Download - Winter 2003 Texas Psychologist
Who will stand up for you if you’re faced with a malpractice suit?
Let one of America’s largest and most trusted providers of mental health professional liability insurance protect you.
w w w . a m e r i c a n p r o f e s s i o n a l . c o m
COVERAGE HIGHLIGHTS
■ New graduate discount■ New business discount■ 35% discount for part-time
(20 hours) employees ■ Discounted rates for additional Ph.D.’s■ Lower rates for employees with
M.A./B.A. degrees■ Risk management/continuing
education credits up to 10%■ $5,000 legal defense for Licensing
Board investigations■ Contractual liability for managed care■ Separate limits for each named insured■ Convenient quarterly payments for
premiums over $1,000■ Risk management consultation service
available via 800# hotline■ Free quarterly risk management
newsletter (also available online)
UNDERWRITTEN BY:
95 Broadway, Amityville, NY 11701
American Professional Agency, Inc.
PROGRAM ADMINISTRATOR
Now, more than ever, you have to be sure of thequality, strength and dependability of yourmalpractice insurer. An “A” rating from A.M.Best, one of the insurance industry’s leadingregulatory bodies, means your insurance
underwriter meets certain stringent criteria – helping to ensurethe kind of protection you need both today and tomorrow.
You deserve an “A++”Professional liability coverage underwritten by ChubbExecutive Risk Indemnity, Inc. and administered by theAmerican Professional Agency, Inc. is even better. BecauseChubb has an “A++” (superior) rating from A.M. Best.
Service you can depend onAs your plan administrator, the American ProfessionalAgency, Inc. also offers outstanding service and peace ofmind. With more than 100,000 policyholders, over 30 yearsof experience and the best claim specialists and legal counselavailable, we can provide an ultra reliable, top-quality insurance program at very reasonable rates.
Protect yourself todayIt’s an unbeatable combination that gives you thecomprehensive coverage you need to safeguard yourpractice and ease your mind. For a free personal quote, calltoll free
1-800-421-6694 or visit us online.
Please visit us at our booth!
Texas Psychologist 1WINTER 2003
Features
10 Career Trends for Texas Master’s Level Psychology Graduates
Emily Sutter, PhD; Howard Eisner, PhD; and Leslye Mize, PhD,
University of Houston - Clear Lake
18 The Empirically Validated Treatments Movement: A Practitioner Perspective
Ronald F. Levant, EdD, ABPP
22 Challenging Issues for Women at Midlife
Donna Davenport, PhD, Robert L. Nutt, PhD, Robbie N. Sharp, PhD, and Melb J.T.Vasquez, PhD
Departments
2 FROM THE PRESIDENT
Deanna Yates, PhD, TPA President
4 FROM TPA HEADQUARTERS:
Success Before Work
David White, CAE, TPA Executive Director
6 Texas Psychological Foundation Contributors
7 Council of Representatives
Joseph C. Kobos, PhD
9 LAS News from Houston Psychological Association
Julie Landis, PhD, HPA President
21 Texas Psychological Association Convention Sponsors
29 Sunrise Fund Contributors
29 PSY-PAC Contributors
30 PSY-PAC Update
30 New Members
33 Classified Advertising
33 Advertisers’ Index
Claire Jacobs, PhDEditor
David White, CAEExecutive Director
Robert McPherson, PhDDirector of Professional Affairs
Lynda KeenMembership Manager/Bookkeeper
Sherry ReismanDirector of Conventions & Non-Dues
TPA BOARD OF TRUSTEES
Deanna Yates, PhDPresident
C. Alan Hopewell, PhDPresident-Elect
Paul Burney, PhDPresident-Elect Designate
Walter Cubberly, PhDPast-President
Board MembersRon Cohorn, PhDPatrick Ellis, PhD
Richard Fulbright, PhDCharlotte Kimmel, PhDJoseph C. Kobos, PhD
Suzanne Mouton-Odum, PhDRoberta L. Nutt, PhD
Dean Paret, PhDElizabeth L. Richeson, PhD
Ollie Seay, PhDJarvis Wright, PhD
EX-OFFICIO BOARD MEMBERS
Richard M. McGraw, PhDFederal Advocacy Coordinator
Melba J. T. Vasquez, PhDCAPP Representative
Jerry R. Grammer, PhDTexas Psychology Foundation President
Mary MartinStudent Division Director
PUBLISHERRector Duncan & Associates
P.O. Box 14667Austin, Texas 78761
512-454-5262
Stephanie ShawManaging Editor
Jared HensleyAdvertising Sales
Julie ManganoArt Director
The Texas Psychological Association islocated at 1011 Meredith Drive, Suite4, Austin, Texas 78748. TexasPsychologist (ISSN 0749-3185) is theofficial publication of TPA and ispublished quarterly.
www.texaspsyc.org
WINTER 2003 VOLUME 54, ISSUE 4
Our legislative goal was to pass
prescriptive authority legislation
in 2003. We did not succeed thisyear; however, it is inevitable that Texas will
eventually get prescriptive authority just as
New Mexico has. I have personally beencommitted to prescriptive authority forpsychologists for many years, and I will
continue working with TPA and APA on
this issue until I see it become a reality inTexas. APA’s Division 55 is committed tothe advancement of psychopharmacology
and I will be working with a committee
whose goal is specifically to help states moveforward with this legislation. It may take afew more years, but we will succeed because
it is the right thing for our patients and it is
the natural evolution of the practice ofpsychology.
Another goal that I had for the year wasto establish two new TPA committees: oneto interact with third party payers and oneto focus on public policy. Both committees
were formed and have worked exceptionally
hard this first year. In the area of public
policy, TPA has begun to develop
relationships with many consumer groups
and hopes to continue to nurture these
relationships. Psychology needs to be
involved in setting mental health public
policy and forming alliances with consumer
groups is a step in that direction. With the
cuts in Medicaid that occurred at the end of
the regular legislative session, the third
party payers committee has been very active
in Austin, working to help get these services
restored. As I write this article, our
legislators are going into the third special
session, so it is still possible to get optional
services funded.
Another goal was to continue preparing
and positioning TPA to begin the Sunsetprocess. The Sunset Committee has metseveral times and has prepared changes in
our licensing act that we feel need to be
made. With the help of our lobbyists weare now working out our strategy, as wecould be in hearings before the Convention
begins. We have also continued to build
the funds to help with the Sunset effort. Iwould like to ask every psychologist whohas not yet sent in the $100.00 to please
make that contribution to the fund now.
Over the past several years, the leaders ofTPA have been working to make TPA anorganization that is run more efficiently and
an organization that is more politically
sophisticated and influential in Austin. Mygoal was to continue this process bytightening some of our organizationalprocedures this year. In running a
volunteer organization such as TPA,
policies can sometimes subtly change from
year to year. In the orientation for the new
board members this year, we discovered that
the bylaws and the policies and procedures
were not always in agreement with one
another. Also, with the yearly change in
leadership, some procedures are inadver-
tently altered. To rectify this situation, I
asked the Bylaws Committee to review the
bylaws and the policies and procedures and
to recommend changes that would align
them and also reflect what actually takes
place in the running of TPA.
The Bylaws Committee, a committee of
one, Dr. Ron Cohorn, worked long and
hard to find discrepancies and to
recommend changes. An example of achange that streamlined procedures was the
policy for nominating individuals for the
annual TPA awards. This process was socomplex that people frequently complainedthat it was just too difficult and too lengthy
to take the time to make a nomination.
Due to streamlining the nominationprocess, we had more people willing tomake nominations this year and we received
many strong nominations. Dr. Roberta
Nutt, Awards Committee chair, did a greatdeal of work on these procedures for theBylaws Committee.
On a personal note, my work on the
President’s New Freedom Commission onMental Health ended. The report was
2 Texas Psychologist WINTER 2003
FROM THE PRESIDENT
Deanna F. Yates, PhD
TPA P r e s i d en t
I suppose it is inevitable that as I write my last president’s column I would reflect on the happeningsof the year. It does not seem like long ago I was writing my first column and looking forward to myyear as president. Being a legislative year, it was expected to be a very busy and challenging year.Legislative years typically add so much to our agenda, and it was this year’s legislative agenda thattook center stage for several months.
Texas Psychologist 3WINTER 2003
published and finally made public in July.Some commisioners feared that the reportwould not be well received by many of thestakeholders or that it would sit on a shelfgathering dust somewhere rather thanbeing implemented. So far we have beenvery happy with the response. I have notheard anything negative about the reportand providers and consumer groups alikehave given us very positive feedback. Nowthe implementation is being planned.
While we hope that Texas is a demon-stration state for the implementation of theCommission’s recommendations, Mr.Charles Curie, the administrator ofSAMHSA, has been given the task ofevaluating the report and implementing
recommendations at the federal level. It is
an honor for me to be able to bring Mr.
Curie to Dallas to be the keynote speaker at
this year’s Convention. He will have the
most up to date information on the
implementation of the Commission’s
recommendations and I hope that many of
you will be there to hear him. In addition
to Mr. Curie’s address, our Program
Committee, chaired by Dr. Pat Ellis, has
put together a superb lineup of
presentations for this year’s convention
which is just around the corner. There
should be something for everyone so I
hope to see you in Dallas.
This has been a year fraught with
excitement, challenge, and frustration.
Nevertheless, I believe TPA is on its way to
being even better prepared to face thechallenges that lie ahead. I leave TPA incapable hands and expect to see the
organization continue to grow stronger and
wiser. I am happy to have had theopportunity to serve as your president thisyear and look forward to a successful future
for TPA and the practice of psychology.
Then when paying, $27 will be deducted from any program you select, including our $27 courses!
(One use per customer • Good through November 15, 2003)
✯
Special ThanksNo event of the magnitude of the TPA Annual Conventioncan be possible without the dedicated and oftenunappreciated work of volunteer members. They arecommitted to insuring that your annual convention willbe the best educational experience possible. Their loyaltyand dedication to this endeavor are vital contributionsthat add value to memberhip in TPA.
Should you bumpinto any of thecommitteemembers listedhere, please take amoment to thankthem.
Patrick J. Ellis PhD (Chair) — HoustonSharon Brown, PhD — Houston
Stacey Bourland, PhD — HoustonMichael Flynn, PhD — Denton
Tom Gray, PhD — VernonStephen McCauley, PhD — Houston
Suzanne Mouton-Odum, PhD — HoustonDean Paret, PhD — Burleson
4 Texas Psychologist WINTER 2003
That is what many of our members
think about the future of this
profession. They think that they
can just get up and go on about their
normal activities and everything will be
provided for them.
Over the last several issues, I have
reported the importance of our Sunset
review, which will take place in 2005. I have
told you about the committee and the
members who will be leading this effort. We
are not only focusing our efforts on Sunset,
we are also revising TPA bylaws and the
policy and procedures manual, discussing
with consultants how to position TPA for
the future, and learning how to gain a
group health insurance program for ourmembers. Needless to say, we have LOTShappening.
So who exactly is doing all the work for
TPA during this monumental time? Well,only 2.6 percent of the entire membershipserves on committees, task forces and TPA’s
Board of Trustees. So, out of 1,473
members we have only 39 working toadvance TPA’s initiatives. Those 2.6 percentactive members are from:
Active Members Serving on Committees/BoardsHouston . . . . . . . . . . . . . .25%
Austin . . . . . . . . . . . . . . . .17% Denton . . . . . . . . . . . . . . .10%
Dallas . . . . . . . . . . . . . . . . .5%
San Angelo . . . . . . . . . . . . .5%
San Antonio . . . . . . . . . . . .5%
Beaumont . . . . . . . . . . . . . .5%
Ft. Worth . . . . . . . . . . . . . .3%
Conroe . . . . . . . . . . . . . . . .3%
Big Spring . . . . . . . . . . . . .3%
Sugarland . . . . . . . . . . . . . .3%
Burleson . . . . . . . . . . . . . . .3%
El Paso . . . . . . . . . . . . . . . .3%
Lubbock . . . . . . . . . . . . . . .3%
Vernon . . . . . . . . . . . . . . . .3%
Huntsville . . . . . . . . . . . . . .3%
Waco . . . . . . . . . . . . . . . . .3%
Compare this involvement with theoverall demographics of TPA. Out of our
entire membership, 25 percent are from
Houston, while 16 percent are from Dallas,15 percent from Austin and 10 percentfrom San Antonio.
2003 DemographicsHouston . . . . .367 . . . . . .25%
Dallas . . . . . .238 . . . . . .16%
Austin . . . . . .220 . . . . . .15% San Antonio . .144 . . . . . .10% Ft. Worth . . . . .54 . . . . . . .4%
Other . . . . . . .450 . . . . . .30%
So it becomes clear that a majority ofactive members come from the larger cities,
but we also know that you can participate
in TPA in another way—your financial
support. Out of all the dues and PAC
revenue we received this year, 50 percent
came from members in Houston, Dallas,
San Antonio or Austin.
TOTAL DUES/PAC REVENUEHouston . . . . . . . . . . . . . . . .19%
Dallas . . . . . . . . . . . . . . . . . .10%
Austin . . . . . . . . . . . . . . . . . .13%
San Antonio . . . . . . . . . . . . . .8%
As TPA continues to position itself as a
political force in the state legislature, one
factor that keeps us “politically involved” is
the PSY-PAC contributions. I want to
provide a few more statistics for you to
consider. Out of all the contributors for thisyear, 63 percent came from the five majorTexas cities, yet only 36 percent of the total
dollars collected came from these folks.
What that indicates is that members outsideof the large cities are being active with theircontributions.
Another form of active participation in
TPA is your attendance at the TPA AnnualConvention. Out of the total conventionattendees, members from the rural areas of
the state represent the larger turnout, with
members from Houston representing thelargest number of attendees from the largercities.
Continued on page 6
Success Before Work . . .David White, CAE
TPA Executive Director
I want you to imagine getting up this morning and not having to go to work. In essence, you are ableto get up and provide a very comfortable living without doing much work at all. You might have investedwisely in the past and are currently reaping the benefits of your past successes, but during that initialtime you did have to work. Think of what it would be like NEVER to have to work and have everythingprovided for you…
FROM TPA HEADQUARTERS
Texas Psychologist 5WINTER 2003
6 Texas Psychologist WINTER 2003
Convention HistorySo, there you have it: an overview of the active members within
TPA. If you are not in one of these categories, I hope you make acommitment beginning NOW to become involved. Let’s change thetrend and WORK TO BE SUCCESSFUL. We need your time,energy, financial resources and your encouragement.
