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2017 Minnesota Psychological Association's Annual Convention Award Winners

Award:  Susan T. Rydell Outstanding Contribution to Psychology Award
Recipient:  Steven P. Gilbert, Ph.D., ABPP, LP

From left to right: Steven P. Gilbert and Duane Ollendick

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Frank B. Wilderson, Jr. Honored with John M. Taborn Award

On February 3, 2017, Frank B. Wilderson, Jr., Ph.D., LP, was recognized as the 2017 recipient of the John M. Taborn Award for Outstanding Contributions as a Mental Health Provider of African Descent.  A reception was held in his honor at the Metropolitan State University Founders Hall in St. Paul. 

Dr. Wilderson is a professor emeritus in the Department of Educational Psychology and co-director of the Center for Research on Correctional Education.  He received his B.A. in education from Xavier University in Louisiana and his M.A. and Ph.D. in child development and educational psychology from the University of Michigan.  He is now retired after 39 years at the University of Minnesota where he held multiple positions. He was a faculty member, becoming the first chair of the Department of African-American Studies; he was an Assistant Dean; and he was the first African American among the University’s vice presidents, serving for 14 years in that role. 

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MPA First Friday Forum: Health Disparities: The Psychological Impact of Breast and Prostate Cancer on African-American Families

On February 3, 2017, the Minnesota Psychological Association and the Metropolitan State University Psychology Department hosted a First Friday Forum titled: “Health Disparities: The Psychological Impact of Breast and Prostate Cancer on African-American Families.”  The presentation was led by Willie Garrett, M.S., LP, Ed.D.  Dr. Garrett is a licensed psychologist with over 35 years of experience working with children, adolescents, adults, and elderly clients both in urban and rural settings.  He is actively involved in MPA, and was the 2016 award recipient for Outstanding Career Achievement in Black Psychology (currently the John M. Taborn Award for Outstanding Contributions as a Mental Health Provider of African Descent).

Dr. Garrett’s presentation was very informative and eye-opening.  He provided various statistics related to breast and prostate cancer, and discussed emotional, psychological, and financial implications African-American families face as a result of this “invisible epidemic” (Garrett, 2017).  There was one statistic that stood out the most.  According to the American Cancer Society, trends in cancer death rates between 1975-2014 show that African-American women have higher death rates than White women.  What made this statistic so powerful was that African-American women actually have lower cancer incidence rates than White women.  

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Integration of Behavioral Health in Population-Based Approaches to Caring for Patients in Primary Care (Based on the presentation given at the MPA Annual Convention April 2016)

In May 2008, the Minnesota legislature adopted health care reform legislation that allows primary care clinics in Minnesota to become certified as Health Care Homes (HCH).  The HCH program provides “an approach to primary care in which primary care providers, families and patients work in partnership to improve health outcomes and quality of life for individuals with chronic or complex health conditions (Minnesota Department of Health, Health Care Homes).”  The goals for HCH are based on the “Triple Aim” put forth by the Institute for Health Care Improvement.  These aims are 1) improving patients’ experience of care, 2) improving health from a population perspective, all while 3) reducing the cost of health care (Institute for Health Care Improvement).

This shifted the perspective of many primary care clinics, as clinics tended to focus on patients who showed up asking for care.  These aims ask clinics to proactively reach beyond their clinic walls and provide evidence-based care for patients in a systematic manner.  Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”  At the core of population management is defining a group of patients (e.g., those on chronic opioids, patients with elevated PHQ-9 scores, patients with diabetes with blood pressures over a set point, etc.) and using available data to actively follow and review patients to ensure the condition is being optimally managed in relation to available evidence-based guidelines for treatment.

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Online Rural Conference Brings CEs to Rural Behavioral Health Professionals

“Critical Issues in Rural Practice” was the subject of the 8th Annual Rural Behavioral Health Practice Conference on Friday, October 21.  The conference was webcast to individuals and group webcast sites across the United States.  Minnesota sites were at Mankato, Marshall, UM-Morris, St. Cloud, and Willmar.

The conference was very well received by participants, with comments such as:  “This has been an absolutely wonderful day/experience.”  “The presentations were excellent and very relevant to our practice.”  A group webcast coordinator said, “Thanks again for a great conference, and we look forward to hosting again next year!”

