This March I was a first-time attendee at the Practice Leadership Conference (PLC). It was a fantastic opportunity to connect with other psychologists interested in advancing the practice of psychology. The PLC is full of forward-thinkers who have an eye toward advocacy, with an aim to equip all psychologists with the tools and the courage to advocate for themselves and the profession at large.
As a psychologist employed in a primary care setting, I naturally gravitated toward the talks and workshops related to the practice of health psychology. With that said, I also went in with my group and systems hat on, and believe that the following summary is relevant to all members of our division.
Advancing Practice Together
The theme of this year’s PLC was “Advancing Practice Together.” This has been a major focus of Dr. Arthur Evans since he became the CEO of APA, urging us as members to think more broadly about our value as psychologists, and to continually assert this value as the practice landscape continues to evolve in turn. In an introductory workshop Dr. Evans stated that we can no longer define ourselves as only psychotherapists if we desire to advance the discipline. Rather, we must clearly define the unique contributions that practicing psychologists make to healthcare, and to focus on the skills we can bring to many different settings.
Dr. Evans listed three areas unique to psychologists which we can better leverage: 1) training as scientist practitioners, 2) conceptualizations of problems, and 3) the ability to develop expertise in a wide range of specialty areas. Dr. Evans contends that making these areas more visible to other professionals in the settings in which we now and will yet work will prepare us to adapt well to current and future healthcare trends. Psychologists in the future will find themselves increasingly accountable for the results produced by interventions, and will be called upon in innovative ways to serve the private and public sector alike. Will we be ready to step in?
Improving the Leadership Group
Another theme that permeated the Practice Leadership Conference, as the name suggests, was leadership, be it in our practice settings, our state associations or divisions, and in our communities. The mood of the conference was one toward psychologists taking the lead in forsaking isolationism in these settings, broadening and deepening collaboration with a range of organizations and professionals outside the discipline. For example, APA currently has worked with the American Diabetes Association to create a clinician education program with the effort of training psychologists to help diabetes in behavior change. It was noted that the rate of depression in individuals with diabetes is twice that of the normal population.
The PLC also encouraged better leadership of our various boards. One speaker, Eloiza Altoro, spoke extensively on this topic. Ms. Altoro is an organizational consultant with a clinical psychology background. She emphasized that high-functioning boards find the “sweet spot” where personal purpose, organizational purpose, and role purpose converge. Successful boards are team-oriented and transparent, and are as flexible as they are formal. On the other hand, relationships in boards (and of course, groups!) break down when there is a lack of trust, misinformation, and lack of strategic direction. Another symptom of poorly-functioning boards is constant turnover.
The attendees at PLC were also encouraged to become leaders in their communities. This was communicated most clearly by Dr. Jessica Henderson Daniel, new president of APA. A main pillar of her presidential term is the “citizen psychologist” initiative, which aims to encourage psychologists to be more active in community settings, and to recognize psychologists who are already highly involved at home. She publicly recognized two such psychologists during a town hall meeting, and reports excitement to honor more.
Advocacy and Activism
The final theme at the PLC was advocacy. This was culminated the final day of the conference with visits to Capitol Hill. Tagging along with the delegation from my home state of California, I had the opportunity to go to the offices of three different California representatives to advocate for causes important to the practice of psychology. This included asking for co-sponsorship of the Medicare Mental Health Access Act, advocating for maintenance and expansion of Medicaid, and advocating for understanding of gun violence as a multifaceted phenomenon.
While it was indeed exciting to participate in his political process, perhaps the most moving piece of advocacy came during the above-mentioned town hall meeting. The first speakers to get up were the delegates from APAGS, APA’s graduate student group. They called for greater diversity and inclusion, and were quite courageous in communicating the ways in which they felt that they had been marginalized throughout the proceedings.
As leaders in group psychology and group psychotherapy, I believe it is incumbent upon the division to continue to have a voice and a presence at this conference. Perhaps it could take the form of leading an intergroup dialogue, or a workshop to help psychologists gain a better understanding of group leadership. Or, in the spirit of advocacy, having a voice to communicate to leaders in the field the importance of understanding the complexities of group treatment in an ever-changing healthcare system. Furthermore, advocating for furthering research in group psychology and group psychotherapy also has a place at the proceedings, as there’s a definite focus on enhancing the productivity, collaboration, and overall success of the professional groups in which we regularly are found. In short, the PLC needs experts in group! And notwithstanding this need for more group expertise, the PLC is also a great conference for anyone generally interested in leadership, advocacy, or in advancing the practice of psychology.
