, 2018, stating, “After an independent review of the record, and consideration of the objections filed, this Court concludes that the Magistrate Judge’s report and recommendation is correct and adopts the findings and conclusions therein as its own.”
Therefore, Judge James dismissed the matter in part on the grounds that the state is immune. However, a second aspect of the suit continued, naming the Executive
Director as an individual.

On April 18, 2019, in response to another Motion to Dismiss, Judge Juneau ordered that a Motion to Dismiss was partly granted and partly denied, leaving Ms. Monic as the sole defendant.

In late 2019, Ms. Monic and her attorneys at the state requested a jury trial. Judge Juneau granted the unopposed Motion to reset the Bench Trial to a Jury Trial, and
scheduled the matter for June 4, 2020 in Lafayette.

On December 19, 2019, Atty. Gen. Jeff Landry submitted a Motion for Summary Judgment and memorandum in support of the motion.

Landry wrote, “Plaintiff cannot prove the Jaime Monic acted outside of the scope of her duties. Absent evidence that Ms. Monic acted outside of the scope of her duties, she is clearly entitled to absolute immunity. Alternatively, Ms. Monic is entitled to qualified
immunity as her actions were reasonable actions to assist the Psychology Board is carrying out its duty to protect the public. Plaintiff cannot demonstrate any violation of a clearly established law and therefore, has no claim pursuant to 42 U.S.C. §1983
against Ms. Monic.”

Defending attorneys argued, “… all of the facts alleged arise out of Ms. Monic’s performance of her official duties. It is clear from Ms. Monic’s deposition that Ms. Monic never acted outside her official capacity.”

“Qualified immunity protects public employees and officials from individual capacity suits under 42 U.S.C. §1983 for performance of ‘discretionary duties’ when their
actions are reasonable regarding the rights allegedly violated.” They quoted that, “Qualified immunity protects public officials from suit unless their conduct violates a
clearly established constitutional right.”

Cerwonka’s attorneys argued that the Supreme Court has refused to extend absolute immunity beyond a very limited class. “Absolute immunity extends only to those ‘whose special functions or constitutional states requires complete protection from suit.’
However, ‘state executive officials are not entitled to absolute immunity for their official actions.’

And, they argued that, “In professions requiring specific licenses, ‘the licenses are not to be taken away without procedural due process required by the Fourteenth
Amendment,'” wrote the attorneys.

“An essential principle of due process is that a deprivation of life, liberty, or property be preceded by notice and opportunity for hearing,” said the attorneys for Cerwonka.

Dr. Tucker Looks at “Nudges” to Aid in Suicide Prevention

Dr. Raymond Tucker is again at the forefront of new research for suicide prevention. Last month he and collaborators authored “A Nudge in a New Direction: Integrating Behavioral Economic Strategies Into Suicide Prevention Work,” published in Clinical Psychological Science.

Dr. Tucker is Assistant Professor of Psychology, Louisiana State University (LSU), and Clinical Assistant Professor of Psychiatry, Louisiana State University Health Sciences Center /Our Lady of the Lake.

In the “Nudge” research, Tucker and co-authors looked at how behavioral economic strategies––using psychological phenomena to improve decision-making–– could improve efforts in suicide prevention. The strategies included nudges where social norms are tweaked, slight changes in question framing are applied, and adjusting item counts, are used to gently shape individual’s decision toward positive outcomes.

“Our research demonstrated that simply, how we advertise online suicide prevention materials can increase public awareness about suicide,” Dr. Tucker said. “College students asked to interact with an online suicide prevention program to help their loved ones cope with suicidal thoughts were 167% more likely to use the resource compared to those asked to click on the resource to help themselves navigate thoughts of suicide they may have in the future.”

“Although this change in wording may seem small, the theory of messaging resources this way is backed by work in behavioral economics and nudge messaging,” Tucker explained. “Specifically, most adults show an ‘optimism bias’ or a belief that negative things are less likely to happen to themselves in the future compared to others. Thus, a ‘nudge’ or change in wording to market mental health materials as helping others, not oneself, can help offset the optimism bias.”

Dr. Tucker’s research broadly focuses on the enhancement of theoretical models of suicide and suicide risk assessment tools, and he has published over 50 peer reviewed academic publications regarding suicide risk and resilience. He is a former member of the board of directors of the American Association of Suicidology and is a consulting editor for the academic journals Suicide and Life-Threatening Behavior and Archives of Suicide Research.

“As suicide prevention continues to extend outside of the therapy office to include public health approaches,” he said, “such as reducing access to lethal means such as firearms, the way suicide prevention resources are communicated to the public will benefit from lessons learned from decades of behavioral economics research.”

Tucker also serves as a consultant for Collaborative Assessment and Management of Suicidality (CAMS) Care and provides trainings in the evidencebased suicide prevention framework to behavioral health providers across the country. He was named the Outstanding Psychology Trainee throughout the VA healthcare system by Division 18 of the American Psychological Association.

What does he think are the most important issues in suicide prevention that psychologists should know about? Two stand out for him.

