Section IV Report - august 2003 meetings

Barry Dauphin, Ph.D., MSPP Section IV Representative

The most recent meetings of Section IV (Local Chapters) of Division 39 took place at the APA Meeting in Toronto, Canada on Friday, August 8, 2003, (Senate Meeting) and Saturday, August 9, 2003, (Open Meeting). As is usually the case, the summer meeting is less well attended than the spring meeting. There were representatives from ten local chapters. On August 8 the minutes of the April 2003 Senate meeting were approved. The 2003 YTD financial report of Section IV was reviewed. The treasurer was asked to gather information from local chapters about the number of allied professionals that each local chapter has in addition to the number of Division 39 psychologist members.  

Bill MacGillivray, Ph.D., reported on the intersection meeting (i.e., the meeting of the representatives of the various sections of Division 39). The issue of allied professionals was addressed, especially in terms of issues of allied professionals not being able to vote and the issue of when the allied professionals become a larger enough group that they could then have a representative to the board. Some members are concerned that allied professionals cannot vote, but there is little information about how the allied professionals feel about that issue. Section III and Section VI have both recruited enough members, so that their voting rights have been restored.  

No nominations for secretary were received. We discussed ways to encourage more involvement. The Chicago chapter representative was approached about having her name placed in nomination and she accepted. The past president will go down the list of local chapters compiled by Bill which have not yet sent a graduate student to the Board meetings as part of the graduate student initiative. MSPP members might be interested to know that MSPP has the highest rate of attendance to Section IV meetings of these remaining local chapters. We reviewed the letters written by the two students from the recent spring meeting. Both students had high praise for their experiences at the meetings.

The president elect has made plans for the programming for next year. As part of his programming philosophy for the next two years, he is interested in having representation of psychoanalytic work with nontraditional clientele, such as psychotics, the developmentally disabled, autistic, etc. The Canadian group which has a program working with psychotic patients (GIFRIC) has agreed to be part of the Section IV panel for spring 2004.  

The president discussed her initiative to increase the visibility of Division 39 in the various local chapters and to encourage people to join Division 39. She had planned to distribute a “care package” to each local chapter representative to take back to the chapters. This is to include membership application and other information pertaining to the division. She is encouraging all local chapter reps to communicate with the chapter to get the word out about Division 39. Local chapters could use their newsletters and websites to provide information about Division 39 on a more regular basis. A “Top Ten” reasons to join Division 39 was crafted by Marsha with much input from the board.

Speakers Bureau
We discussed the progress of the speaker’s bureau. Some discouragement was expressed as this program has not taken off as hoped. There has been very little use of the speakers to date. We discussed possible reasons for this. Many chapters seem to have a two tiered approach to programming. Namely they either try to have a “big” name come to do a conference or they use local people. Issues about lack of familiarity with the presenters was discussed. It was agreed to keep the list available (and one local chapter has discussed using it, although they couldn’t use it this year). Issues of representatives communicating with their chapter’s program chairs were discussed.

Continuing Education Issues
CE reporting procedures were discussed. Bill will step down soon as chair of the Division 39 CE committee. He said that there have been two central problems from local chapters. First, too many local chapters have not been including goals and objectives on the brochures they sent out to advertise their CE programming. This is a mandated part of CE accreditation. If this happens routinely it also affects Division 39’s ability to serve as the umbrella accrediting organization for the local chapters. Second, there has to be a statement on the brochure reflecting that the local chapter is affiliated with Division 39. It was suggested that Pat Strassburg, Ph.D. (incoming CE chair) be invited to a Section IV meeting so that communication on this issue can be facilitated in the future. Bill is already attending the Section IV meetings in his capacity as Secretary.

Spring Meeting
Division 39 will soon be celebrating its 25th anniversary. Bill is looking for someone to write an updated history of Section IV for a new history of the Division 39. The 2004 spring meeting will be held in Miami March 18-21, 2004. The title of the conference is, Psychoanalysis at the Edge: the Transmission of Culture, Class and Institution. Keynote Speakers are Drs. Otto Kernberg and Roy Schafer. We received the report from the Section IV representative to the Division 39 Board after the meeting as she had a scheduling conflict. There are some issues being taken up by the division board that are of interest to us all. Dr. Stanley Greenspan is trying to put together a diagnostic manual for psychoanalysis so there is a better diagnostic scheme. He is working with members of the Consortium and they are looking at treatment outcome research. There are three subcommittees (if you want to join this committee, e-mail Jaine Darwin). The spring meeting turned out to be a financial success as more people registered than were budgeted for.

