2006 Fall Texas Psychologist - Texas Psychological Association

Volume 57
Issue 3
FALL 2006
psychologist
A SS
TT EE XX A
Positive
Psychology
APA President
Candidate Statements
www.texaspsyc.org
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Donna Davenport, PhD
Brian H. Stagner, PhD
Co-Editors
David White, CAE
Executive Director
Sherry Reisman
Assistant Executive Director
George Arredondo
Marketing / CE Coordinator
Lindell Brown
Membership Manager
Lynda Keen
Bookkeeper
FEATURES
8
Amber Frausto
Bonny Gardner, PhD, MPH
Administrative
Bryan White
Intern
TPA Board of Trustees
Where the Rubber Hits the Road: Local Advocacy in
Austin-Travis County for Psychiatric Emergency Services
12
APA President Candidate Statements
18
Positive Psychology in Clinical Practice and in
Non-Clinical Professional Groups
Melba Vasquez, PhD
President
Michael B. Frisch, PhD
M. David Rudd, PhD
President-Elect
Ron Cohorn, PhD
20
President-Elect Designate
Psychological Assessment and Treatment of
Patients with Chronic Pain
Jeff Baker, PhD, ABPP
Paul Burney, PhD
Past President; CAPP Representative
Board Members
Tim Branaman, PhD, ABPP
Mary Alice Conroy, PhD
Donna Davenport, PhD
Alan Fisher, PhD
Robert McPherson, PhD
Randy Noblitt, PhD
Lane Ogden, PhD
Verlis Setne, PhD
Brian Stagner, PhD
Thomas Van Hoose, PhD
Alison Wilson, PhD
Ex-Officio Board Members
Mimi Wright, PhD
PSY-PAC President
24
The Positive Psychology of Humility Relative to Arrogance
Wade C. Rowatt, PhD
28
Uncovering the Elepant in the Living Room
Elizabeth L. Richeson, PhD, M.S. PsyPharm
30
The Great Local Area Society Challenge
Rob Mehl, PhD, PSY-PAC President
DEPARTMENTS
4
From the Editor
Donna Davenport, PhD
Elizabeth Richeson, PhD
Texas Psychological Foundation
5
Business of Practice Network Rep.
Deborah Horn
6
Ollie Seay, PhD
Sherry Reisman
The Texas Psychological Association
Is located at 1005 Congress Avenue,
Suite 410, Austin, Texas 78701.
Texas Psychologist (ISSN 0749-3185)
is the official publication of TPA and
is published quarterly.
From the President
Melba J. T. Vasquez, PhD, ABPP
Student Division Director
Federal Advocacy Coordinators
From TPA Headquarters
David White, CAE
Jerry Grammer, PhD
32
PSY-PAC Contributors
Legislative Champions
2006 TPF Contributors
34
Welcome, New Members
www.texaspsyc.org
FALL 2006
3
Texas Psychologist
FROM THE EDITOR
Donna Davenport, PhD
Welcome to the pre-Convention
issue of Texas Psychologist!
A
s usual, you’ll find articles here
discussing approaches that are on
the cutting edge of the practice
of psychology, articles which we hope will
instruct, inspire, and perhaps provoke you
into sharing your own approaches. Texas is
filled with psychologists who are pushing
the boundaries, reshaping old stereotypes
of what psychologists do. Please consider
submitting an article describing your
emerging thoughts and practices!
We look forward to seeing many of
you in Dallas, and to participating again
in the exciting interchanges that routinely
take place at TPA conventions. If you have
not yet registered, please consider doing
so. Presentations will cover topics similar
to those described in these articles, as well
as issues ranging from neuropsychology to
religion to gender issues. It’s hard to imagine a comparable place where you could
count on renewing your old connections
and forging new ones with such bright, energetic, genuinely nice people--and at the
same time accumulating valuable continuing education hours.
See you in November!
CONFIDENTIAL AND EXPERIENCED
LEGAL REPRESENTATION
FOR
TEXAS PHYSICIANS
Representation before The Texas State Board of Examiners of
Psychologists, Texas Medical Board, The Texas Medical
Foundation, and Medical Staff Peer Review.
• Personal Counsel in Medical Liability Cases
• Non-Profit Certification / Recertification
• Probation Modification / Termination
• Managed Care Exclusions • Licensure
• Reinstatement • Medico-legal Issues
• Expert Review • Telemedicine
• Medical Ethics Opinions
• Physician Assistants.
MICHAEL SHARP*
COURTNEY NEWTON**
TONY COBOS**
SHARP & COBOS, P.C. ATTORNEYS AT LAW
4705 SPICEWOOD SPRINGS ROAD • SUITE 100• AUSTIN, TEXAS 78759 • 512 473 2265 • FAX: 512 473 8525 • www.sharpcobos.com
* Board Certified in Administrative Law by the Texas Board of Legal Specialization. ** Not Board Certified by the Texas Board of Legal Specialization.
4
FALL 2006
Texas Psychologist
FROM TPA HEADQUARTERS
David White, CAE
Connections…milestones…reunions
Faces fade with time as we move past our secondary school years,
but the lessons learned remain. Especially when the lessons help
build the foundation for our values.
I
had one such teacher who set a high
standard for integrity, honesty, and leadership. Thirty-five years later this teacher
entered my life again in an unexpected way
to inspire me in my professional career.
As TPA’s 2006 President, Dr. Melba
Vasquez impacted my life first as my 6th
grade teacher and today she continues to
be a role model in my position as Executive
Director for TPA. She has taught me how
in my family, friends, TPA board members and long time high school friends.
At that time Dr. Vasquez was currently
serving on TPA Board of Trustees and it
was the reconnection with the some of my
high school friends that this past relationship actually surfaced. As the story goes,
prior to my arrival at this party, the invited
guest were visiting and getting to know
each other. It was at this time when my
one of the most memorable birthday parties I have ever had.
Just as she did 35 years ago, Dr. Vasquez
continues to teach me integrity, honesty,
professionalism, leadership and one of
the best qualities anyone could ever have,
a caring and loving heart. She continues
to lead the Texas Psychological Association
and has become a leader at the American
Psychological Association. Her work on
Just as she did 35 years ago, Dr. Vasquez continues to teach me
integrity, honesty, professionalism, leadership and one of the
best qualities anyone could ever have, a caring and loving heart.
to be a leader in all areas of life. To realize
that different perspectives are vital to making important decisions, whether in running an organization or making a strategic
political move. To remember that leaders
must represent various constituents and
take into consideration the viewpoints of
individuals who might not be represented
at the same level as other groups.
The unusual part of this story is that I
didn’t make the connection of our past until a surprise birthday party I had several
years ago. This special occasion brought
FALL 2006
high school friends recognized her as our
long ago 6th grade teacher. The name was
different because she was in her first marriage but her warm personality, her sincere
friendship and her care for her students reminded us that Ms. Garza was in our presence. After a brief search the year book
was found and the stories began about the
type of students we were and whether our
grades in 6th grade English had any correlation with our behavior and professions
in our adult life. The laughter lasted well
into the evening and needless to say it was
the APA Council of Representatives along
with her recent election to the APA Board
of Directors, has made her one of the profession’s strongest advocate.
It has been one of my greatest honors
to work with and for my 6th grade teacher
this year. She continues to encourage me to
grow professionally and personally. She is
a true leader; a mentor to me and a leader
in your profession at the state and national
level.
Connections…milestones…reunions
– they all intertwine.
5
Texas Psychologist
FROM THE PRESIDENT
Melba J. T. Vasquez, PhD, ABPP
Join, Participate, Contribute
I
am sometimes asked why I stay so politically active and involved in psychology
organizations and activities. The answer
is complex, of course, but the simplest answer is because I passionately and sincerely
believe in psychology and its power to improve people’s lives. I learned from my parents that involvement at various political
levels could make a difference. That belief
influenced my pro-activity about concerns
in which I believe. So I would like to devote
this column to encouraging involvement of
all kinds from all of you.
We all make contributions to society
through our work, whether we conduct and
publish research, teach, or practice. But I
would like to suggest that involvement in
organized psychological associations provides additional avenues for implementation of our work for the good of society.
In turn, we benefit from opportunities for
learning through continuing education, as
well as to network, and promote leadership, career, and professional identity. David Rudd eloquently articulated the reasons
that Academic psychologists should join (or
stay with) TPA in the last issue of the Texas
Psychologist. Within TPA there are many
structures to support and promote the human welfare portion of our mission. TPA
indeed works to support psychologists regardless of area of concentration.
Join
This Texas Psychologist goes to all 3561
licensed psychologists in Texas. Of those,
1185 of you are members of TPA, and 266
members are other membership types for a
6
total of 1451 members. I want to invite each
and every one of you to become a member
of TPA if you are not; you can join online at
www.texaspsyc.org or call the Central Office
to have a form sent to you (888) 872-3435.
If you paid a consultant to do a small portion of what this organization does on your
behalf, it would be many times the cost of
membership. The same is true for APA. Join
TPA and/or APA today! I know that most of
us are members of other important specialty
organizations, but these two are the primary
workhorse organizations on our behalf.
Our careers and lives are significantly and
regularly impacted by the work of legislators.
The staff and volunteers involved in TPA
(and other state organizations) and APA (and
other national organizations) work very hard
to address difficulties impinging on our work.
My colleague Jeff Barnett, past president of
Division 42, Psychologists in Independent
Practice, pointed out how they fight: against
destructive managed care policies; for parity
of all mental health services; to include psychology in Medicare/Medicaid funding; for
funding of post-graduate training; for debt
relief programs; for prescriptive authority; for
hospital privileges; against challenges to our
licensure laws and the efforts of other groups
with more limited training seeking to be licensed to do all the same things psychologists
do professionally, as we recently did in Texas.
Most of these concerns are addressed in state
legislatures.
We know from our successful efforts at
the national level to block the Health Insurance Marketplace Modernization and Affordability ACT (HIMMA) that legislators
are responsive when thousands of constituents speak to them and provide them with
needed information. The APA Practice Directorate activated more than 18,000 messages from psychologists to their legislators to
prevent creation of association health plans
exempt from state consumer protection laws,
including mental health parity, psychology
“freedom of choice,” mental health benefit
mandates, and mandated offering laws. The
Practice Directorate collaborated with 224
healthcare and patient advocacy organizations, which generated media coverage and
intense public pressure to defeat the destructive legislation. TPA is also working to build
coalitions at the state level to support our
initiatives. But we need more involvement
from more psychologists to be members of
our organizations, to participate in activities,
and to engage in political giving.
Particpate
Run for office, engage in projects and activities through task forces, committees, divisions, special interest groups. I am pleased and
impressed with the involvement of members
this year. We had more people nominated for
Board of Trustees than ever before. Fifteen
people were nominated for six slots on the
ballot from which we will elect three members. My hope is that each and every one of
the fine candidates perseveres until they have
the opportunity to serve on the TPA BOT.
Most Local Area Society (LAS) presidents or
representatives attended our first spring retreat, and many LAS members attended the
Texas State Board of Examiners of Psychologists meeting to testify against independent
FALL 2006
Texas Psychologist
practice of Psychological Associates.
Vote! I invited the APA Presidential candidates to introduce themselves to Texas
Psychologists through this issue of TP. The
vast majority of APA members do not vote;
ten years ago, 25 percent of the membership
voted. Since then voting has ranged from the
low 20’s to a low of 16.8% in 2005. Let us
increase that percentage in Texas this year,
by informing ourselves and voting for the
candidates of our choice. Of 108 APA presidents, through 2007, only 11 women have
been elected President. Two outstanding
women are running now, including an African American woman for the first time. Our
very talented native Texan James Bray is also
running! Also, vote for one of the outstanding candidates for your TPA President-Elect
Designate, and for members of the Board of
Trustees.
Attend our TPA Convention, to be held at
the Dallas Westin Galleria November 16-18,
2006. We believe that we have a fabulous set
of programs and events to meet the learning
needs of the diverse membership of our association. TPA has Divisions and Special Interest Groups to serve a wide variety of interests.
Go to our website to see the wide variety of
specialties represented by these groups, most
of whom hold meetings at convention.
Contribute
I know that you are asked to contribute to a wide variety of great causes. Our
Texas Psychological Association and our
Political Action Committee (PSY-PAC)
work tirelessly with legislators both during and between legislative sessions advocating for the causes mentioned above, as
well as during our recent Sunset Review
of our licensing board. We are gearing up
for a very important and exciting session.
The Texas Psychological Foundation raises
money to promote educational and research
awards in very important areas. TPF Chair
Betty Richeson has started a new fund for
research against violence; her motivation is
poignantly fueled by the murder of her 18year-old granddaughter this year.
FALL 2006
The Association for the Advancement of
Psychology is the national psychology PAC.
Chair Ron Fox is trying very hard to make
us aware that psychologists’ per capita political giving is far less than physicians’ and
dentists’, less than half that of nurses, and
below that social workers, or of any health
care profession. He suggests that if each licensed psychologist gave a mere $5 to $10
per year, we could be the second largest
health care PAC in the United States. The
American Psychological Foundation, the
APA Practice Directorate and other APA
Directorates request contributions via assessments or otherwise. Giving of our time
and money, in whatever ways we are able,
are contributions well spent. Political giving
should be seen as a contribution to our own
collective and personal futures.
I sincerely believe that we can make a
difference, and
that each and
every one of you
counts in those
efforts. Please
get involved and
be an advocate
on your behalf.
I wish all of you
the very best!
Addendum:
I am delighted that David White has
shared, in this
issue, the fact
that we discovered a few years
ago, after working together for
several
years,
that I was his 6th
grade teacher in
1973-74! When
I taught school,
I was in my first
marriage, had
the name “Ms.
Garza”, and Da-
vid went by another first name. We did not
recognize each other until his 40th birthday
party, when his childhood friends also recognized me (and Jim Miller, my partner,
who was also a teacher at the school, where
we met!). I want to take the opportunity
to say that I have very much enjoyed and
appreciated observing David’s evolution as
one of the most experienced and effective
state executive directors in the country. He
is very popular at the national level (state
leadership conference) for his creative fund
raising and successful conferences. He has
also developed very sophisticated networking and lobbying skills, and we are truly
getting quite a bang for our buck with
David as our Executive Director. We have
a fabulous staff, and he is responsible for
recruiting such loyal and effective staff
members!