“There is an evidence base for providing suicide specific care,” he said, compared to treatment as usual where a practitioner treats mental health concerns while managing suicide risk. He explained that just recently a large review and metaanalysis, the Collaborative Assessment and Management of Suicidality or Cognitive Behavioral Therapy for Suicide Prevention,
compared treatment as usual to specific care.

“This meta-analysis demonstrated that these suicide-specific interventions, ones that few are trained on, enhance protection against suicidal thoughts and behaviors above standard psychotherapy for mental health concerns. Thus, suicide-specific care may help prevent suicide in patient populations.”

“The second point that stands out is that we are not likely to make meaningful changes in the countries suicide rate by providing better mental healthcare,” he said. “Suicide has increased by 30% since 1999 and over this time, research has clearly indicated that suicide is not just a manifestation of an untreated mental health disorder. Access to firearms, social and economic inequality, and even a state’s minimum wage systematically relates to suicide death at the state level. Scholars in suicide prevention argue that adequate mental healthcare is part of, but not the only piece of, reducing the alarming increase in suicide in the U.S.”

At LSU Dr. Tucker leads the Mitigation of Suicidal Behavior (MOSB) laboratory, where he and his students conduct research to guide suicide prevention efforts. “The MOSB lab is a community-based research program that uses research to enhance theoretical models of why people die by suicide as well as interventions and assessment methods based on these models. The MOSB lab is part of suicide prevention efforts on LSU’s campus as well as the department of psychiatry at Our Lady of the Lake.

“We also are involved in the National Suicidology Training Center (NSTC) housed at Baton Rouge the Crisis Intervention Center to improve healthcare provider training in suicide prevention. Across these partnerships, the lab has tested militaryspecific risk factors for suicide in Army soldiers and Veterans, how people’s stories about surviving a suicide attempt may increase help-seeking for mental health concerns, and how the Collaborative Assessment and Management of Suicidality can be used in medical settings to enhance suicide risk assessment and treatment.

Governor Edwards Issues Executive Order in Battle Over Pre-Existing Health Conditions

One of the Governor’s priorities for this legislative session was protecting health insurance coverage for Louisianans with pre-existing conditions. The effort took a hit when Representative Chad Brown’s HB 237 was involuntarily deferred in Committee on Insurance. HB 237 would have prohibited health plans or health insurers from discriminating against a health insurance applicant based upon pre- existing conditions or health status.

On May 21, the Governor announced that he had issued an Executive Order establishing the Protecting Health Coverage in Louisiana Task Force, following efforts to repeal the protections offered to Louisianans with pre-existing medical conditions.

“Protecting coverage for the 850,000 Louisiana residents with preexisting conditions is a top concern of mine and should be a top concern for all lawmakers,” Gov. Edwards said. “Unfortunately, the Attorney General opted to join Louisiana into a lawsuit that threatens the coverage protections offered under the Affordable Care Act. One of the discussed solutions includes taking Louisiana back to the days of the high-risk pool, which only covered around one percent of people prior to the ACA. While we must take any step possible toward protecting our people, we can’t falsely claim we’ve completely solved this problem and risk tragedy for vulnerable people. Louisianans deserve better.”

The new Task Force includes the Governor, the head of the Louisiana Department of Health, the Insurance Commissioner, the Attorney General, members of the Louisiana Legislature, representatives of the insurance industry and health care consumer groups and experts in economic and fiscal modeling.

In the Executive Order the Governor noted, “… 849,000 non-elderly Louisianans had a declinable preexisting medical condition under medical underwriting practices in place prior to the enactment of the Patient Protection and Affordable Care Act (ACA); … that included, but were not limited to: Alzheimer’s/ dementia, arthritis, cancer, diabetes, epilepsy, heart disease, multiple sclerosis, mental disorders, paraplegia, Parkinson’s disease, and stroke;…” […]

“Attorney General Jeff Landry joined a lawsuit, Texas v. Azar, seeking to invalidate the entire ACA;..” the Governor wrote, and said “invalidation of the ACA would eliminate health protections for people with preexisting conditions, eliminate financial assistance for people receiving coverage through the federal Health Insurance Marketplace, and eliminate health insurance for Louisianans receiving coverage through Medicaid Expansion;

Also he wrote, “the Attorney General’s attempted fix in the event he is successful in eliminating the protections of the ACA is contained in SB 173 of the 2019 Regular Session;…” and “this legislation does not provide for the needed protections of the ACA but does include a nebulous study to create a ‘Guaranteed Benefits Pool’ under the exclusive purview of the Commissioner of Insurance;

“… the State’s pre-ACA high risk pool only covered one (1) percent of Louisianans in the individual insurance market; …” he wrote.

Because of what the Governor views as an incomplete and insufficient approach, he is directing that, “No executive branch departments of the State of Louisiana shall abridge a person’s access to health insurance as prescribed by state and federal law.”

And he created the “The Protecting Health Coverage in Louisiana Task Force” is hereby established within the Executive Department.

