In the previous issue of Clinical Science, I noted that 1996 marks the 100th anniversary of what most consider to be the formal beginning of the field of clinical psychology. I also promised to give you details of SSCP's role in celebrating this centennial at this year's APA convention in August in Toronto. Therefore, I would like to take the opportunity in this column to describe the events that SSCP is sponsoring at APA. Before I do this, though, I would like to thank Tom Oltmanns, who devoted considerable time as SSCP program chair in this very important year to organizing two symposia. Tom did a wonderful job of ensuring that the symposia reflect SSCP's central values of integrating clinical science and practice.
The first symposium is organized around the recent Consumer Reports survey evaluating psychotherapy. As I'm sure most of your know, Consumer Reports asked respondents both to indicate their satisfaction with psychotherapy and to evaluate its effectiveness. The results of this survey were remarkably positive, particularly when one contrasts these data with findings of prospective studies of psychotherapy outcome. This report generated a great deal of discussion on SSCPnet, and we are fortunate to have a stellar group of participants in this symposium for APA. Ken Howard will present a paper entitled, Syzygy, Science, and Psychotherapy. Neil Jacobson will present a paper for the symposium entitled, Psychotherapy Research in Transition: Efficacy, Clinical Utility, and Clinical Significance. The title of Judith Hall's presentation is, Using Reader Surveys as Scientific Data. Peter Nathan completes the paper presentations with Controlled Evaluations of Specific Treatments vs. Consumer Satisfaction Surveys. Finally, Marty Seligman has agreed to serve as the discussant for these presentations. Given this line-up I am eagerly looking forward to moderating this symposium.
The second symposium sponsored by SSCP represents a strong integration of psychopathology and medicine. This symposium, entitled Treating Psychological Disorders in Primary Care: Integrating Science and Practice will be moderated by Tom Oltmanns. This issue is becoming increasingly important in the face of recent findings documenting the high proportion of patients at primary care settings who present with diagnosable psychological disorders. In the first paper in this symposium, Kirk Strosahl will present Working with Psychological Disorders in Primary Care: An Evidence-Based Model. Patricia Robinson will present a paper entitled, Integrated Treatment of Depression in Primary Care: Results of a Randomized Trial. Jeanne Miranda will present a paper entitled, Providing Psychiatric Treatments to Disadvantaged, Public Sector Medical Patients. Emily Hauenstein will discuss Depression Treatment in the Community: From Clinical Trial to Community Reality. Ralph Swindle, Jr. will serve as discussant for this symposium.
SSCP was also given an additional hour at APA specifically as part of the centennial celebration. These sessions will be marked in the program with a special centennial logo. Given SSCP's focus and mandate, we have organized a session entitled, The Role of Science in Future Training in Clinical Psychology: A Roundtable Discussion. I have the privilege of moderating this discussion, and we are fortunate to have as panelists Deborah Beidel, Karen Calhoun, Don Fowles, Tom Oltmanns, and Milt Strauss. This group of people ensures that the discussion will be a lively one. We also expect that members of the audience will contribute their views on this issue, so I encourage you all to attend this session.
It is also my pleasure to announce here that this year's recipient of the SSCP's Distinguished Scientist Award, nominated by the three previous awardees, is Peter M. Lewinsohn. I think that Dr. Lewinsohn is a wonderful example of someone who represents SSCP's goals of integrating clinical science and practice, and I am pleased that he has agreed to accept this award. The title of Dr. Lewinsohn's SSCP Distinguished Scientist Award address is Adolescent Depression: Perspectives from a Prospective Research Program. I am also happy to inform you that the winner of this year's SSCP Outstanding Dissertation Award is Thomas E. Joiner, Jr. Dr. Joiner will be present to accept this award. As in past years, the Presidential Address, the Distinguished Scientist Award address, and the presentation of the Outstanding Dissertation Award will be followed immediately by the annual SSCP business meeting. I think that this is an outstanding program. I hope that you agree, and I look forward to seeing you at all of these events.
