Welcome to Spring!  The Minnesota Psychological Association’s annual convention is behind us now, and we are looking forward to the coming months.  While writing this essay to you, I learned that the Minnesota legislature passed a bill containing MPA’s proposed Duty-to-Warn language, and Governor Dayton signed it into law!  There is NO ambiguity remaining – psychology supervisors and psychologists-in-training can rest assured that in Duty-to-Warn situations, you are protected with immunity. 

The issue began about this time last year when the Executive Director of the Minnesota Board of Psychology notified MPA that a Duty to Warn case had been overturned on appeal with a ruling indicating that psychology supervisees are not covered with immunity in our current Psychology Practice Act in situations where a Tarasoff warning is required.  In essence, an appeals court had ruled that when receiving information about a credible homicidal threat, supervisees could be sued effectively should they report this information to authorities.  Due to language in the MN Practice Act, this appeals court ruled that only licensed psychologists have immunity is such situations.  MPA leaders were relieved that the Board of Psychology had given us this heads-up, and then sprang into action.   We knew that not only would we need to work to change the language of the law to achieve important clarification in the Practice Act;  we also recognized that we would be serving all psychologists in Minnesota by submitting an Amicus Curiae Brief to the Minnesota Supreme Court, slated to hear this case in 2016.

With the passage of SF2414, psychologist supervisors are completely covered for their supervisee’s duty to warn under Minnesota’s version of Tarasoff.  What are you talking about you might ask, you thought you were covered already.  As mentioned earlier this year in this newsletter, there was a court case that interpreted the law as it stood as not covering the actions of an unlicensed supervisee and allowed a criminal conviction to be overturned and a civil lawsuit against the supervisee and supervisor to go forward.  This has been argued before the Minnesota Supreme Court with an Amicus Brief filed by MPA and we await the decision of the court.  As we wait we are not idle.  We crafted legislation closing the loophole in the law and have lobbied this law through to the recent passage.

This is what MPA does for you!  We watch for issues and address them as quickly and completely as we can with the resources at our disposal.  This why continued membership is so very important.  In the coming year it seems likely we will have to work on revisions of the Psychology Practice Act to clarify some of the recent confusion in interpretation of that Act. 

Award:  Susan T. Rydell Outstanding Contribution to Psychology Award (two award winners)

Winners:  Rochelle Brandl, Ph.D., L.P. and Mary Tatum Howard, Ph.D.

The original intent of this article was to inform MPA’s membership of our promotion from the Health Care Reform Task Force to the Health Care Reform Committee (HCRC), describe the HCRC’s relatively short history, and report current/future goals (but more about that later in this article).

Given recent changes announced by Medicare, however, it seems more prudent to focus providing information gleaned by the HCRC (and other MPA member/committees) regarding such.  Trisha Stark, Ph.D., L.P., provided the following link for the HCRC’s 5/2/16 monthly call-in committee meeting:  http://healthaffairs.org/blog/2016/04/29/breaking-down-the-macra-proposed-rule/   Dr. Stark is chair of MPA’s Electronic Healthcare Records Task Force and an HCRC committee member. 

Hello to all, my name is Steve Girardeau and I am your president-elect for MPA.  I will serve my presidential year in 2017 beginning my presidency at the same time as the individual we elect to be our next national president.  I offer the observation not because I think my presidency will be as important or impactful for the nation but to connect the processes of the national, state and local elections to our national and state associations. 

In both arenas there has been a great deal of polarization and acrimonious shouting about issues rather than a drive to participate in a rationale discourse on the issues that face us both as a nation and more to the point of this article, as an association.  MPA has weathered a difficult year, the year of EHR implementation, thanks to the strong leadership of Scott Palmer.  The most striking news of 2015 being that quite a few vocal individuals who had not been all that involved in MPA seemed to believe that MPA was a silent partner to the Minnesota Department of Health in the creation and implementation of the EHR mandate.  Having been active in the legislative committee and governing council, and having attended MPA conventions in the years leading up to 2015, I was surprised at their surprise.  MPA had informed the membership of the process as it proceeded, requested feedback, and provided informational content at the conferences in those years.  There was little notice paid and little concern expressed.  It was only after implementation was upon us and there was a direct impact on people’s immediate practice that there was surprise, disappointment and frustration that, “something should have been done.”

I always have thought of MPA’s Annual Convention as much like the Minnesota State Fair for psychologists.  Complete with psychology’s version of admission discounts, a Mid-way area, a Grandstand line-up, vendors displaying items of interest to just about anyone, games of skill and chance, and blue ribbon awards. This year’s MPA Annual Convention has something for every Minnesota Psychologist.  We even will have our own version of free entertainment!  Please play along with me as I expand upon this fun analogy.

