Winter 2005

Psychotherapy O F F I C I A L P U B L I C AT I O N O F D I V I S I O N 2 9 O F T H E A M E R I C A N P S Y C H O L O G I C A L A S S O C I AT I O N www.divisionofpsychotherapy.org

In This Issue Brief Relational Therapy and the Resolution of Ruptures in Therapeutic Alliance

Interview with Mathilda Cantor, Ph.D.

Official Bylaws Voting Ballot

Candidate Statements

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Division of Psychotherapy  2005 Governance Structure ELECTED BOARD MEMBERS President Leon VandeCreek, Ph.D. 117 Health Sciences Bldg. School of Professional Psychology Wright State University Dayton, OH 45435 Ofc: 937-775-3944 Fax: 937-775-5795 E-Mail: [email protected]

Board of Directors Members-at-Large Norman Abeles, Ph.D. , 2003-2005 Michigan State Univ., Dept. of Psychology E. Lansing, MI 48824-1117 Ofc: 517-355-9564 Fax: 517-353-5437 Email: [email protected] James Bray, Ph.D., 2005-2007 Dept of Family & Community Med Baylor College of Med 3701 Kirby Dr, 6th Fl Houston , TX 77098 Ofc: 713-798-7751 Fax: 713-798-7789 Email: [email protected]

President-elect Abraham W. Wolf, Ph.D. Metro Health Medical Center 2500 Metro Health Drive Cleveland, OH 44109-1998 Ofc: 216-778-4637 Fax: 216-778-8412 E-Mail: [email protected] Secretary Armand Cerbone, Ph.D., 2005 3625 North Paulina Chicago IL 60613 Ofc: 773-755-0833 Fax: 773-755-0834 email: [email protected]

Charles Gelso, Ph.D., 2005-2006 University of Maryland Dept of Psychology Biology-Psychology Building College Park, MD 20742-4411 Ofc: 301-405-5909 Fax: 301-314-9566 Email: [email protected]

Treasurer Jan L. Culbertson, Ph.D., 2004-2006 Child Study Ctr University of Oklahoma Hlth Sci Ctr 1100 NE 13th St Oklahoma City , OK 73117 Ofc (405) 271-6824, ext. 45129 Fax: (405) 271-8835 Email: [email protected]

Jon Perez, Ph.D. 2003-2005 IHS Division of Behavioral Health 12300 Twinbrook Parkway, Ste 605 Rockville, MD 20852 Office: 202-431-9952 Email: [email protected]

Libby Nutt Williams, Ph.D., 2005-2007 Associate Professor of Psychology Coordinator of Women, Gender, & Sexuality Studies St. Mary’s College of Maryland 18952 E. Fisher Rd. St. Mary’s City, MD 20686 Phone: 240- 895-4467 Fax: 240-895-4436 Email: [email protected] APA Council Representatives Patricia M. Bricklin, Ph.D. 2005-2007 470 Gen. Washington Road Wayne, PA 19087 Ofc: 610-499-1212 Fax: 610-499-4625 Email: [email protected] Norine G. Johnson, Ph.D., 2005-2007 13 Ashfield St., Roslindale, MA 02131 Ofc: 617-471-2268 Fax: 617-325-0225 Email: [email protected] John C. Norcross, Ph.D., 2005-2007 Department of Psychology University of Scranton Scranton, PA 18510-4596 Ofc: 570-941-7638 Fax: 570-941-7899 E-mail: [email protected]

Alice Rubenstein, Ed.D. , 2004-2006 Monroe Psychotherapy Center 20 Office Park Way Pittsford, New York 14534 Ofc: 585-586-0410 Fax: 585-586-2029 Email: [email protected]

Past President Linda F. Campbell, Ph.D. University of Georgia 402 Aderhold Hall Athens, GA 30602-7142 Ofc: 706-542-8508 Fax: 770-594-9441 E-Mail: [email protected]

COMMITTEES AND TASK FORCES COMMITTEES Fellows Chair: Lisa Porche-Burke Office Address: Phillips Graduate Institute 5445 Balboa Blvd. Encino , CA 91316-1509 Ofc: 818-386-5600 Fax: 818-386-5695 Email: [email protected] Membership Chair: Rhonda S. Karg, Ph.D. Research Triangle Institute 3040 Cornwallis Road Research Triangle Park, NC 27709 Ofc: (919) 316-3516 Fax: (919) 485-5589 Student Development Chair Adam Leventhal, 2005 Department of Psychology University of Houston Houston, Texas 77204-5022 Voice: 713-743-8600 Fax: (713) 743-8588 E-mail: [email protected]

Nominations and Elections Chair: Abe Wolf, Ph.D. Professional Awards Chair: Linda Campbell, Ph.D. Finance Chair: Jan Culbertson, Ph.D. Education & Training Chair: Jeffrey A. Hayes, Ph.D. Counseling Psychology Program Pennsylvania State University 312 Cedar Building University Park, PA 16802 Ofc: 814-863-3799 E-mail: [email protected] Continuing Education Chair: Steve Sobelman, Ph.D. Department of Psychology Loyola College in Maryland Baltimore, MD 21210 Ofc: 410-617-2461 E-mail: [email protected]

Diversity Chair: Jennifer F. Kelly, Ph.D. Atlanta Center for Behavioral Medicine 3280 Howell Mill Road Suite 100 Atlanta, GA 30327 (404) 351-6789 Fax: (404) 351-2932 E-mail: [email protected] Program Chair: Alex Siegel, Ph.D., J.D. 915 Montgomery Ave. #300 Narbeth, PA 19072 Ofc: 610-668-4240 Fax: 610-667-9866 E-mail: [email protected] Psychotherapy Research Chair: William B. Stiles, Ph.D. Department of Psychology Miami University Oxford, OH 45056 Voice: 513-529-2405 Fax: 513-529-2420 Email: [email protected]

PUBLICATIONS BOARD Chair: John C. Norcross, Ph.D., 2003-2008 Department of Psychology University of Scranton Scranton, PA 18510-4596 Ofc:570-941-7638 Fax:570-941-7899 [email protected] Jean Carter, Ph.D., 1999-2005 3 Washington Circle, #205 Washington, DC 20032 Ofc: 202-955-6182 [email protected] Lillian Comas-Dias, Ph.D., 2001-2006 Transcultural Mental Health Institute 908 New Hampshire Ave. N.W., #700 Washington, DC 20037 Ofc: 202-775-1938 [email protected] Raymond A. DiGiuseppe , Ph.D., 2003-2008 Psychology Department St John’s University 8000 Utopia Pkwy Jamaica , NY 11439 Ofc: 718-990-1955 [email protected] Alice Rubenstein, Ed.D. , 2000-2006 Monroe Psychotherapy Center 20 Office Park Way Pittsford, NY 14534 Ofc: 585-586-0410 Fax 585-586-2029 [email protected]

Psychotherapy Journal Editor Charles Gelso, Ph.D. 2005-2011 Psychology 4 University of Maryland College Park, MD 20742 Ofc: 301-405-5909 [email protected] Psychotherapy Bulletin Editor Craig N. Shealy, Ph.D. Department of Graduate Psychology James Madison University Harrisonburg, VA 22807-7401 Voice: 540-568-6835 Fax: 540-568-3322 [email protected] Internet Editor Bryan S. K. Kim, Ph.D. Counseling, Clinical, and School Psychology Program Department of Education University of California Santa Barbara, CA 93106-9490 Ofc & Fax: 805-893-4018 [email protected] Student Website Coordinator: Nisha Nayak University of Houston, Dept of Psychology (MS 5022) 126 Heyne Building Houston, TX 77204-5022 E-mail: [email protected] Phone: 713-743-8600 or -8611 Fax: 713-743-8633

George Stricker, Ph.D., 2003-2008 Institute for Advanced Psychol Studies Adelphi University Garden City , NY 11530 Ofc: 516-877-4803 Fax: 516-877-4805 [email protected]

PSYCHOTHERAPY BULLETIN Psychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American Psychological Association. Published four times each year, Psychotherapy Bulletin is designed to: 1) inform the membership of Division 29 about relevant and upcoming events, awards, and professional opportunities; 2) provide articles and commentary regarding a range of issues that are of interest to psychotherapy theorists, researchers, practitioners, and trainers; 3) establish a forum for students and new members to offer their contributions and perspectives; and, 4) facilitate opportunities for dialogue and collaboration among the diverse members of our association. Contributors are invited to send articles (up to 4,000 words), interviews, commentaries, letters to the editor, and announcements as well as suggestions or questions regarding the newsletter to Craig N. Shealy, Ph.D., Editor, Psychotherapy Bulletin. Please note that Psychotherapy Bulletin typically does not publish book reviews (these are published in Psychotherapy, the official journal of Division 29). All submissions for Psychotherapy Bulletin should be sent electronically to [email protected]; please ensure that any articles conform to APA style. Deadlines for submission are as follows: February 1; May 1; August 1; November 1. Past issues of Psychotherapy Bulletin may be viewed at our website: wwwdivisionofpsychotherapy.org. Other inquiries regarding Psychotherapy Bulletin (e.g., advertising) or Division 29 should be directed to Tracey Martin at the Division 29 Central Office ([email protected] or 602-363-9211).

DIVISION OF PSYCHOTHERAPY (29) Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215 Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: [email protected] www.divisionofpsychotherapy.org

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DIVISION OF PSYCHOTHERAPY American Psychological Association 6557 E. Riverdale Mesa, AZ 85215 www.divisionofpsychotherapy.org

Non-Profit Organization U.S. Postage Paid Utica, NY Permit No. 83

PSYCHOTHERAPY BULLETIN Official Publication of Division 29 of the American Psychological Association PSYCHOTHERAPY BULLETIN Published by the DIVISION OF PSYCHOTHERAPY American Psychological Association 6557 E. Riverdale Mesa, AZ 85215 602-363-9211 e-mail: [email protected]

EDITOR Craig N. Shealy, Ph.D. CONTRIBUTING EDITORS Washington Scene Patrick DeLeon, Ph.D. Practitioner Report Ronald F. Levant, Ed.D. Education and Training Jeffrey A. Hayes, Ph.D. Psychotherapy Research William Stiles, Ph.D. Student Feature Adam Leventhal STAFF Central Office Administrator Tracey Martin

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CONTENTS President....................................................................2 Student Feature ........................................................4 Mid-Winter Board of Directors Meeting ..............8 Ad Hoc Committee on Psychotherapy ................9 Interview ................................................................11 Feature: Brief Relational Therapy and the Resolution of Ruptures in the Therapeutic Alliance ................................................................13 Board of Directors Activities ................................18 Psychotherapy Education and Training ............19 Official Bylaws Voting Ballot ..............................23 Report of APA Council Representatives ............27 Washington Scene ..................................................28 Practitioner Report ................................................34 Candidate Statements ..........................................40

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PRESIDENT Leon VandeCreek, Ph.D. I am pleased to begin my term of office as President of Division 29. I have been involved with governance activities with the Division for several years, beginning as the Chair of the Membership Committee when divisional membership was strong and budgets were substantial, at least compared to now. During the past 15 years, practitioners have seen their incomes level off or decline, opportunities for employment in traditional practice have shrunken, and graduate programs have faced strong pressures to diversify their training into new areas. Psychotherapy has been under attack, or just ignored, on many fronts. In early 2003, then President Pat Bricklin and President-elect Linda Campbell began conversations about the state of the field of psychotherapy in terms of research, teaching, and practice. The discussion turned on such questions as, What do we know in each of these areas? What are psychotherapists excited about? What discourages them? What are the training innovations? What are the external challenges? These questions formed the foundation for a series of initiatives for the Division of Psychotherapy that continued through Linda Campbell’s presidency and now throughout my year as President. As you know from reading Linda’s President’s Columns, a task force has gathered data from researchers, trainers, practitioners, students, and new career professionals. At meetings of the Board of Directors, we rank ordered a long list of possible initiatives and assigned several items to committees and the continuing

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Task Force as action items for the year. Committee chairs will report on their progress on these initiatives throughout the year in the Bulletin. Several other projects are also important to report. In this issue of the Bulletin is a ballot for voting on changes to the Bylaws. Voting on changes to Bylaws often is not a high priority activity; I often do not fully understand the point of changes. But, in this case, I urge you to read the ballot and to vote. As you will read, the Board has approved a change to the name of the Division to “The Society for Psychotherapy: Division 29 of the American Psychological Association.” We will most often refer to it as “The Society for Psychotherapy.” The proposed name change reflects the interest of the Board in attracting new members, including those who are not now members of the APA. We recognize that many psychologists with interests in psychotherapy are not members of APA and we hope to draw them into the activities of the Division. A name change is not essential to do that (we could just change our Bylaws to admit non-APA members), but we believe that the proposed name reflects our broader vision of potential members. If approved by the membership, we will initiate a strong membership campaign. The Division also is completing a policy and procedures manual. Matty Canter has been working on this project for some time, and we are getting close to the end. For some, this is about as exciting as reading about changes to Bylaws. But, if the Division is to attract new faces to governance and if new officers are to hit the ground running, then we need a set of policies and procedures that are clear and that do not need to be reinvented by each new officer. We currently have a disjointed collection of policies and procedures that have

accumulated over the years; by summer I hope we will have a formal manual (paper and online) that guides the work of each officer and board member. At the last meeting of the Board, we agreed to reinstitute sending liaisons to other governance groups in psychology. A few years ago, we dropped this practice, due in large part to budget constraints. We are now in somewhat better fiscal shape, but more importantly the Board was convinced that the Division’s interests are often shared with other groups and that sometimes other groups move in directions that are not in our best interests. We intend to be at the table wherever and whenever relevant issues arise. For the past several years, Abe Wolf has served as the Division’s Internet Editor. If you have checked our web page recently you will recognize that it has been significantly upgraded and expanded. Abe has been elected to serve as President-elect and

Bryan Kim has been selected as the new Internet Editor. On behalf of the Division, I want to express our deep gratitude to Abe for his tireless efforts as Internet Editor and welcome Bryan to that role. Watch the web page for further developments. Finally, I hope you will make plans to attend the 2005 APA convention in Washington, DC. The Division has selected a very strong set of symposia and posters. For the first time, many of the Division’s programs will be available for continuing education credits through the APA’s CE office. I begin my year of presidency with enthusiasm and a sense of pride in what the Division represents—the broad spectrum of psychologists with interests in research, practice, theory, and training in psychotherapy. If you are interested in being involved in the Division’s activities, contact me at [email protected]. I hope to see many of you at the APA convention.