For questions or more information on the PLC, please contact Sean Woodland, PhD at firstname.lastname@example.org.
CAPP Liaison Report
Notes from the open session of the Committee for the Advancement of Professional Practice (CAPP)
Sean Woodland, PhD
I am excited in 2018 to begin my role as Division 49’s CAPP liaison, as well as the Federal Advocacy Coordinator (FAC). My first formal duty under this role was to attend the open session of the CAPP Meeting on February 2-3. Below are some highlights from this meeting.
Day 1 Highlights
Friday morning started off strong with an address from Arthur Evans, PhD, CEO of APA. His objective was to communicate his strategy for “modernizing” APA, along with some specific changes that will be coming soon. Dr. Evans’ strategy is heavily influences by the idea of “transformational change”; that is, change that will better equip APA for the future landscape of the profession in ways that we’ve never seen before. Included is a new membership model in which members will automatically gain access to both APA and its non-profit arm. A moratorium will be placed on member dues for first three years after implementation. This new model is designed to increase capacity for advocacy for both science and practice.
The afternoon also had a flavor of advocacy and change, including discussions on the upcoming Practice Leadership Conference (PLC), and an update on government relations. The PLC will take place March 10-13, 2018. The theme this year is “Advancing Practice Together.” Invited to the PLC each year are state association leadership and designees, as well as division designees. I will be attending PLC this year and will provide a full report for the next newsletter.
Friday’s government relations discussion focused on the efforts that the Political Action Committee (PAC) has been making to further the purposes of psychologists. In the last year the PAC has been focused on lobbying for many causes, most notably preserving the Affordable Care Act. PAC spending in 2017 was equally divided between political parties.
Day 2 Highlights
Saturday morning included a lively discussion on “the Master’s Issue.” For decades graduates of psychology Master’s degrees have been left with an unsure path moving forward for practicing independently. The urgency on this issue has been accelerated because CACREP (the accrediting body for Master’s counseling and specialty programs) has begun to systematically bar psychology Master’s graduates from taking licensing exams. The CAPP views maintaining the status quo on the Master’s Issue no longer an option, and would like to pursue action soon. The key issues include titles, scope of practice, supervised vs. independent practice, and accreditation.
The remainder of Day 2 was highlighted by technology advances and changes in psychology. These include HipaaSmart and PsyPact; HipaaSmart is a new “one-stop shop” for education/information on
privacy, security, and breach notification. PsyPact is the name for policy being put forth across states that will allow for temporary telehealth services from one state to the next. There was also discussion of the EPPP2, which will include an additional examination germane to the independent practice of psychology. Passage of the original EPPP (general knowledge of psychology) will be a prerequisite for taking the second part, but it is planned that students will be able to take the first half earlier than is currently specified. These changes are planned to take effect in January 2020.
There was much more discussed during the two-day open session that could not be included in this summary. Those interested in learning more may email Sean Woodland, PhD at email@example.com.
Recently, a colleague and fellow ECP asked me to help her solve a problem with one of her groups. She is a psychological assistant in an intensive outpatient program for a local hospital. She noticed that in her new Distress Tolerance class patients were quite disengaged with instruction, often preferring side conversation. Relatively new to group treatments, my colleague was left confused and discouraged for future groups. I am grateful that that through my experience teaching, researching, and associating with Division 49 I was able to set her aright. In our exchange I was reminded of previous publications from Division 49 members (Brown, 2011; Burlingame & Woodland, 2013) regarding conducting psychoeducational groups (PEGs). Drawing on their writings and on personal experience thus far, here are a few simple guidelines to follow for any ECP new to PEGs.
Set the Tone
As with any therapeutic encounter, it is important to be prepared. In PEGs this means having a well-defined lesson plan. This is manifest through study and preparation of the material, as well as clearly communicating group rules and norms once the class has begun. This is especially vital in class-oriented groups in which enrollment is open-ended. One rule of thumb that has worked for me is that if there is ever a new member in the class, it’s safe to assume they don’t know the rules and norms. So, instead of assuming they will “figure it out,” make a habit of repeating the class rules, at the very least by leaving a space on the whiteboard to display them.
