Psychotherapy B

BULLETIN

PsychotherapyOFFICIAL PUBLICATION OF DIVISION 29 OF THE

AMERICAN PSYCHOLOGICAL ASSOCIATION

www.divisionofpsychotherapy.org

2011 VOLUME 46 NO. 4

E

In This Issue

Psychotherapy IntegrationInternet-Delivered Psychological Treatments and

Psychotherapy Integration

Education and TrainingEducation and Training: The Internship Imbalance and

Impact in Professional Psychology

Psychotherapy PracticeMusings from the Psychotherapy Office:Money, Psychotherapy, and the Pursuit of

a Life Well Lived

Early CareerJourney Through the Personal vs. the Professional

Public Policy and Social JusticeSexual Assault on Women in the Military:A Need for Prevention, Treatment, and Justice

Ethics in PsychotherapyAttaining Professional and MulticulturalCompetence in Extremis Environments

PPrreessiiddeennttElizabeth Nutt Williams, Ph.D.St. Mary’s College of Maryland18952 E. Fisher Rd.St. Mary’s City, MD 20686Ofc: 240- 895-4467 / Fax: 240-895-2234E-mail: [email protected]

PPrreessiiddeenntt--eelleeccttMarvin Goldfried, Ph.D.Psychology SUNY Stony Brook Stony Brook, NY 11794-2500 Ofc: (631) 632-7823 / Fax: (212) 988-4495 E-mail: [email protected]

SSeeccrreettaarryy Jeffrey Younggren, Ph.D., 2009-2011827 Deep Valley Dr Ste 309 Rolling Hills Estates, CA 90274-3655Ofc: 310-377-4264 / Fax: 310-541-6370E-mail: [email protected]

TTrreeaassuurreerrSteve Sobelman, Ph.D., 2010-20122901 Boston Street, #410Baltimore, MD 21224-4889Ofc: 410-583-1221 / Fax: 410-675-3451Cell: 410-591-5215 E-mail : [email protected]

PPaasstt PPrreessiiddeennttJeffrey J. Magnavita, Ph.D., ABPPGlastonbury Psychological Associates PC 300 Hebron Ave., Ste. 215 Glastonbury, CT 06033 Ofc: 860-659-1202 / Fax: 860-657-1535E-mail: [email protected]

DDoommaaiinn RReepprreesseennttaattiivveessPublic Interest and Social JusticeRosemary Adam-Terem, Ph.D. 2009-20111833 Kalakaua Avenue, Suite 800Honolulu, HI 96815Ofc: 808-955-7372 / Fax: 808-981-9282Cell: 808-292-4793E-mail: [email protected]

Professional PracticeMiguel Gallardo, Psy.D., 2010-2012Pepperdine University 18111 Von Karman Ave Ste 209 Irvine, CA 92612Ofc: (949) 223-2500 / Fax: (949) 223-2575E-mail: [email protected]

Education and TrainingSarah Knox Ph.D., 2010-2012Department of Counselor Education and

Counseling PsychologyMarquette UniversityMilwaukee, WI 53201-1881Ofc: 414/288-5942 / Fax: 414/288-6100E-mail: [email protected]

MembershipAnnie Judge, Ph.D. 2010-20122440 M St., NW, Suite 411Washington, DC 20037Ofc: 202-905-7721 / Fax: 202-887-8999E-mail: [email protected]

Early CareerSusan S. Woodhouse, Ph.D. 2011-2013Department of Counselor Education, Counseling Psychology and Rehabilitation Services

Pennsylvania State University313 CEDAR BuildingUniversity Park, PA 16802-3110Ofc: 814-863-5726 / Fax: 814-863-7750E-mail: [email protected]

Science and ScholarshipNorm Abeles, Ph.D., ABPP, 2011-2013Dept of Psychology, Michigan State University 110C Psych Bldg East Lansing , MI 48824Ofc: 517-337-0853 / Fax: 517-333-0542E-mail: [email protected]

DiversityCaryn Rodgers, Ph.D. 2011-2013Prevention Intervention Research CenterAlbert Einstein College of Medicine1300 Morris Park Ave., VE 6B19Bronx, NY 10461Ofc: 718-862-1727 / Fax: 718-862-1753E-mail: [email protected]

DiversityErica Lee, Ph.D., 2010-201280 Jesse Hill Jr.Atlanta, Georgia 30303Ofc: 404-616-1876 E-mail: [email protected]

AAPPAA CCoouunncciill RReepprreesseennttaattiivveessJohn Norcross, Ph.D., 2011-2013Dept of Psychology, Univ of Scranton Scranton , PA 18510-4596 Ofc: (570) 941-7638 / Fax: (570) 941-7899E-mail: [email protected]

Linda Campbell, Ph.D., 2011-2013Dept of Counseling & Human DevelopmentUniversity of Georgia 402 Aderhold Hall Athens, GA 30602Ofc: 706-542-8508 / Fax: 770-594-9441E-mail: [email protected]

SSttuuddeenntt DDeevveellooppmmeenntt CChhaaiirrDoug Wilson, 2011-2012419 N. Larchmont Blvd. #69Los Angeles, CA 90004Phone: 323-938-9828E-mail: [email protected]

CCoonnttiinnuuiinngg EEdduuccaattiioonnChair: Rodney Goodyear, Ph.D.1100BWPH Rossier School of EducationUniveristy of Southern CaliforniaLos Angeles CA 90089-0001Ofc: 213-740-3267E-mail: [email protected]

EEaarrllyy CCaarreeeerr PPssyycchhoollooggiissttssChair: Rachel Galliard Smook, Ph.D.47 Prospect St.West Boylston, MA 01583Ofc: 5089250530E-mail: [email protected]

EEdduuccaattiioonn && TTrraaiinniinnggChair: Jairo N. Fuertes, Ph.D., ABPPAssociate ProfessorDerner Institute of Advanced Psychological StudiesAdelphi UniversityHy Weinberg Center - Rm 319158 Cambridge AvenueGarden City, NY 11530tel [email protected]

FFeelllloowwssChair: Clara Hill, Ph.D.Dept of Psychology University of Maryland College Park , MD 20742 Ofc: (301) 405-5791 / Fax: (301) 314-9566E-mail: [email protected]

FFiinnaanncceeChair: Jeffrey Zimmerman, Ph.D., ABPP391 Highland Ave.Cheshire, CT 06410Phone: 203-271-1990333 Westchester Ave., Suite E-102White Plains, NY 10604Ofc: 914-595-4040E-mail: [email protected]

MMeemmbbeerrsshhiippChair: Jean Birbilis, Ph.D.University of St. Thomas1000 LaSalle Ave., MOH 217Minneapolis, Minnesota 55403Ofc: 651-962-4654 / Fax: 651-962-4651E-mail: [email protected]

NNoommiinnaattiioonnss aanndd EElleeccttiioonnssChair: Marvin Goldfried, Ph.D.

PPrrooffeessssiioonnaall AAwwaarrddssChair: Jeffrey Magnavita, Ph.D.

PPrrooggrraammChair: Shane Davis, Ph.D. Office on Smoking and Health Centers for Disease Control and Prevention 4770 Buford Highway, MS K-50 Atlanta, GA 30341Ofc: 770-488-5726 / Fax: 770-488-5848E-mail: [email protected]

PPssyycchhootthheerraappyy PPrraaccttiicceeChair: Barbara Thompson, Ph.D.3355 St. Johns Lane, Suite F.Ellicott City, MD 21042Ofc: 443 629-3761E-mail: [email protected]

PPssyycchhootthheerraappyy RReesseeaarrcchhChair: James Fauth, Ph.D.40 Avon St.Keene, NH 03431Ofc: 603-283-2181E-mail: [email protected]

LLiiaaiissoonnssCommittee on Women in PsychologyRosemary Adam-Terem, Ph.D.1833 Kalakaua Avenue, Suite 800Honolulu, HI 96815Tel: 808-955-7372 / Fax: 808-981-9282E-mail: [email protected]

Federal Advocacy CoordinatorBonita Cade, Ph.D.63 Ash St New Bedford, MA 02740 Ofc: (508) 990-1077 / Fax : (508) 990-1077E-mail: [email protected]

Division of Psychotherapy �� 2011 Governance StructureELECTED BOARD MEMBERS

STANDING COMMITTEES

PSYCHOTHERAPY BULLETIN

Published by theDIVISION OF PSYCHOTHERAPYAmerican Psychological Association

6557 E. RiverdaleMesa, AZ 85215602-363-9211

e-mail: [email protected]

EDITORLavita Nadkarni, [email protected]

ASSOCIATE EDITORLynett Henderson Metzger, Psy.D.

[email protected]

CONTRIBUTING EDITORSDiversity

Erica Lee, Ph.D. and Caryn Rodgers, Ph.D.Education and TrainingSarah Knox, Ph.D. andJairo Fuertes, Ph.D.

Ethics in PsychotherapyJennifer A.E. Cornish, Ph.D.Psychotherapy Practice

Miguel Gallardo, Psy.D. and Barbara Thompson, Ph.D.Psychotherapy Research, Science, and ScholarshipNorman Abeles, Ph.D. and

James Fauth, Ph.D.Perspectives on

Psychotherapy IntegrationGeorge Stricker, Ph.D.

Public Policy and Social JusticeRosemary Adam-Terem, Ph.D.

Washington ScenePatrick DeLeon, Ph.D.

Early Career Susan Woodhouse, Ph.D. andRachel Gaillard Smook, Psy.D.

Student FeaturesDoug C. Wilson, M.A.Editorial Assistant

Jessica del Rosario, M.A.

STAFFCentral Office Administrator

Tracey Martin

Websitewww.divisionofpsychotherapy.org

PSYCHOTHERAPY BULLETINOfficial Publication of Division 29 of the American Psychological Association

2011 Volume 46, Number 4

CONTENTSPresident’s Column ......................................................2

Editors’ Column ............................................................5

Psychotherapy Integration ..........................................6Internet-Delivered Psychological Treatments and Psychotherapy Integration

Education and Training ..............................................13Education and Training: The Internship Imbalance and Impact in Professional Psychology

Psychotherapy Practice ..............................................23Musings from the Psychotherapy Office: Money, Psychotherapy, and the Pursuit of a Life Well Lived

Early Career ..................................................................27Journey Through the Personal vs. the Professional

Nomination Ballot ......................................................33

Division 29 Bylaws Changes......................................35

Public Policy and Social Justice ................................37Sexual Assault on Women in the Military: A Need for Prevention, Treatment, and Justice

Ethics in Psychotherapy – Student Feature ............41Attaining Professional and Multicultural Competence in Extremis Environments

Feature ..........................................................................45Grief Therapy Assessment of Traumatic Origin as Both Problem and Solution: A Mystery Tears Vignette

Council of Representatives Report............................47

2011 Norine Johnson PsychotherapyResearch Grant Recipient ..........................................50

2011 Charles J. Gelso PsychotherapyResearch Grant Recipient ..........................................54

Patricia Bricklin Tribute ..............................................50

References ....................................................................64

Membership Application............................................71

1

PRESIDENT’S COLUMN

Elizabeth Nutt Williams, Ph.D.St. Mary’s College of Maryland

In my final columnof my presidentialyear, I’d like to updateyou on the status ofmy three initiatives,give an overview ofthe many accomplish-ments of the Division,

and reflect on my experiences in D29leadership with an eye to the future.

My first and primary presidential initia-tive was to ask the divisional gover-nance to engage in strategic planning.While the initial response was not uni-versally enthusiastic, I feel that both theprocess and the outcome of the efforthave been outstanding. As I noted in mylast column, we had two groups withinthe Board of Directors working on sepa-rate SWOT analyses (i.e., divisionalStrengths, Weaknesses, Opportunitiesand Threats). I found it interesting thatboth groups (the Domain Representa-tives plus Student Representative andthe Executive Committee plus CouncilRepresentatives) came up with verysimilar frameworks, making the nextstep in the analysis quite straightfor-ward. I fused the two SWOT analysesinto one set of draft principles for theBoard to discuss at its fall meeting. Wehad a workshop the day before theBoard meeting in October to review andrevise the principles. We then voted onthe final seven Guiding Principles at theBoard meeting the following day.

The Board of Directors approved the fol-lowing seven Guiding Principles for theDivision:• Support our flagship publication, thejournal Psychotherapy

• Dedicate time and resources to make

clear our mission and communicate itbroadly (e.g., via web, social media)

• Provide opportunities for studentsand early career psychologists to con-nect with the Division and furthertheir professional development (e.g.,via grants, awards, committees, men-toring)

• Offer training and continuing educa-tion to psychologists/psychotherapists

• Inform the public and broader profes-sion (e.g., health policy makers,health care providers) about psy-chotherapy, such as the evidence ofpsychotherapy effectiveness

• Promote diversity within our mem-bership, governance, and psychother-apy research and practice

• Generate, share and disseminate psy-chotherapy research and scholarship

We agreed that these seven principlesshould inform future decisions of the Division and should be reviewed everythree years for revision, updating, andchanges in divisional priorities overtime. It is my hope that these seven prin-ciples help us focus our efforts and com-municate more clearly with ourmembers and with the public at large.

My second presidential initiative was tocreate a theme for the Convention—Psy-chotherapy’s Role in Fostering Resilience. Iwas very pleased with the resulting pro-gram and our divisional attention to is-sues of resilience, diversity and socialjustice. Three excellent examples of ourenduring commitment to these issueswere highlighted in the October Boardof Directors meeting. First, the Board ofDirectors approved a Diversity Scholar-ship for graduate students in the

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amount of $2,000, proposed by DomainRepresentatives Erica Lee and CarynRodgers, to support students who areconducting dissertations on issues re-lated to diversity. Keep an eye out thisspring for the call for nominations forthis new scholarship. Second, we ap-pointed Rosie Adam-Terem (outgoingDomain Representative for Public Policy) as the Chair of the Committee for Social Justice. Rosie will work with incoming Domain Representative Armand Cerbone to appoint membersto the committee and develop initiativesin the coming year. Finally, we voted tosponsor the Division 52 Psychotherapywith Men conference in June 2012 andhope to send a divisional representativeto the meeting.

My third initiative, reviewing ourarchival system, has been launched.With the help of our Central Office Ad-ministrator Tracey Martin, our StudentRepresentative Doug Wilson, and ourincoming President-Elect Bill Stiles, ourPublication Board Chair, Jeff Barnett,and our Internet editor, Ian Goncher,we will be gathering historical dataspanning the last 20 years and making a recommendation for its storage andavailability via the website. This projectwill dovetail nicely with the 50th anniversary issue Mark Hilsenroth isplanning for our journal Psycho -therapy. Specifically for that issue of theJournal, I am very excited to work withMatty Canter on an update of her 1992history of the Division.

Above and beyond my particular presi-dential initiatives, I am pleased to seehow productive the Division has been,particularly in working with other divi-sions (e.g., the Multicultural Tool Kitproject with Division 42), providingcommentary on APA initiatives (e.g.,work related to telepsychology and telespsychotherapy), and proposing aresolution to APA Council that acknowl-

edges the effectiveness of psychother-apy (with particular thanks to LindaCampbell, Nadine Kaslow, John Norcross and Melba Vasquez). We havealso moved forward with technology byallowing online voting (see page 35 ofthe Bulletin for information about thechanges to our bylaws and the requestfor a vote of the membership) and bymaking greater use of social media (suchas Facebook and Twitter). We haveworked hard to be good stewards of our financial resources by updating our grant processes and procedures and making changes suggested by theFinance Committee vis-a-vis budget requests. And we have tried in all waysto be connected with our membership...such as through the awards we distrib-ute, the grant research we support, webupdates and Psychotherapy E-News,our Bulletin articles, our premier journalPsychotherapy, and our robust Conven-tion program. I am so grateful to haveworked with such energetic individualson the Board of Directors, our Editorialteam, and our Committees. I particu-larly want to thank our outgoing Boardmembers (Rosie Adam-Terem, JeffreyMagnavita, and Jeff Younggren) fortheir service and dedication to the Divi-sion and our committee chairs (Jean Bir-bilis, Shane Davis, Jim Fauth, JairoFuertes, Rod Goodyear, Clara Hill,Rachel Smook, Barbara Thompson,and Jeff Zimmerman) for their tenacityand responsiveness throughout the year.I would like to welcome Armand Cer-bone (incoming Domain Representativefor Public Policy), Barry Farber (incom-ing Secretary), and Bill Stiles (incomingPresident-Elect) who will join the Boardof Directors in 2012. Finally, I would liketo wish incoming President Marv Gold-fried all the best in his presidential year.

As I have been reflecting on all the ac-complishments of the Division this year,

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I am delighted that we have been so in-volved in fostering change and develop-ment. Our ability to accomplish so muchhas everything to do with the people onthe Board and on the Committees. Yet Ihad hoped to hear from more of you inthe membership and to see more peoplebecome involved in this vibrant commu-nity. As I did not see my hoped-for surgein widespread participation within themembership, I would like to share twoconcerns with you from my vantagepoint as president. First, I worry that,even with a relatively large member-ship, we have not seen much direct participation of members who are notalready on the Board or on Committees.For example, why was the attendance atour divisional Hospitality Suite at Con-vention so low? Why is there so littleinput or feedback from non-governancegroup members of the Division? As Ileave office, I urge you once more tolook for ways to be connectedwith the Di-vision. We are doing great things andwould love to have more participation.

Second, I find myself troubled by theways in which we continue to strugglewith issues of diversity. I am pleased tosee some new momentum in this area(such as with our new Diversity Schol-arship), but I have noticed that some

voices are still not being heard. I wouldlike to see more diversity represented atthe table... in terms of race/ethnicity,gender, sexual orientation, age, abilitystatus, etc. We are a division that has abroad constituency—clinical and coun-seling psychologists, practitioners andresearchers, seasoned professionals andearly career professionals—our gover-nance should (and does) reflect thoseconstituencies but we also need to mir-ror the salient personal diversity of ourmembership. That is where I think wecould do much more. As you read thisarticle, please think about how youcould get involved. Could you run foran elected office? Offer to serve on acommittee? Write a piece for the Bulletinor the website? Suggest an initiative thathelps us honor diverse people and view-points? Please think about it. Thenplease take action.

So, I conclude my final presidential col-umn with thankfulness for the work ofthe governance team, joy over our manyaccomplishments this year, and hopethat we will continue to find ways tocommunicate broadly, support ourmembers, and promote diversity in allthat we do. It has been an honor to serveyou this year.

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NOTICE TO READERS

References for articles appearing in this issue can be foundin the on-line version of Psychotherapy Bulletin published

on the Division 29 website.

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Welcome to the lastissue of the Psychother-apy Bulletin for 2011.We have thoroughlyenjoyed our first yearas Editor and Associ-ate Editor, and haveappreciated the sup-port from Jeffrey Bar-nett, the PublicationsBoard Chair, LibbyNutt Williams, Divi-sion 29 President,Tracey Martin, Central

Office Administrator, and the Contribut-ing Editors, authors, and Domain repre-sentatives who have graciouslysubmitted articles in a timely manner.

We are again pleased to present youwith papers we hope you will find informative, current and helpful. Thepieces from Psychotherapy Practice andEarly Career will definitely have you re-flecting on your own career and takingstock of where you are at present. Bothemphasize the importance of self-care.To illustrate the international reach ofthis division, you will also find in thisissue a thoughtful article on psychother-apy integration and internet-deliveredtreatments from our colleagues at theUniversity of Bern. For all of us engagedin education and training, there is an im-portant piece on the internship imbal-ance and recommendations for us aseducators and professionals in the com-munity. We are pleased to be able to con-tribute to the important dialogue onsexual assault in the military, with an

article providing some useful resources.Continuing with the theme of trauma is an informative article on the use of assessment in grief therapy when theorigin of the grief may be trauma-related. It is with great pleasure that weare able to provide you with an interest-ing article on multicultural competencyfrom one of our graduate students. Inaddition, you will learn what happenedat Council, and become familiar with theaward winning proposals for the NorineJohnson Psychotherapy Research Grantand the Charles J. Gelso PsychotherapyResearch Grant.