ACT NOW…See you at the TPA convention in Dallas on November 6-8.
BECOME A
CERTIFIEDANGER
RESOLUTIONTHERAPIST™
Register online or by mail, fax, or phone
* Early registration due in our office ONE Week before training
• A three ring binder with extensive materials. • A one hour audio tape, Stop Anger.• A framed CERTIFIED ANGER RESOLUTION
THERAPIST™ certificate.• A free 45-minute follow up phone conference
with Newton Hightower to use as a businessconsultation or as a case supervision.
• Newton Hightower’s book Anger Busting 101: New ABCsfor Angry Men and The WomenWho Love Them.
Winner of the Best Self-Help Book of 2002 Ben Franklin Award
Facilitator - Founding Master Trainer NEWTON HIGHTOWERLMSW-ACP, AAC, CART™
The Center for Anger Resolution, Inc.
2524 Nottingham Houston,Tx 77005713.526.6650
1.877.NO ANGER Fax: 713.526.4342
[email protected] www.AngerBusters.com
REGISTRATION FEESEarly* Regular
Single Registrant $429 $479
2-4 Registrants $389 each $429 each
5 or more $349 each $389 each
CART™ Training Includes:
CART™ TWO DAY CERTIFICATION COURSE
AUSTIN, TEXAS – August 15th - 16th
DALLAS, TEXAS – October 10th - 11th
HOUSTON, TEXAS – November 14th - 15th
1998 1999 2000 2001 2002 Houston 21% 19% 10% 17% 17% Dallas 3% 3% 7% 7% 3% San Antonio 6% 16% 3% 7% 15% Austin 7% 12% 7% 10% 12%
✯
TEXAS PSYCHOLOGICAL FOUNDATIONCONTRIBUTORS
JANUARY 1, 2003 - AUGUST 20, 2003
$100 - $499
Jim Cox
Caryl Dalton
Catherine Matthews
Robert Gordon
Jerry Grammer
George Lazar
Robert McLaughlin
Manuel Ramirez
Oscar Ramirez
Laurie Robinson
Robbie Sharp
Under $100
Barbara Abrams
Connie Benfield
Stacy Broun
Sam Buser
Dennis Coburn
Annete Edens
William Erwin
Deborah Whitehead
Gleaves
Barbara Hall
Jo Beth Hawkins
David Hensley
Victor Hirsch
Burton Kittay
Amelia Kornfeld
Angela Ladogana
Betty Lanier
Marilyn Maas
Karl Neuman
Shelley Probber
James Campbell Quick
David Wachtel
Colleen Walter
Shirley Willis
Deanna Yates
Marian Yeager
Continued from page 4
WINTER 2003
Council of Representatives
Joseph C. Kobos, PhD
As Roseanne Roseanna Danna would say, “If it’s not one thing, it’s another.” At the last Council meeting,we struggled in the snow and many were stranded. In August, we worried about how many would come toToronto for the Council meeting and the Annual Convention. This time the culprit was SARS. When the WorldHealth Organization declared Toronto off limits to travelers in April, all the listservs were concerned aboutwhether to cancel the convention and if individual members would attend even if theconvention were held.
Eventually, Toronto was taken off the WHO list and APA
decided to hold the meeting. Canceling the meeting would be
very costly because of contract penalties and moving the
convention was impossible on such short notice. The decision to go
forward was wise. While attendance revenues were down, the drop was
nowhere near as grim as anyone predicted. APA leadership, which
included our new CEO Norman Anderson and his team, and everyone
in convention planning all deserve kudos. After thoughtful deliberation
and a review of the data, they followed the advice of that old
philosopher, Yogi Berra, “When you come to a fork in the road, take
it.” In the end, perhaps a dozen or more did not attend Council and
either left an empty seat or found replacements.
Norm Anderson continues to settle in as CEO. He gave an excellent
chronology of the issues involved in making a difficult decision and
described the very human and scientific process of making the decision
to go ahead with the convention. In addition to talking about APAfinances, he laid out his capital hill agenda, which included mentalhealth parity, graduate psychology education, and supporting NIH and
other funding for psychosocial research. He described one legislator’s
efforts to use a line item approach todelete funding for sexual behaviorresearch. In an unprecedented
maneuver, the specific research and its
funding ID number were listed in afunding bill. This process would removereview and funding authority from the
NIH. APA’s efforts were successful in
turning back the tide, but it was a closevote and similar efforts are anticipatedin the future.
The big news was the budget and
APA finances. Under the very able
leadership of CFO Jack McKay, APA
refinanced its two buildings. This
freed up money so we will no
longer have cash flow
difficulties. The Finance
Committee continues to
recommend a conser-
vative budgeting pro-
cess and the Board
of Directors and
Council
affirmed the
process, with
one exception
— Council
Texas Psychologist 7
8 Texas Psychologist WINTER 2003
recommended and voted the resumption of acombined Board/Committee, which meansan expenditure of $200K. APA is poised to be$400K in the black in 2004 — a remarkableturnaround from the past several years.
Kurt Salzinger has announced hisintention to leave as head of the ScienceDirectorate. We are currently looking for anew director.
CRSPPP also recommended — andCouncil approved — the renewed recog-nition of clinical neuropsychology as aspecialty in professional psychology.
Look for an APA ballot on amending thebylaws. The issue is whether any bylawchange should be accompanied withclarifying information. Currently whenever a
change in bylaws is presented to the
membership, Council votes on whether
pro/con statements should accompany the
proposed change. Over the years, any
proposed bylaws change with pro/con
statement would be voted down. However,
some thoughtful Council members reasoned
that it is anti-democratic and anti-intellectual
not to include pro/con statements orinformation about any issue that requires avote, because only an informed electorate canmake reasoned decisions. Look for the ballotand also see whether a pro/con statementaccompanies it. Much thoughtfuldeliberation and parliamentary consultationwent into the debate and decision.
In the opening memorial for deceasedmembers, Gladys Guy Brown of Dallas wasacknowledged. Dr. Brown was one of the firstindependent practitioners in Texas. I had theopportunity to interact with her on severaloccasions and she offered very positiveencouragement. Dr. Brown was also one ofthe early Diplomates of the American Boardof Professional Psychology. She represented
the highest standards of our profession.
Congratulations to M. David Rudd of
Baylor University and TSBEP who was
elected to Fellow status in Division 12,
Clinical, and to Dee Yates of San Antonio
who was elected to Fellow status in Division
55, Pharmacotherapy.
Welcome to Bob McPherson, ourProfessional Affairs Officer, who will becomethe Texas Representative to APA Council.Our interests are in good hands, but morehands would be better. Vote 10 for Texas, andlet’s get two representatives from Texas.
This is my last column as APARepresentative. I have enjoyed serving youand representing Texas Psychology interestson Council. My formal tenure ends inDecember but I received my certificate inAugust, which tells you something. Workingwith the TPA Board of Trustees has been afun and stimulating experience. Psychologyin Texas is an exciting and vibrant profession.I urge you to get involved in your localcommunity with your elected representatives
and in your professional organization. You
can make a difference. I will see you at the
TPA Convention in Dallas. If all goes as
planned, my son and his wife who live in
Dallas will be delivering us another
grandchild at that time. Happy trails. ✯
Texas Psychologist 9WINTER 2003
Many of our former leadersattended and were recognized
for their efforts and continued
support. We were also particularly fortunate
to hear Dr. Reuven Baron, an international
expert on Emotional Intelligence, discuss
his research and its application to practice.
At the end of the meeting, Dr. Patrick Ellis
presented the 2003 Media Award to
television personality Jerome Gray, who was
very gracious in his acceptance of the award
for his work on the “My Family/Your
Family” weekly program on Channel 11
(CBS).
In July, HPA members and quite a few
potential new members gathered together
at a luncheon in the first of a series of
planned talks aimed at those in our
association who are in private practice or
are considering it as a career option in thefuture. This series of talks by business
professionals, attorneys, and seasoned
psychologists is aimed at informingpsychologists about the ins and outs ofrunning a small business. At the July
meeting, a panel composed of a certified
public accountant and a business marketingspecialist addressed many of the issuesinvolved in the private practice business
such as developing a marketing plan and
strategy, tax issues, etc. Topics selected to becovered in future gatherings will addressmany of the issues psychologists never
learned in graduate school but need to
know about to survive and prosper in thecurrent economic climate. The series will
continue later this fall with a networkingbreakfast and a talk by a local attorney who
will alert us to the legal pitfalls of private
practice. Plans are also underway to address
our members’ needs for meeting the new
TSBEP requirement of continuing
education hours in ethics.
On a serious note, HPA members came
together to voice their concerns during the
summer after learning of actions by the
Texas Legislature directly affecting the
provision of mental health care here in
Houston as well as all over Texas. Local
psychologists working in public agencies
and private practitioners who service adult
clients with Medicaid and who will be
affected by these changes alerted us. We
contacted TPA leaders who were quick to
respond to our requests for information.
Armed with information gathered by TPA,many of our members organized to get the
word out about the need to attend hearings
in Austin. Others wrote letters of protestand contacted legislative members aboutthe impact to the public. With the
upcoming city council elections and
mayor’s race, HPA is also planning tocontinue its political activeness and to makeour voice heard with regard to mental
health issues in our city. Our legislative
chairs are in the process of arranging briefvisits by candidates for city offices at ourupcoming fall luncheons in September and
October to discuss their views regarding
city services affecting the mental healthprovider community.
As the summer comes to an end, HPAmembers will have an opportunity at our
next luncheon in September to hear Dr.
Michelle York from Baylor College of
Medicine discuss her research and describe
practice issues with regard to patients with
Parkinson’s disease. We will also welcome
back our members and greet the psychology
interns who are new to the city and are
beginning their internships at the five APA
accredited internship sites located at school
districts, hospitals, and medical schools
within Houston. We have many exciting
plans for this new year including efforts to
expand our membership and increase our
visibility within the community. Our
programming chairs are working hard to
develop a program of speakers who will
discuss topics of interest that will entice our
members to become active and regularlyattend our luncheons. Plans are already
underway for our holiday party and other
social events that will provide networkingopportunities and camaraderie. In addition,HPA committees are developing
continuing education workshops of interest
to local psychologists and the mental healthcommunity. We are also working to bringin a nationally-recognized speaker for the
Annual Spring Conference scheduled for
May of 2004. To stay in the know, be sureand check out our web sitewww.hpaonline.org and our monthly
newsletter filled with the latest about what
is happening here in Houston.
LAS NEWS From the Houston Psychological Association
Julie Landis, PhD, HPA President
Members of the Houston Psychological Association (HPA) began the new fiscal year with a bow to ourpast by inviting previous presidents and officers of HPA to the June luncheon meeting to celebrate thecontinuation of our organization as a vital network for professional psychology in Houston.
✯
10 Texas Psychologist WINTER 2003
According to the Texas Higher
Education Coordinating Board figures
(THECB, 2003), Texas public institutions
of higher education award over 600 master’sdegrees in psychology every year. When
added to the psychology master’s degrees
awarded by Texas private institutions ofhigher education, Texas clearly is a majorproducer of master’s level psychology
graduates. Also, according to the THECB,
over the past five years more than two-thirds of the psychology master’s graduatesof Texas public universities obtain their
degrees in clinical, counseling, or school
psychology programs. The Texas publicinstitutions of higher education that awardthe most master’s degrees in psychology are
presented in Table 1. Interestingly,
counseling psychology programs producesome three times more graduates than
Career Trends for Texas Master’s Level Psychology Graduates
Emily Sutter, PhD; Howard Eisner, PhD; and Leslye Mize, PhDUniversity of Houston — Clear Lake
ABSTRACT
Texas produces hundreds of master’s level psychology graduates each year. What have their careerexperiences been? Since 1981, the authors have periodically surveyed all graduates of theprofessional psychology master’s level programs at the University of Houston-Clear Lake to determinethe graduates’ career experiences. In the spring of 2003, surveys were mailed to 669 graduates.Survey questions investigated licensure, employment, salary, and the perceived effects of managedcare on the graduates’ work. The survey produced a 48% return rate. Results suggest that basicmental health service activities have not changed much over the past 20 years but have adapted tojob market conditions. Diagnostic work for school psychology graduates in school districts remains astaple, as does psychotherapy in private practice and outpatient settings for graduates of the clinicaland family therapy programs. As a group, the school psychology graduates tended to be better paid,although respondents earning the highest incomes were psychotherapists in long-term privatepractice. Licensure has become essential over the decades, with the professional counselors license(LPC) the most popular credential. Managed care has affected the psychotherapists much more thanthose doing research or working in school districts, but not enough to drive practitioners out of thefield. Overall, the employment rate for master’s level graduates remains very high.
Table 1
Texas public universities granting the most psychology master’s degrees
Graduates of only Graduates of all Clinical/Counseling/
TX Public Universities Psych. Programs* School Programs
Prairie View A&M 172 170
Univ. of Houston-Clear Lake 50 30
Sam Houston State Univ 46 43
Southwest Texas State Univ 38 37
Stephen F. Austin 31 23
Statewide Total 633 446
Note: Figures are mean numbers of degrees awarded/year, 1998-2002.
* These figures include clinical/counseling/school graduates.
Texas Psychologist 11WINTER 2003
clinical and school psychology programscombined. This fact mirrors figuresobtained at the national level by theAmerican Psychological Association (APA,1999). Clinical, counseling, and schoolprograms are practitioner-trainingprograms that usually lead to licensure inmental health professions. Graduates ofprograms other than psychology also oftenearn such licensure. For instance, programsin counseling and guidance, studentcounseling, and counseling education arefrequently offered by schools of educationand lead to the MEd, as opposed to the MSor MA in psychology. Over 800 of thesecounseling degrees are awarded each year byTexas public institutions alone (THECB,
2003). Other mental health practitioners,
such as marriage and family therapists,
come from even more diverse academic
program areas, such as human development
or home economics. In sum, Texas produces
well over 1,000 potential master’s level
mental health practitioners every year.
