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What Every Mental Health Provider Should Know About Cancer Survivorship

“What Every Mental Health Provider Should Know About Cancer Survivorship” was presented at the Minnesota Psychological Association Friday Forum series on March 6, 2015. Drs. Morrison, Ehlers, and Staab focused on three key questions for treating cancer patients and survivors: What do we know?; How can we identify?; and  How can we treat?

Beginning in 2015, the American College of Surgeons (ACoS) Commission on Cancer requires that all comprehensive cancer centers, in order to maintain accreditation, screen for depression and anxiety symptoms, provide mental health referral when needed, and monitor psychosocial symptoms until remission and beyond. As the number of cancer survivors continues to increase in our state, mental health professionals in Minnesota will undoubtedly encounter cancer patients and survivors, regardless of the professional context of their practice or whether cancer is the primary presenting problem.

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MPA First Friday Forum Presentation: Taking an engineer’s viewpoint on dysfunction in decision-making

On Friday, December 5, 2014, Dr. A. David Redish presented at the Minnesota Psychological Association’s First Friday Forum. The title of his presentation was, “The Mind within the Brain: Implications for Psychology and Psychiatry.”  He presented new ideas from his new book titled, The Mind within the Brain: How we make decisions and how those decisions go wrong.  Dr. Redish has provided a summary below.

At the MPA’s First Friday Forum in December, 2014, I presented a new perspective on psychological and psychiatric dysfunction – if we understand the underlying processes of how we interact with the world (including with each other), then we should be able to identify how and where those processes can break down and how better to treat those breakdowns.  These ideas arise from the burgeoning field known as “Computational Psychiatry” which uses information processing (computation) to connect neuroscience (mechanism) with psychology (behavior).   The presentation concentrated on two new ideas – first, the concept of failure mode, and second, a careful identification of the processes underlying decision-making.

The term failure mode comes from engineering and is about identifying the weak links in a system.   For example, when a bridge collapses, we want to know what allowed the bridge to collapse.   If we know that there are weak gusset plates and that the bridge cannot take the weight we expect, then we can strengthen those gusset plates and we can limit the weight on the bridge.   Similarly, a computer virus accesses processes within the operating system of your computer by finding code that can be executed in unexpected ways.   Knowing where the failure modes of a system are allows us to prevent and treat those potential dysfunctions.  But this means that if we want to understand how the human decision-making system can break down (where the failure modes are), then we need to understand how humans make decisions.

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Rural Conference Expands in 2014

The 6th Annual Rural Behavioral Health Practice Conference, “Integrated Care in Rural Practice,” grew significantly in 2014, with 10 organizational partners and over 200 participants from 21 states.  Co-Chairs Willie Garrett, Ed.D. and Scott Palmer, Ph.D., concluded that this growth shows that the conference is filling a national need.  “MPA’s Rural and Greater Minnesota Division has got a great thing going, and we’re pleased that MPA is really supporting it,” Garrett noted.

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Report on the Committee on Women in Psychology Network Meeting

On August 9, I attended the Committee on Women in Psychology (CWP) Network Breakfast Meeting at the American Psychological Association (APA) Annual Convention in Washington, D.C. as a representative of MPA. The CWP is a part of APA and is “committed to ensuring that women receive equity both within psychology and as consumers of psychological services, and that issues pertaining to women are kept at the forefront of psychological research, education, training, and practice.” The Women’s Program Office at APA provides staff support for the CWP.

Meeting Highlights:

What follows is a summary of meeting highlights plus a contribution by MPA Student Member Yolanda Perkins-Volk who also attended the meeting. The meeting was attended by representatives of APA Divisions and State, Provincial, and Territorial Psychological Associations along with CWP members and APA staff.

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Minnesota Board of Psychology Complaint Resolution Process and Interactive Ethics Module

This was the presentation of the Minnesota Board of Psychology (Board) at the Minnesota Psychological Association (MPA) 2014 Convention on Friday, April 11, 2014 by the following Board members and staff: Dr. Scott A. Fischer, (Vice Chair) Ph.D., LP, Dr. Jeffrey L. Leichter, Ph.D., LP (Chair), Angelina M. Barnes, Esq. (Executive Director), Scott W. Payne (Compliance Director), and Joshua Bramley (Compliance Specialist).