In this issue you will find President Elizabeth Nutt Williams’ final column,with a helpful overview of Division 29’srecent initiatives and accomplishments.Please express your gratitude to her forher outstanding tenure.

Finally, we offer a tribute to PatriciaBricklin, Ph.D., on the one year anniver-sary of her passing.

As usual, please contact us with yourideas, suggestions, criticisms, and com-ments.

Wishing everyone a healthy and happyholiday season, and a wonderful newyear in 2012.

Lavita Nadkarni (303-871-3877, [email protected]) and Lynett Henderson Metzger (303-871-4684, [email protected]).

Lavita Nadkarni, Ph.D.Lynett Henderson Metzger, Psy.D., J.D.University of Denver – Graduate School of Professional Psychology

EDITORS’ COLUMN

Recent years have seenthe emergence of Inter-net-delivered psycho-logical treatments. Thisnew treatment formatmay also mean newquestions and oppor-tunities for psycho -therapy integration. In this article, we first briefly summarizesome of the key char-acteristics and findingsregarding Internet-

based treatments. In the second part, wediscuss Internet treatments from the per-spective of psychotherapy integration.

Why should we consider Internet-delivered treatments as a treatmentoption?Recent global surveys of the WorldHealth Organization report lifetimeprevalence rates of DSM-IV mental dis-orders of up to 47.4% (Kessler et al., 2009).The same data show that only a smallproportion of individuals suffering fromeven seriously impairing mental disor-ders receive treatment (Wang et al.,2007). How can this situation bechanged and how can the prevalence,incidence, and burden of mental disor-ders be reduced? Recently, Kazdin andBlasé (2011) have criticized the heavy re-liance of psychotherapy research andpractice on individual one-to-one psy-chotherapy. They argue that individualpsychotherapy is not likely to be able tomeet the enormous need for psycholog-ical services and that because there aremany different reasons why people donot receive professional help (e.g., lim-ited number of practitioners, limited ac-

cess to practitioners, time or economiclimitations, fear of stigma, ethnic andcultural barriers), only a large portfolioof models of interventions can reduceprevalence and incidence of mental disorders. Naturally, such a portfolioshould include individual psychother-apy, which not only provides individualswith effective therapeutic procedures,but also informs other models of deliveryregarding therapeutic techniques andscientific principles of change. However,because we will never be able to trainand pay enough therapists to provideindividual help for all those who needit, we also need interventions that canreach a greater number of people.

In the same vein as Kazdin and Blasé(2011), Muñoz (2010) has pointed outthat we will never be able to provide ad-equate health care for all those who needit if we continue our reliance on what he called “consumable interventions.”These are interventions that, once used,cannot be used again without investingthe same amount of resources for treat-ing new cases. For instance, in individ-ual psychotherapy, the time spenttreating a patient cannot be used everagain to treat another patient. In orderto effectively reduce disparities in accessto health services, we need interventionsthat can be shared widely and that canbe used repeatedly at low cost. Similarly,a work group commissioned by the USNational Institute of Mental Health hasrecommended the development of inno-vative treatments that can be deliveredat low cost to large populations (Hollonet al., 2002). This workgroup, Muñoz(2010) (who was a member), Kazdin and

PSYCHOTHERAPY INTEGRATIONInternet-Delivered Psychological Treatments and Psychotherapy IntegrationFranz Caspar, Ph.D. and Thomas Berger, Ph.D.,University of Bern

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Blasé (2011) and others explicitly iden-tify the use of the Internet to deliver psy-chological interventions as a promisingtreatment option. The Internet is suitedto making psychosocial interventionsavailable to a large number and varioustypes of people, and many forms of In-ternet-based interventions can reliablybe delivered again and again at low cost.

What are and what do we know aboutInternet-delivered treatments?Different types of Internet-deliveredtreatments can be distinguished accord-ing to the amount and proportion ofself-help material presented on the Weband the level of therapist support andguidance provided during treatment(Berger & Andersson, 2009). There are(a) Web-based unguided self-help programs, which do not require anyinput from a clinician (b) Internet-basedguided self-help approaches, in whichthe presentation of a Web-based self-help program is combined with minimalbut regular therapist contact via e-mail,and (c) Internet-based therapies such ase-mail or chat therapies, in which the In-ternet is only used to communicate. Ev-idence suggests that Internet-deliveredtreatments in which therapists are in-volved (i.e., guided self-help and e-mailor chat-therapy) can lead to significantand enduring improvements in a varietyof mental disorders (Andersson, 2009;Barak, Hen, Boniel-Nissim, & Shapira,2008; Spek et al., 2007). For instance, inthe field of Internet-based guided self-help for anxiety and mood disorders, in-dependent replications have shownlarge effect sizes in comparison withwaiting list or placebo control condi-tions. Moreover, several studies havefound no differences between guided In-ternet-based treatments and face-to-facetherapy (Carlbring et al., 2005; Kiropou-los et al., 2008; Hedman et al., 2011). Al-though the literature on pure e-mail orchat-therapy (as opposed to guided In-ternet-based self-help) is limited, exist-

ing studies suggest that individualizede-mail or chat-therapies are also prom-ising and about equally effective asguided self-help interventions (Kessleret al., 2009; Vernmark et al., 2010). Thus,a growing body of evidence showspromising results for Internet-basedtreatments that involve at least minimaltherapist support. In contrast, Web-based interventions without therapistsupport (unguided self-help programs)seem to result in more modest outcomesand considerably higher dropout rates(Spek et al., 2007; Andersson & Cuijpers,2009). In their meta-analysis, Spek et al.(2007) reported low effect sizes for pro-grams without support. However, somestudies suggest that unguided self-helptreatments are more efficacious and as-sociated with less dropouts when somehuman contact is provided at the begin-ning and at the end of a treatment (e.g.for a diagnostic interview; Berger et al.,2011; Nordin, Carlbring, Cuijpers, & An-dersson, 2010). Thus, when low-cost al-ternatives are needed or no therapistsare available, the dissemination of Web-based unguided treatments could alsobe considered as a treatment option, es-pecially when self-help programs in-clude some human contact.

Internet-delivered treatments andpsychotherapy integrationIn almost all studies of this new treat-ment form, the Internet has been used toprovide cognitive behavior therapy(CBT). That is, the self-help material pre-sented on the Web is based on cognitivebehavioral manuals or self-help booksand/or the therapists involved in thetreatment explicitly follow a cognitivebehavioral approach. There are some ex-ceptions, such as two recent trials on In-ternet-based psychodynamic therapies(Andersson et al., submitted; Johanssonet al., submitted), and some treatmentsthat are integrative or that can be discussed from the perspective of

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psychotherapy integration (see below).Why this dominance of CBT treatments?There are several plausible reasons: • In general, there are more disorder-specific treatments in CBT than inother orientations, and it makes sensethat, similar to somatic medical prob-lems, patients would seek Internet ad-vice and treatment by disorder.

• Declarative knowledge is the mosteasy to convey via Internet, so ap-proaches with a heavy emphasis inpsychoeducation-like many CBT ap-proaches-can contribute most easilyto Internet treatments.

• Forms of therapy in which theprocess in the session with the thera-pist does NOT play a dominant roleare most amenable to the Internet for-mat of treatment.

Internet treatment does not mean sim-ply sitting at the computer, but involvesconcrete exercises, common in CBT, andwhich can be guided via the computer.These and probably additional pointsmake the existing dominance of CBT inInternet treatment plausible, but do inno way suggest that Internet therapyshould be left to CBT therapists. Why is Internet therapy interesting for psychotherapy integration?

Internet-delivered eclectic treatmentsWhen a new form of treatment isintroduced, this can and should be seenas an invitation and an opportunity toraise the question, in a radical andunprejudiced way, of which conceptsand interventions could be useful. An example of an Internet-deliveredintegrative approach corresponding to such an open stance is an onlinetreatment for depression (Deprexis),which has successfully been evaluatedusing both an unguided and a guidedversion (Meyer et al., 2009; Berger,Hämmerli, Gubser, Andersson, & Caspar,in press). Deprexis consists of 10 self-help modules representing interventionsfrom different psychotherapeutic

approaches, such as behavioral activ -ation, mindfulness and acceptance,interventions based on interpersonalpsychotherapy, emotion-focused inter -ventions, and work with dreams. Fromthe perspective of psychotherapy inte -gration, this treatment is eclectic.However, the Internet-based approachdiffers from eclectic psychotherapies inthat it is not the therapist, but the clientwho eclectically selects interventionsaccording to his or her preferences.More specifically, the self-guidedcharacter of Internet-based treatmentsenhances the client’s ownership of thetherapeutic process, and it leaves the de-cision of the time spent on a particularmodule or intervention to the client.This is a possible advantage of Internet-based treatments, and it may also opennew routes to practice and research onpsychotherapy integration. For instance,it would be interesting to explore howmuch time clients spend on a particularpsychotherapeutic approach in relationto clients’ characteristics. Another ques-tion would be whether it is more benefi-cial for clients if therapists prescribeparticular modules, for example, accord-ing to models of aptitude by treatmentinteraction (e.g., Beutler & Clarkin,1990). In another context, first results onInternet-based interventions that tailorthe treatment to the patient’s profile ofcomorbid disorders and symptoms inassociation with anxiety and mood dis-orders showed promising results, bothwhen a therapist prescribed specific self-help modules and when the patient decided which modules to endorse(Carlbring et al., 2011; Andersson et al.,2011). From a practical point of view,matching treatment to client character-istics or preferences could more easily beimplemented in Internet-delivered ap-proaches than in face-to-face approachesbecause the various interventions can bedeveloped by an expert in a particular

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approach and then be used again andagain, which opens particular opportu-nities for psychotherapy integration.Such an integration does not require theextensive training of therapists in vari-ous approaches, for which there will al-ways be limitations.

Internet-based treatments and integra-tive models of therapeutic changeOther examples of Internet-delivered in-tegrative approaches are computer-tai-lored programs in which theintervention is individualized based onintegrative models of therapeuticchange, such as the transtheoretical ap-proach (Prochazka & DiClemente, 1992).For instance, there are online smokingcessation programs that assess the indi-vidual’s stage within the stages ofchange model at baseline and then auto-matically deliver predefined text mes-sages based on each individual’s stage(Etter, 2005). Indeed, Web-based tailoredsmoking cessation interventions seem tobe more effective compared with untai-lored interventions (Shahab & McEwen,2009). Thus, the integrative transtheoret-ical approach has also received empiri-cal support when administered over theInternet.

From the perspective of Internet-basedtreatments, tailoring interventions to anindividual’s stage could also involveproviding some interventions in a self-help format and others in the form of in-dividualized e-mail therapy. Forexample, in early stages of change, anindividualized e-mail format may bemore adequate and promising, whereasCBT-based self-help material providedon the Web may be sufficient during theaction stage. From the perspective oftherapeutic factors (Grawe, 2004), it isinteresting that some guided self-helptreatments provide confrontation (e.g.exposure to traumatic situations by ther-apeutic writing or in vivo) in the self-help part, while the resource activating

part, which is supposed to support theconfrontational part, is provided by atherapist via email. Questions such aswhat kinds of therapeutic processes andinterventions could be delegated to theself-help part, and what kinds ofprocesses and interventions need a ther-apist should be addressed in the future.

Internet-delivered treatments andcommon factors model of psychotherapyStill another avenue of research on Inter-net-based treatments can be related tothe common factors model of psy-chotherapy. Frequently, and mainly be-cause the contact between clients andtherapists is often minimized and re-stricted to purely text-based communi-cation, questions regarding Internet-based treatments are related to the ther-apeutic alliance. It may be amazing tothose who—taking traditional face-to-face therapy as a frame of reference—can hardly imagine that in an Internettherapy a therapeutic relationship coulddevelop and be measured: According topatients’ self ratings as measured by theWorking Alliance Inventory, Internet-based treatments tend to generate agood therapeutic alliance (Cook &Doyle, 2002; Knaevelsrud & Maercker,2006; 2007). Moreover, Knaevelsrud andMaercker (2007) found substantial cor-relations between the working alliancemeasured later in the treatment processand treatment outcome. Such findingschallenge common assumptions aboutwhat is needed to establish a therapeuticrelationship, such as real-time interac-tion in a shared physical space, and theyindicate that the alliance may not onlybe a common factor across different ap-proaches of face-to-face therapies, butalso across various forms of delivery, in-cluding Internet-delivered treatments.The minimal contact in Internet therapyseems to suffice for the development ofsome kind of relationship. It is yet unex-

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plored to what extent this is based on a(possibly idealized) imagining of thetherapist. In general, when comparingan Internet-based therapeutic relation-ship to a “real” one, it should not be for-gotten that many face-to-face therapiesare unfortunately NOT characterized bya good relationship. The additional op-portunities a therapist has to facilitate a good therapeutic alliance in a face-to-face setting may be outweighed bymistakes a therapist does not make inInternet therapy. Such quantitative considerations would, of course, have tobe complemented by qualitative consid-erations.

Internet therapy and various approaches of psychotherapyWhile it has been argued that CBT ap-proaches lend themselves most easily toInternet therapy, this in no way meansthat elements from other orientationscould and should not be included, verymuch in the sense of assimilative inte-gration (Messer, 2001), or that they can-not even be the core and point ofdeparture. For example, an interper-sonal approach could be the basis of anInternet approach that may includeanalyses of the interpersonal situation aswell as an instruction for exercisesaimed at improving interpersonal skillsas well as creating corrective experi-ences. If it is true that every approach,including CBT, has deficits that can becompensated for by utilizing elementsfrom other approaches, there is no rea-son why this should not apply to Inter-net therapy. The “Deprexis” programmentioned above is a good example ofhow several approaches can be inte-grated and how the program itself sup-ports the selection of what is used for aparticular patient. Internet therapy thusopens new possibilities for psychother-apy integration, and it would be a pityif this approach were left to CBT thera-pists alone.

Stepped care and its implications forpsychotherapy integrationAn important stance in the use of Inter-net therapy is that it should not replacetraditional therapy, but rather give ac-cess to psychotherapy to individuals inneed of treatment who would otherwisenot have access to or be willing to usetraditional psychotherapy. One idea is tooffer a start with unguided or guidedself-help, which may be Internet based,and then move on to face-to-face ther-apy if self-help does not show satisfac-tory effects. A factor in facilitating such astepped care approach would be thepossibility of detecting early in Internettreatment when a patient has a smallprobability of profiting from Internettherapy. Some studies show preciselysuch possibilities (Berger et al., 2011).

The question is then, what therapyshould be offered as a second step? Asstated above, current Internet programsheavily exploit CBT concepts and tech-niques. To the extent to which one as-sumes that the possibilities of CBT havebeen fully exhausted in a case, it makessense to switch to other approaches inthe case of failure, assuming that moreof the same would not be the firstchoice. Although, like in face-to-facetherapy, it cannot be excluded that avariation within an approach (such asCBT) could lead to a success, one mightprefer to switch to an approach which is,for example, more process-oriented,such as Emotion-Focused Therapy (EFT;Greenberg, Rice, & Elliott, 1993). In aworld of psychotherapy that is increas-ingly dominated by CBT, the very factthat this approach also dominates Inter-net therapy may lead to a preferentialtreatment of non-CBT approaches in asecond step. This is a point that shouldbe considered by representatives of ap-proaches that are emphasizing process,the therapeutic relationship, etc., and


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who are particularly skeptical towardsInternet treatment.

ConclusionsOverall, Internet therapy offers uniqueopportunities for psychotherapy inte-gration. It is a fresh chance for therapiststo take an open, pragmatic stance ofusing whatever concepts and interven-tions might be useful to patients. In addition, the very fact that, in spite of integrating elements from other ap-

proaches, CBT will probably continue toplay a primary role in Internet therapy,paradoxically opens new chances forother approaches in a second step ofstepped care. This is not integrative in it-self, but it fosters an open attitude witha choice of procedures based on expecta-tions of how much they may help a par-ticular patient, rather than sticking to an a-priori preference of one’s own approach.

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Bulletin ADVERTISING RATES

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Send your camera ready advertisement, along with a check made payable to Division 29, to:Division of Psychotherapy (29)6557 E. RiverdaleMesa, AZ 85215

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All APA Divisions and Subsidiaries (Task Forces,Standing and Ad Hoc Committees, Liaison andRepre sentative Roles) materials will be published atno charge as space allows.

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The education and train-ing community is work-ing collaboratively toaddress the internship im-balance and its impact onprofessional psychology.In general, the field is

troubled by the persistence of the imbal-ance between the number of internshippositions offered through the Associa-tion of Psychology Postdoctoral and In-ternship Centers (APPIC) annual Matchand the number of applicants seekingan internship position (which is re-quired for a doctoral degree in healthservice psychology—clinical, counsel-ing, school, or a combination of thesespecialty areas).

It is important to note that the imbal-ance is longstanding and similar to thatexperienced by other health professions;in 2011 for example, the Medicine matchrate was at 73%, while Dentistry was at64%, compared to Psychology at 79%.The APPIC computer Match in Febru-ary 2011 indicated that the number ofapplicants who were not matched wasat 21% after Phase 2, which was imple-mented in 2011 as an alternative to theprevious “clearinghouse” process. Forfurther information about the Match:(http://appic.org/match/5_2_2_match_about_statistics.html).

Match Summary and Survey Results:The number of registered applicants in2011 increased by 309 or 8%, to a recordof 4,199 applicants (compared to an in-crease of 65, or 1.7%, in 2010. The num-ber of internship positions increased in

2011 by 65, or 2%, to a record 3,166 posi-tions (compared to 2010 when therewere 50 new positions). Furthermore,the number of accredited positions inthe Match increased by 30 (compared to2010 when these slots decreased bytwo), while the number of non-accred-ited positions increased by 35 (com-pared to the 2010 increase of 52). Clearly,the development of new internship po-sitions is not keeping pace with the increase in students, and many of the internship positions have not yet metquality review standards through accreditation.

Following is a nine-year comparison ofthe 2002 and 2011 Match statistics:

Over the past few years, a concerted ef-fort has been made by the educationand training community to address theimbalance and to implement creativesolutions while building an infrastruc-ture that will hopefully reduce the imbalance over time. An impressive col-laboration has developed with all of thetraining councils representing special-ized populations or training models,through the Council of Chairs of Train-

EDUCATION & TRAININGThe Internship Imbalance and Impact on Professional PsychologySharon Berry, PhD, Licensed PsychologistDirector of Training – Children’s Hospitals and Clinics of MNPast Chair, APPIC Board of Directors


2002 2011 9-YR ChangeParticipating Sites 610 690 +80 (+13%) Positions Offered 2,752 3,166 +414 (+15%) Positions Filled 2,410 2,910 +500 (+21%) Positions Unfilled 342 256 -86 (-25%)

Registered Applicants 3,073 4,199 +1,126 (+37%) Withdrawn Applicants 231 352 +121 (+52%) Matched Applicants 2,410 2,910 +500 (+21%) Unmatched Applicants 432 937 +505 (+117%)

ing Councils (CCTC). This group hostedthe CCTC 2010 Conference in Orlandowith over 700 in attendance, represent-ing all 14 training councils. In addition,a committee comprised of membersfrom various training councils workedcollaboratively to develop a resourceguide through the Internship Develop-ment Toolkit, launched in 2010 andavailable at (www.psychtrainingcoun-cils.org/Documents/InternshipToolk-itCCTC.pdf).