Within this very large cohort of
potential mental health practitioners, where
do the graduates of master’s level
psychology programs find their career
identities? Except for the American
Psychological Association data (APA, 1999)
that describes career experiences of new
master’s level psychology graduates at the
national level, there is little recent
information on this topic (Gehlmann,
1994; Lowe, 1997; MacKain, Tedeschi, and
Durham, 2002; Sutter, Mize, and Eisner,1994). One of the first mental healthcredentials for master’s level psychology
practitioners in Texas was the certification
for psychological associates, created withthe Psychologists’ Licensing Act of 1969.Over the years this certification was
replaced by a license for psychological
associates (LPA) to practice undersupervision. The 1980s and early 1990s sawthe introduction of new Texas licenses for
mental health practice, primarily the
professional counselors’ license (LPC), themarriage and family therapists’ license(LMFT), and the chemical dependency
counselors’ license (LCDC). The license forspecialists in school psychology (LSSP) wascreated by the Texas legislature in 1995. Itcredentials individuals to practice schoolpsychology only in Texas public schools andis not a license for private practice.
What trends have occurred in the careerissues of Texas master’s level psychologygraduates? What licenses are the mostpopular? Are these graduates readily able tofind employment and where do the jobsexist? What activities fill their workdays?How much do they earn? How have theybeen affected by managed care? And aretheir experiences similar to psychologymaster’s graduates in the rest of the nation?These career choices would seem of obvious
interest to the faculties of master’s level
psychology programs, to psychology
students themselves, and to the profession
of psychology as a whole. They are the focus
of this study.
To answer these questions, faculty at the
University of Houston-Clear Lake (UHCL)
surveyed the graduates of their three
professional psychology master’s programs
(clinical, school, and family therapy) in
1981, 1993, and again in 2003. Where
appropriate, each new survey has been
compared to the previous decade’s survey
results. Because they are new, the results of
the 2003 survey are presented here in more
detail than the past surveys. The
information concerning trends in career
choices not only assists in curriculum
development within academic programs,but also provides a window into the mentalhealth profession at the master’s level.
Because UHCL is one of the major
producers of these professionals in Texas,the career choices of these graduates mayhave implications for mental health practice
in the state as a whole.
MethodParticipants
The authors surveyed all graduates of the
UHCL professional psychology master’sdegree programs (clinical, school, andfamily therapy). These professional
programs are specifically designed toprepare graduates for licensure andprofessional mental health practice. All theprofessional program areas areapproved/accredited by their respectiveaccrediting agencies. The AmericanAssociation for Marriage and FamilyTherapy (AAMFT) accredits the FamilyTherapy program; the National Associationof School Psychologists (NASP) approvesthe program for School Psychology; and theClinical Psychology program meets thestandards of the Council of AppliedMaster’s Programs in Psychology(CAMPP). The programs all require morethan 60 semester credit hours and involveextensive internships. The average age of the
students is 36, and the majority are white
females.
QuestionnaireThe questionnaire contained 16
questions, mostly in multiple-choice
format. Basic questions about licensure and
employment experiences were the same
each decade with minor updating to reflect
new licenses or practice conditions. Space
was available at the end of the survey for
participant comments.
ProcedureThe study was approved by the institution’s
IRB and the questionnaires were mailed to all
professional psychology graduates. A stamped,return-addressed envelope was included to
enhance the response rate. Results were
tabulated and subjected to chi square analyses.Results reported as significant employed analpha of .01.
ResultsSurvey Return Rate
The current survey was mailed in
January 2003 to all 669 graduates of theClinical Psychology, School Psychology, and
Family Therapy programs at UHCL.Completed surveys were returned by 317
graduates, for a 48% response rate.Response rates were fairly consistent for the
three program areas. Of those who returned
12 Texas Psychologist WINTER 2003
the survey, 310 indicated their primarymajor. Some 115 (37%) were graduates ofthe Clinical Psychology program, 128(41%) were from Family Therapy, and 67(22%) were from School Psychology. TheSchool Psychology program is the smallestand the newest of the programs so thesmaller number responding was notunexpected. Some 10% of the respondentsgraduated between 1976 and 1985; 51%graduated between 1986 and 1995; and theremainder (39%) graduated between 1996and 2002. In general, the return rateappears sufficient to draw meaningfulconclusions from the responses.
Acceptance into Doctoral ProgramsA question newly included in the
current survey asked if the respondent had
been accepted into a doctoral or other
advanced professional degree program since
graduation. Since the three programs are
designed to be “terminal” professional
master’s degrees, it was surprising to learn
that 16% of the master’s graduates had
been accepted into doctoral or other
advanced professional degree programs.
Clinical, counseling, and school psychology
doctoral programs were the most popular.
There was no significant difference among
the three UHCL programs in terms of
acceptance rates into doctoral programs. A
chi square test did show a highly significant
relationship between acceptance into
doctoral programs and time of graduation:the longer the interval since receiving the
professional psychology master’s degree, the
more likely it was that the respondent hadbeen accepted into an advancedprofessional degree program.
Employment RateThe number of graduates employed
outside the home for pay dropped very
slightly from the survey in 1993 (90%) to
the 2003 survey (87%). Only 10individuals indicated they were looking forwork, yielding a 3% unemployment figure.
This is identical to APA’s findings for new
master’s graduates (APA, 1999). Most
(90%) of the employed UHCL graduateswork more than 20 hours per week. This isslightly better than the AmericanPsychological Association’s (APA) figuresfor master’s level employment, but the APAfigures considered only recent graduates(APA, 1999). Of the 13% in the currentsurvey who were not working, 25%indicated they were looking for work; 22%indicated they were not interested in workat this time; 28% indicated they wereretired; and the rest gave various otherreasons for not being employed. It is verydifficult to draw unemployment rateimplications from these data for master’slevel graduates because of the currentrelatively high unemployment figures for
the nation in general (6.2%unemployment). However, if UHCLgraduates are typical of the entire state,then Texas master’s level psychologygraduates fare very well in using theireducational training to obtainemployment.
Licenses ObtainedOf particular interest is the information
concerning the licenses obtained by theUHCL master’s graduates across the threedecades. These data are presented in Table2. Because 16% of the respondentsindicated they had been accepted intodoctoral programs, it is not surprising to seetwo new licensure categories this year, the
Table 2
Credentials obtained by UHXL professional psychology graduates
Credential 1981 1993 2003(N=109) (N=237) (N=317)
LPA 17% 12% 7%
(Psychological Assoc.)
LPC NA 51% 53%
(Professional Counselor)
LMFT NA 35% 31%
(Marriage & Family Therapist)
LSSP NA NA 19%
(Specialist in School Psych.)
LCDC NA 16% 6%
(Chemical Dependency Counselor)
LP no data no data 5%
(Psychologist)
MD no data no data 2%(Medical Doctor)
Other no data no data 7%
None 83% 24% 14%
Note: Percentages exceed 100 because some respondents hold multiple credentials.
Texas Psychologist 13WINTER 2003
Licensed Psychologist (LP) and the MedicalDoctor (MD). The responses in the “other”category generally specified a credential thatwas offered by a professional association asopposed to a license. Licenses were notexamined in the APA national survey sincelicensing is done at the state level.
The professional counselor’s license(LPC) remains the most popular choice(53%) of the 2003 respondents, with 31%of the 317 respondents obtaining thelicense for marriage and family therapists(LMFT). These figures are very similar tothe results from the 1993 respondents. TheUHCL practitioner programs weredesigned with the assumption that mostgraduates would become psychological
associates. However, results suggest that the
percent seeking licensure as an LPA
continues to decline over the decades, with
only 7% of the 2003 respondents
possessing the LPA. New since the 1993
survey is the specialist in school psychology
license (LSSP), with 19% of the
respondents obtaining this license. As more
types of licenses have become available and
as more legal restrictions appear for
individuals attempting to practice in the
mental health field without a license, it is
not surprising to see the percent of
graduates with no license steadily declining
from 83% in 1981 to 14% in 2003.
Employment SettingsWhen asked about their employment
setting and work activity, only those 2003respondents (N=219) who responded to thequestions and who indicated they worked
more than 20 hours per week were included
in the data analyses. From the responses ofthese full-time employed individuals, somepossible trends appear (see Table 3). Since
the demise of psychiatric hospitals in the
early 1990s, only 6% of the respondentswork in inpatient mental health settings.Some of these were specified as prison
hospitals or nursing homes. An increasing
proportion of the graduates now work inpublic schools as well as in outpatientsettings such as mental health agencies. The
spike seen in private practice settings duringthe 1980s seems to have diminishedsomewhat by 2003. In an attempt to more
thoroughly explore the sites involved in the“other” responses, these answers were re-examined and categories for higher
Table 3
Primary employment settings of UHCL professional psychology graduates
Setting 1981 1993 2003(N=109) (N=237) (N=219)*
In-patient 19% 6% 6%
Out-patient agency 18% 14% 22%
Public school 13% 12% 25%
Private practice 15% 30% 24%
University no data no data 6%
Business/Industry no data no data 3%
Medical facility no data no data 5%
Other 35% 38% 9%
*Only data from those employed full time were considered here.
Table 4
Primary work activity of UHCL professional psychology graduates
Nature of work 1981 1993 2003
Psychotherapy 29% 48% 41%
Diagnostics/assessment 14% 6% 22%
Case management 17% 6% 15%
Administration 17% 6% 9%
Teaching 12% 3% 2%
Research no data no data 3%
Consulting no data no data 3%
Other 11% 31% 5%
14 Texas Psychologist WINTER 2003
education, business, and medical facilitieswere included in Table 3 for the 2003respondents. It was also interesting to notethat when the sites were examined in termsof the degree program of the respondent,significant differences emerged. Asexpected, those with school psychologydegrees were employed primarily in publicschools, while those with clinical or familytherapy degrees were employed primarily inprivate practice and outpatient settings.Date of graduation also showed asignificant relationship to employmentsetting, with those receiving degreesbetween 1978-1985 being employed morefrequently in private practice andinstitutions of higher education (58% and
21% respectively) than those graduating
from 1986 to 1993 (29% and 8%), or those
graduating more recently from 1994-2002
(12% and 4% respectively).
Work ActivityWhen queried about the nature of their
work, the current respondents reveal a slight
shift away from psychotherapy and into
more diagnostic jobs or case
management/short term counseling roles.
Again, in an attempt to provide more
specific data, the “other” responses were
examined. Research and consulting
emerged as two additional job categories.
Table 4 compares the work activities during
the three different survey dates.
A significant relationship was found
between the license obtained andrespondents’ primary work, with LSSPsdoing diagnostic work while LPCs and
LMFTs were more involved with
psychotherapy. Further, a significantassociation was found between employmentsetting and job activity. Those employed in
the schools were primarily involved with
diagnostic work and those employed inprivate practice or outpatient settings didpsychotherapy primarily.
EarningsHow much money do the graduates
make? Because of inflation, no attempt was
made to compare incomes across thedecades. However, since income is a veryimportant variable, it was examined in thisyear’s survey in a number of ways: degreeobtained, length of time from graduation,license, employment setting, and workactivity. Tables 5 and 6 present some ofthese data.
As a group, those with the schoolpsychology degree tend to be paid better.This finding was consistent with results ofthe APA survey at the national level (APA,
1999). Some 86% of the school psychologygraduates earned above $40,000 per year.Clinical psychology graduates fared less wellwith 65% earning above $40,000. Familytherapists came in last, with approximately59% of their graduates earning above$40,000. Yet, it was this same practitionergroup (family therapy) that had the greatestpercentage of graduates earning above$70,000. As one might expect, earningsvaried by date of graduation, with graduatesearning more money the longer they were
Table 5
Earnings of UHCL professional psychology graduates by program area
Amount Clinical School Family Tpy. Total(N=75) (N=55) (N=87) (N=217)
Under $30,000 15% 7% 18% 14%
$30,000 - $39,999 20% 7% 24% 18%
$40,000 - $49,999 32% 49% 16% 30%
$50,000 - $59,999 11% 22% 16% 16%
$60,000 - $69,999 9% 9% 9% 9%
Over $70,000 13% 6% 17% 13%
Table 6
Employment of UHCL professional psychology graduates earning over$70,000
Setting % Work activity %
In-patient 0% Psychotherapy 63%
Out-patient agency 7% Diagnostics 7%
Public school 7% Case Management 0%Private practice 48% Administration 7%
University 15% Teaching 4%Business/Industry 7% Research 4%
Medical facility 4% Consulting 4%
Other 12% Other 11%
Texas Psychologist 15WINTER 2003
in the field (i.e., the further out theirgraduation date). As a group, LSSPs (schoolpsychology) earned more than LPCs andLMFTs (clinical and family therapy). Thisis particularly noteworthy since the schoolpsychology yearly incomes are normallybased on a 10-month academic year asopposed to clinician and family therapyincomes that are normally based on a 12-month calendar year.
A separate analysis was done ongraduates earning over $70,000 (see Table6). A substantial number of theseindividuals were involved in the privatepractice of psychotherapy (and were LPCsor LMFTs who had been in the professionfor a long time since graduation).
Managed CareFinally, the 2003 survey queried the
respondents about the effects of managed
care on their work. Since the managed care
phenomenon arose in Texas after the 1993
survey was conducted, no comparison
across decades was possible. Graduates were
asked how much managed care currently
affected their work and what they
anticipated the effects would be in another
five years. Results are presented in Table 7.
The school psychology graduates report
being affected little or not at all by managed
care, while the clinical and family therapy
graduates report being much more affected.
The differences among these three groups
were highly significant. This difference is
equally apparent when the professions wereasked to predict how much managed carewould affect them five years hence. When
these responses to managed care were
examined by types of licenses possessed, itcame as no surprise that the LSSPs werenegligibly affected, but the LPCs and the
LMFTs were much more affected. The
difference was again highly significant.Similarly, those reporting being leastaffected by managed care worked in school
settings (only 2% reported being very much
affected by managed care) and diddiagnostic work (54% reported not beingaffected at all). Some 83% of researchers
also reported not being affected at all bymanaged care. Those working in privatepractice or business reported being verymuch affected by managed care (64% and67% respectively). Some 52% ofpsychotherapists reported being very muchaffected by managed care.