When you arrive at The Crowne Plaza Minneapolis West Hotel in Plymouth on April 15 & 16, you will check in at the registration table where you will be given a nametag, your pre-purchased ticket to everything at the convention.  If for some reason you haven’t yet purchased a ticket, no worries!  Rhea Sullivan, MPA’s Administrative Director, and one of the convention Visitor Guides, will help you get registered so that you will be ready for two days of action-packed fun!  And, if you are new to MPA, she also will let you know about the huge membership discount available to you only at the convention.  Yes, that’s right.  If you have never been a member of MPA, or if your membership lapsed at least three years ago, you can become a full dues-paying MPA member for a discount of $200.  It’s a bargain only offered during the Great Minnesota Psychology Get-Together!

MPA members received the APA Division 31 APAGS Award for an Outstanding State, Provincial, or Territorial Association of the Year at the APA State Leadership Conference in Washington, D.C. Front row, from left to right: BraVada Garrett-Akinsanya, Cynthia (C.J.) Swanlund, Robin McLeod, Sy Gross.  Back row, from left to right: Matthew Syzdek, Daniel Kessler, Yasmine Moideen, Bruce Bobbitt and Willie Garrett.

The Minnesota Psychological Association (MPA) is pleased to announce the formation of the new division, Psychologists in Healthcare Organizations (PHO). The PHO division was developed to serve as a resource for psychologists employed in health care settings or interested in working in health care settings, and to assist with the growth and integration of behavioral medicine services into medical practices, clinics, and centers.

The landscape of health care continues to change, and as part of it, delivering effective, yet affordable and safe health care has received greater emphasis. This has been a focus of both government agencies and the private sector alike. Behavioral medicine has attempted, with mixed results, to address this area for years by forging relationships with medical practices. In primary care settings, psychologists screen medical patients for mental health conditions and triage to appropriate mental health care. In neurology groups, psychologists assist with diagnosing patients and making treatment recommendations. In Sleep Centers, psychologists treat insomnia patients, in lieu of prescription sleep medications. Despite these additions, the overall integration of psychologists into medical centers has been slow, uneven, and mostly untapped.

The social revolution of the 1970s coined the word “marginalized” to describe the experiences of those who live on the fringe of mainstream America.  Such persons are systematically excluded from full participation in the American dream and consequently lack the self-efficacy to improve their life situation.  In the end, society pays the costs when people encounter barriers to achieving their potential.  The term marginalized has expanded from originally referring to minorities and persons from poverty, to include a long list of cultures and populations.  Here is a sample of the most common marginalized groups:

• GLBT
• Senior citizens
• Racial/Cultural minorities
• Military Combat Veterans
• Persons of below average intelligence
• Hearing, visually, and Physically  Challenged Persons
• Persons with a serious and Persistent Mental Illness (SPMI)
• Persons with Cognitive Impairments
• Gamblers and Substance Abusers
• Autism Spectrum Persons
• Gifted and Talented Persons
• Persons with disfigurements
• Persons Living in Poverty
• Sex Offenders
• The Homeless
• Felons

While this is only a listing of those most commonly referred to as marginalized, there are other individual people who just do not fit into mainstream culture, and suffer the same consequences. Such persons are all around us but virtually invisible…unless they cause problems or disrupt the lifestyles of mainstream persons.

The Minnesota Psychological Association recognizes the many years of service to the people of Minnesota with his passing on March 13, 2016. He was an exceptional person and served us with dignity and caring. He was in the U.S. Congress 28 years, 1979-2006, after extensive service in the Minnesota legislature. Congressman Sabo, and his staff, were supportive to the position and visits by Minnesota psychologists sharing his wisdom and time. At one visit during the APA State Leadership Conference he spent more than an hour with two of us, Steve Peltier, Ph.D., L.P. and Sy Gross, Ph.D., L.P., which is  much more time than typical, then or now. We benefitted from his informed ideas about fiscal integrity necessary to seek legislation with his service on the key House Appropriations Committee all of his career in Congress, and Chair of Budget Committee, 1993-94.  He appreciated the challenge faced by psychologists.  His successor in the U.S. Fifth District, Rep. Keith Ellison, has continued being supportive to professional psychology. The Minnesota Psychological Association honors and respects Congressman Martin Olav Sabo.

Written by Sy Gross, Ph.D., L.P., who is the Current Federal Advocacy Coordinator for MPA for the past 12 years, a previous MPA President, and on the Council of Representatives for APA.  His doctoral degree was received from the University of Minnesota Clinical Psychology program and he currently does clinical work at Hennepin County Mental Health Center. His specialization is with persons who are homeless.