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MPA First Friday Forum: Formulating Diagnostic Impressions and Pitfalls of Self-Report

Catherine A. Carlson, Psy.D., LP

There is undetected psychosis and feigning in mental health settings. Some people lie about symptoms and impairments. Those who feign or malinger (feigning for secondary gain), typically emphasize and endorse psychotic symptoms or cognitive impairments for manipulative reasons. The most common motivation for malingering in non-forensic settings is money. Social Security Disability (SSDI) provides a monthly income. When feigning or malingering, dramatic acting and portrayals of purported symptoms are often part of the ruse. These are far from academy award winning performances given the frequent inconsistencies with bona fide mental illnesses. Some mimic portrayals of mental illness in movies, which are rarely accurate. I find much less drama when examining those with genuine disorders. Other people self-report (malinger) extreme anxiety to get benzodiazepines, a controlled substance that has high potential for abuse. I have rarely seen people feign a non-psychotic Major Depression. For some, the feigning itself is intrinsically reinforcing. Psychological needs related to attention and control are met by deceiving and manipulating others. If this behavior is habitual, and there is no evidence of feigning for secondary gain, a diagnosis of Factitious Disorder needs to be carefully considered. Then there are those with undetected and untreated psychosis, a particularly guarded subgroup, who generally deny psychotic symptoms they have experienced. When they voluntarily seek treatment, chief complaints usually consist of extreme anxiety (including panic attacks), ‘overwhelming stress,’ and/or self-diagnosed Posttraumatic Stress Disorder. They are willing to report anxiety but usually too guarded to disclose the underlying paranoid psychosis (including hallucinations) that is generating the intense anxiety.  They do not seek out treatment for ‘psychosis’ because they have limited to no insight into this condition. They know they are anxious (terrified is probably more accurate) but do not recognize the fears stem from irrational or delusional thought processes. People with non-psychotic depression seek out treatment for depression. Those with guarded psychotic illnesses seek treatment for anxiety not psychosis.

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Culturally-Sensitive Diagnostic Interviewing Protocol for Somali Immigrants and Refugees

Dr. Dasherline Cox Johnson presented her dissertation research on Culturally-Sensitive Diagnostic Interviewing Protocol for Somali Immigrants and Refugees at the Minnesota Psychological Association’s 80th Annual Convention on April 16, 2016 and at the 2nd Annual Mental Health Summit on June 17 in Minneapolis and St. Paul respectively, with the following objectives: 1. Demonstrate cultural-specific understanding of Somali mental health, 2. Recognize relevant issues related to Somali mental health, and 3. Apply cultural competent practice to mental health assessment of Somali clients.

Methodology: The researcher conducted semi-structured, in-depth interviews with eight mental health providers from five local agencies with at least two years of experience working with Somalis. A qualitative method of snowball sampling was conducted to identify research participants. Questions addressed challenges of working with Somalis within the current mental health system and how clinicians handle or resolve them. An inductive content analysis was used to analyze the interviews and to inform the development of a culturally sensitive diagnostic interviewing protocol.

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MPA First Friday Forum: Supporting Families During Pregnancy Following a Perinatal Loss

The loss of a baby during pregnancy is estimated to be around 30% of all pregnancies and is almost always unexpected and sudden, thus is a traumatizing experience for the mother and her partner.  Regardless of the cause of the death, it is impossible to have another experience of pregnancy without stimulating memories of the painful past loss. As parents enter a new pregnancy rather than unresolved grief, parents experience a new layer of grief; for their deceased baby and fear that the new unborn child might also die.

Bereaved parents report common themes around their loss experience. These include viewing the loss as a major life event possibly even traumatic in nature, a sense of isolation and loneliness due to the stigma and silence around pregnancy loss, invalidation from family and friends who intentionally or unintentionally diminish their loss in some way as well as lack of support from family and friends. These themes remain as parents move into a subsequent pregnancy with additional themes including an increase in anxiety about the outcome of the subsequent pregnancy, conflicted emotions around how to grieve for one baby while trying to be hopeful for another, and lack of trust in a ‘good outcome’ for this pregnancy. For the pregnant mother, this can present as lack of trust in one’s own body to keep this next baby safe.

