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Sandy and Independent Practice

Question 1: Please describe your contributions to the independent practice of psychology, including any positions held and committee work past and present.

Career focus:

  • Independent group practice—1983-2000 (with 35 staff)

  • Independent consultation/consulting practice—1997-present

Professional Service Roles

  • Division 42

  • Div42 Exec

  • Board of Directors/EB

  • Treasurer

  • Chair, Finance Committee

  • Facilitator/Presenter, Div42 Mid-Winter EB Meeting, Diversity/inclusion workshop

  • Ohio Psychological Association

  • President

  • Finance Officer

  • Council Rep

  • FAC

  • Heiser Award

  • Presentations/consultations--building group independent practices

  • Division 31, Lead Faculty, Diversity Leadership Initiative

  • Division 17 Roles

  • Co-founder, Section for Independent Practice

  • VP for Professional Practice

  • John D. Black Award for Outstanding Practice Achievements

  • FAC

  • APAPO

  • SLC/PLC State Leadership Award

  • Advocacy Award

  • APA Leadership with Practice Emphasis

  • TF on the Future of Practice

  • Chair, Board of Professional Affairs

  • Chair, Executive Coaching TF

  • APA Award, Distinguished Professional Contributions to Independent Practice

  • APF Gold Medal Award for Lifetime Achievement in Practice

Question 2: If APAPO no longer exists in its current form, how do you envision the role of legislative advocacy for psychologists in the future? What measures will you prioritize in order to advance, defend and protect the practice of psychology?

The current C3/C6 reorganization and advocacy integration proposal emerged to save APAPO’s purpose and mission. Expectations for APAPO’s financial self-sustainability became the focus rather than emphasizing the real goal—enhancing the welfare of practicing psychologists. Concluding the current model wasn’t financially viable, every conceivable option was considered for better ways to advocate for psychologists.

Under the proposed structure, my priorities would include:

  • Ensure practice needs and perspectives are components of all integrated legislative/advocacy initiatives. APA-wide advocacy increases resources for psychologists across APA, also avoiding surprises, unintended consequences, and disconnected efforts.

  • Increase numbers/positions/influence of practicing psychologists in decision-making groups at institutional, state and federal levels. Advocacy for psychologists could include direct focus on insurers, hospital systems, and other funder systems.

  • Develop APA-wide initiatives to enhance public perception of psychologists’ distinctive value in healthcare and other contexts. The public doesn’t see psychology’s value yet.

  • Keep all SPTA advocacy for practice afloat.

Question 3a: How do you intend to address The Good Governance Project, particularly the delegation of fiscal and operational responsibilities exclusively to the APA Board?

According to APA’s charter, Council retains ultimate fiduciary responsibility for budgetary and operational matters. The trial delegation now includes a reasonable spending limitation beyond budgeted resources. I continue to believe the Board, as Executive Committee of Council, can be more timely in governing ongoing budget/operational resources, especially with existing spending protections.

Given longstanding issues of mistrust, I believe what is most important is absolute transparency and information access about budgeting and resource decisions, including clear mechanisms for review and input on the front end. My commitment is to find/establish systems and structures to maximize APA’s effectiveness in budgeting and using its resources wisely.

We need engaged governance, committed to adding sustainable value to our practice and discipline. I need Division 42 to work with me to create this, both structurally and functionally. In the current state of tumultuous change in healthcare, we must collaboratively support psychology practice in multiple contexts.

Question 3b: How do you intend to address accreditation of master’s programs in psychology?

In 1948, we began discussion of the role, title and scope of masters-level practice and by 2018 have convened over seventy conferences/summits/meetings to continue this discussion. In 2017, Council authorized development of accreditation standards for the education and training of master’s students in psychology. CEO Arthur Evans has reaffirmed, and I continue to support the definition of psychology as a doctoral level profession. I am also committed to accreditation as the vehicle to determine content quality, sequencing and training for masters’ level programs. The very nature of accreditation, given its focus on curriculum and clinical training, can determine the scope and roles of program graduates. Accreditation is a reasonable way to generate a differential definition of doctoral and masters scope of practice. Accreditation is a viable approach to reinforce the definition of doctoral level psychology practice while determining viable roles for master’s level psychologists.

Question 3c: How do you intend to address the development of treatment guidelines?

As a discipline and profession, we must take a significant role in developing/updating treatment guidelines, based on our best science, establishing psychology as a meaningful part of interprofessional, evidence-based healthcare. We must also be diverse and inclusive scientifically if guidelines are to be maximally helpful and effective for the public. For example, we must ensure guidelines task forces have diverse membership, including practitioners.

Treatment guidelines serve two major purposes: 1) identifying all relevant evidence of effectiveness; and 2) assisting practitioners in implementing guidelines effectively. Guideline development requires an evidence-based approach, incorporating best research, client/patient variables and clinician expertise. We must be vigilant about examining relevant factors, experimenter bias and real-world testing (not just controlled settings) to help practitioners determine effective treatment for any given individual. Mathematical optimization models can be used to better predict differential effectiveness for specific populations/contexts. Finally, our development/adoption process must emphasize robust expertise, inclusion, and feedback.

Question 4: What do you see as additional vital area(s) facing the independent practice of psychology? How do you plan to confront these areas during your presidency?

Currently, a false dichotomy exists between independent practice and integrated care. We can grow together successfully if we recognize synergies that create more opportunities for practitioners, regardless of setting. For example, new technologies and practice management strategies, focused on practitioner connectivity, rather than just linking hospital systems, can help grow independent practice contexts while creating more seamless, integrated treatment for clients, especially those in less accessible areas.

Up to now, costs of innovative treatments, marketing strategies, tracking systems, and emerging technologies have been prohibitively expensive or inaccessible for independent practitioners. Now, with a modicum of linkage, technology investment, and practitioner involvement, we can create a variety of sustainable contexts for independent practitioners to adapt successfully to this changing landscape. Engaged, doctoral-level, independent practitioners can design and bring assessment and evaluation, consultation, forensic and many other culturally relevant skills sets and services to an increasingly diverse public in ways different from the past.

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