In addition, CCTC is working to achievechanges recommended through the 2008Imbalance Meeting with action stepssummarized below (reflecting consen-sus amongst training councils), whichwe believe will make a difference in theimbalance over time. Toward that end,CCTC is represented on an APA WorkGroup to address future training needsfor health service psychology. Anotheraction step was the identification of vol-unteers who will provide assistance tocurrent or developing internships in avariety of ways (seminar development,assistance in preparation for an accredi-tation self-study, etc), and will soon besupplemented by a listing of individualsfrom APA Division 42 (IndependentPractice) who are interested in volun-teering their time and resources to assistinternships: (htttp://www.psychtrain-ingcouncils.org/Documents/Volun-teersforImbalancefromSurvey.DOC).

APPIC developed a second phase of theMatch to replace the Clearinghouse,which was perceived as chaotic and anx-iety producing; initial feedback sug-gested that the new process workedbetter and also yielded a higher Matchrate as well as a mechanism to bettertrack where students are placed afterPhase 1. Additional recommedationsemphasized “truth in advertising” byboth doctoral programs and internshipsto better inform applicants. Toward thisend, various steps have been taken. The

Commission on Accreditation expectsthat “…..doctoral graduate programsprovide potential students, current stu-dents, and the public with accurate in-formation on the program and onprogram expectations. This informationis meant to describe the program accu-rately and completely, using the mostup-to-date data on education and train-ing outcomes, and be presented in amanner that allows applicants to makeinformed decisions about entering theprogram” (Guidelines and Principles,July 2011). APPIC publishes Match Sta-tistics annually to reflect outcomes foreach graduate program and to provideinformation to potential students thatwill inform decision-making. Intern-ships are expected to update their publicmaterials at least annually to assist po-tential applicants. Likewise, varioustraining councils have developed a FactSheet to guide students with graduateschool decision-making.

Also as a result of the 2008 ImbalanceMeeting, doctoral training councils havebeen asked to establish consensusamong their members as to the minimalrequirements for eligibility to participatein the Match. This will help doctoralprograms make clear and predictabledecisions on the readiness of their stu-dents to enter the Match, while inform-ing current and prospective students, aswell as Internship training directorsabout the readiness criteria for eachcouncil (clinical, counseling, school, pro-fessional, integrated programs). Basedon a request from the American Psycho-logical Association of Graduate Students(APAGS), APPIC developed a two-phase Match process, elimination of the“clearinghouse,” and the requirementthat “readiness for internship” be deter-mined before Phase 1. Students not eligi-ble by Phase 1 still have the opportunityto utilize the APPIC Post Match Vacancy


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Service if determined as ready by thattime (after Phase 2 has been completed).APPIC has also worked with internshipsso that funding is intact for the nexttraining year early in the process and atleast by the time rank order lists are sub-mitted (or earlier) so that students arenot unfairly burdened by traveling forinterviews to programs whose fundingis not secure. Many programs appropri-ately pull out of the Match because ofuncertain funding, but then are able toobtain interns through the Post-MatchVacancy Service once the funding is established.

Based on recommendations from the2008 Imbalance Meeting, a commitmentwas made by doctoral training councilsto alter the Internship imbalance by ei-ther increasing the supply of availableinternship positions or decreasing thedemand by reducing the number of stu-dents in their programs. This recom-mendation highlights the responsibilityof each doctoral program to managetheir individual Match (or Placement)rate on an annual basis, starting with a75% Match expectation and a long-termgoal of 90% for every program overtime. Many programs have taken thisrecommendation seriously by workingto develop new internships or addi-tional positions within existing intern-ship programs; it is hoped that doctoralprograms with the lowest Match rates(below 75%) will also alter their enroll-ment as needed to insure their studentsobtain a quality internship. It should benoted that there is no real mechanism toenforce this expectation, although CCTCcontinues to take responsibility for theserecommendations and for ensuring thataction is taken when possible.

The education and training communityis acutely aware of the need for work-force data to guide the field and futuredecisions that could reduce the imbal-ance. This would provide a more accu-

rate picture of what is needed within theprofessional work force and within spe-cific specialty or geographic areas.CCTC has requested that the APA Cen-ter for Workforce Studies address theseneeds through comprehensive andtimely workforce analyses. APA is in theprocess of restructuring the Center andhas indicated their support to addressthese workforce questions.

What can you do to help?As a faculty member with students:Prepare students for Internship and theMatch: • Insure that your graduate departmentaddresses preparation for the Matchbeginning in the first year of graduateschool. This helps students identifydata they will need to track until theyare determined eligible for internship(supervised hours, clinical hours,publications). This will also highlightthe importance of socialization to thefield of professional psychology.

• Make sure your program is accred-ited—students from accredited pro-grams match at a higher rate thanthose from emerging or non-accred-ited programs. Regional accredita-tion is insufficient.

• Emphasize the importance of a balanced approach to preparation forinternship and the Match. Accumulat-ing hundreds or thousands of hours isnot necessary. Equally important arethe completion of all doctoral programrequirements within a reasonabletimeframe, publications and presenta-tions, completion of dissertation.

• Stay in tune with changes to the AAPIand/or Match process through theAPPIC newsletter, conferences, list-servs. The more you know, studentswill be less worried. Role-play withstudents through mock interviews toreduce anxiety and build confidence.Review their essays and edit to re-


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duce drama and improve clarity. • Encourage involvement with APAGSand other venues that guide and sup-port students.

• Be clear about strengths and areas forgrowth as this adds credibility to theapplication.

• Be courageous and help students whoare not good candidates for profes-sional psychology find other careeroptions. Helping them move on whilein graduate school saves them moneyand increased trauma if they try to dointernship and are ill equipped forsuccess.

• Encourage applications to a widerange of internships (submitting 15applications predicts the highestMatch rate). Encourage geographicmobility whenever possible.

If a student does not match: try to staycalm and don’t panic! Many very strongstudents do not match each year andreasons for this can be hard to deter-mine. Work with the student to deter-mine what might make a difference thenext year and problem solve other op-tions for this year: monitoring the PostMatch Vacancy Service, contacting pro-grams you know well or training direc-tors whose opinion you value forfeedback on the application. Identifyways to use one more year before thenext application phase in a productivemanner such as additional research,completing the dissertation, teaching ex-perience, anything that builds a sense ofconfidence and competence.

As a professional:The education and training communitywithin Psychology and APA is dedicatedto altering the Internship Imbalancethrough careful study and recom-mended action steps reached by consen-sus among all training councils.

However, everyone within ProfessionalPsychology can play a valuable role inmoving this forward.

• Keep informed: It is important to un-derstand the myriad of contributingfactors to the imbalance and avoidpointing fingers. Working collabora-tively has helped to create momen-tum and change. Stay connected withgraduate programs and internships inyour area. Ask questions to better un-derstand what helps and what de-tracts from the needs of the field.

• Volunteer to help: Consider what youcould offer a doctoral program or in-ternship. Be creative—common op-tions include the following: serve as asupervisor (often as adjunct faculty);develop a seminar series or offer topresent a specific seminar topic; assistwith grant writing to obtain funding;offer psychotherapy services to stu-dents at low or no cost; consult withprograms regarding accreditation cri-teria and development of a self-study;serve on thesis or dissertation com-mittees; help develop an internshipconsortium comprised of individualagencies that combine resources todevelop a program; identify valuedpracticum sites that might be ready todevelop an internship.

• Advocacy: Advocating for the issuesfacing professional psychology is crit-ically important and requires a uni-fied effort. Get trained as an Advocatethrough workshops provided rou-tinely at the annual APA conventionand other conferences; join the grass-roots advocacy networks establishedthrough the APA Directorates; contactlocal, regional, state, and nationalcongressional members on behalf ofPsychology. Your voice is importantand your influence essential.

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Micki FriedlanderChair, Fellows Committee

The Division of Psychotherapy is now accepting applications from individualswho would like to nominate themselves or recommend a deserving colleaguefor Fellow status with the Division of Psychotherapy. Fellow status in APA isawarded to psychologists in recognition of outstanding contributions to psy-chology. Division 29 is eager to honor those members of our division whohave distinguished themselves by exceptional contributions to psychotherapyin a variety of ways such as through research, practice, and teaching.

The minimum standards for Fellowship under APA Bylaws are:• The receipt of a doctoral degree based in part upon a psychological dissertation, or from a program primarily psychological in nature;

• Prior membership as an APA Member for at least one year and a Member of the division through which the nomination is made;

• Active engagement at the time of nomination in the advancement of psychology in any of its aspects;

• Five years of acceptable professional experience subsequent to the granting of the doctoral degree;

• Evidence of unusual and outstanding contribution or performance in the field of psychology; and

• Nomination by one of the divisions which member status is held.

There are two paths to fellowship. For those who are not currently Fellows ofAPA, you must apply for Initial Fellowship through the Division, which thensends applications for approval to the APA Membership Committee and to theAPA Council of Representatives. The following are the requirements for initialFellow applicants:• Completion of the Uniform Fellow Blank;• A detailed curriculum vitae;• A self-nominating letter (which should also be sent to your endorsers);• Three (or more) letters of endorsement of your work by APA Fellows (at least two must be Division 29 Fellows) who can attest to the fact thatyour “recognition” has been beyond the local level of psychology;

• A cover letter, together with your CV and self-nominating letter, to each endorser.

Division 29 members who have already attained Fellow status through anotherdivision may pursue a direct application for Division 29 Fellow by sending a cur-riculum vitae and a letter to the Division 29 Fellows Committee, indicatingspecifically how you meet the Division 29 criteria for Fellowship.

Initial Fellow Applications can be attained online at:http://apa.org/membership/fellows/

CALL FOR FELLOWSHIP APPLICATIONS Division 29—Psychotherapy


Call for Fellowship Applications, continuedYou may also contact Tracey Martin at APA:

Tracey MartinDivision of Psychotherapy6557 E. Riverdale St.Mesa, AZ 85215Phone: 602-363-9211Fax: 480 854-8966Email: [email protected]

DEADLINE FOR SUBMISSION: The deadline for submission to be consideredfor 2012 is December 15, 2011.

Initial nominees (those who are not yet Fellows of APA in any Division) mustsubmit the following electronically as a packet:

(a) a cover letter, (b) the Uniform Fellow Application, (b) a self-nominatingletter, (c) three (or more) letters of endorsement from current APA Fellows(at least two Division 29 Fellows), and (d) an updated CV.

Current Fellows of APA who want to become a Fellow of Division 29 need onlysend a letter attesting to their qualifications with a current CV.

Completed (electronic) applications should be sent by the nominee directly to:Micki FriedlanderChair, Division 29 Fellows [email protected](phone: 518-442-5049)

Incomplete submission packets after the deadline cannot be considered for this year.

Please feel free to contact Micki Friedlander or other Fellows of Division 29 if youthink you might qualify and you are interested in discussing your qualificationsor the Fellow process. Also, Fellows of our Division who want to recommend de-serving colleagues should contact Micki with their names.

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The Psychotherapy Bulletin is Going Green: Click on www.divisionofpsychotherapy.org/members/gogreen/

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APA PRESENTS THIS PRESIDENTIAL CITATION TO JOHN C NORCROSS Ph.D. for his outstanding contributions as a prolific

scholar, engaging teacher, exemplary mentor, andinfluential leader.

Dr. Norcross is internationally recognized as an authority on psy-chotherapy, clinical training and behavior change. He has co-written or edited 22 books, over 300 publications, and hasprovided numerous presentations in 30 countries. As a dedicatedscholar, he is editor of the Journal of Clinical Psychology: In Sessionand has been on the editorial boards of several other journals.He has served as clinical and research consultant to a number of

organizations, including the National Institute of Mental Health. His dedicationto the field of psychology is evident through his numerous effective, respectfuland inclusive leadership roles, including as past president of APA Division 29,Psychotherapy; as past president of APA Division 12, the Society of Clinical Psy-chology; as an APA Council Representative; and as Director of the National Reg-ister of Health Service Providers in Psychology. He has promoted the best ofpsychology through hundreds of media interviews, and through appearanceson many national television shows, including the Today Show, CBS News, Sun-day Morning, and Good MorningAmerica. In recognition of his many, importantcontributions to psychology, the American Psychological Association presentsDr. Norcross this Presidential Citation.


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Brief Statement about the Grant:The Charles J. Gelso, Ph.D., PsychotherapyResearch Grant, offered annually to quali-fying individuals, provides $2,000 towardthe advancement of research on psy-chotherapy process and/or psycho therapyoutcome.

Eligibility: In alternating years, graduatestudents/predoctoral interns or doctorallevel psychologists/postdoctoral fellowswill be eligible for the Charles J. GelsoGrant. In 2012, graduate students in psy-chology and predoctoral interns who arein good standing at an accredited univer-sity will be eligible. In 2013, doctoral levelpsychologists, including postdoctoral fel-lows, will be eligible. The grant will rotatebiannually between graduate students/predoctoral interns and doctoral level psy-chologists/postdoctoral fellows, such thatnominations will be accepted in even num-ber years for the former group and oddnumber years for the latter group.

DescriptionThis program awards grants for researchprojects in the area of psychotherapyprocess and/or outcome. In alternatingyears the grant is awarded to graduate stu-dents or doctoral level psychologists.

Program Goals• Advance understanding of psycho ther-apy process and/or psychotherapy out-come through support of empiricalresearch

• Encourage talented graduate studentstowards careers in psychotherapy research

• Support psychologists engaged in qual-ity psychotherapy research

Funding SpecificsOne annual grant of $2,000 to be paid inone lump sum to the researcher, to his orher university’s grants and contracts office,or to an incorporated company. Individu-als who receive the funds could incur taxliabilities (see Additional Information sectionbelow).

Eligibility Requirements• In alternating years, graduate students/pre-doctoral interns in psychology(even-numbered years) or psycholo-gists/postdoctoral fellows (odd-num-bered years) will be eligible

• In 2012, graduate students/pre-doctoralinterns who are in good standing at anaccredited university will be eligible

• In 2013, doctoral level psychologists andpostdoctoral fellows will be eligible

• Demonstrated or burgeoning compe-tence in the area of proposed work

• IRB approval must be received from theprincipal investigator’s institution be-fore funding can be awarded if humanparticipants are involved

• The same project/lab may not receivefunding two years in a row

Evaluation Criteria• Conformance with goals listed aboveunder “Program Goals”

• Magnitude of incremental contributionin topic area

• Quality of proposed work• Applicant’s competence to execute theproject

• Appropriate plan for data collection andcompletion of the project

Proposal Requirements for All Proposals• Description of the proposed project to include, title, goals, relevant back-ground, target population, methods, an-ticipated outcomes, and disseminationplans: not to exceed 3 single-spacedpages (1 inch margins, no smaller than11-point font)

• CV of the principal investigator: not toexceed 2 single-spaced pages andshould focus on research activities

• A 300-word biosketch that describeswhy your experiences and qualifica-tions make you suited for successfullycarrying out this research proposal. Thiswill be a blind review so please excludeidentifying information.

CHARLES J. GELSO, PH.D., PSYCHOTHERAPY RESEARCH GRANTREQUEST FOR PROPOSALS


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• Timeline for execution (priority given toprojects that can be completed within 2years)

• Full budget and justification (indirectcosts not permitted), which should takeup no more than 1 additional page (thebudget should clearly indicate how thegrant funds would be spent)

• Funds may be used to initiate a newproject or to supplement additionalfunding. The research may be at anystage. In any case, justification must beprovided for the request of the currentgrant funds. If the funds will supple-ment other funding or if the research isalready in progress, please explain whythe additional funds are needed (e.g., inorder to add a new component to thestudy, add additional participants, etc.)

• No additional materials are required fordoctoral level psychologists who are notpostdoctoral fellows

• Graduate students, predoctoral interns,and postdoctoral fellows should refer tothe section immediately below for addi-tional materials that are required.

Additional Proposal Requirements forGraduate Students, Predoctoral Interns,and Postdoctoral Fellows• Graduate students, pre-doctoral interns,and postdoctoral fellows should alsosubmit the CV of the mentor who willsupervise the work

• Graduate students and pre-doctoral in-terns must also submit 2 letters of rec-ommendation, one from the mentorwho will be providing guidance duringthe completion of the project (note thatthis letter must indicate the nature ofthe mentoring relationship)

• Postdoctoral fellows must submit 1 let-ter of recommendation from the mentorwho will be providing guidance duringthe completion of the project (note thatthis letter should indicate the nature ofthe mentoring relationship)

Additional Information• After the project is complete, a full ac-counting of the project’s income and ex-penses must be submitted within sixmonths of completion

• Grant funds that are not spent on theproject within two years must be re-

turned• When the resulting research is pub-lished, the grant should be acknowl-edged

• All individuals who directly receivefunds from the division will be requiredto complete an IRS w-9 form prior to therelease of funds, and will be sent a 1099after the end of the fiscal year (Decem-ber 31st)

Submission Process and Deadline• If the grant is to be used to support athesis or dissertation, the thesis/disser-tation proposal must be approved bythe thesis/dissertation committee (thisshould be noted in the letter of recom-mendation from the mentor)

• All materials must be submitted elec-tronically

• All applicants must complete the grantapplication form, in MSWord or othertext format

• CV(s) may be submitted in text or PDFformat. If submitting more than 1 CV,then all CVs must be included in 1 elec-tronic document/file

• Proposal and budget must be submittedin 1 file, with a cover sheet to includethe name of the principal investigatorand complete contact information (ad-dress, phone, fax, email)

• Submit all required materials for proposal to: Tracey A. Martin in the Division 29 Central Office, [email protected]

• You will receive an electronic confirma-tion of your submission within 24hours, which will provide you with anassigned application number. If you donot receive confirmation, your proposalwas not received, then please resubmit.

DEADLINE: APRIL 1, 2012

Questions about this program should bedirected to the Division of PsychotherapyResearch Committee Chair (Dr. MichaelConstantino at [email protected]), or the Division of Psychother-apy Science and Scholarship Domain Rep-resentative (Dr. Norman Abeles [email protected]), or Tracey A. Martin inthe Division 29 Central Office, [email protected]

Kathy (name alteredfor confidentiality) hasbeen a psychologist foralmost 30 years and iswell known in hercommunity. She is onthe panel of several insurance companiesand has an active outpatient practice.When I would see herin the hallway, she wasusually compassionateand warm, offering

support and understanding about clientor personal concerns. Often, when I (BV)left work, even on days that I worked the latest, I would noticeKathy’s light still burning. Kathy wasseeing a lot of patients. Suddenly lastyear, I didn’t see Kathy’s light on at all.When I didn’t see her for three weeks Icalled her home and discovered that shehad had a stroke. When Kathy returnedto work more than three months later,she was weak, thin and pale, but recov-ering. Now, a year and a half later, sheworks only three short days a week. Iran into her the other day and she said,“Barbara, I was fooling myself. I wasseeing way too many patients and I wasignoring my exhaustion.” As our con-versation continued, it became clear thatshe had been more concerned about fi-nancially supporting her college ageddaughters than taking care of herself.

We each work in office buildings sharedby other therapists in various disci-plines. In hallway chats between pa-tients or in the parking lot, the topic ofconversation often turns to the issues ofpersonal health, fatigue, and a desire totake time off. In the last five years, outof the 18 therapists that work in one ofour offices, two have had cancer and onehas suffered a heart attack. All of themseemed to struggle with managing theirillness and their practices. When askedwhy they didn’t cut back sooner or takelonger time off to heal, they often have asimple response—money. Sure, theylove their work and find it meaningfuland gratifying, but often they haveresponsibilities that influence their decision on how many people to see a day or a week. This has led us to contemplate the influence of money ontherapist decisions about their privatepractices and personal lives.

