APA Convention in Orlando: Customers, colleagues, and more

From Thursday August 2 through Sunday August 5, 2012, Synergistic Office Solutions exhibited at the American Psychological Association (APA) convention in Orlando. The last time we exhibited at APA was in New Orleans in 2006. As a New Orleanian, it was my way of thanking APA for holding the convention there so soon post-Katrina.

This time, the meeting was held in Orlando. Since the SOS headquarters is located in Clermont, FL, a mere 30 miles west of Orlando, we felt we should attend. We had a few other outstanding reasons to be there.

Three SOS customers also exhibited this year, and we definitely wanted to see and support them.

University of Missouri Community Psychological Service received a large grant that will allow them to expand their services. Dr. Rob Harris was at APA interviewing for their open positions for psychologists.

Alliant University - CSPP booth

Alliant International University – California School of Professional Psychology (CSPP) attends every year. According to Michael Newman, the Assistant Director of Alumni Relations, many CSPP alums attend the convention. For them, it is a great opportunity to reconnect with alumni and to talk with potential new students.

Southeast Psych is a private group psychology practice in Charlotte, NC. Though we had spoken with Dr. Frank Gaskill and Dr. Jonathan Feather many times since 2000 when they started using our software, we had never met. We do receive their monthly newsletter, so we knew that their approach to the practice of psychology is unique. How many practices do you know that have as one of their goals the pursuit of fun?

Dr. Feather and Dr. Verhaagen of Southeast Psych playing at APA

 

 

 

 

 

 

 

 

Southeast Psych has begun to do some consulting with others who also want to develop their Dream Practice. I was glad to join in some of the fun while there.

Kathy with Darth Vader and Storm Trooper

 

 

 

 

 

 

 

I had a few other pleasant tasks while at the convention. I got to visit with and then hear the presentation of my long-time colleague and friend, Dr. Ellyn Kaschak, this year’s Carolyn Wood Sherif Award recipient. I attended a University of Florida reception for alumnae of the program in Clinical and Health Psychology (of which I am a graduate).

Trish and I hosted other visitors/friends at our booth.

Fred Coolidge, Ph.D.

Dr. Fred Coolidge is Seth’s cross-country riding buddy, Professor at University of Colorado – Colorado Springs, author and rock guitarist. Dr. Bob Neimeyer was Seth’s student while at University of Florida. He is Professor at University of Memphis, prolific author and frequent Continuing Education speaker.

Robert Neimeyer, Ph.D.

Finally, I attended a panel on women presidents of APA and the APA Presidential reception hosted by Dr. Suzanne Bennett Johnson, 2012 President of the American Psychological Association.

Suzanne Bennett Johnson, Ph.D. President, APA

Suzanne was an intern and then a post-doctoral fellow when I was a graduate student at University of Florida. We have worked together on the Board of Directors of the Florida Psychological Association over the years. She has had a distinguished career in Health Psychology practice and research, spending many years at U of F and then moving to the Florida State University College of Medicine. It was a special pleasure to attend the APA convention when a career-long colleague and friend was presiding. I’ll bet she had even more fun than we did!

Were you at APA? Do you have memorable convention moments you would like to share? Please do so below.

 

 

 

 

Habits, Habits, Habits: How do they affect your life?

In May, I received an email from Charles Duhigg, NY Times reporter and author of The Power of Habit. Or rather, I should say that I received an email from Charles Duhigg’s publisher/publicist who is very good at finding bloggers who have written about psychological topics and who might be interested in his book. Their marketing research was right on target, (see chapter 7, How Target Knows What You Want Before You Do), no pun intended. I am, indeed, interested in certain psychological research, and I did find his book fascinating and very well written. In my former life as a psychotherapist, I would even have recommended it to patients. Instead, I will recommend it to you.

How many times have you discovered a pattern of behavior that you would like to change? How many times have you been successful in making the change?

If you struggle as much as I do with habit change, it is not because you are weak-willed. It is likely because you do not have a complete understanding of the behavior you are trying to change, what cues the behavior, and how the reward impacts you. Even if you are clear about those elements, you might have ignored the necessary step of substituting a competing behavior to replace the one you are trying to change.

Not sure you know what I am talking about? No surprise to me. Most of us are not very good at even realizing that we are engaged in habitual behavior until someone else points it out to us.

I recently had a visit from my nephew and his family. Near the end of their stay, his 3-1/2 year old son was using the word “actually” appropriately in many of his comments. “Actually, that’s a tufted titmouse. He takes a seed from the feeder, then goes to the bush to eat it.” It was not until he left that my sister-in-law and I heard me using “actually” often in my comments. It took a 3-1/2 year old to help me see habitual speech behavior that has been with me for who knows how long.

Duhigg’s book is an excellent exploration of habits and their power in our personal lives, in business, and in society. He clearly presents a framework for habit change that most individuals and any therapist can use:

THE FRAMEWORK:

• Identify the routine

• Experiment with rewards

• Isolate the cue

• Have a plan

Duhigg, Charles (2012-02-28). The Power of Habit: Why We Do What We Do in Life and Business (p. 274). Random House, Inc. Kindle Edition.