When asked in what specific waysmanaged care affected their work,respondents gave multiple responses. Table8 shows that for those indicating they wereaffected, increased paperwork was the maincomplaint. Other concerns were a decreasein length or amount of services provided toclients and a decrease in fees charged.Interestingly, more respondents reportedthat managed care increased their caseload
rather than decreasing their number of
clients.
DiscussionThe present survey data, when
compared with data collected over the pasttwo decades, suggest that graduates ofprofessional psychology master’s levelprograms are increasingly seeking licensureand seem to be increasingly diversifyingand specializing to meet the needs of aconstantly changing job market. Graduatestended to flock to private practice in the1980s when liberal insurancereimbursement for services prevailed. Afterthe advent of managed care, fewergraduates pursued the private practice ofpsychotherapy. Clearly employment ofthese master’s level graduates in the mentalhealth field remains high. Most are
employed full time with the vast majority
employed in the mental health field in
which they trained. Those in school
psychology seem to benefit from strong job
Table 7
Perceived effects of managed care on UHCL professional psycohlogygraduates now and in five years
PROGRAMS
Clinical School Family Therapy
Effects Now
Very Much 39% 2% 45%
Somewhat 13% 13% 13%
Very little 23% 27% 19%
None 25% 58% 23%
Effects in 5 years
Very Much 56% 4% 35%
Somewhat 14% 19% 34%
Very Little 10% 41% 17%
None 20% 36% 14%
16 Texas Psychologist WINTER 2003
demand, doing primarily diagnostic work,with salaries between $40,000 and$60,000. They report being affected littleby managed care. Those in clinical andfamily therapy programs clearly prefer theLPC and LMFT licenses to the LPA, andfind employment in outpatient agencies orprivate practice. Those in outpatientagencies generally earn less than $40,000per year, while individuals in privatepractice show the widest range of incomes.However, of the respondents earning morethan $70,000 per year, most are in privatepractice and have been there for manyyears. Psychotherapy is the primary activityof the clinical and family therapy graduatesand managed care affects these practitioners
much more than the school psychology
graduates. These practitioners expect
managed care to have a similar, substantialimpact on their professional activities overthe next five years.
The results suggest that while Texasproduces large numbers of master’s levelprofessional psychology graduates eachyear, these individuals continue to findemployment in the mental health field withmost earning over $40,000 per year.Presumably this success speaks to thequality of their work and theircontributions to the lives of those seekingmental health services.
ReferencesAmerican Psychological Association
Research Office (Update 1999). Auguste,
R.M., Wicherski, M., and Kohout, J.L.
1996 Employment Survey: Psychology
Graduates with Master’s, Specialist’s, andrelated Degrees. APA Online. www.apa.org.
Gehlmann, S.C. (1994). Employmentsurvey: Psychology graduates with master’s,specialist’s, and related degrees. Office ofDemographic, Employment andEducational Research, EducationDirectorate, American PsychologicalAssociation, Washington, D.C.
Lowe, R.H. (Spring, 1997).Employment realities and possibilities formaster’s level psychological personnel.Journal of Psychological Practice, 3(2), 47-54.
MacKain, S.J., Tedeschi, R.G., &
Durham, T.W. (August, 2002). So what are
master’s-level psychology practitioners
doing? Surveys of employers and recent
graduates in North Carolina. ProfessionalPsychology: Research & Practice, 33(4), 408-
412.
Sutter, E., Mize, L., & Eisner, H.
(October, 1994). Whither graduates of
master’s psychology programs? The TexasPsychologist, 5-9.
Texas Higher Education Coordinating
Board, Degrees Awarded Data (Profile
020), Masters Degrees Awarded by
Curriculum Area (Report 060), Psychology(Element 4200000000) and Coun
Educ/Std Con & Guid Srvc (Element
1311010000). www.thecb.state.tx.us/netvisual/menu.htm.
Table 8
Ways in which managed care affects UHCL professional psychologygraduates
Effect % (N=220)
Increases # of clients 19%
Decreases # of clients 11%
Increases paperwork 46%
Increases services provided to clients 5%
Decreases services provided to clients 29%
Increases fees charged 5%
Decreases fees charged 27%
Increases overhead expenses 18%
Decreases overhead expenses 1%
No effect 34%
Other responses 11%
Note: Percentages exceed 100 because multiple responses were allowed.
✯
Texas Psychologist 17WINTER 2003
LEARN HOW TO PROVIDE PSYCHOLOGICAL SERVICES TOTEXAS WORKER’S COMP PATIENTS IN AN OUTPATIENT
CHRONIC PAIN MANAGEMENT PROGRAM.K-Med Seminars Presents:
“HOW TO START A CHRONIC PAIN MANAGEMENT PROGRAM”• from womb to tomb• generate 18k per patient• the role of the psychologist/LPC• mental health guidelines• goals of treatment• appropriate use of psychometrics• how to obtain preauthorization• example of daily documentation• TWCC new law requirements• how to contract your services• billing packet examples• role of all other team members• why insurance carriers are motivated
to approve pain Rx
TENTATIVE SPEAKERSKonrad Kuenstler, LPT, MBA
Ajay Mohabeer, MD, DAAPMDirector: Texas Academy of Pain Management
Bob L. Gant, PhD, FAPMDiplomate, American Board of Professional Neuropsychology
Take advantage of this special opportunity to mix with Medical andChiropractic Doctors who are coming to learn how to start pain
management services. Free Beer and Wine Mixer After the Seminar.
CALL FOR INFO: 214-212-1785
Seminar: Jan. 10, 2004Location: Holiday Inn
4440 W. Airport FrwyIrving, TX 75062
Time: 9:30 am - 6:30 pm
18 Texas Psychologist WINTER 2003
Empirically validated treatments is a
difficult topic for a practitioner to
discuss with clinical scientists. In
my attempts to discuss this informally, I
have found that some clinical scientists
immediately assume that I am anti-science
and others emit a guffaw, asking
incredulously, “What, are you for
empirically-unsupported treatments?”
McFall (1991, p. 76) reflects this
perspective when he divides the world of
clinical psychology into “scientific and
pseudoscientific clinical psychology,” and
rhetorically asks, “What is the alternative
[to scientific clinical psychology]?
Unscientific clinical psychology” (see also
Lilienfeld, Lohr, & Morier, 2001).
Thus, there are some ardent clinical
scientists (e.g., McFall and Lilienfeld) whoappear to subscribe to scientific faith and
believe that the superiority of the scientific
approach is so marked that otherapproaches should be excluded. Since this isa matter of faith rather than reason,
arguments would seem to be pointless.
Nonetheless, clinical psychologists haveargued over it for the last eight years.Punctuating these interactions from the
practitioner perspective, the controversy
seems to stem from the attempts of someclinical scientists to dominate the discourseon acceptable practice and impose very
narrow views of both science and practice.
Let’s start with a brief recapitulation of
the events. Division 12, under the
leadership of then President David Barlow,
formed a Task Force “to consider methods
to educate clinical psychologists, third party
payors, and the public about effective
psychotherapies” (APA Division of Clinical
Psychology, 1995, p. 3). The Task Force
came up with lists of “Well-Established
Treatments” and “Probably Efficacious
Treatments.” Not surprisingly, the lists
themselves emphasized short-term
behavioral and cognitive-behavioral
approaches, which lend themselves to
manualization; longer term, more complex
approaches (e.g., psychodynamic, systemic,
feminist, and narrative) were not well
represented.
The empirically validated treatments
movement has had quite an impact on
practitioners. It provided ammunition tomanaged care and insurance companies intheir efforts to control costs by restricting
the practice of psychological health care
(Seligman & Levant, 1998). It has alsoinfluenced many local, state, and federalfunding agencies, which now require the
use of empirically validated treatments.
Moreover, this movement could have aneven greater impact on practitioners in thefuture. For example, it could create
additional hazards for practitioners in the
courtroom if empirically validatedtreatments are held up as the standard ofcare in our field. Further, adherence to
empirically validated treatments could
become a major criterion in accreditation
decisions and approval of CE sponsors, as
the Task Force has urged (APA Division of
Clinical Psychology, 1995, p. 3). Some
clinical scientists have gone so far as to call
for APA and other professional
organizations “to impose stiff sanctions,
including expulsion if necessary,” against
practitioners who do not practice
empirically validated assessments and
treatments (Lohr, Fowler & Lilienfeld,
2002, p. 8).
Given all of this fallout, it should be no
surprise that the Task Force report was soon
steeped in controversy. Critics argued first
and foremost that the Task Force used a
very narrow definition of empirical
research. For example, Koocher (personal
communication, 7/20/03) observed that“‘empirical’ is in the eye of the beholder,and sadly many beholders have very narrow
lens slits. That is to say, qualitative research
[and] case studies…have long been avaluable part of the empirical foundationfor psychotherapy, but are demeaned or
ignored by many for whom ‘empirical
validation’ equates to ‘randomized clinicaltrial’ [RCT]. In addition, a randomizedclinical trial demands a treatment manual
to assure fidelity and integrity of the
intervention; however, the real world ofpatient care demands that the therapist(outside of the research arena) constantly
The Empirically Validated Treatments Movement:A Practitioner Perspective 1
Ronald F. Levant, EdD, ABPP
I would like to weigh in on the issue of what has been called, sequentially, “empirically-validatedtreatments” (APA Division of Clinical Psychology, 1995), “empirically-supported treatments” (Kendall,1998), and now “evidence-based practice” (Institute of Medicine, 2001).
Texas Psychologist 19WINTER 2003
modify approaches to meet the idiopathicneeds of the client…Slavish attention to‘the manual’ assures empathic failure andpoor outcome for many patients.”
Furthermore, Seligman and Levant(1998) argued that, whereas efficacyresearch programs based on RCT’s mayhave high internal validity, they lackexternal or ecological validity. On the otherhand, effectiveness research, such as theConsumer Reports study (Seligman, 1995),has much higher external validity andfidelity to the actual treatment situation asit exists in the community. Additionaleffectiveness studies are needed and couldbe conducted by the Practice-ResearchNetworks that have recently appeared
(Borkovec, Echemendia, Ragusea, & Ruiz,
2001). Finally, others have pointed out that
many treatments have not been studied
empirically. There is a big difference
between a treatment that has not been
tested empirically and one that has not been
supported by the empirical evidence.
A few years later, John Norcross, then-
President of Division 29 (Psychotherapy),
countered by establishing a Task Force on
Empirically Supported Therapy Relation-
ships in 1999, which emphasized the
person of the therapist, the therapy
relationship, and the non-diagnostic
characteristics of the patient (Norcross,
2001). Lambert and Barley (2001)
summarized this research literature,
pointing out that specific techniques
(namely those that were the focus of thestudies underlying the Division 12 TaskForce report) accounted for no more than
15 percent of the variance in therapy
outcomes. On the other hand, the therapyrelationship and factors common todifferent therapies accounted for 30
percent, patient qualities and extra
therapeutic change accounted for 40percent, and expectancy and the placeboeffect accounted for the remaining 15
percent.
Westen and Morrison (2001) reported amultidimensional meta-analysis oftreatments for depression, panic disorder,
and GAD, in which they found that “themajority of patients were excluded fromparticipating in the average study,” due tothe presence of comorbid conditions (p.880). Approximately two-thirds of thepatients in the studies they reviewed wereexcluded, which seems like a highpercentage, but is actually a bit lower thannational figures for comorbidity.Meichenbaum (2003) noted that fewerthan 20 percent of mental health patientshave only one clearly definable Axis Idiagnosis. Thus, the vast majority of casesseen by practitioners do not meet the exactdiagnostic criteria used in the RCT’s thatestablished efficacy for various treatments.
Furthermore, the empirically validated
treatments on these lists have typically been
studied using homogeneous samples of
white, middle-class clients, and therefore
have not often been shown to be efficacious
with ethnic minority clients.
So what does this all mean? Suppose wehad lists of empirically validatedmanualized treatments for all DSM Axis Idiagnoses (which we are actually a longways away from). We would then havetreatments for only 20 percent of the white,middle class patients who come to ourdoors—namely those who meet thediagnostic criteria used in studies thatvalidated these treatments. That’s badenough, but that’s not all. In order to limitservices to only the 20 percent of white,middle class patients who come to us, theaverage practitioner would have to spendmany hours, perhaps years, in training tolearn these manualized treatments. If werestricted ourselves to use only manualized
treatments, we would be limiting our role
to that of a technician. In the end, these
treatments would only account for 15
percent of the variance in therapy outcomes
of these patients. One can readily see why
20 Texas Psychologist WINTER 2003
few practitioners embraced the empiricallyvalidated treatments movement.
My view is that although one ofpsychology’s strengths is its scientificfoundation, the present body of scientificevidence is not sufficiently developed toserve as the sole foundation for practice.Practitioners must be prepared to assess andtreat those who seek our services. To besure, we all get referrals of clients that wedecide to refer to others because we don’tthink that we are the best clinician for thatcase, but those who are in general practicehave to work with the clients that come tothem. Whether we operate from a singletheoretical or a more eclectic perspective,we bring to bear all that we know from the
empirical literature, the clinical case studies
literature, and prior experience, as well as
our clinical skills and attitudes, to help the
client that is sitting in front of us. This is
what is often referred to as clinical
judgement. Some condemn clinical
judgement as subjective. To them I say that
clinical judgement is simply the sum totalof the empirical and clinical knowledge andpractical experience and skill that cliniciansbring to bear when it is our job tounderstand and treat a particular and veryunique person.
Fox (2003) goes even further, pointingout that in many learned fields, science andpractice are often separate endeavors, andthat practice often has to precede science.Physicians were treating cancer long beforethey had much of an idea of what it wasand were using pharmaceutical agents likeaspirin long before the pharmacodynamicswere known. To quote Fox (2003):
The fact of the matter is that if
clinicians restrict themselves to
applying only narrowly validated
or known techniques, they will
never be of much value to society.
Lest you think that statement is an
invitation to charlatanism,
remember that clinicians do not
have the luxury to start from what is. They must start with theneeds of the people who come to them and then apply all the knowledge, information and skill they have to help resolve those problems.