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Working with Native American Patients & Clients - The 3 C's

On April 15, 2016, Dr. Antony Stately (Ojibwe) and Jennifer Waltman (Lakota), a doctorate of psychology student, presented at the MPA Annual Convention on Working With Native American Patients & Clients. The presentation addressed the 3 C’s of integrating Indigenous consideration into your practice:  Context (Understanding the story); Comfort (Building it); Communication (Tools & Techniques for Indigenous relationship building). A recap of the presentation is provided below applying information from both research and applied experience working in the community and intended for generalization.

Context. Understanding historical trauma (HT) for Native Americans is key to conceptualizing the significant stigma related to issues of mental health and the greatest health disparity in Minnesota.  Native Americans commonly use humor to disguise trauma. Humor conversely provides strength to explore distress that may contribute to misdiagnosis and confusion for many non-Native healthcare providers. 

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Social Justice and Ethics: Dilemmas and Opportunities for Psychologists

Before we decided to send this topic for consideration for the MPA 81st Annual Convention we had conversations about the events that were happening around the country related to police brutality and killings of unarmed African Americans, the riots, and the protests. We wondered why voices of psychologists were missing from the commentaries in the media; both on local and national TV, and in print media. We wondered about the psychological impact of the traumatic events in Ferguson, Baltimore, Minneapolis and others to the communities and the country as a whole. We wondered how traumatizing it was for young children and adults to see the body of Michael Brown lying on their streets for hours. We wondered how it was possible for all, except psychologists to frequent newsrooms to comment, analyze, and condemn these acts. We wondered what was stopping psychologists from having a strong presence on the microphones to explain, teach, or even warn about long-term effects of trauma that were unfolding before our eyes. Then we decided to delve into psychology literature on Ethics and Social Justice, and the APA Ethical Guidelines. To say the least, there is ample work that has been done on this topic.  We looked at the history of psychology and social injustice, social justice, and through discussions explored ideas on the role of the psychologist and dilemmas on ethics and legal issues in media presence.

APA’s Multicultural Guidelines (2010)
“Psychologists are in a position to provide leadership as agents of prosocial change, advocacy, and social justice, thereby promoting societal understanding, affirmation, and appreciation of multiculturalism against the damaging effects of individual, institutional, and societal racism, prejudice, and all forms of oppression based on stereotyping and discrimination” (p. 382).

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Friday Forum Recap: Promoting Resilience in Highly Stressed Children

On May 13, 2016, Dr. Abigail Gewirtz presented a Friday Forum Encore on Promoting Resilience in Highly-Stressed Children: Long-term Program Findings. In her presentation, Dr. Gewirtz addressed three key questions: What is resilience in children? What do we know about parenting and its association with child adjustment among families facing traumatic and/or highly stressful events? And, can prevention programs to strengthen parenting improve children’s resilience? A recap of the presentation is provided below.

What is resilience? Children and youth are considered resilient, if they appear to be ‘doing OK’—that is, functioning in the normative range with regard to social, emotional, behavioral, and academic adjustment, despite experiencing adversity (i.e., stressful and/or traumatic living conditions). Several long term studies on resilience have revealed individual, family, and environmental conditions or characteristics that promote resilience. Across multiple studies, the ‘shortlist’ of factors that are associated with children’s resilience includes effective parenting or caregiving. [1]

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MPA First Friday Forum: Population-Based Approaches to Managing Anxiety Disorders

Anxiety disorders are the most common mental health condition in the United States, affecting approximately one-third of the population.1 They frequently co-occur with depression, substance, and other anxiety-related conditions. Anxiety disorders are disproportionately associated with a variety of chronic disease risk factors, such as nicotine use, alcohol consumption, and sedentary behaviors, and chronic diseases, such as cardiovascular disease, diabetes, and asthma.2 The public health impact of untreated anxiety disorders is staggering. The adjusted estimated annual economic impact of anxiety disorders is $62 billion through disability, lost wages, and healthcare costs.3 Although highly effective treatments exist for anxiety, only a minority of patients with clinical anxiety receive some form of care. Unfortunately, even among those individuals being actively treated for their anxiety disorder, very few are receiving pharmacotherapy and/or psychotherapy that meet evidence-based practice guidelines.4

Cognitive behavioral therapy (CBT), especially exposure-based interventions, is the most effective treatment for anxiety disorders. 5 CBT is highly acceptable to patients, and typically outperforms evidence-based pharmacotherapy in the longer-term maintenance of treatment gains.6 Although access to CBT remains challenging, large-scale efforts are being made to change health care delivery systems to improve the dissemination of evidence-based treatments.