7
Texas Psychologist
Where the Rubber Hits the Road: Local Advocacy in
Austin-Travis County for Psychiatric Emergency Services
Bonny Gardner, PhD, M.P.H.
CATALYSTS FOR ACTION
In June 2002, the death of Sophia King, an
East Austin resident with a history of chronic,
relapsing mental illness, helped highlight the
deterioration of our publicly funded mental
health system. This deterioration was due, in
part, to local population growth, increased
demand for service, and budget constraints
at the federal, state, and local levels. The police shooting of Ms .King, who decompensated and apparently threatened the manager
of a public housing complex , drew the attention of the press and the public. Ms. King
in the past had benefited from a variety of
supportive services from MH-MR, including
case management, but appeared to have lost
access to some of these services and gradually deteriorated in the weeks prior to the
incident. The police had been called to the
complex many times. The coverage of the incident focused attention on the local public
mental health system and raised many questions about the wisdom of cuts in health and
human services budgets, given their potential
consequences. Since mental health issues are
very personal and carry some stigma, there is
often silence, and little scrutiny of problems,
until a tragedy occurs.
Texas now ranks 47th relative to other
states in per capita spending on mental
health. In 2003, under House Bill 2292,
in efforts to ration care, public funding for
treatment of mental illness was limited to
fewer diagnoses and those designated by
the state as official priorities for treatment:
schizophrenia, bipolar disorder, and major
depression. A “disease management” approach was taken, rather than an approach
focusing on prevention, early intervention,
and provision of a comprehensive array of
services. Persons with other diagnoses were
to be referred outside the MHMR system to
other local non-profit agencies unless a crisis were to develop. Also, under H.B. 2292
8
outpatient psychotherapy benefits for adults
under Medicaid were eliminated, although
these benefits were restored in 2005 through
the combined efforts of state and local advocacy groups and Health Commissioner Dr.
Eduardo Sanchez. Limitations in funds for
earlier intervention, ie. outpatient community mental health and case management, have
led to deferred treatment seeking and an increased need for more expensive services: ie.
psychiatry emergency services and hospitalization for stabilization. Yet these emergency
services have become increasingly inaccessible
to the public. Austin State Hospital is overburdened in that it serves many central Texas
counties and is strictly limiting new admissions and the only local private ,non profit
inpatient mental health facility, Seton Shoal
Creek is often full, with those with insurance
sometimes turned away as well as low income
persons. Austin Travis County MH-MR operates Psychiatry Emergency Services but
is overwhelmed by local demand and holds
patients only briefly before referring them
on to inpatient or outpatient treatment. According to an Austin American Statesman article on mental health issues by Andrea Ball,
dated July 2, 2006, from September 1, 2003
to August 31, 2005, there was an 84.8% increase in visits to Austin’s PES Center. There
is now a six to eight months waiting list for
patients who need outpatient follow up care
through MH-MR., whereas two years ago
there was not waiting list. Currently, the
regional trauma center and partially publicly
funded Brackenridge Hospital does not offer
psychiatric emergency services or detoxification services. The contract between the City
of Austin and Brackenridge did not include
any provisions for these services. Yet many
persons in a state of crisis present with complicated mental health, substance abuse, and
physical health problems, and for their own
safety, require the full range of medical diag-
nostic and treatment services best offered in
an acute care setting like Brackenridge.
The problems within the mental health
system are now impacting other systems as
well. By default, in Austin-Travis County, the
local jails have become holding environments
and de facto detox centers for many individuals with serious mental illness or substance
abuse problems, particularly low income
persons without insurance. Travis County recently reached a settlement with the family of
a woman who died in the Travis County jail
in early 2004. The woman was withdrawing
from heroin at the time of her death in jail
and was dehydrated. According to data from
the Travis County jail system provided to the
American Statesman, twenty-six percent of
the inmates in the jail system are on psychotropic medications, in contrast to only 15%
in September 2004. Law enforcement officers
with the City of Austin and Travis County
are often using their time inappropriately in
attempting to handle mental health crises,
securing resources, and transporting persons
in need of emergency hospitalization to state
hospitals hundreds of miles from Austin. In
2004, the Gray Panthers of Austin, an advocacy group for health and human services
and social justice, met with Chief Stan Knee
of the Austin Police Department, to discuss
training of police officers in handling mental
health emergencies. Chief Knee commented
that about 30% of police time was then being devoted to issues involving persons with
mental illness and that improved training for
officers was imperative, as well as funding for
more mental health services in Austin-Travis County. A disturbing statistic is that the
number of suicides in Austin-Travis County
for the years from 1999 to 2003 is over two
and a half times the number of homicides,
according to data from the Texas State Department of Health Services. A shortage of
resources poses a public health and safety
FALL 2006
Texas Psychologist
risk and has been frightening to all of us who
deliver mental health services, as well as to
patients and their families.
In a recent development in 2006, Travis
County received a $500,000 grant from the
Texas Task Force on Indigent Defense to establish the nation’s first stand alone public
defender office whose mission is to provide
persons with mental illness with legal aid
and the assistance of social workers and other
caseworkers to connect defendants with resources in the community to divert them
from recycling through the jail system. However, the question remains: how can these
defendants be diverted if so few community
resources are available?
The situation in Austin-Travis County is
probably not atypical of other areas of Texas,
although larger cities with well-funded hospital districts and university medical centers
are probably a step ahead in provision of
psychiatry emergency services and detoxification. The Legislative Budget Board and Governor Rick Perry’s current proposal that state
health and human services agencies plan to
operate on a 10% budget reduction for next
year further endangers our mental health
system. There is a need for systematic, coordinated advocacy for mental health funding
by all stakeholders. Proof that advocacy can
work was the restoration of funding for Medicaid outpatient psychotherapy and also, in
February 2006, the state approved 13.4 million dollars for extra beds at its psychiatric
hospitals.
LOCAL RESPONSES/
LOCAL ADVOCACY
In Summer 2004, Austin Mayor Will
Wynn established a Mayor’s Mental Health
Task Force which included representatives
from city and county government, the state
and local MH-MR system, the courts and
law enforcement, public and private human
service agencies serving persons with mental illness, state and local advocacy groups,
ie. NAMI and the Texas Mental Health Association, and the Hogg Foundation. Some
private sector representatives and representaFALL 2006
tives from local colleges were also included
in the group which totaled over 80 persons.
The Task Force was charged with identifying strengths and gaps in the system, developing criteria defining a mentally healthy
community, and creating an action plan to
close gaps. TPA members Ollie Seay Ph.D.,
TPA Public Policy Chair, Joe White Ph.D.,
Director of Catholic Family Counseling and
Family Life, Diocese of Austin, and I (representing Gray Panthers and Capital Area Psychological Association) participated in the
deliberations which spanned five months.
There was a clear consensus on local needs
and problems and necessity for more funding. However, at the outset, the facilitators
of the Task Force meetings reminded us that
more funding might not be feasible and we
should focus on how we might improve the
system otherwise. To many of us who have
worked in human services over the years,
this was a disheartening and familiar caveat.
Still, the meetings were great opportunities
for all stakeholders to begin collaborating on
advocacy. Remarkably, there was less rivalry
based on agency self-interest than might be
expected. While the Task Force final report
in January 2005 was weakened by not highlighting the critical need for more funding,
worthwhile recommendations included: 1)
establishment of policies consistent with
Task Force criteria and close coordination of
local planning initiatives and funding, with
one entity taking the lead, 2) ongoing monitoring of implementation through a Mental
Health Task Force Monitoring Committee,
3)ensuring relevancy of services, given cultural and linguistic differences, 4) improving education and training of human service
providers and law enforcement as well as the
public in regard to issues of mental health; 5)
adherence to evidence-based best practices
in service delivery, and 6) collection of data
for needs assessment, for determination of
service utilization, and for evaluation of process and outcome.
While there is no disagreement that
prevention, and early intervention in mental health problems, enhanced community
awareness of mental health issues, better interagency coordination, better data and evidence based practices are needed, the critical
lack of psychiatric emergency services has
still not been resolved. The Mayor’s Mental
Health Task Force Monitoring Committee
has continued to meet, as a subcommittee
of the Board of Directors of Austin-Travis
County MHMR, which is the lead agency
for implementation. Ollie Seay Ph.D. represents TPA within this group and now three
TPA Social Justice Task Force members, Dr.
Seay, Sylvia Servin-Lopez Ph.D. and I are
also serving on the Monitoring Committee Community Awareness subcommittee.
Wisely, the Monitoring Committee’s 2005
report has now made a focus on psychiatry
emergency services and suicide prevention a
priority.
In January of 2005, representing TPA
and Capital Area Psychological Association,
I continued networking with a number of
individuals and groups, ie. Gray Panthers
of Austin, Austin Area Human Services Association, West Austin Democrats, Merily
Keller, Director of the Texas Suicide Prevention Network, Austin Child Guidance Center, MHMR Representatives, and the Central Texas Labor Council, to underscore the
need for funding for psychiatry emergency
services. Additionally, District Judge Guy
Herman of Austin was an invaluable ally in
this effort, as was Constable Bruce Elfant and
Travis County Commissioner Karen Sonleitner, and Austin City Councilman Lee Leffingwell. In a meeting of the Gray Panthers
with Toby Futrell, Austin City Manager, we
were encouraged to continue this type of collaborative advocacy to build the public will
for funding increases. The City Manager expressed her own frustration with the local situation and indicated that while the City cannot directly fund mental health services, the
city is willing to provide increased funding
for supportive housing with attached services
for persons with mental illness, once they are
stabilized. In February 2006, representing
Gray Panthers, CAPA, and TPA, I testified
at a public hearing sponsored by the Texas
9
Texas Psychologist
Department of State Health Services on redesign of the state and local mental health
crisis system and the need for funding for
mental health services in general, to avert crises. Capital Area Psychological Association is
also involved in local advocacy efforts: Bruce
Mansbridge Ph.D., CAPA President, Kay Allensworth, CAPA President Elect, and I indicated our concerns to the newly formed Austin-Travis County Hospital District CEO,
Patricia Young. The Hospital District is a
viable source of funding for local psychiatry
emergency services and very recently decided
to allocate $500,000 to underwrite the cost
of inpatient crisis stabilization beds at Seton
Shoal Creek for low income and indigent
persons with mental illness for the first time.
However, there is no guarantee that funding
will continue beyond the first year. According to Ms.Young, in an era of cutbacks there
are many competing and legitimate needs for
funding, and balancing them is difficult. For
this reason, sustained, multi-group advocacy
is the key to success.
In May 2006, CAPA President Bruce
Mansbridge Ph.D, Kay Allensworth Ph.D,
and I arranged for a joint letter from CAPA
and William Holcomb M.D., President of
the Austin Psychiatric Society, explaining
the urgent need for funding for emergency
mental health services locally. Copies were
sent to the City Manager, the Mayor, the
County Commissioners, and the Hospital
District CEO. Two of our local state representatives Elliot Naishtat (D) District
49 and Donna Howard (D) District 48
are champions of mental health and have
indicated support for our efforts, despite
the realities of state fiscal conservatism in
human services. The recent resignation of
the very capable and progressive Eduardo
Sanchez M.D., head of the Texas Sate Dept.
of Health, is yet another setback for health
services in Texas.
In an adverse funding climate, when
change occurs slowly, when processes are
cumbersome, and when it is often difficult
to determine who the real decision-makers
are, it is easy to become discouraged. The
very complexities of the health service system
make it difficult to see where opportunities
for change may exist. However, given state
and federal agencies with mandates to limit
spending on human services, advocacy at the
local level becomes more important than ever
in shaping outcomes. This work has been
exciting and inspiring and I have been surprised at how well-received our efforts have
been. Coalition-building seems to be the key.
It now appears that law enforcement and the
mental health system may be joining forces to
address problems which affect all segments of
the community. I welcome suggestions and
participation from all psychologists here in
Central Texas and across the state who want
to improve our public mental health system.
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FALL 2006
Texas Psychologist
Texas Law and the Practice of Psychology
A Sourcebook
By TPA Editors
Code: XB-205 ISBN: 1886298203 Pages 256 $35.00
The Single Resource for the Legal Guidelines Shaping the Practice of Psychology in Texas.
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FALL 2006
11
APA PRESIDENT CANDIDATE STATEMENT
To follow are the American Psychological Association President candidate statements. TPA does not endorse any
candidate. The statements are for your reference/information if you are participating in the APA elections.
Rosie Phillips Bingham, PhD, ABPP
Inclusion is Power!
APA is a 150,000 member organization of
some of the most able minds in the world. We
have the power to lead the world toward peace
and humanity through the science, education,
and practice of psychology. I want us to realize
that power through drawing a circle that includes
all of our practitioners, all of our scientists, all
people of color, all international psychologists,
all state and regional associations, all genders, all
religions, all with disabilities, all gays, lesbians,
bisexuals, all orientations, all ages, all ethnicitiesall psychologists.
We must solve problems of managed care and prescription
privileges. We can use our science community to bring power to
the fight that practitioners are having with insurance companies and
legislators who do not understand what it takes to bring quality care
to the mental health needs of our society. Further, we need those
same bright minds to support necessary changes in the current reciprocity/mobility efforts by ASPPB, the National Register, and ABPP
as licensing laws change. We need scientific data to substantiate the
practicality and rationality of license portability so that we can support our case to those who have questions.
We must bring together the best minds from our practice,
education, and science communities to implement the Science
Directorate agenda, PSY 21, a plan to set scientific priorities in
APA. We need help with Institutional Review Boards. Practitioners
must be in the science circle so that practice can strengthen scientific research and help those in influential places understand the
essential place of psychological science in the building and flour-
12
ishing of society.
We must include in the circle the best minds
from education, science, and practice so that we
can solve pipeline issues. Who will be the next generations of psychologists? We are aging and need more
psychologists who care about issues that matter.
