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Update on EHR Technology

As a former computer science major, turned psychologist, I have found myself frequently troubled by misunderstandings regarding the realities, capabilities, and actual limitations of computer technology. These misunderstandings seem to undergird at least some of our community conversations regarding Electronic Health Records.

The complete text is rather long.  I have put in bold some of what I think are the highlights of my points of clarification.  Please do not interpret the bold as “speaking loudly” and rather as hoping to create the Cliff notes (oh my, I think I might have dated myself)

  1.  Nothing is stored on the Internet.  The Internet is simply a collection of electronic highways that allow communication between virtual addresses (aka electronic addresses).  Similarly, our highway system provides access to a broad range of physical addresses (e.g., houses, business).

    There are totally public addresses on the Internet – www.cpwmn.com – for example.  Here at CPW, we want people to find us, learn about us, and come to us when they need help.  As such we make our address accessible to a broad audience.There are also password-protected addresses – bank accounts for example.  If one has an online bank account, wherever one can access the Internet he or she can locate the public address for the bank.  After locating the public address, one enters the password-protected aspect that contains her or his personal bank account information.

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The Benefits of Behavioral Health Care and the Need to Reevaluate the Biological Bases of Behavior Perspective

I believe wholeheartedly that the current attempt by some to reduce all mental health issues to neural chains of events in the brain is totally misdirected. There is plenty of evidence that biological changes in the brain are caused by, as well as have an influence upon, psychological factors such as thoughts, feelings and behaviors.  There is no reason to assume that it is a one-way street: Biological and psychological factors both affect the other.

Due to the increased cost of medications and decreases in fees for psychotherapy, it is now a real bargain for the insurance companies to try the psychological methods first, and use medications as a last resort. Perhaps the current Medicaid/Medicare policy that newly diagnosed mental health patients “must” be referred for psychiatric evaluations will eventually be replaced with a new policy stating that all newly diagnosed psychiatric patients “must” be referred for psychological evaluations. Why not require five or ten sessions of psychotherapy, before subjecting patients to the side-effects of medications?  While we are at it, why not require the psychiatry profession to measure pre- and post-serotonin or dopamine levels/markers before and after providing psychiatric medications to patients? Additionally, if the mental health issues are actually related to these types of neurotransmitters, how about psychologists collaborating with M.D.s who would measure these levels before and after psychotherapy?

The medical profession has gained much control over the finances of mental health, both in areas of research and practice. In many ways, it is a very self-serving profession. We need to speak up. By and large, politicians and the general public are extremely naive about these matters. A large section of the population does not even think one should call oneself a doctor unless one prescribes pills. Books such as Anatomy of an Illness provide a sobering look at the failure of the biological approach, especially over the long-term, to treat mental illness in a safe and effective way. There have been some great successes based on the biological approach, such as helping to de-institutionalize individuals, but most of the failures of this approach have been “swept under the rug” so to speak. In my opinion, it is not that biological factors are unimportant. They are very important. It is that psychological factors are equally important. The logical error being made by some is to over-focus on neural circuits simply because they are correlated with psychological factors.

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Harriett Copher Haynes AUCCCD Diversity Leadership Mentoring Award

At the most recent Association of University and College Counseling Center Directors (AUCCCD) conference it was announced that the AUCCCD Diversity Leadership Mentoring Award is now going to be the Harriett Copher Haynes AUCCCD Diversity Leadership Mentoring Award in honor of her contributions to AUCCCD’s ongoing diversity efforts. The Mentoring Award offers mentoring support and funding to attend and present at one AUCCCD conference to a counseling center staff member with at least five years of experience who represents diversity in such areas as race/ethnicity, physical ability or sexual orientation and has had experience advancing a cultural agenda. (University Counseling & Consulting Services Training Director Anshan Eckard was a 2010 recipient of the award.)

Putting Sleep to Rest; A Heads-up for Practicing Psychologists

Our profession is responding to the challenge of a healthcare marketplace that increasingly clamors for more expertise to manage chronic conditions such as pain, IBS, headaches, anxiety and so forth, and demands accountability from practitioners. Sleep health services represent a key set of interventions well within our skill set as applied psychologists and readily adaptable to a variety of treatment settings.

