The APA president also serves as president of the APA Practice Organization (APAPO). The five candidates running for 2019 APA president answered two questions from the Committee for the Advancement of Professional Psychology (CAPP) about the future of professional practice and the APA Practice Organization.

The five candidates in alphabetical order are:

To read each candidate’s reply, click on their name below.

Candidates’ statement reflects their own views and do not represent the position of APA or the APAPO.

Bingham
How do you plan to ensure that psychologists are at the table for critical national health care discussions regarding legislation, coverage and payment in the coming years?

Psychologists must be clear about our role in national health care and the impact federal budgets and legislatures have on our ability to deliver critical services, research and education, and training. APA and APAPO are well versed in advocacy. Staff know how to get us to the table. It's critical that psychologists understand the importance of being part of state psychological associations. Technology has made it easier to reach out to legislators and policy makers. Email blasts from the CEO and APAPO have rapidly focused our attention on issues that need action. When APA CEO Arthur Evans and APAPO sent out a recent call for action on healthcare, over 7,000 responses were garnered right away. I'm proud to say that I was one of those 7,000. We must help psychologists understand that we are needed at the table; that our discipline succeeds when we call on legislators to be certain that there is money for research, practice, training and education. I must help overcome any fear and hesitation about being at the table, so I must clearly and strongly support psychologists. It's the president’s job and that of the CEO to be the No. 1 advocates and role models for psychologists as we fight for appropriate coverage and payments. I will work hard on uniting scientists, educators and practitioners in understanding that there is a place for us at the table and we must step up and take that place.

What is your plan to fund the APAPO sufficiently to vigorously and effectively pursue its mission, goals and priorities?

There is a task group working to develop a stronger working relationship between APAPO and APA. That is an excellent first step. I want the group to assess the issues that are impacting funding for APAPO. We need to understand why membership has been declining for the last several years, and then we need to address those issues. People tend to pay for what they want if it serves a need, and they know it is available. I want to make sure we understand those issues and then deliver. We must expand the mission of APAPO so that it vigorously advocates for the science of psychology, as that is the foundation of our discipline and of our practice. If we can get more psychologists involved and committed to advocacy for science and practice and see that APAPO is the go-to organization, then we can begin to strengthen and fund APAPO. The development of evidenced-based guidelines is one important step in that direction.

We must create a business plan for APAPO that depends primarily on membership. We must right-size the organization so that we deliver the right goods and services at the right time for our members. If we align member needs with knowledge, the right size, the right budget, excellent communication, and demonstrate a great return on investment, I believe we will have an organization that can vigorously and effectively advocate for our members, our discipline and, in the end, society.

DiGiuseppe
How do you plan to ensure that psychologists are at the table for critical national health care discussions regarding legislation, coverage? and payment in the coming years?

The crucial issue facing psychology is the congressional activities to change the Affordable Care Act. No one knows what will happen with U.S. health care, and Congress seems intent on changing this market place. We must be active in Washington to advocate for the inclusion of mental health care in any health care law and clarify how psychologists will be reimbursed for their services. We need all the political and lobbying expertise that APA, APAPO and all the state psychological organizations have to ensure that any new legislation includes adequate coverage for mental health care. We need to mobilize all psychologists and the clients they service to influence any federal changes to health care legislation. Psychologists have invested much time and resources on the building of our professions. We all need to reach out to our congressional representatives and senators to vote for enlightened health care legislation.

APAPO must create alliances with all state and provincial associations, psychology departments and health care organizations to feed information to mass media and social media outlets so the public understands how the present health care crisis and the proposed reductions in mental health care benefits will affect the quality of life for many citizens. Lobbying at the federal, state and provincial levels are necessary for the survival of the services we have struggled to create for the benefit of our citizens. Each of us has a responsibility to do this.

What is your plan to fund the APAPO sufficiently to vigorously and effectively pursue its mission, goals and priorities?

I have always engaged in the practice of psychology. As a faculty member, I always thought that I could not teach what I did not do. I taught students about the realities of psychological practice. My whole career has been committed to delivering high quality psychological services. I think that as president of APA I remain a strong advocate for practitioners.

I asked psychologists I knew who were in full-time practice what they thought APAPO had done for them. Most were not aware of APAPO’s accomplishments and could not address how APAPO was relevant to their practices. APAPO has accomplished much for psychological practitioners. However, if practitioners are not aware of those achievements, it is unlikely they will become dues-paying members. We need to ensure that all practicing psychologists know of APAPO activities and accomplishments.

I would create a file containing the email addresses of all practicing psychologists and send an email blast at least once a month. We need to extend that to communicate with our potential members. Psychologists need to see the accomplishments of APAPO to give up their dollars for dues. Let us educate all psychology of the successes of APAPO. Psychologists cannot assume that as a doctoral level profession the public will see us as the most competent among the mental health professions. We must convince psychologists that membership in APAPO is crucial to the health of psychology as we face competition from a growing number of mental health professionals.

Finnerty
How do you plan to ensure that psychologists are at the table for critical national health care discussions regarding legislation, coverage and payment in the coming years?
First, I plan to ensure that each and every psychologist gets a seat at the table. I don’t want some psychologists to get a seat at the table while others are left out. Current APA policies leave some psychologists without a chair when the music stops. APA does not support them, their ability to get licensed in other states, their ability to get on insurance panels or their ability to work with our largest employers. Despite this we’ve had some recent successes; for example, the VA recently changed its policy to allow for hiring some psychologists who didn’t have APA-accredited internships. If health care reform means that more psychologists will be employees instead of business owners, then we need an APAPO that ensures employers respect our right to practice to the full extent of our state licenses.