Part of what appeals to me about this Framework is that it presents a simple system. My personal inclination in life is toward making things systematic and understanding the systems that apply when something is not of my making; so this approach is appealing to my sense of order.

  1. Observe and assess the behavior. Determine what is included in this habit. Get a good picture of the whole thing and how it functions in your life. In Duhigg’s words, identify the routine.
  2. Take a look at just what is rewarding to you in this behavior. Since the reward is a large part of what is keeping the habit in place, understand it well and look at as many aspects of the reward as you can. You may think one part of the reinforcement is what is maintaining your behavior when another part is actually the driver. As Duhigg says, experiment with rewards.
  3. Get a good understanding of just what the trigger is for the habit. What sets it off? For me, sitting down at my desk at work in the morning is my cue to check email. Even if I have decided to do something else first (like write a blog post), the strong pull is for me to check email. According to Duhigg’s framework, isolate the cue.
  4. Finally, in order to change an habitual behavior, you need to determine what you want to do instead, how you will make yourself aware of the cue so you do not go into automatic, what reward you will use to alter the habit, how long you will do the changed behavior to solidify the new habit…as Mr. Duhigg suggests, have a plan.

The simplicity of this framework is part of its power…and part of the power of habits in our lives. If your own habits, the habits of your business or organization, or the habits of our society are important to you, take a look at this book. It is simultaneously a good read and enlightening.

Do you have experiences with habits and habit change that you would be willing to share? WAIT…this is where you would usually STOP READING. Maybe you could change that habit and offer a comment today? Your reward? My profound thanks for reading and commenting. Just enter your comment below.

 

APA & Climate Change: What psychology can do

I sat down Monday morning to write this week’s blog post. I was intent upon writing about American Psychological Association’s (APA) recent report on climate change and what the psychology community can do about it. I had previously glanced at the executive summary of the report and was excited to learn what the entire report recommended. Unfortunately, I must have been a bit too tired when I started out in my reading. I was only on page three when my eyes glazed over.

I do have a history with APA; I have been a member for 30 years. I joined as soon as I was eligible after completing my Ph.D. In the early 1990’s I served on two different committees within APA—the Public Information Committee and the Committee for the Advancement of Professional Practice. I have read more than my share of scholarly papers and APA organizational documents. Since retiring from the practice of psychology in 1993 and moving to full-time involvement in the business of psychology billing and clinical record software, I have become more removed from scholarly work and more involved in the action orientation of the business world.

Psychology and Global Climate Change: Addressing a Multi-faceted Phenomenon and Set of Challenges, while perhaps intended to be a call to action, is actually a carefully written and documented organizational treatise on the psychological phenomena involved in this crisis, the psychological research and knowledge which are applicable to these events, and recommendations for the role APA as an organization and psychologists as professionals and individuals can and should play as this crisis unfolds. It is what I should have expected, but not what I hoped it would be.

In order to make this document useful, I believe it needs to be broken down into parts and digested in that fashion. Accordingly, over the next few months, I am going to take each section of the report and tell you about what is in that section. I hope this will have the result of helping us glean the recommendations of the APA and determining what constructive actions individual mental health professionals and behavioral health community organizations can take.

The APA Climate Change Task Force considered six questions:

  1. How do people understand the risks imposed by climate change?
  2. What are the human behavioral contributions to climate change and the psychological and contextual drivers of these contributions?
  3. What are the psychosocial impacts of climate change?
  4. How do people adapt to and cope with the perceived threat and unfolding impacts of climate change?
  5. Which psychological barriers limit climate change action?
  6. How can psychologists assist in limiting climate change?

In examining these questions, they reviewed the psychological literature to focus areas in which additional research might be useful and in which current data might enhance the work of climate scientists.  By way of this report, the task force attempted to create bridges between the climate science community and the psychological community.

It is also clear from these questions that the authors were considerably concerned about what the psychosocial effects of climate change might be. Since those of us who work with individuals, families and communities about various emotional and behavioral health concerns will undoubtedly need to address these impacts, it behooves us to be prepared…at least with knowledge.

Finally, the task force recommended that specialists in behavioral and psychological research adopt the following principles in an attempt to maximize the value and use of psychological principles in climate change work:

  1. Use the shared language and concepts of the climate research community where possible and explain differences in use of language between psychology and this community.
  2. Make connections to research and concepts from other social, engineering, and natural science fields.
  3. Present psychological insights in terms of missing pieces in climate change analysis.
  4. Present the contributions of psychology in relation [to] important challenges to climate change and climate response.
  5. Prioritize issues and behaviors recognized as important climate changes causes, consequences, or responses. 
  6. Be cognizant of the possibility that psychological phenomena are context dependent.
  7. Be explicit about whether psychological principles and best practices have been established in climate-relevant contexts.
  8. Be mindful of social disparities and ethical and justice issues that interface with climate change.

If climate change continues and has even some of the potential impacts that are predicted, mental health and behavioral specialists will be deluged with people caught in and reacting to those impacts. What can you and your organization do to prepare for addressing the fallout of some of these impacts? What would be the result of a Katrina-equivalent in your community? What knowledge and expertise do you need to gain?