Information about sleep abounds on the web, with numerous opportunities for all psychologists to become versed in the basics of sleep hygiene, insomnia treatment and circadian rhythms. Fellowships and training programs have been established around the country. We are immersed in a global, 24/7/365 world in which work-life boundaries are fluid, and demands are placed on people during what might have been traditional bedtimes. Electronic devices have proliferated, robbing people of sleep, illuminating their retina and stimulating their hypothalamus, all of which disrupts the circadian pacemaker. Nonetheless, we hear advertising messages about the brevity of life and that we should keep alert and conscious as much as possible in the 24-hour day. Have we figured out a way to eliminate the need to eat? I suspect we would have the same luck with sleep. Ironically, the sleep we do achieve may be deleteriously affected by the subtle but omnipresent “light fields” in which all urban dwellers reside. Such dispersed light pollution can suppress melatonin and fool the brain into thinking that we should be awake, active and cogitating. And more and more of us are living in the urban setting, replete with noise, fumes and activity, further impairing our ability to sleep in a consolidated, restorative fashion. It is in this environmental context that we can offer help to clients with insomnia, a widespread behavioral and public health issue in our society.  Please refer to Morin, Bootzin, Buysse, Edinger, Espie & Lichstein, 2006. Well informed psychologists can debunk many of the myths about sleep that bedevil clients and perpetuate their sleeplessness.

There remain pockets of mental health professionals who regard sleep as a clinical issue outside their purview best left to “medical” practitioners. Nonsense. Sleep is a complex set of behaviors which can be readily quantified, as any sleep study data set can attest. Sleep outcomes (e.g., sleep onset latency, reducing nocturnal awakenings, self-rated sleep quality) can be operationally defined in care plans to satisfy the utilization review or treatment audit process. Traditionally, relaxation therapies have been implemented as a way to manage anxiety and thus facilitate sleep. Hypnotherapy has also been invoked. But the sleep function itself is typically bypassed in the everyday work of clinicians. We perform consultations or treatments in traditional wake time periods during the 24-hour clock. Performance fatigue, a ubiquitous problem vexing over-the-road truck drivers, nuclear power plant operators, military sentinels, pilots, ER workers, law enforcement and shift workers, has been studied extensively because of the huge personal and public safety considerations at play. The mindset of our profession was to buy into traditional concepts of psychiatric impairment, where the focus was presumably on daytime functioning and sleep would just be a background process that would take care of itself. Sleep issues do not always remit spontaneously.  We now understand that there is a delicate interrelationship between how one functions during the day and night. The impact is bi-directional. Psychotherapy, behavior management, biofeedback, neuropsychological evaluations and so forth take place when a patient or client is presumably awake and alert, an assumption which may or may not be true. We have learned that the sleep-wake interface is more fluid and semi-permeable than first thought. We have all heard about dramatic cases of sleepwalking, sleepsex and sleepdriving. People have reportedly engaged in criminal behavior but later claim they were not cognizant or mindful of their actions. Micro-sleeping can occur during the middle of the day when a person is grossly sleep deprived. Sleep debt is cumulative, with insidious effects which cannot be rectified by one or two weekend nights of recovery sleep.

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To Reach A Port We Must Set Sail

Possessing That Critical Global Vision:  One of the most enjoyable experiences of my approximately quarter of a century of involvement within the APA governance was having the opportunity to work closely with Bruce Overmier on the Board of Directors on behalf of all of psychology.  In May of this year, Bruce retired from the University of Minnesota after 49 years of service, a truly amazing accomplishment.  He stated, “I did not stay for the 50th year as some friends suggested; after all, 50 is just a number.”  It is fascinating to reflect upon the extent to which those elected to the APA Board come to appreciate that they must represent all facets of the field – science, education, and practice – and not merely that “special interest” which might have elected them to the Board.  Although we did not succeed, we worked diligently to bring APS back into APA by ensuring that our national association would be responsive to the unique needs of the scientific community.  Similarly, it is important for those training our next generation of clinicians to appreciate, and be responsive to, the underlying mission of the various federal agencies seeking to improve the quality of life of those subpopulations in which one is particularly interested.  For those concerned about the unique needs of our nation’s children and their families, we would suggest that the Fiscal Year 2015 Budget Justification for the Health Resources and Services Administration (HRSA), and particularly for its Maternal and Child Health program, should be of considerable interest.