Find Division 29 on the Internet. Visit our site at www.divisionofpsychotherapy.org

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STUDENT FEATURE Attrition in Child Treatment: The Contribution of Child, Family, and Service Factors Gregory S. Chasson, University of Houston Introduction Client dropout is a pervasive problem in providing mental health care. Regardless of type of treatment or theoretical-orientation, premature termination from psychotherapy presents a host of problems, none more troublesome than the client’s failure to receive services that are necessary for recovery. The literature on client attrition suggests that approximately 47% of clients engaged in psychotherapy terminate prematurely (Wierzbicki & Pekarik, 1993). In addition, a myriad of variables have been implicated in predicting dropout with adult clients, including specific demographics and therapist and client expectations (for an excellent review, see Garfield, 1994). Children have demonstrated similar dropout rates (Wierzbicki & Pekarik, 1993), with reports as high as 60% - 70% (Pekarik & Stephenson, 1988; Singh, Janes, & Schechtman, 1982). Compared to adult literature, however, there is a relative paucity of studies on predictors of child attrition. Indeed, only 1-2% of attrition studies focus on child dropout (Kendall & Sugarman, 1997). There are at least two reasons for the lack of research in this area compared to adult attrition. One, many people may assume that child dropout occurs for the same reasons as adult dropout. Evidence from Pekarik & Stephenson (1988), however, suggests that these two types of attrition should be investigated independently, implying that factors contributing to adult dropout do not necessarily generalize to

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predictors of child dropout. Two, with investigations of adult attrition, there are only two major domains of interest: client and service variables. For instance, client variables such as gender, service variables such as treatment fees, or their interaction may contribute to premature termination. Isolating these variables for investigation is difficult enough, but the child attrition studies must also incorporate an additional element, since the client variables must be bifurcated into family factors and child factors. Children may provide unique contributions to child attrition that are independent of parent or family factors. For example, varying levels of children’s anxiety may result in differential rates of dropout (Kendall & Sugarman, 1997). Similarly, parental age may contribute to the child’s premature termination (Kazdin, Mazurick, & Bass, 1993). As with the adult literature, each of these domains of variables (child, family, and service) must be explored, including their interactions. Most of the research on child attrition has yielded conflicting or non-significant findings, indicating that child terminators and continuers exhibit few salient differentiating characteristics. Among others, three significant problems have contributed to the ambiguous or null findings, many of which are mirrored in the adult dropout literature. First, there has been inconsistency in the operational definition of dropout (Garfield, 1994; Kendall & Sugarman, 1997). Some investigations included in the definition those children who set an initial appointment but refused to come. Others only considered those children who attended at least one session (e.g., Pina et al., 2003). Evidence from Kendall & Sugarman (1997), however, suggests that these two types of child dropouts may

have different types of reasons for dropping out and should be studied separately. Second, many studies fail to specify the populations under investigation, or they include a heterogeneous mix of children, such that attrition is studied with a joint sample of children with unrelated problems. Kendall & Sugarman (1997) suggest that different populations of children differ in their reasons for dropout, which may contribute to the non-significant results found in the literature, implying that different types of populations of children should be studied independently. While problems one and two have been addressed in current investigations of child dropout, a third problem remains that has not been addressed, namely that most dropout studies focus on pretreatment variables rather than those variables at the time of dropout. For example, a child’s pretreatment level of depression is likely not going to contribute to dropout a year later as much as the level of depression a week prior to premature termination. This poses a methodological problem for researchers, however, as it is difficult to maintain continual process data throughout treatment. Nonetheless, research on variables assessed at the time of dropout is sorely needed. Despite current limitations in the study of child attrition, many investigations have uncovered variables that may contribute to dropout. As mentioned above, each of the variables can be classified in the family, child, or service domains. While there are no definitive predictors of dropout, some investigations have provided solid evidence for specific variables predicting attrition. Below, a selection of variables from each of these domains will be discussed. Finally, some specific actions a therapist can take to minimize the likelihood of dropout will be discussed. Child Factors Many child factors have been examined in child attrition studies. The results of most investigations suggest that age does not predict dropout from child treatment despite differing types of samples (Kendall

& Sugarman, 1997; Kazdin et al., 1993; Minty & Anderson, 2004; Pina et al., 2003). Similarly, most data suggest that gender does not differentiate dropouts from completers (Armbuster & Fallon, 1994; Kazdin et al., 1993; Kendall & Sugarman, 1997). Interestingly, however, an interaction was found between age and gender in a sample of suicidal adolescents. Older males were more likely to dropout than younger males, though there was no difference in age-related dropout risk for females (Piacentini et al., 1995). While this interaction needs replication, it may provide helpful information for clinicians who provide services to adolescents at risk for suicide. Often a heated topic, minority status has also been explored in the prediction of child dropout. Like most variables in the child attrition literature, the evidence is conflicting. While some investigations suggest there is no link between minority status and dropout (Dierker, Nargiso, Wiseman, & Hoff, 2001; Garcia & Weisz, 2002), this is not consistent. In a sample of children with anxiety, being a minority predicted dropout (Kendall & Sugarman, 1997), and the same result was found in a sample of children with externalizing problems (Kazdin et al., 1993). Thus, since some evidence indicates minority status may forestall premature termination in varying populations of children, treatment providers should strive to be sensitive to cultural issues. Child demographics are not the only variables explored in child attrition studies. For example, some evidence indicates that pretreatment childhood depression or suicidal ideation does not predict dropout (Dierker et al., 2001), nor does initial externalizing behavior (Kendall & Sugarman, 1997; Pina et al., 2003). However, Kendall and Sugarman (1997) reported a counterintuitive result; terminators were more likely to report less pretreatment anxiety than completers. While this result needs replication, it may imply that the clients with lower levels of anxiety are the ones dropping out of treatment, maybe because of a lack of need or motivation for services.

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Family Factors Many family factors have been studied in child treatment dropout. There is some corroborating evidence that children living in single parent homes are at higher risk for dropout (Kazdin et al., 1993; Kendall & Sugarman, 1997; Minty & Anderson, 2004). In addition, evidence is still conflicted regarding family socioeconomic status (SES) and income. Some data suggest lower SES portends dropout from child treatment (Armbuster & Fallon, 1994; Kazdin et al., 1993), while other results imply no relation between SES and attrition (Garcia & Weisz, 2002; Pina et al., 1993). Most evidence also indicates that parental psychopathology is unrelated to premature treatment termination (Dierker et al., 2001), including depression (Kazdin et al., 1993) and anxiety (Kendall & Sugarman, 1997). A large area of focus is parent’s perceptions. For example, in study of children with externalizing disorders, Kazdin, Holland, Crowley, and Breton (1997) suggest that parents of child dropouts perceived more barriers to treatment than the parents of treatment completers. In addition, parent’s perception of problem severity plays a role. Parents perceiving their child’s problems as less severe predicted dropout. Also, there was no difference found between completers and dropouts in parent perception of stigma associated with treatment or the perception that problems should be handled inside the family (McCabe, 2002). Service Factors Service factors play a role in dropout as well, which is constructive news for clinicians because it affords more control than other characteristics such as a client’s gender. There is evidence that children placed on wait-lists are more likely to drop out (Kendall & Sugarman, 1997), even though the amount of time on the wait-list does not appear to be important (Minty & Anderson, 2004). An investigation by Weisz, Weiss, and Langmeyer (1987) tested many important service factors. Based on their results, therapist gender and age did not predict dropout, nor did the number of

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miles between the treatment setting and the client’s home (Weisz et al., 1987). As an interesting interaction between client and service variables, some evidence indicates attrition is predicted by therapist and client ethnic mismatch (Armbuster & Fallon, 1994; McCabe, 2002). In addition, the therapists of dropouts were more likely to perceive barriers to treatment than therapists of non-dropouts (Kazdin et al., 1997). Conclusion For clinicians concerned about clients dropping out, many of the variables above are difficult to address. A clinician cannot easily derive a strategy for altering a child’s gender, a family’s SES, or whether there are enough resources to avoid using a waitlist. Relatively unalterable variables are best used as information to guide the therapist. Clinicians should be cognizant of the factors associated with dropout. In particular, they should watch for signs of premature termination in children that exhibit numerous risk factors, since evidence from Kazdin et al. (1993) suggests a relationship between multiple risk factors and the likelihood of dropping out. Luckily, certain variables that contribute to dropout are subject to change. For example, Minty & Anderson (2004) found evidence to suggest that lower quality referral letters predicted dropout. Similarly, referral letters without specific requests also predicted dropout (Minty & Anderson, 2004). It seems it would behoove clinicians to provide solid referrals that contain adequate information. In addition, while there is no specific evidence for this, it might be worthwhile to provide some semblance of services for children on a waitlist, such as brief phone calls to the parents or structured activities such as filling out a particular assessment each week. While rare, some of the investigations uncovered some evidence for effective strategies for limiting attrition. For instance, Kendall & Sugarman (1997) found that their time-limited and structured treatment plan assisted with decreasing attri-

tion, which they reported was only 23%. In order to prevent dropout, perhaps more timely and structured interventions are in order if numerous risk factors are uncovered for a particular child. Also, Minty & Anderson (2004) found that contacting the client with a confirmation letter or a call prior to the initial appointment helped decrease premature termination. In addition, including a reply card with a confirmation letter also protected against dropout (Minty & Anderson, 2004). Finally, Kazdin et al. (1997) introduced a validated measure for assessing barriers to treatment called the Barriers to Treatment Participation Scale. Use of this instrument with a child and his or her family may facilitate the development of child-specific strategies for preventing dropout. Thus, while there appears to be a number of variables that influence dropout, there are some strategies a clinician can utilize for addressing this concern in his or her own practice. References Armbuster, P., & Fallon, T. (1994). Clinical, sociodemographic, and systems risk factors for attrition in a children’s mental health clinic. American Journal of Orthopsychiatry, 64(4), 577-585. Dierker, L., Nargiso, J., Wiseman, R., & Hoff, D. (2001). Factors predicting attrition within a community initiated system of care. Journal of Child and Family Studies, 10(3), 367-383. Garcia, J. A., & Weisz, J. R. (2002). When youth mental health care stops: Therapeutic relationship problems and other reasons for ending youth outpatient treatment. Journal of Consulting and Clinical Psychology, 70(2), 439-443. Garfield, S. L. (1994). Research on client variables in psychotherapy. In A. E. Bergen & S. L. Garfield (Eds.), Handbook of Psychotherapy and Behavior Change, 4th Edition (pp. 190-228). Oxford, UK: John Wiley & Sons. Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to Treatment Participation Scale: Evaluation and validation in the context of child outpatient treatment. Journal of Child Psychology and Psychiatry, 38(8), 1051-1062.

Kazdin, A. E., Mazurick, J. L., & Bass, D. (1993). Risk for attrition in treatment of antisocial children and families. Journal of Clinical Child Psychology, 22(1), 2-16. Kendall, P. C., & Sugarman, A. (1997). Attrition in the treatment of childhood anxiety disorders. Journal of Consulting and Clinical Psychology, 65(5), 883-888. McCabe, K. M. (2002). Factors that predict premature termination among MexicanAmerican children in outpatient psychotherapy. Journal of Child and Family Studies, 11(3), 347-359. Minty, B., & Anderson, C., (2004). Nonattendance at initial out-patient appointments at a hospital-based child psychiatric clinic. Clinical Child Psychology and Psychiatry, 9(3), 403-418. Pekarik, G., & Stephenson, L. A. (1988). Adult and child client differences in therapy dropout research. Journal of Clinical Child Psychology, 17(4), 316-321. Piacentini, J., Rotheram-Borus, M. J., Gillis, J. R., Graae, F., Trautman, P., Cantwell, C., Garcia-Leeds, C., & Shaffer, D. (1995). Demographic predictors of treatment attendance among adolescent suicide attempters. Journal of Consulting and Clinical Psychology, 63(3), 469-473. Pina, A. A., Silverman, W. K., Weems, C. F., Kurtines, W. M., & Goldman, M. L. (2003). A comparison of completers and noncompleters of exposure-based cognitive and behavioral treatment for phobic and anxiety disorders in youth. Journal of Consulting and Clinical Psychology, 71(4), 701-705. Singh, H., Janes, C. L., & Schechtman, J. M. (1982). Problem children’s treatment attrition and parents’ perception of the diagnostic evaluations. Journal of Psychiatric Treatment Evaluation, 4, 257263. Weisz, J. R., Weiss, B., & Langmeyer, D. B. (1987). Giving up on child psychotherapy: Who drops out? Journal of Consulting and Clinical Psychology, 55, 916-918. Wierzbicki, M., & Pekarik, G. (1993). A meta-analysis of psychotherapy dropout. Professional Psychology: Research and Practice, 24(2), 190-195

