The APA president also serves as president of the APA Practice Organization (APAPO). The five candidates running for 2020 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.

Cerbone
How do you plan to educate policy makers, health payers, and the public about the value psychologists bring to many areas such as patient care, pain management, forensics and consultation?

Often as the only psychologist at the table, I collaborated with community leaders, doctors, lawyers, and other mental health practitioners, always providing them with evidence-based psychological information they might apply in their spheres of influence. Offering the Professional Practice Guidelines on Psychotherapy with LGB Clients (that I co-authored) became a psychological, science-based tool valued by policymakers. Being able to offer the best of our science generated clear value for psychology.

Advocating for suffering members of the community publicly presented psychology as a powerful provider of compassionate care. Being present and helpful outside the office promoted trust. For example, participating in community fundraising events consistently communicated to interest groups not only encouragement for their work but also an investment in the community. Compassionate support for community causes garnered support for psychology. Perhaps not intuitively but practically, mobilizing my state association was equally important. It extended the reach of our evidence-based messages and enhanced credibility and trust in the value of psychology.

The lessons are clear: To advance psychology,

  • Promote psychology as a science and as a compassionate advocate for people.
  • Provide evidence-based practical measures targeted to stakeholders. and the special needs of individuals and groups.
  • Be present outside the office.
  • Participate in and contribute to community causes and organizations.
What are your plans to ensure that the mission, priorities, and goals of the APAPO are expanded as APA transitions are an integrated c3/c6 model?

An integrated c6 would expand advocacy across the entire spectrum of psychology. My sense is that the advocacy exercised presently by the APAPO would not disappear. Rather, I believe that attending to the needs of all psychology, science, education and public interest will ultimately enhance practice. It is the strength of our diverse disciplines that distinguishes practice among other health professions. The integration of all psychology would make clear how our very diverse sub-disciplines are part of one rich fabric of knowledge. Acting as one collective organization enhances our power collectively and individually. Advancing psychology as one would ultimately advance the mission and priorities of the APAPO.

I also believe it is critical that a c6 foster relationships with policymakers at the community level as well. For instance, I envision an c6 that would make funds available to psychologists at the community level (particularly to those in small and cash-strapped state associations) to establish influential relationships with their congressional representatives or candidates who would promote psychologists’ roles in healthcare delivery and policymaking. As an example, in June I attended a fundraiser for my congressman who has a proven record on mental health. He has invited me to serve on his mental health advisory committee, which has allowed me to press for his support on issues like including psychologists in the Medicare definition of physician. I saw first-hand in Illinois how helpful APAPO funds sustained our drive to include prescriptive authority in scope of practice!

Chin
How do you plan to educate policy makers, health payers, and the public about the value psychologists bring to many areas such as patient care, pain management, forensics and consultation?

I think that psychologists and APA often spend more time arguing the distinctions between practice and science that they fail to present a unified face to the public about psychology. We need to do a better job of educating policy makers, health payers, and the public about who psychologists are, the value they bring, the depth of their training, and the complexity of expertise in psychology — i.e., the scientific study of the human mind and its functions, especially those affecting behavior in a given context. We need to use simple, non-technical language to communicate what psychology is. Next, we need to educate them about practitioner psychologists as doctoral level trained professionals specializing in diagnosing, treating and consulting with other professionals on mental, emotional, and behavioral disorders. I would also emphasize that psychologists can help to identify how psychological factors influence behavior and outcomes in a variety of settings — health care, forensics, sports, education. Psychologists are important in health care settings to address how psychological distress such as anxiety and depression can significantly influence patient care outcomes, compliance and pain management. Psychologists also use a variety of approaches and methods to engage patients, identify their sources of distress, or dysfunctional behaviors and thoughts; it is not simply "talk therapy."

What are your plans to ensure that the mission, priorities, and goals of the APAPO are expanded as APA transitions into an integrated c3/c6 model?

The division between APA and APAPO is a legal distinction that did not serve us well in promoting psychologists or practitioners as a discipline and profession to the public. APA's transition into an integrated c3/c6 model offers greater opportunities to coordinate efforts and leverage resources. The allocation of APA membership dues to the C6 ensures the sustainability of advocacy efforts, not possible under the APAPO.