In our brief exchange, Kathy hadbroached the subject of money, a subjectthat many psychotherapists feel uncom-fortable discussing. A reluctance to dis-cuss money is not uncommon forpsychotherapists who typically did notchoose their professions for financialreasons. However, without discussion,money concerns may operate uncon-sciously, as with Kathy, and some deci-sions about practice parameters may be


PROFESSIONAL PRACTICEMusings from the Psychotherapy Office: Money, Psychotherapy, and the Pursuit of a Life Well LivedBarbara J. Thompson, Ph.D., Private Practice, Ellicott City, MarylandBarbara L. Vivino, Ph.D., Private Practice, Berkeley, California

It is not wealth one asks for, but just enough to preserve one’s dignity, to work unhampered, to be generous, frank and independent.

— W. Somerset Maugham

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unhealthy. It was only after nearly dyingthat Kathy became aware of how her at-titudes about money and work were af-fecting her decision-making. Whiletherapists are encouraged to and seemwilling to explore how all sorts of theirown personal issues may be affectingtheir work, money issues are often leftunexamined. As Freud observed morethan half a century ago, money is aneven bigger taboo than sex. In this timeof financial crisis, we realize it is impor-tant to examine our beliefs about moneyand work, particularly since many ofour patients are grappling with the sameconcerns.

Money symbolizes many things for peo-ple and bears the brunt of negative con-notations. Some of the more commonbeliefs about money are: money equalsworth, money is freedom, the love ofmoney is the root of all evil, if you makea large profit you are greedy. Thephrases, “money-grubber” and “filthyrich” indicate a common negative biastoward making money. In part, becauseof these negative biases, there may be atendency for psychotherapists to avoidattending to money related issues suchas setting appropriate fees, determininghow many patients to see a week, creat-ing an enjoyable lifestyle for themselves,and planning for their own future.

Like most of our colleagues, we didn’tbecome psychotherapists to make a lotof money. We did, however, expect to beable to earn a decent living doing some-thing that we enjoyed, felt a calling for,and performed competently. As Orlin-sky and Ronnestad (2005) noted in theirbook, How Psychotherapists Develop, ther-apists value connecting deeply withclients and value being engaged in“healing involvement.” In graduateschool, we were so engrossed in the clin-ical and theoretical aspects of psychol-ogy that the financial aspects of our fieldwere the last things on our minds. Fast-

forward about 20 years and this issue ofmoney has become one with which wehave found ourselves grappling moreand more.

Calculating how many clients we haveto see to make enough money to pay allof our bills and business expenses andto give ourselves paid vacations and sickleave seems to be taking up more timeof late than we really want it to. Thetherapist’s fee is a boundary that definesthe therapeutic relationship, making itdifferent from social, romantic or othernon-professional relationships. Moneyis, “the most obvious parameter that de-fines the business aspect of therapeuticrelationships” (Zur, 2007). Private prac-tice is a business yet many practitionershave had very little training in how torun a business. Decision-making in pri-vate practice is more complex than inother businesses because therapeuticconcerns must be considered along with“bottom-line” considerations. Often, fi-nancial considerations, therapeutic con-siderations, and self-care considerationscollide and can be difficult to navigatesuccessfully.

For example, new therapists and eventhose of us who have been at it awhilestruggle with being comfortable charg-ing clients’ no-show or late cancellationfees. When a client calls an hour andhalf before her session, barely able totalk and asks if it is “okay” not to meettoday due to her illness, we’re left towonder if she is asking for permission tonot come in but also to not pay the latecancellation fee? If told that she wouldstill be charged, would she have pushedherself to come in, possibly infectingboth the therapist and anyone who hap-pened to be next to her in the waitingroom? What about the highly motivatedclient, who you know is struggling fi-nancially, who misses an appointment?


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Would it be fair to not charge this clientbut to charge your financially comfort-able client a no show fee in a similar sit-uation? We often struggle with charginga fee—and this awkwardness mostlikely complicates dealing with other is-sues such as exploring client barriers tocoming to sessions each week, resistanceor reluctance, or even some disconnectin the client’s ability to recognize thetherapist as a real person.

Another area that has been particularlyhard is the comparison between the re-imbursement rates of managed careclients and private pay clients. Privatepay clients sometimes pay more thandouble that of clients with insurance.Although the Code of Ethics encouragespsychologists to be flexible in their feesetting and to allow some pro bono ap-pointments for those who cannot affordtherapy, they do not address the com-plexities of the decision making that isinherent in each choice. Although we be-lieve that we are able to treat each of ourclients with the same respect and care,the decision about which client to see ismade more difficult when this decisionmay impact our own personal and fi-nancial needs. Would seeing more pri-vate pay clients mean that we could seefewer clients and have more time off tospend with our loved ones or to work onour own professional development?Might we resent the extra hours itwould take to see more managed careand pro bono clients? If we only haveone opening and know ahead of time,would we choose someone with higherreimbursement rate over lower to fillthat spot?

Of all the thorny issues related to moneyand private practice, we find the one re-lated to determining how many patientsto see weekly to be the most troubling.We have been blessed thus far to havefew major health or life crises, however,Kathy’s story is a warning for us and

other therapists. How long and howmuch a therapist in private practiceworks “should” be dictated by that ther-apist’s current state of well being andpsychological health, factors that di-rectly effect our ability to provide goodcare to our clients. But what about thosepesky bills that need to be paid? Withthe cost of food, gas, utilities, and prettymuch everything else going up, andpsychotherapy rates staying relativelystable, how many of us have gone towork with a bad cold versus taking theday off? Sure, we are motivated by ourcommitment to our clients, but aren’t wealso motivated by our need to keep ourbank accounts healthy? If we could takea paid day off, would we choose to andmight not that be, really, in the best in-terests of our patients as well as our bod-ies? There are also those who feelcompelled to work to achieve certainmonetary goals, e.g., sending children tocollege, buying a new house, saving forretirement. We know of therapists whoroutinely see 12 to 14 clients a day andwho will even admit to doing so to meetsome monetary responsibility such aspaying for a child’s college education.Are we kidding ourselves that we cancompetently, compassionately see morethan 30 clients a week or more than 8clients a day and still do as good a job? Apparently we are not alone with ourmusings about money. Concerns aboutmoney have been with our professionfrom the very outset. It appears thateven Freud worried about money! Inhis letter to Fliess, Freud (1899) wroteabout a patient, whom he called a “gold-fish” due to her wealth:A patient with whom I have been nego-tiating, a ‘goldfish’, has just announcedherself—I do not know whether to de-cline or accept. My mood depends verystrongly on my earnings. Money islaughing gas for me. I know from my


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youth that once the wild horses of thepampas have been lassoed, they retain acertain anxiousness for life. Thus I havecome to know the helplessness ofpoverty and continually fear it. You willsee that my style will improve and myideas will be more correct if this city pro-vides me with an ample livelihood.

Freud was clearly exploring his anxietyand attitudes about money! Most psychotherapists would suggest thatconcerns about money are often repre-sentative of other underlying issues. Ifwe dig deeper into our feelings aboutmoney, we find issues of personal free-dom and limitations, issues of puttingourselves before others, valuing our-selves, self-care and gender socializa-tion. Although uncomfortable to look at,some of the deeper money dynamicsthat might be at play in the business ofour private practice, we would suggestthat this self reflection is just as impor-tant to undertake as understanding howthe unique complexities of our child-hood influence our work with clients.

As a woman entering her sixties, Kathywas holding on to the things that gaveher a sense of worth. In this case hermoney making capacity, her practiceand her ability to take care of the peopleshe loved. Her stroke became a wake upcall that pushed her to explore the influ-

ence of money on her life as a therapist.Kathy’s experience prompted us to takean honest look at our attitudes aboutmoney and to commit to periodicallyreevaluate the choices we are making ona day-to-day basis in our psychotherapypractice. This evaluation has led us to make some changes in how we approach our private practice. We havedecided to implement outcome and relationship monitoring described byDuncan (2010) as a way to keep bettertrack of how we are doing as therapists.We are taking a hard look at how manypatients we see in one day to make surewe maintain the energy and emotionalfortitude to deal with our clients’ suffer-ing in a compassionate manner. For oneof us, this means going to a five day perweek, six clients a day schedule. For theother, making sure eight to nine clientsession days are broken up by a twohour break time to go to the gym. Likemany of our colleagues, we are trying todiversify what we do by taking on con-sulting, supervision, part time jobs oradjunct teaching so that all of our in-come doesn’t come from private practicealone. But perhaps the most meaningfulimpact our musings about money andpsychotherapy have wrought is that weare now more consciously aware of howthe day to day decisions we make astherapists may be colored by money andfinancial concerns.

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The constant dilemmabetween the personaland the professional isone that I have grownto know and under-stand all too well.When I was a sopho-

more in college at the University ofDelaware, I decided to pursue my doc-torate in clinical psychology for mainlypersonal reasons; the idea of helpingpeople struggling with emotional issuesresonated with me much more than thecoursework I was completing as an en-gineering major. However, I quickly dis-covered that no matter how significantmy personal reasons, they would not beenough to get me through the incrediblechallenge of graduate school and thusbegan to investigate the wide array ofcareer opportunities allotted to me witha doctorate degree. Around the end ofmy junior year, I began researching clin-ical programs and soon discovered thatthere would be many times along theway that I would need to sacrifice mypersonal endeavors in order to achievethis goal. To name just a few, there weretimes when I had to give up my finan-cial aspirations (due to the amount ofdebt I would incur during my graduatetraining), romantic relationships (due tomoving from state to state because of thescarce and competitive nature of clinicalgraduate programs, internships, andpostdoctoral fellowships), and most im-portantly my favorite sports teams (as Iquickly discovered that only thePhiladelphia area proudly plays allPhiladelphia teams on television anddecorates the area bridges with Phillies,Flyers, and Eagles banners). While thesedilemmas may seem silly to some, I

have discovered that the little things thatcomfort me and make me happy are ex-tremely important in the work of a psy-chologist. When my day has becomeoverwhelmed due to absorbing the painof my patients, the little things remindme of why I do the work I do. This real-ization has come slowly and results inpart from my experiences of sacrificeduring my training; at the beginning ofmy training, I am glad that I decidedthat the little things did not outweighthe potential achievement of becomingDr. Jade Logan, so I set my sights ongraduate school.

After what felt like a long applicationprocess, I was granted a scholarship andresearch assistantship to three clinicalgraduate programs, none of which werenear my hometown, and decided tomove from the Mid-Atlantic region toMassachusetts. After about two months,I was already questioning my decision.A snowstorm hit unlike any other I hadseen. It was the end of September and Icould not believe that the campusstayed open during the storm! I remem-ber wondering if I would be able to livein what felt like a drastically differentenvironment than the one in which I hadgrown up. For example, I was unsure ofhow to drive in the snow, disliked howshort the days felt in the winter months,and could not believe that winterseemed to last until April. Let’s also notforget that the coveted sports teams inthe area were the New England Patriotsand the Boston Red Sox, both of which Istrongly disliked. On the other hand, Igrew to enjoy the long bike ridesthrough the fall New England trails and


EARLY CAREERJourney Through the Personal vs. the ProfessionalJade Logan, PhD, Staff Counselor, Saint Joseph’s University

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the small community of Philadelphiafans I discovered at the local sports bars.Each of these moments providedenough personal satisfaction to permitme to continue my journey toward myprofessional goals. I also came to real-ize that I was building lifelong relation-ships with my lab mates, faculty advisor,clinical supervisors, and fellow graduatestudents. Furthermore, I was receivingtraining in a field that would challengeme not only professionally, but person-ally as well.

In my research, I was addressing one ofmy main struggles in college: writingpapers. To put it simply, I hated writingand could not fathom the idea of writingcomprehensive exams, a master’s thesis,and let alone what came to be a 109-pagedissertation. I wish I could say that Iwrote those papers with poise andgrace; however, I actually was kickingand screaming the whole way. Little didI know, my fellow graduate studentsand faculty advisor supported methrough every page. In my clinical work,a parallel process was occurring. I wasbeing pushed to not only address andexplore my clients’ personal strugglesand dilemmas, but my own as well.With each new client that walkedthrough my door, I learned valuable lessons. I didn’t always appreciate theselessons at the time. Again, I feel that Ididn’t always navigate the process of be-coming a therapist with poise and grace,but my supervisors helped guide methrough.

Throughout this time, I continued to feeldrawn back home. The Philadelphiaarea had been my home for the first 18years of my life and I felt comfortablethere. The ever-increasing mileage onmy Honda can attest to this. I wouldtravel there regularly from my graduateprogram in Amherst, Massachusetts.When I went home, I discovered Iwould stay late on Sundays just to see

the Eagles play and head directly to myfavorite local pizzeria. It had become sonatural to spend most weekends on In-terstates 91 and 95 that I would not thinktwice about taking a 10 hour round triphome for one day with my family andfriends.

So when it became time to apply for clin-ical internships, I decided that the geographical location of a program wasvery important to me, and thus, my personal decision about where to livewould play a big role in this next step inmy professional training. I decided tonarrow my search for internship to theNew York area and mid-Atlantic region(as far south as Virginia); an area I be-lieved felt more like “home.” On a driveto an internship interview one hour westof Richmond, Virginia, I realized thatthat site was too far from home and thatI needed to potentially narrow mysearch even more. At the same time, Iwas struggling with the possibility thatthe choices I was making because of personal factors (constraining my searchgeographically) would affect my profes-sional life (by possibly decreasing thechances that I would “match” with aninternship, especially since I was re-stricting myself to a region that hadsome of the most competitive internshipsites). I tried to strike a balance betweenthe personal and the professional. I de-cided that I would have to make somesacrifices about where I would live forone year in order to reach my final goalof becoming a psychologist. However, Idid not want to sacrifice all the comfortsof home, so I decided that in order forme to rank a site I needed to hear, staticfree, at least four radio stations that fitmy musical tastes when I turned on theradio station in that area.

On match day, when I found out my in-ternship placement, I quickly contactedmy clinical supervisor and informed her


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that I matched and was moving toMaryland. She was ecstatic. She toldme that was one of the best choices forme, and she was right. First I gainedclinical training that continues to be in-valuable. Perhaps equally important, Igot to spend a year near one of my clos-est friends and be there for her weddingand the birth of her twin boys. In someways it seemed that I did not have tosacrifice the personal or the professionalat all and instead I was living in the bestof both worlds. However, during whatturned into a six-hour car ride on the eveof Thanksgiving, I realized that I wasonce again, too far from home. Mystruggle at this juncture was the need tobe able to visit my family and friends atany time during the week, weekends,and holidays. I realized I was still miss-ing valuable moments with them andthe weight of those lost moments wasgrowing heavier with each passing yearof my training. While I was excitedabout being so close to my dear friend, Iwas still only halfway there.

As a result, when applying for postdoc-toral fellowships, I decided to narrowmy search geographically even further.I was only willing to apply to sites inNew York, Philadelphia, and Delaware.While visiting my academic advisor andclinical supervisor in Massachusetts, Igot the call. I was offered a position atNew York University and was excitedthat I was only 90 minutes away fromPhiladelphia. I also quickly realized thatas long as New York sports teams werenot playing simultaneously, I would beable to watch Philadelphia teams fromthe comforts of my apartment. It felt likethe perfect balance. While I would missmy friend and her new family, I was ex-cited professionally, as I felt I was finallybeginning my career, and personally, asI was starting to think about beginning afamily of my own. Three weeks aftermoving to New York, I was feeling greatthat I was so close to “home” and I

would no longer miss important familyevents. Then, my nephew was born on aWednesday, while I was at work, and Imissed his birth. At that moment I fi-nally made a decision I never thought Iwould. I finally let my personal concernsoutweigh my professional ones, and Iwas going to move back to Philly.

This choice did not come without conse-quences; the job search and licensure ap-plications were complicated issues. I stillwas unsure of where I would end up formy job, and I knew that I needed toknow where I would be living before ap-plying for licensure. My cohort at NYUall knew that they would stay in the areaand it seemed that licensure was so sim-ple for them. I watched as they studied,took practice test after practice test andultimately, one by one, passed the exama month shy of finishing the fellowship.I, on the other hand, had applied tocountless jobs across multiple states(many of which I knew I did not want tolive in), did not get an interview at a siteI felt I was an easy pick, and was sortingthrough four different licensure applica-tions in the states of Pennsylvania, NewYork, Maryland, and New Jersey. I hadcome to realize that each state had re-quirements different enough for me toneed to think strategically about thehours I was accruing at my postdoctoralfellowship. I felt I was the last to find outthat you could not just show up for thepsychology licensing exam, but ratheryou needed to be approved to sit for theexam by your respective state’s psychol-ogy board. After a constant back andforth, I finally called my once clinical su-pervisor and now mentor from graduateschool and presented my dilemmas. Sheknew immediately what I did not wantto admit to myself and in her own lov-ing way she said it out loud: [I] neededto move home and focus on finding a jobin the Philadelphia area. It also made the


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licensure process more concrete: onestate, one application, one state board.

In the middle of all of this soul-search-ing, I had applied for a job too far fromthe Philadelphia area and was all but of-fered a position. I remember calling thesite and saying out loud, for the firsttime, that I was withdrawing my appli-cation for personal reasons. I further in-formed the head of the search committeethat I had decided to move back to thePhiladelphia area to be near my new-born nephew and family. She congratu-lated me on my decision, expressed herdismay that I no longer wanted to beconsidered, and wished me the best ofluck in my future endeavors. As soon asI hung up the phone, I went to the com-puter and applied for about five differ-ent positions spanning teaching, clinicalwork, and even undergraduate advis-ing. I had made the decision, finally andofficially, that I was moving back, but Idid not have any income and the jobmarket was extremely competitive evenwith my credentials.

At this point in my journey, I felt that Ihad made the worst decision possible. Iconstantly struggled with the idea that Iwould not find a position and that ulti-mately I would need to settle for any-thing. After spending the majority of mytraining in college counseling centersand having the opportunity to teach un-dergraduate courses, I knew that mydream position would allow me to do acombination of both. I wanted to teachas an adjunct as well as continue myclinical aspirations through direct pa-tient care, outreach, and supervision oftrainees. Thankfully, as I investigatedthe opportunities available to me in thePhiladelphia area, my panic abated as Irealized I was not giving up much pro-fessionally at all. The area was saturatedwith colleges and universities, and it feltlike the opportunities were endless. Ifound myself using any professional

contacts I had in the area to secure eitherteaching or per diem clinical work. I dis-covered that one thing had definitelynot changed: the area was highly cov-eted and the competition for positionswas high. I also was told often that thefield is about who you know. I wish Icould say that I was not discouragedthroughout this process and that therewere not moments when I seriouslyquestioned my decision. I found myselfleaning on my mentors, colleagues, su-pervisors, and friends to consistently re-mind me why I had made such aseemingly drastic and limiting choice.They reminded me of the many conver-sations we had where I all but said Iwanted to move back home. They re-minded me of my nephew and that Iwould get to see him grow up. These arethe moments that helped me continuewith my dream of merging the profes-sional and the personal here in thePhiladelphia area.

About one month shy of the end of myfellowship year, I noticed a posting for astaff psychologist position at SaintJoseph’s University. I hesitated for aboutweek in applying for this position be-cause I was unsure if my qualificationsfitted what they were looking for. Afterseeing the position advertised manytimes on the websites I now frequented,I decided to apply. Within about threedays, I received a call from the directorto complete a phone interview. Within24 hours, I had received notification thatI was invited for an in-person interview.I found myself reaching out to my men-tors and colleagues once again for ad-vice around interviewing and to easemy anxieties about being so close to fin-ishing my fellowship and still not hav-ing secured a job. Before I knew it, I acedthe interview, loved the site, and had anoffer in hand. It all happened soquickly; somehow, I had secured the


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perfect job for me located in the perfectregion of the U.S. Simply put, person-ally and professionally, I could not behappier. Suddenly, instead of filling thehours with panic, worry, and stress, Ispent my time babysitting my nephew,working with my highly talented col-leagues, and socializing with friendsfrom graduate school who have alsomoved to the area.