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DIVISION OF PSYCHOTHERAPY

MID WINTER BOARD OF DIRECTORS MEETING January 15-16, 2005 – Miami, Florida

Armand Cerbone, Jan Culbertson, Leon VandeCreek, Linda Campbell, Craig Shealy, Tracey Martin, John Norcross, and Abe Wolf

Armand Cerbone, Leon VandeCreek, Jan Culbertson, James Bray, Alice Rubenstein, Abe Wolf

Jeffrey Hayes and Bill Stiles

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Pat Bricklin, Norine Johnson, Craig Shealy, John Norcross, and Adam Leventhal

AD HOC COMMITTEE ON PSYCHOTHERAPY Division Commitment to Research Linda Campbell, Ph.D., Co-Chair The Presidential Initiative conducted during my presidency and that continues during Leon VandeCreek’s presidency is being implemented as the Ad Hoc Committee on Psychotherapy. There are so many initiatives that the membership identified for action that the Board decided to move forward through this ad hoc committee rather than a continuance as a presidential initiative. At the Board meeting in January, we reviewed the actions recommended and took stock of their status and course of action recommended. Leon and I hope to keep the membership involved and participating by including articles in the Bulletin that update the progress of our initiatives. This is our first update article. The Ad Hoc Committee on Psychotherapy is pursuing actions in the areas of research, practice, and training in psychotherapy and also included the two member groups of students and early career psychologists. Several action items are already afoot. Research Our committee will be working with APA and with the North American Society for Psychotherapy Research in exploring strategies to remove barriers to federal grant awards for psychotherapy research. Our psychotherapy researchers are often investigating factors that could be classified as process factors, common and relational factors, and data that are not collected through controlled clinical trials. This research is most important and serves a usefulness that cannot be accomplished

through other methodologies. Division 29 is committed to assisting our researchers proactively in their pursuit of support for expanded funding considerations. The APA Presidential Task Force on Evidence Based Research includes our members Jean Carter and John Norcross and is co-chaired by our members Ron Levant and Carol Goodheart. This commitment by Ron Levant to bring researchers together in a collaborative and to advance the definition and development of research also promotes the Division 29 interests. Our research focus groups identified a need for a clearinghouse or common site for researchers, practitioners, and students of research to be able to find others of like interests and to be able to pair up individuals who may work on common projects. Our Research Committee and the Internet Editor, Brian Kim, are working to develop a listing of all opportunities for individual studies, practice research networks, and other research collaboratives to be posted on our Website. And lastly, but very importantly, our research and practice focus groups identified the need to develop a vehicle to summarize and synthesize research that is applicable to the practice of psychotherapy. In response to this need, our journal editor, Charles Gelso, with the support of our Publications Board, chaired by John Norcross, will develop a clinician’s research concept in our journal, Psychotherapy. This feature will identify current relevant research and address what that research contributes to the practice of psychotherapy, the implications of the findings, and the application of the findings to practice. These are some of the activities well underway in the Division, specifically in the area of research. If any

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of our members are interested in involvement in any activities described here, please contact Linda Campbell ([email protected]) or Leon VandeCreek ([email protected]) and we can steer you to the person conducting the activ-

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ity. We will be highlighting an area of the Ad Hoc Committee focus in each Bulletin. In the next issue we will update you on the activities going on in practice. Please stay tuned and stay connected to these important initiatives for psychotherapy.

INTERVIEW AN INTERVIEW WITH DR. MATHILDA CANTER Anna McCarthy, University of Houston

Dr. Mathilda (Matty) Canter has been involved with Division 29, almost since its inception over 35 years ago, and has dedicated countless hours to mentoring students and young professional psycholoMathilda Canter, Ph.D. gists. Dr. Canter became involved in Division 29 activities through her husband, Aaron, a charter member of the Division. Since that time, she has held the positions of Treasurer, Administrative Liaison, Board Member-atLarge, and Council Representative, and was the first woman to be elected president of Division 29. She also was appointed council representative to APA. In APA governance, she has chaired the Ethics Committee, and the Policy and Planning Board, and served on the Committee for the Advancement of Professional Practice (CAPP) and the APA Board of Directors. She was appointed chair of the APA ethics committee in 1990. She is currently on the APA Membership Committee. Despite all of these distinguished roles and accomplishments, Dr. Canter’s first love remains the Division of Psychotherapy. In fact, she considers herself to be the “institutional memory” of Division 29 after such long and varied involvement in Division activities, and indeed considers many members of the Division to be part of her family. Her continued interest in the Division comes from her conviction that it is an organization committed to innovation and a creative spirit. She pointed out,

We were the first Division to start awarding student travel scholarships; we had a successful membership drive for student and minority recruitment in 1987, a year before APAGS was established with the help of some of our leaders; we were the first to have a mid-winter meeting and the first Division to have a hospitality suite at the APA convention. In fact, we even were the first Division to hire someone to go through our journal’s issues to make sure there was no sexist language in them. We were one of the first Divisions to address women’s and ethnic minority issues and to give early career awards. Dr. Canter also stated that she really enjoys working with people who share her professional interests. And she particularly derives enormous pleasure from watching young people “move on up.” As she looks around her, today, and sees some of our top leaders, she smiles, remembering how they were when they started out, and recalls the satisfaction of seeing them blossom over time into their current professional maturity. She recalls one of them (to remain nameless), who was afraid to open her mouth and speak up at Division 29 meetings. Now that person is “a most articulate Division past president!” When asked about where her commitment to mentoring students and young professionals comes from, Dr. Canter replied, “I had a great role model….it comes from being mentored by my husband. He always believed that if you know something and can help someone who needs to know then you help them—he was always willing to help.” Indeed, despite being “semi-retired,” Dr. Canter continues to mentor students through the Arizona Consortium.

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The first mentee assigned to me has earned her PsyD and is doing a post doc. She has joined Division 29 (surprise!) and is working with me on the Division’s Policy and Procedures Manual. Another student was assigned to me this semester, and we are talking up a storm! She is also a supporter of the Division 29 Student Membership Committee’s attempts to create a web-based, members-only, mentor-protégé database, describing it as a “worthwhile project for the Division.” Although Dr. Canter’s tenure as a memberat-large, and hence her last official role for the Division, has come to a close, she is still an avid supporter of Division 29: It is important that this division have a voice in the APA Council. We represent the finest in psychotherapy as a result of the breadth of our interests…. We take into account all of what makes psychotherapy what it is: theory, practice, research, training. Other divisions don’t do that. Indeed, at a time when many Arizonian octogenarians may spend their days enjoying a bridge game with friends, Matty

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Canter continues to flourish in many professional arenas. I must be bad at adding fractions. I’m semi-retired and so I’m still in private practice. I’m very active in the Arizona Psychological Association, and in other professional organizations….I think this adds up to more than one full time job… But all these activities have rewarded me beyond my wildest dreams. In fact, rewards for her dedication to the profession of psychology go far beyond intrinsic – she has been honored with the Gold Medal Award for Life Achievement in the Practice of Psychology by the American Psychological Foundation, the Distinguished Mentor Award by the Arizona Psychological Association, and the Distinguished Psychologist of the Year award by the APA’s Divisions of Psychotherapy and Independent Practice, amongst many others. As one talks to Dr. Mathilda Canter it is easy to understand why she is so revered amongst colleagues. Her energy, dedication, enthusiasm, and drive are extraordinary. She truly is an inspiration to a new generation of psychotherapy researchers, theorists, practitioners, and trainers.

FEATURE Brief relational therapy and the resolution of ruptures in the therapeutic alliance Jeremy D. Safran Ph.D., New School University J.C. Muran, Ph.D., Beth Israel Medical Center

After approximately a half century of psychotherapy research, one of the most consistent findings is that the quality of the therapeutic alliance is the most robust predictor of treatment success (Horvath & Symonds 1991; Martin, Garske & Davis, 2000). This has been evident across a wide range of treatment modalities. A related finding is that poor outcome cases show greater evidence of negative interpersonal process (i.e., hostile and complex interactions between therapists and patients) than good outcome cases (e.g., Henry et al., 1993). There is also a growing body of evidence demonstrating the relationship between resolving alliance ruptures and treatment outcome (e.g., Stiles et al., 2004; see Safran et al., 2002, for a review). Another relevant line of research has demonstrated that some therapists are consistently more helpful than others; differences in therapist ability seem to be more important than therapeutic modality; and the more helpful therapists appear better able to facilitate the development of a therapeutic alliance (e.g., Luborsky et al., 1997). Process and Outcome Research The focus of our clinical research program is on clarifying the principles involved in resolving ruptures in the therapeutic alliance and developing training strategies to facilitate rupture resolution. A rupture in the alliance consists of a period of tension, misunderstanding or lack of collaboration between patient and therapist. In this article, we will briefly describe some of our research findings as well as practice guidelines and training strategies that we have developed and tested for resolving ruptures in the alliance. The interested

reader is referred to Safran and Muran (2000) for an extensive presentation of clinical theory, practice and training, and to Safran and Muran (1996), Safran et al. (in press), and Muran et al. (in press) for some examples of our research efforts. Over the last decade, we have investigated the processes through which alliance ruptures can be resolved at various levels at analysis. At the level of psychotherapy process, we have devoted considerable effort to the study of alliance rupture resolution as a critical change event. This effort has included the development of assessment strategies to identify psychotherapy sessions in which such change events occur (e.g., patient- & therapist-rated postsession questionnaires), as well as those to assess the interactional sequences of various patient states and therapist interventions in the resolution process (e.g., observer-based measures of interpersonal behavior and emotional experience). Common elements of the resolution process identified incude: 1) Therapist identifying and drawing attention to the rupture, 2) exploring patient feelings about the rupture that are being avoided, 3) exploring patient fears and expectations interfering with the expression of feelings about the rupture, and 4) patients expressing underlying wishes (Safran & Muran, 1996). At the level of overall outcome, we have conducted research evaluating the efficacy of a treatment approach that has been influenced by our process research as well as recent developments in relational psychoanalysis. This approach is referred to as brief relational therapy (BRT). In one study

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we evaluated the efficacy of BRT relative to two more traditional models of short-term treatment: one psychodynamic (STDP) and one cognitive-behavioral (CBT). All three brief psychotherapies were designed to treat patients with personality disorder diagnoses. Results indicated that the three treatments were equally effective on standard statistical analyses of change, including those conducted on repeated measures and residual gain scores. Some significant differences were indicated regarding clinically significant change and reliable change, favoring the BRT and CBT models. In addition, there was a significant difference regarding dropout rates, favoring BRT, which suggests that BRT may be more effective in dealing with the type of alliance ruptures that lead to treatment dropout (Muran et al, in press). This finding will need to be replicated. In a second study we found preliminary evidence in a small sample of the unique effectiveness of BRT for patients who had previously demonstrated difficulties in establishing a working alliance in another treatment condition (Safran, et al, in press). These findings will of course need to be replicated on larger samples. Clinical Guidelines Some of the key features of BRT are as follows: 1) It assumes that alliance ruptures take place when both patient and therapist contribute unconsciously to an interpersonal cycle that is taking place between them, 2) there is an intensive focus on the here and now of the therapeutic relationship, 3) there is an ongoing collaborative exploration of both patients’ and therapists’ contributions to the interaction, 4) it emphasizes in-depth exploration of the nuances of patients’ experience in context of the therapeutic relationship, and is cautious about inferring generalized relational patterns, 5) it emphasizes the subjectivity of the therapist’s perceptions, 6) it assumes that the relational meaning of interventions (i.e., the idiosyncratic way in which each patient construes the therapist’s intervention) is as important if not more impor-

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tant than the content of the intervention, and 7) it makes intensive use of therapist self-disclosure and collaborative exploration of what is taking place in the therapeutic relationship for purposes of coming to understand and unhook from the unconscious interpersonal cycle taking place between the patient and therapist, which we refer to as therapeutic metacommunication (adopted from Kiesler, 1996). The therapist’s task when engaging in this type of exploration is to identify his or her own feelings and use them as a point of departure for collaborative exploration. Different forms of exploration are possible. The therapist may provide the patient with feedback about his or her impact on others. For example: “I feel cautious with you…as if I’m walking on eggshells.” Or “I feel like it’s difficult to really make contact with you. On one hand, the things you’re talking about really seem important. But on the other, there’s a subtle level at which it’s difficult for me to really feel you.” Or “I feel judged by you.” Such feedback can also pave the way for the exploration of the patient’s inner experience. For example, the therapist can add: “Does this feedback make any sense to you? Do you have any awareness of judging me?” It is often useful for therapists to pinpoint specific instances of patients’ eliciting actions. For example: “I feel dismissed or closed out by you, and I think it may be related the way in which you tend not to pause and reflect in a way that suggests you’re really considering what I’m saying.” Below are described a number of general principles that are used to guide therapists administering BRT in our research: 1.) Explore with skillful tentativeness and emphasize one’s own subjectivity. Therapists should communicate observations in a tentative and exploratory fashion. The message at both explicit and implicit levels should be one of inviting patients to engage in a collaborative attempt to understand what is taking place, rather than one of conveying information with objective

status. It is also important to emphasize the subjectivity of one’s perceptions since this encourages patients to use the therapist’s observations as a stimulus for self-exploration. 2.) Ground all formulations in awareness of one’s own feelings and accept responsibility for one’s own contributions. All observations and formulations should attempt to take into account what the therapist is feeling. Failure to do so increases the risk of a distorted understanding that is influenced by unconscious factors. It is critical to take responsibility for one’s own contributions to the interaction. We are always unwittingly contributing to the interaction, an important task consists of clarifying the nature of this contribution in an ongoing fashion. In some situations, the process of explicitly acknowledging responsibility for one’s contributions to patients can be a particularly potent intervention, helping patients become aware of unconscious or semi-conscious feelings that they have difficulty articulating and reducing therapist need for defensiveness. 3.) Focus on the concrete and specific and the here and now of the therapeutic relationship. Whenever possible, questions, observations and comments should focus on concrete instances in the here and now rather than generalizations. This promotes experiential awareness rather than abstract, intellectualized speculation. For example, “I experience you as pulling away from me right now. Do you have any awareness of doing this?” 4.) Start where you are. Collaborative exploration of the therapeutic relationship should take into account feelings, intuitions and observations that are emerging for the therapist in the moment. What was true one session may not be true the next and what was true one moment may change the next. Two therapists will react differently to the same patient, and each therapist must begin by fully accepting and making use of his or her own unique experience.