On the other hand, we do have aproblem of accountability in health care,one that will surely affect psychology. Forexample, the current lag between thediscovery of more effective forms oftreatment in health care and theirincorporation into routine patient care ison the average 17 years. DeLeon (2003)predicts that health care in the 21st century,
abetted by technology, will be characterized
by even greater accountability for
practitioners, due to the combined effects
of the increasingly well-informed health
care consumer, who gathers relevant health
care information from the Internet; the
increasingly well-informed practitioner,
Visit www.helper.com today to download your free trial version, or just call 1-800-343-5737.Plus, if you mention code TPFA03, you’ll get 15% off your purchase of Therapist Helper software.
Texas Psychologist 21WINTER 2003
who will be able to obtain best practiceinformation from a PDA; and increasedmonitoring of health care practices to flushout variation in treatment for specificdiagnoses. In this environment we aregoing to need betters ways to evaluatepractice. I would suggest that we considerusing the broad and inclusive definition ofevidence-based practice adopted by theInstitute of Medicine (2001). Thisdefinition consists of three components:best research evidence, clinical expertise,and patient values. This definition makesall components equal, provides a broadperspective that allows the integration ofthe research (including that on empiricallyvalidated treatments and that on
empirically supported therapy relation-
ships) with clinical expertise, and brings the
topic of patient values into the equation.
Such a model that equally values all three
components will better advance knowledge
related to best treatment and provide better
accountability.
As always, I welcome your thoughts on
this column. You can most easily contact
me via e-mail at [email protected].
ReferencesAmerican Psychological Association
Division of Clinical Psychology (1995).
Training in and dissemination of
empirically-validated psychological treat-
ments: Report and recommendations. TheClinical Psychologist, 48, 3-27.
Borkovec, T. D., Echemendia, R. J.,Ragusea, S. A., and Ruiz, M. (2001). ThePennsylvania Practice Research Network
and possibilities for clinically meaningful
and scientifically rigorous psychotherapyeffectiveness research. Clinical Psychology:Science and Practice, 8, 155-167.
DeLeon, P.H. (2003). Remembering
our fundamental societal mission. PublicService Psychology, 28, 8, 13.
Fox, R. E. (2003, August). Towardcreating a real profession of psychology. Paper
presented at the Annual Meeting of theAmerican Psychological Association,Toronto, Ontario, Canada.
Gonzales, J.J., Rngeisen, H. L., &Chambers, D. A. (2002). Clinical Psych-ology: Science and Practice, 9, 204-220.
Institute of Medicine (2001). Crossingthe Quality Chasm: A new Health Systemfor the 21st Century. (2001). Institute ofMedicine: Washington, DC.
Kendall, P. C. (1998). Empiricallysupported psychological therapies. Journal ofConsulting and Clinical Psychology, 66, 3-6.
Lambert, M. J., & Barley, D. E. (2001).Research summary on the therapeuticrelationship and psychotherapy outcome.Psychotherapy: Theory/Research/ Practice/Training, 38, 357-361.
Lilienfeld, S.O., Lohr, J. M., & Morier,D.(2001). The teaching of courses in the
science and pseudoscience of psychology:
Useful resources. Teaching of Psychology, 28,
182-191
Lohr, J. M., Fowler, K. A., & Lilienfeld,
S. O. (2002).The dissemination and
promotion of pseudoscience in clinical
psychology: The challenge to legitimate
clinical science. The Clinical Psychologist,55, 4-10
McFall, R. M. (1996). Manifesto for a
science of clinical psychology. The ClinicalPsychologist, 44, 75-88.
Meichenbaum, D. (2003, May).
Treating Individuals with Angry andAggressive Behaviors: A Life-Span CulturalPerspective. Paper presented at the Annual
Meeting of the Georgia Psychological
Association, Atlanta, GA. Norcross, J. C. (2001). Purposes,
processes, and products of the Task Force
on Empirically Supported TherapyRelationships. Psychotherapy: Theory/Research/ Practice/Training, 38, 345-356
Seligman, M.E.P. (1995). The
effectiveness of psychotherapy. AmericanPsychologist, 50, 965-974.
Seligman, M. E. P., & Levant, R.
(1998). Managed care policies rely on
inadequate science. Professional Psychology:Research and Practice, 29, 211-212.
Westen, D. and Morrison, K. ( 2001). A
multidimensional meta-analysis of
treatments for depression, panic, and
generalized anxiety disorder: An empiricalexamination of the status of empiricallysupported therapies. Journal of Consultingand Clinical Psychology, 60, 875-899.
Biographical SketchRonald F. Levant, EdD, ABPP, is a
fellow of Division 39 and a candidate forAPA President. He is in his second term asRecording Secretary of the AmericanPsychological Association. He was theChair of the APA Committee for theAdvancement of Professional Practice(CAPP) from 1993-95, a member at largeof the APA Board of Directors (1995-97),and APA Recording Secretary (1998-2000). He is Dean of the Center for
Psychological Studies, Nova Southeastern
University, Fort Lauderdale, FL.
Footnote1 Adapted from Levant, R. (in press).
The empirically validated treatments
movement: A practitioner/educator
perspective. Clinical Psychology: Science andPractice.
TEXASPSYCHOLOGICALASSOCIATION ANNUAL CONVENTIONSPONSORS
Please take a moment to thank these sponsors should you meet them at the convention. We could not host such amagnificent program without theirsupport.
AMERICANPROFESSIONAL AGENCY
DALLAS PSYCHOLOGICALASSOCIATION
REMUDA RANCH
✯
22 Texas Psychologist WINTER 2003
Although each of these papers deals with
loss in some way, each one addresses a
different perspective and a different life
lesson. Dr. Davenport shares her thoughts
about anticipatory grief, drawing from her
experiences of losing her own mother. She
discusses what remains after the death of a
loved one and emphasizes the importance
of ritual and symbol. Dr. Nutt entertains us
by debunking the stereotype of the middle-
aged woman being over the hill. She
examines the research about the feminine
role and dwells on the positive aspects of
aging. Dr. Sharp discusses her work in grief
recovery. She presents a model of growing
through the grief process by looking at
spiritual, psychological, and sociological
issues. Dr. Vasquez describes theimportance of our mentors in ourprofessional growth. She examines how
their losses impact our thoughts about our
career goals and challenge us to look toourselves as mentors for those who canprofit from our experiences.
Part I: Midlife Loss of a Parent
For those of us who are lucky, ourparents did not die when we were youngand still quite dependent. Instead, we dealt
with their deaths when we were adults and
often after a significant period of caregivingand anticipatory grief during their decline.
Women typically carry the brunt of the
responsibility for caregiving of elderly
parents (Davenport, 1998). Accordingly,
they are often in more physical and
psychological contact with their parents in
the months or years preceding their deaths
than they had been heretofore, and the
ensuing sense of loss after death can be
especially acute. Further, as the Stone
Center’s Cultural/Relational theory
suggests, the connection between mother
and daughter can be especially close
(Jordan1997), which suggests that part of
the bereaved daughter’s identity may feel in
jeopardy as she attempts to come to terms
with what the loss means to her.
The Experience of LossThere is often a sense of generational
shift after a parent dies, especially after thedeath of the second parent (Donnelly,
2000; Myers 1997). Some authors (e.g.
Bartocci, 2000; Brooks, 1999; Levy, 2000)of popular books on loss of parentsadditionally suggest that it is inevitable for
the adult child survivor to feel like an
orphan; there is no longer any one to turnto for guidance, to share memories, or toserve as a buffer between herself and death.
The longest lasting familial bond has been
severed. Classical theories of bereavementwould support this contention, withdecathexis considered the goal of healthy
resolution of grief (Freud, 1917/1957).
Other writers (e.g., Davenport, 2002)
however, point out that while death ends
life, it does not end the relationship. For
many bereaved persons, the presence of the
deceased loved one may still be accessible.
Recent research (Francis, Kellaher, &
Lee, 1997; Klass & Walter, 2001; Rees,
1979) confirms that large numbers of
apparently healthy survivors report some
sense of ongoing connection with the
deceased. Sometimes this takes the form of
actually talking to the lost loved one. For
women, this is usually done in the home;
men often talk with their deceased fathers at
cemeteries. One study (Marwit & Klass,
1995) examined the function of the bond
that seems to transcend death and foundthat it was often maintained to providemoral guidance during difficult life
situations or to offer solace by claiming the
legacy imparted from the deceased.Sometimes the conversation is audible orwithin the bereaved person’s mind,
sometimes the parent’s memory is invoked,
and sometimes the past relationship is usedas a way to clarify values.
Another qualitative study of
psychologists (Davenport, et al., 2002)
indicated that a large majority of thoseinterviewed said that they also sometimesfelt the presence of their deceased parent—
sometimes through dreams, sometimes by
Challenging Issues for Women at Midlife
Donna Davenport, PhD; Roberta L. Nutt, PhD; Robbie N. Sharp, PhD; and Melba J.T. Vasquez, PhD
The following papers were written for a symposium sponsored by the Psychology of Women SpecialInterest Group at the Texas Psychological Association’s Annual Convention in 2002. The authors areall psychologists who have been involved in professional societies, academia, clinical practice, andfriendship, and who have shared the journey into midlife. We, as women and psychologists, wanted toaddress important issues at this point in our experiences, so that we might learn from our reflectionsand those of others.
Texas Psychologist 23WINTER 2003
doing an activity their parent used to do,and sometimes by deliberately invokingtheir memory. It seems clear that suchexperiences cannot be written off as asymptom of some psychopathology.
Spiritual/religious beliefs may be helpfulbut are not requisite for survivors to claimthis sense of ongoing connection. Forpsychologists who need psychologicalexplanations of the phenomenon,understanding it as accessing theinternalized love object works well (Baker,2001). Whether the continuingrelationship is conceptualized astranscendent or merely psychological, theexperience of it is often undeniable formany bereaved persons.
MemorialsSpecific activities or rituals are often
helpful for bereaved individuals (Combs &
Friedman, 1990) but perhaps especially so
for adult children who have lost their
parents. Creative expression, designed not
only to facilitate grief but also to honor the
deceased, can provide tangible memorials
that evoke the quality of the parent/child
relationship. One client of mine is
collecting all the pithy pieces of advice her
father was noted for dispensing and is
making a scrapbook for his grandchildren.
Another artist client painted a landscape
that her father was especially fond of and
said, “It’s like I’m shouting into the void—
See, I still love him! You can’t take him
away!” In writing the memoir after my own
mom’s death (Davenport, 2002), I found
that recollecting stories about her and about
her/our ancestors that she had told me overthe years provided an ongoing sense oflegacy we are both part of. During the
process, I wrote a poem in tribute to her
and our relationship. Now, four yearsalmost to the day since she died, it is whatseems to best capture my resolve to
maintain her importance in my life:
There is evil, I now know. I see it.Destruction that attacks you,
That deprives you of choice,That undermines your every effort.It feeds on our despair.My mother, it shall not win. This battle is not the last.So when you die,When it has taken you away—Piece by piece until finally gone—I will remember your love, your colors, The melody that is you.In some shining part of me,Your song will still be sung.More: Nothing can touch what
I prize the most.Far past these indignities,Past your death, past mine also,Through all the eons yet to come,I will always be your daughter.
Part II: Confronting CulturalStereotypes: Midlife as Liberation
As is true in many contexts, there has
been too much emphasis on the negatives
associated with midlife—particularly losses.
Losses are only one part of the story.
Media and Cultural AssumptionsOne of the biggest challenges of midlife
for women is confronting cultural
stereotypes routinely presented in media,
movies, television, magazines, etc. Middle-
age and older women are presented as sweet
little old ladies, hags, old bats, evil witches(ever see any evil old man costumes atHalloween? [Matlin, 1993]), and crones.
Aging is described as a scary process
generally leading to depression. Cultureassumes that aging is paired withincreasingly rigid ideas, loss of hearing, and
general ugliness—white hair, wrinkles, and
stooped posture.Advertising in the media spends millions
pushing cover-up makeup and a variety of
lotions and creams to fight the effects of
aging (Friedan, 1993). Even dishwashingdetergents claim to soften hands and makethem appear more youthful (Matlin, 1993).
Women are encouraged to seek cosmeticsurgery to change their natural looks and lieabout their age.
Double Standard of AgingMany experts on the aging process
describe a double standard of aging(Etaugh, 1993; Sontag, 1979). As men age,it is assumed that wrinkles give themcharacter and grey hair represents wisdom(Deutsch, Zolenski, & Clark, 1986). Withmaturity come increased competencies,respect, and financial security. Old men areseen as distinguished.
The opposite is typically true forwomen. As their appearance ages, they areless valued or even noticed (Bazzini,
McIntosh, Smith, Cook, & Harris, 1997;
Fodor & Franks, 1990). They do not gain
in perceptions of wisdom or distinction.
For women, aging is viewed as a
problem to be overcome, denied, or
avoided. Old women may be criticized for
using up resources and being a burden on
society and their families. Aging equals
deterioration, helplessness, frailty, and
confusion.
Culture assumes all elderly persons are
incompetent and living in nursing homes
(Friedan, 1993; Matlin, 1993). They are
isolated and hidden.
Well-Kept SecretIn reality, the advantages of midlife and
older for women are a well-kept secret.There is no denying the bodily changes and
increases in aches and pains and health risks
(Bee, 1996; Etaugh, 1993). However, thesechanges are well balanced by the positiveand dynamic increases in freedom and self-
definition. Women’s roles change, many
earlier obligations drop away, and womenhave a greater number of role choices andfeel less concern for the outside opinions
and criticisms of others. There was a recent
Oprah interview on television with SusanSarandon and Goldie Hawn, who had bothpassed 50. Both interviewees reported
feeling freer, sexier, and more joyous after
passing 50.
24 Texas Psychologist WINTER 2003
Psychological research has supportedthis positive view of aging for women fordecades. In today’s U.S. society, youngadulthood is often protracted, marriage isdelayed and overall health has improved(Matlin, 1993). The life span has grownlonger. Even the definition of midlife hasshifted upward. In 1900, the life expectancyfor women was less than 50; now it is closerto 80 (U.S. Bureau of the Census, 1993).The quality of life is also better, barringillness. Nutrition is better, people exercisemore, and new role possibilities haveincreased.