We must include practitioners, scientists, and
educators who can help us implement the diversity
guidelines and implement the recommendations
from the Presidential Task Force on Enhancing Diversity within APA.
Within APA we have too many factions and fractures and far
too many groups and individuals feel disenfranchised. When we
have factions and fractures, our power is diluted and we do not
have the energy TO take on the major issues. I will establish a task
force charged to bring action-based solutions for strengthening
the science-practice collaboration. WE can host a summit that is
structured as a practice/science collaboration that is problem-based
and solution focused. The problem could be “Managing Managed
Care: Insuring that Psychologists Can Earn a Living” or it could
be “Funding the Science of Psychology.” The team of psychologists would determine the problem. It is the duty of the President
to present the larger picture and then ask colleagues to bring their
time and talent as practitioners, educators, and scientists to help
specify the problems and find the methods that direct us toward
solutions.
I want to be your President.
Please give me your number 1 vote.
http://saweb.memphis.edu/binghamforapapresident/
FALL 2006
APA PRESIDENT CANDIDATE STATEMENT
James H. Bray, PhD
As a member of TPA (1986) and APA governance
for over 15 years, I will work tirelessly to enhance
psychology through expanding opportunities in science, practice, education and public interest for all
psychologists. This broad experience earned strong
endorsements by science and practice divisions, APA
caucuses, and state psychological associations.
APA is a strong and powerful organization, much
better than when I ran for president in 2002. However, in discussions with hundreds of psychologists;
practitioners, scientists and educators, many are
deeply concerned about their future in psychology.
should work together for the mutual benefit of all
psychologists.
Education Issues
Educators are also struggling with funding cutbacks. Our young psychologists are leaving graduate school with record levels of debt, making it
difficult for them to make a reasonable living.
Students considering a career in psychology are
re-thinking their decisions because of economic
limitations within the profession and this disproportionately impacts students from disadvantaged
backgrounds.
Practice Issues
Practitioners are besieged with threats to scope of practice from
other professions. Managed care continues to ravage our profession,
as they over-regulate and withhold psychological services from our
clients/patients. We cannot let an overly rigid evidence-based practice
perspective interfere with long held practices in psychology. Primary
care providers treat over 60% of mental health problems, without
assistance from psychologists. Minority, underserved, and elderly patients suffer even more from these systems of care. Psychologists can
provide solutions to effectively prevent and treat the major health
and mental health problems of our nation because we are the profession that knows the most about human behavior and how to change
it. We need to use our psychological science to enhance our practice
and expand into primary care and gain prescriptive authority.
A Culturally Expanded Profession
We require more psychologists who are culturally and linguistically competent and to get more minority students we need to start
earlier in the educational pipeline. The president has the power to
keep a focus on issues and diversity and problems related to socioeconomic status will be priorities.
We need to work together to support all psychologists. Through
my extensive experience and established working relationships within APA, we can do this and much more.
I thank the Texas Psychological Association for the opportunity
to address our members. I look forward to working with TPA as APA
President.
Science Issues
Over 50% of health problems are caused by psychosocial factors, yet less than 7% of the NIH budget is spent to research them.
Although NIH budgets are at record high levels, many scientists cannot get their research funded. It is time for APA to join with other
behavioral science groups to increase the percentage of the NIH and
NSF budgets for psychological science, which will provide incentives for young scientists to join APA. Furthermore, APA and APS
FALL 2006
James H. Bray, PhD is Associate Professor of Family and Community
Medicine and Psychiatry, Baylor College of Medicine. He teaches psychology students, resident physicians, and medical students. He conducts
research on divorce, remarriage, adolescent substance use, and applied
methodology. He has a clinical practice in family psychology and behavioral medicine. Please visit my web page: http://www.bcm.tmc.edu/
familymed/jbray for more information.
13
APA PRESIDENT CANDIDATE STATEMENT
Alan E. Kazdin, PhD, ABPP
My Priorities
My Background
• Clinical Practice and Service. For many of us
employment depends on overcoming impediments to practice. Suitable reimbursement
for services, license portability, expanded services (e.g., prescription authority), and greater participation in health care more broadly
are essential priorities. My own clinic is on
the ropes because of the reimbursement issues alone. I will lobby vigorously for our
clinical agenda and convey to our colleagues
that all of our profession must be involved.
• I am licensed psychologist in two states and a
Diplomate (ABPP). I direct an outpatient service and
see children and families everyday. I work with managed care agencies and the state legislature to lobby
(effectively) for improved services and reimbursement.
My clinical and research experience with medication
(e.g., published medication trials and work with pharmaceutical companies) will help me lobby strongly for
prescription authority.
• Diversity, Culture, and Identity. I intend to move diversity,
culture, and identity to center stage of APA in training, service, and science. Most programs have insufficient training,
mentoring, and research opportunities. We need to understand how identity operates so we can to provide more sensitive and informed clinical services and educational programs
and extend our service and science worldwide.
• Children and Families. Children and families are a focal
point for many aspects of service, practice, science and have
been my career focus. Child and family issues also unite many
of our professional concerns (e.g., day-care, education, family leaves, addiction, exposure to advertising) and APA Divisions.
• International Focus. Globalization is critical to us, and we
should become a more effective international force and partner with other countries and organizations. There is an opportunity to strengthen our global reach to help people and
expand the impact of our profession.
14
• I have chaired two departments (at Yale and Yale
Medical School) and have increased the proportion of
senior and junior women, minority, and lesbian/gay faculty. I
have also obtained NIMH grants to train minority students in
clinical-research.
• In my administrative positions, I have overseen programs in all
50 states of the US, including of course the Great State of Texas,
and in 57 countries (e.g., on terrorism or trauma from natural
disasters).
• My clinical research with children and families focuses on process
and outcome of child and family therapy, therapeutic alliance,
barriers to treatment among underserved families, child violence
and aggression, parent stress, and family relations. The 600+
publications from this work will help me be a credible advocate
for our practice as well as our science.
Your Vote and Support
I am Alan E. Kazdin, John M. Musser Professor of Psychology
and Child Psychiatry at Yale University and Director of the Yale Parenting Center and Child Conduct Clinic. I ask for your support and
your vote. I will be a strong and vibrant voice for all of psychology. I
am eager to work with you to improve the conditions of our country
and advance our profession and practice (please see http://votekazdinapa.yale.edu). Thank you!
FALL 2006
APA PRESIDENT CANDIDATE STATEMENT
Nora S. Newcombe, PhD
The existence of a discipline called psychology
is widely taken for granted. At some level, most
of us assume that the organization of the world of
knowledge will remain as we have always known it.
We also believe, without too much reflection, that
the relation of practice and science will continue in
the traditional way, a strained yet long-term marriage that both partners have doubts about. But
actually there is good reason to believe that revolutionary changes are underway. Managing these
changes represents an exciting challenge that APA
is uniquely well-situated to address.
• First, in an era of translational research, scientists must clarify
the relation of their work to questions that concern policy makers and the public. The best way to accomplish this goal is by
forging dynamic new connections between science and practice.
APA must provide the contexts in which dialogue can occur and
productive partnerships can be formed.
• Second, knowledge is simultaneously becoming more specialized
and more interdisciplinary. Therefore, many scientists’ allegiance
is no longer to the traditional discipline of psychology, and therefore not to APA. APA must seek new ways to connect to its science constituency, leading the way to a transformed psychology
by organizing the “big picture” activities that only an over-arching organization can offer.
• Third, in an increasingly evidence-based environment, for both
practice and education, APA must build on what it has done
recently, to delineate the most appropriate ways in which to generate new kinds of evidence and evidence on uncharted areas, as
FALL 2006
well as addressing what is best done when evidence is
unavailable yet decisions must nevertheless be made.
The major reason I am running for the APA Presidency is my passionate commitment to the unity of
psychology. However, in addition, I would want to
focus on certain specific initiatives.
• The public face of psychology. The public is not
clear about what psychology is. The science-practice
split has created a fuzzy “brand” for our discipline.
Are we quasi-shrinks or quasi-scientists? If we are quasi-shrinks, are we second-class ones? If we are quasiscientists, where are our test tubes, or do we just discover what
Grandma already knew? The key to influence begins with healing
the science-practice split.
• Work and family. Childcare is often seen as a “women’s issue”,
rather than a family-work issue. These different framings have
important consequences. I want to focus on how to best pose
problems so that women and men, families and children, all get
the support they need for healthy development.
• Psychology and education. The science of learning is an interdisciplinary enterprise whose time has arrived. Various sub-disciplines of psychology (e.g., cognitive, developmental, educational
and school psychology) have important roles to play in a science
of learning, and yet communication among these sub-disciplines
has not been optimal. APA needs to take initiatives to strengthen cross-talk both within psychology and with other disciplines
(e.g., mathematics and science education, computer science) to
support the emergence of a dynamic science of learning.
15
APA PRESIDENT CANDIDATE STATEMENT
Stephen A. Ragusea, PsyD, ABPP
Dear Colleague,
My name is Steve Ragusea and I’m running for
the position of President of APA. Some folks have
asked me why I’m running. Here’s the answer.
This is now the fifth time I’ve been asked to run
for the presidency of the American Psychological Association and it’s always an honor to be asked. I never refuse the profession that has given me so much.
This time, more than others, I very much want to
win and, if I can win at all, it’s going to be because
I have the support of all the practitioners in APA.
And, that means I need the support of the membership of the state
psychological associations.
I am past president of the Pennsylvania Psychological Association
and currently on the Board of Directors of the Florida Psychological
Association. For virtually my entire career, I have contributed time
and effort to my state psychological association. No other organization is more dedicated to the support of psychological practice.
This year, four of the five presidential candidates are primarily
academic psychologists. I am the only candidate who derives my
primary income from providing services to patients. Indeed, 100%
of my income comes from practice, as it has for almost all of my
26-year career. It has been many years since a full time practitioner
was elected president of APA. There are lots of reasons for that piece
of hard reality.
What will it mean if another academic is elected president of
APA? It means that once more, the point of view of the average
16
practicing psychologist will not be expressed at the
highest level of APA governance. Once again, there
will be nobody to focus APA’s attention on the major
income loss suffered in recent years by tens of thousands of practicing psychologists. Once again, there
will be nobody at the top who really understands the
managed care dilemma. Once again, nobody on top
will represent the average member of APA, who is a
practitioner.
This year, the practice community has an opportunity to elect somebody who has been in practice
for a quarter century, somebody who understands
practice and the need to expand the market for our services, somebody who understands the need for relevant psychological research
and relevant psychological organizations at the state and national
levels.
My name is Steve Ragusea and I’d like your support. I need your
#1 vote and I need you to tell your friends. I’m willing to serve
you at APA, but I need you to help me get elected. Practitioners have
run in the past but the practice community has not given them the
necessary support. Will you help me win this year?
This time can be different.
This time we can do better.
This time, a practitioner for a change.
That’s why I’m running for president of APA. If you’d like to
know more about my background, please explore my website:
www.raguseaforapa.com
FALL 2006
Texas Psychologist
Join one of TPA’s Special Interest Groups (SIG) or Divisions.
Contact Amber Frausto at [email protected] to let her know if you wish to join.
You must be a TPA member in order to participate.
Binational Issues SIG
Aging Division
Child/Adolescent Issues SIG
Forensic Practice Division
Gay/Lesbian/Bisexual/
Psychopharmacology Division
($10 dues required)
Transgender Issues SIG
Mental Retardation/
Women in Psychology Division
($10 dues required)
Developmental Disabilities SIG
Diversity SIG
Psychologists in Schools Division
($10 dues required)
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FALL 2006
17
Positive Psychology
Positive Psychology in Clinical Practice and in Non-Clinical Professional Groups
Michael B. Frisch, PhD
Professor Department of Psychology and Neuroscience Baylor University
PO Box 97334 • Waco, TX 76798
A Million Ain’t Enough
and Rationale for Positive
Psychology Intervention.
According to a client, “A Million Ain’t
Enough”, a million dollars is no longer a secure nest egg for business people. Indeed at
least fifty million is necessary. “Million” was a
software tycoon from Dallas who, while unhappy in some respects, did not have a bone
fide DSM clinical disorder per se (In keeping
with the APA Ethics Code this case is disguised
enough to make it impossible to identify the
client). An initial quality of life assessment,
using the author’s QOLI or Quality of Life
Inventory (Frisch et al., 2005; Frisch 1994)
indicated a rather impoverished existence
dominated by work. Million’s overall QOLI
score was low enough to put him at risk for a
clinical disorder in the future, especially clinical depression (Frisch et al., 2005). In terms
of Million’s valued areas of life that made up
his “happiness pie, salad, or stew,” he was satisfied with the areas of Goals-and-Values and
Spiritual Life, Self-Esteem, Health, Relationships with friends, relatives, and co-workers,
Learning, Creativity, and Surroundings—
Home, Neighborhood, Community. Million
was dissatisfied, however, with the highly
prized areas of Love Relationship, Helping,
Play, Work, and Money.
Million was quite lonely and longed to
have a family life. As a Conservative Jew, he
insisted on marrying another Jew rather than
the many shiksas in his acquaintance. Million
admired the noblesse oblige spirit of wealthy
entrepreneurs like Bill Gates who (prior to
retirement) set aside part of their wealth and
time to run charitable foundations. After
hearing about the powerful effects of service
work or Helping activities on quality of life,
Million decided to pursue this area along
with Love Relationship as the initial foci of
his counseling or coaching, the latter term denoting work with non-clinical populations.
18
Million created a non-profit foundation
aimed at educating the poorest people of color in Dallas through innovative programs that
brought indigenous counselors into the home
from infancy to school-aged. Parents were
empowered to teach and raise their children
in a way that might make their children’s lives
more fulfilling and less difficult than their
own. Million sought out Board members for
his non-profit corporation. The added life
focus of a charitable foundation did nothing directly for Million’s business. Rather. it
constituted a “frivolous flow” that was nevertheless highly engaging and fulfilling both
through the cause it served and through the
myriad social contacts it engendered (Frisch
2006). Finding a like-minded Conservative
Jew for a mate proved daunting. After meeting women from around the country, Million
fell in love with a woman from Mexico. Her
origin became a counseling issue as a result of
prejudice on the part of Million, his family,
and associates; interestingly, his love interest,
although born in Mexico, was from a Russian
Jewish family as was Million. After some multicultural counseling and positive psychology
relationship interventions, Million proceeded
to marry his love interest who was a business
person herself.
