24 Feb 2017

Adventures in Integrated Care Collection Booklet

Adventures in Integrated Care Collection Booklet

Improving the health of people requires that they have access to effective and efficient psychological services for the prevention and treatment of a wide range of emotional and behavioral conditions. Psychologists are actively involved in clinical treatment, health system design, and the implementation of innovative approaches to health care.

To illustrate this important connection and promote the valuable role psychology plays in health care, the Monitor on Psychology published Adventures in Integrated Care, a yearlong series of articles that showcase psychology practitioners who work on a variety of medical teams, reporting on what these practitioners do and how they got the education and training to do it.

We have placed all these articles into a collection booklet for you to read in one convenient place. Please enjoy.

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15 Feb 2017

Survey: Many Americans Stressed About Future of Our Nation

Survey: Many Americans Stressed About Future of Our Nation

New APA Stress in America™ survey shows more Americans reporting symptoms of stress after the election.

With the 2016 elections behind us and having entered a new year, how are Americans feeling?

According to the American Psychological Association’s (APA) report Stress in America™: Coping with Change, two-thirds of Americans say they are stressed about the future of our nation.

An APA poll conducted in January found that the current political climate is a very or somewhat significant source of stress for more than half of Americans (57 percent).  Nearly half (49 percent) say the same about the outcome of the election.

While Democrats were more likely than Republicans (72 percent vs. 26 percent) to report the outcome of the 2016 presidential election as a significant source of stress, a majority of Republicans (59 percent) said the future of the nation was a significant source of stress for them, compared with 76 percent of Democrats.

“The stress we’re seeing around political issues is deeply concerning, because it’s hard for Americans to get away from it,” said Katherine C. Nordal, PhD, APA’s executive director for professional practice. “We’re surrounded by conversations, news and social media that constantly remind us of the issues that are stressing us the most.”

Nordal also noted that while APA is seeing continued stress around politics, the survey also showed an increased number of people reporting that acts of terrorism, police violence toward minorities and personal safety are adding to their stress levels.

These results come on the heels of an APA survey, conducted by Harris Poll last August among 3,511 adults.  The August survey found that 52 percent of Americans reported that the presidential election was a significant source of stress. The latest survey was conducted online by Harris Poll in early January 2017, among 1,019 adults ages 18+ who reside in the U.S.

Between August 2016 and January 2017, the overall average reported stress level of Americans rose from 4.8 to 5.1, on a scale where 1 means little or no stress and 10 means a great deal of stress, according to the APA survey. At the same time, more Americans said that they experienced physical and emotional symptoms of stress in the prior month, health symptoms that the APA warns could have long-term consequences. 

The percentage of people reporting at least one health symptom because of stress rose from 71 percent to 80 percent over five months. A third of Americans have reported specific symptoms such as headaches (34 percent), feeling overwhelmed (33 percent), feeling nervous or anxious (33 percent) or feeling depressed or sad (32 percent).

“While these common health symptoms might seem minor, they can lead to negative effects on daily life and overall physical health when they continue over a long period,” said Nordal.

APA encourages people to stay informed but know their own limits when it comes to taking in information as one way to diminish the constant exposure to potentially distressing news and the resulting physical symptoms.

“For many, the transition of power and the speed of change can cause uncertainty and feelings of stress, and that stress can have health consequences. If the 24-hour news cycle is causing you stress, limit your media consumption,” said Nordal. “Read enough to stay informed but then plan activities that give you a regular break from the issues and the stress they might cause. And remember to take care of yourself and pay attention to other areas of your life.”

This marks the 10-year anniversary of the Stress in America report, part one of a two-part release. APA released part two on Feb. 23, highlighting how technology use affects stress among Americans. To read the full report go here. (PDF)

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25 Jan 2017

Growing and Sustaining a Private Practice: Opportunities Are Where You Find Them and Where You Make Them

There are forces that impinge on the ability to develop a successful independent practice. These include lack of training in the business of practice, cognitive distortions on the part of clinicians regarding how a practice “has to be” and a lack of recognition of possible practice opportunities that utilize the doctoral-level clinician’s entire skill set. This presentation focuses on the process of creativity, and how entrepreneurial thinking can shape a thriving private practice. Numerous examples are presented on how mental health professionals may consider expanding their current practice patterns beyond providing traditional psychotherapy services in their offices.