The Administration’s Priorities:  The stated objective of the Maternal and Child Health block grant program is to improve the health of all mothers, children, and their families.  These legislated responsibilities reduce health disparities, improve access to health care, and improve the quality of health care.  As one of the nation’s bona fide healthcare professions, psychology must appreciate that it is our responsibility to ensure that the critical psychosocial-economic-cultural element of quality care is affirmatively included.  As the then-President of the Institute of Medicine (IOM) stated in 2006, “Dealing equally with health care for mental, substance-use, and general health conditions requires a fundamental change in how we as a society and health care system think about and respond to these problems and illnesses.  Mental and substance-use problems and illnesses should not be viewed as separate from and unrelated to overall health and general health care.”

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Systems Training for Emotional Predictability and Problem Solving (STEPPS™): An Introduction for Psychologists

Problem: Borderline personality disorder (BPD) is highly prevalent in individuals treated in both psychiatric hospital units and outpatient clinics, and occurs even more frequently among those incarcerated in prisons. Black and colleagues (2007) assessed 220 offenders entering the Iowa prison system and found nearly 30% met criteria for BPD, including 55% of women and 27% of men.  Patients suffering from the disorder present a greater risk for serious behavioral problems at the institution without treatment (Warren et al., 2002). There are few effective, easily implemented, evidence-based treatment programs for BPD in correctional settings.

The STEPPS Program: The 20-week outpatient, cognitive-behavioral, skills-based program is delivered in a group setting with weekly two-hour sessions led by two facilitators who follow a detailed lesson plan. The program is fully manualized, and is designed to be easily delivered in a classroom or seminar setting. Each lesson focuses either on an emotion management or a behavioral skill, and is augmented with homework assignments. STEPPS does not include individual therapy, and is referred to as an “adjunctive” program because it is added to whatever treatment group members are currently receiving (e.g., medications). The program has three main components: (1) Awareness of Illness, (2) Emotion management skills, and (3) Behavior management skills. The term BPD is reframed as Emotional Intensity Disorder (EID) which seems to better reflect the experience of those with BPD. The systems component is implemented with a two-hour session that educates family members, friends, healthcare professionals, and correction workers, about the disorder and the program. The STEPPS program is described in more detail by Blum et al. (2008).

Conclusion: STEPPS was introduced in the Iowa Department of Corrections (IDOC) in 2005, and continues to be used in several prisons; the program has since been extended into community corrections. Secondary data analysis of results in both male and female offenders at eight facilities demonstrated “robust improvement in BPD symptoms, mood, and negative affectivity.” Further, the program significantly reduced both suicidal/self-harm behaviors and disciplinary infractions (Black et al., 2013).  Previous surveys of group participants and therapists showed high acceptance of, and satisfaction with, the program (Blum et al., 2002).

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What is the ACA (the Patient Protection and Affordable Care Act), what is MNsure (Minnesota’s public health insurance exchange) and why should psychologists care?

The purpose of the ACA is to curb and control runaway increases in healthcare costs, while improving overall population health. The ACA regulates private health insurance payers as well as expanding access to public health insurance, and setting standards for state-run health insurance systems.

The ACA incorporates parity rules set by the Paul Wellstone and Pete Domenici Mental Health Parity and Addictions Equity Act (passed in October, 2008 and mostly implemented by 2011). “Parity” did not require insurers to pay for mental health care; however, “parity” means that when a group health plan cannot impose treatment limitations or financial requirements for mental health benefits that are stricter than for medical or surgical benefits. The law corrects practices that had been commonplace, such as putting a limit on the number of times an insured person could see a mental health professional or capping the number of days the person could spend in a mental health or substance abuse facility (Erwin, Emmett, & Buchanan, 2012).