Finally, on behalf of the SSCP membership, I would like to thank Paul Rokke, who has been doing an outstanding job of editing Clinical Science. Unfortunately, Paul has decided to step down, so we are now searching for a new editor for our newsletter. If you would like to be considered for this position, or would like to nominate someone for this position, please contact Jack Blanchard, Secretary/Treasurer (see the SSCP Mid-Winter Board Meeting report for details).
Two recent national movements have created a furor among psychologists: national health care reform and managed care. The American Psychologist (Fowler, 1993) devoted a special section to health care reform and Professional Psychology (Benedict, 1995) highlighted articles on managed care. Behavioral interventions have a substantive role in both arenas. Research exists to demonstrate the value of such interventions in primary health care. Also, such interventions often meet the criteria that should be attractive to managed care decisions, such as being empirically validated. However, Barlow (1994) points out that psychological interventions for depression are not often considered, compared to pharmacological approaches, because "the problem is political" (p. 110) and associated with public relations. The issue is the same for psychological services for primary health care.
Therefore, I offer the following information for two purposes: 1) to identify psychological interventions found valuable for primary care, and 2) to identify cost-savings from such interventions relevant to managed care cost-accountability concerns. I will cover two areas of service: services to protect health and prevent disease, and services once physical disease occurs. I will also provide some cost-comparison data reported in the literature.
Poor health is costly; total health care costs in 1992 reached $800 billion (U.S. Congressional Budget Office, 1992). Bernard and Krupat (1993) estimate that the total costs of health care amounted to 30% of the gross national product, if lost productivity is added. Psychological services can reduce medical costs, e.g., stress management reduced surgical recovery time, with cost-savings of over $11,000 (Wells, Howard, Nowlin, & Vargas, 1986). Help from psychological programs in pain clinics led to lifetime savings from medical costs, disability payments, and lost potential earnings calculated to be more than $250,000 per patient (Steig & Williams, 1983). In Canada, a problem- solving and a telephone support system reduced direct health service expenditures by about $2,000 for patients with chronic medical disorders, such as diabetes, epilepsy, Parkinson's, and arthritis (Roberts, et al. 1995).
A similar analysis by Jacobs (1987) estimated medical cost offset from psychological programs for reducing hospital stays and outpatients visits to exceed $7 million. In this analysis, programs such as stress management, pain control, and coping skill training led to major cost-saving benefits. For instance, biofeedback training led to 72 per cent reduction of hospital days and 63 per cent reduction of clinic visits, while the pain control program led to reductions of 72 per cent of hospital and 50 per cent of clinic utilization. Such findings have received similar support from other studies using brief psychological interventions to reduce hospital stays of clinic use (Milgrom, Walter, & Green 1994; Caudill, Schnable, Zuttermeister, Benson, 1991).
The leading causes of death are smoking, alcoholism, obesity, hypertension, and poor physical fitness. Psychologists have already described successful research outcomes for each: smoking - Flay (1985), Lichtenstein and Glasgow (1992); alcoholism - Epstein and McCrady (1994), Marlatt & Gordon (1985); obesity - Epstein, Valoski, Wing, and McCurley (1994), Stunkard (1980); hypertension - Blanchard, Martin, and Dubbert (1988), Chesney and Black (1986); low exercise - Dishman (1991, 1993), Lombard, Lombard, and Winett (1995). Anger management (Nakano, 1990; Suinn 1990) is available for controlling the anger component of Type A behaviors.
Treatment of Diseases
The research literature also confirms the use of behavioral interventions aimed at the major chronic diseases:
Cancer: Andersen (1992) applies a stress model for understanding the different cognitive/behavioral treatment goals across the stages of cancer. Behavioral interventions to reduce children's distress during bone marrow diagnostics, and for reducing anticipatory emesis from chemotherapy have been described in the literature (Jay, Elliott, & Varni, 1986; Redd, Andresen & Minagawa, 1982). A program aimed at improving communications with physician or family members, and controlling pain was associated with extended survival (Spiegel, Bloom, Kraemer, & Gottheil, 1989).