5.) Do not assume a parallel with other relationships. Therapists should be wary of prematurely attempting to establish a link between the interpersonal cycle that is being enacted in the therapeutic relationship and other relationships in the patient’s life. Attempts to make links of this type (while useful in some contexts) can be experienced by patients as blaming and can serve a defensive function for therapists. Instead the focus should be on exploring patients’ internal experience and actions in a nuanced fashion, as they emerge in the here and now. 6.) Collaborative exploration of the therapeutic relationship and unhooking take place at the same time. It is not necessary for therapists to have a clear formulation prior to metacommunicating. In fact, the process of thinking out loud about the interaction often helps the therapist to unhook from the cycle that is being enacted by putting into words subtle perceptions that might otherwise remain implicit. Moreover, the process of telling patients about an aspect of one’s experience that one is in conflict over, can free the therapist up to see the situation more clearly. 7.) Remember that attempts to explore what is taking place in the therapeutic relationship can function as new versions of an ongoing unconscious interpersonal cycle. It is critical to track the quality of patients’ responsiveness to all interventions and to explore their experience of interventions that have not been facilitative. Does the intervention deepen the patient’s selfexploration or lead to defensiveness or compliance? The process of exploring the way in which patients experience interventions that are not facilitative helps to refine the understanding of the unconscious interpersonal cycle that is taking place. Training and Supervision Training in BRT and rupture resolution includes an important emphasis on experiential learning and self-exploration.

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Therapists are trained to attend to and explore their own feelings as important sources of information about what is going on in the therapeutic relationship. We often use role-playing exercises in order to provide therapists with the opportunity to simulate working with difficult patients and experimenting with metacommunication. The purpose of these exercises is not just to provide them with the opportunity to practice technical skills, but also to provide them with the opportunity to develop the skill of exploring their own feelings and internal conflicts as they emerge during alliance ruptures. These are referred to as “awareness-oriented role plays” (Safran & Muran, 2000). Supervisors monitor the roleplays carefully and intervene at critical moments to direct therapists’ attention to their inner experience, and encourage them to put unarticulated feelings and intuitions into words. Supervision also employs mindfulness training for purposes of helping therapists refine their capacity to observe their own inner experience as well as the nature of their own contributions to alliance ruptures. Mindfulness practice involves learning to direct one’s attention in a disciplined fashion, in order to become aware of one’s thoughts, feelings, fantasies, or actions as they take place in the present moment. Through this training, therapists learn to refine their capacity to investigate their own experience and observe their own actions in a detached fashion. In fact, we conceptualize metacommunication as a type of “mindfulness in action” (Safran & Muran, 2000). An important byproduct of mindfulness practice is the discovery of internal space. This consists of the loosening of attachment to one’s cognitive-affective processes –an ability to see them as constructions of the mind. This in turn reduces the experience of constriction resulting from an over identification with these processes and allows one to reflect on them and to use them therapeutically. Conclusion To date we have accumulated preliminary evidence regarding some of the processes

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involved in the resolution of alliance ruptures and the effectiveness of brief relational therapy. Future research will be needed to further refine our understanding of the rupture resolution process and to evaluate the effectiveness of brief relational therapy in other samples. Address all correspondence to: Jeremy D. Safran, Ph.D. Psychology Department New School University, 65 Fifth Ave. New York, NY 10003, U.S.A. [email protected] References Henry, W.P., Strupp, H.H., Butler, S.F., Schacht, T.E., & Binder, J.L. (1993). Effects of training in time-limited psychotherapy: Changes in therapist behavior. Journal of Consulting and Clinical Psychology, 61, 434-440. Horvath, A.O., & Symonds, B.D. (1991). Relation between working alliance and outcome in psychotherapy: A metaanalysis. Journal of Counseling Psychology, 38, 139-149. Kiesler, D.J. (1996). Contemporary Interpersonal Theory & Research. NY: John Wiley. Luborsky, L., McLellan, A.T., Diguer, L., Woody, G., & Seligman, D.A. (1997). The psychotherapist matters: comparison of outcomes across twenty-two therapists and seven patient samples. Clinical Psychology: Science and Practice. 4, 5365. Martin, J.D., Garske, J.P., Davis, M,K. (2000). Relation of the therapeutic alliance with outcome and other variables. Journal of Consulting and Clinical Psychology, 68, 438-450. Muran, J.C., Safran, J.D., Samstag, L.W., & Winston, A. (in press). Evaluating an alliance-focused treatment for personality disorders. Psychotherapy. Safran, J.D. & Muran, J.C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press. Safran, J.D. & Muran, J.C. (1996). The reso-

lution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology, 64, 447-458. Safran, J.D., Muran, J.C., Samsag, L.W., & Stevens, C. (2002). Repairing alliance ruptures. In J.C. Norcross, Ed., Psychotherapy Relationships that Work (pp. 235-254). New York: Oxford University Press. Safran, J.D., Muran, J.C., Samstag, L.W., & Winston, A. (in press). Evaluating an

alliance-focused treatment for potential treatment failures. Psychotherapy. Stiles, W.B., Glick, M.J. Osatuke, K., Hardy, G.E., Shapiro, D.A., Agnews-Davies, R. Rees, A. & Barkham, M. (2004). Patterns of alliance development and rupturerepair hypothesis: Are productive relationships U-shaped or V-shaped? Journal of Counseling Psychology, 51, 81-92.

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DIVISION OF PSYCHOTHERAPY

BOARD OF DIRECTORS ACTIVITIES

Leon VandeCreek recognizes Linda Campbell for her presidential year

Abe Wolf, Bill Stiles, and Craig Shealy

John Norcross, Armand Cerbone, Linda Campbell, Leon VandeCreek and Jam Culbertson

James Bray, Alice Rubenstein, and Abe Wolf

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PSYCHOTHERAPY, EDUCATION AND TRAINING Critical Events in Psychotherapy Supervision Nicholas Ladany, Lehigh University

Psychotherapy supervision is arguably the primary means of facilitating supervisee development as a therapist. Unlike psychotherapy, which has garnered a relatively long history of theoretical and empirical attention, supervision has received limited consideration either theoretically or empirically. To be sure, it stands to reason that we cannot train someone in psychotherapy until we know what works in psychotherapy, or at the very least, have a general sense and a decent conviction about what we think works in psychotherapy. All said, it seems we have indeed reached the point of formulating and providing models of supervision. The purpose of this article is to review the Critical Events-Based Supervision model (Ladany, Friedlander, & Nelson, in press), a new supervision model that is theoretically grounded in the supervision realm, is informed by the empirical supervision literature, and is clinically meaningful to the supervision practitioner. While a full review of the model is beyond the scope of this article, my intent is to provide an overview of the primary tenants of the model and illustrate it with a clinical example.

place in supervision are potentially limitless, we focus on those we believed were key critical and reoccurring events in supervision: remediating skill difficulties and deficits, heightening multicultural awareness, negotiating role conflicts, working through countertransference, managing sexual attraction, repairing gender-related misunderstandings and missed understandings, and addressing problematic supervisee emotions and behaviors. A process model based on each of these critical events has been constructed. For each critical event, there are four primary constructs to consider: (a) the supervisory working alliance, (b) marker, (c) task environment, and (d) resolution (see Figure 1 for an illustration of the model). The supervisory FIGURE 1

The Critical Events-Based Supervision model is intended to be pantheoretical and assumes that supervision can be understood as an interpersonal approach toward teaching psychotherapy. The model is based on the task-analytic approach of understanding psychotherapy, the supervision theoretical and empirical literature, and our own supervisory practice. Another assumption of the model is that supervision can be thought of as consisting of a series of events that can take place within a session or across multiple sessions. While the number of critical events that can take

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working alliance is considered the foundation upon which the effectiveness of supervision is based and serves as the figureground object in the model. Early in the supervisory work and when difficult times arise, the alliance becomes the figure. At other times it is the ground. We largely base our conceptualization of the alliance on Bordin’s (1983) model which identifies the supervisory working alliance as consisting of three factors: a mutual agreement between the supervisee and supervisor on the goals of supervision (e.g., increase conceptualization skills), a mutual agreement between the supervisee and supervisor on the tasks of supervision (e.g., listening to audiotapes), and an emotional bond between the supervisee and supervisor (i.e., mutual caring, liking, and trusting).

process, (c) focus on skill, (d) focus on therapeutic process, (e) focus on self-efficacy, (f) exploration of feelings, (g) focus on the supervisory alliance, (h) assessing knowledge, (i) focus on evaluation, (j) case discussion, (k) focus on multicultural awareness, and (l) focus on countertransference. For each critical event, there are common interaction sequences that make up the task environment. Figure 1 shows the likely interaction sequences for the supervisee who is self-disclosing inappropriately.

Having considered the supervisory working alliance as the foundation, the next thing to look for in supervision is a marker. A marker is like a trigger or signal to the supervisor that the supervisee needs something and a particular critical event is about to take place. For example, in remediating a skill deficit event, the supervisor may notice from an audiotape review that a supervisee is self-disclosing too frequently with a client and that the self-disclosures do not appear to be in the service of the client. The self-disclosures are the marker of the critical event.

As mentioned previously, this article is only able to provide a cursory overview of the Critical Events Supervision model. Hopefully, the model will serve as a stimulus for further thought in relation to psychotherapy supervision.

Once the marker has been identified, the supervisory work proceeds into the task environment, which is comprised of interaction sequences. These interaction sequences pertain to the supervisor’s actions and the supervisee’s reactions. The most common interaction sequences include: (a) normalizing experience, (b) attend to parallel

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Finally, following the task environment comes the resolution of the event. A resolution pertains to the extent to which the supervisor successfully or unsuccessfully, influences the supervisee’s self-awareness, knowledge, or skills.

Reference Ladany, N., Friedlander, M. L., & Nelson, M. L. (in press). Critical events in psychotherapy supervision: An interpersonal approach. Washington, DC: American Psychological Association. Correspondence concerning this chapter should be directed to Nicholas Ladany, Ph.D., 111 Research Drive, Counseling Psychology Program, Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, 18015. Electronic mail may be sent to [email protected].

2004 INTERNATIONAL CONGRESS OF PSYCHOLOGY

Three former Division of Psychotherapy presidents -John C. Norcross, James Bray, and Robert J. Resnick -presenting at the 2004 International Congress of Psychology in Beijing, China.

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PROPOSED REVISIONS TO EXISTING BYLAWS At the Division’s midwinter meeting on January 15–16 2005, the Board of Directors voted on changes to the Bylaws of the Division. The most substantive revisions are 1) changing the name of the Division to “The Society for Psychotherapy: Division 29 of the American Psychological Association” and 2) adding a new membership category, Psychologist Affiliate, which will allow doctoral-level psychologists who are not members of APA to join the Division. Other changes addressed dated procedural issues. Finally, formatting, grammar, and spelling problems were corrected. A full listing of all the changes is available on the Division web site at http://www.divisionofpsychotherapy.org/bylawschanges.pdf . 1) CHANGING THE NAME OF THE DIVISION The name of the Division will be changed from “The Division of Psychotherapy” to “The Society for Psychotherapy: Division 29 of the American Psychological Association.” The references to “The Division” in the Bylaws will be changed to reflect this. Pro: A name change will maintain our status as an APA Division while broadening our appeal and membership. Non-APA psychologists would be more likely to join a Society, as opposed to an APA Division. Con: A name change may dilute the historical character of the Division. A new name that is similar to an existing organization, such as the Society for Psychotherapy Research, may lead to confusion. 2) ADDING A MEMBERSHIP CATEGORY A new membership category of Psychologist Affiliate is being added to the existing bylaws categories of Member, Fellow, and Student Affiliate ARTICLE II SECTION E The minimum qualification for election to the category of Psychologist Affiliate shall be an earned doctoral degree from a program recognized on the designated doctoral programs in psychology list jointly maintained by the National Register of Health Service Providers in Psychology and the Association of State and Provincial Psychology Boards. ARTICLE III, SECTION D Psychologist Affiliates of The Society shall be entitled to attend and to participate in the meetings of The Society and shall receive its publications. While Psychologist Affiliates are not eligible to vote in Society elections and are not eligible to hold elected office in The Society, they may chair ad hoc committees or task forces and may serve as voting members of all Society committees or task forces. A majority affirmative vote on these sections will have the effect of adding “Psychologist Affiliate” to all instances where classes of membership are specified. Pro: Division 29 could expand its membership base and increase its revenue by inviting non-APA psychologists to join. They would receive the Journal and receive the Bulletin in exchange for their membership dues. Our publishing contract with APA stipulates that APA will send the journal free of cost to up to 4,000 members. Members over 4,000 will be billed to the Division at $11.50 per member per year. Unless we exceed the 4,000 limit, the

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journal cost to the Division for non-APA psychologists would be essentially zero. Con: Perhaps a few Division 29 members will drop their APA membership, but this has rarely occurred when other divisions have added similar membership categories. The change would require a few extra hours per month for our administrative officer in maintaining the membership list.