The duties of the Task Force include, but are not limited to, the following: The Task Force shall develop policy proposals to maintain health care coverage for Louisianans at risk of losing health insurance or health protections due to Texas v. Azar. The Task Force shall study and develop policy proposals to mitigate the impact of the loss of preexisting condition protections including, but not limited to: 1) guaranteed issue; 2) preexisting condition exclusion prohibition; 3) prohibition of lifetime and annual limits on coverage; 4) essential health benefits, 5) nondiscrimination. The Task Force shall study and develop policy proposals to mitigate the impact of more than 465,000 Louisianans losing Medicaid coverage due to Texas v. Azar. The Task Force shall study and develop policy proposals to determine the aggregate funding needed and financing options for the health coverage and health protections afforded by the ACA. The Task Force shall study and develop policy proposals to maximize insurance coverage and minimize out-of-pocket medical costs in Louisiana.

The members shall include: The Governor, or designee; The Secretary of Health, or designee; The Commissioner of Insurance, or designee; The Attorney General, or designee; The Chairmen of the House and Senate Health and Welfare Committees, or their designees; Two at-large members representing consumer health groups, appointed by
the Governor; Two at-large members representing the insurance industry appointed by the Governor; and One at-large member with expertise in economics and/or fiscal modeling, appointed by the Governor.

2nd Special Session Likely HB1 “Not a Serious Attempt” at Solution Says Governor

The Governor will likely call a second special session in late May or early June to attempt to deal with the on-going financial problems in the state, following a House operating budget bill that squeaked by and that threatens cuts in higher education, hospital closures, and kicking 46,000 elderly and disabled out of their nursing homes beds.

The House barely passed House Bill 1 for the state’s operating expenses with a 55 yea to 47 nay vote on April 19. It has been pending in the Senate Finance since April 24.

The measure that squeaked by on April19 contains $648 million in cuts, reported the Advocate, and leaders from LSU medical schools in New Orleans and Shreveport are said to be asking for a remedy and delay so that medical residents, students, and faculty do not begin to look for safe harbors elsewhere. Additionally the effort would cut TOPS to 80 percent, the popular scholarship program for 50,000 Louisiana residents yearly.

The Advocate reported that 46,000 elderly and disabled would lose their nursing home placements and care as early as July if the House budget were passed.

The House vote was down party lines with the Republican House. Only one Democrat voted for the measure and eight republicans voted against the effort.

The Governor released a comment even before the vote, saying on April 16, “This budget document is not worth the paper it’s printed on, and gives nothing but false hope to students and parents who want to attend a Louisiana university or community and technical college. What we saw today from the House Appropriations Committee was not a serious attempt to tackle the problems we face.”

According to the Advocate, Republican leaders asked members to pass the budget to move it forward but said the health care cuts should not be taken seriously and could be balanced out by additional taxes passed in another special session.

In the first special session this year, the Legislature was unable to pass any tax measures to relieve Louisiana budget crisis. Two years ago lawmakers passed over $1 billion in temporary taxes but these expire. The House Fiscal Office estimated that $1.38 billion in revenue was expiring on June 30, 2018.

“I’ve proposed a plan that would replace a portion of the expiring revenue, resulting in a net tax reduction on the people of Louisiana by almost $400 million, while still imposing more than $120 million in state general fund spending cuts,” the Governor said before the House vote. “However,” Gov. Edwards said, “ we would adequately fund health care, higher education, and TOPS, among other priorities, most of which we are simply unable to fund under the House’s proposal or the executive budget.”

Magistrate Says Lack of Federal Jurisdiction in Cerwonka v LSBEP

Magistrate Judge Carol B. Whitehurst of the U.S. District Court Western District has recommended that a federal lawsuit against the state psychology board filed by Dr. Eric Cerwonka, be dismissed based on lack of federal jurisdiction.
In August 2017, Cerwonka filed a lawsuit in federal court against the Louisiana State Board of Examiners of Psychologists (LSBEP) alleging violations of his Constitutional rights. This followed a July 2017 ruling by 19th Judicial District Court Judge Michael Caldwell negating a February 2017 LSBEP disciplinary decision against Cerwonka, on grounds that the board’s methods “… violated the Constitutional rights of Dr. Cerwonka.”

In Whitehurst’s “Report and Recommendation,” filed March 26, she finds that the Louisiana State Board of Examiners falls under the umbrella of state immunity provided by the Eleventh Amendment.
Dr. Cerwonka and his attorney have fourteen days from service of the Report and Recommendation to file specific, written objections.

In Whitehurst’s Report, she wrote, “The Eleventh Amendment bars an individual from suing a state in federal court unless the state consents or Congress has clearly and validly abrogated the state’s sovereign immunity,” wrote Whitehurst. Citing Fairley v. Louisiana, (5th Cir. 2007), a lawsuit involving the state medical board, Whitehurst wrote, “A suit against a state agency or department is considered a suit against the state under the Eleventh Amendment.”

Whitehurst recommends that the motion to dismiss for lack of federal jurisdiction be granted, and that the plaintiff’s claims against the Board be denied and dismissed without prejudice. (In a civil case, dismissal “without prejudice” is a dismissal that allows for refiling of the case.)

Since Whitehurst recommends dismissal on jurisdictional grounds, she explained that she makes no recommendation on the LSBEP’s request for a dismissal based on failure to state a claim.