Chronic pain: The report of the NIH Technology Assessment Conference (NIMH, 1995) on treatment of pain concluded that "The evidence is strong for the effectiveness" of psychological interventions as straightforward as relaxation training (p. 10) and noted the value of cognitive- behavioral methods for low back pain, arthritis, and biofeedback for migraine and tension headaches.
HIV Infection and AIDS: With AIDS achieving epidemic level, psychologists are making substantial progress toward identifying the psychosocial variables influencing risk reducing behaviors, namely self-efficacy, social support, control over alcohol and drug use (Stall, Coates, & Hoff, 1988). Psychologists have also been involved in promoting change of peer norms, as well as individual behavioral change for preventing high risk behaviors (Hobfoll, Jackson, Lavin, Britton, & Shepherd, 1994; Kelly, St. Lawrence, Diaz, Stevenson, Hauth, Brasfield, Kalichman, Smith, & Andrew, 1991; St. Lawrence, Jefferson, Alleyne, & Brasfield, 1995).
Diabetes: Psychologists are offering stress management for insulin control, and have examined the use of feedback training and self-monitoring for glucose level discriminations (Gross et al., 1983; Wing, Epstein, Nowalk, & Lamparski, 1986).
I have documented the contributions which psychologists are already making
for health maintenance and treatment of physical diseases. Psychological
services have clear roles in primary health care, a point supported by Barlow's
Division 12 conclusion that "psychological interventions have demonstrable,
substantial, and long-lasting effects on neurobiological processes and even
genetic expression (of physical disorders). (Barlow, 1994, p. 110.)
Richard M. Suinn is professor of psychology, past member of the APA Board of Directors, Fellow in Divisions 12 and member of SSCP, and a candidate for the APA presidency.
This article summarizes a briefing I gave on Capitol Hill, and updates an article initially published in the Register Report. For the bibliography, write to: Richard M. Suinn, Ph.D., Psychology Dept., Colorado State Univ., Ft. Collins, CO 80523.
Thanks to Charlotte D'Orsaneo, Database Specialist, APA central office for her help.
The Executive Board of SSCP met at the Mid-Winter meeting of Division 12 of APA in St. Augustine Florida on January 13-14. The Executive Board consists of Ian Gotlib, President; Susan Mineka, Past-President; Robert Klepac, President-Elect; Jack J. Blanchard, Secretary/Treasurer; and Diane Chambless, Representative to the Division 12 Board. A number of issues were addressed at the meeting and I will provide a brief review of some of these discussions:
1996 SSCP AWARDS: Pete Lewinsohn was selected as the recipient of the 1996 Distinguished Scientist Award. The winner of the SSCP Dissertation Award was Thomas E. Joiner. Thomas completed his dissertation work under the supervision of Gerald Metalsky. Each of the awardees will receive $1,000. Awards will be presented at the APA conference in Toronto.
MEMBERSHIP AND BUDGET: SSCP has continued to grow with yet another increase in membership this year. We currently have over 600 members and continue to add new members every month. The budget is healthy and we are able to meet all of our current and anticipated expenses. The growth and vitality of SSCP is in part attributable to the relevance of this organization’s goals in an environment of real and threatened changes in psychology as well as the active participation of SSCP’s members on SSCPnet. The Board voted to capitalize on SSCP’s financial strength by “reinvesting” in our student membership through student grants for dissertation research.
DISSERTATION GRANTS-IN-AID-OF-RESEARCH: Given the growth and financial health of SSCP, the Board has decided to establish small grants to aid in the conduct of dissertation research. Although the Board will continue to discuss details of these awards it is anticipated that approximately six awards of $500 each will be available for 1997, with applications due in the fall of 1996. Details regarding application procedures and deadlines will appear in the next Newsletter and on SSCPnet.