3) ARTICLE II SECTION B Delete: As described in Article XI Section G of these bylaws, there shall be a Membership Committee. This committee shall review new applications for Member, Associate Member, or Student Affiliate status. A two-thirds (2/3) vote of this committee shall determine the membership status for each applicant and accept new members. The Board of Directors shall be notified about such determinations. Pro: Persons may submit application for membership to the Society’s administrative office. The administrative office will review the applicant’s credentials and inform the applicant about the status of that application. The Membership Committee no longer votes on division membership. The status of applicants is reviewed by the Central Office. Con: None identified

4) ARTICLE IV SECTION C From: Resigned members of the Division shall be eligible for reinstatement upon request in writing to the Secretary and upon payment of any back dues or assessments. To: C. Resigned members of The Society shall be eligible for reinstatement upon reapplication. Pro: Resigned members are automatically reinstated upon payment of dues. Con: None known

5) ARTICLE V SECTION E (Secretary Duties) Delete: shall inform the membership of actions taken by the Board of Directors; shall notify applicants for membership and fellowship about the status and outcome of their applications; Pro: The first section is redundant, since the Secretary informs the membership of actions taken by the Board of Directors in the minutes of those meetings. The second section is performed by the Central Office. Con: None identified.

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OFFICIAL BYLAWS VOTING BALLOT 1) CHANGING THE NAME OF THE DIVISION  YES

 NO

2) ADDING A MEMBERSHIP CATEGORY  YES

 NO

3) ARTICLE II SECTION B  YES

 NO

4) ARTICLE IV SECTION C  YES

 NO

5) ARTICLE V SECTION E (Secretary Duties)  YES

 NO

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REPORT OF APA COUNCIL REPRESENTATIVES The APA Council of Representatives met February 17-20, 2005 in Washington, DC. The Division of Psychotherapy was represented by the three of us, and this report was prepared specifically for members of Division 29. APA Presidential Initiatives. 2005 APA President Ron Levant provided outstanding leadership during the 2.5 day meeting. He respectfully promoted open discussions while moving a full agenda forward. The meeting opened with Dr. Levant introducing his presidential Initiatives: Promoting Health Care for the Whole Person; Making Psychology a Household Word; Presidential Task Force to Explore the Ethical Aspects of Investigations Related to National Security; and Presidential Task Force on EvidenceBased Practice in Psychology APA’s Delegation to the UN Conference in Durbin, South Africa 2001. Governance provided an effective and moving model for conflict resolution. Extensive time was allocated for debate, testimonials, and discussion of the recommendations presented by a Task Force appointed by Dr. Diane Halpern to consider the difficult issues. Council approved unanimously a substitute motion that, in addition to acknowledging the outstanding work of the APA delegation, provided the following: APA’s President is requested to appoint a working group to develop a resolution condemning anti-Semitic and anti-Jewish and other religious, religion-related, and/or religion-derived prejudice and discrimination for adoption by Council. Also, the APA President was requested to appoint a working group to develop a resolution condemning prejudice and discrimination in all its form for adoption by Council. The report of the APA Delegation was received. The Task Force on the World Conference against Racism was directed to create an annotated version of the UN Declaration.

APA Priorities and Psychotherapy. Division 29 Council Representatives during brainstorming break-out sessions were able to add Psychotherapy to a list of probable APA priorities for guiding the Association. If you are a member of Division 29 but represent another division or state, please consider giving psychotherapy advocacy some of your votes on the priority lists. If you are a member of your state association or another division, please ask other council representatives to consider giving the item on psychotherapy consideration. It is important that APA reassert the importance of Psychotherapy for all of Psychology. Finances. “I am happy to report that our finances have stabilized following some uncertain times and a major restructuring of our real estate debt.” Dr. Norman Anderson, APA’s CEO, announced during the meeting. After seeing the precise figures and open discussion lead by Carol Goodheart, APA’s Treasurer, and Jack McKay, APA’s CFO, Council approved a $98,500,000 plus budget for 2005 with a projected small surplus. Those interested in more detail are welcome to back channel any of the Division 29 representatives. Task Forces. Council approved and funded a number of Task Forces. If you are interested in being considered for any of these task forces, here they are with the specific APA Directorate you should contact. Public Interest Directorate: 1) Socioeconomic status; 2) Sexualization of girls; 3) Gender identity, Gender variance and intersex conditions; 4) Urban psychology; 5) Psychoactive medication for children and adolescents; and 6) Empirically supported sex education and HIV prevention programs for adolescents. Education Directorate: 1) Strengthening the teaching and learning of undergraduate psychological sciences 2) Continued on page 33

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WASHINGTON SCENE A Renewed Vision For Psychology by Pat DeLeon, former APA President On September 20, 1963 President John F. Kennedy addressed the United Nations General Assembly. “Never before has man had such capacity to control his own destiny, to end thirst and hunger, to conquer poverty and disease, to banish illiteracy and massive human misery. We have the power to make this the best generation of mankind in the history of the world – or make it the last.” Psychology is one of the “learned professions” and as such, we have a collective responsibility to provide visionary leadership. Our colleague Henry David has accepted (and personified) this important challenge over the years with distinction.“The 28th International Congress of Psychology convened, just after the APA Hawaii convention, in Beijing, provided a welcome opportunity to revisit China after 22 years. Our first visit, in 1982, had been as members of a group of psychologists led by Ray Fowler. On this trip we were primarily in Beijing and Shanghai with a visit to Guilin and a Yangtze river cruise in between. “We will recount some personal observations on the many changes we noted. In 1982, China was (and still is) the world’s most populous nation with over one billion people. At that time, we were engulfed by men and women wearing shapeless blue grey unisex Mao suits; in 2004 we saw none. In 1982 the never-ending flow of bicycles was interspersed by an occasional black government car; today cars clog congested streets with drivers often ignoring the ‘zebra’ crossings and endangering pedestrians. We were told that in Shanghai alone there are more than one million cars, including 48,000 taxis, all contributing to pervasive smog. Twenty-two years ago the shops were mostly government owned and operated, selling primarily Chinese produced goods; in 2004 they are largely indi-

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vidually owned enterprises. High rise glitzy shopping malls feature prestigious European boutiques with foreign made clothes and other luxury goods. The old ‘Friendship’ stores still exist but offer no bargains. The red banner propaganda posters of earlier years have been replaced by outdoor bill boards displaying western models with advertisements using English subtitles to increase marketing appeal. The only portrait of Mao we saw was the familiar one in Tiananmen Square. There were no portraits of government or party officials in the hotels, offices, or shops we visited. Starbucks and McDonalds are everywhere. The dynamic economic growth is reflected in the towering cranes, the new glass and marble office buildings, and the super modern hotels and new or remodeled cultural centers such as the Shanghai Museum. All this is in stark contrast to life in the countryside. But even there, some farmers have turned their simple homes into accredited (by local authorities) rentable accommodations for weekend guests. Along the banks of the Yangtze river, in areas flooded as part of the gigantic Three Gorges Dam development, villagers have been moved into apartment buildings with elevators installed only if the building rises eight floors or higher. “The physical and political changes we observed were dramatic. Since Deng Xiaoping’s famous statement of a quarter century ago, ‘To get rich is glorious,’ China has seen the greatest burst of wealth creation in human history. Per capita income has increased significantly while income inequality between urban rich and rural poor has widened to a worrisome degree. Urban residents earn on average three or more times as much as migrant workers or farmers. The relentless ‘march to capitalism’ has greatly influenced Communist

Party policies. A socialist market economy is replacing the centrally planned economy. There is a widespread belief that economic growth will solve all problems. This is unsettling for a government that likes to identify itself as ‘socialist’ though many Chinese joke privately that presently the United States has a better claim to that description. Millions of migrants, largely unemployed peasants displaced by development projects or workers dismissed from state-owned enterprises, are pouring into urban centers, providing cheap labor. Of Shanghai’s 16.4 million inhabitants, three million are migrant workers. Most are unregistered as city dwellers and ineligible for many social services. Prostitution, officially illegal, is tolerated. Aggressive beggars and scam artists prey on visitors. Air pollution has become an acknowledged urban environmental problem. Water pollution exists primarily in rural areas where some of the dirtiest polluting industries have been relocated. A new book on China’s environment documents how the air quality in two-thirds of Chinese cities is below World Health Organization standards. Some public health observations: cigarette smoking was banned in the Congress halls and in our hotels. We saw little on the streets of Beijing and Shanghai. We also noted very few obese Chinese. “One of the purposes of our 1982 visit was to learn about the dramatic social action program designed to curb population growth. In 1979 China became the first country in history to restrict the right to procreate, a policy enforced through stateand party-guided incentives and disincentives. The psychologists we met at that time endorsed the rationale for the onechild family policy but wondered about longer term effects, emphasizing the need for research on physical and intellectual development as well as on the personality of only children. “Professor Ching (now Jing) was the

President of the very well organized 2004 International Congress. He welcomed suggestions for symposia on reproductive health and sexuality topics. Two symposia and a Conversation Hour, organized under the auspices of the World Federation for Mental Health Committee on Responsible Parenthood, attracted participants from several countries and a culturally diverse audience. We were impressed by the many English-speaking Chinese students at the Congress. English is the second language of the educated (many trained in the U.S.) and of international commerce. In Shanghai, English instruction begins in the third grade. “At the Conversation Hour a Chinese psychologist reported on her research, noting that well educated young Beijing couples seldom want more than one child because the cost of education has become a burden. Families have to pay rising school related fees from kindergarten through college. In Shanghai, tuition is free up to the 9th grade but parents must pay for books, uniforms, and food. Several psychologists in urban areas are focusing their studies on parental stress and coping behavior. Another problem is that previously free public health services have deteriorated. For example, China is currently the only country in the Western Pacific Region which relies on parents to finance childhood immunizations. The underfunding of health services has led to ‘red packets’ (bribes) to assure good treatment from physicians and nurses. Underfunding is not, however, the sole reason for public health service problems. A Beijing-based economist told us that it was a combination of a choice for market-based funding and price regulations. Some health services and products can be offered at prices that allow hospitals and physicians to earn a profit. Other services and products can only be provided at a loss – for which hospitals and physicians may then request additional compensation. “We wondered about urban universityeducated only children now in their midtwenties. They belong to the first cohort of

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Chinese youth whose formative years were spent amid rapid economic growth and an explosion of commercialism. The privations and turmoil of the Maoist years and the Cultural Revolution are often merely a part of family lore. Parental resources do not have to be shared with siblings. Often they still live at home, even when married, postpone having a baby, and are not afraid to borrow money. Keenly aware of fashion, brands, and quality, they crowd the boutiques on Nanjing Road in Shanghai. “Hardee, Xie, and Gu reported some of the effects of the one-child family policy (modified over the years) on women’s lives in rural areas. They used survey and focus group data collected in 1996 and 1998 with three generations of women. The oldest women had more children than they wanted and regretted not having access to modern contraceptives. Middle age women had desired fewer children but would have preferred making their own fertility decisions. The youngest women had grown-up with and were largely resigned to the restrictions on family size. Across generations, the majority of women believed family planning had a positive effect on women’s lives, citing better health, less household work, and more educational and career opportunities for their children. All women, regardless of age, felt strong pressure to have a son. Currently, rural families are permitted to have two children if the first is a girl or if the first child has a disability or died. Moreover, if couples themselves are only children, they may have a second child. Members of minorities may also have two children and Tibetans are allowed three. “During one day of the Congress, Baochang Gu, Deputy Executive Director of the Chinese Family Planning Association (with a Ph.D. in sociology and demography from the University of Texas in Austin) and co-author of the rural inquiry, drove us to a regional family planning center located about one hour north of Beijing. The three story air-conditioned facility dispenses contraceptives free of