“When a district court finds it lacks subject matter jurisdiction, its determination is not on the merits of the case, and does not bar the plaintiff from pursuing the claim in a proper jurisdiction,” she wrote.

In the Report, Whitehurst stated that the party asserting jurisdiction bears the burden of proof for a 12(b)(1) motion to dismiss, such that, “the plaintiff constantly bears the burden of proof that jurisdiction does in fact exist.”

“The plaintiff’s argument that the Board’s financial autonomy prohibits the Board from being a state agency is not persuasive,” wrote Whitehurst.

“A legally sufficient complaint must establish more than a ‘sheer possibility’ that plaintiffs’ claim is true. Id. It need not contain detailed factual allegations, but it must go beyond labels, legal conclusions, or formulaic recitations of the elements of a cause of action.”

“Although acknowledging there is no jurisprudence directly finding that the Louisiana State Board of Examiners of Psychologists, which was created by the Louisiana Department of Health and Hospitals (“LDHH”), is a state agency, defendant argues the Board is similar to the Louisiana
State Board of Medical Examiners, which was also created by the LDHH, and which has been held to be a state agency entitled to Eleventh Amendment immunity. Because the Board argues it has not waived its immunity from suit, it asserts the plaintiff’s claims against it are barred.

In Fairley, the Fifth Circuit recognized that the Louisiana State Board of Medical Examiners is a state agency for purposes of Eleventh Amendment Immunity.

“The Louisiana State Board of Examiners of Psychologists argues that the statute creating its existence and the statute creating the Board of Medical Examiners are similar, with similar powers and rights being granted to each Board, and with each Board being subject to the provisions of La. Rev. Stat. 36:803.4. Each board is created within the Louisiana Department of Health and each is given oversight over their respective fields.”

Attorney for Cerwonka, Brown Sims attorney Mr. L. Lane Roy, had argued in the “Opposition of Plaintiff to Defendant’s Motion to Dismiss,” filed on November 30, 2017:

“An important case for this Court’s consideration on the issue of the Eleventh Amendment Immunity is the United States Supreme Court decision in the matter of North Carolina State Board of Dental Examiners vs. Federal Trade Commission, 135 Sup. Ct.1101(2015). While the North Carolina State Board case involves as one of its principal issues federal anti-trust laws, one of the main topics decided by the court was whether the State of North Carolina possessed Eleventh Amendment immunity from application of the federal law and its being subject to suit before the federal courts. In a lengthy discussion, the court found that North Carolina did not possess Eleventh Amendment immunity.” […]

“Here, there is absolutely no showing whatever that the State of Louisiana had active control over the Board in this matter and in fact, the exact opposite is correct.”

“The State has virtually no control of this agency as shown by the decisions that its rendered in this matter, not involving a state person but private attorneys hired for the persons, private investigators, private members of the community acting as judges at the hearing before the Board, private employees acting as persons, though illegally, who made decisions on interim suspension without a hearing whatsoever,” Mr. Roy wrote.

Counsel for the LSBEP, Attorney General Jeff Landry, signed for by Jeremiah Sams, Assistant Attorney General, wrote that, “Under the Eleventh Amendment of the United States Constitution, an unconsenting state is immune from any lawsuit seeking monetary damages or equitable relief brought in federal courts by her own citizens or by the citizens of another state …” And, he wrote, “The Board is an agency of the State of Louisiana.”

In another section of the Attorney General’s “Motion to Dismiss,” Sams wrote, “Alternatively, Plaintiff has failed to state a claim against the Board under 42 U.S.C. §1983, as the Board is not a “person” under the meaning of §1983.

“To state a claim under §1983, a plaintiff must establish that a person, acting under color of law, deprived him of some constitutional right.

“State agencies and state officials acting in their official capacity are not ‘persons’ within the meaning of the statute, and it is a well settled point of law that a state is not capable of being sued under 42 U.S.C. § 1983, as the state is not a “person” under 42 U.S.C. §1983.34” […] “Accordingly, Plaintiff’s §1983 claims against the Board should be dismissed.”

Cerwonka also filed an amendment to the complaint adding Ms. Jaime Monic, current Executive Director, to the lawsuit.

The matter of state supervison of the boards has been a topic for some legislators since the 2015 Supreme Court decision. In 2016 Senator Fred Mills put forth a measure creating the Task Force on Meaningful Oversight to help address compliance with the North Carolina v. FTC and minimize exposure to antitrust claims. In the Task Force’s report, in this case having to do with antitrust laws, authors wrote, “a board must satisfy two prongs in order to claim state action immunity.” One involves the “inherent, logical, or ordinary result of the exercise of authority delegated by the state legislature.” The second prong is “active supervision,” satisfied by having a state review and approval of board’s policies. Mills put forth legislation in 2017 to help remedy the supervision issue and also this year, in his SB 40.

According to a report by the Louisiana Legislative Auditor published in 2017, individuals can file general liability claims against the state because Louisiana waived sovereign immunity in the 1974 Constitution. State law limits damages to $500,000 for personal injury and wrongful death claims. However, there is no cap on economic damages or medical expenses, according to the report, “Types and Costs of General Liability Claims, Office of Risk Management.”