INTERNSHIP DIRECTORY: Since its publication in the Fall of 1994 over 340 copies of the SSCP’s Directory of Research Opportunities for Clinical Psychology Interns have been sold through Graywind Publications. Although we have enjoyed a wonderfully successfully collaboration with Graywind recent changes at Graywind have required us to alter how distribution of the Directory will be handled in the future. Copies of the Directory can now be obtained through Jack Blanchard at the University of New Mexico. Additionally, the early success of the Directory and change in distribution will allow us to decrease the price of the Directory (originally $18.50) by 46% to $10. (Please see the accompanying note in this newsletter for full details regarding ordering).
BYLAWS CHANGES: The Board continued to review SSCP’s bylaws and drafted several changes. There will be a mailing regarding these suggested changes which will be put to a vote by the membership of SSCP.
SSCPnet: The Executive Board was enthusiastic about the continued success of SSCPnet. The net has served to provide a forum for a wide range of compelling topics and has provided a meaningful method of keeping our membership in touch and informed. The Board acknowledged with gratitude Michael Bailey’s efforts at keeping the SSCPnet functioning and credits SSCPnet with the continued growth of SSCP’s membership.
NEWSLETTER EDITOR: The Executive Board will be reviewing nominees for Editor of SSCP’s newsletter, Clinical Science. Paul D. Rokke has served as Editor of Clinical Science since 1993. During these years Paul has done an outstanding job of publishing the Newsletter. Individuals interested in serving as Editor of Clinical Science should contact Jack Blanchard (phone: 505-277-0635; email: BLANCHAR@UNM.EDU). Candidates will be reviewed by the Executive Board with a final selection determined by the summer. The Editor will serve a 3-year (renewable) term and with the appointment beginning for the Fall 1996 edition of Clinical Science.
ASSEMBLY OF SCIENTIST-PRACTITIONER PSYCHOLOGISTS: The Board voted to continue its Organizational Membership in ASPP for 1996. ASPP is one of the Council of Representative member caucuses along with science (CASAP), practice (AAP), rural, child, and women’s caucuses. Membership in ASPP was determined to be a useful mechanism for SSCP to support a scientist/practitioner perspective in APA and to have a voice in APA. Karen Calhoun will serve as SSCP’s representative to ASPP.
Please note that SSCP membership fees for 1996 were due last December. There will be a notice mailed in the upcoming weeks reminding those of you have who have not yet paid your 1996 dues. Please be sure to renew your membership in SSCP. If 1996 dues are not paid this will be the last newsletter received and access to SSCPnet will be discontinued.
The Division 12 board met on January 12 and 14, 1996. Particular issues of interest to SSCP members were the following:
1. Lynn Rehm, an SSCP member, attended his first meeting in his capacity as President-Elect. Rehm indicated that, as his presidential initiative, he will appoint a task force to develop recommendations concerning methods of meaningful continuing education in empirically validated treatments. This initiative has great promise for extending the work of the SSCP-sponsored Task Force for Promotion and Dissemination of Psychological Procedures.
Rehm has appointed Clinical Science editor Paul Rokke as Division 12 APA Program Chair and Nadine Kaslow as Postdoctoral Institutes Chair. Both are SSCP members.
2. Nate Perry, current Division 12 President and SSCP member, announced that his presidential initiative will be the formation of a group to develop guidelines for an area of clinical psychology practice for which there is solid and plentiful empirical support. This effort would serve as a test case for the use of the APA Template for Developing Guidelines: Interventions for Mental Disorders and Psychosocial Aspects of Physical Disorders. The Template was developed under the leadership of SSCP members David Barlow and Sue Mineka, among others. Perry welcomes suggestions for a treatment to select as the test case.
3. The Task Force on Psychological Interventions, the successor to the Task Force for Promotion and Dissemination of Psychological Procedures will continue for another year under Perry's presidency. Dianne Chambless will continue to chair the task force. Chambless presented the 1995 report of the task force to the board for discussion. This report contains an updated list of examples of empirically supported treatments the task force has identified and will be submitted to The Clinical Psychologist.