I’m a solo practitioner and I’ll remain my own boss. My practice emphasizes psychological evaluations (something we must advocate for more vigorously). Psychologists who don’t want to work within the health care system have the option to step outside it into different worlds, but only if we defend and maintain them. Integrated care is a mantra for one slice of practicing psychology, but there are other worlds that psychologists practice in. These worlds must also be protected and expanded.

Let’s not trumpet reforms which don’t help psychologists. Let’s help our small businesses survive while dealing with large corporations and government regulations. Let’s not do more; let’s focus on psychologists. Please rank me No. 1.

What is your plan to fund the APAPO sufficiently to vigorously and effectively pursue its mission, goals and priorities?

This question is depressing. Now we’re all forlornly staring at APAPO’s dwindling checkbook and limited funds. Why do we talk about APA as having “members” while APAPO is something we must “fund?” Where are the calls for APAPO members to volunteer more than money — their blood, sweat and tears — on national advocacy campaigns? Where’s the organization part of the practice organization? I don’t see it (I don’t see it because it isn’t there). I wish this question was “how do you plan to organize and mobilize a large, national army of psychologists?” When I’m president that’s the question we’ll ask. Advocacy isn’t about something you pay for — it’s about something you fight for.

Psychologists have things backwards. APA is a charity, not a flagship organization. Psychologists shouldn’t be required to make a charitable donation to APA before they can become a member of APAPO. Breaking APAPO free from APA will take a little paperwork (something we’re used to). However, it’ll increase the number of psychologists eligible to join. It will also give APAPO the freedom to partner with state associations more effectively.

If we’re going to mobilize a national army of psychologists, it must be done locally all over the country. Psychologists will organize and mobilize — not just “fund the APAPO.” We’ll cut waste and increase efficiency. We’ll counter our nebulous mission creep (like focusing on whatever social issue is in the news instead of focusing on psychologists). I don’t want to do more; I want to focus on psychologists.

Hollon
How do you plan to ensure that psychologists are at the table for critical national health care discussions regarding legislation, coverage and payment in the coming years?
There is no non-psychotic disorder for which psychotherapy is not at least as efficacious and more enduring than medications. The United Kingdom recently invested £700 million to train psychotherapists in a program called Increasing Access to Psychological Therapies (IAPT) because clinical practice guidelines produced by the National Institute for Health and Clinical Evaluation (NICE) make it clear that psychotherapy is simply more cost-effective than medications. The nature of reimbursement is about to change in the United States and we not only need to make sure that we have a place at the table but that those decisions are made on the basis of the best available empirical evidence. If we do then psychotherapy will prevail and psychologists will prosper. Parity is not simply a matter of fairness or professional self-interest. It is in the public interest. As Richard Layard, the health care economist, and David Clark, the research psychologist, describe in their marvelous treatise Thrive, the best way to make the case for the provision of mental health services is to stress the economic benefits to society. For the psychotic disorders, you start with medications and use psychosocial interventions as an adjunct (albeit important), but for the non-psychotic disorders the evidence is clear: Medications are purely palliative and provide only transient relief, whereas the psychosocial interventions have broad and lasting effects that reduce subsequent risk and improve productivity. This is the case that we can make with respect to legislation and reimbursement, and I know how to make it.
What is your plan to fund the APAPO sufficiently to vigorously and effectively pursue its mission, goals and priorities?

I will work tirelessly to promote the mission and goals of APAPO and to encourage other members of APA to join. My father spent 40 years in independent practice and I know from the many friends he treated that he did it well. We need to protect psychologists in independent practice and ensure that they get fair reimbursement for services they provide. Psychiatry has long tried to encroach on the former (my father beat back such an effort as president of the Illinois Psychological Association in the 1960s) and third-party payers often undervalue the latter. We have the facts on our side in any economic argument regarding reimbursement; psychotherapy is simply more cost-efficient than medication treatment for the non-psychotic disorders that constitute the vast majority of people seeking treatment. As chair of the advisory steering committee we encouraged the APA follow Institute of Medicine (IOM) recommendations that called for conducting systematic reviews of the best available scientific evidence and to present to multidisciplinary panels comprised of physicians and social workers as well as psychologists (something that psychiatry has yet to do). The results from our first guidelines are clear; psychosocial interventions get the strongest recommendations. My plan is to make common cause with the other major professions so as to “force” them to play by IOM rules. When we do, it will be clear that psychotherapy is more cost-effective than medication treatment. This is the evidence that we can use to press for independent practice and parity in reimbursement.

Kitaeff
How do you plan to ensure that psychologists are at the table for critical national health care discussions regarding legislation, coverage and payment in the coming years?
As president of the APA, I will stress the importance at every public opportunity of psychologists as being the premiere doctoral-level health professional of all the mental health professionals. I will promote our profession and professional identity with vigor and pride. We are not social workers or counselors, we are doctors of the clinical and behavioral sciences with the highest degrees of training and ethical standards of all the professions. I will stress parity with physicians at the state level with appropriate legislation. This will include a vigorous campaign for promoting prescription privileges in all jurisdictions.
What is your plan to fund the APAPO sufficiently to vigorously and effectively pursue its mission, goals and priorities?

As a practicing licensed clinical psychologist, professor, consultant and author, I will select key grant writers and encourage grant writing and multiple incentives to invigorate applied, theoretical and consulting programs relevant to the APAPO. Psychology graduate students will also be provided incentives to generate grants and spur new areas of scientific and interdisciplinary needs assessment. Both psychologists who are new doctors, and seasoned professionals, will be given support and grounding to create key funding conduits for traditional as well as novel practice elements. I will encourage an invigorating process of collaborative outreach, and continue onward and forward.