Learning Objective 1
Discuss three concepts from entrepreneurship that relate to the expansion of a clinical practice.

Learning Objective 2
List three potential practice areas based on data-based research.

Learning Objective 3
Identify one Standard from the APA Ethics Code that relates to the developing new practice areas.

Presenter: Steven Walfish, PhD (deceased)

Dr. Walfish was a private practice psychologist in Atlanta and a partner at The Practice Institute and Clinical Professor at Emory University School of Medicine. He was the editor of Earning a Living Outside of Managed Care: Fifty Ways to Expand Your Practice, co-editor of Translating Psychological Research into Practice, co-author of Financial Success in Mental Health Practice: Practical Strategies and Ethical Practice and Billing and Collecting for Your Mental Health Practice: Effective Strategies and Ethical Practice and co-author of The Ethics of Private Practice: A Practical Guide for Mental Health Clinicians. In 2012, he served as President of APA Division 42. In 2016, he was awarded a Presidential Citation for his excellence in synthesizing practice and scholarship in all of his professional endeavors and his dedication mentoring countless others in relation to his forward looking view of what psychology is and psychologists can become. Learn more

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26 Oct 2016

Member Profile: Kristin Krueger Introduces Improv to Therapy

Member Profile: Kristin Krueger Introduces Improv to Therapy
APA Member Kristin Krueger, is exploring how improv can be used to improve mental health outcomes as well as improv as a cognitive activity.
APA Member Kristin Krueger is exploring how improv can be used to improve mental health outcomes and as a cognitive activity.

Chicago psychologist Kristin Krueger took her first class in improvisational theater at the famed The Second City Theater and Training Center in Chicago in 2006 for fun, but she soon realized improv's tenets and techniques could be useful in her work as well. Today, you might say Krueger has come full circle.

Not only does she employ improv in her group therapy and conduct research into how the use of improv techniques in therapeutic settings can affect mental health outcomes, but she is also a member of the Therapy Players, a professional improv group made up entirely of therapists.

"Being part of an improv community is therapeutic in itself," she says.

For Krueger, the key to improv, a form of live theater in which actors create scenes without prior preparation, is "to be yourself, and to be comfortable with that." That’s therapy's goal as well, she notes. Krueger is by no means the first psychologist to notice the commonalities between the two. "A lot of people are using improv in therapy, but as far as I know, nobody else is measuring it," she says.

Krueger was already a psychologist, and working as a waitress to help pay the bills in her hometown of Chicago a decade ago, when a co-worker suggested they take improv classes together. Krueger thought improv might help her with public speaking, but she mostly went along "just for fun." She suggested taking classes nearby, in their North Side neighborhood, but her friend said, "No way. It's Second City or nothing," Krueger recalls.

It was a serendipitous choice, because The Second City, founded in 1959, stands in a direct line back to Viola Spolin, who developed the system of games and exercises that are the bones of improv. In the 1920s, Spolin trained to be a settlement house worker with Neva Boyd, a pioneer in recreational therapy who was using games and groups in revolutionary ways in education. Spolin eventually moved her career into the performing arts, and took exercises she had developed herself into classes she taught for prospective actors, first in a crossover program in Chicago for the federal Works Progress Administration's Recreation Project during the Great Depression. Spolin's son, Paul Sills, was one of the founders of The Second City.

Krueger went through a good chunk of the improv training series at The Second City, and later took classes at different centers in San Antonio, Texas, and San Francisco, Calif. When she returned to Chicago in 2012, she retook the basic course at The Second City and went on for advanced training there. Meanwhile, she held a number of professional research and clinical positions, notably at Rush University Medical Center, where she coordinated the adaptation for a Spanish-speaking population of two large NIH-funded, longitudinal studies on aging, and served as a staff neuropsychologist for the Veterans Administration and the Cook County Health and Hospitals System in Chicago.