Although support in the Division 12 leadership for this task force continues to be strong, the initial report is controversial with some other APA constituencies, in particular Division 42 (Independent Practice), or at least its president, Arthur Kovacs. Kovacs argues that the task force's examples of empirically validated treatments will be misconstrued as practice guidelines and used against psychologists not practicing these treatments by third party payers. To quell this controversy, the Division 12 agreed to issue a statement indicating that the task force's reports are neither guidelines nor official Division 12 or APA policy. For this same reason, the 1995 and future reports will be published by the members of the task force as individuals rather than as a task force.
4. A search is being conducted for the Editor-Elect of The Clinical Psychologist. Members wishing to nominate themselves or others should write Linda Wilcoxon Craighead at the Dept. of Psychology, University of Colorado, Boulder, CA 80309-0345, or firstname.lastname@example.org.
5. Perry appointed a task force to draft an application for the Committee for Recognition of Specialties and Proficiencies in Psychology, requesting recognition of clinical psychology as a specialty. Board members continued to express dismay at the thought of submitting such a request, arguing that clinical psychology is a field, under which specialties and proficiencies exist. Nonetheless, the prevailing view was that such an application is necessary to prevent other groups from defining parts of what has traditionally been thought of as clinical psychology as exclusive to their specialties or proficiencies.
6. The board agreed to return to a schedule of meeting three times yearly. Members thought that the recent practice of meeting twice yearly, a cost-cutting effort, precluded meaningful discussion of important issues facing our profession. The next board meeting will take place June 1-2. At least a day of that meeting is to be devoted to long-range planning. Members who have suggestions for SSCP's agenda for that meeting should contact the SSCP representative: Dianne Chambless, Psychology, UNC-CH, Chapel Hill, NC 27599-3270, or email@example.com.
Last November the SSCP membership elected Robert K. Klepac, of Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, to the position of President-Elect. Dr. Klepac has served on the faculty at Western Washington University, was chair of the psychology department at North Dakota State University, and Director of Clinical Training at Florida State University. He is currently Director of Psychology Training at Wilford Hall Medical Center, directing the internship program and overseeing the postdoctoral program in behavioral health psychology. He also serves as National Coordinator for Air Force Psychology Training. As past chair of the board of directors of the Association of Psychology Postdoctoral and Internship Centers, he has served as liaison to and active participant in the Council of University Directors of Clinical Psychology and the Division of Clinical Psychology of APA. He also serves as an APPIC representative to the Interorganizational Council for Accreditation of Postdoctoral Programs in Professional Psychology, and is a member of the Education and Training Committee of the Association for the Advancement of Behavior Therapy. Earlier, Klepac was editor of Clinical Science, SSCP's newsletter, computer columnist for the Behavior Therapist, newsletter for AABT, and served on the board of directors of the Assembly of Scientist-Practitioner Psychologists.
Dr. Klepac's research interests lie in the area of behavioral health, especially the reduction of fear, pain, and avoidance attendant to medical and dental procedures. A central theme of his career has been the development and promotion of the scientist-practitioner model in psychology training and practice. Hobbies include travel and thoroughbred handicapping, the latter aided by a computer program developed by him and a dentist colleague - purportedly as an aid to teaching statistics to dental students. Klepac's wife, Rosalie, is a reading teacher in San Antonio. His daughters are gearing up to more effectively criticize his professional activities: Lisa is a doctoral candidate in social psychology at Kent State University; and Terri is a sophomore psychology major at the University of Texas - Austin.
It is frightening but true that the process of applying to clinical psychology internship programs will soon begin anew. The SSCP Internship Directory is an outstanding resource for identifying programs that best meet a student’s training goals. And now the price of the Directory has been reduced by 46% to only $10 (that includes shipping and handling)! Information on each of the 155 internship programs in the Directory includes data on 1) where past interns have come from (i.e., clinical, counseling, or school psychology programs and the accreditation status of graduate programs), 2) a listing of training provided for 25 empirically validated treatments, 3) a description of the research activities of internship faculty, 4) the research productivity of past interns (the number of conference presentations and publications authored by interns over the past four years), 5) facilities and support provided to interns (e.g., whether computers are available or if interns have secretarial support), and 6) the job placements of interns over the past four years (e.g., the number of interns taking positions that were primarily clinical/service, academic/research faculty appointments, or postdoctoral fellowships). Order soon as only 200 copies remain available. To order SSCP’s Directory of Research Opportunities for Clinical Psychology Interns send $10.00 (check, made out to SSCP) to: Jack J. Blanchard, Department of Psychology, Logan Hall, The University of New Mexico, Albuquerque, NM, 87131-1161 (Phone: 505-277-0635; Email: BLANCHAR@UNM.EDU).