Contradicting Cultural AssumptionsResearch studies going back to the
1960s and 1970s (Hyde, Krajnik, &
Skuldt-Niederberger, 1991; Neugarten,
1968) found that women and men grow
closer together in personality characteristics
as they age. Women become more assertive
and independent, and men grow more
emotional, nurturing, and interpersonally
connected. A repeated midtown Manhattan
Longitudinal study assumed women’s
mental health deteriorates with age for
every decade after 20, but found drastic
improvement after 40. Later, the National
Center for Health Statistics found women
in their 40s, 50s, and 60s to be in as good
as or better mental health than women in
their 20s and 30s (Friedan, 1993). They
concluded there is more stress in the lives of
younger women.Few women have been shown to suffer
seriously with the stereotyped empty-nest
syndrome when children leave home (Bart,1971; Grambs, 1989; Rubin, 1979).Mitchell and Helson (1990) went so far as
to suggest that the early 50s are the prime
of life for women. Freed from parentingresponsibilities, women have new energy topursue other interests (Brown & Kerns,
1985). They demonstrate a joy in living
and liberation from monthly cycles, a highinterest in sex, an increased sense ofautonomy, and an ongoing interest in
friends, family, and careers (Jackson,
Chatters, & Taylor, 1993; Mitchell &Helson, 1990). Connectedness has been
shown to have a direct effect on positivemental health and mortality.
Research that has emphasized negativeaspects of aging has been criticized for usingthe institutionalized elderly while general-izing to the total population. These sampleswere convenient but did not representreality. It has also been suggested that thepersonal fear of aging in researchers mayhave caused bias in their research. Forexample, the assumed decline inintelligence for aging adults has been tied totest bias rather than any actual decline foractive individuals.
Suicide rates, another measure of mentalhealth, is significantly higher in males over65 (45.6 per 100,000) than women over 65
(7.5 per 100,000). Studies based upon
European-American, middle-class, edu-
cated women has shown them to be
independent, in charge of their lives,
adventurous, hard-headed, unconventional,
opinionated, individualistic, self-confident,
complex, and demonstrating high self-
esteem. They were reflective and
contemplative, demonstrated integrity, gave
high priority to instrumental functions,
were positive about menopause, and
welcomed new experiences. They were
interested in politics, social issues, and were
joyfully engaged in the present.
Career-oriented women at midlife
demonstrate more internal locus of control.
Women in leadership roles are confident,
sure of their own opinions, conscientious,
serious, assertive, determined, and creative.They value mentoring and empoweringothers.
Positive mental health of midlife and
older women is even more obvious incultures that revere older women (Grambs,1989). Many Native American tribes
valued wisdom in older women. Aboriginal
women in Australia are respected—theiradvice is sought on matters of importanceand they are involved in spiritual ritual and
community decision making. Among the
Kung people of southern Africa, statusincreases with age, as do spiritual powers.Older women can handle taboo and ritual
substances that are considered too powerful
for women still involved in bearing andcaring for children. Midlife is viewed as anew beginning.
It is time to change our culturalstereotypes. Midlife for women needs to beviewed in balance, describing both itsinherent changes and excitingopportunities.
Part III: Grieving and HelpingOthers To Do
One of the most gratifying and painfultasks I have encountered in professional lifewas finding a healthy way of addressing myown losses and helping patients andstudents to do the same. As a
developmental psychologist, I understand
and embrace the concept of change, letting
go of what was and making what is now a
part of my life. Too often we make these
transitions without allowing ourselves time
and energy to experience the feelings,
explore them, and say goodbye. In our busy
professional and personal lives, many of us
have adapted by rushing through this
process again and again. We lose so much
by not treating our losses as an important
component of our development — one that
teaches profound lessons.
What I found and continue to find in
the lives of others is how loss changes all the
relationships in our lives and how each of
these relationships must be examined and
renegotiated, at a time when emotions andexperiences are askew and structure seems
to be missing. Finding ways of grieving that
link the intellectual self with the emotionaland the spiritual self sustains us throughlosses by integrating the past with the
present. Across the past six years, my
colleague, the Reverend Dr. Peter Thomas,and I have developed our thinking abouthow to help persons grow through their
grief process. What began as a way to help
structure and organize those in our church-based grief recovery groups has evolved aswe have incorporated information from
participants and as we have discussed our
thoughts about grief as a developmentalprocess.
Texas Psychologist 25WINTER 2003
Our PhilosophyGrief occurs when persons experience
the loss of dreams, loved ones, jobs, homes,businesses, way of life, and health. Ratherthan passing through a series of stages thatcompartmentalize our emotional reactionsto these losses (e.g., Kuebler-Ross, 1969),we see people who are encompassed in anamalgam of spiritual, sociological, andpsychological changes that are interactive,in a constant state of flux, and commandattention. If these emotions, attitudes,behaviors, and thoughts can be structuredand organized within these dimensions(spiritual, sociological, and psychological),we find that healing can begin to take place.We see the loss as a crisis event, a life-
changing incident, and the crisis experience
as the amalgam of changes that are set in
motion by the crisis event.
Spiritual ProcessesUsing the twenty-third Psalms as a
metaphor for the experience of grief and
loss, Dr. Thomas describes a spiritualjourney from: 1) orientation — life that isgoing along in the expected manner, 2) to acrisis event, 3) to disorientation — the crisisexperience in the valley of the shadow ofdeath, and finally 4) to re-orientation —learning to incorporate the loss and to copein the new life. As an Episcopalian priest,Dr. Thomas is able to address many of thereligious belief systems that are shakenduring the crisis experience. He weaves thisinto the same developmental model ofchange, change experience, and integration(death, resurrection, and new life).
Psychological ProcessesUsing the familiar psychosexual stages
set out by Erik Erikson (1968), those who
are grieving can be reminded that they have
experienced this developmental sequence
time and again as they have progressed from
one stage of life to another. We have also
used this model to demonstrate how each
person has gained patterns of strength and
weakness as they have progressed throughthe process of growing and changing. Welook at a model of attachment, separation,and bereavement that allows participants toconsider how their families handled change,grief, and loss (Gerkin, 1989). We also haveformulated a model for presentingemotions of grief and loss and layers ofemotional responses that can get set upduring the grieving process.
Sociological ProcessesWe formulated a model that describes all
the relationships we believe personsexperiencing grief must negotiate orrenegotiate. This model sets out severalmajor areas of one’s self: spiritual (God,
worship, afterlife), family and friends,
institutions (legal, governmental),
vocation/avocation, and identity (roles,
work, play). Each relationship within those
categories is addressed during a crisis
experience. Some of these relationships are
greatly changed following the loss; some of
For 54 years, Hazelden has provided the broadest range of proven products and services for every aspect of chemical dependency.
As a professional, Hazelden offers you easy access to a world of adolescent and adult services, research, books, videos, pamphlets and
education. Proven tools to help you help your clients. For more information, call toll-free
800-257-7800, or visit www.hazelden.org. Hazelden. We can help. It’s what we do. HAZELDEN©2003 Hazelden Foundation
WE’LL DO ANYTHING TO HELP.
Assessment And Evaluation ◆ Residential And Outpatient Recovery
Services ◆ Special Programs Designed For Seniors & Adolescents
◆ Continuing Care ◆ Intermediate & Extended Care ◆ Mental Health
Services ◆ Nicotine Recovery ◆ Books, Videos & Recovery-Related
Resources ◆ Graduate School of Addiction Studies ◆ Expertise in
Treating Impaired Professionals ◆ Parent And Family Programs
Centers in Minnesota, Florida, Oregon, Illinois, and New York.
26 Texas Psychologist WINTER 2003
these relationships are only slightlyimpacted. We believe that much of thework of grief is in reconciling one’s loss ineach of these relationships.
The WorkDr. Thomas and I find that discussing
ways of letting go, how old habits inhibitnew habits, the use and importance ofrituals, ways to acknowledge the reality ofthe past, and a format to plan for the futureand evaluate the present helps orient thosein grief. We have structured our GriefRecovery Course to be a psychoeducationalgroup rather than a therapy group. Webelieve that the group setting and groupprocess is an integral part of the healing
process, although we emphasize that each
person experiences grief in his or her own
way and at his or her own pace.
The midlife challenge for me has been to
find a means of coping with inevitable
losses and changes. By incorporating
written materials, conducting groups,
encountering examples in my clinical work,
and formulating my ideas and perspectives
on how I see loss, change, and coping, a
framework has evolved that allows me to
help structure and organize the
overwhelming experience of grief. As we
complete our book, both Dr. Thomas and I
have found ways of communicating these
ideas to others, thus allowing them to grow
through their own grieving.
Part IV: Mentoring at Midlife:Losses, Gains andChallenges
One of the most important difficulties
faced by women graduate students andyoung professionals has to do with
obtaining mentors. Worell and Johnson(1997) describe the reasons as the lack of
female faculty, and the tendency for malefaculty to have less identification and
contact with female students than they dowith male students. Women of color have
even less access to informal contact with
advisors, especially with mentors who arefamiliar with ethnic as well as gender issues.Often, women, and women of color, obtain“situational mentoring” from varioussources and persons. I am one of many whohas obtained rich and diverse mentoringfrom a number of sources, including fromsome of the few women of colorpsychologists who came before me. I amnow at the age, chronologically andprofessionally, when those mentors areretiring or dying. At midlife, one of thedevelopmental issues is the loss of mentorsthrough retirement, disability and/or death.The loss of a couple of my mentors has hada major impact, and I’d like to share theexperience of one of those losses.
Dr. Martha Bernal contributed
significantly to the advancement of ethnic
minority psychology. She unfortunately
suffered from three different bouts of
cancer, including the final one that took her
life prematurely on September 28, 2001 in
Black Canyon City, Arizona.
Martha was the first Latina in the
United States of America to receive a PhD
in Psychology; she received it at Indiana
University at Bloomington. The focus of
her research during the first part of her
career was on parent-training approaches
for behaviorally deviant children. For the
last 20 years of her career, her research
focused on the ethnic identity of Mexican
American children. Dr. Bernal published
about 60 articles and book chapters, several
books, was guest editor of journals, andpresented numerous papers. In the early1970s, she dedicated herself to the goal of
ensuring that more Latinas and Latinos had
the opportunity to receive graduatetraining. She applied much of her researchto increase the status of ethnic minority
recruitment, retention and training. Her
social action research was designed to focusattention on the dearth of Latino/apsychologists and to recommend steps for
addressing that problem. She published
seminal articles in the American Psychologist(Bernal and Castro, 1994; Bernal & Padilla,1982) and The Counseling Psychologist
(Quintana & Bernal, 1995) thatdocumented the dearth of minoritygraduate students and faculty members inpsychology departments throughout theUnited States. James Jones, anothermentor, said:
I have known Martha since the mid-1970s. She has always been a focused advocate for people of color in psychology, and for Latinas in particular. She was a leader at the Dulles Conference that established the foundation for so many of the ethnic/racial minority programs, organizations we are involved in today. She was always tough-minded, but equally tender-hearted. She was
creative as a scientist, administrator,
teacher and advocate, and
compassionate as a friend and
colleague. Martha was a giant in our
field, a first among many, and a
gift to us all. I was privileged to
count her as a friend, and I will
miss her.
When I first met Dr. Bernal at a
California symposium on Chicano
psychology, I was a graduate student. My
peers and I were enthralled to see her—we
could not believe that she was only five feet
tall! Yet, she stood very tall to many of us.
She was such an important symbol of
success, achievement, persistence, and
spunkiness. She could push and challenge
us. She could be tender, gentle and
supportive. She was a treasure.People assumed that I was one of her
students. I never was. She was willing to be
a “situational mentor” at times, serving as
Chair of Symposia at APA, and otherwiseproviding consultation for variousprofessional situations. She directly and
indirectly provided guidance and
inspiration to a wide range and number ofpsychologists of color, men and women.Those who knew her perceived her as an
exceptional and phenomenal woman. She
blazed a trail that allowed many of us to behere.
I realize with relief that I had a couple of
Texas Psychologist 27WINTER 2003
opportunities to honor Dr. Bernal beforeshe died. Steve Lopez and I organized hernomination for a major APA award the yearbefore she died, and she was awarded thehonor! That is partly the reason that he andI worked together to publish her obituaryin the American Psychologist; we had thematerial and the emotional motivation. Inaddition, the National Latino PsychologyConference held in San Antonio in 2000was in her honor, and as a keynote speaker,I focused much of the talk on her and herwork (Vasquez, 2000). All of this wasbefore we knew she was ill. At APA inChicago 2002, my talk for an award whichI received was also in her honor (Vasquez,2002). A version of that talk is published in
the American Psychologist. This realization
leads me to underscore what we know:
demonstrating care before and after the
death of someone helps the grief process.
She knew we cared about and honored her.
In 1999, the first National Multicultural
Conference and Summit was held in
Newport Beach, California. Four
psychologists of color, including myself,
devoted our APA divisional presidential
year to cohosting this conference. One of
my projects was a panel, “Honoring Senior
Women of Color.” Reiko True, Carolyn
Payton, Martha Bernal, and Carolyn
Attneave (posthumously) were honored and
asked to speak about their experiences with
racism and sexism (Sue, Bingham, Porche-
Burke & Vasquez, 1999). It was a powerful,
funny, poignant and unforgettable event!Three of the four pioneer women of colorhonored at the first National Multicultural
Conference and Summit in 1998 have now
died, meaning that the numerousprofessionals whom they mentored haveexperienced a significant loss of mentors.
Consequently, women of color who are
developmentally, professionally andchronologically at midlife may be findingthemselves the “senior” mentors available to
graduate students and young professionals.
This position can be terrifying as well as anhonor. Most of us do not feel ready to be inthe role in which we find ourselves.
Developmental models describe transitionperiods as both a challenge and anopportunity. Challenges include theexpectations and requests from varioussources, which can be overwhelming. Stressmanagement models seem inadequatewhen I find myself with requests from somany graduate students and youngprofessionals. Even those of us not inacademia get called upon to review thecredentials of young multiculturalprofessionals up for tenure, to beinterviewed by students for a class onmulticulturalism, to give talks atuniversities for programs attempting toprovide multicultural psychologists rolemodels, etc. Setting boundaries and
providing referrals to colleagues are of
course important strategies, but every time
I do so, I am aware of the missed
opportunity to provide someone with the
experiences that I so treasured from others.