Between 2010 and 2015 the state paid over $42M in Constitutional and Civil Rights violations, the Auditor reported.

“Hoffman Report” Defamation Suit Continues in Washington, DC Defendants Claim Free Speech Rights; Plaintiffs Point to Leaks as “Actual Malice”

A dispute involving the ramifications of the “Hoffman Report,” a document prepared by the Chicago attorney David Hoffman and commissioned by the American Psychological Association (APA), during conflicts over the role of military psychologists, APA ethics decisions, and human rights policies in APA, was filed in Washington D.C. in late August, immediately following dismissal by an Ohio judge who said the case was not in his jurisdiction.

Motions put forth in the Ohio pleadings and in the new D.C. litigation indicate that the defense attorneys may be positioning themselves to argue that the report falls under free speech protections.

The defamation lawsuit is being brought against David Hoffman, his law firm, and APA, by retired Colonels and psychologists Morgan Banks, Debra Dunivin and Larry James, and also two psychologists who are former employees of the APA, Drs. Stephen Behnke and Russ Newman. The lawsuit alleges reckless disregard for the truth and false statements in a 2015 Hoffman Report.

In December, defense attorneys filed a motion seeking the Court to compel arbitration based on the employment agreements of Drs. Behnke and Newman with APA. Hoffman’s law firm, Sidney, also filed a request that Behnke and Newman arbitrate the dispute with Hoffman’s firm.

In both Ohio and D.C., the defendants filed motions asking for dismissal based on free speech protection laws, called Anti-SLAPP laws. “SLAPP” or “strategic lawsuit against public participation” are lawsuits without merit which are aimed to intimidate or silence free speech, according to the Public Participation Project.

The defense wrote, “Here, APA’s publication of the Report constitutes an ‘[a]ct in furtherance of the right of advocacy on issues of public interest.’ Id. § 16-5501(1). The publication of the Report is a ‘written . . . statement’ that APA allegedly made ‘[i]n a place open to the public or a public forum.’”

The motion to dismiss also says that the Plaintiffs are public officials or limitedpurpose public figures, calling for the higher standard of not only false statements but of the level of “actual malice,” to be met.

The Plaintiffs filed a Motion for Discovery, saying that they are entitled to limited discovery and that the Plaintiffs are private citizens and plaintiffs should not have to show “actual malice.” AntiSLAPP laws narrow discovery provisions.

The Plaintiffs’ attorneys say that the report was given to James Risen, a New York Times reporter, prior to review and publication, and these actions are evidence of actual malice, said the attorneys.

Mr. Hoffman was hired by APA in 2014 to review interactions between military psychologists, APA officials, and the Bush administration. Then APA president Dr. Nadine Kaslow sought to resolve ongoing accusations that APA was involved in supporting unethical behavior by military psychologists.

The accusations were voiced by human rights activists and psychologists, and had been outlined in several publications, including a book by New York Times’ journalist, James Risen, Pay Any Price.

Hoffman said that communications of a 2005 APA members’ task force amounted to “collusion” with military psychologists and therefore with the Department of Defense. A media furor commenced following publication of the Report, splashing the issue of “torture” and APA across national news outlets. APA paid Hoffman $4.1 million for the Report, according to sources.

In February 2017 plaintiffs filed the defamation lawsuit in Ohio, alleging how the expansion of the investigation was hidden, how Hoffman over-relied on the accusers and aligned with the accusers’ goals, and that Hoffman failed to consider and follow evidence that contradicted the final conclusions.

The attorneys also allege that APA failed to adequately review the Report, failed to give Plaintiffs an opportunity to respond to allegations, and failed to respond to evidence of the mistakes and errors in the Report.

The Complaint states, “The false light in which the Plaintiffs Behnke, Dunivin, and James have been placed would be highly offensive to the reasonable person,” and has caused mental anguish, emotional distress, and “severe personal and professional humiliation and injury to their reputations in the community – reputations they have built over many years.”

For many of us the Holidays can be a time of Major Stress. Some dread that time with family that brings back all those childhood issues. Some stress over having to spend so much money that they do not have for the children or for gifts they feel obligated to buy. For others, it is the tug-a-war between obligations and in-laws. Or, should we say, in-laws and out-laws? And, for still others, it is too much eating and drinking. And, too much to do.

How much stress you allow to touch you has everything to do with how conscious you are or can be about what is in your mind. How aware are you of what pushes your buttons? How much can you prepare for avoiding being stressed by in-laws and sis’ jealousy and mom’s critical attitude? Do you have a plan? If you have a plan, will you follow it? Too often we think we can just play it off the cuff. But, when we try to do that, we are often overwhelmed by a concert of things going Not Quite as You Wanted or Expected.

If you are truly aware and conscious, you will be monitoring your mental pulse all the time. What will you do if something gets under your skin? Will you be able to quietly slip out and find a quiet place to regroup, meditate and do some mindful breathing. If you are the Cook or Host and things are not going according to schedule, what can you do to regain mental control? Self-talk about how the season is about love and joy and not how spectacular the turkey is could help.