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charge to all who request them without inquiring about age or marital status. (An attractively packaged box of condoms included the word ‘condom’ printed in big English capital letters.) Additional services include free once-a-year health checks, ultrasound screening, and abortion via vacuum aspiration. In the Conference Room a very large wooden plaque proclaimed in huge gold colored Chinese characters ‘Control Population Quantity; Improve Population Quality.’ Great efforts are devoted to strengthen reproductive health services and HIV/AIDS prevention programs in the surrounding countryside but sexuality education continues to be a very sensitive topic. It is embarrassing for teachers and parents. Abortion of unwanted pregnancies among unmarried adolescents has increased and premarital sex has become the norm. “Over the years the Chinese Family Planning Association (CFPA), affiliated with the International Planned Parenthood Federation, has become one of the largest nongovernmental organizations in the country. It works in close cooperation with the government and receives major funding from the state. In Shanghai, local CFPA leaders told us about devoting considerable resources to improving sexuality education, reinforcing the fight against HIV/AIDS, and developing specialized counseling services for unmarried adolescent migrant women (among other activities). “While the one-child family policy resulted in an estimated 300 million fewer births over the last 10 years, one of the unintended consequences has been a growing gender imbalance. Chinese census figures for 2000 show 117 boys born for every 100 girls, described as ‘the largest, highest, and longest’ gender imbalance in the world. Many couples abort female fetuses, hoping to try again for a boy. Nearly all babies placed for adoptions abroad are girls. The gender gap has led to warnings by social scientists that in coming years some 40 million men might not find wives, fueling

social tensions. The Chinese call such men ‘bare branches’ of the family tree that will never bear fruit. There have already been press reports of kidnapping as bachelors try ‘purchasing’ wives. “To reduce the imbalance in the next 10 years, the government has banned the use of ultrasound for sex determination and sex-selective abortion. Such a policy is difficult to enforce when physicians are increasingly dependent on private income. Programs are being launched in more than a dozen of China’s poorest provinces to foster more respect and concern for women and girls, teaching rural families to value their daughters more. Financial aid is being expanded to farmers 60 years of age and older, living in poor areas, who have no children, no son, or just one child, or two daughters, or whose children are deceased or disabled. There is a shift in policy from using disincentives, punishing families who have too many children, to rewarding those who had fewer children and abided by the one-child policy. Still looming ahead, however, is the ‘demographic time bomb’ created by rising longevity and falling fertility. Some cities are relaxing the one-child family policy to permit the birth of a second child under certain conditions. As Gu indicates ‘there is no road map yet on how to achieve the goal of a normal sex ratio’ in China. “When discussing China, the sensitive question of free access to information inevitably arises. Newspapers are censored, some books and movies are banned. Satellite TV is available in four and five star hotels but requires special permission for home installation. Controversial Web sites and internet servers are blocked. Sexual mores can only be pushed so far: homosexual bars remain officially taboo, magazine sex columnists are shut down when they become too prominent, and a museum on ancient Chinese sex culture was moved from Shanghai to a town a two-hour drive away. Political activists risk imprisonment. However, there seems to be a greater governmental and party willingness to accept

criticism when related, for example, to environmental disasters, long term governmental planning, or corruption. Many people believe that, over time, economic growth will inevitably bring greater freedom and democratic reforms. A new generation is emerging adept in accessing the Internet. Their capacity to disseminate once ‘secret’ information was proven during the SARS epidemic. As one consequence, governmental actions on health policy and HIV/AIDS prevention improved significantly. “One amusing personal note. We were surprised by how many people approached us to inquire about our ages. Most Chinese women and men of a certain age dye their hair black. We have never changed our hair color. When one woman stared at Tema’s white hair and asked her age, she replied: ‘75 and my husband standing over there is 81.’ The woman looked surprised and blurted out in English: ‘Oh, an antique!’ “Two weeks of revisiting Beijing and Shanghai and seeing a bit of the countryside do not make us China specialists. We found our Chinese hosts most hospitable, invariably courteous, and very willing to answer our many questions, even when we inquired about their personal contraceptive preferences (mostly IUDs and condoms). We came away with an appreciation of an ancient people, whose culture has evolved over more than 40 centuries. China is an awakening giant whose economic, political, and military influence in the region and in world affairs will grow steadily in the foreseeable future.” With former APA President “Dr. Bob” Resnick present at the 28th International Congress of Psychology, the issue of psychology prescribing (RxP) naturally arose. Back in April, 2003 Dr. Bob authored a featured article in The Psychologist, published by the British Psychological Society. “To Prescribe Or Not To Prescribe – Is That The Question? The professional practice of psychology began about a hundred years ago. At each step in its evolution internal

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opposition from psychologists and vehement opposition by medicine have routinely occurred. Psychology’s interest in prescription privileges is no exception. When the First World War catapulted American psychology into testing, many psychologists were concerned and opposed. Testing went on to become a staple of professional practice and training. The end of the Second World War brought an urgent need for psychotherapy for returning military personnel and their families, and training of psychologists as psychotherapists began. Again, training to be psychotherapists was not quickly or unanimously embraced within psychology. As with psychological testing, it took years, but eventually psychotherapy became mainstream psychology. By the late 1960s and early 1970s psychologists had become the preeminent and dominant providers of psychotherapy. Psychological practice has continued to evolve from outpatient therapists to hospital-based practice, in nursing homes, residential treatment centers, and so on. Wherever there are mental health services, you will find psychologists. So the evolutionary next step towards prescribing medications is not surprising. Indeed it is the logical next step as we embrace, and no longer deny, the mind/body integration that has been so amply demonstrated by the brain/behaviour research of the last 25 years.... For almost a hundred years American psychology has debated the expansion of its competence and scope of practice. While never achieving unanimity, it has matured as a healthcare profession and will continue to do so.... Finally, I would argue that the best reason for psychologists having the ability to prescribe medications is not that it is good for psychology, but that it is good for the consumers. Psychologists have not entered this area of practice quickly or impulsively, but did so with deliberation and debate beginning in 1984. As a result, the additional training required for psychologists to prescribe medications has crucial differences from medical school training. Our training model is not disease-

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based. We include intensive and extensive training in the interaction of psychotherapy and medication, stressing when one is therapeutically superior to the other and when the use of both is in the best interest of the patient. In the final analysis, isn’t this what this should be about? Isn’t it what is best for the individuals, families and public we serve? It should be.” John Norcross serves as the President of the International Society of Clinical Psychology (ISCP) which is the “first independent international organization dedicated to the largest specialization in psychology – clinical psychology.” In Beijing, John discussed: “More Accessible, Psychological and Integrated Pharmacotherapy: Prescription Privileges for Psychologists.” His vision is very similar to Dr. Bob’s. “In a nutshell, my argument is that prescription privileges for psychologists will provide more accessible, psychologically oriented, and integrated care to the populace. That is why we should acquire prescription privileges. However, multiple arguments abound that we can or could prescribe. These weak arguments confuse whether we could secure prescription privileges with whether we should do so.... “‘(S)trong’ arguments are based on sound principles of science and practice and are, in my view, strong arguments precisely because they serve the common good. 1. Public accessibility: Psychologists’ prescription privileges will promote increased public access to trained prescribers of psychotropic medications.... 2. Psychological model: Psychologists will use – or choose not to use – pharmacotherapy based on a psychological model of treatment in contrast to a medical one.... The ability to prescribe is also the ability to discontinue the use of inappropriately or ineffectively prescribed medicines by other providers.... 3. Integrated treatment: Psychologists’ prescriptive authority will enhance the sophisticated and efficient integration of psychotherapy and pharmacotherapy.... 4. Evidence-based care: Prescribing psychologists are more likely to understand,

adhere and apply the scientific literature.... “In closing: Having ambivalently swum in these turbulent waters for many years now, I have arrived at a few definite conclusions, which serve as my summing up today. The debate on prescription privileges has been characterized by professional histrionics, confusing terminology, weak arguments and several strong arguments. The prescription privileges debate must be dedicated on the basis of scientific and practice evidence pertaining to patient care, not on

professional rivalries, not on emotional reactions, not on financial motives. Adding medication to psychologists’ armentarium will entail tradeoffs in our identity, training and scope of practice.... At the same time, prescription privileges promise more accessible, psychological, integrated, and empirically supported care for the populace. And those, my friends, are scientifically and morally compelling reasons to acquire prescription privileges for psychologists.” Aloha,

Council Report, continued from page 27 Impact of elementary & secondary school zero tolerance policies 3) Revisions of learner-centered psychological principles. Ethics Office: Presidential Task Force to explore the ethical aspects of investigations related to national security. Policy Issues. The discussion of the establishment of a new APA Division — the Society for Human-Animal Studies occurred in executive session. The motion to approve the new division failed. You may go to the APA web site or back channel any of your Div 29 council reps for information on the following policies that were approved at the February 2005 Council: APA Policy Formulation on Mental Illness and the Death Penalty; Guidelines for Education and Training at the Doctoral and Postdoctoral Level in Consulting Psychology/Organizational

Consulting Psychology; Recognition of Clinical Geropsychology as a Proficiency in Professional Psychology. The Policy and Planning Board 5-year report will be published. This very thoughtful report includes areas of concern for all psychology. Diversity Training. An informative presentation by John F. Dovidio, PhD, on understanding and combating implicit racism focused on helping Council Representatives to take individual responsibility in their sphere of influence in increasing diversity across APA. Thank you for your support in allowing us to represent the Division of Psychotherapy at APA Council. Please keep us informed of the issues that you want Council to address. Pat Bricklin, Ph.D., Norine G. Johnson, Ph.D., & John C. Norcross, Ph.D.

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PRACTITIONER REPORT Year of the Whole Person Ilene Serlin In 2005, the Practitioner Report—Dr. Ron Levant’s popular column—will instead feature periodic perspectives on his initiatives as President of the American Psychological Association. A feature article in the June issue of the APA Monitor recently stated that the “public is hungry for mind/body alternative and complementary interventions” (Dittman, 2004, p. 42). In the same issue, another article quotes David Myers (2000) that “Compared with their grandparents, today’s young adults have grown up with much more affluence, slightly less happiness and much greater risk of depression and assorted social pathology” and that “consumer culture has reached a fever pitch”(p. 53). Finally, the January 2005 issue of the Monitor focused on the epidemic of obesity, showing the range and cost of this problem. What do alternative and complementary interventions, consumer culture and obesity have in common? What they have in common is that they are aspects of a paradigm shift, a new holistic perspective on psychology that is needed to address symptoms of mind, body and spirit. Psychology has celebrated the “Decade of Behavior” and the “Year of Cognition:” it is time for a psychology of the “Whole Person.” Behavior and cognition have been polarized in the past, but the new paradigm of the Whole Person brings behavior and cognition together in a dialectical relationship through consciousness. A psychology of the Whole Person integrates behavior, cognition and consciousness, or body, mind and spirit. For example, while depression and obesity have biological dimensions, they are symptoms of a consumer culture of increasing

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speed, lack of connections and social support, and personal inner emptiness. The recent film “Super Size Me” shows the lack of real nourishment from a diet of McDonalds and consumer culture where “more” is bigger but not necessarily better. Cynthia Belar, APA’s Executive Director for Education, called for an integrative psychology in the September 2000 issue of the Monitor: I have spent years educating physicians and other health professionals that psychology had a scientific knowledge base and practice relevant to both ‘mental’ and ‘physical’ health…the biopsychosocial model cannot be segmented into its component parts without attention to interactive efforts… (p. 49). The theme of the Whole Person is a centerpiece of APA’s President-Elect, Ron Levant’s, presidential initiative. It was also the title of a Presidential mini-convention that was co-sponsored by Division 32 (Humanistic) and Division 43 (Family) in 2001 on Healthy Families, Healthy Society and Healthy Workplace called “Healthy families: A dialogue between holistic and systemic-contextual approaches,” and was published as an article called “Year of the Whole Person” (Serlin, 2001, 2002). What is the approach of the Whole Person and why is this important for psychologists today? The Whole Person approach is integrative, and considers the person in the context of his or her world. It seeks to understand the meaning of symptoms such as obesity, as well as its biological and behavioral causes. Learning Whole Person approaches is important for psychologists because the public and patients are already clamoring for integrative approaches and finding them in medicine, but not psychology.

People are turning to healthcare practitioners to reduce stress through meditation, yoga, and acupuncture; psychologists can make a valuable contribution by contextualizing behavioral techniques in the framework of a therapeutic relationship and process. The recent popularity of the Bill Moyers’ show on alternative healing and the revelation in the January 28, 1993 issue of The New England Journal of Medicine that over one-third of Americans utilize unconventional medicine signals a major shift in attitudes toward healing. The National Institutes of Health funded an Office of Alternative Medicine (OAM) to support research into alternative approaches, whose budget has been growing yearly. The NIH issued a “Roadmap” with an emphasis on prevention and education. The Consortium of Academic Medical Centers for Integrative Medicine (CAMCIM), consists of 23 medical schools with programs in integrative medicine that have educational, research and clinical training. The work of Candace Pert has shown that the processing of emotions often affects physical illnesses and the ability to heal. Research on healthy humans as well in cancer and HIV-positive patients has shown significant increases in immune function or positive health outcomes with emotional expression (Pert, 1997). A holistic perspective on psychology and a holistic concept of the self is central to humanistic psychology, positive psychology, and wellness health psychology. Since the movement toward integrative healthcare in inevitable, it is time for psychology as a primary healthcare profession to bring its unique contribution to a multi-disciplinary approach. New approaches would also revive the morale and effectiveness of practitioners, and help provide new opportunities for practice. Integrative psychology thus addresses a three-fold crisis in healthcare: 1) the “completely disgruntled healthcare consumer,” 2) a “disenfranchised, disillusioned physician,” and 3) our “healthcare is a broken model” (Gazella, 2004, p. 86).

example, one-third of California’s 2 million teens are very overweight or risk becoming obese and are at risk for life-threatening illnesses by the time they reach 30. The highest rates were among Latino and African Americans. In addition, the death rate among young Americans due to cardiac arrest rose during the 1990’s, especially among women and African Americans, and seems to be related to the epidemic of obesity (Haney, 2001). Since these lifestyle issues include too much junk food and video games, increased stress, and lack of role-modeling and social support, an educational campaign stressing healthy lifestyles would be beneficial.

An integrative approach is urgent to address today’s complex health issues. For

The overuse of psychotropic medications among preschoolers is another problem

In a study carried out by the US Department of Agriculture, over one-half of all American adults are considered overweight or obese, spending about $33 billion each year on diet books, diet pills and weight loss programs (Squires, 2001). Both taking and keeping weight off are psychological issues. These require understanding of motivation, stress factors, coping mechanisms, and social support. In fact, an encouraging study at UCSF suggests positive results from a non-medical approach to weight loss (PRNewswire, 2000), in which sustained weight loss resulted from training people in two basic internal skills of self-nurturing and limit setting. Nonmedical interventions are also extremely relevant for regulating mood. The use of anti-depressants is at an all-time high for Americans. Studies have shown a relationship between changes in energy and anxiety levels and eating and exercise habits. The relationship is not a simple causal one, but a complex interactive one, in which mood affects behavior, and behavior affects mood. Using psychological interventions gives people more conscious control over their lives, and improves their self-esteem and sense of meaning. In an increasingly speeding world, we can no longer coast on data points (“knowledge”), but need wisdom to make constructive choices, and establish and maintain priorities.