In terms of outcome, Million’s overall
quality of life score moved to within the average range at his post-intervention assessment.
This overall improvement seemed traceable
to greater fulfillment in Million’s pre-intervention areas of dissatisfaction, that is, Love
Relationship, Helping, Play, Work, and
Money. Million now reported satisfaction in
each of these areas. Million also reported the
empirically supported (although largely correlational) “holy trinity of happiness benefits”
(Frisch 2006) , including improved health
and fitness, more rewarding relationships in
general, that is, beyond his love relationship
which was a target of treatment, and greater
success in life and work. According to the
positive psychology literature, while money
can’t buy you happiness, happiness can buy
you money. For example, happier people
seem to have more initiative and productivity at work, their customers are more satisfied with them, and they enjoy greater annual incomes than less contented people (see
Diener and Seligman, 2004, for review). This
may explain Million’s increased income and
greater satisfaction with Money after counseling/coaching even though Money per se was
not a target of intervention.
The holy trinity of happiness benefits is
a major rationale for positive psychology interventions in the first place. Interestingly,
Million reported greater satisfaction with and
income from Work, even though this was
not a focus of his counseling. Indeed there
is a “Get Happy In General” intervention
strategy(Frisch 2006) that seems to impact
multiple areas of life and not just one. This
strategy is versatile, simple and appealing to
therapist/coaches and clients alike. The goal
of this strategy is for clients to become happier or more satisfied in general. The strategy
may be operationalized as simply following a
comprehensive positive psychology approach
such as that offered by Seligman (2002) or
the present author (Frisch 2006).
Quality of Life Therapy/Coaching(QOLT/
C; Frisch 2006), which was used in the Million case, attempts to incorporate the most
current theory and research with respect to
positive psychology, quality of life, social indicators, life satisfaction, happiness, and the
management of negative affect along with insights from the author’s clinical and positive
psychology practice. Diener (2006, p. vii) asserts that these attempts have been successful
in his foreword to the book or intervention
manual for QOLT/C (Frisch 2006), stating
that QOLT/C “presents state-of-the-art findings in positive psychology, brought to life
FALL 2006
Positive Psychology
with practical exercises that make the research
findings accessible to readers.” Ben Dean,
founder of MentorCoach and Robert BiswasDiener say that QOLC/T is “by far the best
and most comprehensive approach to positive psychology intervention currently available” (personal communication, March 31,
2006). Similar evaluations of QOLC/T have
been made by Christopher Peterson (2006),
C.R. Snyder (2006), Kenneth Land (2006),
David A. Clark (2006) and, with respect to
behavioral medicine applications, James R.
Rodrigue (personal communication, October 30, 2005), and, with respect to coaching
and industrial/organizational psychology applications, Paul Lloyd, past-President of the
American Psychological Association’s Society
of Consulting Psychology (personal communication, October 27, 2005). QOLT/C
is being taught to students in the University
of Pennsylvania’s Masters of Applied Positive Psychology Program founded by Marty
Seligman (James O. Pawelski, personal communication, July 30, 2006). QOLC/T has
been empirically supported in a randomized
trial which found QOLT/C to be “more
effective”(pp. 2430) than the standard treatment (Rodrigue et al., 2005).
Positive psychology.
Positive psychology approaches to enhancing human fulfillment, happiness, and quality
of life may boost the acute treatment response
to psychotherapy and/or medication (Clark,
2006). When presented near the end of therapy it may prevent relapse much as schema
work and mindfulness training have been cast
to do, according to the co-author of Aaron T.
Beck’s latest theory of psychopathology and
cognitive therapy, David A. Clark (Clark,
2006; Clark and Beck, 1999—also see empirical studies by Fava and colleagues, 2003).
Positive psychology interventions can also
be applied to an entirely new area of practice,
that is, “positive psychology clients” such as
professionals devoid of psychological disorders who nevertheless wish to be happier and
more content with their lives (Frisch 2006;
Seligman 2002). These professionals have
FALL 2006
included lawyers, teachers, business-people,
physicians, clergy of all stripes and persuasions, police and probation personnel, university student life professionals, and even quality of life/positive psychology researchers and
students themselves from around the world.
In an era in which executive coaching is in
vogue, many CEOs wish to have an executive
coach to help them feel and function better;
often the intervention of choice is positive
psychology. In this way and others, positive
psychology is a dominant paradigm in Industrial/Organizational psychology.
In either case—clinical or organizational/
professional, positive psychology intervention
may be as simple as applying interventions to
valued areas of life that are less than satisfying or fulfilling at the present time. According
to QOLC/T, these areas of life may include
Goals-and-Values which may include Spiritual Life, Self-Esteem, Health, Relationships
(with friends, lovers, children, relatives, coworkers, deceased or unavailable loved ones,
and the self ) and, Work and Retirement,
Play, Helping, Learning, Creativity, Money,
and Surroundings—Home, Neighborhood,
Community (see Frisch 2006 for specific definitions of these areas as well as area-specific
interventions). Much as B.F. Skinner used to
tout his “technology of behavior,” there exists an empirically derived and often validated
technology of positive psychology intervention along with various comprehensive systems of positive psychology intervention that
may be applied to areas of dissatisfaction as
clients build a more balanced life, one allowing for fulfillment in all valued areas of life
and one that is consonant with their overall
goals and values.
References
Clark, D.A. Foreword. (2006). In M.B. Frisch,
Quality of Life Therapy: Applying a Life Satisfaction
Approach to Positive Psychology and Cognitive Therapy (pp. xi-x). Hoboken, New Jersey: John Wiley
& Sons.
Clark, D. A., & Beck, A. T. (1999). Scientific foundations of cognitive theory and therapy of depression.
New York: Wiley.
Diener, E. Foreword. (2006). In M.B. Frisch, Quality of Life Therapy: Applying a Life Satisfaction Ap-
proach to Positive Psychology and Cognitive Therapy
(pp. vii-viii). Hoboken, New Jersey: John Wiley &
Sons.
Diener, E., & Seligman, M. E. P. (2004). Beyond
money: Toward an economy of well-being. Psychological Science in the Public Interest, 5(1), 1–31.
Fava, G. A., & Ruini, C. (2003). Development and
characteristics of a well-being enhancing psychotherapeutic strategy: Well-being therapy. Journal of
Behavior Therapy and Experimental Psychiatry, 34,
45–63.
Frisch, M. B. (1998a). Quality of life therapy and
assessment in health care. Clinical Psychology: Science
and Practice, 5, 19–40.
Frisch, M. B. (2006). Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy. Hoboken, New Jersey:
John Wiley & Sons.
Frisch, M. B., Clark, M. P., Rouse, S. V., Rudd, M.
D., Paweleck, J., & Greenstone, A. (2005). Predictive and treatment validity of life satisfaction and
the Quality of Life Inventory. Assessment, 12(1),
66–78.
Frisch, M. B. (1994). Manual and treatment guide
for the Quality of Life Inventory or QOLI®. Minneapolis, MN: Pearson Assessments (formerly, National Computer Systems).
Land, K. C. (2006). Quality of Life Therapy for
All!: A review of Frisch’s approach to positive psychology, Quality of Life Therapy. SINET (Social
Indicators Network News), 85, 1-4.
Peterson, C. (2006). Back cover. In M.B. Frisch,
Quality of Life Therapy: Applying a Life Satisfaction
Approach to Positive Psychology and Cognitive Therapy (pp. back cover of book). Hoboken, New Jersey:
John Wiley & Sons.
Rodrigue, J. R., Baz, M.A., Widows, M.R. , &
Ehlers, S.L. (2005). A Randomized Evaluation
of Quality of Life Therapy with Patients Awaiting
Lung Transplantation. American Journal of Transplantation, 5(10), 2425-2432.
Seligman, M. E. P. (2002). Authentic happiness.
New York: Free Press.
Snyder, C.R. (2006). In M.B. Frisch, Quality of
Life Therapy: Applying a Life Satisfaction Approach
to Positive Psychology and Cognitive Therapy (pp.
back cover of book). Hoboken, New Jersey: John
Wiley & Sons.
Author Notes
Correspondence regarding this article may
be directed to Michael B. Frisch, PhD, Professor, Department of Psychology and Neuroscience, Baylor University, P.O. Box 97334
, Waco, TX 76798-7334; telephone(254)
710-2252 or -2961; Fax(254) 710-3033;
Email: [email protected] .
19
Positive Psychology
Psychological Assessment and Treatment of Patients with Chronic Pain
Jeff Baker, PhD, ABPP
Associate Professor & Chief Psychologist
Anesthesiology Pain Clinic
University of Texas Medical Branch
Galveston, Texas 77555-1152
T
he psychological assessment of patients with chronic pain is typically
done by a licensed psychologist to
provide the patient and other health care
providers with insight into the psychological
functioning and/or overlay that may be influencing the patients’ pain experience. The
integration of psychological assessment and
treatment of patients with this unique and
complicated medical condition has become
part of the gold standard in the medical
world. Primary care psychology addresses the
“whole” patient and an effective psychologist
does not ignore medical issues anymore than
an effective medical doctor would ignore
psychological issues. Integrated care is still
atypical, but medical centers and teaching
hospitals are experiencing increasing opportunities for psychologists as more health care
providers are exposed or trained in “alternative” intervention strategies.. Anecdotal data
suggests that patients are less likely to address
these issues if care is provided off-site versus
integrated into the medical providers setting.
Patients like one-stop shopping and since
chronic pain has a higher likelihood of involving multiple providers such as the medical doctor, physical therapist, occupational
therapist, psychologist and the vocational rehabilitation counselor, it is a great benefit to
the patient when they can all work together
on site.
Integrated care is the current buzzword in
health care and psychologists would do well
to prepare for empirically based treatments
with chronic medical conditions. One area of
growth for psychologists is in Clinical Health
Psychology. There are a few doctoral programs
out there that have an emphases in health psychology but most training still involves more
20
severe mental health and DSMIV diagnostic
intervention training than familiarity with
ICD9 and chronic medical conditions. More
and more health care providers are looking for
primary care psychology providers. Primary
care psychology is also a relatively new description for providing care to patients with
medical problems. Bob Frank, author of an
excellent book on primary care psychology,
provides a must read for those interested in
learning more about this new area. In addition, there are several articles out that address
providing psychological services in a medical
setting (Robinson & Baker, PPRP, 2005).
This brief newsletter article will address
one area of growth with a focus of working
with patients with chronic pain. Pain clinics
continue to open and expand throughout Texas and the U.S. As the U.S. population continues to age, there is an increasing need for
psychologists interested in addressing quality
of life issues and how these are many times
negatively affected by medical problems. As a
body ages there is a higher likelihood that low
back pain develops and as Americans continue
to increase their body size/weight, low back
pain, as well as other forms of chronic pain,
becomes almost inevitable.
Progression of Chronic Pain
Patients do not see the psychologist if their
condition is within the normal expectations
such as acute pain from a recent injury. However, there are a number of flyers around the
clinic advertising a pain group and relaxation
training provided by psychology and some
patients request to be seen by the psychologist. Patients are expected to resolve their pain
in conjunction with seeing their primary care
provider and are usually given a simple an-
algesic such as NSAIDS (nonsteroidal antiinflammatory agents) or something slightly
more potent such as Hydrocodone (Vicodin).
In normal circumstances the injury will begin to heal, swelling decreases, nerve endings
begin healing, blood vessels and muscle tissue are repaired. These patients return to full
functioning and the pain has decreased significantly over the normal healing period and is
completely gone within a 12 week period of
time. Another group of patients includes those
that may need extended healing time but continue to do better; the pain, range of motion
and flexibility are slow in returning but there
is continued improvement over time usually
within 6 monts. . Finally,, there are a number
of patients that do not experience this normal healing period and thus the definition of
chronic pain. Patients who do not experience
much pain relief may find themselves taking
more pain medication than prescribed and
developing a syndrome known as analgesic
failure. They are literally taking so much pain
medication that it actually does nothing but
provide a euphoria which doesn’t do much for
the pain, but does provide some psychological
relief from the misery of the pain. This unfortunately leads to more indiscriminate use of
the pain medication which results in medication seeking behaviors for the patient. This is
a time when the psychologists are called in to
assist with the care of the patient.
Characteristics of Chronic Pain
Chronic pain has a number of characteristics that need to be addressed by both
medical professionals and psychologists. Most
patients are interested in a quick fix that will
allow them to return to their previous pain
free condition as soon as possible. This is not
FALL 2006
Positive Psychology
an unreasonable goal but it is highly unlikely
when the pain continues for an extended period of time. Unfortunately, after an extended
period of time, full pain relief is rare and most
patients go through a very difficult period
of time as they begin to realize there are few
things that will bring pain relief, much less return them to their previous level of physical
functioning. After an extended period of time
experiencing pain, pre-existing psychological
conditions often become more complicated
and have significant consequences on both the
physical and medical condition of the patient.
Also, having unrelenting chronic pain usually
increases depressive symptoms (loss of sleep,
appetite, increase in stress, loss of income and
self-esteem if the patient can not work, and an
increase in problems in relationships since the
patient can often not do much work around
the house or yard. It is for these reasons that
psychosocial stressors, personality, pain behaviors, and coping skills are best addressed
by including a psychologist in assessing and
providing interventions for patients with this
type of a medical problem.
Chronic pain is best defined as pain that
continues for an extended period of time
(greater than 6 weeks). Pain from an injury
is expected, but pain is not expected to continue past the initial 6 weeks of time unless
there are complications or difficulties with the
injury. When this happens the patients may
begin to spiral down as they enter a period of
time when they don’t fully understand what
is happening and why someone cannot address (fix) their pain. The medical professionals are sometimes considered incompetent or
not helpful if there is not immediate relief. In
truth most practitioners are very hesitant to
provide opioid medications beyond that initial
injury period. If there are no organic findings
to substantiate or correlate with the reported
pain experience, medical professionals actually
become more reticent to provide therapeutic
levels of analgesics.