Complaint Resolution Process

The Board’s Complaint Resolution process begins with the receipt of a written complaint. The complaint is reviewed to ensure it is jurisdictional; whether the Board has the power to preside over the complaint.  The Board has jurisdiction over matters only to the extent granted to it by state statute (see Minn. Stat. sec. 148.905).  A question regarding jurisdiction asks whether there is power over the person, the subject matter, or the geographic location.  For the Board, this equates to power over applicants and licensees of the Board, the practice of psychology, and/or the State of Minnesota.

Complaints are acknowledged by written notice to the complainant within 14 days after the receipt of a complaint (see Minn. Stat. sec. 214.103, subd. 1a[a]).   The Board is required to “notify a licensee within 60 calendar days after receiving a complaint against a licensee” unless such notice would “compromise the board’s investigation and that such notice cannot reasonably be accomplished within this time” (see Minn. Stat. sec. 214. subd. 1a[b] and [d]).

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MPA Student Division Launches Mentorship Program

In collaboration with the Membership Committee and New Psychologist Network, the Student Division launched the MPA Mentorship Program on Saturday, April 12 at the Annual Convention. Designed as part of the “Student & New Psychologists track” for the convention, the goal of the Mentorship Program Launch was to provide students and new psychologists (“mentees”) with the opportunity to establish mentoring relationships with experienced psychologists (“mentors”) working in various specialties.  The concept was born out of the strategic retreat in the fall of 2013, when MPA leaders discussed the association’s goals for the following year.  These goals broadly included connection, protection, and growth – the theme of the 2014 Annual Convention.

The strategic retreat buzzed with energy as MPA leaders discussed the benefits of establishing connections across generations and the accompanying challenges for connecting individuals with different interests, needs, and preferred modes of communication.  As always, the membership committee was interested in developing innovative ways for protecting and growing the association, and instead of asking potential members “what can MPA do for you,” the question evolved into “what can you do with MPA?”  The latter question promoted a high level of member engagement, and the leaders continued to discuss ways of tapping into the impressive human capital of MPA.  Eventually, the idea of connecting individuals across professional developmental stages in the spirit of protecting and growing the community of psychologists emerged in the shape of a mentorship program.

The Mentorship Program Launch was a successful event at the convention, as over twenty students and new psychologists gathered to connect with eleven mentors from multiple disciplines.  The mentors worked in a variety of treatment settings, including university counseling centers, private practices, community mental health clinics, hospitals, among other settings.  Also, the mentors reported expertise in working with specific populations, including children and families of individuals with Autism Spectrum Disorders, LGBT populations, homeless individuals, college students, individuals with sexual concerns, children and adults with AD/HD, among other populations.  Several experienced psychologists expressed interest in sharing their valuable time, insights, and unique expertise with a new or future psychologist, but were unable to attend the session, and they were asked to provide their information for a “mentorship database.”   If mentees have interests beyond the specialties represented at the convention or were unable to attend the session, they may contact the Student Division to access contact information of additional mentors within the database.

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Communities Invested in African American Youth: Strengthening Relationships among Children, Caregivers, and Teachers