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where a Whole Person approach would be helpful. In response to an article in the Journal of the American Medical Association showing a dramatic increase in the use of psychotropic medications for preschoolers between 1991 and 1995, Levant advised First Lady Hillary Rodham Clinton that psychological and pharmacological interventions for children need equal attention. Finally, psychosocial support groups used to treat cancer show increased quality of life and survival time (Fawzy et al., 1993; Spiegel et al., 1989). Supportive-expressive group therapies are existentially based and aim to help patients live their lives more fully in the face of a life-threatening illness. A wellness model would focus on how to help healthy individuals cope with these extraordinary circumstances. Support groups can address questions of meaning, mortality and expression. New Paradigm Roger Sperry, an eminent psychobiologist who died in 1994, described the paradigm shift from “scientific materialism” to a holistic, non-mechanistic, bidirectional model. Instead of prediction and control, this model provided “...a more realistic realm of knowledge and truth, consistent with science and empiric verification” (Sperry, 1991b, p. 255), and including an “ultimate moral basis” (Sperry, 1995, p. 9) of environmental and population sustainability. In Sperry’s interactionist, nondualistic model of mental and physical states, causation is determined upward from physical states, as well as downward from mental states. Consciousness, which brings together the physical and mental states, comprises the area of meaning, beliefs, and existential choice. An illness such as breast cancer, for example, involves the meaning of the breast for a woman, her attitude and spirituality, as well as her confrontation with death and mortality. Out of this confrontation with mortality can come a renewed will to live. Hardiness and optimism support coping patterns (Maddi & Hightower 1999). Stories of death and rebirth, descent

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into sadness and ascent into joy, and disconnection and reconnection are ancient myths common to all humankind. With the courage to create (May, 1975), our new narratives create a self that moves from deconstruction to reconstruction (Feinstein & Krippner, 1988; May, 1989; Sarbin, 1986; Gergen, 1991). Healing narratives are experienced as coherent and meaningful, and the use of narrative therapies has been gaining attention in family therapy (Epston, White & Murray, 1992; Howard, 1991; Omer & Alon, 1997; Polkinghorne, 1988; Rotenberg, 1987). The act of telling stories has always helped human beings deal with the threat of non-being, and sometimes the expressive act itself has a healing effect (Pennebaker, 1990). Not all expressive acts are verbal, however; a Whole Person psychotherapy would embrace diversity of technique and approaches that include non-verbal and multi-modal modalities like the expressive therapies and mindfulness meditation (Jon Kabat-Zinn, 1994). Bringing the body and community into therapy also serves diversity by re-balancing the dominance of a white, individualistic European male verbal psychological tradition. Whole Person goals include achieving a gender balance of emotional empathy, emotional selfawareness, assertiveness and instrumental problem-solving (Levant, 2001). Ultimate questions about the nature and fate of human beings are religious or spiritual dimensions that need to be brought back in to a Whole Person psychology. Spirituality as a way of knowing adds to the diversity in psychology. One of the three major themes at APA’s 1999 National Multicultural Conference and Summit was “spirituality as a basic dimension of the human condition” and it recommended that: psychology must break away from being a unidimensional science... that it must recognize the multifaceted layers of existence, that spirituality and meaning in the life context are important, and that psychology must balance its reductionistic tendencies with the knowledge that the whole is greater than the sum of its

parts. Understanding that people are cultural and spiritual beings is a necessary condition for a psychology of human existence (Sue, Bingham, PorcheBurke, Vasquez, 1999, p. 1065). Further, a psychology that separates science from spirit is culturally narrow, and “may not be shared by three quarters of the world nor by the emerging culturally diverse groups in the United States” (Sue et al, p. 1065). Spiritually based rituals have been shown to be effective coping strategies for dealing with life stresses (Pargament, 1997) and serious trauma (Frankl, 1959). However, while a national survey showed that 92% of all American reported that “my religious faith is the most important influence in my life” (Bergin &Jensen, 1990, p. 5), most psychologists are unprepared to deal with these issues (Shafranske &Malony, 1990). In conclusion, training psychologists in Whole Person therapies would not only help psychologists become more inclusive, therefore, but would revitalize our work. In the new paradigm of the whole person, psychologists would rediscover our modern yet ancient roles as healers of the psyche. Address all correspondences to: Ilene A. Serlin, Ph.D., ADTR Union Street Health Associates, Inc. 2084 Union Street San Francisco, CA 94123 (415) 931-3819 In Sonoma: (707) 235-7959 [email protected] www.ileneserlin.com References American Psychological Association (2002) Ethical Principles and Code of Conduct. American Psychologist, 57 (12), 1060-1073. American Psychological Association (2003) Guidelines for Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists. American Psychologist,

58 (5), 377-402. Belar, C. (2000, Sept.). Learning about APA. APA Monitor, 31 (8), 49. Bugental, J. (1963). Humanistic psychology: A new breakthrough. American Psychologist, 18, 563-567. Classen, C., Diamond, S., Soleman, A., Fobair, P., Spira, J., & Spiegel, D. (1993). Brief supportive-expressive group therapy for women with primary breast cancer: A treatment manual. Stanford University School of Medicine, Stanford, CA. DeAngelis, T. (2004). Consumerism and its discontents. American Psychological Association Monitor. Vol. 35, No. 6. 52. De Leon, P. Newman, R., Serlin, I., Di Cowden, M. et al. (1998, August). Town Hall, “Integrated Health Care.” Symposium conducted at the meeting of the American Psychological Association 106th Convention, San Francisco, CA. Dittman, M. (2004). Alternative health care gains steam. American Psychological Association Monitor. Vol. 35, No. 6. 42. Dossey, L. (1991). Meaning and medicine. New York: Bantam. Dossey, L. (1992). Era III medicine: the next frontier. ReVision: a journal of consciousness and transformation. 14(3): 128-139. Eisenberg D., Davis R., Ettner, S., Appel S., Wilkey S., Van Rompay M., Kessler R. (1998). Trends in alternative medicine use in the United States, 1990-1997; results of a follow-up national survey. JAMA Nov. 11; 280 (18): 15691575. Epston, D., White M., & Murray, K. (1992). A proposal for the authoring therapy. In S. McNamee & K. J. Gergen (Eds.), Therapy as social construction. London: Sage. Fawzy, F. I., N. W. Fawzy, et al. (1993). Malignant melanoma. Effects of an early Structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Archives of General Psychiatry 50(9): 681-689. Feinstein, D. & Krippner, S. (1988). Personal Mythology. Los Angeles: Jeremy P. Tarcher.

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Frankl, V. (1959). Man’s search for meaning. New York: Praeger Gazella, K. (July/Aug. 2004). Mark Hyman, MD. Practicing medicine for the future. Alternative Therapies, Vol. 10, No. 4, 83-89. Gergen, K. (1991) The saturated self. New York: Basic Books. Goldberger, N. (1996). Knowledge, difference and power: Women’s ways of knowing. New York: Basic Books. Haney, D. (2001). Heart failure killing young people at growing rate. San Francisco Chronicle. March 2, 2001. A13. Hoge, D.R. (1996) Religion in America: The demographics of belief and affiliation. In Shafranske, E.(Ed.) Religion and the clinical practice of psychology. American Psychological Association. Howard, G. (1991). Culture tales: A narrative approach to thinking, cross-cultural psychology, and psychotherapy. American Psychologist, 46:187-97. Kabat-Zinn, J. (1994). Foreword. In M. Lerner, Choices in Healing, Cambridge, MA: The MIT Press. xi-xvii. Levant, R. (2001). We are not from Mars and Venus! Paper presented in symposium, “Healthy Families: A Dialogue Between Holistic and SystemicContextual Approaches.” American Psychological Association, San Francisco, CA. Lieblich, A. & Josselson, R. (Eds.).(1997). The narrative study of lives. Vol. 5. Thousand Oaks: Sage Publications. Maddi, S., and Hightower, M. (1999). Hardiness and optimism as expressed in coping patterns. Consulting Psychology Journal: Practice and Research, 51 (2): 95-105. Manese, J., Saito, G., & Rodolfa, E. (2004) Diversity Based Psychology: What Practitioners and Trainers Need to Know. Board of Psychology Update, No. 11, Jan. p.1-19. Maslow, A.H. (1962). Toward a psychology of being. New York: Van Nostrand. May, R. (1975). The courage to create. New York: Bantam Books. May, R. (1989). The art of counseling. New York: Gardner Press.

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Murphy, M. & Donovan, S.(1997). The physical and psychological effects of meditation. (2nd,) ed., Sausalito, CA: Institute of Noetic Sciences. Myers, D. (2000). The American paradox: Spiritual hunger in an age of plenty. Yale University Press. Omer, H., & Alon, N. (1997). Constructing therapeutic narratives. Northvale, NJ: Jason Aronson. Pargament, K.I.(1997). The psychology of religion and coping. New York: Guilford. Pennebaker, J.W. (1990). Opening up: The healing power of expressing emotions. New York: The Guilford Press. Pert, C.B.(1997). Molecules of Emotion. New York: Scribner. Polkinghorne, D. E. (1988). Narrative knowing and the human sciences. Albany: State University of New York Press. PRNewswire, (Oct. 18, 2000). First obesity treatment to report sustained weight loss-skill training vs. drugs and diets. Rossi, E.L. (1986). The psychobiology of mind-body healing. New York: W. W. Norton. Rotenberg, M. (1987). Re-biographing and deviance: Psychotherapeutic narrativism and the Midrash. New York: Praeger. Sarbin, T. (Ed.). (1986). Narrative psychology: The storied nature of human conduct. New York: Praeger. Serlin, I.A.; Classen, C., Frances, B. & Angell, K. (2000). Symposium: Support groups for women with breast cancer. The Arts in Psychotherapy. Vol. 27, No. 2, pp. 123-138. Serlin, I., Levant, R., Kaslow, N., Patterson, T., Criswell, E., and Schmitt, R. (2001). Healthy families: a dialogue between holistic and systemic-contextual approaches. APA Convention, San Francisco. Serlin, I.A. (Fall/Winter, 2001-2). Year of the whole person. Somatics. 4-7. Shafranske, E.P. &Maloney,H.N.(1990). Clinical psychologists’ religious and spiritual orientations and their practice of psychotherapy. Psychotherapy, 27, 72-78.

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worldview. Journal of Humanistic Psychology, 35(2), 7-34. Squires, S. (2001). Only high-carb, modestfat diets work for long. San Francisco Chronicle, Jan. 10. A2. Sue, D. W.; , R.P.; Porche-Burke, L.; & Vasquez, M.(1999) The diversification of psychology: A multicultural revolution. American Psychologist. 54, 12, 1061-1069. Yalom, I. D. (1980). Existential Psychotherapy. New York, Basic Books.

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CANDIDATE STATEMENTS President-elect Jean Carter, Ph.D. There are a number of responsibilities inherent in the honor and opportunity of serving as President of Division 29. The president should be committed to: • Leadership in the Division, in APA and in psychology in sup• porting, enhancing and promoting psychotherapy—theory, research and practice; • Leadership in enhancing the Division’s ability to be responsive to the needs of members and serve as a good home for the range of psychologists who are committed to psychotherapy as an enterprise; and • Leadership in ensuring the effective organizational management of the Division. Issues that the Division faces include 1) continuing the efforts of current leadership of the Division to reinvigorate and enhance the commitment to psychotherapy; 2 maintaining influence within APA to ensure appropriate attention to the role of psychotherapy and its protection in the healthcare system; 3) continuing the commitment fiscal and organizational soundness; 4) promoting activities that enhance the Division’s ability to be responsive to members and their needs; 5) ensuring that APA policies are based on respect for psychotherapy process, the therapeutic relationship and multiple sources of evidence, including policies around accreditation and practicum issues, evidence based practice initiatives, and healthcare.

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First and foremost, I have maintained a successful psychotherapy practice in Washington, DC, for over 25 years. I understand and love the practice of psychotherapy, and am deeply committed to it. In addition, I am committed to the teaching and research on psychotherapy. I have served on several editorial boards and have a history of publication on the psychotherapy relationship and on the integration of science and practice. I serve as an Adjunct member of the Graduate Faculty in the counseling psychology program at the University of Maryland— College Park. A Division president must also understand and work well with the larger APA system and with other Divisions. Some of my relevant experience includes service as Member at Large and the Publications Board for Division 29; Vice President for Professional Practice and President (19992000) of The Society of Counseling Psychology (Division 17); and President (2002), Secretary and Council Representative of Psychologists in Independent Practice (Division 42). I have just completed a term as co-chair of CAPP (Committee for the Advancement of Professional Practice), as well as having chaired the Committee on Division/APA Relations. I also serve on the 2004 APA Presidential Task Force on Evidence Based Practice in Psychology. I enjoy participating in volunteer governance within APA. It is an opportunity to serve and enhance the profession and build strong relationships with good friends and colleagues. I would be honored to receive your vote for me for President of Division 29.

President-elect continued Sandra R. Harris, Ph.D., ABPP As a Fellow of Division 29, I am honored to be nominated for President-Elect and it would be a privilege to serve, if elected. My professional life for 27 years has been spent primarily as a practitioner of psychotherapy in both private and public sectors of psychology. After 21 years in University Counseling Services at California State University, Northridge (CSUN), I retired in 2002, and am Emeritus Clinical Psychologist at CSUN. Presently I work full-time as a Clinical Psychologist at the VA Greater Los Angeles Health Care System. As a VA psychologist, I conduct groups for men and women veterans and individual psychotherapy for clientele ranging from World War II to Iraq War veterans. I am grateful to be able to serve those who have given so much and who need the help that psychotherapy offers. On a part-time basis, I was in independent practice for 11 years, and as an adjunct professor, taught theory and interventions courses at the California School of Professional Psychology in Los Angeles, now Alliant University and as a Lecturer at CSUN. My research interest has been in performance anxiety reduction, and at CSUN I conducted a study using virtual reality therapy for treatment of public speaking anxiety. I feel passionately about psychology and strive to be an advocate for our profession and the people we serve. My leadership roles and recognition for service include: • President of the California Psychological Association (CPA), 1996; CPA’s Distinguished Contribution to Psychology Award, 1999.