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2016 Minnesota Psychological Association's Annual Convention Award Winners

Award:  Susan T. Rydell Outstanding Contribution to Psychology Award (two award winners)

Winners:  Rochelle Brandl, Ph.D., L.P. and Mary Tatum Howard, Ph.D.

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Essential Advocacy at State Leadership Conference (SLC)

MPA members received the APA Division 31 APAGS Award for an Outstanding State, Provincial, or Territorial Association of the Year at the APA State Leadership Conference in Washington, D.C. Front row, from left to right: BraVada Garrett-Akinsanya, Cynthia (C.J.) Swanlund, Robin McLeod, Sy Gross.  Back row, from left to right: Matthew Syzdek, Daniel Kessler, Yasmine Moideen, Bruce Bobbitt and Willie Garrett.

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MPA First Friday Forum - Cognitive Behavioral Therapy for Binge Eating Disorder

“Cognitive Behavioral Therapy for Binge Eating Disorder” was presented at the Minnesota Psychological Association’s First Friday Forum on January 8, 2016. Drs. Koball and Grothe focused on discussing diagnostic criteria for binge eating disorder, reviewed recent research on the efficacy of CBT for binge eating disorder, and described specific CBT skills using pertinent case examples. Finally, they offered information on behavioral weight management for individuals who are in remission from binge eating disorder, but who desire further weight-related intervention.

Binge Eating Disorder (BED) is characterized by episodes of eating in a discrete period of time (e.g., within 2 hours) a larger amount of food than what most people would eat in a similar period of time under similar circumstances (e.g., 4 bowls of cereal, 1 pint of ice cream). Additionally, individuals with BED experience a sense of lack of control over eating during the episode(s) (e.g., feeling that one cannot stop eating or control what or how much one is eating). Furthermore, to meet criteria for BED, binge eating episodes must be associated with 3 or more of the following: 1) eating much more rapidly than normal, 2) eating until feeling uncomfortable full, 3) eating large amounts of food when not feeling physically hungry, 4) eating alone because of feeling embarrassed by how much one is eating, and/or 5) feeling disgusted with oneself, depressed, or very guilty afterward. Finally, marked distress regarding binge episodes must be present to meet diagnostic criteria, binge eating must occur on average at least once a week for 3 months, and binge eating is not associated with recurrent compensatory behaviors (e.g., vomiting or laxative use; APA, 2013). Today, BED is more common in the U.S. than anorexia nervosa or bulimia nervosa, occurs in approximately 3-5 % of women and 2% of men, and is commonly associated with other mental health conditions including low self-esteem, borderline personality disorder, substance abuse, and depression (ANAD, 2012). Individuals who engage in binge eating often struggle to balance eating, and may cycle between periods of significant restrictive eating, episodes of binge eating, and severe guilt and shame.

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Assessment and Treatment of Mood Disorders in Children and Adolescents

"Assessment and Treatment of Mood Disorders in Children and Adolescents” was presented at the Minnesota Psychological Association Friday Forum series on November 6, 2015.  Dr. Leffler focused on the following three areas: enhancing diagnostic skills related to mood disorders in youth, utilizing assessment strategies for identifying mood disorders in youth, and applying treatment techniques for youth with mood disorders.

Pediatric mood disorders, which include depression and bipolar spectrum disorder, are among the more severe childhood disorders. These disorders have been found to result in significant impairments in numerous areas including interpersonal interactions, communication patterns, academic and employment functioning, family engagement, and suicide.

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Newly Licensed Psychologist Reception a Success!

The MPA Membership Committee hosted a reception in June for newly licensed psychologists who earned their license within the past two years. The reception took place at the home of Dr. Trisha Stark, and was a huge success! The goal of this reception was to invite newly licensed psychologists to become familiar with how MPA advocates for psychologists in our state, and hopefully convince them of how important it is for psychologists to support their professional association by becoming members.