Working in an anesthesiology pain clinic
at a major medical center brings in a wide
variety of patients. There are some common
factors. Patients are frustrated, depressed, anxFALL 2006
ious, tired, exasperated, and disappointed that
something has not already been done to relieve
their pain. Most patients have been through
several doctors, some have been through
multiple surgeries, and some are angry that
traditional medicine cannot do anything to
treat their pain. Most patients do not have a
psychiatric diagnosis; they are distressed but
do not meet diagnostic criteria beyond adjustment disorder. The stigma of psychology
works against our profession and patients are
typically distrustful. Their fear is that they are
being written off as a “head case” and they
only reluctantly follow through to seeing a
psychologist. In this clinic providing care to
patients that are in the last desperate search
is especially successful since psychology is well
integrated into the clinic.The psychologists’
offices are connected to the anesthesiologists’
offices in the same suite where medical residents and psychology postdocs intermingle
in a joint conference room. Anesthesiologists
consult with the psychologists to get clarification of the patient’s ability to manage and psychologically cope with chronic pain. Similarly,
psychologists seek out the anesthesiologists to
check out medical questions regarding the patients current complaints or side effects from
medication. An example of such collaboration
occurred with a patient who was complaining
of panic attacks late at night.
After consultation with the anesthesiologist it was learned that the patient was using
Chinese herbs to treat prostrate problems.
The herb increased the patients’ anxiety level
and late at night his cognitions and high blood
pressure exacerbated the herbs and led to anxiety attacks.
Psychological Assessment
Initial consultation with the patient involves an extensive clinical interview which
assesses the history and onset of the pain, the
patient’s pain rating (0-10), the history of the
progression of the pain (has it always been a
10?) and the radiation (where does it start and
spread to?) as well as what patients do for relief
of the pain (e.g., takeshot baths or showers,
lies down, takes medication, prays, etc). In ad-
dition, a review of medications including past
failures and successes with managing the pain,
a thorough family history including support
and understanding, as well as how close the
patient is with her or his family, are all important aspects when assessing patients’ ability to
manage their pain. The clinical interview normally takes 60 – 90 minutes and is billed either
as a psychiatric code (CPT90801) or a health
and behavior assessment code (CPT96150).
The latter requires no psychiatric diagnosis
and is typically much more appropriate for the
vast majority of patients with chronic pain.
After the extensive clinical interview the
patient is given a series of psychological assessments including the MMPI (Minnesota Multiphasic Personality Inventory-2); the CSQ
(Coping Skills Questionnaire); the BDI-FMS
(Beck Depression Inventory Fast Medical
Screen); The Type D Questionnaire (an instrument developed to measure recovery from
heart attack that also provides clinical data on
the patient’s ability to recover from chronic
pain); and the BPI (Brief Pain Inventory).
There are times when not all of these assessment instruments are given and times when
additional assessments are given to assess cognitive abilities, interpersonal relationships, etc.
These instruments will give the practitioner an
idea of how the patient’s psychological overlay
may or may not affect the patient’s ability to
cope with hie or her pain. These instruments
take 1-2 hours additional time and can be
billed as CPT96101 and includes administration, scoring, interpretation, as well as writing
the results in a report. It is not permissible to
bill for the patients’ time for taking the tests
but it is appropriate to bill for the actual time
the psychologist spent with the patient for giving instructions or tests that the psychologist
administers directly face-to-face. It is permissible to bill for time administering (explaining
the instructions or direct administration to
the patient) as well as writing and interpreting
the results in the report. Psychologists in our
clinic meet with the patient and as part of the
assessment process provides an interpretation
to the patient. This is part of the assessment
and intervention to assist the patient in reach21
Positive Psychology
ing a better understanding of how their pain is
affected by psychosocial stressors, personality,
support, and coping styles.
There is not enough space to fully explain
the psychological instruments or the meaning
of the results so the discussion in this article is
very limited. The MMPI-2 has been one of the
most widely studied instruments for working
with patients and chronic pain. It is expected
the majority of the patients will have a 1-3-2
profile. When other scales are elevated or the
patient has a validity profile where F minus
K is greater than 11, it brings into question
the patients’ ability to manage chronic pain.
As with any psychological instrument much
of the interpretation depends on the clinical
interview and how those correlate with other
data.
The CSQ provides 6 measures of coping
(reinterpreting pain, coping self statements,
ignoring pain sensations, catastrophizing, behavioral activity, pain behaviors, diverting attention and spirituality) will give the clinician
additional insight on how the patient manages
their pain. The BDI-FMS is a very brief assessment of depression for medical patients. It
is expected there will be a correlation between
the MMPI-2 and the clinical interview and the
BDI-FMS. If there is not, there is likelihood
that the results are suspect. The Type D Questionnaire provides a measure of negative affect
and social inhibition. This questionnaire was
first studied with heart patients, and results
indicated that patients with high negative affect and high social inhibition indicated they
were less likely to fully recover from a heart
attack. The results of the Type D are part of
the full assessment with chronic pain that is
still being reviewed by us. It appears to provide some very rich clinical data. Patients with
high scores (negative affect and social inhibition) are less likely to be able to manage their
chronic pain. The BPI provides the patients’
report of the pain in the last 24 hours, last 7
days and the last 30 days both at its best and
its worst. Again, this information is expected
to correlate with the clinical interview and the
other test results. As discussed earlier, when
there is inconsistent information, the case is
22
more complicated and the expected results of
success in managing chronic pain are significantly reduced.
treatment. Less than ½ individuals recommended for group treatment actually choose
to participate, even when there is no cost to
participate.
Psychological Intervention
Such assessment provides clinicians with
important information as they begin to develop an intervention plan for a patient with
chronic pain. In general, the higher the scores
on the psychological instruments the less likely the patient will be responsive to pain management including both pain medications and
psychological interventions. The vast majority
of those patients do not return for follow-up
psychological treatment. Anesthesiologists
have limited resources and may require the patient to follow-up for psychological care and if
they do not, they are often hesitant to provide
increasing doses of pain medication or other
interventions if the patients are not addressing their psychosocial stressors. Psychological
interventions are focused on empirically based
treatment programs such as cognitive behavioral therapy. The vast majority of the patients
with chronic pain also have symptoms of depression. In addition, a number of other types
of intervention may be offered to a patient.
These include relaxation training and stress
reduction treatment for anxiety and muscle
tension. Biofeedback and hypnosis are used to
treat similar issues. Group treatment is provided in a structured 6 week treatment program
that addresses coping, stress management,
relaxation training, cognitive reframing, pharmacology and physiology and family support.
This is a common treatment program offered
at this clinic. It appears to be helpful especially
because many of these patients feel very isolated and lack social support. The group treatment program is very effective for treating the
psychological overlay in patients with chronic
pain as well as providing needed human interaction and support. It is sometimes difficult to
get a patient to agree to participate in this type
of a program due to the many hurdles such
as traveling long distances, parking, transportation, etc. These are hurdles that need to
be addressed or at least acknowledged at the
patient contemplates participating in group
Common forms of Medical
Intervention for Chronic Pain
Anesthesiologists involved in the management of chronic pain are very interested in
providing integrated care as they have discovered that a number of their patients do not
seem to get much better, no matter how much
medication is given to them. At some point,
the anesthesiologist becomes very uncomfortable with the increasing medication doses that
seem to have little or no effect on the patient’s
pain. This is one of the reasons for referring
the patient to the psychologist, but there are a
number of other reasons for a referral. There
are a number of medical interventions that anesthesiologists can provide to patients. Having
a psychological evaluation provides additional
rationale for what procedure the anesthesiologist, along with the patient, may choose to address chronic pain. In addition to providing
patients with opioid medications, the following can be very effective :
Epidural Steroid Injections (ESIs) are provided at trigger points to decrease swelling and
provide anesthetic directly at the nerve root.
Some patients experience 3-6 months relief,
some patients experience 1-3 weeks of relief,
some patients experience only an hour or two
relief and a few patients either feel no relief or
the ESI makes their pain worse.
Intrathecal Morphine Pumps are implanted underneath the skin and allow the medication to be delivered in a steady dose in order
to provide constant relief. This removes the
euphoria from oral analgesics and provides
the patient with stable pain relief. This procedure is usually not indicated until a number of
conservative treatments have failed to address
the pain.
Dorsal Cord Stimulators are implanted
electrical stimulation units. The electrical discharge is managed by the patient and works
on the gait theory of pain. When the nerve
pathway is interrupted by the mild electrical
FALL 2006
Positive Psychology
discharge the pain is lessened and the patient
experiences more control over the management of their pain. This procedure appears to
be more effective for leg pain that has resulted
from extended low back pain.
All of these medical interventions require
a psychological assessment in our pain clinic.
The assessment will give the anesthesiologist
better information about the psychological
overlay and can result in better care of the
patient. Integrated treatment is one place
where psychologists can be more involved in
the medical care of the patient as psychology
gains a larger place in the medical treatment of
patients with chronic medical conditions.
Case Example
A 21 year old female patient was previously
diagnosed with cancer at age 3 and currently
reports fibromyalgia, PTSD symptoms, an
eating disorder, unrelenting pain and depressive symptoms. The patient is currently cancer
free but complains of general pain. A history
determines she is committed to pain reduction but is hesitant to take opioid medication
and prefers to only take Tylenol. She was very
pleasant and cooperative throughout the interview but seemed guarded . She reported that
her father was also being treated for chronic
pain. The patient was remarkable for suicidal
ideation but reported no previous attempts.
She reported a pain rating of 6-7 on a scale
of 0-10. She was able to ride her bike on the
seawall and used it as her main transportation
around this part of Galveston. The patient
reported no history of sexual abuse and had
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one sister living in another state. Both parents
were concerned and she continued to live with
them though they had moved to Galveston
only a few months before.
The patient reported no depressive symptoms on the BDI-FMS but reported depressive symptoms on the MMPI-2. Her scores
were elevated on social inhibition but low on
negative affect. Her scores were elevated on
scales 1, 3 and 2 and were also elevated on
scale 7 and 9 on the MMPI-2. These scores
were inconsistent with each other and did not
correlate with the clinical interview.
The patient atient was provided cognitive
behavioral therapy and relaxation training to
address stress and muscle tension. Biofeedback was used in session 2 and 3 with fair to
moderate results. She was provided access to
group treatment but declined. Pt continued to
report improving symptoms and less pain.
After session 4 it was reported the patient
had been hospitalized for suspected suicide
and test results indicated she had injested
methadone and 20-30 aspirin The patient
denied she was trying to commit suicide but
stated she knew it was suspicious. The patient
reported she was just trying to take something for the pain and forgot how much she
had taken. She was put on restrictive access to
medications (father agreed to lock up medications) and patient agreed to be “more honest”
in her interactions with the treating psychologist. She was referred for psychiatric treatment
but was also allowed to continue in pain management therapy. Eating disorder characteristics were addressed as well as how the patient
7ERECOGNIZETHATNOTALLEATING
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FALL 2006
might have been trying to play out her “good
girl” role in the therapeutic relationship. These
issues were only addressed as to how they affect her pain and how she has learned to be
somewhat helpless.
Follow up treatment strategies continue
to focus on pain management and encouraging her to address psychiatric issues with the
treating psychiatrist and pain issues with the
pain management team though many times
these are intertwined. Goals for the patient include decreasing pain, cognitive retraining for
managing stress and support as she explores
possible PTSD symptoms from the cancer
treatment. Pain management continues with
addressing pain reduction strategies and biofeedback.
This case was chosen to demonstrate the
complexity of chronic pain and how psychosocial stressors may play a significant role in
pain management. Physicians have agreed on
a conservative approach with medication but
have also agreed to explore with the patient
other options to manage her pain. The patient
has agreed to this plan.
References
Block, A.R.; Garchel, R.J.; Deardorff, W.W.; and
Guyer, R.D. (2003), American Psychological Association, Washington, DC.
Frank, RG; McDaniel, SH; Bray, JH; and Heldring, M. (Editors) (2004) Primary Care Psychology, American Psychological Association, Washington, D.C.
Turk, DC and Melzack, R. ( 1992) Handbook of
Pain Assessment, The Guilford Press, New York.
7EHAVEDEVELOPEDTOOLSTO
ASSISTYOUINPROVIDINGONGOING
TREATMENTSUCHASOURONLINE
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*OURNALOF%ATING$ISORDERS
1-800-445-1900 • www.remudaranch.com
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23
Positive Psychology
The Positive Psychology of Humility Relative to Arrogance
Wade C. Rowatt, PhD
Department of Psychology & Neuroscience
Baylor University
[email protected]
T
his article reviews emerging theory
and research that point to the positive nature of dispositional humility,
and possible benefits afforded to those who
are humble. Challenges to the measurement
of humility are discussed, along with some
preliminary ideas about its development.
A Zen Story
In the Zen story, A Cup of Tea (see Senzaki
& Reps, 1957/1998), there are some hints
about the role of humility in everyday life
and learning. As the story goes, when a university professor approaches a Japanese master to inquire about Zen, he is served tea. The
master pours the professor’s cup full…and
then keeps pouring. “The professor watches
the overflow until he can no longer restrain
himself.” “It is overfull. No more will go in!”
says the professor. “Like this cup,” the master
says, “you are full of your own opinions and
speculations. How can I show you Zen unless you first empty your cup?”
Characteristics and Paragons
of Humility
Some of us are so full of ourselves and
preconceptions that we have little room for
growth. However, a variety of facets of humility (see Table 1) could be intertwined
with intellectual or interpersonal flourishing.
Facets of arrogance – such as egotistical, selfcentered, or conceited – are not only uniformly disliked (Anderson, 1968) but could
be impediments to such growth.
A few probable paragons of humility are
listed in Table 2. However, many of the most
humble people are not famous and are out
of the limelight. As Mother Teresa remarked,
“humility must always be doing its work like
a bee making honey in the hive; without humility all would be lost.”