Even the AARP put out a list of things to do to Reduce Holiday Stress. So, I guess no matter how old you get, little things can still upset you and frazzle you during the holidays.
AARP suggests you
1. Create a Game Plan,
2. Make a budget and stick to it,
3. Accept the reality of guests arriving late and your mother
getting on your nerves,
4. Beware of unhealthy stress relievers, such as drinking or
eating too much,
5. Create new traditions,
6. Make time for your own health by keeping your sleep
schedule and getting regular exercise,
7. Give yourself a break in the midst of doing things for
others; listen to calming music, do some deep breathing or
just sit,
8. Be proactive and think about h
ow to do things differently so
you won’t be so stressed out, and
9. Enjoy! Remember to savor the time with people you love.

Meditation: It IS What You Think

by Susan Andrews, PhD

From The Psychology Times, Vol. 6, No. 4

Years ago when first learning to meditate, I saw a T-shirt I liked with this logo on it. That slogan says it all. As psychologists, we know the importance of monitoring our thoughts and how interrelated thinking and feeling really are. A major cause of stress and one of the most important stress solutions has to do with our thoughts and our thinking. Turns out that Stress IS what you think, too. So here we have a Zen moment; both a stressed state of mind and a calm focused state of mind are related to our thinking.

The mind is an amazing thing. To a large extent, the negative consequences of stress are directly due to a busy mind. You do not have to be physically busy to have a busy mind. Most professionals would say they spend the day thinking and they might agree that thinking all day – without lifting a single shovel – is fatiguing.

If you are almost always thinking and worrying over a problem or you continue to dwell on the events of the day even after they are over, that is a chronic issue and your cortisol levels are likely to remain high. Cortisol levels do not drop until your mind calms and becomes quiet or still. So the longer you remain mentally active, even if you are lying in bed or sitting in an easy chair, the longer your high levels of cortisol will remain. And, that leads to an exhausting list of bad things, physically, mentally and emotionally. Let’s just say it does not lead to longevity and happiness.

Meditation, on the other hand, is a great antidote to stress caused by too busy a mind. In the past, meditation seemed more strange or alien to the Western mind. But, with the gradual advance of information about different forms of meditation and the acceptance of meditation as having value, it has actually become easier to learn and to include in your daily practice. Sanskrit words and chanting are no longer required. The rapid spread of Mindfulness is an excellent example. This technique takes minutes to learn and very little more to perfect. It is so simple that it is recommended for children and found helpful with children who are having problems with attention and/or with behavior. The book, Sitting Still Like A Frog: Mindfulness Exercises for Kids (and their parents) by Eline Snell, (2013) was featured at a 2014 LPA workshop by Dr. Michelle Moore. This book comes with a CD that has a number of great 5-minute Mindfulness exercises. I have recommended this book to many of my patients, old and young. It is inexpensive and easy to use. I recommend it for everyone who needs to learn this simple meditation technique.

Mindfulness is growing in popularity across the country. It is recommended for so many different reasons:

  • stress relief and pain relief
  • taking mental breaks during a busy day
  • assistance falling asleep
  • combat depression and/or anxiety

Do yourself a favor: Give Mindfulness a try.

Guest Editorial: The Perfect Cultural Storm For A Tragedy by Dr. David M.Brady

Dr. David M.Brady
Naturopathic medical physician
Clinical Nutritionist

For those of you with your nerves still frayed and hearts broken over the horrific act of violence in Newtown, the holiday season was a very difficult one this year, and particularly so for those of us here in the neighboring communities of Connecticut. However, while we may all want to forget about it and move on, this incident had better not be forgotten so easily like those that have happened prior. It had better be a call to action on a multitude of fronts or these precious children and adult educators will be added to the long list of those who have recently died in vain. There are a multitude of cultural issues facing us as a society that we simply can no longer delay facing and effectively dealing with head-on.

The immediate reaction to tragedies like this latest one is to concentrate on gun access and availability. No matter what side of the issue you are on politically on the Constitutional right to bear arms, it is becoming impossible to rationally support the need for public access to semi-automatic assault rifles, high capacity magazines, and military-style ammunition. Their only real purpose, by design, is to kill lots of people very quickly. There is a big difference between defending rational rights to gun ownership, and even concealed weapon permits, versus private access to military-style weapons. However, regardless of these issues, the guns remain the low-hanging fruit in this conversation. Other issues are equally, if not more, important and responsible for creating an environment for this kind of situation to occur.

The constant exposure to violent video games, movies, TV shows, and music of our children during their developmental years creates desensitization to violence and, in a small number of subjects, a tolerance for actually committing these kinds of acts as a way of living out for real what they do on the television or computer screen on a daily basis. Would anyone really be surprised if next year you can buy a video game where the theme is a person with an assault rifle entering a school to shoot up the place?

The breakdown of the family unit which has occurred in the past several decades is yet another issue that must be honestly evaluated. This is complex and due to many issues such as the steep rise in divorce, escalating numbers of births by single mothers, and fatherless homes being the norm in large segments of our population, and all are clearly taking a toll on our children. Declining spirituality and faith, and the aggressive, and many believe excessive, level of politically-correct secular pressure to defer from categorizing anything as unacceptable behavior with negative societal influence also has not helped.