Another way in which the PEG therapist sets the tone is in setting up the room such that the environment promotes engagement in instruction. In my colleague’s Distress Tolerance group, the pre-established norm was for group members to be seated along three walls of a large, rectangular multi-purpose room. While this configuration allowed for all group members to see each other clearly, it also created a great deal of space between teacher and learner. This space seemed to invite side conversation, and also put a strain on members trying to see across the entire room toward the whiteboard. Some members also had to re-adjust in their chairs to properly see instruction. The solution to this problem was simple and surprisingly effective: chairs were placed in two rows of semicircles around the instructor. This moved the dead space in the room from between the teacher and learner to behind the entire class. And more importantly, side conversation was nearly eliminated.
Focus on Emotional Learning
If you were to ask group members what they learned in their last group, chances are the majority would not be able to recite the principles that were taught, much less grasp the content in the way in which the therapist intended for them. Rather, group members and class members alike retain what they are ready to learn. And in most instances, this learning is tied to an emotion. With this said, it is important that the PEG therapist not be committed to “getting through” all the lesson material. They should, rather, reward active engagement with reflection, expounding productive comments, and setting a foothold for engaging other class members. Focusing on emotional learning can also lead to the use of experiential activities, which if used properly can enhance understanding.
For example, I recently taught a PEG on ADHD. As might be expected, “telling” about things like executive function was not as effective as having them experience it. An activity we called “Sound Ball” was particularly effective. In this activity, participants were asked to make nonsense sounds while passing a ball in a circle. They were required to repeat the sound produced by the ball-thrower as they received the ball. They were then required to make up a nonsense sound as they passed the ball to someone else. For almost all patients this created a challenge in executive function, a fair share of awkward moments, and was a powerful teaching tool. Class members readily reported that experiencing difficulties mentally shifting, processing, and storing information during the activity illustrated a type for these same challenges in their daily lives.
In PEGs following up can be incredibly important. For example, using homework assignments can help clients gain clear direction about the message the PEG therapist is trying to communicate. If the PEG only constitutes one session, creating a memorable experience in which the therapist polls “takeaways” can be a useful tool. This may also be effective for the final class in a multi-session PEG. Either way, if the instructor has done their job, there was likely a small change wrought upon the patient. The proper handling of that change can help clients retain important knowledge and skills, and will enhance learning of principles to guide their own lives.
Recently I employed the “takeaway” strategy in a pain management class. I asked class members what (if anything) they would take with them after the class was over. One member expressed an excitement for instruction on mindfulness meditation, and stated that she would try mindfulness on a daily basis to help cope with her pain. Conversely, another stated that mindfulness was not for her, but that she preferred coping with a hot bath and a good book. While at first it may seem that the first class member “got it” while the other did not, both reactions to the instruction were valuable! Both class members left with greater knowledge of how to cope with their condition: one found a new tool that works, and another confirmed to herself what didn’t. As the instructor, I decided to reinforce both types of learning. This not only validated the disparate experiences, but also silently validated the varied experiences of the other members of the class.
As with any therapeutic modality, in psychoeducational groups (PEGs) rests great potential for learning. This may be didactic or “academic” learning, and can also be practical or emotional. When treated with this scope and with the proper preparation, PEGs have the potential to be transformed from the reading of slides to seeing change on and individual and group level. And perhaps most of all, they can be enriching to the instructor. As PEGs continue to gain favor in the therapeutic array, seeing them as fertile ground for therapeutic gain will transform them from classes into therapy that reflects the emotional and interpersonal learning for which group attendees will continue to yearn.
Brown, N. W. (2011). Psychoeducational groups: Process and practice. Taylor & Francis.
Burlingame, G. M., & Woodland, S. (2013). Conducting psychoeducational groups. In Koocher, G. P. Norcross, J. C., & Greene, B. A. (Eds.) Psychologists’ desk reference, 3rd ed. (pp. 380-383). New York, NY, US: Oxford University Press.
*Sean Woodland, PhD is a psychological assistant registered in the State of California, and works at Kaiser Permanente Stockton Medical Center. The opinions expressed belong to Dr. Woodland, and may not reflect those of Kaiser Permanente. For questions or concerns, Dr. Woodland may be reached by email at firstname.lastname@example.org, or by phone at 801-602-8278.