MISSION

Minnesota’s Health Professionals Services Program protects the public by providing monitoring services to regulated health care professionals whose illnesses may impact their ability to practice safely.

In late 2015, NAMI Minnesota received another MNsure grant to help people with mental illnesses and their family members obtain health insurance. In addition, NAMI Minnesota is working to educate individuals on how insurance works and how to utilize the benefits offered.  Two fact sheets on health insurance basics have been written, are on our website, and can be sent on request. Presentations are also being offered. Here are some health insurance terms that you or your clients will learn with these fact sheets and at these presentations:

Premium – Monthly amount paid for health insurance plan. This amount must be paid whether or not you actually use your health insurance.

As Chair of the Oklahoma Colleague Assistance program for the Oklahoma Psychological Association, I have been involved in helping establish a colleague assistance program over the past several years.  A critical turning point in my efforts occurred while working clinically with other health care professionals.  I began to examine the practice acts for various disciplines (i.e., medicine, nursing, pharmacy) and this led me to wonder how our psychology practice act compared.  I determined six areas in which we differed significantly from our health professional peers in Oklahoma.  I have posed these in the form of questions below.  Even if you have a formal Colleague Assistance Program (CAP) in your state, it may be useful to review your state’s practice act as it lines up with the workings of your CAP.  It may help to obtain a copy of your state’s psychology practice/licensing act as you read through the list.

1. Does your practice act contain a reference to practicing with skill and safety that can be compromised by substance abuse and/or a psychiatric condition?  Does your state practice act go further to include medical conditions and neurocognitive conditions which can impair functioning?  Language about impairment is fairly commonplace in practice acts, but knowing how impairment is defined in your practice act is important.
2. What does your state practice act say about reporting an impaired colleague?  In Oklahoma, there is no explicit mandate in their licensing act for psychologists to report.  Other professions in Oklahoma are explicit about a mandate to report impaired colleagues, and some professionals (e.g., physicians) are required to report across health profession lines.  In some states, like Oregon, there is a requirement to make such reports within a specific time period, 10 days (ORS 676.150, signed into law January 1, 2010).
3. Related to reporting an impaired colleague, does your state practice act grant civil and criminal immunity if the report is made in good faith?  In our Oklahoma psychology practice act, this is not addressed.
4. Will your colleague know that you reported her/him to the licensure board? In Oklahoma, the psychologist being reported to the licensure board will receive a copy of the Request for Inquiry (i.e., complaint form) that is sent to the board.  This complaint form contains a description of what is being alleged and the name and contact information of the person making the report.  Other boards in Oklahoma provide statutory protection of the identity of the person filing a complaint.  This of course, lowers the threshold for reporting.
5. Does your state practice act require you to answer questions upon annual renewal of your license regarding impairment, treatment, or current suitability to practice with skill and safety?  In Oklahoma, this is not addressed in the practice act.  Other health professional boards do include a section in their practice act regarding continued suitability to practice with skill and safety. In addition, the licensee is required to complete an annual attestation about suitability or continued ability to practice with skill and safety, among other questions such as legal problems.
6. Does your state practice act empower your state licensure board to create or affiliate with an entity that can aid in addressing impairment among psychologists?  In Oklahoma, the ability of our licensure board to affiliate with a program was not explicitly outlined in the practice act or Rules of the Board. An interpretation of the board rules by the State Attorney General’s Office determined that the licensure board had the authority to establish such an affiliation. Consequently, our licensure board moved forward with an agreement that allows psychologists to participate in the state's physician monitoring program. 

Examining our psychology practice act in Oklahoma and comparing it to the practice act of our healthcare professional peers illuminated some stark differences.  When I presented these differences at our annual state psychological association meeting several years ago it created strong momentum to make changes. 

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

I work as a psychologist, speaker, author, and art playgroundist. The common thread through out these is my colorful pursuit of the human heart: to listen deeply for the stunning beauty within, to address what may be getting in the way of seeing the beauty and fully living it out, and to reflect it back to people with spoken and published words, art, and even in my colorful clothing. My education is from the University of Minnesota’s Ed Psych/CSPP program.  I’ve counseled 22 years since then, and am currently in a solo St. Paul private practice.

Most people enjoy dogs and find great pleasure in having them around. All of that is fine, but there is a growing trend among those who want to be with their dogs that should be of particular concern for psychologists.

Psychologists are frequently being asked by their patients to attest to their need for an Emotional Support Animal (ESA) for mental health purposes, which allows that animal to be present in what previously would have been a restricted environment.