The ACA requires state-approved public payers to provide mental health and substance abuse coverage.  Minnesota’s state healthcare exchange, “MNsure,” provides access to insurance for any citizen who is not insured through an employer. MNsure staff help low-income individuals enroll in public assistance programs (Medicaid, Minnesota Care). In addition, MNsure staff help individuals of any income level who do not have health care through an employer. The MNsure “exchange” lists several private insurance agencies called “QHP’s” (qualified health providers) who have contracted with Minnesota to meet the standards set by healthcare reform law. People who enroll with those networks can receive state subsidies, reducing their premiums, based on their income, household size, and where they reside. The ACA says that those payer networks “must maintain a sufficient number and type of providers including those specializing in mental health and substance abuse to assure availability of all services without unreasonable delay” (MNsure, 2012).

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Psychology and Aging: Resources for an Ever-Growing Population’s Needs

There is a growing need for all psychologists to have a basic understanding of the psychology of aging. People 65 years of age and older are the fastest growing segment of the U.S. population and by 2030 will account for 20% of our nation’s people. As discussed in the American Psychologist article, “Aging and Mental Health in the Decade Ahead: What Psychologists Need to Know,” the demand for psychologists with a substantial understanding of later life wellness, cultural, and clinical issues will expand in future years as the older population grows and becomes more diverse (Karel, Gatz, & Smyer, 2012). The recently updated APA Guidelines for Psychological Practice with Older Adults(2013) notes that the demand for psychological services for older adults is expected to rise as Baby Boomers become old, and will continue to increase as cohorts of middle-aged and younger individuals, who are receptive to psychological services, move into old age.

Even if you did not begin practice with the intent of working with older adults, clients do age and their needs often change. Additional issues specific to mid and late life may arise.  Also, age-related issues may arise in work with younger clients (e.g., caring for aging parents, grandchildren being raised by grandparents). Finally, even if you do not work directly with older adults or their families or caregivers, weare all aging. Becoming informed of the science of the psychology of aging will prove useful at a personal level, for ourselves and our families.

In terms of psychological practice with older adults, opportunities abound. The number of psychologists who work with older adults is not keeping up with and will not meet the anticipated need. The decade ahead will require an approximate doubling of the current level of psychologists’ time with older adults. The need for services is particularly anticipated to grow in primary care, dementia and family caregiving services, decision making capacity evaluation, and end-of-life care (Karel, Gatz, & Smyer, 2012). However, only 4.2% of respondents of the 2008 APA Survey of Psychology Health Service Providers reported that geropsychology was their current focus and work (APA Center for Workforce Studies, 2010). This workforce shortage is not limited to psychology. The Institute of Medicine report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands (2012) described the dire need for health providers across professions to address the mental and behavioral health needs of older adults. It found that although the aging population continues to grow in number, diversity, and mental health needs, the geriatric mental health workforce is disconcertingly small and is dwarfed by the pace at which the population is growing.

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The Importance of Addressing Tobacco Reduction Among Individuals Living With Mental Illnesses

Although there has been a significant reduction in tobacco use within the past fifty years, smoking remains high among individuals with mental illnesses. They smoke at rates two to three times higher than the general population. Because of this and other factors like limited access to health care, the average life expectancy for those living with mental illnesses is about twenty-five years less than their peers. One of the most effective ways of reducing this disparity is by focusing on tobacco reduction.

Tobacco use has many harmful effects on health and mental health. Smoking increases how quickly some psychiatric medications are broken down in the body. This can cause an individual to require higher doses of medication and experience more severe side effects. There are a number of benefits to quitting smoking. It can reverse many of the negative effects that cigarettes cause and is associated with an improved mood state as well as a decrease in symptoms of depression and anxiety.

A majority of those who live with mental illnesses and smoke express interest in quitting. By regularly asking about tobacco use and assessing their interest and readiness to quit, mental health providers can assist people in developing a plan for quitting. This may include cessation medication, a quit line, counseling, or a health coach. Providers face a number of demands, but even short discussions with their clients on tobacco use can have a great impact on length and quality of life.

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Current Procedural Terminology (CPT), Healthcare & Psychological Services

For the last 25 years I have focused my efforts on matching psychologists’ education, training, expertise, and talents to the reimbursement system approved by the federal government’s Medicare system, and to the Current Procedural Terminology. Starting in the late 1980s, I worked for five years on developing health insurance codes in collaboration with the American Psychological Association (APA).  In 1992, when APA received a seat for a formal advisor, I began to represent psychology and APA. During the last six years, I have served on the actual panel. More descriptive information on this panel can be found at the AMA website.