In closing, the constant struggle betweenthe personal and the professional is notan easy one. In my experience, as psy-chologists we find ourselves needing touproot because of our careers. I havediscovered that what makes my careermore enjoyable is being able to come

home and feel comfort in the littlethings. It actually makes me appreciatemy career much more. While I wouldnot change one part of my journey, I be-lieve that each dilemma has made me abetter psychologist. I know that I willcontinue to have to work at balancingmy personal and professional livesthroughout my career, but as I sit herefinishing this essay, I feel very happywith the balance I have found betweenthe personal and professional aspects ofmy life at this point in my life and mycareer. I can spend some time studyingfor the EPPP today, and look forward toSunday dinner with my one-year-oldnephew and the rest of my family.

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Find Division 29 on the Internet. Visit our site atwww.divisionofpsychotherapy.org

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DIVISION OF PSYCHOTHERAPY (29)AMERICAN PSYCHOLOGICAL ASSOCIATION

Enter the Annual Division of PsychotherapyStudent Competitions

The APA Division of Psychotherapy offers four student paper competitions:� The Donald K. Freedheim Student Development Award for the best paper on psychotherapy

theory, practice or research.

� The DiversityAward for the best paper on racial/ethnic gender, and cultural issues in psychotherapy.

� The Mathilda B.Canter Education andTrainingAward for the best paper on education, supervisionor training of psychotherapists.

� The Jeffrey E. Barnett Psychotherapy Research paper Award for the best paper that addressespsychotherapist factors that may impact treatment effectiveness and outcomes, to include typeof training, amount of training, professional degree or discipline of the psychotherapist, and therole of psychotherapists’ personal characteristics.

What are the benefits to you?� Cash prize of $250 for the winner of each contest.

� Enhance your curriculum vitae and gain national recognition.

� Plaque and check presented at the Division 29 Awards Ceremony at the annual meeting of theAmerican Psychological Association.

� Abstract will be published in the Psychotherapy Bulletin, the official publication of the Divisionof Psychotherapy.

What are the requirements?� Papers must be based on work conducted by the first author during his/her graduate studies.

Papers can be based on (but are not restricted to) a masters thesis or a doctoral dissertation.

� Papers should be in APA style, not to exceed 25 pages in length (including tables, figures, andreferences) and should not list the authors’ names or academic affiliations.

� Please include a title page as part of a separate attached MS-Word or PDF document so that thepapers can be judged “blind.” This page can include authors’ names and academic affiliations.

� Also include a cover letter as part of a separate attached MS-Word or PDF document.Thecover letter should attest that the paper is based on work that the first author conducted whilein graduate school. It should also include the first author’s mailing address, telephone number,and e-mail address.

Submissions should be emailed to:DougWilson

Chair, Student Development Committee, Division of PsychotherapyE-mail: [email protected]

DDeeaaddlliinnee iiss AApprriill 11,, 22001122

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Dear Division 29 Colleague:Division 29 seeks great leaders! Bring our best talent to the Division of Psychotherapy (29) as weput our combined talents to work for the advancement of psychotherapy.

NOMINATE YOURSELF OR SOMEONE YOU KNOW TO RUN FOR OFFICE IN THE DIVISION OF PSYCHOTHERAPY.

THE OFFICES OPEN FOR ELECTION IN 2012 ARE:• President-elect • Treasurer

• Domain Representative for Professional Practice• Domain Representative for Education & Training

• Domain Representative for Diversity • Domain Representative for MembershipAll persons elected will begin their terms on January 2, 2013

A Domain Representative is a voting member of the Board of Directors. The open positions willbe responsible for creative initiatives and oversight of the Division’s activities in the areas of pro-fessional practice, education & training, membership, or diversity, respectively. Candidatesshould have demonstrated interest and investment in the area of their Domain.

For details of the responsibilities of each office, see the Division 29 Bylaws at:http://www.divisionofpsychotherapy.org/members/documents/

The Division’s eligibility criteria for all positions are:1. Candidates for office must be Members or Fellows of the division and APA.2. No member may be an incumbent of more than one elective office.3. A member may only hold the same elective office for two successive terms.4. Incumbent members of the Board of Directors are eligible to run for a position on the Board onlyduring their last year of service or upon resignation from their existing office prior to acceptingthe nomination. A letter of resignation must be sent to the President, with a copy to the Nomina-tions and Elections Chair.

5. All terms are for three years, except President-elect, which is one year.Return the attached nomination ballot in the mail. The deadline for receipt of all nominations bal-lots is December 31, 2011. We cannot accept faxed copies. Original signatures must accompanyballot.

EXERCISE YOUR CHOICE NOW!If you would like to discuss your own interest or any recommendations for identifying talentin our division, please feel free to contact the division’s Chair of Nominations and Elections, Dr. William Stiles at 1-513-280-0190 or by Email at [email protected],Elizabeth Nutt Williams, Ph.D. Marvin Goldfried, Ph.D. William Stiles, Ph.D.President President-elect Chair, Nominations & Elections

NOMINATION BALLOT (INCLUDING SELF-NOMINATIONS!)

2012 NOMINATIONS BALLOT

President-elect Domain Representative for Professional Practice____________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________

Treasurer Domain Representative for Education & Training____________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________

Domain Representative for Diversity Domain Representative for Membership____________________________________ ________________________________________________________________________ ________________________________________________________________________ ____________________________________Name your nominees, and mail now! In order for your ballot to be counted, you must put

your signature in the upper left hand corner of the reverse side where indicated.

FOLD THIS FLAP IN.

Fold Here.

__________________________________

__________________________________

__________________________________

Division29Central Office6557 E. Riverdale St.Mesa, AZ 85215

Fold Here.

______________________________________Signature

______________________________________Name (Printed)

Dear Division of Psychotherapy Colleagues,

The Division of Psychotherapy Board of Directors requests your approval of the revisions to the bylaws of the Division of Psychotherapy. Proposed revisions arepresented on our website: www.divisionofpsychotherapy.org. Periodically, organ-izations need to update their bylaws to ensure that they reflect their actual structureand workings. Bylaws are by design intended to be broad and general. In someareas changes are suggested to make the bylaws less detailed and specific.

The changes to the Division 29 bylaws that you are being asked to approve mostlyrelate to methods of voting. The APA would like the Divisions to be able to moveto electronic voting, and restrictions in our current bylaws prevent that. Proposedchanges include:

• Article VII, Sections C-5, I, I-1, are changed to allow electronic nominations foropen positions in the division’s elected governance to be received.

• Article IX, Section C, is changed to allow electronic voting of referenda.

• Article XI, Section G-5 is changed at the request of the Division’s Finance Com-mittee As a financial execution, the word “audit” carries a very specific meaning.Since the Division does not currently conduct an annual audit, which would beprohibitively costly, the committee requests that the wording be changed to reflect current practice: that of an annual review of the financial records.

• Article XVI, Section C is changed to allow electronic voting of bylaws amend-ments.

Thank you for your careful reading of these proposed bylaws and for your ongo-ing support of Division 29. We respectfully request your approval of the revi-sions to the bylaws. You may indicate your vote using the ballot below.

On behalf of the Division 29 Board of Directors,

JeffJeffrey Barnett, Psy.D., ABPPDivision 29 Past-President and Ad Hoc Bylaws Committee Chair

BALLOT – DIVISION 29 BYLAWS CHANGES

� YES! I accept all the bylaws changes as proposed by the Division 29 Board ofDirectors

� NO! I reject all the bylaws changes as proposed by the Division 29 Board of Directors

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At the Women in Psy-chology breakfast atAPA’s Annual Con-vention in WashingtonDC this August, amajor topic of discus-sion was Military Sex-

ual Trauma, the official term used todescribe the psychological trauma causedby rape, sexual assault, and sexual harassment in the military.

Women now make up 15% of active dutymilitary personnel, with more than350,000 women serving currently. Ofthese some 220,000 have been deployedto war zones in Iraq or Afghanistan. Al-though women are ostensibly not permit-ted to take part in combat, they areworking in combat zones in a variety ofpositions where the lines between com-bat and non-combat are blurred by thenature of warfare. This places them atrisk for what is seen as a “doublewhammy”: trauma from the stresses ofwar and sexual victimization trauma.The strongest predictor for PTSD in menis combat experience, while for women itis rape, sexual assault, and sexual harass-ment (Street et al, 2008; Kang et al, 2005).

Sexual assault is a serious problem in themilitary. The Servicewomen’s ActionNetwork (SWAN) reported in a factsheet in February of this year (Stalsburg,2011) that in 2009 in Iraq andAfghanistan alone 215 sexual assaultson servicewomen were reported, and atotal of 3,230 military sexual assaultswere reported for that year. These con-cerns are by no means new. A 2007 series

of reports by National Public Radio(Norris, 2007) highlighted the issues,noting that since 2002 the Miles Founda-tion had received almost 1,000 reports ofassault from women serving in Iraq,Afghanistan, the Horn of Africa andother combat zones. A growing numberof reports were received by the privatenon-profit organizations, and suggestedhigher rates of assault than those re-flected in Department of Defense (DoD)statistics, probably as a result of theavailability of private and confidentialreporting and access to treatment out-side of the military structure. Nor, ofcourse, are military sexual assaults re-stricted to women: SWAN noted that theVeterans’ Health Administration hadtreated 65,264 patients in connectionwith military sexual trauma, and 60% ofthe survivors were female; 40% weremale (Department of Veterans’ Affairs,2010). The DoD acknowledges sexual as-sault as a serious problem, and there isnow a Pentagon Sexual Assault Preven-tion and Response Program. Nonethe-less, the DoD estimates that 80% of casesgo unreported (DoD, 2008, 2009). Whileunderreporting of sexual offences is auniversal concern, for women in thearmed forces there may be additionalpressures to remain silent.

The sexual victimization of women inthe military is seen by some to be a con-sequence of lack of equal opportunityfor women in the armed forces (includ-ing the Combat Exclusion policy, thenow defunct Don’t Ask, Don’t Tell pol-icy, and the VA health care and benefits

PUBLIC POLICY AND SOCIAL JUSTICESexual Assault on Women in the Military: A Need for Prevention, Treatment, and JusticeRosemary Adam-Terem, Ph.D.Honolulu, Hawaii


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system). Servicewomen may not be seenas equal or as “real” soldiers, and therank system allows for assault by seniorranking personnel who have immensepower over lower ranks, a phenomenonwidespread enough to be known as“rape by rank” (Norris, NPR, 2007). Ser-vicewomen are generally assaulted byone or more “known assailants,” not bystrangers. Multiple assailants (gangrapes) or multiple victims of one as-sailant are reported. Women hesitate toreport the crimes because of humilia-tion, fear of retaliation, threat to their ca-reers, and fear of the investigativeprocess. Many believe they have to“tough it out” and others succumb tothe reasoning that if a women enters thisquintessentially male domain, they are“asking for trouble.”

The Miles Foundation reports that evenwhen complaints are investigated bycommands, discipline is more likely tobe administrative than judicial. In 2009,only 18% of sexual assault cases wereprosecuted (DoD, SAPRO, 2009). The alleged assailant may be fined, or sus-pended for some time, but then returnsto duty, often working alongside the victim.

The dynamics of military sexual traumalead to a number of important implica-tions for psychotherapy with service-women or female veterans, beginningwith the need for clinicians to recognizethat some form of sexual assault mayhave occurred and gone unreported andmay underlie presenting problems ofdepression, anxiety or PTSD. As noted,data suggest that these assaults have far

more likely than not gone unreported.Survivors may not expect a fair hearingor fair treatment and may be unwillingto divulge the experience unless askedspecifically. Many may blame them-selves for the assault, for putting them-selves in harm’s way, especially ifalcohol was involved in the incident.The absence of perceived justice in themilitary can lead to a sense of helpless-ness and despair.

Treatment options are obviously goingto be restricted if the crimes are un- orunderreported. Campbell et al. (2005)report dissatisfaction with help-seekingexperiences within the military and VAsystems, and even note that secondaryvictimization can occur, along with in-creased rates of depression and PTSD.However, among military personnel,women are less likely to receive a diag-nosis of PTSD compared to men, likelybecause PTSD is more associated withcombat experience than sexual assault(Grossman et al, 1997). Those who donot report and do not seek treatment aremore likely to turn to substance abuse totry to cope (Skinner, 2000).

SWAN has begun a national movementto end military rape, sexual assault, sex-ual harassment, and domestic violence,and to eliminate all barriers to equal op-portunity for servicewomen. Psycholo-gists are encouraged to learn about thechallenges faced by military women, in-cluding the Combat Exclusion policy,Military Sexual Trauma, the effects ofthe Don’t Ask, Don’t Tell policy, and theVA health care and benefits system.

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Brief Statement about the Grant:The Norine Johnson, Ph.D., PsychotherapyResearch Grant, offered annually to quali-fying individuals, provides $20,000 towardthe advancement of research on psy-chotherapist factors that may impact treat-ment effectiveness and outcomes,including type of training, amount of train-ing, professional degree or discipline of thepsychotherapist, and the role or impact ofpsychotherapists’ personal characteristicson psychotherapy treatment outcomes.

Eligibility: Doctoral-level researchers witha successful record of publication are eligi-ble for the grant.

DescriptionThis program awards grants for researchon psychotherapist factors that may im-pact treatment effectiveness and outcomes,including type of training, amount of train-ing, professional degree or discipline of thepsychotherapist, and the role or impact ofpsychotherapists’ personal characteristicson psychotherapy treatment outcomes.

Program Goals• Advance understanding of psychother-apist factors that may impact treatmenteffectiveness and outcomes throughsupport of empirical research

• Encourage researchers with a successfulrecord of publication to undertake re-search in these areas

Funding SpecificsOne annual grant of $20,000 to be paid inone lump sum to the researcher, to his orher university’s grants and contracts office,or to an incorporated company. Individu-als who receive the funds could incur taxliabilities (see Additional Information sectionbelow).

Eligibility Requirements• Doctoral-level researchers• Demonstrated competence in the area ofproposed work

• IRB approval must be received from theprincipal investigator’s institution be-fore funding can be awarded if humanparticipants are involved

• The selection committee may elect toaward the grant to the same individualor research team up to two consecutiveyears

• The selection committee may choosenot to award the grant in years when nosuitable nominations are received

Evaluation Criteria• Conformance with goals listed aboveunder “Program Goals”

• Magnitude of incremental contributionin topic area

• Quality of proposed work• Applicant’s competence to execute theproject

• Appropriate plan for data collection andcompletion of the project

Proposal Requirements for All Proposals• Description of the proposed project toinclude title, goals, relevant back-ground, target population, methods, an-ticipated outcomes, and disseminationplans: not to exceed 3 single-spacedpages (1 inch margins, no smaller than11-point font)

• CV of the principal investigator: not toexceed 2 single-spaced pages andshould focus on research activities

• A 300-word biosketch that describeswhy your experiences and qualifica-tions make you suited for successfullycarrying out this research proposal. Thiswill be a blind review so please excludeidentifying information.

• Timeline for execution (priority given toprojects that can be completed within 2years)

• Full budget and justification (indirectcosts not permitted), which should takeup no more than 1 additional page (thebudget should clearly indicate how thegrant funds would be spent)

NORINE JOHNSON, PH.D., PSYCHOTHERAPY RESEARCH GRANTREQUEST FOR PROPOSALS


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Funds may be used to initiate a new proj-ect or to supplement additional funding.The research may be at any stage. In anycase, justification must be provided for therequest of the current grant funds. If thefunds will supplement other funding or ifthe research is already in progress, pleaseexplain why the additional funds areneeded (e.g., in order to add a new compo-nent to the study, add additional partici-pants, etc.)

Additional Information• After the project is completed, a full ac-counting of the project’s income and ex-penses must be submitted within sixmonths of completion

• Grant funds that are not spent on theproject within two years of receipt mustbe returned

• When the resulting research is pub-lished, the grant must be acknowledgedby footnote in the publication

• All individuals directly receiving fundsfrom the division will be required tocomplete an IRS w-9 form prior to therelease of funds, and will be sent a 1099after the end of the fiscal year (Decem-ber 31st)

Submission Process and Deadline• All materials must be submitted elec-tronically

• All applicants must complete the grant

application form, in MSWord or othertext format

• CV(s) may be submitted in text or PDFformat. If submitting more than 1 CV,then all CVs must be included in 1 elec-tronic document/file

• Proposal and budget must be submittedin 1 file, with a cover sheet to includethe name of the principal investigatorand complete contact information (address, phone, fax, email)

• Submit all required materials for proposal to: Tracey A. Martin in the Division 29 Central Office, [email protected]

• You will receive an electronic confirma-tion of your submission within 24hours, which will provide you with anassigned application number. If you donot receive confirmation, your proposalwas not received. Please resubmit.

DEADLINE: APRIL 1, 2012

Questions about this program should bedirected to the Division of PsychotherapyResearch Committee Chair (Dr. MichaelConstantino at [email protected]), or the Division of Psychother-apy Science and Scholarship Domain Rep-resentative (Dr. Norman Abeles [email protected]), or Tracey A. Martin inthe Division 29 Central Office, [email protected]

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STUDENT FEATURE

Ethics in Psychotherapy: Attaining Professional and Multicultural Competence in Extremis EnvironmentsPage Fischer, B.A.University of Denver-GSPP

For many years , psychologists have at-tempted to conceptu-alize the process bywhich internal and ex-ternal factors merge tobring about positiveand effective interven-

tion strategies and outcomes. Successfullearning and application of interventionstrategies assures professional and multicultural competence, an essentialelement in the psychology field. Profes-sional competence has been defined asthe ability to carry out specific tasks ap-propriately and effectively (Elman &Forrest, 2007; Johnson et al., 2008). Sueet al. (1982) presented a three-factormodel of multicultural competence thatremains widely used. According to Sueet al., multicultural competence is deter-mined by beliefs and attitudes about selfand other, including awareness of one’sown biases; knowledge and recognitionof cultural groups and societal views;and acquisition of the skills and abilitiesrequired to work effectively with indi-viduals having specific cultural needs.In the following essay, I outline twomodels and demonstrate how thesemodels challenge this generation of cli-nicians to increase levels of professionaland multicultural competence and fulfillthe cultural demands of today’s society.

Professionals in the psychology field areamong the most likely to work in ex-tremis settings, defined as environmentscharacterized by consistent and over-whelming stress (Johnson, et al., 2011).According to Johnson et al., functioningin extremis settings increases the risk of

competence problems. Monat andLazarus (1991) focus specifically on psy-chological stress, described as “cognitivefactors leading to the perception ofthreat”(p. 2). While Lazarus acknowl-edges the detrimental impacts of psychological stress in a professionalsetting, he also recognizes the positiveimpact of stress, which allows “us toachieve more than we believed could beaccomplished, and it can even lead to agreater appreciation of life” (Lazarus,2006, p. 20). Cognitive, emotional, andintellectual learning, experiences, andresponses play a strong role in determin-ing whether individuals attain profes-sional and multicultural competencewithin the psychology field. Learningand experiences can be interpreted andreacted to by different individuals in dif-ferent ways, leading to varying levels ofdisplayed professional and multicul-tural competence. By understandingand managing their own reactions, ther-apists are better equipped to understandand assist their clients (Hayes & Freder-ickson, 2008).

According to Schwartz-Mette (2009),graduate training is one of the moststressful professional times for psychol-ogists. Results from a study of studentsin clinical, counseling, school, or com-bined psychology graduate programsshow that roughly 50% recognize hav-ing a peer with competence problems(Shen-Miller et al., 2011). According tothe authors, this number appears lowerthan findings from other recent studies,suggesting that the actual percentagemay in fact be higher. The most common


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problems include professional behavior,interpersonal skills, clinical skills, aca-demic skills, and mental health prob-lems. Intertwined within these types ofproblems, psychological stress can dras-tically hinder one’s ability to act in a pro-fessional and multiculturally competentmanner.