Please share you comments by clicking on the title of this article and entering your comment in the box at the bottom of the page.

Integrating Behavioral Health and Primary Care

The September 29, 2009 edition of NJAMHA Newswire reports on a trend appearing strongly in New Jersey and in many other states: attempts to provide primary care treatment at the behavioral health setting or alternatively, to integrate behavioral health treatment into the primary care setting. In fact, the National Council, the major membership organization of community behavioral health care providers, has introduced an online Resource Center for primary care and behavioral health collaboration on their web site. This center comes out of six years of work in this arena.

FierceHealthcare, a daily newsletter for health care executives, reported on this trend in its September 30, 2009 edition. The article mentions the research literature that documents the tendency of primary-care physicians to miss the signs of common mental health issues like depression. Overlooking the mental health issues can often complicate both behavioral health and physical health treatment. A diabetic who experiences some debilitating mental health issue may not be able to comply with their required diet and self-care, just as a pregnant woman taking lithium to manage her bipolar disorder faces consequences for her child from her medication. The behavioral health and physical issues are inextricably intertwined.

Behavioral Healthcare online edition of October 1, 2009 reported a SAMHSA-funded study that indicated that general practitioners, not psychiatrists, are the most frequent prescribers of psychotropic medications. This includes pediatricians among the GP category since they usually are the primary care physicians for children.

The FierceHealthcare article identifies the financial and health benefits of the integration of mental health screening and prescribing into primary health care settings. Making sure that mental illness is not overlooked is one way of assuring that patients get the most effective treatment for all of their illnesses.

Since mental health treatment has usually been considered specialist-level care, there is concern among behavioral health providers that such screening and treatment by GPs is not the appropriate care in the right setting. Given how busy primary care providers are, it is highly likely that medications will be prescribed without psychotherapy or other appropriate behavioral interventions.

Health care reform is focused on saving money and providing effective care as efficiently as possible. Some would argue that the primary care provider’s intervention in behavioral health issues is the appropriate, cost-effective way to assure proper diagnosis and treatment. Most mental health providers I know would disagree, perhaps arguing that screening and referral to specialists is the appropriate and most effective way to provide care.

What are your thoughts on this issue? Do you see the possible integration of behavioral health care and primary care as positive for you and your clients? How is this likely to impact the way you currently provide services? What about those of you who already work in primary care settings; is this the ideal way to provide care to all patients, to complicated patients, or to no one at all?

Please let us know your thoughts on this issue. Just click on the title of the article and enter your comments in the box at the bottom of the page.

E-prescribing and a Behavioral Health EHR: Where to from here?

For the past several years Synergistic Office Solutions, Inc. has had the privilege and pleasure of participating as a member of the Software and Technology Vendor Association (SATVA), a group of vendors of software and other technology for the Behavioral Health and Social Services community. Last Thursday, I returned from our semi-annual member meeting…charged up with information about what is happening in the behavioral health world and full of questions about how all of the current events will impact SOS and our customers.

Standards for Electronic Health Records (EHR) for Behavioral Health were our primary discussion topic at this meeting. The community mental health world has long known that they will need to use EHRs to maximize the efficiency of their services and document the effectiveness of their treatments. State reporting requirements alone make use of an EHR a worthwhile way to simplify the lives of clinicians and administrators. Psychologists and psychiatrists in the private practice community have been slower to embrace the idea that electronic clinical records will improve care. The cost of the product and the time it takes to learn and use such software has been an obstacle for many organizations. While our mental health clinical record software has been around since 1992, we have many fewer users of that product than of our billing software.

Some states and payers are rapidly moving toward mandates for implementation of aspects of an EHR. FierceHealthIT, a newsletter for those working in information technology for health care, reported last week that MA BCBS will be requiring e-prescribing by January 1, 2011 for physicians who participate in their incentives program. The Centers for Medicare and Medicaid Services (CMS) has developed an electronic prescribing incentive that will increase physician reimbursement by 4.5% by 2014 for those who use qualified electronic prescribing products. The National Governor’s Association (NGA) has provided a forum and support for states to move forward on Health Information Exchange (HIE), electronic prescribing and computerized physician order entry (CPOE) . At the federal level, a public-private partnership has been formed in the AHIC Successor, Inc. to move forward the process of developing a National Health Information Network (NHIN); and the Certification Commission for Healthcare Information Technology (CCHIT) has formed the necessary work group to certify a Behavioral Health EHR.

While the names and acronyms of these bodies may be new to many of you, they are working hard to assure that interoperable EHRs are widely implemented by 2014. Many in the industry consider this an unrealistic goal date for such comprehensive change, but many entities are dedicated to seeing successful adoption of this technology in the not very distant future.

How will the requirement for health care providers to utilize EHRs affect psychologists, psychiatrists and social workers in private practice? Will the expectations be different for private care providers than for behavioral health providers in a community setting? How do you expect these changes to affect your organization? Are you already using an EHR? Let’s talk about where you see this going in your world.