Under the new model, APA can present itself as one voice for psychology and psychologists while recognizing the complexity of its science, practice, education, and public interest components. It can distinguish C6 activities to advocate for practitioner economic and marketplace interests (e.g., Medicare, reimbursement, parity, scope of practice) from C3 activities to promote the practice of psychology (e.g., guidelines, model licensure, accreditation). It can benefit from the economies of scale given the overlap between the C6 and C3 on shared administrative functions. Both work with federal and state legislators, the insurance industry, and SPTAs to address legal and regulatory initiatives. Both provide public education to promote and support practicing psychologists, albeit in different areas, e.g., to manage and market professional practice vs. clinical guidelines.

The greatest fear among practitioners is that the new model would diminish APA’s support to practitioners. I would work to ensure that the APAPO goals are expanded by prioritizing practitioner issues (they make up 2/3 of the APA membership). I would work to ensure representation of practitioners on governance committees, and provide incentives to address their loss in income when serving.

Hollon
How do you plan to educate policy makers, health payers, and the public about the value psychologists bring to many areas such as patient care, pain management, forensics and consultation?

Patient care starts with the generation of multidisciplinary clinical practice guidelines. There is no non-psychotic disorder for which psychotherapy with its enduring effect is not superior to medications and yet we have lost market share over the last quarter century since that advent of the selective serotonin reuptake inhibitors (SSRIs). As recently as the late 1980s two thirds of patients with non-psychotic disorders were treated with psychotherapy as opposed to medications; those proportions have flipped and most non-psychotic patients (the vast majority of patients treated) now get medications only. This is not good for the public, not good for psychology, and it is not even good for psychiatry (most of the prescriptions for SSRIs are written by general practitioners). Clinical practice guidelines make it clear that psychotherapy has long-term enduring effects that medications lack that make them more cost-efficient over time. Where third party payers are guided by clinical practice guidelines the preferences is clearly for psychotherapy over medications. The National Health Service in the United Kingdom has invested £700 million to train psychotherapists to provide those interventions recommended as efficacious by the NICE guidelines. We can do the same in the states. If we generate multidisciplinary clinical practice guidelines in conjunction with psychiatry we can make that clear to third party payers in the states. We also have efficacious psychosocial pain management strategies that unlike the opioids are not addictive. I do not know forensics or consultation but suspect that we are strong in those areas too.

What are your plans to ensure that the mission, priorities, and goals of the APAPO are expanded as the APA transitions into an integrated c3/c6 model?

I will work tirelessly to promote the mission and goals of APAPO within the integrated model. My father spent 40 years in independent practice and I know from the friends he treated that he did it very well. We need to protect psychologists in independent practice and ensure they get fair reimbursement for their services. 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 to follow Institute of Medicine (IOM) recommendations that called for conducting systematic reviews of the best available scientific evidence to present to multidisciplinary panels so that they could generate guidelines that the public can trust. 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 the IOM rules. When we do it will be clear that psychotherapy is more cost-effective than medications and we can use that to press for parity in reimbursement just as they do in the UK. Psychotherapy trumps medications because it endures and we need to tell the public.

Shullman
How do you plan to educate policy makers, health payers, and the public about the value psychologists bring to many areas such as patient care, pain management, forensics and consultation?

We must create and fund a robust practice advocacy strategy/education plan as follows:

  1. Present the public with compelling stories of licensed psychologists clearly demonstrating effectiveness of psychological treatments, as both alternatives and adjuncts to pharmacological approaches. The opioid crisis, pain management, and depression/anxiety present such opportunities.
  2. With an intense campaign, build a sustainably healthy PAC to ensure psychology has a seat at the table for patient services access, especially for marginalized populations, and reimbursement issues. Engage policy makers/health payers to demonstrate value. Use well-crafted data briefs/briefings, highlighting psychological treatment effectiveness across a variety of integrated treatment approaches, where psychologists take the lead in creating or leading value.
  3. Partner with SPTAs who have existing relationships with health payers and policy makers. Include consulting/organizational/forensic psychologists to communicate value to state/regional employer institutions, legislators and policy organizations.
  4. Engage ECPs to develop an energized, internal/external communications social media network, able to respond to different audiences — timely, targeted and integrated — supported by common, accessible data bases/platforms for APA staff, SPTAs and practicing psychologists.
  5. Strategically invest in public education at multiple levels — create substantive, new compelling value cases (e.g., featuring pain management, psychotherapy), starting with psychological science. Connect to fiscal value for funders and palpable effectiveness and value for the public. Create public education/advocacy teams comprised of clinical scientists, practitioners and applied practice experts, developing cases targeted to specific groups/systems.
  6. Continue building/leveraging external coalitions with other healthcare/professional organizations, where providers, payers, employers and client groups promote public education.
What are your ideas to ensure that the mission, priorities, and goals of APAPO are expanded as APA transitions into an integrated c3/c6 model?
  1. SPTAs can serve as the geographic/organizational foundation for expanded advocacy/education efforts. Invest to ensure all SPTAs keep their doors open and build capacity for more leveraged, integrated advocacy efforts — advocacy for psychologists/psychology often occurs at state/regional levels. Prepare for increasing demands likely generated by integrated c3/c6 efforts.
  2. Make sure practitioners are integrally involved in the c3c6 transformation to support all types of advocacy. Create a strategic practice advocacy plan that includes standing integrated APA advocacy/education consulting teams, using practicing psychologists and other APA resource people. Focus on key practice advocacy areas, support for independent practice, other HSPs.
  3. Continue developing non-dues revenue to support advocacy efforts.
  4. Find cost-effective ways to deliver culturally responsive advocacy skills/training to all psychologists/trainees.
  5. Build further support for PLC goals and diversity leadership development initiatives.
  6. Build a common data platform for advocacy with easy access across all APA, SPTA, CESPPA, and Div. 31 advocacy initiatives. A common data platform will reduce response time for all urgent advocacy issues and responses to the public.
  7. Create new ways to strategically target groups for advocacy approaches, perhaps through enhanced social media approaches.
  8. Broaden the definition of practicing psychologists to include current and emerging practice roles at individual, group and systems levels of care and performance (e.g., consulting/organizational, forensic, sport, military). Engage them to increase leverage with employers, health system leaders/teams, policy groups, and populations in specific contexts.
  9. Ensure all voices in the integrated model have a direct line to the president.
Whitbourne
How do you plan to educate policy makers, health payers and the public about the value psychologists bring to many areas such as patient care, pain management, forensics and consultation?

I already have a large online following and will use my social media presence, as well as that of APA’s, to provide updates and information to the public about the value of psychologists in health care settings. My presidential platform already includes a focus on public education, and by communicating to the public about the value of psychology, we will give both the organization and mental health care professionals the necessary attention our field deserves. Additionally, my expertise in geropsychology will be of relevance to the treatment of the older adult population, which is an area of particular concern given the burgeoning health care costs as the number of aging individuals continues to grow. Nursing home care and prescription drugs are among the largest sources of expenditures in the U.S., and both of these areas can benefit from what psychology has to offer. Treating older adults with psychological interventions not only makes sense from an economic standpoint, but will also provide longer-lasting and more beneficial services to those seeking both mental and physical health care.

What are your plans to ensure that the mission, priorities and goals of the APAPO are expanded as APA transitions into an integrated c3/c6 model?

The expansion of APA into the C3/C6 model represents a major shift for the organization, and it is one that has to be handled with great care and sensitivity to all relevant parties. My primary constituency comes from academic psychology, but my long experience in APA governance, as well as my role as a board member in my state association, have given me insight into the concerns that APAPO will have moving forward. I also believe that science and practice are integrally connected, and as a scientist, I will continue to listen to and work with my colleagues in practice and ensure that their concerns are both heard and incorporated into this new organization. My presidential platform includes the position that we must both retain our current members across the discipline as well as attract those who have are not yet members. By working hand-in-hand with practice, I intend to ensure that psychologists continue to identify with APA as their primary professional organization.