24
Perceptions of Humility as a
Strength
Exline and Geyer (2004) found that college students perceive humility to be a psychological strength and do not see humility to be synonymous with low self-esteem
or humiliation. When asked why a humble
person was seen as humble, “participants
identified positive characteristics such as
being kind or caring toward others (56%),
refraining from bragging (55%), success or
intelligence (47%), and unselfish or self-sacrificing stance (21%; Exline & Geyer, 2004,
p. 103).” Some students (14%) noted that
the humble person was timid, quiet, or unassertive (Exline & Geyer, 2004). However,
people often like or admire individuals who
give modest accounts for success (Hareli &
Weiner, 2000).
In contrast to humble persons, arrogant
individuals often brag too much or erupt in
repulsive in-your-face dominance displays.
Rather than accept success or victory with
grace, the egotistical person may continue
to derogate a competitor or take more credit
and glory for success than deserved. Sometimes the conceited person really is talented
and continues to excel. However, when an
arrogant person eventually fails, observers
may experience a wry sense of enjoyment or
schadenfreude (Smith et al., 1996). Although
narcissistic persons might think they’re highand-mighty, such self-perceptions could be
signs of insecurity, vulnerability, or weakness
(Wink, 1991).
Potential Benefits of Humility
“To know when one does not know is
best. To think one knows when one does not
know is a dire disease.” This passage from
the Tao Te Ching hints at the value of intellectual humility. Modern philosophers also
posit that, “humility seems to promote more
constructive research collaborations among
colleagues, teachers, and students than intellectual arrogance or vanity. Intellectually
vain people might not admit or notice valid
objections or threats to the validity of one’s
research findings; they might fake some data
or exaggerate the stability of one’s findings
(Roberts & Wood, 2003, p. 272).”
In a study of Israeli undergraduates, overconfident students earned significantly lower
grades on a psychology test than students who
were not overconfident (Zakay & Glicksohn,
1992). More recently, Rowatt et al. (in press)
found that an implicit measure of humility
correlated positively with college students’
course grades in a psychology course.
In a recent survey 70% of respondents
said that modesty was an important quality for elected leaders (The Modesty Survey,
2006). Some successful leaders appear to realize that humility is not only necessary, but
critical for personal and corporate success.
For example, the current Supreme Court
Chief Justice (John G. Roberts Jr.) wrote to
members of the Senate Judiciary Committee before his confirmation hearings, “that a
good judge must have humility to be fully
open to the views of his fellow judges….and
must recognize when their initial perceptions
turn out to be wrong (see Stolberg & Rosenbaum, 2005).”
Collins’ (2001) research demonstrates the
remarkable applied value of humility when
coupled with competitiveness. CEOs who
possessed a rare combination of extreme humility and strong professional will appeared
to be catalysts for transforming a good company into a great one (Collins, 2001). Genuine humility likely engenders flourishing in
other domains as well.
The Paradox of Self-Reported Humility:
FALL 2006
Positive Psychology
Will humble people say they’re humble?
C. S. Lewis (1952/2001, p. 128) surmised
that, “If you think you are not conceited, it
means you are very conceited indeed.” Preliminary indications are that most people say they
are humble, not conceited. For example, Rowatt et al. (in press) found that 92% of students
“agreed” or “strongly agreed” with the item, “I
try to be humble.” When asked to report, on a
semantic differential item, the degree to which
they were conceited or not conceited, 80% of
students selected a value above the item’s midpoint (Rowatt et al., in press).
These high baseline levels of self-reported
humility/modesty are a reminder of pervasive
self-enhancement biases largely inconsistent
with humility. For example, Rowatt et al.
(2002) found that 74% of students rated the
self to be better than others on positive traits
(e.g., kind, intelligent, attractive) and 98%
Table 1
Tendencies of Persons with Humility or Arrogance
HUMILITY
open to new ideas and contradictory information
eager to learn from others
acknowledges his or her own limitations and mistakes,
and attempts to correct those than can be corrected
accurate sense of one’s abilities and achievements
accepts failure with pragmatism
asks for advice
has a genuine desire to serve others
respects others
shares honors and recognition with collaborators
accepts success with simplicity
is not narcissistic and repels adulation
shuns public adulation; never boastful
doesn’t blame others
relatively low focus on the self or an ability to “forget the self ”
down-to-earth
ARROGANCE
conceited, egotistical, condescending
overly competitive with others
denies faults; overly defensive when criticized
overestimates abilities and accomplishments
attempts to hide failures
know-it-all
self-serving
disrespectful of others
takes more credit than s/he deserves
brags about successes
narcissistic, seeks praise
attempts to be center of attention
blames others for mistakes/failures
overly concerned with self-image; high vanity
high-and-mighty
FALL 2006
of students reported that they followed biblical commandments more closely than did
other people. It might be of interest to know
that Rowatt et al.’s (2002) study was inspired
in part by a New Testament scripture that
reads, “in humility count others better than
yourself (Philippians 2:3).”
Smith (2006) wondered if persons living
in a monastery confess being very humble.
They didn’t. Within a small sample of Cistercian nuns and monks, only 3 out of 57
individuals (5%) reported that they were very
successful, “always exhibiting humility in one’s
heart and anywhere else” (Smith, 2006).
And therein is a paradox. The most humble people on earth probably will not admit
being humble. However, the most arrogant
-- those with Narcissistic Personality Disorder -- may attempt to create an appearance
of humility to mask their narcissism (see
American Psychiatric Association, 1994, p.
659). As Schimmel (1992, p. 39) puts it, “in
a society which rewards humility with social
esteem, some people may mimic behaviors
typical of authentic humility.” Such patterns point to the great difficulty of measuring humility. Tangney (2002, p. 415) even
concluded that, “humility may represent
a rare personality construct that is simply
unamenable to direct self-report methods.”
The Measurement of Humility
Despite Tangney’s critique, there are a few
internally consistent self-report measures of
humility/modesty. More evidence is needed
for the predictive and known-groups validity
of these measures.
1. Costa & McCrae’s (1992) 8-item measure of modesty is positioned within the
Agreeableness dimension of the NEO-PIR. One item reads, “I try to be humble.”
2. Peterson & Seligman’s (2004) 10-item
measure of humility-modesty was theorized to fit with other character strengths
of temperance (e.g., forgiveness, prudence, self-regulation). Specific items
focus on not wanting to appear special,
not bragging, and not wanting to appear
arrogant.
25
Positive Psychology
3. Ashton, Lee, and their colleagues found
that humility-related words in several
languages loaded on a personality dimension interpreted to be honesty-humility
(Ashton, Lee, & Goldberg, 2004; Ashton, Lee, Perugini et al., 2004). Facets of
this dimension include sincerity, fairness,
greed avoidance, and modesty (Lee &
Ashton, 2004).
My collaborators and I are in the process
of developing and validating an implicit measure of humility based on the reaction-time
to associate humility trait terms with the self
relative to others (Rowatt et al., in press). The
logic is that a more humble person will more
quickly associate humility terms with the
self and be more slow to associate “arrogant”
terms with the self. The Humility Implicit
Association Test (IAT) was found to be internally and temporally consistent. Implicit
humility correlated with self-reported humility relative to arrogance, implicit self-esteem,
and self-reported narcissism (inversely). Humility was not associated with self-reported
low self-esteem, pessimism, or depression. In
fact, self-reported humility relative to arrogance correlated positively with self-reported
self-esteem, gratitude, forgiveness, spirituality, and general health (see also Powers et al.,
2006). These patterns appear to support the
construal of humility as a positive dimension.
However, even IATs are not without limits
(see Blanton & Jaccard, 2006; Greenwald et
al., 2006).
Preliminary Thoughts About
Cultivating Humility
Given the relative stability of personality
traits in adulthood (Terracciano, Costa, &
McCrae, 2006), the range in which dispositional humility could change within a person over time may be narrow regardless of
one’s motivational strength. Nevertheless, it
seems worthwhile for personal and interpersonal reasons for individuals to strive to be
genuinely humble.
Like many personality traits, a complex
combination of genetics, environment, and
other influences likely affect the development of humility or lack thereof. About
64% of the variability in a measure of narcissism was attributed to genetic influences (Livesley et al., 1993). Steger et al. (in
press), found that 25% of the variability in
self-reported humility/modesty was attributable to genetic similarity. Non-shared environmental influences contribute substantially to individual differences in humility
and other character strengths (Steger et al.,
in press).
If humility/modesty can be accurately
assessed, and there prove to be benefits associated with humility (such as intellectual
advancement, effective leadership, or prosocial relations), how might one go about
cultivating humility as character strength? Is
it possible for persons who desire to develop
humility to do so?
At present, there appears to be no solid
Table 2
Some Probable Paragons of Humility
Individual
Jimmy Carter
Mahatma Ghandi
Thich Nhat Hanh
Rosa Parks
Ichiro Suzuki
Albert Schweitzer
Mother Teresa
26
Notable Contribution(s)
39th President of the United States, 2002 Nobel Peace laureate
Political and spiritual leader of India
Vietnamese Buddhist monk, peace activist
African American seamstress, civil rights activist
Major League Baseball All-Star
German theologian, philosopher, physician, medical missionary
Albanian Catholic nun, founded the Missionaries of Charity
research evidence to support a conclusive
or exhaustive list of steps to achieve humility. However, there are clues about how to
develop humility within existing models of
character strength (Exline et al., 2004) and
effective leadership (Collins, 2001; Morris,
Brotheridge, & Urbanski, 2005; see Table
3).
Possible Ways to Develop
Humility
Realize pride. C. S. Lewis (1952/2001,
p. 128) remarked that, “if anyone would
like to acquire humility…the first step is
to realize that one is proud.” Pride is one
of the seven deadly sins (Schimmel, 1992);
however, being proud and being humble are
not mutually exclusive experiences. Geyer
(2006) reported that feelings of humility
were elicited by thoughts about experiences
of being praised. People appeared to feel
proud and humble when they were praised
by a person they respected and felt that they
deserved the praise.
Realize limits and broaden perspective.
To Lewis’ insight we might add that to acquire humility...the second step is to realize that one is limited. Humans are finite,
yet gifted in many ways. On a sensory level
humans (able to see) can only detect a narrow spectrum of electromagnetic energy….
yet how wonderful it is to be able to see.
Our lifespan is short. We’re small relative
to the magnificent, expanding universe (or
universes). To be humble requires a broadening of one’s perspective. The humble person seems to look up at the stars and accept
his/her place in the universe, limits and all.
The arrogant person, on the other hand,
seems rather oblivious about his/her finiteness, and usually acts as if s/he is the center
of the universe.
Reflection and mentoring. Collins (2001)
writes about a five-level leadership model.
The best leaders, Level 5 leaders, “build
enduring greatness through a paradoxical
combination of personal humility plus professional will (Collins, 2001, p. 70). About
FALL 2006
Positive Psychology
developing leaders, Collins (2001, p. 7576) writes, “there are two categories of people: those who don’t have the Level-5 seed
within them and those who do. The first
category consists of people who could never
in a million years bring themselves to subjugate their own needs to the greater ambition
of something larger and more lasting than
themselves…The second category consists
of people who evolve to Level 5…the capability resides within them…under the right
Table 3
Possible Steps to
Cultivate Humility
Personal Attitudes and Practices
1. Realize that one is not that humble
2. Be honest about one’s mistakes &
limits
3. Accept success with simplicity and
grace
4. Avoid bragging and boasting about
accomplishments
5. Avoid taking too much responsibility
for success
6. Attempt to be well-grounded (downto-earth & approachable)
7. If timid, maintain assertiveness
8. Give best effort even on seemingly
small or menial tasks
Social and Communication Practices
1. Acknowledge strengths in others
2. Avoid blaming others
3. Ask others for advice
4. Be open to others’ ideas and perspectives
5. Give credit where credit is due
6. Share honors and recognition with
collaborators
7. Be respectful, especially when disagreements arise
8. Engage in community service activities (on a regular basis)
9. Appreciate the beauty in each person
and of the natural world
FALL 2006
circumstances – with self-reflection, a mentor, loving parents, a significant life experience, or other factors – the seed can begin
to develop.”
Modeling and responsiveness to feedback.
Exline and her colleagues (2004, p. 470)
suggest that, “in order to become humble,
it seems crucial that a child learn that both
positive feedback and negative feedback
are worth considering. Such lessons could
come from parental modeling of humility,
or they might come from humbling feedback. Reality-based feedback from a parent
or teacher about one’s strengths and weaknesses would probably be especially useful,
particularly if conveyed in an atmosphere of
caring and respect.” Exline et al. (2004, p.
471) also point out that several experiences
could work against the development of humility in children such as extreme emphasis
on perfect performances, inaccurate or excessive praise or criticism, or frequent comparisons to others coupled with competitive
messages.
Serving others and practicing humility.
For some people humility could develop
during years of selfless service or work with
disadvantaged persons. For others humility may be the result of a gradual religious/
spiritual conversion or might develop after
a significant loss or coping with that experience (Worthington, 1998). Character development programs or psychotherapeutic
interventions aimed at reducing narcissistic
processes (Schwartz & Smith, 2002) might
also be effective at increasing humility or at
least reducing unhealthy pride.
Conclusion
Humility appears to be associated with
a variety of positive experiences. If humility
is possible to cultivate, it probably develops gradually, perhaps like the way a river
slowly carves a small path into a grand canyon. Over time, good habits of helping and
serving others, acknowledging one’s own
limits and sharing credit for success, and
being open to others views, could lead to
beneficial forms of humility. However, trying to learn humility without practicing
humility or other virtuous behaviors could
be difficult. Likewise, focusing too much
on developing humility could backfire and
lead one to be overly meek or too analytical
or self-focused. As the Zen master queried
in the “Cup of Tea” story (Senzaki & Reps,
1957/1998), “How can I show you Zen
unless you first empty your cup?” When
asked by this professor, “How can one learn
humility?” the Zen master might reply,
“Would you like a cup of tea?”
References
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders.
4th Edition. Washington, DC: Author.