According to a study involving the ma-jority (56%) of counseling psychologydoctoral programs identified by APA,approximately 90% of programs teachlesbian-gay-bisexual and multiculturalguidelines (88% and 93%, respectively),while guidelines relevant to age andgender are incorporated into only 50%and 17% of the programs, respectively(Miville et al., 2009). Miville et al. con-clude that combining multiple aspects ofdiversity into one curriculum of teach-ing competency constitutes a substan-tially more effective approach, allowingfor salience fluctuations and the consid-eration of aspects of diversity that maynot yet be specified in a formal set ofguidelines.

Standard 2.06 of the APA Ethics Codeprovides general guidelines for main-taining competency, stating that:

a) Psychologists refrain from initiat-ing any activity when they know orshould know that there is a sub-stantial likelihood that their per-sonal problems will prevent themfrom performing their work-relatedactivities in a competent manner.

b) When psychologists become awareof personal problems that may in-terfere with their performing work-related duties adequately, they takeappropriate measures, such as ob-taining professional consultation orassistance, and determine whetherthey should limit, suspend, or ter-minate their work-related duties(APA, 2010).

Matthews, Zeidner, and Roberts (2002,p. 97) produced a transactional model ofstress that demonstrates how emotionsand emotional competencies play a rolein dictating human reactions. Matthewset al.’s model suggests that personalvariables and situational parameters cre-ate primary and secondary appraisals aswell as state anxiety. These two factorsinfluence each other, while appraisalscreate coping reactions that dictateadaptive outcomes. Further, feedbackfrom outcomes influences each of thesefactors, while situational parameters di-rectly influence adaptive outcomes. Thismodel depicts a balance between inter-nal and external factors and the role ofemotion in reactions and outcomes.

Miville et al. (2009) extended studies ofexperiences, reactions, and behavior topresent a model describing the process ofdeveloping professional and culturalcompetence. The Integrative TrainingModel (ITM) stresses a cyclic structurethat separates training into four stages ofdeveloping competency in individualand cultural diversity. Each of the fourstages provide a framework and goalsthat include understanding the multicul-tural self; understanding others based onthe common themes among guidelines;understanding others based on thespecifics of each set of guidelines; and de-veloping specific strategies for interven-tion. A competence assessment occursbetween each stage, and an efficacy as-sessment occurs after the final stage.

Models such as the two presented in thisarticle challenge us to step back andevaluate ourselves as professionals inthe psychology field. Numerous studiesimply that we may be falling short ofour potential as researchers and psy-chologists. It is essential that we remainconscious of our professional and cul-tural competencies and weaknesses. By


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reconsidering our conceptualizations ofculture and our responses to culturalneeds and demands, we can challengeourselves to integrate new and more effective intervention strategies (Fouad& Arredondo, 2007). Ultimately, achiev-ing professional and cultural compe-tence ensures that clients receive thehighest quality of service available. Bymastering and implementing effective techniques and practices in daily inter-actions, we will more naturally maintainhigh levels of competence in extremisenvironments as well.

In order to increase our cultural compe-tence, we must first work toward under-standing cultural differences. Thisinvolves increasing our level of knowl-edge about the potential impact of di-versity on our clinical practices,including how to best integrate materialfocused on culture-of-origin, accultura-tion, and shared or disparate culturalunderstandings. In educating ourselves,it behooves us to remain mindful of tra-ditionally underserved or nondominantcategories of difference, as addressingthese issues in a broad range of environ-ments is becoming commonplace (Seh-gal et al., 2011).

This exploration, understanding, and ac-ceptance of cultural variations and char-acteristics present service providers withthe opportunity to establish rapport anddevelop healthy and open relationshipswith our clients. A healthy professionalrelationship includes honesty, integrity,and commitment. Cultural incompe-tence hinders our ability to provide highquality service to our clients. A trustingrelationship increases effectiveness ofservice to our clients and encouragesopen and honest communication. Thisallows clients to feel comfortable whileencouraging them to be more openabout their own cultural and personalneeds. Particularly in high stress envi-ronments, the establishment of rapport,

honesty, and empathy may ultimatelydictate the success of the client-therapistrelationship.

In the end, a healthy, culturally compe-tent therapeutic relationship includesempowering clients, using appropriateintervention techniques and strategies,and advocating on behalf of clients. Inorder to effectively accomplish thesegoals, we must continuously and con-structively evaluate our own practicesand responses. This involves under-standing and accepting the limitationsof our own knowledge and competen-cies and striving to address these gaps.Furthermore, this process involves rec-ognizing high-stress environmental fac-tors that could hinder our ability toadhere to typical protocols.

The process of becoming professionallyand culturally competent is a sequential,continuous process that involves con-stant assessments, self-awareness, andreflection. Using evidence, research,peers, and mentors, we must criticallyevaluate ourselves as professionals inorder to recognize distinct areas withpotential for personal growth. Biases,emotions, behaviors, and lack of compe-tencies hinder our ability to empathizeand intervene, especially in extremis en-vironments or situations. In an expand-ing and increasingly demanding field, itis essential to recognize our own innatevulnerabilities and identify the amplifi-cation effects of working in extremis set-tings. Our reaction to these high stressenvironments will determine our suc-cess as professionals in this field. Recentpsychological research, refinements intheory, and adaptations challenge cur-rent psychologists to surpass previousethical expectations and establish professional and culturally competentethical precedents. We must accept this challenge and take personal respon-


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sibility for implementing the higheststandards of professional and culturalcompetence.

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NOTICE TO READERS

References for articles appearing in this issue can be foundin the on-line version of Psychotherapy Bulletin published

on the Division 29 website.

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Robert Neimeyer veryrecently expanded hissubstantial work ondeath and dying with abook of several hun-dred brief interventiontechniques for grief

therapy (Neimeyer, 2011). In collaborat-ing with him, there was an opportunityto develop some of the internationaltrauma intervention techniques (Mor-gan, 2011) as they intersect with grieftherapy. These bridging chapters in-cluded anticipatory trauma, intergener-ational trauma, and vicarious traumaticgrief.

This sample vignette, not from theNeimeyer book, on the assessment oftraumatic origins as key to clinical inter-vention illustrates the integration possi-bilities of the two growing fields of griefand trauma treatment in the techniquesformat used by Neimeyer.

Patients: Children experiencing trau-matic grieving for a deceased familymember.

Method: We have long known thatmeasuring something can change whatis being measured.

Those who do psychotherapy may findabundant examples of how an incorrectassessment, or its consequences, mayhave created substantial problems fortheir eventual client (Morgan, 2004).

Conversely, the application of an effec-tive assessment, cognitive, personality,or vocational, can be used as a treatment

in itself, particularly where grief under-lies the presenting issues.

Example: Andy’s mother had broughthim to me in the last week of our NovaScotia, Canada, Summer Clinic. He wasfive years old and he had just spent thewhole first week of his first publicschool experience crying. He did pausenow and then for breath, but wheneverthe teacher approached him withcrayons or pencils he would start sob-bing again, without explanation.

His mother, it seemed to me, was gen-uinely concerned and Andy seemed tofeel safer in her presence so I let her staywith him while I read through the socialwork report. By the time I was donereading, the origin of his traumatic griefwas clear.

Andy was an only child and his motherwas his only parent. He had not alwaysbeen an only child. There had been abrother, one year older, who had gone tothe public school the year before. There,the same teacher had determined thatAndy’s brother was developmentallydelayed and, with the support of a localpsychiatrist, had the brother committedto a provincial institution. There, thebrother had become ill and died. He wasburied in a cemetery that could be seenfrom Andy’s living room window. Andnow it was Andy’s turn to go to thesame school and be tested. Understand-ably, he had no interest in pencils orcrayons or much else in that school. Hismother had done well to bring him tothe clinic.

FEATURE

Grief Therapy Assessment of Traumatic Origin as Both Problem and Solution: A Mystery Tears VignetteRobert F. Morgan, Ph.D.University of Arkansas, Little Rock


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I drew a stick figure (the limit of myartistic ability) on half a sheet of paper.With his mother’s firm reassurance, hedrew a similar figure on the other half ofthe paper. Then I drew an extension ofmy stick figure’s hand to go shake hisstick figure’s hand. Andy laughed.Building on this, I got out a book of pic-tures, four to a page. This was thePeabody Picture Vocabulary Test (PPVT)(“Which of these pictures is a tree?”).Andy, safe in his mother’s space, com-plied with the instructions and an-swered progressively more challengingpicture selection choices until I hadenough information to determine hisverbal intelligence. It was normal.

I did continue on in this PPVT gamelong after I had the data by going backto easier choices so Andy could end thistesting experience with sequential suc-cesses instead of the cumulating failuresthat end most intelligence testing se-quences.

Now, another departure from expectedpractice process, I gave Andy’s motherthe results of this screening test whilethe child was still there to hear it. Andywas as smart as the other children. Hewould not be sent away. He could con-tinue to live with his mother. He woulddo just fine in school.

My report was very clear that he should

not under any conditions be institution-alized nor did the testing yield any need.But it was not only my report that madethe difference. It was the social worker’sreport. Without it, I might have triedsystematic desensitization to pencils orrelaxation CBT at school or any other ap-proach that might have addressed hissurvival defenses but not their traumaticgrieving origin.

With a very thorough background his-tory, and the intervention of assessmentinterpretation, I could complete Andy’scase in a single session and a single fol-low-up. Timely information and assess-ment, if effectively shared, can behealing.

Concluding thought: Ever since thedawn of applied psychology, includingthe arguments of William James withLightner Witmer (McReynolds, 1997),there has been tension between seeingpsychological testing as research orpractice, and as iatrogenic or essential(Morgan, 2004). A more modern view isthat the administration of a test must bestandardized and consistent for thenorms to have any meaning, but the de-livery of the results is in itself an inter-vention. In other words, administeringthe test is research while providing theresults is practice. Once the data are in,the assessment process can in itself be-come a treatment.

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As is often the case,Council was a mixtureof highly significantitems, housekeepingmatters, essential pol-icy review, and “I can’tbelieve we are talkingabout this” subjects.We will report herethose decisions thathave impact or interestfor our division; how-ever we are certainlyhappy to answer any

additional questions or address any itemwith our membership.

Psychotherapy EffectivenessPerhaps the most important item to us isone that was not even on the agenda andwas not discussed. That is the proposedresolution on the “Recognition of Psy-chotherapy Effectiveness.” Two yearsago when Melba Vasquez was runningfor APA President-Elect, she came to ourdivision and talked about her valuing ofpsychotherapy in her practice and in theprofession. We endorsed Melba andafter her election, she decided to make“Recognition of Psychotherapy Effec-tiveness” part of her presidentialagenda. At the time, Nadine Kaslow was our president and Linda Campbellone of our Council Representatives. Thethree of them became the movers of thisitem through Council. Well, here we aretwo years later, having gone throughgovernance groups for review twice. Wehave heard scuttlebutt that some inter-ested members want to broaden the res-olution to include more psychologicalservices than psychotherapy. We havenot heard any specifics yet, but want toassure you that Linda Campbell andJohn Norcross are alert and will keepyou posted on the situation.

Budget ReportWe’ll start with the good news and saythat APA is in good financial standingand has made a very impressive recoveryfrom a few years ago. The 2011 budget iscoming in with $20,000 surplus with op-erational revenues at $106,877,300 andoperational expenses at 106,857,3000.The 2012 budget is projected at revenuesat $106,160,000 and expenses at$106,104,000 with a $56,000 surplus. TheCouncil voted to approve the goal of abalanced budget annually. Congratula-tions to our stewards of the treasury.

Convention Changes (Again)The primary goals for the changes inconvention is twofold: (1) to reduce thesize of the convention by reducing hoursby 20% which is 1250 hours and (2) tocreate more cross cutting themes be-tween divisions, divisions and othergovernance groups, and to foster collab-oration that represents the breadth andscope of the profession. A Central Groupwill have hours that can be allocated forcross cutting sessions and every divisionwill have at least 10 hours with addi-tional hours being allocated in accor-dance to the membership of the divisionfor the previous three years. In the newformula, 1000 hours will be allocated todivisions with no distinction betweensubstantive and non substantive hoursand the remaining 250 hours will be al-located by the Central Group.

There is mixed reaction, as can be ex-pected, because various groups don’tknow how they would fair under thisplan. There is willingness by the gover-nance groups to step up and give thenew plan a chance, but all eyes will beon the convention when the plan makesits debut.


COUNCIL OF REPRESENTATIVES REPORTLinda F. Campbell, Ph.D. and John C. Norcross, Ph.D.

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Dues Exemption and Life MembershipAPA continues to try to find the meansby which the various member categoriescan be fairly treated while also retainingmembers. As we recall, last year themember dues was reduced by $45.00 be-cause of the strength of the budget. Thisyear, dues exemption and life member-ship were reviewed with the followingrecommendations:

Any member who has reached the ageof 69 (formerly 65) and has belonged tothe APA for a total of 29 (formerly 25)years, may choose to become dues exempt. Those dues exempt membersopting out of the subscription price/ser-vicing will be charged a minimal admin-istrative fee as set by Council.

Strategic InitiativesDuring the last three years, APA has de-veloped its first strategic plan. In orderto implement the strategic plan, initia-tives needed to be developed andfunded. Following are the seven initia-tives which will be funded at differentlevels:

1. Assess and restructure business mod-els for membership dues, annul con-vention and APA products to increasemember engagement and value.

2. Conduct ongoing analyses of currentand future demand for the psychol-ogy workforce to meet nationalneeds.

3. Continue to develop and promulgatetreatment guidelines to promote thetranslation of psychological science.

4. Evolve and expand the public educa-tion campaign to include the entirediscipline of psychology.

5. Promote opportunities for graduateand continued professional develop-ment to advance psychology inhealth, including interdisciplinarytraining.

6. Increase support for research, train-

ing, public education, and interven-tions that reduce health disparitiesamong underserved/marginalizedpopulations.

7. Forge strategic alliance with healthcare organizations to include psy-chologists in integrated health careservices.

ResolutionsThree resolutions passed with enthusi-asm and support. None failed. These arethe Resolution Advocating for Psychol-ogy as a STEM Discipline, Resolution onMarriage Equality for Same Sex Cou-ples, and Resolution on Family Care-givers.

Educational AffairsSeveral specialties were up for renewaland were approved by Council. Theseare Sport Psychology, Clinical HealthPsychology, and Industrial- Organiza-tional Psychology. Also, the Council of-ficially adopted the new NationalStandards for High School PsychologyCurriculua.

ICD UpdateDr. Geoffrey Reed, a former staffer atAPA, and Dr. Pierre Ritchie reported onthe progress of the development of theICD-10 CM and the status of involve-ment for APA. Geoff and Pierre reportedthat the ICD-10 must be applicable glob-ally and for various health care settings.An exciting prospect is that the classifi-cation system is being developed independent of the pharmaceutical com-panies and also that is not psychiatrydominated. Psychologists, including Dr.Reed, are members of the revision groupwhich is an enormous step forward forpsychologists.

BPA has recommended the creation of avirtual working group to develop strate-gies for education and training psycholo-


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gists in the use of the ICD-10 CM throughonline CE course for psychologists.

Division 29 SpotlightsNormally, we would not draw attentionto our own recognition, but in this case“The Presidential Citation,” awardedthis year to 8 individual psychologistsfor distinguished contribution to theprofession. Our divisions APA Council

Representatives were two of the eightreceiving the recognition.

We are honored to represent the Division of Psychotherapy in the APACouncil and welcome any and all exchanges of questions, concerns, andperspectives. Linda Campbell: [email protected] and John Norcross: [email protected].

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We are delighted thatwe were awarded theNorine Johnson Psy-chotherapy ResearchGrant that has just beenestablished by Division29. This grant willgreatly enable us toconduct research in ourMaryland Psychother-apy Clinic and Re-search Lab, which wefounded three yearsago to allow us to do

research on long-term psychodynamicpsychotherapy. Given the funding forsuch research is very difficult to obtainfrom other sources, we feel grateful thatthis grant will allow us to conduct thetype of research we believe is necessaryfor the advancement of psychotherapy.

The Norine Johnson Grant was estab-lished to further our understanding oftherapist effects in psychotherapy. Recent evidence (e.g., Bolt, Wampold, & Kim, 2006) has suggested that thera-pist effects account for a considerableamount of variance in psychotherapyoutcome. In other words, some thera-pists generally have good outcomes,whereas others have poor results. Un-fortunately, apart from findings over theyears on the importance of a few rela-tional conditions (e.g., therapist empa-thy), we have no definitive evidenceabout what variables go into the makingof effective psychotherapists.

In our proposal, we described two majorstudies that we hope will lead to furtherunderstanding of therapist effects. Thefirst study involves investigating the ef-fects of training on therapists, or morespecifically changes across the course of

therapist training. The second study in-volves examining therapist characteris-tics that might influence the process andoutcome of psychotherapy. More specif-ically, we examine the effects of therapistattachment, therapist countertransfer-ence, and session outcome. We presentthe proposal here for these studies.

Changes in Therapist Behavior andSession Outcome Across TrainingIn a review of the literature on trainingand supervision that we are conducting(Hill & Knox, in press), we have founda huge number of studies that have indi-rectly assessed the effects of training. Forexample, many studies have includedtherapist experience level as a predictorin studies of therapist outcome. But suchstudies provide only very tentative evi-dence for the effects of training since ex-perience level is not a good proxy fortraining. Similarly, therapists have beenasked in surveys to judge the relative in-fluence of different aspects (e.g., train-ing, personal therapy, experience withclient) of their experience on their effec-tiveness as therapists, but again such ev-idence is of limited use in directlyproviding evidence for the effectivenessof training since it is retrospective andvery global. There have also been manystudies that examined the effects ofhelping skills training, but these studiesfocus mainly on very novice traineesrather than covering longer time spans.Similarly, studies have been conductedon manual-guided training, however,these focus primarily on very experi-enced therapists, which again truncatesthe range of training.

There have been a few studies that havelooked more directly at changes over the

2011 NORINE JOHNSON PSYCHOTHERAPY RESEARCH GRANT RECIPIENTSClara E. Hill, Ph.D. and Charles J. Gelso, Ph.D.


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course of graduate training. Data fromsuch studies are also problematic interms of drawing conclusions about theeffects of training, since a number of con-founds (e.g., personal therapy, experiencewith clients) cannot be controlled. How-ever, these studies provide somewhatbetter evidence for the effects of training.Going into this area, researchers of coursehave to remain humble because of theimpossibility of conducting true experi-ments that randomly select people fortraining, randomly assign them to train-ing or no training or placebo conditions,and test the effects of such training overthe course of graduate training and pro-fessional careers.

A few studies used very brief encounters(15-30 minutes) with volunteer clients toassess changes over time. Hill, Charles,and Reed (1981), O’Donovan, Bain, andDyck (2005), Pope, Nudler, Norden, andMcGee (1976), Thompson, (1986) allfound a variety of changes across time,but there was no replication of resultsacross studies. Furthermore, the use ofsuch brief sessions with volunteerclients describes only the ability to veryquickly establish a relationship with anon-client rather than the ability to ac-tually work with a real client.

More relevant to the present study arethose studies that assessed changes withactual clients. In Multon, Kivlighan, andGold’s (1996) study of training in time-limited dynamic psychotherapy (TLDP),they found increases in adherence toTLDP and in client-rated working al-liance across 4 sessions with a single vol-unteer client. Hilsenroth, Defife, Blagys,and Ackerman (2006) investigatedchanges within and across the first twocases seen by 15 clinical psychologygraduate students working in a clinicwhile learning to implement short-termpsychodynamic psychotherapy. Thera-pists used more psychodynamic-inter-personal techniques from sessions 3 to 9

in the 1st case but had no comparablechanges in the 2nd case, and they usedmore PI techniques in the 2nd as com-pared with the 1st case in the 3rd sessionbut not the 9th session. The inconsistentresults across cases in the Hilsenroth etal. study make us wonder if it was diffi-cult to find changes across cases giventhat there were only two cases across thecourse of a single year; it may take muchlonger for changes to consolidate.