While at Cook County’s John H. Stroger, Jr. Hospital, Krueger introduced some small weekly groups for patients with anxiety and depression that employed exercises she had learned in improv classes. She evaluated the effectiveness of the games on improvements in her patients’ mood and functioning, based on self-reporting. The findings on that work have been submitted for publication.

Krueger now has a private practice in a Chicago suburb with an emphasis on issues of aging. She conducts neuropsychological evaluations in an aging population, leads groups, teaches healthy aging classes, and maintains collaborations at Rush. She finds therapy groups to be a good place to use the interactive games and exercises designed to help improv practitioners become comfortable enough to engage with one another.

One problem with traditional therapy groups can be that some members tend to talk more than others, she says, "but improv exercises are timed and concrete. Everybody can talk equally, and the exercises give people the structure they need to manage their own emotions." Krueger says she thinks improv has a lot in common with that aspect of cognitive-behavioral therapy that encourages patients to "celebrate who you are."

Krueger is following two threads of research into the use of improv in therapy. One thread explores how improv can be used to improve mental health outcomes. For this study, patients engage in a series of psychotherapeutic improv sessions. After the sessions, the patients rate their symptoms of depression and anxiety, self-esteem, perfectionism and ability to relate to others socially.

The second thread looks at improv as a cognitive activity. In this area, Krueger is working with Clifton Saper, PhD, at Amita Health, and Jeff Winer, a PhD candidate, to put together a panel of neuropsychologists who will categorize improv games according to the cognitive domains they align with.

She says she believes "improv can make a big contribution to making people feel better about themselves, live more collaboratively and improve their mental health."

Krueger performs as often as she can with The Therapy Players, which she joined shortly after it began in 2013. This is founder Dave Carbonell's second improv group; he founded The Freudian Slippers in graduate school 30 years ago. The Therapy Players are all full-time therapists, and about half their routines are based in some way on their work, says Carbonell, a clinical psychologist who specializes in anxiety disorders. Members practice for two hours every Sunday morning and typically perform more than a dozen dates a year, at mental health conferences and other meetings, and at clubs like The Den Theater and Stage 773 in Chicago, where, Carbonell says, "We get really good crowds, they come back and, boy, do they have a good time."

Kristin Krueger, center, is a member of the Therapy Players, a professional improv group made up entirely of therapists. (Photo: Ellen Carbonell)
Kristin Krueger, center, is a member of the Therapy Players, a professional improv group made up entirely of therapists. (Photo: Ellen Carbonell)

Of Krueger, Carbonell says, "She's coming at improv from both ends. She's generating research in an area where there's hardly any. She's going to make a big mark—and, she's funny as all get out."

When she was growing up, psychology was "the only thing I wanted to do," Krueger says, but she took several years off between college at the University of Wisconsin and the graduate work that culminated in a PhD degree from the Illinois Institute of Technology in 2004.

"I wanted to have a lot of life experience before I tried to help people. Otherwise, I thought, anything I had to say wouldn't have much weight," she says. That life experience included getting a master's degree in linguistics, extensive travel, and numerous diverse jobs. She is fluent in Spanish, Portuguese and German.

Early on, Krueger was attracted to the role of the therapist as portrayed in popular culture. Her mother's cousin, Dan Kiley, in 1983 wrote the best-selling, popular-psychology book The Peter Pan Syndrome, based on his own research with boys and men who resisted accepting adult responsibilities. Krueger met Kiley as a girl and was impressed. She also was intrigued by the television miniseries Sybil, about a woman with dissociative identity disorder, in which the actress Joanne Woodward portrayed the real-life clinician Dr. Cornelia Wilbur. And she was a big fan of educator, author and motivational speaker Leo Buscaglia, long a popular lecturer on public television.

"He was so present in my childhood," she recalls. "He embodied unconditional positive regard in so many ways."

