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From MPA's President Tabitha Grier-Reed, Ph.D., L.P.

Strategic Updates

I am now entering the last quarter of my Presidency, and am happy to share with you the strategic accomplishments MPA has achieved this year. The objectives for 2013 included identifying gaps and strategies to strengthen four major areas: organization structure and operations; fiscal solvency; leadership and governance; and, member engagement. First, let me tell you that at this point MPA is financially solvent.  In addition, the 2013 Governing Council has worked to review and approve policies to secure the foundation for financial stability and organizational health into the future in all four major areas of MPA. For example, with respect to leadership and governance, the organization has instituted board training for each Governing Council as well as clear documentation of Governing Council Members’ Duties and Responsibilities. Similar documents have been developed and approved for MPA Division Chairs and Committee/Task Force Chairs. Moreover, to increase oversight, MPA has passed a Whistle Blower Policy as well as an Annual Audit Policy. We have also updated our Travel, Reimbursement and Expenditure Requests policies and forms. Finally, we have increased our membership to close to 700 members, and we are focused on continuing to work toward the protection, connection, and growth of psychologists.

Connection, Protection, and Growth

MPA exists for the protection, connection, and growth of psychologists, and we need you to effectively serve this function. Many of you may be aware of changes occurring within Blue Cross/Blue Shield (BCBS) who recently implemented a drastic fee reduction affecting psychologists and switched to the Mihalik Group’s Medical Necessity Review Criteria for Behavioral Health. As a result psychologists have complained about difficulty getting access to the manual.

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From MPA's President-Elect Steve Vincent: Calling All Psychologists

The Easily Observed Contributions

A quick scan of MPA’s home page shows a wide variety of events, information and opportunities for all psychologists.   These include the upcoming Fifth Annual Rural Behavioral Health Practice Conference showcasing Advances in Rural Practice (October 11), the Annual President’s Conference on the Jigsaw Puzzle of Cognition and Affect (November 11), the  accompanying pre-conference workshop on  November 9 on the topic of cultural influences and individual differences, and multiple excellent First Friday Forums.  MPA continues to present excellent learning opportunities and the ability to earn useful CEs for licensed psychologists.  MPA serves psychology and all of the citizens of Minnesota, just as our Mission Statement says.

More Happening Behind the Scenes

Also, MPA continues to advocate effectively with state agencies and with payers.  Currently the State of Minnesota is developing its criteria for Behavioral Health Homes, a form of medical home aimed at meeting all health care needs of people with chronic mental illness.  The state has developed an advisory council to work on these criteria, and MPA has a member on that council.  MPA has been present and actively involved with legislative and regulatory affairs.   We want to ensure that psychologists are able to lead behavioral health homes. Without MPA’s previous and on-going involvement, psychology would not be represented.  Simultaneously, MPA is working with payers and regulators to ensure that the public has access to medical necessity criteria.

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Electronic Health Records Update

MPA’s work with Electronic Health Records issues

MPA is working to find decision-making tools and financial assistance for members to select, acquire, and implement electronic health records. The State Innovation Model grant may provide this assistance.

Timeline to adopt Electronic Health Records

In discussions with state officials, it has been communicated that while the deadline in statute for implementing electronic records is January 2015, they would prefer that mental health professionals get the product that is right for their practice, even if it means that a product is not in place on the deadline. This is in recognition that there are currently few appropriate products for small mental health providers. They prefer that psychologists get something that will meet their needs, rather than purchasing anything for the sake of meeting the deadline. Officials anticipate that more appropriate products will be forthcoming. An electronic health record must eventually be purchased, and consequences for failure to adopt an electronic record will be coming at some point.

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Industry News: SafeTALK

Did you know that suicide has surpassed car accidents as a leading cause of death in our country according to the Centers for Disease Control and Prevention?  Or that suicide is the second leading cause of death among 15-34 year olds in Minnesota, higher than the national rate for that age group?  Also, the Minnesota Department of Health reports that 16.5 % of ninth graders in 2010 reported having thoughts of killing themselves. While suicide is often thought of as an individual problem, it actually impacts families, communities and our entire state in both human and economic ways.