Hence, the purpose of the present studywas to replicate Hilsenroth et al.’s find-ings with trainees seeing a larger num-ber of clients and to extend Hilsenroth’set al. study by also investigating sessionoutcome measures. Our research ques-tion is: Do therapists-in-training in a psy-chodynamically-oriented clinic changeover time in their ability to conduct ef-fective psychodynamic/interpersonaltherapy (e.g., increase use of psychody-namic interventions, have higher client-rated working alliance and sessionoutcome in 3rd and 9th sessions withclients) across 1 to 3 years of training?Psychodynamic interventions in the 3rdand 9th sessions will be coded by 2 to 3trained graduate students using the 10-item Psychodynamic-Interpersonal (PI)scale from the Comparative Psychother-apy Process Scale (Hilsenroth et al.,2006). Hierarchical linear modeling andgrowth curve analyses will be used to ex-amine changes over time in the use ofpsychodynamic/interpersonal interven-tions, client-rated working alliance, andsession outcome. Regression analyseswill be used to investigate the relation-ships among therapist attachment, coun-tertransference, and treatment outcome.

Attachment and Countertransferencein Relation to Psychotherapy Processand OutcomeOver the past decade, adult attachmentstyle has emerged as one of the mostpromising constructs in psychotherapy


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research. A number of studies havefound that client attachment patternsplay an important role in psychotherapyprocess and outcome (e.g., Levy, Ellison,Scott, & Bernecker, 2011). Less work hasbeen done on therapist attachmentstyles, and the extant research hasyielded mixed results. For example,Ligiero and Gelso (2002) did not detectany relationships among different thera-pist attachment styles and working al-liance. In contrast, Sauer, Lopez, andGormley (2003) found that high thera-pist attachment anxiety was associatedwith initially high alliance ratings thatdeclined over time. Dinger, Strack,Sachsse, and Schauenburg (2009) foundthat therapist attachment security wasnot related to alliance development, buthigher therapist preoccupation (similarto Sauer et als’ anxiety dimension) wasassociated with lower levels of alliancequality. Schauenburg et al. (2010) foundno main effects for therapist attachment,although higher therapist attachment se-curity was associated with better al-liance and outcome in more severelydisturbed clients. Finally, in Fuertes,Mislowack, Brown, Gur-Arie, Wilkin-son, and Gelso’s (2007) study, therapists’avoidant attachment, but not anxiety at-tachment, predicted poorer progress intreatment. Studies using empirically val-idated, gold standard measures areclearly needed to clarify the results inthis area. In addition, given that most in-vestigations have been of brief therapy,we need to study therapist attachmentpatterns in relation to treatment out-come in longer-term psychotherapy.

The countertransference construct hashad a long history in psychotherapy the-ory, but it has only recently been studiedempirically to any significant extent. Intheir meta-analysis, Hayes, Gelso, andHummel (2011) found that therapistcountertransference was negatively as-sociated with psychotherapy outcome.Thus, the more the therapist’s unre-

solved conflicts were aroused in ses-sions, the more likely it was that the out-come of psychotherapy was negative.Although these meta-analytic findingswere significant, Hayes et al. noted thepaucity of studies in this area, that mostof the existing studies have been con-ducted with analogue clients, and thatthe measurement of countertransferencehas been inconsistent and often inade-quate. Thus, there is a need for studiesusing real clients and reliable, theoreti-cally sound measures of countertrans-ference. In addition, next to no researchhas examined the association of thera-pist countertransference with actualtreatment outcome, rather than proxiesof outcome (e.g., the working alliance).Such research is sorely needed in thisarea (Gelso & Hayes, 2007).

We can also think about the interactionbetween attachment and countertrans-ference. In a sample of pre-practicumstudent trainees paired with volunteerclients, Mohr, Gelso, and Hill (2005)found that therapists’ dismissing attach-ment patterns were associated with hos-tile countertransference, especially withcertain clients. In contrast, Ligiero andGelso (2002) uncovered a significant andinverse relation between therapists’ se-cure attachment patterns and counter-transference behavior. These findingshint at the complexity in the connectionof therapist countertransference and at-tachment. In their review, Gelso andHayes (2007) suggested that future re-search combine therapist attachmentand countertransference in more com-plex ways to advance our understand-ing of the influence of these therapistvariables on session and treatment out-come. For example, the effects of thera-pists’ attachment patterns on treatmentoutcome may be at least partially mediated by therapist countertransfer-ence behavior (e.g., attachment affectscountertransference, which in turn


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affects outcome). Alternatively, it seemstheoretically reasonable that the effectsof therapist attachment patterns aremoderated by therapist countertransfer-ence behavior. For example, it may wellbe that when negative countertransfer-ence exists to a high degree, therapistanxious and avoidant attachment pat-terns will be associated with poor out-comes, whereas when negativecountertransference is low, neither anx-ious nor avoidant therapist attachmentwill be related to outcomes. Such inter-action effects would help explain someof the inconsistent findings in the thera-pist attachment literature.

We formulated the following questionsand hypotheses about therapist attach-ment and countertransference in relationto psychotherapy process and outcome. • How does therapist attachment stylerelate to the process and outcome ofpsychodynamic treatment? Morespecifically, we hypothesize that ther-apist attachment avoidance and anx-iety will be negatively related totreatment outcomes, whereas attach-ment security will be positively re-lated to treatment outcome.

• How does therapist countertransfer-ence relate to the process and out-come of psychodynamic treatment?More specifically, we hypothesize thatboth positive and negative counter-transference will be negatively relatedto treatment outcome.

• Are the effects of therapist counter-transference on outcome mediated byattachment patterns?

• Are the effects of therapist attachmentpatterns on treatment outcome mod-

erated therapists’ countertransferencebehavior?

About 15 doctoral counseling psychologystudent-therapists who had at least twopractica prior to externing at a psychologydepartment clinic were paired withclients from the community in that clinic.

Psychotherapist-trainees (all of whomindicate an interest in learning psycho-dynamic and interpersonal psychother-apy) complete a self-report measure ofattachment patterns (Experiences inClose Relationship Scale, ECR) prior tostarting at the Clinic. After every ses-sion, therapists and clients completemeasures of alliance and session out-come; in addition, therapists and super-visors rate countertransference. Prior tostarting therapy, after every 8 sessions,and at the end of therapy, clients com-plete measures of symptomatology andinterpersonal functioning.

Clients are assigned to therapists ac-cording to availability. Treatment isopen-ended (within the boundaries ofthe therapist’s time at the Clinic) andpsychodynamic/interpersonal. Thera-pists participate in weekly psychody-namically-oriented individual supervision and bi-weekly group supervision.

ConclusionsWe are excited about the opportunity toinvestigate these questions about thera-pist effects within the context of ourClinic. We would be eager to hear feed-back from readers about other possiblethings we might investigate within thisdata set or ideas for improved methodsfor investigating these questions.

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I w a s h ono red t o receive the Division 29Charles J. Gelso, Ph.D.,Psychotherapy ResearchGrant, which was es-tablished to help fundresearch in the area of

psychotherapy process and/or outcome.I am using the monetary award to sup-port a collaborative, multi-site projectexamining patients’ perceptions of cor-rective experiences in individual psy-chotherapy. Although this monetaryaward is specific to the work that I amconducting at my site (the University ofMassachusetts; UMass), I would like toacknowledge my collaborators on theoverarching project: Lynne Angus (YorkUniversity), Kathrin Moertl (York Uni-versity), Barry Farber (Teachers College,Columbia University), Stanley Messer(Rutgers University), Myrna Friedlan-der (University at Albany), and JesseGeller (Yale University). I would alsolike to acknowledge and thank my grad-uate students who have assisted im-mensely with the work at our site:Rebecca Ametrano, Samantha Ber-necker, and Joan DeGeorge. Below Ipresent a summary of the research pro-posal on which this grant was based.

GoalsThe construct of corrective experiencehas a long history in psychotherapy(Alexander & French, 1946; Wallerstein,1990). Although definitions vary amongclinical theorists and across treatmentorientations, all suggest a type of trans-formative experience or set of experi-ences for the psychotherapy patient.Despite a rich theoretical history,though, there is little empirical informa-

tion on patients’ perceptions of what istherapeutically corrective, or transfor-mative. Thus, the primary aim of thisproject is to investigate patients’ post-treatment accounts of corrective experi-ences in psychotherapy using aqualitative interview methodology. Asecondary aim, in a subset of patients (atUMass), is to examine quantitatively pa-tients’ experience of their therapist dur-ing treatment (namely, experiences thatmight detract from the effectiveness, or“correctiveness,” of treatment).

Relevant BackgroundIn the psychotherapy literature, muchhas been written about patients’ experi-ences in therapy and possible therapeu-tic change mechanisms (e.g., Elliott &James, 1989; Llewelyn, 1988; Mohr &Woodhouse, 2001; Timulak, 2007). Onerelevant construct is the corrective experi-ence, which can be defined broadly as atime at which a patient comes to under-stand or experience affectively an eventor relationship in a different or unex-pected way (Castonguay & Hill, inpress). Such shifts in understandingand/or experience are more than justacutely helpful or novel, but also trans-formative in some manner.

Although there has been considerabletheorizing regarding the nature of cor-rective experiences, little is known aboutwhat patients perceive to be correctiveand whether these perceptions squarewith theoretical accounts. This lack isnotable considering that corrective expe-riences ultimately “belong” to the pa-tient. To address this lack, the presentstudy is assessing, across multiple com-

2011 CHARLES J. GELSO, PH.D., PSYCHOTHERAPYRESEARCH GRANT RECIPIENTMichael J. Constantino, Ph.D.University of Massachusetts Amherst


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munity-based outpatient settings, pa-tients’ accounts of corrective experiencesas they reflect back on their recentlycompleted treatment. This study com-plements and extends recent work bylargely the same multi-site researchteam that examined patients’ post-ses-sion accounts of corrective experienceswhile engaging in the ongoing therapyprocess (Heatherington, Constantino,Friedlander, Angus, & Messer, in press).

The primary research questions include:(1) In reflecting back on the time sincebeginning and ultimately completingtherapy, what do patients perceive as as-pects of self, other, and/or relationships(cognitive, affective, or relational in na-ture) that get corrected? (2) In reflectingback on the same time frame, what dopatients perceive as corrective experiences(i.e., instances in therapy, outside oftherapy, or in interaction with others, in-cluding possibly the therapist) that fos-tered what was corrected?

Secondarily, at the UMass site only, thisproject is also assessing quantitatively theconstruct of therapist minimization as apotential patient experience that may de-tract from the effectiveness, or “correc-tiveness,” of psychotherapy. As acommon type of social support, minimiz-ing involves downplaying the severity ofother people’s painful experiencesthrough messages that imply that the ex-perience “could have been worse” or thatthe person who experienced the eventshould not feel as bad as she or he does(e.g., Dakof & Taylor, 1990; Hays, Magee,& Chauncey, 1994). Despite the intuitiveappeal of support attempts that involveminimization, recipients of these mes-sages describe them as hurtful rather thanhelpful (e.g., Ingram, Betz, Mindes,Schmitt, & Smith, 2001). However, mini-mization as a type of support has yet tobe examined in the therapy setting.

Thus, patients of the UMass outpatienttraining clinic who are participating in

the parent posttreatment interviewstudy are also being asked to completea brief minimization questionnaire atregular session intervals throughouttheir treatment. These data will bepooled with prior data collected at thesame site under the same procedures,which will allow assessment of the fre-quency and severity of therapists’ deliv-ery of minimizing messages, as well astheir impact on other important treat-ment processes (e.g., patient-therapistalliance quality) and outcomes (e.g., ses-sion evaluation). Data related to this sec-ondary aim will also speak tominimization as a potential mechanismthat interferes with adaptive treatmentprocess and corrective experience.

Target PopulationPatients are consenting adult outpa-tients who complete a course of natura-listically delivered psychotherapy at oneof three study sites (i.e., UMass, York, orColumbia). At UMass, approximately 30patients will ultimately be included inthe present study. These patients aretreated at the outpatient training clinic,which reflects an ideal setting given its well-established data collection infrastructure, evidence-based practiceculture, and ecological validity. Approx-imately 15 of the 30 PSC patients will beinterviewed for the multi-site qualitativeanalysis of patients’ posttreatment per-spectives on corrective experiences.These patients will be pooled with ap-proximately 15 patients at York and fiveat Columbia to create a sample size ofapproximately 35 patients across thesites. This reflects a large sample for theintensive qualitative analyses that willbe conducted, and it should safely allowfor saturation/stability of the emergingcategories.

All patients at UMass also complete therelevant during-treatment measures forthe secondary aspect of the project. Data


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from the 30 patients involved in thepresent study will be pooled with datafrom 40 additional patients, which werecollected as part of a previous study. Theresulting pooled sample of 70 UMasspatients will allow for preliminaryquantitative analyses of therapists’ de-livery of minimizing messages, as wellas their impact on other important treat-ment processes (e.g., alliance quality)and outcomes (e.g., session evaluation).The Gelso Research Grant was crucial tothe success of the project, as it allowedus to continue to compensate patientsfor their time and effort both for the dur-ing-treatment data collections and theposttreatment interviews.

MethodsTherapistsTherapists are graduate and postdoc-toral trainees delivering psychotherapyunder the supervision of a licensed psy-chologist. Restricting our sample tothose patients being seen by trainees cre-ates a more homogeneous sample, al-lowing for greater data stability andconfidence in the findings.

Interview and InterviewersFollowing their termination from treat-ment, patients engage in a semi-struc-tured interview that assesses theirreflections on broad and therapy specificcorrective experiences. The interviewsare conducted in person by trainedgraduate research assistants and last ap-proximately 1 hr. Each interview con-sists of the same set of open-endedquestions with flexible follow-upprompts. The principal investigator ateach site trains and supervises their localinterviewers on the protocol.

Judges and Data AuditorsA team of six coders (two per site) willjudge the interview data. The codingteams comprise a blend of the site prin-cipal investigators (Angus, Constantino,Farber, and Moertl) and graduate stu-

dents, whereas the role of three collabo-rators (Friedlander, Geller, and Messer)will be centered on data auditing.

Data AnalysisData will be analyzed based on audiorecordings and transcripts of the post-treatment interviews according togrounded theory analysis (GTA; Glaser& Strauss, 1967). This method will allowus to gain a rich understanding of pa-tients’ first hand experiences of correc-tive experiences. GTA provides a set ofsystematic coding procedures that facil-itates the development of a tailor-madecategory system and a conceptual modelthat are grounded in the data under in-vestigation (rather than applying a set ofa priori established categories).

Step 1: Consensual identification ofcontent domains. Interview questionswill provide a guided inquiry into pa-tients’ firsthand accounts of what theyexperienced as corrected and what wascorrective in psychotherapy. To capturethis distinction, coders will first identifydistinct content domains in the inter-view transcripts following proceduresused in Consensual Qualitative Re-search (Hill, Thompson, & Williams,2005). Any discrepancies in domainidentification will be settled via discus-sion and consensus decisions among theprimary coding team and data auditors.

Step 2: Coding content domains usinggrounded theory procedures. Withineach identified content domain, coderswill identify individual meaning unitsthat represent each distinct idea ex-pressed by the patient related to correc-tive experiences. Coders will add a newcategory each time a new idea (meaningunit) is introduced by the patient. Thecoders will apply category names thatare low in abstraction and favor a spe-cific description (e.g., therapist’s disclo-sure of personal information gave me


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hope) rather than a general one (e.g.,hope). In the open coding phase, mean-ing units will be successively sorted intorepresentative categories that summa-rize and capture the core meaning of patients’ corrective experiences. Modifi-cations are made to the category systemas new categories emerge in the contextof coding successive interview tran-scripts. This strategy enables coders togroup systematically specific categoriesinto overarching subcategories and corecategories that define patients’ correc-tive experiences (Lepper & Riding, 2005;Strauss & Corbin, 1990). According toGTA, category saturation is achievedwhen additional data would not sub-stantively add to the understanding ofthe phenomenon under study. Once sat-uration is achieved at each site, codingteams and data auditors will come to-gether to organize thematically and tointegrate the emerging category systemfor the articulation of a transtheoreticalmodel of patient corrective experiencesin psychotherapy.

Secondary Materials and AnalysesAt UMass only, the secondary questionfocused on patients’ experience of ther-apist minimization will be examined inrelation to session outcomes, alliancequality, and treatment outcomes via hi-erarchical linear modeling. Patients’ per-ception of therapist minimization

messages (across five different sessions)is assessed with a study-specific briefquestionnaire. Patients’ perception ofsession impact, treatment progress, psy-chological state, and therapist helpful-ness is assessed with the SessionProgress Scale extracted from the Thera-pist Session Report (Orlinsky &Howard, 1975). Therapeutic alliancequality is assessed with the Working Al-liance Inventory (WAI; Horvath &Greenberg, 1989) and treatment out-come is assessed with the TreatmentOutcome Package-Clinical Scales (TOP-CS; Kraus, Seligman, & Jordan, 2005),which are both administered routinelyat the UMass clinic.

Anticipated OutcomesThis project is exploratory in that priorresearch has yet to focus on patients’constructions of their corrective experi-ences or their perceptions of therapistminimization. However, to the extentthat therapist minimization occurs, I an-ticipate that it will be associated withpoorer treatment process and outcomes.

ConclusionsI am excited about the opportunity toengage in this exciting collaboration,and I am grateful for receiving supportfrom the Division in the form of theGelso Research Grant. I look forward tosharing our findings!

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If we ask those of youwho knew Pat Bricklinto image Pat in yourmind, each of youwould likely report see-ing Pat walking towardyou with a smile on her

face, making direct eye contact, and slow-ing her pace so that she could stop andask you how you are doing. The commonthread among passages I have read aboutPat over the years are the terms kindness,generosity, and breaking the glass ceiling.How true these characteristics are of Pat.

Pat was our President in 2003. While shewas president, I became president-elect,and Leon VanderCreek became presi-dent-elect designate. Those were leanyears in the division and we were eachserving with the understanding that asmy mother would have said, the divi-sion “didn’t have two dimes to rub to-gether.” Leon and I had cooked up ashared presidential initiative that wethought could have significant value forthe division and cost next to nothing.The initiative would only have workedwell if we could conduct it over threeyears. Pat had been pursuing her owninitiative and serving very effectively asour president. Leon and I carefully ap-proached Pat, playing of course on Leonand Pat’s common roots as Pennsylva-nians and explained our plan. Our divi-sion is continually vigilant regarding thehealth and wellbeing of psychotherapyin these times of quickly shifting factorsthat affect our work. We proposed doingfive focus groups by phone asking thesingle question, “what would be themost important action and/or goal thatour division should achieve in order toenhance and preserve psychotherapy.”

Our focus groupswould be (1) leadersof the division, (2)educators/trainers,(3) practitioners, (4) psychotherapy re-searchers, and (5) students. When Patheard our plan, she gave it somethought and came back to us saying thisis most important and we must do it.That became one of the few times a divi-sion of APA has conducted a presiden-tial initiative over three years, and moreimportantly, the data from those focusgroups guided our decision making andour objectives for several years.

This was the person of Pat Bricklin, hervalue of making a difference and doingsomething important, not being in thespotlight or getting all the recognitionfor a success. Pat saw herself as part of agreater whole. She had a vision of wherepsychology could go and how to getthere without factoring herself in as theflag bearer at each turn. This value madePat a person whom everyone wanted tobe part of a project because she was theultimate team player. You would neverknow this by talking to Pat but she mademajor contributions to APA, ASPPB (thelicensing association), the APA Insur-ance Trust, and served on the Pennsyl-vania licensing board. Even among ourmost accomplished leaders, we rarelysee a person become an integral part ofso many of our major professional enti-ties. Some of those major contributionsare as follows.