Until relatively recently, yoga, meditation, and non-traditional spirituality – as opposed to classical religious practices – were widely perceived in the West as esoteric pursuits with little to offer mainstream society. Now they are highly-valued, prominent fields of endeavor with massive cultural buy-in. Having dedicated 40+ years to this “questionable arena,” it is rewarding to note the positive shift in public opinion, and, the appreciable enhancement such activities have made on so many lives. In fact, writing an article like this is challenging because there is no longer a dearth of information on the topic but, rather, an exhaustive volume of research requiring extensive time to read, process, and apply. On the up side, an abundance of scientific literature now attests to a range of psycho-social and body/mind benefits resulting from meditation and Sacred practices, (i.e., pertaining to religion or spirituality). Fortunately, these positive outcomes are no longer points of anecdotal testimony subject to academic dispute, but, matters of established fact. For psychologists then, several especially relevant questions arise regarding how to include this domain within the scope of practice. Specifically, when is it appropriate to engage patients on topics pertaining to the Sacred, meditation, and related activities? When is it viable to suggest patients explore such in adjunctive alignment with on-going therapy? And, when should these topics or practices not be addressed?

Such questions require more time and space to address than this brief article allows. Accordingly, readers may find additional value and a more comprehensive understanding of these issues in theAPA Handbook of Psychology, Religion, & Spirituality (Pargament, 2013).  However, to capsulize two key areas let me answer the last question first: Psychotic patients and those with too severe a character disorder are best served by not engaging in mystical or meditative pursuits as such activities could de-stabilize their mental coherence or trigger added psychiatric complications. However, many less severe patients confronting depression, anger, anxiety, stress, hypertension, addiction, insomnia, chronic pain, or, mild-to-moderate neuroses, defensiveness, compromised self-awareness, and self-destructive behaviors may benefit considerably from intelligently applied meditation if they are sufficiently motivated to practice. There is even related evidence suggesting that therapists who engage in meditative practices themselves, or hold to compassionate spiritual paradigms, may passively contribute to enhanced therapeutic outcomes.

When people ask me where I am from originally or where I grew up, my answer typically is that I am from the Army.  Yes, I grew up as an Army brat, which is a term of endearment in my world.  In the military, when a leader begins a new position, there is a formal change of command ceremony.  In the Minnesota Psychological Association, not so much.  We all just wake up on January 1, and a new President of our association is leading the charge.  Welcome to 2016!

This first month of 2016 has started much more calmly and slowly than we saw last year at this time.  Do not let that fool you.  The Minnesota Psychological Association has much on the horizon.  Volunteers serving on MPA’s Legislative Committee are initiating legislation designed to correct the Duty to Warn oversight in our psychology practice act.  We have retained an attorney to assist MPA in presenting an amicus brief before the Minnesota Supreme Court on this same issue.  Hopefully you will join other psychologists for Mental Health Day on the Hill (March 31, 2016) as MPA volunteers join with other professional associations including the Minnesota Medical Association to oppose efforts to rescind the upcoming sunset of the Provider Tax.  Finally, MPA psychologists have entered into talks with the Minnesota Department of Human Services to work toward modifying documentation requirements for psychologists practicing in integrated health care settings.  I hope you will make 2016 the year that you join other MPA psychologists who are volunteering to make things happen for psychologists in our state.

The Minnesota Psychological Association (MPA) is in great shape and great hands.  Ringing in the New Year inspires us to look ahead to 2016 and gives us the opportunity to reflect on the events that shaped 2015.  As MPA’s President for 2015, I thank you for the opportunity to serve you and am proud to be a psychologist in Minnesota.  Our 2016 MPA President, Robin McLeod, is fantastic and I thank my mentor and friend, Steve Vincent, for serving MPA well as our 2014 President and our 2015 past president.  MPA’s Executive Committee and Governing Council members have worked hard to implement strategic initiatives for 2015.  Our strategic initiatives for 2016 move MPA forward in a way that expands the resources and support for psychologists in Minnesota.  A special thanks to MPA’s Treasurer, Pearl Barner II and to MPA’s secretary, Mimi Sa for their service to you and to MPA.

So what is happening in MPA as we start out the New Year?

Nominations for each of three MPA Teaching Awards (Graduate Faculty in Psychology, Mink Outstanding Undergraduate Teacher Award, Outstanding Teaching of Psychology in Community/Two-Year Colleges) should be submitted to the MPA Office no later than Friday, March 4, 2016.  The criteria and nomination process for each award are outlined below.  Questions can be directed to Jack Rossmann at Macalester College ([email protected]).

MPA Award for Outstanding Graduate Faculty in Psychology