• Elected for third term representing California on the APA Council of Representatives, 2005-2008, 1998-2002; APA’s Karl F. Heiser Award for advocacy, 2001. • President of Division 31, State and Provincial Psychological Association Affairs, 2000; Outstanding Psychologist Award, Division 31, 2003. • Board of Directors, Women in Psychology for Legislative Action, 19982002; Exceptional Service Citation, 2004. I hope to have the opportunity to serve Division 29’s 3700 members by building on the outstanding leadership of those who have served the Division as President and Board members. We are the fourth largest of APA’s 55 Divisions. Our strength is in the diversity of the field of psychotherapy, encompassing research, education, training and practice from differing theoretical orientations, which provides opportunities for collaboration among members from these diverse fields. An important goal is to attract new professionals, to increase and sustain our Division. The focus groups conducted recently by Dr. Linda Campbell and Dr. Leon VandeCreek point to important opportunities to advance and advocate for psychotherapy, including: • Utilizing advances in the Division’s technological capabilities to mentor new professionals, by linking groups of mentors with those seeking mentoring; • Seeking ways to assist with obtaining grant and funding support for psychotherapy researchers; • Affirming the Division’s support for future psychologists by including an APAGS Student Representative on the Division Board. I am always available at [email protected] to answer your questions and to hear your ideas. I would appreciate your support and pledge to fulfill the responsibilities of this office to the best of my ability.

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Secretary Lisa Porche-Burke, Ph.D. My nomination for Secretary of Division 29 is an honor, and I would consider it a pleasure to serve the APA Division which, after so many years of professional growth, continues to feel like home. My service in Division 29 covers a span of over 20 years. I started my involvement in APA through the Division of Psychotherapy as a student and then became Chair of the Ethnic Minority Affairs Committee. Having served on a number of committees within the APA governance structure including the Council of Representatives, I am aware of the myriad of issues confronting psychology in general and practitioners more specifArmand Cerbone, Ph.D. Any office in Division 29 is one that carries with it responsibilities important to the life and interests of the Division. It also provides opportunities for furthering those interests. Any Secretary, then, must bring to the table a commitment to service, vision, and both experience and demonstrated effectiveness in governance and leadership. I have a substantial history of leadership and effectiveness in APA and in my home state of Illinois. I am a past president of Division 44 and one of its present representatives to Council. I am the Chair-elect of the Board for the Advancement of Psychology in the Public Interest (BAPPI) and a former chair of the Committee on Lesbian, Gay, and Bisexual Concerns (CLGBC). As president of the Illinois Psychological Association, as a former mem-

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ically. We are facing many challenges as a profession and it is critical that we come together as a discipline to develop strategies and solutions to ensure that the field of psychology continues to grow and prosper. As an educator and trainer of practicing psychologists, I realize the changes that managed care has brought to the field and the impact it has had on its ability to attract future practitioners. Also, I am keenly aware that today’s practitioners, as they increasingly work with diverse populations, are confronting challenges in the development of effective interventions and treatment strategies. If elected, I shall continue to strive for the advancement and unification of the field of professional psychology and to help ensure that the discipline remains dynamic, relevant, and rewarding for those who choose it as their life’s work. ber of the Committee on Professional Practice and Standards, and as a longtime independent practitioner in Chicago, I would also bring to the Division a deep and comprehensive understanding of the issues affecting the provision of clinical services. I consider my most satisfying contributions to the profession to date my co-authoring APA Guidelines on Psychotherapy with Lesbian, Gay, and Bisexual Clients, adopted as APA policy in 2000 and my chairing the task force that drafted the policies on gay marriage and gay families, adopted by APA in July of this year. Over the more than 30 years as a psychologist, my enthusiasm for the profession and my respect for so many of our colleagues has continued to swell. To work with the present leadership, to foster the development of new leadership, to contribute to the advancement of the field, would be a very great pleasure. It would also afford an opportunity to thank Division 29 for electing me a Fellow last year.

Member-at-Large J G. Benedict, Ph.D. My interest in serving Div 29 as a member at large to the Board of Directors reflects my longstanding concern about the process of psychotherapy in public as well as private practice venues, concern about the relevance of various treatment approaches, and concerns about the evidence based treatment demands on practitioners to more and more tailor their intervention techniques to a narrower and more restrictive set of treatment techniques for a DSM condition. The diagnostic classifications within DSM IV, although the best we have, are still of too low reliability to restrict practice. It has been the hallmark of Div 29 to maintain an active dialogue among practicing psychologists in all practice and training environments about effective therapy techniques. The exploratory and interactive discussions have supported a search for effective and efficient use of familiar Irene Deitch, Ph.D. I appreciate the opportunity to continue serving our Division. A long standing member, Fellow and Chairperson of several Committees, Researcher, Practitioner and Educator, I believe I have demonstrated that I can make a positive contribution in the interest of our division’s future. I welcome your support. I am a Professor Psychology, City University of New York, College of Staten Island. Producer and Host of Cable TV: “Making Connections” (featuring Psychologists/ Psychological Issues); Practicing Psychotherapist; Certified Thanatologist (Grief

old approaches and new or specially developed ones for the treatment of new adaptive problems. The utility of diagnosis in determining therapy strategies may still be awaiting an alternative to the DSM, such as the ICIDH-2. I have been involved in treatment, practice, training, and publication issues for psychologists for the past 43 years in a Denver public then private practice setting and am currently on the consulting editorial staff of Professional Practice: Research and Practice. I have served on a various governance committees and boards of APA and its clinical divisions representing the concerns of practitioners for preserving existing treatment strategies and developing new ones. As a member of the National Academy of Practice, I am also concerned about the broader issues of treatment involving other disciplines besides Psychology. I continue to supervise psychology graduate students, keeping aware of the needs and issues that new professionals as well as experienced psychologists face in their work. Therapist, Death Educator); Edited books, published extensively; Supervise internships; Mentor culturally diverse students. DIVISION OF PSYCHOTHERAPY: Organized /Chaired: Coalition of Psychologists Working with Elderly (COPE) Organized /Chaired: Psychologists Enhancing Quality of Life Experiences. (EQUAL) Convention Presenter/ Reviewer/ CE Workshops Recipient of Divisional Award APA: Chair: Public Information Committee Member: Committee International Relations in Psychology Chair: Membership Committee

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Member-at-Large, continued Deitch, continued Trained as Legislative Advocate Practitioners’ Public Education Campaign Task Force on Violence Prevention Task Force to Write “ What Psychologists Need to Know to Work with Older Adults” DIVISIONAL GOALS: • Increase Membership Retention through opportunity for divisional service, involvement, advancement • Address Cultural Diversity issues through training, practice, education • Increase division’s visibility & memberSusan M. Neral, Ph.D. It is an honor to be nominated and to have the opportunity to seek this position of responsibility with the Division of Psychotherapy. Due to the changes in my career over the past year, I am in a position to accept this challenge. After 20 years as faculty with the Department of Psychiatry and Human Behavior, Division of Psychology, at The University of Mississippi Medical Center, I transitioned to a solo private practice in June of 2004. Relinquishing the teaching and administrative duties of the department and medical school, diminishing the research-oriented responsibilities, and focusing completely on clinical work, allows me the time to give something back to Division 29. At UMC, my establishment, administra-

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ship outreach, through greater use of media, public information, convention and mid-year workshops. • Establish inter-divisional coalitions for projects and programs • Greater use of Divisional User-Friendly Internet Listserve Information • Promote /support, research and training i.e. retirement, caregiving, New Americans, terrorism, disasters, death and dying, working with community health needs, diversity sensitivity • Create welcoming climate to graduate students, early career psychologists, culturally diverse members. tion, and staffing of the first Medical Center Academic Counseling Service contributed to the acceptance of psychological treatment. In my private practice and while teaching residents and fellows, I developed and taught a note-taking system with focus on empirical assessment of outcomes in psychotherapy. Adapted now to meet HIPPA guidelines, this system isolates factors for multidisciplinary treatment, enables protection of confidential monitoring of process, and promotes assessment of goal-oriented treatment. In the last century of health care, psychotherapy was the revolution that enabled individuals to gain insight into the power to influence lives by changing ideas and perceptions. In this century, our challenge is the refinement of that revolution and the development of further proof of efficacy. It would be my privilege to serve as member-at-large. Win or lose, I look forward to contributing to our division over the coming years.

Member-at-Large, continued Matthew B.R. Nessetti, M.D., Ph.D., ABMP I am honored to be nominated for the Division 29 board. Our division has a history of advancing theory, practice, research, and training in psychotherapy, and we hold a unique position to advocate for the integration and utilization of psychotherapeutic interventions within mental health, medical, and other professional environments. I will continue this tradition by working for the development of research-based protocols that integrate biological, psychological, and social domains. Psychotherapy is underutilized and continuous research is necessary to better understand psychotherapy‚s contribution to healing. I have served in a number of leadership positions. I was the first Director of Steve Sobelman, Ph.D. I have spent approximately three decades teaching, practicing and advocating for Psychology through leadership positions at the National and State levels and within the academic arena. First and foremost, I am a strong proponent for the art of psychotherapy through my full-time academic position in the psychology department at Loyola College in Maryland. I am currently the President and Newsletter Editor of Division 49 (Group Psychotherapy), regularly attend APA’s Educational Leadership Conference and State Leadership Conference, served as President of the Maryland Psychological Association (MPA), continue to serve as the

Professional Affairs for the Nebraska Psychological Association and served as its treasurer. I have been active with APA as a charter participant of the Business of Practice Network, State Leadership Conference participant. In addition, I worked to create APA‚s newest division, The American Society for the Advancement of Pharmacotherapy. I am president of this division and served on its executive board member and as the convention chair. I hope to be a liaison among to other divisions in APA to promote research and practice protocols.. Psychotherapy is central to my professional work. As a practitioner, I am awed by its power to ease psychological illness and pain. As the director of an internship and residency program, I am gratified in observing the growth and development of early career psychologists is rewarding. I look forward to assisting the division in promoting psychotherapy within and outside of psychology. Federal Advocacy Coordinator for Maryland, and remain in touch with APA policy and advocacy. Additionally, I was the founder and clinical director of a large private mental health facility. If elected as a Member-at-Large, I will continue previous commitments to promote a greater understanding of the needs of Division 29. And, I will bring new challenges by providing: 1) increased membership (especially graduate students); 2) exposure to professionals and the public through technological innovations; 3) continued support for research efforts; and, 4) fiscal responsibility to our members. I strongly believe that “if you want to get something done, give it to a busy person.” I’m a busy person and will “get it done” for you. Thank you for your consideration and I welcome your vote.

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Student Development Chair Per the bylaws changes that were approrved in 2004, the Division members have authorized the position of Student Development Chair, a voting member of the Division 29 Board of Directors. The following students are candidates for Student Development Chair. The election of the position will be held separately, with student members receiving ballots.

Gregory Chasson My name is Gregory Chasson, and I am currently pursuing a Ph.D. in Clinical Psychology at the University of Houston. My eclectic clinical and research interests include the treatment of autism, defining a professional standard for child custody evaluations, and treatment effectiveness for children who have been physically and sexually abused. With your support, I intend on continuing the strong presence of student leadership within Division 29. In addition to maintaining student initiatives previously implemented, as your student chair for

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the division, I will strive to expand Div 29 student relations and initialize services to facilitate student edification and transition into the professional world. For example, I would push for continual Div 29 student voice in the APAGS publication, effectively marketing Div 29 to a wider student audience and providing some credible, domain-specific material for publication. In addition, I would promote the development of a division website forum to allow anybody, including Div 29 students and professional members, to interact on a more immediate basis. With proper marketing, this forum could also serve to expand Div 29 and its influences outside of APA and serve a useful function to students and professionals needing some guidance.

Michael Stuart Garfinkle Psychotherapy is psychology’s arm to society, the incorporation of the corpus of psychological knowledge and graduate students planning to working in mental health fieldsin clinical psychology are the future generation of psychotherapy’s champions. To that end, developing programs for the benefit of graduate students in psychology is of the utmost importance and to that end, I feel especially well suited to this essential task. Having served on student governments and departmental advisory boards in college matched with a passion for psychology that translates into a life project of advancing our profession and increasing its reach, I bring research experience and dedication that makes me a suitable candidate for this position.

Developing opportunities for student publications is an essential first step in advancing psychological knowledge and expanding membership in Division 29 is part of that goal. From some discussion with fellow graduate students in the New York City area, the division’s visibility has emerged as a first concern. Many graduate students are not members of the APA and of course, would have little to no idea that our division exists and partnering our division’s initiatives with broader APA initiatives will be key in increasing our exposure. In sum, the achievement of our goals requires dedication and commitment, both only possible with passion for psychotherapy and psychology and if elected, my intention would be to tirelessly apply myself to the ideals of the Division of Psychotherapy.

Theodore M. Nnaji My name is Theodore M.Nnaji. I am a first graduate student in the (Psy.D) program at the School of Professional Psychology, Wright State University Dayton, Ohio. I am running for the chair student development committee because of believe that I can make a positive difference and contribute to its growth. I have

served as the Nigerian graduate student union liaison officer to City College gradute the student government, where I had the opportunity to sharpen my networking skills. Increasing student enrollment and active participation in the division will be some of my primary objectives if elected, and I think my networking abilities and organizational skill will facilitate this. Another objective is to create a forum where students can come together and exchange ideas

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