Common Procedural Terminology (CPT), developed almost 50 years ago by surgeons and physicians, is the most widely accepted nomenclature used in the reporting of health services under public and private health insurances. CPT is owned and copyrighted by the American Medical Association (AMA) and licensed by the Center for Medicare & Medicaid Services (CMS). These codes are maintained by the CPT Editorial Panel who meets three times a year to discuss issues associated with new and emerging health care practices, procedures and technologies.  A new CPT code for professional psychological services is developed initially by a Health Care Professional Advisory Committee (also called HCPAC), all non-physicians, then is edited and researched by a selected CPT work group and finally moves to the CPT panel for review and possible approval. These ideas are often vetted simultaneously by a panel of experts convened by APA. This was done for the health and behavior, central nervous system assessment as well as the psychotherapy and applied behavior analysis codes. If successful, this process can take anywhere from two years to twelve years. If not successful, the results may be more clearly visible within two years.

Out of the approximately 8,000 codes, around 60 are possible codes for psychologists to utilize. These codes fall within a few major categories including Psychiatric/Mental Health, Central Nervous System Assessment, and Health and Behavior. Miscellaneous codes also cover things such as preventative measures and telehealth. Psychiatric/Mental health codes were added in the 1970s, testing codes 20 years later and Health and Behavior codes soon thereafter. In between, biofeedback codes were modified as well as expanded and almost all codes currently used were significantly modified and re-valued.

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Father-Absent Homes: Implications for Criminal Justice and Mental Health Professionals

ABSTRACT

The number of single-parent households in the United States has reached high levels in recent decades. As the extant literature suggests that children raised in single-parent households experience more physical and psychological problems compared to those raised in two-parent households, the implications of homes in which fathers are absent may be important to explore for criminal justice and mental health professionals. The present article aims to examine the extant literature base on father-absent homes, seeking to provide a fair and balanced account of this phenomenon. Specifically, we highlight ten adverse outcomes associated with homes missing a father. Findings suggest that a negative developmental trajectory may result for children lacking a father in the home, albeit further research in this area is warranted.

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In Appreciation of Sam Scher, Ph.D., L.P.

Sam Scher passed away June 3, 2014 at age 87 having touched the personal and professional lives of many hundreds of people.  This is not a formal obituary, which you can find in the Star Tribune documenting his accomplishments in a detailed article published on June 8, 2014 as Samuel Charles Scher.

My purpose is to provide an appreciative salute to an accomplished psychologist who was a pioneer in promoting the advancement of our profession as a Clinical Psychologist.  When community mental health was actively seeking to meet the needs of persons who typically were not likely to seek professional psychological services, he was at the forefront creating an opportunity through the Walk In Counseling Center, Youth Emergency Services and Bridge for Youth.   He had leadership in those areas as well as in the Minnesota Psychological Association.  While he was active in public mental health, he also was an extraordinary therapist and consultant, and taught at many of the Twin Cities colleges and universities.   He knew the importance of collegial consultation and actively was a leader in high level psychotherapy consultation groups.

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APA Adopts a More Efficient Governance System

From the APA Governance Affairs Office

Over the past several years, the APA Council has been working on developing a more nimble, efficient and responsive governing system, as part of the APA Good Governance Project (GGP).  This project was an outgrowth of the strategic plan focused on optimizing organizational effectiveness. APA’s existing governance system is a 1950s model built for a world where twice annual meetings was sufficient for conducting the business of the association. The new model, proposed after a thorough assessment with input from many different groups, has three primary goals: nimbleness, strategic alignment across the organization and increased member engagement. Under this model, members will have a more direct voice in the decision-making process and more opportunities for service.

In February 2014, Council voted to begin a three-year trial delegation of authority to the Board of Directors for: financial and budgetary matters; oversight of the CEO; alignment of the budget with the Strategic Plan; and internally focused policy development.  The Board composition changes with 6 member–at-large seats now open to election from and by the general membership, the addition of a public member and the guarantee that both a student and early career psychologist voice will be present. Two seats are reserved for members of the Council Leadership Team, to ensure a bridge between the two bodies.