On Friday, February 7, 2014, Dr. Willie Winston III and Dr. Sonya S. Brady co-presented at the Minnesota Psychological Association’s First Friday Forum. The title of their presentation was Communities Invested in African American Youth: Strengthening Relationships among Children, Caregivers, and Teachers. The presentation described results from a five-year research partnership between the Minnesota Association of Black Psychologists (ABPsi) and the University of Minnesota School of Public Health, funded by the University of Minnesota Medical School, Program in Health Disparities Research. Minnesota’s ABPsi chapter is a non-profit organization focused on enhancing the well-being of African Americans through social change programs and positive approaches to research. Formative research was conducted in two stages with a partnering elementary school in St. Paul, Minnesota including: (1) Focus groups of 16 African American children and their caregivers to discuss the most important issues affecting the well-being and future success of young people in the African American community; and (2) structured interviews of 46 African American children and caregivers to begin testing a conceptual model informed by empirical literature and clinical experiences of Minnesota ABPsi members. The model posits that externalizing behavior among disadvantaged African American youth may be a response to stressors within the home, school, and community. Inadequate resources may lead professionals to focus solely on children’s behavior, without also addressing underlying affective symptoms, such as depression, related attitudes, and low academic investment. Youth assets and resources for resilience fostered by parents, teachers, and community members may protect youth from negative outcomes. Further, advocacy on the part of caring adults may reduce the likelihood that mental health referrals, diagnoses, and treatments are exclusively focused on behavior.

Dr. Winston and Dr. Brady presented data in support of their conceptual model. Key interview findings discussed with the First Friday Forum audience included the following: (1) When children experience many stressors or have poor relationship quality with their caregiver, children report more symptoms of depression, anxiety, anger, aggression, and rule breaking; (2) When caregivers feel more supported by others in their social networks, children feel more supported by their caregiver; (3) When children feel more supported by teachers, they exhibit fewer externalizing symptoms, are more academically invested, and perform better academically; (4) When African American boys engage in greater levels of problem-focused coping, they perform better academically and have higher standardized test scores; and (5) Different facets of African American identity are associated with academic investment and performance among boys and girls. Key focus group findings discussed with the First Friday Forum audience included the following: (1) It is sometimes difficult for caregivers to acknowledge information suggesting that children are struggling with behavior because this may reflect poorly on the caregiver; (2) children hesitate to trust professionals with their problems, particularly those involving events at home; (3) words such as “depression” and “anxiety” are not used in the African American community, despite the need for help in coping with feelings; (4) teachers and parents need to work together to help children reach their full potential; (5) African American families address racism and discrimination in different ways. Collectively, findings demonstrate a need to strengthen relationships among African American children, caregivers, and teachers. In addition, it is essential that mental health practitioners and other professionals improve the conceptualization and treatment of behavioral problems among youth who experience adversity.

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Fifth Rural Behavioral Health Practice Conference Focused on Rural Issues

Behavioral health professionals from several states joined MPA’s Rural and Greater MN Division (RGMD) October 11 for their fifth annual conference, focusing on “Advances in Rural Behavioral Health.”  Evaluations showed high satisfaction with conference content and format.  Dr. Willie Garrett, RGMD Chair and Conference Co-Chair, commented, “Rural professionals were offered an inexpensive ‘blueprint’ for success, in preparation for the new era of rural psychology practice and healthcare reform.”

Partnering with the Illinois Psychological Association was a successful experiment this year.  IPA contributed three committee members and pulled in nearly 30% of the participants.  Other partners included the Psychology Discipline at UM-Morris, the Western Interstate Commission on Higher Education, and APA’s Committee on Rural Health.

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Land of 10,000 Lakes and Exceptional Vision

Having the 121st Annual APA Convention in Honolulu, Hawaii was extraordinarily memorable for the 11,400 registrants and HPA.  The vision, vitality, and enthusiasm of the next generation were infectious.  From a health policy perspective, it was especially gratifying to see the extent to which new career psychologists and graduate students were actively embracing the notion of integrated, patient-centered care which is the hallmark of President Obama’s landmark Patient Protection and Affordable Care Act (ACA).  Unprecedented change, driven primarily by historically escalating costs and a new appreciation for the potential contribution of the advances occurring in communications technology (i.e., electronic health records, comparative effectiveness research, and telehealth), is rapidly impacting the nation’s healthcare environment.  Cynthia Belar described how from the APA Education Directorate’s vantage point, psychology’s training institutions and internship sites are successfully adapting to the changing demands of the 21st century.  Personally, one of the most gratifying presentations at the convention was the symposium chaired by Patti Johnson, who has now served in the U.S. Army for over 20 years, addressing the unique psycho-social needs of military families and especially their children.  The nation’s protracted conflicts have had a significant impact upon the behavioral health of military children and youth.  Patti’s panel discussed a number of innovative programs that were making a real difference.  All of psychology owes President Don Bersoff our gratitude for his vision and passion in developing special Presidential programmatic initiatives focusing upon how psychology can contribute to the nation’s responsibility for our Wounded Warriors and their families.