Anderson, N. H. (1968). Likableness ratings of
555 personality-trait words. Journal of Personality
and Social Psychology, 9, 272-279.
Ashton, M. C., Lee, K., & Goldberg, L. R. (2004).
A hierarchical analysis of 1,710 English personality-descriptive adjectives. Journal of Personality
and Social Psychology, 87, 707-721.
Ashton, M. C., Lee, K., Perugini, M., Szarota,
P., De Veries, R. E., Di Blas, L., Boies, K., & De
Raad, B. (2004). A six-factor structure of personality-descriptive adjectives: Solutions from psycholexical studies in seven languages. Journal of
Personality and Social Psychology, 86, 356-366.
Blanton, H., & Jaccard, J. (2006). Tests of multiplicative models in psychology: A case study using
the unified theory of implicit attitudes, stereotypes, self-esteem, and self-concept. Psychological
Review, 113, 155–169.
Collins, J. (2001). Level 5 leadership: The triumph of humility and fierce resolve. Harvard
Business Review, 79, 67-76.
Costa, P. T., Jr. & McCrae, R. R. (1992). Revised
NEO Personality Inventory (NEO-PI-R) Professional Manual. Odessa, FL: Psychological Assessment Resources.
Exline, J. J., Campbell, W. K., Baumeister, R. F.,
Joiner, T., Krueger, J., & Kachorek, L. V. (2004).
Humility and modesty. In Peterson, C., & Seligman, M. (Eds.), The Values In Action (VIA) classification of strengths (pp. 461-475). Cincinnati, OH:
Values in Action Institute.
Exline, J. J., & Geyer, A. L., (2004). Perceptions
of humility: A preliminary investigation. Self and
Identity, 3, 95-114.
References continued on page 31
27
Texas Psychologist
Uncovering the Elephant in the Living Room
Texas Psychological Foundation
Spotlight on the prevention of violence
Elizabeth L. Richeson, PhD, M.S. PsyPharm
President TPF
O
ne of the many roles of the Texas
Psychological Foundation (TPF)
is to facilitate the education of the
public in areas of psychological significance,
where to do so would create a more mentally
healthy environment. Thanks to the financial
support of TPA members and others, TPF
has been involved in creating and awarding
grants to students in psychology for four
years. We are now exploring ways to reach
out to our communities, to provide direct
services that will engender mental health for
the public.
from 2003, these preventable losses remain
unacceptable.
Christy Still, 38 – San Antonio – Christy
was found shot to death at her home. According to police, Christy and her ex-boyfriend
Jason Edward Love, 25, had a short and violent relationship. She had called police several
times in the past when Love turned violent.
He was charged with her death.
Cynthia Wilkerson, 22 - Texarkana Cynthia’s body was found in the driveway
of a manufacturing plant warehouse where
her husband worked. Her husband Hance
Violence toward women has
been the elephant in the
living room of psychology.
While contemplating the potential issues
on which to focus, a heartbreak was thrown
at us this year by the murder of an 18 year
old woman in Austin the day after Valentine’s
Day. Jennifer was known to many of us in
TPA and APA by her attendance at numerous conventions. It was her plan to become a
psychologist – to help others.
As a result of that tragedy, we began the
process of taking steps to educate consumers
about domestic violence and violence against
women in Texas in particular, in order to uncover the elephant in the living room. In 2004,
the last year that statistics are available, there
were 182,087 family violence incidents and
115 women killed by intimate male partners* in Texas alone. While the 2004 statistics show a decrease of about 25 percent
28
Lee Wilkerson, 34, was arrested and charged
with her death. . . Hance allegedly got into
his truck and ran over Cynthia. She sustained
fatal injuries as a result of the impact.
Lorena Godoy, 21 – Richardson – In an
apparent murder-suicide, Lorena was thrown
to her death from a freeway overpass by her
boyfriend, Paul Stephens, 30. Stephens
jumped from the overpass and later died at
an area hospital. . .Stephens was arrested in
2000 in connection with an assault against
Lorena, but he was not convicted. An exgirlfriend had a restraining order against Stephens in 1998.
Maria Navarro, 37 – Houston – Maria
died of stab wounds to her neck, chest and
arms after a fight with her boyfriend, Benito
Sanchez Jimenez, 22. According to witnesses,
he was also stabbed in the neck, chest and
arms. Police have not established a motive for
the incident.****
Jennifer Crecente, 18 – Austin – Jennifer’s
body was found in a wooded area near her
home one day after she was reported missing.
She died of a gunshot wound to her head. An
ex-boyfriend, Justin Crabbe, 19, also of Austin, has been charged in her murder.
“In 2002, The Texas Council on Family
Violence conducted a statewide polling on
prevalence and attitudes on domestic violence. Below are some of the findings:
• “74% of all Texans have either themselves,
a family member and/or a friend experienced some form of domestic violence.
• “47% of all Texans report having personally experienced at least one form of
domestic violence, severe (physical or sexual), verbal and/or forced isolation from
friends and family at some point in their
life time.
• “31% of all Texans report that they have
been severely abused (physically or sexually abused) at some point in their life
time. Women report severe abuse at a
higher rate than men.
• “75% of all Texans report that they would
be likely to call the police if they were to
experience some form of domestic violence. Yet only 20.3% indicated that they
actually did call the police when they or
a family member experienced domestic
violence.
• “73% of all Texans believe that domestic
violence is a serious problem in Texas.
HHSC (Formerly DHS) estimates that
924,042 Texas women were battered in
2004.”***
FALL 2006
Texas Psychologist
In 2005 the U. S. Senate voted to renew
the Violence Against Women Act. That same
year according to Robert Kleeman of the
Daily Texan, there was “A wall of red wooden cutouts representing the 115 of Texas
women killed by domestic violence in 2004
covered the Capitol Steps. . .” Now in 2006
to launch TPF and psychology’s investment
in the understanding and prevention of violence, TPF created a new graduate student
award, is collaborating with APA for redistribution of their brochure Warning Signs,
and added a convention presentation.
The graduate student award has been
named The Jennifer Ann Crecente Memorial
Grant, in memory of our Jennifer, the first
homicide victim in Austin in 2006. This
grant will provide $5,000 support for a
currently enrolled psychology graduate student in good standing, who is conducting
research addressing potential causes and/or
prevention of violence against women. (See
the TPF section of the TPA website for further information on this and other grants
and awards.)
The TPF/TPA campaign, in conjunction with the TPA Education Committee chaired by Dr. Edward Davidson, will
be kicked off this year at the TPA annual
convention where APA brochures will be
distributed**. Phase II of our campaign will
commence with a Texas specific brochure
that will be made available for distribution
by our member in a downloadable format.
The statistics on violence are frightening
and seem to be rising around the country
– perhaps around the world. The Warning
Signs Campaign was begun by the American
Psychological Association in 1999 and included an Outreach to the Community component. This is the opportunity for Texas to
take lessons from that successful campaign
and tailor it to Texas.
The convention workshop, entitled
Stand against Violence: a Community Outreach Plan scheduled for Thursday, November 16, 1-2:50 p.m., will take attendees from the identification of the problem
FALL 2006
through plans for education and prevention that can be implemented in their own
community. This program will be presented by this author with Dr. Michael Hand
as a part of the kick-off for the grass roots
efforts planned throughout the state. Look
for other presentations on this subject at
the convention.
An additional component of the project
will include information about a Speaker’s
Bureau with the TPA website and the Local
Area Societies’ offices as point of contact.
This will facilitate a community’s request
for psychologists to address their organization concerning demographics, risks and,
most importantly, prevention of violence.
The violence towards women in Texas
has been the elephant in the living room of
psychology for too long and it is time to recognize it and rid it from our lives once and
for all.
YOU CAN HELP – please contact TPA
at 1-888-872-3435 or go to their website at
www.texaspsyc.org and click on the Texas
Psychological Foundation link to make your
TAX DEDUCTIBLE donation.
* defined as husbands, ex-husbands, common-law husbands, boyfriends and ex-boyfriends.
** numbers of brochures available per attendee are limited, however, additional brochures can be ordered for a nominal fee. The
downloadable brochure will be available at a
later date TBA free of charge.
*** taken from the Texas Council on Family
Violence website www.tcfv.org
**** List of Women Killed in Texas - partial
list 2004 - www.tcfv.org
29
Texas Psychologist
The Great Local Area Society Challenge
Rob Mehl, PhD, PSY-PAC
Greetings, fellow Psychologists!
Thank each of you who have taken the time and made the effort to contribute to
PSY-PAC! Your donations support the efforts of our legislative committee to protect,
sustain, and advance our profession!
Your PSY-PAC Board has worked diligently through the summer with efforts to raise
professional awareness concerning the importance of active political action. We are in
the process of considering a name change for PSY-PAC in order for TPA members,
non-members, and the public at large to understand at once that the purpose of this
arm of TPA is to support and advance psychology as a profession in Texas. This should
be finalized before the 2006 TPA Annual Convention in November.
Please feel free to contribute to the PAC and to get more actively involved. Be prepared
to have fun at Convention and enjoy the exciting, friendly competition that Dr. Rob
Mehl explains below!
Sincerely,
Mimi H. Wright, PhD, 2006 PSY-PAC President
One of the penalties for refusing to participate in politics is that you end up being
governed by politicians (adapted from Plato).
Politicians with the best motives certainly
have a limited understanding of the issues
that face psychologists. Within the legislature every year, there are multiple challenges to good mental health delivery, to
availability of mental health services, to
psychological services you may provide, to
payment amounts, and challenges to the
profession of psychology as a whole. While
you are working in your offices, TPA constantly monitors this flurry of legislative
activity and Psy-Pac works to raise money
to fund the legislative and lobbying efforts. Without this effort in the past few
years, we would be earning less money, be
defined as a masters level profession, and
be increasingly limited in the services we
can provide. Recent activity has been well
documented in the Texas Psychologist by
30
Dr. Melba Vasquez, Dr. Mimi Wright, David White and others. Like it or not, we
must participate in the legislative process,
and we must fund the lobbying efforts. Be
helpful to those that are helpful to you.
Support Psy-Pac and the legislative efforts.
For the past several years at the TPA annual convention, there has been a Psy-Pac
Challenge pitting the Houston Psychological Association against the Dallas Psychological Association. The two largest local
area societies (LASs) have vied for top honors as the largest contributor to Psy-Pac.
There are a number of problems with this
challenge of the past.
The first problem is that Houston seems
to win. There is nothing wrong with Houston winning, but it always seems to win.
The second problem is that only two LASs
are involved, accounting for only 39% of
the TPA membership. Why should the
rest be left out? A little research showed
one reason why Houston dominates. Not
that their political giving isn’t stellar, but
Houston has 329 TPA members and Dallas
has 233. Is that really fair to Dallas? Why
not level the playing field and include all
of TPA? Hence, “The Great Local Area Society Challenge.”
The Group Challenge: In order to include all LASs and make it a fair challenge,
each society was grouped with a large association anchor. Because of the size of the
Houston LAS, the math dictates that no
more than four groups be formed. The goal
was to make the groups as closely identical
in size as possible and to create a rough geographic association. With size of the group
most important, sometimes geographic association was sacrificed (Fort Worth, you’re
with San Antonio; Corpus Christi, you’re
with Dallas). TPA automatically geographically assigns each member to a LAS whether or not you actually belong to that LAS.
Thus, every TPA member can participate
in this challenge. Group One: San Antonio, Fort Worth and West Texas includes
the Abilene Psychological Association,
Bexar County Psychological Association,
El Paso County Psychological Association,
Fort Worth Area Psychological Association, Panhandle Psychological Association,
Psychological Association of Greater West
Texas, Red River Psychological Association,
South Plains Association of Psychologists,
and the out of state psychologists. Group
Two: Austin, Central Texas and Rio
Grande Valley includes the Bell County
Psychological Association, Brazos Valley
Psychological Association, Capital Area
Psychological Association, McClennan
County Psychological Association, Montgomery County Psychological Association,
and the Rio Grande Valley Psychological
Association. Group Three: Dallas, East
and North Texas, and Nueces County
includes the Collin County Psychological
FALL 2006
Texas Psychologist
Association, Dallas Psychological Association, East Texas Psychological Association,
Nueces County Psychological Association,
and the Texoma Psychological Association. Group Four: Houston, Sugar Land,
Beaumont includes Fort Bend County
Psychological Association, Houston Psychological Association and the Southeast
Texas Psychological Association.
The group that contributes the largest
amount to Psy-Pac from September 18 until the convention deadline will win a trophy that may be kept until the Challenge
next year. All of the LASs have already been
informed. The Group Challenge is on!
The Per Capita Challenge: The research revealed that there is a great discrepancy among the LAS groups in terms
of per capita giving. Top honor goes to
the Red River Psychological Association (Wichita Falls area) with a giving of
$37.50 per capita. A close second is the
Psychological Association of Greater West
Texas with giving of $31.25 per capita. It
falls off rapidly after that, with three LASs
at $0 (ZERO????). Our goal is to increase
contributions across the board both for
the LAS and the individual psychologists.
Therefore, a second trophy will be awarded
to the LAS which shows the largest dollar
increase per capita from September 18 until the convention deadline. Red River and
Greater West Texas set the standard. The
Per Capita Challenge is on!
Can Houston maintain the lead with
Sugar Land and Beaumont are helping?
Contribute as much as you can. Come to the
convention and see who wins. Houston, the
Challenge is set!
2006 Board Members
Patrick Ellis, PhD, Past President
Michael Pelfrey, PhD
Robert Mehl, PhD
Dee Yates, PhD
Stephen Loughhead, PhD
FALL 2006
References continued from page 25
Geyer, A. (January 2006). Proud and Humble, not
Proud versus Humble. Conference poster presented
at the annual meeting of the Society for Personality and Social Psychology. Palm Springs, CA.
Greenwald, A. G., Rudman, L. A., Nosek, B. A.,
& Zayas, V. (2006). Why so little faith: A reply
to Blanton and Jaccard’s (2006) skeptical view of
testing pure multiplicative theories. Psychological
Review, 113, 170-180.