Our population is also literally eating “junk” and goes through their daily life consuming calorie-rich, nutrient-insufficient, foods of convenience routinely just like they are encouraged to do on all of the television commercials. The cold hard truth is that even in a country of abundance like the U.S. people are malnourished. Yes, I said it, malnourished! Of course, I am referring to the inadequate consumption of real or whole foods and the critical micronutrients they contain, not the amount of calories. This has significantly contributed to the epidemic of chronic illness, including mental illness, and skyrocketing healthcare expenditures. We are frankly, as a society, becoming fatter, stupider, and more culturally regressed by the day. Yes, all of this matters!
Finally, one of the most important factors, in my opinion (and credible data backs this up) creating the soil for this reality we now confront is the literal breakdown of the mental health system. Since an almost total federal defunding of comprehensive mental health services in the 60s, 70s and 80s we have seen serious negative effects on our society. Almost total privatization of the system has led to non-livable wages for counselors and many front-line mental health professionals and no funding for their continued education. In fact, many have pointed out correctly that the U.S. effectively has no mental health “system” at all. However, in an outstanding Medscape article published as a response to the Newtown tragedy, psychiatrist James Knoll, IV, MD stated “It is my contention that there exists no legitimate ‘system’ in the United States when it comes to mental health treatment. From a literal perspective, one might define a system as an organized, regularly interacting set of principles forming a network — especially for distributing something or serving a common purpose.” The reality is that we really have no “system” at all by the classic definition to even blame. After one tragedy in Massachusetts, the state’s former mental health director responded, “Will this case be the canary in the coal mine? Will it signal that we’ve gone too far in reducing client-staff ratios, in closing hospitals, in pushing independence for people who may still be too sick?”

The reality is that the standard of care has been reduced to the cheapest solution, if you want to call it that, which is basically a “drug them and shove them” (out the door) approach. People with serious mental illness, and clearly violent tendencies, are no longer institutionalized and given the long-term comprehensive care they need. It is cheaper and easier to just prescribe an antidepressant, an antipsychotic medication, or both, and send them off unsupervised to live among us. It has been reported that Adam Lanza, the Newtown shooter, was taking the atypical antipsychotic drug Fanapt (formerly known as Zomaril), a medication with a very problematic history of its own. We know from medical studies that while antidepressant drugs may be marginally effective and necessary for some, other large meta-studies show they may be no better than placebo. We now have over 30,000,000 Americans taking SSRIs and the majority of those prescriptions are written by GPs, NPs, and PAs, most of who have no advanced psychiatric training. We also know that teenagers and young adults can react differently to these medications than adults do, and a small but significant percentage of them can be made worse by these drugs. Many teenage girls have committed suicide after starting antidepressant medications for what was only mild depression prior. Some boys and young men have virtually disassociated from reality and have committed horrendous acts of violence, sometimes in a manner completely out of character for them previously.

I have, since this latest incident, heard some discussion about the lack of funding for mental health, but will more funding really just mean more of these medications being handed out to our already drugged-silly children without serious thought to who they may be inappropriate for, or will it finally result in the addition of more comprehensive services and approaches? The handing out of medications to our children like it is candy is out of control and the link between their use and these incidents is becoming compelling. Could this be one of the main elements in the rise of such incidents? After all, guns have been widely available for a very long time, while the mass and almost reflexive use of these medications, like these incidents, is relatively new.

Fellow health care providers, citizens, and especially parents, we have a toxic soup of issues facing us, and particularly for our children, which may very well be leading to the acts of horror we have witnessed now on a multitude of occasions since Columbine. However, having an honest and non-political discussion as a nation about them will be difficult, but imperative. This will ultimately involve taking on powerful interests including the NRA, Big Pharma, Big Food, and the entertainment industry. These days our politicians are financially beholden to these very same powerful interests, they are barely capable of speaking civilly across the aisle to one another, and have become virtually worthless in affecting any kind of meaningful change. Do the politicians really have the backbone? I seriously doubt they do unless their feet are held to the fire by an outraged populous, and a united health care workforce, that will no longer stand by and see our children slaughtered in their schools.

Dr. Brady is a licensed naturopathic medical physician and certified clinical nutritionist. He is currently the Vice Provost of the Division of Health Sciences, Director of the Human Nutrition Institute, and associate professor of clinical sciences at the University of Bridgeport. He is also the Chief Medical Officer of Designs for Health, Inc., and maintains a private practice, Whole Body Medicine, in Trumbull, CT. Dr. Brady has been a featured presenter at many of the most prestigious conferences in integrative and functional medicine, including the Institute for Functional Medicine, American College for Advancement in Medicine, American Academy of Anti-Aging Medicine, International and American Associations of Clinical Nutritionists, and more. He is a contributing author for Integrative Gastroenterology, the first integrative medical textbook on gastroenterology by Johns Hopkins physician Gerard Mullin, MD, and is a contributing author for Laboratory Evaluations for Integrative and Functional Medicine by Lord and Bralley and the second edition of Advancing Medicine with Food and Nutrients, Second Edition, by Ingrid Kohlstadt, MD.