I currently have the opportunity of serving at the Uniformed Services University of the Health Sciences (USUHS) (DoD) where psychology and nursing have made a special, and in my judgment visionary, commitment to fostering true interdisciplinary training.  “As a graduate student in the clinical psychology doctoral program at USUHS, I study alongside advanced nursing students.  Participating in interdisciplinary classes has taught me that psychology and nursing share similar goals and pursue complementary research questions.  When looking for allies to improve the health care of our warriors and our nation, nurses and psychologists have to look no further than to each other.  And, by collaborating in our formative years, we maximize our impact as team-based healthcare providers (Joanna Sells).”

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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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New Psychologist Network at Lyon's Pub, January 9, 2013

Ever heard of a Zombie Pub Crawl? Throngs of masterfully dressed “zombies” make their way through popular watering holes yelling “BRAINS!” and swapping imaginary apocalypse stories, drawing shrieks, giggles, and stares from all of the living people trying to have an after-work cocktail in peace. Though MPA does not specialize in the undead, on January 9, 2013, more than 30 early-career psychologists gathered at Lyon’s Pub to help with the organization’s own return to life of the New Psychologist Network. Thankfully, psychologists have significantly more decorum and pleasantry than zombies, so the other bar patrons and wait-staff were happy to welcome this talkative and excited group! NPN co-chairs Julia Kidwell and Miriam Gerber were pleased to welcome professionals from a wide variety of practice settings who were eager to meet other new psychologists and talk shop. Thanks to the MPA Governing Council’s personal donations, the crowd enjoyed delicious appetizers.  A quick audio scan of the group revealed conversations ranging from EPPP strategies and licensure questions to client referrals and job openings. Even without apocalypse stories, this event was full of energy and curiosity about MPA and benefits of being part of the New Psychologist Network. Everyone was hopeful about future events being even more jam-packed with people and early-career discussions.

Julia and Miriam will be working on another networking event that will occur in May and hope to see more activity on the NPN listserve, available to current members by emailing Katie Hunt ([email protected]). The NPN is also hoping to be active on the MPA Facebook page, so be sure to “like” MPA to get real-time updates on social and networking events, CEU opportunities, legislature information, and other goodies. Please feel free to contact Julia ([email protected]) or Miriam ([email protected]) with any NPN questions!

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MPA Award Winners 2011

Four organizations received the Psychologically Healthy Workplace Award during the 2011 MPA convention. Each organization met all five criteria for the award (i.e., employee involvement, employee recognition, employee development, work-life balance, and health & safety); however, each organization is also expected to be exceptional in at least one of these criteria. I will single out an exceptional practice for each of our award winners.

Hennepin County has more than 9,000 employees serving the largest county in Minnesota. To better serve its employees, the County recently reviewed employee health claims and conducted a health survey. This study revealed that 53% of employees or their spouses reported that they experienced “emotional concerns.” In addition, 3 of the top 10 prescription drugs taken by employees and spouses were anti-depressives. The county suspected that these issues were driving disability claims and requests for ADA workplace accommodations. In response, Hennepin County launched an Emotional Wellness Project. This project provided training for supervisors in two departments on recognizing and working with employees whose performance may be impacted by emotional concerns. A 90-day, follow-up survey of these supervisors found that 50% had a recent performance issue with a “troubled employee” and more than 96% reported that they had used the tools and resources from their training to work more effectively to resolve performance issues with their supervisees. As a result of this project and other initiatives, Hennepin County realized a return of $81 for every $1 spent on this program. The County hopes to expand this training program to other departments. 

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