Psychotherapy OFFICIAL PUBLICATION OF DIVISION 29 OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION Features In This Issue A Failure Of Survival Chronic Disease and Psychotherapy Part I Reflections On The Practice Directorate’s Data Base Project Exercise And Eating: The Good, The Bad, And The Ugly Male Survivors Of Sexual Assault: Issues Of Socialization And Treatment Managed Care: Time To Fight Or Flee? The Story Hour: Narrative And Multicultural Perspectives On Managed Care and Time-Limited Psychotherapy VOLUME 31 WINTER 1996Division of Psychotherapy OF MEMPSYCHOTHERAPY BULLETIN PSYCHOTHERAPY BULLETIN ee Official Publication of Division 29 of the DIVISION OF ‘American Psychological Assocation PSYCHOTHERAPY ‘American Psychological Association ale Volume 31, Number 1 Winter 1996 3900 East Camelback Road ‘Suite 200 Phoenix, Arizona 85018-2684 CONTENTS (602) 912-5329 President's Message. 4 EDITOR ; 2 ror Editor's Column. Student Column..... fi CONTRIBUTING EDITORS cE Washington Scene.. Finance, Practitioner Report Feature: A Failure Of Survival. ‘Medical Psychology David B. Adams, PhD. PSYColumn Mathilda Canter, Ph.D. i Feature: Chronic Disease and ‘Washington Scene Patrick DeLeon, Ph.D. Psychotherapy Part I. Practitioner Report Feature: Reflections On The Practice Ronald F Levant, Ed.D. Directorate’s Data Base Project sermon 26 ‘Student Column Feature: Exercise and Eating: The Good, The Bad, Stacey Hofiman And The Ugly. as Satea0 Profesional Liability Mid-Winter Progratt ene Leon VandeCreek, Ph.D. pose 2 Commentary. 45 Finance Jack Wiggins, PhD. Feature: Male Survivors Of Sexual Assault Substance Abuse Issues Of Socialization And Treatment. ....47 Harry Wexler, PuD. Feature: Managed Care: Time To Gender Issues Tight Or Flas Gary Brooks, Ph.D. Group Psychotherapy Feature: The Story Hour. Morris Goodman, Ph.D. Gender Issues. Letters To The Editor. Fine anple/sus Wels || Workshops. 73 Production Coordinator ‘Susan ReaPRESID) MESSAGE Change Management And Psychotherapy Patricia $. Hannigan-Farley, Ph.D. It has been said that the only § thing that is constant is change. Particularly for those of us living in the last half of the last decade of the 20th century, the amount and speed of change is unprece- dented. It is, therefore, difficult to tum to history for all the lessons that we néed to learn in order to adapt to the impact of change in our lives. As psy- chotherapists, we also share in the impact of change on our clients and/or student's lives. Afterall, isn’t the management of change at the very heart of the practice of psychotherapy. Our clients bring to us the many forms of distortions that can occur due to the impact of change ~ anxiety and depres- sion, for example. Our role becomes one of helping people match up their capabilities to the challenges that change portends for them, Itis often quite apparent in our work that cer- tain types and amounts of change really rock certain people to their core. For other persons, the same type or amount of change has only minor effects. We see everyday the individual- ized nature of the human response to change From my previous training in gestalt therapy, I am reminded of what Laura Perls said in a workshop, that “change is becoming more or less of what you already are.” This seems apparent as we witness the growth of our clients in managing change. On a collective level, we psychologist-psy- chotherapists also are greatly impacted by the type, amount of speed of change, both in our personal and professional lives. In the profes- sional arena, the past few years have been par- ticularly tumultuous for providers of health care services, It could be said that just as we were coming into our own in the health care delivery system, marketplace change appeared to threaten to displace ‘As we know from our work with clients, the real work of respond- ing to change in our lives, person- ally or professionally, involves going back to basics. These basics are the three R’s of (1) identifying our resources, 2) connecting with our resilience and (3) affirming our resolve. Psychologists, in general, and psychologist-psychotherapists, in particu- lar, are the most resourceful people available in our society. Our education and training puts us in the position to provide insight into so many issues that face humankind today. Likewise, our individual and collective resolve is appar- ent in the many ways that we respond to our changing environment. The concern I hear voiced at times is our own belief in our capabil- ity to recover or our capacity for resilience. A major attribute of resilient people is focus. This, ‘may be part of our difficulty in recognizing our own resilience, the lack of focus. It is my hope that our professional association, APA, and our Division, in particular, can help all its members ‘maintain their focus and work together to pros per in these changing times. Tlook forward to working with our Division’s officers, Board of Directors and members dur- ing this year and may we live in interesting times together 4The Ratcheting Down Of Psychological Testing Linda Campbell Psychologists in several states including Louisiana and Georgia seemingly have been chosen as testing grounds for yet another “scope of practice struggle.” Iam writing about it here because there is a sense that the same strategy is going to be applied in other states. This issue takes the form of interest by mental health professionals other than psychologists in practicing psychological testing. Specifically in my state, licensed professional counselors have requested licensure rules to allow psychologi- cal testing including for those with a masters degree only. The issue is being contested by psychologists primarily on the basis of the fact that there are no curriculum requirements for testing courses and no supervised experience in test administration required. This fact in itselfis, compelling. Thave a very different take on this issue, appar- ently, than many of my colleagues who are quite concemed and involved in opposing this movement. It seems to me that psychological testing is not just coursework to be taken, but is. an integral part of the essence of psychology. Among mental health professions, only psy- chology and psychiatry have defined the core of their professional practice as assessing, diag- nosing, and treating mental disorders Assessing an individual for the purpose of diagnosing a personality disorder, a leaning disability, attention deficit, a neurological prob- lem, competency to stand trial, ot a psychotic disorder is a decision that can dramatically alter the course of an individual's life, in some cases forever. This is a responsibility that psycholo- gists take very seriously. It is a professional commitment that means five to seven years of doctoral level work inclusive of a masters degree, doctoral level coursework of three years, a full time one year intemship, and a full time postdoctoral training year Let’s say, hypothetically, that counseling licen- sure boards required five, six, or seven courses in testing, Psychological testing is done for the purpose of making a decision about a particu- Jar mental status of an individual. Taking test- ing courses does not meet the competency requirements for making these decisions. The reason the training programs in psychology are five to seven years long is that all coursework contributes to the competency of psychologists in assessing, diagnosing, and treating mental disorders. These areas of study include abnor mal psychology, personality theory, diagnostic classification, research, social psychology, eaming theory, physiological psychology, and supervision of test administration and interpre- tation to name only the core. In order to com- petently assess an individual through psycho- logical testing, one would need the comprehen sive training described above. The most widely recognized introduction to counseling texts define the practice of counsel- ing as (a)". uunique because itis the only mental health service that defines itself as focusing on the developmental problems of normal peo- ple..” (Nugent, 1987, p.3); (b) trained to seek and promote the healthy growth and develop- ment of their clients ...while psychotherapists are trained to understand and treat pathology, dysfunctional behavior, or mental illness of clients and their families (Hershenson & Power, 1987); (c) ..conducted with persons who are considered to function within the “normal range,”..who have adjustment, developmen- tal, or situational concems. They are not con- sidered “sick” but “stuck” (Gladding, 1996); 5