We (Debjani Mukherjee and Lori Osborne) wanted to introduce ourselves as the new SSCP Student Membership Co-chairs. Because we are taking over from Sharon Lambert and Ernestine Briggs, who will be a hard act to follow, we are seeking the help of you, other SSCP student members. In what ways can SSCP meet the specific needs of students? What issues would you like to see addressed in the newsletter? What issues of interest to students should be included on the SSCP Web page? Please let us know any ideas you have.
Just so you know you're talking to, we're including some information about ourselves.
Hello. I (Debjani) am a second year graduate student in the clinical and community psychology program at the University of Illinois at Urbana-Champaign. I was an undergrad at Cornell University, in Ithaca, New York. In the four years after I graduated, I did research (social psych/women's studies, language processing in Alzheimer's Disease), and worked (as a psychometrist and a Research and Clinical Assistant) while living in Buffalo, Boston and India (where my family immigrated from a year before I was born). Then I decided to settle down and move to central Illinois for graduate school. I currently work with Wendy Heller and am interested broadly in social and emotional functioning of neurologically impaired individuals. More specifically we are trying to develop ways of assessing and remediating impairments in social and emotional functioning that may occur after brain damage.
I (Lori) grew up in Chicago, attended the University of Chicago as an undergraduate, and for graduate school traveled all the way to the University of Illinois at Urbana-Champaign. I'm currently a 4th year graduate student in Clinical Psychology and have had the opportunity to work with Frank Fincham, Karen Rudolph, and Wendy Heller. My main interest is in developmental psychopathology, and specifically how children's perceptions of marital conflict and of parent-child relationships affect their adjustment. Recently, I've been trying to integrate neuropsychological perspectives on depression with these other approaches to understanding children's adjustment. I've been a member of SSCP for several years, and have found it useful not only in my own research but in helping me teach Abnormal Psychology.
We are writing to ask your help in getting other clinical graduate students in your university to become members of the Society for a Science of a Clinical Psychology (SSCP), Section III of Division 12 of APA.
As a current student member, you are already aware of the benefits of SSCP membership:
FOR ONLY $5.00 PER YEAR:
Please feel free to forward this message to all of the clinical psychology graduate students in your department We would be happy to send you application forms, or to send application forms directly to anyone who is interested. Email us at either: firstname.lastname@example.org or email@example.com. OR, you can also down load an application form from this site. See the top of the homepage.
Help our numbers grow.
As many of you know, the SSCP Student Poster Session is a great opportunity available to all student members of SSCP. We are writing to remind current members of this opportunity, and to encourage students and faculty members to alert other students who may want to join SSCP and participate.
We are now accepting submissions for the SSCP Annual Student Poster Session. The poster session will be held at the APA convention in Toronto, August 9 - 13, 1996. This year, the first prize award for the best poster will be $100.00. All submissions will be reviewed and those not accepted may have the opportunity to revise and resubmit.
Here's how you can enter:
If you are not a student member of SSCP, it's easy to join. Just submit the application and the $5.00 student membership fee. (If you need an application, please email either firstname.lastname@example.org or email@example.com)
Submit three copies of a 500 word abstract (double-spaced) describing the study to be presented. Abstracts should include title, author (s), and affiliation. Also include any tables and/or figures that will appear on the poster.
Mail your submission and 1 self-addressed stamped envelope to:
The deadline for submission is May 1, 1996.
Participants will be notified by June 1, 1996.
Any questions? Please feel free to contact one of us at the addresses listed above.