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ADHD and Sleep-Related Disturbances: A General Introduction

Sleep-related disturbances are common among children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD; Mick, Biederman, Jetton, & Faraone, 2000).  Recent estimates suggest that approximately one-third of children diagnosed with ADHD experience moderate to severe sleep problems (Sung, Hiscock, Sciberras, & Efron, 2008).  These problems include difficulties initiating sleep, delayed sleep onset, bedtime resistance, maintaining sleep, restlessness during sleep, and chronic tiredness upon awakening from sleep (Corkum, 2001; Lecendreux & Córtese, 2007; Owens, et al., 2009). The causes of sleep-related disturbances range from environmental (e.g., family, neighborhood, school) to psychological (e.g., depression and anxiety) to biological (e.g., obesity and diabetes).  They also frequently result in co-morbidities such as Restless Leg Syndrome, Sleep Disordered Breathing, and/or Periodic Limb Movement Disorder (Chervin, et al., 2002; Córtese, et al., 2005; Konofal, 2008).

Although there appears to be a fairly clear connection between sleep-related disturbances and ADHD, the reasons for this co-morbidity is largely unknown. Research has shown that even subtle changes in the sleep patterns of children diagnosed with ADHD potentially impacts cognitive and psychological development in children (Kirov et al., 2012). Hence, understanding the nature of the co-morbidity between sleep problems and ADHD and the adoption of interventions based on this understanding may improve these children’s quality of life. For example, when it is possible to create a connection between disordered sleep and the effects of stimulant medication used to treat ADHD, medical professionals, educators, and family members may be able to intervene more quickly and more effectively (Cortese et al., 2012).

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In Memoriam: Dorothy Loeffler, Ph.D., ABPP

Dr. Dorothy Loeffler, a past president of the Minnesota Psychological Association (1979-1981), passed away on June 16, 2013.  She earned her Ph.D. in educational psychology (1965) at the University of Minnesota and was employed there at University Counseling and Consulting Services where she worked as a psychologist and Director of Training until her retirement in 1995.  Dr. Loeffler was an adjunct professor in the Department of Educational Psychology.  A highly respected professional, she mentored many young psychologists and modeled how to share energy and expertise.  Dr. Loeffler generously gave her time and energy to make sure that students received the best counseling training and developed excellent research skills.  She demonstrated the responsibility of the profession to support women in their development when she was the founding “mother” of Minnesota Women in Psychology and the creator of the course, “Women a Sense of Identity.”  Dr. Loeffler, an ABPP in psychology, actively served on the national level as a member and fellow in the American Psychological Association (Divisions 37, 31, & 35) and member of Division 20 – Student Personnel Psychology Program.

Creative Minds - Fascinating Journeys

When many of us think of the contributions of Minnesota psychology, the MMPI immediately comes to mind, as it well should — dating back to 1943.  The personal journey of MMPI expert, and now Professor Emeritus, James Butcher exploring Watercolors as a late-life adventure, and the extraordinarily impressive APA governance service of his University of Minnesota colleagues Bruce Overmier and Jo-Ida Hansen, seem equally significant however.  As editor of Psychological Services, I had the pleasure of working closely with Shelia Brandt on behalf of the profession’s public service members.  Having worked on Capitol Hill for nearly four decades, I was very pleased to learn of her growing interest in becoming involved in the public policy process.  This year she is serving as a Humphrey School of Public Affairs Fellow.  Those fortunate to attend the annual Practice Directorate State Leadership Conferences (SLC), which in my judgment are one of the highlights of the APA year, have recently been exposed to the vision and dedication of another explorer, Art Evans, Commissioner of the Department of Behavioral Health and Intellectual Disability Services for the City of Philadelphia.

Arthur C. Evans, Jr. is a psychologist and frontline policymaker who oversees a one billion dollar behavioral healthcare system in Philadelphia.  Growing up in Florida in the 1970s, the unlikely journey that brought the son of a school teacher and an Air Force electronics technician to his current position was somewhat circuitous.  After graduating as a music major at a local community college, his psychology teacher asked him what he planned to do next.  He admitted he didn’t know, but, while he enjoyed the field a great deal, he did not want to major in psychology, because he thought it would take him too long to complete school through to a doctorate.  That brief conversation altered the course of his life as his teacher encouraged him to pursue his real interest and identified a couple of colleges that he could attend, including Florida Atlantic University (FAU) where he would matriculate with a bachelors and master’s degree in experimental psychology.  At FAU he received rigorous training in research, including a year of full time work experience through a co-op at the United States Army Aeromedical Research Laboratory.  He credits this strong scientific foundation to a core belief; that the answers to many of the complex problems that society faces may lie in psychological research.  But, he has observed, the dots between the researchers and those trying to resolve the problems often remain unconnected.