Hareli, S. & Weiner, B. (2000). Accounts for success as determinants of perceived arrogance and
modesty. Motivation and Emotion, 24, 215-236.
Lewis, C. S. (1952/2001). Mere Christianity: A revised and amplified edition. NY: Harper-Collins.
Lee, K., & Ashton, M. C. (2004). Psychometric
properties of the HEXACO Personality Inventory.
Multivariate Behavioral Research, 39, 329-358.
Livesley, W. J., Jang, K. L, Jackson, D. N., Vernon,
P. A. (1993). Genetic and environmental contributions to dimensions of personality disorder.
American Journal of Psychiatry, 150, 1826-1831.
Morris, J. A., Brotheridge, C. M., & Urbanski, J.
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Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and classification. Washington, DC: American Psychological
Association; New York: Oxford University Press.
Powers, C., Nam, R., Rowatt, W. C., Hill, P.
(2006). Associations between humility, spiritual
transcendence, and forgiveness. Manuscript under
editorial review.
Roberts, C. R. & Wood, W. J. (2003). Humility
and epistemic goods. In M. DePaul & L. Zagzebski (Eds.) Intellectual virtue: Perspectives from ethics
and epistemology. Oxford University Press.
Rowatt, W. C., Ottenbreit, A., Nesselroade, K.
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Rowatt, W. C., Powers, C., Targhetta, V., Comer,
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Author Note
Preparation of this article was supported
in part by a grant from the John Templeton
Foundation. Portions were adapted from
Rowatt et al. (in press).
31
Texas Psychologist
2006 PSYPAC CONTRIBUTORS
Donations received 1/1 - 8/31
The only organizations that represent psychologists in the Texas Legislature are the Texas Psychological Association and the Psychology
Political Action Committee (PSY-PAC). Legislative monitoring for bills which are detrimental to psychology and proactively introducing
legislation to further the field are essential to the survival of our profession. These activities are not for just a few special interests, but for the
profession as a whole. Unfortunately, only ten percent of TPA members contribute to the PAC and two percent contribute the majority of
total funds. Please consider a contribution, consistent with your income, and help your profession. We can do great things if everyone pulls
together.
$500 and above
Edward Davidson, PhD
Lane Ogden, PhD
Dean Paret, PhD
$300 - $499
Sam Buser, PhD
$100 - $299
Joan Anderson, PhD
Judith Andrews, PhD
Paul Andrews, PhD
Larry Aniol, PhD
Kyle Babick, PhD
Eileen Barbella, PhD
Julie Bates, PhD
Joan Berger, PhD
James Berkshire, EdD
Peggy Bradley, PhD
Tim Branaman, PhD, ABPP
Ray Brown, PhD
Timothy Brown, PhD
Larry Brownstein, PhD
Joan Bruchas, PhD
Erica Burden, PhD
L. Carol Butler, PhD
Brian Carr, PhD
Betty Cartmell, PhD
Ron Cohorn, PhD
Sean Connolly, PhD
Mary Alice Conroy, PhD
Donna Copeland, PhD
Mary Cox, PhD
James Crawford, PhD
Walter Cubberly, PhD
Ronald Davis, PhD
32
Sally Davis, PhD
Mary De Ferreire, PhD
Leah Dick, PhD
Michael Downing, PhD
Marie-Elise DuBuisson, PhD
Richard Eckert, PhD
Anette Edens, PhD
Wayne Ehrisman, PhD
Patrick Ellis, PhD
Donald Ennis, PhD
Alan Fisher, PhD
Ft. Worth Area Psychological
Association
Richard Fulbright, PhD
Cynthia Galt, PhD
Bonny Gardner, PhD
Elizabeth Garrison, PhD
Karen Gollaher, PsyD
Michael Gottlieb, PhD
Jerry Grammer, PhD
Charles Gray, PhD
Dennis Grill, PhD
Edmund Guilfoyle, PhD
Michael Hand, PhD
James Hardin, PhD
Charles Haskovec, PhD
Sophia Havasy, PhD
Lillie Haynes, PhD
Robert M. Hochschild, PhD
Charles Holland, PhD
C. Alan Hopewell, PhD
David Hopkinson, PhD
Sandra Hotz, PhD
Carola Hundrich-Souris, PhD
Daniel W. Jackson, PhD
Charlotte Jensen, MA
Krista D. Jordan, PhD
Rita Justice, PhD
Stephen Karten, PhD
Burton A. Kittay, PhD
Joseph Kobos, PhD
Amelia Kornfeld, PhD
Richard Krummel, PhD
John W. Largen, PhD
David S. Litton, PhD
Victor Loos, PhD
Stephen Loughhead, PhD
Alaire Lowry, PhD
Thomas Lowry, PhD
Ann Matt Maddrey, PhD
Janna Magee, PhD
Patricia P. Mahlstedt, EdD
Rebecca Marsh, PsyD
Patricia R. Martinez, EdD
Stephen McCary, PhD, JD
Jill McGavin, PhD
Richard M. McGraw, PhD
Sherry McKinney, PhD
Robert J. McLaughlin, PhD
Robert Mehl, PhD
Robert S. Meier, PhD
Daneen Milam, PhD
Maritza Milan, PhD
Janel H. Miller, PhD
Robert W. Mims, PhD
Suzanne Mouton-Odum, PhD
Gina Novellino, PhD
Fernando Obledo, PhD
Sherry L. Payne, PhD
P. Caren Phelan, PhD
Shelley Probber, PsyD
Manuel Ramirez, PhD
Robert Rankin, PhD
Robin Reamer, PhD
Carolyn B. Reed, PhD
Catherine Rees, PhD
Herbert Reynolds, PhD
M. David Rudd, PhD
David M. Sabine, PhD
Gordon C. Sauer, Jr., PhD
Steven Schneider, PhD
Leigh S. Scott, PhD
Robbie Sharp, PhD
Joyce Sichel, PhD
Sonia Simon, PsyD
Karen E. Smith, PhD
W. Truett Smith, PhD
Brian Stagner, PhD
Daniel J. Thompson, PhD
Willson S. Thornton, PhD
Thomas Van Hoose, PhD
Deborah J. Voorhees, PhD
Ann P. Vreeland, PhD
Laural Wagner, PhD
Michael Walker, EdD
Beverly Walsh, PhD
Joan Weltzien, EdD
Richard Wheatley, PhD
David White, CAE
Connie S. Wilson, PhD
James Womack, PhD
John W. Worsham, PhD
Jarvis A. Wright, PhD
Mimi Wright, PhD
Gary Yorke, PhD
Sharon Young, PhD
Robert Zachary, PhD
FALL 2006
Texas Psychologist
Less than $100
Constance Adler, PhD
Kay Allensworth, PhD
Mary Alvarez-del-Pino, PhD
Kim Arredondo, PhD
Lisa Balick, PhD
Patricia Barth, PhD
Bexar County Psychological
Association
Bonnie Blankmeyer, PhD
Ronald Boney, PhD
Joy Breckenridge, PhD
Glenn Bricken, PsyD
Michael Bridgewater, PhD
Amos Jerry Bruce, PhD
Constance Byers, PhD
Kay Campbell, PsyD
Marla Craig, PhD
Leslie Crossman, PhD
Maria Concepcion Cruz, PhD
Mark Cunningham, PhD
Stephanie Darsa, PhD
Dana Davies, PhD
Daniel Diaz, PhD
Sid Dickson, PhD
James Duncan, PhD
S. Jean Ehrenberg, PhD
Emily Fallis, PhD
Joseph Fogle, PhD
William Frazier, PhD
Cheryl Fuller, PhD
Sylvia Gearing, PhD
Martin Gieda, PhD
Guillermo Gonzalez, PhD
Linda Gotts, PhD
B. Thomas Gray, PhD
Pamela Grossman, PhD
Ranee Gumm, PhD
William Gumm, PhD
Cheryl Hall, PhD
Paul Hamilton, PhD
Philip Hanson
JoBeth Hawkins, PhD
Barbara Pugh Hinojosa, PhD
William J. Holden, PhD
Nahid Hooshyar, PhD
David Ivey, PhD
Linda Jackson, PhD
Thomas Johnson, PhD
Cliff Jones, PhD
LEGISLATIVE CHAMPIONS
$100 - $299
Larry Aniol, PhD
Connie Benfield, PhD, ABPP
Joan Berger, PhD
James Berkshire, EdD
Constance Byers, PhD
Sean Connolly, PhD
Mary Cox, PhD
Anette Edens, PhD
Burton A. Kittay, PhD
FALL 2006
Marcia Laviage, PhD
Sherry McKinney, PhD
Ann Salo, PhD
James Womack, PhD
Constance D. Wood, PhD
Less than $100
William Frazier, PhD
Richard Fulbright, PhD
Dorothy C. Pettigrew, PsyD
Bruce Kruger, PhD
Trinh Le, PhD
Doreen Lerner, PhD
Arthur Linskey, PhD
Deborah M. Longano, PhD
Melinda J. Longtain, PhD
Martin Lumpkin, PhD
Bruce Mansbridge, PhD
Stephen K. Martin, PhD
Lynn M. Matherne, PhD
Donald C. McCann, PhD
Marsha D. McCary, PhD
Charles McDonald, PhD
Rose McDonald, PhD
James McLaughlin, PhD
Robert McPherson, PhD
Richard S. Mechem, PhD
William Montgomery, PhD
Craig Moore, PhD
George R. Mount, PhD
Gary Neal, PhD
Margaret P. Norris, PhD
Will Norsworthy, PhD
Ronald Palomares, PhD
Freddy A. Paniagua, PhD
Carmen Petzold, PhD
Randy E. Phelps, PhD
Cynthia Pladziewicz, PhD
John Price, PhD
Lynn Price, PhD
Glenda Rice
Tova Rubin, PhD
Dale Rudin, PhD
James Ryan, PsyD
Earl S. Saltzman, PhD
Ollie Seay, PhD
Verlis Setne, PhD
Robert M. Setty, PhD
Terri L. Thompson, PhD
Dana Turnbull, PhD
Jennifer Unterberg, PhD
Melba Vasquez, PhD
Alisha Wagner, PhD
Ken Waldman, PhD
Mac Walling, PhD
Patricia D. Weger, PhD
Nancy Wilson, PhD
Burton Zung, PhD
2006 TPF CONTRIBUTORS
$1,000 and above
Less than $100
Anonymous
B. Thomas Gray, PhD
Arthur Linskey, PhD
$100 - $299
Michael Blain
Nicolas Carrasco, PhD
Mary De Ferreire, PhD
Jerry Grammer, PhD
Victor Loos, PhD
Ann P. Vreeland, PhD
33
Texas Psychologist
WELCOME NEW MEMBERS 5/25 - 8/31
Member
Verna Barron, PhD
Sarah Carpentieri, PhD
Susan Church, PhD
Christine French, PhD
Jennifer Hartman, PhD
Gabriel Holguin, PhD
Jennifer Jagielko, PhD
Judy Sonnenberg, PsyD
Member Out of State
Susan Gelberg, PhD
Recent Graduate Member
Jennifer Farnum, PsyD
Bret Moore, PsyD
Celeste Riley, PhD
Cressida Suess, PhD
Student
Ami Bhaga
Ashlee Brown, MA
Arthur Cardona, BA
Cindy Cheshier, MA
Amy Collins, MS
Laura Cooper
Sandra Cordova, BS
Teresa Correia, MS
M L Dantzker, PhD
Todd Dunn, MS
Shawn Ferreiro, BS
David Fonteno
Charlotte Haley, BA
Daniel Hoard, MA
Jonathan Horowitz, MA
Patricia Imadomwanyi, BS
Chelsea Janke
Carolina Jimenez, MA
Tracie Kaip, MA
Katherine Kelsey, BS
Charlene Key
Felix Leal, MA
Angela Lindley, BA
Needhi Patel
Andrew Reichert, MS
Amanda Richter, BS
Stacy Roddy, BA
Pamela Schaber, MA
Amber Simpler, MS
Rebecca Stein, MA
Deanna Vokes
Eric Wood
Elizabeth Young, MS
Jason Yu, MA
Karri Zumwalt, MS
Benefit Your Practice.
All TPA members are eligible for this unique member
benefit that easily enables your practice to accept credit and debit cards.
You can accept every form of payment from every client and not waste your
time managing the billing process. Accept payment for consultation fees,
counseling sessions and insurance co-pays.
Benefit Your Profession.
Take advantage of a unique member benefit that gives back to the Texas
Psychological Association with every transaction. Each credit or debit card
payment you accept supports the future of TPA and our efforts to educate
and support the profession of psychology.
Charge into Action!
Support TPA by
Taking Credit Cards
Member Benefit Includes:
• Reduced processing rates
• VIP member service
• No minimum processing
• No start-up fees
• Supports multiple psychologists per office
• No cost to transfer services –call and compare!
Your participation makes a difference. For more information contact
Sabine with Affiniscape at (800) 644-9060, ext. 6973 or visit our website
at www.texaspsyc.org/creditcards.
In partnership with Affiniscape Merchant Solutions
“The Power of the Association Network”
“Affiniscape Merchant Solutions,” a registered ISO/MSP in association with Bank of America, N.A.
34
FALL 2006
B
eing insured through Rockport Insurance
Associates doesn’t provide you with just another
policy; it provides you with a partner to help you
navigate through difficult liability and risk
management issues. Committed to bringing you
the best in professional liability coverage, Rockport
offers a superior combination of service, price, and
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harbor from the risks associated with liability claims.
Put the strength of Rockport to work for you today.
Call 1-800-423-5344 or visit our website at www.rockportinsurance.com.
Save the dates for these Texas Psychological Association
Continuing Education Events
2007
Annual
Convention
2006
Annual
Convention
November 16-18, 2006
November 15-17, 2007
Dallas, Texas
San Antonio, Texas
Westin Galleria
Westin La Cantera Resort
13340 Dallas Parkway
16641 La Cantera Pkwy
(discounted rate of $129
for reservations made
before 10/27/06)
3 full days of
continuing education
credit available
Additional information coming to www.texaspsyc.org soon!