Division of Psychoanalysis in State Psychological Associations--New York
The New York State Psychological Association NYSPA – wants to establish a Division of Psychologist-Psychoanalysts within its organization. At the Spring Board Meeting, Lew Aron requested $1000 for start-up money. Currently, they have received 150 signatures; even though they only needed 50. Next November, they will present their petition to establish a Division of Psychologist-Psychoanalysts; They have written a mission statement that has been published in the NYSPA July/August newsletter.

HIPAA
The APA is getting calls related to HIPAA and privacy; any member can feel free to call the APA Regulatory Staff. Many of these questions require the APA to go back to HHS, as there are some gray areas in the wording.  

In the near or distant future, insurance companies will eventually require that participating psychologists use the electronic format. Insurance companies are working with managed care companies as we speak. (The private market insurers can require that for participation; this is not something that will be required by law.)

Evidence-Based Treatment
“Evidence-based treatment” (EBT) has been endorsed by the Institute of Medicine. Pressure for EBT is coming from various sectors: the insurance industry, policy makers, legislators, and consumers. Proponents argue that all medical and psychological treatment should be based on empirical evidence. Some argue that the evidence should come from randomized controlled trials for different kinds of psychotherapy. Those forms of therapy that do not lend themselves to this method of “outcome” testing would be seen as not supported by empirical evidence. Treatments that people would otherwise find valuable would be lost to them due to a narrowly defined version of evidence-based treatment. A broader definition of “evidence” includes three components:  

1.   Scientific research related to treatment
2.   Clinical experience
3.   Patient values (Patients want their values respected—what do patients want?   What do they find valuable? This also expresses outcome data.)

This is a developing debate that will get bigger. Right now there is no consensually agreed upon definition. The practice directorate is trying to get the broader definition used; not the narrower one. We don’t want to negate treatments that we know are valuable, but could be negated by the narrower definition.

If we turn away from the terminology, we will be kicked out of the debate. They want randomized, controlled trials that usurp what analysts have done. What is legitimate research? This battle will be fought in two arenas: in the public sphere as well as within our own profession. (Especially as it relates to training, education, and supervisory roles.) Division 39 is going to provide Russ Newman with information to help him better understand that there is long term research supporting the effectiveness of psychoanalysis that is no longer cited but has made a significant difference.

A discussion was facilitated around this topic. It began with Lisa Pomeroy, who passed around a 15-page report, entitled, “Talking Points.” She noted that this was the result of the work of many individuals including Sidney Blatt, Drew Westin and Ken Levy, who are now all on the Section VI Board. Board members were not allowed to keep them and distribute them at this time as Lisa reminded us this is a rough draft. But the bottom line is, this document clearly shows that psychoanalysis has been effective.

Bert Karon discussed how several Divisions, notably 12 and 29, are in favor of the Evidence Based Treatment (EBT) and outcome research movement. This is a hot political issue. More complex approaches to treatment require longer treatment, which is not the managed care model. The need to provide an educational process within our profession was discussed because some psychoanalytically informed psychologists have a hard time seeing psychoanalysis as empirically supported treatment. Bert suggested that we need to be able to distribute these talking points to heads of clinical psychology programs as well as professors in colleges and universities in their training for graduate students. At the January Board Meeting, Lisa plans to put together a more updated “Talking Points.”

News About Local Chapters
The local chapters discussed their various programs and the state of their chapters. One common theme involved leadership issues. Many of the local chapters cite difficulty recruiting people to work on executive boards and committees. It’s often the same old folks doing the work year after year. Many chapters see this as a chronic issue, whether or not the chapter is experiencing financial success. Some of the chapters are using a format of small workshops for education, CE credits, and fundraising. They hold fairly frequent four-hour meetings, charge only a modest fee (say $40-50), and ask the speaker to accept either no stipend or a small stipend. The new chapter in Indiana is off to a very good start, having had two conferences (Nancy McWilliams and Christopher Bollas). Several of the local chapters are struggling with attendance at meetings or size of membership, while others are doing fairly well. The chapters which seem to be doing well finically and in terms of membership appear to have little local competition for psychoanalytic programming (e.g., San Antonio/Austin/Appalachian), whereas those which have somewhat more of a struggle in these ways have substantial competition in programming from local institutes (e.g., Chicago/Southeast Florida/MSPP).

Many other chapters were curious about MSPP’s position against MCE. We discussed and debated this issue for about the last half hour of the meeting. Many local chapters feel it has helped their bottom line, as members must earn CE credits. Several reps voiced concerns that certain people need to be forced to educate themselves because they will not undertake any continuing education unless compelled to by the state. One rep likened the need for MCE to the need for motorcycle helmet laws.