Attention is being focused on the rising rate of suicide, and our communities are recognizing that we can no longer afford to avoid or dismiss this serious public health concern as a weakness that can only happen in other families.  Suicide is everyone’s problem, not only because it can happen in any family, but because when it does, we are all affected.

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A Review of Cultural Disparities Regarding Suicidal Behavior in At Risk Populations

Adolescent suicide remains a debilitating and tragic phenomenon in the United States. Suicide is the third leading cause of death among adolescents, accounting for a greater number of fatalities than the next seven leading causes combined for 15- to 24-year-olds (Centers for Disease Control and Prevention [CDC], 2006). Distinct ethnic groups show unique patterns of suicidal behavior. “At risk” populations are those with elevated rates of suicide death, attempt, or ideation, among them being Latinos, African Americans, and American Indian/Alaska Natives. Latino adolescents have shown a tendency to be at greater risk for depressive symptoms, suicide ideation, and suicide attempts than other racial/ethnic minority adolescents (Canino & Roberts, 2001; Hovey & King, 1996; Zayas, Lester, Cabassa, & Fortuna, 2005). Across the lifespan, the median age of suicide death is approximately a decade earlier for African American suicide victims than for other ethnic groups (CDC, 2006), and among American Indians between the ages of 15 and 19, suicide accounts for nearly 20% of deaths (CDC, 2006).

Culture-specific beliefs and behaviors can act as either hazardous or preventive agents on self-injurious behaviors. Analysis of the literature has produced five salient motifs accounting for cultural disparities in suicidality: family, cultural environment, history, identity, and religiosity.

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MPA's Rural Conference Goes National and Adds Group Webcast Sites, Requests Posters

October 11, 2013, will be the first day MPA presents a conference with national partners!  Advances in Rural Practice: The Fifth Annual Rural Behavioral Health Practice Conference, still has MPA’s Rural and Greater Minnesota (R&GM) Division as its principal partner.  Other partners are joining us this year:  The Committee on Rural Health of the American Psychological Association, the Western Interstate Commission on Higher Education, the Illinois Psychological Association, and the University of Minnesota-Morris Psychology Discipline.

The other big enhancement for the 2013 conference is group webcast sites to facilitate interpersonal networking.  The conference will be available in-person to participants in Morris, MN, and to individuals in their homes or offices, as in previous years.  It will also be available to participants who gather for group webcasts, available in St. Cloud, Fargo, and northern and southern Illinois sites (and perhaps other sites TBA).

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New Member Spotlight: CJ Swanlund

1)     What is your background in psychology (e.g., education)?

I am currently a student in the Psy.D. Program at Saint Mary’s University of Minnesota.  In 2009, I received my B.A. in Communication, a related field, from the College of Saint Benedict.

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APA Praises DOMA Decision as Victory for Science, Human Dignity

The American Psychological Association commended the June 26 U.S. Supreme Court ruling that the federal Defense of Marriage Act is unconstitutional.

“The U.S. Supreme Court ruling today overturning the Defense of Marriage Act is a triumph for social science and recognition of the basic dignity of all American citizens,” said APA President Donald N. Bersoff, Ph.D., J.D. “The American Psychological Association is gratified that the court found there is no legitimate reason for denying equal treatment under federal law to same-sex couples.”

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From MPA's President-Elect Steven M. Vincent, Ph.D., L.P. - MPA's Progress Serves and Needs All of Us

In October of this year, Minnesota is scheduled to open its on-line insurance exchange, part of the health care reform measures in the Affordable Care Act that passed Congress in 2009.  They have been working their way through the courts and the regulatory process ever since.  In January, Minnesota will begin its Medicaid (known in Minnesota as Medical Assistance) expansion to cover more people, many of whom have no insurance now—another provision of the Affordable Care Act, also frequently referred to as Obama Care.  MPA’s work at the capitol in St. Paul, in collaboration with many others, helped to provide an increase of 5% in Medical Assistance rates that goes into effect on September 1, 2014.