Yet the opportunity to give in these ways
also provides meaning to my professional
life and allows me to experience the basic
need to make contributions and to be
productive.
According to Gelso and Lent (2000) in
their chapter on research in the Handbookon Counseling Psychology, research on
mentoring relationships underscores the
major importance of this relationship in the
professional’s life. Professionals who
recollect their graduate school experience
comment on the centrality of the
relationships and the negative impact oflack of mentoring. Despite the research thatis out there, there is now no formal theory
of the mentoring relationship, although
informal observations such as mine exist.This is an area of inquiry in its early stages.However, I hope that theory development
includes the aspects of the transition from
student to mentor, and the losses, gains andchallenges involved in that process.
ConclusionThe challenges at midlife include
various kinds of losses, the literal loss ofparents and mentors, changes in roles, and
increased risk of health and bodily achesand pains! Loss changes every relationshipin our lives. Each of these relationships andtheir impact must be examined andrenegotiated at a time when emotions andexperiences are askew and structure seemsto be missing. These challenges, however,are also opportunities for life-enhancingtransformation. Indeed, the pain of lossmay be conceptualized as simply a part ofthe process of developmental trans-formation. Midlife is a time when we are allstruggling with losses, but these changes arewell balanced by the positive and dynamicincreases in freedom and self-definition.This paper identifies ways to transform andbenefit from the challenges of loss, and
enjoy the opportunity for increased
contribution, productivity, and a sense of
well-being. Our profession as well as our
society must that emphasize and appreciate
this perspective.
ReferencesBaker, J. (2001). Mourning and the
transformation of object relationships.
Psychoanalytic Psychology, 18, 55-73.
Bart, P. B. (1971). Depression in
middle-aged women. In V. G. Gornick &
B. K. Moran (Eds), Women in sexist society.New York: Basic Books.
Bartocci, B. (2000). Nobody’s childanymore. IN: Sorin Books.
Bazzini, D. G., McIntosh, W., Smith, S.,
Cook, S., & Harris, C. (1997). The aging
woman in popular film: Underrepresented,unattractive, unfriendly, and unintelligent.Sex Roles, 36, 531-543.
Bee, H. (1996). The journey ofadulthood. Upper Saddle River, NJ: PrenticeHall.
Bernal, M. E. & Castro, F. G. (1994).
Are clinical psychologists prepared for
service and research with ethnic minorities?Report of a decade of progress. AmericanPsychologist, 49, 797-805.
Bernal, M. E. & Padilla, A. M. (1982).
Status of minority curricula and training inclinical psychology. American Psychologist,37, 780-787.
✯
28 Texas Psychologist WINTER 2003
Brown, J. K., & Kerns, V. (Eds.) (1985).In her prime: A new view of middle-agedwomen. South Hadley, MA: Bergin &Garvey.
Combs, G. & Friedman, J. (1999).Symbol, story, & ceremony. NY: Norton.
Davenport, D.S. (2002). Singing motherhome: A psychologist’s journey throughanticipatory grief. Denton: UNT Press.
Davenport, D.S. (1999). Dynamics andtreatment of middle-generation women. InM. Duffy, Ed. Handbook of counseling andpsychotherapy with older adults. NY: JohnWiley.
Denmark & M. A. Paludi (Eds.),Psychology of women: A handbook of issuesand theories. Westport, CT: Greenwood
Press.
Deutsch, F. M., Zalenski, C. M., &
Clark, M. E. (1986). Is there a double
standard of aging? Journal of Applied SocialPsychology, 16, 771-785.
Donnelly, K (2000). Recovering from
the loss of a parent. NE: iUniverse.
Erikson, Erik. (1968). Identity: Youthand Crisis. New York: W. W. Norton & Co.
Etaugh, C. (1993). Psychology of
women: Middle and older adulthood. In F.
L. Denmark & M. A. Paludi (Eds.),
Psychology of women: A handbook of issuesand theories. Westport, CT: Greenwood
Press.
Fodor, I. G., & Franks, V. (1990).
Women in midlife and beyond: The new
prime of life. Psychology of Women Quarterly,14, 445-450.
Francis, D., Kellaher, L. & Lee, C.(1997). Talking to people in cemeteries.
Journal of the Institute of Burial andCremation Administration, 65, 14-25.
Freud, S. (1917/1957). Mourning andmelancholia. In J. Strachey (Ed.), Thestandard edition of the complete works ofSigmund Freud, 14. London: Hogarth.
Friedan, B. (1993). The fountain of age.New York: Simon & Schuster.
Gerkin, Charles V. (1989). CrisisExperience in Modern Life :Theory andtheology for pastoral care. CA: Abigon Press.
Grambs, J. D. (1989). Women over forty:
Visions and realities, (rev. ed.). New York:Springer.
Hyde, J. S., Krajnik, M., & Skuldt-Niederberger, K. (1991). Androgyny acrossthe life span: A replication and longitudinalfollow-up. Developmental Psychology, 27,516-519.
Jackson, J. S., Chatters, L. M., & Taylor,R. J. (Eds) (1993). Aging in Black America.Newbury Park, CA: Sage.
Jones, J. (2001, December 2). Personalcommunication.
Klass, D. & Walter, T. (2001). Process ofgrieving: How bonds are continued. InStroebe, M.S., Hansson, R.O., Stroebe, W.,& Schut, H. (Eds.), Handbook ofbereavement research. Washington D.C.:
American Psychological Association.
Kuebler-Ross, E. (1969). On Death andDying: What the dying have to teach doctors,nurses, clergy and their own families. N.Y.,
N.Y.: Macmillan
Levy, A. (2001). The orphaned adult.NY: Perseus.
Marwit, S.J. & Klass, D. (1995). Grief
and the role of the inner representation of
the deceased. Omega, 30, 283-298.
Matlin, M. W. (1993). The psychology ofwomen. Fort Worth, TX: Harcourt Brace
Jovanovich.
Mitchell, V., & Helson, R. (1990).
Women’s prime of life: Is it the 50s?
Psychology of Women Quarterly, 14, 451-
470.
Myers, E. (1997). When parents die. NJ:Penguin Putnam.
Neugarten, B. L. (Ed.). (1968). Middleage and aging: A reader in social psychology.Chicago: University of Chicago Press.
Quintana, S. M. & Bernal, M. E.(1995). Ethnic minority training in
counseling psycology: Comparisons with
clinical psychology and proposed standards.The Counseling Psychologist. 23, 102-121.
Rees, W.D. (1997). Death andbereavement. London: Whurr.
Rubin, L. (1979). Women of a certainage. New York: Harper & Row.
Sontag, S. (1979). The double standard
of aging. In J. H. Williams (Ed.), Psychology
of women: Selected readings (pp. 462-478).New York: Norton.
Sue, D. W., Bingham, Rosie P., Porche-Burke, L., Vasquez, M. J. T. (1999). TheDiversification of Psychology: AMulticultural Revolution. Report of theNational Multicultural Conference andSummit. American Psychologist. 54, 1061-1069.
Thomas, Peter G. and Sharp, Robbie N.(2001). Grief Recovery Course. Unpublishedmanuscript.
U. S. Bureau of the Census (1993).Statistical abstract of the United States: 1993.Washington, DC: U.S. GovernmentPrinting Office.
Vasquez, M. J. T. (2000, November).
The Amazing Challenges and
Achievements of Latino Psychologists: A
Tribute to Martha Bernal, PhD Invited
Keynote Address presented at the
Conference, Latino Psychology 2000:
Bridging Our Diversity. San Antonio,
Texas.
Vasquez, M. J. T. (2002). Complexities
of the Latina Experience: A tribute to
Martha Bernal. American Psychologist, 57,
878-888.
Worell, J. & Johnson, N. G. (1997).
Introduction: Creating the future: Process
and promise in feminist practice. In J.
Worell and N. G. Johnson (eds.). Shapingthe future of feminist Psychology: Education,research and practice. Washington, D. C.:
American Psychological Association. Pp 1-
14.
Texas Psychologist 29WINTER 2003
Ramona Aarsvold PhD Marcia Abbott PhD Marianna Adler PhD Joan Anderson PhD
Carolyn Anderson PhD Judith Norwood Andrews PhDLarry Aniol PhD Richard Austin, Jr. PhD Laurie Baldwin PhD Eileen Barbella PhD Elizabeth Barry PhD Patricia Barth PhD Deborah Barton PhD Julie Bates PhD James L. Baxter MA Karen Belter PhD Robert Blake PhD Bonnie Blankmeyer PhD Deborah Boelter PhD Hautina Bollinger PhD Rosie Bostick PhD Joy Breckenridge PhD Bonnie Brookshire PhD Stacy Broun PhD J. Martin Brown PhD Timothy Brown PhD Joan Bruchas PhD Erica Burden PhD Robin Burks PhD Roger Burns PhD Mary Burnside PhD Sam Buser PhD Kay Campbell PsyD Bob L. Carpenter Ralph Casazza PhD Joseph M. Casciani
Mercy Chieza PsyD Gloria Chriss PhD Antoinette R. Cicerello PhDPauline Clansy EdD Donna Copeland PhD Carol Cossum EdD Ray Coxe PhD Harold Crasilneck PhD Rosalie Cripps PhD Maria Concepcion Cruz PhDWalter Cubberly PhD Jack Deines PhD Anitra DeMoss PhD Alexandria H. Doyle PhDPatricia Driskill PhD Michael Duffy PhD, ABPPMelody A. Dunbar MS Dianne Dunn PsyD Ann L. Dunnewold PhD
Richard E. Eckert PhD Anette T. Edens PhD Richard R. Eiles PhD Virginia (Ginger) Enrico PhDRichard Ermalinski PhD Robert Federman EdD
Stephen E. Finn PhD Alan T. Fisher PhD Joseph E. Fogle PhD Duncan L. Forest PhD Edward Framer PhD Eric Frey PhD Lois C. Friedman PhD Shirley Friedman EdD Lois C. Friedman PhD Cheryl Fuller PhD Marsha T. Gabriel PhD Ronald Garber PhD Lauren M. Gaspar Michael Gaubatz Michael R. Ghormley BS Martin Gieda PhD Penny M. Goffman PhD Rolf W. Gordhamer PhD Addison Gradel EdD Melissa Graham MEd
Dennis Grill PhD Pamela B. Grossman PhD Carol A. Grothues PhD Gerald (Jerry) Grubbs EdD, MSCP William B. Gumm PhD Ranee B. Gumm PhD Michele Guzmßn PhD Cheryl L. Hall PhD Lester E. Harrell PhD Michelle T. Hart PhD Sophia K. Havasy PhD Marian H. Higgins PhD Robin Hilsabeck PhD Clifford L. Hirsch PhD Tamara Hodges C. Alan Hopewell PhD David Hopkinson PhD Melanie L. Horn PhD Sandra L. Hotz PhD Donna Hughes PhD Cheryl F. Hughes PhD Mary A. Gordon Hurd PhD Adele H. Hurst PhD C. Robert Ingram Daniel W. Jackson PhD Linda J. Jackson PhD A. Jack Jernigan PhD Thomas Johnson A. Michael Johnson PhD
William Jones PhD Krista D. Jordan PhD Frances H. Kimbrough PhDBurton A. Kittay PhD Christopher L. Klaas PhD Joseph C. Kobos PhD Kenneth Kopel PhD Bruce Kruger PhD Richard P. Krummel PhD Tom Kubiszyn PhD Angela Ladogana PhD John W. Largen PhD Sarah Lederer Snow Mark Lehman PhD Bert D. Levine PhD Franklin D. Lewis PhD Mary A. Little PhD David S. Litton PhD
Daniel L. Logan PhD Dwayne D. Marrott PhD Xavier Martinez PhD Lynn M. Matherne PhD Patricia McBride-Houtz PhDJames C. McCabe PhD Donald C. McCann PhD David G. McCarley PhD Joyzelle H. McCreary PhD
Robert F. Mehl PhD Muriel Meicler PhD Maritza Milan PhD Robert W. Moats PhD William Montgomery PhD Leon Morris EdD Gary Neal PhD Naomi D. Nelson PhD Walter Newsom PhD Norma Ngo PsyD Christopher G. NikolaidisMargaret P. Norris PhD Gina R. Novellino PhD Roberta L. Nutt PhD Frank D. Ohler PhD George Parker PhD Carole G. Pentony PhD Harold Perry PhD P. Caren Phelan PhD Kim Praderas PhD John Price PhD
Lynn Aikin Price PhD Jayne M. Raquepaw PhD Karen Rasile PhD John K. Reid PhD Herbert Reynolds PhD Elizabeth L. Richeson PhD Dan Roberts PhD
Richard Rogers PhD Olga Ruiz de Arana EdD Earl S. Saltzman PhD Barbara Sanford PhD Gordon C. Sauer, Jr. PhD John Savell PhD Lawrence Schneider PhD R. Gaston Scott EdD John Sell PhD Cristina Serrano PhD Verlis L. Setne PhD Theresa Sharpe PhD Huntly Shelton PhD Jeffrey C. Siegel PhD Tana Slay PhD W. Truett Smith PhD Nanette Stephens PhD Jana Swart PhD Arthur R. Tarbox PhD Daniel J. Thompson PhD Thomas J. Tully EdD Dana B. Turnbull M.A. Thomas A. Van Hoose PhD Nancy D. Van Morkhoven Dr PHJessica Varnado PhD Melba J. T. Vasquez PhD Laurel Bass Wagner PhD Belinda Walker PhD Michael Walker EdD David J. Welsh PhD Joan Weltzien EdD
Peggy Wheaton PhD Thomas L. Whiddon MS Jim C. Whitley EdD Christina Williams PhD Alison Wilson PhD Nancy E. Wilson PhD James R. Womack PhD Murray E. Worsham PhD Mimi Wright PhD Jarvis A. Wright, Jr. PhD
Sara Young PsyD Robert Zachary PhD Carol Zuccone EdD Burton J. Zung PhD
Sunrise Fund Contributors
30 Texas Psychologist WINTER 2003
Doctoral MembersSheryl Gordon Beatty, PhDJoan Biever, PhDKier Bison, PhDWilliam Brown, PhDLyle Cadenhead, PhDMimi Cotellesse, PhDMary Damkroger, PhDJosephine De Los Santos, PhDSid Dickson, PhDMarie-Elise DuBuisson, PhDPhilip Dunbar, PhDKelly Goodness, PhDHenry Hanna, PhDMargaret Jordan, PhDJon Lasser, PhDLisa Lind, PhDAlice Lottes, PhD
Gloria Miller, PsyDMonte Miller, PsyDFrankie Paulson-Lee, PhDJoellen Peters, PhDAdam Saenz, PhDCharles Scherzer, PhDTheresa Sharpe, PhDSonia Simon, PsyDGregroy Simonsen, PhDVictoria Sloan, PhD
Associate MembersManuel Dominguez, MADana Truman-Schram, MAStephanie Tong, MA
StudentsDaniel Altman, MS
Trisha Bement, MSCatherine Callender, MS, MEdLisa Cepeda, BARachel ChaunceyMelissa Graham, MEdMelenie Hohensee, MEdWilliam Jarrold, MAMarie Lamothe-Francois, BAJulie Maggard, BAIvana RadovancevicNora Resendez, BAJack Tsan, BASusana Verdinelli, MEdAlicia Valle, BSKenneth Whitton, Jr.Mickie Wong
New MembersThe following individuals joined TPA between June 26, 2003 and August 20, 2003.