Breaking the Glass CeilingEvery passage I have read about Pat hasused this term and it’s true. Amongthose ceilings are these achievements:(a) Pat received her master’s degree in

PAT BRICKLIN’S FOOTPRINT IN OUR DIVISION OF PSYCHOTHERAPYBy Linda Campbell, Ph.D.


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1954 a time when very few women wereadmitted to graduate school in anythingexcept nursing and teaching. (b) She thendared to apply, be accepted, and gradu-ate from a Ph.D. program at Temple, (c)Pat matriculated and graduate from herdoctoral program while also raising afamily which was a major shattering ofglass. This was squarely during the timewhen Katherine Hepburn had declaredthat women must choose career or family.You cannot have both and don’t kidyourself otherwise, she proclaimed.Adding insult to discrimination, admis-sions committee often were leery ofwomen applicants because it wasthought, if they have children they willdrop out and we will have wasted our re-sources. It took many more years actuallyto break that particular ceiling. (d) Laterin the 1970’s, after taking a position atWidener and being one of the onlywomen faculty, Pat was instrumental indrafting the first Practice Act of 1972 forPennsylvanian psychologists. (e) Patsoon became the first and only womanappointed to the first state board for reg-ulation of psychologists in Pennsylvania.

Her Legacy to UsPat Bricklin’s influence and wise deci-sion making is still with us in so manyways. She served for thirty years on thePennsylvania Board intermittently andcrafted much legislation that has beenadopted across jurisdictions. She wasappointed by both political parties’ gov-ernors because she was a voice of reasonand collaboration. Pat served as presi-dent of the Pennsylvania PsychologicalAssociation, the Association of State andProvincial Psychology Bards, the Societyfor Personality Assessment, and the Na-tional Council of Schools and programsin Professional Psychology as well asseveral divisions including our Divisionof Psychotherapy. Pat also chaired theAPA Insurance Trust, the APA Commit-

tee for the Advancement of ProfessionalPractice, the APA Board of ProfessionalAffairs, and the Committee on Structureand Function of Council. And finally,Pat served as a site visitor for the APACommission on Accreditation, the Com-mission for Recognition of Specialtiesand Proficiencies in Psychology, the APACouncil of Representatives, the APA Fi-nance Committee, and the APA Board ofDirectors. This is one astounding list ofaccomplishments but more importantly,contributions to our field and to us as in-dividual psychologists.

Most Deserved RecognitionPat’s contributions have been very justlyrecognized. In 2007, Pat received theAmerican Psychological Foundation’sGold Medal Award for Life Achieve-ment in the Practice of Psychology. Shewas awarded the APA State LeadershipAward, the APA Award for Distin-guished Professional Contributions, thePPA’s Distinguished Service and Distin-guished Contributions to School Psy-chology Awards, and the ASPPB’sMorton Berger and Roger C. SmithAwards. Pat was also awarded two hon-orary degrees form the Chicago Schoolof Professional Psychology and SaintJoseph college. Perhaps less known is the fact that earlyin her career, she and her husband Barryengaged in yet another first, they werehosts of one of the first call in radioshows focusing on interpersonal prob-lems and challenges faced by every daypeople. Perhaps this is one of the waysthat Pat gained her extraordinary in-sight, patience, appreciation for theother’s point of view, and her compas-sion or it may just be who she was. Few of us are able to have the lasting in-fluence on those people and things wevalue, but Pat Bricklin is unquestionablyamong those who can and did.

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In consultation with the Division 29 Board of Directors, the Division 29 Re-search Committee is seeking nominations for The Distinguished Publication ofPsychotherapy Research Award. This award recognizes the best empirical (i.e.,data-based) published peer reviewed article on psychotherapy in the preced-ing calendar year. Articles appearing in any journal (i.e., they need not have ap-peared in the Division’s journal) are eligible for this award.

We ask members of the Division to nominate articles for consideration by April1. Nominations should include the complete citation for the article, and shouldbe emailed to the Chair of the Research Committee, Dr. Michael Constantino,[email protected]

A selection committee appointed by the Chair of the Research Committee, inconsultation with the President of the Division, will evaluate all nominatedarticles, and will make a recommendation to the Division’s Board of Directorsby May 1. Upon approval by the Board, the author(s) of the winning articlewill be notified so that they may be recognized and receive the award at the up-coming APA Convention. Accompanying this award is a plaque.

All methods of research will be equally valued (experimental, quasi-experi-mental, qualitative, descriptive/correlational, survey). Current members ofthe Research Committee and the Selection Committee will not be eligible forthe award, so no articles by members of the Research Committee will be con-sidered. Also, committee members will recuse themselves from voting on ar-ticles by current or former students, as well as collaborators. Self-nominationsare accepted.

The criteria for the award appear below.• the rationale for the study and theoretical soundness • the methods • the analyses • the explanation of the results • the contribution to new knowledge about psychotherapy (e.g., the work isinnovative, creative, or integrative; the work advances existing research ina meaningful way); greater weight will be given to novel/creative elementthan to methodological/statistical rigor

• relevance to psychotherapy practice.

The Distinguished Publication of Psychotherapy Research Award is accompanied by a $500 cash award sponsored by Wiley and Sons.

CALL FOR DISTINGUISHED PUBLICATION OF PSYCHOTHERAPY RESEARCH AWARD

APA’s Division of Psychotherapy is pleased to announce:

The Distinguished Publication of Psychotherapy Research Award for 2012

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Call for Nominations: Distinguished Psychologist AwardThe APA Division of Psychotherapy invites nominations for its 2012 Distin-guished Psychologist Award, which recognizes lifetime contributions to psy-chotherapy, psychology, and the Division of Psychotherapy.Deadline is January 1, 2012. All items must be sent electronically. Letters ofnomination outlining the nominee’s credentials and contributions (along withthe nominee’s CV) should be emailed to the Chair of the Professional AwardsCommittee, Dr. Libby Nutt Williams, at [email protected].

• • • • • • • • • •

Call for Nominations: Division 29 Award for Distinguished Contributions to Teaching and MentoringThe APA Division of Psychotherapy invites nominations for its 2012 Award forDistinguished Contributions to Teaching and Mentoring, which honors a memberof the division who has contributed to the field of psychotherapy through theeducation and training of the next generation of psychotherapists. Committee, Dr. Libby Nutt Williams, at [email protected].

• • • • • • • • • •

Both self-nominations and nominations of others will be considered. The nom-ination packet should include: 1) a letter of nomination describing the individual’s impact, role, and activi-

ties as a mentor; 2) a vitae of the nominee; and,3) three letters of reference for the mentor, written by students, former stu-

dents, and/or colleagues who are early career psychologists. Letters of ref-erence for the award should describe the nature of the mentoringrelationship (when, where, level of training), and an explanation of the roleplayed by the mentor in facilitating the student or colleague’s developmentas a psychotherapist. Letters of reference may include, but are not limitedto, discussion of the following behaviors that characterize successful men-toring: providing feedback and support; providing assistance with awards,grants and other funding; helping establish a professional network; servingas a role model in the areas of teaching, research, and/or public service;giving advice for professional development (including graduate schoolpostdoctoral study, faculty and clinical positions); and treatingstudents/colleagues with respect.

Deadline is January 1, 2012. All items must be sent electronically. The letterof nomination must be emailed to the Chair of the Professional Awards Com-mittee, Dr. Libby Nutt Williams, at [email protected].

DIVISION 29 PSYCHOTHERAPYOF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (APA)

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APF provides financial support for inno-vative research and programs that en-hance the power of psychology toelevate the human condition and advance human potential both now andin generations to come. It executes thismission through a broad range of schol-arships and grants. For all of these, it en-courages applications from individualswho represent diversity in race, ethnic-ity, gender, age, disability, and sexualorientation.

The Division 29 program recognizes anearly career psychologist for promisingcontribution to psychotherapy, psychol-ogy, and the Division of Psychotherapy.Its description, application require-ments, and procedures appear below.

APF supports original, innovative researchand projects. Although APF favors unique,independent work, the Foundation does fundderivative projects that are part of largerstudies.

DescriptionThis program supports the mission of APA’s Division of Psychotherapy (Division 29) by recognizing Divisionmembers who have demonstrated out-standing promise in this field early intheir career. Recognized achievementsmay be in the areas of psychotherapy.

Program GoalsEncourage further development andcontinuing contributions of early-careerprofessionals in this field

Funding SpecificsOne $2,500 award presented annually

We do not allow indirect costs to be taken outof grant monies, although applicants can use

grant monies for stipend support and otheradministrative costs (software, materials,etc.). Our policy on this is as follows, from thegrant terms and conditions document:

No Institutional Indirect Costs. The entiregrant must be provided to the individualgrantee for the stated purpose. The grant maynot be used to pay institutional indirect costsor overhead. If funds will be administered bythe grantee’s institution, the institution mustaffirm in writing that it will waive all admin-istrative fees and charges for indirect costs.This assurance may be provided through thesignature of a responsible official on thisagreement. This assurance must be receivedbefore the funds can be released.

Eligibility Requirements:• Division 29 membership• Within 7 years post-doctorate• Demonstrated achievement relatedto psychotherapy theory, practice,research or training

Evaluation Criteria:• Conformance with stated programgoals and qualifications

• Applicant’s demonstrated accom-plishments and promise

Nomination Requirements:• Nomination letter written by a colleague outlining the nominee’scareer contributions (self-nomina-tions not acceptable)

• Current CV

Submission Process and Deadline: Submit a completed application onlineat http://forms.apa.org/apf/grants/ byJanuary 1, 2012.

Questions about this program should bedirected to Parie Kadir, ProgramOfficer,at [email protected].

CALL FOR NOMINATIONSDIVISION 29 EARLY CAREER AWARDAmerican Psychological Foundation (APF)

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THE DIVISION OF PSYCHOTHERAPYThe only APA division solely dedicated to advancing psychotherapy

MEMBERSHIP APPLICATIONDivision 29 meets the unique needs of psychologists interested in psychotherapy.

By joining the Division of Psychotherapy, you become part of a family of practitioners, scholars, and students who exchange ideas in order to advance psychotherapy.

Division 29 is comprised of psychologists and students who are interested in psychotherapy. Although Division 29 is a division of the AmericanPsychological Association (APA), APA membership is not required for membership in the Division.

JOIN DIVISION 29 AND GET THESE BENEFITS!

Name ____________________________________________ Degree ____________________

Address _____________________________________________________________________

City _______________________________________ State ________ ZIP________________

Phone _________________________________ FAX ________________________________

Email _______________________________________________

Member Type: � Regular � Fellow � Associate

� Non-APA Psychologist Affiliate � Student ($29)

� Check � Visa � MasterCard

Card # ________________________________________________ Exp Date _____/_____

Signature ___________________________________________

Please return the completed application along with payment of $40 by credit card or check to:

Division 29 Central Office, 6557 E. Riverdale St., Mesa, AZ 85215You can also join the Division online at: www.divisionofpsychotherapy.org

FREE SUBSCRIPTIONS TO:PsychotherapyThis quarterly journal features up-to-datearticles on psychotherapy. Contributorsinclude researchers, practitioners, and educators with diverse approaches.Psychotherapy BulletinQuarterly newsletter contains the latest newsabout division activities, helpful articles ontraining, research, and practice. Availableto members only.

EARN CE CREDITSJournal LearningYou can earn Continuing Education (CE)credit from the comfort of your home oroffice—at your own pace—when it’s con-venient for you. Members earn CE creditby reading specific articles published inPsychotherapy and completing quizzes.

DIVISION 29 PROGRAMSWe offer exceptional programs at the APA convention featuring leaders in the field ofpsychotherapy. Learn from the experts in personal settings and earn CE credits atreduced rates.

DIVISION 29 INITIATIVESProfit from Division 29 initiatives such asthe APA Psychotherapy Videotape Series,History of Psychotherapy book, and Psychotherapy Relationships that Work.

NETWORKING & REFERRAL SOURCESConnect with other psychotherapists sothat you may network, make or receive referrals, and hear the latest important information that affects the profession.

OPPORTUNITIES FOR LEADERSHIPExpand your influence and contributions.Join us in helping to shape the direction ofour chosen field. There are many opportu-nities to serve on a wide range of Divisioncommittees and task forces.

DIVISION 29 LISTSERVAs a member, you have access to our Division listserv, where you can exchangeinformation with other professionals.

VISIT OUR WEBSITEwww.divisionofpsychotherapy.org

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If APA member, please provide membership #

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Internet-Delivered PsychologicalTreatments and Psychotherapy IntegrationAndersson, G. (2009). Using the Inter-net to provide cognitive behaviourtherapy. Behaviour Research and Therapy, 47, 175-180.

Andersson, G., & Cuijpers, P. (2009).Internet-based and other computer-ized psychological treatments foradult depression: A meta-analysis.Cognitive Behaviour Therapy, 38, 196-205.

Andersson, G., Estling, F., Jakobsson,E., Cuijpers, P., & Carlbring, P.(2011). Can the patient decide whichmodules to endorse? An open trialof tailored Internet treatment of anx-iety disorders. Cognitive BehaviourTherapy, 40, 57-64.

Andersson, G., Paxling, B., Roch-Nor-lund, P., Östman, G., Norgren, A.,Almlöv, J., et al. (submitted). Inter-net-based psychodynamic vs. cogni-tive behavioural guided self-help forgeneralized anxiety disorder: A ran-domised controlled trial.

Barak, A., Hen, L., Boniel-Nissim, M.,& Shapira, N. (2008). A comprehen-sive review and a meta-analysis ofthe effectiveness of Internet-basedpsychotherapeutic interventions.Journal of Technology in Human Serv-ices, 26(2), 109-160.

Berger, T., & Andersson, G. (2009). In-ternetbasierte Psychotherapien:Besonderheiten und empirische Evi-denz. Psychotherapie, Psychosomatik,Medizinische Psychologie, 59, 159-170.

Berger, T., Caspar, F., Richardson, R.,Kneubühler, B., Sutter, D., & Anders-son, G. (2011). Internet-based treat-ment of social phobia: Arandomized controlled trial compar-ing unguided with two types ofguided self-help. Behaviour ResearchTherapy, 49, 158-169.

Berger, T., Haemmerli, K., Gubser, N.,Andersson, G., & Caspar, F. (inpress). Internet-based treatment ofdepression: A randomized con-trolled trial comparing guided withunguided self-help. Cognitive Behav-iour Therapy.

Beutler, L. E., & Clarkin, J. (1990). Sys-tematic treatment selection: Toward tar-geted therapeutic interventions. NewYork: Brunner/Mazel.

Carlbring, P., Maurin, L., Törngren, C.,Linna, E., Eriksson, T., Sparthan, E.,et al. (2011). Individually-tailored,internet-based treatment for anxietydisorders: a randomized controlledtrial. Behaviour Research and Therapy,49, 18-24.

Carlbring, P., Nilsson-Ihrfelt, E., Waara,J., Kollenstam, C., Burhman, M.,Kaldo, V., et al. (2005). Treatment ofpanic disorder: live therapy vs. self-help via the Internet. Behaviour Re-search and Therapy, 43, 1321-1333.

Cook, J. E., & Doyle, C. (2002). Work-ing alliance in online therapy ascompared to face-to-face therapy:preliminary results. Cyberpsychologyand Behavior, 5(2), 95-105.

Etter, J.-F. (2005). Comparing the Efficacyof Two Internet-Based, Computer-Tailored Smoking Cessation Pro-grams: A Randomized Trial. Journalof Medical Internet Research, 7(1), e2.

Grawe, K. (2004). Psychological Therapy.Seattle: Hogrefe & Huber.

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DIVISION OF PSYCHOTHERAPY (29)Central Office, 6557 E. Riverdale Street, Mesa, AZ 85215

Ofc: (602) 363-9211 • Fax: (480) 854-8966 • E-mail: [email protected]

PSYCHOTHERAPY BULLETINPsychotherapy Bulletin is the official newsletter of Division 29 (Psychotherapy) of the American PsychologicalAssociation. Published four times each year (spring, summer, fall, winter), Psychotherapy Bulletin is designedto: 1) inform the membership of Division 29 about relevant events, awards, and professional opportunities;2) provide articles and commentary regarding the range of issues that are of interest to psychotherapy the-orists, researchers, practitioners, and trainers; 3) establish a forum for students and new members to offertheir contributions; and, 4) facilitate opportunities for dialogue and collaboration among the diverse mem-bers of our association.Contributors are invited to send articles (up to 2,250 words), interviews, commentaries, letters to theeditor, and announcements to Lavita Nadkarni, PhD, Editor, Psychotherapy Bulletin. Please note that Psy-chotherapy Bulletin does not publish book reviews (these are published in Psychotherapy, the official journalof Division 29). All submissions for Psychotherapy Bulletin should be sent electronically to [email protected] the subject header line Psychotherapy Bulletin; please ensure that articles conform to APA style. Dead-lines for submission are as follows: February 1 (#1); May 1 (#2); August 1 (#3); November 1 (#4). Past issues of Psychotherapy Bulletinmay be viewed at our website: www.divisionofpsychotherapy.org. Otherinquiries regarding Psychotherapy Bulletin (e.g., advertising) or Division 29 should be directed to TraceyMartin at the Division 29 Central Office ([email protected] or 602-363-9211).

PUBLICATIONS BOARDChair : Jeffrey E. Barnett, Psy.D., ABPP Department of PsychologyLoyola University Maryland4501 N.Charles StreetBaltimore, MD 21210(410)-617-5382Email: [email protected]

Raymond A. DiGiuseppe, Ph.D., 2009-2014Psychology DepartmentSt John’s University 8000 Utopia Pkwy Jamaica , NY 11439 Ofc: 718-990-1955 Email: [email protected]

Laura Brown, Ph.D., 2008-2013Independent Practice3429 Fremont Place N #319 Seattle , WA 98103 Ofc: (206) 633-2405 Fax: (206) 632-1793Email: [email protected]

Jonathan Mohr, Ph.D., 2008-2012Department of PsychologyBiology-Psychology BuildingUniversity of MarylandCollege Park, MD 20742-4411Ofc: 301-405-5907 Fax: 301-314-5966Email: [email protected]

Beverly Greene, Ph.D., 2007-2012Psychology St John’s University 8000 Utopia Pkwy Jamaica , NY 11439 Ofc: 718-638-6451Email: [email protected]

William Stiles, Ph.D., 2008-2011Department of Psychology Miami University Oxford, OH 45056 Ofc: 513-529-2405 Fax: 513-529-2420 Email: [email protected]

On sabbatical: Jean Carter, Ph.D.

\EDITORSPPssyycchhootthheerraappyy JJoouurrnnaall EEddiittoorrMark J. HilsenrothDerner Institute of Advanced Psychological Studies220 Weinberg Bldg.158 Cambridge Ave.Adelphi UniversityGarden City, NY 11530Email: [email protected]: (516) 877-4748 Fax (516) 877-4805

PPssyycchhootthheerraappyy BBuulllleettiinn EEddiittoorrLavita Nadkarni, Ph.D.Director of Forensic StudiesUniversity of Denver-GSPP2460 South Vine StreetDenver, CO 80208Ofc: 303-871-3877Email: [email protected]

Associate EditorLynett Henderson Metzger, Psy.D.University of Denver GSPP2460 S. Vine St.Denver, CO 80208Ofc: 303-871-4684Email: [email protected]

DDiivviissiioonn ooff PPssyycchhootthheerraappyy IInntteerrnneett EEddiittoorrIan Goncher405 Lake Vista Circle Apt JCockeysville, MD 21030Ofc: 814-244-4486Email: [email protected]

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