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In Memoriam: Donald H. Blocher, Ph.D.

On November 9, 2013, Donald H. Blocher of Hugo, MN, a highly influential psychologist and my former graduate program advisor, passed away. Don died at the age of 85; he is survived by his wife, Betty, his three children, John (Carolyn), Susan and Mark, and a grandson, Matthew.

A 1959 doctoral graduate of the University of Minnesota, Don had a distinguished career as a scholar and educator in counseling psychology.  Upon the completion of his graduate degree (which was done under the guidance of Dr. Gilbert Wrenn), he took a position at the university where he stayed until 1975—leaving to take a position at the University of Western Ontario.  In 1977 he joined the faculty at the University of Albany where he stayed until he retired in 1991.  He then returned to Minnesota.

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NAMI Minnesota to Partner with MNsure

Starting January 1, 2014, all Americans must have health insurance, with very few limited exceptions. To help make insurance affordable, tax credits are available and in Minnesota Medical Assistance was expanded to include low income adults. Many people with mental illnesses faced barriers to accessing insurance due to a pre-existing condition, no coverage for mental health treatment, high deductibles or not meeting disability criteria for Medical Assistance.

NAMI Minnesota recently received a grant to provide outreach and assistance to people with mental illnesses and their families to access insurance through Minnesota’s health care exchange MNsure. NAMI Minnesota is collaborating with mental health providers to ensure statewide outreach.

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Answers to the Most Important Questions about Health Care Reform

The Patient Protection and Affordable Care Act (ACA) is the most important piece of health care legislation at least since the founding of Medicare and Medicaid in the 1960s, and may prove even more important than that.  Reactions among psychologists to the process that the ACA has instigated vary between dumbfounded anxiety, extreme skepticism, and cautious optimism.  Whatever your opinion of those changes, there are some questions to which you need the answers.  This article is our best effort at giving you answers to those questions.  Far more change is in the works than has occurred already, so read this article knowing that some of these answers will inevitably be outdated in the near future.

Thirty years ago I was told I was doomed if I didn’t join managed care.  I decided against it and the apocalypse never happened.  Isn’t this fear about health care reform just more of the same hysteria?  

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What is HPSP? What Does it Do?

As your representative who sits on the Advisory Board of Health Professionals Services Program (HPSP), it is time again for me to give a little information about this valuable but little known program. It provides monitoring services to health professionals with illnesses that may impact their ability to practice. HPSP promotes public safety in health care by implementing monitoring plans that are related to appropriate illness management and patient safety. A plan may include the participant’s agreement to comply with continuing care recommendations, practice restrictions, random drug screening, and support group participation.

The functions of HPSP include:

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Diversity Statement

The Minnesota Psychological Association actively encourages the participation of all psychologists regardless of age, creed, race, ethnic background, gender, socio-economic status, region of residence, physical or mental status, political beliefs, religious or spiritual affiliation, and sexual or affectional orientation.Although we are an organization of individuals from diverse cultures and backgrounds, the Minnesota Psychological Association also recognizes our core unifying identities as Psychologists who practice in America. We also recognize that we may hold unintentional attitudes and beliefs that influence our perceptions of and interactions with others. Within this context of unity and self-exploration, we are committed to increasing our sensitivity to all aspects of diversity as well as our knowledge and appreciation of the unique qualities of different cultures and backgrounds.We aspire to becoming alert to aspects of diversity, previously unseen or unacknowledged in our culture. In this spirit, we are committed to collaborating with multicultural groups to combat racism and other forms of prejudice as we seek to promote diversity in our society. To this end, we are dedicated to increasing our multicultural competencies and effectiveness as educators, researchers, administrators, policy makers, and practitioners.