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23 Sep 2016

Getting Reimbursed for Treatment of Behavioral and Neurocognitive Disorders

APA President-elect Antonio Puente, PhD, discusses effective billing strategies using ICD-10-CM codes specific to mental, behavioral and neurocognitive disorders. This webinar is geared to help psychologists having problems documenting and billing for cognitive deficits covered under ICD-10-CM chapters G and R.

This webinar is brought to you by the Practice Organization, advocating for psychologists on reimbursement issues. The Practice Organization is a legally separate companion organization to APA.

Presenter Bio:

Antonio E. Puente, PhD, is president-elect of the American Psychological Association and the APA Practice Organization. Dr. Puente maintains a private practice focused on clinical neuropsychology. He is an authority on coding and billing for psychological services. Between 1993 and 2008, he was APA’s representative to the American Medical Association’s (AMA) Current Procedural Terminology (CPT) panel. Dr. Puente served two terms on the AMA Editorial Panel of the CPT panel. He was also on the Center for Medicare and Medicaid’s Medicare Coverage Advisory Committee.

Discussant Bio:

Lynn Bufka, PhD, is Associate Executive Director, Practice Research and Policy, at the American Psychological Association. Dr. Bufka oversees programs and projects related to expanding opportunities for professional psychology including integration of psychology in the health care delivery system, diagnostic and functional classification, clinical practice guideline development and outcomes measurement. She frequently serves as a media spokesperson for APA on these topics and other policy matters relevant to professional practice. Additionally, Dr. Bufka is a Maryland licensed psychologist and continues to provide treatment and clinical consultation on a limited basis.

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20 Sep 2016

Research Roundup Articles from Practice Update

Research Roundup Articles from Practice Update

The APA Practice Organization, a separate companion organization to APA, supports practicing psychologists in all settings and at all stages of their career. The Practice Organization advocates for the profession of psychology regarding licensure, reimbursement for services and professional standing.

Practice Update is the e-newsletter of the Practice Organization. This collection research roundup articles address some of the latest literature covering a range of issues from the use of animals as a therapeutic agent and the growing field of concussion research and treatment to current research on body image among young girls and clinical considerations for psychologists who see patients with opioid misuse.

Please enjoy this collection of selected research roundup articles from Practice Update.

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18 Sep 2016

Emerging Career Paths for Clinical Practitioners

This 30-minute webinar discusses ways in which clinicians like you have broadened their career options by taking the path less traveled.

Learn more about:

• Creating opportunities in emerging practice areas
• Maximizing your full scope of practice and training
• Practical tips and resources for exploring innovative paths

…and more!

Presenter Bio:

Vaile Wright is Director of Research and Special Projects in the Practice Research and Policy office at APA. Their office focuses on the development and implementation of programs and policies related to expanding opportunities for professional psychology, including projects aimed at increasing access to psychological services for the public through the integration of psychology in the health care delivery system. She received her PhD in psychology from the University of Illinois, Urbana-Champaign in 2007, and is licensed in the District of Columbia.

Moderator Bio:

Garth A. Fowler is an Associate Executive Director for Education, and the Director of the Office for Graduate and Postgraduate Education and Training at APA. He leads the Directorate’s efforts to develop resources, guidelines, and policies that promote and enhance disciplinary education and training in psychology at the graduate and postdoctoral level. He has served as a consultant for universities and research institutions on program development and assessment, creating learning outcome for graduate and postdoctoral training, creation of career and professional development resources, submitting federal training grants, and teaching responsible conduct of research.

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29 Jul 2016

Evidence-Base and Clinical Use of Mobile Applications

This webinar provides valuable insight on choosing and using mobile health applications.

Telehealth and technology experts provide insight on the clinical value of mobile apps and how they can provide useful patient information, give patients immediate feedback, further treatment goals, promote engagement and more.

This webinar presents resources for clinicians seeking the right app for the right purpose. The presenters will explore key qualities relevant to the clinical utility of apps including safety, validity, relevance to particular goals, effectiveness, usability, interoperability, engagement and comparison with alternative apps.

Help us plan future webinars by taking five minutes to complete our survey.

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