TPA welcomes all of our new members.
PSY-PAC UPDATE
J. Paul Burney, PhD
I want to personally thank all TPAmembers who have contributed to PSY-PACthis year, our PSY-PAC Board of Directors,and Dr. Ron Cohorn, PSY-PAC PastPresident, for his advice, insight, andwisdom.
PSY-PAC had an excellent year in spite ofthe Texas and national economy. FromJanuary to August of 2002, 95 PSY-PACmembers donated $29,085.29, including
funds for RxP. During the same period this
year; 204 PSY-PAC members contributed
$35,583.13, including RxP. This represents
a 22 percent increase of $6,497.84 in
donations and a 115 percent increase of 109
additional members. In January throughAugust of 2002, we received 12 donations of$1000, one donation of $2000, and onedonation of $4000. For the same timeperiod this year, we also received sixdonations of $1000.
The year 2004 will be an important yearfor TPA and PSY-PAC as we beginpreparation for the 2005 Sunset Review ofour Psychology License and Practice Act.
We will need to be present at legislative
events, fundraisers, and receptions to
educate our legislators about the importance
of psychology as a profession and the
benefits we provide to society.
TPA’s legislative success requires effectivegrassroots activism, personal contact withlegislators, solid lobbying, and generousfinancial contributions. If you are notcurrently a member of PSY-PAC, take theopportunity to join and contribute at TPA’sAnnual Convention in Dallas on November6-8. PSY-PAC’s Annual Board Meeting willbe 8 a.m. - 9 a.m., Saturday, November 8and all members are encouraged to attend.
All members who have contributed $100 or
more are eligible to vote on all PSY-PAC
matters. Thank you for your current and
continued support and for making this a
very successful PSY-PAC year.
Texas Psychologist 31WINTER 2003
$2000
Edward Davidson, PhD
$1,000 - $1,999
Walter Bordages, PhD
Tim Branaman, PhD
Paul Burney, PhD
Cheryl Hall, PhD
Ethel Hetrick, PhD
Alan Hopewell, PhD
Kenneth Huff, PhD
James Quinn, PhD
Deanna Yates, PhD
$500 - $999
Frankie Clark, PhD.
Richard Fulbright, PhD
Morton Katz, PhD
Lane Ogden, PhD
Dean Paret, PhD
Mimi Wright, PhD
$100 - $499
Barbara Abrams, EdD
Laurence Abrams, PhD
Joan Anderson, PhD
Kyle Babick, PhD
Elizabeth Barry, PhD
Patricia Barth, PhD
Barbara Beckham, PhD
Connie Benfield, PhD, ABPP
Joan Berger, PhD
Lee Berryman-Tedman, PhD
Malcom Bonnheim, PhD
Peggy Bradley, PhD
Ray Brown, PhD
Bradford Brunson, PhD
Erica Burden, PhD
Robin Burks, PhD
Lyle Cadenhead, PhD
Linda Calvert, PhD
Elaine Calaway, PhD
Paul Chafetz, PhD
Gloria Chriss, PhD
Pauline Clansy, EdD
Karen Claridge, PhD
Ron Cohorn, PhD
Maria Concepcion Cruz, PhD
Sean Connolly, PhD
Raye Coxe, PhD
Jim Cox, PhD
Robert Cross, PhD
Walter Cubberly, PhD
Caryl Dalton, PhD
Patricia Driskill, PhD
Michael Duffy, PhD, ABPP
Annette Edens, PhD
Wayne Ehrisman, PhD
Raymon Finn, PhD
Alan Fisher, PhD
Joseph Fogle, PhD
Ann Friedman, PhD
Michael Gottlieb, PhD
Steven Gray, PhD
Susan Gifford, PhD
Jerry Grammer, PhD
Chuck Gray, PhD
Josue Gonzalez, PhD
T. Walter Harrell, PhD
Charles Haskovec, PhD
Sophia Havasy, PhD
Swen Helge, PhD
Scott Hickey, PhD
David Hopkinson, PhD
Robert Hughes, PhD
Sheila Jenkins, PhD
Kevin Jones, PhD
Charles Keller, PhD
Burton Kittay, PhD
Christopher Klaas, PhD
Harry Klinefelter, III, PhD
Kenneth Kopel, PhD
Angela Ladogana, PhD
Mark Lehman, PhD
Nancy Leslie, PhD
Alaire Lowry, PhD
Tom Lowry, PhD
Janna Magee, PhD
Patricia Martinez, EdD
Xavier Martinez, PhD
Donald McCann, PhD
Glen McClure, PhD
Joseph McCoy, PhD
Jerry McGill, PhD
Richard McGraw, PhD
Robert McKenzie, PhD
Robert McLaughlin, PhD
Robert Mehl, PhD
Muriel Meicler, PhD
James Meredith, PhD
Brad Michael, PhD
Charles Middleton, PhD
Robert Mims, PhD
Lee Morrisson, PhD
Leon Morris, EdD
Suzanne-Mouton-Odom, PhD
Joanne Murphey, PhD
Frank Ohler, PhD
Michael Pelfrey, PhD
Laurence Perotti, PhD
Sally Porter, EdD
Shelly Probber, PsyD
Walter Quijano, PhD
Lynn Rehm, PhD
John Reid, PhD
Elizabeth Richeson, PhD
Laurie Robinson, PsyD
Leigh Scott, PhD
Robbie Sharp, PhD
Jev Sikes, PhD
Laura Spiller, PhD
Nannete Stephens, PhD
Alan Stephenson, PhD
Thomas Van Hoose, PhD
Mark Voeller, PhD
David Wachtel, PhD
Michael Walker, PhD
David Welsh, PhD
Joan Weltzien, EdD
Richard Wheatley, PhD
Michael Whitley, PhD
M. Wright Williams, PhD
Shirely Willis, PhD
Connie Wilson, PhD
James Womack, PhD
Eirene Wong-Liang, PhD
Kathryn Wortz, PhD
John Worsham, PhD
Jarvis Wright, PhD
Under $100
Elizabeth Abbott, PhD
Lynn Aiken Price, PhD
Bruce Allen, PhD
Martin Ancona
Carolyn Anderson, PhD
Karen Belter, PhD
Karen Berkowitz, PhD
Ronald Boney, PhD
Bonnie Brookshire, PhD
Stacy Broun, PhD
Timothy Brown, PhD
Amos Bruce, PhD
Sam Buser, PhD
L.Carol Butler, PsyD
Jane Carr, MA
Ralph Casazza, PhD
Terri Chadwick, PhD
C. Munro Cullum, PhD
Kenneth Cyr, PhD
Dana Davies, PhD
Sally Davis, PhD
Sharon Davis, PhD
John Deines, PhD
Alfred Dooley, EdD
Alexandria Doyle, PhD
Jean Ehrenberg, PhD
William Erwin, PhD
George Faibish, PhD
Elizabeth Fowler, EdD
Alan Frol, PhD
Adrienne (Ann) Gardner, PhD
Sylvia Gearing, PhD
Jayne Gordon, PhD
Lois Graham, PhD
Pamela Grossman, PhD
Carol Grothues, PhD
Barbara Hall, PhD
Jo Beth Hawkins, PhD
Annette Helmcamp, PhD
David Hensley, PhD
Victor Hirsch, PhD
Carola Hundrich-Souris, PhD
Adele Hurst, PhD
Sarah Kramer, PhD
Richard Krummell, PhD
Wanda Kuehr, PsyD
Betty Lanier, EdD
Rebecca LeBlanc, PhD
Rochelle Levit, PhD
Stephen Loughhead, PhD
Marilyn Maas, PhD
Patricia Mahlstedt, EdD
Dwayne Marrot, PhD
Charles McDonald, PhD
Stuart Nathan, PhD
Dorothy Pettigrew, PsyD
Aurelio Prifitera, PhD
Janet Rexroad, EdD
Harriet T. Schultz, PhD
Norman Shulman, EdD
Gregory Simonsen, PhD
Jana Swart, PhD
Thomas Tully, EdD
Patricia Weger, PhD
Mark Wernick, PhD
Deborah Gleaves, PhD
Alison Wilson, PhD
2003 PSY-PAC ContributorsApril 1, 2003 – June 25, 2003
32 Texas Psychologist
WINTER 2003
@Does TPA have your e-mail address?If not, you could be missing out on
important announcements about
upcoming CE opportunities and
numerous other important updates.
If you have not been receiving
announcements from us via e-mail,
then we don’t have your current
address. To have your e-mail address
added, send your updated address to
E-mail Updates
Training Workshops
Contact the Special EducationAssessment Specialist at your Regional
Service Center to register or for more information.
A workshop fee may be charged at some centers.
ESC Region 1 Edinburg 10-Nov 11-NovESC Region 2 Corpus Christi 18-NovESC Region 3 Victoria 4-Sep 1-OctESC Region 4 Houston 9-Dec 15-Jan 4-Mar 3-JunESC Region 5 Silsbee 10-DecESC Region 6 Huntsville 23-OctESC Region 7 Kilgore 30-OctESC Region 8 Mt. Pleasant 5-DecESC Region 9 Wichita Falls 2-DecESC Region 10 Richardson 25-Sep 26-Sep 3-Nov 4-NovESC Region 11 Fort Worth 23-Sep 28-OctESC Region 12 Waco 20-OctESC Region 13 Austin 17-Sep 17-Oct 27-OctESC Region 14 Abilene 21-OctESC Region 15 San Angelo 15-SepESC Region 16 Amarillo 21-AugESC Region 17 Lubbock 8-SepESC Region 20 San Antonio 30-Sep 14-Oct
presented by Dr. Donna SmithThe Psychological Corporation
Child therapy toys, games, books, My First Therapy Game.
www.childtherapytoys.com.
Austin group looking for a colleague!
Come join an existing group of solo practitioners each with a
minimum of 10 years in private practice. Very nice office in central
Austin with support staff. Pleasant atmosphere with well-
established professionals. This is a wonderful opportunity to
establish or expand a practice in Austin with the possibility for
immediate referrals. (512) 454-3685.
Psychologist. Expanding interdisciplinary private group practice
seeks a Texas licensed Psychologist, must have experience in working
with children school age to adolescents. Located in a prominent part
of Houston, the office has a very attractive setting. Very little
managed care/emergency work. Forward resumes by fax to
713.621.7015. www.tarnowcenter.com.
NeuroPsychologist. Expanding interdisciplinary private group
practice seeks a Texas licensed NeuroPsychologist, must have
experience in working with children school age to adolescents.
Located in a prominent part of Houston, the office has a very
attractive setting. Very little managed care/emergency work.
Forward resumes by fax to 713.621.7015. www.tarnowcenter.com.
PSYCHOLOGISTS needed P/T (weekdays—at least 6-8 hours per
week) to do assessment and treatment in nursing homes. We have
400 contracted facilities in Texas we serve, throughout the state.
Visit our web site: www.vericare.com. Please send your C.V./resume
to Vericare (Formerly Senior Psych Services): Email:
[email protected], FAX: (800) 503-3842, PHONE: (800) 508-
5151.
CLASSIFIEDS
American Professional Agency inside front cover
CE-credit.com 3
Center for Anger Resolution 6
EMDR 17
Hazelden 25
K-MED 17
Professional EDU, LLC 32
The Psychological Corporation 32
ProfessionalCharges.com 19
Remuda Ranch 8
Rockport Insurance Associates 5
Senior Connections, Inc. 17
Systems-Centered Training 33
Therapist Helper / Vantage 20
ADVERTISERS INDEX
Texas Psychologist 33WINTER 2003
Systems-Centered� Training: January, 2004 Austin Workshops
An innovative method for:Group and Individual TherapyCouples and Family Therapy
Organizational Change
Learn about Systems-Centered® methods for change: participate inthe weekend Foundational and Intermediate training workshop onJanuary 23-25, and/or attend the SCT® OrganizationalDevelopment training on January 26-27. Developed by Yvonne M.Agazarian, Systems-Centered� Training (SCT) is a method thatreduces unproductive and defensive patterns blocking the inherentdriving forces in human systems toward healthy change.Defensive and unproductive patterns are modified in a systematicorder. Learning to undo defenses at one level provides afoundation set of skills for undoing defenses at the next level.Modifying the defenses reduces the symptoms that people entertherapy to manage (anxiety, tension, depression and hostile actingout) and increases the capacity to use one’s emotional andcognitive intelligence. Undoing unproductive patterns inorganizations, allows the organization to direct its energy towardsproductive work and toward the goal for which the organizationwas developed.
For information contact Rich Armington at (512) 306-0166.
SCT�, Systems-Centered� and Systems-CenteredTherapy� are registered trademarks of
Dr. Yvonne M. Agazarian and the SystemsCentered Training & Research Institute.
For more information, call
888.872.3435512.280.4099
or visit www.texaspsyc.org.
TEXAS PSYCHOLOGICALASSOCIATION
2003 ANNUAL CONVENTION
NOVEMBER 6 - 8DALLAS, TEXAS
THE WESTIN GALLERIA