Also, as I reported last month, MPA’s bill passed in this year’s legislative session, and now psychologists are included with psychiatrists and advanced practice psychiatric nurses as mental health professionals who can be paid by Medical Assistance for providing consultation to primary care providers.  At the same time, Minnesota is working its way towards establishing a structure for Behavioral Health Homes, a version of Healthcare Homes that focuses on serving people with serious and persistent mental illnesses.  Integration of primary care and psychological services are a central tenet of such homes.

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From MPA's President Tabitha Grier-Reed, Ph.D., L.P.

Strategic Updates

I love summer in Minnesota—the biking, the walking, the parks, the trails. For MPA it’s a slower time of year. For this reason at the May Governing Council (GC) meeting, we all agreed to recruit one new member to MPA which currently has over 700 members.

In terms of strategic directions, this June the Executive Committee (EC) followed up on the GC recommendation to develop a financial audit policy for MPA. Consequently, the EC proposed the development of an Audit Committee comprising general members as well as governing MPA members. If this interests you, stay tuned; look out for a call for Audit Committee Members. The July  GC focus is on communications, including outlining a process for proposing new projects.

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Sponsor/Exhibit at the Fifth Annual Rural Behavioral Health Practice Conference

Standard Benefits included in all levels:

  • 8-ft. display table and two chairs
  • Organization name and contact information included in the conference program and on a PDF for webcast participants so webcast participants can call with questions.
  • One free admission to the conference
  • Snacks and lunch

Conference Sponsor – $500

  • Standard Benefits plus organization logo prominently displayed before all speaker sessions
  • Recognition as a conference sponsor at the beginning and end of conference

Lunch Sponsor – $400

  • Standard Benefits plus recognition and organization logo prominently displayed during lunch

Morning and Afternoon Break Sponsor – $300

  • Standard Benefits plus recognition and organization logo prominently displayed during the break

Exhibitor – $200

  • Standard Benefits

Sign up now!

IMPORTANT: Electronic Records

Guidance for Understanding the Minnesota 2015 Interoperable EHR Mandate.

Click to find out more.

MPA's Progress Prepares for Health Care Reform

By Steven M. Vincent, Ph.D., President Elect

For at least two decades we have heard nearly constant discussion about health care reform, to the point that many people have come to doubt that anything substantive is going to happen.   However, among policy makers, pundits and progressive thinkers, health care reform is now seen as inevitable.  In March I wrote about the APA State Leadership Conference which took place in Washington, D.C. from March 9-12 with the theme of “Countdown to Health Care Reform.”  Seventy-five State, Provincial and Territorial Associations, and APA divisions, focused their attention on preparing psychology for reform, with an emphasis on ensuring that our profession will have an important and powerful role in this process.  MPA’s own annual convention on April 5 and 6 took a similar theme, “Surviving and Thriving:  Psychology in the Era of Health Care Reform.”  With the conclusion of the Minnesota State Legislature’s 2013 session on Monday, May 20, MPA can claim real progress preparing the way for psychology’s place in health care reform.

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New Member Spotlight: Miriam Gerber, Psy.D., L.P.

1)    What is your background in psychology (e.g., education)?

I received my M.A. in Personality Psychology from American University in Washington DC in 2004 and completed my Psy.D. in Clinical Psychology at Loyola University Maryland in Baltimore in 2009.

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Psychotherapy code changes confuse providers, payers

By Paula E. Hartman-Stein, Ph.D.

January brought changes in the business of psychotherapy with a new family of Current Procedural Terminology (CPT) codes that are wreaking havoc, and APA underestimated the confusion that would ensue. A Sept. 13 email to members said, “The changes are minimal.”

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The Disaster Response Network

The Disaster Response Network (DRN) is a group of licensed mental health professionals who volunteer their time and expertise to fulfill the mission of the American Red Cross to prevent and alleviate human suffering in the face of emergencies.