Benefits of a Gluten-Free Brain

From The Psychology Times, Vol. 3, No. 2

Nutrition and Health

Most of us have seen the gluten-free alternatives now offered at grocery stores and restaurants.  Celiac disease is an auto-immune disease. When a person is exposed to wheat gluten the body starts to destroy the gut lining which leads to mal-absorption, diarrhea, malnutrition, stunted growth, and even other auto-immune diseases like Hashimoto’s thyroiditis.  Celiac has also been linked to psychiatric conditions such as schizophrenia,[1] depression, and behavioral disorders.[2]

You might be thinking that since you don’t have celiac disease, that gluten-free products aren’t for you. But some people have gluten sensitivity. This means that, for example, a woman’s medical tests show she does not have celiac disease, but she has brain fog and fatigue when she eats gluten-containing foods and her symptoms go away on a gluten-free diet.

A gluten-free diet may be beneficial for patients struggling with mood disorders, schizophrenia, learning disabilities, behavioral disorders, autism, migraine headaches, irritable bowel syndrome, inflammatory bowel syndrome, and eczema.

More about celiac disease and gluten sensitivity can be found at

 [1] A. De Santis, G. Addolorato, A. Romito, S. Caputo, A. Giordano, G. Gambassi, C. Taranto, R. Manna, and G. Gasbarrini, J Intern Med 242 (1997) 421. [2] P. A. Pynnonen, E. T. Isometsa, M. A. Verkasalo, S. A. Kahkonen, I. Sipila, E. Savilahti, and V. A. Aalberg, BMC Psychiatry 5 (2005) 14.

Eating One’s Young

From The Psychology Times, Vol. 3, No. 2


Dr. Bolter presented excerpts from the law showing that medical psychologists can practice psychology and he asked the board to see that the intent of Act 251 was to transfer ALL aspects of the practice of psychology. He also said that since the psychology board validates supervisors from other states who were not licensed under the LSBEP, then they should validate medical psychologists, who are not licensed under LSBEP.

Aside from the non sequitur, the issue has more to do with our profession than with the practice of psychology.

Of course the psychology board accepts supervision hours by psychologists licensed under other state psychology boards. We have a whole infrastructure for this issue. The Association of State and Provincial Psychology Boards handles problems of standards, license exams, mobility, and so on. But nowhere in the country are psychologists licensed by medicine. Until Act 251, a shorthand definition of who could supervise, a “psychologist,” was all that had been needed.

And supervision, the nurturing of new psychologists into our profession, is concerned with more than just practice. It is the profession’s way of transferring our identity and values to the next psychologists.

LSBEP has placed the burden on our young psychologists who, if they ever go to another state, just might find out the hard way whether a psychologist needs to have been supervised by someone licensed under a state psychology board.

Our new Chair should reexamine this matter and get testimony from all sides, taking time to carefully review all the applicable laws, not just the parts that support the political agenda of one group.


Letters to the Editor

From The Psychology Times, Vol. 3, No. 2

I, too, am glad to hear that Darlyne Nemeth is helping with Sunset issues, I served on the Board with her and appeared before the legislature myself to answer questions about whether our Board was doing anything useful.

Isn’t it ironic that Sunset appears just at the time when we have two Boards (?) overseeing psychology. Wonder if those whose idea it was to join the medical board are interested in the opportunity this presents. For example, now we learn that persons who are not licensed by our board can nevertheless supervise psychologists for licensure. What’s next??

My thought is that they would ask why have two boards and suggest only one, doubtless under the newly formed medical committee (!).

Time to listen to the folks at AASPB, a group I know well from my time on the Board, and who are wise in these matters.  They counsel that we are doing something very different, which may be very wrong.

I hate to think that simple power politics is at the bottom of all this, but it sure seems that way.

Time for LSBEP to rise up and assert their role in our state. Sunset hearings may be such an opportunity, but we have to get tough with a minority that wants to control things.

Our response had better be ready. And powerful.

Dr. Fred Davis

NSU Psychology Dept Offers Honors Courses

-L. Jackson, NSU News

Northwestern State University is implementing an Honors Program this semester to give outstanding students the opportunity to enrich their academic experience, study topics in greater depth and improve their leadership skills. Students enrolled in the Honors courses will participate in research and projects in addition to regular coursework, which administrators hope will engage them in their disciplines and get them excited about research.

Dr. Susan Thorson-Barnett and her colleagues in the Department of Psychology worked for over a year to coordinate the Honors components she plans to imple-ment in her Psychology 1010 class this semester that will be tied to a service-learning project.

“The Honors students will follow the same grading scale and take the same tests as the rest of the students, but their coursework will have a research component,” Thorson-Barnett said. “We will meet every two weeks. First, the students will learn about the project, then we will meet at the library to learn to find resources in scholarly journals. Over the course of the semester, the students will write a group research paper and will work in groups of two to create informational posters they will present to the class before Thanksgiving.”

Thorson-Barnett’s project will expose the freshmen Honors students to concepts normally presented to upperclassmen.

“We want them to be able to present the research during next spring’s Research Day and we hope we can continue the project and tie it in with service learning and present at the spring Serving Learning conference,” she said.

See complete story at