The program included brief talks from Dr. Scott Fischer, chair of the Minnesota Board of Psychology, Dr. Robin McLeod, president-elect of MPA, Dr. Ken Solberg, co-chair of MPA’s Membership Committee, and Dr. Trisha Stark, chair of MPA’s Legislative Committee. New licensees were able to hear about how MPA’s primary purpose is to serve the interests of psychologists in Minnesota, and does so via advocacy, ethics consultations, continuing education opportunities, career growth, and networking, amongst many other benefits of membership.

This reception of 50 attendees drew new licensees locally, as well as from the Iron Range, Duluth, and some who even had moved to Minnesota recently from the east coast. Our guests enjoyed networking with each other, MPA Membership Committee members, Division chairs and co-chairs, and MN Board of Psychology representatives.  Newly licensed psychologists are important members of our professional community.  It is important for MPA to understand their needs, so that we can support their growth and get them involved in MPA. We look forward to making this an important annual event. Thanks very much to the always generous Trisha Stark for allowing us to host this event in her home!

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Managing Difficult Patients in an Era of Interprofessionalism

“Managing Difficult Patients in an Era of Interprofessionalism” was presented at the Minnesota Psychological Association First Friday Forum series on June 5, 2015, by William Robiner, Ph.D., A.B.P.P., L.P.

Who are difficult patients and why should health professionals be concerned about managing them?  Like beauty, difficulty lies in the eye of the beholder.  Patients might be labeled “difficult” when health professionalshave difficulty working with them (Wessler, Hankin & Stern, 2001).  In health care, patients may be considered challenging if they are “interpersonally ‘difficult,’ psychiatrically ill, chronically medically ill, or lacking in social support (Adams & Murray, 1998).”  Difficult patients are those with whom health professionals feel frustrated, uncomfortable, ineffective, or threatened (Duxbury, 2000) or whose disorders do not respond to treatment (Pollack, Otto, & Rosenblum, 1996). Because health professionals invariably will encounter difficult patients they need to be prepared to manage them so as to provide quality health care and to cushion their impact on individual clinicians and the system.

Behavioral aspects that lead a patient to be seen as difficult include being demanding, blaming, unappreciative, defensive or angry.  Other factors are perceived risk of abuse, violence, suicide, litigiousness, or making reports to regulatory boards. Various pejorative terms have been used with reference to difficult patients, including “train wreck,” “crock,” “frequent flyer,” and “heart sink” (i.e., patients who cause clinicians’ hearts to sink when they encounter them).

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2015 Minnesota Psychological Association’s Annual Convention Award Winners

Award:  Susan T. Rydell Outstanding Contribution to Psychology Award

Winner:  Trisha Stark, Ph.D., L.P., M.P.A.  

From left to right: Scott Palmer, Trisha Stark, and Scott Slattery

Trisha Stark, Ph.D., L.P., M.P.A., is this year’s recipient of the Susan T. Rydell Outstanding Contribution to Psychology Award.  Dr. Stark was recognized by MPA for her considerable advocacy efforts on behalf of individuals most needing of psychological support by promoting the ongoing strength of our profession.  Recognizing that our own professional complacency does not serve clients well, Dr. Stark has, over the course of the past decade, dared to leave the comfort of our professional village, climb the next mountain on the horizon, and peek over the crest to glimpse what the future portends. A bellweather for psychology during a time of significant change, she has come back from these excursions with news we are not always ready (or don’t want) to hear.  Despite this, she has persisted in educating psychologists and forming collaborative partnerships across the state (e.g., Minnesota Mental Health Workforce Plan) – all to ensure that individuals relying on the availability of psychological services will be represented at the tables where policy and funding are decided.  Dr. Stark’s efforts epitomize the essence of this award.

Award:  Leadership in Diversity Award
Winner:  Jim Ayers, Ph.D., L.P.

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APA State Leadership Conference (SLC) Recap

I was privileged to have the opportunity to attend the annual APA State Leadership Conference (SLC) in Washington, D.C. as the Early Career Psychologist (ECP) delegate from Minnesota March 14-17, 2015. The theme this year was “Practice Innovation.” The keynote speaker, Jason Hwang, MC, described his idea of disruptive innovation and its impact on the health care field. He provided a different perspective on the changes we have been, and will continue to, experience.

As the ECP delegate, I attended programs that focused on increasing the participation of early career psychologists in their State, Provincial and Territorial Associations (SPTA), particularly in leadership roles. I was able to exchange ideas with other ECP delegates from other states that have experienced similar difficulties.

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