The DRN was formed in 1992, the result of an agreement between the American Psychological Association and the American Red Cross, with the goal to develop a multi-disciplinary approach to disaster response that included management of traumatic stress.  Today, there are Stress Teams in most states, comprised of an array of mental health professionals who are deployed by the Red Cross as needed.  In general, local teams respond to local crises such as fires and floods, but may be called into service on a national level in the event of a large scale disaster that overwhelms the resources of local or regional chapters.  In addition, the American Psychological Association leadership provides and/or critiques brochures and other materials going to disaster sites.

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My Experience as a Prescribing Psychologist

It was a frigid February day in Grand Marais in 2006 when I received a flyer with a picture of Fort Lauderdale and the Nova Southeastern campus. The flyer was advertising a master’s degree in psychopharmacology created for doctoral level psychologists. It required the students come to  Fort Lauderdale for a 6-day weekend every other month, for two years. It must have been psychologists who thought of sending this flyer to me in Northern Minnesota in the dead of winter.

While the palm trees caught my attention, what kept my interest was gaining further training in psychopharmacology. Due to the remote location of my practice, it was difficult to get psychiatric care for my patients. Instead, I worked with the five local family doctors to obtain psychotropics for my patients. The doctors, by their own reports, did not have advanced training in mental health disorders nor in psychotropic medications. The idea behind obtaining this advanced training was to return back to my community and share the knowledge obtained.

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What is Industrial/Organizational Psychology?

This was the topic of the May 3, 2013 First Friday Forum panel discussion with Harry Brull, M.S., Kraig King, Psy.D, MBA, and Jane Coffey, Psy.D., LP.   Industrial/Organizational Psychology (I/O) applies to individuals and organizational units and involves defining, measuring, and developing the components required to help employees and organizations achieve success.  Although I/O psychology may draw from traditional counseling and clinical practice, the majority of its tools come from other, less well known areas of psychology.   For example, I/O psychology draws heavily from testing and measurement, learning theory, and statistics. However, there are several close parallels between I/O psychology and clinical or counseling psychology.  For example, I/O psychologists occupy positions in academia, within organizations, or as external consultants. While they may be involved in research, or clinical-type activities, much of their focus is on assisting organizations with the human side of their operations – ensuring that personnel are well placed, trained, and motivated to perform capably.

Group Behavior:  It has long been recognized that individuals behave differently in groups than they do alone or in one-on-one situations.  Much of the work done by social psychologists revolve around this fact.  Additionally, being a member of an organization adds another level of complexity:  you now have individuals, groups, and the organization itself.  This aspect of I/O psychology is seen in tasks such as team building (which hopefully helps a group of individuals work more smoothly together), as well as consultation dealing with interpersonal communications.  Often, the skills I/O psychologists draw upon when working with groups closely align with the skills in family or marital counseling.

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Book Review: Getting the Most Out of Clinical Training and Supervision - A Guide for Practicum Students and Interns by Carol A. Falender & Edward P. Shafranske, APA Books

Reviewed by Gary R. Schoener, M.Eq., Licensed Psychologist

This new book from the American Psychological Association is a unique resource. It is, I believe, the first book to instruct trainees on how to get the most out of their supervised experience.

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The Clinical Utility of a Dimensional Classification of BPD - A Literature Review

With the upcoming release of DSM-5, many personality disorder experts have posited the potential success of a dimensional classification system. Borderline Personality Disorder (BPD) is often at the forefront of discussion because it is the most prevalent personality disorder (Skodol et al., 2002) and individuals with BPD have a notoriously low quality of life (Masthoff et al., 2007). While many propositions for specific dimensional models have been introduced, few have examined the clinical utility of such models, which is a continuing concern of many psychologists and psychiatrists. Through a review of existing literature, with consideration for the major aspects of clinical utility, it is evident that a dimensional model of BPD would improve clinical utility and improve the validity of diagnoses.

The BPD construct has caused significant disagreement among researchers and clinicians. These disagreements include not only the clinical utility of the classification of the disorder but also conceptual issues regarding its classification (Griffiths, 2011). Many researchers assert that any taxonomy of psychological disorders is only practical if appropriate for the clinical settings in which patients’ improvement depends upon the quality of their assessment (First et al., 2004; Verheul, 2005).

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